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Current Science on TGF-β as a Biochemical Target in Hair Loss

    Regulation of DHT by 5 alpha-reductase inhibitors is a proven method to reduce hair loss, improve follicle performance, and regrow hair in some individuals. It is the accepted mechanism of action of Propecia®, and the prevailing theory in androgenetic alopecia.

    In the last 13 years, a new theory has emerged that promises a more precise understanding of androgen-sensitive hair loss, and a more selective therapeutic target for intervention. This theory holds that inhibition of DHT is effective partially or primarily because it limits the protein Transforming Growth Factor beta, or TGF-β, in the catagen cascade.

    As a downstream factor in the androgen cascade, TGF-β may prove to be a more effective target than DHT. The growing consensus among leading hair loss researchers is that TGF-β causes premature entry into catagen, and that it may be the primary agent responsible for follicle miniaturization and dysfunction.

    The following papers discuss the relationship between TGF-β and hair follicle dysfunction. Taken together, they present a compelling case that undermines the prevailing theory that DHT "causes" hair loss in AGA. They also suggest that using TGF-β inhibitors may prevent premature entry into catagen, lengthen the anagen phase of hair growth, and prevent miniaturization of androgen-sensitive hair follicles.


1994
Philpott MP, Sanders D, Westgate GE, Kealey T.
Human hair growth in vitro: a model for the study of hair follicle biology.
J Dermatol Sci. 1994 Jul;7 Suppl:S55-72.
"We identify transforming growth factor-beta (TGF-beta) as a possible negative regulator of hair follicle growth..."
1996
Mori O, Hachisuka H, Sasai Y.
Effects of transforming growth factor beta 1 in the hair cycle.
J Dermatol. 1996 Feb;23(2):89-94.
"...TGF beta 1 is at least partly responsible for regulating hair follicles as a negative growth factor."
Wollina U, Lange D, Funa K, Paus R.
Expression of transforming growth factor beta isoforms and their receptors during hair growth phases in mice.
Histol Histopathol. 1996 Apr;11(2):431-6.
1997
Paus R, Foitzik K, Welker P, Bulfone-Paus S, Eichmuller S.
Transforming growth factor-beta receptor type I and type II expression during murine hair follicle development and cycling.
J Invest Dermatol. 1997 Oct;109(4):518-26.
"This... supports the concept that both TGF-betaRII and TGF-betaRI stimulation is involved in... the control of catagen induction."
1998
Soma T, Ogo M, Suzuki J, Takahashi T, Hibino T.
Analysis of apoptotic cell death in human hair follicles in vivo and in vitro. < Full Study
J Invest Dermatol. 1998 Dec;111(6):948-54.
"Furthermore, this study strongly indicates that the transforming growth factor-β pathway is involved in the induction of catagen phase in human hair cycle."
2000
Foitzik K, Lindner G, Mueller-Roever S, Maurer M, Botchkareva N, Botchkarev V, Handjiski B, Metz M, Hibino T, Soma T, Dotto GP, Paus R
Control of murine hair follicle regression (catagen) by TGF-beta1 in vivo.
FASEB J. 2000 Apr;14(5):752-60.
"TGF-betaRII agonists and antagonists may provide useful therapeutic tools for human hair growth disorders based on premature or retarded catagen development (effluvium, alopecia, hirsutism)."
2002
Otomo S.
[Hair growth effect of minoxidil] [Article in Japanese]
Nippon Yakurigaku Zasshi. 2002 Mar;119(3):167-74.
"...minoxidil... inhibits of TGF beta induced apoptosis of hair matrix cells..."
Soma T, Tsuji Y, Hibino T.
Involvement of transforming growth factor-beta2 in catagen induction during the human hair cycle.
J Invest Dermatol. 2002 Jun;118(6):993-7.
"These results strongly suggest that transforming growth factor-beta2 plays an essential part in the induction of the catagen phase of the human hair cycle."
Inui S, Fukuzato Y, Nakajima T, Yoshikawa K, Itami S.
Androgen-inducible TGF-beta1 from balding dermal papilla cells inhibits epithelial cell growth: a clue to understand paradoxical effects of androgen on human hair growth.
FASEB J. 2002 Dec;16(14):1967-9. Epub 2002 Oct 18.
2003
Tsuji Y, Denda S, Soma T, Raftery L, Momoi T, Hibino T.
A potential suppressor of TGF-beta delays catagen progression in hair follicles.
J Investig Dermatol Symp Proc. 2003 Jun;8(1):65-8.
"Our results suggest that... a suppressor of TGF-beta could be effective in preventing male pattern baldness."
Inui S, Fukuzato Y, Nakajima T, Yoshikawa K, Itami S.
Identification of androgen-inducible TGF-beta1 derived from dermal papilla cells as a key mediator in androgenetic alopecia.
J Investig Dermatol Symp Proc. 2003 Jun;8(1):69-71.
"W
e suggest that androgen-inducible TGF-beta1 derived from DPCs mediates hair growth suppression in AGA.
Soma T, Dohrmann CE, Hibino T, Raftery LA.
Profile of transforming growth factor-beta responses during the murine hair cycle.
J Invest Dermatol. 2003 Nov;121(5):969-75.
"Transforming growth factor-beta (TGF-beta) appears to promote the regression phase of the mammalian hair cycle, in... human hair follicles."
2004
Hibino T, Nishiyama T.
Role of TGF-beta2 in the human hair cycle.
J Dermatol Sci. 2004 Jun;35(1):9-18.
"Male pattern baldness is the result of premature entry into catagen due to androgens. In order to prevent hair loss, it is important to understand two critical steps, i.e., the induction mechanism of premature entry and the regression process of catagen... these lines of evidence strongly suggest the presence of a "catagen cascade" in male pattern baldness... these sequential events contribute to the shortening of the human hair cycle."
Itami S.
[Pathomechanism of androgenetic alopecia and new treatment] [Article in Japanese]
Nippon Ronen Igakkai Zasshi. 2004 Nov;41(6):598-600.
"Minoxidil and Finasteride were recently introduced for the treatment of androgenetic alopecia in Japan, and TGF-beta1 is the next target for innovative treatment."
2005
Ito T, Ito N, Saathoff M, Bettermann A, Takigawa M, Paus R.
Interferon-gamma is a potent inducer of catagen-like changes in cultured human anagen hair follicles.
Br J Dermatol. 2005 Apr;152(4):623-31.
"...catagen induction probably occurs at least in part via upregulation of the recognized catagen-stimulatory growth factor TGF-beta2."
Mazzieri R, Jurukovski V, Obata H, Sung J, Platt A, Annes E, Karaman-Jurukovska N, Gleizes PE, Rifkin DB.
Expression of truncated latent TGF-beta-binding protein modulates TGF-beta signaling.
J Cell Sci. 2005 May 15;118(Pt 10):2177-87. Epub 2005 May 3.
"Transgenic animals displayed... an abbreviated growth phase and an early initiation of the involution (catagen) phase of the hair cycle. This phenotype appears to result from excess active transforming growth factor-beta..."
Foitzik K, Spexard T, Nakamura M, Halsner U, Paus R.
Towards dissecting the pathogenesis of retinoid-induced hair loss: all-trans retinoic acid induces premature hair follicle regression (catagen) by upregulation of transforming growth factor-beta2 in the dermal papilla.
J Invest Dermatol. 2005 Jun;124(6):1119-26.
"...topical TGF-beta2/TGF-beta receptor II antagonists deserve to be explored for the prevention and management of retinoid-induced hair loss."
Itami S, Inui S.
Role of androgen in mesenchymal epithelial interactions in human hair follicle.
J Investig Dermatol Symp Proc. 2005 Dec;10(3):209-11.
2006
Yoo HG, Kim JS, Lee SR, Pyo HK, Moon HI, Lee JH, Kwon OS, Chung JH, Kim KH, Eun HC, Cho KH.
Perifollicular fibrosis: pathogenetic role in androgenetic alopecia.
Biol Pharm Bull. 2006 Jun;29(6):1246-50.
"Our findings suggest that T-induced TGF-beta1 and type I procollagen expression may contribute to the development of perifollicular fibrosis in the AGA, and the inhibitory effects on T-induced procollagen and TGF-beta1 expression may explain another possible mechanism how finasteride works in AGA."
Kamimura A, Takahashi T, Morohashi M, Takano Y.
Procyanidin oligomers counteract TGF-beta1- and TGF-beta2-induced apoptosis in hair epithelial cells: an insight into their mechanisms.
Skin Pharmacol Physiol. 2006;19(5):259-65. Epub 2006 Jun 16.
"...addition of procyanidin B-2 to the culture neutralized the growth-inhibiting effects of both TGF-beta(1) and TGF-beta(2) and protected the cells from apoptosis."

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