Contact: Leonard N. Karp
215-575-3720
lkarp@philadelphiamedicine.com
May 24, 2007
For immediate release:
In this month’s edition:
- First Demonstration of New Hair Follicle Generation in an Animal Model Implications for Treating Hair Loss, Skin Disorders, According to Penn Study
- Live Webcast -- Fox Chase Cancer Center Hosts "Toward a Future Without Cancer: Goals for the 21st Century;" Symposium Features Heads of NCI, FDA, ACS, BIO and the CEO Roundtable on Cancer
- Bare-Metal Stents are Better for Some Heart Patients, Jefferson Scientists Find
Editors note: Research, new techniques and improved facilities by Philadelphia International Medicine hospitals and physicians may lead to new ways to treat some of our most challenging diseases. Below are just some examples from our hospitals.
First Demonstration of New Hair Follicle Generation in an Animal Model
Implications for Treating Hair Loss, Skin Disorders, According to Penn Study
PHILADELPHIA - Researchers at the University of Pennsylvania School of Medicine have found that hair follicles in adult mice regenerate by re-awakening genes once active only in developing embryos. These findings provide unequivocal evidence for the first time that, like other animals such as newts and salamanders, mammals have the power to regenerate. These findings were published in the May 17 issue of Nature.
A better understanding of this process could lead to novel treatments for hair loss, other skin and hair disorders, and wounds.
"We showed that wound healing triggered an embryonic state in the skin which made it receptive to receiving instructions from wnt proteins," says senior author George Cotsarelis, MD, associate professor of Dermatology. "The wnts are a network of proteins implicated in hair-follicle development."
Researchers previously believed that adult mammal skin could not regenerate hair follicles. In fact, investigators generally believe that mammals had essentially no true regenerative qualities. (The liver can regenerate large portions, but it is not de novo regeneration; some of the original liver has to remain so that it can regenerate.)
In this study, researchers found that wound healing in a mouse model created an "embryonic window" of opportunity. Dormant embryonic molecular pathways were awakened, sending stem cells to the area of injury. Unexpectedly, the regenerated hair follicles originated from non-hair-follicle stem cells.
"We’ve found that we can influence wound healing with ‘wnts’ or other proteins that allow the skin to heal in a way that has less scarring and includes all the normal structures of the skin, such as hair follicles and oil glands, rather than just a scar," explains Dr. Cotsarelis.
By introducing more wnt proteins to the wound, the researchers found that they could take advantage of the embryonic genes to promote hair-follicle growth, thus making skin regenerate instead of just repair. Conversely by blocking wnt proteins, they also found that they could stop the production of hair follicles in healed skin.
Increased wnt signaling doubled the number of new hair follicles. This suggests that the embryonic window created by the wound-healing process can be used to manipulate hair-follicle regeneration, leading to novel ways to treat hair loss and hair overgrowth.
These findings go beyond just a possible treatment for male-pattern baldness. If researchers can effectively control hair growth, then they could potentially find cures for people with hair and scalp disorders, such as scarring alopecia where the skin scars, and hair overgrowth.
This research was funded in part by the National Institute of Arthritis, Musculoskelatal and Skin Disease and the Pennsylvania Department of Health. Other co-authors in addition to Dr. Cotsarelis are Mayumi Ito, Zaixin Yang, Thomas Andl, Chunhua Cui, Noori Kim, and Sarah E. Millar, all from Penn.
Dr. Cotsarelis and Ito are listed as inventors on a patent application related to hair-follicle neogenesis and owned by the University of Pennsylvania. Dr. Cotsarelis also serves on the scientific advisory board and has equity in Follica, a start-up company that has licensed the patent from the University of Pennsylvania. Dr. Cotsarelis was also a co-founder of Follica.
Live Webcast — Fox Chase Cancer Center Hosts
"Toward a Future Without Cancer: Goals for the 21st Century;"
Symposium Features Heads of NCI, FDA, ACS, BI
and the CEO Roundtable on Cancer
Fox Chase Cancer Center will host an afternoon webcast featuring top representatives from government, industry, advocacy and academia called "Toward a Future Without Cancer: Goals for the 21st Century." This special event and its esteemed speakers were assembled to welcome Fox Chase’s new president, Michael V. Seiden, MD, PhD, and to honor out-going president, Robert C. Young, MD, for 18 years of service to Fox Chase Cancer Center.
The symposium can be seen live via video streaming at www.fccc.edu/symposium beginning at 1:30 p.m. on Thursday, June 21, 2007.
The symposium features:
- Michael V. Seiden, MD, PhD, President and CEO, Fox Chase Cancer Center (1:30 p.m.)
- John E. Niederhuber, MD, Director, National Cancer Institute (1:45 p.m.)
- Andrew C. von Eschenbach, MD, Commissioner, U.S. Food and Drug Administration (2:05 p.m.)
- Ed Harlow, PhD, Harvard Medical School (2:25 p.m.)
- Robert A. Ingram, Chairman, CEO Roundtable on Cancer (2:45 p.m.)
- John R. Seffrin, PhD, CEO, American Cancer Society (3:05 p.m.)
- The Honorable James C. Greenwood, President and CEO, Biotechnology Industry Organization (3:25 p.m.)
The symposium concludes with a panel discussion with all participants beginning at 4:15 p.m. Clifford Goodman, PhD, senior vice president of The Lewin Group, will moderate.
Bare-Metal Stents are Better for Some Heart Patients, Jefferson Scientists Find
While drug-eluting stents are effective in keeping open diseased heart arteries, they should not be used for patients who need to have non-cardiac surgery a short time after an interventional heart procedure. A presentation at the Society for Cardiovascular Angiography and Interventions in Orlando by cardiologists at Jefferson Medical College indicates that for these patients, bare metal stents provide a safer choice.
"The issue here," says Michael Savage, MD, Catheterization Laboratory Director at Thomas Jefferson University Hospital in Philadelphia, "is that studies have demonstrated that those patients who receive drug-eluting stents may develop life-threatening cardiac complications if they undergo subsequent, non-cardiac surgery."
This prescription for the potentially deadly problem begins when a person, often a senior citizen, learns that she or he must have elective surgery. The surgery can be for a minor to a major problem--from vascular surgery to fix blood flow problems, to broken hips or bones, neurological or urological issues and more.
Often, severe coronary artery disease is discovered during the pre-surgical testing. If severe, it presents a more-immediate problem and therefore, must be treated before the patient undergoes the elective surgery.
Prior studies have shown that patients may suffer fatal heart attacks due to clotting inside of the stents when surgery is performed within a few weeks after stent placement. In the case of drug-eluting stents, clotting of the stent may occur even months or years after their heart procedure, particularly when their blood thinning medicine (usually aspirin and Plavix) are stopped before the surgery.
To avoid the potentially deadly scenario, the Jefferson Medical College researchers developed a clinical protocol to enable patients to have both procedures successfully with little risk. Led by Agostino Ingraldi, MD, a fellow in cardiovascular diseases, they developed the following four-part strategy:
- Avoidance of drug-eluting stents in favor of bare metal stents during the interventional heart procedure.
- A four-week course of the blood thinner clopidogrel (Plavix) after an interventional heart procedure.
- Deferral of the second, non-cardiac surgery for five to 12 weeks after the interventional procedure.
- Discontinuation of clopidogrel (Plavix) at least five days prior to the non-cardiac surgery.
The researchers studied a total of 60 patients (33 men and 27 women) who averaged 68 years old and who were treated with the strategy. Twenty-seven percent suffered from diabetes that can complicate surgery.
The results show the coronary interventional procedure was successful in all patients where a total of 82 heart lesions were treated with bare-metal stents. The second, non-cardiac, surgery was performed an average of 47 days later. All were performed under general anesthesia and were successful. There were no deaths or clotting leading to problems. Also, clotting of the stents -- a major problem seen with drug-eluting stents in this setting -- was not seen in any patient.
"This research provides a safe treatment strategy for interventional cardiologists and their patients who will be undergoing further surgery," adds Dr. Savage, who is also associate professor of Medicine, Jefferson Medical College of Thomas Jefferson University. "Drug-eluting stents have proven benefits but may not be the best solution for every patient."
Editor’s Note: Members of the team who conducted this study at Thomas Jefferson University Hospital in Philadelphia, are: Agostino Ingraldi, MD, Nicholas J. Ruggiero II, MD, Mark Awar, MD, Saum Shamimi-Noori, MD, Utpal Sager, MD, David Fischman, MD, Paul Walinsky, MD, Howard H. Weitz, MD, and Michael Savage, MD.