14 The National Hair Journal Spring 2010 The National Hair Journal Medical Section
P R O M O T I N G C O O P E R A T I O N B E T W E E N T H E A R T I S T R Y O F H A I R R E P L A C E M E N T A N D T H E S C I E N C E O F H A I R R E S T O R A T I O N
the variable factors that influence AGA by observing
N THE BEGIN- growth agonist.
how many ways people can suffer from the disease.
Some people lose hair in front, others only in back,
while still others lose hair across the entire front and
Dr. M: Hair Genesis was orig-
top of the scalp. So clearly it’s not simply about one
factor, i.e. dihydrotestosterone. And so what we set
out to do was to say, “Okay, we need a new hypothe-
sis. If there are other things going on, wouldn’t you
THE FOLLICLE
get a better clinical outcome if you could identify one
or more of these other causative factors and then tar-
get those contributing factors while simultaneously
hitting dihydrotestosterone and 5-alpha-reductase?”
Does Hair Genesis Belong pounds within saw palmetto,
So that was our overarching hypothesis. We were
fortunate to have sharp collaborators at the
University of Albany and elsewhere who helped us
think creatively about this part of the problem for a
couple of years. Ultimately, we identified several
A Google search for “hair loss treatments” delivers
inflammation-related events in the hair follicle that
45,100,100 hits. Narrow it down to “hair loss
seemed to be really important. From that, we went on
lotions” and you get 1,100,100 with names like
to identify a series of genetic markers that seemed
Spironolactone, Phytologie PhytocyAne, Doo Gro
relevant in the setting of pattern hair loss. We tested
Mega and Triple Gro Tea Tree Oil. You get the point.
our theory in a set of basic science experiments, for
So how can a poor hair loss victim decide what works
example using a well-respected analog for hair folli-
and what is simply a money pit? The answer is
well-controlled European trials that show that saw
precipitated by the same metabolic chain of events
cle biodynamics called HaCaT cells. These cells are
research. Not just anecdotal evidence and friendly
palmetto in high enough doses has a tendency to pro-
that causes pattern hair loss. It may be helpful to
a type of keratinocyte found in the skin and, specifi-
testimonials, but serious studies validated by an inde-
vide clinical benefits. So we began testing different
think about dihydrotestosterone, or DHT, as the gaso-
cally the hair follicle. Once we had identified the
pendent third party. In this interview Geno
compositions and formulations incorporating various
line that causes the inferno in hair loss that damages
important gene markers that were associated with
Marcovici, PhD, Chief Scientific Officer at Advanced
strengths of saw palmetto and its glycoside beta-
hair follicles. In the prostate gland, DHT is triggered
inflammation in the hair follicle, we designed a set of
Restoration Technologies (ART) describes clinical
sitosterol. We came up with a formula that showed
by an enzyme called 5-alpha-reductase. 5-alpha-
experiments where we actually went in and used a
studies that culminated in Hair Genesis, a botanical-
striking benefits in our clinic population. We went to
reductase is like the match that lights the fuse, okay?
type of irritant, called lipopolysaccharide, or LPS. ly based hair care product that he claims is the only
market with that formula in the mid-1990s.
In the prostate DHT causes pathological growth that
Then we applied a formulation representative of our
non-drug hair loss treatment tested and developed in
results in pain on urination and the potential for
latest generation of product and we were able to show
collaboration with a university-based research team
inflammation, infection, etc. In the hair follicle, the
a statistically significant reduction in the level of key
and the only non-drug hair loss treatment with aDr. M: Hair Genesis is technically not a drug. It’s a
hormone causes the opposite effect in that the hair
markers of inflammation. Given what we know
demonstrable dual mechanism of action. The Hair
naturally derived composition. This is significant
follicle involutes, or becomes miniaturized. So it
about inflammation and hair loss, from a basic sci-
Genesis “Generation IV” regimen comprises oral
when you consider the pluses and minuses of the
occurred to me that if this stuff could block 5-alpha-
ence standpoint, that’s a reasonable proof of principle
softgels, a topical activator serum, and a special revi-
pharmaceutically-based hair growth drugs. The ben-
reductase in the prostate, why couldn’t we come up
that you have a new mechanism of action as well as
efits of the FDA-approved drugs are self-evident;
with a way to reformulate some of the key fatty and
a new way to treat the problem. So next, and to pro-
clinical evidence indicates that you can slow down,
sterols in saw palmetto into a composition that would
tect our hard won efforts, we took the extra step of
NHJ: Dr. Marcovici, you recently completed a hair
arrest, or in some cases reverse pattern hair loss. The
going back to our IP council and filed a USPTO
regrowth study. Could you tell readers of The
downside however, is that both minoxidil and finas-
NHJ: What happened next? Did you lock yourself
application to protect the novelty of what we’d come
National Hair Journal in layman’s language, what this
teride have been shown to present potentially signifi-
away in a laboratory for six months, or form a new
up with. We then submitted the results of our work
all-natural productis, and how it can help their
cant negative side effects. If you read the side of the
to a well-respected journal, and that’s the link we sent
bottle, or if you look it up online, you’ll find a lengthy
Dr. M: This was in the mid-1990s and we had a Dr. M: The formal name for the most common
list of negative side effects. So these are real caveats
small laboratory and also a clinical facility. We also
Dr. M: These new data, coupled with our previous
form of hair loss is “androgenetic alopecia.” That’s a
when you consider how badly you want to protect
had some nice relationships with collaborative
clinical research, gave us the impetus to create our
big word, but in layman’s terms “pattern hair loss”
your hair. The nice thing about using naturally
researchers, so we had access to the materials and
Generation 4 Hair Genesis product formulations
suffices. Let’s put hair loss in context. In the United
derived substances is that you have a much stronger
tools we needed. Because we were a hair clinic, we
which are just now hitting the market.
States, 40 million men are believed to be affected by
safety profile. You don’t see the sort of teratogenic
had a built in population of highly motivated folks
NHJ: Do the medical and research communities,
pattern hair loss, and perhaps the more surprising sta-
effects, (i.e. feminizing birth defects), pulmonary
who were keen to help us find ways to help them stop
accept your results and your conclusions/
tistic is that 20 million women in America are also
edema, loss of libido, etc. that you do with the drug-
losing their hair. From these people, we selected
Dr. M: Yes.
affected. These statistics can be extrapolated out to
based choices. Another thing we found particularly
appropriate individuals - which for us meant relative-
NHJ: What would it take to go to the next step and
much larger numbers when you consider the global
compelling was data from several investigators that
ly young to middle aged people in generally good
conduct a study that would satisfy the Federal Drug
suggested that carefully composed extracts of saw
health and also in the early stages of hair loss – and
palmetto potentially offered between a 3-fold and 15-
we put them on various test compositions to see what
Dr. M: If we were interested in characterizing
fold greater efficacy in inhibiting the pathogenic five
sort of response we would get. From that early work,
Hair Genesis as a drug, there’s a research regimen
alpha-reductase enzyme without triggering concomi-
we developed a set of formulas that became the prod-
protocol we’d have to follow. However, our pref-
tant negative side effects. So we thought that this was
uct we market advanced versions of today. We origi-
erence is to remain an all-natural or a cosmetic
a set of substances worth investigating. After several
nally called the line “ProAcTabs,” but then we came
product. We’re operating under the auspices of the
years of work we were able to demonstrate clinical
up with a little bit better name, “Hair Genesis®.”
1993 DSHAE (Dietary Supplement Health and
benefits through two open-label studies before went
NHJ: What is involved in setting up a clinical study?
Education Act) rule. So though we’re fairly confi-
to market. An “open-label” study, as you may know,
Dr. M: To validate the clinical efficacy of Hair
dent that the product does even more good in the
is a study where the test material is dispensed with an
Genesis we needed to test the product under scientif-
hair follicle than we describe, we prefer to under
open label meaning that the investigator and study
ically rigorous conditions. We enlisted a third-party
subject are aware that the active material is being test-
clinical facility that was in the business of conducting
NHJ: What new research is planned?
ed. This is in contrast to a placebo-controlled blind-
independent tests like this one. The entire process
Dr. M: We’d like to do a multi-arm study where we
ed study where an inert material is dispensed to part
was carefully monitored by an institutional review
might have gender-specific populations. We might
of the study population while another group receives
board, or IRB, which exists to ensure that everything
even test Hair Genesis against some of the well-
is done according to highly stringent FDA regula-
NHJ: What is the significance of the test subjects
tions. The study was undertaken in 1999 and the data
NHJ: Who could benefit from Hair Genesis? Is it
knowing they are using an active product? Is it to
gathered between the end of ’99 and early 2000. The
ensure compliance so they will stay with the pro-
results were clearly in favor of treatment. The place-
Dr. M: Yes, the product works equally well in women
bo population continued to experience hair loss,
and men. However, the regimen is most beneficial
Dr. M: Not really. The benefit of an open-label
while the treatment population showed a complete
when it is begun early in the disease process. As an
study is that it constitutes what’s called a proof of
arresting of the progression of loss. Two out of three
analogy, our viewpoint is that a parachute works best
principle. If you see a demonstrable benefit under
participants actually had thicker hair at the end of the
before you hit the ground. For people who have lost
population. Hair loss has always been acutely dis-
open-label conditions, then there’s a reasonable prob-
trial. So that was a fairly impressive outcome.
most or all of their hair, laser therapy’s not going do it,
tressing. Until recently, there hasn’t really been much
ability that you’d achieve similar results randomizing
NHJ: How do these results compare with other test-
and Hair Genesis is probably not going to do it either.
that’s been effective in treating the disorder. Going
the study subjects and going to a full double-blind
The hair follicle at some point loses the ability to hear
back to ancient times in Egypt, historians have dis-
trial. That’s what we did in the late 1990s and 2000. Dr. M: Outside of the big drug companies, to my
a signal or to receive a signal to return to healthy vig-
covered that they used crocodile dung and all sorts of
The results of that placebo-controlled, IRB moni-
knowledge no one else is doing serious research in
orous growth. So our suggestion is that it’s better to
interesting substances that were purported to thicken
tored, double-blind study still represent the only
the category. If you go to Pubmed.com also known
start any treatment sooner rather than later and we find
the hair. And in the 19th Century, the term snake oil
example of a non-drug-based hair-loss treatment to
as Medline and type in “botanical” and “hair loss,”
our clients are most happy when they use Hair Genesis
came into widespread use because they actually
show clinical efficacy in pattern hair loss. That par-
only one research study comes up, and that is our
as a hair maintenance program rather than trying to
extracted oil from rattlesnakes and other reptiles as a
ticular study is available for anyone to see on
clinical trial. If you think about it, it’s astounding that
hair growth accelerant. Today, we have more respon-
nobody else has thought it important to validate their
NHJ: Does Hair Genesis arrest hair loss or promote
sible choices… though a quick surf around the web
NHJ: People searching for hair loss remedies online
products using the same high level of scientific
could easily make you think otherwise.
will be presented with a list of products, some
Hair Genesis inhibits the factors that are
NHJ: The FDA, has officially approved two hair
authentic, many unscrupulous. Why should they
NHJ: How do your results compare with Rogaine?
known to trigger hair loss. So if you can block 5-
growth drugs. Is that where the hair regrowth story
Dr, M: We compare favorably with finasteride where
alpha-reductase, and if you can reduce the pathologic
Dr. M: A valid question. Here’s why. We were the
two out of three patients showed a response. Where
inflammation of the hair follicle, then you can, from an
first to market with a botanically based hair loss treat-
I think we have potentially an inside track is the fact
anatomical and physiological standpoint, preserve
presently indicated for pattern hair loss. The first is
ment in 1996. At the time there just wasn’t anything
that our product line doesn’t suffer from the negative
those structures so that they can produce a more robust
Minoxidil, which originally was a blood pressure
else like Hair Genesis® out there. We opened the
caveats that finasteride, dutasteride, and minoxidil
product, which is the hair shaft. othing grows new hair.
medication. It is a topical product and is now trade
door to naturally derived substances in the hair loss
You die with the same number of hair follicles that you
named Rogaine. The second is Finasteride, which is
treatment category. Early compositions of Hair
NHJ: What is Advanced Restoration Technologies
were born with. Pattern hair loss is miniaturization of
an inhibitor of the Type 2 5-alpha-reductase enzyme,
Genesis incorporated minoxidil and some of our
the structures and sub-compartments of the hair folli-
a key enzyme associated with androgen metabolism
competitors took a page from our playbook. A couple
Dr. M: We realized that pattern hair loss is not sim-
cle. But if you can get ten hairs that are twice as thick,
that in genetically susceptible individuals triggers the
of years later however, new data suggested that there
ply the result of 5 alpha reductase mediated dihy-
it’s as good as having twenty hairs.
disorder. The third drug is a dual inhibitor of both
were naturally occurring substances that could actu-
drotestosterone damaging the follicle, even though
NHJ: Final question; how did you get into the thin-
Type 1 and Type 2 5-alpha-reductase and that is
ally outperform Minoxidil plus saw palmetto. We
most of our competitors have been chasing that
called Dutasteride. It is sold under various trade
used those compositions in the 2002 published IRB-
metabolism forever. AGA is known as a complex
Dr. M: My mother was a manicurist for 45 years, my
trait disorder. This means that there are numerous
dad a hairstylist from Europe. So I started out with
NHJ: Dutasteride has not received FDA clearance. NHJ: What is the plant or tree from which saw pal-
factors, genetic, biochemical, epigenetic and environ-
perm solution in my blood. (Laughs) I’m married to
mental that are responsible for triggering the onset
a hair scientist. I guess you could say I’m contin-
Dr. M: I think it’s in Phase 3 trials at this point, but Dr. M: The saw palmetto tree is like a weed version
and progression of the disease. One can appreciate
RECENT CHALLENGES OF PSYCHOANALYTIC THERAPIES Whoever is interested in psychotherapic practices will not fail to hear this fre-quent advice coming from authors claiming to give credit to „evidence-basedtechniques”: psychoanalysis is not „in” any more; new techniques have showngreater efficacy at lower cost. As we will see, not only have these assumptionproven to be flawed, but a
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