Alopecia - Hair Loss

Rationale

• "Medication for men plagued by hair loss has become a topic of interest in Japan since a drug company began marketing it at the end of last year." March 5th, 2006 – Source
• "An increasing number of companies are apparently turning the Chinese fear of a bald spot into big bucks with some doing so well they are branching out into other countries." February 16, 2006 – Source

"There is something in the air, or should we say in the hair, these days. Scientific research into hair loss remedies has never been more active or more exciting." June 7, 2006 - Source

Introduction

Hair basics

• Hair is a complex and delicate part of the body.
• Keeping it healthy and beautiful is a challenge.
• Hair grows everywhere on the body with the exception of lips, eyelids, palms of the hands and soles of the feet.
• Hair is basically a form of skin.
• Hair is made up of a protein called keratin.
• Each shaft of hair is made of two or three inter-twined layers of keratin which grow from a follicle beneath the skin.
• Hair Structure - Source
• Hair Cycle - Source

What causes hair loss?

• Decrease in growth of hair
• Increase in shedding of hair
• Breakage of hair
• Conversion of thick terminal hairs to thin vellus hairs

Survey results from Japan

Both men and women lose hair for similar reasons. Hair loss in men is often more dramatic, and follows a specific pattern of loss, one of which has been termed “Male Pattern Baldness" or "Androgenetic Alopecia".

Types of alopecia

• Alopecia Areata (AA): Hair loss occurring in patches anywhere on the body.
• Alopecia Totalis (AT): Total loss of the hair on the scalp.
• Alopecia Universalis (AU): Total loss of all hair on the body.
• Alopecia Barbae: Loss of facial hair (for a man) especially in the beard area.
• Alopecia Mucinosa: A type of alopecia which results in scaley patches.
• Androgenetic Alopecia (AGA): Also known as male pattern baldness. It is a thinning of the hair to an almost transparent state, in both men or women. It is thought to be a hereditary form of hair loss.
• Traction Alopecia: Traction alopecia is usually due to excessive pulling or tension on hair shafts as a result of certain hair styles. It is seen more often in women, particularly those of East Indian and Afro-Caribbean origin. Hair loss depends on the way the hair is being pulled. Prolonged traction alopecia can stop new hair follicles from developing and leads to permanent hair loss.
• Anagen Effluvium: This hair loss is generally caused by chemicals such as those used to treat cancer. Initially it causes patchy hair loss, which often then leads to total hair loss. The good news is that when you stop using these chemicals the hair normally grows back (usually about 6 months later). Other drugs also can cause hair loss. Many medicines used to treat even common diseases can cause hair loss.
• Scarring Alopecia: A form of alopecia which leaves scarring on the area of hair loss.
• Telogen Effluvium: A form of hair loss where more than normal numbers of hair fall out. There is a general 'thinning' of the hair. Unlike some other hair and scalp conditions, it is temporary and the hair growth usually recovers. (Source)

Androgenetic alopecia

• Gradual onset
• Transition from large, thick, pigmented terminal hairs to thinner, shorter, indeterminate hairs and finally to short, wispy, non-pigmented vellus hairs in the involved areas
• Characterized by a receding hairline and/or hair loss on the top of the head

Main causes

• Genetic predisposition
• Hormonal effect of androgen
• Reduction of blood circulation around hair follicle
• Deactivation of hair matrix cells

Some facts from Japan

• Market size: ¥ 30 Billion
• Number of products: more than 100

(JICST-EPlus - Japanese Science & Technology)

IP activity over the years

The graph indicates:

• Number of patents filed every 5 years (except for first 7 years).
• First solution proposed in 1973
• Filing trend indicates steep rise in activity recently.

IP Activity over years

Major players

Assignees with more than 20 patents

Assignees with fewer than 20 patents

• Active assignees

Assignees currently active with more than 5 patents to their credit during 2000-2005.

• Warner with 9 patents,
• Bristol with 6 and
• Abbott with 5.

Active Assignees

Treatment Approaches

Composition of treatment for causes are identified and categorized as follows:

• Anti-androgens (Finasteride) source
• Vasodilators (Minoxidil) source
• Double action (Anti-androgen + Vasodilator)
• Hair matrix cells activator

Cause	Treatment approach	Pathways affected
Hormonal effect of androgen	Anti-androgens	Testosterone pathway
Reduction of blood circulation around hair follicle	Vasodilators (eg. Minoxidil)	NO/cGMP Pathway
Deactivation of hair matrix cells	Hair matrix cells activator	Wnt pathway STAT pathway TGF beta/BMP Pathway FGF Pathway MAPK Pathway NOTCH Pathway Hedgehog Pathway

Anti-androgens

• Anti-androgens are used in hormone therapy.
• Anti-androgens are designed to affect the hormones made in the adrenal glands. They don't stop the hormones from being made, but they stop them from having an effect leading to hair loss.

What causes hair loss?

• Testosterone is reduced to its active metabolite, Dihydrotestosterone (DHT) by the enzyme 5 alpha reductase.
• DHT attaches to androgen receptor sites at the hair follicle.
• DHT causes gradual miniaturization of the follicle, which eventually results in hair loss.

How do anti-androgens treat hair loss?

• Anti-androgens compete with DHT to bind to the androgen receptor.
• Upon binding of anti-androgen in place of DHT, follicle miniaturization is lowered and hair loss prevented.

Functions of Anti-androgen

Anti-androgen

Functions of Anti-androgen

IP Map for anti-androgen

Pat/Pub#	Nature	Composition	Composition action
US20060009430 BLOTECH (2004)	Natural extracts	Palmetto berry extract (fatty acids & sterols), Pumpkin seed extract (Vitamins-B, alpha-linolenic acid, amino acids and phytosterols), Quercetin (Flavonoids) and Beta-sitosterol (Rice bran, wheat germ, corn oils and soybeans)	Fatty acids – Inhibit testosterone Sterols - Mechanism of action unknown. Quercetin results in cell growth cycle. Beta-sitosterol reduce inflammation on scalp
US20060009427 WARNER LAMBERT(2004)	Organic compound	New class of 4-cycloalkoxy benzonitrile derivatives and salts	Acts as androgen receptor modulator and blocks formation of DHT.
US20050085467 WARNER LAMBERT(2004)	Organic compound	New class of 6-sulfonamido-quinolin-2-one and 6-sulfonamido-2-oxo-chromene derivatives.	The compounds inhibit, or decrease, activation of androgen receptor by androgens.
US20050118282 APHIOS Corp (2003)	Natural extracts	Supercritical fluid isolate of Saw Palmetto and Sperol (Serenoa repens berry) and their analogs or derivatives.	Modulates androgenic activity by inhibiting 5.alpha.-reductase activity.
US20060009429 Fundacion Pablo Cassara (2003)	Nucleotide	Pharmacologically active oligonucleotides (encompass both DNA and S-DNA bond)	Oligonucleotides inhibit androgen receptor (AR) expression at very low concentrations in skin and hair follicle
US20030007941 PFIZER INC (2001)	Organic compound	Thyromimetic compounds (structurally similar to thyronine) with finasteride, or cyproterone acetate	Activates thyroid hormone receptors in hair follicle which in turn promote elasticisation of follicle walls and hair follicle
US20030073616 N/A (1995)	Peptides/nucleic acid	Bradykinin antagonist (peptide of plasma origin from kininogen precursor-kallikrein)	Inhibits synthesis of bradykinin receptors or compounds by binding to B2 receptor
EP0279010 KAO Corp (1987)	Natural extracts	Walnut extract (leaves/pericarps) with an organic solvent	Blocks formation of DHT

Minoxidil (Vasodilators)

• Minoxidil is a "potassium channel opener" that leads to vasodilation.
• The drug is available in two forms. Oral minoxidil is used to treat high blood pressure and the topical solution form is used to treat hair loss and baldness.

What causes hair loss?

• A thick network of tiny veins and arteries line the outer wall of the follicle. Blood pumps through the bulb and hair via this network.
• DHT accumulates in the hair follicles and roots, constricting the blood supply of oxygen and nutrients to the hair roots; which is also seen to possibly contribute towards hair loss.

How does Minoxidil treat hair loss?

• Minoxidil is applied to the scalp topically, where it dilates blood vessels in the scalp and sustains the hair follicles for longer period of time.
• Minoxidil is thought to have a direct mitogenic effect on epidermal cells, as has been observed both in vitro and in vivo. Though the mechanism of its action for causing cell proliferation is not very clear, minoxidil is thought to prevent intracellular calcium entry. Calcium normally enhances epidermal growth factors to inhibit hair growth, and Minoxidil by getting converted to minoxidil sulfate acts as a potassium channel agonist and enhances potassium ion permeability to prevent calcium ions from entering into cells. (Source)
• Minoxidil sulfate (MS) appears to be the active metabolite responsible for hair growth stimulation.

Functions of Vasodilators

Functions of Monoxidil source

IP Map for Vasodilators

Pat/Pub#	Nature	Composition	Composition action
US20040157856 WARNER LAMBERT(2002)	Organic compound	Benzopyran compounds	Rapidly metabolizes, and causes reduced cardiovascular effects as compared to other known potassium channel openers
US20050053572 LG HOUSEHOLD & HEALTH CARE(2001)	Natural extracts	Sophora flavescens extract (alkaloids & flavonoids, luteolin-7-glucose and cytosine) Hinokitiol (Taiwan hinoki oil, Aomori, Western Red Cedar oil) and Nicotinamide (Vitamin B complex)	Promotes function of cell activity and dilates blood vessels

Double action (Anti-androgen + Vasodilator)

• Combination of Vasodilator + Anti-androgen (double action) composition for effective treatment of Male-Pattern Baldness.

What is the problem with using only Anti-androgen therapy?

• Anti-androgen is not effective in addressing the issue of vasocontriction around hair follicles due to sebum oil build up.
• Anti-androgen only prevents binding of DHT to androgen receptors. However, the effects of improper oxygen and nutrient supply to the brain due to vasocontriction still remains and gradually causes hair loss.

What is the problem with using only Vasodilator (or Minoxidil only) therapy?

• Vasodilator or Minoxidil-based products are generally not effective in stopping hair loss as vasodilators (or Minoxidil) do not block the harmful effects of DHT in the scalp and hair follicles.
• Vasodilators or Minoxidil simply dilate blood vessels in the scalp. However, the harmful DHT still gets produced in the body, enters the scalp and hair follicles causing hair loss.

How is the combination of Anti-androgens and Vasodilator (or Minoxidil) effective?

• Anti-androgens target the problem of DHT binding to androgen receptors and prevents follicle miniaturization.
• Vasodilators like Minoxidil cause vasodilation and therefore improve supply of oxygen and nutrients to the hair follicle and roots.
• Combination therapy therefore proves to be much more effective than individual therapy.

Functions of (Anti-androgen + Vasodilators)

Anti-androgen and Minoxidil

Functions of (Anti-androgen + Vasodilators)

IP Map for (Anti-androgen + Vasodilators)

Pat/Pub#	Nature	Composition	Composition action
US20060052405 N/A(2000)	Peptides	Testosterone blocker or vascular toner (Flutamide, cyproterone acetate, spironolactone, progesterone, or analogs or derivatives) and minoxidil mixed along with non-retinoid penetration enhancer and sunscreen	Inhibits 5.alpha.-reductase activity (block DHT) and increase blood flow on the scalp
US20050123577 L'OREAL(2000)	Peptides	Prostaglandin (polyunsaturated fatty acids) EP-2, EP-3 EP-4 receptor agonist with Minoxidil, 2,4-diaminopyrimidine 3-oxide, and Aminexil, cyclic AMP	Minoxidil (designed to mimic nitric oxide's effects) grows hair via prostaglandin-H synthase stimulation. EP-3 and EP-4 are expressed in anagen hair follicles which induce a reduction in the level of cAMP
US6447762 COLOMER GROUP(1999)	Natural extract	Hop extract (oil contains terpenes and humulene), Rosemary extract (hydroalcohol), Swertia extract (glycol with a swertiamarin), Silanodiol salicylate (biologically active silicon compound)	Inhibits activity of 5-alpha-reductase, protects follicular cell membranes by neutralizing action of oxidation reaction in tissues, stimulates hair follicles and blood circulation to the hair root, supplies oxygen and nutrients to base of follicle, retains humidity, avoids dehydration of scalp

Hair matrix cell activator

Hair matrix cell activator is a substance that acts at the matrix cells in the hair follicle preventing their degradation.

What causes hair loss?

• Stem cells are interspersed within the basal layer of the outer root sheath and in an area called the bulge.
• Stem cells migrate to hair matrix where they start to divide and differentiate, under the influence of substances produced by cells of the dermal papilla.
• Perifollicular matrix cells undergo slow degradation which prevents follicle stimulation.
• Hair follicle activation is required for hair growth and thus inhibition of follicle activation eventually leads to hair loss.

How does hair cell matrix activator treat hair loss?

• Hair cell matrix activator slows down and inhibits degradation of the perifollicular matrix.
• This leads to an increase in hair follicle matrix cells that differentiate from progenitor stem cells.
• Matrix activator allows activation of hair matrix cells and therefore follicle stimulation leading to hair growth.

Functions of Hair matrix cell activator

Hair matrix cell activator

Functions of Hair matrix cell activator

IP Map for Hair matrix cell activator

Pat/Pub#	Nature	Composition	Composition action
US20020052498 SHISEIDO(1999)	Organic compound	(2-substituted oxyphenyl) alkanamide derivative and its salt	Mechanism of action has not been made clear, having excellent hair follicle activating action and regrowth promoting effect
US20040071647 L'OREAL(1998)	Peptides	Metalloprotease (MMP-9) inhibitor (thiol or a hydroxamate) other than chelating calcium ions	Reducing the expression of MMPs (Metalloproteases) in the scalp - slows down or inhibits the degradation of the perifollicular matrix (extracellular matrix surrounding the hair follicle)

Technology mapping based on patents analyzed

IPMap: Composition nature matrix

Year	Organic Compound	Natural extracts	Peptides	Nucleotides	Natural extract + Organic comp
2005	....	....	....	....	UNILEVER (1)
2004	WARNER (1)	BLOTECH (1)	....	....	KAO (1)
2003	WARNER (1)	APHIOS (1)	....	FUNDACION (1)	....
2002	WARNER (1)	....	....	....	....
2001	PFIZER (1)	LG HEALTH-CARE (1)	....	....	....
2000	....	....	L’OREAL (1) / N/A (1)	....	....
1999	SHISEDIO (1)	COLOMER (1)	....	....	....
1998	....	....	L’OREAL (1)	....	....
1995	....	....	N/A (1)	....	....
1987	....	KAO (1)	....	....	....
1982	UNILEVER (1)	....	....	....	....

Focus of patents

Focus of patents	Patent no.	Rec. no.
2-substituted oxyphenyl alkanamide derivative having excellent hair growth effect.	US20020052498	1
Thyromimetic compounds, and its role in treating hair loss	US20030007941	2
Saw Palmetto berry extract, pumpkin seed extract, sitosterol and quercetin for the treatment and prevention of the biologically detrimental effects of DHT	US20060009430	3
4-cycloalkoxy benzonitriles and its use as androgen receptor modulators	US20060009427	4
Supercritical fluid isolate of Saw Palmetto, Sperol for inhibition of 5-.alpha.-reductase activity	US20050118282	5
New class of quinolin-2-ones and chromen-2-ones andtheir use as androgen receptor antagonists	US20050085467	6
Antiandrogen oligonucleotides usable for the treatment of dermatological androgen-related disorders	US20060009429	7
Bradykinin antagonists for stimulating or inducing hair growth and/or arresting hair loss	US20030073616	8
Extract from walnut leaves and/or pericarps as 5 alpha -reductase inhibitor	EP0279010	9
Stimulating hair growth using benzopyrans	US20040157856	10
Sophora flavescens extract, Coicis semen extract, clove extract, etc for promoting hair growth, function of cell activity and dilating peripheral blood vessels.	US20050053572	11
Compositions to prevent or reduce hair loss	US20060052405	12
Prostaglandin EP-3 receptor antagonists for reducing hair loss	US20050123577	13
Synergic effect arising from the interaction of active ingredients, consisting of three plant extracts and a synthetic organosilicic compound for prevent hair loss and stimulate hair growth	US6447762	14
Metalloprotease inhibitors to induce and/or stimulate the growth	US20040071647	15
Method of decreasing sebum production and pore size	US20050277699	16
Method for reducing sebum on the hair and skin	US4529587	17

Technology focus

Technology focus

Distribution of patents

By patent types

Distribution based on patent types

By key ingredients

Distribution of key ingredients

By target disease

Distribution based on target diseases

Key ingredients vs. Target disease

Key ingredients vs. Target disease

Target species

Target species

Mode of administration

Mode of administration

Product type vs. Product form

Product type vs. Product form

Patents by target diseases

Target disease/ disorder	Patent no.	Rec. no.
Alopecia areata, alopecia pityrodes or alopecia seborrheica, or androgenic alopecia (i.e. male pattern baldness)	US20020052498	1
Alopecia areata, male pattern baldness and female pattern baldness	US20030007941	2
Androgenic alopecia (i.e. male pattern baldness), prostatic hyperplasia or both.	US20060009430	3
Inappropriate activation of the androgen receptor, acne, oily skin, alopecia	US20060009427	4
Prostatic hyperplasia, prostatic cancer, hirsutism, acne, male pattern baldness, seborrhea, and other diseases related to androgen hyperactivity	US20050118282	5
Alopecia, acne, oily skin, prostrate cancer, hirsutism, and benign prostate hyperplasia	US20050085467	6
Androgen-associated hair loss and androgen-skin related disorders.	US20060009429	7
Androgenetic or androgenic alopecia or androgeno-genetic alopecia	US20030073616	8
Diseases caused by testosterone (male-pattern alopecia)	EP0279010	9
Alopecia areata, female pattern hair loss, hair loss secondary to chemotherapy or radiation treatment, stress-related hair loss, self-induced hair loss, scarring alopecia, and alopecia in non-human mammal	US20040157856	10
Male pattern alopecia	US20050053572	11
Alopecia, androgenic alopecia	US20060052405	12
Hair loss	US20050123577	13
Male pattern alopecia	US6447762	14
Androgenetic, androgenic or androgenogenetic alopecia	US20040071647	15
Curing other scalp related problems	US20050244362	16

Patents by application

Distribution of patents based on application

Pathways and linkages

Pathways associated with hair matrix cell activation

Molecular mediators of hair follicle embryogenesis: Identification of the molecular pathways controlling differentiation and proliferation in mammalian hair follicles provides the crucial link to understanding the regulation of normal hair growth, the basis of hereditary hair loss diseases, and the origin of follicle-based tumors. Homeobox (hox), hedgehog (hh), patched (ptc), wingless (wg}/wnt, disheveled (dsh), engrailed (en), Notch 1 and armadillo/B-catenin genes are all critical for hair follicle.

• Wnt pathway: Maintains hair-inducing activity of the dermal papilla.
• Hedgehog pathway: Sonic hedgehog (SHH) signaling plays a critical role in hair follicle development. Sonic hedgehog gene. Sonic hedgehog, SHH for short, helps guide hair follicles from a resting stage into growth activity. SHH is particularly important in the embryonic formation of hair follicles.
• STAT pathway
• TGF beta/BMP Pathway: Bone morphogenetic protein (BMP) signaling have been implicated in the regulation of both proliferation and differentiation in the hair follicle. BMP2 is expressed in the embryonic ectoderm, but then localizes to the early hair follicle placode and underlying mesenchyme. BMP4 is expressed in the early dermal condensate. Research results show that BMPs are a key component of the signaling network controlling hair development and are required to induce the genetic program regulating hair shaft differentiation in the anagen hair follicle. Transforming growth factor beta (TGF-beta), inhibits mitogen - induced dermal papilla cell proliferation
• FGF Pathway: Fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) potentiate the growth of dermal papilla cells. It is proposed that these proteins increase the synthesis of stromelysin (an enzyme, matrix metalloproteinase) which acts on the papilla cells and accelerates their growth.
• MAPK Pathway: Mitogen-activated protein kinase (MAPK) activation, increases keratinocyte turnover.
• NOTCH Pathway: Notch-1 is expressed in ectodermal-derived cells of the follicle, in the inner cells of the embryonic placode and the follicle bulb, and in the suprabasal cells of the mature outer root sheath. Delta-1, one of the three ligands is only expressed during embryonic follicle development and is exclusive to the mesenchymal cells of the pre-papilla located beneath the follicle placode, and appears to promote and accelerate placode formation, while suppressing placode formation in surrounding cells. Other ligands, Serrate 1 and Serrate 2, are expressed in matrix cells destined to form the inner root sheath and hair shaft.

Pathways associated with Anti Androgen

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Alopecia pathways