Verteporfin HAIR REGENERATION HUMAN TRIAL Dr. Barghouthi *OFFICIAL THREAD

[Square1]

14 hours ago, alopeciaphobia said:

It's beyond fantastic that we have two full FUE case studies coming up, and that these are with even higher dosages, and an improved injection technique.

 

These should really be able to give us a much better idea of whether HT+verteporfin is or isn't the world's first procedure that can effectively multiply hair follicles.

 

By summertime next year, we may finally have a decent indication of whether this may be the major breakthrough that many of us hoped it would be ever since the first animal study. It's really really cool to be following this. Thank you @DrTBarghouthi.

The Bloxham-trial started over 3 months ago. He estimated that he could probably draw some preliminary conclusions after 3-4 months. He is, like dr. Barghouthi, probably a super busy guy, so it might take him awhile, but I guess he will be reporting about it soon. 

It is unlikely that the whole skin of the patient healed without scars, there is probably some optimization we have to do regarding dosages / application methods etc, but if there is a semblance of scarless skin that would be a very good sign that verteporfin works in humans as well.

Easily the most promising development in hairloss ever. 

 

[alopeciaphobia]

8 hours ago, Square1 said:

The Bloxham-trial started over 3 months ago. He estimated that he could probably draw some preliminary conclusions after 3-4 months. He is, like dr. Barghouthi, probably a super busy guy, so it might take him awhile, but I guess he will be reporting about it soon. 

It is unlikely that the whole skin of the patient healed without scars, there is probably some optimization we have to do regarding dosages / application methods etc, but if there is a semblance of scarless skin that would be a very good sign that verteporfin works in humans as well.

Easily the most promising development in hairloss ever. 

 

True, although in the case of FUT the entire wound is sutured, so we can't assess regrowth potential.

Of course reduced scarring is also a very interesting outcome, but it's not nearly as much of a potential breakthrough as donor regeneration.

[Square1]

2 hours ago, alopeciaphobia said:

True, although in the case of FUT the entire wound is sutured, so we can't assess regrowth potential.

Of course reduced scarring is also a very interesting outcome, but it's not nearly as much of a potential breakthrough as donor regeneration.

According to theory, they should go hand in hand. 

Whether that is the case remains to be seen, but I do think that if we get scarless healing, donor regeneration is a very real possibility.

 

[sansi]

10 hours ago, alopeciaphobia said:

True, although in the case of FUT the entire wound is sutured, so we can't assess regrowth potential.

Of course reduced scarring is also a very interesting outcome, but it's not nearly as much of a potential breakthrough as donor regeneration.

IMO it should regenerate hair in FUT also, but big amount of skin is being sutured into very narrow one, so regrowth would be much smaller that what was originally taken. Hair in strip line would be very good indicator of regrowth potential.

[Fox243]

57 minutes ago, sansi said:

IMO it should regenerate hair in FUT also, but big amount of skin is being sutured into very narrow one, so regrowth would be much smaller that what was originally taken. Hair in strip line would be very good indicator of regrowth potential.

Agreed, the FUT should actually have a better chance of regrowing hair because of increasing Shh signaling in a deeper wounds. It’s similar to how unsuccessful attempts have been made to apply Verteporfin after microneedling – the deeper the wound, the better the results.

[bigmistake]

On 10/12/2023 at 11:05 PM, DrTBarghouthi said:

Hi guys. I did follow up with the first patient and took some photos. I must say a quick view of the patient showed a nice 0.4 mg site. I’ll arrange the photos and share them once I download them- just wanted to update. 

I am so excited.

[Nikoni]

Would be awesome if it showed improvement since last update. Can't wait to see photos.

[-TheHairUpThere-]

The only thing I'm confused by as far as hair regeneration. Is how would a new hair form after the follicle was already removed from its root?....so an entirely new root just simply manifests itself?....Is there a scientific explanation for this?....even though I'm excited I know it's probably a long shot. 

Hair cloning is probably our best bet in the future. 

Edited October 15, 2023 by -TheHairUpThere-

[Dieter987]

5 hours ago, -TheHairUpThere- said:

The only thing I'm confused by as far as hair regeneration. Is how would a new hair form after the follicle was already removed from its root?....so an entirely new root just simply manifests itself?....Is there a scientific explanation for this?....even though I'm excited I know it's probably a long shot. 

Hair cloning is probably our best bet in the future. 

There are no scars in a human fetus, if you were to scar it, no scar would appear until the end of the 2nd trimester. If there is no scar, hair follicles should also be present. I don't know exactly how it works, probably about stem cells somehow. The YAP protein activates Engrailed-1. Engrailed-1 leads to the formation of scars. That is why it is necessary to use a YAP inhibitor such as verteporfin.

[sansi]

7 hours ago, -TheHairUpThere- said:

The only thing I'm confused by as far as hair regeneration. Is how would a new hair form after the follicle was already removed from its root?....so an entirely new root just simply manifests itself?....Is there a scientific explanation for this?....even though I'm excited I know it's probably a long shot. 

Hair cloning is probably our best bet in the future. 

Body has capacity to regenerate hair. During remodeling if it goes to skin regeneration process it is likely to regenerate also hair, as hair is part of the skin.

[alopeciaphobia]

On 10/13/2023 at 8:15 PM, Fox243 said:

Agreed, the FUT should actually have a better chance of regrowing hair because of increasing Shh signaling in a deeper wounds. It’s similar to how unsuccessful attempts have been made to apply Verteporfin after microneedling – the deeper the wound, the better the results.

Interesting. In light of this I wonder if regrowth potential would be affected by FUE punch size. I noticed from @DrTBarghouthis work and his results that he's very specialized with very small punch sizes. No doubt this is perfect for reducing scarring, but perhaps excising more skin could be more condicive to follicle regeneration?

[sansi]

A student from Stanford had dissertation about wound regeneration.
A lot more information about pig trial is included here - https://stacks.stanford.edu/file/druid:rp239gf7751/Talbott HE Dissertation-augmented.pdf

@DrTBarghouthi

[takuma]

On 10/14/2023 at 8:31 PM, -TheHairUpThere- said:

The only thing I'm confused by as far as hair regeneration. Is how would a new hair form after the follicle was already removed from its root?....so an entirely new root just simply manifests itself?....Is there a scientific explanation for this?....even though I'm excited I know it's probably a long shot. 

Hair cloning is probably our best bet in the future. 

When we get a hair follicle extracted, the process of puncturing the dermis to pull out the follicular units creates a scarred tissue as those micro wounds heal after the extraction, scar tissue is different from regular healthy skin, hair and sweat glands don't grown on scar tissue, but these appendages can grow back in healthy skin. From my understanding, Verteporfin inhibits the scar formation, thus returning completely healthy scarless skin, this allows for the hair and even sweat glands to regrow in the healthy new skin. At least that's what it showed in animal models, i believe it's been tested on both rats and pigs, and we now have at least two hair transplant doctors testing it on human patients now, this drug is FDA approved and has an excellent safety profile already...so we're not really worried about that aspect of it... We're focused on two things...non scarred skin is a game changer for so many different ailments and conditions such as for burn victims, and also for hair transplants, and Hair follicle regeneration is the holy grail for hair loss and hair transplants.

[sansi]

 

So, in pig trial they used 2mg/ml, 4mg/ml and 8 mg/ml concentrations. 2mg showed the best results. This means we are very close to the optimal dosage. 0.4mg per cm2 is close to 2mg used for 5cm. The difference is that in pig  case the scar was linear and had no width. In fue the dosage is calculated for cm2. So I think it is worth to increase dosage to test the improvement, but the good news is we wouldn't need to increase it dramatically.

[DrTBarghouthi]

Hi guys,

Apologies for the delay. I like to process the photos myself and I couldn’t get to that yet in clinic. Nonetheless, I know most of you are waiting for some sort of update. 
I had a look at the areas and the patient and I must say I’m quite happy with how the 0.4 mg and to some extent the 0.32 mg areas have developed. The 0.4 mg I found to be nicely healed . I will share the photos ofcourse but thought at least to give some update of what I saw thus far. 

[Nikoni]

8 hours ago, DrTBarghouthi said:

Hi guys,

Apologies for the delay. I like to process the photos myself and I couldn’t get to that yet in clinic. Nonetheless, I know most of you are waiting for some sort of update. 
I had a look at the areas and the patient and I must say I’m quite happy with how the 0.4 mg and to some extent the 0.32 mg areas have developed. The 0.4 mg I found to be nicely healed . I will share the photos ofcourse but thought at least to give some update of what I saw thus far. 

This is huge ! Thank you Doctor, you are going down in history.

Please also consider doing existing FUE scars revision, maybe this patient would like to repair his control boxes.

[bigmistake]

10 hours ago, DrTBarghouthi said:

Hi guys,

Apologies for the delay. I like to process the photos myself and I couldn’t get to that yet in clinic. Nonetheless, I know most of you are waiting for some sort of update. 
I had a look at the areas and the patient and I must say I’m quite happy with how the 0.4 mg and to some extent the 0.32 mg areas have developed. The 0.4 mg I found to be nicely healed . I will share the photos ofcourse but thought at least to give some update of what I saw thus far. 

@DrTBarghouthiBarghouthi we really appreciate all the effort that you have put in and we are so thankful that you are going out of your way for these trials. Was there any hair regrowth in addition to scar reduction ?

Also I agree with @Nikoni is there any chance you can do an FUE scar revision on this patient. One way to do so is to make slits (similar to how they are made in recipient area) in the FUE scars and then to inject verteporfin.

[takuma]

I'm curious to know if verteporfin if results in hair regeneration from the donor site if it will regenerate hair at the recipient site as well after wounding the scalp 

[Alex11]

As far as I know, the dosages used in the Verteporfin studies at Stanford have not been published anywhere. Even in the detailed dissertation by Talbott (https://stacks.stanford.edu/file/druid:rp239gf7751/Talbott HE Dissertation-augmented.pdf), only discussions concerning concentrations (e.g. 2 mg/mL) are being made, with no mentioning of volumes injected (i.e. the dosages).

You wrote: "This means we are very close to the optimal dosage. 0.4mg per cm2 is close to 2mg used for 5cm.". Could you please clarify the source for this claim.

 

On 10/16/2023 at 9:16 PM, sansi said:

So, in pig trial they used 2mg/ml, 4mg/ml and 8 mg/ml concentrations. 2mg showed the best results. This means we are very close to the optimal dosage. 0.4mg per cm2 is close to 2mg used for 5cm. The difference is that in pig  case the scar was linear and had no width. In fue the dosage is calculated for cm2. So I think it is worth to increase dosage to test the improvement, but the good news is we wouldn't need to increase it dramatically.

 

Edited October 19, 2023 by Alex11

[Square1]

4 hours ago, Alex11 said:

As far as I know, the dosages used in the Verteporfin studies at Stanford have not been published anywhere. Even in the detailed dissertation by Talbott (https://stacks.stanford.edu/file/druid:rp239gf7751/Talbott HE Dissertation-augmented.pdf), only discussions concerning concentrations (e.g. 2 mg/mL) are being made, with no mentioning of volumes injected (i.e. the dosages).

You wrote: "This means we are very close to the optimal dosage. 0.4mg per cm2 is close to 2mg used for 5cm.". Could you please clarify the source for this claim.

 

 

Maybe I am missing something here, but what is the point of research if the outcomes are being hidden?

[Alex11]

5 minutes ago, Square1 said:

Maybe I am missing something here, but what is the point of research if the outcomes are being hidden?

The official paper for the pig trial is in peer review -stage, and has not been published yet. This is most likely the reason for the confidentiality of some details.

[sansi]

5 hours ago, Alex11 said:

As far as I know, the dosages used in the Verteporfin studies at Stanford have not been published anywhere. Even in the detailed dissertation by Talbott (https://stacks.stanford.edu/file/druid:rp239gf7751/Talbott HE Dissertation-augmented.pdf), only discussions concerning concentrations (e.g. 2 mg/mL) are being made, with no mentioning of volumes injected (i.e. the dosages).

You wrote: "This means we are very close to the optimal dosage. 0.4mg per cm2 is close to 2mg used for 5cm.". Could you please clarify the source for this claim.

 

 

In dissertation 2mg/ml is mentioned both in terms of concentration and dosage. I assume 2mg/ml was used to inject 1ml in 2mg concentration for 5 cm.

[Square1]

4 hours ago, Alex11 said:

The official paper for the pig trial is in peer review -stage, and has not been published yet. This is most likely the reason for the confidentiality of some details.

But what is the harm done when the public knows these details?

[Fox243]

Hi @DrTBarghouthi, would love when to hear when you think you could share the photos.

Edited October 20, 2023 by Fox243

[TV_on_LazerDisk]

18 hours ago, sansi said:

In dissertation 2mg/ml is mentioned both in terms of concentration and dosage. I assume 2mg/ml was used to inject 1ml in 2mg concentration for 5 cm.

I know in general there are rules of thumb about the volume and body part can hold safely for injections 

 

Large subcutaneous injection volumes are associated with pain. In this sense, the maximum volume generally accepted is around 1.5 ml, although volumes of up to 3 ml are well tolerated when injected in the abdomen.

Subcutaneous Injection of Drugs: Literature Review of Factors ...

 

ILCs preferably triamcinolone acetonide is the first-line therapy for adult patients with less than 50% of scalp involvement.[2,4,12] Concentrations of 2.5 to 10 mg/mL may be used, but 5 mg/mL (maximum volume of 3 mL per session) is the preferred concentration for scalp

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002419/

If we know the type of injection in this case it's either subq or intramuscular we can guess the dosage 

 

Asking a dermatologist or even veteranian to make a educated guess would could give us a good estimation 

 

Edit 

 

There is also an upper limit for concentration based on the suspension being used as well as other factors, someone who worked at a compounding pharmacy would be able to calculate that. 

 

In case later on we want to try higher concentrations than in the original experiment. 

Edited October 20, 2023 by TV_on_LazerDisk