JAK inhibitors

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Research into JAK inhibitors and hair loss

Alopecia Areata (AA), the second most common form of hair loss, can occur at any age and affects men and women equally. The disease usually causes hair loss on the scalp, but some patients also experience facial and body hair loss with devastating consequences, particularly in children. Currently, there are no known treatments that can completely restore hair.

Columbia University Medical Center (CUMC) researchers published the results of a promising pilot trial in September 2016 and bring with them renewed hope for people with Alopecia Areata (AA).

Columbia University’s Latest JAK Inhibitor Hair Loss Treatment Study has Shown Promising Regrowth in Recent Mice Trials Where Half of Each Mouse was Treated Over a 5 Day Period

Patients with moderate to severe baldness caused by alopecia areata (AA), an autoimmune disorder where the person’s own cells attack their hair follicles, were given the JAK inhibitor ruxolitinib. The drug proved to be almost miraculous in its hair-raising powers. 75% of patients gained more than 90% of their lost hair during the 3 to 6 months of treatment with the drug.

Previously, the Columbia researchers identified the specific immune cells and the dominant inflammatory signaling pathways responsible for attacking the hair follicle in alopecia areata and putting those follicles into a dormant state. Experiments with mouse and human hair follicles showed that topical and oral drugs that inhibit the Janus kinase (JAK) family of enzymes, known as JAK inhibitors, reawaken these dormant follicles by blocking inflammatory signaling. Two such JAK inhibitors already approved by the U.S. FDA are ruxolitinib, a medication that is used to treat bone marrow malignancies, and tofacitinib, a treatment for rheumatoid arthritis.

Janus kinase inhibitors, more commonly known as JAK inhibitors, are a type of drug which suppresses the functionality of JAK enzymes within the body. These drugs were initially trialed in patients with Alopecia Areata, an autoimmune condition which causes patchy hair loss through to total baldness. This is because hair fall from AA occurs when something triggers the normal hair growth cycle to get stuck in its resting (telogen) phase. What this trigger might be is still unknown, although stress or sudden shock is thought to be a contributing factor in many cases. Whilst in most cases the hair will generally recover and regrow on its own, when this will happen is currently impossible to predict.

The initial, ‘accidental’ discovery of this JAK inhibitor’s potential for promoting hair regrowth came about when Yale University was investigating Tofacitinib as a treatment for plaque psoriasis. The patient they were treating also happened to have Alopecia Universalis and had not grown any hair in seven years, yet at the end of the seven month trial, his hair had fully regrown.

JAK inhibitor treatment specifically targets the enzymes inside hair follicles which are responsible for maintaining their dormant state (telogen phase) in cases of AA. In doing so, they stimulate the follicles to move out of the telogen phase and back into active growth (anagen phase).

Current research has shown that applying the JAK inhibitors topically (directly to the skin) results in a rapid onset of the anagen phase and subsequent hair growth.

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