Abstract 3478: Management of chemotherapy induced alopecia using a topical botanical lotion via a proposed triple-action on apoptosis, inflammation and collagen
Authors: Shiiba Tadafumi , Harti Saad , Mello Angelo , Cauwenbergh Geert , Liu Jiawei 
Published: July 2016

Abstract
Background: Chemotherapy induced alopecia (CIA) is the most visible and emotionally distressing side effect of cancer therapies. No approved pharmacologic treatment is yet available for CIA. Hair follicular cells are damaged by chemoagents and prematurely undergo unwanted apoptosis, consequently resulting in massive hair loss. Such apoptosis-driven chemo toxicities generally cause dystrophic anagen and dystrophic catagen. Dystrophic anagen hair follicles recover much more slowly than dystrophic catagen hair. As anagen hair proportion represents &gt;80%, hair recovery following chemotherapy may become a long term issue. Besides, shortened anagen will impede collagen production causing unhealthy scalp and hair. A previous study demonstrated that p53 knock-out mice did not undergo CIA, indicating the importance to modulate apoptosis pathways in CIA management. Secondary necrosis stimulates production of pro-inflammatory mediators, triggering or sustaining inflammatory conditions in the scalp. Unwanted apoptosis of more hair follicular cells will occur due to exacerbated inflammation. This vicious circle further contributes to excessive follicular cell death, consequently resulting in hair loss and delay of hair regrowth. Therefore, normalizing apoptosis process, dampening scalp inflammation, as well as improving scalp health by increasing collagen content and remodeling are essential to counteract the negative impact on hair by chemotherapies.
Objective: To test a novel topical botanical lotion for CIA management
Methods: Bcl-2 level in scalp biopsy of androgenetic alopecia (AGA) subjects was analyzed via immunohistochemistry before, after 3 months’ application of the topical botanical lotion (n = 20), and compared with Bcl-2 level in healthy volunteers (n = 25). Expressions of E-selectin, ICAM-1 and il-8 were measured using HUVEC, +/- Product & TNF a. Type I collagen was analyzed using scalp biopsies from 11 AGA subjects before and after 4 months product application. Product's efficacy and tolerance were assessed on female cancer patients suffering from CIA (n = 30), Pictures were taken for comparison.
Results: Product restored Bcl-2 from 1.7 to 3.2, near normal level (4.73). Collagen content was increased by 79.93% after 4 months’ product application. Biopsy analysis revealed collagen remodeling. Product inhibited TNFα-induced expressions of E-selectin, ICAM-1 & il-8. For patients undergoing chemotherapy, the product allowed faster hair recovery in CIA patients (5-16 weeks quicker than historical control). For “long-term CIA” patients, first improvement was observed in 33%, 52% and 76% of subjects after 1, 2 and 3 months, respectively. No side effect was reported.
Conclusion: We developed a novel topical product for CIA through local actions on apoptosis, inflammation and collagen.
Citation Format: Tadafumi Shiiba, Saad Harti, Angelo Mello, Geert Cauwenbergh, Jiawei Liu. Management of chemotherapy induced alopecia using a topical botanical lotion via a proposed triple-action on apoptosis, inflammation and collagen. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3478.