A BRIEF CLINICAL AND BASIC SCIENCE PRIMER

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When tissues are deprived of their blood supply, even briefly, the damage to the cells comes not so much from the lost blood supply, but from the RE-PERFUSION! Perfusion is blood flow, so reperfusion means that the formerly oxygen-deprived tissues suddenly experience a flood of blood into their midst. This can cause tissue damage. On a biochemical level, what happens is this: free radicals are formed. What are free radicals? Well, they are usually highly charged, highly energetic oxygen species, like OH- (hydroxyl), H2O2 (peroxides), O- (superoxides), and others. These free radicals act as “little bullets”, if you will, and can damage cell membranes, and contents of the nuclei of cells. Of these, superoxide specifically is known to break down nitric oxide and to inhibit hair follicle cell growth. Interestingly, nitric oxide is also a “free radical”; however, in small amounts, it exerts a positive effect. Only when its production is out of control, such as in septic shock, is it damaging to the body.
Now, these free radicals are also part of normal metabolism, and are often used by certain white blood cells to destroy viruses, bacteria and other invaders. But as is often the case, it’s a matter of balance. Too many of them is bad, and in too concentrated an area. This is a major way that heart muscle is damaged after coronary occlusion (blockage), brain tissues killed after occlusive stroke and so on.
These Hair Cycle products are physician-formulated, safe, and naturally-based, delivered in a vehicle that is gentle and effective, and leaves the hair soft and manageable. The products are ideal for those undergoing hair transplant surgery, and for the millions of men and women worldwide experiencing hair loss.
So, how is this pertinent to our field of hair transplant surgery? Well, our follicular unit grafts are tissues deprived of perfusion (they are ischemic). What ameliorates reperfusion injury and free radical formation? Cold for one thing (we use chilled saline as a storage solution, right?) and brevity of ischemic time (minimal time out of body). Certain substances like tetrahydrobiopterin (BH4), which we have yet to figure out how to apply to our work, can protect cells from ischemia-reperfusion injury. There are also fascinating studies which show that ischemic pre-conditioning (IPC) can protect tissues in remote locations from ischemia-reperfusion injury (IR). Thus, using IPC on a limb, like the forearm, may help protect tissues elsewhere in the body (possibly follicular unit grafts?)
One of the things that we can do is to use various antioxidants to shift the balance in the tissue’s favor. Our product line contains many antioxidants. Any antioxidant “quenches” free radicals, i.e., it allows itself to be oxidized rather than the cellular structures at risk. Our bodies have a very sophisticated antioxidant system; ascorbic acid (vitamin C), tocopherols (vitamin E), glutathione, glutathione synthetase, carotenoids (vitamin A-like substances), and many more. With our product line, we are placing these and others topically, that is, directly on the scalp and hair.