Early Treatment to prevent Alopecia Areata Progression (E-TAAP) Expand Alopecia UK funds invested: £4350 When: March 2018 Start date: September 2020 Project type: Feasibility work to optimise study design Project Lead: Dr Matthew Harries Length of project: 18 months – 2 years Research Institute: Salford Royal NHS Foundation Trust Condition of interest: Children and adults with first episode patchy scalp alopecia areata (AA) Funds being used for: whole feasibility study including focus groups, statistical support, study team costs, specialist IT support for development of surveys and data management, and printing costs. Research question: Can progression of alopecia areata be prevented by early diagnosis and treatment? Justification for research project: There is no robust evidence that any treatment improves the long-term outcomes in AA. The British Association of Dermatologists guidelines currently recommend conservative management as an option for limited patchy AA. However, further episodes of hair loss are common in AA and progression to more extensive disease (from which spontaneous re-growth is unlikely) is well recognised, particularly in those with more extensive or longstanding alopecia at presentation. This study hypothesises that the early identification and treatment of AA at first presentation will increase hair regrowth rates and reduce the risk of relapse and disease progression in the longer term. This pilot work will help inform study design and strengthen a bid for a larger, prospective, multi-centre RCT in AA. If early treatment does improve longer term outcomes this will lead to a paradigm shift in AA management in the UK, with early effective therapy being instituted in primary care and reducing onward referrals to secondary care. Lower numbers of patients progressing to extensive alopecia areata will not only reduce the overall psychological impact of the disease, but will lower treatment costs and diminish wig provision requirements, with significant cost benefit to the NHS. Who is leading the project: The project is being run by Dr Matthew Harries who is a Consultant Dermatologist and Honorary Senior Lecturer in Manchester. The majority of his research experience has been with translational hair loss clinical studies during his PhD (awarded in 2011) and in various studies since. Dr Harries was the co-champion and clinical lead for the hair loss and alopecia areata priority setting partnerships (PSP) run in conjunction with the James Lind Alliance and Alopecia UK. He runs a regional specialist hair loss service with a large AA cohort. Dr Harries will be working alongside a team of people including clinicians, researchers and patient representatives.
The application of ‘Nanokicking’ in immune disorders Expand Alopecia UK funds invested: £10,500 Further Alopecia UK funds committed: £3000 for Year 3 When: December 2017 Project type: PhD Studentship Project Lead: Teontor Simakou Length of project: 3 years Research Institute: University of the West of Scotland (UWS) Condition of interest: Alopecia Areata Funds being used for: Consumables costs for cell culture, nanokicking experiments, PCR and screening of serum and faecal samples for autoimmune factors. Overall Aim of the Project: To treat alopecia areata using a non-chemical technology based on nanovibrations (Nanokicking) Justification for research project: UWS propose that in the future stem cell therapies will be key in developing regenerative therapies for many conditions, including those affecting the immune response. This project will study the application of nanoscale mechanical stimulation protocols, called ‘Nanokicking’ to manipulate the differentiation of cells that have immune function, thus impacting on the resolution of different immune conditions, such as autoimmune disorders, immunodeficiency and vaccine development. ‘Nanokicking’ has already been successful in the targeted differentiation of Mesenchymal Stem Cells (MSCs) to bone and shows huge potential for bone regeneration and bone disorders. UWS have data to suggest it can play a role in other tissue type development. In addition to providing insight into the immunological mechanisms underpinning human disease, the technology has the potential to provide in vitro models which could be exploited commercially. Who is leading the project: The project is being run by research student, Teontor Simakou, who is working as part of an interdisciplinary team of enthusiastic scientists, experts in biology and physics. Teontor has a good knowledge of immunology, immunoassays and molecular biology. Teontor’s ambition is to learn how physics can boost biological applications and have a positive impact on global healthcare. Updates on the project: Visit our Blogs section to read Ted's views on alopecia research. Research outcomes: Ted has published a review of alopecia, available here.
The effectiveness of mindfulness based cognitive group therapy for social anxiety symptoms in people living with alopecia areata: A single case series. (COMPLETED) Expand Alopecia UK funds invested: £9840 When: April 2017 Project type: A single case series. Project Lead: Dr Andrew Thompson Length of project: 16 months (end date extended due to adoption leave) Research Institute: Sheffield University Condition of interest: Those living with AA and clinically significant levels of social anxiety Funds being used for: Research Associate (staff costs), Accredited Mindfulness Based Cognitive Therapy (MBCT) Sessions (e.g. group facilitators & room hire/refreshments), Research team and patient travel expenses, dissemination costs, and trial registration with ISRCTN (clinical trial registry). Research question: The main aim of the proposed study is to provide an initial test of the effectiveness of Mindfulness based cognitive group therapy (MBCT) in reducing clinically significant levels of social anxiety in people living with alopecia areata (AA). The proposed research will also examine whether the intervention impacts on depression, generalised anxiety and quality of life. Justification for research project: Whilst AA has few physical health consequences, it can lead to psychological consequences. A recent study found that 42.4% of respondents reported clinically significant social anxiety symptoms. The prognosis for AA is highly variable leading to frustration and uncertainty for the patient, and health care professionals may feel ‘stuck’ with how to support patients. Currently, there is a lack of psychological support for people with AA, despite the clear need. Mindfulness based cognitive group therapy (MBCT) has been found to be helpful in reducing distress in other conditions, but has not been tested with people with AA. The Hair Loss Priority Setting Partnership identified the need for psychological interventions as a top ten priority for patients and clinicians. The proposed research will provide initial evidence on the effectiveness of MBCT for people with AA who experience social anxiety. The data provided from single case research will give (i) a detailed insight into the process of change which can inform intervention development and (ii) detailed information on the types of difficulties people with AA experience. Who is leading the project: Dr Andrew Thompson will lead the project. Dr Thompson has specialist expertise within psychodermatology and has conducted research in this area for the last 15 years. Dr. Thompson has developed skin specific self-help using randomised control trials and qualitative methods. He will be working alongside a team of people including psychologists, PhD students, therapists and dermatologists. Project Outcomes: This was a small-scale study to see whether there is promise in using MBCT to help reduce social anxiety in individuals with alopecia. Five participants took part in an 8-week MBCT group. All participants found some improvement in social anxiety (as defined by themselves), suggesting MBCT is a useful intervention for some individuals with alopecia. Larger scale studies should be carried out to more thoroughly test the impact of MBCT in individuals with alopecia and social anxiety.
Biobank for alopecia research Expand Alopecia UK (AAR-UK at time of donation) funds invested: £20,000 When: March 2017 Project type: Biobank for alopecia research Project Lead: Professor Simon Milling Length of project: 3 years Research Institute: University of Glasgow Condition of interest: Alopecia areata/totalis/universalis (samples also being taken from people without alopecia, for comparison) Funds being used for: Research Nurse to collect biopsies and blood samples for alopecia studies More information about the biobank: AAR-UK set out to establish the first alopecia biobank registry within the UK. To establish this, AAR-UK’s founder Jayne Waddell organised a meeting with Professor Iain McInnes from Glasgow University with a view to finding the best way to proceed for the biobank to be viable. An AAR-UK crowd funding campaign then followed which raised the £20,000 that was required to pay for the clinic to take the samples. Nicola McBride (AAR-UK Research Co-ordinator) worked closely with Simon Milling and Kym Bain from Glasgow University to set up the clinic for the biobank samples. Together with dermatologist Susan Holmes they secured the necessary ethical approval and developed the questionnaires required for the participants to fill in at the clinic with the research nurse. They also put provisions in place to safeguard the samples and ensure that participant’s personal information is protected. The clinic is now up and running and currently runs once a week on a Monday afternoon, usually at the Queen Elizabeth University Hospital in Glasgow. Volunteers from the Glasgow area contact the Research Nurse by e-mail, and an appointment is arranged. At the clinic, the Research Nurse obtains patient consent, completes the questionnaires with participants to get a detailed history, and takes the blood and tissue samples, giving the participant the home kit for stool samples to be handed back into the clinic. The samples are then stored within the biobank at the University of Glasgow. Participants are offered the opportunity to provide blood samples, skin swabs, skin biopsies and stool samples. The biobank was set up in conjunction with Glasgow University student, Kym Bain’s, PhD project which looks at the pathogenesis of alopecia areata and the potential link to intestinal inflammation. Kym's project is funded by Medical Research Scotland and has industry funding from pharmaceutical company, AstraZeneca. The project supervisors are Professor Simon Milling and Professor Iain McInnes (from Glasgow University) and Annika Ȧstrand (from AstraZeneca). Interested scientists can apply for access to samples from the biobank by contacting Professor Milling at the University of Glasgow. Potential participants from the Glasgow area can find more details about the study here. Updates from the Biobank: To date, over 100 volunteers have given samples to the Biobank, which is fantastic. Kym writes regular blog posts for us, to keep us updated on the outcomes of her research project using samples from the Biobank. These are available here: Time for T-cells (November 2018) Making sense of molecules (June 2019) Research Outcomes: Kym has published a paper looking at the immune system in alopecia, available here.
Professor Simon Milling Expand Profession: Professor of Immunology Relevant organisations/institutions: University of Glasgow & Chair of Research Committee Research areas of interest/specialisms: The immunology of the intestine Inflammation and autoimmunity Work/academic background: Simon received his PhD in Immunology in 1996 from Imperial College, London. He then worked as a researcher in Philadelphia and Oxford. Simon took up a position as a lecturer in Immunology in Glasgow in 2007. The work in his lab focuses on two areas, both involving the immunology of the intestine: basic studies of the functions of dendritic cells in controlling healthy intestinal immune responses and more applied projects to understand potentially intestine-related inflammatory and autoimmune conditions. Relevant weblinks: Further information about Simon can be found on the University of Glasgow website.Further information about Simon's lab can be found here.See Simon's Google Scholar list here.
Dr Matthew Harries Expand Profession: Consultant Dermatologist Relevant organisations/institutions: Consultant Dermatologist, Salford Royal NHS Foundation Trust Honorary Senior Lecturer, The University of Manchester Fellow, The Royal College of Physicians of London Committee Member, British Hair and Nails Society Steering Committee member, UK-Dermatology Clinical Trials Network Research areas of interest/specialisms: Clinical = All types of hair and scalp disorders Research = Cicatricial (Scarring) alopecias (particularly the immunology of Lichen planopilaris) and alopecia areata Work/academic background: Matthew received his medical degree from the University of Leeds, UK in 1998. In 2001, he gained membership of the Royal College of Physicians of London, and in January 2003 took a post as a Specialist Registrar in Dermatology in Manchester. During training Matthew took time out of programme to study the hair immune system in primary cicatricial alopecias, working as a Clinical Research Fellow at the University of Manchester, and a visiting Research Fellow in Experimental Dermatology at the University of Lübeck, Germany. He was awarded a PhD from the University of Manchester in 2011 for this work. Matthew now works as a Consultant Dermatologist at Salford Royal Foundation Trust in Manchester and has an Honorary Senior Lecturer post at the University of Manchester. He is also a Fellow of the Royal College of Physicians of London. Matthew has a special interest in hair loss disorders, in particular the scarring alopecias, receiving specialist referrals from around the region. He is a founder member of the British Hair and Nails Society (BHNS) and acts as the research lead on the BHNS executive committee. Relevant weblinks: The following are links to some of the research institutions that Matthew has mentioned: The University of Manchester Research & Innovation (working with Salford Royal NHS Foundation Trust) National Institute for Health Research Manchester Biomedical Research Centre
Harry Brunt (AUK) Expand Profession: Property Developer Relevant organisations/institutions: Alopecia UK Trustee Research areas of interest/specialisms: Harry will be on the Committee as an Alopecia UK Trustee as well as representing the alopecia areata (universalis) patient perspective. Harry is interested in all areas of research that might further understanding of the disease and help lead to the development of effective treatments and ultimately a cure. Relevant weblinks: You can find Harry's Alopecia UK Trustee Profile link here.
Professor Fiona Henriquez Expand Profession: Research Group Leader Relevant organisations/institutions: School of Health and Life Sciences University of the West of Scotland (UWS) Research areas of interest/specialisms: clinical immunology host-pathogen relationships immunomodulation by mechanotransduction Work/academic background: Fiona is a Professor of Parasitology and leads the Infection and Microbiology Research Group within the Institute of Biomedical and Environmental Health Research of the School of Science and Sport at UWS. She is currently focused on leading high quality interdisciplinary research, teaching and mentoring early career researchers and PhD students in the area of Infectious Disease, Immunology and Biomedical Science. Fiona gained her BSc (Hons) in Immunology and Microbiology at the University of Strathclyde, where she continued on to a PhD focusing on the characterisation of secretory proteins of the obligate parasite Toxoplasma gondii. She has carried out postdoctoral positions at the Universities of Strathclyde and Glasgow and won a Royal Society International Fellowship pursue host-pathogen relationship research at the University of Chicago. Fiona joined UWS in November 2005 as a Lecturer in Immunology, embedding important parasitology and immunology research skills in the curriculum and establishing important networks with NHS biomedical laboratories. In parallel, her research on amoeba pathogens (Acanthamoeba and Paramoeba) has gained international recognition and has also made a considerable impact on public, industrial and health service engagement. She is a Fellow of the Royal Society of Biology, Higher Education Academy and Leadership Foundation for Higher Education. She is a Member of the Royal Society of Edinburgh Young Academy of Scotland and a passionate STEM ambassador to encourage young people into Science. Relevant weblinks: Further information about Fiona can be found on the University of the West of Scotland website.
Professor Desmond J. Tobin Expand Profession: Professor of Dermatological Science Relevant organisations/institutions: The Charles Institute of Dermatology, University College Dublin Honorary Visiting Research Professor, Centre for Skin Sciences, Faculty of Life Sciences, University of Bradford Research areas of interest/specialisms: Skin & Hair in Health and Disease using Cell Biology and Immunology research approaches. Work/academic background: Dr Desmond J. Tobin is Professor of Dermatological Science and Director of the Charles Institute of Dermatology, University College Dublin, Ireland (2018-) and former Director of the Centre for Skin Sciences at University of Bradford, where he now holds an Honorary Visiting Research Professorship. Des holds a BSc from the National University of Ireland (Maynooth), a PhD from the University of London (St. John’s Institute of Dermatology) and post-doctoral training from New York University Medical School - Dept. of Dermatology. Over the past 25 years he has researched basic, applied and translational skin/hair sciences, with a particular focus on the biology of human melanocytes/ pigmentation and hair growth disorders (immune based). He is a Fellow of Royal College of Pathologists; Fellow of the Institute of Biomedical Sciences, Fellow of the Royal Society of Biology, and Fellow of the Institute of Trichologists (Vice-president). He has published over 170 publications and his H-Index is currently 56 (Scopus, 2018). Relevant weblinks: University College Dublin, Charles Institute of DermatologyUniversity of Bradford, Centre for Skin Sciences
Dr Annika Åstrand Expand Profession: Project Leader/Principal Scientist Relevant organisations/institutions: AstraZeneca Gothenburg - R&D Research areas of interest/specialisms: Autoimmunity, respiratory and cardiovascular diseases Work/academic background: Annika has a PhD in renal Physiology. She has thirty years of Pharma experience ranging from bench scientist, line management to project leader.
Professor Andrew Messenger Expand Profession: Consultant Dermatologist Relevant organisations/institutions: British Association of Dermatologists European Hair Research Society British Hair and Nail Society British Society for Investigative Dermatology Research areas of interest/specialisms: Biology and disease of hair growth Work/academic background: Andrew is a semi-retired clinical dermatologist. He has had a clinical and research interest in hair disease for many years, including alopecia areata, female pattern hair loss and frontal fibrosing alopecia. Andrew was president of the European Hair Research Society 2004-6, of the North of England Dermatological Society 2008-9 and has been president of the Institute of Trichologists since 2009. Andrew was also Chair of the 7th World Congress for Hair Research in 2013.
Dr Abby Macbeth Expand Profession: Consultant Dermatologist Relevant organisations/institutions: Norfolk & Norwich University Hospitals NHS Trust (Consultant Dermatologist) University of East Anglia (Honorary Senior Lecturer) NIHR Clinical Research Network (Eastern Dermatology Speciality Lead) Research areas of interest/specialisms: Hair loss disorders Alopecia areata Outcomes for research Work/academic background: Dr Abby Macbeth is a Consultant Dermatologist at the Norfolk and Norwich University Hospitals Trust. Abby has a clinical and research interest in hair disorders, in particular Alopecia areata (AA). She was Co-Champion and Data lead for the Hair Loss Priority Setting Partnership funded by Alopecia UK. Current work is looking at ‘outcomes’ for clinical trials in AA, with a focus on what is most important to patients (ROMA- refining outcome measures for trials in alopecia areata). This is funded by the UK Dermatology Clinical Trials Network (UK DCTN). She is the Clinical Research Network Eastern Dermatology lead, a former UK DCTN Registrar fellow, a founder member of the UK DCTN Trainees Research Group and recipient of the Maxwell Charnley Dermatology Research Fellowship. Abby is also a former Trainee Representative of the British Hair and Nail Society. Relevant weblinks: Norfolk and Norwich University Hospitals NHS Foundation Trust University of Nottingham, Refining Outcome Measures for trials in Alopecia Areata (ROMA)