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Hair Loss News Archives
December 2010
A Hair Loss Researcher With Purpose
Angela Christiano, 45, an associate professor of dermatology and genetics at Columbia University Medical Center, studies hair.
Dec 2010
Q. When did you first learn that you had alopecia?
A. In 1995, a time of big transitions in my life. After doing highly
successful postdoctoral research on genetic blistering skin diseases
at Jefferson Medical College, I’d arrived here at Columbia to start
my own laboratory. I had just turned 30. I was getting a divorce.
When you start your first lab, a researcher is expected to find
something different from their postdoc work. For my first six months
here, I sat thinking, “What am I going to do when I grow up?”
In the midst of all this, I went to a beauty parlor and the stylist
said: “What’s happened here? You have a big patch of hair missing
from the back of your head.” I ignored that. But the next day at the
lab, I asked a colleague to take a look. She let out a bloodcurdling
scream: “You have a huge bald spot!”
I immediately went over to the clinic here. They said: “Oh, you have
alopecia. There’s not much we can do to treat it.”
Q. Alopecia is genetic. Do you have relatives with it?
A. My mom and her mother had hair loss from a young age. I have a
cousin also who lost all of her hair. Ironically, hair is a big part
of my family’s life. My grandfather was a barber in Italy and then
later in New Jersey. And my mother was a hairdresser before
retiring. I’m the first person in my family to go to college and
graduate school: Rutgers. My mother now says, “You’re just another
hair person — you just do it differently.”
Q. How did this history lead to your research?
A. In the months after my diagnosis, I went through panic and shock.
Every morning, I’d wake up wondering if it was all going to fall
out. And new spots did show up. I’d cover them with the most careful
combing. Then there’d be a new one. It was like plugging holes in a
dam. It finally stopped after two years.
I began reading all the papers on alopecia. In my training, nobody
had talked much about hair. I thought maybe the reason was because
it had all been figured out. When I started digging, I saw the
opposite was true. I thought, “Maybe this is the hand of fate
directing me to a topic? This is a wide-open field.” If I could
identify the genes involved in alopecia, then maybe we could figure
out what they did, and that might be the way to a treatment.
Having the chance to work it through in the lab was one of the
things that kept me sane in this period of my life. The disease was
very destabilizing.
Q. Why had hair loss been so minimally researched?
A. I suspect it’s because it’s seen as a “cosmetic” problem. It’s
the life-threatening diseases that get priority — and money. The
other problem was that in 1996, the tools weren’t ready. The Human
Genome Project hadn’t finished its work. There were no road maps.
Nobody had yet solved a complex disease where multiple genes are
involved, which is what alopecia is.
Q. So how’d you overcome that?
A. You could see the tools were on their way. Every year, you’d go
to conventions and there was excitement about what was coming. My
plan was to get all the ducks in a row for when the genome was
mapped. While we waited, we tried to lay some groundwork by trying
to find single genes that control the normal hair growth cycle. By
looking for rare hair-loss diseases where only one gene was the
factor, we learned some of that. My lab found six such genes.
The other thing we did was to line up a patient registry for
alopecia. That way, when the time was right, we could compare the
genomes of people with the disease to those of people without it. An
advocacy group, National Alopecia Areata Foundation, N.A.A.F.,
helped us connect with patients.
Q. When were you able to actually do the study?
A. In 2008. We published our findings this past July. Ours was the
first study of alopecia to use a genome-wide approach. By checking
the DNA of 1,000 alopecia patients against a control group of 1,000
without it, we identified 139 markers for the disease across the
genome.
We also found a big surprise. For years, people thought that
alopecia was probably the stepchild of autoimmune skin diseases like
psoriasis and vitiligo. The astonishing news is that it shares
virtually no genes with those. It’s actually linked to rheumatoid
arthritis, diabetes 1 and celiac disease.
Q. What will this new information mean for patients?
A. It should have amazing benefits. There are existing drugs on the
market for several of these diseases. Based on the overlapping
genetics, we have a chance of pushing forward with clinical trials
for potentially effective drugs much sooner than we’d thought. One
approach would be as a new indication for an already approved drug.
Going the other way, our research opens up possibilities for the
three related diseases. With them, till now it’s been hard to study
aspects of how the immune response goes wrong because it is
difficult to biopsy the pancreas or a joint. But now researchers
might be able to use a patient’s skin, a much more accessible organ.
Already, the finding has helped with diagnosis. At Columbia, we have
large clinics for diabetes and celiac disease. Since we’ve published
our paper, those clinics are asking patients, “Have you experienced
hair loss?” About 10 percent say, “Oh, yes, I lose hair in clumps.”
Q. What does it feel like to have accomplished this?
A. It’s wonderful, of course. This summer, I spoke at the patient
conference of N.A.A.F. and told the young people there, for the
first time, about their genes. Before I could finish my talk, they
gave me a standing ovation. I was in tears. Many of them later said,
“We wouldn’t wish this on you, but we’re glad you got this disease.”
I understood what they meant. Without it, a serious geneticist might
never have given their attention to what was thought of as a
cosmetic disease.
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