Complex Changes in the Apoptotic and Cell Differentiation Programs during Initiation of the Hair Follicle Response to Chemotherapy Tatyana Y. Sharova,

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Complex Changes in the Apoptotic and Cell Differentiation Programs during Initiation of the Hair Follicle Response to Chemotherapy Tatyana Y. Sharova, Krzysztof Poterlowicz, Natalia V. Botchkareva, Nikita A. Kondratiev, Ahmar Aziz, Jeffrey H. Spiegel, Vladimir A. Botchkarev, Andrey A. Sharov Journal of Investigative Dermatology Volume 134, Issue 12, Pages 2873-2882 (December 2014) DOI: 10.1038/jid.2014.267 Copyright © 2014 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 Doxorubicin induces premature catagen development in human HFs cultured ex vivo. (a) Scheme illustrating the experimental design of this study. (b) Morphological changes in HFs treated with 1μM doxorubicin (DXR) for 1hour at different time points after treatment. Bars=300μm and 100μm. (c) Dynamics of catagen development in HFs treated with 0.3 or 1μM doxorubicin versus the controls (mean±SD, *P<0.05, Student’s t-test). CH, club hair; DP, dermal papilla, DXR, doxorubicin; ES, epithelial strand; HF, hair follicle; HM, hair matrix. Journal of Investigative Dermatology 2014 134, 2873-2882DOI: (10.1038/jid.2014.267) Copyright © 2014 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Increase in apoptosis and decrease in cell proliferation in the hair follicles treated with DXR. (a) Double immuno-detection of apoptotic (TUNEL+, green arrowhead) and proliferating (Ki-67+, red arrow) cells in the HFs treated with DXR versus controls. Scale bar=100μm. (b) Increase in the number of TUNEL+ cells in the HFs exposed to 0.3 or 1μM DXR (mean±SD, ***P<0.001, Student’s t-test). (c) Decrease in the number of Ki-67+ cells in the HFs exposed to 0.3 or 1μM DXR (mean±SD, *P<0.05, **P<0.01, Student’s t-test). DAPI, 4,6-diamidino-2-phenylindole; DXR, doxorubicin; HF, hair follicle. Journal of Investigative Dermatology 2014 134, 2873-2882DOI: (10.1038/jid.2014.267) Copyright © 2014 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 3 Microarray, quantitative real-time reverse-transcriptase–PCR (qRT-PCR), and immunohistochemical profiling of human hair follicles 3–24hours after doxorubicin treatment. (a) Microarray analysis of the global gene expression in hair follicles (HFs) collected 3hours after 1μm doxorubicin treatment versus control HFs: functional assignments of the genes with altered expression induced by DXR. (b, c) Validation of microarray results by qRT-PCR reveals changes in expression of the genes encoding distinct pro- and anti-apoptotic markers (b) (left and right panels, respectively) and cell differentiation–associated markers (c) after doxorubicin treatment compared with controls. (d) Increase in expression of P53, FAS, TRAIL, TRAIL-R1, caspase-8, cFLIP, P21, and KAP1 in the epithelial (arrows) or mesenchymal (asterisks) portions of the hair bulb 24hours after doxorubicin treatment. Note, lack of cFLIP expression in hair matrix keratinocytes located at the bottom part of the hair bulb (arrowheads), whereas prominent cFLIP expression is seen in the differentiating hair shaft keratinocytes (arrow) and dermal papilla (asterisk). Scale bar=100μm. Journal of Investigative Dermatology 2014 134, 2873-2882DOI: (10.1038/jid.2014.267) Copyright © 2014 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 4 TRAIL or TRAIL-R1/R2 antagonistic antibodies and caspase-8 inhibitor decrease apoptosis in the hair follicles treated with doxorubicin (DXR). HFs were treated with TRAIL-neutralizing antibody (5μgml-1), TRAIL-R1 or TRAIL-R2 antagonistic antibodies, or with caspase-8 inhibitor (50μm) for 24hours prior to doxorubicin treatment. (a) Histomorphology of the HFs exposed for 48hours to the different treatments. (b) Detection of apoptotic cells by TUNEL (green) reveals numerous apoptotic cells in the HFs treated with doxorubicin (arrow). Scale bars=100μm. (c) Quantitative analysis of apoptosis shows dramatic elevation in TUNEL+ cells in doxorubicin-treated HFs, whereas treatment with TRAIL-neutralizing antibody and caspase-8 inhibitor significantly reduced doxorubicin-induced apoptosis (mean±SD, ***P<0.001 Student’s t-test). (d) Treatment with TRAIL-R1 or TRAIL-R2 antagonistic antibodies significantly reduced doxorubicin-induced apoptosis and number of TUNEL+ cells in the HFs (mean±SD, *P<0.05, **P<0.01, ***P<0.001; Student’s t-test). Journal of Investigative Dermatology 2014 134, 2873-2882DOI: (10.1038/jid.2014.267) Copyright © 2014 The Society for Investigative Dermatology, Inc Terms and Conditions