doi: 10.1242/10.1242/dev.00201
`Cyclic alopecia' in Msx2 mutants: defects in hair cycling and hair shaft differentiation
Liang Ma1,2,
Jian Liu3,
Tobey Wu3,
Maksim Plikus3,
Ting-Xin Jiang3,
Qun Bi2,
Yi-Hsin Liu4,
Sven Müller-Röver5,
Heiko Peters1,
John P. Sundberg6,
Rob Maxson7,
Richard L. Maas1,* and
Cheng-Ming Chuong3,*
1 Division of Genetics, Department of Medicine, Brigham and Women's Hospital and
Harvard Medical School, Boston, MA 02115, USA
2 Department of Cell and Molecular Biology, Tulane University, New Orleans, LA
70118, USA
3 Department of Pathology, University of Southern California, Los Angeles, CA
90033, USA
4 Center for Craniofacial Molecular Biology, University of Southern California,
Los Angeles, CA 90033, USA
5 Department of Dermatology, University Hospital Hamburg-Eppendorf, 20246
Hamburg, Germany
6 The Jackson Laboratory, Bar Harbor, ME 04069, USA
7 Department of Biochemistry, University of Southern California, Los Angeles, CA
90033, USA

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Fig. 1. Expression of Msx1 and Msx2. Wild-type ICR pups were
sacrificed at indicated time-points and their skin harvested, sectioned and
hybridized to 35S-labeled Msx1 or Msx2 cRNA
probes. Msx1 and Msx2 are initially co-expressed in the
developing hair follicle. Expression of Msx1 is limited to the matrix
cells (A,C) and its expression disappears during catagen (E). Msx2
expression in the hair follicle is more dynamic: first it is expressed only in
the matrix and precortical cells, then it is expanded into the hair cortex and
medulla (B,D). Msx2 continues to be expressed during catagen, when
Msx1 expression is no longer expressed (E,F). Scale bar: 50 µm.
(G) A schematic diagram of hair follicle structures and the hair cycle. During
anagen, germinative matrix cells proliferate to generate progenitor cells,
which receive signals from the dermal papilla to differentiate into either
hair shaft cells or inner root sheath cells. During catagen, hair production
ceases and hair follicle degenerates to form a club hair. During telogen, hair
follicle rests and at the end of telogen, dermal papilla at the base of the
hair follicle interact with the adjacent bulge region to initiate the second
round of hair follicle morphogenesis. IRS, inner root sheath; ORS, outer root
sheath; HF, hair follicle.
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Fig. 2. Abnormal hair cycling in Msx2 knockout mutant mouse. (A) Hair
distribution of the same mouse, pictures taken 1 month apart. Note the
dramatically different hair patches. In 1 month, hairy regions became bald,
and bald regions became hairy. (B) Asynchronous hair cycle domains in the same
mutant mouse over time. Msx2 knockout mice show a cyclic balding pattern. To
examine the balding pattern, we followed five mice (1 month old) over an
80-day period, taking photos about once every 3 days. One example is shown
here. Hair regrowth first appears in the shoulder region, spreads to the whole
trunk, and then starts to get lost from cephalic to caudal end until all hairs
are lost. This pattern then repeats. The times when most trunk hairs are in
anagen are boxed in red.
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Fig. 5. Changes of hair filament differentiation in Msx2 knockout mice.
(A,B) Plucked hairs from Msx2 knockout mice are short and curly,
reflecting defects in hair structures. Scale bar: 100 µm. (C,D) Medulla
patterning is affected as suggested by the irregular septations in the hair.
Scale bar: 50 µm. (E-H) Scanning EM showing unevenness in diameter of
Msx2 knockout mice hairs. Cuticles fail to form, resulting in a
smooth, wrinkled surface. Scale bar: 30 µm in E,F; 10 µm in G,H. (I,J)
Trunk hairs from wild-type (I) and Msx2 knockout (J) mice. Both club
ends are morphologically similar (arrowheads). Septation patterns are
irregular in the mutants, but there are no breakages in the middle of the
shaft. Scale bar: 100 µm. (K,L) BrdU labeling was performed at P5, P9, P11
and P15, and representative panels from P11 are shown. BrdU-positive cells
were detected in both the hair matrix and the outer root sheath (arrows).
Quantitation of BrdU-positive cells in the matrix showed similar levels of
incorporation in the mutants. (M,N) Apoptotic cells detected by TUNEL assay
carried out at P5, P9, P11, P14 and P30 (an example is shown from P30).
Positive cells were observed in epidermis and dermis. No apparent differences
between wild-type and Msx2 knockout mutant skins were observed. Scale
bars: 250 µm.
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Fig. 3. Histopathological changes of Msx2 knockout mice in different hair
cycle stages. Left column, normal cycling showed shortened anagen. Differences
in skin and hair follicle morphology between wild-type and Msx2
knockout mice start to show at postnatal day 3 (P3). There is a lack of hair
cortex differentiation at P5 (A,B). Anagen in Msx2 knockout mutant is
shorter and hair follicles at P10 have already entered catagen (C,D). Catagen
progression is also delayed compared with wild type. At P21, wild-type
follicles have entered telogen, whereas Msx2 knockout mutant
follicles are still in catagen (E,F). At P24, control skin has entered anagen,
while Msx2 knockout mutants are still in telogen (G,H). Msx2
knockout mutant skin eventually re-entered anagen at P31. Examination of
Tgfa expression supported the histological observation (E,F, insets).
No Tgfa expression was detected in wild type hair follicles at P21
whereas strong Tgfa expression was still present in Msx2
knockout mutant hair follicles (arrow, in inset of F). Scale bars: 500 µm.
Quantification (below) was carried out by counting about 50 hair follicles (at
designated days after birth) and converting them into percentage of hair
follicles in different hair cycle stages. Orange is anagen, green is catagen
and blue is telogen. Error bar represents one standard deviation. (Right
column) Regeneration after plucking showed defect in re-entry into anagen.
One-month-old mice were stripped with hot wax and followed at 6, 10, 14 and 20
day post-stripping. Note that normal hair follicles re-enter anagen at day 6
(C,E), while those of Msx2 knockout mutants remain in telogen (D,F),
and do not enter anagen until 20 days after stripping (H). At this time,
control skin has re-entered telogen (G). Quantification is achieved as
described in the development column. Scale bar: 500 µm. Arrowheads in E,F
indicate dermal papilla stained with alkaline phosphatase.
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Fig. 4. Cross between Msx2 and Fgf 5go/Fgf5go (Angora) mice.
To address the genetic relationship between Msx2 and Fgf5 in
hair cycle regulation, double mutant mice for Msx2 and Fgf5
were generated by crossing the two mutants. Hair loss in Msx2
knockout mice occurs invariably at P14 (A,B). By contrast,
Fgf5go/Fgf5go mice grow long pelage hairs as a
result of prolonged anagen (A). Mice doubly homozygous for both mutations
exhibited long pelage hairs and no longer lose their pelage hairs at P14.
Instead, hair loss in these mice eventually occurs between P18 and P30,
depending on the genetic background of the mouse (B). (C) The hair cycle
length in each genetic mutant. Anagen in double mutant is prolonged, similar
to Fgf 5 mutants. Hair loss still occurs, but is also delayed
accordingly. Catagen and telogen in double mutants are approximately similar
to that of Msx2 mutants. The result suggests that hair loss in
Msx2 knockout mutants is associated with a specific time-point in
catagen and is delayed by mutation in Fgf5, which prolongs anagen
length.
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Fig. 6. Changes of other molecular pathways in Msx2 knockout mutant hairs. (A)
Timecourse RNase protection assays. Expression analyses of molecules
implicated in hair differentiation. A 1 cm2 dorsal skin sample from
indicated time points extracted for RNA. Examination of hair cortex
differentiation markers by RNase protection assay revealed significantly lower
levels of Foxn1 and its target gene Ha3 in Msx2
knockout mutants. At P13 (postnatal day; d on figure) Ha3 expression
sharply decreases in the mutant skin and is barely detectable at P15 and P17
(A,C). This loss of Ha3 expression correlates with hair loss in Msx2
knockout mutants. Lef1 expression in the hair matrix cells and in the
wild-type skin, increases from P7 to P11, which was not seen in Msx2
knockout mutants. Although the difference is not striking, the trend is
consistent in different experiments. Expression of two other genes,
Bmp4 and Tgfa (not shown) is not affected by the
Msx2 mutation. Scale bar: 200 µm. (B) Quantitation of
Foxn1 and Ha3 message levels at P11 revealed that
Foxn1 and Ha3 mRNA is downregulated 50% compared with that
in wild-type littermates. A much more dramatic 72% reduction in Ha3
expression was observed at P15. (C) Indirect immunohistochemistry with an
affinity-purified Foxn1 antibody showed reduced Foxn1 protein in Msx2 knockout
mutant cortex.
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Fig. 7. Summary diagram for hair shaft differentiation and hair cycle regulators.
(A) Regulators and check points at each hair cycle phase transition. In
essence, the hair cycle is orchestrated by molecules that regulate the
transition between anagen-catagen, catagen-telogen and telogen-anagen. Each
checkpoint is likely to be regulated by a group of factors. Some promote and
some suppress the transition. The observed length of each hair cycle phase
reflects the summation of the activities that promote or suppress the entry to
the next phase. In the Msx2 knockout mutants, catagen starts earlier
and lasts longer, and telogen hair has difficulty re-entering anagen.
Therefore, it is most likely that the normal role of Msx2 in hair
cycling is to maintain hairs in anagen phase. (B) Role of Msx2 in
hair shaft differentiation. Upon induction of dermal papilla, stem cells in
outer root sheath (ORS) generate TA cells that migrate to the matrix region.
TA cells proliferate to generate cellular masses for making differentiated
hair structures, and the regulation of this cellular flow can determine the
size of hairs (Wang et al., 1999). The specified cell types are arranged in
concentric layers from outside to inside. Several major molecular pathways are
known to be involved in this specification and differentiation process (see
text for detail). Msx2 is one of the central integrators that
transmits growth factor signals to regulate hair differentiation.
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© The Company of Biologists Ltd 2003