Adult stem cells (SCs) are essential for maintaining tissue homeostasis by replacing dying cells and repairing damaged tissues upon injury. These SCs are defined by their ability to undergo continual self-renewal and to differentiate into various cell lineages 1-3. The best studied systems, which are dependent upon adult SCs for their replenishment, include the hematopoietic system, the intestine and the skin 1,2,4.
During embryogenesis, the skin begins as a single layer of epidermal cells. Morphogenesis of the hair follicle (HF) starts when mesenchymal cells populate the skin and form an underlying collagenous dermis 5. Specialized mesenchymal cells, that later constitute the dermal papilla (DP), organize directly beneath the epidermal layer and stimulate the epithelium to form hair placodes that begin to grow downwards 6. Highly proliferating matrix cells, situated at the bottom of the HF, envelope these mesenchymal cells and form the hair bulb, while the inner layer begins to differentiate into concentric cylinders to form the hair shaft (HS) and the surrounding inner root sheath (IRS) 2,3.
In postnatal life the skin epidermis is comprised of three compartments: the interfollicular epidermis (IFE), the sebaceous gland (SG) and the HF. In contrast to the IFE and SG which are in a constant state of homeostasis, the HF is a dynamic mini-organ which undergoes continuous cycles of growth (anagen), destruction (catagen) and rest (telogen) 4,7. The hair follicle stem cells (HFSCs) that fuel this perpetual cycle, reside in a specialized niche within the HF known as the bulge 4. During anagen the HFSCs exit the bulge, following activation signals from the DP, begin proliferating and descend downward thus creating a long linear trail of cells known as the outer root sheath (ORS) 8-10. The matrix cells, that surround the DP at the base of the HF, rapidly cycle and migrate upward undergoing terminal differentiation thus generating the HS and the IRS 10 (Figure 1). The duration of anagen determines the length of the hair and is dependent on the proliferative and differentiation capacity of the matrix cells 6. When the HF enters catagen, the transit-amplifying matrix cells in the bulb cease to proliferate, undergo apoptosis and regress entirely while pulling the DP upward until it reaches the non-cycling part of the HF 8,11. During this retraction the HF forms a temporary structure known as the epithelial strand, which is characteristic of catagen, and contains many apoptotic cells. In mice, catagen lasts between 3-4 days and is highly synchronized in the first hair cycle. When the HF reaches telogen all HFSCs become quiescent. The distinct stages of the HF cycle are also characterized by changes in the color of the mouse's skin owing to melanin production. The skin changes from black during anagen to dark grey during catagen to pink during telogen 6,7,12,13.

Figure 1: The Hair Follicle Cycle. The HF is composed of a permanent upper part and a lower constantly remodeling, cycling portion that undergoes continuous cycles of rapid growth (anagen), destruction (catagen) and a relative quiescence phase or rest (telogen). Please click here to view a larger version of this figure.
The SCs maintaining the HF were initially identified using chase experiments, with tritiated thymidine, that revealed a population of slow cycling label retaining cells (LRC) that resided in the permanent region of the HF just below the SG 14. Advances in HFSC characterization revealed a small number of markers that can be used to identify and isolate specific SCs from the HF niche 15. Perhaps the best marker for enrichment of HFSCs is CD34, a cell surface marker also identified as a hematopoietic SC marker in humans 16. Within this CD34+ populations two distinct populations have also been isolated based on α6 integrin expression 2. Another marker is keratin 15 (K15) which is highly expressed in the bulge region, co-localizes with CD34 expression and a K15 promoter is used for targeting and isolating HFSCs in transgenic animals 15,17-19. In the past decade several other distinct populations of HFSCs and progenitor cells have also been reported to reside within the HF 17,20-27.
An additional exciting feature of HFSCs is their contribution to skin repair. Under normal conditions HFSCs replenish the HF and do not take part in IFE homeostasis. However, in response to wounding, these cells exit their SC niche and aid in repopulating the IFE 9. We have recently demonstrated that mice deleted for the pro-apoptotic Sept4/ARTS gene display an increased number of CD34, K15 and Sox9+ HFSCs, which demonstrate a resistance to apoptosis. HFSCs were isolated from Sept4/ARTS-/- dorsal skins utilizing fluorescence activated cell sorting (FACS) and there was more than a two fold increase in the number of CD34+ and K15+ HFSCs. These Sept4/ARTS-/- HFSCs were expanded in vitro and not only gave rise to more colonies but were also able to withstand harsher conditions as compared to controls 28.
As a result of having an increased number of HFSCs, Sept4/ARTS-/- mice healed significantly faster in response to skin excision injuries. Strikingly, Sept4/ARTS-/- mice displayed a large number of regenerated HFs from the wound bed, and significantly smaller scars. Furthermore, mice deleted for XIAP (X-linked inhibitor of apoptosis), the biochemical target of ARTS, demonstrated impaired healing 28.
Our results and work performed in other laboratories have shown that HFSCs serve as an ideal model for studying the biology and function of adult SCs. Here, we describe the methodology for the enrichment and isolation of HFSCs and epidermal keratinocytes based on the expression of four markers: integrin α6; integrin β1; Sca-1 (a marker for epidermal keratinocytes) and CD34. Similar isolation of K15+ HFSCs can also be performed using the K15-GFP reporter mouse 19.