Exploring NamiRNA networks and time-series gene expression in osteogenic differentiation of adipose-derived stem cells

BACKGROUND

Adipose-derived stem cells (ADSCs) are a type of stem cell found in adipose tissue with the capacity to differentiate into multiple lineages, including osteoblasts. The differentiation of ADSCs into osteoblasts underlies osteogenic and pathological cellular basis in osteoporosis, bone damage and repair.

METHODS

Focused on ADSCs osteogenic differentiation, we conducted mRNA, microRNA expression and bioinformatics analysis, including gene differential expression, time series-based trend analysis, functional enrichment, and generates potential nuclear activating miRNAs (NamiRNA) regulatory network. The screened mRNAs in NamiRNA regulatory network were validated with correlation analysis.

RESULTS

The NamiRNA Regulatory Network reveals 4 mRNAs (C12orf61, MIR31HG, NFE2L1, and PCYOX1L) significantly downregulated in differentiated group and may be associated with ADSCs stemness. Furthermore, the significantly upregulated 10 genes (ACTA2, TAGLN, LY6E, IFITM3, NGFRAP1, TCEAL4, ATP5C1, CAV1, RPSA, and KDELR3) were significantly enriched in osteogenic-related pathways, and negatively correlated with ADSCs cell stemness in vitro.

CONCLUSION

These findings uncover potential genes related to ADSCs osteogenic differentiation, and provide theoretical basis for underlying ADSCs osteogenic differentiation and related diseases.

Green synthesis of magnesium oxide nanoparticles using the extract of Falcaria vulgaris to enhance the healing of burn wounds

Treating burn lesions has always been challenging because any product should be cheap, accessible, and have anti-bacterial commodities and tissue regeneration properties. The green synthesis of magnesium oxide nanoparticles (GS-MgONPs) can create an optimal prospect that is safe with low toxicity in biological tissue and better safety for application while including the antibacterial effect. This recent study aimed to evaluate the effectiveness of burn wound treatment using GS-MgONPs in rats. GS-MgONPs were synthesised for the first time using a Falcaria vulgaris extract (FVE) and characterised. Thirty male Wistar rats were divided into five groups: An untreated group, conventional product treated group, GS-MgONPs (1 wt%), GS-MgONPs (3 wt%) and 5. FVE (1 wt%). Treatments commenced immediately following burn induction and were administered daily for a duration of 21 d. GS-MgONPs showed a spherical morphology with a diameter of less than 100 nm. The NPs (1% and 3 wt%) and FVE demonstrated significant growth inhibition against Staphylococcus aureus while showing no cytotoxic effects on human fibroblast cells. The proposed subjects treated with 1 wt% and 3 wt% GS-MgONPs were able to significantly increase the rate of wound closure (p < 0.05). Histological observations revealed that collagen formation and epithelial regeneration were more pronounced in the groups receiving 1 wt% and 3 wt% MgONPs. These results indicate that GS-MgONPs effectively enhance the regeneration process.

The potential of Spirulina maxima extract-treated conditioned medium from adipose-derived mesenchymal stem cells for hair growth promoting effect on human dermal papilla cells

Introduction

Therapeutic applications using adipose-derived mesenchymal stem cells (ADMSCs) have been highlighted as an attractive option to treat multiple diseases. It is widely accepted that ADMSCs exhibit their curative effects on hair loss via diverse secretory factors which promote hair follicle growth and remodeling of hair growth cycle. Recently, further studies using marine resources have been carried out to stimulate ADMSCs, enhancing both the quantitative and qualitative secretion to obtain more effective ADMSCs-derived conditioned medium (ACM).

Methods

Our study investigated the effects of Spirulina maxima on cell proliferation in ADMSCs and determined optimal treatment condition. Human growth factor array was performed to evaluate the effects of S. maxima treatment on the alterations of growth factors secretion in ADMSCs. Subsequently, we examined the effects of S. maxima-treated ACM (SACM) on cell proliferation and alkaline phosphatase (ALP) activity in human dermal papilla cells (HDPCs). The underlying mechanisms of hair growth promotion effect of SACM was illustrated by confirming the expression levels of proteins related to mTOR/Akt and Wnt/β-catenin signaling pathway.

Results

S. maxima extract promoted cell proliferation in ADMSCs and stimulated the secretion of fibroblast growth factor (FGF), hepatocyte growth factor (HGF), and vascular endothelial growth factor (VEGF). SACM treatment also increased cell proliferation and ALP activity in HDPCs, similar with those of ACM treatment. Furthermore, SACM significantly enhanced in vitro hair growth promotion by activating mTOR/Akt and Wnt/β-catenin signaling pathway.

Conclusion

SACM could be a more effective regenerative therapy for the promotion of hair growth and might have the potential to utilizing in pharmaceutical and cosmeceutical industries compared to non-treated ACM, suggesting the potential of S. maxima as an ADMSCs-preconditioning agent.

Post-Acute Sequelae of COVID-19 on Alopecia Areata in Individuals With Mental Illness in South Korea and Japan: A Binational Population-Based Cohort Study

While previous studies have primarily focused on post-acute sequelae of COVID-19, the long-term effects of SARS-CoV-2 infection on alopecia areata (AA) among individuals with mental illness remain underexplored. Thus, this study aimed to address this gap by examining the association between post-acute sequelae of COVID-19 and AA, with a specific focus on individuals with mental illness. This study utilized bi-national, large-scale, and population-based cohorts of individuals with pre-existing mental illness: a Korean nationwide cohort (K-COV-N cohort; main cohort; total n = 3 248 448) and a Japanese claims-based cohort (JMDC cohort; replication cohort; total n = 696 332). The outcome focused on the new onset of AA following 30 days after SARS-CoV-2 infection, defined using ICD-10 codes L63. Using a propensity score-based overlap weighted algorithm, the adjusted hazard ratio (aHR) for AA following COVID-19 was calculated for individuals with mental illness. In the main cohort, the risk of AA as post-acute sequelae of COVID-19 was identified among individuals with mental illness (aHR, 1.32 [95% CI, 1.23-1.43]). The risk was significant for mild mental illness (aHR, 1.33 [95% CI, 1.24-1.44]) and within 6 months postinfection (aHR, 1.48 [95% CI, 1.35-1.63]). Similar findings were observed in the replication cohort. In conclusion, among individuals with mental illness, the risk of post-acute sequelae of COVID-19 on AA was elevated-particularly in those with mild mental illness-though this risk decreased over time. Our findings highlight the importance of early screening, integrated care, and equitable healthcare access for managing post-acute sequelae of COVID-19.

Obesity, white adipose tissue and cancer

White adipose tissue (WAT) is crucial for whole-body energy homeostasis and plays an important role in metabolic and hormonal regulation. While healthy WAT undergoes controlled expansion and contraction to meet the body's requirements, dysfunctional WAT in conditions like obesity is characterized by excessive tissue expansion, alterations in lipid homeostasis, inflammation, hypoxia, and fibrosis. Obesity is strongly associated with an increased risk of numerous cancers, with obesity-induced WAT dysfunction influencing cancer development through various mechanisms involving both systemic and local interactions between adipose tissue and tumors. Unhealthy obese WAT affects circulating levels of free fatty acids and factors like leptin, adiponectin, and insulin, altering systemic lipid metabolism and inducing inflammation that supports tumor growth. Similar mechanisms are observed locally in an adipose-rich tumor microenvironment (TME), where WAT cells can also trigger extracellular matrix remodeling, thereby enhancing the TME's ability to promote tumor growth. Moreover, tumors reciprocally interact with WAT, creating a bidirectional communication that further enhances tumorigenesis. This review focuses on the complex interplay between obesity, WAT dysfunction, and primary tumor growth, highlighting potential targets for therapeutic intervention.

Application of Platelet-Rich Plasma-Based Scaffolds in Soft and Hard Tissue Regeneration

Platelet-rich plasma (PRP) is a blood product with higher platelet concentrations than whole blood, offering controlled delivery of growth factors (GFs) for regenerative medicine. PRP plays pivotal roles in tissue restoration mechanisms, including angiogenesis, fibroblast proliferation, and extracellular matrix development, making it applicable across various regenerative medicine treatments. Despite promising results in different tissue injuries, challenges such as short half-life and rapid deactivation by proteases persist. To address these challenges, biomaterial-based delivery scaffolds, such as sponges or hydrogels, have been investigated. Current studies exhibit that PRP-loaded scaffolds fix these issues due to the sustained release of GFs. In this regard, given the widespread application of PRP in clinical studies, the use of PRP-loaded scaffolds has drawn significant consideration in tissue engineering (TE). Therefore, this review briefly introduces PRP as a rich origin of GFs, its classification, and preparation methods and discusses PRP applications in regenerative medicine. This study also emphasizes and reviews the latest research on the using scaffolds for PRP delivery in diverse fields of TE, including skin, bone, and cartilage repair.

Mir-574-3p and Mir-125a-5p in Adipose Derived Mesenchymal Stem Cell Exosomes Synergistically Target TGF-β1/Smad2 Signaling Pathway for the Treatment of Androgenic Alopecia

Androgenetic alopecia (AGA) is the most common hair loss disorder, influenced by distinct genetic factors and intricate environmental factors. The exosomes (Exo) from adipose-derived mesenchymal stem cells (ADMSCs) have diverse effects, including the promotion of cell proliferation, inhibition of apoptosis, analgesia, and enhancement of wound healing. The miRNAs are essential components of the paracrine secretion of ADMSCs-Exo. This study revealed that ADMSCs-Exo could counteract the impairment of dermal papilla cells (DPCs) induced by dihydrotestosterone (DHT) by inhibiting the TGF-β1 signaling pathway`s activation. Two miRNAs, miR-574-3p and miR-125a-5p, were identified as being predominantly expressed and specifically targeting TGF-β1 and SMAD2, respectively. Notably, individually knocking down miR-574-3p or miR-125a-5p did not affect the therapeutic efficacy of ADMSCs-Exo. Yet, when both miR-574-3p and miR-125a-5p were concurrently knocked down, the efficacy of ADMSCs-Exo was markedly reduced. Ultimately, our findings indicate that ADMSCs-Exo target the TGF-β1/SMAD2 signaling pathway via miR-574-3p and miR-125a-5p, which are integral to the therapeutic action of ADMSCs-Exo on DHT-induced DPCs and AGA murine models. This discovery offers significant insights into the pathogenesis of AGA and suggests potential therapeutic approaches. Further investigation into the role and interaction of these miRNAs in ADMSCs-Exo may lead to the development of more precise and efficacious treatments for AGA.

Gelatin methacryloyl bioinks for bioprinting nasal cartilage: Balancing mechanical integrity and extracellular matrix formation

Gelatin methacryloyl (GelMA) is widely recognized as a versatile hydrogel, though few studies have examined its role in nasal cartilage engineering. In this study, we investigated how variations in GelMA concentration and lysyl oxidase-like 2 (LOXL2) supplementation would affect mechanical properties, extracellular matrix (ECM) deposition, and human nasoseptal chondrocyte remodeling in 3D bioprinted constructs. Using human serum-supplemented media to enhance clinical feasibility, we evaluated a Good Manufacturing Practices (GMP)-grade GelMA at 5, 10, and 15 % w/v. To improve mechanical properties, we investigated LOXL2's potential to enhance crosslinking of newly synthesized collagen, an approach not previously evaluated in gelatin biomaterials. After six weeks, higher GelMA concentrations increased stiffness, as demonstrated by suture pull-out, three-point bending, and compressive equilibrium moduli. However, improved mechanical performance accompanied a reduction in ECM deposition and elevated catabolic gene expression. These findings suggest that cells encapsulated in stiffer, more densely crosslinked constructs exhibited an altered anabolic-catabolic balance and chondrocyte behavior These results underscore the need to balance mechanical integrity with a microenvironment conducive to collagen synthesis and remodeling. By examining how GelMA concentration, crosslinking, and human serum-based conditions influence ECM deposition, this work advances macromolecular interactions in GelMA-based constructs in the development of clinically translatable cartilage grafts.

Corticosteroids versus platelet-rich plasma injections for knee osteoarthritis: Where is there more evidence? A systematic review of 60 years of literature

BACKGROUND

Corticosteroid (CS) injections are often recommended by international societies for knee osteoarthritis (OA) treatment, but platelet-rich plasma (PRP) has shown higher safety and efficacy in comparative analyses. Despite this, PRP use is often not endorsed by scientific societies due to perceived insufficient body of evidence. This study aims to quantify clinical data documenting CS and PRP intra-articular injections for knee OA.

METHODS

A systematic review of the literature was conducted on CS and PRP injections for knee OA. The search, performed in March 2024, used PubMed, Cochrane, and Web of Science databases, following PRISMA and Cochrane guidelines. Data collected included publication trends, number of articles, patients evaluated, and study designs documenting CS or PRP injections.

RESULTS

Of 16,979 records, 356 studies were analyzed, covering 24,435 knee OA patients. Both treatments showed an increasing publication trend, with PRP surpassing CS in 2020. The analysis included 9,322 CS patients and 15,113 PRP patients. Among CS studies, there were 103 RCTs with 5,478 patients, 18 comparative studies with 1,095 patients, and 31 case series with 2,749 patients. Among PRP studies, there were 119 RCTs with 6,028 patients, 33 comparative studies with 2,011 patients, and 72 case series with 7,074 patients.

CONCLUSIONS

PRP injections for knee OA have been documented in more studies and in larger patient numbers compared with CS injections. The higher number of high-level trials for PRP, combined with the lower safety and efficacy documented for CS by previous meta-analyses directly comparing the two products, strongly suggests reconsidering current guidelines that favor CS, highlighting PRP's body of evidence and the potential role in the effective and safe treatment of knee OA.

Structural Rhinoplasty through the Endonasal Approach

Structural endonasal rhinoplasty, unlike traditional reductive rhinoplasty, achieves aesthetic and functional objectives while maintaining key structural anatomical elements and minimizing complications.Previously, rhinoplasty was performed using primarily reductive techniques that frequently led to poor functional and cosmetic consequences.Pertinent nasal framework anatomy is reviewed in select highlighted cases.Preferred tools/technology are reviewed for each procedure, including the use of ultrasonic devices.Indications for each endonasal technique are systematically outlined.The most common techniques are reviewed: dorsal hump reduction, spreader graft placement, alar batten and rim grafts, and columellar strut, and caudal extension grafts.Endonasal rhinoplasty allows for reduced postoperative swelling, loss of nasal tip support, as well as decreased scar tissue/contracture formation.Structural endonasal techniques continue to evolve and become more refined with studies demonstrating cosmetic and functional outcomes similar to that of open surgery while achieving less operating time, postoperative complications, and long-term complications. As a result, structural endonasal rhinoplasty is an important surgical principle and approach for the modern rhinoplasty surgeon.

Nanofat Use in Regenerative Medicine: A Systematic Literature Review and Consensus Recommendations from Expert Opinions

Objective: To report in vitro, preclinical, and clinical effectiveness of nanofat in adults undergoing reconstructive or functional surgery and to produce a series of consensus statements about nanofat definition by experts. Methods: We conducted a systematic review using PubMed and Web of Science database, retaining studies about nanofat alone. To produce consensus recommendations about nanofat, we invited experts to answer a survey about manufacturing, biological characteristics, and nomenclature of nanofat. Results: A review of 39 articles showed that nanofat seems to have strong regenerative potential. There were 16 studies about the clinical effectiveness of the nanofat in wound healing, aesthetic surgery, and functional disabilities. However, majority of applications lack robust clinical evidence, mainly due to the design of the clinical studies. The experts suggested that nanofat refers to lipoaspirate that benefits from a washing step, followed by emulsification (20-30 passes) with a connector size between 1.2 and 1.6 mm, and a final filtration step (pore size around 300-500 µm). Conclusion: Nanofat seems to have strong regenerative potentials but with a lack of robust clinical evidences. Our experts have suggested the first consensus about a definition of the nanofat that can be used by the academic societies in the coming years.

The role and implication of platelet-rich plasma in male factor infertility: A systematic review of human studies

BACKGROUND

Cryopreservation causes sperm injury and the success of surgical sperm retrieval (SSR) for azoospermic men is just over half depending on the cause of azoospermia. The role of autologous platelet-rich plasma (PRP) in male factor infertility (MFI) is unclear.

OBJECTIVE

To conduct a systematic review of the role of PRP in MFI focusing on human studies.

METHODS

A systematic review was conducted using PubMed with reference to the PRISMA 2020 statement. The risk of bias assessment of the included studies was performed using the JBI assessment checklists. Outcome measures included the effects of PRP on cryopreservation, semen parameters, and SSR.

RESULTS

The search retrieved 119 articles and 10 met the pre-defined PICO criteria. These included 7 prospective studies, 1 randomised-controlled study, 1 retrospective study, and 1 case report. PRP appeared to improve semen parameters, decrease DNA fragmentation, improve recovery of cryopreserved sperm, and improve SSR rate. A case report demonstrated successful intracytoplasmic sperm injection and pregnancy following incubation of semen with PRP in a patient with previous failed IVF attempts.

DISCUSSION AND CONCLUSION

This is the first systematic review summarising data from human studies on the role of PRP in MFI. The inclusion criteria and outcomes of across studies varied, limiting the ability to conduct a quantitative analysis. Data from early studies on PRP in MFI are promising. However, there is a lack of well-designed clinical studies on this topic, and further research is needed to replicate current findings and evaluate the potential benefits of PRP in MFI.

Cool Fat, Hot Topic: A Systematic Review on Cryopreservation of Adipose Tissue

Autologous fat grafting is increasingly used in plastic, reconstructive, and esthetic surgery. Cryopreservation offers a promising solution for the long-term storage of adipose tissue, enabling multiple grafting sessions while minimizing patient discomfort associated with repeated liposuction for fat harvesting. This systematic review aims to analyze the current literature focusing on factors that influence the outcome of cryopreservation, including the use of cryoprotectants, the cooling and warming rate, the storage temperature, and the enrichment of cryopreserved fat grafts. A systematic search of the PubMed/MEDLINE database up to November 2024 was performed, including original preclinical and clinical studies written in English describing the cryopreservation of unprocessed or mechanically processed adipose tissue (macrofat, microfat, or nanofat). Eligible articles needed to describe the applied cryopreservation protocol, at least the storage temperature. Studies on cryopreservation of adipose-derived stem cells (ASCs), stromal vascular fraction, microvascular fragments, and other isolated components of adipose tissue were excluded. Data on cryoprotectants, cooling and warming rates, storage temperature, and eventual supplementation or enrichment of frozen fat were collected. Of the 679 records identified, 59 met the inclusion criteria. Adipose tissue cryopreservation at -80°C with a cryoprotectant, controlled slow cooling, and fast warming represented the most often applied protocol with encouraging outcomes in maintaining tissue survival and histological structure. Several studies indicated that the supplementation of frozen adipose tissue with ASCs improves tissue survival. Taken together, existing studies present diverse, and to some extent, conflicting results regarding cryopreservation protocols and their effects on adipose tissue viability. Hence, the ideal cryopreservation protocol for autologous fat remains to be established. Moreover, tailored protocols may be necessary for the cryopreservation of fat derivatives, such as nanofat.

LncRNA H19 inhibited dermal papilla cell senescence process through miR-29a by targeting Wnt/β-catenin signaling pathway

Androgenetic alopecia is a common type of hair loss disease. As the most promising seeder for cell-based therapy, dermal papilla cells are prone to undergo premature senescence during passaging in vitro. Our previous studies revealed high expression of lncRNA H19 in early-passage dermal papilla cells and the maintenance of hair follicle-inducing ability upon prolonged culture. However, the exact mechanism of H19 regulating Wnt signaling pathway related to hair follicle regeneration has not been fully elucidated. Here, a cell senescence model was constructed by continuous cultivation in vitro to investigate the molecular mechanism of H19 in human dermal papilla cells. Animal hair follicle inductivity, cell proliferation and molecular experiments were performed to evaluate the cell inductivity, proliferation, senescence, expression of Wnt signaling key factors in early- and late-passage dermal papilla cells. Ectopic expression and silencing experiments were conducted to estimate effects of H19 on the proliferation and senescence of dermal papilla cells and the possible mechanism. Hair follicles from frontal baldness-prone and occipital non-balding areas of patients with androgenetic alopecia were exploited to detect the expression of H19 and relevant factors. Results showed late-passage DP8 cells exhibited lost hair follicle inductive properties, attenuated cell proliferation, elevated senescent marker and key Wnt factor levels, decreased inducing marker levels. Furthermore, overexpression of H19 inhibited senescence marker expression by binding to SAHH to upregulate miR-29, thus activating the Wnt signaling pathway to maintain inducing ability of DP cells. Knockdown of H19 showed opposite experimental results. Consistently, H19 together with miR-29a levels were lower and the expression levels of miR-29a target genes (DKK1, SFRP2) increased in the dermal papilla cells from frontal baldness-prone and occipital non-balding areas. Conclusively, our data provide a novel insight into the regulation and mechanism of H19 in inhibiting dermal papilla cell senescence, suggesting a potential therapy strategy for androgenetic alopecia.

Alloplastic implants for skeletal augmentation in Parry-Romberg syndrome: A systematic review

Parry-Romberg syndrome (PRS) is a rare disorder characterized by progressive hemifacial atrophy affecting soft tissue and, in severe cases, bone. Reconstructive surgery is commonly used to manage PRS-related facial deformities. This systematic review assesses the current literature on alloplastic implants for facial reconstruction in PRS. Following PRISMA guidelines, we conducted a systematic review across MEDLINE, Google Scholar, and Cochrane databases, including English-language studies on PRS managed with alloplastic implants. Eleven studies, including 74 PRS patients (age range 12-45, mean 22.3), were analyzed. Most patients received off-the-shelf implants, with a single case using a 3D-modeled titanium implant. Implants, often adjunctive to free flap-based soft tissue augmentation, fat grafting, or orthognathic surgery, were typically placed in the malar, mandibular, or mental regions, with porous polyethylene (Medpor) being the most frequently used material. Complications were minimal, with infections (n = 2) and one aesthetic issue requiring removal (follow-up range: six months to 13 years; mean 39 months). Alloplastic implants effectively restore facial symmetry in PRS, commonly alongside soft tissue reconstruction. Future studies on custom-designed implants are warranted to enhance treatment consistency and long-term outcomes.

Recent Advances in Drug Development for Hair Loss

Hair loss disorders pose a substantial global health burden, affecting millions of individuals and significantly impacting quality of life. Despite the widespread use of approved therapeutics like minoxidil and finasteride, their clinical efficacy remains limited. These challenges underscore the pressing need for more targeted and effective therapeutic solutions. This review examines the latest innovations in hair loss drug discovery, with a focus on small-molecule inhibitors, biologics, and stem cell-based therapies. By integrating insights from molecular mechanisms and leveraging advancements in research methods, the development of next-generation therapeutics holds the potential to transform the clinical management of hair loss disorders. Future drug development for hair loss disorders should prioritize antibody therapy and cell-based treatments, as these approaches offer unprecedented opportunities to address the limitations of existing options. Antibody therapies enable precise targeting of key molecular pathways involved in hair follicle regulation, providing highly specific and effective interventions. Similarly, cell-based therapies, including stem cell transplantation and dermal papilla cell regeneration, directly address the regenerative capacity of hair follicles, offering transformative potential for hair restoration.

Human Fibroblast Growth Factor 9 Induces Hair Follicle Cycle Transition via TGF-β/BMP/Smad Pathway

Background

Fibroblast growth factor 9 (FGF9) is a crucial regulator of hair follicle development; however, the precise regulatory role of FGF9 on the biological behavior of hair follicles remains unclear.

Purpose

Explore the effects of recombinant human fibroblast growth factor (rhFGF9) on hair follicle growth and cycle transition in mice, as well as the associated mechanisms.

Methods

We utilized soluble recombinant human fibroblast growth factor 9 (rhFGF9), expressed in Escherichia coli, and injected it into the dorsal skin of mice. RNA sequencing (RNA-seq) was employed to identify differentially expressed genes and associated key metabolic pathways in skin tissue. Additionally, immunohistochemistry, quantitative PCR (qPCR), and Western blotting techniques were applied to assess the expression of factors related to metabolic pathways across different groups.

Results

RhFGF9 stimulated hair growth by inducing the anagen phase in C57BL/6 N mice. Histological analysis revealed that intradermal injections of rhFGF9 enhanced hair follicle development. Transcriptomic analysis revealed that the mechanism underlying this effect might involve the transforming growth factor-β (TGF-β) signaling pathway. Immunohistochemistry, quantitative PCR, and Western blot analyses further demonstrated the upregulation of TGF-β2, TGF-β3, bone morphogenetic protein 4 (BMP4), and pSmad2 expression in the experimental group.

Conclusion

These results indicate that rhFGF9 might promote hair growth via the TGF-β/BMP/Smad signaling pathway and highlight its potential as a therapeutic option for treating hair loss.

Elliptical Lipoaspirate Activation Versus Coleman Technique: A Randomized Double-Blinded Clinical Trial on Adipose Tissue Grafting for Scar Treatment

BACKGROUND

Autologous fat grafting is widely used in reconstructive surgery and its use is increasing in different areas of regenerative medicine. This study evaluates the impact of elliptical lipoaspirate activation on adipose tissue grafting outcomes, focusing on scar-related pain reduction, improved scar characteristics, and increased tissue elasticity, comparing these outcomes with the traditional Coleman method.

METHODS

This randomized double-blinded clinical trial study was conducted at the Humanitas Research Hospital in Milan from October 2022 to December 2023. Forty-three women aged 18-75 undergoing second-stage breast reconstruction were enrolled. The control group (19 patients) received the Coleman technique, while the study group (24 patients) underwent an additional elliptically oriented centrifugation. Method for evaluations included the Visual Analog Scale (VAS) for pain, Range of Movement (ROM), the Patient and Observer Scar Assessment Scale (POSAS), and shear wave elastography for tissue elasticity.

RESULTS

Both groups showed significant improvements over time. The case group demonstrated a greater decrease in VAS scores at 3 months (p = 0.015). POSAS scores were consistently better in the elliptical lipoaspirate activation group, significantly improving scar pruritus, pain, color, stiffness, thickness, and irregularity. Total POSAS score for both patient and observer scales were statistically higher for the case group at 12 months (p = 0.009 and p = 0.003, respectively). Elastography showed higher tissue softness in the case group at 6 months (p = 0.015) and 12 months (p = 0.0005). Tissue hardness, measured with elastography, was significantly lower for the case group at 12 months (p = 0.003).

CONCLUSIONS

The elliptical lipoaspirate activation technique significantly enhances clinical outcomes, reducing pain and improving scar quality and tissue elasticity compared to the standard Coleman method.

LEVEL OF EVIDENCE I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Anti-Cancer Stem Cell Properties of Square Planar Copper(II) Complexes with Vanillin Schiff Base Ligands

Current breast cancer therapies are unable to positively impact the lives of a significant proportion of diagnosed patients (24% based on 10-year survival rate). Breast cancer relapse and metastasis, the leading cause of breast cancer-associated deaths, is linked to the existence of breast cancer stem cells (CSCs). Redox-modulating metal complexes have been used to perturb the redox balance in breast CSCs and effect cell death. Here, we sought to expand this promising class of anti-breast CSC agents. Specifically, we report the synthesis, and anti-breast CSC properties of a series of copper(II) complexes bearing regioisomeric vanillin Schiff base ligands (1-4). X-ray crystallography studies show that the copper(II) complexes 1-4 adopt square planar geometries with the copper(II) centre coordinated to two vanillin Schiff base ligands. The most effective copper(II) complex within the series 4 displays low micromolar potency towards breast CSCs, up to 4.6-fold higher than salinomycin and cisplatin. Mechanistic studies indicate that copper(II) complex 4 elevates reactive oxygen species levels in breast CSCs, leading to activation of the JNK/p38 pathway and caspase-dependent apoptosis. Overall, this work expands the library of anti-breast CSC copper(II) complexes and provides insight into their mode of action.

Combining Deep Plane Face and Neck Lift with Periorbital Rejuvenation and Ancillary Surgical Procedures of the Face: A Critical Evaluation of Over 434 Consecutive Cases

BACKGROUND

Over time, all the face structures inevitably undergo the effects of chrono-aging with changes in their intrinsic characteristics, position and volume. Keeping in mind that all the possible aging defects may be concomitant, in the authors' vision, a careful preoperative evaluation of the patient's aging signs should take consideration of the face as a whole. This study reported the senior author's experience and complications on over 400 patients who consecutively underwent deep plane face and neck lifting combined with periorbital rejuvenation procedures.

MATERIALS AND METHODS

434 consecutive patients who underwent deep plane face and neck lifting combined with periorbital rejuvenation procedures were enrolled in this study. Administration of a subjective/patient-specific and objective surgeon/specific questionnaire allowed to investigate satisfaction level at 12 and 18 months after surgery. Statistical analysis was conducted with Prism9. Surgical drawings, techniques and complications were described.

RESULTS

Data deriving from patients' and surgeons' questionnaires evidenced a high level of satisfaction with the combined surgery. The patients' satisfaction tended to increase, even if with a no statistically significant manner, from 12 to 18 months.

DISCUSSION

Authors outlined the importance of focus the attention also on the correction of the cranial part of the middle third soft tissues aging signs, often "neglected" during facelift, and on the periorbital area.

CONCLUSION

A satisfactory total and harmonious rejuvenation of the face and neck should include a combo surgery combining periorbital rejuvenation procedures with a more "traditional" extended deep plane face and neck lift depending on the aging signs.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Improving Fat Graft Survival Using Soluble Molecule Preconditioning

Fat grafting is widely used in plastic surgery to correct soft tissue deformities. A major limitation of this technique is the poor long-term volume retention of the injected fat due to tissue remodeling and adipocyte death. To address this issue, various optimizations of the grafting process have been proposed. This scoping review focuses on preclinical and clinical studies that investigated the impact of various classes of soluble molecules on fat grafting outcomes. Globally, we describe that these molecules can be classified as acting through three main mechanisms to improve graft retention: supporting adipogenesis, improving vascularization, and reducing oxidative stress. A variety of 18 molecules are discussed, including insulin, VEGF, deferoxamine, botulinum toxin A, apocynin, N-acetylcysteine, and melatonin. Many biomolecules have shown the potential to improve long-term outcomes of fat grafts through enhanced cell survival and higher volume retention. However, the variability between experimental protocols, as well as the scarcity of clinical studies, remain obstacles to clinical translation. In order to determine the best preconditioning method for fat grafts, future studies should focus on dosage optimization, more sustained delivery of the molecules, and the design of homogenous experimental protocols and specific clinical trials.

Platelet-rich plasma for androgenetic alopecia: intradermal injection or microneedle delivery?

OBJECTIVE

This study compared the clinical effectiveness of two methods of platelet-rich plasma (PRP) administration for treating androgenetic alopecia (AGA): microneedle delivery and intradermal injection. The study also evaluated adverse reactions associated with both methods.

PATIENTS AND METHODS

Twenty patients with AGA were selected according to specific inclusion and exclusion criteria. The scalp of each patient was divided into two treatment areas along the midline, each randomly assigned to receive PRP either via intradermal injection (n = 20) or microneedle delivery (n = 20). The treatment comprised three sessions spaced 1 month apart. Scalp photographs and trichoscopic measurements were obtained before the first session and 6 month after the final session. Patient outcomes were assessed 6 month after the last treatment using the Global Aesthetic Improvement Scale and a self-satisfaction questionnaire. Pain levels during the first session were measured using a Numerical Rating Scale, and adverse reactions were recorded throughout the study.

RESULTS

Six month after completing all treatments, no significant differences were observed between the microneedle delivery and intradermal injection groups for hair density, hair diameter, single hair follicle ratio, or trichoscopic findings (p > .05). However, the microneedle group reported significantly lower pain levels than the intradermal injection group (p < .001). No adverse events were observed during the treatment period.

CONCLUSION

The clinical efficacy of microneedle delivery of PRP was comparable to that of intradermal injection for AGA treatment, with the added benefit of significantly lower pain levels. This suggests that microneedle delivery may be a promising alternative for AGA management.

A Comprehensive Review of Medial Thighplasty: The Role of Liposuction in Reducing Complications and Optimizing Patient Outcomes

Background/Objectives: Medial thighplasty is a widely performed body contouring procedure, particularly in patients with massive weight loss. Despite advancements in surgical techniques, complications remain a significant concern. The integration of liposuction into thigh lift procedures has shown promise in improving both aesthetic and functional outcomes while reducing risks. This review aims to assess the role of liposuction in medial thighplasty by evaluating its impact on surgical outcomes and complications. Methods: This systematic review was conducted following PRISMA guidelines. A comprehensive search was performed in the MEDLINE/PubMed database using predefined keywords. A total of 52 records were identified, of which 19 studies met the inclusion criteria, encompassing 1113 patients who underwent liposuction-assisted medial thighplasty. Two independent reviewers screened and selected the studies, resolving discrepancies through discussion or consultation with a third reviewer. Data on surgical techniques, complications, and outcomes were extracted and analyzed. Statistical comparisons were performed using the Chi-square test, with significance set at p < 0.05. Results: The incorporation of liposuction significantly reduced the overall complication rate (36.75% vs. 70.68%, p < 0.001). Specific complications, including infections (1.77% vs. 9.02%), hematomas (1.30% vs. 6.77%), and seromas (8.95% vs. 24.81%), were markedly lower in the liposuction group. Conclusions: Liposuction appears to reduce complication rates and improve surgical outcomes in medial thighplasty. Further standardization of techniques and additional research on advanced liposuction technologies are necessary to refine this surgical approach and optimize patient outcomes.

Closed Treatment of the Internal Nasal Valve

The internal nasal valve, the narrowest portion of the nasal airway, is prone to collapse and is often targeted for improvement in nasal reconstruction and rhinoplasty. Endonasal techniques can reduce surrounding trauma and reduce operative times compared to traditional open methods. Options include the use of spreader, butterfly and alar batten grafts, suspension and flaring sutures, and Z-plasty for scarring. These techniques offer structural support and improved airflow with less risk of external changes, but also the challenges of limited visibility and the need for precise graft placement.

Effects of Nanofat and PRP on Type I Collagen Production in Striae Distensae: Preliminary Findings from a Prospective, Randomized Single-Blind Study

INTRODUCTION

Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called "striae rubrae" (SR) and a chronic phase in which they are called striae albae (SA). This study investigates the synergistic effect of nanofat and platelet-rich plasma (PRP) injections on collagen production in fibroblasts derived from SA (SAF).

MATERIAL AND METHODS

A prospective, randomized single-blind study was conducted in fifty women presenting with SA in the abdominal region who had voluntarily sought a conventional abdominoplasty procedure and accepted to test an autologous treatment for their SDs. SA were treated using: PrP 10 ml; PrP 2ml (20%) + nanofat 8ml (80%); nanofat 10ml. Following the abdominal dermolipectomy, biopsies from treated and untreated SDs were taken and analyzed for type I collagen quantification. Results were processed through statistical analysis models using the Student's t test.

RESULTS

Collagen concentration in untreated SA biopsies was significantly lower than in healthy skin. Both PRP and nanofat treatments significantly increased collagen biosynthesis compared to controls, with the combined PRP-nanofat treatment showing the highest increase in collagen levels (p < 0.0001). A superior clinical improvement was observed in the areas that received the combined treatment of PRP and nanofat (p  =  0.001).

CONCLUSION

Our findings indicate that both PRP and nanofat treatments effectively enhance collagen production in SA, with the combined PRP-nanofat treatment showing a synergistic effect. This combined therapy holds promise for effectively treating SA, providing a new potential treatment avenue for SMs and similar skin conditions. Further studies are needed to validate these results and explore clinical applications.

LEVEL OF EVIDENCE I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Novel method for preparation of autologous leucocyte rich platelet-rich plasma (L-PRP) under closed system and assessment of its clinical efficacy in androgenetic alopecia-A retrospective cohort study

Autologous PRP prepared using commercially available kits is being utilized by many centers for the treatment of androgenic alopecia. However, consensus guidelines for preparation, quality standards, and application schedule are still lacking. This retrospective study was conducted to assess clinical efficacy of L-PRP in androgenetic alopecia (AGA) and the effect of a number of PRP applications on the extent of clinical benefit. A total of 46 (8 mild, 26 moderate, and 12 severe alopecia) AGA patients undergoing autologous PRP therapy for 5 years (2016 to 2021) were included in the analysis. L-PRP prepared from 150 ml autologous whole blood by a novel method, was applied at monthly intervals. Effect of number of applications on outcome measures [percent negative on pull (PN-pull) and tug (PN-tug) tests, global pictures, and a patient satisfaction score] across different grades of AGA, was analyzed using appropriate statistical tools. Significant improvement was seen in mild and moderate grades of alopecia while no improvement was observed in PN-tug across all grades of severity irrespective of the number of PRP sessions. Patient satisfaction score (5.2/10) was best in patients with moderate severity of alopecia after 2 sessions. Global pictures showed an increment in hair density in 52%, 46%, and 16% of patients with mild, moderate, and severe alopecia, respectively. Overall, 2 applications of auto L-PRP showed clinical benefit in patients with mild-moderate alopecia while the third application was not found to offer any added benefit. Longer controlled trials are needed to establish a standardized protocol.

Bibliometric Analysis of Platelet-Rich Plasma Treatment for Hair Restoration, Facial Rejuvenation, Dental Procedures, and Gynecological Rejuvenation

Introduction

Autologous platelet-rich plasma (PRP) technologies offer an attractive treatment option for various medical fields. Owing to its high concentration of growth factors, PRP has been posited to induce proliferation, differentiation, and angiogenesis at the cellular level, as well as wound-healing and remodeling at the tissue level. The goal of the present bibliometric analysis was to characterize the growing body of literature concerning PRP use in various medical applications.

Methods

A comprehensive literature search was performed on June 28, 2024, using Web of Science and SCOPUS databases, covering all available publications in selected categories from 2001 to present.

Results

PRP use for hair restoration had both the greatest number of total publications among the investigated applications, whereas PRP use in dental procedures had the longest-standing history of publications. PRP use in hair restoration and facial rejuvenation had the greatest number of placebo-controlled and double-blinded randomized controlled trials; however, the impact of results may suffer from a lack of consistency in PRP preparation and outcome measurement between different studies.

Conclusion

To effectively validate the utility of PRP across various medical interventions, careful consideration of methodology should be undertaken for future studies to ensure validity of results.

Enhanced Hair Regrowth Through Dual-Wavelength Low-Level Laser Therapy: A Comparative Study on Mice

Low-level laser therapy (LLLT) is a non-invasive treatment that uses low-power lasers or light sources to stimulate biological responses. Previous studies focused on single-wavelength effects on hair growth in mice. In this study, we investigated dual-wavelength combinations to enhance hair regrowth. Using light-emitting diodes (LEDs) at 670, 680, 780, and 880 nm, we assessed the correlation between different wavelength pairs and hair regrowth after shaving in mice. Phototherapy was conducted over 14 days, with results analyzed through surface image analysis and histological examination. Our findings indicate that dual-wavelength therapy is superior to single-wavelength treatment and significantly more effective than the untreated control, demonstrating its potential for improved hair regrowth.

Kyoh® Rocket Leaf Extract Regulates Proliferation and VEGF and FGF7 Expression in Human Dermal Follicle Papilla Cells

Androgenetic alopecia is the most common cause of hair loss for women and men. Current treatments for androgenetic alopecia, such as those based on drugs like Minoxidil, Finasteride, or Dutasteride, have been associated with a variety of side effects, such as irritation, contact dermatitis, scalp pruritus, burning, etc. In this regard, plant extracts have emerged as promising alternatives to available chemical-based treatments for androgenetic alopecia given their efficacy, customer acceptability, and potentially minimized side effects. In this study, we evaluated the efficacy of Kyoh®, an extract from rocket leaves, as a treatment to improve the signs of androgenetic alopecia. We found that Kyoh® contained 2.1% total flavonoids, with kaempferol, quercetin, and isorhamnetin diglucosides being the most abundant. Additionally, Kyoh® showed a stimulating effect on the growth of human dermal follicle papilla cells in laboratory conditions. Most importantly, Kyoh® enhanced the gene expression of the hair growth-associated growth factors VEGF (Vascular Endothelial Growth Factor) and FGF7 (Fibroblast Growth Factor 7). Specifically, VEGF expression increased by 60.7% after 4 h and 267.3% after 24 h, while FGF7 expression increased by 50.3% after 4 h and 244.3% after 24 h, indicating both a rapid induction of gene expression and a sustained effect lasting at least one day. Moreover, Kyoh® increased the gene expression of NRF2 (Nuclear factor erythroid 2-related factor 2) by 71.2%, which encodes for a protein participating in the antioxidant response. Overall, our study shows that flavonol-rich rocket extract (Kyoh®) is a promising treatment for promoting hair growth, demonstrated by its proliferation-promoting effect, potential antioxidant priming, and induction of the expression of growth factors associated with hair growth and health.

Isolation of adipose stromal cells from blood using a two-step microfluidic platform ASCfinder

Mesenchymal stromal cells (MSCs) hold significant promise for their therapeutic potential and their possible role as disease biomarkers. While evidence suggests the presence of circulating Adipose-derived MSC (ASC) in peripheral blood (PB), isolating them is particularly challenging due to their low abundance, size variability, and incomplete characterization of their native immunophenotype in PB. Consequently, the relationship between ASC frequency in blood and various physiological or pathological conditions has been underexplored. In this study, we introduce ASC-Finder, a label-free isolation method specifically designed for adipose stromal cells (ASCs), a key MSC population. ASC-Finder integrates two independent modules: a size-dependent hydrodynamic filtration unit for sorting erythrocytes directly from PB and a negative enrichment module based on immunological markers to deplete remaining leukocytes. The device enabled removal of 99.98% of erythrocytes while achieving high recovery rates of spiked ASCs (> 81%) at rare-event concentrations (< 100 ASC/mL blood). Remarkably, ASC-Finder operates without clogging, even after multiple runs with donor blood samples. Crucially, our method bypasses the need for harsh lysis, centrifugation, or dilution buffers, preserving both cell integrity and phenotype-key factors for the discovery of novel cellular events. This work represents a significant advancement in the direct enrichment of circulating ASCs from whole PB without cell lysis, offering a crucial step toward investigating the characterization and role of blood-circulating ASCs.

Mesenchymal stem cell exosomes enhance the development of hair follicle to ameliorate androgenetic alopecia

BACKGROUND

Mesenchymal stem cells (MSCs) and their secretome have significant potential in promoting hair follicle development. However, the effects of MSC therapy have been reported to vary due to their heterogeneous characteristics. Different sources of MSCs or culture systems may cause heterogeneity of exosomes.

AIM

To define the potential of human adipose-derived MSC exosomes (hADSC-Exos) and human umbilical cord-derived MSC exosomes (hUCMSC-Exos) for improving dermal papillary cell proliferation in androgenetic alopecia.

METHODS

We conducted liquid chromatography-mass spectrometry proteomic analysis of hADSC-Exos and hUCMSC-Exos. Liquid chromatography-mass spectrometry suggested that hADSC-Exos were related to metabolism and immunity. Additionally, the hADSC-Exo proteins regulated the cell cycle and other 9 functional groups.

RESULTS

We verified that hADSC-Exos inhibited glycogen synthase kinase-3β expression by activating the Wnt/β-catenin signaling pathway via cell division cycle protein 42, and enhanced dermal papillary cell proliferation and migration. Excess dihydrotestosterone caused androgenetic alopecia by shortening the hair follicle growth phase, but hADSC-Exos reversed these effects.

CONCLUSION

This study indicated that hair development is influenced by hADSC-Exo-mediated cell-to-cell communication via the Wnt/β-catenin pathway.

Nonsurgical Facial Esthetic Procedures

Nonsurgical facial esthetic procedures have revolutionized cosmetic enhancement, offering minimally invasive options for facial rejuvenation. This comprehensive overview covers a wide range of techniques, including wrinkle relaxation with botulinum toxin, skin volumization using dermal fillers and biostimulators, hair restoration, and various skin tightening and texture improvement methods. The article details the mechanisms, applications, and potential risks of each procedure, highlighting recent advancements and trends in the field. It classifies these treatments into clinically-oriented categories based on patients' desired changes.

The 100 most cited articles in androgenetic alopecia: A bibliometric analysis

Androgenetic alopecia (AGA) is a condition with a rapidly evolving research landscape. The expanding volume of AGA research necessitates synthesis to identify trends and gaps. Bibliometric analysis can be used to quantify the characteristics of a body of literature, and this technique has not been previously applied to AGA. We aimed to evaluate the bibliometric characteristics of the top 100 most cited AGA articles over the past 50 years. This includes the analysis of contributing authorship, institutional affiliation, journal representation, publication years, citation counts, country productivity, and funding sources, among other characteristics. We used the Web of Science to identify and characterize the 100 most cited AGA publications between 1975 and 2024. A secondary analysis was performed to identify and characterize the top 20 most cited AGA articles from 2020 to 2024. The top 100 articles amassed 24,289 citations. Authors from the United States contributed the most articles (n = 56). The University of Pennsylvania contributed the most articles (n = 11). Dr Elise A Olsen and Dr George Cotsarelis were the most frequent contributors. The Journal of the American Academy of Dermatology published the most number of articles. From 1975 to 2024, most studies primarily discussed pathophysiology (45%) and treatment (35%). However, from 2020 to 2024, 75% of the top articles focused on the treatment options. This bibliometric analysis provides an overview of influential AGA research over the last 50 years, highlighting shifting trends toward treatment optimization and emerging therapies.

Alpha-1-Antitrypsin Enhances Fat Graft Survival in a Murine Model

Objective: Fat grafting is widely applied for various purposes, including volume restoration, improving tissue quality, and promoting wound healing, but it has poor long-term graft survival predictability. Alpha-1-antitrypsin (AAT) administration is hypothesized to improve fat graft outcomes by expediting inflammatory resolution and graft vascularity and reducing necrosis. Approach: Mice heterozygote to human AAT was grafted fat under the scalp alongside 400 µg/graft AAT or albumin (ALB) on days 0 and 3. Graft volume was determined by micro-magnetic resonance imaging, and explants were assessed for viability, histology, immunohistochemistry, and expression of selected genes. AAT expression was examined in hypoxia-exposed adipose-derived stem cells (ADSCs). Results: After 90 days, AAT-treated grafts maintained higher volumes (70.06% vs. 34.54%, n = 8, p = 0.02) and displayed improved tissue quality. On day 10 after grafting, grafts exhibited more blood vessels (mean 1.94/mm2 vs. 0.33/mm2) and 6.25-fold more adiponectin transcript levels (n = 12, p = 0.02). Although day-3 interleukin (IL)-1β expression was 5-fold greater in AAT-treated grafts (n = 6, p = 0.4), day-10 IL-1β expression was 2-fold lower compared to ALB-treated grafts (n = 22, p = 0.01). In the Methoxynitrosulfophenyl-tetrazolium carboxanilide (XTT) assay, day-3 AAT-treated grafts were 1.56-fold more metabolically functional (n = 6, p = 0.04) and exhibited greater perilipin-positive regions (18.5% versus 3.1%). Hypoxia-exposed ADSC expressed 9-fold higher AAT transcript levels (p = 0.04). Innovation: Fat grafting outcomes improved by early AAT treatment, probably by accelerating inflammatory resolution. Due to its marked safety profile, the study's findings are for adjunct clinical-grade AAT therapy. Conclusion: AAT has a promising potential to be utilized as a fat graft outcome enhancer in terms of volume retention predictability and tissue quality.

Engineered stromal vascular fraction for tissue regeneration

The treatment of various tissue injuries presents significant challenges, particularly in the reconstruction of large and severe tissue defects, with conventional clinical methods often yielding suboptimal results. However, advances in engineering materials have introduced new possibilities for tissue repair. Bioactive components are commonly integrated with synthetic materials to enhance tissue reconstruction. Stromal vascular fraction (SVF), an adipose-derived cell cluster, has shown considerable potential in tissue regeneration due to its simple and efficient way of obtaining and its richness in growth factors. Therefore, this review illustrated the preparation, characterization, mechanism of action, and applications of engineered SVF in various tissue repair processes, to provide some references for the option of better methods for tissue defect reconstruction.

Cost-Effectiveness Analysis for Managing Diabetic Foot Ulcer (DFU) in USA: Platelet-Rich Plasma (PRP) vs Standard of Care (SoC)

Purpose

Chronic skin ulcers in diabetic foot patients are a significant health concern. Diabetic foot ulcers (DFUs) significantly threaten the health and longevity of individuals with diabetes, leading to severe complications like infection and amputation and contributing to high morbidity and mortality rates. Given the severe implications, practical strategies to prevent and manage DFUs are crucial to reducing amputation rates. Platelet-rich plasma (PRP) has emerged as a popular treatment option due to its properties that mimic the body's natural healing process. The objective of the study was to evaluate the cost-effectiveness of PRPR vs standard of care in US context.

Methods

Decision analytical model was used to synthesize clinical and economic parameters. In detail a CEA analysis was employed using a Markov decision-making model to evaluate patients with chronic DFUs lasting over three weeks and at high risk for orthopedic complications. The study assessed the effectiveness of different treatments, measured in quality-adjusted life years (QALYs), and reported costs in 2023 dollars using a micro-costing approach alongside a clinical trial.

Results

The study concluded that PRP gel is a cost-effective treatment for non-healing DFUs, resulting in lower care costs over one year compared to other treatments and cost savings over five years.

Conclusion

Thus, PRP treatment is a promising and practical option, improving patient outcomes and reducing healthcare costs. It is an attractive choice for healthcare providers and insurers in managing non-healing diabetic foot ulcers.

Multifocal FDG Uptake of the Breasts Caused by Autologous Fat Injection for Breast Augmentation

ABSTRACT

Autologous fat grafting for cosmetic breast augmentation is becoming increasingly popular. Late complications after intramammary fat injection include fat necrosis, liponecrotic cyst, calcification, and lymphadenopathy. We describe FDG PET/CT findings in a patient with multiple-injection-site fat necrosis after intramammary fat injection. FDG PET/CT showed multifocal activity in the subcutaneous and subglandular regions corresponding to the fat injection sites of the bilateral breasts and multiple FDG-avid lymph nodes of the axillae, mimicking malignancy. Careful correlation with clinical history and familiarity with the imaging findings of the complications after intramammary fat injection are helpful for avoiding misdiagnosis.

Advanced progress of adipose-derived stem cells-related biomaterials in maxillofacial regeneration

The tissue injury in maxillofacial region affects patients' physical function and specific mental health. This decade, utilizing regenerative medicine to achieve tissue regeneration has been proved a hopeful direction. Seed cells play a vital role in regeneration strategy. Among various kinds of stem cells that effectively to regenerate the soft and hard tissue of maxillofacial region, adipose-derived stem cells (ADSCs) have gained increasing interests of researchers due to their abundant sources, easy availability and multi-differentiation potentials in recent decades. Thus, this review focuses on the advances of ADSCs-based biomaterial in maxillofacial regeneration from the progress and strategies perspective. It is structured as introducing the properties of ADSCs, biomaterials (polymers, ceramics and metals) within ADSCs and the latest applications of ADSCs in maxillofacial regeneration, including temporomandibular joint (TMJ), bone, periodontal tissue, tooth, nerve as well as cosmetic field. In order to further facilitate ADSCs-based therapies as an emerging platform for regenerative medicine, this review also emphasized current challenges in translating ADSC-based therapies into clinical application and dissussed the strategies to solve these obstacles.

The Pharmacokinetics of Topical Finasteride 0.25% Spray in Chinese Adult Male Volunteers with Androgenic Alopecia: A Phase I Study

INTRODUCTION

This study aimed to evaluate the pharmacokinetics (PK), safety, and local tolerability of local finasteride spray (0.25% solution in HPCH, once daily, volume 200 μL) after single and multiple doses in Chinese male volunteers with androgenetic alopecia.

METHODS

Twelve male patients with androgenetic alopecia received once-daily scalp application of the solution for 7 days. Blood samples were collected at specified time points (on day 1, days 3-6, and day 7 of the trial) and plasma finasteride concentrations were determined by HPLC-MS.

RESULTS

After single-dose administration, the Cmax of finasteride was 15.2 ± 5.54 pg/mL, Tmax was 11.00 (3.00, 20.00) h, AUC0-24h was 263 ± 76.6 h·pg/mL, t1/2 was 35.3 ± 47.7 h, and CL/F was 974 ± 518 L/h. After 7 days of multiple doses, Cmax,ss was 29.7 ± 12.9 pg/mL, Tmax,ss was 8.00 (3.00, 12.00) h, AUCtau,ss was 530 ± 251 h·pg/mL, AUC0-t,ss was 790 ± 464 h·pg/mL, t1/2,ss was 22.6 ± 10.7 h, and CL/Tss was 1080 ± 658 L/h. No clinically significant adverse events occurred during the study.

CONCLUSION

Compared to single-dose administration, multiple-dose administration of finasteride resulted in a stable half-life, minimal changes in clearance rate, and approximately twofold accumulation in exposure over 7 days. Multiple-dose administration of finasteride spray was well tolerated in Chinese male volunteers with androgenetic alopecia.

Navigating Tumor Microenvironment Barriers with Nanotherapeutic Strategies for Targeting Metastasis

Therapeutic strategy for efficiently targeting cancer cells needs an in-depth understanding of the cellular and molecular interplay in the tumor microenvironment (TME). TME comprises heterogeneous cells clustered together to translate tumor initiation, migration, and proliferation. The TME mainly comprises proliferating tumor cells, stromal cells, blood vessels, lymphatic vessels, cancer-associated fibroblasts (CAFs), extracellular matrix (ECM), and cancer stem cells (CSC). The heterogeneity and genetic evolution of metastatic tumors can substantially impact the clinical effectiveness of therapeutic agents. Therefore, the therapeutic strategy shall target TME of all metastatic stages. Since the advent of nanotechnology, smart drug delivery strategies are employed to deliver effective drug formulations directly into tumors, ensuring controlled and sustained therapeutic efficacy. The state-of-the-art nano-drug delivery systems are shown to have innocuous modes of action in targeting the metastatic players of TME. Therefore, this review provides insight into the mechanism of cancer metastasis involving invasion, intravasation, systemic transport of circulating tumor cells (CTCs), extravasation, metastatic colonization, and angiogenesis. Further, the novel perspectives associated with current nanotherapeutic strategies are highlighted on different stages of metastasis.

Optimizing the regenerative potential of vaginal fibroblasts: The role of autologous platelet-rich plasma and hyaluronic acid in vitro

OBJECTIVE

Many postmenopausal women suffering from vulvovaginal atrophy are looking for non-hormonal treatments. Platelet-rich plasma (PRP) therapy has emerged as a novel and promising approach for gynecological applications. PRP is an autologous blood product rich in growth factors used to stimulate tissue regeneration. On the other hand, hyaluronic acid (HA) is used as a treatment for vaginal dryness as it improves tissue hydration thanks to its strong capacity to retain water. This study examines the in vitro effects of PRP alone or combined with HA on vaginal fibroblasts (VFs) isolated from mucosal samples of postmenopausal women undergoing surgery for vaginal prolapse.

METHODOLOGY

Vaginal and blood samples were collected from postmenopausal women undergoing pelvic organ prolapse surgery. PRP was prepared alone or combined with HA (PRP-HA) from peripheral blood. Vaginal fibroblasts were isolated via enzymatic dissociation and cultured in 2D and 3D (spheroids) systems. Biological activities were assessed by measuring cell growth, proliferation, senescence, metabolic activity, and collagen accumulation, along with immunocytochemistry for (myo-)fibroblast markers.

RESULTS

VFs cultured with PRP or PRP-HA showed dose-dependent higher proliferation compared with the control condition, with increased S and G2M cell cycle phases correlating with enhanced proliferation. Expression of vimentin, a protein that plays a key role in maintaining cellular structure and function, was stable, while alpha-SMA decreased, indicating a shift from myofibroblasts to fibroblasts. Collagen production, crucial for wound healing and tissue regeneration, increased under PRP or PRP-HA treatment. PRP and PRP-HA also prevented cell senescence in long-term low-density cultures. These findings were consistent across 2D and 3D culture systems.

CONCLUSIONS

This study provides in vitro evidence supporting the potential of PRP and PRP-HA as autologous treatments for vaginal rejuvenation.

The role of SFRP1 in human dermal papilla cell growth and its potential molecular mechanisms as a target in regenerative therapy

Background

Secreted frizzled-related protein 1 (SFRP1) inhibits Wnt signaling and is differentially expressed in human hair dermal papilla cells (DPCs). However, the specific effect of SFRP1 on cell function remains unclear. Telomerase reverse transcriptase (TERT) representing telomerase activity was found highly active around the hair dermal papilla. TERT levels can be enhanced by activation of the Wnt pathway in cancer cells and embryonic stem cells. Whether this regulatory mechanism is still present in DPCs has not been studied so far.

Methods

In this study, DNA plasmids and siRNAs were constructed against the SFRP1 gene and transfected into DPCs cultured in vitro. We detected the viability, proliferation, and migration of DPCs by Calcein/PI fluorescence, CCK-8, trans-well, or cell scratch experiments, and the expression of potential target genes was also determined through quantitative detection of RNA and protein.

Results

The results demonstrate a significant difference in SFRP1 levels from the control group, suggesting successful transfection of the DNA plasmid and siRNA of SFRP1 into IDPCs. Also, SFRP1 regulates the cell proliferation capacity of IDPCs and reduces their migration functions. The DPCs' living activity, proliferation, and migration function exhibited a negative correlation with the level of SFRP1. SFPR1 also inhibits the protein or RNA expression of β-catenin and TERT in DPCs.

Conclusion

It was proven that in human DPCs, different levels of SFRP1 change how cells work and control Wnt/β-catenin signaling or telomerase activity. This means that blocking SFRP1 could become a new way to treat hair loss diseases in the future.

A Comprehensive Review of the Role of UV Radiation in Photoaging Processes Between Different Types of Skin

Ultraviolet (UV) radiation significantly contributes to photoaging, with its effects varying among different Fitzpatrick skin types. Light skin (Types I-III) has a natural sun protection factor (SPF) of only 3.3, making it particularly vulnerable to DNA damage, collagen degradation, and skin cancer. Darker skin (Types IV-VI) has a natural SPF of 13.4, providing greater photoprotection while elevating the risk of post-inflammatory hyperpigmentation and delaying skin cancer diagnosis. UVA penetrates deep into the dermis, promoting collagen degradation, whereas UVB causes DNA mutations, increasing the risk of cancer. Eumelanin in darker skin mitigates oxidative stress, while pheomelanin in lighter skin functions as a pro-oxidant, increasing vulnerability to photoaging. Although incidence rates are lower, melanoma is identified at more advanced stages in those with darker skin, resulting in poorer outcomes. Protective measures, such as broad-spectrum sunscreens, antioxidants, and hydration, are crucial for all skin types but necessitate customized strategies. Individuals with lighter skin benefit from SPF 50+ and DNA-repairing compounds, whereas those with darker complexion necessitate SPF 30-50 and pigmentation-focused skincare. Comprehending the biological mechanisms and variations in UV damage facilitates the creation of customized photoprotection solutions, enhancing skin health and mitigating long-term UV-related issues for all skin types.

Peritoneal adipose stem cell-derived extracellular vesicles mediate the regulation of ovarian cancer cell proliferation and migration through EGFR-NF-κB signaling

Peritoneal dissemination frequently develops in patients with ovarian cancer (OC) and is associated with recurrence and metastasis. However, the cellular components and mechanisms supporting OC peritoneal metastasis are poorly understood. To elucidate these, we utilized RNA sequencing to investigate the cellular composition and function. Insights from transcriptome analyses suggested that OC cells from malignant ascites persisted in a quiescent state of low metabolic activity and after metastases to the peritoneum, arrested OC cells were reactivated and induced back to the cell cycle, suggesting that the peritoneum served as a favor tumor microenvironment. To elucidate the mechanisms, we then developed long-range migration and competitive inhibition assays and showed that peritoneal adipose-derived stem cells-derived extracellular vesicles (ADSCs-EVs) mediated preferential migration of OC cells toward peritoneal ADSCs but not other representative cells from the peritoneal cavity. In line with phenotypic changes, transcriptomic analysis revealed that patient peritoneal ADSCs-EVs stimulated the expression of numerous genes associated with OC cell proliferation and migration; among them, the epidermal growth factor receptor (EGFR) and nuclear factor kappa B (NF-κB) signaling pathways were highly enriched. We also found that peritoneal ADSCs produced and secreted key EGFR signaling molecules, including EGF and EGFR, into ADSCs-EVs. Upon fusion with OC cells, ADSCs-EVs up-regulated the EGFR-NF-κB axis and promoted OC cell proliferation and migration. Interference with either ADSCs-EVs production or EGFR signaling abolished the proliferation and migration effect. The results show that ADSCs modulate OC cell proliferation and migration at multiple layers, constituting a key mechanism in OC progression.

PRP Injections for the Treatment of Knee Osteoarthritis: The Improvement Is Clinically Significant and Influenced by Platelet Concentration: A Meta-analysis of Randomized Controlled Trials

BACKGROUND

Platelet-rich plasma (PRP) has emerged as a promising therapeutic intervention for knee osteoarthritis (OA), attracting substantial clinical and research attention. However, the clinical relevance of the treatment benefit remains controversial.

PURPOSE

To evaluate the effectiveness of PRP compared with placebo in patients with knee OA in terms of minimal clinically important difference (MCID) and to investigate the possible influence of platelet concentration on the clinical outcome.

STUDY DESIGN

Meta-analysis. Level of evidence 1.

METHODS

The search was conducted on 5 databases (PubMed, Cochrane Library, Scopus, Embase, Web of Science) using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were randomized controlled trials comparing PRP and placebo injections to treat knee OA, written in the English language, with no time limitation. The effects were quantified at 1-, 3-, 6-, and 12-month follow-up points. Visual analog scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used, with subanalyses based on platelet concentration performed using a 1,000,000 ± 20% platelets/µL cutoff. The MCID values (VAS, 1.37; WOMAC, 6.4) were used to interpret clinical improvement. The articles' quality was assessed using the Revised Tool for Risk of Bias in Randomized Trials and the Grading of Recommendations Assessment, Development and Evaluation guidelines.

RESULTS

Among the 5499 articles retrieved, 18 randomized controlled trials (1995 patients) were included. PRP presented statistically superior improvements in VAS and WOMAC scores compared with placebo at all follow-up points, exceeding the MCID at 3- and 6-month follow-up points for VAS and at all follow-up points for WOMAC. The subanalysis based on platelet concentration showed that high-platelet PRP provided clinically significant pain relief with the improvement exceeding the MCID compared with placebo at 3-, 6-, and 12-month follow-up points. In contrast, low-platelet PRP failed to offer a clinically perceivable benefit in terms of VAS score. WOMAC results showed that both products provided a clinically significant improvement at 3 and 6 months of follow-up. This benefit was maintained up to the 12-month follow-up in the high-platelet group but not in the low-platelet group, where the improvement compared with placebo did not reach statistical significance.

CONCLUSION

This meta-analysis showed that PRP offered clinically relevant functional improvement at 1-, 3-, 6-, and 12-month follow-up points and pain relief at 3- and 6-month follow-up points compared with placebo for the treatment of knee OA. Platelet concentration was found to influence treatment efficacy, with high-platelet PRP providing superior pain relief and more durable functional improvement compared with low-platelet PRP.

Local Injection versus Topical Microneedling of Platelet-Rich Plasma for Androgenetic Alopecia: A Systematic Review

Autologous platelet-rich plasma (PRP) has gained popularity for hair restoration due to its effectiveness and safety. PRP could be administered through direct local injections to the scalp or applied topically with the aid of microneedling therapy. This systematic review aims to elaborate on the effectiveness of PRP administered with syringe injection and topical PRP with microneedling combination for the treatment of androgenetic alopecia (AGA). A literature search was employed through PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and Scopus. The database was searched using terms and keywords: "platelet-rich plasma" and "microneedling" and "androgenetic alopecia." Inclusion criteria are human study, patients with AGA, studies that compare PRP with syringe injection and the combination of PRP and microneedling. Exclusion criteria are animal study, review, case reports, or studies on other form of alopecia. A total of 108 articles found in the database. Title and abstract screening yield 12 articles. After full-text reading three articles were included in the review. A combination of PRP and microneedling appears to yield more superior results than direct syringe injection. Topical PRP and microneedling potentially give better results on AGA cases. Further high-quality studies with uniform protocol are needed to confirm these findings. Level of Evidence  I.

Back pain in patients with macromastia: what a spine surgeon should know?

Large and heavy breasts, termed macromastia, is a common cause of neck and back pain in females that may present as early as puberty. With focus usually elsewhere, macromastia is not usually a primary consideration when a patient initially presents to a spine specialist, particularly a spine surgeon. Axial pain is among the most common indications for breast reduction by plastic surgeons. Breast reduction surgery has been demonstrated to be an effective treatment for many women with back pain from macromastia. Awareness among spine specialists may prevent unneeded spinal intervention prompted by an overestimation of the contribution of vertebral degenerative changes to axial pain in affected women. This review aims to broaden spine providers' understanding of macromastia and its evaluation and treatment, including the role of breast reduction surgery to lessen axial pain.

Sisters But Not Twins: A Critical Appraisal of Long-Term Results in Breast Asymmetry Correction

BACKGROUND

Breast asymmetry is a common disorder, which can lead to significant emotional distress. Despite this, there is currently no widely accepted approach for managing this prevalent condition. Due to the high dimorphism of the breast, despite a satisfactory result in the short-term post-op, the recurrence of asymmetry is one of the most common weak points of breast recontouring. The purpose of this paper is to investigate the long-lasting maintenance of breast symmetry in women who have undergone surgical correction of asymmetric breasts through mastopexy or reduction mammoplasty and to try to identify some specific elements to achieve more stable outcomes in the long term.

METHODS

A retrospective study was conducted on 1,984 breast surgical procedures carried out between 2002 and 2020 to evaluate patient satisfaction and the recurrence rate of asymmetry disorders. All the patients enrolled in this study were given a questionnaire to evaluate their satisfaction level. A retrospective iconographic-chart review was investigated by the same senior surgeon, who recorded the presence or the absence of recurring breast asymmetry.

RESULTS

In total, 1984 patients were enrolled who respected the minimum standard of the study; 596 showed up at post-op follow-up longer than three years. Most of the patients showed great satisfaction with the results, even if several recurrences of asymmetry were reported.

CONCLUSIONS

The recurrence of asymmetry is one of the most common weak points of breast asymmetry correction procedures due to the high dimorphism of the breasts. In order to fully assess the results of asymmetric breast correction, patients should be required to attend a post-op follow-up examination after a long time frame. Indeed, the strength of this paper lies in the focus on long-term postoperative follow-up.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .