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Tejapira K, Yongpisarn T, Sakpuwadol N, Suchonwanit P. Platelet-rich plasma in alopecia areata and primary cicatricial alopecias: A systematic review. Front Med (Lausanne) 2022; 9:1058431. [PMID: 36507528 PMCID: PMC9731377 DOI: 10.3389/fmed.2022.1058431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background Immune-mediated alopecias (IMAs), a group of hair disorders associated with immunological reactions, remain a therapeutic challenge since available treatments are generally unfavorable with potential side effects. Platelet-rich plasma (PRP) has been recently proposed as a treatment option based on several limited-quality studies; however, there is no systematic evaluation of PRP efficacy on IMAs in the literature. Objective To assess PRP's effects in treating IMAs using a systematic review. Methods Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases. A search strategy was designed to retrieve all studies exploring PRP in treating IMAs, including alopecia areata (AA) and primary cicatricial alopecias (PCAs). In addition, all randomized and non-randomized studies reporting subjective and/or objective outcomes of alopecia treatment with PRP were included. Results Thirty-two studies were included, comprising 621 patients with AA and 19 patients with PCAs. PRP had superior efficacy as monotherapy in five studies, comparable to intralesional corticosteroids in six studies in AA treatment. In addition, in the analysis of PCAs, including lymphocytic and neutrophilic subtypes, PRP was efficacious in alleviating disease progression in nine studies. Conclusion PRP is considered a promising treatment for AA and PCAs in patients who experienced unfavorable outcomes from conventional treatment. However, its clinical application remains to be standardized, and its recommendation as a treatment for IMAs could not be ascertained due to a lack of high-quality evidence. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353859], identifier [CRD42022353859].
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Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther 2022; 16:635-645. [PMID: 35300222 PMCID: PMC8922312 DOI: 10.2147/dddt.s356858] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Platelet rich plasma (PRP) was described as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia. To date, it was discovered that there are several growth factors and cytokines that can accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical field, such as in sport medicine, regenerative medicine, and aesthetic medicine. Several studies have shown that PRP can be used effectively for treatment of hair loss. Although it has been widely used, the exact mechanism of action of PRP is still not fully elucidated. In this article, we aim to review and update current information on the definition, classification, mechanism of action, clinical efficacy in hair regrowth, and adverse events of PRP.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
- Correspondence: Anon Paichitrojjana, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, 36/87-88 PS Tower 25Fl, Asoke Road, Sukhumvit 21, Klong Toey Nua, Wattana, Bangkok, 10110, Thailand, Tel +66 81-9343050, Email
| | - Anand Paichitrojjana
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Tawfik AA, Mostafa I, Soliman M, Soliman M, Abdallah N. Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background: Non-scarring alopecia areata (AA) is a disease that is mediated through autoimmunity. Recently, autologous platelet-rich plasma (PRP) and photobiomodulation (PBM), commonly known as low-level laser (or light, LLLT) have been suggested to provide a valuable role in stimulating the growth of hair follicles (HF)
Aim: Compare between the significance and wellbeing of PRP and LLLT in the management of AA.
Patients & methodology: Thirty patients, each having three patches of AA participated in the study. Patches were assigned randomly to have one of the two treatments: PRP or LLLT. The third patch served as a control and received placebo treatment. PRP was done once weekly whereas LLLT was done 3 sessions per week for a maximum of 6 weeks. Patients were followed up at one month and three months. The thickness and density of hair were evaluated by the folliscope.
Results: A noteworthy higher improvement was detected in the thickness and the density of hair in the PRP treated patches as evaluated by the folliscope and patients satisfaction. The obtained outcomes were sustained during the 12 week follow-up period in most of patients.
Conclusion: PRP and LLLT could be considered as efficacious alternatives for the treatments of AA with the least morbidity in addition to a little cost profit ratio.
KEYWORDS: Alopecia areata, platelet-rich plasma, folliscope, photobiomodulation, low level laser therapy.
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Shome D, Kapoor R, Doshi K, Patel G, Vadera S, Kumar V. Effectiveness of QR678 and QR678 Neo ® with intralesional corticosteroid vs. intralesional corticosteroid alone in the treatment of alopecia areata -A randomized, comparative, prospective study. J Cosmet Dermatol 2021; 21:358-367. [PMID: 34825770 DOI: 10.1111/jocd.14630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/22/2021] [Accepted: 11/03/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an inflammatory disorder, marked by chronic, persistent, and patchy loss of hair. At present intralesional/topical corticosteroids, Minoxidil solution, and topical immune-therapies are used for treatment. Though all these have side effects and high rate of relapse. As QR678 Neo® is proved to be effective in hair regrowth in male and female pattern hair loss, the aim of the study is to compare the efficacy of QR678 Neo® with intralesional steroid therapy vs. intralesional steroid alone in the treatment of AA of scalp in men and women. MATERIALS AND METHODS A total of 20 participants in age group of 20-50 years with nonscarring patchy hair loss were chosen for the study. Patients were arbitrarily divided into two groups (Group A-intralesional steroid with placebo and Group B-intralesional steroid with QR678 Neo® ). All the participants were evaluated at baseline, 3 months and 6 months with standard global photography, dermoscopic assessment, and self-evaluation questionnaire at the end of study. RESULT Marked improvement was seen in the global assessment score after 6 months (mean- 6.6 SALT) as compared to baseline (38.5 SALT score) in group B. There was significant reduction of black dots, yellow dots, broken hairs, and tapered hair at 6 months on video dermoscopic examination in group B. Also, higher satisfaction was experienced with the treatment in group B patients. CONCLUSION QR678 Neo® in combination with intralesional steroids therapy proved to be significantly beneficial, efficient, and can be considered as safer treatment option for alopecia areata.
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Affiliation(s)
- Debraj Shome
- Department of Facial Plastic Surgery & Facial Cosmetic Surgery, Director, The Esthetic Clinics, Mumbai, India
| | - Rinky Kapoor
- Department of Dermatology, Cosmetic Dermatology & Dermato-Surgery, The Esthetic Clinics, Mumbai, India
| | - Komal Doshi
- Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | | | - Sapna Vadera
- Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
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Gupta AK, Renaud HJ, Rapaport JA. Platelet-rich Plasma and Cell Therapy: The New Horizon in Hair Loss Treatment. Dermatol Clin 2021; 39:429-445. [PMID: 34053596 DOI: 10.1016/j.det.2021.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Current medicinal therapies for treating hair loss have shortcomes due to variability and ineffectiveness, noncompliance, and adverse effects. The prevalence of hair loss and its associated negative psychological impact have driven research into regenerative medicine approaches, such as platelet-rich plasma (PRP) and cell-based therapies, in an attempt to find alternative, safe, effective, and reproducible treatments. Current research shows promising results from these therapies; however, more robust trials are needed to confirm the reported efficacies of PRP and cell-based therapies. Moreover, standardization of treatment preparation as well as dose and regimen are needed.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada; Mediprobe Research Inc., 645 Windermere Road, London, Ontario N5X 2P1, Canada.
| | - Helen J Renaud
- Mediprobe Research Inc., 645 Windermere Road, London, Ontario N5X 2P1, Canada
| | - Jeffrey A Rapaport
- Cosmetic Skin and Surgery Center, 333 Sylvan Avenue, Suite 207, Englewood Cliffs, NJ 07632, USA
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Ragab SEM, Nassar SO, Morad HA, Hegab DS. Platelet-rich plasma in alopecia areata: intradermal injection versus topical application with transepidermal delivery via either fractional carbon dioxide laser or microneedling. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.35] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Almohanna HM, Ahmed AA, Griggs JW, Tosti A. Platelet-Rich Plasma in the Treatment of Alopecia Areata: A Review. J Investig Dermatol Symp Proc 2020; 20:S45-S49. [PMID: 33099384 DOI: 10.1016/j.jisp.2020.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Platelet-rich plasma (PRP) is an autologous preparation of plasma with concentrated platelets containing various growth factors and cytokines that enhance the body's inherent capacity to repair and regenerate hair follicles. A few studies and case reports support the use of PRP for the treatment of alopecia areata (AA). Further large-scale studies are needed to evaluate the efficacy of PRP as monotherapy or in association with other therapeutic modalities for AA. Although PRP is relatively safe and potentially effective, there is no standardized protocol or recommendations for the number of PRP sessions required to treat and maintain hair growth.
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Affiliation(s)
- Hind M Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
| | - Azhar A Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia
| | - Jacob W Griggs
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, Florida, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, Florida, USA
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Abstract
Platelet-rich plasma (PRP) therapy is a new approach in dermatology and there is evidence to suggest that it provides excellent adjuvant treatment for nonscarring alopecia cases. There is evidence supporting the hypothesis that PRP therapy increases hair growth and thickness in patients with nonscarring alopecia. Studies including participants with scarring alopecia are limited and larger scale studies with tighter controls in PRP preparation, administration, and follow-up are needed to determine whether this is a clinically sound approach. Further symptom control analysis is also warranted as in both single and combination PRP therapy trials there are little data to support treatment effect on symptoms such as burning and itching. In this article, the author explains PRP preparation processes and PRP types and compares stand-alone PRP therapy with combination PRP study results. The author also makes recommendations for treatment and discusses the future of PRP research.
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Emerging Nonsteroid-Based Procedural Therapies for Alopecia Areata: A Systematic Review. Dermatol Surg 2020; 45:1484-1506. [PMID: 31403534 DOI: 10.1097/dss.0000000000002053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a common form of patchy, nonscarring hair loss. Although intralesional steroid injections are currently the mainstay procedural therapy for AA, other nonsteroid-based procedural therapies, including platelet-rich plasma (PRP), ultraviolet radiation (UVR), and laser-based modalities, are emerging as practical options. OBJECTIVE To systematically review nonsteroid-based procedural therapies for AA and recapitulate the available clinical data. MATERIALS AND METHODS A systematic review of the literature was performed searching PubMed/MEDLINE databases identifying studies investigating PRP, UVR, and laser-based modalities for AA treatment. RESULTS Literature search yielded 644 articles encompassing PRP, UVR, and laser treatment modalities for AA. Of the 644 articles, 46 met inclusion criteria. Although numerous reports demonstrate strong potential for PRP, UVR, and laser modalities in treating AA, high-quality evidence supporting their efficacy is still lacking. CONCLUSION There is an abundance of evidence for nonsteroid-based procedural therapies in the treatment of AA. Randomized control trials comparing these treatment options head-to-head should be performed to better understand the true efficacy of these treatments.
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Rinaldi F, Marzani B, Pinto D, Sorbellini E. Randomized controlled trial on a PRP-like cosmetic, biomimetic peptides based, for the treatment of alopecia areata. J DERMATOL TREAT 2018; 30:588-593. [PMID: 30513014 DOI: 10.1080/09546634.2018.1544405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Alopecia areata (AA) is a non-scarring auto-immune hair disorder. Recent researches explained the role of growth factors (GFs) in hair follicle cycling. The main reservoir of GFs are alpha-granules of platelets and novel procedures have been implemented aimed at collecting platelet-rich plasma (PRP). PRP has been safely implemented in many medical applications and has also been successfully used as alternative cell-based therapy for the treatment of hair growth disorders, among which also AA. Objectives: By means of a randomized double-blinded, placebo and active-controlled, parallel group study we have studied the efficacy of a cosmetic product (named TR-M-PRP plus) comprising biomimetic peptides specific for hair growth, mimicking PRP composition for the treatment of AA. Subjects were treated for three months and evaluated, at the end of the study and after one month of follow-up, as regards hair growth using SALT score. Results: TR-M-PRP plus-like topic produced a statistically significant (p < .001) clinical improvement in SALT score after 3 months of therapy, compared to baseline. Hair growth results further improved after 1 month of follow-up. Conclusions: This clinical investigation suggests that the biotechnological designed PRP-like cosmetic could represent a valid and safer alternative to autologous PRP for the treatment of AA.
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Affiliation(s)
- Fabio Rinaldi
- a International Hair Research Foundation , Milan , Italy
| | | | - Daniela Pinto
- a International Hair Research Foundation , Milan , Italy
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11
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Anitua E, Pino A, Jaén P, Navarro MR. Platelet rich plasma for the management of hair loss: Better alone or in combination? J Cosmet Dermatol 2018; 18:483-486. [PMID: 29904992 DOI: 10.1111/jocd.12683] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 12/11/2022]
Abstract
Platelet-rich plasma (PRP) and autologous protein-based treatments have recently emerged as a potential therapeutic approach for hair loss-related disorders including androgenetic alopecia and alopecia areata. The safety and efficacy of repeated intradermal injections of PRP has proved to promote hair growth in a number of randomized clinical trials. Biologically active proteins and cytokines released upon platelet activation have shown to induce folliculogenesis and activate the anagen growing phase of dormant bulbs. Interestingly, further studies have revealed that combining PRP with other hair loss-related products may enhance the final performance of the treatment. These synergistic approaches include Food and Drug Administration (FDA) approved drugs such as finasteride or minoxidil, bioactive macromolecules and cell-based therapies. Here, recent research involving alone or combined therapy with platelet-rich plasma for the management of hair loss-related disorders are outlined and future prospects are discussed.
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Affiliation(s)
- Eduardo Anitua
- BTI Biotechnology Institute, Vitoria, Spain.,Eduardo Anitua Foundation, Vitoria, Spain
| | - Ander Pino
- BTI Biotechnology Institute, Vitoria, Spain
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12
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Acharya S, Timilshina M, Jiang L, Neupane S, Choi DY, Park SW, Lee SY, Jeong BS, Kim JA, Nam TG, Chang JH. Amelioration of Experimental autoimmune encephalomyelitis and DSS induced colitis by NTG-A-009 through the inhibition of Th1 and Th17 cells differentiation. Sci Rep 2018; 8:7799. [PMID: 29773813 PMCID: PMC5958108 DOI: 10.1038/s41598-018-26088-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/04/2018] [Indexed: 12/13/2022] Open
Abstract
CD4+ T cells are the central for the mammalian adaptive immune system. Naïve CD4+ T cells mainly differentiate in to pro-inflammatory Th1, Th2 and Th17 cells upon antigenic stimulation. IFN-γ secreting Th1 cells and IL-17 secreting Th17 cells are found to play key roles in autoimmune diseases like multiple sclerosis (MS) and ulcerative colitis (UC). In this study we found NTG-A-009, 6-aminopyridin-3-ol, has great inhibitory effect on in vitro differentiation of Th1 and Th17 cells without affecting regulatory T cells. Moreover, NTG-A-009 had no effect on CD4+ T cell proliferation and viability. In vivo treatment has shown that NTG-A-009 has ameliorated experimental autoimmune encephalomyelitis (EAE) and dextran sulfate sodium (DSS) induced colitis through the inhibition of Th1 and Th17 cells differentiation. Mechanistically, NTG-A-009 suppressed Th1 and Th17 cells differentiation via the modulation of JAK/STAT signaling pathway. Thus, our data demonstrated that NTG-A-009 ameliorated inflammation through the inhibition of Th1 and Th17 cells generation making it a potential therapeutic candidate for the treatment of inflammatory diseases.
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Affiliation(s)
- Suman Acharya
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | | | - Liyuan Jiang
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Sabita Neupane
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Dong-Young Choi
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Sang Won Park
- Department of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, Republic of Korea
| | - Sang Yeul Lee
- Department of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, Republic of Korea
| | - Byeong-Seon Jeong
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Jung-Ae Kim
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Tae-Gyu Nam
- Department of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, Republic of Korea.
| | - Jae-Hoon Chang
- College of Pharmacy, Yeungnam University, Gyeongsan, 38541, Republic of Korea.
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Strazzulla LC, Avila L, Lo Sicco K, Shapiro J. An Overview of the Biology of Platelet-Rich Plasma and Microneedling as Potential Treatments for Alopecia Areata. J Investig Dermatol Symp Proc 2018; 19:S21-S24. [PMID: 29273100 DOI: 10.1016/j.jisp.2017.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
Platelet-rich plasma and microneedling have been investigated recently as potential therapeutic options for the treatment of hair disorders. Evidence from laboratory studies indicates that these treatments enhance growth factor production that in turn facilitates hair follicle development and cycling. Several small studies and case reports have presented encouraging findings regarding the use of these treatments for alopecia areata. Future investigations will be needed to validate these therapeutic techniques for patients with alopecia areata and further refine which subtypes of the disease these methods are best indicated for.
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Affiliation(s)
- Lauren C Strazzulla
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Lorena Avila
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA.
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Strazzulla LC, Avila L, Lo Sicco K, Shapiro J. An Overview of the Biology of Platelet-Rich Plasma and Microneedling as Potential Treatments for Alopecia Areata. J Invest Dermatol 2017:S0022-202X(17)32751-3. [PMID: 29103820 DOI: 10.1016/j.jid.2017.07.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/21/2017] [Indexed: 10/18/2022]
Abstract
Platelet-rich plasma and microneedling have been investigated recently as potential therapeutic options for the treatment of hair disorders. Evidence from laboratory studies indicates that these treatments enhance growth factor production that in turn facilitates hair follicle development and cycling. Several small studies and case reports have presented encouraging findings regarding the use of these treatments for alopecia areata. Future investigations will be needed to validate these therapeutic techniques for patients with alopecia areata and further refine which subtypes of the disease these methods are best indicated for.
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Affiliation(s)
- Lauren C Strazzulla
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Lorena Avila
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA.
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