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Kieling L, Konzen AT, Zanella RK, Valente DS. Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials ⋆. An Bras Dermatol 2024:S0365-0596(24)00136-3. [PMID: 39013743 DOI: 10.1016/j.abd.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 07/18/2024] Open
Abstract
FUNDAMENTALS Platelet-rich plasma (PRP) has been progressively more used in androgenetic alopecia (AGA). OBJECTIVES The authors aimed to evaluate PRP efficacy compared to placebo in AGA. METHODS A comprehensive search was conducted across seven databases, until 01/04/2023. Randomized clinical trials focusing on AGA and PRP use to increase hair density were included. Patients aged between 15 and 63 years, diagnosed with AGA characterized by Norwood I‒VII and Ludwig I‒III scales, were included. Studies with a sample size <10, lacking PRP processing method, focusing on complementary therapies or other alopecias, were excluded. The authors conducted subgroup analysis for activator, spin method, study design, risk of bias, and gender. Meta-regression was conducted for activator, spin method, design, and gender. The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias. Asymmetry was measured through a Funnel plot followed by Egger's test. The protocol was registered at PROSPERO (CRD42023407334). RESULTS The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis, with 13 studies included in the meta-analysis. Meta-analysis demonstrated a mean difference of 27.55 hairs/cm2 and 95% CI (14.04; 41.06), I2 = 95.99%, p < 0.05. Hair diameter meta-analysis presented a mean difference of 2.02 μm, 95% CI (-0.85 μm; 4.88 μm), and I2 = 77.11% (p = 0.02). That is, low quality evidence. LIMITATIONS OF THE STUDY Studies were highly heterogeneous, of low quality, and presented evident publication bias. CONCLUSIONS Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA, so further high-quality randomized clinical trials are recommended to strengthen the evidence.
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Affiliation(s)
- Lucas Kieling
- Division of Surgical Clinics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Ana Terezinha Konzen
- Division of Surgical Clinics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Rafaela Koehler Zanella
- Graduate Program in Medicine and Health Sciences, Faculdade de Medicina da Pontifícia, Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Denis Souto Valente
- Division of Surgical Clinics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Zhang Q, Wang Y, Ran C, Zhou Y, Zhao Z, Xu T, Hou H, Lu Y. Characterization of distinct microbiota associated with androgenetic alopecia patients treated and untreated with platelet-rich plasma (PRP). Animal Model Exp Med 2024; 7:106-113. [PMID: 38720238 PMCID: PMC11079158 DOI: 10.1002/ame2.12414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/10/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Androgenic alopecia (AGA) is the most common type of hair loss in men, and there are many studies on the treatment of hair loss by platelet-rich plasma (PRP). The human scalp contains a huge microbiome, but its role in the process of hair loss remains unclear, and the relationship between PRP and the microbiome needs further study. Therefore, the purpose of this study was to investigate the effect of PRP treatment on scalp microbiota composition. METHODS We performed PRP treatment on 14 patients with AGA, observed their clinical efficacy, and collected scalp swab samples before and after treatment. The scalp microflora of AGA patients before and after treatment was characterized by amplifying the V3-V4 region of the 16 s RNA gene and sequencing for bacterial identification. RESULTS The results showed that PRP was effective in the treatment of AGA patients, and the hair growth increased significantly. The results of relative abundance analysis of microbiota showed that after treatment, g_Cutibacterium increased and g_Staphylococcus decreased, which played a stable role in scalp microbiota. In addition, g_Lawsonella decreased, indicating that the scalp oil production decreased after treatment. CONCLUSIONS The findings suggest that PRP may play a role in treating AGA through scalp microbiome rebalancing.
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Affiliation(s)
- Qian Zhang
- Beijing Life Science AcademyBeijingChina
| | - Yanan Wang
- Department of PathologyAffiliated Hospital of Hebei UniversityBaodingChina
| | - Cheng Ran
- Department of OtolaryngologyAffiliated Hospital of Hebei UniversityBaodingChina
| | - Yingmei Zhou
- Department of DermatologyHuazhong University of Science and Technology Union Shenzhen HospitalShenzhenChina
| | - Zigang Zhao
- Department of DermatologyHainan Hospital of PLA General HospitalSanyaChina
| | - Tianhua Xu
- Department of OtolaryngologyAffiliated Hospital of Hebei UniversityBaodingChina
| | - Hongwei Hou
- Beijing Life Science AcademyBeijingChina
- Department of Chemical EngineeringTsinghua UniversityBeijingChina
| | - Yuan Lu
- Department of DermatologyHuazhong University of Science and Technology Union Shenzhen HospitalShenzhenChina
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Behrangi E, Rahimi ST, Zare S, Goodarzi A, Ghassemi M, Khodadad F, Nouri M, Mozafarpoor S, Dehghani A, Nilforoushzadeh MA, Roohaninasab M. Evaluation of the effects of adding an adipose tissue-derived stromal vascular fraction to platelet-rich plasma injection in the treatment of androgenetic alopecia: A randomized clinical trial. Skin Res Technol 2024; 30:e13700. [PMID: 38634195 PMCID: PMC11024502 DOI: 10.1111/srt.13700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Stromal vascular fraction (SVF) cells derived from adipose tissue and platelet-rich plasma (PRP) are among novel treatments for androgenetic alopecia (AGA). We aimed to investigate the effect of adding SVF to PRP and compare it to administering PRP injection alone. METHODS Eighteen patients were randomly divided into two groups of nine. The PRP group was treated with PRP at all three visits at 1-month intervals, while the SVF-PRP group received an SVF injection on the first visit and a PRP injection on the second and third visits. Each group was evaluated at baseline and 20 weeks after the therapy's initiation. RESULTS Changes in mean hair diameter and hair count compared to baseline were significant in both groups. The PRP group experienced a greater increase in mean hair count than the SVF-PRP group, and the SVF-PRP group had a marginally greater increase in hair diameter than the PRP group. These differences were not statistically significant compared to each other. The patient and physician assessment scores exceeded the mean (on a scale from 0: poor to 3: excellent) in both groups. CONCLUSION Adding one SVF injection to two PRP treatment sessions versus three PRP injections alone had no significant difference in evaluated variables. If additional research demonstrates the same results, we suggest that multiple SVF injection sessions may be required to produce a statistically significant difference compared to PRP injection alone. Moreover, considering lower cost and greater accessibility of PRP, it can be used before SVF in the treatment of AGA.
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Affiliation(s)
- Elham Behrangi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Seyyedeh Tahereh Rahimi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Sona Zare
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
- Laser Application in Medical Sciences Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Stem Cell and Regenerative Medicine CenterSharif University of TechnologyTehranIran
- Department of Mechanical EngineeringSharif University of TechnologyTehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Mohammadreza Ghassemi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Fariba Khodadad
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Maryam Nouri
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Samaneh Mozafarpoor
- Department of DermatologyFaculty of MedicineIsfahan university of Medical SciencesIsfahanIran
| | - Abbas Dehghani
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Mohammad Ali Nilforoushzadeh
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
- Skin Repair Research CenterJordan Dermatology and Hair Transplantation CenterTehranIran
| | - Masoumeh Roohaninasab
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC)School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
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Li M, Qu K, Lei Q, Chen M, Bian D. Effectiveness of Platelet-Rich Plasma in the Treatment of Androgenic Alopecia: A Meta-Analysis. Aesthetic Plast Surg 2024; 48:977-984. [PMID: 37644190 PMCID: PMC10980625 DOI: 10.1007/s00266-023-03603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a common yet difficult-to-treat condition, which is an important psychosocial problem. Platelet-rich plasma (PRP) therapy has been considered as a promising treatment for AGA. However, the current evidence on the efficacy of PRP for treating AGA is still controversial. This study evaluated the efficacy of PRP monotherapy in the treatment of AGA. METHODS We searched PubMed, Embase, Cochrane Library and Web of Science to collect randomized controlled trials on use of PRP in AGA for a meta-analysis. RESULTS Ten trials with a total 555 treatment units were identified. The hair density in PRP group was significantly higher than control group [MD = 25.09, 95%CI: 9.03-41.15, p = 0.002], but there was no significant difference in hair diameter between two groups [SMD = 0.57, 95%CI: - 0.23 to 1.38, p = 0.16]. Subgroup analyses indicated that hair density was significantly higher among the male-only trials than in the mixed-sex samples (p = 0.02). In addition, neither the split-head design nor the year of publication affected hair density (p = 0.05, p = 0.06). However, hair density was significantly higher in trials with a sample size less than 30 (p = 0.0004). CONCLUSIONS PRP treatment increased hair density in participants with AGA, but not hair diameter. In terms of hair density, PRP elicits stronger effects in male patients. There was a trend toward differed treatment effect by gender with PRP injection, which warrants further investigation. Especially in the case of female. LEVEL OF EVIDENCE III 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 https://www.springer.com/00266 .
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Affiliation(s)
- Meijia Li
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China
| | - Kaipan Qu
- Department of Burn and Plastic Surgery, Shandong Provincial Third Hospital, Jinan, China
| | - Qiang Lei
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China
| | - Mingrui Chen
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China
| | - Donghui Bian
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China.
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Ntshingila S, Oputu O, Arowolo AT, Khumalo NP. Androgenetic alopecia: An update. JAAD Int 2023; 13:150-158. [PMID: 37823040 PMCID: PMC10562178 DOI: 10.1016/j.jdin.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 10/13/2023] Open
Abstract
Androgenetic alopecia (AGA) is the most common nonscarring alopecia and is characterised by distinct gradual patterned hair loss. AGA is mediated by genetic predisposition and excessive follicular sensitivity to androgens, mainly in males, leading to the progressive conversion of scalp terminal hair into vellus hair. Although highly prevalent, it is not fatal but may have a severe psychosocial impact, especially on females and younger males. Significant advances have been made in understanding AGA's epidemiology and pathophysiology, but only 2 drugs remain approved by the FDA - finasteride and minoxidil. Prolonged use of these drugs, is a prerequisite for enhanced treatment response. However, this leads to poor medication adherence and adverse effects from extended use eg, the "postfinasteride syndrome" which persists beyond stopping the drug. Hence, there is a need for research on more effective alternative treatments for AGA, with fewer side effects. This paper reviewed recent advances in AGA pathophysiology and its treatment options. The recently characterized structure of type 2, 5-alpha reductase holds significance in comprehending present and prospective treatments of AGA.
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Affiliation(s)
- Sincengile Ntshingila
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ogheneochuko Oputu
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Afolake T. Arowolo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P. Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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6
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de Oliveira AFQ, Arcanjo FPN, Rodrigues MRP, Rosa E Silva AA, Hall PR. Use of autologous platelet-rich plasma in androgenetic alopecia in women: a systematic review and meta-analysis. J DERMATOL TREAT 2023; 34:2138692. [PMID: 36264022 DOI: 10.1080/09546634.2022.2138692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to verify the efficacy of using autologous platelet-rich plasma (PRP) in female pattern alopecia (FPA). BACKGROUND Androgenetic alopecia is the leading cause of hair loss in men andwomen and often impacts self-esteem and quality of life. DATA SOURCES MEDLINE/PubMed, Cochrane Library, ClinicalTrials.gov, and EMBASE up to May 2021. STUDY SELECTION AND DATA EXTRACTION We identified all studies evaluating the effect of PRP in FPA. A narrative synthesis was performed from data on the efficacy of PRP treatment and adverse effects; quantitative results of PRP use compared to control treatment for female androgenetic alopecia (AGA) were synthesized. The outcomes analyzed were terminal density and hair thickness. RESULTS Seven articles were selected for this review. Meta-analysis showed that PRP-based interventions were able to increase terminal hair density compared to control (standardized mean difference (SMD)=2.98, 95% confidence intervals (CIs)=1.10, 4.85), with no significant increase in hair thickness (SMD = 1.16, 95% CI= -0.96, 3.28). During and after treatment, no major side effects were reported by patients or researchers. CONCLUSIONS The use of autologous PRP injections in female AGA seems to be promising, with more consistent results on terminal hair density. However, caution is recommended in the interpretation of these results until they can be replicated in larger and more representative samples. PROSPERO registration number CRD42021257154.
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Li P, Sun Y, Nie L, Shavandi A, Yunusov KE, Hua Y, Jiang G. Fabrication of carboxymethyl cellulose/hyaluronic acid/polyvinylpyrrolidone composite pastes incorporation of minoxidil-loaded ferulic acid-derived lignin nanoparticles and valproic acid for treatment of androgenetic alopecia. Int J Biol Macromol 2023; 249:126013. [PMID: 37517761 DOI: 10.1016/j.ijbiomac.2023.126013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Androgenetic alopecia (AGA) is a transracial and cross-gender disease worldwide with a higher prevalence among young individuals. Traditional oral or subcutaneous injections are often used to treat AGA, however, they may cause severe side-effects and therefore effective treatments for AGA are currently lacking. In this work, to treat AGA, we developed a composite paste system based on minoxidil (MXD)-loaded nanoparticles and valproic acid (VPA) with the assistance of roller-microneedles (roller-MNs). The matrix of composite paste systems is carboxymethyl cellulose (CMC), hyaluronic acid (HA) and polyvinylpyrrolidone (PVP). The roller-MNs can create microchannels in the skin to enhance drug transdermal efficiency. With the combined effects of the stimulation hair follicle (HF) regrowth by upregulating Wnt/beta-catenin of VPA and the mechanical microchannels induced by roller-MNs, the as-prepared composite paste systems successfully boost perifollicular vascularization, and activate hair follicle stem cells, thereby inducing notably faster hair regeneration at a lower administration frequency on AGA mouse model compared with minoxidil. This approach offers several benefits, including the avoidance of efficacy loss due to the liver's first-pass effect associated with oral drug, reduction in the risk of infection from subcutaneous injection, and significant decrease in the side effects of lower-dose MXD.
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Affiliation(s)
- Peixin Li
- School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China; International Scientific and Technological Cooperation Base of Intelligent Biomaterials and Functional Fibers, Hangzhou, 310018, China
| | - Yanfang Sun
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Lei Nie
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
| | - Amin Shavandi
- Université Libre de Bruxelles (ULB), École Polytechnique de Bruxelles, 3BIO-BioMatter, Avenue F.D. Roosevelt, 50 - CP 165/61, 1050 Brussels, Belgium
| | - Khaydar E Yunusov
- Institute of Polymer Chemistry and Physics, Uzbekistan Academy of Sciences, Tashkent 100128, Uzbekistan
| | - Yinjian Hua
- School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China; International Scientific and Technological Cooperation Base of Intelligent Biomaterials and Functional Fibers, Hangzhou, 310018, China
| | - Guohua Jiang
- School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China; International Scientific and Technological Cooperation Base of Intelligent Biomaterials and Functional Fibers, Hangzhou, 310018, China.
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Zhang X, Ji Y, Zhou M, Zhou X, Xie Y, Zeng X, Shao F, Zhang C. Platelet-Rich Plasma for Androgenetic Alopecia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Cutan Med Surg 2023; 27:504-508. [PMID: 37533146 DOI: 10.1177/12034754231191461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Platelet-rich plasma (PRP) contains a variety of growth factors and has been widely used in maxillofacial surgery, orthopedics, plastic surgery, ophthalmology, and other fields. In recent years, with the increasing morbidity of androgenetic alopecia (AGA), the use of PRP has also increased. The objective of this article was to evaluate the efficacy and safety of PRP for AGA. We searched PubMed, Embase, Web of Science, and Cochrane Library, covering the databases from their earliest records until March 2022. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to explore the effects of PRP for hair density, hair count, and hair diameter in AGA. Nine trials involving 238 patients were included. The meta-analysis showed that PRP for AGA increased hair density at 3 and 6 months with statistically significant differences compared with the placebo (P < .05). PRP also increased hair count and hair diameter compared with the baseline, but there was no significant difference compared with the placebo (P > .05). Two of the 7 studies reported adverse reactions. No serious adverse reactions were found. In conclusion, PRP is an effective and safe treatment for increasing the hair density in AGA. Trial registration: The systematic review was registered with PROSPERO (CRD42022362432).
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Affiliation(s)
- XiuXiu Zhang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
| | - YuXiu Ji
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
| | - MingChun Zhou
- The People's Hospital in Longmatan District of Luzhou, Sichuan, People's Republic of China
| | - XiaoZhu Zhou
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
| | - Yu Xie
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
| | - Xin Zeng
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
| | - FangLin Shao
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
| | - Chi Zhang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, People's Republic of China
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Olisova O, Potapova M, Suvorov A, Koriakin D, Lepekhova A. Meta-analysis on the Efficacy of Platelet-rich Plasma in Patients with Androgenetic Alopecia. Int J Trichology 2023; 15:117-126. [PMID: 38765721 PMCID: PMC11098138 DOI: 10.4103/ijt.ijt_90_22] [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: 08/10/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 05/22/2024] Open
Abstract
Platelet-rich plasma (PRP) is an autologous platelet concentrate in plasma enriched with growth factors that may stimulate tissue regeneration, collagen formation, re-epithelization, and angiogenesis. PRP is widely used as an androgenetic alopecia treatment option. The present work aims to test the efficacy of various PRP methods, including those with single-spin and double-spin centrifugation. We performed a review of articles published from 2011 to 2021 in PubMed and ScienceDirect. The studies vary in the preparation procedure, dose, number, intervals between the procedures, and the injection technique because of low standardization of PRP preparation, complicating the evaluation of the clinical efficacy of the method. Based on the conducted statistical analysis, we came to the conclusion that the double-spin PRP preparation method was superior to the single-spin technique, which may be taken into account for AGA management.
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Affiliation(s)
- Olga Olisova
- Department of Dermatology and Venereology, Sechenov University, Moscow, Russia
| | - Mariia Potapova
- Department of Dermatology and Venereology, Sechenov University, Moscow, Russia
| | - Aleksandr Suvorov
- Centre for Analysis of Complex Systems, Research Center “Digital Biodesign and Personalized Healthcare,” Sechenov First Moscow State Medical University, Moscow, Russia
| | - Danila Koriakin
- Department of Dermatology and Venereology, Sechenov University, Moscow, Russia
| | - Anfisa Lepekhova
- Department of Dermatology and Venereology, Sechenov University, Moscow, Russia
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10
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Graca FA, Stephan A, Minden-Birkenmaier BA, Shirinifard A, Wang YD, Demontis F, Labelle M. Platelet-derived chemokines promote skeletal muscle regeneration by guiding neutrophil recruitment to injured muscles. Nat Commun 2023; 14:2900. [PMID: 37217480 DOI: 10.1038/s41467-023-38624-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
Skeletal muscle regeneration involves coordinated interactions between different cell types. Injection of platelet-rich plasma is circumstantially considered an aid to muscle repair but whether platelets promote regeneration beyond their role in hemostasis remains unexplored. Here, we find that signaling via platelet-released chemokines is an early event necessary for muscle repair in mice. Platelet depletion reduces the levels of the platelet-secreted neutrophil chemoattractants CXCL5 and CXCL7/PPBP. Consequently, early-phase neutrophil infiltration to injured muscles is impaired whereas later inflammation is exacerbated. Consistent with this model, neutrophil infiltration to injured muscles is compromised in male mice with Cxcl7-knockout platelets. Moreover, neo-angiogenesis and the re-establishment of myofiber size and muscle strength occurs optimally in control mice post-injury but not in Cxcl7ko mice and in neutrophil-depleted mice. Altogether, these findings indicate that platelet-secreted CXCL7 promotes regeneration by recruiting neutrophils to injured muscles, and that this signaling axis could be utilized therapeutically to boost muscle regeneration.
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Affiliation(s)
- Flavia A Graca
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Anna Stephan
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Benjamin A Minden-Birkenmaier
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
- Department of Oncology, Division of Molecular Oncology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Abbas Shirinifard
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Yong-Dong Wang
- Department of Cell and Molecular Biology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Fabio Demontis
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
| | - Myriam Labelle
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
- Department of Oncology, Division of Molecular Oncology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
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Kinoshita-Ise M, Fukuyama M, Ohyama M. Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases. J Clin Med 2023; 12:jcm12093259. [PMID: 37176700 PMCID: PMC10179687 DOI: 10.3390/jcm12093259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses revealed molecular mechanism underlying the disease susceptibility of hair loss conditions, such as androgenetic alopecia (AGA) and female pattern hair loss (FPHL). Hair loss attracted public interest during the COVID-19 pandemic. The knowledge of hair loss diseases is robustly expanding and thus requires timely updates. In this review, the diagnostic and measurement methodologies applied to hair loss diseases are updated. Of note, novel criteria and classification/scoring systems published in the last decade are reviewed, highlighting their advantages over conventional ones. Emerging diagnostic techniques are itemized with clinical pearls enabling efficient utilization. Recent advances in understanding the etiopathogenesis and management for representative hair diseases, namely AGA, FPHL, AA, and major primary cicatricial alopecia, including LPP, are comprehensively summarized, focusing on causative factors, genetic predisposition, new disease entity, and novel therapeutic options. Lastly, the association between COVID-19 and hair loss is discussed to delineate telogen effluvium as the predominating pathomechanism accounting for this sequela.
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Affiliation(s)
- Misaki Kinoshita-Ise
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Masahiro Fukuyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
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Balasundaram M, Kumari R, Ramassamy S. Efficacy of autologous Platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: A randomized open-label trial. J DERMATOL TREAT 2023; 34:2182618. [PMID: 36800229 DOI: 10.1080/09546634.2023.2182618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) is an adjunctive treatment in androgenetic alopecia (AGA). Its role as a monotherapy, when compared to FDA-approved therapies in moderate grades of androgenetic alopecia is not established. OBJECTIVES We sought to study the efficacy and safety of standardized non-activated PRP preparation against topical minoxidil in AGA. METHODS Men aged 20-50 with Grade III and IV (Modified Hamilton-Norwood) AGA were randomized to receive 5% Minoxidil (x6 months) or PRP injections (monthly x3). The primary endpoints were global photographic assessment at week 24, change in target area hair counts, density, and anagen hair at week 12. Other outcomes were subjects' satisfaction and adverse events. RESULTS In total, 64 participants were randomized. At week 24, 56% responded to Minoxidil arm and 38% to PRP (p= 0.124). There was a significant increase in target area hair count and density at week 12 within the groups. The difference between the groups was not statistically significant. Adverse events occurred in 53% and 37% of the PRP and minoxidil groups, respectively. Patient satisfaction was better with Minoxidil. CONCLUSION PRP is effective in the treatment of moderate grades of androgenetic alopecia in men, although perhaps not different from minoxidil. Side effects occur more frequently with PRP.
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Affiliation(s)
- Mithinkumar Balasundaram
- Dr. Mithinkumar Balasundaram, MD, Senior resident, Department of Dermatology, Venereology, and Leprosy, JIPMER, Pondicherry, India. E-mail:
| | - Rashmi Kumari
- Dr. Rashmi Kumari, MD, Professor, Department of Dermatology, Venereology, and Leprosy, JIPMER, Pondicherry, India. E-mail:
| | - Sivaranjini Ramassamy
- Dr.Sivaranjini Ramassamy, MD, Associate Professor, Department of Dermatology, Venereology, and Leprosy, JIPMER, Pondicherry, India. E-mail:
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Li C, Pan L, Yang L, Kong J, Zhang L. An umbrella review of the use of platelet-rich plasma in the treatment of androgenetic alopecia. J Cosmet Dermatol 2023; 22:1463-1476. [PMID: 36718799 DOI: 10.1111/jocd.15617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of androgenetic alopecia, as well as establish an effective treatment protocol and optimal PRP preparation procedure. METHODS We searched the PubMed, Scopus, Embase, Cochrane, CNKI, and Wanfang databases from inception to October 29, 2021, using PROSPERO's International Prospective Register of Systematic Reviews (registration ID: CRD42022295921). RESULTS The original literature search revealed 215 reviews; after duplication removal, 89 papers were eliminated, 95 were eliminated after reading the titles and abstracts, and eventually, 28 articles were included after reading the complete text. CONCLUSIONS PRP treatment for androgenetic alopecia is effective, and we recommend the following: (1) a PRP volume of at least 0.05 ml/cm2 , preferably 0.1 ml/cm2 ; (2) at least three consecutive treatments at an interval of 1 month; (3) intensive therapy is beneficial and can be provided from 3 to 6 months after continuous treatment; (4) objective indicators such as hair diameter, hair count; (5) long-term follow-up.
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Affiliation(s)
- Caihong Li
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Lingfeng Pan
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Liehao Yang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Jiao Kong
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Lianbo Zhang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
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Autologous Platelet-Rich Plasma (PRP) for Treating Androgenetic Alopecia: A Novel Treatment Protocol Standardized on 2 Cases. J Clin Med 2022; 11:jcm11247327. [PMID: 36555943 PMCID: PMC9787984 DOI: 10.3390/jcm11247327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Platelet-rich plasma (PRP) treatment has emerged in recent years as a valuable, effective, and affordable treatment for androgenetic alopecia. Androgenetic alopecia is the most common type of alopecia, affecting both men and women, and is characterized by diminished hair follicles mainly pronounced in the frontal region and vertex. A considerable variety of PRP treatment regimens have been described so far, but there is no consensus on the standardization of PRP preparation or administration protocol. Our study was conducted on two patients to test the efficacy of a new PRP application protocol of only two treatments by using a combination of a PRP collecting device and a conventional kit. Efficacy of treatment was assessed after a 6-month follow-up by artificial intelligence (AI)-driven software on microscopic images of treated regions. An average number of hairs, cumulative hair thickness, and the number of follicular units increased in the vertex region of both patients by 30/59%, 35/53%, and 14/48%, respectively. The novel treatment regimen showed significant effectiveness in only six months.
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Hetz SP, Martin J, Pototschnig H. Patient Satisfaction and Clinical Effects of Platelet-Rich Plasma on Pattern Hair Loss in Male and Female Patients. Cureus 2022; 14:e28801. [PMID: 36225399 PMCID: PMC9534340 DOI: 10.7759/cureus.28801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Hair loss is a widespread condition in both genders. Over the past decade, platelet-rich plasma (PRP) has become a common treatment for hair loss. Our goal was to analyze patient satisfaction and the clinical effects of PRP on male and female pattern hair loss. Methods Over a period of 12 months, we treated a total of 56 patients for androgenetic alopecia with PRP. All of these patients were included in this study; 15 cc of whole blood was spun in an ACP double syringe (Arthrex Inc., Naples, Forida) for five minutes. The yielded 5 to 6 cc of PRP were then injected into the scalp. Forty-nine patients were treated with a series of three injections at monthly intervals, three patients with a series of four injections, two patients with a series of five injections, one patient was treated with a series of seven injections, and one patient with a series of eight injections. Follow-ups were conducted one month after the last treatment. A self-drawn questionnaire was used to assess the satisfaction and clinical results from the patient's and the clinician's perspectives. Results The average age was 41 years (20-68 years). Fifty-seven percent of all patients were male and 43% female. In total, the patients were satisfied with the treatment results. The average score was 7.29 on a scale from 0 to 10. The clinician's rating was similar (6.46). Moreover, with an average score of 8 on a scale from 0 to 10, it is very likely that the patients will recommend PRP treatments to friends. The probability of occurrence of clinical effects among the entire study population was reported as follows: improvement in hair density (patient‘s rating: 64%; clinician's rating: 46%), thickness (38%; 45%), quality (46%; 54%), sheen/lustre (27%; 21%), new hair growth (57%; 68%), less hair loss (48%; 20%), other positive effects (5%, 2%), no effects (4%; 4%), negative effects (0%; 0%). Conclusion Our study revealed encouraging results for the treatment of male and female pattern hair loss with PRP. The autologous treatment was rated with high satisfaction scores and can be considered a safe and effective treatment modality.
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Gressenberger P, Kopera D. [Platelet-rich plasma (PRP) for the treatment of androgenetic alopecia (AGA): a review of the current literature]. Hautarzt 2022; 73:353-357. [PMID: 35364687 DOI: 10.1007/s00105-022-04979-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Platelet rich plasma (PRP) injections have been reported to be an effective and low side effect treatment for androgenetic alopecia (AGA). However, robust data concerning this therapy are lacking. AIM We address some potentially critical aspects of PRP treatment and give some reasons why study results may differ. MATERIALS AND METHODS In the following review we give a brief overview of the current literature and compare the results of the various trials. RESULTS In recent years, several clinical trials have been published that have revealed different but rather positive results, which offers hope to those affected by AGA and to physicians as well. However, the results were observed in methodologically weak trials and data from randomized controlled trials are lacking. Differences in trial designs have made it difficult to draw concrete conclusions about its clinical efficacy. Even in the studies where no hair-growth-promoting effect could be observed, the majority of subjects were at least satisfied with the result. The combination of several treatment approaches seems to lead to optimal improvement in hair growth. CONCLUSION There are many factors that could have influenced the results of the different studies. The results were observed in methodologically weak studies, giving reason for caution when drawing conclusions. Nevertheless, the majority of the subjects were at least satisfied with the result. Given the current low level of evidence, PRP treatments need to be further investigated in larger studies.
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Affiliation(s)
- P Gressenberger
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich.
| | - D Kopera
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich.
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Gupta AK, Bamimore MA. The effect of placebo in split-scalp and whole-head platelet-rich plasma trials for androgenetic alopecia differs: Findings from a systematic review with quantitative evidence syntheses. J Cosmet Dermatol 2022; 21:1454-1463. [PMID: 35100488 DOI: 10.1111/jocd.14813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Some studies have shown that platelet-rich plasma (PRP) improves androgenetic alopecia (AGA)-while others do not. We determined whether the placebo effect significantly varies between split-scalp and whole-head trials on PRP monotherapy for AGA. Our rationale was based on the plausibility of PRP diffusing to the control (i.e., 'placebo') side of split-scalp trials. This is not possible in whole head studies. METHODS We systematically searched the literature for available data. Our choice of analyses and outcomes were determined by the available data. RESULTS Our endpoint was change in total hair density six months after baseline. Our regression showed that total hair density after six months was significantly (p<0.05) higher in the placebo arm of split-scalp trials, compared to whole-head studies, by 37 hairs/cm2 . Our one-arm meta-analyses showed that the pooled change in total hair density between the PRP side and placebo side in split scalp studies was -3 hairs/cm2 (p=0.37), that is, a slight decrease in hair density in the placebo side of the scalp. For whole head stdies the corresponding difference in total hair density between patients receiving PRP and those on placebo was -30 hairs/cm2 (p=0.000017), that is, a much larger decrease in hair density. Patients in the placebo group in whole-head trials lost significantly more hair than in the placebo side of the split-head trials where hair loss was comparatively reduced-presumably because of PRP diffusing from the treatment side of the scalp. CONCLUSIONS The association between design (i.e., split-scalp vs. whole-head) and outcome, in placebo arms of AGA trials on PRP monotherapy, had never been reported. This 'design effect' could partly reconcile the incongruent conclusions across the PRP literature for AGA; furthermore, clinical guidelines can consider 'design effect' when selecting evidence to base care practices on.
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Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc, London, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
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Gentile P, Garcovich S. Systematic review: The platelet-rich plasma use in female androgenetic alopecia as effective autologous treatment of regenerative plastic surgery. J Plast Reconstr Aesthet Surg 2021; 75:850-859. [PMID: 34872877 DOI: 10.1016/j.bjps.2021.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 09/03/2021] [Accepted: 11/03/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The number of clinical trials evaluating platelet-rich plasma (PRP) efficacy in female androgenetic alopecia (F-AGA) has exponentially increased during the last five years. A systematic review focused on this specific field has been performed by assessing the local infiltrations of PRP compared with any control for F-AGA in the selected studies. OBJECTIVES The aim of this study was to evaluate the safety and efficacy of the use of PRP in F-AGA. METHODS The protocol was developed in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A multistep search of PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify papers on female pattern hair loss (FPHL) treatment with PRP. Of the 63 articles initially identified, 11 articles focusing on AGA were selected and, consequently, only 5 articles focused exclusively on F-AGA were analyzed. Of this amount, 3 articles were randomized-controlled trials (RCTs), 1 clinical trial, and 1 double-blind placebo-controlled pilot study (DBPCPS). The studies included had to match predetermined criteria according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach. RESULTS Eight percent of the articles selected and analyzed, reported a positive effect of PRP for F-AGA treatment. The information analyzed highlights the positive effects of PRP on F-AGA, without major side effects and thus, it may be considered as a safe and effective alternative procedure to treat hair loss compared with traditional drugs as Minoxidil® and Finasteride®. CONCLUSIONS The use of PRP in F-AGA was safe and effective for F-AGA.
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Affiliation(s)
- Pietro Gentile
- Associate Professor of Plastic and Reconstructive Surgery, Department of Surgical Science, "Tor Vergata" University, 00173, Via Montpellier 1, Rome 00133, Italy; Scientific Director of Academy of International Regenerative Medicine and Surgery Societies (AIRMESS), Geneva 1201, Switzerland.
| | - Simone Garcovich
- Institute of Dermatology, F. Policlinico Gemelli IRCSS, Università Cattolica del Sacro Cuore, Rome 00168 Italy
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Abellan Lopez M, Magalon J, Magalon G. Commentary on: What Is the Adequate PRP Dose for an Effective Treatment? An In Vitro Experimental Study on the Skin. Aesthet Surg J 2021; 41:NP902-NP904. [PMID: 33765113 DOI: 10.1093/asj/sjaa403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Jérémy Magalon
- Cell Therapy Department, Hôpital de la Conception, INSERM CIC BT 1409, Marseille, France
| | - Guy Magalon
- Cell Therapy Department, Hôpital de la Conception, INSERM CIC BT 1409, Marseille, France
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Zhou LB, Cao Q, Ding Q, Sun WL, Li ZY, Zhao M, Lin XW, Zhou GP, Fan WX. Transcription factor FOXC1 positively regulates SFRP1 expression in androgenetic alopecia. Exp Cell Res 2021; 404:112618. [PMID: 33965401 DOI: 10.1016/j.yexcr.2021.112618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 11/19/2022]
Abstract
Androgenetic alopecia (AGA) is the most common type of hair loss dysfunction. Secreted frizzled related protein 1 (SFRP1) is found to be associated with hair loss, but its role in AGA and the regulation mechanism of its transcription level is unclear. The aim of our study is to explore the expression of SFRP1 in AGA samples and its transcriptional mechanism. Male frontal and occipital scalp hair follicles from AGA patients were collected, and human dermal papilla cells (DPCs) were isolated and cultured. SFRP1 gene was cloned and constructed into recombinant plasmids to perform dual-luciferase reporter assay. Transcription factor binding sites were predicted through the Jaspar website and further confirmed by the chromatin immunoprecipitation (ChIP) assay. Expression of genes in DPCs was determined by immunofluorescence (IF) staining, quantitative real-time PCR (qRT-PCR) and western blotting. Our findings showed that SFRP1 was highly expressed in DPCs of AGA patients. The core promoter region of SFRP1 was from -100 to +50 bp and was found to be positively regulated by forkhead box C1 (FOXC1), a transcription factor related to hair growth, both at mRNA and protein level in DPCs. Our study suggests that FOXC1 plays an important role in regulating SFRP1 transcription, which may provide new insights into the development of therapeutic strategies for the treatment of AGA.
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Affiliation(s)
- Lan-Bo Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Qian Cao
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Qi Ding
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Wei-Ling Sun
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Zhi-Yu Li
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Min Zhao
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Xue-Wen Lin
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Guo-Ping Zhou
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Wei-Xin Fan
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
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Zhou S, Qi F, Gong Y, Zhang C, Zhao S, Yang X, He Y. Platelet-Rich Plasma in Female Androgenic Alopecia: A Comprehensive Systematic Review and Meta-Analysis. Front Pharmacol 2021; 12:642980. [PMID: 34140889 PMCID: PMC8204330 DOI: 10.3389/fphar.2021.642980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/19/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction: The population of young women who suffered from female pattern hair loss (FPHL) or female androgenic alopecia (AGA) is gradually increasing. Platelet-rich plasma is a novel and promising therapeutic method as a nonsurgical treatment for FPHL. Objective: To summarize different preparation methods of PRP and treatment regimes in FPHL, qualitatively evaluate the current observations, and quantitively analyze the efficacy of PRP in FPHL treatment. Methods: Six databases, MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, LILACS, and CNKI, were searched with terms "platelet-rich plasma," synonyms for AGA and FPHL. Meta-analysis was conducted with enrolled observational studies and randomized controlled trials separately. Results: We evaluated 636 studies and 12 trials from all searched databases. A total of 42 studies of 1,569 cases, including 776 female participants covering 16 randomized controlled trials and 26 observational trials, were included for qualitative synthesis study and systematic review. PRP showed positive efficacy in treating FPHL in hair density compared to the control groups with odds ratio (OR) 1.61, 95% CI 0.52-2.70, and compared to baseline with OR 1.11, 95% CI 0.86-1.37. Conclusion: PRP showed excellent efficiency as a novel therapy of FPHL through hair density evaluation. Further studies are needed to define standardized protocols, and large-scale randomized trials still need to be conducted to confirm its efficacy.
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Affiliation(s)
- Shuying Zhou
- Department of Dermatology, The 305 Hospital of PLA, Xicheng, China
| | - Fei Qi
- Capital Medical University, Beijing Chaoyang Hospital, Beijing, China
| | - Yue Gong
- Department of Dermatology, The 305 Hospital of PLA, Xicheng, China
| | - Chenxi Zhang
- Department of Dermatology, The 305 Hospital of PLA, Xicheng, China
| | - Siqi Zhao
- Capital Medical University, Beijing Chaoyang Hospital, Beijing, China
| | - Xutong Yang
- Capital Medical University, Beijing Chaoyang Hospital, Beijing, China
| | - Yanling He
- Capital Medical University, Beijing Chaoyang Hospital, Beijing, China
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Roohaninasab M, Goodarzi A, Ghassemi M, Sadeghzadeh-Bazargan A, Behrangi E, Najar Nobari N. Systematic review of platelet-rich plasma in treating alopecia: Focusing on efficacy, safety, and therapeutic durability. Dermatol Ther 2021; 34:e14768. [PMID: 33421285 DOI: 10.1111/dth.14768] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/12/2020] [Accepted: 12/31/2020] [Indexed: 02/06/2023]
Abstract
Considering the different forms, alopecia could be a very common condition with particular therapeutic concerns; thus, recent therapies still require further assessments. Aim of this systematic review was to evaluate efficacy, safety, and therapeutic durability of platelet rich plasma (PRP) in treating various forms of alopecia. A total of 64 articles were found through a systematic search, and eight original articles were included in the study, based on inclusion/exclusion criteria. In most studies (62.5%) patients' conditions had improved by receiving PRP therapy; these cases experienced an increase in growth and thickness of hair. Simultaneous use of PRP and Minoxidil demonstrated the highest rate of improvement and satisfaction. The highest efficacy in patients with alopecia areata was 76% and the lowest efficacy was 31.7% and in patients with androgenetic alopecia the highest efficacy was 42.75% and the lowest reported efficacy was 25.55%. The main side effect was pain due to PRP injection, which disappeared after ending the treatment and only one article reported more serious side effects. Recurrence after treatment was also reported in only one article. PRP is a safe and easy method for treating hair loss and has limited adverse effects. Optimization of this method depends on dosage, number of sessions and their intervals, and injection techniques. According to the results, the use of PRP due to its relatively high efficiency, low and tolerable side effects, and low recurrence rate can be a good method for the treatment of alopecia and hair loss.
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Affiliation(s)
- Masoumeh Roohaninasab
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Ghassemi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | | | - Elham Behrangi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Najar Nobari
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
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Sharma A, Chouhan K, Bhatia S, Dashore S. Platelet-rich plasma in androgenetic alopecia. Indian Dermatol Online J 2021; 12:S31-S40. [PMID: 34976879 PMCID: PMC8664169 DOI: 10.4103/idoj.idoj_328_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/13/2021] [Accepted: 07/21/2021] [Indexed: 12/05/2022] Open
Abstract
The goal of these recommendations is to provide a framework to practitioners for implementing useful, evidence-based recommendations for the preparation of platelet-rich plasma (PRP) and its use in androgenetic alopecia (AGA). The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these recommendations to its taskforce on PRP. A comprehensive literature search was done in the English language on the PRP across multiple databases. The grade of evidence and strength of recommendation were evaluated on the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) framework. A draft of clinical recommendations was developed on the best available evidence, which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, the final consensus statement was prepared. A total of 30 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], and case series) were critically evaluated, and the evidence thus gathered was used in the preparation of these recommendations. This expert group recommends use of manual double-spin method for the preparation of PRP for AGA. Minimum three to five sessions of PRP are recommended for AGA with a gap of 1 month between the two sessions. Patients with Grade II to V Norwood Hamilton classification of AGA are the ideal subset for PRP. A total of 5 to 7 mL of PRP and 0.05 to 0.1 mL/cm2 is the recommended dose of PRP for AGA. Activation of PRP is not required when it is used for AGA. About 1 to 1.5 million platelets/μL of platelets in PRP is the recommended platelet concentration in PRP for the treatment of AGA. I-PRF (injectable platelet-rich fibrin) has also been found to be useful in AGA, although further studies are required to establish its role. PRP can also have an adjunctive role in hair transplantation procedures.
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Andia I, Perez-Valle A, Del Amo C, Maffulli N. Freeze-Drying of Platelet-Rich Plasma: The Quest for Standardization. Int J Mol Sci 2020; 21:ijms21186904. [PMID: 32962283 PMCID: PMC7555364 DOI: 10.3390/ijms21186904] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023] Open
Abstract
The complex biology of platelets and their involvement in tissue repair and inflammation have inspired the development of platelet-rich plasma (PRP) therapies for a broad array of medical needs. However, clinical advances are hampered by the fact that PRP products, doses and treatment protocols are far from being standardized. Freeze-drying PRP (FD-PRP) preserves platelet function, cytokine concentration and functionality, and has been proposed as a consistent method for product standardization and fabrication of an off-the-shelf product with improved stability and readiness for future uses. Here, we present the current state of experimental and clinical FD-PRP research in the different medical areas in which PRP has potential to meet prevailing medical needs. A systematic search, according to PRISMA (Preferred Reported Items for Systematic Reviews and Meta-Analyses) guidelines, showed that research is mostly focused on wound healing, i.e., developing combination products for ulcer management. Injectable hydrogels are investigated for lumbar fusion and knee conditions. In dentistry, combination products permit slow kinetics of growth factor release and functionalized membranes for guided bone regeneration.
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Affiliation(s)
- Isabel Andia
- Bioprinting Laboratory, Regenerative Therapies, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Plaza Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (A.P.-V.); (C.D.A.)
- Correspondence: ; Tel.: +34-609419897 or +34-946007964
| | - Arantza Perez-Valle
- Bioprinting Laboratory, Regenerative Therapies, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Plaza Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (A.P.-V.); (C.D.A.)
| | - Cristina Del Amo
- Bioprinting Laboratory, Regenerative Therapies, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Plaza Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (A.P.-V.); (C.D.A.)
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentristry, 84084 Salerno, Italy;
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London E1 4DG, UK
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Pakhomova EE, Smirnova IO. Comparative Evaluation of the Clinical Efficacy of PRP-Therapy, Minoxidil, and Their Combination with Immunohistochemical Study of the Dynamics of Cell Proliferation in the Treatment of Men with Androgenetic Alopecia. Int J Mol Sci 2020; 21:ijms21186516. [PMID: 32899959 PMCID: PMC7555524 DOI: 10.3390/ijms21186516] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 02/01/2023] Open
Abstract
Platelet-rich plasma (PRP) therapy has been considered as a promising treatment for androgenetic alopecia (AGA). The aim of the study was comparative evaluation of the clinical efficacy of PRP-therapy, minoxidil, and their combination in the treatment of men with AGA and to evaluate the effects of PRP on the proliferation of hair follicle (HF) cells in skin biopsy. MATERIALS AND METHODS The study involved 69 men who were divided into 3 groups who received PRP therapy, minoxidil, and their combination. The clinical efficacy of the therapy was evaluated by the dynamics of morphometric of hairs. To assess cell proliferation antibodies to β-catenin, CD34, Ki67, and to Dkk-1 were used. RESULTS PRP treatment was more effective than minoxidil therapy (p = 0.005). Complex therapy turned out to be more effective than minoxidil monotherapy (p < 0.0001) and PRP monotherapy (p = 0.007). After applying PRP the absolute and relative values of the β-catenin and CD34 expression area increased; an increase in Ki67+ index was also significant. CONCLUSIONS PRP can be considered as a treatment option for AGA. Combined PRP and minoxidil use seems promising for the treatment of AGA. PRP increase in the proliferative activity of HF cells and improves hair morphology in patients with AGA.
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Affiliation(s)
- Elena E. Pakhomova
- Department of Infectious Diseases, Epidemiology and Dermatovenereology, St. Petersburg State University, 199034 St. Petersburg, Russia;
- Thichology Center of Hair Treatment, 191123 St. Petersburg, Russia
- Correspondence: ; Tel.: +7-921-932-3341
| | - Irina O. Smirnova
- Department of Infectious Diseases, Epidemiology and Dermatovenereology, St. Petersburg State University, 199034 St. Petersburg, Russia;
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