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Garcia CSC, Garcia PMC, Santos OBAF, Steffens D, Martins ST, Pranke P, Crespo JS, Henriques JAP, Roesch-Ely M. Red propolis extract associated to platelet-rich plasma and stromal cells with focus in cell therapy and functional tissue regeneration. AN ACAD BRAS CIENC 2024; 96:e20240100. [PMID: 39166613 DOI: 10.1590/0001-3765202420240100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/11/2024] [Indexed: 08/23/2024] Open
Abstract
The use of platelet-rich plasma (PRP) and adipose-derived stromal cells (ADSC) have been investigated as a form of wound healing enhancement. The objective of this work was to evaluate the association of red propolis (RP) and PRP as inducers of ADSC for application in tissue regeneration. Adipose tissue post-collection and post-cryopreservation was isolated with type II collagenase, characterized by flow cytometry, and differentiated into osteogenic, chondrogenic and adipose cell. The viability of ADSC was evaluated when exposed to different concentrations of RP using the MTT and trypan blue assay. Acridine orange and ethidium bromide (AO/EB) was performed to evaluate cell death events. Horizontal migration methods were investigated in ADSC using autologous and homologous PRP associated with RP (PRP/RP). All assays were processed in triplicate. Flow cytometry and cellular differentiation showed that type II collagenase was effective for isolating ADSC post-collection and post-cryopreservation. RP extracts at concentrations of up to 50 μg.mL-1 presented no cytotoxic effects. Association of PRP and RP at 25 and 50 μg.ml-1 influenced ADSC migration, with total closure on the seventh day after exposition. The results here presented could stimulate proliferation of ADSC cells that may contribute directly or indirectly to the reconstructive process of tissue regeneration.
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Affiliation(s)
- Charlene S C Garcia
- Universidade de Caxias do Sul, Institute of Biotechnology, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
| | - Paulo Miguel C Garcia
- Universidade de Caxias do Sul, Institute of Biotechnology, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
- Brazilian Society of Plastic Surgery - SBCP, Rua Funchal 129, 2º andar, Vila Olímpia, 04551-060 São Paulo, SP, Brazil
| | - Otávio B A F Santos
- Brazilian Society of Anesthesiology - SBA, Rua Prof. Alfredo Gomes, 36, Botafogo, 22251-080 Rio de Janeiro, RJ, Brazil
| | - Daniela Steffens
- Universidade de Caxias do Sul, Institute of Biotechnology, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
| | - Sandro T Martins
- Universidade de Caxias do Sul, Area of Knowledge of Exact Sciences and Engineering, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
| | - Patricia Pranke
- Universidade Federal do Rio Grande do Sul, Hematology and Stem Cell Laboratory, Faculty of Pharmacy, Av. Ipiranga, 2752, Azenha, 90610-000 Porto Alegre, RS, Brazil
- Stem Cell Research Institute, R. dos Andradas, 1464 - Conj 133, Centro Histórico, 90050-170 Porto Alegre, RS, Brazil
| | - Janaína S Crespo
- Universidade de Caxias do Sul, Area of Knowledge of Exact Sciences and Engineering, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
| | - João Antonio P Henriques
- Universidade de Caxias do Sul, Institute of Biotechnology, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
| | - Mariana Roesch-Ely
- Universidade de Caxias do Sul, Institute of Biotechnology, Rua Francisco Getúlio Vargas 1130, Petrópolis, 95070-560 Caxias do Sul, RS, Brazil
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Pozo-Pérez L, Tornero-Esteban P, López-Bran E. Clinical and preclinical approach in AGA treatment: a review of current and new therapies in the regenerative field. Stem Cell Res Ther 2024; 15:260. [PMID: 39148125 PMCID: PMC11328498 DOI: 10.1186/s13287-024-03801-5] [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: 04/26/2024] [Accepted: 06/11/2024] [Indexed: 08/17/2024] Open
Abstract
Androgenetic alopecia (AGA) is the most prevalent type of hair loss. Its morbility is mainly psychological although an increased incidence in melanoma has also been observed in affected subjects. Current drug based therapies and physical treatments are either unsuccessful in the long term or have relevant side effects that limit their application. Therefore, a new therapeutic approach is needed to promote regenerative enhancement alternatives. These treatment options, focused on the cellular niche restoration, could be the solution to the impact of dihydrotestosterone in the hair follicle microenvironment. In this context emerging regenerative therapies such as Platelet-rich plasma or Platelet-rich fibrine as well as hair follicle stem cells and mesenchymal stem cell based therapies and their derivatives (conditioned medium CM or exoxomes) are highlighting in the evolving landscape of hair restoration. Nanotechnology is also leading the way in AGA treatment through the design of bioinks and nanobiomaterials whose structures are being configuring in a huge range of cases by means of 3D bioprinting. Due to the increasing number and the rapid creation of new advanced therapies alternatives in the AGA field, an extended review of the current state of art is needed. In addition this review provides a general insight in current and emerging AGA therapies which is intented to be a guidance for researchers highlighting the cutting edge treatments which are recently gaining ground.
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Affiliation(s)
- Lorena Pozo-Pérez
- Dermatology Department, Clínico San Carlos Hospital, Madrid, Spain.
- Institute for Health Research of Clinico San Carlos Hospital (IdISSC), Madrid, Spain.
| | - Pilar Tornero-Esteban
- Cellular GMP Manufacturing Facility, Institute for Health Research of Clinico San Carlos Hospital (IdISSC), Madrid, Spain
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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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Santos LC, Lana GL, Santos GS, Visoni SBC, Brigagão RJ, Santos N, Sobreiro R, da Cruz Silva Reis A, Rodrigues BL, Ferrari S, Tambeli CH, Lana JF. The Biological Role of Platelet Derivatives in Regenerative Aesthetics. Int J Mol Sci 2024; 25:5604. [PMID: 38891792 PMCID: PMC11172268 DOI: 10.3390/ijms25115604] [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: 04/24/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Bioproducts derived from platelets have been extensively used across various medical fields, with a recent notable surge in their application in dermatology and aesthetic procedures. These products, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), play crucial roles in inducing blood vessel proliferation through growth factors derived from peripheral blood. PRP and PRF, in particular, facilitate fibrin polymerization, creating a robust structure that serves as a reservoir for numerous growth factors. These factors contribute to tissue regeneration by promoting cell proliferation, differentiation, and migration and collagen/elastin production. Aesthetic medicine harnesses these effects for diverse purposes, including hair restoration, scar treatment, striae management, and wound healing. Furthermore, these biological products can act as adjuvants with other treatment modalities, such as laser therapy, radiofrequency, and microneedling. This review synthesizes the existing evidence, offering insights into the applications and benefits of biological products in aesthetic medicine.
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Affiliation(s)
| | - Giselle Lobo Lana
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Gabriel Silva Santos
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Silvia Beatriz Coutinho Visoni
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Rayssa Junqueira Brigagão
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Napoliane Santos
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Rafaela Sobreiro
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Andreza da Cruz Silva Reis
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Bruno Lima Rodrigues
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Sabrina Ferrari
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | | | - José Fábio Lana
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
- Medical School, Max Planck University Center (UniMAX), Indaiatuba 13343-060, Brazil
- Regenerative Medicine, Orthoregen International Course, Indaiatuba 13334-170, Brazil
- Clinical Research, Anna Vitória Lana Institute (IAVL), Indaiatuba 13334-170, Brazil
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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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6
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Rosenthal A, Conde G, Greco JF, Gharavi NM. Management of androgenic alopecia: a systematic review of the literature. J COSMET LASER THER 2024; 26:1-16. [PMID: 38852607 DOI: 10.1080/14764172.2024.2362126] [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: 01/08/2024] [Revised: 06/01/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
We aimed to determine the efficacy of the various available oral, topical, and procedural treatment options for hair loss in individuals with androgenic alopecia. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the National Library of Medicine was performed. Overall, 141 unique studies met our inclusion criteria. We demonstrate that many over the counter (e.g. topical minoxidil, supplements, low-level light treatment), prescription (e.g. oral minoxidil, finasteride, dutasteride), and procedural (e.g. platelet-rich plasma, fractionated lasers, hair transplantation) treatments successfully promote hair growth, highlighting the superiority of a multifaceted and individualized approach to management.
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Affiliation(s)
- Amanda Rosenthal
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Geena Conde
- Department of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph F Greco
- Department of Research, Greco Hair Restoration, Sarasota, FL, USA
| | - Nima M Gharavi
- Department of Dermatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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7
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Gupta AK, Wang T, Bamimore MA, Polla Ravi S, Talukder M. Relative Effects of Minoxidil 5%, Platelet-Rich Plasma, and Microneedling in Pattern Hair Loss: A Systematic Review and Network Meta-Analysis. Skin Appendage Disord 2023; 9:397-406. [PMID: 38058547 PMCID: PMC10697753 DOI: 10.1159/000534196] [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: 05/24/2023] [Accepted: 09/18/2023] [Indexed: 12/08/2023] Open
Abstract
Background Combination treatments may improve the utility of approved agents for the treatment of pattern hair loss (PHL); however, head-to-head comparisons are lacking. Objective The aim of the study was to compare the efficacy of 5% minoxidil, platelet-rich plasma (PRP), and microneedling across adults with PHL insofar as change in total hair density at 24 weeks. Methods We conducted a literature search in July 2022. Through our Bayesian network meta-analysis, we estimated treatments' surface under the cumulative ranking distribution (SUCRA) values and relative effects - in terms of mean difference (MD). Results Data from 27 trials, totaling 1,110 patients, were extracted. Interventions were ranked based on the probability of inducing hair density improvements: 5% minoxidil plus microneedling (SUCRA = 95.8%), 5% minoxidil plus PRP (SUCRA = 64.7%), 5% minoxidil (SUCRA = 53.9%), PRP (SUCRA = 34.9%), microneedling (SUCRA = 27.8%), and PRP with microneedling (SUCRA = 22.9%). The efficacy of 5% minoxidil plus microneedling in improving total hair density was significantly greater (p < 0.05) than 5% minoxidil monotherapy (MD = 13 hairs/cm2), PRP monotherapy (MD = 16 hairs/cm2), and microneedling monotherapy (MD = 17 hairs/cm2). Conclusion Five percent minoxidil plus microneedling is an effective treatment option for improving hair density at 6 months in adult PHL patients.
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Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc., London, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tong Wang
- Mediprobe Research Inc., London, ON, Canada
| | | | | | - Mesbah Talukder
- Mediprobe Research Inc., London, ON, Canada
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
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Pixley JN, Cook MK, Singh R, Larrondo J, McMichael AJ. A comprehensive review of platelet-rich plasma for the treatment of dermatologic disorders. J DERMATOL TREAT 2023; 34:2142035. [PMID: 36318219 DOI: 10.1080/09546634.2022.2142035] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Platelet-rich plasma (PRP) offers anti-inflammatory and regenerative properties through angiogenesis, cell differentiation, and proliferation. Although studied in many dermatologic conditions, its efficacy is not well-understood. Our objective is to review the use and effectiveness of PRP for dermatologic conditions. A literature search was performed through PubMed and yielded 54 articles published between January 2000 and November 2021; articles written in English were reviewed. Intradermal injections were associated with increased hair density in androgenic alopecia. Successful treatment of inflammatory nail diseases with PRP has been reported. Improvement in psoriasis was described, but only two studies were available. PRP was associated with higher patient self-assessment scores of photoaging and fine lines. Treatment with PRP in melasma has been associated with improved subjective satisfaction, but not with objective measures of disease improvement. PRP can serve as a safe and potentially effective adjunct for hair loss, vitiligo, nonhealing wounds, photoaging, and acne scars. An important barrier to interpreting PRP research is lack of standardization of PRP preparation protocols, inconsistent clinical endpoints, and frequent combination treatments. However, PRP is relatively noninvasive, has a well-established safety profile, and patient satisfaction is often high as patients perceive great benefit from treatment with PRP.
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Affiliation(s)
- Jessica N Pixley
- Wake Forest Department of Dermatology, Medical Center Boulevard, Winston-Salem, NC, USA
| | - Madison K Cook
- Wake Forest Department of Dermatology, Medical Center Boulevard, Winston-Salem, NC, USA
| | - Rohan Singh
- Wake Forest Department of Dermatology, Medical Center Boulevard, Winston-Salem, NC, USA
| | - Jorge Larrondo
- Wake Forest Department of Dermatology, Medical Center Boulevard, Winston-Salem, NC, USA
| | - Amy J McMichael
- Wake Forest Department of Dermatology, Medical Center Boulevard, Winston-Salem, NC, USA
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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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Guan Q, Guo ZH, Dai DM, Fan ZX, Chen J, Wu SL, Liu XM, Miao Y, Hu ZQ, Qu Q. Platelet lysate promotes hair growth: In vitro and in vivo mechanism and randomized, controlled trial. Biomed Pharmacother 2023; 161:114517. [PMID: 36913893 DOI: 10.1016/j.biopha.2023.114517] [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: 01/01/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Platelet lysate (PL), a novel platelet derivative, has been widely used in regenerative medicine and is a potential therapy for improving hair growth. It is necessary to fully clarify the potential mechanism and evaluate preliminary clinical effect of PL on hair growth. METHODS We used the C57BL/6 model, organ-cultured hair follicles, and RNA-seq analysis to explore the mechanisms of PL regulating hair growth. Then, we performed a randomized, controlled, double-blind study of 107 AGA patients to verify the therapeutic efficacy of PL. RESULTS The results confirmed that PL improved hair growth and accelerated hair cycling in mice. Organ-cultured hair follicle evaluation confirmed that PL prolonged anagen remarkably and down-regulated IL-6, C-FOS, and p-STAT5a. Clinically, diameter, hair counts, absolute anagen counts and changes from baseline in the PL group showed a significant improvement at 6 months. CONCLUSIONS We elucidated the specific molecular mechanism of PL action on hair growth and proved equal changes in hair follicle performance after PL vs PRP in AGA patients. This study provided novel knowledge of PL, making it ideal for AGA.
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Affiliation(s)
- Qing Guan
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China; Department of Plastic and Aesthetic Surgery, Guiyang First People's Hospital, Guiyang, China
| | - Ze-Hong Guo
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China
| | - Da-Mao Dai
- Department of Plastic and Cosmetic Surgery, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University Medical College, 1st Affiliated Hospital of Southern University of Science and Technology, China
| | - Zhe-Xiang Fan
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China
| | - Jian Chen
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China
| | - Shu-Lin Wu
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Min Liu
- Department of Plastic and Aesthetic Surgery, clifford-hospital, Guangzhou, China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China.
| | - Zhi-Qi Hu
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China.
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery, Nan Fang Hospital, Southern Medical University, Guangzhou, China.
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11
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Yue Z, Yang F, Zhang J, Li J, Chuong CM. Regulation and dysregulation of hair regeneration: aiming for clinical application. CELL REGENERATION (LONDON, ENGLAND) 2022; 11:22. [PMID: 35773427 PMCID: PMC9247129 DOI: 10.1186/s13619-022-00122-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Hair growth and regeneration represents a remarkable example of stem cell function. Recent progress emphasizes the micro- and macro- environment that controls the regeneration process. There is a shift from a stem cell-centered view toward the various layers of regulatory mechanisms that control hair regeneration, which include local growth factors, immune and neuroendocrine signals, and dietary and environmental factors. This is better suited for clinical application in multiple forms of hair disorders: in male pattern hair loss, the stem cells are largely preserved, but androgen signaling diminishes hair growth; in alopecia areata, an immune attack is targeted toward the growing hair follicle without abrogating its regeneration capability. Genome-wide association studies further revealed the genetic bases of these disorders, although the precise pathological mechanisms of the identified loci remain largely unknown. By analyzing the dysregulation of hair regeneration under pathological conditions, we can better address the complex interactions among stem cells, the differentiated progeny, and mesenchymal components, and highlight the critical role of macroenvironment adjustment that is essential for hair growth and regeneration. The poly-genetic origin of these disorders makes the study of hair regeneration an interesting and challenging field.
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Affiliation(s)
- Zhicao Yue
- Department of Cell Biology and Medical Genetics, International Cancer Center, and Guangdong Key Laboratory for Genome Instability and Disease Prevention, Shenzhen University, A7-455 XiLi Campus, Shenzhen, 518060, Guangdong, China.
| | - Fang Yang
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Jianglin Zhang
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Cheng-Ming Chuong
- Department of Pathology, University of Southern California, Los Angeles, CA, USA
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12
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Abdin R, Zhang Y, Jimenez JJ. Treatment of Androgenetic Alopecia Using PRP to Target Dysregulated Mechanisms and Pathways. Front Med (Lausanne) 2022; 9:843127. [PMID: 35372424 PMCID: PMC8965895 DOI: 10.3389/fmed.2022.843127] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/14/2022] [Indexed: 11/19/2022] Open
Abstract
Androgenetic alopecia (“AGA”) is the most prevalent type of progressive hair loss, causing tremendous psychological and social stress in patients. However, AGA treatment remains limited in scope. The pathogenesis of androgenetic alopecia is not completely understood but is known to involve a hair follicle miniaturization process in which terminal hair is transformed into thinner, softer vellus-like hair. This process is related to the dysregulation of the Wnt/β-catenin signaling pathway, which causes premature termination of the anagen growth phase in hair follicles. Historically used for wound healing, platelet rich plasma (“PRP”) has recently been at the forefront of potential AGA treatment. PRP is an autologous preparation of plasma that contains a high number of platelets and their associated growth factors such as EGF, IGF-1, and VEGF. These factors are known to individually play important roles in regulating hair follicle growth. However, the clinical effectiveness of PRP is often difficult to characterize and summarize as there are wide variabilities in the PRP preparation and administration protocols with no consensus on which protocol provides the best results. This study follows the previous review from our group in 2018 by Cervantes et al. to analyze and discuss recent clinical trials using PRP for the treatment of AGA. In contrast to our previous publication, we include recent clinical trials that assessed PRP in combination or in direct comparison with standard of care procedures for AGA such as topical minoxidil and/or oral finasteride. Overall, this study aims to provide an in-depth analysis of PRP in the treatment of AGA based on the evaluation of 17 recent clinical trials published between 2018 and October 2021. By closely examining the methodologies of each clinical trial included in our study, we additionally aim to provide an overall consensus on how PRP can be best utilized for the treatment of AGA.
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Affiliation(s)
- Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Yusheng Zhang
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
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13
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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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14
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Zhang Y, Huang J, Fu D, Liu Z, Wang H, Wang J, Qu Q, Li K, Fan Z, Hu Z, Miao Y. Transcriptome Analysis Reveals an Inhibitory Effect of Dihydrotestosterone-Treated 2D- and 3D-Cultured Dermal Papilla Cells on Hair Follicle Growth. Front Cell Dev Biol 2021; 9:724310. [PMID: 34604224 PMCID: PMC8484716 DOI: 10.3389/fcell.2021.724310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
Dermal papillae are a target of androgen action in patients with androgenic alopecia, where androgen acts on the epidermis of hair follicles in a paracrine manner. To mimic the complexity of the dermal papilla microenvironment, a better culture model of human dermal papilla cells (DPCs) is needed. Therefore, we evaluated the inhibitory effect of dihydrotestosterone (DHT)-treated two-dimensional (2D)- and 3D-cultured DPCs on hair follicle growth. 2D- and 3D-cultured DPC proliferation was inhibited after co-culturing with outer root sheath (ORS) cells under DHT treatment. Moreover, gene expression levels of β-catenin and neural cell adhesion molecules were significantly decreased and those of cleaved caspase-3 significantly increased in 2D- and 3D-cultured DPCs with increasing DHT concentrations. ORS cell proliferation also significantly increased after co-culturing in the control-3D model compared with the control-2D model. Ki67 downregulation and cleaved caspase-3 upregulation in DHT-treated 2D and 3D groups significantly inhibited ORS cell proliferation. Sequencing showed an increase in the expression of genes related to extracellular matrix synthesis in the 3D model group. Additionally, the top 10 hub genes were identified, and the expression of nine chemokine-related genes in DHT-treated DPCs was found to be significantly increased. We also identified the interactions between transcription factor (TF) genes and microRNAs (miRNAs) with hub genes and the TF-miRNA coregulatory network. Overall, the findings indicate that 3D-cultured DPCs are more representative of in vivo conditions than 2D-cultured DPCs and contribute to our understanding of the molecular mechanisms underlying androgen-induced alopecia.
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Affiliation(s)
- Yufan Zhang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Junfei Huang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Danlan Fu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Zhen Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Hailin Wang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Jin Wang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Kaitao Li
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Zhexiang Fan
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
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