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

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.

Evidence from a humanized mouse model of androgenetic alopecia that platelet‐rich plasma stimulates hair regrowth, hair shaft diameter and vellus‐to‐terminal hair reconversion in vivo

“…18 of 24 xenografts), while the xenografts of two patients were unresponsive to autologous PRP treatment. This corresponds very well to the highly variable outcome of PRP treatment during AGA management seen in clinical practice 2,5,6 . Thus, the current humanized AGA mouse model may provide an excellent preclinical research tool for elucidating the as yet entirely unknown molecular basis of what distinguishes PRP responders from nonresponders.…”

“…Dear Editor , Xenografts of scalp skin from patients with androgenetic alopecia (AGA) on immunocompromised mice provide an excellent preclinical research system for testing candidate AGA therapeutics under clinically relevant conditions in vivo 1 . Therefore, we sought to determine, in a further refined version of this humanized AGA mouse model, whether autologous platelet‐rich plasma (PRP), which has been used increasingly for AGA management, 2 significantly impacts on the two aspects of AGA that are critical for the therapeutic outcome: (i) the anagen/telogen ratio and (ii) reconversion of the vellus into terminal scalp hair follicles (HFs) 3 …”

“…On day 30 following xenotransplantation, the mice were divided into two groups that received once‐monthly intradermal autologous PRP injections for a total of 4 months: eight control mice received nonactivated PRP (without CaCl 2 ), while eight test mice were injected with CaCl 2 ‐activated PRP (100 μL PRP/xenograft, total number of grafts per group = 24). Autologous PRP was prepared following a standardized protocol 2 without the use of commercial PRP kits. Xenografts were harvested 120 days after the first PRP injection, and processed for quantitative hair‐cycle histomorphometry and immunohistomorphometry for Ki‐67 and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) to measure proliferation/apoptosis of hair matrix keratinocytes in situ .…”

Optimal use of topical minoxidil in management of female pattern hair loss in India: an expert opinion

“…• After 17 weeks, significantly less grafted hair was lost by minoxidil-treated patients versus placebotreated patients (22% versus 52%; p=0.001). 39 PRP combined with 5% minoxidil…”

Clinical Assessment of the Therapeutic Options for Alopecia Treatment

“…However, the same study revealed an improved quality of life after PRP, which was not noted after minoxidil. Pakhomova et al conducted a study on 69 men to evaluate PRP, minoxidil and their combination and the results were analysed both clinically and imunohistochemical [29]. PRP therapy was found to be more effective than minoxidil, while the combination of the 2 treatments had better results than each treatment used separately.…”