Growth factor concentrations in platelet‐rich plasma for androgenetic alopecia: An intra‐subject, randomized, blinded, placebo‐controlled, pilot study

Abstract

Background Platelet‐rich plasma (PRP), processed from autologous peripheral blood, is used to treat androgenetic alopecia (AGA). Objective To determine the efficacy of PRP for hair growth promotion in AGA patients in a randomized, blinded, placebo‐controlled, pilot clinical trial (NCT02074943). Methods The efficacy of an 8 week, five session, PRP treatment course was determined by measuring hair density and hair caliber changes in 10 AGA affected patients. For each PRP sample, the concentrations of selected growth factors were determined using a multiplex assay system. The clinical results were then correlated with the growth factor concentrations in PRP. Results At 16 weeks, 8 weeks after the last PRP injection, treated areas exhibited increased mean hair density (+12.76%) over baseline compared to placebo (+0.99%). Mean hair caliber decreased in both treated and placebo regions (−16.22% and −19.46%, respectively). Serial analysis of PRP significant variability in concentrations between patients. Overall, there was a positive correlation between GDNF concentration and hair density (P = .004). Trends, though not statistically significant, were also observed for FGF2 and VEGF. Limitations Small sample size and lack of comparative cohorts receiving protocol variations limit confidence in the study data. Conclusions This small pilot clinical trial suggests PRP treatment may be beneficial for AGA. However, the variable hair growth responses between patients indicate there is a significant opportunity to improve PRP therapy protocols for hair growth promotion. The variability in growth factor concentration in PRP suggests standardization of growth factors postprocessing might improve hair growth responses.

Heterogeneity in amount of growth factors secreted by platelets in platelet‐rich plasma samples from alopecia patients

“…The variable levels of secretion by platelets highlight the existence of inherent heterogeneity between individual patients. Our findings are consistent with a recent study [ 25 ] which measured physiologic GF concentrations in inactivated PRP used for treatment of AGA patients, indicating that clinical improvements to therapy may also be variable. Therefore, the inherent heterogeneity in gene expression and secretion in platelets among patients may be dependent on genetic and environmental factors driving epigenetic changes in megakaryocyte.…”

Platelet‐rich plasma for androgenetic alopecia: Efficacy differences between men and women

“…Another source of heterogeneity is likely the wide range of growth factor concentrations present in PRP preparations between individuals. Supporting this, a recent study by Siah et al 50 quantified growth factor concentrations in PRP for each participant and found significant variability. They discovered a correlation between hair density increase and the concentrations of glial cell line‐derived neurotrophic factor (GDNF) and vascular endothelial growth factor (VEGF).…”

Platelet Rich Plasma and Its Use in Hair Regrowth: A Review

“… 15–17 Activated platelets in PRP release numerous growth factors and cytokines from their alpha granules, including platelet-derived endothelial growth factor (PDGF), transforming growth factor β (TGF-β), fibroblast growth factor-2 (FGF-2), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), insulin-like growth factor-1 (IGF-1), glial cell line–derived neurotrophic factor (GDNF), which play a major role in stimulating hair growth through cell proliferation, differentiation and angiogenesis. 18–22 GDNF can stimulate cell proliferation and protect hair follicle from premature catagen transition. 23 , 24 VEGF play a major role as a potent hair growth stimulator via an angiogenesis induction.…”