Platelet-Rich Plasma and Micrografts Enriched with Autologous Human Follicle Mesenchymal Stem Cells Improve Hair Re-Growth in Androgenetic Alopecia. Biomolecular Pathway Analysis and Clinical Evaluation

Abstract

Platelet rich plasma (PRP) and Micrografts containing human follicle mesenchymal stem cells (HF-MSCs) were tried as a potential treatment for androgenetic alopecia (AGA). However, little to no work has yet to be seen wherein the bio-molecular pathway of HF-MSCs or PRP treatments were analyzed. The aims of this work are to report the clinical effectiveness of HF-MSCs and platelet-rich plasma evaluating and reviewing the most updated information related to the bio-molecular pathway. Twenty-one patients were treated with HF-MSCs injections and 57 patients were treated with A-PRP. The Wnt pathway and Platelet derived-growth factors effects were analyzed. 23 weeks after the last treatment with mean hair thickness increments (29 ± 5.0%) over baseline values for the targeted area. 12 weeks after the last injection with A-PRP mean hair count and hair density (31 ± 2%) increases significantly over baseline values. The increment of Wnt signaling in Dermal Papilla Cells evidently is one of the principal factors that enhances hair growth. Signaling from mesenchymal stem cells and platelet derived growth factors positively influences hair growth through cellular proliferation to prolong the anagen phase (FGF-7), inducing cell growth (ERK activation), stimulating hair follicle development (β-catenin), and suppressing apoptotic cues (Bcl-2 release and Akt activation).

Single-cell RNA-seq highlights heterogeneity in human primary Wharton’s jelly mesenchymal stem/stromal cells cultured in vitro

“…By comparing gene expression between ADMSCs and WJMSCs at the single-cell level, we found that HVGs are largely overlapped between them (Additional file 3: Figure S6A). These shared HVGs include genes, such as HGF, FGF2, FGF7, VEGFA, TGFB2, IGF2, IGFBP3-7, CSF3, PDGFA, PTGES, and PTGS2, coding proteins which are involved in bio-molecular pathways that could promote cell proliferation, differentiation, and neo-angiogenesis and suppress apoptotic cues, to favor wound healing and hair regrowth processes [98,105,109]. Furthermore, functional enrichment analysis of HVGs from ADMSCs showed similar results as those from WJMSCs (Additional file 3: Figures S6B-G), though they exhibited distinct differentiation propensity (Additional file 3: Figure S5).…”

Systematic Review of Platelet-Rich Plasma Use in Androgenetic Alopecia Compared with Minoxidil®, Finasteride®, and Adult Stem Cell-Based Therapy

“…Preparation procedures are not standardized yet and regenerative mechanisms are still the object of study due to their various growth factors (GFs). The effects of the GFs contained in AA-PRP and A-PRP in HG have been reported [1][2][3][4].…”

Autologous Micrografts from Scalp Tissue: Trichoscopic and Long-Term Clinical Evaluation in Male and Female Androgenetic Alopecia

“…To better explain the clinical results obtained by the use of minoxidil, finasteride, A-PRP, and HFSCs, it is necessary to report the most recent outcomes in hair density and hair count obtained for these treatments. In detail, in a recent study of Gentile et al [19], hair density improvement for A-PRP 23 weeks after the third infiltration (one infiltration was performed three times for 30 days each) was 28 ± 2% hairs/cm 2 compared with placebo (saline solution). In the same study, hair density improvement for HFSC treatment 23 weeks after the second infiltration (one infiltration was performed every 60 days for two times) was 29 ± 5% hairs/ cm 2 compared with placebo (saline solution) [19].…”

“…In detail, in a recent study of Gentile et al [19], hair density improvement for A-PRP 23 weeks after the third infiltration (one infiltration was performed three times for 30 days each) was 28 ± 2% hairs/cm 2 compared with placebo (saline solution). In the same study, hair density improvement for HFSC treatment 23 weeks after the second infiltration (one infiltration was performed every 60 days for two times) was 29 ± 5% hairs/ cm 2 compared with placebo (saline solution) [19]. In a study of Van Nestle et al [20], 212 males affected by AGA were selected in a randomized model to receive 1 mg finasteride daily (study group) or placebo (control group) for 48 Ws.…”