Hair Follicle Micrografts with Stem Cells in the Treatment of Hair Loss
Updated: Apr 21, 2020
For therapeutic hair regrowth, the use of micrografts containing autologous human hair follicle & stem cells is showing very promising results. Androgenetic alopecia (AGA) is a progressive form of hair loss that affects many people both men and women. Existing medications and treatments are minoxidil, finasteride, and hair transplant. The effect of autologous platelet-rich plasma (PRP) has also shown promising success.
In hair loss the scalp and hair follicle stem cell numbers stay unaltered, however, the number of regenerative progenitor cells diminishes . The objective of the present work is to evaluate the hair regrowth obtained by cell micrograft injections, along with the long-term clinical efficacy of micrograft injections.
The below placebo-controlled, randomised, evaluator-blinded study looked to compare long-term results in hair regrowth with micrografts enriched stem cells vs. placebo. The secondary outcome was to confirm hair follicle quantity, safety, and feasibility.
Patients 27 patients, of whom 17 males and 10 females with AGA.
Micrograft Procedure Autologous micrografts of hair follicle and stem cells were prepared using simple process. The first step is harvesting of the small scalp tissues with punch biopsy (2 mm diameter). The second step the samples being mixed with saline and then process using the Regenerative Protocol. The third step is mechanical and controlled infiltration, using 10 ml syringes in the selected area of the scalp through a medical device.
Following on from treatment the clinical evaluation of hair growth was performed at different intervals.
Outcomes and discussion
Minoxidil has been shown to extend the anagen period and to increase follicle diameter. Minoxidil has also been shown to improve the survival of dermal papilla cells. Finasteride is a type II 5-alpha-reductase inhibitor which decreases dihydrotestosterone (DHT) by about 65% in serum, prostate, and scalp. It was registered in Europe in 1992 for treatment of benign prostatic growth. The drug became registered for AGA therapy (mild to moderate) in male patients in the late 90's.
Treatments based on autologous sources and minimal invasive approaches, are represented by P-PRP and adult stem cells. A more invasive surgical approach was limited to hair transplant indicated only for patients affected by aggressive conditions of AGA and hair loss.
The clinical effectiveness of P-PRP for hair loss has been reported in many recent studies. Adult stem cells can be harvested, prevalently, from two tissues, represented by fat tissue and scalp tissue. The fat contains a great number of mesenchymal stem cells (MSCs) with multilineage separation potential.
For scalp tissue, in previous research conducted by Gentile et al., a procedure was tuned to collect hair follicle stem cells with minimal manipulation obtained by punch biopsy. Yu et al. demonstrated that human hair folicles contain a stem cells that may be separated into a muscle cell, neuron, and melanocyte. Each mature hair follicle is a regenerating framework, which physiologically experiences cycles of growth (anagen), relapse (catagen), and rest (telogen) at various times in an adult's life.
Ultimately, tissue engineering in hair regrowth aims to develop new procedures to advance the hair regrowth. The above study looked to compare hair regrowth with micrografts containing human hair follicle mesenchymal stem cells. After 58 weeks, 27 patients displayed in the targeted area an increase of hair count and hair density, respectively, of 18.0 hairs per 0.65 cm2and 23.3 hairs per cm2 compared with baseline. Hair follicle stem cells contained in micrografts can represent a safe and viable treatment alternative against hair loss. The discoveries propose that scalp stem cell-enriched fat grafting may represent a promising elective way for treating hair loss in people.
 Garza L. A., Yang C.-C., Zhao T., et al. Bald scalp in men with androgenetic alopecia retains hair follicle stem cells but lacks CD200-rich and CD34-positive hair follicle progenitor cells.Journal of Clinical Investigation.2011;121(2):613–622. doi: 10.1172/jci44478]
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