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      The Effect of Autologous Activated Platelet Rich Plasma (AA-PRP) Injection on Pattern Hair Loss: Clinical and Histomorphometric Evaluation

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          Abstract

          To investigate the safety and clinical efficacy of AA-PRP injections for pattern hair loss. AA-PRP, prepared from a small volume of blood, was injected on half of the selected patients' scalps with pattern hair loss. The other half was treated with placebo. Three treatments were given for each patient, with intervals of 1 month. The endpoints were hair re-growth, hair dystrophy as measured by dermoscopy, burning or itching sensation, and cell proliferation as measured by Ki-67 evaluation. At the end of the 3 cycles of treatment, the patients presented clinical improvement in the mean number of hairs, with a mean increase of 18.0 hairs in the target area, and a mean increase in total hair density of 27.7 ( number of hairs/cm 2) compared with baseline values. Microscopic evaluation showed the increase of epidermis thickness and of the number of hair follicles two weeks after the last AA-PRP treatment compared to baseline value ( P < 0.05). We also observed an increase of Ki67 + keratinocytes of epidermis and of hair follicular bulge cells and a slight increase of small blood vessels around hair follicles in the treated skin compared to baseline ( P < 0.05).

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          Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth.

          Jeung-Gweon Lee, Kye Young Lee, Hye Lim Choi … (2012)
          Recently, autologous platelet-rich plasma (PRP) has attracted attention in various medical fields, including plastic and orthopedic surgery and dermatology, for its ability to promote wound healing. PRP has been tested during facelift and hair transplantation to reduce swelling and pain and to increase hair density. To investigate the effects of PRP on hair growth using in vivo and in vitro models. PRP was prepared using the double-spin method and applied to dermal papilla (DP) cells. The proliferative effect of activated PRP on DP cells was measured. To understand the mechanisms of activated PRP on hair growth, we evaluated signaling pathways. In an in vivo study, mice received subcutaneous injections of activated PRP, and their results were compared with control mice. Activated PRP increased the proliferation of DP cells and stimulated extracellular signal-regulated kinase (ERK) and Akt signaling. Fibroblast growth factor 7 (FGF-7) and beta-catenin, which are potent stimuli for hair growth, were upregulated in DP cells. The injection of mice with activated PRP induced faster telogen-to-anagen transition than was seen on control mice. Although few studies tested the effects of activated PRP on hair growth, this research provides support for possible clinical application of autologous PRP and its secretory factors for promotion of hair growth. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
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            Active hair growth (anagen) is associated with angiogenesis.

            M Peters, Craig S. Pohl, R Paus … (2000)
            After the completion of skin development, angiogenesis, i.e., the growth of new capillaries from pre-existing blood vessels, is held to occur in the skin only under pathologic conditions. It has long been noted, however, that hair follicle cycling is associated with prominent changes in skin perfusion, that the epithelial hair bulbs of anagen follicles display angiogenic properties, and that the follicular dermal papilla can produce angiogenic factors. Despite these suggestive observations, no formal proof is as yet available for the concept that angiogenesis is a physiologic event that occurs all over the mature mammalian integument whenever hair follicles switch from resting (telogen) to active growth (anagen). This study uses quantitative histomorphometry and double-immunohistologic detection techniques for the demarcation of proliferating endothelial cells, to show that synchronized hair follicle cycling in adolescent C57BL/6 mice is associated with substantial angiogenesis, and that inhibiting angiogenesis in vivo by the intraperitoneal application of a fumagillin derivative retards experimentally induced anagen development in these mice. Thus, angiogenesis is a physiologic event in normal postnatal murine skin, apparently is dictated by the hair follicle, and appears to be required for normal anagen development. Anagen-associated angiogenesis offers an attractive model for identifying the physiologic controls of cutaneous angiogenesis, and an interesting system for screening the effects of potential antiangiogenic drugs in vivo.
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              The role of platelet plasma growth factors in male pattern baldness surgery.

              Carlos Oscar Uebel, Denise Cantarelli, Pedro Martins … (2006)
              Follicular units are commonly used in baldness surgery, and they have become a global procedure for both male and female patients. The yield from micrografts varies between 70 and 85 percent. Yield is determined by factors such as quality of the harvested donor area, preparation of the units, care taken during the implantation procedure, and follicular apoptosis. To improve hair density and stimulate follicular unit growth, an experimental study was designed using platelet plasma growth factors obtained from the patient's autologous plasma. The author established a protocol within a group of 20 patients with male pattern baldness. The data showed a gaussian distribution; to compare the two procedures involved in this clinical trial, the paired t test was used. The author observed a significant difference in the yield of follicular units when comparing the experimental with the control areas of the scalp (p < 0.001). The areas treated with platelet plasma growth factors demonstrated a yield of 18.7 follicular units per cm2, whereas the control areas yielded 16.4 follicular units per cm2, an increase in follicular density of 15.1 percent. Among patients who used the experimental protocol, some experienced only 3 percent and others experienced a 52 percent increase in density. This study provides a new perspective and contribution to baldness surgery with follicular unit megasessions, and demonstrates an improvement that can be introduced into baldness surgery clinics with less morbidity and a low cost-to-benefit ratio. Further studies may improve the efficiency of the technique and allow digital programs to better evaluate the increase in hair density.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Biomed Res Int
                Journal ID (iso-abbrev): Biomed Res Int
                Journal ID (publisher-id): BMRI
                Title: BioMed Research International
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2314-6133
                ISSN (Electronic): 2314-6141
                Publication date (Print): 2014
                Publication date (Electronic): 6 May 2014
                Volume: 2014
                Electronic Location Identifier: 760709
                Affiliations
                1Plastic and Reconstructive Surgery Department, University of Rome Tor Vergata, Via Montpellier, No. 1, 00173 Rome, Italy
                2Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
                3Institute of Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, No. 1, 00173 Rome, Italy
                4Science Education Department, University of Rome Tor Vergata, Via Montpellier, No. 1, 00173 Rome, Italy
                5San Salvatore in Lauro Place, No. 15, 00186 Rome, Italy
                Author notes

                Academic Editor: Garrett McGuinness

                Article
                DOI: 10.1155/2014/760709
                PMC ID: 4032742
                PubMed ID: 24883322
                SO-VID: f31fe788-6bd4-4223-b36c-4657aa555f81
                Copyright © Copyright © 2014 V. Cervelli et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 28 November 2013
                Date revision received : 23 January 2014
                Date accepted : 5 March 2014
                Categories
                Subject: Clinical Study

                Data availability:

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