RESUMEN
BACKGROUND: Exosomes are small extracellular vesicles with potential roles in modulating the hair growth cycle and are an emerging therapy for patients with alopecia. In recent years, researchers have made significant progress in deciphering the network of cellular interactions and signaling pathways mediated by the transfer of exosomes. This has opened the door to a wide range of potential therapeutic applications with an increasing focus on its application in precision medicine. AIM: To evaluate current published evidence, both preclinical and clinical, on the use of exosomes for hair restoration. METHODS: In January 2023, a systematic search was conducted using PubMed, Embase, and the Cochrane Library. Records were identified, screened, and assessed for eligibility as per the PRISMA guideline. RESULTS: We identified 16 studies (15 preclinical and 1 clinical) showing varying degrees of efficacy using exosomes derived from sources including adipose-derived stem cells (ADSCs) and dermal papilla cells (DPCs). Applications of exosomes isolated from ADSCs (ADSC-Exo) and DPCs have shown early promising results in preclinical studies corroborated by results obtained from different model systems. Topical ADSC-Exo has been tried successfully in 39 androgenetic alopecia patients demonstrating significant increases in hair density and thickness. No significant adverse reactions associated with exosome treatment have been reported thus far. CONCLUSIONS: Although current clinical evidence supporting the use of exosome treatment is limited, there is a growing body of evidence suggesting its therapeutic potential. Further studies are warranted to define its mechanism of action, optimize its delivery and efficacy, and to address important safety concerns.
Asunto(s)
Exosomas , Humanos , Exosomas/metabolismo , Tejido Adiposo , Cabello , Adipocitos , Alopecia/terapia , Alopecia/metabolismoRESUMEN
Current medicinal therapies for treating hair loss have shortcomes due to variability and ineffectiveness, noncompliance, and adverse effects. The prevalence of hair loss and its associated negative psychological impact have driven research into regenerative medicine approaches, such as platelet-rich plasma (PRP) and cell-based therapies, in an attempt to find alternative, safe, effective, and reproducible treatments. Current research shows promising results from these therapies; however, more robust trials are needed to confirm the reported efficacies of PRP and cell-based therapies. Moreover, standardization of treatment preparation as well as dose and regimen are needed.
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Alopecia , Plasma Rico en Plaquetas , Alopecia/terapia , Tratamiento Basado en Trasplante de Células y Tejidos , HumanosRESUMEN
Alopecia areata (AA) is an autoimmune hair loss condition that is difficult to treat and frequently disruptive to the psychosocial well-being of patients. Platelet-rich plasma (PRP) is an innovative therapy that provides concentrated GFs that impart anti-inflammatory effects. Optical coherence tomography (OCT) is a noninvasive imaging modality with the potential for providing quantitative monitoring of AA response to PRP. Our objective is to share our experience using OCT to monitor the therapeutic progress of patients with AA treated with PRP. Two patients with patchy AA and one with alopecia universalis were treated with PRP three times at 6-week intervals as part of a larger clinical trial. Patients were followed from baseline to week 24 with OCT imaging. OCT demonstrates an increase in hair density associated with improvement in inflammation at week 24. Conversely, the patient with alopecia universalis did not experience any significant change in follicular activity. This case series exemplifies the potential of PRP in inflammatory regulation as well as hair regrowth in patchy AA, whereas there is no notable advantage in alopecia universalis. Our findings add evidence on the possible value of OCT in quantitatively assessing hair growth progress throughout a treatment course.
Asunto(s)
Alopecia Areata/diagnóstico por imagen , Alopecia Areata/terapia , Factores Biológicos/uso terapéutico , Plasma Rico en Plaquetas , Cuero Cabelludo/diagnóstico por imagen , Tomografía de Coherencia Óptica , Anciano , Alopecia/diagnóstico por imagen , Alopecia/terapia , Femenino , Cabello/crecimiento & desarrollo , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Exosome therapy is a promising new approach for the treatment of hair loss. Current treatments for androgenetic alopecia, the most common form of hair loss, fall short of providing satisfactory efficacy with minimal side effects; thus, the fact that exosome therapy delivers impressive hair growth with no reported adverse events makes this therapy an attractive avenue to be explored; nevertheless, due to the novelty of this treatment, clinical trials to confirm its efficacy and safety are lacking. The current state of knowledge that is publicly available on the efficacy of exosome therapy for treatment of hair loss is reviewed, and the potential of exosomes as an alternate therapy for hair restoration is discussed.