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

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/cm2) 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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A Histological study on the effect of Platelet Rich Plasma on Hair Growth in Male Albino Rat Model of Androgenic Alopecia

QJM ◽

10.1093/qjmed/hcab099.010 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hoda Fouad Nada ◽

Sarah Abdel Gawad ElSebay ◽

Dalia Alaa El-Din Aly El-Waseef ◽

Nancy Sultan Saad

Keyword(s):

Platelet Rich Plasma ◽

Hair Follicles ◽

Control Group ◽

Albino Rats ◽

Epidermal Thickness ◽

Immunohistochemical Examination ◽

Androgenic Alopecia ◽

Ki 67 ◽

Anagen Hair ◽

The Mean

Abstract Background Androgenetic alopecia (AGA) is the commonest cause of hair loss in men with limited treatment options. Platelet-rich plasma (PRP) is defined as an autologous concentration of plasma with a greater count of platelets than that of whole blood. Its action depends on the released growth factors from platelets. It has been investigated and used in numerous fields of medicine. Recently, PRP has received growing attention as a potential therapeutic tool for hair loss. Aim of the work This study aimed at evaluating the efficacy of PRP therapy on experimentally induced AGA in male albino rats. Materials and Methods Eighteen rats were divided into 3 groups - Group I (the control group), Group II (testosterone group): rats were injected 0.1 ml testosterone daily in the shaved area of the dorsum , Group III (PRP group): rats were injected 0.1 ml of testosterone daily+ 0.1 ml of PRP every 3 days in the shaved area of their dorsum. After 21 days from the start of the experiment, skin samples were collected from the site of injection and prepared for histological examination by hematoxylin and eosin stain and immunohistochemical examination by anti Ki 67. Morphometrical and statistical analysis were performed. Results Testosterone group when compared to the control group showed a significant decrease in the mean epidermal thickness, decreased mean number of anagen hair follicles, increase in the mean number of telogen hair follicles and decreased anagen/telogen ratio, all were statistically significant (P < 0.05). PRP group showed significant increase in the mean number of anagen hair follicles (p < 0.05), and a decrease in the mean number of telogen hair follicles (p < 0.05). This resulted in an increase in anagen/telogen ratio. There was also a significant increase in the mean epidermal thickness in the PRP group as compared to the other groups (p < 0.05). Immunohistochemical examination of anti Ki 67 stained sections showed significant decrease of the mean number of Ki 67 positive basal epidermal cells (P < 0.05) in the testosterone group compared to control group, and an increase in the mean number of Ki 67 positive basal epidermal cells in the PRP group (p < 0.05) as compared to the control group and the testosterone group. Conclusion Our data suggest that PRP injections may have a positive therapeutic effect on experimentally induced androgenic alopecia in adult male albino rats.

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Does Estradiol Level in Platelet-Rich Plasma Improve Efficacy of Androgenic Alopecia Treatment?

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa155 ◽

2020 ◽

Vol 40 (11) ◽

pp. NP613-NP618

Author(s):

Bilsev Ince ◽

Munur Selcuk Kendir ◽

Ibrahim Kilinc ◽

Mustafa Cihat Avunduk ◽

Mehmet Dadaci ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Androgenic Alopecia ◽

Hair Density ◽

Level Of Evidence ◽

Literature Report ◽

Male Patients ◽

The Mean ◽

Group 2 ◽

Estrogen Concentration ◽

Group 1

Abstract Background Although some studies in the literature report that autologous and homologous platelet-rich plasma (PRP) can be employed in the treatment of androgenic alopecia (AGA), no study, to the authors’ knowledge, has examined the estrogen concentration of prepared PRP. Objectives The authors aimed to determine the presence of estrogen in PRP and to investigate the effect of estrogen concentration of PRP on AGA treatment. Methods Between 2017 and 2018, 30 male patients with hair loss complaints were included in this prospective study. Autologous PRP was injected in patients in Group 1. Homologous PRP with high estrogen levels was injected in the patients in Group 2. PRP was injected in both groups 4 times at 0, 1, 3, and 6 months. The obtained photographs were evaluated and hair densities of each patient at controls were calculated. Results The mean estrogen level measured in PRP was statistically significantly higher in Group 2. In both groups, the increase in hair density was observed from the first month, but this increase was statistically significantly higher in all controls in Group 2. In Group 2, there was a statistically significant increase in the 1st and 3rd months compared with the previous control, but there was no difference between the 6th and 12th months and the 3rd month. Conclusions Increased hair density is greater and earlier in the group receiving estrogen-rich PRP than in the group utilizing autologous PRP. The authors think that estrogen-rich PRP may be employed in the treatment of AGA in the presence of an appropriate donor. Level of Evidence: 2

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Evaluation of Automated Measurement of Hair Density Using Deep Neural Networks

Sensors ◽

10.3390/s22020650 ◽

2022 ◽

Vol 22 (2) ◽

pp. 650

Author(s):

Minki Kim ◽

Sunwon Kang ◽

Byoung-Dai Lee

Keyword(s):

Deep Learning ◽

Object Detection ◽

Hair Loss ◽

Medical Image Analysis ◽

Density Measurement ◽

Hair Follicles ◽

Learning Technologies ◽

Tissue Imaging ◽

Learning Technology ◽

Hair Density

Recently, deep learning has been employed in medical image analysis for several clinical imaging methods, such as X-ray, computed tomography, magnetic resonance imaging, and pathological tissue imaging, and excellent performance has been reported. With the development of these methods, deep learning technologies have rapidly evolved in the healthcare industry related to hair loss. Hair density measurement (HDM) is a process used for detecting the severity of hair loss by counting the number of hairs present in the occipital donor region for transplantation. HDM is a typical object detection and classification problem that could benefit from deep learning. This study analyzed the accuracy of HDM by applying deep learning technology for object detection and reports the feasibility of automating HDM. The dataset for training and evaluation comprised 4492 enlarged hair scalp RGB images obtained from male hair-loss patients and the corresponding annotation data that contained the location information of the hair follicles present in the image and follicle-type information according to the number of hairs. EfficientDet, YOLOv4, and DetectoRS were used as object detection algorithms for performance comparison. The experimental results indicated that YOLOv4 had the best performance, with a mean average precision of 58.67.

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The Female Pattern Hair Loss: Review of Etiopathogenesis and Diagnosis

BioMed Research International ◽

10.1155/2014/767628 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 22

Author(s):

Anja Vujovic ◽

Véronique Del Marmol

Keyword(s):

Hair Loss ◽

Current Knowledge ◽

Diagnostic Testing ◽

Clinical Manifestations ◽

Hair Follicles ◽

Hair Density ◽

Female Pattern Hair Loss ◽

Significant Impairment ◽

Pattern Distribution

Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Initial signs may develop during teenage years leading to a progressive hair loss with a characteristic pattern distribution. The condition is characterized by progressive replacement of terminal hair follicles over the frontal and vertex regions by miniaturized follicles, that leads progressively to a visible reduction in hair density. Women diagnosed with FPHL may undergo significant impairment of quality of life. FPHL diagnosis is mostly clinical. Depending on patient history and clinical evaluation, further diagnostic testing may be useful. The purpose of the paper is to review the current knowledge about epidemiology, pathogenesis, clinical manifestations, and diagnosis of FPHL.

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Morphological substantiation of clinical efficacy of platelet rich plasma in males with androgenic alopecia

Vestnik of Russian military medical Academy ◽

10.17816/brmma12245 ◽

2018 ◽

Vol 20 (3) ◽

pp. 67-71

Author(s):

E E Pakhomova ◽

I O Smirnova ◽

I N Telichko

Keyword(s):

Clinical Efficacy ◽

Growth Parameters ◽

Platelet Rich Plasma ◽

Hair Follicles ◽

Androgenetic Alopecia ◽

Sweat Glands ◽

Androgenic Alopecia ◽

Hair Density ◽

Plasma Therapy ◽

Four Levels

Morphological substantiation of the clinical efficacy of platelets rich plasma was carried out in the treatment of 22 men with androgenetic alopecia from the 1st to the 4th stage according to the Norwood-Hamilton scale were included. All patients received intradermal injections of platelets rich plasma 0,15 ml per injection. The course of treatment consisted of 4 procedures with an interval of 4 weeks. Clinical efficacy was assessed by the dynamics of morphometric indices of hair growth. Histological examination was carried out on horizontal sections, stained with hematoxylin and eosin, the morphology of the hair was counted at four levels. Evaluation of morphometric growth parameters conducted before treatment and 4 months after the onset of it. It was established that the therapy of platelet-rich plasma has a pronounced clinical efficacy, consisting in a significant (p=0,00025) increase in hair density by 11% and average hair diameter by 10% (p=0,00766), a 14% decrease in the share of hair follicles (p=0,00959). Histologically, the increase in hair density was significant at the level of the bulb of the hair follicles by 148% (p=0,0034) and at the level of the sweat glands by 65% (p=0,0326), and also by the tendency to increase their number at the level of the sebaceous glands. This was combined with a significant decrease in the proportion of telogen hair at 47% (p=0,0153). Thus, the positive clinical effect of plasma-rich plasma therapy in men suffering from androgenetic alopecia is based on reliable morphofunctional changes in the hair follicles.

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The Therapeutic Response of Platelet Rich Plasma (PRP) for Androgenetic Alopecia Showed No Correlation with Growth Factors and Platelet Number

Blood ◽

10.1182/blood.v128.22.2637.2637 ◽

2016 ◽

Vol 128 (22) ◽

pp. 2637-2637 ◽

Cited By ~ 2

Author(s):

Bruno Lima Rodrigues ◽

Silmara Aparecida De Lima Montalvão ◽

Joyce Annichinno-Bizzacchi ◽

Rebeca Cancela ◽

Francesca Silva ◽

...

Keyword(s):

Growth Factors ◽

Growth Factor ◽

Hair Loss ◽

Hair Growth ◽

Therapeutic Response ◽

Platelet Rich Plasma ◽

Androgenetic Alopecia ◽

Autologous Serum ◽

Platelet Number ◽

The Mean

Abstract Background: Androgenetic alopecia (AGA) is characterized by a pattern hair loss. Currently, treatment with platelet-rich plasma (PRP) has shown promising results due to the growth factors (GFs) released by the platelets. However, the analysis of therapeutic response according to GFs levels and platelet number in PRP has not been established. Objective: Investigate the therapeutic response to treatment of AGA using a standard method of PRP preparation, and the relation with GFs levels and platelet number. Methods: Inclusion criteria comprised diagnosis of AGA-III-vertex profile according to the Norwood-Hamilton scale, age between 18 and 50 years. Exclusion criteria comprised female gender, previous hair transplantation, any disease related to hair loss such as thyroid disease and/or iron deficiency, neoplasia present or past, kidney, liver, infectious, hematologic or rheumatoid disease, use of antiplatelet and/or anti-inflammatory drugs. All patients provided written informed consent approved by the ethic committee from the Faculty of Medical Sciences of the State University of Campinas (UNICAMP). The protocol comprised 20 subcutaneous injections of 100 µL in the scalp totaling 4 applications every fifteen days, with evaluation performed pretreatment (t0), 45 (t1) and 150 (t2) days after the start of the protocol. The endpoints for therapeutic response were hair growth and increase of percentage of anagen hairs evaluated by TrichoScan. For each patient 40 mL of peripheral blood were collected in ACD tubes. L-PRP (PRP with leukocytes) was performed, with double centrifugation (300 g for 5 minutes, and 700 g for 17 minutes). The platelets were counted in the baseline and in the PRP samples. PRP was activated with autologous serum. The platelet-derived growth factors (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) were measured by Luminex technique (Millipore®, USA), in two different PRP samples from each patient. Results: During the period of August to December of 2014, 15 male patients were included in the study. The median of platelets in PRP was increased by 5 folds in all four PRP preparations with a minimum of 728.9 and maximum 1.901,90 x 106 cel/uL, and median values of 1.082 x 106 cel/uL (range 608 - 2.023). The baseline number of platelets and PRP preparation showed a significant correlation (r = 0.839, p < 0.0001). The variability of platelet numbers from each individual during the four applications was 19.7% with a minimum of 0.50% and a maximum 56.3%. GF quantification of two different PRP preparations showed a similar intra-individual variation, with a mean of variability coefficient of 18.4% for VEGF, 20.9% for PDGF, and 21.6% for EGF (Table 1). EGF and PDGF concentrations showed a significant correlation to PRP platelets number (r = 0.8287 and P < 0.0001, and r = 0.6925 and P=0.0014, respectively) (Figure 1). Our results showed a significant increase in hair count (P = 0.0018) and anagen hairs (P = 0.0070) in 86.6% and 53.3% of patients, respectively. However, no correlation was found between platelet counts and GFs levels with therapeutic response. The patients who presented high levels of GFs did not show better results for hair growth or anagen hair than who presented lower levels. Conclusion: Our results corroborate previous studies that showed PRP as a quite promising therapeutic option for AGA, up to 3 months after the injections. However, there was a lack of correlation between the therapeutic responses and platelet numbers or GFs levels. Although, the GFs were not considered biomarker for PRP, it may play an important role in the PRP therapeutic effect. In addition, our results suggest that the PRP effects depend on an orchestration between many mechanisms involved in the increase of number of hairs and its growth. Furthermore, local receptors might present a central role in this response. Graphs of correlation between the platelet mean in PRP and the mean of the growth factor concentrations Graphs of correlation between the platelet mean in PRP and the mean of the growth factor concentrations Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Platelet Hypersensitivity in Acute Malaria (Plasmodium falciparum) Infection in Man

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653407 ◽

1981 ◽

Vol 46 (02) ◽

pp. 547-549 ◽

Cited By ~ 21

Author(s):

E M Essien ◽

M I Ebhota

Keyword(s):

Plasmodium Falciparum ◽

Malaria Infection ◽

Light Transmission ◽

Human Platelet ◽

Platelet Rich Plasma ◽

Wave Pattern ◽

Falciparum Infection ◽

Secondary Wave ◽

Control Subjects ◽

The Mean

SummaryDuring acute malaria infection, platelets in human platelet-rich plasma are hypersensitive to the addition of ADP between 1.0 uM and 5.0 uM, or adrenaline 0.11 uM as aggregating agents. The mean maximum aggregation amplitude (as % of light transmission) obtained from 8 subjects in response to added ADP (1.0 uM), 39.8 ± 27 (1SD), was significantly greater than the value in 6 controls (5.2±6.7 (1SD); t = 3, 51 P <0.005). A similar pattern of response was obtained with higher ADP concentrations (2.4,4.5 or 5.0 uM) in 22 patients and 20 control subjects (89.9±14.9% vs 77.8±16.5% (1SD) t = 2.45, P <0.02). Addition of 4.5 uM ADP to patient PRP usually evoked only a single aggregation wave (fused primary and secondary waves) while the typical primary and secondary wave pattern was usually obtained from controls.Mean plasma B-thromboglobulin (BTG) concentration in 7 patients (208.3 ± 15.6 ng/ml) was significantly higher than the value in 6 control subjects (59.2±15.7 ng/ml; t = 13.44, P <0.002).

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The Quantitation of Platelet Aggregation Induced by Four Compounds: A Study in Relation to Myocardial Infarction

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655660 ◽

1966 ◽

Vol 16 (03/04) ◽

pp. 752-767 ◽

Cited By ~ 23

Author(s):

J. R O’Brien ◽

F. C Path ◽

Joan B. Heywood ◽

J. A Heady

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Platelet Aggregation ◽

Platelet Rich Plasma ◽

Myocardial Infarct ◽

Control Groups ◽

The Mean ◽

Platelet Shape

SummaryMethods for measuring and comparing day to day differences in the response of platelet aggregation in platelet-rich plasma to added ADP, 5-H.T., adrenaline and collagen are reported. Platelet aggregation induced by ADP, 5-H.T. and adrenaline was studied in patients with acute myocardial infarction and in others 3 months to 5 years after an infarct; some were receiving anti-coagulants and others not: these three groups were compared with three control groups. The mean platelet shape was rounder and the response to ADP and to 5-H.T. and one parameter of the response to adrenaline was significantly greater in all groups of patients with myocardial infarct taken together than in the controls. The platelet-rich plasma from patients with recent infarction were most responsive to ADP and 5-H.T. immediately after the infarct. Anti-coagulants had no effect on these tests. However, there was wide variation within the individuals and much overlap between groups, and these tests can only reliably distinguish between groups and not between individuals. The significance of these findings is discussed.

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Hair Loss Prevention by a Scalp Cooling Device in Early Breast Cancer Patients: The Poliambulanza Preliminary Experience

Reviews on Recent Clinical Trials ◽

10.2174/1574887113666181120111104 ◽

2019 ◽

Vol 14 (1) ◽

pp. 66-71 ◽

Cited By ~ 2

Author(s):

Tiziana Prochilo ◽

Alessandra Huscher ◽

Federica Andreis ◽

Mara Mirandola ◽

Elisabetta Zaina ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hair Loss ◽

Depression Scale ◽

Hair Follicles ◽

Common Side Effect ◽

Scalp Cooling ◽

Breast Cancer Patients ◽

Cooling Device ◽

End Of Treatment

Background: The most effective agents in the treatment of breast cancer have a common side effect, the hair loss. Some studies reported a reduction of hair loss with the use of the scalp cooling device. Indeed, it decreases the drug accumulation in the hair follicles. We report our preliminary experience with a scalp cooling device in reducing chemotherapy-induced alopecia and related distress in breast cancer patients undergoing adjuvant chemotherapy. </P><P> Methods: Hair loss grading and treatment tolerability were evaluated during chemotherapy every 21 days and 3 weeks after the last cycle of chemotherapy via Dean’s scale by patients and operators and a comfort analogic scale by patients. We administered the Hospital Anxiety and Depression Scale questionnaire at the baseline and at the end of treatment to assess the distress related to chemotherapy- induced alopecia. Results: Among the 46 patients identified, 27 accepted the device. The eligible chemotherapy regimens included docetaxel+cyclophosphamide (TC), doxorubicin+cyclophosphamide (AC) and paclitaxel (P) weekly+trastuzumab (T). 24 pts (89%) completed the treatment; 3 pts (11%) treated with AC prematurely interrupted use of the scalp-cooling device due to inefficacy. After the last cycle of chemotherapy, the number of patient who perceived a HL < grade 2 was 16 (59%). The hair retention reported by operators has been higher (78%). 81.5% of patients well tolerated the treatment. Conclusion: In our study, the scalp-cooling device reduced chemotherapy-induced alopecia in taxane- based chemotherapy. Furthermore, it suggests a discordance in hair loss perception between patients and operators.

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Kinetic analysis and optimisation of 18F-rhPSMA-7.3 PET imaging of prostate cancer

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05346-8 ◽

2021 ◽

Author(s):

Simona Malaspina ◽

Vesa Oikonen ◽

Anna Kuisma ◽

Otto Ettala ◽

Kalle Mattila ◽

...

Keyword(s):

Prostate Cancer ◽

Metastatic Disease ◽

Uptake Kinetics ◽

Whole Body ◽

Target Area ◽

Post Injection ◽

The Mean ◽

Pet Radiopharmaceutical ◽

Time Frames ◽

Over Time

Abstract Purpose This phase 1 open-label study evaluated the uptake kinetics of a novel theranostic PET radiopharmaceutical, 18F-rhPSMA-7.3, to optimise its use for imaging of prostate cancer. Methods Nine men, three with high-risk localised prostate cancer, three with treatment-naïve hormone-sensitive metastatic disease and three with castration-resistant metastatic disease, underwent dynamic 45-min PET scanning of a target area immediately post-injection of 300 MBq 18F-rhPSMA-7.3, followed by two whole-body PET/CT scans acquired from 60 and 90 min post-injection. Volumes of interest (VoIs) corresponding to prostate cancer lesions and reference tissues were recorded. Standardised uptake values (SUV) and lesion-to-reference ratios were calculated for 3 time frames: 35–45, 60–88 and 90–118 min. Net influx rates (Ki) were calculated using Patlak plots. Results Altogether, 44 lesions from the target area were identified. Optimal visual lesion detection started 60 min post-injection. The 18F-rhPSMA-7.3 signal from prostate cancer lesions increased over time, while reference tissue signals remained stable or decreased. The mean (SD) SUV (g/mL) at the 3 time frames were 8.4 (5.6), 10.1 (7) and 10.6 (7.5), respectively, for prostate lesions, 11.2 (4.3), 13 (4.8) and 14 (5.2) for lymph node metastases, and 4.6 (2.6), 5.7 (3.1) and 6.4 (3.5) for bone metastases. The mean (SD) lesion-to-reference ratio increases from the earliest to the 2 later time frames were 40% (10) and 59% (9), respectively, for the prostate, 65% (27) and 125% (47) for metastatic lymph nodes and 25% (19) and 32% (30) for bone lesions. Patlak plots from lesion VoIs signified almost irreversible uptake kinetics. Ki, SUV and lesion-to-reference ratio estimates showed good agreement. Conclusion 18F-rhPSMA-7.3 uptake in prostate cancer lesions was high. Lesion-to-background ratios increased over time, with optimal visual detection starting from 60 min post-injection. Thus, 18F-rhPSMA-7.3 emerges as a very promising PET radiopharmaceutical for diagnostic imaging of prostate cancer. Trial Registration NCT03995888 (24 June 2019).

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