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Jedlowski PM, Anthony M. Use of fractionated laser therapy for the treatment of androgenetic alopecia: a systematic review and meta-analysis. Lasers Med Sci 2023; 39:4. [PMID: 38087122 DOI: 10.1007/s10103-023-03946-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Abstract
Procedural management, including fractionated laser therapy, has been increasingly investigated for the management of androgenetic alopecia (AGA). However, no comprehensive resources exist detailing the efficacy of fractionated laser therapies used for the treatment of AGA. A systematic review investigating fractionated laser use for AGA was performed, separated into each distinct fractionated laser modality. A meta-analysis was performed to examine improvement in hair counts and hair shaft diameter. Fourteen studies were included for systematic review, which identified the use of erbium-glass, thulium, erbium-ytrrium:aluminum garnet (YAG), and carbon dioxide (CO2) fractionated laser for the treatment of AGA. In the meta-analysis, fractionated laser combination therapy showed significant improvement in hair shaft diameter (2.51, 95% CI 2.37-2.65, I2 = 90.54). Fractionated laser monotherapy alone significantly improved hair shaft diameter (2.28 95% CI 2.03-2.52, I2 = 91.20%). This effect was durable on subgroup analysis for both erbium-glass (2.36 95% CI 2.01-2.71, I2 = 92.05%) and thulium (1.61 95% CI 1.08-2.15, I2 = < 0.00%). There was no improvement in hair shaft count for any laser modality. Erbium-glass laser is an effective modality as either monotherapy or combination with topical/injectable therapies to improve hair shaft diameter in AGA.
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Affiliation(s)
- Patrick M Jedlowski
- Division of Dermatology, Banner University Medical Center, University of Arizona College of Medicine - Tucson, 1765 N Pima Canyon Dr, Tucson, AZ, 85718, USA.
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2
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Vathananai W, Jimenez F. What Do We Know About Hair Growth Induced by Wounding and Its Therapeutic Applications? Dermatol Surg 2023; 49:995-1000. [PMID: 37606639 DOI: 10.1097/dss.0000000000003901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Many studies have reported the role of hair follicles (HFs) in the wound healing response, and vice versa, the creation of superficial injuries may stimulate hair growth, which has encouraged new treatments for hair loss. OBJECTIVE To review the phenomenon of wound-induced hair growth and the usefulness of therapeutic procedures based on skin wounding in androgenetic alopecia (AGA). METHODS A literature search was conducted to review cases of localized hypertrichosis induced by wounds and the role of microneedling, fractional laser, and scalp threading as monotherapy for AGA. RESULTS Localized hypertrichosis has been extensively reported after bone fractures, burn injury, chronic venous ulcer, etc. Only 2 cases of wound-induced hair neogenesis in humans have been reported. As monotherapy for AGA, 1 of 3 studies of microneedling, 4 of 6 of fractional lasers, and 2 of 3 studies of scalp threading show good efficacy. CONCLUSION Certain types of wounds seem to stimulate localized hair growth in humans, but the underlying mechanism is unclear. Reports on wound-induced HF neogenesis in humans are anecdotal and questions remain as to whether this is a true phenomenon in humans. Further clinical studies are needed before recommending wound-induced hair growth procedures as therapies for AGA.
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Affiliation(s)
- Wipawan Vathananai
- Mediteknia Dermatology and Hair Transplant Clinic, Las Palmas de Gran Canaria, Spain
| | - Francisco Jimenez
- Mediteknia Dermatology and Hair Transplant Clinic, Las Palmas de Gran Canaria, Spain
- Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
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3
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Cai Y, Jia Z, Zhang Y, Kang B, Chen C, Liu W, Li W, Zhang W. Cell-free fat extract restores hair loss: a novel therapeutic strategy for androgenetic alopecia. Stem Cell Res Ther 2023; 14:219. [PMID: 37612726 PMCID: PMC10464375 DOI: 10.1186/s13287-023-03398-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/12/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Androgenetic alopecia (AGA) is one of the most common hair loss diseases worldwide. However, current treatments including medicine, surgery, and stem cells are limited for various reasons. Cell-free fat extract (CEFFE), contains various cell factors, may have potential abilities in treating AGA. This study aims to evaluate the safety, effectiveness and the underlying mechanism of CEFFE in treating AGA. METHODS Sex hormone evaluation, immunogenicity assay and genotoxicity assay were conducted for CEFFE. In vivo study, male C57BL/6 mice were injected subcutaneously with dihydrotestosterone (DHT) and were treated with different concentration of CEFFE for 18 days (five groups and n = 12 in each group: Control, Model, CEFFELow, CEFFEMiddle, CEFFEHigh). Anagen entry rate and hair coverage percentage were analyzed through continuously taken gross photographs. The angiogenesis and proliferation of hair follicle cells were evaluated by hematoxylin-eosin, anti-CD31, and anti-Ki67 staining. In vitro study, dermal papilla cells (DPCs) were incubated with different concentrations of CEFFE, DHT, or CEFFE + DHT, followed by CCK-8 assay and flow cytometry to evaluate cell proliferation cycle and apoptosis. The intracellular DHT level were assessed by enzyme-linked immunosorbent assay. The expression of 5α-reductase type II, 3α-hydroxysteroid dehydrogenase and androgen receptor were assessed through reverse transcription-quantitative polymerase chain reaction (RT-qPCR) or/and western blot. RESULTS In CEFFE-treated mice, an increase in the anagen entry rate and hair coverage percentage was observed. The number of CD31-positive capillaries and Ki67-positive cells were increased, suggesting that CEFFE promoted the proliferation of DPCs, modulated the cell cycle arrest, inhibited apoptosis caused by DHT, reduced the intracellular concentration of DHT in DPCs, and downregulated the expression of AR. CONCLUSIONS CEFFE is a novel and effective treatment option for AGA through producing an increased hair follicle density and hair growth rate. The proposed mechanisms are through the DHT/AR pathway regulation and regional angiogenesis ability.
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Affiliation(s)
- Yizuo Cai
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Zhuoxuan Jia
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Yichen Zhang
- Department of Biological and Environmental Engineering, Cornell University, Ithaca, USA
| | - Bijun Kang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Chingyu Chen
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Wei Liu
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China.
| | - Wei Li
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China.
| | - Wenjie Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, National Tissue Engineering Center of China, 639 ZhiZaoJu Road, Shanghai, 200011, China.
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Hasegawa K, Fujimoto T, Mita C, Furumoto H, Inoue M, Ikegami K, Kitayama T, Yamamoto Y, Shimbo T, Yamazaki T, Tamai K. Single-cell transcriptome analysis of fractional CO 2 laser efficiency in treating a mouse model of alopecia. Lasers Surg Med 2022; 54:1167-1176. [PMID: 35916125 DOI: 10.1002/lsm.23590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/03/2022] [Accepted: 07/16/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Hair loss, including alopecia, is a common dermatological issue worldwide. At present, the application of fractional carbon dioxide (CO2 ) laser in the treatment of alopecia has been documented; however, the results vary between reports. These varying results may be due to the limited knowledge of cellular action in laser-irradiated skin. The objective of this study was to investigate the molecular and cellular mechanisms of laser treatment under effective conditions for hair cycle initiation. METHODS A fractional CO2 laser was applied and optimized to initiate the hair cycle in a mouse model of alopecia. Several cellular markers were analyzed in the irradiated skin using immunofluorescence staining. Cellular populations and their comprehensive gene expression were analyzed using single-cell RNA sequencing and bioinformatics. RESULTS The effective irradiation condition for initiating the hair cycle was found to be 15 mJ energy/spot, which generates approximately 500 μm depth columns, but does not penetrate the dermis, only reaching approximately 1 spot/mm2 . The proportion of macrophage clusters significantly increased upon irradiation, whereas the proportion of fibroblast clusters decreased. The macrophages strongly expressed C-C chemokine receptor type 2 (Ccr2), which is known to be a key signal for injury-induced hair growth. CONCLUSIONS We found that fractional CO2 laser irradiation recruited Ccr2 positive macrophages, and induced hair regrowth in a mouse alopecia model. These findings may contribute to the development of stable and effective fractional laser irradiation conditions for human alopecia treatment.
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Affiliation(s)
- Kouichi Hasegawa
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | | | - Chihiro Mita
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | - Hidehiro Furumoto
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | - Masako Inoue
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | - Kentaro Ikegami
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | - Tomomi Kitayama
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan.,Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukari Yamamoto
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | - Takashi Shimbo
- StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan.,Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takehiko Yamazaki
- Drug Discovery Department, StemRIM Incorporation, Osaka, Japan.,StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan
| | - Katsuto Tamai
- StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Osaka, Japan.,Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Osaka, Japan
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5
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Koptev MY, Morozov AN, Shatilova KV, Muravyev SV, Zapryalov AE, Likhachev ME, Kim AV. All-fiber high-power erbium-doped laser system generating optical pulses with a duration of 200 µs to 5 ms for fractional photo-rejuvenation. APPLIED OPTICS 2022; 61:4851-4856. [PMID: 36255969 DOI: 10.1364/ao.455761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/31/2022] [Indexed: 06/16/2023]
Abstract
An all-fiber high-power erbium-doped fiber laser (EDFL) source generating optical pulses from 200 µs to 5 ms with a stable rectangular envelope for fractional photo-rejuvenation is proposed and experimentally demonstrated. A master oscillator power amplifier (MOPA) configuration composed of a master oscillator, an acousto-optic modulator (AOM), and a one-stage amplifier is designed and employed in the EDFL to serve as an efficient laser system with excellent output performance. To avoid multistage amplifiers, the master oscillator generates 1.5 W, and a Yb-free Er-doped large-mode-area (LMA) active fiber is used for a one-stage power amplifier. There are two benefits to this approach: first, modulation of both pump and seed pulses is used to achieve clear rectangular shaped pulses without amplified spontaneous emission (ASE) growth; and second, there are no power limitations in the amplifier and undesirable 1 µm ASE compared to Er/Yb systems. We have reached 28.6 W of peak power with 26% slope efficiency limited only by available pump power, so the system can be easily scaled for achieving a higher peak power.
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6
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A study to assess the efficacy of fractional carbon dioxide laser with topical platelet-rich plasma in the treatment of androgenetic alopecia. Lasers Med Sci 2022; 37:2279-2286. [PMID: 34981272 DOI: 10.1007/s10103-021-03496-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
Abstract
Owing to the inadequate response to and limitations of the approved medications for androgenetic alopecia, novel therapies are warranted to enhance outcomes. The objective of this paper is to ascertain the effectiveness of fractional carbon dioxide laser followed by platelet-rich plasma application on hair regrowth and to compare the two laser settings. Seven participants were enrolled in this half-head pilot study based on different laser pulse energy and density values (12 mJ, 800 spots/cm2 and 22 mJ, 400 spots/cm2). Ten treatment sessions were performed every 2 weeks with 12-week follow-up. The evaluation methods were based on hair density from standardized phototrichograms, global photographic assessment, and patient satisfaction. Significantly increased total and terminal hair densities were observed during treatment in both groups as compared with baselines. The mean total hair density has weekly increased significantly with high pulse energy (1.42 hair/cm2) as compared to low pulse energy (1.04 hair/cm2) throughout the study period (p = 0.023; 4.89 hair/cm2). Global photographs and patient satisfaction scores demonstrated improvement, but only the latter showed statistical significance (p = 0.029). The average pain intensity scores were not different between the groups (p = 0.760) all over the procedure. The adverse events were minor and well tolerated. This synergistic treatment remarkably leads to hair restoration and high patient satisfaction. The parameters of 22-mJ beam energy with 400 spots/cm2 density are appropriate and superior to 12-mJ beam energy with 800 spots/cm2. Albeit higher energy, no more pain is indicated in the high pulse energy group. Trial registration number (TRN): TCTR20180619004, Thai Clinical Trials Registry (TCTR) since 2018-05-15 13:39:48.
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7
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Tsai PF, Chou FP, Yu TS, Lee HJ, Chiu CT. Depilatory creams increase the number of hair follicles, and dermal fibroblasts expressing interleukin-6, tumor necrosis factor-α, and tumor necrosis factor-β in mouse skin. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2021; 25:497-506. [PMID: 34697260 PMCID: PMC8552827 DOI: 10.4196/kjpp.2021.25.6.497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/02/2021] [Accepted: 04/05/2021] [Indexed: 11/15/2022]
Abstract
Besides using for hair removal, depilatory agents have been considered to be used as a penetration enhancer for transepidermal drug delivery. To examine the effect in hair follicles (HFs), two commercially available depilatory creams were tested on the dorsal skin of mice to monitor the effect deep into the skin structure. Fifteen male BALB/c mice were used in this study. Depilatory creams were applied to the dorsal skin of the same animal using shaved and untouched treatments as controls to minimize individual differences. Skin samples were collected at three days, one week and two weeks (n = 5 for each) after the treatment, and subjected for hematoxylin-eosin staining, and immunohistochemical analysis for proinflammatory cytokines. The morphological examination showed an increase in the thickness of epidermal layer of the depilatory cream-treated skin at early time points and in the subcutis at two weeks. Depilatory cream promoted entry of anagen phase and increased the number of hair follicles in the subcutis at one and two weeks. Immunohistochemistry showed elevated percentages of dermal fibroblasts expressing interleukin-6, tumor necrosis factor-α, and tumor necrosis factor-β. Shaving process increased the thickness of epidermis and dermis as depilatory creams did, but did neither induce the expression of proinflammatory cytokines in the dermal fibroblasts nor the number of HFs. The results suggested that the commercially available depilatory creams caused a transient minor inflammatory response of the skin and increased the levels of cytokines that might subsequently affect hair growth.
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Affiliation(s)
- Pi-Fen Tsai
- Institute of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Fen-Pi Chou
- Department of Biochemistry, School of Medicine, College of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Ting-Shuan Yu
- Institute of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan
| | - Huei-Jane Lee
- Department of Biochemistry, School of Medicine, College of Medicine, Chung Shan Medical University, Taichung 40221, Taiwan.,Department of Clinical Biochemistry, Chung Shan Medical University Hospital, Taichung 40221, Taiwan
| | - Chun-Tang Chiu
- Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan 33382, Taiwan
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8
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Heng K, Meephansan J, Suchonwanit P. Alterations of collagen type 1, skin fibroblasts, and macrophages in the scalp following the treatment of 1550-nm erbium glass fractional laser for androgenetic alopecia. J Cosmet Dermatol 2021; 21:1762-1763. [PMID: 34129740 DOI: 10.1111/jocd.14287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/07/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Kunthearithy Heng
- Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Jitlada Meephansan
- Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
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9
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Daszczuk P, Mazurek P, Pieczonka TD, Olczak A, Boryń ŁM, Kobielak K. An Intrinsic Oscillation of Gene Networks Inside Hair Follicle Stem Cells: An Additional Layer That Can Modulate Hair Stem Cell Activities. Front Cell Dev Biol 2020; 8:595178. [PMID: 33363148 PMCID: PMC7758224 DOI: 10.3389/fcell.2020.595178] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022] Open
Abstract
This article explores and summarizes recent progress in and the characterization of main players in the regulation and cyclic regeneration of hair follicles. The review discusses current views and discoveries on the molecular mechanisms that allow hair follicle stem cells (hfSCs) to synergistically integrate homeostasis during quiescence and activation. Discussion elaborates on a model that shows how different populations of skin stem cells coalesce intrinsic and extrinsic mechanisms, resulting in the maintenance of stemness and hair regenerative potential during an organism’s lifespan. Primarily, we focus on the question of how the intrinsic oscillation of gene networks in hfSCs sense and respond to the surrounding niche environment. The review also investigates the existence of a cell-autonomous mechanism and the reciprocal interactions between molecular signaling axes in hfSCs and niche components, which demonstrates its critical driving force in either the activation of whole mini-organ regeneration or quiescent homeostasis maintenance. These exciting novel discoveries in skin stem cells and the surrounding niche components propose a model of the intrinsic stem cell oscillator which is potentially instructive for translational regenerative medicine. Further studies, deciphering of the distribution of molecular signals coupled with the nature of their oscillation within the stem cells and niche environments, may impact the speed and efficiency of various approaches that could stimulate the development of self-renewal and cell-based therapies for hair follicle stem cell regeneration.
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Affiliation(s)
- Patrycja Daszczuk
- Laboratory of Stem Cells, Development and Tissue Regeneration, Centre of New Technologies (CeNT), University of Warsaw (UW), Warsaw, Poland
| | - Paula Mazurek
- Laboratory of Stem Cells, Development and Tissue Regeneration, Centre of New Technologies (CeNT), University of Warsaw (UW), Warsaw, Poland
| | - Tomasz D Pieczonka
- Laboratory of Stem Cells, Development and Tissue Regeneration, Centre of New Technologies (CeNT), University of Warsaw (UW), Warsaw, Poland
| | - Alicja Olczak
- Laboratory of Stem Cells, Development and Tissue Regeneration, Centre of New Technologies (CeNT), University of Warsaw (UW), Warsaw, Poland
| | - Łukasz M Boryń
- Laboratory of Stem Cells, Development and Tissue Regeneration, Centre of New Technologies (CeNT), University of Warsaw (UW), Warsaw, Poland
| | - Krzysztof Kobielak
- Laboratory of Stem Cells, Development and Tissue Regeneration, Centre of New Technologies (CeNT), University of Warsaw (UW), Warsaw, Poland
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Chen CL, Huang WY, Wang EHC, Tai KY, Lin SJ. Functional complexity of hair follicle stem cell niche and therapeutic targeting of niche dysfunction for hair regeneration. J Biomed Sci 2020; 27:43. [PMID: 32171310 PMCID: PMC7073016 DOI: 10.1186/s12929-020-0624-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/23/2020] [Indexed: 01/05/2023] Open
Abstract
Stem cell activity is subject to non-cell-autonomous regulation from the local microenvironment, or niche. In adaption to varying physiological conditions and the ever-changing external environment, the stem cell niche has evolved with multifunctionality that enables stem cells to detect these changes and to communicate with remote cells/tissues to tailor their activity for organismal needs. The cyclic growth of hair follicles is powered by hair follicle stem cells (HFSCs). Using HFSCs as a model, we categorize niche cells into 3 functional modules, including signaling, sensing and message-relaying. Signaling modules, such as dermal papilla cells, immune cells and adipocytes, regulate HFSC activity through short-range cell-cell contact or paracrine effects. Macrophages capacitate the HFSC niche to sense tissue injury and mechanical cues and adipocytes seem to modulate HFSC activity in response to systemic nutritional states. Sympathetic nerves implement the message-relaying function by transmitting external light signals through an ipRGC-SCN-sympathetic circuit to facilitate hair regeneration. Hair growth can be disrupted by niche pathology, e.g. dysfunction of dermal papilla cells in androgenetic alopecia and influx of auto-reacting T cells in alopecia areata and lichen planopilaris. Understanding the functions and pathological changes of the HFSC niche can provide new insight for the treatment of hair loss.
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Affiliation(s)
- Chih-Lung Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Yen Huang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | | | - Kang-Yu Tai
- Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Sung-Jan Lin
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan. .,Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan. .,Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. .,Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan. .,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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11
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Laser-assisted Hair Regrowth: Fractional Laser Modalities for the Treatment of Androgenic Alopecia. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2157. [PMID: 31321172 PMCID: PMC6554163 DOI: 10.1097/gox.0000000000002157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/19/2018] [Indexed: 11/26/2022]
Abstract
Background: A large proportion of the population is at sometime affected by androgenic alopecia. Current therapies consisting of minoxidil or finasteride are often the first choices for treatment. These regimens are limited by their efficacy, side-effect profiles, and often lengthy treatment courses. Low level laser/light has shown to be relatively effective and safe for the treatment of hair loss, and a number of products are currently available to consumers. Recently, fractional lasers have been examined as treatment options for androgenic alopecia. The mechanism of action of these minimally invasive resurfacing procedures is thought to be 2-fold. First, the microscopic injuries created by these treatments may induce a favorable wound healing environment that triggers hair growth. Alternatively, disruption of the stratum corneum allows for improved transdermal passage of well-established therapeutic drugs to the hair roots. Methods: A literature review was performed to evaluate the efficacy of these emerging treatments on hair regrowth. Results: Nine original studies examining the effect of fractional lasers on hair growth in androgenic alopecia have been reviewed. Conclusions: Preliminary evidence suggests that fractional laser therapies have a positive effect on hair regrowth; however, most of the literature is limited to case reports, and small prospective and retrospective series. Further studies, in the form of well-designed randomized controlled trials, are necessary to evaluate the efficacy, safety, and optimal treatment courses.
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12
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Effects of CO2 fractional laser on hair growth in C57BL/6 mice and potential underlying mechanisms. Chin Med J (Engl) 2019; 132:1257-1260. [PMID: 30913066 PMCID: PMC6511434 DOI: 10.1097/cm9.0000000000000220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Supplemental Digital Content is available in the text
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13
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Efficacy of 1,550-nm Erbium-Glass Fractional Laser Treatment and Its Effect on the Expression of Insulin-Like Growth Factor 1 and Wnt/β-Catenin in Androgenetic Alopecia. Dermatol Surg 2018; 44:1295-1303. [DOI: 10.1097/dss.0000000000001619] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Yu AJ, Luo YJ, Xu XG, Bao LL, Tian T, Li ZX, Dong YX, Li YH. A pilot split-scalp study of combined fractional radiofrequency microneedling and 5% topical minoxidil in treating male pattern hair loss. Clin Exp Dermatol 2018; 43:775-781. [PMID: 29952106 DOI: 10.1111/ced.13551] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 02/03/2023]
Affiliation(s)
- A.-J. Yu
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Y.-J. Luo
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - X.-G. Xu
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - L.-L. Bao
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - T. Tian
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Z.-X. Li
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Y.-X. Dong
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Y.-H. Li
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
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Huang Y, Zhuo F, Li L. Enhancing hair growth in male androgenetic alopecia by a combination of fractional CO2 laser therapy and hair growth factors. Lasers Med Sci 2017; 32:1711-1718. [DOI: 10.1007/s10103-017-2232-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/12/2017] [Indexed: 01/04/2023]
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Abstract
Androgenetic alopecia (AGA) is characterized by a non-scarring progressive miniaturization of the hair follicle in predisposed men and women with a pattern distribution. Although AGA is a very prevalent condition, approved therapeutic options are limited. This article discusses the current treatment alternatives including their efficacy, safety profile, and quality of evidence. Finasteride and minoxidil for male androgenetic alopecia and minoxidil for female androgenetic alopecia still are the therapeutic options with the highest level evidence. The role of antiandrogens for female patients, the importance of adjuvant therapies, as well as new drugs and procedures are also addressed.
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Affiliation(s)
- Yanna Kelly
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil. .,Department of Dermatology, Hospital do Servidor Publico Municipal de São Paulo, São Paulo, SP, Brazil. .,, 1364, Oscar Freire Street, São Paulo, SP, 05409-010, Brazil.
| | - Aline Blanco
- Department of Dermatology, Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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17
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Wat H, Wu DC, Chan HHL. Fractional resurfacing in the Asian patient: Current state of the art. Lasers Surg Med 2016; 49:45-59. [PMID: 27605303 DOI: 10.1002/lsm.22579] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Fractionated photothermolysis (FP) has revolutionized modern laser technology. By creating selective columns of microthermal damage, fractionated devices allows for greater treatment depths to be achieved without the prolonged downtime and risk of complications seen in traditional fully ablative laser resurfacing. Fractional resurfacing is a proven method to treat a variety of cutaneous conditions. In the Caucasian patient, a wide range of devices and treatment settings can be utilized safely and effectively. However, ethnic skin requires special consideration due to its unique pigmentary characteristics and clinical presentations. In this review article, we detail the current indications and strategies to optimize results and mitigate complications when utilizing fractional resurfacing for the Asian patient. METHODS A review of the MEDLINE English literature was conducted on fractionated laser devices studied in the Asian population. Articles included describe non-ablative devices including fractionated erbium glass, thulium fiber, diode, and radiofrequency devices; and ablative devices including fractionated carbon dioxide (CO2 ) laser, erbium yttrium aluminum garnet and yttrium scandium gallium garnet (YSGG) laser. These data were integrated with the expert opinion of the authors. CONCLUSION Taking into account the unique characteristics and cosmetic concerns of the Asian population, fractional resurfacing can be considered a safe and effective option for the treatment of atrophic and hypertrophic scarring, and photorejuvenation in ethnic skin types. Select cases of melasma may be treated with fractionated non-ablative devices, but utilized with caution. The predominant complication associated with fractional resurfacing for these conditions is post-inflammatory hyperpigmentation (PIH) and rebound worsening of melasma. A greater number of treatments at lower density settings and wider treatment intervals typically produce the lowest risks of PIH without compromising treatment efficacy. Lasers Surg. Med. 49:45-59, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Heidi Wat
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada, T6G 2G3
| | - Douglas C Wu
- Goldman, Butterwick, Groff, Fabi, and Wu Cosmetic Laser Dermatology, San Diego, California, 92121
| | - Henry Hin Lee Chan
- Division of Dermatology, Department of Medicine, University of Hong Kong, Hong Kong, SAR, China.,Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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