The Role of Autologous Micrografts Injection from The Scalp Tissue in The Treatment of Covid-19 Associated Telogen Effluvium: Clinical and Trichoscopic Evaluation

Systematic review and meta-analysis of the use of micrografting technology in humans

AimTo critically assess the evidence on micrografting technology to evaluate its effectiveness when used alone or as an adjunct to regenerative treatment in various medical and dental applications.MethodsSeven electronic databases, including Cochrane Central Register of Controlled Trials (CENTRAL), Medline Ovid, Embase Ovid, Cumulative Index to Nursing and Allied Health Literature EBSCOhost, Web of Science Core Collection, System for Information on Grey Literature in Europe, and Bielefeld Academic Search Engine, were searched until 15 July 2024. Risk of bias assessment and qualitative and quantitative (random-effect models) analyses were conducted.ResultsA total of 55 studies were identified. Most studies (n = 24) reported on burns, followed by 10 studies on ulcers/wounds, 7 on androgenetic alopecia, 3 on vitiligo, 3 on cartilage and bone defects, and 1 on coronary artery bypass graft surgery. Dental applications included sinus lift (three studies), socket preservation (two studies), and intrabody defects (two studies). A meta-analysis of four studies on the management of burns confirmed that micrografting led to reduced healing periods compared with other grafting techniques (weighted mean difference: -0.98, 95% confidence interval: -1.84 to -0.12, p = 0.03), with a high level of heterogeneity (83.57%) and risk of bias.ConclusionMicrografting technology may lead to shorter healing time and improved patient morbidity.

Systematic review: Impact of stem cells-based therapy, and platelet-rich plasma in hair loss and telogen effluvium related to COVID-19

BACKGROUND

The incidence of hair loss (HL) and telogen effluvium (TE) in COVID-19 patients has been reported in several studies.

OBJECTIVES

Evaluate both the increased incidence of HL and TE in COVID-19 and the effectiveness of Platelet-Rich Plasma (PRP), Adipose-derived Mesenchymal Stem Cells (AD-MSCs), and Human Follicle Stem Cells (HFSCs) in these patients.

METHODS

The protocol was developed by the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. A multistep search of PubMed, MEDLINE, Embase, Clinicaltrials. gov, Scopus, and Cochrane databases has been performed to identify papers focusing on HL and TE COVID-19 related, and papers focusing on AD-MSCs, HFSC, and PRP use.

RESULTS

Of the 404 articles initially identified focusing on HL and TE, 44 were related to COVID-19, and finally, only 6 were analyzed. On the other way, 331 articles focusing on AD-MSCs, HFSC, and PRP were initially identified. Of these, only 6 articles PRP (n = 3), AD-MSCs, and HFSCs (n = 3) have been analyzed.

CONCLUSION

Collected data confirmed both an increased incidence of HL and TE in COVID-19 patients, preliminarily, the related effectiveness of AD-MSCs, HFSCs, and PRP without major side effects.

Effective and economical cell therapy for hair regeneration

We reviewed and summarized the latest reports on the characteristics of stem cells and follicular cells that are under development for hair loss treatment. Compared with conventional medicine, cell therapy could be effective in the long term with a single treatment while having mild adverse effects. Adipose-derived stem cells (ASCs) have the advantages of easy access and large isolation amount compared with dermal papilla cells (DPCs) and dermal sheath cup cells (DSCs), and promote hair growth through the paracrine effect. ASCs have a poor potential in hair neogenesis, therefore, methods to enhance trichogenecity of ASCs should be developed. DSCs can be isolated from the peribulbar dermal sheath cup, while having immune tolerance, and hair inductivity. Therefore, DSCs were first developed and finished the phase II clinical trial; however, the hair growth was not satisfactory. Considering that a single injection of DSCs is effective for at least 9 months in the clinical setting, they can be an alternative therapy for hair regeneration. Though DPCs are not yet studied in clinical trials, we should pay attention to DPCs, as hair loss is associated with gradual reduction of DPCs and DP cell numbers fluctuate over the hair cycle. DPCs could make new hair follicles with epidermal cells, and have an immunomodulatory function to enable allogeneic transplantation. In addition, we can expand large quantities of DPCs with hair inductivity using spheroid culture, hypoxia condition, and growth factor supplement. 'Off-the-shelf' DPC therapy could be effective and economical, and therefore promising for hair regeneration.