Autologes plättchenreiches Plasma in der Behandlung der Alopezie

Zusammenfassung

Autologes plättchenreiches Plasma wird aufgrund seiner wundheilenden Eigenschaften vielfach angewandt u. a. in Orthopädie, Chirurgie und Dermatologie. Zunehmend stellt plättchenreiches Plasma außerdem bei bestimmten Formen der Alopezie eine interessante neue Behandlungsoption dar, sei es als alleinige Therapie oder auch als Adjuvans im Rahmen einer Haartransplantation. Kontrollierte klinische Studien an kleineren Patientengruppen zeigten vielfach positive Ergebnisse, größere Studien stehen bislang noch aus. Die Wirkung auf das Haarwachstum wird sehr wahrscheinlich über die in plättchenreichem Plasma enthaltenen Wachstumsfaktoren und Zytokine vermittelt.

Abstract

Autologous platelet-rich plasma is used e. g., in orthopaedics, surgery and dermatology mainly because of its properties to promote wound healing. Furthermore, increasing use of platelet-rich plasma is made as new and interesting option in the treatment of certain kinds of alopecia, either as stand-alone therapy or as adjuvant treatment during hair transplantation. Controlled clinical trials in smaller patient groups predominantly showed positive results, larger studies still must be conducted. Efficacy of platelet-rich plasma in hair growth is most probably mediated through its contained growth factors and cytokines.

Publication History

Article published online:
10 December 2021

• Literatur

• 1 Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP?. Implant Dent 2001; 10: 225-228 DOI: 10.1097/00008505-200110000-00002.
• 2 Alves R, Grimalt R. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage Disord 2018; 4: 18-24 DOI: 10.1159/000477353. Epub 2017 Jul 6.
• 3 Uebel CO, da Silva JB, Cantarelli D. et al. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg 2006; 118: 1458-1466 DOI: 10.1097/01.prs.0000239560.29172.33.
• 4 Malkud S. Telogen Effluvium: A Review. J Clin Diagn Res 2015; 9: WE01-WE03 DOI: 10.7860/JCDR/2015/15219.6492.
• 5 Darwin E, Hirt PA, Fertig R. et al. Alopecia areata: Review of epidemiology, clinical features, pathogenesis, and new treatment options. Int J Trichol 2018; 10: 51-60
• 6 Fidler B. Lilly drug regrows hair in autoimmune disease study, but safety questions linger. 2021 Im Internet (Stand 16.06.2021): https://www.biopharmadive.com/news/lilly-incyte-jak-inhibitors-alopecia-areata-results/596062/
• 7 Stough D, Stenn K, Haber R. et al. Psychological Effect, Pathophysiology and Management of Androgenetic Alopecia in Men. Mayo Clin Proc 2005; 80: 1316-1322
• 8 Norwood OT. Male Pattern Baldness: Classification and Incidence. South Med J 1975; 69: 1359-1365
• 9 Ludwig E. Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex. Br J Dermatol 1977; 97: 247-254
• 10 PharmNet. Bund-Arzneimittel-Informationssystem. Im Internet (Stand 12.04.2021): www.pharmnet-bund.de
• 11 Wolff H, Fischer TW, Blume-Peytavi U. The diagnosis and treatment of hair and scalp diseases. Dtsch Arztebl Int 2016; 113: 377-386 DOI: 10.3238/arztebl.2016.0377.
• 12 Traish AM. Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It's Time to Sound the Alarm. World J Mens Health 2020; 38: 323-337 DOI: 10.5534/wjmh.200012.
• 13 Alves R, Grimalt R. Platelet-Rich Plasma and its Use for Cicatricial and Non-Cicatricial Alopecias: A Narrative Review. Dermatol Ther (Heidelb) 2020; 10: 623-633 DOI: 10.1007/s13555-020-00408-5.
• 14 European Dermatology Forum (EDF). S3-European Dermatology Forum Guideline for the Treatment of Androgenetic Alopecia in Women and in Men (2017). Im Internet (Stand: 20.08.2021): https://www.edf.one/home/Guidelines/Guidelines.html
• 15 Verma K, Tegta GR, Verma G. et al. A Study to Compare the Efficacy of Platelet-rich Plasma and Minoxidil Therapy for the Treatment of Androgenetic Alopecia. Int J Trichology 2019; 11: 68-79 DOI: 10.4103/ijt.ijt_64_18.
• 16 Puig CJ, Reese R, Peters M. Double-Blind, Placebo-Controlled Pilot Study on the Use of Platelet-Rich Plasma in Women With Female Androgenetic Alopecia. Dermatol Surg 2016; 42: 1243-1247 DOI: 10.1097/DSS.0000000000000883.
• 17 Dubin DP, Lin MJ, Leight H. et al. The effect of platelet-rich plasma on female androgenetic alopecia: A randomized controlled trial. J Am Acad Dermatol 2020; 83: 1294-1297 DOI: 10.1016/j.jaad.2020.06.1021.
• 18 Singh SK, Kumar V, Rai T. Comparison of efficacy of platelet-rich plasma therapy with or without topical 5% minoxidil in male-type baldness: A randomized, double-blind placebo control trial. Indian J Dermatol Venereol Leprol 2020; 86: 150-157
• 19 Trink A, Sorbellini E, Bezzola P. et al. A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol 2013; 169: 690-694 DOI: 10.1111/bjd.12397.
• 20 Almohanna HM, Ahmed AA, Griggs JW. et al. Platelet-Rich Plasma in the Treatment of Alopecia Areata: A Review. J Investig Dermatol Symp Proc 2020; 20: S45-S49 DOI: 10.1016/j.jisp.2020.05.002.
• 21 Balakrishnan A, Joy B, Thyvalappil A. et al. A Comparative Study of Therapeutic Response to Intralesional Injections of Platelet-Rich Plasma Versus Triamcinolone Acetonide in Alopecia Areata. Indian Dermatol Online J 2020; 11: 920-924 DOI: 10.4103/idoj.IDOJ_6_20.
• 22 Kapoor P, Kumar S, Brar BK. et al. Comparative Evaluation of Therapeutic Efficacy of Intralesional Injection of Triamcinolone Acetonide versus Intralesional Autologous Platelet-rich Plasma Injection in Alopecia Areata. J Cutan Aesthet Surg 2020; 13: 103-111 DOI: 10.4103/JCAS.JCAS_16_19.
• 23 Xiao S, Wang J, Chen Q. et al. The mechanism of activated platelet-rich plasma supernatant promotion of hair growth by cultured dermal papilla cells. J Cosmet Dermatol 2019; 18: 1711-1716 DOI: 10.1111/jocd.12919.
• 24 Gupta AK, Carviel J. A mechanistic model of platelet-rich plasma treatment for androgenetic alopecia. Dermatol Surg 2016; 42: 1335-1339
• 25 Li ZJ, Choi HI, Choi DK. et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg 2012; 38: 1040-1046
• 26 Giusti I, D'Ascenzo S, Mancò A. et al. Platelet concentration in platelet-rich plasma affects tenocyte behavior in vitro. Biomed Res Int 2014; 2014: 630870 DOI: 10.1155/2014/630870.
• 27 Tajima T, Yoshida E, Yamashita A. et al. Hemoglobin stimulates the expression of matrix metalloproteinases, MMP-2 and MMP-9 by synovial cells: a possible cause of joint damage after intra-articular hemorrhage. J Orthop Res 2005; 23: 891-898 DOI: 10.1016/j.orthres.2005.01.003.
• 28 Dovi JV, He LK, DiPietro LA. Accelerated wound closure in neutrophil-depleted mice. J Leukoc Biol 2003; 73: 448-455 DOI: 10.1189/jlb.0802406.
• 29 Dovi JV, Szpaderska AM, DiPietro LA. Neutrophil function in the healing wound: adding insult to injury?. Thromb Haemost 2004; 92: 275-280 DOI: 10.1160/TH03-11-0720.
• 30 DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classification system. Arthroscopy 2012; 28: 998-1009 DOI: 10.1016/j.arthro.2012.04.148.
• 31 Carofino B, Chowaniec DM, McCarthy MB. et al. Corticosteroids and local anesthetics decrease positive effects of platelet-rich plasma: an in vitro study on human tendon cells. Arthroscopy 2012; 28: 711-719 DOI: 10.1016/j.arthro.2011.09.013.
• 32 Reith B, Mojto V, Kottman T. Verbessert eine Haartransplantation auch die Gesundheit – ist sie doch mehr eine medizinische als eine kosmetische Indikation?. Kosmetische Medizin 2018; 4: 14-19
• 33 Garg S. Outcome of Intra-operative Injected Platelet-rich Plasma Therapy During Follicular Unit Extraction Hair Transplant: A Prospective Randomised Study in Forty Patients. J Cutan Aesthet Surg 2016; 9: 157-164 DOI: 10.4103/0974-2077.191657.
• 34 Slaninka I, Fibír A, Kaška M. et al. Use of autologous platelet-rich plasma in healing skin graft donor sites. J Wound Care 2020; 29: 36-41 DOI: 10.12968/jowc.2020.29.1.36.
• 35 Garg AK, Garg S. A Histological and Clinical Evaluation of Plasma as a Graft-holding Solution and Its Efficacy in Terms of Hair Growth and Graft Survival. J Cutan Aesthet Surg 2020; 13: 50-56 DOI: 10.4103/JCAS.JCAS_97_19.
• 36 Abdelkader R, Abdalbary S, Naguib I. et al. Effect of Platelet Rich Plasma versus Saline Solution as a Preservation Solution for Hair Transplantation. Plast Reconstr Surg Glob Open 2020; 8: e2875 DOI: 10.1097/GOX.0000000000002875.