TABLE 8.
Studies regarding mesenchymal stromal cell-conditioned medium for hair restoration in humans.
| MSC source | Method of tissue extraction | MSC characterization | MSC treatment | Indication | Study type | Age (years) | Sex (male: female) | Groups of treatments and via of administration | Follow-up (days) | Assessment | Main outcomes | |
| Oh et al., 2020 | Human umbilical cord | Umbilical cord section | Flow cytometry (CD14, CD45, HLA-DR, PE-conjugated human CD73, CD166, BD, CD90, and CD105) | MSCs of passaged 5 at 60–70% confluence were used. CM enriched with TGF-1 and LiCl (primed-MSC-CM). CM was collected without pretreatment with TGF-1 and LiCl to act as the control | Healthy adults diagnosed with AGA (males: Type II according to the modified Norwood–Hamilton classification, women: Ludwig classification Type I) | Double blind placebo-controlled clinical trial | 46.9 (range 33–55) | 1:30 | 5% CM topically applied twice daily - Primed-MSC-CM (n = 16) - Placebo (n = 14) |
112 | Hair density and diameter (phototrichogram), hair density (hair count/cm2, counting the total number of hairs in the target area), hair thickness (mm) and hair growth rate (mm/day), rate of hair growth | Primed-MSC-CM improved androgenetic alopecia. Hair density increased by 14.24% in primed-MSC-CM group, while no improvement was observed in placebo group. Hair thickness increased by 28.19%, and hair growth rate increased by 19.54% in primed-MSC-CM-treated group. Primed-CM significantly increased the viability of DPCs |
| Narita et al., 2020 | Human subcutaneous adipose tissues | Liposuction | Flow cytometry (CD73+/CD90+/ CD34−/CD14−). Adipogenic and osteogenic differentiation | MSCs of passage 4 were used. Cells were cultured under hypoxia conditions. CM was then collected | Patients with AGA | Prospective observational study | Range 23–74 | 21:19 | Intradermal injection of ADSC-CM every month (n = 40) | 180 | Trichograms, physiological examinations (TEWL, SCH lipid level), ultrasonogray (dermal thickness and echogenicity), histology (HE, Elastica Masson–Goldner staining, Sirius red/fast green staining) | Hair density and anagen hair rate increased significantly compared with baseline. TEWL increased, while SCH and lipid level showed no obvious changes. Dermal thickness and dermal echogenicity increased significantly |
| Lee et al., 2020 | Human subcutaneous adipose tissues | Liposuction | Flow cytometry (CD73+/CD90+/ CD34−/CD14−). Adipogenic and osteogenic differentiation | MSCs are cultured with hydrogel, and the CM is collected, after being filtered using 0.22-mm filters. Then, it is added to a solution, and SCM2-Black3 is obtained | Patients with AGA | Double-blinded, randomized placebo-controlled study | 46.6 (range 20–61) | 1:1 | Before CM application, a single session of treatment was performed at the first visit and weekly single-pass self-applications of microneedle stamps. Topically applied once per week - MSC-CM - Normal saline (placebo) (n = 30) |
84 | Macroscopic appearance (photography), phototrichograms (hair density), gross hair volume improvement, investigator’s improvement (measured by questionnaire response) | MSC-CM group had significantly higher hair density than placebo (102.1 ± 4.09 vs. 89.3 ± 3.79/cm2). The gross hair volume of the MSC-CM group was also significantly higher (2 ± 0.13 vs. 1.2 ± 0.19/cm2). Investigator’s improvement was similar in both groups. No adverse effects associated with ADSC-CM were reported |
| Shin et al., 2015 | Human subcutaneous adipose tissues | Liposuction | Flow cytometry (CD73+/CD90+/ CD34−/CD14−), Adipogenic and osteogenic differentiation | MSCs of passage 4 were used. Cells were cultured under hypoxia conditions. CM was then collected | Patients with AGA, female pattern hair loss | Retrospective observational study. | 41.9 ± 13.4 (range 22–69) | 0:27 | Intradermal injection of MSC-CM every week (n = 27) | 84 | Patients’ medical records and phototrichographic images (hair density and thickness) | Hair density increased from 17.3 hairs/cm2, and hair thickness increased by 6.5 μm compared with baseline. None of the patients reported severe adverse events. The only inconvenience reported was the pricking of the needles during application |
AGA, androgenetic alopecia; CM, conditioned medium; DPC, dermal papilla cells; HE, hematoxylin and eosin; IHC, immunohistochemistry; IF, immunofluorescence; MSCs, mesenchymal stromal cells; MT, Masson’s trichrome; PBS, phosphate-buffered saline; qRT-PCR, real-time quantitative polymerase chain reaction; SCH, stratum corneum hydration; TEWL, transepidermal water loss.