Mechanisms and clinical progress of adipose-derived stem cells and their derivatives in the treatment of hair loss

Abstract

The rising prevalence of alopecia poses a significant challenge for both clinicians and researchers. As the global incidence of hair loss continues to increase, research into hair biology and regenerative mechanisms has gained considerable attention. However, current treatment options for alopecia are often constrained by limited efficacy and notable adverse effects. This underscores an urgent need for innovative therapeutic strategies to address these gaps. Adipose-derived stem cells (ADSCs), a subset of mesenchymal stem cells, represent a promising new approach in the treatment of alopecia. This review provides a detailed examination of the fundamental properties of ADSCs and their derivatives, exploring their mechanisms of action in alopecia therapy. Analysis of the efficacy of ADSCs and their derivatives in both preclinical and clinical settings highlight their potential to stimulate hair regeneration. Additionally, the review discusses various pre-treatment methods designed to enhance the regenerative capacity of ADSCs in hair growth, elucidating the mechanisms involved. The review also addresses the challenges and future directions for the use of ADSCs in alopecia treatment, aiming to offer valuable insights for both theoretical research and clinical practice. Ultimately, this work seeks to contribute to the development of more effective treatment regimens for alopecia.

1. Introduction

Hair loss is a common condition caused by a variety of factors, including endocrine disorders, stress, nutritional and metabolic imbalances, diseases and infections, genetic predispositions, and aging [1]. Studies suggest that over 50% of the global population will experience some degree of hair loss in their lifetime, with androgenetic alopecia (AGA) and alopecia areata (AA) being the most prevalent types. Notably, AGA accounts for 90% of all hair loss cases [2]. The underlying mechanism of AGA involves hair follicles being highly sensitive to dihydrotestosterone (DHT), an androgen metabolite, which leads to the gradual shrinkage of hair follicles, shortening of the anagen phase, and eventually, hair loss [2]. This condition not only affects physical appearance but also significantly impacts the mental health of affected individuals, often leading to social isolation, depression, and anxiety [3–5].

Currently, the FDA has approved only two drugs for the treatment of AGA: finasteride and minoxidil [6]. Although these drugs are effective in slowing hair loss, they come with potential side effects and can lead to dependence with long-term use [7]. In addition to these medications, other commonly employed treatment modalities include dutasteride, platelet-rich plasma (PRP), hair transplantation, low-dose oral minoxidil (LDOM), low-level laser therapy (LLLT), botulinum toxin type A (BTX-A), and micro needling. However, these approaches exhibit significant limitations in terms of efficacy, safety, and applicability [8–14]. Compounding these challenges, approximately 20 million patients do not respond to traditional treatments, creating an urgent need for new therapeutic options [15].

Stem cell therapy has emerged in recent years as a promising approach to treating a variety of diseases [16]. Stem cells are characterized by their ability to self-renew and differentiate into multiple functional cell types under specific conditions, allowing them to repair and replace damaged tissues. Because of these properties, stem cells have broad applications in treating various conditions, including hematologic disorders, burns, bone defects, and cardiovascular diseases [17–19]. For example, stem cells can promote lung tissue repair by differentiating into various lung cell types [20]. Moreover, stem cells can be used to treat conditions such as pneumonia, sepsis, and acute lung injury by inhibiting inflammatory responses, reducing vascular leakage, and enhancing bacterial clearance [21–24]. In the context of immunomodulation, stem cells secrete immunosuppressive cytokines like IL-7, IL-11, IL-14, and IL-15, which have been used in the treatment of autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis [25, 26].