Not all sources of exosomes are identical. Different mesenchymal stem cell lines produce different amounts of various growth factors within their exosomes or secretome. Carefully selected lines of mesenchymal stem cells (MSCs) can be used to produce conditioned media that contain powerful growth factors that influence hair follicle function. Hair regrowth studies are underway using the secretome from MSCs derived from bone marrow. These exosomes are utilized in a non-cellular treatment regimen in the office as well as at home by the patient that desires improved hair growth. Hair loss patients need to be evaluated and diagnosed before ANY hair regrowth regimen is initiated. The ongoing research results from this pilot study will continue to be made available by Dr. Alan Bauman - Bauman Medical Hair Transplant & Hair Loss Treatment Center. Thank you to AnteAGE / Cellese for their ongoing support of this clinical trial. Please visit baumanmedical.com for more information on hair loss and its treatment. Professionals, please visit haircoach.net for training geared toward those interested in providing help to those suffering from hair loss conditions.
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Stem Cell Growth Factor Exosomes for Hair Regrowth - DrAlanBauman_final
1. Microneedling for Hair Regrowth
Using Specialized Stem Cell Growth Factors
Alan J. Bauman, MD, ABHRS
Diplomate, American Board of Hair Restoration Surgery
11.19.2019 - Boca Raton, FL
9. HAIR & SKIN ANATOMY
“A highly accessible dermal appendage which is a musculo-neurovascular-endocrine mini-organ containing a stem cell niche capable of
degeneration and regeneration which en masse can elicit a significant emotional response in the owner or observer.”
-Dr. Alan Bauman
The Pilosebaceous Unit:
100,000-150,000 - scalp
~84% growing phase
1/2 inch per month
50,000 inch / month total
1667 inches / day total
138 feet of hair per day!
5 million body hair follicles
(c)Copyright2018BaumanMedical.AllRightsReserved.
18. Mesenchymal Stem Cells are NOT All Alike
17
Tissue of origin determines in vivo function and is not a predictor of clinical usefulness.
ADIPOSE UMBILICAL CORD
NEURAL
DENTAL PULP AMNION
28. Growth Factor Functions
IGF-1
Major mediator of growth hormone stimulated
somatic growth and GH-independent anabolic
responses.
IGF-2
Major mediator of growth hormone stimulated
somatic growth and GH-independent anabolic
responses.
aFGF
Stimulates hair growth by beta-Catenin expression
and inducing the anagen phase in resting hair
follicles.
bFGF
Stimulates hair growth by beta-Catenin expression
and inducing the anagen phase in resting hair
follicles.
KGF
Binds to KGF receptor to stimulate hair growth.
Stimulates epithelia cell proliferation,
differentiation, and migration and promotes a
number of cell protective mechanisms.
KGF-2
Binds to KGF receptor to stimulate hair growth.
Stimulates epithelia cell proliferation,
differentiation, and migration and promotes a
number of cell protective mechanisms.
SCF
Expression of stem cell factor necessary for the
maintenance of differentiated melanocytes and hair
pigmentation.
CSF-1
Immunomodulatory cytokine that regulates cell
proliferation and differentiation, and may play important
role in regulating hair growth.
PDGF-a
Plays a role in stimulating the proliferation of dermal
mesenchymal cells that contribute to the formation of the
dermal papillae.
EPO
Promotes hair shaft growth and modulation by stimulating
dermal papilla cells..
Noggin
Cellular signaling required for induction of the hair follicle
growth phase (anagen.)
CG-VEGF
Strongest regulator of physiological angiogenesis, induces
proliferation of human hair follicle dermal papilla cells.
29. Wnt / β-catenin Pathway Essential To Hair Follicle
28
TChoi YS, Zhang Y, Xu M, et al. Distinct functions for Wnt/β-catenin in hair follicle stem cell proliferation and survival and interfollicular epidermal homeostasis. Cell Stem Cell. 2013;13(6):720–733.
TP, Kuhl M. An updated overview on Wnt signaling pathways a prelude for more. Circ Res. 2010;106(12):1798–1806.
Tsai SY, Sennett R, Rezza A, et al. Wnt/β-catenin signaling in dermal condensates is required for hair follicle formation. Dev Biol. 2014;385(2):179–188.
30. The Wnt/β-catenin Pathway in Hair Follicle Development & Function
Cell membrane receptor stimulation activates
a cascade of intracellular bio-signals that
results in Wnt target genes being expressed.
“Wnt signaling is intimately involved in hair
follicle stimulation and phase transitions.”
Signaling involved in hair follicle morphogenesis and
development. Int J Mol Sci. 2014 Jan 22;15(1):1647-70.
31. Wnt Pathway Hair Regeneration
Treatment of MSCs with Wnt1a-conditioned medium activates DP cells and promotes hair follicle regrowth.
Dong L, Hao H, Xia L, Liu J, Ti D, Tong C, Hou Q, Han Q, Zhao Y, Liu H, Fu X, Han W. Treatment of MSCs with Wnt1a-conditioned medium activates DP cells and promotes hair
follicle regrowth. Sci Rep. 2014 Jun 25;4:5432. doi:10.1038/srep05432. PubMed PMID: 24961246; PubMed Central PMCID: PMC4069670.
33. Inhibition of JAK-STAT Signaling Promotes Hair Growth
Harel S, Higgins CA, Cerise JE, Dai Z, Chen JC, Clynes R, Christiano AM. Pharmacologic inhibition of JAK-STAT signaling promotes hair growth. Sci Adv. 2015 Oct
23;1(9):e1500973. doi: 10.1126/sciadv.1500973. eCollection 2015 Oct. PubMed PMID: 26601320; PubMed Central PMCID: PMC4646834.
• JAK (Janus kinases) are activated with cell membrane receptor stimulation.
• JAK adds phosphates to the receptor.
• STATs (signal transducer and activator of transcription proteins) bind to phosphates.
• STATs are phosphorylated by JAKs to form a STAT dimer.
• Dimer enters nucleus, binds to DNA, and causes transcription of target genes.
• In hair follicles, Inhibition of JAK-STAT promotes hair growth.
JAK-STAT inhibition
promoted hair growth
in human DP cells
samples grafted to
immunologic
suppressed mice.
Vehicle JAK inhibitor
34. • Cucurbitacin B – a blocker of PAK1 (serine/threonine-protein kinase)
demonstrated to promote hair growth.
• Adenosine – stimulates dermal papilla cell proliferation & prolongs anagen.
• 3Cpipa- affects pyruvate / lactate ratio which regulates stem cell function.
• Caffeine – counteracts suppression of hair shaft production by testosterone.
• Baicalin – activates Wnt/β-catenin pathway to promote anagen from telogen.
• Quercetin – inhibitor of prostaglandin D2 which is increased in bald scalp.
• L-Carnitine – promotes FFA transport to enhance mitochondrial energy.
• Vitamin E Acetate – antioxidant to reduce oxidative stress in scalp.
Additional Actives with Demonstrated Efficacy
36. Micro-needling as a Treatment for Hair Loss
Fertig RM, Gamret AC, Cervantes J, Tosti A. Microneedling for the treatment of hair loss? J Eur Acad Dermatol Venereol. 2018 Apr;32(4):564-569. doi:10.1111/jdv.
14722. Epub 2017 Dec 21. Review. PubMed PMID: 29194786.
Dhurat R, Mathapati S. Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy. Indian J Dermatol.
2015;60(3):260–263. doi:10.4103/0019-5154.156361
Male androgenetic alopecia treated with microneedling alone or associated with injectable minoxidil by microinfusion of drugs into the skin, DOI: http://dx.doi.org/
10.5935/scd1984-8773.201682782
38. 37
Scalp Microneedling with Growth Factors
Home Care
• AnteAGE® Hair SCS
• AnteAGE® Hair Polybotanical
• Dermal Stamp
In-Office
• Microneedling thinning/balding scalp
(1.0mm)
• Stem cell-derived and synthetic growth
factor topical solution
• 8tx’s: Every other week x 16wks
39. Prior AnteAGE Clinical Trial Results
• Duration: 12 weeks (28 subjects) and 24 weeks (12 subjects)
• Protocol:
• Microneedling biweekly (1.0mm) with application of stem cell-derived and synthetic
growth factor solution.
• Use of homecare system including growth factor and botanical formulas and dermal
stamp (0.2mm)
• Hi-resolution photography, trichoscope, and self-appraisal data collection.
• Appraisal of before and after photos by investigator
44. Bauman-AnteAGE Hair Study
n=12
6 mos
every other week in-office tx plus at-home alternating SCS, botanical.
Participants:
women: 30-65 y/o AGA LW2, deep temporal recession, frontal
thinning, no medical conditions, no medications, no prior tx, non
smokers, no current tx for hair within two years, no HRT/OCP.
men: 28-67y/o AGA, NW3-5, vertex/crown thinning, deep temporal
recession; no hair treatments within two years (minox, finasteride,
laser therapy, prp, etc.).
45. Bauman-AnteAGE Study Endpoints
• Global Photography
• HairCheck® Cross-Sectional
Measurements
• Self-Assessment
• Physician-Assessment
• Microphotography
60. How to Use AnteAGE MD:
Adjunct to PRP or other Hair Loss Treatments
• Stand-alone
• Take-home
Clinic+Home = “Team” Approach = Compliance
Non-MD provider
Ask Michele or Liz how to get started!!"
Consider HairCoach® Certification: HairCoach.net
Q&A