雄激素性脱发(AGA)和斑秃(AA)是两种非常普遍的疾病,影响不同年龄的男性和女性,这极大地影响了他们的生活质量和自尊。两种病理都被认为是可逆的,尽管常规疗法显示出有限的范围和疗效。新的治疗方法,专注于毛囊发生的退行性变化,需要取得更好的成果。例如,脂肪干细胞(ADSC),丰富且易于获得,在卵泡再生中具有巨大的潜力。ADSC可以通过脂肪抽吸物的酶消化作为基质血管部分(SVF)或通过脂肪细胞的机械分解作为纳米脂肪分离。此外,ADSC分泌组条件培养基的商业制剂(ADSC-条件培养基[CM])已作为吸引人的替代品进入市场,因为它们的成本和可及性相对较低。进行了搜索,交叉相关术语,在PubMedCentral和谷歌学者上。纳入标准是过去10年对AGA或AA患者的研究,其中要么是SVF,nanofat,或ADSC-CM作为主要治疗方法。11个出版物合格:两个研究过的纳米卫星,三,ADSC-CM,六、SVF,单独或与其他疗法结合使用。根据Sackett量表,仅发现一项随机对照试验(RCT)并将其归类为证据2b。其余为病例对照研究或小样本病例系列,无对照,分级为证据3b和4。由于研究设计的异质性,无法进行荟萃分析。鉴于获得的证据,建立了D级NICE建议。然而,我们认为,积极的结果足够一致,可以支持进一步制定相同标准和方法的RCT.
Androgenic alopecia (AGA) and alopecia areata (AA) are two highly prevalent conditions, affecting both men and women of a wide range of ages, which strongly impact their quality of life and self-esteem. Both pathologies are deemed to be reversible, although conventional therapies have shown limited scope and efficacy. New therapeutic approaches, focusing on the degenerative changes that take place in the hair follicle, are needed to achieve better outcomes. For instance, adipose-derived stem cells (ADSC), abundant and easy to obtain, hold great potential in follicular regeneration. ADSCs can be isolated as stromal vascular fraction (SVF) by the enzymatic digestion of the lipoaspirate or as nanofat by the mechanical breakdown of adipocytes. In addition, commercial preparations of the conditioned medium of the ADSCs secretome (ADSC-conditionate medium [CM]) have entered the market as an appealing alternative because of their comparatively lower cost and accessibility. A search was conducted, crossing relevant terms, on PubMed Central and Google Scholar. Criteria for inclusion were studies in the past 10 years on humans with AGA or AA, where either SVF, nanofat, or ADSC-CM was tested as the main treatment. Eleven publications qualified: two studied nanofat, three, ADSC-CM, and six, SVF, either individually or in combination with other therapies. Only one randomized controlled trial (RCT) was found and classified as evidence 2b according to the Sackett scale. The rest were case-control studies or case series with small samples and no control, graded as evidence 3b and 4. A meta-analysis could not be conducted due to the heterogenicity of the study designs. Given the evidence obtained, Level D NICE recommendation was established. However, we consider that the positive findings are sufficiently consistent to support the elaboration of further RCTs that share criteria and methods.