Exosomal Treatment for Hair Loss
Dr. Ken Williams before you choose a treatment program.
Exosomes are the latest generation of naturally bioactive amnion-based products for patient treatment of hair thinning and loss. Exosomes act as paracrine effectors, i.e., they have a theoretical role in signaling or stimulating nearby cells. The stimulating effect upon tissues and cells is caused by transferring biochemical stimulating contents from one cell to another. These messengers are termed exosomes and microvesicles, collectively known as extracellular vesicles (EVs).
Regenerative cells by nature work to heal, repair, stimulate, and restore cells and tissues. The hair follicle is susceptible and vulnerable to miniaturization by genetic and hormonal effects from DHT. The exact mechanism of action is theoretical and further study of this product is pending.
The safety and tolerability of the Exosomes is not known, and no scientific studies or case reports are available in hair restoration patients to determine the safety or efficacy of Exosomes. As such, no guarantee of success can be made with this product, and clinical responses to these medical therapies vary from one patient to another. Treatment for hair loss with novel regenerative therapies is potentially exciting, but without safety and efficacy studies our office is only watching the use of this product and not actively injecting it into patients.
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There are several sources of novel and cellular therapy for regeneration of hair follicles that have not been proven, or where the safety and efficacy have not been demonstrated. Those sources include autologous cells originating from adipose and bone marrow, and placental cell-derived exosome products.
As a hair researcher, Dr. Ken Williams is involved in clinical trials with novel hair restoration procedures. He is not currently offering this product as its safety, tolerability, and efficacy has not been established. It does not have FDA clearance at this time.
Exosomes originate from placental derived mesenchymal stem cells. They are purified microcellular elements using a proprietary filtration process. Exosomes are not cells but microvesicles that contain no nucleus or DNA. Some researchers view this product as one of the purest forms of cellular therapy available, as their function provides tissue stimulation, and wound healing by triggering the patient’s own regenerative cells to become active.
The tiny size of EVs allows for easy injection with local anesthesia into the superficial dermis of scalp. Common autologous scaffolds can be used such as High Density-Platelett Rich Plasma (HD-PRP) or A-Cell™ because they assist in cell retention and cell migration. The procedure is performed in the same manner as other simple procedures done in our office such as HD-PRP injections.
Microvesicles and exosomes of mesenchymal stem cells potentially may provide therapeutic benefits. At the very core of these cells are their trophic (regenerative) and immunomodulatory capabilities. The trophic effects of EVs requires an understanding of the resident stem cells they act upon. Tissue-resident stem cells lie quiescently or in a resting phase within the niche of the hair follicle. We have niches throughout our bodies.
This population of cells are partially undifferentiated and once activated can proliferate and migrate to sites of injury where they acquire a mature phenotype in order to facilitate repair, stimulation, and remodeling. The balance of progenitor cell quiescence and activation is a hallmark of a functional niche and is regulated by internal and external signals. Known niches are seen in the central nervous system, skeletal muscles, liver, skin, kidney, heart, lung, and joints.
Exosomes, the smaller of these two vesicles, measure 40 to 100 nm and are lipid membrane packets formed by a two-step budding process. Formed by inward budding of membranous vesicles in a multi- vesicular body, they fuse with the plasma membrane to release these ultra-tiny vesicles into surrounding cells. They do Not contain a nucleus or DNA.It is regarded as one of the purest forms of cellular therapy as they function to provide healing, scell stimulation, and regenerative effects
Microvesicles are larger by a few hundred nanometers and are formed by budding directly from the plasma membrane. Both exosomes and microvesicles contain transmembrane proteins from their parent cells, which are important in regulating uptake by other cells. By conserving these transmembrane proteins, it has been shown that uptake is facilitated by other cells to a much greater degree than if the cargo was simply released into the extracellular environment. Exosomes and microvesicles are not exclusive to stem cells and are released by many cells throughout the body. Immune cells, cancer cells and aging cells all secrete different vesicles which contain vastly different cargos of information.
This information includes messenger RNAs, micro RNAs, and various proteins. The intrinsic durability of the extracellular vesicle membranes makes them uniquely durable and naturally biocompatible. Additionally, the wide spectrum of proteins and messenger RNA contained within these EVs allows for a vastly greater capacity of information compared with single molecule messengers like hormones , growth factors and cytokines. Finally, the transmembrane protein receptors allow EVs to traffic or home to areas of injury and inflammation while facilitating uptake by numerous cells.
EVs are important in autocrine signaling (local between same cells), paracrine signaling (local between different cells) and endocrine signaling (between distant cells). EVs have been found in all bodily fluids. EV cargos are specific to each type of cell, while cells grown in different environments will also modify their production of EV contents.
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