Tejapira Kasama, Yongpisarn Tanat, Sakpuwadol Nawara, Suchonwanit Poonkiat
Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Front Med (Lausanne). 2022 Nov 24;9:1058431. doi: 10.3389/fmed.2022.1058431. eCollection 2022.
Immune-mediated alopecias (IMAs), a group of hair disorders associated with immunological reactions, remain a therapeutic challenge since available treatments are generally unfavorable with potential side effects. Platelet-rich plasma (PRP) has been recently proposed as a treatment option based on several limited-quality studies; however, there is no systematic evaluation of PRP efficacy on IMAs in the literature.
To assess PRP's effects in treating IMAs using a systematic review.
Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases. A search strategy was designed to retrieve all studies exploring PRP in treating IMAs, including alopecia areata (AA) and primary cicatricial alopecias (PCAs). In addition, all randomized and non-randomized studies reporting subjective and/or objective outcomes of alopecia treatment with PRP were included.
Thirty-two studies were included, comprising 621 patients with AA and 19 patients with PCAs. PRP had superior efficacy as monotherapy in five studies, comparable to intralesional corticosteroids in six studies in AA treatment. In addition, in the analysis of PCAs, including lymphocytic and neutrophilic subtypes, PRP was efficacious in alleviating disease progression in nine studies.
PRP is considered a promising treatment for AA and PCAs in patients who experienced unfavorable outcomes from conventional treatment. However, its clinical application remains to be standardized, and its recommendation as a treatment for IMAs could not be ascertained due to a lack of high-quality evidence.
[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353859], identifier [CRD42022353859].
免疫介导性脱发（IMAs）是一组与免疫反应相关的毛发疾病，由于现有治疗方法通常效果不佳且存在潜在副作用，仍然是一个治疗难题。基于一些质量有限的研究，富血小板血浆（PRP）最近被提议作为一种治疗选择；然而，文献中尚无对PRP治疗IMAs疗效的系统评价。
通过系统评价评估PRP治疗IMAs的效果。
使用PubMed、Embase、Scopus和Cochrane图书馆数据库进行电子检索。设计了一种检索策略，以检索所有探索PRP治疗IMAs的研究，包括斑秃（AA）和原发性瘢痕性脱发（PCAs）。此外，纳入了所有报告PRP治疗脱发主观和/或客观结果的随机和非随机研究。
共纳入32项研究，包括621例AA患者和19例PCAs患者。在五项研究中，PRP作为单一疗法具有更高的疗效，在六项AA治疗研究中与皮损内注射皮质类固醇相当。此外，在对包括淋巴细胞性和中性粒细胞性亚型在内的PCAs的分析中，PRP在九项研究中有效缓解了疾病进展。
对于传统治疗效果不佳的患者，PRP被认为是治疗AA和PCAs的一种有前景的方法。然而，其临床应用仍有待规范，由于缺乏高质量证据，尚不能确定将其推荐为IMAs的治疗方法。
[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353859]，标识符[CRD42022353859]。
