Vrapcea Adelina, Pisoschi Cătălina Gabriela, Ciupeanu-Calugaru Eleonora Daniela, Traşcă Emil-Tiberius, Tutunaru Cristina Violeta, Rădulescu Patricia-Mihaela, Rădulescu Dumitru
Doctoral School, University of Medicine and Pharmacy of Craiova, 200585 Craiova, Romania.
Biochemistry Department, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200585 Craiova, Romania.
Diagnostics (Basel). 2025 Apr 28;15(9):1123. doi: 10.3390/diagnostics15091123.
Hair loss (alopecia) presents both aesthetic and psychological challenges, significantly impacting quality of life. Platelet-rich plasma (PRP) therapy has gained prominence due to its ability to deliver growth factors and modulate local inflammation. However, uncertainties remain regarding the mechanisms through which systemic inflammation, oxidative stress, and coagulation factors influence PRP's efficacy. This narrative review explores the impact of inflammatory biomarkers (e.g., NLR, PLR, IL-6, TNF-α) and growth factors (VEGF, TGF-β, FGF) on hair regeneration in PRP therapy. It discusses how oxidative stress and vitamin status (B12, D, folate) correlate with therapeutic success. Additionally, it examines the PRP preparation protocols and combined approaches (microneedling, minoxidil, LLLT) that may amplify clinical responses. The synthesized data highlight that elevated systemic inflammation (increased NLR/PLR values) can limit PRP's effectiveness, while the regulation of inflammation and optimization of antioxidant status can enhance hair density and thickness. Integrating vitamins and an anti-inflammatory diet into the therapeutic protocol is associated with more stable hair growth and reduced adverse reactions. The variability in PRP's preparation and activation methods remains a major obstacle, underscoring the need for standardization. Integrating inflammatory biomarkers with oxidative stress indicators provides fresh insights for tailoring PRP therapies in alopecia. Multimodal treatment strategies combined with collaborative multicenter studies-in which biological markers are embedded within rigorous protocols-could establish standardized methodologies and significantly enhance the treatment success.
脱发（秃头症）带来了美学和心理方面的挑战，对生活质量有重大影响。富血小板血浆（PRP）疗法因其能够递送生长因子并调节局部炎症而受到关注。然而，关于全身炎症、氧化应激和凝血因子影响PRP疗效的机制仍存在不确定性。这篇叙述性综述探讨了炎症生物标志物（如中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、白细胞介素-6、肿瘤坏死因子-α）和生长因子（血管内皮生长因子、转化生长因子-β、成纤维细胞生长因子）对PRP疗法中毛发生长的影响。它讨论了氧化应激和维生素状态（维生素B12、维生素D、叶酸）与治疗成功的相关性。此外，它还研究了可能增强临床反应的PRP制备方案和联合方法（微针疗法、米诺地尔、低能量激光疗法）。综合数据表明，全身炎症升高（中性粒细胞与淋巴细胞比值/血小板与淋巴细胞比值升高）会限制PRP的有效性，而炎症调节和抗氧化状态的优化可以增加头发密度和厚度。将维生素和抗炎饮食纳入治疗方案与更稳定的毛发生长和减少不良反应相关。PRP制备和激活方法的变异性仍然是一个主要障碍，这突出了标准化的必要性。将炎症生物标志物与氧化应激指标相结合为定制脱发的PRP疗法提供了新的见解。多模式治疗策略与协作性多中心研究相结合——其中生物标志物被纳入严格的方案中——可以建立标准化方法并显著提高治疗成功率。
