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再生医学治疗特定皮肤疾病障碍:随机对照临床试验的系统评价。

Regenerative medicine in the treatment of specific dermatologic disorders: a systematic review of randomized controlled clinical trials.

机构信息

Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Niayesh Street, Sattar Khan Avenue, Tehran, 1445613131, Iran.

Faculty of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, 1449614535, Iran.

出版信息

Stem Cell Res Ther. 2024 Jun 18;15(1):176. doi: 10.1186/s13287-024-03800-6.

Abstract

AIMS AND OBJECTIVES

The aim of this study is to systematically review randomized controlled clinical trials (RCTs) studying various types of regenerative medicine methods (such as platelet-rich plasma, stromal vascular fraction, cell therapy, conditioned media, etc.) in treating specific dermatologic diseases. Rejuvenation, scarring, wound healing, and other secondary conditions of skin damage were not investigated in this study.

METHOD

Major databases, including PubMed, Scopus, and Web of Science, were meticulously searched for RCTs up to January 2024, focusing on regenerative medicine interventions for specific dermatologic disorders (such as androgenetic alopecia, vitiligo, alopecia areata, etc.). Key data extracted encompassed participant characteristics and sample sizes, types of regenerative therapy, treatment efficacy, and adverse events.

RESULTS

In this systematic review, 64 studies involving a total of 2888 patients were examined. Women constituted 44.8% of the study population, while men made up 55.2% of the participants, with an average age of 27.64 years. The most frequently studied skin diseases were androgenetic alopecia (AGA) (45.3%) and vitiligo (31.2%). The most common regenerative methods investigated for these diseases were PRP and the transplantation of autologous epidermal melanocyte/keratinocyte cells, respectively. Studies reported up to 68.4% improvement in AGA and up to 71% improvement in vitiligo. Other diseases included in the review were alopecia areata, melasma, lichen sclerosus et atrophicus (LSA), inflammatory acne vulgaris, chronic telogen effluvium, erosive oral lichen planus, and dystrophic epidermolysis bullosa. Regenerative medicine was found to be an effective treatment option in all of these studies, along with other methods. The regenerative medicine techniques investigated in this study comprised the transplantation of autologous epidermal melanocyte/keratinocyte cells, isolated melanocyte transplantation, cell transplantation from hair follicle origins, melanocyte-keratinocyte suspension in PRP, conditioned media injection, a combination of PRP and basic fibroblast growth factor, intravenous injection of mesenchymal stem cells, concentrated growth factor, stromal vascular fraction (SVF), a combination of PRP and SVF, and preserving hair grafts in PRP.

CONCLUSION

Regenerative medicine holds promise as a treatment for specific dermatologic disorders. To validate our findings, it is recommended to conduct numerous clinical trials focusing on various skin conditions. In our study, we did not explore secondary skin lesions like scars or ulcers. Therefore, assessing the effectiveness of this treatment method for addressing these conditions would necessitate a separate study.

摘要

目的和目标

本研究旨在系统地综述各种类型的再生医学方法(如富含血小板的血浆、基质血管部分、细胞治疗、条件培养基等)治疗特定皮肤疾病的随机对照临床试验(RCT)。本研究未研究皮肤损伤的再生、瘢痕形成、伤口愈合和其他次要情况。

方法

精心搜索了包括 PubMed、Scopus 和 Web of Science 在内的主要数据库,以查找截至 2024 年 1 月的 RCT,重点是针对特定皮肤疾病(如雄激素性脱发、白癜风、斑秃等)的再生医学干预措施。提取的关键数据包括参与者特征和样本量、再生治疗类型、治疗效果和不良事件。

结果

在这项系统综述中,共检查了 64 项涉及 2888 名患者的研究。研究人群中女性占 44.8%,男性占 55.2%,平均年龄为 27.64 岁。研究最多的皮肤疾病是雄激素性脱发(AGA)(45.3%)和白癜风(31.2%)。针对这些疾病最常研究的再生方法分别是 PRP 和自体表皮黑素细胞/角质形成细胞移植。研究报告的 AGA 改善率高达 68.4%,白癜风改善率高达 71%。综述中还包括斑秃、黄褐斑、硬化性萎缩性苔藓(LSA)、炎症性寻常痤疮、慢性休止期脱发、侵蚀性口腔扁平苔藓和营养不良性大疱性表皮松解症等疾病。在所有这些研究中,再生医学被发现是一种有效的治疗选择,与其他方法一起。本研究中调查的再生医学技术包括自体表皮黑素细胞/角质形成细胞移植、分离的黑素细胞移植、毛囊起源的细胞移植、PRP 中的黑素细胞-角质形成细胞混悬液、条件培养基注射、PRP 和碱性成纤维细胞生长因子的组合、静脉注射间充质干细胞、浓缩生长因子、基质血管部分(SVF)、PRP 和 SVF 的组合以及 PRP 中保存毛发移植。

结论

再生医学有望成为治疗特定皮肤疾病的一种方法。为了验证我们的发现,建议进行多项针对各种皮肤状况的临床试验。在我们的研究中,我们没有探讨疤痕或溃疡等二次皮肤损伤。因此,评估这种治疗方法对解决这些情况的有效性需要进行单独的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f419/11184747/c79701bd66e5/13287_2024_3800_Fig1_HTML.jpg

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