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Application of micrografting technology in managing AGA

Updated: Sep 10


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Hair follicles are unique “mini-organs” that regenerate through a growth cycle of anagen (growth), catagen (involution), telogen (resting), and exogen (hair shedding) (1). Hair loss (alopecia) is common in both men and women and affects appearance, social interaction, self-esteem, and quality of life (2). The most common cause of hair loss in males is androgenetic alopecia (AGA)(3). 


Prevalence of Androgenetic Alopecia


The prevalence of AGA in Indian males aged 30-50 years is 58% (4). The mature hair follicle is enriched in different stem cells including progenitor cells, multipotent stem cells, and mesenchymal stem cells (5). Androgens induce the catagen factors in the hair follicle leading to progressive follicle miniaturization and ultimate destruction of hair follicle (6). 

Hair thinning starts at puberty, with a rise in androgen levels, and the severity increases with age. Patients with AGA show high levels of 5 alpha-reductase which acts upon testosterone and through a signaling cascade leads to the shortening of the anagen phase of the hair follicle (Figure 1) (2). 


Figure 1: Signal cascade leading to hair loss in Androgenic alopecia (AGA).


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Treatment of Androgenetic Alopecia


Currently multiple treatment options are available to manage AGA including topical applications, oral medication, injectable medicines, platelet‑rich plasma, laser light therapy, and surgical methods (2, 5). 


Topical treatments include FDA-approved drugs, namely Minoxidil and Finasteride. Minoxidil increases vascular dilation which improves the anagen phase and Finasteride inhibits 5 alpha-reductase type 2 which lengthens the anagen phase. The main drawback of these remedies is the adherence to the timely application of the medication which makes it unfeasible, costly, and it affects the quality of life (2). Ongoing research is currently focused on identifying treatment options that can plug the gaps and address the unmet needs of those suffering from AGA. 


Application of micrografting technology in treating AGA


Patients with AGA have intact hair follicle stem cells; however, the number of progenitor cells is greatly reduced. Micrografting technology relies on the regenerative property of stem cells extracted from scalp biopsy of healthy hair follicles. The extracted stem cells are injected subdermally into the bald areas of the patient with AGA. The innovative autologous micrografting technology from Rigenera® Activa is designed on this technique and is proven to be beneficial without any adverse effects, or rejection (7).


Autologous Micrografting Technology (AMT) procedure


In this procedure, the tissue is extracted via punch biopsy and disaggregated using a novel disposable class I CE-certified medical device called Rigeneracons (See Figure 2). Rigeneracons kits contain micro blades to disaggregate the tissue biopsy, and the sterile viable cell suspension of pluripotent progenitor cells and growth factors (micrograft) is selected by passing through holes of diameter 50 microns (7). 


The scalp tissue is extracted from the occipital area by punch biopsy and placed into a Rigeneracons kit in saline solution. The Rigeneracons kit is placed onto the Rigenera machine or Rechargeable Sicurdrill which centrifuges the kit at 80 rpm and the micrografts suspension is collected via syringe (7).


The micrografts are injected subdermally in the bald area (5). The micrografts act by inducing the development of new hair follicles and stimulating the quiescent hair follicle (8). 

This non-surgical painless procedure leaves no scar compared to the surgical methods. The autologous micrografting procedure requires a single session of 30 minutes. The procedure does not need further follow-up sessions which is the limitation of platelet‑rich plasma and low‑level light therapy (7). 


Figure 2: Autologous Micrografting Technology


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Clinical evidence on micrografting technology


The technology was evaluated in multiple clinical studies. In a clinical trial conducted with 100 patients with AGA, investigators observed a significant increase in total hair count by 218% (8). Data from three clinical studies demonstrated a mean rise of ~30% in hair density over the baseline value while, the placebo showed less than a 1% increase (5, 8, 9). Interestingly, a clinical study has reported a 47.09% reduction in hair loss following the AMT procedure (3). 

Currently, this procedure has been approved in more than 30 countries providing effective results for patients with AGA worldwide. 

About the Author


Pooja Kumari is a medical writer with a PhD in Biotechnology. She has experience in manuscript writing and developing content for HCP blogs and medico-marketing material. Her forte is in-depth knowledge of the subject and accurate statements of facts. She is persistent in gaining knowledge in the emerging field of biomedical sciences.


Reference


  1. Schneider MR, Schmidt-Ullrich R, Paus R. The hair follicle as a dynamic miniorgan. Current biology. 2009;19(3):R132-R42.

  2. Ntshingila S, Oputu O, Arowolo AT, et al. Androgenetic alopecia: An update. JAAD international. 2023;13:150-8.

  3. Álvarez X, Valenzuela M, Tuffet J, et al. Microscopic and histologic evaluation of the Regenera® method for the treatment of androgenetic alopecia in a small number of cases. IJRSMHS. 2017;2:19-22.

  4. Mysore V, Parthasaradhi A, Kharkar R, et al. Expert consensus on the management of Androgenetic Alopecia in India. International journal of trichology. 2019;11(3):101-6.

  5. Gentile P, Scioli MG, Bielli A, De Angelis B, et al. Platelet-Rich Plasma and Micrografts Enriched with Autologous Human Follicle Mesenchymal Stem Cells Improve Hair Re-Growth in Androgenetic Alopecia. Biomolecular Pathway Analysis and Clinical Evaluation. Biomedicines. 2019;7(2):27.

  6. Blume‐Peytavi U, Blumeyer A, Tosti A, et al. S1 guideline for diagnostic evaluation in androgenetic alopecia in men, women and adolescents. British Journal of Dermatology. 2011;164(1):5-15.

  7. Regenera Activa Products. Available at https://www.regeneraactiva.com/en/products. Accessed on 17 Oct 2024

  8. Ruiz RG, Rosell JM, Ceccarelli G, et al. Progenitor‐cell‐enriched micrografts as a novel option for the management of androgenetic alopecia. Journal of cellular physiology. 2020;235(5):4587-93.

  9. Gentile P, Scioli MG, Bielli A, et al. Stem cells from human hair follicles: first mechanical isolation for immediate autologous clinical use in androgenetic alopecia and hair loss. Stem cell investigation. 2017;4.

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