Экзосомы: перспективный метод лечения выпадения волос, требующий стандартизации

Exosomes – nano-sized extracellular vesicles derived from various cell types – have emerged as a “promising therapeutic modality” in thrichology; the scientific study of the human hair and scalp, according to a team of medical researchers. Writing in a review, they said existing preclinical and clinical studies show exosomes to be promising in the treatment of hair loss conditions, as well as improving overall hair health. “These vesicles deliver bioactive molecules, such as growth factors, cytokines, and microRNAs, that regulate key cellular processes, including proliferation, differentiation, and signalling, which are critical for hair follicle regeneration,” they wrote. Transformative? Preclinical, clinical and emerging evidence According to preclinical findings, exosomes from various sources can be used to enhance dermal papilla cell proliferation, activate signalling pathways, and promote the transition of hair follicles from the resting phase of hair growth to the active growth phase. Some clinical data also shows promising results for improvements to overall hair health, such as hair density, thickness and follicular health, as well as use in treatments targeting hair loss disorders like androgenetic alopecia, alopecia areata and chemotherapy-induced alopecia. Emerging evidence suggests exosome therapy can potentially be combined with other modalities, like low-level laser therapy or platelet-rich plasma, for synergistic effects in targeting hair follicle regeneration. Importantly, the researchers said all of the reviews and case series highlighted the “favourable safety profile of exosome-based therapies”. “Exosomes represent a transformative approach in trichology, offering a minimally invasive and biologically active solution for hair loss disorders,” the researchers wrote. Currently, though, human data is limited, with most evidence still in preclinical or early clinical stages, they said. More clinical investment, therefore, is required to better understand and advance use of exosomes in hair and scalp health; ideally via scaled, long-term, standardised and randomised controlled clinical trials. Harmonised regulatory frameworks and improved manufacturing and quality controls will also be key in ensuring reproducibility and safety moving forward, they said. If all of this is achieved, the researchers said exosomes hold “significant potential as a next-generation therapeutic tool in hair restoration”. A complimentary approach: “It is very early days” Speaking to Premium Beauty News, Eva Proudman, consultant trichologist and founder of clinical network UK Hair Consultants, said exosomes are certainly promising but agreed that more robust clinical research is needed. “It is very early days and, currently, exosomes are more likely to be used alongside proven treatments rather than a single treatment,” Proudman said. Exosomes for hair and scalp health can be extracted from a range of sources, including plants, salmon testes, fat tissue and bone marrow, among others, and can be applied either topically onto the scalp or intradermally via microneedling, she explained. But, today, she said exosomes could not be defined as ’transformative’ for trichology. Instead, Proudman said exosomes offer an “additional level of treatment”, topically and intradermally. “They may support hair growth and regeneration by communicating with the dermal papilla and hair stem cells, but it is early days and there is a lot of research still to be carried out.” The regulatory landscape is also restrictive, she said, with no Food and Drug Administration (FDA) approval on exosomes in the US and no Therapeutic Goods Administration (TGA) approval in Australia, for example. In the EU and UK, human cell-derived materials in cosmetics are also banned. “More research and testing is required before exosomes can really be seen as the next introduction to every clinic,” Proudman said. The case for a standardised translational framework Dr Amit Jaiswal, assistant professor at the University of Dr. D. Y Patil Vidyapeeth in India, said the review was timely and well-structured. Writing via published correspondance with two colleagues, Jaiswal said the work represents “an important contribution” to a rapidly expanding translational frontier within reconstructive and aesthetic surgery. “As enthusiasm for exosome therapeutics accelerates, however, the field now stands at a critical inflection point: the transition from biologic plausibility to disciplined clinical integration. We believe that the next decisive step is the establishment of a standardised translational framework capable of ensuring reproducibility, safety, and scientific credibility.” According to Jaiswal and his colleagues, future clinical investigations should be transparent in the disclosure of cellular origin and manufacturing conditions of exosomes; use standardised vesicle characterisation; include dose reporting to facilitate reproducibility and comparability; remain objective; and contain structured adverse-event reporting with extended follow-up. “Such measures would not impede innovation but instead elevate the scientific rigor necessary for durable clinical adoption. By aligning trichologic applications with broader regenerative medicine standards, the specialty can ensure that therapeutic enthusiasm is matched by methodological precision,” he wrote.