Androgenic Alopecia(AGA) is a highly prevalent condition for which existing pharmacological and surgical interventions present limitations and side effects, creating a clinical need for safer and more effective therapies. In response, human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-Exos) have emerged as a cell-free therapeutic strategy. Characterized by their rich bioactive components, absence of tumorigenic risk, and high safety profile, hUCMSC-Exos represent a promising approach for hair regeneration. This study aims to evaluate the safety and efficacy of hUCMSC-Exos combined with automated microneedle delivery for treating AGA. By utilizing innovative lyophilization technology to maintain exosomal bioactivity and employing precision microneedle systems for enhanced delivery, this research seeks to provide a new generation solution for androgenic alopecia treatment.
Androgenic Alopecia (AGA) is a prevalent hereditary condition with significant limitations in current treatment options. Pharmacological therapies are often associated with gender-specific restrictions and adverse effects including sexual dysfunction and hypertrichosis, while surgical and immunotherapeutic approaches face challenges of high cost, limited efficacy, and potential complications. These shortcomings highlight the urgent clinical need for safer and more effective treatment strategies. Human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-Exos), nano-scale vesicles measuring 30-150 nm in diameter, present a promising alternative. Enriched with bioactive components including proteins and lipids, these cell-free structures demonstrate no proliferative capacity, tumorigenic risk, or significant cytotoxicity, offering a superior safety profile compared to conventional stem cell therapies. This study employs an innovative "dual-layer membrane lyophilization system" that maintains exosomal bioactivity while enabling room temperature storage and transportation through optimized freeze-drying and reconstitution processes. To address transdermal delivery challenges, the research utilizes an automated microneedle system that overcomes the limitations of traditional injection and roller microneedle methods in achieving uniform penetration and depth control. This advanced delivery platform ensures precise, consistent, and efficient exosomal permeation into scalp tissues.This study aims to evaluate the safety and efficacy of the combined approach of hUCMSC-Exos and automated microneedle delivery for treating AGA. By integrating innovative lyophilization technology with precision delivery, this research seeks to establish a new generation therapeutic solution for androgenic alopecia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
18
Following the standard treatment protocol, subjects were instructed to topically apply 1 mL of 5% minoxidil twice daily until the completion of the 3-month treatment course. Self-recorded usage of minoxidil was documented in a daily log, which was reviewed by the investigators during each treatment visit.
Performed with a needle length of \~1.2 mm (adjusted to scalp thickness) at 100-200 Hz. The procedure is conducted in sections (e.g., forehead, vertex, temporal regions) until mild pinpoint bleeding (indicating dermal stimulation) is achieved.
A solution of exosomes (3 mL) prepared using the traditional purification process, for topical application after microneedling.
A solution of exosomes (3 mL) prepared using a novel purification process with an inner-outer bilayer membrane lyoprotection system, for topical application after microneedling.
Affiliated Union Hospital of Fujian Medical University
Fuzhou, Fujian, China
RECRUITINGHair Density in the Alopecia Area
Trichoscopic hair count (hairs/cm²) in a fixed 1 cm² frontal/vertex scalp area.
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Mean Change in Hair Shaft Diameter
The diameter of at least 20 randomly selected terminal hairs in the alopecia area will be measured using trichoscopy with integrated measurement software, and the mean value will be calculated,Unit of measure: micrometer (μm).
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Vellus-to-Terminal Hair Ratio
Within a standardized alopecia area , vellus hairs (diameter \< 30 μm) and terminal hairs (diameter ≥ 30 μm) will be counted separately via trichoscopy,Their ratio will be calculated. This is a dimensionless value reported as a ratio (e.g., 0.5) or a percentage (e.g., vellus hair proportion of 50%).
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Photographic Hair Density Score
Standardized photographs (90-degree vertex and 45-degree frontal views) are taken under fixed conditions. A trained, blinded rater will assign a score based on a predefined photographic scale that correlates with hair density (e.g., 1=Sparse to 5=Dense).
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Physician Global Assessment
Hair loss severity was assessed using the Hamilton-Norwood Classification Scale. It classifies male androgenetic alopecia into ordered categorical stages (I through VII) with recognized variant patterns (e.g., types IIA, IIIA, IVA, VIA). The scale's minimum defined stage is Stage I, representing minimal to no frontotemporal recession. The maximum defined stage is Stage VII, characterized by the most advanced presentation of fusion of the frontotemporal and vertex regions of alopecia, with only a narrow, posteriorly situated horseshoe-shaped band of residual parietal and occipital hair. Evaluations were independently performed by two physicians from the department. In cases of significant discrepancy between the two assessors, a third physician was consulted. The final result was derived from the two most concordant assessments.
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Patient Satisfaction Evaluation
Patient satisfaction was evaluated using a self-reported satisfaction scale. The scale categories were: Very Satisfied (improvement ≥ 75%), Satisfied (improvement 50% to 75%), Neutral (improvement 25% to 49%), and Dissatisfied (improvement ≤ 25%). The satisfaction rate was calculated as follows: (Number of Very Satisfied + Number of Satisfied) / Total number of patients × 100%.
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Adverse Events Monitoring
Adverse events, including but not limited to erythema, burning, pruritus, dryness, irritation, hyperpigmentation, edema, hypertrophic scarring, skin ulceration, and infection, were monitored.
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
Visual Analog Scale (VAS) for Pain
Pain was assessed using the Visual Analog Scale (VAS). A linear scale marked from 0 to 10 was used, where the "0" end was labeled "No Pain" and the "10" end was labeled "Worst Pain Imaginable." Patients were instructed to mark on the line corresponding to their subjective pain level, allowing for a quantitative assessment of pain intensity. The VAS scoring criteria were as follows:0: No Pain;1-3: Mild Pain;4-6: Moderate Pain;7-9: Severe Pain;10: Worst Pain Imaginable。
Time frame: Within one week prior to treatment initiation, and at Weeks 4, 12, and 24 after the first treatment
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