{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:43:32Z","timestamp":1791229412312,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"21","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aesth Plast Surg"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>Harnessing the regenerative capabilities of stem cell-derived exosomes holds great promise for developing novel hair growth therapies, offering hope for individuals experiencing hair loss or alopecia. This aimed to elucidate the effect of \u201cforeskin-derived mesenchymal stromal cells derived exosome\u201d injection into the scalp on hair density in patients with androgenetic alopecia and the contribution of this treatment on patient satisfaction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>This prospective study included 30 male patients, aged between 22 and 65, with hair type III-VI according to the Norwood-Hamilton scale. Characterization of the stem cell exosomes was performed with the nanoparticle tracking analysis (NTA), hair densities were calculated via digital imaging analysis, and patient satisfaction was questioned with a modified survey.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>NTA results showed a characteristic distribution of peaks for exosomes 139.7\u2009\u00b1\u20092.3\u00a0nm in diameter. A statistically significant increase in hair density was observed in the 4th and 12th weeks after treatment (<jats:italic>p\u2009<\/jats:italic>&lt;\u20090.05). Patient-reported satisfaction revealed a statistically significant difference in the answers given in the 12th week compared to the 4th week (<jats:italic>p\u2009<\/jats:italic>&lt;\u20090.05). No side effects or complications were observed after exosome injection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Foreskin-derived mesenchymal stromal cells derived exosome injection increased hair density, with sustained patient satisfaction throughout the study. The exosome application resulted in no side effects.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of Evidence IV<\/jats:title>\n                <jats:p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.springer.com\/00266\">www.springer.com\/00266<\/jats:ext-link>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00266-024-04332-3","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T17:27:05Z","timestamp":1724434025000},"page":"4262-4271","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Effectiveness of Exosome Treatment in Androgenetic Alopecia: Outcomes of a Prospective Study"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6109-8919","authenticated-orcid":false,"given":"Mert","family":"Ersan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5006-2774","authenticated-orcid":false,"given":"Emre","family":"Ozer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9605-8738","authenticated-orcid":false,"given":"Ozlem","family":"Akin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0455-9894","authenticated-orcid":false,"given":"Pakize Neslihan","family":"Tasli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7208-8967","authenticated-orcid":false,"given":"Fikrettin","family":"Sahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"issue":"4","key":"4332_CR1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1111\/jdv.19768","volume":"38","author":"L Rudnicka","year":"2024","unstructured":"Rudnicka L, Arenbergerova M, Grimalt R et al (2024) European expert consensus statement on the systemic treatment of alopecia areata. J Eur Acad Dermatol Venereol 38(4):687\u2013694. https:\/\/doi.org\/10.1111\/jdv.19768","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"4332_CR2","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.jdin.2023.07.005","volume":"13","author":"S Ntshingila","year":"2023","unstructured":"Ntshingila S, Oputu O, Arowolo AT, Khumalo NP (2023) Androgenetic alopecia: an update. JAAD Int 13:150\u2013158. https:\/\/doi.org\/10.1016\/j.jdin.2023.07.005","journal-title":"JAAD Int"},{"issue":"2S","key":"4332_CR3","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.jaad.2023.05.048","volume":"89","author":"LJ Goldberg","year":"2023","unstructured":"Goldberg LJ (2023) Alopecia\u2014new building blocks. J Am Acad Dermatol 89(2S):S1\u2013S2. https:\/\/doi.org\/10.1016\/j.jaad.2023.05.048","journal-title":"J Am Acad Dermatol"},{"issue":"10","key":"4332_CR4","doi-asserted-by":"publisher","first-page":"CD013719","DOI":"10.1002\/14651858.CD013719.pub2","volume":"10","author":"M Mateos-Haro","year":"2023","unstructured":"Mateos-Haro M, Novoa-Candia M, Vanegas GS et al (2023) Treatments for alopecia areata: a network meta-analysis. Cochrane Database Syst Rev 10(10):CD013719. https:\/\/doi.org\/10.1002\/14651858.CD013719.pub2","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"4332_CR5","first-page":"9","volume":"162","author":"AJ Stefanis","year":"2023","unstructured":"Stefanis AJ (2023) Adipose tissue in the treatment of androgenic alopecia. Tukov\u00e1 tk\u00e1\u0148 v l\u00e9\u010db\u011b androgenn\u00ed alopecie. Cas Lek Cesk 162(1):9\u201312","journal-title":"Cas Lek Cesk"},{"issue":"1","key":"4332_CR6","doi-asserted-by":"publisher","first-page":"7","DOI":"10.12788\/cutis.0924","volume":"113","author":"J Donovan","year":"2024","unstructured":"Donovan J (2024) Androgenetic alopecia: what works? Cutis 113(1):7\u20139. https:\/\/doi.org\/10.12788\/cutis.0924","journal-title":"Cutis"},{"issue":"8","key":"4332_CR7","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s40265-023-01880-x","volume":"83","author":"S Devjani","year":"2023","unstructured":"Devjani S, Ezemma O, Kelley KJ, Stratton E, Senna M (2023) Androgenetic alopecia: therapy update. Drugs 83(8):701\u2013715. https:\/\/doi.org\/10.1007\/s40265-023-01880-x","journal-title":"Drugs"},{"issue":"5","key":"4332_CR8","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1007\/s12010-015-1795-8","volume":"177","author":"\u00d6S Somuncu","year":"2015","unstructured":"Somuncu \u00d6S, Ta\u015fl\u0131 PN, \u015ei\u015fli HB, Somuncu S, \u015eahin F (2015) Characterization and differentiation of stem cells isolated from human newborn foreskin tissue. Appl Biochem Biotechnol 177(5):1040\u20131054. https:\/\/doi.org\/10.1007\/s12010-015-1795-8","journal-title":"Appl Biochem Biotechnol"},{"issue":"1","key":"4332_CR9","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s11033-024-09378-9","volume":"51","author":"D Sa\u011fra\u00e7","year":"2024","unstructured":"Sa\u011fra\u00e7 D, Ayd\u0131n S, K\u0131rba\u015f OK, \u00d6zt\u00fcrko\u011flu D, \u015eahin F (2024) Extracellular vesicles derived from human foreskin cells (hFS-Exo) accelerate cell migration and angiogenesis through MAPK pathway: an in vitro study. Mol Biol Rep 51(1):471. https:\/\/doi.org\/10.1007\/s11033-024-09378-9","journal-title":"Mol Biol Rep"},{"issue":"3","key":"4332_CR10","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3109\/09546639809160551","volume":"9","author":"BL Barber","year":"1998","unstructured":"Barber BL, Kaufman KD, Kozloff RC, Girman CH, Guess HA (1998) A hair growth questionnaire for use in the evaluation of therapeutic effects in men. J Dermatol Treat 9(3):181\u2013186","journal-title":"J Dermatol Treat"},{"issue":"1","key":"4332_CR11","doi-asserted-by":"publisher","first-page":"1535750","DOI":"10.1080\/20013078.2018.1535750","volume":"7","author":"C Th\u00e9ry","year":"2018","unstructured":"Th\u00e9ry C, Witwer KW, Aikawa E et al (2018) Minimal information for studies of extracellular vesicles 2018 (MISEV2018): a position statement of the international society for extracellular vesicles and update of the MISEV2014 guidelines. J Extracell Vesicles 7(1):1535750. https:\/\/doi.org\/10.1080\/20013078.2018.1535750","journal-title":"J Extracell Vesicles"},{"issue":"1","key":"4332_CR12","doi-asserted-by":"publisher","first-page":"19159","DOI":"10.1038\/s41598-019-55477-0","volume":"9","author":"OK K\u0131rba\u015f","year":"2019","unstructured":"K\u0131rba\u015f OK, Bozkurt BT, Asutay AB et al (2019) Optimized isolation of extracellular vesicles from various organic sources using aqueous two-phase system. Sci Rep 9(1):19159. https:\/\/doi.org\/10.1038\/s41598-019-55477-0","journal-title":"Sci Rep"},{"key":"4332_CR13","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1146\/annurev-physiol-042222-024535","volume":"86","author":"E Cunha","year":"2024","unstructured":"Cunha E, Rocha K, Ying W, Olefsky JM (2024) Exosome-mediated impact on systemic metabolism. Annu Rev Physiol 86:225\u2013253. https:\/\/doi.org\/10.1146\/annurev-physiol-042222-024535","journal-title":"Annu Rev Physiol"},{"issue":"1","key":"4332_CR14","doi-asserted-by":"publisher","first-page":"15560","DOI":"10.1038\/s41598-017-15505-3","volume":"7","author":"RL Rajendran","year":"2017","unstructured":"Rajendran RL, Gangadaran P, Bak SS et al (2017) Extracellular vesicles derived from MSCs activates dermal papilla cell in vitro and promotes hair follicle conversion from telogen to anagen in mice. Sci Rep 7(1):15560. https:\/\/doi.org\/10.1038\/s41598-017-15505-3","journal-title":"Sci Rep"},{"issue":"7","key":"4332_CR15","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1111\/exd.13927","volume":"28","author":"MH Kwack","year":"2019","unstructured":"Kwack MH, Seo CH, Gangadaran P et al (2019) Exosomes derived from human dermal papilla cells promote hair growth in cultured human hair follicles and augment the hair-inductive capacity of cultured dermal papilla spheres. Exp Dermatol 28(7):854\u2013857. https:\/\/doi.org\/10.1111\/exd.13927","journal-title":"Exp Dermatol"},{"issue":"11","key":"4332_CR16","doi-asserted-by":"publisher","first-page":"2996","DOI":"10.1111\/jocd.15890","volume":"22","author":"G Wang","year":"2023","unstructured":"Wang G, Wang Z, Zhang J et al (2023) Treatment of androgenetic alopecia by exosomes secreted from hair papilla cells and the intervention effect of LTF. J Cosmet Dermatol 22(11):2996\u20133007. https:\/\/doi.org\/10.1111\/jocd.15890","journal-title":"J Cosmet Dermatol"},{"issue":"4","key":"4332_CR17","doi-asserted-by":"publisher","first-page":"4354","DOI":"10.1021\/acsnano.8b09573","volume":"13","author":"G Yang","year":"2019","unstructured":"Yang G, Chen Q, Wen D et al (2019) A therapeutic microneedle patch made from hair-derived keratin for promoting hair regrowth. ACS Nano 13(4):4354\u20134360. https:\/\/doi.org\/10.1021\/acsnano.8b09573","journal-title":"ACS Nano"},{"issue":"1","key":"4332_CR18","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1186\/s13287-021-02614-0","volume":"12","author":"W Deng","year":"2021","unstructured":"Deng W, Zhang Y, Wang W et al (2021) Hair follicle-derived mesenchymal stem cells decrease alopecia areata mouse hair loss and reduce inflammation around the hair follicle. Stem Cell Res Ther 12(1):548. https:\/\/doi.org\/10.1186\/s13287-021-02614-0","journal-title":"Stem Cell Res Ther"},{"issue":"5","key":"4332_CR19","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1016\/j.cell.2011.07.019","volume":"146","author":"E Festa","year":"2011","unstructured":"Festa E, Fretz J, Berry R et al (2011) Adipocyte lineage cells contribute to the skin stem cell niche to drive hair cycling. Cell 146(5):761\u2013771. https:\/\/doi.org\/10.1016\/j.cell.2011.07.019","journal-title":"Cell"},{"issue":"8","key":"4332_CR20","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1002\/sctm.19-0410","volume":"9","author":"YJ Tak","year":"2020","unstructured":"Tak YJ, Lee SY, Cho AR, Kim YS (2020) A randomized, double-blind, vehicle-controlled clinical study of hair regeneration using adipose-derived stem cell constituent extract in androgenetic alopecia. Stem Cells Transl Med 9(8):839\u2013849. https:\/\/doi.org\/10.1002\/sctm.19-0410","journal-title":"Stem Cells Transl Med"},{"issue":"6","key":"4332_CR21","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1111\/ijd.12650","volume":"54","author":"H Shin","year":"2015","unstructured":"Shin H, Ryu HH, Kwon O, Park BS, Jo SJ (2015) Clinical use of conditioned media of adipose tissue-derived stem cells in female pattern hair loss: a retrospective case series study. Int J Dermatol 54(6):730\u2013735. https:\/\/doi.org\/10.1111\/ijd.12650","journal-title":"Int J Dermatol"},{"issue":"1","key":"4332_CR22","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12964-022-00959-4","volume":"20","author":"J Rezaie","year":"2022","unstructured":"Rezaie J, Feghhi M, Etemadi T (2022) A review on exosomes application in clinical trials: perspective, questions, and challenges. Cell Commun Signal 20(1):145. https:\/\/doi.org\/10.1186\/s12964-022-00959-4","journal-title":"Cell Commun Signal"},{"issue":"1","key":"4332_CR23","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s13287-023-03287-7","volume":"14","author":"A Lotfy","year":"2023","unstructured":"Lotfy A, AboQuella NM, Wang H (2023) Mesenchymal stromal\/stem cell (MSC)-derived exosomes in clinical trials. Stem Cell Res Ther 14(1):66. https:\/\/doi.org\/10.1186\/s13287-023-03287-7","journal-title":"Stem Cell Res Ther"},{"issue":"1","key":"4332_CR24","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s13287-024-03652-0","volume":"15","author":"H Shi","year":"2024","unstructured":"Shi H, Yang Z, Cui J, Tao H, Ma R, Zhao Y (2024) Mesenchymal stem cell-derived exosomes: a promising alternative in the therapy of preeclampsia. Stem Cell Res Ther 15(1):30. https:\/\/doi.org\/10.1186\/s13287-024-03652-0","journal-title":"Stem Cell Res Ther"},{"issue":"8","key":"4332_CR25","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1093\/asj\/sjy029","volume":"38","author":"HP Stevens","year":"2018","unstructured":"Stevens HP, Donners S, de Bruijn J (2018) Introducing platelet-rich stroma: platelet-rich plasma (PRP) and stromal vascular fraction (SVF) combined for the treatment of androgenetic alopecia. Aesthet Surg J 38(8):811\u2013822. https:\/\/doi.org\/10.1093\/asj\/sjy029","journal-title":"Aesthet Surg J"}],"container-title":["Aesthetic Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-024-04332-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00266-024-04332-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-024-04332-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:11:30Z","timestamp":1732558290000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00266-024-04332-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,22]]},"references-count":25,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["4332"],"URL":"https:\/\/doi.org\/10.1007\/s00266-024-04332-3","relation":{},"ISSN":["0364-216X","1432-5241"],"issn-type":[{"value":"0364-216X","type":"print"},{"value":"1432-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,22]]},"assertion":[{"value":"18 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Ethics committee approval has been granted from our institution with protocol number 1809, and informed consent has been obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}