Hair Follicle as a Source of Pigment-Producing Cells for Treatment of Vitiligo: An Alternative to Epidermis?
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Online ISSN 2212-5469
REVIEW ARTICLE
Hair Follicle as a Source of Pigment-Producing Cells for Treatment of Vitiligo: An Alternative to Epidermis? Mahshid Ghasemi1,2 • Amir Bajouri1,3 • Saeed Shafiiyan1 • Nasser Aghdami1,4
Received: 30 May 2020 / Revised: 4 July 2020 / Accepted: 15 July 2020 Ó The Korean Tissue Engineering and Regenerative Medicine Society 2020
Abstract To discuss the advantages and limitations of hair follicle-derived cell transplantation (FCT) in vitiligo, compared to the epidermal cell transplantation (ECT), and the knowledge gap which is required to be bridged. The papers relevant to the purpose was reviewed. Surgical approaches for treating vitiligo are based on the idea of replenishing lost melanocytes. Skin and hair follicles as the main sources of melanocytes have been applied for this purpose transferring the whole tissue or tissue-derived cell suspension to the vitiligo lesions. Considering the differences between hair follicle and epidermis in terms of the constituting cell populations, phenotype and function of melanocytes, and micro-environmental factors, different response of vitiligo patients to treatment with FCT or ECT would be expected theoretically. However, there is currently a lack of evidence on such a difference. However, ECT appears to be a more feasible, less time-consuming, and more comfortable treatment for both physicians and patients. Although the current evidence has not shown a significant difference between ECT and FCT in terms of efficacy, ECT appears to be more feasible specifically in the treatment of large lesions. However, further randomized controlled clinical trials with larger sample sizes and longer follow-up durations are required to be conducted to draw a definite conclusion on comparing FCT with ECT in terms of the safety, efficacy, durability of the therapeutic effects, and indications in vitiligo patients. Keywords Vitiligo Regenerative medicine Cell therapy Hair follicle Melanocyte
1 Background
& Nasser Aghdami [email protected] 1
Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, No. 9, Shaghayegh Deadend, Banihashem St., Resalat Ave., Tehran, Iran
2
University of South Australia, Future Industries Institute, Adelaide, SA, Australia
3
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
4
Department of Infectious Diseases, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Various surgical approaches have been introduced in recent decades for treatment of vitiligo [1]. Skin autografting for treatment of vitiligo was initially reported in 1964 when split-thickness grafting technique was employed. Later, blister roof grafting (in 1971) and punch grafting (in 1978) were introduced as alternative skin transplantation techniques in vitiligo patients [2]. In 1987, autologous epidermal cell transplantation (ECT) was introduced as a novel surgical treatment for vitiligo. Since then, numerous
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