Adjuvant measures and genetic evaluations to improve results of hair transplantation. 2022

Jalal Hamasalih Fattah
Head of Plastic Surgery Unit, College of Medicine, Hawler Medical University, Erbil-Iraq. jalal.hamasalih@hmu.edu.krd.

Follicular unit extraction (FUE) has evolved dramatically as the most recent advancement in surgical hair restoration as it leaves a tiny scar and creates natural and pleasing results. This study aims to show the effectiveness of adjuvant measures and genetic evaluations in improving outcomes. Prospective analysis of 271 male patients with androgenic alopecia who underwent hair transplantation with FUE technique between August 2015 and February 2020 at our center was conducted. The mean age was 35.93 ±4.40 years. At one year postoperatively, patients were asked to fill up a questionnaire which included their satisfaction level, need for 2nd session, and complications. Informed written consent was obtained from all patients. Also, blood samples were provided from patients before the operation. RNA extraction and cDNA synthesis were performed using the RNX-Plus kit (Cinnagen, Iran) and Vivantis kit (Malaysia). Amplification of SRD5A2 and GAPDH genes (as internal standard) for measuring gene expression was performed by real-time PCR. Data were analyzed using the statistical package for social science SPSS V. 23. In the last 156 cases, the addition of 40 mg of Triamcinolone to the LA solution led to a dramatic reduction of the incidence of postoperative oedema, from 40% to 9%. Adding three sessions of PRP at 2nd, 4th and 6th months postoperatively resulted in an increased patient satisfaction rate with better hair density and thickness where the rate of highly satisfied patients increased from 64.5% to 83.7%. The addition of 40 mg Triamcinolone to the LA solution was highly effective in reducing postoperative oedema. Three sessions of PRP at 2nd, 4th and 6th months postoperatively were recommended. The results of SRD5A2 gene expression showed that the expression of this gene in satisfied (P = 0.049) and dissatisfied (P = 0.028) patients were significantly higher than highly satisfied patients, which means that the SRD5A2 gene expression had an essential role in the successfulness of hair transplantation. The increased expression of this gene could reduce the response to hair transplantation.

UI MeSH Term Description Entries
D008297 Male Males
D008565 Membrane Proteins Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. Cell Membrane Protein,Cell Membrane Proteins,Cell Surface Protein,Cell Surface Proteins,Integral Membrane Proteins,Membrane-Associated Protein,Surface Protein,Surface Proteins,Integral Membrane Protein,Membrane Protein,Membrane-Associated Proteins,Membrane Associated Protein,Membrane Associated Proteins,Membrane Protein, Cell,Membrane Protein, Integral,Membrane Proteins, Integral,Protein, Cell Membrane,Protein, Cell Surface,Protein, Integral Membrane,Protein, Membrane,Protein, Membrane-Associated,Protein, Surface,Proteins, Cell Membrane,Proteins, Cell Surface,Proteins, Integral Membrane,Proteins, Membrane,Proteins, Membrane-Associated,Proteins, Surface,Surface Protein, Cell
D002921 Cicatrix The fibrous tissue that replaces normal tissue during the process of WOUND HEALING. Scars,Cicatrization,Scar,Scarring
D006197 Hair A filament-like structure consisting of a shaft which projects to the surface of the SKIN from a root which is softer than the shaft and lodges in the cavity of a HAIR FOLLICLE. It is found on most surfaces of the body. Fetal Hair,Hair, Fetal,Lanugo,Fetal Hairs,Hairs,Hairs, Fetal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000505 Alopecia Absence of hair from areas where it is normally present. Alopecia, Androgenetic,Baldness,Male Pattern Baldness,Pseudopelade,Alopecia Cicatrisata,Alopecia, Male Pattern,Androgenetic Alopecia,Androgenic Alopecia,Baldness, Male Pattern,Female Pattern Baldness,Hair Loss,Pattern Baldness,Alopecia Cicatrisatas,Alopecia, Androgenic,Alopecias, Androgenic,Androgenic Alopecias,Baldness, Female Pattern,Baldness, Pattern,Hair Losses,Loss, Hair,Losses, Hair,Male Pattern Alopecia
D013741 3-Oxo-5-alpha-Steroid 4-Dehydrogenase An enzyme that catalyzes the reduction of TESTOSTERONE to 5-ALPHA DIHYDROTESTOSTERONE. 3-Keto-5-alpha-Steroid delta-4-Dehydrogenase,5-alpha-Reductase, Testosterone,Testosterone 5-alpha-Reductase,Testosterone delta-4-5-alpha-Reductase,3-oxo-5 alpha-Steroid 4-Dehydrogenase (NADP+),3-oxo-5alpha-Steroid 4-Dehydrogenase (NADP+),4-Ene-3-Oxosteroid-5alpha-Reductase,4-Ene-5-alpha-Reductase,NADH-5-alpha-Reductase,NADPH delta(4)-3-Ketosteroid 5 alpha-Oxidoreductase,Steroid 5-alpha-Reductase,Steroid 5Alpha Reductase,Steroid delta-4-5-alpha Reductase,delta 4-3-keto Steroid 5 alpha-Oxidoreductase,delta(4)-3-Ketosteroid-5alpha-Reductase,delta4-3-ketosteroid 5alpha-Oxidoreductase,3 Keto 5 alpha Steroid delta 4 Dehydrogenase,3 Oxo 5 alpha Steroid 4 Dehydrogenase,4 Ene 3 Oxosteroid 5alpha Reductase,4 Ene 5 alpha Reductase,5 alpha Reductase, Testosterone,5-alpha-Reductase, Steroid,5Alpha Reductase, Steroid,5alpha-Oxidoreductase, delta4-3-ketosteroid,NADH 5 alpha Reductase,Reductase, Steroid 5Alpha,Reductase, Steroid delta-4-5-alpha,Steroid 5 alpha Reductase,Steroid delta 4 5 alpha Reductase,Testosterone 5 alpha Reductase,Testosterone delta 4 5 alpha Reductase,delta 4 3 keto Steroid 5 alpha Oxidoreductase,delta-4-5-alpha Reductase, Steroid,delta-4-5-alpha-Reductase, Testosterone,delta-4-Dehydrogenase, 3-Keto-5-alpha-Steroid,delta4 3 ketosteroid 5alpha Oxidoreductase
D014221 Triamcinolone A glucocorticoid given, as the free alcohol or in esterified form, orally, intramuscularly, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. (From Martindale, The Extra Pharmacopoeia, 30th ed, p739) Aristocort,Volon
D018859 Hair Follicle A tube-like invagination of the EPIDERMIS from which the hair shaft develops and into which SEBACEOUS GLANDS open. The hair follicle is lined by a cellular inner and outer root sheath of epidermal origin and is invested with a fibrous sheath derived from the dermis. (Stedman, 26th ed) Follicles of very long hairs extend into the subcutaneous layer of tissue under the SKIN. Follicle, Hair,Follicles, Hair,Hair Follicles

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