Dr. Hitzig Presents Hair Duplication & Other Uses of Extracellular Matrix
19th Annual ISHRS Scientific Meeting – Anchorage (2011) – Presented on Friday/September 16, 2011, Dr. Gary Hitzig describes clinical applications of porcine urinary bladder matrix – UBM (i.e., ACell MatriStem). UBM is an extracellular matrix, FDA-approved wound healing agent being studied for its practical uses in hair restoration surgery. Use of this agent has been found to stimulate regenerative potential including angiogenesis and recruitment of stem cells.
Intro: ACell (Matristem) attracts Adult Stem Cells to the site of injury (in this case Hair Transplantation) and converts them into active progenitor cells which is what becomes missing during hair miniatuization. It also sets up a non-crosslinked temporary scaffolding for the tissue reconstruction mimicking the surrounding healthy but damaged tissue. This scaffolding contains and slowly releases growth factors (VEGF etc.). The ACell also contains an abundance of necessary materials for remodeling including Collagen IV.
This process has resulted in increased hair counts in the grafts in the recipient area (increased hair density) plus remarkable healing in the donor area.
Much has been written as of late in the use of PRP (Platelet Rich Plasma) Injections to slow down or stop balding as well as to re-grow miniaturizing scalp hairs. A lot of the early reported variable successes (Greco1) have been attributed to the fact that there are significant vital proteins (Collagen IV etc.) as well as multiple growth factors (ie: VGRF) that are vital to terminal hairs along with hair survival and enhancement in general. It has been postulated (Greco1) that the addition of ECM (Extracellular matrix) may significantly improve the results.
What Is ACell (Matristem)?
ACell is the by-product of urinary bladder tissue (which has remarkable regenerative properties). The product is stripped of all cells (ACell) as well as muscle tissue thereby preventing graft vs. host reactions (Allergic Reactions) when introduced in humans. The way it works (in wound healing) is by recruiting huge numbers
PRP Prepared and ready to mix with the Matristem
of Adult Stem Cells along with tremendous blood supply to the sight of a wound. It then effectively changes these inactive Adult Stem Cells back into Progenitor Cells (the Active Form) to direct healing by duplication of normal tissue rather than scar formation which is the only method normally available to humans for healing. What is important to understand is that when we are in-utero (mother’s womb), we develop by the direction of Embryonic Stem Cells. Upon birth, these stem cells still remain in our bloodstream, however they change to Adult Stem Cells which are inactive.
ACell also provides a multitude of growth factors and proteins necessary for tissue regeneration as well as a scaffold on which to reconstruct the tissue. The scaffold is only temporary and soon disappears allowing the healing and regeneration to be carried out by one’s own cells and tissue.
Why ACell for Hair Restoration?
Matristem is unique in that it is Bi-Modal and contains a Basement Membrane necessary to attract and propagate both Epithelial and Endothelial Cells—necessary elements for duplication and restructuring of skin and hairs. Matristem works by setting up a temporary cellular scaffold or bridge and then by attracting massive blood supply plus Adult Stem Cells (there are large numbers of inactive adult stem cells circulating in all humans after we are born) to the site of injury where they are converted back into Progenitor Cells.
Preparation of the PRP
ACell also contains more than ample amounts of the necessary Proteins and Growth Factors to reconstruct and copy tissue along with nerves and appendages (hair for example). Recently it has been shown that PRP (as well as, we suspect, the serum from spun down arterial blood) contain large numbers of Adult Stem Cells. By premixing the ACell with either the Arterial Serum (or more easily the PRP in a non-surgical patient) we are skipping the step of waiting for the Adult Stem Cells to migrate to the injection sites and in essence pre-activating the injections. The injection sites serve as microwounds, which ACell requires to begin the healing (duplication) process. In our opinion, wounds cannot be superficial, but rather, must be down to the subcutaneous tissue level in order to maximize effectiveness.
Our future studies are focused on comparing side by side (in the same patient with thinning hair) the results of injections of PRP alone with PRP + Matristem. Early results in transplant patients (where it is easier to obtain Arterial blood from the surgical donor area) have shown that when Matristem plus spun down Arterial Blood Plasma are combined, then injected in thinning areas other than where the transplants are placed, there appears to be re-growth of these miniaturizing hairs. The results are still very early but make sense in light of previous reported (Greco1) PRP injection results. We postulate that there must also be some sort of Competitive Inhibition with the Androgen Receptors or interruption in delivery by Messenger RNA for this to actually succeed. We are working with Harvest Technologies (PRP Specialists) to see where this will take us.
We are cautiously optimistic at this point.
1. Greco, J, Brandt, R. The effects of autologous platelet rich plasma and various growth factors on non-transplanted miniaturized hair. Hair Transplant Forum Int’l, Vol 19:2, 49-50, March /April 2009.
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