Hair transplantation in wound healing and scar repair in special areas_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Zhewei ^1,2 , QIAN Xifei ^1,2 , XU Yanwen ² , Kaindi Samuel Tumaini ¹ , Pakaya Collins Daniel ¹ ,  ZHANG Jufang ²

1. Fourth Clinical Medical College Affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou Zhejiang, 310013, P. R. China;
2. Department of Medical Beauty, Hangzhou First People’s Hospital Affiliated to Medical College of West Lake University, Hangzhou Zhejiang, 310006, P. R. China;

Corresponding author：

ZHANG Jufang, Email: zhjuf@sina.vip.com

Keywords：

Hair transplantation; hair follicle; hair follicle stem cells; wound healing; scar repair

DOI：

10.7507/1002-1892.202502051

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review recent advances in the application of hair transplantation in wound healing and scar repair in special areas. Methods An extensive review of the literature on the application of hair transplantation in wound healing and scar repair in special areas was conducted, focusing on cellular functions, molecular mechanisms, and clinical applications. Results Hair transplantation has been shown to effectively promote wound healing and scar repair in special areas. The underlying mechanisms are complex, but current understanding emphasizes a strong association with hair follicle-associated stem cells (including epidermal stem cells, dermal papilla cells, dermal sheath cells, etc). Conclusion The application of hair transplantation in wound healing and scar repair in special areas remains in its early stages. Further investigation into its mechanisms of action is essential, and additional randomized controlled clinical trials are needed to establish its efficacy.

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2.	Guzey S, Alhan D, Şahin I, et al. Our experiences on the reconstruction of lateral scalp burn alopecia with tissue expanders. Burns, 2015, 41(3): 631-637.
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6.	Brown JB, McDowell F. Epithelial healing and the transplantation of skin. Ann Surg, 1942, 115(6): 1166-1181.
7.	Levy V, Lindon C, Zheng Y, et al. Epidermal stem cells arise from the hair follicle after wounding. FASEB J, 2007, 21(7): 1358-1366.
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9.	Fuchs E, Merrill BJ, Jamora C, et al. At the roots of a never-ending cycle. Dev Cell, 2001, 1(1): 13-25.
10.	Panteleyev AA. Functional anatomy of the hair follicle: The secondary hair germ. Exp Dermatol, 2018, 27(7): 701-720.
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26.	Nuutila K, Singh M, Kruse C, et al. Wound healing from dermal grafts containing CD34+ cells is comparable to wound healing with split-thickness skin micrografts. Plast Reconstr Surg, 2017, 140(2): 306-314.
27.	Yari A, Heidari F, Veijouye SJ, et al. Hair follicle stem cells promote cutaneous wound healing through the SDF-1α/CXCR4 axis: an animal model. J Wound Care, 2020, 29(9): 526-536.
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1. Freedman BR, Hwang C, Talbot S, et al. Breakthrough treatments for accelerated wound healing. Sci Adv, 2023, 9(20): eade7007. doi: 10.1126/sciadv.ade7007.
2. Guzey S, Alhan D, Şahin I, et al. Our experiences on the reconstruction of lateral scalp burn alopecia with tissue expanders. Burns, 2015, 41(3): 631-637.
3. 张鹏程, 尤丽娜, 周宗贵, 等. 毛发移植术和头皮组织扩张术修复大面积瘢痕性秃发的效果及适用范围探讨. 实用妇科内分泌电子杂志, 2020, 7(21): 181-182.
4. Orentreich N. Autografts in alopecias and other selected dermatological conditions. Ann N Y Acad Sci, 1959, 83: 463-479.
5. Noori A, Rabiee M, Mehrabani D, et al. Head and neck restoration in scar alopecia: Hair transplantation in scalp, eyebrows, beard and mustache. World J Plast Surg, 2021, 10(3): 90-98.
6. Brown JB, McDowell F. Epithelial healing and the transplantation of skin. Ann Surg, 1942, 115(6): 1166-1181.
7. Levy V, Lindon C, Zheng Y, et al. Epidermal stem cells arise from the hair follicle after wounding. FASEB J, 2007, 21(7): 1358-1366.
8. 李建福, 付小兵, 盛志勇, 等. 创面愈合过程中创缘表皮干细胞的异位. 中国修复重建外科杂志, 2006, 20(3): 264-267.
9. Fuchs E, Merrill BJ, Jamora C, et al. At the roots of a never-ending cycle. Dev Cell, 2001, 1(1): 13-25.
10. Panteleyev AA. Functional anatomy of the hair follicle: The secondary hair germ. Exp Dermatol, 2018, 27(7): 701-720.
11. Xing YZ, Guo HY, Xiang F, et al. Recent progress in hair follicle stem cell markers and their regulatory roles. World J Stem Cells, 2024, 16(2): 126-136.
12. Las Heras K, Royo F, Garcia-Vallicrosa C, et al. Extracellular vesicles from hair follicle-derived mesenchymal stromal cells: isolation, characterization and therapeutic potential for chronic wound healing. Stem Cell Res Ther, 2022, 13(1): 147. doi: 10.1186/s13287-022-02824-0.
13. Li KN, Jain P, He CH, et al. Skin vasculature and hair follicle cross-talking associated with stem cell activation and tissue homeostasis. Elife, 2019, 8: e45977. doi: 10.7554/eLife.45977.
14. Dekoninck S, Blanpain C. Stem cell dynamics, migration and plasticity during wound healing. Nat Cell Biol, 2019, 21(1): 18-24.
15. Jang H, Jo Y, Lee JH, et al. Aging of hair follicle stem cells and their niches. BMB Rep, 2023, 56(1): 2-9.
16. Amoh Y, Hoffman RM. Hair follicle-associated-pluripotent (HAP) stem cells. Cell Cycle, 2017, 16(22): 2169-2175.
17. Rim EY, Clevers H, Nusse R. The Wnt pathway: From signaling mechanisms to synthetic modulators. Annu Rev Biochem, 2022, 91: 571-598.
18. Kretzschmar K, Cottle DL, Schweiger PJ, et al. The androgen receptor antagonizes Wnt/β-catenin signaling in epidermal stem cells. J Invest Dermatol, 2015, 135(11): 2753-2763.
19. Varshney S, Stanley P. Notch ligand binding assay using flow cytometry. Bio Protoc, 2017, 7(23): e2637. doi: 10.21769/BioProtoc.2637.
20. Perdigoto CN, Bardin AJ. Sending the right signal: Notch and stem cells. Biochim Biophys Acta, 2013, 1830(2): 2307-2322.
21. Zhang L, Stokes N, Polak L, et al. Specific microRNAs are preferentially expressed by skin stem cells to balance self-renewal and early lineage commitment. Cell Stem Cell, 2011, 8(3): 294-308.
22. Liu J, Shu B, Zhou Z, et al. Involvement of miRNA203 in the proliferation of epidermal stem cells during the process of DM chronic wound healing through Wnt signal pathways. Stem Cell Res Ther, 2020, 11(1): 348. doi: 10.1186/s13287-020-01829-x.
23. Yang R, Wang J, Chen X, et al. Epidermal stem cells in wound healing and regeneration. Stem Cells Int, 2020, 2020: 9148310. doi: 10.1155/2020/9148310.
24. Shi Y, Yang R, Tu L, et al. Long non-coding RNA HOTAIR promotes burn wound healing by regulating epidermal stem cells. Mol Med Rep, 2020, 22(3): 1811-1820.
25. Ito M, Liu Y, Yang Z, et al. Stem cells in the hair follicle bulge contribute to wound repair but not to homeostasis of the epidermis. Nat Med, 2005, 11(12): 1351-1354.
26. Nuutila K, Singh M, Kruse C, et al. Wound healing from dermal grafts containing CD34+ cells is comparable to wound healing with split-thickness skin micrografts. Plast Reconstr Surg, 2017, 140(2): 306-314.
27. Yari A, Heidari F, Veijouye SJ, et al. Hair follicle stem cells promote cutaneous wound healing through the SDF-1α/CXCR4 axis: an animal model. J Wound Care, 2020, 29(9): 526-536.
28. Snippert HJ, Haegebarth A, Kasper M, et al. Lgr6 marks stem cells in the hair follicle that generate all cell lineages of the skin. Science, 2010, 327(5971): 1385-1389.
29. Lough DM, Wetter N, Madsen C, et al. Transplantation of an LGR6+ epithelial stem cell-enriched scaffold for repair of full-thickness soft-tissue defects: The in vitro development of polarized hair-bearing skin. Plast Reconstr Surg, 2016, 137(2): 495-507.
30. Madaan A, Verma R, Singh AT, et al. Review of hair follicle dermal papilla cells as in vitro screening model for hair growth. Int J Cosmet Sci, 2018, 40(5): 429-450.
31. Gharzi A, Reynolds AJ, Jahoda CA. Plasticity of hair follicle dermal cells in wound healing and induction. Exp Dermatol, 2003, 12(2): 126-136.
32. Bassino E, Gasparri F, Giannini V, et al. Paracrine crosstalk between human hair follicle dermal papilla cells and microvascular endothelial cells. Exp Dermatol, 2015, 24(5): 388-390.
33. Leirós GJ, Kusinsky AG, Drago H, et al. Dermal papilla cells improve the wound healing process and generate hair bud-like structures in grafted skin substitutes using hair follicle stem cells. Stem Cells Transl Med, 2014, 3(10): 1209-1219.
34. Qi SH, Liu P, Xie JL, et al. Experimental study on repairing of nude mice skin defects with composite skin consisting of xenogeneic dermis and epidermal stem cells and hair follicle dermal papilla cells. Burns, 2008, 34(3): 385-392.
35. Wang Y, Shen K, Sun Y, et al. Extracellular vesicles from 3D cultured dermal papilla cells improve wound healing via Krüppel-like factor 4/vascular endothelial growth factor A-driven angiogenesis. Burns Trauma, 2023, 11: tkad034. doi: 10.1093/burnst/tkad034.
36. Jahoda CA, Reynolds AJ. Hair follicle dermal sheath cells: unsung participants in wound healing. Lancet, 2001, 358(9291): 1445-1448.
37. Qiu W, Lei M, Li J, et al. Activated hair follicle stem cells and Wnt/β-catenin signaling involve in pathnogenesis of sebaceous neoplasms. Int J Med Sci, 2014, 11(10): 1022-1028.
38. Juniantito V, Izawa T, Yuasa T, et al. Immunophenotypical analyses of myofibroblasts in rat excisional wound healing: possible transdifferentiation of blood vessel pericytes and perifollicular dermal sheath cells into myofibroblasts. Histol Histopathol, 2012, 27(4): 515-527.
39. Tao Y, Yang Q, Wang L, et al. β-catenin activation in hair follicle dermal stem cells induces ectopic hair outgrowth and skin fibrosis. J Mol Cell Biol, 2019, 11(1): 26-38.
40. 李幼忱, 刘杰, 王德文, 等. 毛囊真皮鞘细胞在皮肤创伤愈合中作用的实验研究. 军事医学科学院院刊, 2009, 33(2): 144-147.
41. Higgins CA, Roger MF, Hill RP, et al. Multifaceted role of hair follicle dermal cells in bioengineered skins. Br J Dermatol, 2017, 176(5): 1259-1269.
42. Herskovitz I, Hughes OB, Macquhae F, et al. Epidermal skin grafting. Int Wound J, 2016, 13 Suppl 3(Suppl 3): 52-56.
43. Zakine G, Mimoun M, Pham J, et al. Reepithelialization from stem cells of hair follicles of dermal graft of the scalp in acute treatment of third-degree burns: first clinical and histologic study. Plast Reconstr Surg, 2012, 130(1): 42e-50e.
44. Martínez ML, Escario E, Poblet E, et al. Hair follicle-containing punch grafts accelerate chronic ulcer healing: A randomized controlled trial. J Am Acad Dermatol, 2016, 75(5): 1007-1014.
45. Yang Z, Liu J, Zhu N, et al. Comparison between hair follicles and split-thickness skin grafts in cutaneous wound repair. Int J Clin Exp Med, 2015, 8(9): 15822-15827.
46. Wong TW, Yang CC, Hsu CK, et al. Transplantation of autologous single hair units heals chronic wounds in autosomal recessive dystrophic epidermolysis bullosa: A proof-of-concept study. J Tissue Viability, 2021, 30(1): 36-41.
47. Alam M, Cooley J, Plotczyk M, et al. Distinct patterns of hair graft survival after transplantation into 2 nonhealing ulcers: Is location everything? Dermatol Surg, 2019, 45(4): 557-565.
48. Navsaria HA, Ojeh NO, Moiemen N, et al. Reepithelialization of a full-thickness burn from stem cells of hair follicles micrografted into a tissue-engineered dermal template (Integra). Plast Reconstr Surg, 2004, 113(3): 978-981.
49. Nordström RE. Punch hair grafting under split-skin grafts on scalps. Plast Reconstr Surg, 1979, 64(1): 9-12.
50. Jackson WM, Nesti LJ, Tuan RS. Mesenchymal stem cell therapy for attenuation of scar formation during wound healing. Stem Cell Res Ther, 2012, 3(3): 20. doi: 10.1186/scrt111.
51. Cheng H, Huang H, Guo Z, et al. Role of prostaglandin E2 in tissue repair and regeneration. Theranostics, 2021, 11(18): 8836-8854.
52. Meng HF, Jin J, Wang H, et al. Recent advances in the therapeutic efficacy of hepatocyte growth factor gene-modified mesenchymal stem cells in multiple disease settings. J Cell Mol Med, 2022, 26(18): 4745-4755.
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