A study of noncultured extracted hair follicle outer root sheath cell suspension for transplantation in vitiligo

Abstract

Context:Vitiligo surgeries have come a long way from tissue grafts to cultured and non cultured cell transplantation. Extracted hair follicle outer root sheath cell transplantation (EHF ORS) suspension is more enriched with melanocyte. In a hair bulb, there is one melanocyte for every five keratinocytes which is much higher than the epidermal melanin unit.Aims:To analyse the effectiveness of cultured EHF ORS and to perform objective evaluation based on clinical improvement & photographic evidence. To observe any untoward events or side effects.Settings and Design:The study was open and uncontrolled. All the patients were screened at preliminary visit. Reviews were done every two weeks. The endpoint selected was six months post procedure.Materials and Methods:Twenty five patients of stable Vitiligo were included in the study and follicular unit were harvested by Follicular Unit Extraction method. Outer root sheath cells were extracted by trypsinization. The solution was transplanted over dermabraded recipient site. Pressure dressing was given. Patients were followed up regularly.Statistical Analysis Used:Descriptive Statistics, Chi-Square.Results:Mean ± SD repigmentation was 80.15% ± 22.9% with excellent repigmentation (90-100%) in 60% of patients.Conclusions:This method is safe, effective, and simpler than the other methods involving cell culturing and requiring a laboratory set-up but selection of patients is crucial for the success of the outcome.

Study of efficacy and safety of noncultured, extracted follicular outer root sheath cell suspension transplantation in the management of stable vitiligo

“…Although a good cell viability of cell suspension was noted (80 ± 17.7%), our patient had lower mean repigmentation as compared to Mohanty et al . and Shah et al . Many researchers have reported a defect in the keratinocyte lineage in vitiligo pathogenesis, therefore we analyzed the CD200 marker of this lineage using flow cytometry and noticed that although a higher proportion of patients with CD200 cells of >10% showed good repigmentation, this was not statistically significant ( P = 0.142) …”

“…Mean (±S.D.) repigmentation noted was 80.15% ± 22.9% with excellent repigmentation (90–100%) in 60% of patients . In a small series from our center, noncultured outer root sheath cell suspension was used in 14 patients of stable vitiligo .…”

Melanocyte Chitosan/Gelatin Composite Fabrication with Human Outer Root Sheath-Derived Cells to Produce Pigment

“…In vitiligo, although the lesional epidermis is eventually completely devoid of MCs, the pigmentation of terminal hairs is usually preserved, which suggests the presence of an intact bulge MC reservoir in depigmented vitiligo skin that is spared from the effects of the immune attack 19 . In clinical practice, non-cultured extracted human hair follicle outer root sheath cell suspension (NCORSHFS) has been proven to be effective in treating stable vitiligo patches 20 – 23 . However, methods like NCORSHFS that involve repigmentation through cellular grafting are generally used for small depigmentary lesions.…”

Autologous non-cultured melanocyte–keratinocyte transplantation in the treatment of vitiligo: patient selection and perspectives

“…Recipient vitiligo skin may be prepared by different methods including cryoblebbing, 7 , 29 , 30 , 47 dermabrasion 2 – 4 , 8 , 15 – 18 , 25 – 28 , 33 – 38 , 41 , 43 , 44 , 46 , 51 or laser resurfacing. 5 , 9 , 29 , 40 , 45 , 52 , 53 The ideal method should be simple to perform, safe with minimal side effects and efficient reaching the dermoepidermal junction to avoid scarring or loss of the grafted melanocytes.…”