Efficacy of Adipocyte-Derived Stem Cells-Conditioned Media in Telogen Effluvium

Figures & data

Table 1 Baseline Demographic and Clinical Parameters (N = 50)

Parameter	Level	Frequency	Percentage
Gender	Male	2	4.0
	Female	48	96.0
Age at intervention (years)	Mean, SD	37.40	10.95
	Range	20	70
Type of telogen effluvium	Secondary	25	50.0
	Idiopathic	25	50.0
Cause	Hormonal	12	24.0
	Anemia	13	26.0
	Weight loss	3	6.0
	Recent surgery	4	8.0
	Thyroid dysfunction	2	4.0
No. causes by patient	None	25	50.0
	1	17	34.0
	2	7	14.0
	3	1	2.0

Note: Values are frequencies, percentages, except if otherwise specified.

Figure 1 Change in hair growth indicators, by scalp region, in patients with telogen effluvium after treatment with ADSC-CM. Left panels show the adjusted relative % change of the 5 positive (green bars) and 2 negative (Orange bars) parameters, where the bar height represents the percentage change in the given parameter by reference to the population baseline mean. Right panels (in blue) show the mean derived Sinclair grade in baseline versus after treatment with ADSC-CM. Panels are organized by scalp region, including frontal (upper), temporal (middle), and occipital (lower) region.

Table 2 Pre- and Post-Intervention Trichometry Findings by Scalp Region (Intrasubject Analysis)

Parameter (Unit)	Scalp Region	Baseline		Outcome		Mean Absolute Change	Effect Size (Cohen’s D)	p-value
		Mean	SD	Mean	SD
Positive parameters
Hair density (N/cm^2)	Frontal	194.46	46.38	214.98	47.17	20.52	0.7	<0.001*
	Temporal	134.00	28.79	154.96	34.65	20.96	0.8	<0.001*
	Occipital	188.00	41.61	217.06	46.46	29.06	1.0	<0.001*
Average hair shaft thickness (μm)	Frontal	67.10	7.12	68.40	7.53	1.30	0.2	0.090
	Temporal	63.34	8.05	66.06	7.28	2.72	0.5	<0.001*
	Occipital	63.14	6.59	67.12	5.92	3.98	0.8	<0.001*
% thick hair	Frontal	78.26	10.43	93.10	96.27	14.84	0.2	0.285
	Temporal	73.86	12.94	77.00	12.05	3.14	0.3	0.025*
	Occipital	76.06	11.45	80.20	12.54	4.14	0.3	0.046*
Cumulative hair thickness (mm/cm^2)	Frontal	12.95	2.93	14.64	3.19	1.69	0.7	<0.001*
	Temporal	8.42	1.76	10.16	2.31	1.75	1.0	<0.001*
	Occipital	11.80	2.62	14.47	2.79	2.67	1.4	<0.001*
No. follicular unit (%)	Frontal	86.22	12.78	105.18	18.74	18.96	1.3	<0.001*
	Temporal	63.40	11.57	76.78	16.76	13.38	1.0	<0.001*
	Occipital	74.56	12.72	89.96	14.45	15.40	1.0	<0.001*
Negative parameters
% thin hair	Frontal	5.20	4.65	4.14	4.33	−1.06	0.2	0.100
	Temporal	8.08	6.96	6.20	6.19	−1.88	0.3	0.052
	Occipital	4.88	4.68	2.38	2.05	−2.50	0.6	<0.001*
% medium hair	Frontal	16.58	7.67	16.36	7.15	−0.22	0.0	0.826
	Temporal	18.02	8.54	16.88	7.66	−1.14	0.2	0.277
	Occipital	19.16	8.38	15.84	6.18	−3.32	0.5	0.001*
Trichometry-Derived Sinclair scale	Frontal	2.01	0.40	1.79	0.38	−0.21	0.8	<0.001*
	Temporal	2.73	0.38	2.42	0.38	−0.31	1.0	<0.001*
	Occipital	2.17	0.37	1.81	0.34	−0.36	1.3	<0.001*

Notes: Test used: Paired t-test; *Statistically significant result (p<0.05). Effect size interpretation: Small (Cohen’s d ≥ 0.2), medium (≥0.5), large (≥0.8).

Figure 2 Pre- and post ADSC-CM clinical photography of a 39-year-old female patient showing an aesthetic improvement of the midline and bitemporal areas. The figures have been used with written consent of the patient.

Figure 3 Pre- and post ADSC-CM trichometry of a 39-year-old female patient with telogen effluvium.

Table 3 Favorable Response Rate by Trichometry Parameter and Extent of Change Among Responders

Parameter (Unit)	Scalp Region	Favorable Response Rate (%)	Mean Absolute Change (Unit)	Mean Adjusted Relative Change (%)
Hair density (N/cm^2)	Frontal	78.0	31.10	15.21
	Temporal	80.0	28.60	20.32
	Occipital	84.0	37.12	18.73
Average hair shaft thickness (μm)	Frontal	58.0	4.69	6.92
	Temporal	64.0	5.66	9.07
	Occipital	72.0	6.19	9.69
% thick hair	Frontal	52.0	34.00	42.58
	Temporal	60.0	8.67	12.20
	Occipital	74.0	8.78	11.40
Cumulative hair thickness (mm/cm^2)	Frontal	78.0	2.45	17.88
	Temporal	82.0	2.21	25.22
	Occipital	92.0	2.95	23.53
No. follicular unit (%)	Frontal	90.0	21.91	24.53
	Temporal	84.0	17.42	26.71
	Occipital	80.0	20.68	27.58
% thin hair^§	Frontal	50.0	−4.28	−68.82
	Temporal	52.0	−6.62	−71.91
	Occipital	68.0	−4.32	−92.75
% medium hair^§	Frontal	46.0	−6.00	−39.83
	Temporal	48.0	−6.79	−37.62
	Occipital	62.0	−7.45	−40.46
Trichometry-Derived Sinclair scale^§	Frontal	70.0	−0.35	−18.16
	Temporal	78.0	−0.42	−15.64
	Occipital	88.0	−0.42	−20.53

Notes: Adjusted relative change is calculated as the absolute mean change divided by the baseline population mean, and is expressed as percentage. It provides an indication for the % change weighed by the parameter average at baseline population. ^§Favorable evolution is indicated by decrease; otherwise, increase is considered favorable outcome. All results are statistically significant (p<0.05).

Table 4 Comparison of the Absolute Change in Trichometry Parameters Between Idiopathic and Secondary Telogen Effluvium After Treatment with ADSC-CM

Parameter (Unit)	Scalp Region	Idiopathic		Secondary		p-value
		Median	IQR	Median	IQR
Hair density (N/cm^2)	Frontal	32.0	43.0	8.0	30.5	0.093
	Temporal	17.0	32.0	21.0	35.5	0.786
	Occipital	38.0	49.5	14.0	31.0	0.154
Average hair shaft thickness (μm)	Frontal	2.0	4.5	1.0	6.5	0.527
	Temporal	3.0	8.0	3.0	5.5	0.884
	Occipital	2.0	7.5	5.0	7.5	0.704
% thick hair	Frontal	4.0	9.0	0.0	12.0	0.236
	Temporal	3.0	7.0	2.0	14.0	0.648
	Occipital	3.0	6.0	3.0	16.5	0.351
Cumulative hair thickness (mm/cm^2)	Frontal	2.2	3.65	0.8	2.4	0.140
	Temporal	1.8	2.4	1.2	2.2	0.662
	Occipital	3.1	3.2	2.3	2.95	0.248
No. follicular unit (%)	Frontal	21.0	22.0	16.0	25.5	0.573
	Temporal	16.0	15.5	11.0	15.5	0.528
	Occipital	19.0	23.0	16.0	27.0	0.200
% thin hair	Frontal	−1.00	4.50	0.00	4.50	0.640
	Temporal	−1.00	8.50	−1.00	6.50	0.778
	Occipital	0.00	3.50	−3.00	4.50	0.008*
% medium hair	Frontal	−1.00	6.00	1.00	13.5	0.403
	Temporal	0.00	8.50	−1.00	9.00	0.454
	Occipital	−3.00	7.00	−3.00	14.5	0.356
Trichometry-Derived Sinclair scale	Frontal	−0.30	0.45	−0.10	0.30	0.137
	Temporal	−0.30	0.40	−0.30	0.40	0.619
	Occipital	−0.40	0.50	−0.30	0.40	0.130

Notes: *Statistically significant result (p<0.50); test used: Mann-Whitney U test.

Abbreviations: ADSC-CM, Adipocyte-derived mesenchymal stem cells-conditioned media; IRQ, Interquartile range.