Effects of Combined Platelet-Rich Plasma and Tressfix Serum Therapy on MicroRNA Expression and Clinical Outcomes in Patients with Alopecia Areata: A Randomized Clinical Trial.

Abstract

Background:

Alopecia Areata (AA) is a chronic autoimmune disorder causing non-scarring hair loss. MicroRNAs (miRNAs) are increasingly recognized as important regulators of immune activity and disease progression in AA. Platelet-rich plasma (PRP) and Tressfix serum may offer therapeutic benefits, but their combined clinical and molecular effects remain unclear. This study compared combined PRP and Tressfix serum therapy with PRP alone and Tressfix serum alone in patients with AA.

Methodology:

This single-blind, three-arm randomized clinical trial included 45 patients with patchy AA. Participants were randomized equally to receive combined PRP and Tressfix serum, PRP alone, or Tressfix serum alone for 14 weeks. Expression of six miRNAs was measured using qRT-PCR before and after treatment. Clinical response was assessed using the Severity of Alopecia Tool (SALT) score at baseline, week 7, and week 14.

Results:

All participants completed the study. Significant reductions in multiple miRNAs were observed across treatment groups, with the greatest changes occurring in the combination therapy group. Group A demonstrated statistically significant reductions in all six evaluated miRNAs (all p < 0.001), whereas Group B showed significant reductions in five miRNAs and Group C in three miRNAs. SALT scores improved progressively in all groups throughout the study period. After adjustment for baseline differences, the combination therapy group demonstrated the greatest reduction in SALT score at week 14, followed by the PRP monotherapy group and the Tressfix monotherapy group. Treatment-related adverse events were mild and self-limiting, consisting primarily of transient injection-site pain, burning sensation, and erythema.

Conclusion:

Combined PRP and Tressfix serum therapy produced greater clinical improvement and stronger modulation of selected miRNAs than either treatment alone. These findings suggest potential clinical and molecular benefits of combination therapy in AA.