Convergent Regenerative Strategies in PM&R for Musculoskeletal and Hair Restoration: Integration of PRP, Exosomes, and Physical Modalities

The review discusses regenerative strategies for musculoskeletal and hair restoration, focusing on platelet-rich plasma (PRP), exosomes, and physical modalities like low-level laser therapy (LLLT) and mechanotransduction. These treatments target shared biological mechanisms such as stem cell activity, angiogenesis, and inflammation modulation, using pathways like Wnt/ẞ-catenin and TGF-ß. PRP and exosomes have shown efficacy in enhancing hair count and density in androgenetic alopecia, with exosomes facilitating tissue repair through paracrine signaling. LLLT is FDA-cleared for androgenetic alopecia and promotes hair growth by stimulating hair follicle stem cells and reducing inflammation. Despite promising results, challenges remain in standardization and dosing, highlighting the need for further research to optimize these therapies for true tissue regeneration. Future advancements depend on harmonizing biologic preparations, developing precision-based treatments, and integrating emerging technologies to enhance regenerative outcomes.