Fermented Morinda citrifolia extract stimulates hair growth by promoting dermal papilla cell proliferation and modulating the follicular microenvironment

ETHNOPHARMACOLOGICAL RELEVANCE: Morinda citrifolia (Noni) is a traditional medicinal plant widely utilized in tropical regions for its antioxidant and anti-inflammatory properties. While its traditional applications extend to skin and hair health, its specific pharmacological effects on hair follicle biology-particularly when its phytochemical profile and bioavailability are enhanced through fermentation-remain largely unexplored. AIM OF THE STUDY: This study aimed to investigate the pro-regenerative effects and underlying molecular mechanisms of fermented M. citrifolia extract (FME) as a potential therapeutic intervention for hair loss. MATERIALS AND METHODS: The pharmacological effects of FME were evaluated using human dermal papilla cells (hDPCs) and ex vivo human hair follicle organ cultures. Assessments included cell viability, cell cycle progression, protein expression analysis, hair shaft elongation, and transcriptomic profiling. RESULTS: FME significantly enhanced hDPC viability and promoted cell cycle progression into the S-phase. Mechanistically, FME activated Wnt/β-catenin signaling by stabilizing β-catenin, thereby increasing the secretion of key hair growth factors (VEGF, bFGF, IGF2) and enhancing antioxidant defense. In ex vivo cultures, FME induced dose-dependent hair shaft elongation, prolonged the anagen phase, and preserved hair bulb architecture. Transcriptomic profiling revealed that FME upregulated stemness-related and hair structure pathways while downregulating matrix remodeling enzymes and pro-inflammatory signaling networks. CONCLUSIONS: FME promotes hair growth through the activation of dermal papilla cells and modulation of follicular signaling networks, primarily via the Wnt/β-catenin axis. These findings provide mechanistic evidence supporting FME as a promising and safe therapeutic candidate for alopecia.