International Society for Stem Cell Application (ISSCA) and Marmara University Launch Stem Cell and Regenerative Medicine Fellowship Program in Turkey
Participants in the program will have access to over 200 hours of valuable online content and hands-on laboratory practice in the state-of-the-art facilities at Marmara University and StemBio. Generally, the program will cover a series of topics related to the general principles of regenerative medicine, including:
- Stem cell biology;
- Evidence-based treatments; and
- Tissue engineering.
Hear from Certified and Established Industry Leaders
The Stem Cell and Regenerative Medicine Fellowship Program aims to provide attendees with the chance to meet, interact, and learn from ISSCA-certified doctors, scientists, experts, and Marmara University professors with in-depth expertise in the field. There will be seven days of in-person training and a comprehensive digital course offering practical experience in stem cell classifications and laboratory applications, with a high emphasis on Good Manufacturing Practice (GMP) guidelines.
Learn About the Best Stem-Cell Application Practices and Procedures in Clinical and Manufacturing Operations
By attending the program, participants should be able to gain valuable answers to the “how to” questions related to the practical applications of stem cell biology and regenerative medicine in research laboratories and manufacturing facilities. Attendees can expect to learn the following:
- How to culture stem cells;
- How to meet quality control standards;
- How to comply with cGMP functions;
- How to operate within the recommended clinical procedures;
- How to apply and implement the regulations for stem cell processing in a certified manufacturing facility; and
- How to apply clinical guidelines and regulatory policies when developing a GMP facility
Besides, the seven-day fellowship program will also offer participants resources to bolster their stem cell operations, including copies of presentations, procedural guidelines, and all forms and documentation related to a GMP facility.
Moreover, the Stem Cell and Regenerative Medicine Fellowship Program will cover a range of clinical procedures, including:
- Tissue processing;
- Isolation of mesenchymal stem cells;
- Culture, Expansion and cryopreservation; and
- Clinical Application of stem cells for wide-ranging indications: participants will get case books and complete protocols for about 30 indications.
Why Attend the Stem Cell and Regenerative Medicine Fellowship Program?
The program provides a learning experience for medical professionals and scientists who’d love to further their knowledge and skills in stem cells and regenerative medicine. Attendees will get the opportunity to learn from the top professionals in the field and gain practical hands-on experience in world-class laboratory facilities.
Here’s what Global Stem Cells Global’s CEO, Benito Novas, had to say: “We are delighted to hold the Stem Cells and Regenerative Medicine Fellowship Program, which is designed to provide participants with the opportunity to gain and further their knowledge in stem cell biology and tissue engineering. In addition, ISSCA’s partnership with Marmara University will ensure attendees have access to professors with deep knowledge in the field and practical training in stem cell and regenerative medicine.”
For more information on the Stem Cell and Regenerative Fellowship Program, visit the ISSCA website or contact Global Stem Cells Group.
About Marmara University
Marmara University is a leading research university nestled in Istanbul, Turkey. It’s a distinguished academic institution with high authority in scientific research and academic excellence, specifically in medicine. The university provides undergraduate, graduate, and doctorate degrees, as well as certificate programs. Marmara University also boasts state-of-the-art facilities and dedicated faculty that chronicle its dedication to giving scholars world-class learning experiences and contributing to the advancement of knowledge in wide-ranging fields.
The International Society for Stem Cell Application (ISSCA) is a multidisciplinary community of scientists and physicians who aspire to treat diseases and lessen human suffering through advances in science, technology, and the practice of regenerative medicine. ISSCA serves its members through advancements made in the specialty of regenerative medicine.
The mission of the International Stem Cell Certification Agency (ISSCA) is to establish itself as a global leader in regenerative medicine certification, education, research, and training.
ISSCA provides certification training in cities worldwide because it recognizes the importance of standards and certifications in regenerative medicine as a medical specialty. To help more people, both locally and globally, as the demand for more doctors interested in and comfortable with regenerative medicine surges. ISSCA’s mission is to advance quality and uniformity in regenerative medicine worldwide.
About Global Stem Cells Group:
The Global Stem Cell Group is a family of several companies focused on stem cell medicine and research. The company uses its network to bring leadership in regenerative medicine training, research, and patient applications.
GSCG’s mission is to allow physicians to present the benefits of stem cell medicine to patients worldwide. The company also partners with policymakers, educators, and regulators to promote regenerative medicine.
Global Stem Cells Group is a publicly traded company operating under the symbol MSSV. https://finance.yahoo.com/quote/mssv/
To learn more about Global Stem Cells Group, Inc.’s companies visit our website www.stemcellsgroup.com or call +1 305 560 5331
Safe Harbor Statement:
Statements in this news release may be “forward-looking statements”. Forward-looking statements include, but are not limited to, statements that express our intentions, beliefs, expectations, strategies, predictions, or any other information relating to our future activities or other future events or conditions. These statements are based on current expectations, estimates, and projections about our business based partly on assumptions made by management. These statements are not guarantees of future performance and involve risks, uncertainties, and assumptions that are difficult to predict. Therefore, actual outcomes and results may and are likely to differ materially from what is expressed or forecasted in forward-looking statements due to numerous factors. Any forward-looking statements speak only as of the date of this news release, and The Global Stem Cells Group undertakes no obligation to update any forward-looking statement to reflect events or circumstances after the date of this news release. This press release does not constitute a public offer of any securities for sale. Any securities offered privately will not be or have not been registered under the Act and may not be offered or sold in the United States absent registration or an applicable exemption from registration requirements.
The Stem Cell Center Network ( a Division of Global Stem Cells Group ) is an international network of regenerative medicine practitioners . Dedicated to promoting the research and development of the field of regenerative medicine, and strives to bring patients cutting-edge treatments that make use of the ever-growing list of benefits that regenerative medicine carry. This week, in a part of their effort to expand their foothold in medical communities around the world, the Stem Cell Center Network has announced the opening of a new training facility in Lisbon, Portugal.
Over the years, the Stem Cell Center Network has sought out to aggressively expand and roll out new membership opportunities, programs, events, and more– an effort that has been redoubled in the last five years. As a result, we have added members that practice regenerative medicine under our banner in over twenty five countries spread across five continents.
The new Portuguese center will be located in the clinic of Dr. Hugo Madeiras, a highly-accredited physician and scientist who will preside over the facility as the Global Stem Cells Group chief representative in Portugal. As the CEO and founder of the Clinic of Advanced Implantology, he focuses exclusively on implantology, esthetics, and digital workflows, and collaborates with over twenty doctors and seventy resources in total. He is also the clinical collaborator for the Straumann Group, a faculty which includes product testing, lecturing, and the creation and delivery of educational content.
Dr. Madeiras graduated from the Instituto Superior de Ciências da Saúde Egas Moniz in Medicine in 2007, and with a Master in Oral Rehabilitation from CESPU in 2009. With his over ten year of experience in the field, he acts as a speaker at several national and international congresses that go over developments and new treatment protocols in the field of dentistry.
“This new center will help in bringing regenerative medicine to the people of Lisbon. It will treat patients with a wide variety of different diseases, but with a special emphasis on Aesthetic Medicine,” Said Benito Novas CEO of the Global Stem Cells Group about the new Stem Cell Center Network partnership, “This new facility will be at the top of the line, a place where Portuguese doctors can come to learn about regenerative medicine protocols, and the advancements that have been made in the field. I am incredibly excited to be working in partnership with Global Stem Cells Group , and look forward to many years as a program leader here in Portugal,”
Stem Cell Center Network plans for the clinic to open in September 2020– and with that date looming closer and closer with each passing week, a date has also been agreed upon for the clinic’s inaugural training– indeed, it will be a place for doctors around the country to convene and learn, share, and research the complexities and applications of regenerative medicine. Barring any extenuating circumstances, the next first Regenerative Medicine Certification Training in the Portuguese clinic will take place on September 25 & 26th, 2020– just weeks after its formal opening. With only 10 spots available, applicants are encouraged to sign up soon for the hands-on training course.
To sign up today, visit: https://issca.us
About Global Stem Cells Group
Global Stem Cells Group (GSCG) is a worldwide network that combines seven major medical corporations, each focused on furthering scientific and technological advancements to lead cutting-edge stem cell development, treatments, and training. The united efforts of GSCG’s affiliate companies provide medical practitioners with a one-stop hub for stem cell solutions that adhere to the highest medical standards.
Global Stem Cells Group is a publicly traded company operating under the symbol MSSV.
Some people believe that stem cell does all of this but studies have shown that It’s unlikely only in a few unique cases. You can observe minimal growth a year after the patient took treatment, but this doesn’t mean replacement of the cartilage.
The cartilage has a reduced regenerative capacity, and current and present pharmacological medications only offer symptomatic pain relief. Osteoarthritis patients that respond poorly to conventional therapies are ultimately treated with surgical procedures to promote cartilage repair by implantation of artificial joint structures (arthroplasty) or total joint replacement (TJR). Surgery has been the last resort for serious cartilage problems.
In the last two decades, stem cells derived from various tissues with varying differentiation and tissue regeneration potential have been used for the treatment of osteoarthritis, damage to bones and others either alone or in combination with natural or synthetic scaffolds. The stem cells derived from these tissues primarily aid cartilage repair. Although stem cells can be differentiated into chondrocytes in vitro or aid cartilage regeneration in vivo, their potential for Osteoarthritis management remains limited as cartilage regenerated by stem cells fails to fully recapitulate the structural and biomechanical properties of the native tissue. It isn’t easy for the cartilage to regrow and assume its original biomechanical and structure form.
Apparently, Due to the limited intrinsic capacity of resident chondrocytes to regrow the lost cartilage post-injury, stem cell-based therapies have been proposed as a novel therapeutic approach for cartilage repair.
Also, stem cell-based therapies using mesenchyme stem cells (MSCs) or induced pluripotent stem cells (iPSCs) have been used successfully in clinical and preclinical situations.
Part of the issues associated with Mesenchyme stem cells can be averted by using iPSCs. iPSCs are an ideal patient-specific unlimited cell source for autologous tissue regeneration. With the Promising in vitro; studies have shown that vitro results have already been demonstrated in the cartilage engineering field for iPSCs. These were generated from various cell types.
What Is Cartilage and How Does It Get Damaged?
Cartilage is a connective tissue in the human body and body of other animals. In our joints, we have a few kinds of cartilage, but most often people refer to the smooth lining of a joint called articular or hyaline cartilage. This kind of cartilage gives rise to a soft layer of cushion on the end of a bone at the joint. The cushion is essential for balance, mechanical functions and athletics. This tissue of the cartilage is very strong, yet it can compress, readjust and absorb varying degrees of energy. It is also very slippery, smooth and flexible and these features allow the joint to glide effortlessly through a broad range of physical motions of any kind.
When joint cartilage is not working correctly or damaged, this smooth-cushioning-layer can be worn away, and this becomes a problem. In the case of traumatic injuries, sometimes a sudden force causes the cartilage to break off or poorly become damaged, exposing the underlying bone of the body. In the case of osteoarthritis (also called degenerative/wear-and-tear arthritis), over time that smooth layer can wear thin and uneven. Aging can also cause the cartilage to break off and certain life factors and diseases too, e.g. autoimmune diseases.
Eventually, as that cushion of the bones wears away, joint movements can become inflexible, stiff and painful on one or both legs (bones). Joints can even become inflamed and swollen. And as all these conditions, typically causes pain and limitations in activity become problematic. The action or activities that involve these bones leads to crushing pain and discomfort, depending on the severity of the case. Almost all activities involve the movement of bones; hence this condition is not an easy one.
There are some treatments for cartilage damage and arthritis. Although there some medicines, most of these treatments are focused either on relieving symptoms by smoothing down the damaged cartilage or concentrate on replacing the joint surface with an artificial implant. The later is for end-stage conditions, and the artificial plane is procedures such as knee replacement or hip replacement surgery.
How Can Stem Cells Help?
Stem cells are specialized cells that can multiply reform and develop into different types of tissue. In the developmental stages of a fetus, stem cells are plentiful and surplus. However, in adulthood, stem cells are restricted to specific tasks of regenerating a few types of cells, such as blood cells and liver cells in some cases of damage. There are almost no stem cells found in cartilage tissue, and therefore there is little to no capacity to heal or regrow new cartilage. For adults, the ability to regrow new cartilage is even more difficult due to age and lack of stem cells in the cartilages.
Most often, in the setting of orthopedic surgery and joint problems, stem cells are obtained from adult stem cell sources. The primary sources are bone marrow and fatty tissue. These stem cells can develop into cartilage cells, called chondrocytes.
They also exhibit some other helpful qualities by stimulating the body to reduce inflammation, stimulate cell repair, and improve blood flow. This process is caused by the secretion of cellular signals and growth factors to stimulate the body to initiate healing processes.
Once stem cells have been obtained, they need to be delivered to the area of the cartilage that damaged. One option is to inject the stem cells into the joint. There have been many studies investigating just this, and some data shows improvement in symptoms. How much of this improvement is the result of new cartilage growth versus other effects of stem cells (the healing properties listed above, including the anti-inflammatory effects) is unknown.
There is a challenge with giving stem cell injection. The problem with just injecting stem cells is that cartilage is a complex tissue that is comprised of more than only cells hence this can pose a challenge because the stem can’t regenerate all the things in the cartilage.
To regrow the cartilage, the complex tissue structure and biomechanics of cartilage must also be reconstructed to its former status. Cartilage can often /described as having a scaffold-like structure that is composed of water, cells, collagen, and proteoglycans, and infection-fighting antibodies. Injecting just the stem cells is thought to be less effective in stimulating the formation of the entire cartilage structure hence the challenge.
Some studies are investigating the types of 3-dimensional tissue scaffolds engineered to have a cartilage-like structure. The stem can then be injected into the scaffold, in hopes of better restoring a healthy type of cartilage. Three-dimensional printing is becoming an exciting part of this type of research. If everything works out as expected, the cartilage reconstruction could be achieved to a very high percentage.
How do stem cells work?
Necessarily, stem cells are progenitor cells which are capable of regeneration and differentiation into a wide range of specialized cell types. Once injected, stem cells follow inflammatory signals from damaged tissues and have multiple ways of repairing these damaged areas. It works as though the part is developing new; like what is seen during a child’s development.
The mesenchyme stem cells (MSCs) we are using are considered to be multipotent (they can transform into different cell types but cannot form an organ) but not pluripotent. In the body, these cells Do NOT function by transforming into different cell types or tissues.
They act via anti-inflammatory activity, immune modulating capacity, and the ability to stimulate regeneration. We go through a very high thorough screening process to find cells that we know have the best anti-inflammatory activity, the best immune modulating capacity, and the best ability to stimulate regeneration process on the tissue with damage.
ISSCA (International Society for Stem Cells Applications) www.issca.us
This is a business located in Miami, FL, where people around the world come to take a certification in the newest Stem Cells Protocols.
Some organizations have put in efforts to help discover some solutions in stem medicine. International Society for Stem Cell Application (ISSCA ) is one of the leading associations in setting standards and promoting excellence in the field of Regenerative Medicine, researches, publications related education, certification, research and publications.
The ISSCA is a unique-multidisciplinary community of physicians, stem specialist and scientists with a mission to advance the science, technology and practice of Regenerative Medicine. Their aim is to treat disease and lessen human suffering. ISSCA generally advances the specialty of Regenerative Medicine and serves its members.
The ISSCA provides certifications and standards in the practice of Regenerative Medicine as a medical specialty.
Although the expectation on this stem cell course is yet to be achieved; however, this is a part of medicine that can offer one-end-solution to various bone and body problems.
With the recent high-tech studies, efforts and dynamics, stem cell treatment can be a breakthrough in the future as its perspectives are very promising and unique. It is also not dangerous on the long-run.
Fact: According to research, PRP treatments are one of the most in-demand treatments available in healthcare.
This is impressive considering the following.
PRP is not supported by the medical industry. No big pharma funding on extensive research or marketing. No medical associations lobbying to increase its awareness.
PRP is shunned by the insurance companies. No reimbursements from them. So getting patients to pay is difficult. Especially for a treatment that’s relatively “unproven” like this.
The cost of PRP treatments are actually rising. In 2006, you can get a PRP treatment for $450. Today it costs $800. The cheapest we’ve seen is $650. The prices are still robust as demand keeps up.
However, we believe the best of PRP is not even here yet. We’re just one breakthrough study away from exploding into mainstream hospitals and clinics. We see the biggest growth in Platelet-Rich Plasma happening in Asia.
Strongly based on fundamental healing theory
The growth can be attributed to PRP’s fundamental healing property. More platelets. More growth factors and cytokines. And therefore more healing. It’s as simple as that. And no one can argue this fact.
Our body’s natural healing mechanism operates with 150,000/ul-350,000/ul platelets in blood. Using Platelet-Rich Plasma means this number is amplified by 3X to 5X. How can this be not translated into better healing?
Believe it or not, the best orthopedic doctors use Platelet-Rich Plasma. And do so regularly.
PLATELET-RICH PLASMA TRENDS
PRP can be used to promote healing of injured tendons, ligaments, muscles, and joints, can be applied to various musculoskeletal problems. And they conduct regular studies to test it’s effectiveness.
One landmark study involved double-blind randomized controlled trials to see the effect of PRP on patients with chronic low back pain caused by torn discs. The study outcome says 60% of the patients felt significant improvements.
Some were cured. CURED!
Platelet-Rich Plasma Variants
So far, there are the following type of PRP variants.
Plasma Rich in Growth Factors (PRGF)
Plasma Rich in Platelets and Growth Factors (PRPGF)
Platelet-Rich Plasma (PRP); Platelet Poor Plasma (PPP)
Plasma Rich in Platelets and Rich in Leukocytes (LR-PRP)
Plasma Rich in Platelets and Poor in Leukocytes (LP-PRP)
Platelet-Rich Fibrin Matrix (PRFM)
All of them involve Plasmapherisis — the two stage centrifugation process to separate platelets from blood. However, what happen what happens after that can be different. And the industry hasn’t found it’s middle ground as to which variant to be standardized. We believe the confusion will clear up in 3-5 years.
PLATELET-RICH PLASMA TRENDS
No matter which variant you end up using, the bio-factors at play are the following:
Growth factors: TGF-B, PDGF, IGF-I,II, FGF, EGF, VEGF, ECGF
Adhesive proteins: Fibrinogen, Fibronectin, Vitronectin, Thrombospondin-1
Clotting & Anti-Clotting factors: Proteins, Antithrombin, Plasminogen, Proteases, Antiproteases
How Platelet-Rich Plasma Actually Work
Why is the treatment commonly used for wound healing and pain management? The answer is because the platelets’ main job is to aid coagulation, act as a biological glue and support stem or primary cell migration. In addition, it also helps in restoring hyaluronic acid and accelerates the synthesis of collagen and glycosaminoglycans and increases cartilage matrix.
Not only that, the platelets are delivered in a clot which means it can immediately act as a scaffold to enable the healing process. 95% of the bio-active proteins are released within 1 hour of injecting Platelet-Rich Plasma. The platelets continue to release growth factors for 7-10 days. Thus it’s recommended to re-inject PRP every 7 days.
PLATELET-RICH PLASMA TRENDS
Why are patients coughing up their hard earned money for this?
This reminds me of hundreds of thousands of PRP treatments paid from patient’s own pocket even though they’ve been paying for years to get covered by their respective insurance provider. In 2015, PRP costs were anywhere between $600 and $800 per site per treatment. And most patients go for repeated treatments. So why were they forking up their hard earned money if the treatment was not working? Weren’t there any better alternatives under the “coverage” of their insurance provider? The answer is 1) the treatment works. 2) there’s nothing else out there that’s as natural and side-effect-free as PRP.
Consider the case of osteoarthritis. 27 millions Americans are impacted by it. 33.6% of people older than 65 are victims. All of them experience gradual degeneration of cartilage and bones — they lose roughly 5% cartilage per year. Yet, our medical industry doesn’t have a fix to stop it.
However, when doctors started doing PRP treatments for their osteoarthritis patients, they found a large majority of them had no further cartilage loss.
To me, it means we should make PRP treatments the default first-line treatment for osteoarthritis across the country.
Another huge market is hair loss and cosmetic facial applications. I know there are many people who believe PRP doesn’t work for hair. Here’s what one of the Platelet-Rich Plasma studies found were the effect of the treatment on hair loss.
“Hair loss reduced and at 3 months it reached normal levels. Hair density reached a peak at 3 months (170.70 ± 37.81, P < 0.001). At 6 months and at 1 year, it was significantly increased, 156.25 ± 37.75 (P < 0.001) and 153.70 ± 39.92 (P < 0.001) respectively, comparing to baseline. Patients were satisfied with a mean result rating of 7.1 on a scale of 1-10. No remarkable adverse effects were noted.”
I’ll take that.
That’s me getting PRP for hair. ??
PLATELET-RICH PLASMA TRENDS
PRP market is expected to hit $126 million in 2016
That number looks paltry. But that’s an 180% increase over the 2009 figure of $45 million.
Consider this. Just for osteoarthritis alone, if all the 27 million Americans receive 1 PRP shot a year at a conservative $400 per treatment, it would be a market of $10 billion. And that’s one condition out of the many that Platelet-Rich Plasma injections are proven to work.
Another condition that PRP is known to work very well is Tennis Elbow. It affects on average 1% to 3% of the overall population. That number is as high as 50% among tennis players.
Do the math.
Just getting Platelet-Rich Plasma covered by insurance will unleash the market big time and will help heal millions of patients naturally, more effectively.
Oh ya, that means the insurance companies will have to pay more. Why would they?
HOWEVER, if this treatment could reduce further expensive intervention like surgery then it may actually be a blessing for the insurance guys in terms of savings. One surgery avoided by a patient through right intervention through PRP treatments will save the insurance companies at least $25,000. Now, that’s a win-win for both patients and insurance.
I believe it’s a matter of time before insurance companies start realizing their folly of not supporting this treatment.
PLATELET-RICH PLASMA TRENDS
After all is said and done, it’s still “unproven”
The problem with PRP is that it can be used for just about everything, which is a good problem to have until health care officials (and insurance companies) start realizing that people are going to misuse it.
So it’s classified as unproven. The VAST scope of the treatment calls for urgent structure and guidelines. There are some 20+ conditions where researchers have found it “helps” in one way or another. It’s a daunting task to prove its efficiency in all the areas. Nevertheless, we’ll get there.
Though we’ll need a lot of funding for that.
And yes, we need to standardize the procedure. As well as come up with optimized protocols for each conditions. Someone need to take initiative on that. We’re counting on independent doctors and medical institutions. The big pharma won’t jump in because what’s in it for them, right?
It’s so simple, you’d be an idiot to not try it.
You only need a vacuum blood harvesting tube like what we offer here, a centrifuge with adapter for the tube, pipettes and 10ml ampules of 10% calcium chloride.
The only complexity comes from not following a standard PRP system. Because the final platelet count can depend on a variety of factors. Like initial volume of blood, the technique used and relative concentration of WBC and/or RBC. As well as on the patient’s side, there are factors such as age, growth factor and WBC content.
However, concentration-wise, there’s little confusion as once a sufficiently high range is reached, more doesn’t have any adverse or enhancing effect — it saturates at a certain point. So that’s the minimum. Once you reach that, you’re good. Although the outcome is not always guaranteed to be same, with the right number of platelets, platelet activation and cytokine release, you can get a consistency in your PRP offerings.
There’s still some uncertainty over the number of injections, the timing and delivery method of Platelet-Rich Plasma. But with wide-spread adoption, some kind of structure will emerge.
Let’s hope the first glimpses of it will arrive this year.
Do you know in 2015, the world saw approximately 1 million knee arthroplasties for osteoarthritis? At $25,000 apiece, $25 billion.
How many of these patients had the good fortune of their doctor recommending PRP early on?
Yep, it’s Platelet-Rich Plasma. There has been numerous speculations about which one among the latest Platelet-Rich family was the greatest—is it the plasma or the fibrin or even latest the A-fibrin? That confusion is somewhat over now.
Platelet-products are known to facilitate angiogenesis, hemostasis, osteogenesis, and bone growth. But see, the only reason plasma can do that is because of the growth factors it carries. Let’s review the specific roles of these growth factors in the healing process.
Growth Factors In Platelet-Rich Plasma
These are growth factors that are traditionally known to have played a vital healing role in PRP. If you’re seeing your patients get better as a result of that injection you gave, these are guys you need to thank for.
Platelet-Derived Growth Factor (PDGF): Regulates cell growth and division. Especially in blood vessels. In other words, this guy is the reason the blood vessels in our body reproduces.
Transforming Growth Factor Beta(TGF-b): Responsible for overall cell proliferation, differentiation, and other functions.
Fibroblast Growth Factor (FGF): Plays a vital role in the wound healing process and embryonic development. Also behind the proliferation and differentiation of certain specialized cells and tissues.
Vascular Endothelial Growth Factor: Responsible for vasculogenesis and angiogenesis. Restores oxygen supply in cells when inadequate. It also helps create new blood vessels after injury.
Keratinocyte Growth Factor (KGF): Found in the epithelialization-phase of wound healing. In other words, it causes the formation of epithelium immediately after a wound or injury occurs.
Connective Tissue Growth Factor: Major functions in cell adhesion, migration, proliferation, angiogenesis, skeletal development, and tissue wound repair.
These growth factors are what enables a Platelet-Rich product in tissue regeneration.
Platelet-Rich Plasma Rules
However, this new study suggests Platelet-Rich Plasma and it’s gelled cousin Platelet-Rich Fibrin both differ in the release of these growth factors which can significantly affect the healing outcome.
Here’s the takeaway:
“The advantage of PRP is the release of significantly higher proteins at earlier time points whereas PRF displayed a continual and steady release of growth factors over a 10-day period.”
Some argue that PRP enriched with large number of growth factors (a portion of it may even be excess) produce short-term effect and so is less desirable than a PRF whose release is slower and thus more beneficial in the long run.
That being said, PRF do have some advantage over PRP. Mainly:
It doesn’t need thrombin and anticoagulants.
It results in better healing due to its slow polymerization process.
And it helps in hemostasis.
How Platelet-Rich Plasma Differs From Platelet-Rich Fibrin
Platelet-Rich Plasma is a result of double spin method — a hard spin to separate red blood cells from everything everything else in the autologous (or whole) blood and a soft spin to separate the platelets and white blood cells. The result is Platelet-Rich Plasma (PRP), Platelet-Poor Plasma (PPP) and Red Blood Cells.
PRF is a newer method. Here after the first centrifugation, the middle layer is taken—which contains less platelets but more clotting factors. This gradually forms into a fibrin network and traps in the cytokines. It is then centrifuged in a PRF centrifuge resulting in PRF, a fibrin layer containing platelets and plasma.
What Matters In Healing
Obviously, when it comes to accelerating healing, immediate availability of growth factors and cytokines matter. So I believe PRP does a better job in this than PRF. Also the immediate release of growth factors for PRP means we can repeat the PRP injections for more healing factors just days after initial injection.
Platelet-derived products are in it’s infancy now. However, considering the huge potential benefits, there’s still a lot more research to be done. How about you? Which of these do you find beneficial?
If you’re a physician using any or both of these, do write to us and let us know of your experiences. Use the contact form here.
“You start out happy that you have no hips or boobs. All of a sudden you get them, and it feels sloppy. Then just when you start liking them, they start drooping.”
Just like men associate (some of) their masculinity with the shape and size of their muscles, women associate (some of) their femininity with the shape and size of their breasts. However, unlike the muscles, exercise won’t be of much help for augmenting the size of breasts.
Fortunately, we have an array of procedures to the rescue. And today, we’re going to take a look at everything that Platelet-Rich Plasma can do for breast augmentation.
Platelet-Rich Plasma For Breast Augmentation
PRP & Breasts: The Incorrect Perception
Currently the traditional breast augmentation procedures like breast implant surgery and fat grafting are still the most effective methods. However, the general public do talk about Platelet-Rich Plasma for breast augmentation. And often times, they have a wrong perception of it. Here’s their typical conversation with a dermatologist goes.
Patient:”Hey, I heard about this thing called PRP, and I was told it’s just a couple of injections with stuff drawn from our own blood.”
Doctor: “Yeah, they are really good.”
Patient: “Really? You think so? I also heard they’re good for breast augmentation. Can you do it for me?”
This follows by the doctor slapping on their forehead. Then the doctor patiently explains how PRP is a healing tool and not an implant tool.
Platelet-Rich Plasma For Breast Augmentation
How Platelet-Rich Plasma For Breast Augmentation Works
Here are two ways PRP is used for breast procedures.
- Fat Transfer & Platelet Rich Plasma For Breast Lift
Fat transfer is the process of taking unwanted body fat (liposuction procedure) from other parts of the body and processing it before injecting it to upper part of the breast and in the cleavage area. This is immediate enhancement. And since it’s immediate, the sudden expansion of the breast can cause blood vessels to be blocked causing some parts of the breasts or the nipples to lose sensitivity. Sometimes it can even cause the skin at those areas to go haywire.
So the best way to avoid that is to make sure enough collagen and growth factors are supplied, well in excess of the area’s needs. That’s why it makes sense to combine the Fat Transfer procedure with Platelet-Rich Plasma. In this combination, the doctor adds PRP (Platelet Rich Plasma) derived from the patient’s own blood, to the fat when processing the fat, which includes many blood-derived growth factors and tissues containing collagen for skin rejuvenation. The end-product is then injected like a typical PRP Injection. The result is firmer breasts with not just a change in size, but also changes in skin texture and shape of the breast. And there’s no worry of losing sensitivity. Some call the entire procedure as Platelet-Rich Plasma Facelift. Results generally last from 9-18 months.
This great procedure has boosted the confidence levels of thousands of women who wanted to overcome their unnatural shaping and aging of breasts. However, even though it works for all kind of breast sizes, it’s not recommended for women with:
Extreme Loss of Volume
Previous Breast Implants
- Only Platelet Rich Plasma For Breast Rejuvenation
This second procedure is purely PRP for rejuvenation purposes. It’s for women who’re happy with their breast size but would love to rejuvenate the skin for youthful looks, restore fullness for healthy breasts and regain sensitivity in areas where it’s diminished. The procedure is same as any other Platelet-Rich Plasma procedures. It starts with drawing 20ml of patient’s blood, spinning it (twice) in a tabletop centrifuge and then injecting to necessary areas. PRP injection not only enhances the looks, it actually produces new tissues in the area because of all that growth factors resulting in better cleavage and fullness.
So if any of your beautiful, intelligent and man-loving female patients need a little help in augmentation, you can confidently recommend these two Platelet-Rich Plasma procedures for breasts. It works.
Some of us in the medical profession hold the opinion that, “if you want to enlarge your breasts, stick with the gold standard. Breast Implants performed by a board certified plastic surgeon.” Artificial implants are anything but gold standard. Natural is the new gold. Besides, to implant artificial stuff you need to cut up the breasts. And the scars that results can take time to heal. Plus, implants may need to be replaced sometime after 10 or 20 years.
“It wasn’t just her beauty. It was the attitude in her smile, the tilt of her head, and the loving look in her eyes when she caught me sneaking a peek down her shirt.”
John L. Monk, Kick
Platelet-Rich Plasma has a proven record for healing soft-tissues and other living tissues. But can it actually heal the bones itself?
This could mean PRP, when applied to an affected area whether it’s an elbow joint or knee or back bone area, actually heals everything within it’s reach including the bones. Is that really why PRP actually works?
Platelet-Rich Plasma For Bone Healing
Bones are not just lifeless matter attached to living tissues. It’s as much living as the tissues themselves. And just like the tissues, it’s constantly changing too. The old bone cells are broken down and replaced with new ones in a three-part process called bone remodeling the involves resorption (digestion of old bone cells), reversal (new cells are birthed) and formation (new cells turn into fully formed bones).
This process, just like any other biological processes in the body, requires hormones and growth factors. Some of the names include parathyroid hormone (PTH), calcitriol, insulin-like growth factors (IGFs), prostaglandins, tumor growth factor-beta (TGF-beta), bone morphogenetic proteins (BMP), and plain old cytokines. For this discussion we need to remember only one thing: a large cytokines and growth factors are involved in bone remodeling process.
Which means we accelerate the bone remodeling process by supplying these cytokines and growth factors as suggested by studies like this, this, this, this, this and this.
Why Platelet-Rich Plasma?
Autologous Platelet-Rich Plasma (PRP), being completely “whole and natural” can more closely simulate a highly efficient in-vivo situation that anything else out there that are made up of artificial recombinant proteins. In PRP, we are taking advantage of the biological benefits of growth factors whose functions we know as well as those we do not know of yet. From the 15+ factors we know are in PRP including platelet derived growth factor (PDRF), transforming growth factor-beta (TGF-beta), platelet factor 4 (PF4), interleukin 1 (IL-1), platelet-derived angiogenesis factor (PDAF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), platelet-derived endothelial growth factor (PDEGF), epithelial cell growth factor (ECGF), insulin-like growth factor (IGF), osteocalcin (Oc), osteonectin (On), fibrinogen (Fg), vitronectin (Vn), fibronectin (Fn) and thrombospontin-1 (TSP-1)… we’re actually supplying a “holistic” set of nutrients for healing that cannot be mimicked by those obtained artificially.
Platelet-Rich Plasma For Bone Healing
Organic Fertilizers For The Body
The PRP difference is like adding chemical fertilizers versus organic fertilizers on plants. Chemical fertilizers are rich in essential nutrients that we know are needed for crops. On the other hand, organic fertilizers supply nutrients not only to the plants but also to the soil, improving the soil structure and tilth, water holding capacity, reduces erosion as well as promote slow and consistent release of nutrients to the plants itself.
Clearly, organic fertilizers are better, aren’t they?
Platelet-Rich Plasma are like organic fertilizers for our body.
Bonus: Strong Antimicrobial Properties
It seems that the Platelet-Rich Plasma’s healing function has synergistic function to anti-microbial properties. A new study confirms that using Platelet-Rich Plasma in surgeries may have the potential to prevent infection and to reduce the need for costly post-operative treatments.
That’s a nice bonus for the organic fertilizer of our bodies. Perhaps, there are more. So why wouldn’t anyone not take advantage of them?
The scope of Platelet-Rich Plasma is growing as the scientific community continues to unearth its inherent properties. PRP is an unignorable, and unavoidable component of healing.
According to many physicians, PRP (Platelet-Rich Plasma) has been a lifesaver for their practice, while others claimed that it helped them become passionate about medicine again. This is because not only is it 100% from the body of the patient themselves, but it is also natural and comes with pretty much no side effects. It can also be used to treat a plethora of medical ailments, to the point where no other treatment options come close.
Although the above are all fantastic and solid reasons for offering PRP therapies, there are also a couple other reasons as well.
For instance, it is extremely simple compared to other treatment options. For about 1000$ as an initial investment, you can get started with offering PRP. The equipment is relatively cheap, and it pays for itself over a relatively short amount of time.
It also is not just a passing trend, as it has been going popular for a long time and shows no signs of slowing down. The market for PRP therapies is expected to reach almost 500 million dollars within the next 10 years, or an annual growth rate of 12.5% since 2015.
Patient satisfaction is another reason. In certain situations, the satisfaction rate for patients have been as high as 95%. This shocks many of the patients, who believe, although justifiably, that they cannot reverse or halt their condition without side effects, down time, and invasive surgeries.
The time for you to start including PRP into your practice is now, while the supply is low but the demand is booming. There is still a lot more promise when it comes to PRP as well, including combining PRP with other treatments to increase efficacy. Since no standard has yet to be established, you may be starting these standards yourself.
It is vital that we get more doctors to utilize PRP therapy so that they can be a pioneer in this field. PRP can turn medicine on its head, and missing out should not be a smart option.
The best part about it, is that PRP can be utilized in almost every field and specialty, from sports medicine, to pain management, skin rejuvenation, hair care, and even urology. Most of the physicians who utilize this treatment also saw higher patient retention rates as well.
So is there a legitimate reason to not add PRP to your practice?
Despite being rather simple, PRP extraction has been shrouded with debate on the reliability of the methods for the past decade. We are going to help clear up the debate by providing information on choosing the best PRP kit.
Using a kit is in itself vital to the creation of PRP. While it is possible to draw blood into a test tube and put it through a centrifuge and claim it is PRP, it’s otherwise ineffective. This is what is known as “bloody PRP,” and it might hold 1.5x the amount of blood platelets if you’re lucky, but it will also contain a ton of red and white blood cells. Because of this, this ineffective form of PRP can potentially cause flare ups after injection.
However, if you use a kit, that concentration of platelets can be as high as 5-7 times the baseline.
What Makes A PRP Kit Good?
This concentration of 5-7 times is vital for PRP to work, and kits allow you to choose whether or not you want to keep in the red and white blood cells, or whether you don’t. Each one would work on different ailments. However, some commercial kits may not deliver what you may want in your PRP, so it is good to know the difference between the kits.
- Gel Separators
Gel separators is pretty much just a test tube with some gel on the bottom. This gel is able to separate the blood from the platelets due to osmosis. The main issue is that when the test tube goes through the centrifuge, most of the platelets will also be caught by the gel as well. This will wind up with 1.5 times concentration of platelets at most, but it does take out the white and red blood cells as well, so that’s a plus.
- Buffy Coat
The kits that allow you to see a buffy coat are most likely to give you concentrations of 5-7 times. A buffy coat is a thin layer that is formed between the blood and the plasma after being in a centrifuge. This is mainly just platelets and white blood cells, with plasma on top, and packed blood underneath.
After this, you have to be able to separate the bufy coat from the red blood cells without contamination. This will help you to get PRP with less than 10% red blood cells.
- Buffy Coat with a Double Spin
The third and final type utilize a buffy coat which is devoid of red blood cells. This is the best kit on the market, because what you do is after separating the PRP from the red blood cells, you spin it again to further get rid of the red blood cells and to concentrate the platelets even more. After this, all that is needed to do is to separate the buffy coat, and this is PRP.
The Biosafe Kit
Although there are many kits that create PRP, the Biosafe kit has to be the best on the market. This is because it give you full control over the end product. Using this machine, you wind up with 10cc of usable product, which you can then double spin for that 5-7 times concentration. You can also choose whether or not you want some red blood cells in the finished product as well.
What is Leukocyte-poor PRP?
Leukocytes are otherwise known as White Blood Cells, and some researchers believe that they can be detrimental to PRP therapy. While there is no consensus as of yet, it is believed by many that these blood cells may trigger an inflammatory response, and even prevent growth factors from creating new cells.
However, some researchers believe that white blood cells are vital to a beneficial response. They believe that without these cells, you will be left with a lot of scar tissue at the site of healing. This Leukocyte-rich PRP also tends to have much more growth factors as well.
If you want to try leukocyte-poor PRP, you will need a Leukocyte Reduction filter, also known as an LR filter. These filters use electrostatic attraction to separate the white blood cells from the rest of the PRP. Although some filters can get clogged, a CIF-LR filter will be able to prevent that and filter out 99.99% of white blood cells.
There Is Plenty Of Evidence To Back This Up
Many people are highly skeptical about PRP, and are willing to ignore it without tons of randomized double-blind studies. Ignoring that some of the things that they do in their practice is also not proven in this manner. Many refuse to even look at the evidence, including the long line of evidence since the 1970’s, ranging over 6000 scientific studies.
The best evidence is how much clients will pay for this despite not being covered by insurance. This shows without any doubt that something about this treatment must be working. As long as there are clients, Adimarket will be there to provide the equipment for practices.
Although the clinical demand for bioengineered blood vessels continues to rise, current options for vascular conduits remain limited. The synergistic combination of emerging advances in tissue fabrication and stem cell engineering promises new strategies for engineering autologous blood vessels that recapitulate not only the mechanical properties of native vessels but also their biological function. Here we explore recent bioengineering advances in creating functional blood macro and microvessels, particularly featuring stem cells as a seed source. We also highlight progress in integrating engineered vascular tissues with the host after implantation as well as the exciting pre-clinical and clinical applications of this technology.
Ischemic diseases, such as atherosclerotic cardiovascular disease (CVD), remain one of the leading causes of mortality and morbidity across the world (GBD 2015 Mortality and Causes of Death Collaborators, 2016, Mozaffarian et al., 2016). These diseases have resulted in an ever-persistent demand for vascular conduits to reconstruct or bypass vascular occlusions and aneurysms. Synthetic grafts for replacing occluded arterial vessels were first introduced in the 1950s following surgical complications associated with harvesting vessels, the frequent shortage of allogeneic grafts, and immunologic rejection of large animal-derived vessels. However, despite advances in pharmacology, materials science, and device fabrication, these synthetic vascular grafts have not significantly decreased the overall mortality and morbidity (Nugent and Edelman, 2003, Prabhakaran et al., 2017). Synthetic grafts continue to exhibit a number of shortcomings that have limited their impact. These shortcomings include low patency rates for small diameter vessels (< 6 mm in diameter), a lack of growth potential for the pediatric population necessitating repeated interventions, and the susceptibility to infection. In addition to grafting, vascular conduits are also needed for clinical situations such as hemodialysis, which involves large volumes of blood that must be withdrawn and circulated back into a patient several times a week for several hours.
In addition to large-scale vessel complications, ischemic diseases also arise at the microvasculature level (< 1 mm in diameter), where replacing upstream arteries would not address the reperfusion needs of downstream tissues (Hausenloy and Yellon, 2013, Krug et al., 1966). Microvascularization has proven to be a critical step during regeneration and wound healing, where the delay of wound perfusion (in diabetic patients, for example) significantly slows down the formation of the granulation tissue and can lead to severe infection and ulceration (Baltzis et al., 2014, Brem and Tomic-Canic, 2007, Randeria et al., 2015).
In order to design advanced grafts, it is important to take structural components of a blood vessel into consideration, as understanding these elements is required for rational biomaterial design and choosing an appropriate cell source. Many of the different blood vessel beds also share some common structural features. Arteries, veins, and capillaries have a tunica intima comprised of endothelial cells (EC), which regulate coagulation, confer selective permeability, and participate in immune cell trafficking (Herbert and Stainier, 2011, Potente et al., 2011). Arteries and veins are further bound by a second layer, the tunica media, which is composed of smooth muscle cells (SMC), collagen, elastin, and proteoglycans, conferring strength to the vessel and acting as effectors of vascular tone. Arterioles and venules, which are smaller caliber equivalents of arteries and veins, are comprised of only a few layers of SMCs, while capillaries, which are the smallest vessels in size, have pericytes abutting the single layer of ECs and basement membrane. Vascular tissue engineering has evolved to generate constructs that incorporate the functionality of these structural layers, withstand physiologic stresses inherent to the cardiovascular system, and promote integration in host tissue without mounting immunologic rejection (Chang and Niklason, 2017).
A suitable cell source is also critical to help impart structural stability and facilitate in vivo integration. Patient-derived autologous cells are one potential cell source that has garnered interest because of their potential to minimize graft rejection. However, isolating and expanding viable primary cells to a therapeutically relevant scale may be limited given that patients with advanced arterial disease likely have cells with reduced growth or regenerative potential. With the advancement of stem cell (SC) technology and gene editing tools such as CRISPR, autologous adult and induced pluripotent stem cells (iPSCs) are emerging as promising alternative sources of ECs and perivascular SMCs that can be incorporated into the engineered vasculature (Chan et al., 2017, Wang et al., 2017).
Importantly, a viable cell source alone is not sufficient for therapeutic efficacy. Although vascular cells can contribute paracrine factors and have regenerative capacity, merely delivering a dispersed mixture of ECs to the host tissue has shown limited success at forming vasculature or integrating with the host vasculature (Chen et al., 2010). Therefore, recent tissue engineering efforts have instead focused on recreating the architecture and the function of the vasculature in vitro before implantation, with the hypothesis that pre-vascularized grafts and tissues enhance integration with the host. In this review, we explore recent advances in fabricating blood vessels of various calibers, from individual arterial vessels to vascular beds comprised of microvessels, and how these efforts facilitate the integration of the implanted vasculature within a host. We also discuss the extent to which SC-derived ECs and SMCs have been incorporated into these engineered tissues.
The first reported successful clinical application of TEBV in patients was performed by Shin’oka et al., who implanted a biodegradable construct as a pulmonary conduit in a child with pulmonary atresia and single ventricle anatomy (Shin’oka et al., 2001). The construct was composed of a synthetic polymer mixture of L-lactide and e-caprolactone, and it was reinforced with PGA and seeded with autologous bone marrow-derived mesenchymal stem cells (BM-MSCs). The authors demonstrated patency and patient survival 7 months post-implant, and expanded their study to a series of 23 implanted TEBVs and 19 tissue patch repairs in pediatric patients (Hibino et al., 2010). They were noted to have no graft-related mortality, and four patients required interventions to relieve stenosis at a mean follow-up of 5.8 years. The first sheet-based technology to seed cultured autologous cells, developed by L’Heureux et al., was iterated by the group to induce cultured fibroblast cell sheet over a 10-week maturation period and produce tubules of endogenous ECM over a production time ranging between 6 and 9 months. They dehydrated and provided a living adventitial layer before seeding the constructs with ECs (L’Heureux et al., 2006). Their TEBV, named the Lifeline graft, was implanted in 9 of 10 enrolled patients with end-stage renal disease on hemodialysis and failing access grafts in a clinical trial. Six of the nine surviving patients had patent grafts at 6 months, while the remaining grafts failed due to thrombosis, rejection, and failure (McAllister et al., 2009). An attempt to create an “off the shelf” version of this graft in which pre-fabricated, frozen scaffolds were seeded with autologous endothelium prior to implantation led to 2 of the 3 implanted grafts failing due to stenosis, and one patient passed away due to graft infection (Benrashid et al., 2016).
Most recently, results were reported for the phase II trial of the decellularized engineered vessel Humacyte in end-stage renal disease patients surgically unsuitable for arterio-venous fistula creation (Lawson et al., 2016). This clinical scenario offers a relatively captive patient population in which graft complications are unlikely to be limb or life-threatening, and infectious and thrombotic event rates for traditional materials such as ePTFE are high (Haskal et al., 2010). The manufacturers seeded a 6mm PGA scaffold with SMCs from deceased organ and tissue donors and decellularized the scaffold following ECM production in an incubator coupled with a pulsatile pump prior to implantation. Humacyte demonstrated 63% primary patency at 6 months, 28% at 12 months, and 18% at 18 months post-implant in 60 patients. Ten grafts were abandoned. However, 12-month patency and mean procedure rate of 1.89 per patient-year to restore patency were comparable to PTFE grafts, while higher secondary patency rates were observed (89% versus 55%–65% at 1 year) (Huber et al., 2003, Lok et al., 2013). Although Humacyte revealed no immune sensitization and a lower infection rate than PTFEs (reported up to 12%) (Akoh and Patel, 2010), there remains much work to be done to improve primary patency and reduce the need for interventions.
Harnessing the regenerative functions reported in ECs derived from adult stem cells and iPSCs offers the promise of improving TEBV patency. Mcllhenny et al. generated ECs from adipose-derived stromal cells, transfected them with adenoviral vector carrying the endothelial nitric oxide synthase (eNOS) gene, and seeded the ECs onto decellularized human saphenous vein scaffolds (McIlhenny et al., 2015). They hypothesized that through inhibition of platelet aggregation and adhesion molecule expression, nitric oxide synthesis would prevent thrombotic occlusion in TEBV. Indeed, they reported patency with a non-thrombogenic surface 2 months post-implantation in rabbit aortas. While introducing additional complexities, engineering ECs and SMCs with other regenerative, anti-inflammatory, anti-thrombotic genes could perhaps bridge the functional difference between SC-derived cells and native primary cells.