Thursday, January 15, 2009
The public, commerical, and medical community are becoming increasingly aware of the potential promise of platelet rich plasma, growth factors, and stem cell therapy. While I use PRP for tendon and cartilage disorders, physicians in South Africa have been using PRP for facial rejuvination and wrinkles by potentially stimulating collagen synthesis.
Also research is being conducted to treat alopecia (hair loss) by stimulating follicular growth. Adult Stem cells the precusor for these proteins may hold the most promise.
It is my opinion that there is much more to be learned regarding PRP. However ultimately we may find that isolating individual growth factors with specific responsibilities may be more effective. Researchers are already working on isolating individual growth factors for specific tasks like cartilage regeneration etc.
With musculoskeletal ultrasound to examine the heel (much like looking obstetrician's use to examine a fetus), physicians are able to accurately target heel pain.
With the advancement of technology we are able to further our understanding of disease as well as offer innovative treatments.
At the December 08 annual Radiological Society of North America, Luca M. Sconfienza, MD, from University of Genoa in Italy demonstrated 95% efficacy with dry needling followed by cortisone.
Plantar Fasciitis is one of the most common foot problems affecting 1 million people. Patients typically complain of inner heel pain with stiffness in the morning and later throughout the day with weight bearing.
44 patients were treated who had previously failed extra corporeal shockwave therapy. Shock wave therapy works by a similar means through creation of micro trauma that increases blood flow and promotes healing in a deficient ligament or tendon.
A similar procedure is done with platelet rich plasma therapy, which involves needling of the thickened and oxygen deficient plantar fascia under ultrasound guidance. But rather than using cortisone, the patients own growth factors (extracted from their arm from a blood draw) are injected into the area of injury to promote natural healing. Unlike cortisone, platelets & growth factors have no reported ill effects of tendon tearing or rupture, but rather regenerate the tissue.
Military medics often struggle to get donated blood to soldiers in battle, which can take weeks to deliver. Also hospitals in the US have seen a sharp drop in donated blood resulting from risks associated with hepatitis and other disease. This supply shortage has increased the cost of transfused blood to hospitals which are already suffering in a recession.
Researchers at the Defense Advanced Research Projects Agency (DARPA) were recently awarded a large grant to implement technology developed from John Hopkins University using nanofibers to mimic marrow to produce blood and stem cells. Theoretically this would decrease the need for transfusions and decrease the costs associated with them.
This work may contribute the the global understanding & usage of stem cells to help save lives and cure disease. Clearly in our lifetime we will see more and more stories on stem cells and growth factors unlocking some of the chains of disease.