The Dracula Therapy

The major interest of using activated Platelets and patient’s own serum for Aesthetic indications

Eur. J. Aesth. Medicine and Dermatology. 2011;1;(1):8-10

Platelets are formed when cytoplasmic fragments of megakaryocytes, in the bone marrow, are released into the circulation on their mature form. The mature megakaryocites are round or oval cells, approximately 2 μm in diameter (1) and metabolically more active than the red blood cell and have a variety of functions. Platelets lack nuclei but contain organelles and structures such as mitochondria, microtubules, and granules (alpha, delta and lambda), play an important and not fully understood role in the formation of the blood clot, store and transport several chemicals, including serotonine, epinephrine, and histamine and they are able to phagocytize foreign bodies.

In the wound healing environment, platelets will degranulate (2) within 10 minutes of the formation of the clot, releasing growth factors into the local environment; 95% of the pre- synthesized and existing platelet growth factors are present in the wound within the first hour. However, normal platelets will continue to synthesize and release growth factors (3,4) over the next 7- 10 days, thus supporting angiogenesis, collagen production and other aspects of wound healing. Numerous proteins are contained within the alpha-granules of platelets including: 3 isomeres of platelet-derived growth factor (PDGF):transforming growth factor (TGF)-[1 and 2], vascular endothelial growth factor (VEGF), epidermal growth factor (EGF). In addition the activated thrombocytes have onto their surface a multitude of signalisation molecules: CD9, CD-W17, CD41, CD42a-d, CD51, CD-W60, CD61, CD62P, CD63 (5). As the direct platelet influence begins to subside, macrophages, which arrive by means of vascular ingrowth stimulated by the platelets, assume responsibility for wound-healing regulation by secreting their own factors. Thus, the platelets at the repair site ultimately set the pace for wound repair. (1)

PLATELET-RICH PLASMA (P.R.P) Platelet-rich plasma is defined as a small volume of plasma of autologous blood having a platelet concentration above baseline. It is therefore inherently safe and free of transmissible diseases such as HIV and hepatitis.

PRP development via centrifugation has been greatly simplified so that now it can be easily used in the medical office setting. However, the centrifugation process must be sterile and precisely suited to platelet separation from red blood cells and their sequestration in high concentrations without lysing the platelets or damaging them so that they no longer can actively secrete their growth factors. (Rotation speed, time, deceleration, separation) (6)

PRP works via the degranulation of the alpha granules in platelets, which contain the synthesized and pre-packaged growth factors. The active secretion of these growth factors is initiated by the clotting process of blood and begins within 10 minutes after clotting. More than 95% of the pre synthesized growth factors are secreted within 1 hour. That generates the formation of 3D fibrin mesh and platelet cohesion, via calcium and thrombin, (7) which in turn will lead to:

– Local stem cell proliferation

– Local tissue stem cell differentiation and therefore enhanced tissue regeneration and tissue remodelling.

– Enhanced proliferation and differentiation of keratinocytes that are essential for a smooth complexion.

– Enhanced release of collagen from activated fibroblasts, thus restoring the extra cellular matrix (ECM) and enhancing thickening of the dermis.

Because it is an autogenous preparation, PRP is inherently safe and therefore free from concerns over transmissible diseases such as HIV, hepatitis, West Nile fever, and Cruetzfeld-Jacob disease (CJD).

The importance of this knowledge is that the PRP growth factors never enter the cell or its nucleus, they are not mutagenic, and they act through the stimulation of normal healing, just much faster. Therefore, PRP has no ability to induce tumour formation and has never done.(8)

Cosmetic practitioners started mid-2000 to use PRP for skin rejuvenation and hair growth(9) But apart from a meta-analysis published in 2007 by Borzini and Mazucco, only the subjective aspect has been traditionally evaluated either based on the patient or physician’s subjective level of satisfaction.

The G. Amgar study (2011) uses biometric parameters for scientifically measurable means of assessing the results from the PRP injections. The study tracked 37 patients for a period of 3 weeks following PRP treatment, and 27 for an additional 10 weeks post-PRP treatment. A good anti-ageing effect was assessed by measured anisotropy values of -24.1% and – 16.9%., respectively. Additionally, a cross-analysis involving the initial anisotropy readings demonstrated further improvement. The anisotropy correlates were -33% and -39.7%, respectively, if the treatment is provided to patients who would mostly benefit from it (anisotropy > 30 %).

Even not considering the PRP use for aesthetic purposes as “youth elixir”, this relatively new approach seems to be a very interesting approach for treatment of the aging. A more stringent definition of PRP, a standardized preparation and application method and more biological studies are needed.


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