The Age of Regenerative Medicine

Growth Factors (GF)

The two initial growth factors, epidermal and neural, were discovered in 1953 by Levi-Montalcini and Cohen (Nobel 1986 Nobel Prize winner). Today we know over 300.

A growth factor is a naturally occurring protein in the body, usually released from the alpha granules within the platelets. These are signalling molecules between cells, capable of acting on different targets within the body: from cellular differentiation to cellular proliferation, to healing, and cellular growth

Some of those GFs work to stimulate fibroblasts, collagen and bone formation and to prompt neo-vascularisation. But they all need to be present at the same time as each needs the others to be optimally active. It is not a solo act but more like a symphony with many different instruments playing together.

Because GFs are in the patient’s plasma and because the blood circulates everywhere in the body, virtually every organ can benefit from them.  The autologous factor means there is zero risk to the patient. 

How are GFs used

  • In cardiac and open-heart surgeries, myocardial regeneration and post cardio vascular surgery (studies shows that the healing process is 50% faster, with fewer complications and shorter hospital stay) 
  • In organ transplants
  • In cancer treatment procedures 
  • In dentistry: dental implants, sinus lift, receding gums 
  • in neural regeneration, peripheral neuropathies, spinal cord injury 
  • in E.N.T. : tympanic membrane perforation, meuniere disease, anosmia, vocal fold injury, bone grafting and fractures  
  • in ophthalmology: retina, eye corneal surgery, corneal ulcers and perforations
  • in re-building muscle and tendons 
  • in gynaecology: sexual rejuvenation, decreasing post pregnancy and/or post menopausal incontinence, cervical ectopy, vulvar dystrophy, reconstructive surgery post vulvar cancer, genital fistulae, post genital prolapse, premature ovarian failure, refractory endometrium, lichen sclerosus, etc..
  • in plastic surgery for treatment of scars, flaps and healing
  • for wound healing and burns
  • to treat hair loss and in hair transplants
prp therapy dr sister before after
Dr Sister (https://drdanielsister.com/tag/prp-therapy/) achieves remarkable results using PRP therapy to treat baldness. Before and after (2 months post treatments) images clearly show the improvement. Hair loss is arrested and the scalp is re-garnished.

As knowledge develops, the protocols for preparation and application of the plasma therapy evolve. 

Stem Cells

We all have sleeping stem cells everywhere in the body and the idea of our bodies being able to auto-heal through stem cell therapy is fascinating. 

For various reasons (philosophical, religious, financial…) stem cell treatments took longer to gain traction, but the controversy notwithstanding, regenerative medicine is now a reality. 

What are stem cells? 

Essentially, this is a type of cell that can develop into many other different types of cell (the new cell may be specific, such as a blood cell, a brain cell, or a muscle cell). They can also renew themselves by dividing, even if they have been inactive for a long time. Once again, as the technology for harvesting stem cells evolves, treatments become less expensive and applications proliferate.  

Stem cells could help the body heal itself and therefore play an important role in regeneration as they can keep replacing dead/defective cells.

Scientists believe this may offer potential treatment for conditions such as diabetes and heart disease. In a small-scale study published in the Journal of Cardiovascular Translational Research stem cell researchers reported a 40% reduction of the size of scarred heart tissue caused by heart attacks.  In the past, this kind of scarring was taken as permanent and untreatable.

In another stem cell study involving just 11 participants, all of whom had advanced heart failure, a 30% average improvement in heart function was reported. Additionally, patients reported a 70 % improvement in quality of life, some 24 months after being injected with the stem cells.

Another study published in Nature Communications suggested that stem cell therapies could form the basis of personalized diabetes treatment. In mice and laboratory-grown cultures, the researchers successfully produced insulin-secreting cells from stem cells derived from the skin of people with type 1 diabetes.

Jeffrey R. Millman, assistant professor of medicine and of biomedical engineering at Washington University School of Medicine, commented:

“In theory, if we could replace the damaged cells in these individuals with new pancreatic beta cells – whose primary function is to store and release insulin to control blood glucose – patients with type 1 diabetes wouldn’t need insulin shots anymore.”

Millman hopes that these stem cell-derived beta cells could be ready for research in humans within 3 to 5 years. “What we’re envisioning is an outpatient procedure in which some sort of device filled with the cells would be placed just beneath the skin,” he said.

PRP in aesthetic medicine

When I graduated from medical school we had nothing beside re-constructive surgery.  Since then, I have been able to witness the astonishingly fast evolution of growth factors and stem cell research and its application.

Today, we are no longer looking to repair the skin. Repair is a physiological process. Instead, we obtain a new tissue with somewhat inferior characteristics to the original one and look to regenerate. The goal is to rebuild the injured tissue with an exact copy of the original, restoring both morphology and function.

My interest in Platelet Rich Plasma (PRP) began in the early 2000. 

The more I researched, the more I was convinced that stem cells were the real future of medicine.

In the past few years, we have witnessed a vastly increased demand for PRP treatments – it is akin to having discovered a whole new continent.  

The PRP Protocol explained

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are known for their importance in clotting blood, however, they also contain hundreds of growth factors.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation.

During the centrifugation, three distinct fractions are obtained: red cells at the bottom, then Platelets Rich Plasma and on top, the Platelet Poor Plasma. Originally the idea was to use only the middle fraction (PRP).

In order to obtain a maximum efficacy, I use a specific tube without any chemical buffer between plasma and red cells (latest generation). The centrifugation speed and time is also calibrated to obtain an increase in the initial concentration (peripheral blood) by a factor of 3,44.  This concentration factor is important to avoid any risk of self-activation.

My protocol takes into context the benefits of both Platelet Rich Plasma AND Platelet Poor Plasma, at the correct concentration. I inject first deep close to the periosteum to slow down/ stop the resorption process associated with the aging bone. I then apply an intra-muscular injection and a final one sub-dermally, using all of the plasma that contains all growth factors and chemokines (a family of signalling proteins secreted by cells). 

The platelets bio-stimulation of stem cells occurs in 4 stages:

  1.  The platelets release growth factors which triggers the creation of a tri-dimensional mesh of fibrin
  2. Creation of a chemo attraction or migration of stem cells
  3. Proliferation of the stem cells 
  4. Differentiation of stem cells

In conclusion, the plasma stimulates the skin’s stem cells to produce more collagen, grow new cells and naturally rejuvenate it with lasting results.