Sánchez-López JM, Alcaraz-Rubio J, Oliver-Iguace A

Language: Spanish
References: 12
Page: 21-33
PDF size: 984.47 Kb.

ABSTRACT

Background: Platelet-rich plasma is now a common medical technique known as regenerative medicine, through power cell activation and differentiation, which produces different growth factors, depending on the cell fraction recovered in the final product both locally and systematically.
Objective: To report the benefit of the systemic application of plasma growth factors in patients with cerebral palsy undergoing specific programs of neurorehabilitation.
Material and Method:: A case-control study done in a population of 50 Caucasian patients under the same program of neurorehabilitation and age range between 5 and 15 years with perinatal cerebral palsy, cognitive impairment, and marked and severe generalized spasticity; we administered an intravenous injection of concentrated leukocyterich plasma (25 cc) in a group of 25 of them. We performed follow-up at 1, 2, 3, 4, 5 and 6 months after the injection. All serum samples for determination were obtained by ELISA technique and Beckman Coulter. Cognitive Barthel scale was used before and after treatment. The determination protocol that was applied before the analysis was performed manually and the self-transfusion was considered suitable for treatment. We determined cellular composition and the plasma levels of factor similar to insulin-1 (IGF-1), platelet-derived growth factor (PDGF), vasculo-endothelial growth factor (VEGF), and transforming growth factor β (TGF-β) before, in the final product obtained in both groups before treatment and at 24 hours and at 1, 2, 3, 4, 5 and 6 months after treatment. Correlations between Cognitive responses in the two population groups throughout the follow-up period were analyzed by Fisher correlation analysis.
Results: No adverse effects were observed in the patients except for a small hematoma in the area channeling venous access. We observed a clear improvement in the cognitive sphere (memory, ability to perform more complex tasks, and acquisition of new skills) clearly higher in the group of patients treated with plasma rich in leukocyte growth factors, significantly statistical difference at 2 months follow-up (p=0.013), maintaining stable from the third month follow-up. Although after 24 hours of treatment in the group of treatment, serum levels of growth factors type VEGF and TGF-β increased 5-6 fold over baseline levels and the group control (p=0.02), it was not correlated with cognitive improvement over six months of clinical follow-up in this group, since virtually objectified plasma levels of growth factors were similar in both groups from the month follow-up study.
Conclusions: We propose that this therapy is useful in these patients to harness the neurostimulative and neuroregenerative power of endogenous growth factors derived from leukocytes, enhancing the effect of neurorehabilitation and shortening cognitive recovery

REFERENCES

1. Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Aurologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 2004;91:415.

2. Lorente A, Ortega R, Martín M, López J, Martínez JM. Quantification of growth factors by using a new system for obtaining platelet-rich plasma. Med Oral Patol Oral Cir Bucal 2011;614-618.

3. Weibrich G, Kleis W, Hafner G. Growth factor levels in the platelet-rich plasma produced by 2 different methods: curasan-type kit versus PCCS PRP system. Int J Oral Maxillofac Implats 2002;17:184-190.

4. Weibrich G, Kleis W, Hafner G. Growth factor levels in platelet-rich plasma and correlations with donor age, sex and platelet count. J Craniomaxillofac Surg 2002;30:97-102.

5. Harguindey S. Apoptosis y antiapoptosis en cáncer. Alzheimer y procesos neurodegenerativos: ¿una dialéctica de contrarios? Nuevo abanico de posibilidades terapéuticas y peligros potenciales. Oncología 2004;27:579-589.

6. Brea D, Sobrino T, Ramos P, Castillo J. Reorganización de la vascularización cerebral tras la isquemia. Rev Neurol 2009;49:645-654.

7. Legido A, Valencia I, Katsetos C, Papadopoulos M. Neuroprotección en la encefalopatía hipóxico isquémica perinatal. Tratamientos con eficacia clínica demostrada y perspectivas futuras. Medicina (Buenos Aires) 2007;67(6/1):543-555.

8. Devesa J, Alonso B, Casteleiro N, Couto P, et al. Effects of recombinant growth hormone (GH) replacement and psychomotor and cognitive stimulation in the neurodevelopment of GH-deficient (GHD) children with cerebral palsy: a pilot study. Ther Clin Risk Manag 2011;7:199-206.

9. Taudorf K, Hansen FJ, Mechior JC, Pedersen H. Spontaneous remission of cerebral palsy. Neuropediatrics 1986;17:19-22.

10. Alcaraz J, Oliver A, Sánchez JM. Platelet rich plasma in a patient with cerebral palsy. Am J Case Rep 2015;16:1-4.

11. Alcaraz, J, Oliver, A, Sánchez JM. Nuevo método de obtención de plasma rico en factores de crecimiento plaquetario (PRP). Estudio descriptivo en 15 pacientes y comparación con los resultados publicados en la bibliografía. Rev Hematol Mex 2015;16:210-216.

12. Alcaraz J, Oliver A, Sánchez JM, Lajara J. Clinical use of platelet-rich plasma: A new dimension in Regenerative Medicine. Med Sci Rev 2015;2:111-120.