What does cellular therapy mean?
Under this heading falls the application, back to the same person, of biological products obtained from that person’s own blood or fat tissue. The shared rationale is to concentrate the cells and signalling molecules that will support the tissue’s own mechanisms of repair, and to deliver them to the target region.
All of these applications are autologous: the source and the recipient are the same person. This is the fundamental difference that removes the risk of tissue rejection and of transmission of infection.
This field is developing rapidly. The use of some applications is established, while for others the scientific evidence is still forming. The right approach is to distinguish how much data lies behind each method in each situation.
Methods used
| Method | Source | How it is prepared | Underlying rationale |
|---|---|---|---|
| PRP (platelet-rich plasma) | The person’s own blood | The blood is separated in a centrifuge; the platelet-rich portion of the plasma is taken | The growth factors contained in the platelets supporting the repair of tissue |
| SVF (stromal vascular fraction) | The person’s own fat tissue | Fat tissue taken by liposuction is processed and the cell-rich fraction separated out | The contribution of the stem cells and supporting cells within fat tissue to the process of repair |
| Autologous exosome | The person’s own blood | Extracellular vesicles are separated out in an ultracentrifuge | The vesicles that carry communication between cells directing the response of the tissue |
Exosomes are very small sacs secreted by cells. They carry proteins and genetic messenger molecules within them and provide for the transfer of information between cells. Separating them from blood calls for separation at high speed because of their size; an ultracentrifuge is used for this reason.
In which areas is it considered?
- Support for the quality of the skin, for the repair of tissue and for wound healing
- Support in hair loss on the scalp
- Together with the transfer of fat tissue, support for the take of the transferred tissue
- As a supportive application in scars and in problems of healing
In most cases these applications are planned not as a treatment on their own but as a component supporting the existing treatment.
Level of evidence and the regulatory framework
It is necessary to be honest on this subject:
- PRP is a method that has been in use for a long time and has been studied in a variety of fields; its effectiveness nevertheless varies according to the situation in which it is used, and there is not the same level of data for every indication.
- Scientific studies are continuing in SVF and exosome applications. For many indications the evidence is still at the stage of forming; these applications do not take the place of established treatments.
- The preparation and the application of cellular products are subject to the regulations of the Ministry of Health. The procedure is carried out under authorised conditions and in accordance with defined rules.
For this reason a recommendation of cellular therapy should not be given without the diagnosis of the condition, the established treatment options and realistic expectations having been discussed together. Approaches that carry the promise of a certain result should be regarded with scepticism.
The procedure and afterwards
In blood-derived applications the procedure is completed in the same session, with the taking of blood followed by the application of the prepared product. In applications derived from fat tissue a limited liposuction is carried out first; this part is a surgical procedure and is performed under appropriate conditions.
After the procedure there may be temporary redness, tenderness and swelling in the region. With most applications daily life is resumed the same day or the following day. The number of sessions and the interval between them are determined according to the method applied and to the aim.
Who is it not suitable for?
The procedure is not carried out, or is postponed, in people with active infection, with blood disorders and disorders of clotting that are not under control, in the course of active cancer treatment, in pregnancy and breastfeeding, and in those with active skin disease in the region of application. The medicines used, blood thinners in particular, affect the planning.
Realistic expectations
These applications are not a guarantee of rejuvenation, nor an alternative to surgery. The contribution provided is most often at a supportive level and varies from person to person.
The result depends on age, on the quality of the tissue, on smoking and on accompanying illnesses. It is not realistic to expect a marked change after a single session.
Assessment
The right question is not “which application should I have” but “how much will a given method contribute in my case”. In some people these applications are not suitable; in others an established treatment gives a more correct result.
You may arrange an appointment for assessment; bringing information on your current illnesses, the medicines you use and any applications carried out previously will speed up the planning.