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Laver L, Filardo G, Sanchez M, Magalon J, Tischer T, Abat F, Bastos R, Cugat R, Iosifidis M, Kocaoglu B, Kon E, Marinescu R, Ostojic M, Beaufils P, de Girolamo L. The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma). Knee Surg Sports Traumatol Arthrosc 2024; 32:783-797. [PMID: 38436492 DOI: 10.1002/ksa.12077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE The aim of this European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) consensus is to provide recommendations based on evidence and expert opinion to improve indications, decision-making and administration-related aspects when using blood-derived orthobiologics (for simplicity indicated as PRP-platelet-rich plasma-with PRP being the most common product) for the management of knee osteoarthritis (OA). METHODS Leading European expert clinicians and scientists were divided into a steering group, a rating group and a peer review group. The steering group prepared 28 question-statement sets divided into three sections: PRP rationale and indications, PRP preparation and characterisation and PRP protocol. The quality of the statements received grades of recommendation ranging from A (high-level scientific support) to B (scientific presumption), C (low-level scientific support) or D (expert opinion). The question-statement sets were then evaluated by the rating group, and the statements scored from 1 to 9 based on their degree of agreement with the statements produced by the steering group. Once a general consensus was reached between the steering and rating groups, the document was submitted to the peer review group who evaluated the geographic adaptability and approved the document. A final combined meeting of all the members of the consensus was held to produce the official document. RESULTS The literature review on the use of blood-derived products for knee OA revealed that 9 of 28 questions/statements had the support of high-level scientific literature, while the other 19 were supported by a medium-low scientific quality. Three of the 28 recommendations were grade A recommendations: (1) There is enough preclinical and clinical evidence to support the use of PRP in knee OA. This recommendation was considered appropriate with a strong agreement (mean: 8). (2) Clinical evidence has shown the effectiveness of PRP in patients for mild to moderate degrees of knee OA (KL ≤ 3). This recommendation was considered appropriate with a strong agreement (mean: 8.1). (3) PRP injections have been shown to provide a longer effect in comparison to the short-term effect of CS injections. They also seem to provide a safer use profile with less potential related complications. This recommendation was considered appropriate with a very strong agreement (mean: 8.7). Six statements were grade B recommendations, 7 were grade C and 12 were grade D. The mean rating score was 8.2 ± 0.3. CONCLUSIONS The consensus group reached a high level of agreement on all the questions/statements despite the lack of clear evidence for some questions. According to the results from this consensus group, given the large body of existing literature and expert opinions, PRP was regarded as a valid treatment option for knee OA and as a possible first-line injectable treatment option for nonoperative management of knee OA, mainly for KL grades 1-3. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Lior Laver
- Department of Orthopaedics, Hillel Yaffe Medical Center (HYMC), Hadera, Israel
- Rappaport Faculty of Medicine, Technion University Hospital (Israel Institute of Technology), Haifa, Israel
- Arthrosport Clinic, Tel-Aviv, Israel
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Mikel Sanchez
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France
- SAS Remedex, Marseille, France
| | - Thomas Tischer
- Department of Orthopaedic Surgery, University of Rostock, Rostock, Germany
| | - Ferran Abat
- Department of Sports Orthopaedic, ReSport Clinic, Universitat Autònoma Barcelona, Barcelona, Spain
| | - Ricardo Bastos
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence and Dom Henrique Research Centre, Porto, Portugal
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Ramon Cugat
- Instituto Cugat, Hospital Quironsalud Barcelona, Barcelona, Spain
- Fundación García Cugat, Mutualidad de Futbolistas Españoles-Delegació Catalana, Barcelona, Spain
| | - Micahel Iosifidis
- OrthoBiology Surgery Center, Thessaloniki, Greece
- 3rd Orthopaedic Department, European Interbalkan Medical Center, Thessaloniki, Greece
| | - Baris Kocaoglu
- Acibadem Altunizade Sports Therapy and Health Unit, Department of Orthopedics and Traumatology, Acibadem MAA University Faculty of Medicine, Istanbul, Turkey
| | - Elizaveta Kon
- IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Rodica Marinescu
- Department of Orthopaedics, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Marko Ostojic
- Department of Orthopaedics, University Hospital Mostar, Mostar, Bosnia and Herzegovina
- Osteon Clinic, Mostar, Bosnia and Herzegovina
| | | | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milano, Italy
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Prost D, Bardot T, Baud A, Calvo A, Aumont S, Collado H, Borne J, Rajon O, Ponsot A, Malaterre A, Dahak Y, Magalon G, Sabatier F, Magalon J. Long term improvement of knee osteoarthritis after injection of single high/very high volume of very pure PRP: A retrospective analysis of patients optimally managed in dedicated centers. Regen Ther 2024; 25:203-212. [PMID: 38234679 PMCID: PMC10792744 DOI: 10.1016/j.reth.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction PRP is gaining increasing interest for pain relief and improvement of joint function in patients with knee osteoarthritis (KOA) but practices and results remain heterogeneous limiting its adoption as standard of care. Current international recommendations are to collect real-life evidence of efficacy with a systematic monitoring of PRP quality and patients' outcomes. We aimed to analyze the response of patients presenting KOA and treated with standardized PRP injection in routine care. We also investigated the potential contributing factors including patient's phenotype and PRP characteristics. Methods Patients with symptomatic KOA and that failed first-line therapy received a single injection of a qualified PRP prepared using medical devices allowing to recover a high/very high volume of very pure PRP. Visual analogue scale (VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded at baseline and during 18 months follow-up. Results 431 patients had available follow-up data at 3 months, 291 at 6 months, 137 at 12 months and 44 at 18 months. PRP induced a significant decrease of WOMAC score at all follow up endpoints (29.2 ± 19.2 at 3 months, p < 0.001 and 25.9 ± 19.7 at 12 months, p < 0.01, compared to 39.7 ± 18.9 at baseline). Similar results were observed for pain VAS (38.9 ± 23.3 at 3 months, p < 0.001 and 35.3 ± 24.1 at 12 months, p < 0.05, compared to 56.0 ± 20.7 at baseline). Changes at 12 months were correlated to baseline scores and to the level of improvement at 3 months. The proportion of OMERACT OARSI responders reached 56.2 % for the total cohort and 60.4 % for severe patients at 6 months. Treatment failure occurred for 8.4 % of patients. Age, BMI or Kellgren-Lawrence grade did not impact on efficacy. Conclusion This real-life study evidences the clinical benefit of a standardized high or very high-volume injection of very pure PRP in patients with KOA, including those with a severe grade. It opens perspectives in the positioning of such strategy to delay arthroplasty and provide insights on factors able to anticipate long term efficacy.
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Affiliation(s)
- Didier Prost
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Thomas Bardot
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Alexandre Baud
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Anthony Calvo
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Stephane Aumont
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Herve Collado
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Julien Borne
- Regenerative Medicine Department of Excellence, Lyon, France
| | - Olivier Rajon
- Regenerative Medicine Department of Excellence, Lyon, France
| | - Antoine Ponsot
- Regenerative Medicine Department of Excellence, Lyon, France
| | | | - Yannis Dahak
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Guy Magalon
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Florence Sabatier
- Regenerative Medicine Department of Excellence, Marseille, France
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Jeremy Magalon
- Regenerative Medicine Department of Excellence, Marseille, France
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
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Reale D, Feltri P, Franceschini M, de Girolamo L, Laver L, Magalon J, Sanchez M, Tischer T, Filardo G. Biological intra-articular augmentation for osteotomy in knee osteoarthritis: strategies and results : A systematic review of the literature from the ESSKA Orthobiologics Initiative. Knee Surg Sports Traumatol Arthrosc 2023; 31:4327-4346. [PMID: 37330935 DOI: 10.1007/s00167-023-07469-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE To assess whether there is evidence supporting the use of augmentation strategies, either cartilage surgical procedures or injective orthobiologic options, to improve the results of osteotomies in knees with osteoarthritis (OA). METHODS A systematic review of the literature was performed on the PubMed, Web of Science and the Cochrane databases in January 2023 on osteotomies around the knee associated with augmentation strategies (either cartilage surgical procedures or injective orthobiologic options), reporting clinical, radiological, or second-look/histological outcomes at any follow-up. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS). RESULTS Out of the 7650 records identified from the databases, 42 articles were included for a total of 3580 patients and 3609 knees treated; 33 articles focused on surgical treatments and 9 on injective treatments performed in association with knee osteotomy. Out of the 17 comparative studies with surgical augmentation, only 1 showed a significant clinical benefit of an augmentation procedure with a regenerative approach. Overall, other studies showed no differences with reparative techniques and even detrimental outcomes with microfractures. Regarding injective procedures, viscosupplementation showed no improvement, while the use of platelet-rich plasma or cell-based products derived from both bone marrow and adipose tissue showed overall positive tissue changes which translated into a clinical benefit. The mean modified CMS score was 60.0 ± 12.1. CONCLUSION There is no evidence to support the effectiveness of cartilage surgical treatments combined with osteotomies in terms of pain relief and functional recovery of patients affected by OA in misaligned joints. Orthobiologic injective treatments targeting the whole joint environment showed promising findings. However, overall the available literature presents a limited quality with only few heterogeneous studies investigating each treatment option. This ORBIT systematic analysis will help surgeons to choose their therapeutic strategy according to the available evidence, and to plan further and better studies to optimize biologic intra-articular osteotomy augmentation. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Davide Reale
- Ortopedia e Traumatologia, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Pietro Feltri
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900, Lugano, Switzerland
| | - Marco Franceschini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli-1, 40136, Bologna, Italy.
| | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy
| | - Lior Laver
- Department of Orthopaedics, Hillel Yaffe Medical Center (HYMC), 38100, Hadera, Israel
- Arthrosport Clinic, Tel-Aviv, Israel
- Rappaport Faculty of Medicine, Technion University Hospital, Israel Institute of Technology, 32000, Haifa, Israel
| | - Jeremy Magalon
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005, Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, 13005, Marseille, France
- SAS Remedex, 13008, Marseille, France
| | - Mikel Sanchez
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain
| | - Thomas Tischer
- Department of Orthopaedic Surgery, University of Rostock, 18051, Rostock, Germany
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
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Abellan Lopez M, Philandrianos C, Daumas A, Velier M, Arcani R, Jouve E, Jaloux C, Bertrand B, Magalon J, Dignat-George F, Granel B, Casanova D, Sabatier F. Assessing the effect of PRP addition to facial micro-lipofilling for patients suffering from Scleroderma: A prospective routine care analysis. ANN CHIR PLAST ESTH 2022; 68:152-161. [PMID: 35987670 DOI: 10.1016/j.anplas.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Combining fat graft with platelet derived products is now common practice in regenerative surgery. We proposed to assess the safety and efficacy of Platelet-Rich Plasma (PRP) addition to a micro-lipofilling protocol for facial treatment of patients suffering from Systemic Sclerosis (SSc). OBJECTIVE Main objective was to evaluate the improvement of the Mouth Handicap In Systemic Sclerosis (MHISS) scale score at 6 months post-therapy. METHOD Included SSc patients had a MHISS score equal or up to 20. Surgery was performed under general anesthesia. Micro-fat and PRP (CCA-NA from DEPA Classification) were mixed in a 70/30 ratio, before injection in peri-oral sites according to a specific protocol. Efficacy criteria were recorded at baseline, 3 and 6 months. Moreover, we compared this cohort (current study) to a former (2015) non-enriched micro-lipofilling cohort in the same indication, using the same protocol. RESULTS Thirteen women patients with mean age of 53.2 years (±14.3) have been included. At baseline, mean MHISS score was 29.5 (±8.7) and significantly decreased to 22.5 (±7.8) at 6 months (P=0.016), corresponding to a 22.0% of improvement from baseline, with a mean decrease of 6.5 points (±7.5) at 6 months. Patients received a mean volume of 30.8ml PRP-micro-fat (±8.1ml). CONCLUSION PRP addition appeared beneficial, however, controlled studies are required to determine its superiority to facial micro-lipofilling.
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Affiliation(s)
- M Abellan Lopez
- Plastic Surgery Department, La Conception Hospital, AP-HM, 13005 Marseille, France; Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
| | - C Philandrianos
- Plastic Surgery Department, La Conception Hospital, AP-HM, 13005 Marseille, France.
| | - A Daumas
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, 13005 Marseille, France; Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
| | - M Velier
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
| | - R Arcani
- Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
| | - E Jouve
- Service de Pharmacologie Clinique et Pharmacovigilance, Assistance Publique Hôpitaux de Marseille (AP-HM), CIC-CPCET, 13005 Marseille, France.
| | - C Jaloux
- Plastic Surgery Department, La Conception Hospital, AP-HM, 13005 Marseille, France.
| | - B Bertrand
- Plastic Surgery Department, La Conception Hospital, AP-HM, 13005 Marseille, France.
| | - J Magalon
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
| | - F Dignat-George
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
| | - B Granel
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, 13005 Marseille, France.
| | - D Casanova
- Plastic Surgery Department, La Conception Hospital, AP-HM, 13005 Marseille, France.
| | - F Sabatier
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France.
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Magalon J, Frey A, Kaux JF. Intra-articular Platelet-Rich Plasma vs Placebo Injection and Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis. JAMA 2022; 327:1185-1186. [PMID: 35315896 DOI: 10.1001/jama.2022.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, Marseille, France
| | - Alain Frey
- Sports Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Jean-Francois Kaux
- Physical, Rehabilitation, and Sports Trauma Department, University Hospital of Liège, Liège, Belgium
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Charnay T, Silvestre A, Magalon J. Platelet-Rich Plasma Injections vs Placebo for Patients With Ankle Osteoarthritis. JAMA 2022; 327:780. [PMID: 35191935 DOI: 10.1001/jama.2021.24736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Theo Charnay
- Cell Therapy Laboratory, Hôpital de la Conception, Marseille, France
| | - Alain Silvestre
- Osteoarticular Medical Imaging Center, Bordeaux Sports Clinic, Mérignac, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, Marseille, France
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François P, Rusconi G, Arnaud L, Mariotta L, Giraudo L, Minonzio G, Veran J, Bertrand B, Dumoulin C, Grimaud F, Lyonnet L, Casanova D, Giverne C, Cras A, Magalon G, Dignat-George F, Sabatier F, Magalon J, Soldati G. Inter-center comparison of good manufacturing practices-compliant stromal vascular fraction and proposal for release acceptance criteria: a review of 364 productions. Stem Cell Res Ther 2021; 12:373. [PMID: 34210363 PMCID: PMC8252207 DOI: 10.1186/s13287-021-02445-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Even though the manufacturing processes of the stromal vascular fraction for clinical use are performed in compliance with the good manufacturing practices applying to advanced therapy medicinal products, specifications related to stromal vascular fraction quality remain poorly defined. We analyzed stromal vascular fraction clinical batches from two independent good manufacturing practices-compliant manufacturing facilities, the Swiss Stem Cell Foundation (SSCF) and Marseille University Hospitals (AP-HM), with the goal of defining appropriate and harmonized release acceptance criteria. Methods This retrospective analysis reviewed the biological characteristics of 364 batches of clinical-grade stromal vascular fraction. Collected data included cell viability, recovery yield, cell subset distribution of stromal vascular fraction, and microbiological quality. Results Stromal vascular fraction from SSCF cohort demonstrated a higher viability (89.33% ± 4.30%) and recovery yield (2.54 × 105 ± 1.22 × 105 viable nucleated cells (VNCs) per mL of adipose tissue) than stromal vascular fraction from AP-HM (84.20% ± 5.96% and 2.25 × 105 ± 1.11 × 105 VNCs per mL). AP-HM batches were significantly less contaminated (95.71% of sterile batches versus 74.15% for SSCF batches). The cell subset distribution was significantly different (higher proportion of endothelial cells and lower proportion of leukocytes and pericytes in SSCF cohort). Conclusions Both centers agreed that a good manufacturing practices-compliant stromal vascular fraction batch should exert a viability equal or superior to 80%, a minimum recovery yield of 1.50 × 105 VNCs per mL of adipose tissue, a proportion of adipose-derived stromal cells at least equal to 20%, and a proportion of leukocytes under 50%. In addition, a multiparameter gating strategy for stromal vascular fraction analysis is proposed. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02445-z.
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Affiliation(s)
- Pauline François
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France.,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Giulio Rusconi
- Swiss Stem Cell Foundation, Gentilino, Lugano, Switzerland.,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Laurent Arnaud
- Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Luca Mariotta
- Swiss Stem Cell Foundation, Gentilino, Lugano, Switzerland
| | - Laurent Giraudo
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France
| | - Greta Minonzio
- Swiss Stem Cell Foundation, Gentilino, Lugano, Switzerland
| | - Julie Veran
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France
| | - Baptiste Bertrand
- Plastic Surgery Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Chloé Dumoulin
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France
| | - Luc Lyonnet
- Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Dominique Casanova
- Plastic Surgery Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Camille Giverne
- Normandie Univ, UNIROUEN, INSERM, U1234, Rouen University Hospital, Department of Immunology and Biotherapy, Rouen, France
| | - Audrey Cras
- Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Cell Therapy Unit, Cord blood Bank and CIC-BT501, Paris, France
| | | | - Françoise Dignat-George
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Florence Sabatier
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France.,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Remedex, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 147 Bd Baille, 13005, Marseille, France. .,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France. .,Remedex, Marseille, France.
| | - Gianni Soldati
- Swiss Stem Cell Foundation, Gentilino, Lugano, Switzerland
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Gentile P, Alves R, Cole JP, Andjelkov K, Van Helmelryck T, Fernandez J, Trivisonno A, Guillaume L, Verpaele A, Tonnard P, Magalon J, Magalon G, Menkes S. AIRMESS - Academy of International Regenerative Medicine & Surgery Societies: recommendations in the use of platelet-rich plasma (PRP), autologous stem cell-based therapy (ASC-BT) in androgenetic alopecia and wound healing. Expert Opin Biol Ther 2021; 21:1443-1449. [PMID: 33769906 DOI: 10.1080/14712598.2021.1908995] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Many investigations showed that platelet-rich plasma (PRP), human follicles stem cells (HFSCs), and adipose-derived stem cells (ASCs), considered autologous stem cell-based therapy (ASC-BT), are effective for hair regrowth (HR) in patients affected by androgenetic alopecia and for wound healing (WH). The aim of this article is to analyze the in vitro and in vivo impact of different PRP, HFSCs, and ASCs preparation methods on HR and in WH. AREAS COVERED The analyzed data intended to clarify the molecular mechanism in which PRP, HFSCs, and ASCs are involved, the clinical use and related indications, fully respecting the European rules. Comparative studies between different systems of PRP, HFSCs, and ASCs preparation revealed differences in terms of HR and WH. EXPERT OPINION Despite a lack of standardized protocols, there is convincing evidence with objective measurement modalities that display positive outcomes of ASC-BT in HR and WH.
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Affiliation(s)
- Pietro Gentile
- Plastic and Reconstructive Surgery, Surgical Science Department, University of Rome "Tor Vergata", Rome, Italy.,Scientific Director of AIRMESS, Academy of International Regenerative Medicine & Surgery Societies, Geneva, Switzerland
| | - Rubina Alves
- Dermatology Department, Hospital Central Do Funchal, Funchal, Portugal.,Treasurer of AIRMESS, Academy of International Regenerative Medicine & Surgery Societies, Geneva, Switzerland
| | - John P Cole
- Cole Hair Transplant Group, Alpharetta, GA, USA.,Vice President of AIRMESS, Academy of International Regenerative Medicine & Surgery Societies, Geneva, Switzerland
| | - Katarina Andjelkov
- Research Associate, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Secretary of AIRMESS, Academy of International Regenerative Medicine & Surgery Societies, Geneva, Switzerland
| | | | - Jonathan Fernandez
- Plastic-Reconstructive and Hand Surgery Unit, University Hospital of Nice, Nice, France
| | - Angelo Trivisonno
- Department of Surgical Science, University of Rome "La Sapienza", Rome, Italy
| | | | - Alexis Verpaele
- Plastic Surgery Unit, Coupure Center for Plastic Surgery, Ghent, Belgium
| | - Patrick Tonnard
- Founder of Coupure Center for Plastic Surgery, Ghent, Belgium
| | - Jeremy Magalon
- Aix Marseille University, INSERM, INRAE, C2VN, Marseille, France
| | - Guy Magalon
- Plastic Surgeon, Plastic Surgery Department, Assistance Publique Hôpitaux De Marseille (APHM), Aix Marseille University, Marseille, France.,Honorary President of AIRMESS, Academy of International Regenerative Medicine & Surgery Societies, Geneva, Switzerland
| | - Sophie Menkes
- Forever Institute, Geneva, Switzerland.,President of AIRMESS, Academy of International Regenerative Medicine & Surgery Societies, Geneva, Switzerland
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9
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Bec C, Francois P, Rousset A, Magalon J. Response to P. Harrison et al : Characteristics of L-PRP preparations for treating Achilles tendon rupture within the PATH-2 study. Platelets 2021; 32:850-851. [PMID: 33818256 DOI: 10.1080/09537104.2021.1902968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Cecilia Bec
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
| | - Pauline Francois
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Inserm, INRA, C2VN, Aix Marseille Univ, Marseille, France
| | - Axelle Rousset
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Inserm, INRA, C2VN, Aix Marseille Univ, Marseille, France.,Sas Remedex, Marseille, France
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10
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Magalon J, Brandin T, Francois P, Degioanni C, De Maria L, Grimaud F, Veran J, Dignat-George F, Sabatier F. Technical and biological review of authorized medical devices for platelets-rich plasma preparation in the field of regenerative medicine. Platelets 2020; 32:200-208. [PMID: 33155867 DOI: 10.1080/09537104.2020.1832653] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Platelet-rich plasma (PRP) has seen increased interest and utilization over the past decade, particularly in the field of musculoskeletal disease. This growth has been accompanied by the development of medical devices to realize PRP preparation which includes blood collection, centrifugation, and PRP isolation. The final PRP composition is directly influenced by this preparation step and absence of biological quality control led to a lack of comparability between PRP products that could explain the large variability in the clinical benefit of PRP reported in literature. To circumvent this issue, the scientific community developed different PRP classifications but none of them have been adopted. The goal of this review is to furnish both technical and biological characteristics from PRP commercial systems. On review of 1379 studies, 105 studies were selected according to inclusion criteria for technical analysis and led to the identification of 50 commercial systems that have been classified in three technical categories based on the blood harvesting technique (tubes, syringes or bags). Twelve studies were selected and sufficiently describe biological characteristics from only 14 commercial systems from the 50 identified in the technical analysis. Inclusion of duplicates characterization from a same PRP system lead to the final analysis of 36 PRP preparations that met the inclusion criteria of the biological analysis. All these PRP preparations have been classified among the seven existing classifications. Comparison from all biological parameters and classifications revealed a large heterogeneity among the available current PRP commercial systems. Index of biological sensitivity of classifications to distinguish PRP preparations were also variable. Although these findings should help clinicians in selecting a system that meets their specific needs, this also raises the question to standardize the parameters to biologically define PRP preparation among users and to systematically performed PRP qualification when used.
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Affiliation(s)
- Jeremy Magalon
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France.,INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France.,SAS Remedex, Marseille, France
| | - Thibault Brandin
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Pauline Francois
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France.,INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France
| | - Clara Degioanni
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Lucille De Maria
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Julie Veran
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | | | - Florence Sabatier
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France.,INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France.,SAS Remedex, Marseille, France
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11
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Magalon J, Brandin T, Grimaud F, Rabarimeriarijaona S, Veran J, Dignat George F, Sabatier F. Platelet-rich plasma preparations in sports rehabilitation: Where we started and where we should go. Ann Phys Rehabil Med 2020; 65:101414. [PMID: 32622011 DOI: 10.1016/j.rehab.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Jeremy Magalon
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France; Inserm, Inra, C2VN, Aix Marseille université, Marseille, France.
| | - Thibault Brandin
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France
| | - Fanny Grimaud
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France
| | | | - Julie Veran
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France
| | - Françoise Dignat George
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France; Inserm, Inra, C2VN, Aix Marseille université, Marseille, France
| | - Florence Sabatier
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France; Inserm, Inra, C2VN, Aix Marseille université, Marseille, France
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12
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Kon E, Di Matteo B, Delgado D, Cole BJ, Dorotei A, Dragoo JL, Filardo G, Fortier LA, Giuffrida A, Jo CH, Magalon J, Malanga GA, Mishra A, Nakamura N, Rodeo SA, Sampson S, Sánchez M. Platelet-rich plasma for the treatment of knee osteoarthritis: an expert opinion and proposal for a novel classification and coding system. Expert Opin Biol Ther 2020; 20:1447-1460. [PMID: 32692595 DOI: 10.1080/14712598.2020.1798925] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Platelet-rich plasma (PRP) is able to modulate the joint environment by reducing the inflammatory distress and promoting tissue anabolism. Therefore, it has gained increasing popularity among clinicians in the treatment of osteoarthritis (OA), and it is currently proposed beside consolidated options such as viscosupplementation. AREAS COVERED A systematic review of all available meta-analyses evaluating intra-articular PRP injections in patients affected by knee OA was performed, to understand how this biologic treatment approach compares to the traditional injective therapies available in clinical practice. Moreover, a novel coding system and 'minimum reporting requirements' are proposed to improve future research in this field and promote a better understanding of the mechanisms of action and indications. EXPERT OPINION The main limitation in the current literature is the extreme variability of PRP products used, with often paucity or even lack of data on the biologic features of PRP, which should not be considered as a simple substance, but rather a 'procedure' requiring accurate reporting of the characteristics of the product but also all preparation and application modalities. This approach will aid in matching the optimal PRP product to specific patient factors, leading to improved outcomes and the elucidation of the cost-effectiveness of this treatment.
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Affiliation(s)
- Elizaveta Kon
- Department of Biomedical Sciences, Humanitas University , Milan, Italy.,Humanitas Clinical and Research Center, IRCCS , Rozzano, Milan, Italy
| | - Berardo Di Matteo
- Department of Biomedical Sciences, Humanitas University , Milan, Italy.,Humanitas Clinical and Research Center, IRCCS , Rozzano, Milan, Italy.,First Moscow State Medical University - Sechenov University , Moscow, Russia
| | - Diego Delgado
- Advanced Biological Therapy Unit, Hospital Vithas San José , Vitoria-Gasteiz, Spain
| | - Brian J Cole
- Department of Orthopaedics, Rush University Medical Center , Chicago, Illinois, USA
| | - Andrea Dorotei
- Department of Biomedical Sciences, Humanitas University , Milan, Italy.,Humanitas Clinical and Research Center, IRCCS , Rozzano, Milan, Italy
| | - Jason L Dragoo
- Department of Orthopedic Surgery, University of Colorado , Englewood, Colorado, USA
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
| | - Lisa A Fortier
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University , Ithaca, NY, USA
| | - Alberto Giuffrida
- Department of Biomedical Sciences, Humanitas University , Milan, Italy.,Humanitas Clinical and Research Center, IRCCS , Rozzano, Milan, Italy
| | - Chris H Jo
- Department of Orthopedic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine , Seoul, Republic of Korea
| | - Jeremy Magalon
- Aix Marseille Univ, INSERM, INRA, C2VN , Marseille, France.,Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, IN, SERM CIC BT , Marseille, France
| | - Gerard A Malanga
- New Jersey Regenerative Institute LLC, Cedar Knolls, NJ; Department of Physical Medicine and Rehabilitation, Rutgers University, New Jersey Medical School , Newark, NJ, USA
| | - Allan Mishra
- Department of Orthopaedic Surgery, Menlo Medical Clinic, Stanford University Medical Center, Menlo Park , CA, USA
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University , Osaka, Japan
| | - Scott A Rodeo
- Orthopaedic Soft Tissue Research Program, Hospital for Special Surgery , New York, New York, USA
| | - Steven Sampson
- David Geffen School of Medicine at UCLA , Los Angeles, CA, USA
| | - Mikel Sánchez
- Advanced Biological Therapy Unit, Hospital Vithas San José , Vitoria-Gasteiz, Spain.,Arthroscopic Surgery Unit, Hospital Vithas San José , Vitoria-Gasteiz, Spain
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13
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Magalon J, Abellan-Lopez M, Brandin T, Degioanni C, Grimaud F, Veran J, Dignat George F, Bertrand B, Sabatier F. Response to Universal Classification System for Platelet-Rich Plasma (PRP): A Method to define the variables in PRP production. Burns 2020; 47:489-490. [PMID: 32843239 DOI: 10.1016/j.burns.2020.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Affiliation(s)
- J Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT, 1409, Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - M Abellan-Lopez
- Plastic Surgery Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - T Brandin
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT, 1409, Marseille, France
| | - C Degioanni
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT, 1409, Marseille, France
| | - F Grimaud
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT, 1409, Marseille, France
| | - J Veran
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT, 1409, Marseille, France
| | | | - B Bertrand
- Plastic Surgery Department, Hôpital de la Conception, AP-HM, Marseille, France.
| | - F Sabatier
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT, 1409, Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
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14
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Bertrand B, Eraud J, Velier M, Cauvin C, Macagno N, Boucekine M, Philandrianos C, Casanova D, Magalon J, Sabatier F. Supportive use of platelet-rich plasma and stromal vascular fraction for cell-assisted fat transfer of skin radiation-induced lesions in nude mice. Burns 2020; 46:1641-1652. [PMID: 32475796 DOI: 10.1016/j.burns.2020.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/15/2019] [Accepted: 04/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND External radiotherapy has become indispensable in oncological therapies. Unfortunately, radiation is responsible for serious side effects, such as radiodermatitis. The skin is weakened and ulcerated. Our study aimed to evaluate the subcutaneous transfer of microfat (MF) alone and two mixes: MF+Platelet-rich plasma (PRP) and MF+stromal vascular fraction (SVF) to treat radiation-induced skin lesions. METHOD We defined randomly five experimental groups of nine mice: 1 healthy control group and 4 irradiated (60 Grey) and treated groups. The skin lesions were treated 3 months after irradiation by MF, MF+PRP (50%-50%), MF+SVF (90%-10%) or Ringer-lactate subcutaneous injections. Wound healing was evaluated at 1, 2 and 3 months post-injection and histological wound analysis at 3 months, after euthanasia. RESULTS All the irradiated mice presented with wounds. After sham-injection, the wound area increased by 91.1±71.1% versus a decrease of 15.9±23.1% after MF alone (NS), 27.3±23.8% after MF+SVF (NS) and 76.4±7.7% after MF+PRP (P=0.032). A significative reduction of skin thickness in wound periphery was measured for the three treated groups compared to sham-injection (P<0.05) but not in the healed wounds (NS). The most important subcutaneous neo-vessel density was shown after MF+SVF injection. CONCLUSION The MF+PRP mix was the most efficient product to increase healing. The MF+SVF mix showed the highest rate of neo-angiogenesis but was disappointing in terms of healing. LEVEL OF EVIDENCE Not gradable.
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Affiliation(s)
- Baptiste Bertrand
- Department of Plastic Surgery, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France; Aix-Marseille Univ, C2VN, INSERM, INRA, France.
| | - Julia Eraud
- Department of Plastic Surgery, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
| | - Mélanie Velier
- Aix-Marseille Univ, C2VN, INSERM, INRA, France; Culture and Cell Therapy Laboratory, INSERM CICBT-1409, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
| | - Cécile Cauvin
- Department of Radiotherapy, Hopital Privé Clairval, Marseille, France.
| | - Nicolas Macagno
- Department of Pathology, la Timone Hospital, Assistance Publique - Hôpitaux de Marseille, France.
| | - Mohamed Boucekine
- Aix-Marseille Univ, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, France.
| | - Cécile Philandrianos
- Department of Plastic Surgery, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
| | - Dominique Casanova
- Department of Plastic Surgery, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
| | - Jeremy Magalon
- Aix-Marseille Univ, C2VN, INSERM, INRA, France; Culture and Cell Therapy Laboratory, INSERM CICBT-1409, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
| | - Florence Sabatier
- Aix-Marseille Univ, C2VN, INSERM, INRA, France; Culture and Cell Therapy Laboratory, INSERM CICBT-1409, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
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15
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Boissier R, François P, Gondran Tellier B, Meunier M, Lyonnet L, Simoncini S, Magalon J, Legris T, Arnaud L, Giraudo L, Dignat George F, Karsenty G, Burtey S, Lechevallier E, Sabatier F, Paul P. Perirenal Adipose Tissue Displays an Age-Dependent Inflammatory Signature Associated With Early Graft Dysfunction of Marginal Kidney Transplants. Front Immunol 2020; 11:445. [PMID: 32256495 PMCID: PMC7089962 DOI: 10.3389/fimmu.2020.00445] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Better understanding of the contribution of donor aging and comorbidity factors of expanded criteria donors (ECD) to the clinical outcome of a transplant is a challenge in kidney transplantation. We investigated whether the features of donor-derived stromal vascular fraction of perirenal adipose tissue (PRAT-SVF) could be indicative of the deleterious impact of the ECD microenvironment on a renal transplant. Methods: A comparative analysis of cellular components, transcriptomic and vasculogenic profiles was performed in PRAT-SVF obtained from 22 optimal donors and 31 ECD deceased donors. We then investigated whether these parameters could be associated with donor aging and early allograft dysfunction. Results: When compared with the PRAT-SVF of non-ECD donors, ECD PRAT-SVF displayed a lower proportion of stromal cells, a higher proportion of inflammatory NK cells. The global RNA sequencing approach indicated a differential molecular signature in the PRAT-SVF of ECD donors characterized by the over-expression of CXCL1 and IL1-β inflammatory transcripts. The vasculogenic activity of PRAT-SVF was highly variable but was not significantly affected in marginal donors. Periorgan recruitment of monocytes/macrophages and NK cells in PRAT-SVF was associated with donor aging. The presence of NK cell infiltrates was associated with lower PRAT-SVF angiogenic activity and with early allograft dysfunction evaluated on day 7 and at 1 month post-transplant. Conclusions: Our results indicate that human NK cell subsets are differentially recruited in the periorgan environment of aging kidney transplants. We provide novel evidence that PRAT-SVF represents a non-invasive and timely source of donor material with potential value to assess inflammatory features that impact organ quality and function.
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Affiliation(s)
- Romain Boissier
- Department of Urology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France.,C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France
| | - Pauline François
- C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France.,Cell Therapy Department, La Conception University Hospital APHM, Aix-Marseille Univ., INSERM CIC 1409, Marseille, France
| | - Bastien Gondran Tellier
- Department of Urology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France.,C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France
| | - Maité Meunier
- Department of Nephrology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France
| | - Luc Lyonnet
- Department of Hematology and Vascular biology, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix Marseille Univ., Marseille, France
| | | | - Jeremy Magalon
- C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France.,Cell Therapy Department, La Conception University Hospital APHM, Aix-Marseille Univ., INSERM CIC 1409, Marseille, France
| | - Tristan Legris
- Department of Nephrology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France
| | - Laurent Arnaud
- Department of Hematology and Vascular biology, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix Marseille Univ., Marseille, France
| | - Laurent Giraudo
- Cell Therapy Department, La Conception University Hospital APHM, Aix-Marseille Univ., INSERM CIC 1409, Marseille, France
| | - Françoise Dignat George
- C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France.,Department of Hematology and Vascular biology, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix Marseille Univ., Marseille, France
| | - Gilles Karsenty
- Department of Urology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France
| | - Stéphane Burtey
- C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France.,Department of Nephrology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France
| | - Eric Lechevallier
- Department of Urology and Renal Transplantation, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix-Marseille Univ., Marseille, France
| | - Florence Sabatier
- C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France.,Cell Therapy Department, La Conception University Hospital APHM, Aix-Marseille Univ., INSERM CIC 1409, Marseille, France
| | - Pascale Paul
- C2VN, INSERM 1263, Aix-Marseille Univ, INRAE, Marseille, France.,Department of Hematology and Vascular biology, La Conception University Hospital, Assistance Publique-Hôpitaux Marseille (APHM), Aix Marseille Univ., Marseille, France
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16
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Guenoun D, Magalon J, de Torquemada I, Vandeville C, Sabatier F, Champsaur P, Jacquet C, Ollivier M. Treatment of degenerative meniscal tear with intrameniscal injection of platelets rich plasma. Diagn Interv Imaging 2019; 101:169-176. [PMID: 31727602 DOI: 10.1016/j.diii.2019.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/19/2019] [Accepted: 10/03/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE The purpose of this retrospective study was to describe our preliminary results of intra-meniscal administration of platelet rich plasma (PRP) in patients with degenerative meniscal tears of the knee. MATERIAL AND METHOD Ten patients with degenerative meniscal tears according to the Stoller classification and without knee osteoarthritis were included. There were 7 men and 3 women with a mean age of 40.4±13.6 [SD] years (range: 18-59 years). Patients were prospectively assessed at baseline and 3- and 6-months after intra meniscal PRP administration. Evaluation included the knee injury and osteoarthritis outcome score (KOOS), pain visual analog scale, and return to competition and training. MRI follow-up was performed 6 months after PRP administration. Adverse events were recorded. RESULTS Volume of injected PRP was standardized to 4.0mL. Adverse events during PRP administration was moderate pain in 8 patients (8/10; 80%). Mean KOOS total score significantly improved from 56.6±15.7 (SD) to 72.7±18.5 (SD) (P=0.0007). All six patients practicing sports regularly were able to recover competition or training. In seven patients who underwent MRI follow-up at 6 months, MRI showed stability of the meniscal tears and similar Stoller grades. CONCLUSION Intra-meniscal administration of PRP under ultrasound guidance directly into meniscal degenerative lesions is feasible and safe. Further randomized controlled studies are needed to definitely confirm the effectiveness of this procedure.
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Affiliation(s)
- D Guenoun
- Department of Radiology, Sainte-Marguerite Hospital, Institute of Movement and Locomotion, AP-HM, 13009 Marseille, France; CNRS, ISM, Inst Movement Sci, Aix Marseille Université, 13009 Marseille, France.
| | - J Magalon
- Inserm CIC BT 1409, Cell Therapy Department, Conception Hospital, AP-HM, 13000 Marseille, France; INSERM, INRA, C2VN, Aix Marseille Université, 13000 Marseille, France
| | - I de Torquemada
- Inserm CIC BT 1409, Cell Therapy Department, Conception Hospital, AP-HM, 13000 Marseille, France
| | - C Vandeville
- Inserm CIC BT 1409, Cell Therapy Department, Conception Hospital, AP-HM, 13000 Marseille, France
| | - F Sabatier
- Inserm CIC BT 1409, Cell Therapy Department, Conception Hospital, AP-HM, 13000 Marseille, France; INSERM, INRA, C2VN, Aix Marseille Université, 13000 Marseille, France
| | - P Champsaur
- Department of Radiology, Sainte-Marguerite Hospital, Institute of Movement and Locomotion, AP-HM, 13009 Marseille, France; CNRS, ISM, Inst Movement Sci, Aix Marseille Université, 13009 Marseille, France
| | - C Jacquet
- CNRS, ISM UMR 7287, Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, Aix Marseille Université, 13288 Marseille, France
| | - M Ollivier
- CNRS, ISM UMR 7287, Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, Aix Marseille Université, 13288 Marseille, France
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17
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Boissier R, Gondran-Tellier B, Francois P, Meunier M, Simoncini S, Lyonnet L, Legris T, Arnaud L, Magalon J, Giraudo L, Dignat-George F, Burtey S, Karsenty G, Lechevallier E, Sabatier F, Paul P. Utilisation de la graisse péri-rénale du donneur pour analyser la fonction/dysfonction endothéliale du transplant rénal. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Daumas A, Magalon J, Delaunay F, Abellan M, Philandrianos C, Sabatier F, Granel B, Magalon G. Fat Grafting for Treatment of Facial Scleroderma. Clin Plast Surg 2019; 47:155-163. [PMID: 31739892 DOI: 10.1016/j.cps.2019.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Reparative, angiogenic, and immunomodulatory properties have been attributed to the cells in the adipose tissue-derived stromal vascular fraction. Because of these characteristics, in the last decade, fat grafting for treatment of autoimmune diseases has grown. This article focuses on systemic sclerosis, a rare autoimmune disease characterized by skin fibrosis and microvascular damage. Lesions of the face are almost always present; however, current therapy is insufficient and patients have considerable disability and social discomfort. This article presents our approach to using fat grafting in the face as an innovative and promising therapy for patients with systemic sclerosis.
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Affiliation(s)
- Aurélie Daumas
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Timone Hospital 264 Rue St Pierre, 13005 Marseille, France
| | - Jeremy Magalon
- Culture and Cell Therapy Laboratory, INSERM CBT-1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Conception Hospital 147 Bd Baille, 13005 Marseille, France
| | - Flore Delaunay
- Plastic Surgery Department, Centre Hospitalier du Belvédère, 72 rue Louis Pasteur, 76130 Mont Saint Aignan, France; Aix-Marseille University, Marseille, France
| | - Maxime Abellan
- Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Conception Hospital 147 Bd Baille, 13005 Marseille, France
| | - Cécile Philandrianos
- Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Conception Hospital 147 Bd Baille, 13005 Marseille, France
| | - Florence Sabatier
- Culture and Cell Therapy Laboratory, INSERM CBT-1409, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Conception Hospital 147 Bd Baille, 13005 Marseille, France
| | - Brigitte Granel
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Timone Hospital 264 Rue St Pierre, 13005 Marseille, France
| | - Guy Magalon
- Plastic Surgery Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Aix-Marseille University, Conception Hospital 147 Bd Baille, 13005 Marseille, France.
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Magnani A, Pondarré C, Bouazza N, Magalon J, Miccio A, Six E, Roudaut C, Arnaud C, Kamdem A, Touzot F, Gabrion A, Magrin E, Couzin C, Fusaro M, André I, Vernant JP, Gluckman E, Bernaudin F, Bories D, Cavazzana M. Extensive multilineage analysis in patients with mixed chimerism after allogeneic transplantation for sickle cell disease: insight into hematopoiesis and engraftment thresholds for gene therapy. Haematologica 2019; 105:1240-1247. [PMID: 31537695 PMCID: PMC7193509 DOI: 10.3324/haematol.2019.227561] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/18/2019] [Indexed: 12/25/2022] Open
Abstract
Although studies of mixed chimerism following hematopoietic stem cell transplantation in patients with sickle cell disease (SCD) may provide insights into the engraftment needed to correct the disease and into immunological reconstitution, an extensive multilineage analysis is lacking. We analyzed chimerism simultaneously in peripheral erythroid and granulomonocytic precursors/progenitors, highly purified B and T lymphocytes, monocytes, granulocytes and red blood cells (RBC). Thirty-four patients with mixed chimerism and ≥12 months of follow-up were included. A selective advantage of donor RBC and their progenitors/precursors led to full chimerism in mature RBC (despite partial engraftment of other lineages), and resulted in the clinical control of the disease. Six patients with donor chimerism <50% had hemolysis (reticulocytosis) and higher HbS than their donor. Four of them had donor chimerism <30%, including a patient with AA donor (hemoglobin >10 g/dL) and three with AS donors (hemoglobin <10 g/dL). However, only one vaso-occlusive crisis occurred with 68.7% HbS. Except in the patients with the lowest chimerism, the donor engraftment was lower for T cells than for the other lineages. In a context of mixed chimerism after hematopoietic stem cell transplantation for SCD, myeloid (rather than T cell) engraftment was the key efficacy criterion. Results show that myeloid chimerism as low as 30% was sufficient to prevent a vaso-occlusive crisis in transplants from an AA donor but not constantly from an AS donor. However, the correction of hemolysis requires higher donor chimerism levels (i.e ≥50%) in both AA and AS recipients. In the future, this group of patients may need a different therapeutic approach.
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Affiliation(s)
- Alessandra Magnani
- Department of Biotherapy, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France .,Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - Corinne Pondarré
- Centre de référence de drépanocytose, CHIC Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Inserm U955, Paris XII University, Créteil, France
| | - Naïm Bouazza
- Université Paris Descartes, EA7323, Sorbonne Paris Cité, CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - Jeremy Magalon
- Cell Therapy Unit, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
| | - Annarita Miccio
- Laboratory of Chromatin and gene regulation during development, Imagine Institute, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris
| | - Emmanuelle Six
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris.,Human Lymphohematopoiesis Laboratory, Inserm UMR 1163, Imagine Institute, University Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Cecile Roudaut
- Department of Biotherapy, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Arnaud
- Centre de référence de drépanocytose, CHIC Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Annie Kamdem
- Centre de référence de drépanocytose, CHIC Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Fabien Touzot
- Department of Immunology-Allergy-Rheumatology, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Aurélie Gabrion
- Department of Biotherapy, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Elisa Magrin
- Department of Biotherapy, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - Chloé Couzin
- Department of Biotherapy, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mathieu Fusaro
- Study Center for Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker-Enfants Malades University Hospital, Paris, France
| | - Isabelle André
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris.,Human Lymphohematopoiesis Laboratory, Inserm UMR 1163, Imagine Institute, University Paris Descartes Sorbonne Paris Cité, Paris, France
| | | | - Eliane Gluckman
- Monacord Hôpital Saint Louis Paris, Centre Scientifique de Monaco, Monaco and Eurocord, Hôpital Saint Louis, Université Paris Diderot, Paris, France
| | - Françoise Bernaudin
- Centre de référence de drépanocytose, CHIC Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Dominique Bories
- Hématologie Moléculaire, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | - Marina Cavazzana
- Department of Biotherapy, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris.,Human Lymphohematopoiesis Laboratory, Inserm UMR 1163, Imagine Institute, University Paris Descartes Sorbonne Paris Cité, Paris, France
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20
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Levy N, Wang Yin GH, Noharet R, Ghazouane R, Grimaud F, Aboudou H, Darque A, Delmotte N, Veran J, Hoffart L, Denis D, Sabatier F, Magalon J. A retrospective analysis of characteristic features of responder patients to autologous serum eye drops in routine care. Ocul Surf 2019; 17:787-792. [PMID: 31103732 DOI: 10.1016/j.jtos.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/18/2019] [Accepted: 05/15/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE Autologous serum eye drops (ASEDs) are used worldwide to treat dry eye disease (DED). However, the biological composition of ASEDs has not been well investigated, and effectiveness predictive factors remain to be identified. The main objective of this study was to compare the response of patients treated with ASEDs biologically characterized and used for DED routine care. METHODS This retrospective observational study was conducted in a single university hospital, and included 50 patients (87 eyes) with DED refractory to conventional treatment and resulting from various etiologies with Ocular Surface Disease Index (OSDI) ≥ 20. Each patient used eight drops a day per treated eye with 20% diluted ASEDs. Undiluted serum extensive biological characterizations were performed, and symptoms were recorded before the initiation of ASEDs and closer to the sixth month of treatment. Responders were defined as presenting an improvement from baseline ≥14 points in OSDI and/or ≥1 grade in corneal fluorescence staining for all eyes treated. RESULTS The OSDI and the Oxford scale were significantly reduced from 68.7 ± 23.2 to 54.8 ± 25.7 and 3.2 ± 1.5 to 2.1 ± 1.3 (p ≤ 0.0001), respectively. A total of 68% of the patients were responders. Nonresponding patients had significantly higher epidermal growth factor concentrations in the serum compared to responders (p = 0.017). CONCLUSIONS ASED administration resulted in significant clinical improvement in the management of DED. Biological differences observed between responders and nonresponders suggested that a better understanding of the biological activity of ASEDs is still required.
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Affiliation(s)
- Natanael Levy
- Ophtalmology Department, CHU Timone, AP-HM, Marseille, France
| | - Gaelle Ho Wang Yin
- Ophtalmology Department, CHU Timone, AP-HM, Marseille, France; Equipe DiMABio, Université d'Aix-Marseille, Institut Fresnel, Faculté des Sciences de Saint-Jérôme, Avenue Escadrille Normandie-Niemen, 13397, Marseille, Cedex, France
| | - Roxane Noharet
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Rkia Ghazouane
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Houssein Aboudou
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Albert Darque
- Pharmacy Department, CHU Conception, AP-HM, Marseille, France
| | | | - Julie Veran
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Louis Hoffart
- Ophtalmology Department, Ramsay Générale de Santé, Clinique Monticelli-Velodrome, Marseille, France
| | - Daniele Denis
- Ophtalmology Department, CHU Timone, AP-HM, Marseille, France
| | - Florence Sabatier
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.
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21
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Velier M, Magalon J, Simoncini S, Dignat-George F, Granel B, Paul P, Sabatier F. Response to: 'Could autologous adipose-derived stromal vascular fraction turn out an unwanted source of profibrotic myofibroblasts in systemic sclerosis?' by Manetti. Ann Rheum Dis 2019; 79:e56. [PMID: 30967396 DOI: 10.1136/annrheumdis-2019-215327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Melanie Velier
- Cell Therapy Department, Hopital de la Conception, Marseille, France.,Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Department, Hopital de la Conception, Marseille, France.,Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France
| | - Stephanie Simoncini
- Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France
| | - Françoise Dignat-George
- Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France
| | - Brigitte Granel
- Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France.,Internal Medicine Department, Hopital Nord, Marseille, France
| | - Pascale Paul
- Cell Therapy Department, Hopital de la Conception, Marseille, France.,Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France
| | - Florence Sabatier
- Cell Therapy Department, Hopital de la Conception, Marseille, France .,Cardiovascular and Nutrition Research Center, INSERM, INRA, Aix-Marseille Universite, Marseille, France
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22
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Magalon J, Velier M, Vogtensperger M, Veran J, Grimaud F, Sabatier F. Allogenic Pure Platelet-Rich Plasma Therapy for Rotator Cuff Disease: A Bench and Bed Study: Letter to the Editor. Am J Sports Med 2019; 47:NP36-NP37. [PMID: 30943081 DOI: 10.1177/0363546519835825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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23
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Guillibert C, Charpin C, Raffray M, Benmenni A, Dehaut FX, El Ghobeira G, Giorgi R, Magalon J, Arniaud D. Single Injection of High Volume of Autologous Pure PRP Provides a Significant Improvement in Knee Osteoarthritis: A Prospective Routine Care Study. Int J Mol Sci 2019; 20:ijms20061327. [PMID: 30884774 PMCID: PMC6472196 DOI: 10.3390/ijms20061327] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 12/25/2022] Open
Abstract
Background: Evidence is growing regarding the ability of platelet-rich plasma (PRP) injections to enhance functional capacity and alleviate pain in knee osteoarthritis (OA). However, heterogeneity in common practice regarding PRP preparation and biological content makes the initiation of this activity in a hospital complex. The aim of this study was to document the efficacy of a single PRP injection to treat knee OA and validate a routine care procedure. Methods: Fifty-seven patients with symptomatic knee OA received a single injection of large volume of very pure PRP. They were assessed at baseline and after one, three and six months, by measuring Knee Injury and Osteoarthritis Score (KOOS), Observed Pain after a 50-foot walk test and Visual Analog Scale (VAS) assessments. Magnetic Resonance Imaging (MRI) analysis was performed at baseline and six months after the procedure. The objective was to recover 50% of responders three months after the procedure using OMERACT-OARSI criteria. Results: A single administration of high volume pure PRP provided significant clinical benefit for 84.2% of the responders, three months after the procedure. The KOOS total score significantly increased from 43.5 ± 14.3 to 66.4 ± 21.7 six months after the procedure (p < 0.001). Pain also significantly decreased from 37.5 ± 25.1 to 12.9 ± 20.9 (p < 0.001). No difference was observed on MRI parameters. Conclusion: A single injection of large volume of very pure PRP is associated with significant functional improvement and pain relief, allowing initiation of daily PRP injection within our hospital.
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Affiliation(s)
| | - Caroline Charpin
- Rheumatology Department, Hôpital Saint Joseph, 13008 Marseille, France.
| | - Marie Raffray
- Rheumatology Department, Hôpital Saint Joseph, 13008 Marseille, France.
| | - Annie Benmenni
- Rheumatology Department, Hôpital Saint Joseph, 13008 Marseille, France.
| | | | | | - Roch Giorgi
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, 13005 Marseille, France.
| | - Jeremy Magalon
- Cell Therapy Department, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France.
| | - Denis Arniaud
- Rheumatology Department, Hôpital Saint Joseph, 13008 Marseille, France.
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24
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Bembo F, Eraud J, Philandrianos C, Bertrand B, Silvestre A, Veran J, Sabatier F, Magalon G, Magalon J. Combined use of platelet rich plasma and micro-fat in sport and race horses with degenerative joint disease: preliminary clinical study in eight horses. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.02.2016.06] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- F. Bembo
- Veterinary Clinic, Luynes France
| | - J. Eraud
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - C. Philandrianos
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - B. Bertrand
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - A. Silvestre
- Radiology Department, Bordeaux Merignac Sports Clinic, Merignac, France
| | - J. Veran
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
| | - F. Sabatier
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
| | - G. Magalon
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - J. Magalon
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
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25
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Bausset O, Magalon J, Giraudo L, Louis ML, Serratrice N, Frere C, Magalon G, Dignat-George F, Sabatier F. Impact of local anaesthetics and needle calibres used for painless PRP injections on platelet functionality. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2014.04] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- O. Bausset
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
| | - J. Magalon
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
| | - L. Giraudo
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
| | - M.-L. Louis
- Orthopaedic Surgery Unit, CHU La Conception, Assistance Publique des Hôpitaux de Marseille, France
| | - N. Serratrice
- Department of Plastic and Reconstructive Surgery, CHU La Conception, Assistance Publique des Hôpitaux de Marseille, France
| | - C. Frere
- Faculty of Pharmacy, Inserm UMR-S1076, Marseille, France
| | - G. Magalon
- Department of Plastic and Reconstructive Surgery, CHU La Conception, Assistance Publique des Hôpitaux de Marseille, France
| | - F. Dignat-George
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
- Faculty of Pharmacy, Inserm UMR-S1076, Marseille, France
| | - F. Sabatier
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
- Faculty of Pharmacy, Inserm UMR-S1076, Marseille, France
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26
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Benyamine A, Magalon J, Sabatier F, Kaplanski G, Mazodier K, Reynaud Gaubert M, Morange S, Rossi P, Dignat-George F, Paul P, Granel B. Les cellules natural killer de patients souffrant de sclérodermie systémique ont un profil phénotypique particulier et sont de puissants inducteurs de libération de microparticules endothéliales. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Graiet H, Lokchine A, Francois P, Velier M, Grimaud F, Loyens M, Berda-Haddad Y, Veran J, Dignat-George F, Sabatier F, Magalon J. Use of platelet-rich plasma in regenerative medicine: technical tools for correct quality control. BMJ Open Sport Exerc Med 2018; 4:e000442. [PMID: 30498575 PMCID: PMC6241975 DOI: 10.1136/bmjsem-2018-000442] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 01/01/2023] Open
Abstract
Background/aims Platelet-rich plasma (PRP) injections are used in sports medicine and have been the subject of increased clinical interest. However, there have been very few reports of the composition of initial whole blood and the final PRP product. The objective of this study was to provide technical tools to perform a correct characterisation of platelets, leucocytes and red blood cells (RBCs) from whole blood and PRP. Methods Blood and PRP were obtained from 26 healthy volunteers and prepared according to the varying parameters encountered within PRP process preparation and quantification (harvesting method, anticoagulant used, sampling method, counting method). Concentrations were measured at t=0, t=1, t=6 and t=24 hours. Results Sampling of blood in Eppendorf tubes significantly decreased platelet concentration over time, whereas sampling in Microvette EDTA-coated tube kept platelet concentration stable until 24 hours. A non-significant difference was observed in platelet counts in PRP with impedance (median (IQR): 521.8 G/L (505.3–524.7)) and fluorescence (591.5 G/L (581.5–595.8)) methods. Other studied parameters did not influence platelet concentrations in blood or PRP samples. Leucocytes and RBC counts were similar whatever the anticoagulant, sampling, harvesting and counting methods used for both blood and PRP samples. Conclusions Systematic sampling of blood and PRP in EDTA-coated tubes for quality control is recommended. The use of a validated counter for PRP sample should also be taken into account.
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Affiliation(s)
- Hajer Graiet
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Anna Lokchine
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pauline Francois
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France
| | - Melanie Velier
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Maxime Loyens
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Yael Berda-Haddad
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Julie Veran
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Francoise Dignat-George
- INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France.,Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | | | - Jeremy Magalon
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France
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28
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Louis ML, Magalon J, Jouve E, Bornet CE, Mattei JC, Chagnaud C, Rochwerger A, Veran J, Sabatier F. Growth Factors Levels Determine Efficacy of Platelets Rich Plasma Injection in Knee Osteoarthritis: A Randomized Double Blind Noninferiority Trial Compared With Viscosupplementation. Arthroscopy 2018; 34:1530-1540.e2. [PMID: 29366744 DOI: 10.1016/j.arthro.2017.11.035] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the noninferiority of a single platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA), to alleviate pain and enhance functional capacity in knee osteoarthritis, and identify biological characteristics of PRP that may affect their efficacy. METHODS Fifty-four patients with symptomatic knee osteoarthritis received a single injection of either PRP (26 patients) or HA (28 patients). They were assessed at baseline and at 1, 3, and 6 months. The primary endpoint was the change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at 3 months, and secondary endpoints were responders' rate (improvement of at least 5 points or 40% of WOMAC total score at 3 months) of pain evaluation and patient's subjective satisfaction. Cell counts and the contents of vascular endothelial growth factor (VEGF), platelet-derived growth factor-AB (PDGF-AB), transforming growth factor beta 1 (TGF-β1) content of injected PRP were assessed to analyze their relationship with clinical outcome. RESULTS Both treatments proved their improvement in knee functional status and symptom relief, with a significant decrease observed at 1 month on all scores except for pain VAS in PRP group and WOMAC function score in the HA group. No difference between groups regarding WOMAC and VAS scores was observed. A higher percentage of responders was observed in the PRP group (72.7%) than in the HA group (45.8%) without significance (P = .064). The quantity of injected PDGF-AB and TGF-β1 correlated with the change in WOMAC scores at 3 months and was lower in responders than in nonresponders (P = .009 and P = .003, respectively). CONCLUSIONS Current results indicated that a single injection of very pure PRP offers a significant clinical improvement in the management of knee osteoarthritis, equivalent to a single HA injection in this patient population. Moreover, a significant correlation between the doses of TGF-β1 and PDGF-AB and the worsening of WOMAC score 3 months after the procedure was found. LEVEL OF EVIDENCE Level II, randomized double blind controlled trial.
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Affiliation(s)
- Marie Laure Louis
- Orthopedic Department, Hôpital Nord, AP-HM, Marseille, France; ICOS, Sport and Orthopedics Surgery Institute, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France; Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, INSERM UMR 1076, Marseille, France.
| | - Elizabeth Jouve
- Unité de Pharmacométrie CIC-CPCET, Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, AP-HM, Marseille, France
| | | | | | | | | | - Julie Veran
- Unité de Pharmacométrie CIC-CPCET, Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, AP-HM, Marseille, France
| | - Florence Sabatier
- Unité de Pharmacométrie CIC-CPCET, Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, AP-HM, Marseille, France; Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, INSERM UMR 1076, Marseille, France
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Beylerian M, Lazaro M, Magalon J, Veran J, Darque A, Grimaud F, Stolowy N, Beylerian H, Sabatier F, Hoffart L. [Autologous serum tears: Long-term treatment in dry eye syndrome]. J Fr Ophtalmol 2018; 41:246-254. [PMID: 29602451 DOI: 10.1016/j.jfo.2017.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 11/11/2017] [Accepted: 11/17/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Dry eye disease is a multifactorial pathology of the ocular surface. The high incidence of this pathology, as well as its significant impact on quality of life and vision and its financial cost, makes it a real public health problem. While the treatment of mild cases is generally simple and effective, treatment of severe forms is often disappointing. The use of autologous serum tears (AST) represents a therapeutic alternative for the most severe cases. The purpose of our study is to evaluate the efficacy of long-term AST treatment in patients with severe dry eye disease refractory to conventional treatment or secondary to systemic diseases such as Sjögren's syndrome or Graft versus Host disease (GVH), or ocular pathologies such as neurotrophic keratitis, chemical burns and ocular cicatricial pemphigoid. PATIENTS AND METHODS This is a monocentric retrospective observational study conducted on 47 patients, with 83 eyes treated with autologous serum eye drops for isolated or secondary dry eye disease at the Marseille Public Hospitals between April 2014 and April 2017. The patients' subjective symptoms (ocular surface disease index [OSDI] score), their degree of satisfaction and the side effects were collected using questionnaires. Tear Break Up Time (BUT) and Schirmer scores were noted. A clinical evaluation based on fluorescein staining (Oxford score) was carried out prior to treatment with AST at P0 followed by 5 periods: P1 (between 1 and 3 months), P2 (3 to 9 months), P3 (9 to 15 months), P4 (15 months to 24 months), and P5 (>24 months). RESULTS Out of the 83 eyes treated, the mean age was 54.39±21.56. There were 20 males (42.55 %) and 27 females (57.44 %); treatment indications consisted mainly of 25.53 % GVH, 21.27 % severe dry eye disease and 19.14 % Sjögren syndrome. The mean duration of follow-up was 9.82 months±15.50. The OSDI score decreased by 19.32 points±29.37 (P<0.05) between P0 and P1 and by 23.06 points±18.41 (P<0.05) between P0 and P4. The Oxford clinical score showed a significant decrease by the third month of treatment, between P0 and P2, by 1.32 points±1.76 (P<0.05). The Schirmer test and the BUT also showed an improvement in dry eye symptoms over time with AST, significantly at P1 (P<0.05). DISCUSSION Complementary biological analyzes on the composition of AST are under way in order to identify predictive factors of effectiveness; patients not responding to AST treatment might respond to allogeneic serum from healthy donor cord blood. CONCLUSION On this first series of 83 eyes treated with ASD, clinical efficacy was noted in most of the patients. No infectious complications were reported, and the satisfaction rate was very high.
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Affiliation(s)
- M Beylerian
- Service d'ophtalmologie, CHU de Hôpital La Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - M Lazaro
- Pharmacie, CHU Hôpital La Conception, 13005 Marseille, France
| | - J Magalon
- Laboratoire de cultures et de thérapies cellulaires (LCTC), CHU de La Conception, 13005 Marseille, France
| | - J Veran
- Laboratoire de cultures et de thérapies cellulaires (LCTC), CHU de La Conception, 13005 Marseille, France
| | - A Darque
- Pharmacie, CHU Hôpital La Conception, 13005 Marseille, France
| | - F Grimaud
- Pharmacie, CHU Hôpital La Conception, 13005 Marseille, France
| | - N Stolowy
- Service d'ophtalmologie, CHU de Hôpital La Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - H Beylerian
- Service d'ophtalmologie, CHU hôpital Gui-De-Chauliac, 34000 Montpellier, France
| | - F Sabatier
- Laboratoire de cultures et de thérapies cellulaires (LCTC), CHU de La Conception, 13005 Marseille, France
| | - L Hoffart
- Service d'ophtalmologie, CHU de Hôpital La Timone, 264, rue Saint-Pierre, 13385 Marseille, France
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Mesguich Batel F, Bertrand B, Magalon J, François P, Velier M, Veran J, Mallet S, Jouve E, Sabatier F, Casanova D. [Treatment of wrinkles of the upper lip by emulsified fat or "Nanofat": Biological and clinical study about 4 cases]. ANN CHIR PLAST ESTH 2017; 63:31-40. [PMID: 29157877 DOI: 10.1016/j.anplas.2017.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/09/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Emulsified fat injection showed its interest in aesthetic facial surgery. The adipose tissue harvested is mechanically emulsified and filtered. The suspension obtained is injected into the dermis through small diameter needles (27 to 30 gauges). The objective of our study was to evaluate the biological composition of emulsified fat and its clinical effectiveness in the treatment of peri-oral wrinkles in 4 patients aged 50 to 59 years. MATERIAL AND METHOD Each patient received an intradermal injection of emulsified fat in the peri-oral wrinkles prepared from abdominal fat under local anesthesia. The cell viability, stromal vascular fraction (FVS) composition in emulsified fat and the adipocyte differentiation capacity of mesenchymal stem cells (MSC) were studied. The clinical results were evaluated by standardized photographs, 3D microphotography, confocal microscopy, and self-evaluation of patient satisfaction over a period of 4 months. RESULTS The biological study of the emulsified fat found a lysis of all the adipocytes. The mean number of FVS cells was 126,330±2758 cells by cc of emulsified fat with preserved cell viability (85.1±6.84 %) and a good proportion of regeneratives cells (18.77±6.2 %). The clinical study found a tendency to decrease the volume of wrinkles on standardized photography and 3D microphotography no significative. Patients were satisfied with treatment with an average score of 7±1.15/10 to 4 months. CONCLUSION Intradermal injection of emulsified fat seems to be an interesting treatment of face wrinkles. Our study has shown its safety, but additional studies seems necessary to confirm its clinical efficacy.
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Affiliation(s)
- F Mesguich Batel
- Service de chirurgie plastique, hôpital de La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France.
| | - B Bertrand
- Service de chirurgie plastique, hôpital de La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France; UMRS-1076 Inserm, vascular research center of Marseille, université Aix-Marseille, 13005 Marseille, France
| | - J Magalon
- UMRS-1076 Inserm, vascular research center of Marseille, université Aix-Marseille, 13005 Marseille, France; Inserm CICBT-1409, laboratoire de culture et de thérapie cellulaire, hôpital de La Conception, université Aix-Marseille, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - P François
- UMRS-1076 Inserm, vascular research center of Marseille, université Aix-Marseille, 13005 Marseille, France; Inserm CICBT-1409, laboratoire de culture et de thérapie cellulaire, hôpital de La Conception, université Aix-Marseille, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - M Velier
- UMRS-1076 Inserm, vascular research center of Marseille, université Aix-Marseille, 13005 Marseille, France; Inserm CICBT-1409, laboratoire de culture et de thérapie cellulaire, hôpital de La Conception, université Aix-Marseille, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - J Veran
- Inserm CICBT-1409, laboratoire de culture et de thérapie cellulaire, hôpital de La Conception, université Aix-Marseille, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - S Mallet
- Service de dermatologie, hôpital de La Timone, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - E Jouve
- Unité de pharmacométrie CIC-CPCET, service de pharmacologie clinique et pharmacovigilance, hôpital de La Timone, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France; Service d'évaluation médicale, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - F Sabatier
- UMRS-1076 Inserm, vascular research center of Marseille, université Aix-Marseille, 13005 Marseille, France; Inserm CICBT-1409, laboratoire de culture et de thérapie cellulaire, hôpital de La Conception, université Aix-Marseille, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - D Casanova
- Service de chirurgie plastique, hôpital de La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
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Ghazouane R, Bertrand B, Philandrianos C, Veran J, Abellan M, Francois P, Velier M, Orneto C, Piccerelle P, Magalon J. What About the Rheological Properties of PRP/Microfat Mixtures in Fat Grafting Procedure? Aesthetic Plast Surg 2017. [PMID: 28639068 DOI: 10.1007/s00266-017-0905-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Fat grafting has emerged as a reference procedure in daily plastic surgery practice. Unpredictable fat resorption is the main clinical problem. For this purpose, the addition of PRP to enhance fat revascularization is now an easy and popular procedure. However, no consensus exists regarding the respective volume of fat and PRP used to obtain the ideal mixture. This study investigated the rheological properties of microfat mixed with different proportions of PRP. Results obtained were compared with commercialized hyaluronic acid fillers. METHODS Microfat and PRP preparations were performed using standardized techniques. Lipoaspirate residue and blood were obtained from six patients undergoing aesthetic facial microlipofilling. Elastic modulus G' and tan δ (proportion of elasticity versus fluidity) were obtained for the following conditions: microfat alone and microfat mixed with 10, 30 or 50% of PRP. RESULTS An expected decrease in elastic modulus was observed by adding increase volumes of PRP. Two groups of products with different rheological properties were considered based on statistical differences highlighted regarding the value of G'. Mean tan δ varied from 0.20 ± 0.04 (microfat alone) to 0.28 ± 0.08 (50% microfat/50% PRP). Microfat mixed with 10% of PRP presents consistency comparable to stiffer fillers, whereas microfat mixed with 30 or 50% corresponds to softer fillers. CONCLUSION Rheological differences were highlighted given the proportion of PRP added to the microfat. Further studies assessing the impact of increased doses of platelets in microfat/PRP mixtures on clinical outcomes should also be investigated. Our findings will help clinicians to choose a mixture that meets their specific needs for a given indication. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Velier M, Magalon J, Daumas A, Cassar M, Francois P, Ghazouane A, Philandrianos C, Bertrand B, Frere C, Bernot D, Villani P, George FD, Sabatier F. Production of platelet-rich plasma gel from elderly patients under antithrombotic drugs: Perspectives in chronic wounds care. Platelets 2017; 29:496-503. [DOI: 10.1080/09537104.2017.1336212] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- M. Velier
- Cell therapy laboratory, CBT-1409, INSERM, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - J. Magalon
- Cell therapy laboratory, CBT-1409, INSERM, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
- Vascular Research Center Marseille, UMR-1076 INSERM, Aix-Marseille University, Marseille, France
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - A. Daumas
- Geriatric and Internal Medicine Department, Hôpital de la Timone, AP-HM, Marseille, France
| | - M. Cassar
- Cell therapy laboratory, CBT-1409, INSERM, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - P. Francois
- Cell therapy laboratory, CBT-1409, INSERM, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - A. Ghazouane
- Cell therapy laboratory, CBT-1409, INSERM, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - C. Philandrianos
- Plastic Surgery Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - B. Bertrand
- Plastic Surgery Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - C. Frere
- Hematology Department, Hôpital de la Timone, AP-HM, Marseille, France
| | - D. Bernot
- Hematology Department, Hôpital de la Timone, AP-HM, Marseille, France
| | - P. Villani
- Geriatric and Internal Medicine Department, Hôpital de la Timone, AP-HM, Marseille, France
| | - F. Dignat George
- Vascular Research Center Marseille, UMR-1076 INSERM, Aix-Marseille University, Marseille, France
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - F Sabatier
- Cell therapy laboratory, CBT-1409, INSERM, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
- Vascular Research Center Marseille, UMR-1076 INSERM, Aix-Marseille University, Marseille, France
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
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Abstract
Vocal fold microstructure is complex and can be affected by laryngeal microsurgery, inducing scarring that prevents mechanical uncoupling of epithelium and muscle, leading to vibration disorder and disabling dysphonia. Treatment options presently are few, and often without efficacy for vibration, having only an impact on volume to reduce glottal closure defect. The present review of the literature had two aims: (i) to report the current state of the literature on cell therapy in vocal fold scarring; and (ii) to analyze the therapeutic interest of the adipose-derived stromal vascular fraction in the existing therapeutic armamentarium. A PubMed® search conducted in September 2016 retrieved English or French-language original articles on the use of stem cells to treat vocal fold scarring. Twenty-seven articles published between 2003 and 2016 met the study selection criteria. Mesenchymal stem cells were most widely used, mainly derived from bone marrow or adipose tissue. Four studies were performed in vitro on fibroblasts, and 18 in vivo on animals. End-points comprised: (i) scar analysis (macro- and micro-scopic morphology, viscoelastic properties, extracellular matrix, fibroblasts); and (ii) assessment of stem cell survival and differentiation. The studies testified to the benefit of mesenchymal stem cells, and especially those of adipose derivation. The stromal vascular fraction exhibits properties that might improve results by facilitating production logistics.
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Affiliation(s)
- A Mattei
- Aix Marseille université, 13000 Marseille, France; Service d'oto-rhino-laryngologie et chirurgie cervicofaciale, La Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France.
| | - J Magalon
- VRCM Inserm UMR 1076, faculté de pharmacie de Marseille, Aix Marseille université, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Inserm CBT-1409, laboratoire de culture et thérapie cellulaire, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - B Bertrand
- Service de chirurgie plastique et réparatrice, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - C Philandrianos
- Service de chirurgie plastique et réparatrice, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - J Veran
- Inserm CBT-1409, laboratoire de culture et thérapie cellulaire, La Conception, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - A Giovanni
- Service d'oto-rhino-laryngologie et chirurgie cervicofaciale, La Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France; CNRS, laboratoire parole et langage, Aix Marseille université, 5, avenue Pasteur, 13100 Aix-en-Provence, France
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Bembo F, Eraud J, Philandrianos C, Bertrand B, Silvestre A, Veran J, Sabatier F, Magalon G, Magalon J. Combined use of platelet rich plasma & micro-fat in sport and race horses with degenerative joint disease: preliminary clinical study in eight horses. Muscles Ligaments Tendons J 2016; 6:198-204. [PMID: 27900293 DOI: 10.11138/mltj/2016.6.2.198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To assess the safety and potential efficacy of a standardized technique consisting of intra-articular injection of 10 cc of a homogeneous mixed product using autologous micro-fat and platelet rich plasma (PRP) (ratio 1:1) in the carpus or the fetlock joint of sport horses presenting degenerative joint disease (DJD). METHODS Eight sport horses with DJD confirmed by radiography and ultrasonography and causing lameness and the impossibility to compete were treated. PRP was prepared after a double centrifugation whereas micro-fat was harvested and purified using a closed system. The two products were connected and mixed by gentle back and forth shaking of the syringes to finally obtain 10 ml of an homogeneous mixed product. Follow up was performed from 5 to 10 months with assessment of AAEP lameness score and return to training and competition. RESULTS Nine joints were treated with significant improvement of the AAEP lameness score three months after the procedure (p = 0.021). Four horses returned to official competition between 5 to 10 months after the procedure (7.0±2.5) and three of them resumed intensive training between 5 to 9 months (6.3±2.3). No adverse event occurred. CONCLUSION This study is a first step in the development of innovative therapy for DJD which combines the potential chondrogenic differentiation of MSCs inside equine adipose tissue with the proliferative effect of growth factors present in PRP.
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Affiliation(s)
| | - Julia Eraud
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Cecile Philandrianos
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Baptiste Bertrand
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Alain Silvestre
- Radiology Department, Bordeaux Merignac Sports Clinic, Merignac, France
| | - Julie Veran
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
| | - Florence Sabatier
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
| | - Guy Magalon
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Jeremy Magalon
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
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Boissier R, Magalon J, Sabatier F, Veran J, Giraudo L, Giusiano S, Garcia S, Dignat-George F, Arnaud L, Magalon G, Lechevallier E, Berdah S, Karsenty G. Histological and Urodynamic Effects of Autologous Stromal Vascular Fraction Extracted from Fat Tissue with Minimal Ex Vivo Manipulation in a Porcine Model of Intrinsic Sphincter Deficiency. J Urol 2016; 196:934-42. [PMID: 27265221 DOI: 10.1016/j.juro.2016.04.099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 01/28/2023]
Abstract
PURPOSE To evaluate the healing abilities of autologous stem cell therapy (stromal vascular fraction) prepared from adipose tissue we used an automated system without an ex vivo culture phase in a pig model of intrinsic sphincteric deficiency. MATERIALS AND METHODS A total of 15 pigs underwent endoscopic section of the urethral sphincter. Animals were then randomly assigned to 3 groups, including 1) controls without stromal vascular fraction injection, 2) early injection with stromal vascular fraction 2 to 3 days after section and 3) late stromal vascular fraction injection delivery 30 days after injury. Extraction and stromal vascular fraction injection were performed as a single procedure. The stromal vascular fraction was characterized by flow cytometry. Mesenchymal stem cell-like cells were enumerated by clonogenicity (cfu fibroblast) assay. Study end points included histological assessment of the urethral injury surface and urodynamics to determine maximum urethral pressure. RESULTS Flow cytometry analysis revealed a mesenchymal stem cell-like phenotype in a mean ± SD of 47.3% ± 11.8% of stromal vascular fraction cells. The cfu fibroblast frequency was 1.3 to 6.6/100 stromal vascular fraction cells (1.3% to 6.6%). Stromal vascular fraction injection was associated with a reduction of the urethral injury surface in the early and late injection groups compared with the respective controls (7% vs 17% and 1% vs 13%, p = 0.050 and 0.029, respectively). On day 30 after injection maximum urethral pressure was significantly higher in the injected groups than in the control group, that is 64% vs 50% of maximum urethral pressure on day 0 (p = 0.04). CONCLUSIONS These data demonstrate the ability of an autologous stromal vascular fraction to improve the urethral healing process in a large animal model of intrinsic sphincteric deficiency.
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Affiliation(s)
- Romain Boissier
- Aix-Marseille University, 13284, Marseille, France; Department of Urology and Kidney Transplantation, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France.
| | - Jeremy Magalon
- Institut national de la santé et de la recherche médicale Unités mixtes de recherche 1076, Aix-Marseille University, 13284, Marseille, France; Department of Cell Therapy, Institut national de la santé et de la recherche médicale Unités mixtes de recherche 1076, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France; Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Florence Sabatier
- Institut national de la santé et de la recherche médicale Unités mixtes de recherche 1076, Aix-Marseille University, 13284, Marseille, France; Department of Cell Therapy, Institut national de la santé et de la recherche médicale Unités mixtes de recherche 1076, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France; Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Julie Veran
- Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Laurent Giraudo
- Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Sophie Giusiano
- Aix-Marseille University, 13284, Marseille, France; Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France; Department of Pathology, 13015, Assistance Publique Hôpitaux de Marseille, Nord University Hospital, Marseille, France
| | | | - Françoise Dignat-George
- Department of Biology and Hematology, 13285, Assistance Publique Hôpitaux de Marseille, Hospital Conception, Marseille, France
| | - Laurent Arnaud
- Department of Biology and Hematology, 13285, Assistance Publique Hôpitaux de Marseille, Hospital Conception, Marseille, France
| | - Guy Magalon
- Aix-Marseille University, 13284, Marseille, France; Department of Plastic and Reconstructive Surgery, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Eric Lechevallier
- Aix-Marseille University, 13284, Marseille, France; Department of Urology and Kidney Transplantation, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Stephane Berdah
- Center for Research and Teaching in Surgery, Aix-Marseille University, 13284, Marseille, France; Aix-Marseille University, 13284, Marseille, France
| | - Gilles Karsenty
- Aix-Marseille University, 13284, Marseille, France; Department of Urology and Kidney Transplantation, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France
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Guillaume-Jugnot P, Daumas A, Magalon J, Sautereau N, Veran J, Magalon G, Sabatier F, Granel B. State of the art. Autologous fat graft and adipose tissue-derived stromal vascular fraction injection for hand therapy in systemic sclerosis patients. Curr Res Transl Med 2016; 64:35-42. [PMID: 27140597 DOI: 10.1016/j.retram.2016.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 01/04/2016] [Indexed: 01/27/2023]
Abstract
Systemic sclerosis is an autoimmune disease characterized by sclerosis (hardening) of the skin and deep viscera associated with microvascular functional and structural alteration, which leads to chronic ischemia. In the hands of patients, ischemic and fibrotic damages lead to both pain and functional impairment. Hand disability creates a large burden in professional and daily activities, with social and psychological consequences. Currently, the proposed therapeutic options for hands rely mainly on hygienic measures, vasodilatator drugs and physiotherapy, but have many constraints and limited effects. Developing an innovative therapeutic approach is crucial to reduce symptoms and improve the quality of life. The discovery of adult stem cells from adipose tissue has increased the interest to use adipose tissue in plastic and regenerative surgery. Prepared as freshly isolated cells for immediate autologous transplantation, adipose tissue-derived stem cell therapy has emerged as a therapeutic alternative for the regeneration and repair of damaged tissues. We aim to update literature in the interest of autologous fat graft or adipose derived from stromal vascular fraction cell-based therapy for the hands of patients who suffer from systemic sclerosis.
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Affiliation(s)
- P Guillaume-Jugnot
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), 13915 Marseille cedex 05, France
| | - A Daumas
- Service de médecine interne, gériatrie et thérapeutique, hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - J Magalon
- Laboratoire de culture et thérapie cellulaire, Inserm CBT-1409, hôpital de la Conception, AP-HM, 13385 Marseille cedex 05, France
| | - N Sautereau
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), 13915 Marseille cedex 05, France
| | - J Veran
- Laboratoire de culture et thérapie cellulaire, Inserm CBT-1409, hôpital de la Conception, AP-HM, 13385 Marseille cedex 05, France
| | - G Magalon
- Service de chirurgie plastique et réparatrice, hôpital de la Conception, AP-HM, 13385 Marseille cedex 05, France
| | - F Sabatier
- Laboratoire de culture et thérapie cellulaire, Inserm CBT-1409, hôpital de la Conception, AP-HM, 13385 Marseille cedex 05, France; Inserm UMR 1076 Vascular Research Centre of Marseille, Aix-Marseille université, 13385 Marseille cedex 05, France
| | - B Granel
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), 13915 Marseille cedex 05, France; Inserm UMR 1076 Vascular Research Centre of Marseille, Aix-Marseille université, 13385 Marseille cedex 05, France.
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Magalon J, Chateau AL, Bertrand B, Louis ML, Silvestre A, Giraudo L, Veran J, Sabatier F. DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport Exerc Med 2016; 2:e000060. [PMID: 27900152 PMCID: PMC5117023 DOI: 10.1136/bmjsem-2015-000060] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 11/26/2022] Open
Abstract
Background/aim Significant biological differences in platelet-rich plasma (PRP) preparations have been highlighted and could explain the large variability in the clinical benefit of PRP reported in the literature. The scientific community now recommends the use of classification for PRP injection; however, these classifications are focused on platelet and leucocyte concentrations. This presents the disadvantages of (1) not taking into account the final volume of the preparation; (2) omitting the presence of red blood cells in PRP and (3) not assessing the efficiency of production. Methods On the basis of standards classically used in the Cell Therapy field, we propose the DEPA (Dose of injected platelets, Efficiency of production, Purity of the PRP, Activation of the PRP) classification to extend the characterisation of the injected PRP preparation. We retrospectively applied this classification on 20 PRP preparations for which biological characteristics were available in the literature. Results Dose of injected platelets varies from 0.21 to 5.43 billion, corresponding to a 25-fold increase. Only a Magellan device was able to obtain an A score for this parameter. Assessments of the efficiency of production reveal that no device is able to recover more than 90% of platelets from the blood. Purity of the preparation reveals that a majority of the preparations are contaminated by red blood cells as only three devices reach an A score for this parameter, corresponding to a percentage of platelets compared with red blood cells and leucocytes over 90%. Conclusions These findings should provide significant help to clinicians in selecting a system that meets their specific needs for a given indication.
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Affiliation(s)
- J Magalon
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, CIC BT 1409, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, Marseille, France
| | - A L Chateau
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, CIC BT 1409, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, Marseille, France
| | - B Bertrand
- Plastic Surgery Department , Hôpital de la Conception, AP-HM , Marseille , France
| | - M L Louis
- ICOS, Sport and Orthopedics Surgery Institute , Marseille , France
| | - A Silvestre
- Radiology Department , Bordeaux Merignac Sports Clinic , Merignac , France
| | - L Giraudo
- Cell Culture and Therapy Laboratory , Hôpital de la Conception, AP-HM, CIC BT 1409 , Marseille , France
| | - J Veran
- Cell Culture and Therapy Laboratory , Hôpital de la Conception, AP-HM, CIC BT 1409 , Marseille , France
| | - F Sabatier
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, CIC BT 1409, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, Marseille, France
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Magalon J, Maiers M, Kurtzberg J, Navarrete C, Rubinstein P, Brown C, Schramm C, Larghero J, Katsahian S, Chabannon C, Picard C, Platz A, Schmidt A, Katz G. Banking or Bankrupting: Strategies for Sustaining the Economic Future of Public Cord Blood Banks. PLoS One 2015; 10:e0143440. [PMID: 26624279 PMCID: PMC4666404 DOI: 10.1371/journal.pone.0143440] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/04/2015] [Indexed: 12/14/2022] Open
Abstract
Background Cord blood is an important source of stem cells. However, nearly 90% of public cord blood banks have declared that they are struggling to maintain their financial sustainability and avoid bankruptcy. The objective of this study is to evaluate how characteristics of cord blood units influence their utilization, then use this information to model the economic viability and therapeutic value of different banking strategies. Methods Retrospective analysis of cord blood data registered between January 1st, 2009 and December 31st, 2011 in Bone Marrow Donor Worldwide. Data were collected from four public banks in France, Germany and the USA. Samples were eligible for inclusion in the analysis if data on cord blood and maternal HLA typing and biological characteristics after processing were available (total nucleated and CD34+ cell counts). 9,396 banked cord blood units were analyzed, of which 5,815 were Caucasian in origin. A multivariate logistic regression model assessed the influence of three parameters on the CBU utilization rate: ethnic background, total nucleated and CD34+ cell counts. From this model, we elaborated a Utilization Score reflecting the probability of transplantation for each cord blood unit. We stratified three Utilization Score thresholds representing four different banking strategies, from the least selective (scenario A) to the most selective (scenario D). We measured the cost-effectiveness ratio for each strategy by comparing performance in terms of number of transplanted cord blood units and level of financial deficit. Results When comparing inputs and outputs over three years, Scenario A represented the most extreme case as it delivered the highest therapeutic value for patients (284 CBUs transplanted) along with the highest financial deficit (USD 5.89 million). We found that scenario C resulted in 219 CBUs transplanted with a limited deficit (USD 0.98 million) that charities and public health could realistically finance over the long term. We also found that using a pre-freezing level of 18 x 108 TNC would be the most cost-effective strategy for a public bank. Conclusion Our study shows that a swift transition from strategy A to C can play a vital role in preventing public cord blood banks worldwide from collapsing.
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Affiliation(s)
- Jeremy Magalon
- ESSEC Business School, Paris-Singapore, France
- Assistance Publique Hôpitaux de Marseille CIC BT 1409, Marseille, France
- Vascular Research Center of Marseille, Aix Marseille University, Marseille, France
| | - Martin Maiers
- National Marrow Donor Program, Minneapolis, Minnesota, United States of America
| | - Joanne Kurtzberg
- Carolinas Cord Blood Bank, Duke University, Durham, North Carolina, United States of America
| | | | - Pablo Rubinstein
- National Cord Blood Program, New York Blood Center, New York, New York, United States of America
| | - Colin Brown
- NHS Cord Blood Bank, NHS Blood and Transplant, London, United Kingdom
| | | | | | - Sandrine Katsahian
- INSERM U1138, Paris Descartes University, UPMC, Paris, France
- Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | - Gregory Katz
- ESSEC Business School, Paris-Singapore, France
- * E-mail:
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Abina SHB, Gaspar HB, Blondeau J, Caccavelli L, Charrier S, Buckland K, Picard C, Six E, Himoudi N, Gilmour K, McNicol AM, Hara H, Xu-Bayford J, Rivat C, Touzot F, Mavilio F, Lim A, Treluyer JM, Héritier S, Lefrere F, Magalon J, Pengue-Koyi I, Honnet G, Blanche S, Sherman EA, Male F, Berry C, Malani N, Bushman FD, Fischer A, Thrasher AJ, Galy A, Cavazzana M. Outcomes following gene therapy in patients with severe Wiskott-Aldrich syndrome. JAMA 2015; 313:1550-63. [PMID: 25898053 PMCID: PMC4942841 DOI: 10.1001/jama.2015.3253] [Citation(s) in RCA: 271] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Wiskott-Aldrich syndrome is a rare primary immunodeficiency associated with severe microthrombocytopenia. Partially HLA antigen-matched allogeneic hematopoietic stem cell (HSC) transplantation is often curative but is associated with significant comorbidity. OBJECTIVE To assess the outcomes and safety of autologous HSC gene therapy in Wiskott-Aldrich syndrome. DESIGN, SETTING, AND PARTICIPANTS Gene-corrected autologous HSCs were infused in 7 consecutive patients with severe Wiskott-Aldrich syndrome lacking HLA antigen-matched related or unrelated HSC donors (age range, 0.8-15.5 years; mean, 7 years) following myeloablative conditioning. Patients were enrolled in France and England and treated between December 2010 and January 2014. Follow-up of patients in this intermediate analysis ranged from 9 to 42 months. INTERVENTION A single infusion of gene-modified CD34+ cells with an advanced lentiviral vector. MAIN OUTCOMES AND MEASURES Primary outcomes were improvement at 24 months in eczema, frequency and severity of infections, bleeding tendency, and autoimmunity and reduction in disease-related days of hospitalization. Secondary outcomes were improvement in immunological and hematological characteristics and evidence of safety through vector integration analysis. RESULTS Six of the 7 patients were alive at the time of last follow-up (mean and median follow-up, 28 months and 27 months, respectively) and showed sustained clinical benefit. One patient died 7 months after treatment of preexisting drug-resistant herpes virus infection. Eczema and susceptibility to infections resolved in all 6 patients. Autoimmunity improved in 5 of 5 patients. No severe bleeding episodes were recorded after treatment, and at last follow-up, all 6 surviving patients were free of blood product support and thrombopoietic agonists. Hospitalization days were reduced from a median of 25 days during the 2 years before treatment to a median of 0 days during the 2 years after treatment. All 6 surviving patients exhibited high-level, stable engraftment of functionally corrected lymphoid cells. The degree of myeloid cell engraftment and of platelet reconstitution correlated with the dose of gene-corrected cells administered. No evidence of vector-related toxicity was observed clinically or by molecular analysis. CONCLUSIONS AND RELEVANCE This study demonstrated the feasibility of the use of gene therapy in patients with Wiskott-Aldrich syndrome. Controlled trials with larger numbers of patients are necessary to assess long-term outcomes and safety.
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Affiliation(s)
- Salima Hacein-Bey Abina
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
- UTCBS CNRS 8258- INSERM U1022, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France
- Immunology Laboratory, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France
| | - H. Bobby Gaspar
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Johanna Blondeau
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
| | - Laure Caccavelli
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
| | - Sabine Charrier
- INSERM, U951; University of Evry, UMR_S951; Molecular Immunology and Innovative Biotherapies, Genethon, Evry, F-91002 France
- Genethon, Evry, F-91002 France
| | - Karen Buckland
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Capucine Picard
- Centre d’Étude des Déficits Immunitaires, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- Immunology and Pediatric Hematology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuelle Six
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- INSERM UMR 1163, Laboratory of human lymphohematopoiesis, Paris, France
| | - Nourredine Himoudi
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Kimberly Gilmour
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Anne-Marie McNicol
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Havinder Hara
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Jinhua Xu-Bayford
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Christine Rivat
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Fabien Touzot
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- Immunology and Pediatric Hematology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Annick Lim
- Groupe Immunoscope, Immunology Department, Institut Pasteur, Paris, France
| | - Jean-Marc Treluyer
- Clinical research Center Necker-Enfants Malades and Cochin Hospital Assistance Publique, Hôpitaux de Paris, Paris Descartes University
| | - Sébastien Héritier
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- Immunology and Pediatric Hematology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Francois Lefrere
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeremy Magalon
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
| | - Isabelle Pengue-Koyi
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | | | - Stéphane Blanche
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- Immunology and Pediatric Hematology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric A. Sherman
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Frances Male
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Charles Berry
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Nirav Malani
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Frederic D. Bushman
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Alain Fischer
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- Immunology and Pediatric Hematology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Laboratory of human lymphohematopoiesis, Paris, France
- Collège de France, Paris, France
| | - Adrian J. Thrasher
- Section of Molecular and Cellular Immunology, University College London Institute of Child Health, London, UK
- Dept of Clinical Immunology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Anne Galy
- INSERM, U951; University of Evry, UMR_S951; Molecular Immunology and Innovative Biotherapies, Genethon, Evry, F-91002 France
- Genethon, Evry, F-91002 France
| | - Marina Cavazzana
- Biotherapy Department, Necker Children’s Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
- Paris Descartes – Sorbonne Paris Cité University, Imagine Institute, Paris, France
- Immunology and Pediatric Hematology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Laboratory of human lymphohematopoiesis, Paris, France
- To whom correspondence should be addressed: Marina Cavazzana, MD, PhD: Address: Biotherapy Department, Necker Children’s Hospital, 149 rue de Sèvres, 75015 Paris, France. Phone number: 00.33(1)44.49.50.68,
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Magalon J, Daumas A, Veran J, Magalon G, Rossi P, Granel B, Sabatier F. Autologous Adipose Tissue-Derived Cells: Are We Talking About Adipose Derived Stem Cells, Stromal Vascular Fraction, or Coleman Fat Grafting? Cell Transplant 2015; 24:2667-8. [PMID: 25715080 DOI: 10.3727/096368915x687552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- J Magalon
- Culture and Cell Therapy Laboratory, INSERM CBT-1409, Assistance Publique Hôpitaux de Marseille, Marseille, France
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Magalon J, Bausset O, Veran J, Giraudo L, Serratrice N, Magalon G, Dignat-George F, Sabatier F. Physico-chemical factors influencing autologous conditioned serum purification. Biores Open Access 2014; 3:35-8. [PMID: 24570844 PMCID: PMC3929001 DOI: 10.1089/biores.2013.0041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Autologous conditioned serum (ACS) is a recent biotherapy based on certain cytokines anti-inflammatory properties mainly used for the reduction of osteoarthritis (OA) symptoms. Here we investigated different physico-chemical factors influencing ACS purification and cytokine production. Human venous blood was incubated in the presence of different diameter beads (respectively 2.5, 3, 3.5, and 4 mm) or glass beads with different types of coating (polished or coated with CrSO4). Sera were recovered, and the concentrations of pro-inflammatory and anti-inflammatory relevant cytokines were measured using Luminex® technology. Fresh whole blood incubated for 24 h highly increased production of interleukin (IL)-6 and IL-8 cytokines. At the same time, the concentrations of IL-1β, IL-1 receptor agonist (IL-1Ra), IL-10, and tumor necrosis factor (TNF)-α were slightly induced. The highest cytokine concentrations were obtained with the exposure of whole blood to 3-mm glass beads and 3.5-mm polished beads. The minimum IL-1β/IL-1Ra ratio obtained was 3.2±1.3 after 24-h incubation without any beads. ACS has been shown to alleviate clinical symptoms of OA in clinical studies. This descriptive study demonstrated that different pro- and anti-inflammatory cytokines are present in ACS since no selective anti-inflammatory cytokines were produced based on the different protocols. Furthermore, we showed that CrSO4-treated glass beads are not necessary and that the absence of beads combined with a 24-h incubation could also lead to an enriched serum.
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Affiliation(s)
- Jeremy Magalon
- Culture and Therapy Unit, CHU La Conception (AP-HM) , Marseilles, France
| | - Olivier Bausset
- Culture and Therapy Unit, CHU La Conception (AP-HM) , Marseilles, France
| | - Julie Veran
- Culture and Therapy Unit, CHU La Conception (AP-HM) , Marseilles, France
| | - Laurent Giraudo
- Culture and Therapy Unit, CHU La Conception (AP-HM) , Marseilles, France
| | - Nicolas Serratrice
- Department of Plastic & Reconstructive Surgery, CHU La Conception (AP-HM) , Marseilles, France
| | - Guy Magalon
- Department of Plastic & Reconstructive Surgery, CHU La Conception (AP-HM) , Marseilles, France
| | | | - Florence Sabatier
- Culture and Therapy Unit, CHU La Conception (AP-HM) , Marseilles, France . ; Department of Hematology, CHU La Conception (AP-HM) , Marseilles, France
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Magalon J, Gamerre M, Picard C, Chabannon C. Increase the quality of banked cord blood units without limiting HLA diversity: how cord blood banks could face this dilemma. Transfusion 2014; 54:495-6. [PMID: 24517133 DOI: 10.1111/trf.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jeremy Magalon
- Cell Therapy Facility, Institut Paoli-Calmettes, Cord Blood Bank, Inserm CBT-510, Centre d'Investigations Cliniques en Biothérapie, Marseille, France.
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Bausset O, Magalon J, Giraudo L, Louis ML, Serratrice N, Frere C, Magalon G, Dignat-George F, Sabatier F. Impact of local anaesthetics and needle calibres used for painless PRP injections on platelet functionality. Muscles Ligaments Tendons J 2014; 4:18-23. [PMID: 24932442 PMCID: PMC4049644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED The platelet-rich plasma (PRP) is an autologous biotherapy commonly used for its healing properties. Once activated, platelets released a real "cocktail" of growth factor and cytokines implied in numerous regenerative processes. However the impact of medical practices associated to PRP therapeutic use on platelets functionality remains poorly known. OBJECTIVES we evaluated the in vitro effects of two commonly used local anesthetics (Xylocaine(*) and Naropin(*)) on PRP functionality. We also investigated the quantity and quality of PRP that passed through the smallest gauge needle commercialized. MATERIALS AND METHODS PRP from 9 healthy volunteers were prepared using our previously described home made purification protocol. Platelet aggregation capacity was evaluated by aggregometry assays and the growth factor release was determined by ELISA after platelet activation. We also evaluated the platelet activation status, reactivity and stability of platelets by flow cytometry using the P-selectin expression marker. RESULTS the association of local anaesthetics with PRP injections resulted in a significant decrease of platelets functionality, assessed by their capacity of aggregating. Local anaesthetics did not interfere with the growth factor release. The different needle sizes and calibres tested for PRP injections did not influence the platelet functionality. CONCLUSIONS the use of local anaesthetics to prevent pain during PRP injections could compromise the therapeutic potential of PRP. These results suggest using carefully local anaesthetics or limiting their use as often is possible. To minimize injection pain, we recommend using 30 G needles. These data will lead to clinical recommendations for painless and controlled PRP injections.
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Affiliation(s)
- Olivier Bausset
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
| | - Jeremy Magalon
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
| | - Laurent Giraudo
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
| | - Marie-Laure Louis
- Orthopaedic Surgery Unit, CHU La Conception, Assistance Publique des Hôpitaux de Marseille, France
| | - Nicolas Serratrice
- Department of Plastic and Reconstructive Surgery, CHU La Conception, Assistance Publique des Hôpitaux de Marseille, France
| | - Corrine Frere
- Faculty of Pharmacy, Inserm UMR-S1076, Marseille, France
| | - Guy Magalon
- Department of Plastic and Reconstructive Surgery, CHU La Conception, Assistance Publique des Hôpitaux de Marseille, France
| | - Françoise Dignat-George
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
- Faculty of Pharmacy, Inserm UMR-S1076, Marseille, France
| | - Florence Sabatier
- Culture and Therapy Unit, Assistance Publique des Hôpitaux de Marseille, France
- Faculty of Pharmacy, Inserm UMR-S1076, Marseille, France
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Magalon J, Billard-Daufresne LM, Gilbertas C, Hermanche E, Simon S, Lemarie C, Calmels B, Sabatier F, Gamerre M, Picard C, Chabannon C. Assessing the HLA diversity of cord blood units collected from a birth clinic caring for pregnant women in an ethnically diverse metropolitan area. Transfusion 2013; 54:1046-54. [PMID: 23944705 DOI: 10.1111/trf.12379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/26/2013] [Accepted: 06/28/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND New strategies are emerging in cord blood banking where focusing on birth clinics caring for a high number of mothers belonging to ethnic minorities could offer new possibilities for allotransplantation both for patients of European origin and for patients from ethnic minorities or mixed ancestries. STUDY DESIGN AND METHODS Marseilles Cord Blood Bank works with one university birth clinic caring for a culturally and sociologically diverse population. Stringent French legal restrictions apply to recording the geographic origin of parents. To circumvent this limitation and evaluate the contribution of newly banked cord blood units (CBUs) to increasing HLA diversity, we applied an algorithm that allows for the determination of parents' putative haplotypes and thus grossly deduce information on their ancestry. Generic resolution HLA-A, HLA-B, and allelic resolution HLA-DRB1 genotyping for 328 CBUs and 2691 unrelated donors (UDs) between January 2009 and May 2012 were performed. Enrichment from international CBU registry with nonreferenced generic HLA-A, HLA-B, and allelic HLA-DRB1 phenotypes was compared between CBUs identified with one or two non-European haplotypes and CBUs identified with two European haplotypes. RESULTS Marseilles CBUs display an increased proportion of HLA antigens frequently expressed in African populations compared to UDs. Whereas 93% of 199 CBUs identified with one or two non-European haplotypes enrich international CBU registry, this result is reduced to 42% for the 129 CBUs identified with two European haplotypes. CONCLUSION This study supports a new method to assess HLA diversity. However, such an increased of HLA diversity raises questions about frequencies of CBUs released and clinical relevance from their uses.
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Affiliation(s)
- Jeremy Magalon
- Cell Therapy Facility, Institut Paoli-Calmettes, Marseille; Cord Blood Bank, Marseille; Inserm CBT-510, Centre d'Investigations Cliniques en Biothérapie, Marseille
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Bausset O, Giraudo L, Veran J, Magalon J, Coudreuse JM, Magalon G, Dubois C, Serratrice N, Dignat-George F, Sabatier F. Formulation and storage of platelet-rich plasma homemade product. Biores Open Access 2013; 1:115-23. [PMID: 23516671 PMCID: PMC3559222 DOI: 10.1089/biores.2012.0225] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The platelet-rich plasma (PRP) is an autologous biotherapy based on platelet-healing properties. Here, we developed a simple and reproducible PRP purification protocol based on two successive centrifugations. We evaluated different centrifugation speeds and time-storage durations on the platelet quantity and quality. Sterility and stability of our PRP homemade product were also performed. We prepared PRP from 54 healthy volunteers. We tested activation state, reactivity, and stability of platelets by flow cytometry using basal and adenosine diphosphate (ADP)-induced P-selectin expression markers; growth factor release after platelet activation by an enzyme-linked immunosorbent assay (ELISA); platelet aggregation capacity by aggregrometry assays; clot formation and retraction by thromboelastography; and platelet morphology by ultrastructural analysis. About 130 and 250 g successive speed centrifugations further concentrated platelets while preserving their bioactivity during 6 h (after that, platelet functions were significantly altered). In these conditions, we obtained a highly concentrated pure PRP product (with a low leukocyte count) suitable to study platelet properties. To avoid the loss of efficacy, we recommend injecting PRP under 3 h after preparation.
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