Autologous blood therapy

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Autologous blood therapy, also known as autologous blood injection or autohemotherapy, comprises certain types of hemotherapy using a person's own blood ( auto- + hemo- + therapy ). There are several kinds, the original belonging only to traditional medicine, alternative medicine, and some newer kind of medicine under investigation. The original, unscientific form is "the immediate intramuscular or subcutaneous reinjection of freshly drawn autologous blood". It was used in the early 20th century, when some physicians believed that it had efficacy and a logical mechanism of action; it was abandoned as advancing science made clear that it lacked those. [1]

Contents

The other forms involve some change to the blood before it is reinjected, typically oxygenation, ozonation (ozonated autohemotherapy), [2] [3] ultraviolet light exposure, or centrifugation. Forms include platelet-rich plasma (PRP), and autologous conditioned serum (ACS). [4]

It is possible that ozonated or UV autohemotherapy may have real efficacy and effectiveness in autoimmune diseases, if they are immunomodulatory in some way (such as by interfering with the deranged autoantibodies), [2] but this mechanism of action, if it exists, is not yet well understood; [2] it is also logical that whatever molecular changes the ozone and UV bring about are unlikely to act specifically on just the desired target molecules, meaning that risks are involved.

Although autologous blood donation and plasmapheresis are conceptually analogous, they are differentiated from autologous blood therapy in the autohemotherapy sense of that term, having thoroughly scientific bases.

History

Autohemotherapy use in dermatology was popular in the early 1900s but was abandoned by conventional dermatologists due to a lack of supporting evidence of efficacy. A resurgence of interest in the 2000s [1] has led to several investigations evaluating the use of autohemotherapy as a treatment for specific dermatological conditions such as hives (urticaria) and eczema. [1] A review of these studies concludes that, though safe, autohemotherapy is only somewhat more effective than injection of saline solution. [1]

Scientific research

In 2022, autohemotherapy was studied for its effect on ME/CFS, in which 220 patients were treated with oxygen-ozone autohemotherapy for X weeks, at least two 30min long sessions per week. Significant improvements in ME/CFS were noted at statistically significant p-value < 0.0001. When treated with O2-O3-AHT fatigue symptoms within the first one-two weeks ameliorated from a score value of 7 (meaning the worst) to 1 (meaning the best, i.e., completely absent symptoms) in almost half of the oxygen-ozone treated patients (43.5%). However, researchers did not determine the mechanism of action resulting in patient improvement. The study did not include a control group, making it impossible to know if the treatment had any effect greater than a placebo. No randomized control trial, considered the standard for medical research, has shown ozone autohemotherapy to be effective.

"Vampire facials"

One fringe dermatologic application of autohemotherapy, colloquially called a "vampire facial", came to public attention in 2013 when an Instagram posting by celebrity Kim Kardashian West portrayed her "blood-soaked face" during the administration of the procedure. [5] Kardashian West later stated the she regretted undergoing the painful procedure. [6] A vampire facial procedure involves a combination of microneedling [6] followed by topical application of platelet-rich plasma derived from the centrifugation of the subject's own blood into various autologous blood products. [6] Proponents claim that autologous platelet-rich plasma delivered subcutaneously to the skin of the face can improve its health by stimulating skin cell growth and collagen [5] though the treatment is considered to lie outside of mainstream medicine because claimed benefits are unsupported by scientific evidence from clinical studies. [6] Side effects of the treatment may include redness, swelling, bruising, tenderness, tingling, numbness, lumpiness, and/or a feeling of pressure or fullness at the injection sites [6] which, providers claim, people recover from within two days with outlying reports from patients whose recovery took a week or more with scabbing and other problems. [6]

More serious safety concerns have been cited for these treatments when performed in non-medical settings by people untrained in infection control. [5] [7] The New Mexico Department of Health issued a statement that at least one such business offering vampire facials "could potentially spread blood-borne infections such as HIV, hepatitis B and hepatitis C to clients.” [5] This was subsequently confirmed by the CDC following a number of HIV infections first reported in 2024. [8]

In contrast, so-called "vampire filler" is autologous platelets used as dermal filler in the platelet-rich fibrin matrix method of cosmetic surgery; [9] it is generally not described as autohemotherapy and the FDA-approved machines for it are approved for use by only licensed surgeons.[ citation needed ]

See also

Related Research Articles

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Whole blood (WB) is human blood from a standard blood donation. It is used in the treatment of massive bleeding, in exchange transfusion, and when people donate blood to themselves. One unit of whole blood brings up hemoglobin levels by about 10 g/L. Cross matching is typically done before the blood is given. It is given by injection into a vein.

<span class="mw-page-title-main">Ozone therapy</span> Unproven alternative medicine

Ozone therapy is an alternative medical treatment that introduces ozone or ozonides to the body. The United States Food and Drug Administration (FDA) prohibits all medical uses of ozone "in any medical condition for which there is no proof of safety and effectiveness", stating "ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. In order for ozone to be effective as a germicide, it must be present in a concentration far greater than that which can be safely tolerated by man and animals."

In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel. It is the first stage of wound healing. Hemostasis involves three major steps:

<span class="mw-page-title-main">Hematopoietic stem cell transplantation</span> Medical procedure to replace blood or immune stem cells

Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient and to produce additional normal blood cells. It may be autologous, allogeneic or syngeneic.

<span class="mw-page-title-main">Wiskott–Aldrich syndrome</span> Medical condition

Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia, immune deficiency, and bloody diarrhea. It is also sometimes called the eczema-thrombocytopenia-immunodeficiency syndrome in keeping with Aldrich's original description in 1954. The WAS-related disorders of X-linked thrombocytopenia (XLT) and X-linked congenital neutropenia (XLN) may present with similar but less severe symptoms and are caused by mutations of the same gene.

Prolotherapy, also called proliferation therapy, is an injection-based treatment used in chronic musculoskeletal conditions. It has been characterised as an alternative medicine practice.

<span class="mw-page-title-main">Cholinergic urticaria</span> Medical condition

Cholinergic urticaria is a type of hives (urticaria) that is triggered by an increase in body temperature, such as during exercise, sweating, or exposure to heat. It is also sometimes called exercise-induced urticaria or heat hives. The condition is caused by an overreaction of the immune system to the release of histamine and other chemicals in response to the increase in body temperature. This results in the characteristic red, itchy, and sometimes raised bumps or welts on the skin that are associated with hives.

Autotransfusion is a process wherein a person receives their own blood for a transfusion, instead of banked allogenic (separate-donor) blood. There are two main kinds of autotransfusion: Blood can be autologously "pre-donated" before a surgery, or alternatively, it can be collected during and after the surgery using an intraoperative blood salvage device. The latter form of autotransfusion is utilized in surgeries where there is expected a large volume blood loss – e.g. aneurysm, total joint replacement, and spinal surgeries. The effectiveness, safety, and cost-savings of intraoperative cell salvage in people who are undergoing thoracic or abdominal surgery following trauma is not known.

<span class="mw-page-title-main">Rilpivirine</span> HIV treatment

Rilpivirine, sold under the brand names Edurant and Rekambys, is a medication, developed by Tibotec, used for the treatment of HIV/AIDS. It is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with higher potency, longer half-life and reduced side-effect profile compared with older NNRTIs such as efavirenz.

<span class="mw-page-title-main">Platelet-rich plasma</span> Blood product used in transfusion medicine

Platelet-rich plasma (PRP), also known as autologous conditioned plasma, is a concentrate of platelet-rich plasma protein derived from whole blood, centrifuged to remove red blood cells. Though promoted to treat an array of medical problems, evidence for benefit is mixed as of 2020, with some evidence for use in certain conditions and against use in other conditions.

Cryofibrinogenemia refers to a condition classified as a fibrinogen disorder in which a person's blood plasma is allowed to cool substantially, causing the (reversible) precipitation of a complex containing fibrinogen, fibrin, fibronectin, and, occasionally, small amounts of fibrin split products, albumin, immunoglobulins and other plasma proteins.

The "platelet-rich fibrin matrix" (PRFM) method is a process in cosmetic surgery. It is a way of extracting platelets from the patient's own blood and using them as a dermal filler – that is, as a substance injected under the skin of the face to try to fill out wrinkles.

Platelet-Poor Plasma (PPP) is blood plasma with very low number of platelets (< 10 X 103/μL). Traditionally, PPP was recommended for use in platelet aggregation studies to both adjust the platelet-rich plasma concentration, and to serve as a control. PPP may have elevated levels of fibrinogen, which has the ability to form a fibrin-rich clot once activated. Wound healing requires cell migration and attachment, which is facilitated by this fibrin clot.

Ixekizumab, sold under the brand name Taltz, is an injectable medication for the treatment of autoimmune diseases. Chemically, it is a form of a humanized monoclonal antibody. The substance acts by binding interleukin 17A and neutralizing it, reducing inflammation.

<span class="mw-page-title-main">Collagen induction therapy</span> Cosmetic procedure

Collagen induction therapy (CIT), also known as microneedling, dermarolling, or skin needling, is a cosmetic procedure that involves repeatedly puncturing the skin with tiny, sterile needles. CIT should be separated from other contexts in which microneedling devices are used on the skin.

Autologous conditioned serum, also known as Orthokine and Regenokine, is an experimental procedure in which a person's own blood is extracted, manipulated, and then reintroduced with claimed benefit in osteoarthritis. There is limited evidence on safety and effectiveness as of 2017. It is not included in medical guidelines as of 2017. It is a type of autologous blood therapy.

Injectable filler is a soft tissue filler made of polysaccharides injected into the skin at different depths.

Platelet-rich fibrin (PRF) or leukocyte- and platelet-rich fibrin (L-PRF) is a derivative of PRP where autologous platelets and leukocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue and is used as a tissue-engineering scaffold in oral and maxillofacial surgeries. PRF falls under FDA Product Code KST, labeling it as a blood draw/Hematology product classifying it as 510(k) exempt.

Plasma needling is a minimally invasive aesthetic medical procedure purported to rejuvenate skin, minimize the appearance of hypertrophic and hypotrophic scars and stretchmarks, and reduce pattern hair loss through multimodal physical and biochemical cellular stimulation. It is a combination of classical medical micro-needling by Dermaroller or DermaPen. Both are used in Collagen induction therapy and PRP. The latter is used in Prolotherapy as well as in the Vampire facelift. The effects on fibroblasts, cells, and micro-needling stem cells are published in scientific publications regarding micro-needling, and the injection of PRP, has also been tested as a combined treatment.

<span class="mw-page-title-main">Abrocitinib</span> Chemical compound

Abrocitinib, sold under the brand name Cibinqo, is a medication used for the treatment of atopic dermatitis (eczema). It is a Janus kinase inhibitor and it was developed by Pfizer. It is taken by mouth.

References

  1. 1 2 3 4 A Systematic Review of Autohemotherapy as a Treatment for Urticaria and Eczema / Devon D. Brewer, Cureus 6(12): e233. doi:10.7759/cureus.233
  2. 1 2 3 Sheikhi, A; Azarbeig, M; Karimi, H (2014), "Autohemotherapy in chronic urticaria: what could be the autoreactive factors and curative mechanisms?", Ann Dermatol, 26 (4): 526–527, doi:10.5021/ad.2014.26.4.526, PMC   4135115 , PMID   25143689.
  3. ↑ Molinari, F; et al. (2014), "Ozone autohemotherapy induces long-term cerebral metabolic changes in multiple sclerosis patients", Int J Immunopathol Pharmacol, 27 (3): 379–389, doi:10.1177/039463201402700308, PMID   25280029, S2CID   23209243.
  4. ↑ Wehling, P; Evans, C; Wehling, J; Maixner, W (August 2017). "Effectiveness of intra-articular therapies in osteoarthritis: a literature review". Therapeutic Advances in Musculoskeletal Disease. 9 (8): 183–196. doi:10.1177/1759720X17712695. PMC   5557186 . PMID   28835778.
  5. 1 2 3 4 Jennings, Rebecca (2018-09-14), ""Vampire facials" are massively popular. And — surprise! — potentially dangerous", Vox , retrieved 2019-01-14.
  6. 1 2 3 4 5 6 Hall, Harriet (3 December 2018). "Vampire Facials". Skeptical Inquirer. CSI. Retrieved 14 January 2019.
  7. ↑ Robertson, Michelle (2018-09-14). "New Mexico officials urge 'vampire facial' spa clients to get HIV tests". San Francisco Chronicle . Retrieved 2018-09-15.
  8. ↑ "CDC describes first known cases of HIV transmitted via 'vampire facial' injections". NBC News. 2024-04-25. Retrieved 2024-04-27.
  9. ↑ Sclafani, AP (2011). "Safety, efficacy, and utility of platelet-rich fibrin matrix in facial plastic surgery". Arch Facial Plast Surg. 13 (4): 247–51. doi:10.1001/archfacial.2011.3. PMID   21339469.
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