Autologous Cell Therapy: Current Treatments and Future Prospects
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However, due to a high reabsorption rate, a degree of necrosis at the donor site and necessary pre-treatment of the fat to remove any pro-inflammatory mediators have hindered the use of this procedure as a widely used corrective treatment.52
Currently, bovine collagen is the most common commercially available and administered material. This product, although not a stand alone, is used as the benchmark for all injectable materials that are already available on the market or currently in development. This soft implant receives excellent scores in terms of efficacy, longevity, cost effectiveness, and the magnitude and frequency of allergic response. The implant is not without its drawbacks—the effects do not last indefinitely (approximately 6–8 months due to reabsorption by the body) and require skin tests prior to injection in order to rule out allergic reaction. The advantage of autologous cellular fillers is that the potential for hypersensitivity reactions is eliminated, thus mandatory intra-dermal skin testing is not required. Previous studies have reported allergic reactions with collagen including local site abscess and granuloma formation in response to collagen implants.53–56
The pursuit for a new injectable material in the mid- 1990s spawned the research and development on Isolagen Therapy™ (Isolagen, Inc., Exton, PA), which consists of autologous dermal fibroblasts (Table 2).22 These cells, as major components of the dermis, are responsible for the synthesis and secretion of the extracellular environment (collagen, elastin, hyaluronic acid, and glycosaminoglycans), and when injected, can recognize and replenish self-diminished areas.52,56,57
Another cosmetic treatment currently in Phase II clinical trials is Trichocyte® (Intercytex Ltd, UK), which is composed of in-vitro cultivated dermal papilla cells to treat male androgenic alopecia and female diffuse alopecia (Table 2). These cells, found at the base of the hair shaft surrounding the follicle, have the potential to regenerate new hair follicles when injected intradermally into the scalp.58 This product is marketed primarily for administration in dedicated hair transplant centers by dermatologists or plastic surgeons. This product has the potential to take a large sector of the hair regeneration market if proven effective.
Autologous therapy has also been used as a cosmetic treatment for vitiligo (Table 2). Occurring in approximately 1% of the population, this hypopigmentation disorder affects individuals indiscriminately. Various autologous transplantation techniques exist, including mini-grafting, epidermal blister grafting, split-thickness grafting, of which the latter has shown reduced scarring. Although a promising course of treatment, it still remains to be seen whether such treatment is a permanent solution to the underlying problem or just a temporary fix; further studies and investigations in to the plausibility of melanoma promotion are warranted.59
The application of ACT to cosmetic treatments is proving to be highly effective and increasing in demand. With reports appearing on television and in newspapers, public support and intrigue look to make this form of treatment a strong competitor for other corrective or cosmetic enhancement surgeries.
Much of the work and treatments discussed in this review are merely the tip of the iceberg. Autologous therapy is under vast exploration in pursuit of other avenues and ventures that may benefit from such an approach and immediate availability of a donor. As discussed earlier in this article, the future of autologous therapies lies in a multitude of tangents.
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