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FUNDAMENTALS OF TOPICAL AUTOLOGOUS TISSUE GROWTH FACTOR THERAPEUTICS



Abstract

INTRODUCTION: Tissue growth factors have been extensively investigated as agents for acceleration of wound repair. Individual recombinant molecules have shown promise in animal models, but in humans both safety and efficacy remain questionable1,2 and costs are substantial. Recently introduced technologies allow intra-operative collection of the full naturally occurring array of tissue growth factors contained in platelets and white cells.3 These preparations rely on the normal healing cascade for their performance, and their activity is limited solely to the wound site without undesirable proliferative or inappropriate tissue formation and no systemic effects. Numerous methodologies have been proposed for intra-operative preparation of autologous tissue growth factors for topical application, and an ever widening variety of approaches and formulations are available to the practitioner.3 Physicians trying to decide which technique to adopt can easily find themselves bewildered while attempting to sift through myriad proponent’s claims.4

PURPOSE: This presentation will review the state of the art, including: a summary of the role of autologous growth factors in bone fusion; a discussion of the importance of dosage and carrier matrix effects; an outline of the mechanics of intraoperative preparation; a survey of the capabilities of various techniques, and; an overview of in vitro, experimental and clinical studies. Audience members will receive a detailed understanding of the physiology, mechanics and clinical range of applicability for this newly emerging technology. This information will aid clinicians in choosing the most appropriate methodology for their practice.

The abstracts were prepared by Dr Robert Moore. Correspondence should be addressed to him at Spine Society of Australia, c/o the Adelaide Centre for Spinal Research, Institute of Medical and Veterinary Science, PO Box 14, Rundle Mall, Adelaide SA 500, Australia.

References:

1 Robson, M.C., Mustoe, T.A. and Hunt, T.K., The future of recombinant growth factors in wound healing., Am J Surg, 176(Suppl 2A):80S–82S, 1998 Google Scholar

2 Lane, J.M., BMPs: Why are they not in everyday use?, J Bone Joint Surg (Am), 83-A (Suppl 1 Pt 2):S161–S163, 2001 Google Scholar

3 Zimmermann, R., Jakubietz, R., Jakubietz, M., et al, Different preparation methods to obtain platelet components as a source of growth factors for local application., Transfusion, 41:1217–1224, 2001 Google Scholar

4 Snyder, E.L. and Calhoun, B.C., Topical platelet growth factor therapy: of lotions and potions., Transfusion41:1186–1189, 2001 Google Scholar