Survivor Blood to be used as an Ebola Treatment

The Ebola epidemic is spreading and there is no cure.  Treatment options even in the United States are limited because there are no approved drugs and even the supply of experimental ones have been exhausted.  (See Washington Post Article)

Is it possible that blood could cure Ebola?

That is exactly what the New York Times (read full article here) is reporting as a possible treatment.  The concept is actually pretty simple.  Patients who have been infected with Ebola and survive develop antibodies to the virus.  These virus destroying proteins live in the serum of the blood.  A transfusion of serum or perhaps even whole blood may be the best option as a stop gap measure to treat the expanding number of patients with the disease.  The World Health Organization even has a specific guidance document on the topic.  (WHO convalescent blood for Ebola)

In this space over many years, I have discussed how to use blood therapeutically for regenerative medicine.  Discussions about platelet-rich plasma, bone marrow concentrates and stem cells from peripheral blood have focus primarily on orthopedic injuries and disorders.  Blood as a treatment for Ebola will receive more attention in this blog.  Anyone with blood expertise of any kind should do whatever they can to help.  Please post comments or send me information about how blood is being used to treat Ebola:   @bloodcure on Twitter.

The potential restorative powers of blood are considerable and if it is possible to stop the epidemic or at least slow it down by using the serum of survivors as a treatment, we should do everything we can do execute on that strategy in addition to pursuing containment, supportive care, and experimental drugs.

AM
TotalTendon

Platelet Rich Plasma Forum at AAOS

The American Academy of Orthopaedic Surgery and AAOS Now will be conducting a Platelet Rich Plasma Forum on February 14, 2011 just prior to the Annual Meeting in San Diego.  Participating in this meeting are an elite group of clinicians and researchers including but not limited to Dr. James Andrews, Dr. Steven Arnoczky, Dr. Terry Canale, Dr. William Clancy, Dr. Freddie Fu, Dr. Taco Gosens, Dr. Elizaveta Kon, Dr. Nicola Maffulli, Dr. Robert Marx, Dr. Allan Mishra, Dr. Pietro Randelli, Dr. Scott Rodeo, and Dr. JR Woodall.

This group along with several others has been tasked with evaluating the state of platelet rich plasma.  It will be the most comprehensive discussion of the topic with regard to orthopedics and sports medicine.  The goal is to hopefully make some sense of how to best evaluate and potentially use PRP.

Stay tuned for details.

AM

Platelet Rich Plasma JAMA Article

A recently published article by de Vos et al in JAMA has resulted in a flurry of lay press articles declaring platelet rich plasma (PRP) does not work.  Much like the overhype of PRP after Hines Ward was treated just before the Super Bowl last year, this declaration cannot be defended.

In their study, patients with MODERATE achilles tendinopathy did not do better with PRP compared to saline controls.  All patients received eccentric strengthening exercises.  Their data does support the conclusion that PRP is not better than saline but ONLY for moderate tendinopathy (as measured clinically, no imaging data was reported) at six months of follow up.    The authors stated they will be following those patients for a year.  If for some reason, the PRP patients continue to improve and the saline ones do not, there could be a difference at one year.  However, the conclusion could then only be made that PRP works for MODERATE achilles tendinopathy not any other clinical entity.  Patients with SEVERE tendinopathy that has failed eccentric training was not tested in this study.

The authors need to be recognized for completing this study as we need more level one evidence like it to best define how to use PRP.  Soon, we will have more published literature to discuss. 

We still need to define the optimal formulation and dosage of PRP.  No data was collected on the patients with regard to what was actually put into the patient in terms of total platelet concentration and or white blood cell concentration.  Importantly, we also need a better understanding of the mechanisms behind PRP.

Platelet Rich Plasma New York Times Article

The New York Times just published an article about the use of Platelet Rich Plasma for professional and weekend warrior athletes.

NY Times PRP Article

Check it out and post your comments here.

AM
Total Tendon

ApexPRP