Cell-Free Blood Cell Secretome (BCS) Counteracts Skin Aging and Restores Firmness and Elasticity

June 2021 | Volume 20 | Issue 6 | Original Article | 682 | Copyright © June 2021


Published online May 17, 2021

Martina Kerscher MDa, Dominique Hertz-Kleptow a, Attyla Drabik MDb, Tanju Kaptan MDc, Julio Reinecke PhDc

aDivision of Cosmetic Sciences, University of Hamburg, Hamburg, Germany
bClinical Trial Support, Münster, Germany
cORTHOGEN AG, Düsseldorf, Germany

Abstract
Background: Blood Cell Secretome, BCS (also Autologous Conditioned Serum, ACS) is efficacious in treatment of musculoskeletal disorders. It contains inflammation resolving cytokines, growth factors, exosomes, and lipid mediators. Skin aging is associated with reduced TGF-ß signaling and collagen synthesis and chronic (sub-acute) inflammation, among other factors. Pre-clinically, BCS counteracts these mechanisms, suggesting it as a treatment against cutaneous aging.
Objective: This 24-week study evaluated the effects of deep dermal to immediate sub-dermal micropuncture injections of cell-free BCS in patients with age-related reduced facial skin elasticity.
Methods: In this prospective, single-armed, mono-center study, 21 women underwent 4 BCS treatment sessions over 12 weeks with follow-up at 24 weeks. The primary endpoint was skin elasticity measured by cutometry. Secondary endpoints were safety, skin hydration, and aesthetic assessments using global aesthetic improvement scale.
Results: Skin firmness increased significantly between baseline and 12 weeks (P<0.001) and further increased by 24 weeks (P<0.001). Skin tiring was congruently reduced (P<0.001). Skin hydration and aesthetic ratings improved significantly. No BCS-related adverse reactions occurred.
Conclusion: BCS treatment resulted in increased firmness and hydration, usually attributed to younger skin. BCS is potentially the first cell-free autologous therapy for skin rejuvenation derived from patients’ own blood.

J Drugs Dermatol. 2021;20(6):682-688. doi:10.36849/JDD.5018

INTRODUCTION

Longer life expectancy and the desire for a youthful appearance have led to increased demand for nonsurgical and minimally invasive skin anti-aging interventions, including micropuncture injections.1-3 Skin aging is complex and results from the interaction of many intrinsic and extrinsic/environmental factors.4,5 A recent expert consensus recommended a “pan-facial combined approach” combining aesthetic interventions, to target different manifestations of aging, often lead to better results than single modalities alone.6

Common treatments for reduced facial skin elasticity, botulinum toxin (BTX), and dermal fillers do not target the underlying mechanisms of skin aging. In contrast, regenerative medicine consists of therapies intending to replace or restore damaged tissues. Products derived from the patient themselves, such as stem cells or blood plasma, are thought to provide personalized regenerative therapies.

For example, platelet rich plasma (PRP) is produced by centrifuging patient’s own blood to concentrate platelets. PRP cell therapy has shown limited efficacy in wound healing, orthopedics, and more recently in facial skin rejuvenation.7,8 Recent publications have reported the potential of injectable growth factors and cytokines for skin rejuvenation.9-11 In contrast to PRP, Blood Cell Secretome (BCS) is produced by incubating the patient’s own blood. This process fundamentally differentiates BCS from injections such as PRP, which also contain potentially aggressive cells with innate immune functions, complement proteins, clotting factors, and additives.

BCS is efficacious in musculoskeletal disorders, including osteoarthritis, radiculitis, tendon, and muscle injury due to its inflammation resolving and regenerative/remodeling effects.12 BCS has a unique potential to alter molecular and cellular processes underlying skin aging towards regeneration and