Preprint Concept Paper Version 1 Preserved in Portico This version is not peer-reviewed

Intrathecal Autologous Thrombin-Activated Condensed Platelet Cytokines in Chronic Neurodegenerative Disease: Anti-inflammatory and Regenerative Responses, Phase I

Version 1 : Received: 8 June 2023 / Approved: 12 June 2023 / Online: 12 June 2023 (09:12:30 CEST)

A peer-reviewed article of this Preprint also exists.

Sills ES, Chu HI, Wang JW, Wood SH, Tan SL. Intrathecal autologous thrombin-activated condensed platelet cytokines in chronic neurodegenerative disease: A hypothesis for anti-inflammatory and regenerative response. Neuro Endocrinol Lett. 2023 Sep 29;44(6):418-425. Epub ahead of print. PMID: 37776559. Sills ES, Chu HI, Wang JW, Wood SH, Tan SL. Intrathecal autologous thrombin-activated condensed platelet cytokines in chronic neurodegenerative disease: A hypothesis for anti-inflammatory and regenerative response. Neuro Endocrinol Lett. 2023 Sep 29;44(6):418-425. Epub ahead of print. PMID: 37776559.

Abstract

Choroid plexus insufficiency or glymphatic stasis are often classified as prequels to harmful accretion of toxic proteins in neurodegenerative disease. Cognitive decline and memory loss subsequently become cardinal features of Alzheimer’s disease (AD), typically progressing with amyloid-ß and tau protein accumulation. For Parkinson’s disease (PD), α-synuclein deposits and dopamine depletion are linked to impaired movement, resting tremor, and rigidity. Importantly, both diagnoses are accompanied by hyperinflammation and intrathecal cytokine changes. Thus far, numerous clinical trials for investigational drugs have produced nothing effective for AD or PD, yet the anti-inflammatory and regenerative potential of platelet-rich plasma (PRP) remains largely unexamined in this context. This report explores a proposed Phase I study on intrathecal condensed plasma growth factors processed from autologous thrombin-activated PRP as monotherapy for AD or PD. The concept gains support from related work where cytokines of platelet origin successfully lowered inflammation, corrected background fibrosis, deactivated abnormal cells, and recovered local tissue function—all desirable outcomes in AD and PD. PRP-mediated effects on membrane potentials, electrolyte balance, and water clearance are less well characterized, but experimental evidence suggests these pathways could likewise influence glymphatic drainage to ameliorate proteinopathies. As a well-tolerated ‘orthobiologic’ with no hypersensitivity risk, intrathecal PRP and its derivatives bring advantages distinct from synthetic pharmaceuticals. If age-associated neuroinflammation in AD and PD is an upstream event contributing to neural disruption, then dampening local oxidative stress by a patient’s own platelet cytokines (as already proven in other tissues) could offer therapeutic relevance to these neurodegenerative conditions as well.

Keywords

Alzheimer’s disease; Parkinson’s disease; condensed cytokines; intrathecal; PRP

Subject

Biology and Life Sciences, Neuroscience and Neurology

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