|Year : 1953 | Volume
| Issue : 2 | Page : 61-63
On the use of placental extracts
Department of Ophthalmology, Medical College, Lucknow, India
|Date of Web Publication||15-May-2008|
S P Gupta
Department of Ophthalmology, Medical College, Lucknow
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta S P. On the use of placental extracts. Indian J Ophthalmol 1953;1:61-3
This new type of therapy has been introduced by Filatov, the well known Russian Ophthalmologist. When animal or vegetable tissues are isolated front the organism and subjected to the action of environmental factors that inhibit their vital processes. they undergo a biochemical readjustment. In consequence of this readjustment the tissues develop substances which stimulate their vital processes. These substances were named by Filatov as "Biogenic stimutlators".
Filatov's observations which led to this form of treatment are interesting. (1) In certain cases of corneal grafts of the total penetrating type the recepient opaque cornea showed an area of clearing around the graft. (2) Clinical effect was far better with preserved than with fresh grafts. (3) Tissues removed but preserved were well tolerated and not expelled out. (4) It was noticed that fresh grafting of liver had little clinical value as compared to preserved liver or its extract.
It means that there is something in preserved tissues which is responsible for improvement. They start producing certain substances which may be in the form of hormones. These are produced by cells which face death, but certainly not by cells which are dead. This action is just like that of the biogenic stimulator produced during active diseased processes. Thus it may be said that excised tissue preserved at temperatures below 0° C. produces and accumulates within itself an active substance known as "Biogenic Tissue Stimulator". which is produced by cells in their struggle for life. It is oil this assumption that this therapy is based. Scientists have been very liberal in selecting biogenic stimulator substances for their use - skin, cornea, vitreous, muscles, liver, kidney, ovaries, testes cartilage, placenta. Vegetable sources and green leaves preserved in dark places have also ben tried.
The nature of the biogenic stimulators has not vet been substantiated. They are Mostly to be found in the skin and placenta, the latter being widely used in tissue therapy because of its ease availability.
Which is the active part of these tissues? Placental extract can be separated out into 4 factors:
1. Aqueous extract.
2. Lipoid extract.
3. Immune gamma globulins.
4. Tissue coagulants.
Only the aqueous placental extract acts as the biogenic stimulator. It has the following actions:
(a) accelerates cellular metabolism,
(b) aids in absorption of exudates,
(c) Stimulates regeneration processes,
(d) increases physiological functions of an organ.
Filatov stated that the biogenic stimulator is nonspecific but it is contradicted by the fact that certain implants have selective action e.g. suprarenal glands in bronchial asthma and reproductive glands in diseases of the skin.
1. Method of Preparation of Intramuscular Injections
(Filatov's method) 0.10 gms of minced placenta is placed in a bowl containing 100 c.c. distilled water. This is left to macerate for one hour and then brought to boil for 2 minutes. It is filtered several times through gauze and the filtrate is kept for a few minutes again in a water bath. It is put up in 2 c.c. ampoules which are sterilized and which can be preserved for 3 months in the cold. The extract is practically albumin free and a rigid bacteriological control should be carried out to test its sterility. Certain deposits on walls of the ampoules do not affect the quality of the extract. To render the injection painless ˝ c.c. of 2% procain is added. The full course is of 30 injections, given daily or every other day.
It. has been suggested by Saint-Martin, since some placentas seem to have a better therapeutic value than others, an extract of five placentas mixed together should be surer in its action than that of a single placenta.
2. Subconjunctival Inclusion (Filatov's technique modified by Amsler)
After ascertaining the absence of Syphilis, the placenta is placed aseptically in a glass bowl in frigidation for 24 hours. Pieces 3-4 mm. in size are cut and placed in a flask and returned to frigidation for 24 hours at 4 to 5° C.
After anaesthetisation, a conjunctival incision is made and a piece of the prepared placenta is inserted as far back as possible. No sutures are required and no bandage. Five inclusions are made at 1-2 weeks interval. This number was arrived at empirically since in favourable cases improvement occurs after 2nd or 3rd inclusion and continues during 2 more. If there is no improvement after the fifth the method is considered useless.
3. Preparation of Powder of Extract
Filatov has described a third method, that of preparing the extract in a powder form, which is rather complicated and is not likely to be better or easier to use and therefore is not described.
4. Placental Extract Without Proteins
This is prepared by precipitating practically all the proteins by the addition of alcohol to the aqueous placental extracts prepared in the way described.
| Clinical Application|| |
This therapy has been tried in almost every type of ocular disease, like interstitial keratitis. trachoma and trachomatous pannus, old retinal detachment, recurrent haemorrhage in vitreous, diabetic retinitis, senile macular degeneration, stubborn allergic conjunctivitis, tuberculous iridocyclitis, herpetic keratitis, optic atrophy, superficial punctate keratitis, ulcerative blepharitis, phlycten, vernal conjunctivitis. Certain war injuries were treated by this method. Xerosis, vitamin deficiency were also treated.
Filatov lately has claimed good results in other diseases than in the eve, e.g. tubercular skin ulcers, lupus vulgaris, frost bite, burns, gastric ulcer, bronchial asthma, neuritis, nonunion of fractures. The broad scope of action is explained by the fact that the biogenic stimulant raises the vitality of the entire body.
It will thus be seen that the clinical application of this type of therapy is possible for practically any disease under the sun. However, one must guard against early good results and the sometimes too exaggerated claims from certain schools for this therapy. A very rigid control of central as veil as peripheral vision is most essential. As a general observation we arc tempted to state that this type of therapy is useful in the early stages of inflammatory and degenerative conditions of the eve where the respective cells face extinction. Once the cells are dead and replaced by fibrous tissue it is unconceivable how such a therapy can act.
If one remembers this fact and tries this therapy as an adjuvant one has every reason to expect improvement in the ocular condition and encouragement for tissue therapy.