Year : 1953 | Volume
: 1 | Issue : 2 | Page : 57--60
Tissue Therapy - An analysis of the result obtained by the use of aqueous extract of human placenta in 50 unselected cases
BK Das Gupta, GC Sen
B K Das Gupta
|How to cite this article:|
Das Gupta B K, Sen G C. Tissue Therapy - An analysis of the result obtained by the use of aqueous extract of human placenta in 50 unselected cases.Indian J Ophthalmol 1953;1:57-60
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Das Gupta B K, Sen G C. Tissue Therapy - An analysis of the result obtained by the use of aqueous extract of human placenta in 50 unselected cases. Indian J Ophthalmol [serial online] 1953 [cited 2022 Jan 28 ];1:57-60
Available from: https://www.ijo.in/text.asp?1953/1/2/57/40799
Filatov's (1944) work on Tissue Therapy is mainly based on the theory that tissues stored and preserved under unfavourable conditions become rich in substances which stimulate bio-chemical processes and allow tissue regeneration. These substances which he named "Biogenic Stimulators", when placed in contact with a diseased tissue, stimulate the regenerative processes of the organ by increasing the cellular metabolism.
Filatov and other workers used various animal and vegetable tissues in this form of therapy. They have used placenta, placental extract, codliver oil, aloes, lip-mucosa and various other live tissues. This form of treatment included auto-transplants, homologous and heterologous transplants, injections and rectal administration of tissue extracts.
Of all the materials that have been used in this form of therapy, the most readily available homologous tissue is the human placenta. The human placenta can be freshly obtained front the mothers immediately after parturition and can he preserved very easily in a refrigerator, in a sterile covered container before the extract is prepared. The Wasserman Reaction of the women is always checked up before the preparation of the placental extract.
The placenta contains various substances including hormones, vitamins, enzymes, antibodies etc.
Kronenberg (1948) liberated 4 factors from the placental extract:
(1) Aqueous extract containing water soluble vitamins, hormones and most likely the "biogenic stimulators".
(2) Lipoid extract containing cholesterin and lecithin.
(3) Immune-Gamma globulin containing many antibodies.
(4) Tissue coagulants containing a factor which lowers the bloodclotting time.
Uptill now various ocular conditions have been treated by different extracts from the human placenta. Kronenberg (1948) is of opinion that the aqueous extract is efficacious in the treatment of virus diseases of the cornea and immune-gamma globulins in the treatment of Uveitis. He did not get favourable responses in cases of retinitis pigmentosa.
Gorduren (1950), on the other hand, by treating 25 cases of retinitis pigmentosa - 20 by implantation of placenta and 5 by injections of placental extract - obtained increase of visual acuity in 94 per cent. Of cases, increase of visual field in 38 per cent of cases and a slight improvement in (lark adaptation in 32 per cent. of cases.
He was of opinion that prognosis in this form of therapy was better in early cases and in earlier ages. His claim of improvement is witch higher than that found in the literature, which varies from 27 to 87 per cent., and is mainly attributed to the method of preparation of placental extract.
Fromaget et al (1949) reported favourable responses in cases of grave myopia. Other workers specially Arruga (1948) employed this form of therapy in the treatment of tuberculosis and herpetic keratitis, iritis, optic atrophy, and retinitis pigmentosa with varying results.
For the last 5 months, we have been trying to assess the value of the aqueous extract of human placenta in a variety of ocular conditions. The extract used was aqueous, prepared front a freshly obtained human placenta which was kept in refrigerator at 4° C. for 6 days.
The clinical material presented was obtained from a study of 50 cases treated with aqueous extract of humans placenta. In most of the cases the extract was given by the intramuscular route and in only a few cases it was given subconjunctivally. No local or general reaction was noticed except in one case of retinitis pigmentosa in a female, aged 20, where oil the 8th injection rashes appeared on the skin and the blood count showed an increase of eosinophilia front 5 per cent to 16 per cent. The haemoglobin percentage came down to 55 front 60. When discharged. 16 days after the rashes had appeared, haemoglobin percentage showed a further decrease to 45 and increase of eosinophilia to 31 per cent. Total leucocytic count increased front 6400 to 10,200 per c.mm. with slight decrease it) polymorphonuclear count (from 69 to 54). It is, however, of interest to note that the analysis of the aqueous extract of placenta prepared by Boros (1950) and others showed the presence of histamine-like substances to the extent of 0.0001 to 0.005 Mg. in 1 c.c. of the solution. The skin rashes and the increase in eosinophilia in this particular case may be explained by the allergic response to histamine-like substances.
Two of the female patients in the same series remarked about a feeling of well-being and increase in appetite. In none of the female cases there was any change regarding the regularity, quality and quantity of the menstruation.
Of the 50 cases under report, 40 were males and 10 females. The age groups of the cases were as follows: -
1-10 yrs. - 2 31-40yrs -- 10
11-20 yrs. - 9 41-50 vrs. - 7
21-30 yrs- 13 51-65 vrs. - 9
The end-results of conical ulcers were very remarkable. Of the 33 cases, 27 were cured, 3 did not show a favourable response and in 3 cases treatment could not be continued. The remarkable features of the treatment in these cases were (i) rapid healing up of the ulcer with epithelialisation, (ii) smoothness of the ulcerated surface and corneal scar, and (iii) very rapid absorption of hypopyon.
It is important to keep in mind that no other form of treatment e.g antiseptics, antibiotics, chemotherapy, foreign protein shock therapy or cauterization of the ulcer, was administered to any of these cases. The only other medicine which was applied was atropine locally. The percentage of success thus roughly come to 81.8, but considering the fact that in 3 cases treatment could not be continued, percentage of success could have been higher. Most of the cases left the hospital with surprisingly good vision. It is worth mentioning here that in our experience no other form of therapy gives such a gratifying result in such a very short time.
In two cases of corneal injury the result obtained was good. There was early epithelialisation with very little scar formation. Of the six cases of corneal opacity, two were of recent origin and the result was satisfactory. The other four cases which were old, the placental therapy did not show any alteration, either in the extensity or in the density of the opacity. Two cases of retinitis pigmentosa treated by placental extract both by subconjuctival and intramuscular routes did not show any alteration. Thus, we are not in a position to corroborate Filatov's and Gorduren findings. Our findings agree with that of Kronenberg (1948) and V.Azzoline who did not find any favourable response in cases of retinitis pigmantosa. It must be appreciated however that the cases of retinitis pigmentosa. It must be appreciated however that the cases of retinitis pigmentosa treated so far are so meager that will be unjustifiable on our part to arrive at a definite conclusion. Further work in this direction is being carried out at the present moment.
One case of chorio-retitinis treated with placental extract did not show any improvement in either the acuity or the field of vision. Ina case of contusion injury of the eye where the vision dropped down to 6/60 and there was fine vitreous haze, after eight injections of placental extract and local atropine drops, vitreous cleared up remarkably and the vision improved to 6/9. In one case of subacute iridocyclitis where the vision dropped down to 6/36 and K.P's were rather plenty, after subconjuctival and intramuscular placental extract, K.P's disappeared and vision improved to 6/6, the pigmented ones being the last to disappear.
In a case of trachoma with corneal infiltrates, the corneal opacity disappeared but pannus remained.
In a case of interstitial keratitis where WR was negative, Mantoux' 1 in 100.000 + + treated with only placental extract and atropine, the cornea cleared up form the centre, the peripheral rim remained opaque but the subjective symptoms considerably improved. In two other cases of parenchymatous keratitis where WR was negative and Mantoux test 1 in 100.000 +, the vision improved in one case from hand movements to 6/24 and in the other case from 4/60 to 6/18.
From the above findings it is seen that the aqueous extract of human placenta has a definite favourably influence on the diseases affecting mostly the anterior segment of the eye. The repair of the corneal ulcer with remarkable rapidity and absorption of hypopyon opens up a new line of treatment. Antibiotics, antiseptics, chemo-therapy, or other measures to combat the destructive process of the corneal ulcer could never guarantee the satisfactory results which could be obtained by the administration of the placental extract. In our series the cure to the extent of 81.8 per cent. seems to be a remarkable achievement riot hitherto obtained by any other measures previously known. The reason that this result has not been claimed by any other Worker previously is possibly due to a different method in the preparation of the placental extract. The placental extract acts by liberating the "biogenic stimulators" in the system. Whether these stimulators act throughout the system or are selectively taken up by the diseased tissues or specifically by the corneal tissue is riot known. It is however safe to presume that these substances stimulate the cellular metabolism and thereby help in repairing the diseased tissues at an unexpected rate. The same phenomenon is seen in corneal injuries, recent corneal opacities and comical infiltrations in trachoma. where the deeper layers of cornea are involved and in cases of iridocyclitis the same phenomenon of repair is evident. We, however could not get any favourable response in cases of retinitis pigmentosa curd chorio-rctitritis.
(1) Very gratifying results with the aqueous-extract of placenta prepared after refrigeration at 4°C. for 6 days, in ulcerative and non-ulcerative lesions of the cornea are reported. A successful result of no less than 81.8% is claimed in such cases.
(2) The remarkable features were (a) rapid healing. (b) smoothness of scar, (c) rapid absorption of exudates.
(3) No other treatment, except atropin drops locally Was supplemented.
(4) One case of a severe allergic reaction probably due to an allergic response to histamine-like substances, present in the extract is reported.
(5) There was no response in cases of retinitis pigmentosa and chorioretinitis to this form of therapy.
|1||Aruga, H. ( 1948 ) Arch. de la Soc. Oftal. Hispans. Americana, Madrid 8, 404-406.|
|2||Boros. ( 1950) Szerneszet 1, 10-18.|
|3||Filatov et al ( 1944 ) Soviet AMJ 2.|
|4||Filatov V. P. ( 1945 ) "Keratoplasty and Tissue Therapy," State Publications of Medical Literature, Moscow.|
|5||Fromaget, H. and GilTo E. ( 1949 ) Bull. des Soc. d'Ophth. de France, 696.|
|6||Gorduren. Sureyya ( 1950) XV1 Concilium Ophthalmologicum, Bitania Vol. 1, 552.|
|7||Kronenberg B. ( 1948) A. J. of Ophth. 31, 1101.|