Video : Irina Conboy Utilising Plasmapheresis for treatment of Dementia / Alzheimer’s disease Dobri Kiprov dilution of plasma benefits stem cells by removal of pro aging factors.
The equipment is the Blood Cell Separator (Plasmapheresis System), anti-coagulant, disposable tubing clamp and catheter. This will separate blood into its various components. Plasma is extracted then replaced with a isotonic saline solution (having the same osmotic pressure as some other solution) and 5% Albumin (or immunoglobulin (IVIG). IVIG contains antibodies (proteins that attack and kill infectious agents (bacteria, viruses, etc). a plasma-derived protein).
The Plasmapheresis technique can reverse aging tested by Age Related Biomarkers And Epigenetics, remove toxins (improving cell communication), reduce progression of Dementia / Alzheimer’s disease, prevent age related disorders reducing cellular senescence and increase Angiogenesis .
Apheresis Diagram: The blood is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation.
Whole blood enters the centrifuge (1) and separates into Plasma (2), Platelets and Leukocytes - White blood cells (3), and Erythrocytes - Red blood cells (4). Removal of harmful substances from the liquid portion of blood (5). The plasma is replaced with a replacement solution.
5% Human Serum Albumin in saline was used as a replacement solution, though it leads to transient mild deficiencies of most plasma proteins. Albumin solutions are pasteurized to inactivate viruses, carry a very low risk of febrile and allergic reactions, and are convenient to store and administer.
Alternatively replacment with frozen donor plasma, which must be type specific, ordered in advance, then thawed carries a higher risk of reactions.
One of the initial approaches of anti-ageing therapy is detoxification, recorrection and immunocorrection. Methods of extracorporeal hemocorrection (blood correction occurring outside the body) showed good results in this area. The use of plasmapheresis is very effective during prophylaxis, treatment and rehabilitation after various diseases/injuries. The main effects of plasmapheresis are related to removal of :
Resetting signalling pathways to a core gene expression, reducing "inflammatory response" ,"biological noise" and DNA damage whilst boosting stem cell proliferation
Stem cells improve Homeostasis, Autophagy and Apoptosis (programmed cell death the body uses to get rid of unneeded or abnormal cells). Lysosome signalling problems can be reset with stem cells, which research is directly linked to Alzheimers disease
Endotoxins, Exotoxins, including products of lipid peroxidation
A draining effect as a result of a heavy flow of interstitial fluid containing products of pathometabolism (Metabolic Dysfunction) into the blood stream within concentration gradient.
The result is a normalisation, recalibration to a younger expression profile and "dynamic equilibrium" in concentration of different substances in intracellular, interstitial and intravascular compartments. These effects are also related to release of receptors, their sensitisation to their own "neurohumoral regulation mechanisms". Neurohumoral activation refers to increased activity of the sympathetic nervous system, renin-angiotensin system, vasopressin and atrial natriuretic peptide.
Performed monthly, body detoxification interventions lower the risks of developing age-related diseases, decrease number of disability cases and improve longevity. With age, there is an increase in blood plasma levels of :
LDL (Low Density Lipoprotein) : Makes up most of your body's cholesterol. High levels cause heart disease and stroke
Triglycerides : A fat (lipid) found in blood. The body converts unused calories into triglycerides
Homocysteine : An amino acid. Without treatment, elevated homocysteine increases the risks for dementia, heart disease and stroke
Urea : The waste product of the breakdown of amino acids, excreted by the kidneys. Reduced kidney function results in the rise of Blood Plasma Urea. Urea is the major constituent of the Urine and the principal means for disposal of nitrogen derived from amino acid metabolism
Proteome Analysis : show underpinning the aging process, Oxidised Guanosine, RNA transcriptome profiling of the immune status, Monthly plasmapheresis data shows :
Reduction in : Instances of DNA Damage, P16 Senescence marker
Increase in : CD3 (T-cells), CD4 (Helper T-Cells), CD8 (Cytotoxic T-cels), CD19 (B-cells), B220 (B-cells), CD94 (NK cells), Lymphoid vs. Myeloid boost in immune system aging
Cost of "Therapeutic Plasma Exchange (TPE)" (with Albumin Replacement) Approach :
ACE Alzheimer Center, C/ Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain : Session = £1,444
Total 18 Sessions = £26,000 Pre Examination 1st Visit (€600 or £500): Medical Report, Interview with Neurologist and Neuropsychologist for 2 hours by videoconference, Electrocardiogram, Body-Mass Index, Vascular Function Analysis. Pre Treatment tests 6 x (€2,200 or £1,850) 1 per 2 weeks, 12 x (€1,400 or £1,200) 1 per month: Blood test, Urine Sediment, Electrocardiogram, PCR test for COVID, Cranial Magnetic Resonance, Coagulation including Fibrinogen should be tested prior to the first plasma exchange.
Image : Plasmapheresis no Human Serum Albumin (HSA) Replacement. No contaminated Human Serum Albumin (HSA) from donated human plasma. Within 3 days Albumin returns back to normal levels. Foods to support Albumin Levels (e.g. eggs). whilst remaining fully hydrated from loss of fluids.
Video : Steve Hill : "Historically bovine serum albumin was commonly used as replacement" Michael Conboy : "Once old plasma is removed, showing dramatic rejuvinative effects." Tony Wyss-Coray : "Once old plasma is removed, adding just saline will offer benefits" Oliver Medvedik : "Plasmapheresis treatment every 30 days" Dr. Aubrey de Grey : "Replacment Albumin is not the active ingredient" Irina Conboy : "Plasma Dilution Rejuvenation : Old tissue after a single procedure, becomes indistinguishable from young tissue. Old plasma inhibits the cells to divide, once old plasma is removed, cell division occurs even with added Human Serum Albumin (HSA) or not adding Albumin. Replacement Albumin infusion does not cause rejuvinative effects" Dr Harold Katcher : "Patients donating blood plasma live longer. Plasmapheresis visibly leads to a partially rejuvenated, temporary metabolic toxin re-set"
Chart "Relative rejuvenation" : shows the average of the selected proteins in each group is normalised by the old group. The net change between groups shows relative rejuvenation even at middle age. Middle age can be reset to lower aged proteins than that of the young control group. The age (40, 60, 70) indicates the lowest age reduction in each age group. Analysis of the relative biological noise age via TPE treatment demonstrated that it becomes reduced more sharply in individuals aged 60-70+ years, as compared to people who are 46-52 years old
Chart TPE reduces biological age : shows biological age shifts after repeated TPE treatment. Compared to before TPE treatment, all patients show a decrease in biological age in the last round of TPE, demonstrating significant rejuvenation by TPE.
Plasmapheresis : Plasma removal only - No Human Serum Albumin (HSA) Replacement
Altering the balance of signal molecules in blood plasma is the most promising road to anti-aging in humans, not rebalancing proteins (like Albumin) purified from human blood donations. Cells can invaginate, ingest fluid, molecules, and particles by endocytosis. Small molecules are more promising than proteins because small molecules are the main components of cells and have no major histocompatibility antigens.
Human Serum Albumin (HSA) is not returned in Plasmapheresis. There was no dramatic change in effect when replacement Albumin was not included.
Removal / donation of old plasma using a Fresenius Kabi 6R4601 Aurora Plasmapheresis System, whilst drinking volumes of water as replacement offer the same benfit towards stem cells, muscle, liver, and hippocampal neurogenesis.
Cognition : Plasmapheresis rejuvenates the Glymphatic System. During sleep, cerebrospinal fluid squirts into the brain clearing Amyloid plaques and Tau, reduces neuroinflammation which causes rejuvenation effects on the brain. The glymphatic system is a glial-dependent waste clearance pathway in the brain, in place of lymphatic vessels, dedicated to drain away soluble waste proteins and metabolic products. Microglia are resident cells of the brain that regulate brain development, maintenance of neuronal networks, and injury repair. Neurons are responsible for sending and receiving neurotransmitters-chemicals that carry information between brain cells. Neurons which do not divide but are physiologically dependant on Microglia which does divide and have turnover. Resetting signalling pathways to a core gene expression using Plasmapheresis will have an effect on Microglia.
Factors in old blood inhibit regeneration caused by gene expression change by the antagonistic pleiotropy hypothesis.The "feedback loop" generates cellular damage, even at middle age. Aging is malleable using Plasmapheresis for multiple organs: liver, muscle, brain, neuro-plasticity cognition, spinal cord health, kidney, bone, cartilage, etc.
Attenuating Aβ levels using Plasmapheresis by the peripheral sink hypothesis. Amyloid β (Aβ) plaque, comprised mainly by Aβ peptides, is an important pathology of Alzheimer’s brains. Neurotoxic Aβ peptide is found in both the brain and the periphery. In the blood plasma there is some form of equilibrium for the Aβ. Aβ can be transported across the blood-brain barrier. By modulating the periphery Aβ levels, it is predicted that the brain Aβ levels will undergo concomitant changes, forming the basis of the “sink hypothesis” for lowering Aβ.
Dehydration : If the liquid component of the blood (plasma) is decreased, as in dehydration, the red and white blood cell ratio increases. Sauna's and electric heated mattress pads (electric blankets) are also dehydrating to the body.
Rehydration :
Drinking more fluids. Drinking plenty of water will help flush out salt in the body.
Immersion of the body in water (bathing) for therapeutic purposes.
Hydration is essential for Plasmapheresis
Plasmapheresis results in :
Higher turnover of the liquid component of the blood (plasma)
Amyloid plaques and Tau bind to albumin which is removed
When centrifuging whole blood (outside of plasma) the returned cells become damaged, clumped and sheared therefore frequent procedures could sustain damage. Red blood cells don't have a nucleus, so they don't have the ability to repair themselves. The kidneys filter out dead red blood cells from the blood. Some of the materials get recycled, but others are excreted with the urine
The PCS2 offers self-loading pumps, auto-priming, comprehensive messaging, high quality optical sensors, minimal alerts, and an easy-to-read display. With multiple safety features, including redundant air detectors, a donor line pressure monitor, a fluid sensor, and an enclosed centrifuge.
The PCS2 is small, lightweight, and easy to move. The PCS2 system also includes multiple protocols, and is intended for use as an automated cell separator system and blood component collector in conjunction with single use sterile disposable sets. Products that can be collected using the PCS2 system LN6002 automated cell separator include source plasma, plasma for reinfusion and plasma and leukocytes.
The PCS2 can use a wide range of disposable harnesses which are all single needle :
A disposable set. catheter, hemostatic tubing clamp, plasma collection bag (disposable bowl for the plasma collection only, not infuse saline solution).
Venipuncture materials, swabs, plasters
CompoSeal Mobilea II
Anticoagulant (4% Citrate)
Harnesses
Un bundled kits if required
Electric warming blanket
Pressure Cuff
Regulation Stages :
(MHRA) Medicines and Healthcare products Regulatory Agency contacted with reference CEC 127555 from Yvonne, 10 South Colonnade, Canary Wharf, London E14 4PU. Tel: 020 3080 6000 MHRACustomerServices@mhra.gov.uk
Consultation with General Practitioners (GP) Bramingham Park Medical Centre, Lucas Gardens, Luton, LU3 4BG
(NHSBT Therapeutic Apheresis Services) NHS Blood and Transplant contacted Teresa Baines, Head of TAS / Deputy Chief Nurse Clinical Services. E-mail: teresa.baines@nhsbt.nhs.uk. TAS will offer plasmapheresis on a referral from a consultant, but cannot offer medical supervision from another nurse who has apheresis experience to oversee the process.
(NHSBT Medical Director Cell, Apheresis & Gene Therapies) NHS Blood and Transplant James Griffin explained rules E-mail: James.Griffin@nhsbt.nhs.uk.
A specialist to make an assessment of the patient and suitability for plasma exchange sending a NHS referral form, NHSBT would screen the referral and discuss with the consultant if required. If the consultant doesn’t work for an NHS organisation then a service-level agreement (SLA) is a contract between a service provider and its customers that documents what services the provider will furnish and defines the service standards the provider is obligated to meet. A service-level commitment (SLC) is a broader and more generalised form of an SLA. NHSBT would need to agree one off terms and conditions and invoicing arrangements as well as the clinical discussion. The AMBAR study was phase 3 but not good enough data to fund plasma exchange (PEX). Plasma exchange (PEX) involves a machine that removes patients' plasma and replaces it with fresh plasma. No safety concerns in this setting. As such if we have capacity we can do it but not clearly plasmapheresis would provide benefit and not sure if the patient will be fit enough. Would be better if there is a trial to be part of that.
Page 27 - 2.4 Depending on the clinical setting of the blood collection
Page 27 - 2.4 Active bacterial infection
(CQC) Care Quality Commission contacted Jennie Mackle, NCSC Co-Ordinator, Inspection Support enquiries@cqc.org.uk for outpatient plasmapheresis treatment with reference ENQ1-16295005762. The Health and Social Care Act 2008 : Regulations 2014 are the regulated activities specified for the purposes of the Act. Regulated activities specified in Schedule 1 in England, require registration with CQC unless an exception or exemption applies under Section 8 "Supply of blood and blood derived products".
Example 1, on Page 4 : An individual medical practitioner working at a registered CQC clinic, the same individual when working privately is not required to register with CQC, unless treatments include shown on : Point 3, on Page 3.
Regulation 8 of the flow chart, on Page 5 : Phlebotomists operating a plasmapheresis machine do not require CQC registration under Scope of registration, citing there being no intravenous, intrathecal or epidural administration of medicines or diagnostic agents of :
a. the therapeutic or diagnostic use of x-rays, radiation, protons or magnetic resonance imaging; b. invasive cardiac physiology tests.
Page 5, the centre orange box of the flow chart asks "Is the care or treatment carried out in a surgery, or a consulting room? This could include an outpatient consulting room". We are proposing to be (carried out at a clean, sterile domestic environment, seated in the "semi-sitting Fowler's patient position")
NHS Phlebotomy Training CourseDr Shahbaz A Cheema, info@phlebotomy.org.uk Part 1 - Live Blood Sessions - £227- NHS Phlebotomy Training Course. Maxis Healthcare UK Limited, 59 Greenford Avenue, London, W7 1LL Part 2 £250/- Live Blood Training Sessions with patients at the NHS with Azmat Sabir, Hammond Road Surgery, 95 Hammond Road, Southall, Middlesex, UB2 4EH. Certificate of Competence Phlebotomy + Essential practical experience with real patients.
Training Haemonetics PCS2 in situ (situated in the original place.)
Not working in a practice with access to a mentor to oversee and sign off your completion of competencies. Require a witness with apheresis experience for the patient to attend, experienced under a framework with the process, in which if an adverse event occurred would be needed as a medical consultant.
Online test, to receive "Certificate of Completion for the Precertification Test"
"Register for a Maintenance Training Class", "Attend a Maintenance Training Class", finally recertifying online annually "Complete Recertification Annually", where a Haemonetics manager will issue a letter to our corporate trainer for retraining.
PLASMA held down, then POWER ON to enter Configuration - Danish language change (remove memory protection) - Toggle the write protect switch on the Processor Card (list card on the left side, at the bottom is the silver switch) 2-5
Therapeutic Plasma Exchange (TPE) :
Apheresis Diagram: The blood is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation.
