PROFESSIONAL athletes who opt for an emerging treatment called 鈥渂lood-spinning鈥� in the hope of healing their injuries faster could fall foul of the World Anti-Doping Agency. The agency ruled last week that the procedure, based on concentrating and re-injecting a person鈥檚 own blood, could introduce banned substances into the body.
But proponents of blood-spinning argue that the ruling may deny injured athletes access to a technique that could heal their injuries faster than existing treatments and potentially with fewer complications.
WADA, based in Montreal, Canada, already bans the concentration, storage and re-injection of an athlete鈥檚 own red blood cells just prior to competition, because the procedure boosts oxygen supply and enhances performance.
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But blood-spinning is different: small samples of a patient鈥檚 blood are centrifuged to discard red blood cells and concentrate the platelets into platelet-rich plasmas (PRPs). When the platelets are concentrated to typically five times their normal level, calcium and the enzyme thrombin are added to the mix, which makes the platelets coagulate to form a clot-like gel. The platelets then start releasing the natural growth factors (NGFs) that accelerate healing, just as they would in a natural wound, but at five times the usual concentration. The gel can be applied to a wound or injected into the site of an internal injury.
It is the NGFs produced by the procedure that concern the anti-doping agency, which already bans other NGFs such as growth hormones. Blood-spinning usually produces copious amounts of NGFs, and so the procedure contravenes WADA鈥檚 criteria, even though it is not used specifically to enhance performance. 鈥淏ecause it is a recovery procedure, it鈥檚 unlikely the athletes would benefit from it in a competition,鈥� admits Oliver Rabin, WADA鈥檚 science director. 鈥淏ut we don鈥檛 want to open the door, so for now the chapter is closed.鈥�
Robert Marx, a maxillofacial surgeon at the University of Miami鈥檚 Miller School of Medicine who pioneered blood-spinning in 1998, thinks the WADA ruling is misguided. He says that the platelets and growth factors are all in the patient to start with: 鈥淵ou don鈥檛 increase the body鈥檚 number of platelets 鈥� you simply direct them to where you need them.鈥�
Marx developed the technique for use in dentistry and in facial reconstruction. By applying gels made from blood-spinning to wounds and damaged tissues, he says he can almost halve the recovery time. But importantly, the quality of healing is better too. There is less permanent scarring in skin wounds, for example. 鈥淚t just heals faster and better,鈥� he says.
The technique is now working its way from periodontal and other general types of surgery into sport. Frank Stephenson of Harvest Technologies in Plymouth, Massachusetts, a company developing the treatment, says that PRPs are increasingly being used to heal tendon and ligament injuries faster. 鈥淎necdotal reports are that it works well,鈥� he says.
Stephenson says that PRP treatments don鈥檛 wear out tissue, as can happen with standard treatments for inflammation, such as steroids. Although they ease pain, 鈥渟teroids are themselves degenerative and can hurt tissue鈥�, he says. But he accepts that large-scale clinical trials are needed to find out if PRP therapy heals sports injuries better than existing treatments.
In sport, the matter came to a head last month after the London soccer team Chelsea considered, but rejected, the idea of using the treatment on injured players. 鈥淣o Chelsea player has undergone this treatment,鈥� says a club spokesman.
WADA has issued its verdict to all national sporting authorities. 鈥淲e鈥檒l be seeking assurances from Chelsea that the technique being offered to players is in line with the rules that have been set out,鈥� says a spokesman from UK Sport, the nation鈥檚 sporting authority. 鈥淚n the meantime, we will continue to advise caution in the use of this technique.鈥�
In a conciliatory gesture, WADA says athletes who are injured and not competing can apply for special permission for the treatment. The agency will decide for how long after treatment the player should not compete.
