A Study on Effectiveness of Platelet-poor Plasma as a Media in Autologous Noncultured Epidermal Cell Suspension in the Treatment of Stable Vitiligo

Abstract

Introduction: Replenishing melanocytes selectively in vitiliginous macules by autologous noncultured epidermal cell suspension (NECS) is a promising approach. Limitation of this surgery is its expensive reagents. Platelet-poor (PPP) plasma may replace these expensive reagents.Objective: To evaluate the surgical results when two reagents, namely trypsin inhibitor and Dulbecco's modified Eagle's medium (DMEM), are replaced by patient's PPP as media in NECS.Materials and methods: Descriptive and inferential statistical analysis has been carried out in a clinical study that enrolled 60 stable vitiligo lesions from 60 patients who formed the study group. Patients received melanocytes suspended in their own PPP.Results: Results show that 96.7% repigmentation was achieved in 29 of 30 lesions. Additionally, 3.3% lesions achieved poor repigmentation. Statistical analysis revealed no significant differences with respect to the repigmentation achieved or adverse effects observed.Discussion: Trypsin inhibitor can be replaced by blood plasma as plasma contains alpha 1 antitrypsin, which covalently binds and inactivates action of trypsin. Effective results with blood plasma was possibly due to growth factors in serum which may enhance activity of melanocytes. It also enhances the viscosity of suspension. Conclusion:Platelet-poor plasma can be one of the novel surgical modalities. It is cost-effective and beneficial for our vitiligo patients.