What is Hyperacute Serum?
Hyperacute serum (HAS) is an autologous blood-derived regenerative product designed to approximate the natural coagulation cascade through a single-step, additive-free preparation method, primarily investigated for use in musculoskeletal regenerative therapies, particularly osteoarthritis. 1
Preparation Method and Composition
- HAS is prepared using a method similar to platelet-rich plasma (PRP) but without anticoagulants or additives, allowing natural coagulation to occur 2
- The preparation eliminates the disadvantages of both PRP and platelet-rich fibrin (PRF) while maintaining or improving regenerative potential 2
- Unlike PRP prepared with EDTA or citrate, HAS preserves the natural ionic balance of blood, which may be advantageous for cell function 2
- The protein composition of HAS differs markedly from PRP despite similar production methods, with HAS showing more antiangiopoietic properties while PRP is more angiopoietic 3, 2
Clinical Applications and Mechanisms
- HAS is used as a "proliferative agent" for the local mesenchymal stem cell (MSC) pool in musculoskeletal diseases like osteoarthritis and osteonecrosis 4
- The product promotes proliferation of various cell types and controls inflammation in vitro 1
- HAS treatment of osteoarthritic joint tissues reduces inflammatory cytokines including IL-1β, TNF-α, and IL-6Rα while increasing IL-1RA (interleukin-1 antagonist) 5
- Cell viability increases significantly with HAS treatment, and it induces higher COL1A1 (collagen) expression compared to PRP 1, 5
Regenerative Efficacy
- In human bone oxygen-glucose deprivation models, HAS restored cell proliferation capacity and rescued viable cell numbers following injury, while multiple PRP preparations had no effect 3
- HAS supplementation in MSC cultures shows significantly higher metabolic activity after 5 days compared to fetal calf serum (FCS), with markedly increased osteoblast-specific mRNA expression 4
- Lyophilized formulations of HAS have been developed to create a stable and standardized therapeutic that overcomes the variability limitations of PRP 1
- In 3D subchondral bone and marrow explants, HAS demonstrates markedly higher bone marrow preservation compared to FCS 4
Important Distinctions from Other Blood Products
- HAS contains significantly different levels of growth factors and cytokines compared to EDTA PRP, with PRP containing higher levels of platelet-derived angiogenic and inflammatory proteins due to higher platelet counts 2
- The natural ionic balance preserved in HAS (absent in EDTA and citrate PRP) may provide functional advantages for cellular activity 2
- HAS reduces matrix metalloproteinases (MMPs) progression and decreases RANKL (receptor activator of nuclear factor kappa-B ligand) in osteoarthritic tissues 5
Note: This is distinct from the term "hyperacute" used in stroke care guidelines, which refers to the time-sensitive period in the first 24 hours after stroke onset 6. The hyperacute serum discussed here is a specific blood product for regenerative medicine applications.