Autologous Conditioned Serum (ACS)
Los Angeles
WHAT IS AUTOLOGOUS CONDITIONED SERUM?
Autologous conditioned serum (ACS) is a blood-derived cell-free treatment that is rich in anti-inflammatory components including growth factors and cytokines. Research has suggested that some of these components in ACS may be associated with inhibiting the destruction of cartilage and other joint structures as well as tissues such as tendons and ligaments. The main component of ACS is interleukin-1 receptor antagonist (IL-1ra) which can limit the activity of one of the main pro-inflammatory signaling proteins, interleukin-1 (IL-1). IL-1 has been associated with the destruction of cartilage along with causing joint and tissue inflammation. Some of the other components found in ACS include:
| Protein | Physiologic effects |
|---|---|
| Interleukin-1 receptor antagonist (IL-1ra) | Blocks the IL-1 inflammatory cytokine. |
| IL-4 | Inhibits IL-1, TNFα, and MMP production; reduces nitric oxide. |
| Interleukin-10 (IL-10) | Suppresses inflammatory cytokines TNFα, IL-1, and IL-6, which can contribute to tissue damage. |
| IL-13 | Inhibits IL-1 and TNFα, suppresses cartilage catabolism, and reduces nitric oxide. |
| IGF-1, TGFβ, EGF, bFGF, PDGF | Anabolic growth factors. |
HOW DOES ACS WORK?
Autologous conditioned serum (ACS) is a concentration of various cytokines and growth factors from blood that have been linked with decreasing existing pro-inflammatory mediators. Decreasing pro-inflammatory and catabolic proteins such as interleukin-1 (IL-1), tumor necrosis factor alpha (TNF⍺), and interleukin-6 (IL-6), matrix metalloproteinases (MMP-1, MMP-3, MMP-9, MMP-13) has been discussed in research as a possible mechanism to assist the body with decreasing inflammation and possibly assisting with pain. By potentially modifying the inflammatory environment in the joint, ACS can assist the body with protecting joints and tissues. The addition of growth factors can also assist with this cause as well as support the natural tissue healing process.
BENEFITS OF ACS:
Autologous conditioned serum (ACS) is a non-surgical treatment option that can naturally support joints and tissues. Research has indicated that ACS may be associated with a reduction in inflammation and assist with improved function. By reducing certain inflammatory proteins such as IL-1, ACS can potentially reduce the presence of harmful proteins that break down cartilage, ligaments, and tendons and encourage disease-modifying effects and support tissue repair and integrity.
WHO IS A CANDIDATE FOR ACS?
Individuals may consider ACS therapy as part of a comprehensive plan designed to support joint health. Candidates may be seeking for a natural therapy to assist with the body’s response to injury. Some individuals explore ACS therapy if other supportive measures such as rest, activity modification, medication, and physical therapy do not suffice. A consultation with Dr. Yoon is recommended to review the individual’s history, current condition, imaging, and goals to determine whether ACS therapy is appropriate.
WHAT CAN I EXPECT WITH ACS?
The consultation with Dr. Yoon will include a thorough evaluation and discussion of your condition, goals, and available options and if ACS can help support the injury. If ACS therapy is pursued, Dr. Yoon’s office will provide a pre- and post- therapy handout. Additional prescriptions may also include orthotics and braces, biomechanics evaluations, physical therapy, and other supportive measures when appropriate. Because each patient and injury is different, expected outcomes and recovery recommendations will be discussed individually. Follow-up evaluations will be scheduled to assess progress and help optimize the overall recovery plan.
WHY CHOOSE DR. STEVE YOON FOR ACS?
Dr. Steve Yoon is a highly regarded biologics expert utilizing autologous conditioned serum (ACS) therapy in professional sports making him a top choice for patients in Los Angeles and around the country. He has extensive experience utilizing ACS while in his role as Director of Clinical Regenerative Medicine at the Cedars Sinai Kerlan Jobe Institute and as a consultant for many professional sports teams and sports agencies throughout the country. Dr. Yoon has successfully helped patients over two decades while specializing in the use of ACS and other regenerative therapies to enhance recovery and performance. His personalized and tailored approach with patients and helping them with their quality of life has earned him numerous honors including being recognized annually in Los Angeles as a Super Doctor as well as a Top Doctor nationally by Castle Connolly.
RESEARCH ARTICLES
Fudalej P, Witkowski G, Kowalewski P. A comprehensive evaluation and meta-analysis of the efficacy of autologous conditioned serum in knee osteoarthritis. AAEM Medicine & Biology. 2023; (article ID: 2). doi:10.5604/01.3001.0014.1167
Vitali M, Ometti M, Drossinos A, Pironti P, Santoleri L, Salini V. Autologous conditioned serum: clinical and functional results using a novel disease modifying agent for the management of knee osteoarthritis. J Drug Assess. 2020;9(1):43-51. doi:10.1080/21556660.2020.1734009
Raeissadat SA, Rayegani SM, Sohrabi MR, Jafarian N, Bahrami MN. Effectiveness of intra-articular autologous-conditioned serum injection in knee osteoarthritis: a meta-analysis study. Future Sci OA. 2021;7(9):FSO759. doi:10.2144/fsoa-2021-0069
Simon MJK, Aartsen VE, Coghlan JA, Strahl A, Bell SN. Shoulder injections with autologous conditioned serum reduce pain and disability in glenohumeral osteoarthritis: longitudinal observational study. ANZ J Surg. 2021;91(4):673-679. doi:10.1111/ans.16672
Leone R, De Rosa A, Iudicone P, et al. Pain control and functional improvement in patients treated by autologous conditioned serum after failure of platelet-rich plasma treatments in knee osteoarthritis. Transfus Med. 2021;31:357-364. doi:10.1111/tme.12801
Damjanov N, Zekovic A, et al. Intra-articular autologous conditioned serum and triamcinolone injections in patients with knee osteoarthritis: a controlled, randomized, double-blind study. J Int Med Res. 2023;51(10):3000605231203851
Coşkun HS, Yurtbay A, Say F. Platelet rich plasma versus autologous conditioned serum in osteoarthritis of the knee: clinical results of a five-year retrospective study. Cureus. 2022;14(4):e24500. doi:10.7759/cureus.24500
Vitali M, Ometti M, Pironti P, Salvato D, Sandrucci A, Leone O, Salini V. Clinical and functional evaluation of bone marrow aspirate concentrate vs autologous conditioned serum in the treatment of knee osteoarthritis. Acta Biomed. 2022;93(5):e2022222. doi:10.23750/abm.v93i5.12845
Damjanov N, Barac B, Colic J, Stevanovic V, Zekovic A, Tulic G. Intra-articular autologous conditioned serum and triamcinolone injections in patients with knee osteoarthritis: a controlled, randomized, double-blind study. J Int Med Res. 2023;51:3000605231203851. doi:10.1177/03000605231203851
Jeyaraman N, Jeyaraman M, Ramasubramanian S, et al. Autologous conditioned serum in knee osteoarthritis: a systematic review of current clinical evidence. Cureus. 2024;16(9):e68963. doi:10.7759/cureus.68963