Plasma Exchange: Flushing Out Aging, One Drop at a Time

Ever tried exchanging your clothes with someone younger to look youthful?

What if I told you that now you could exchange your blood plasma to achieve the same effect?

This wouldn’t just make you look younger on the outside but could actually rejuvenate you from within.

Sounds bizarre?

Yet, such a procedure has already been performed by tech entrepreneur, Bryan Johnson, known for his extreme anti-aging experiments. He conducted the world’s first multigenerational plasma exchange with his 17-year-old son. In a world where people are more conscious about their health and appearance than ever before, many are willing to go to extreme lengths to slow down aging. But has this person taken it a step too far?

What is Total Plasma Exchange (TPE) ?

Total Plasma Exchange (TPE), also known as plasmapheresis, is a procedure that removes plasma—the liquid part of blood composed mostly of water, proteins and nutrients—which is replaced with substitutes like albumin or donor plasma. Originally developed in 1952 to treat hyperviscosity in multiple myeloma, TPE is now used for autoimmune diseases, neurological conditions, and more, aiming to remove harmful antibodies, toxins, or abnormal proteins. Emerging studies suggest that TPE may rejuvenate the biological state of the body by removing aging-associated factors and replenishing plasma with younger, healthier components. By influencing immune modulation and reducing pro-inflammatory cytokines, TPE could unlock new possibilities for delaying aging and promoting better health.  Johnson claims that plasma exchange reduced his epigenetic age by 5.1 years. He also says his father's aging slowed by 25 years after receiving a litre of his plasma.

How is TPE performed?

• An IV (intravenous) needle is put into a vein in each arm as an access point. In some cases, a large vein in the shoulder or groin may be used. Tubing connects the access point to the exchange machine.

• As blood flows through the tubing to the machine, anticoagulant medications are added to prevent clotting.

• The machine separates the blood components, isolating and removing the plasma.

• A plasma substitute is then mixed with the remaining blood.

  
  

Finally, the filtered blood, now combined with the new plasma, is returned to the body through the tubing.

Mechanism of Action of TPE

1. Centrifugation-Based Separation – Blood is spun to separate plasma from cellular components, which are then mixed with a replacement fluid and reinfused.

2. Filtration-Based Separation – Blood passes through a membrane that retains cells while allowing plasma removal. Plasma can be discarded and replaced or further purified using double filtration plasmapheresis (DFPP).

   
   

Elimination of Harmful Substances

TPE works by removing the pathogenic factors circulating in the plasma, including:

• Autoantibodies that attack healthy tissues (e.g., in autoimmune diseases like myasthenia gravis and lupus).

• Cytokines and inflammatory mediators that contribute to excessive immune responses.

• Immune complexes that accumulate in diseases like rheumatoid arthritis and vasculitis.

• Paraproteins and abnormal proteins, such as those seen in neurological disorders and blood disorders.

Immune System Modulation

Removal of these substances lead to a temporary immunosuppressive effect, reducing excessive immune responses seen in autoimmune and inflammatory diseases. TPE causes a decrease in the number of overactive T and B cells, responsible for producing harmful antibodies and promoting inflammation, while increasing the number of regulatory T cells that help maintain balance. It also reduces the number of pro-inflammatory cytokines and hence moves the immune system toward a less inflammatory state, reducing damage to healthy tissues. Overall, TPE calms an overactive immune system. However, its immunomodulatory effects are temporary, often necessitating repeated treatments for sustained benefits.

Replacement of Plasma Components:

The removed plasma is then replaced with substitute fluids such as:

• Saline and Albumin Solution: In many cases, the removed plasma is replaced with a mixture of saline (a sterile salt solution) and albumin (a protein that helps maintain blood volume and pressure). This ensures the blood retains its normal consistency and circulation.

• Donor Plasma: In certain conditions, fresh frozen plasma (FFP) from human donors is used as a replacement. This provides essential clotting factors, proteins, and other vital components that may be lacking in the patient’s own plasma.

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In my view, Total Plasma Exchange (TPE) is a fascinating breakthrough that not only helps manage autoimmune and neurological disorders but is now being explored for its potential in longevity and anti-aging. The idea of resetting the body by replacing plasma is both revolutionary and controversial, pushing the boundaries of modern medicine. While the science is still evolving, TPE highlights the exciting possibilities of biohacking and regenerative therapies, making me wonder could this be a key to extending healthspan in the future?

The future of aging may be younger than we think

References:

1. Reeves, H. M., & Winters, J. L. (2014). Mechanism of action of therapeutic plasma exchange. British Journal of Haematology, 164(3), 342–351. https://doi.org/10.1111/bjh.12629

2. Bobati, S. S., & Naik, K. R. (2017). Therapeutic plasma exchange - An emerging treatment modality in patients with neurologic and non-neurologic diseases. Journal of Clinical and Diagnostic Research, 11(8), EC35-EC39. https://doi.org/10.7860/JCDR/2017/27045.10480

3. Understanding Therapeutic Plasma Exchange (TPE). Retrieved from https://www.saintlukeskc.org/health-library/understanding-therapeutic-plasma-exchange-tpe