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Girgin M, Binnetoglu K, Duman K, Kanat BH, Cetinkaya Z, Ayten R, Ilhan YS, Ilhan N, Seker I, Timurkaan N. Effects of platelet rich plasma on fascial healing in rats with fecal peritonitis. Acta Cir Bras 2017; 31:314-9. [PMID: 27275852 DOI: 10.1590/s0102-865020160050000004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/17/2016] [Indexed: 09/11/2023] Open
Abstract
PURPOSE To evaluate the effects of platelet rich plasma (PRP) on the healing of fascia wherein peritonitis has been created. METHODS Twenty eight Wistar Albino rats were divided into four groups. Only a primary fascial repair following laparotomy was performed on Group 1, a primary fascial repair performed and PRP treatment applied following laparotomy on Group 2, and a fecal peritonitis created following laparotomy and a primary fascial repair carried out on Group 3. A fecal peritonitis was created following laparotomy and primary fascial repair and PRP treatment on the fascia was carried out on Group 4. RESULTS TNF-α was found to be significantly lower in the control group (Group 1). It was detected at the highest level in the group in which fecal peritonitis was created and PRP applied (Group 4). TGF-β was determined as being significantly higher only in Group 4. Histopathologically, the differences between the groups in terms of cell infiltration and collagen deposition were not found to be significant. CONCLUSION When platelet rich plasma was given histologically and biochemicaly as wound healing parameters cellular infiltration, collagen accumulation, and tissue hydroxyiproline levels were not increased but neovascularization, fibroblast activation and TNF Alfa levels were increased and PRP accelerated wound healing.
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Affiliation(s)
- Mustafa Girgin
- Associate Professor, Department of General Surgery, Faculty of Medicine, Firat University, Elazig, Turkey. Design of the study, surgical procedures, statistical analysis., Firat University, Department of General Surgery, Faculty of Medicine, Firat University, Turkey
| | - Kenan Binnetoglu
- MD, Department of General Surgery, Faculty of Medicine, Firat University, Elazig, Turkey. Design of the study, surgical procedures, statistical analysis., Firat University, Department of General Surgery, Faculty of Medicine, Firat University, Turkey
| | - Kazim Duman
- MD, Department of General Surgery, Elazig Military Hospital, Elazig, Turkey. Interpretation of data, manuscript preparation and writing., , Department of General Surgery, Elazig Military Hospital, Elazig , Turkey
| | - Burhan Hakan Kanat
- MD, Department of General Surgery, Elazig Training and Research Hospital, Elazig, Turkey. Statistical analysis, interpretation of data, manuscript preparation., Department of General Surgery, Elazig Training and Research Hospital, Elazig , Turkey
| | - Ziya Cetinkaya
- Full Professor, Department of General Surgery, Faculty of Medicine, Firat University, Elazig, Turkey. Design of the study, statistical analysis., Firat University, Department of General Surgery, Faculty of Medicine, Firat University, Elazig , Turkey
| | - Refik Ayten
- Full Professor, Department of General Surgery, Faculty of Medicine, Firat University, Elazig, Turkey. Design of the study, statistical analysis., Firat University, Department of General Surgery, Faculty of Medicine, Firat University, Elazig , Turkey
| | - Yavuz Selim Ilhan
- Full Professor, Department of General Surgery, Faculty of Medicine, Firat University, Elazig, Turkey. Design of the study, statistical analysis., Firat University, Department of General Surgery, Faculty of Medicine, Firat University, Elazig , Turkey
| | - Necip Ilhan
- Full Professor, Department of Biochemistry, Faculty of Medicine, Firat University, Elazig, Turkey. Manuscript preparation, critical revision. , Firat University, Department of Biochemistry, Faculty of Medicine, Firat University, Elazig , Turkey
| | - Ibrahim Seker
- Full Professor, Department of Zootechnics, Faculty of Veterinary, Firat University, Elazig, Turkey. Critical revision, final approval., Firat University, Department of Zootechnics, Faculty of Veterinary, Firat University, Elazig , Turkey
| | - Necati Timurkaan
- Full Professor, Department of Pathology, Faculty of Veterinary, Firat University, Elazig, Turkey. Critical revision, final approval., Firat University, Department of Pathology, Faculty of Veterinary, Firat University, Elazig , Turkey
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Autologous method for ex vivo expansion of human limbal epithelial progenitor cells based on plasma rich in growth factors technology. Ocul Surf 2017; 15:248-256. [PMID: 28115245 DOI: 10.1016/j.jtos.2017.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE Develop an autologous culture method for ex vivo expansion of human limbal epithelial progenitor cells (LEPCs) using Plasma Rich in Growth Factors (PRGF) as a growth supplement and as a scaffold for the culture of LEPCs. METHODS LEPCs were cultivated in different media supplemented with 10% fetal bovine serum (FBS) or 10% PRGF. The outgrowths, total number of cells, colony forming efficiency (CFE), morphology and immunocytochemistry against p63- α and cytokeratins 3 and 12 (CK3-CK12) were analyzed. PRGF was also used to elaborate a fibrin membrane. The effects of the scaffold on the preservation of stemness and the phenotypic characterization of LEPCs were investigated through analysis of CK3-CK12, ABCG-2 and p63. RESULTS LEPCs cultivated with PRGF showed a significantly higher growth area than FBS cultures. Moreover, the number of cells were also higher in PRGF than FBS, while displaying a better morphology overall. CFE was found to be also higher in PRGF groups compared to FBS, and the p63-α expression also differed between groups. LEPCs cultivated on PRGF membranes appeared as a confluent monolayer of cells and still retained p63 and ABCG-2 expression, being negative for CK3-CK12. CONCLUSIONS PRGF can be used in corneal tissue engineering, supplementing the culture media, even in a basal media without any other additives, as well as providing a scaffold for the culture.
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Rocco ML, Balzamino BO, Esposito G, Petrella C, Aloe L, Micera A. NGF/anti-VEGF combined exposure protects RCS retinal cells and photoreceptors that underwent a local worsening of inflammation. Graefes Arch Clin Exp Ophthalmol 2016; 255:567-574. [PMID: 28013393 DOI: 10.1007/s00417-016-3567-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/26/2016] [Accepted: 12/06/2016] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Our previous study highlighted the potential nerve growth factor (NGF) effect on damaged photoreceptors from a rat model of spontaneous Retinitis Pigmentosa (RP). Herein, we tested the combined NGF/anti-vascular endothelial growth factor (αVEGF) effect on cultured retinal cells isolated from Royal College of Surgeons (RCS) rats receiving an intravitreal VEGF injection (iv-VEGF) to exacerbate retinal inflammation/neovascularization. METHODS RCS (n = 75) rats were equally grouped as untreated (n = 25), iv-saline (single saline intravitreal injection; n = 25) and iv-VEGF (single VEGF intravitreal injection; n = 25). Morphological and biochemical analysis or in vitro stimulations with the biomolecular investigation were carried out on explanted retinas. Isolated retinal cells were treated with NGF and αVEGF, either alone or in combination, for 6 days and cells were harvested for morphological and biomolecular analyses. RESULTS Infiltrating inflammatory cells were detected in iv-VEGF exposed RCS retinas, indicative of exacerbated inflammation and neovascularization. In cell cultures, NGF/αVEGF significantly increased retinal cell survival as well as rhodopsin expression and neurite outgrowth in photoreceptors. Particularly, NGF/αVEGF upregulated Bcl-2 mRNA, downregulated Bax mRNA, upregulated trkANGFR mRNA and finally upregulated both NGF mRNA and protein. CONCLUSIONS These data confirm and extend our previous findings on NGF-photoreceptor crosstalk, highlighting that the NGF/αVEGF combination might be an interesting approach for improving neuroprotection of RCS retinal cells and likewise photoreceptors in the presence of neovascularization. Further studies are required to translate this in vitro approach into clinical practice.
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Affiliation(s)
| | - Bijorn Omar Balzamino
- Research Laboratories in Ophthalmology, IRCCS-G.B. Bietti Foundation, Via Santo Stefano Rotondo, 6 I-00184, Rome, Italy
| | - Graziana Esposito
- Research Laboratories in Ophthalmology, IRCCS-G.B. Bietti Foundation, Via Santo Stefano Rotondo, 6 I-00184, Rome, Italy
| | - Carla Petrella
- Institute of Cell Biology and Neurobiology, CNR, Rome, Italy
| | - Luigi Aloe
- Institute of Cell Biology and Neurobiology, CNR, Rome, Italy
| | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS-G.B. Bietti Foundation, Via Santo Stefano Rotondo, 6 I-00184, Rome, Italy.
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Riestra AC, Alonso-Herreros JM, Merayo-Lloves J. Platelet rich plasma in ocular surface. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2016; 91:475-490. [PMID: 27062018 DOI: 10.1016/j.oftal.2016.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/28/2016] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
The use of platelet-rich preparations has experienced a significant increase in recent years due to its role in tissue-repair and regeneration. The aim of this study is to examine the available evidence regarding the application of plasma rich in growth factors, and its variations, on the ocular surface. A review is also presented on the effects of platelet-derived growth factors, the implications of the preparation methods, and the existing literature on the safety and efficacy of these therapies in ocular surface diseases. Despite the widespread use of platelet preparations there is no consensus on the most appropriate preparation method, and growth factors concentration vary with different systems. These preparations have been used in the treatment of ocular surface diseases, such as dry eye or persistent epithelial defects, among others, with good safety and efficacy profiles, but further studies are needed to compare to the currently available alternatives.
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Affiliation(s)
- A C Riestra
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, España.
| | | | - J Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, España
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Anitua E, Muruzabal F, de la Fuente M, Riestra A, Merayo-Lloves J, Orive G. PRGF exerts more potent proliferative and anti-inflammatory effects than autologous serum on a cell culture inflammatory model. Exp Eye Res 2016; 151:115-21. [DOI: 10.1016/j.exer.2016.08.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 07/26/2016] [Accepted: 08/23/2016] [Indexed: 01/15/2023]
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Merayo-Lloves J, Sanchez-Avila RM, Riestra AC, Anitua E, Begoña L, Orive G, Fernandez-Vega L. Safety and Efficacy of Autologous Plasma Rich in Growth Factors Eye Drops for the Treatment of Evaporative Dry Eye. Ophthalmic Res 2016; 56:68-73. [DOI: 10.1159/000444496] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 02/07/2016] [Indexed: 11/19/2022]
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Suri K, Gong HK, Yuan C, Kaufman SC. Human Platelet Lysate as a Replacement for Fetal Bovine Serum in Limbal Stem Cell Therapy. Curr Eye Res 2016; 41:1266-1273. [PMID: 26863375 DOI: 10.3109/02713683.2015.1116586] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To evaluate the use of human platelet lysate (HPL) as an alternative supplement for limbal explant culture. METHODS Culture media were prepared using either 10% pooled HPL (PHPL), single donor HPL, or fetal bovine serum (FBS). Limbal tissues, obtained from the Minnesota Lions Eye Bank, were cultured in each medium on plastic plates or on denuded amniotic membrane (AM). Immunofluorescence staining was performed for ABCG2, tumor protein p63α, and cytokeratin 3 (K3). Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was used to evaluate the expression of ABCG2 and p63. Limbal explants grown in each medium were labeled with bromodeoxyuridine (BrdU) to assess the proliferative capacity in each medium. Concentration of growth factors including epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and platelet derived growth factor (PDGF) in HPL and PHPL was compared to that in human serum (HS). RESULTS Immunofluorescence staining on AM showed prominent expression of ABCG2, p63α but sparse expression of K3 in HPL and PHPL supplemented medium. Real time-PCR showed 1.7 fold higher expression of ABCG2 in PHPL supplemented medium (p = 0.03), and similar expression of p63 in HPL and PHPL supplemented medium compared to FBS medium. The proliferation assay showed that LSCs retained their proliferative potential in HPL supplemented medium. Higher concentration of growth factors were found in HPL, compared to HS. CONCLUSIONS Human platelet lysate has higher concentration of grown factors and is effective in maintaining growth and stem cell phenotype of corneal limbal explant cultures.
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Affiliation(s)
- Kunal Suri
- a Department of Ophthalmology , University of Minnesota , Minneapolis , MN , USA
| | - Hwee K Gong
- a Department of Ophthalmology , University of Minnesota , Minneapolis , MN , USA
| | - Ching Yuan
- a Department of Ophthalmology , University of Minnesota , Minneapolis , MN , USA
| | - Stephen C Kaufman
- a Department of Ophthalmology , University of Minnesota , Minneapolis , MN , USA.,b State University of New York-Downstate Medical Center , Brooklyn , NY , USA
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Anitua E, Muruzabal F, de la Fuente M, Merayo J, Durán J, Orive G. Plasma Rich in Growth Factors for the Treatment of Ocular Surface Diseases. Curr Eye Res 2016; 41:875-82. [PMID: 26828610 DOI: 10.3109/02713683.2015.1104362] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE The purpose of this work is to describe and review the technology of plasma rich in growth factors (PRGF), a novel blood derivative product, in the treatment of ocular surface disorders. METHODS To demonstrate the importance of this technology in the treatment of ocular pathologies, a thorough review of the preclinical and clinical literature results obtained following use of the different therapeutic formulations of PRGF was carried out. A literature search for applications of PGRF plasma in the ophthalmology field was carried out using the PubMed database. RESULTS PRGF involves the use of patient's own biologically active proteins, growth factors, and biomaterial scaffolds for therapeutic purposes. This procedural technology is gaining interest in regenerative medicine due to its potential to stimulate and accelerate the tissue healing processes. The versatility and biocompatibility of this technology opens the door to a personalized medicine on ocular tissue regeneration. This review discusses the state of the art of the new treatments and technologies developed to promote ocular surface tissue regeneration. The standardized protocol that has been developed to source eye drops from PRGF technology is also described. The preclinical research, together with the most relevant clinical applications are summarized and discussed. CONCLUSIONS The preliminary results suggest that the use of PRGF to enhance ocular tissue regeneration is safe and efficient.
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Affiliation(s)
- Eduardo Anitua
- a Department of R&D , Biotechnology Institute (BTI) , Vitoria , Spain.,b Department of R&D , Fundación Eduardo Anitua , Vitoria , Spain
| | | | | | - Jesús Merayo
- c Fundación de Investigación Oftalmológica , Instituto Oftalmológico Fernández-Vega , Oviedo , Spain
| | - Juan Durán
- d Department of R&D , Instituto Clínico-Quirúrgico de Oftalmología , Bilbao , Spain.,e Department of Ophthalmology, School of Medicine and Dentistry, BioCruces Health Research Institute , University of the Basque Country , Leioa , Spain
| | - Gorka Orive
- a Department of R&D , Biotechnology Institute (BTI) , Vitoria , Spain.,b Department of R&D , Fundación Eduardo Anitua , Vitoria , Spain
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Anitua E, Muruzabal F, Tayebba A, Riestra A, Perez VL, Merayo-Lloves J, Orive G. Autologous serum and plasma rich in growth factors in ophthalmology: preclinical and clinical studies. Acta Ophthalmol 2015; 93:e605-14. [PMID: 25832910 DOI: 10.1111/aos.12710] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 02/06/2015] [Indexed: 01/22/2023]
Abstract
The use of blood derivatives represents an alternative therapeutic approach that is gaining interest in regenerative medicine due to its potential to stimulate and accelerate tissue healing. Autologous serum eye drops and platelet-enriched plasma eye drops are being used in the treatment of different ophthalmological disorders. In this review, we summarize the different blood-derived formulations used in the treatment and care of ocular surface disorders. The biological basis and use of autologous serum and plasma rich in growth factors are deeply evaluated as well as the challenges to be addressed in the future in this new generation of blood-derived therapies.
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Affiliation(s)
| | | | - Ali Tayebba
- Microbiology & Immunology; Walter G. Ross Chair in Ophthalmic Research; Ocular Surface Center; Bascom Palmer Eye Institute; University of Miami Miller School of Medicine; Miami Florida USA
| | - Ana Riestra
- Fernandez-Vega Ophthalmological Institute; Eye Research Foundation; University of Oviedo; Oviedo Spain
| | - Victor L. Perez
- Microbiology & Immunology; Walter G. Ross Chair in Ophthalmic Research; Ocular Surface Center; Bascom Palmer Eye Institute; University of Miami Miller School of Medicine; Miami Florida USA
| | - Jesus Merayo-Lloves
- Fernandez-Vega Ophthalmological Institute; Eye Research Foundation; University of Oviedo; Oviedo Spain
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Merayo-Lloves J, Sanchez RM, Riestra AC, Anitua E, Bego�a L, Orive G, Fernandez-Vega L. Autologous Plasma Rich in Growth Factors Eyedrops in Refractory Cases of Ocular Surface Disorders. Ophthalmic Res 2015; 55:53-61. [DOI: 10.1159/000439280] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 11/19/2022]
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Rafols C, Monckeberg JE, Numair J, Botello J, Rosales J. Platelet-Rich Plasma Augmentation of Arthroscopic Hip Surgery for Femoroacetabular Impingement: A Prospective Study With 24-Month Follow-up. Arthroscopy 2015; 31:1886-92. [PMID: 25980923 DOI: 10.1016/j.arthro.2015.03.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 03/01/2015] [Accepted: 03/18/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE The objective of this study is to evaluate the clinical and immunologic effects of intra-articular doses of platelet-rich plasma (PRP) in arthroscopic hip surgery for femoroacetabular impingement. METHODS Preoperatively, patients were randomized either to receive an intra-articular injection of PRP (group I, n = 30) or not to receive PRP (group II, n = 27) at the end of hip arthroscopic surgery. To evaluate the clinical outcome and follow-up, we used the modified Harris Hip Score (mHHS) 3, 6, and 24 months after surgery. Pain was evaluated using a visual analog scale 24 hours, 48 hours, 3 months, and 6 months after surgery. The radiologic outcome was analyzed using radiographs and magnetic resonance imaging (MRI) obtained before surgery and 6 months after surgery. Labral integration and joint effusion were evaluated with MRI at 6 months. For statistical analysis, an independent t test and the Wilcoxon rank sum test were used (P < .05 was considered statistically significant). RESULTS The visual analog scale score 48 hours after surgery was 3.04 in group I compared with 5.28 in group II (P < .05). At the 3-month follow-up, the mHHS was 91.79 in group I versus 90.97 in group II (P = .65). At the 24-month follow-up, the mHHS was 93.41 in group I (P = .56) versus 92.32 in group II (P = .52). At the 6-month follow-up, MRI showed no effusion in 36.7% of patients in group I versus 21.1% of patients in group II (P = .013). Regarding labral integration, no statistical differences were observed between the groups (P = .76). CONCLUSIONS In this randomized study, PRP resulted in lower postoperative pain scores at 48 hours and fewer joint effusions at 6 months. These findings suggest that PRP may have a benefit regarding postoperative inflammation; however, the long-term clinical benefit is unclear. LEVEL OF EVIDENCE Level II, lesser-quality randomized controlled trial.
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Sonker A, Dubey A, Bhatnagar A, Chaudhary R. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft. Asian J Transfus Sci 2015; 9:155-8. [PMID: 26420935 PMCID: PMC4562136 DOI: 10.4103/0973-6247.162712] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background and objectives: Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Materials and Methods: Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at −80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. Results: There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. Conclusion: This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality.
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Affiliation(s)
- Atul Sonker
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anju Dubey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ankur Bhatnagar
- Department of Plastic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rajendra Chaudhary
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Abstract
Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and nanocarriers for corneal drug delivery are discussed. Attention is also paid to problems in wound healing understanding and treatment, such as lack of specific epithelial stem cell markers, reliable identification of stem cells, efficient prevention of haze and stromal scar formation, lack of data on wound regulating microRNAs in keratocytes and endothelial cells, as well as virtual lack of targeted systems for drug and gene delivery to select corneal cells.
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Affiliation(s)
- Alexander V Ljubimov
- Eye Program, Board of Governors Regenerative Medicine Institute, Departments of Biomedical Sciences and Neurosurgery, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Mehrnoosh Saghizadeh
- Eye Program, Board of Governors Regenerative Medicine Institute, Departments of Biomedical Sciences and Neurosurgery, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Tomás-Juan J, Murueta-Goyena Larrañaga A, Hanneken L. Corneal Regeneration After Photorefractive Keratectomy: A Review. JOURNAL OF OPTOMETRY 2015; 8:149-69. [PMID: 25444646 PMCID: PMC4502084 DOI: 10.1016/j.optom.2014.09.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 08/01/2014] [Indexed: 05/20/2023]
Abstract
Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain.
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Affiliation(s)
- Javier Tomás-Juan
- Department of Visual Science, VallmedicVision International Eye Clinic, Andorra.
| | | | - Ludger Hanneken
- Department of Visual Science, VallmedicVision International Eye Clinic, Andorra
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Alcalde I, Íñigo-Portugués A, Carreño N, Riestra AC, Merayo-Lloves JM. Effects of new biomimetic regenerating agents on corneal wound healing in an experimental model of post-surgical corneal ulcers. ACTA ACUST UNITED AC 2015; 90:467-74. [PMID: 26101128 DOI: 10.1016/j.oftal.2015.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/23/2015] [Accepted: 04/13/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The purpose of this study is to assess the effectiveness of the topical application of cacicol regenerating agent (RGTA) in an experimental model of corneal ulcer after photorefractive keratectomy (PRK) in mice. METHODS Mice were subjected to PRK surgery with a 2.0mm ablation zone on the central cornea and 45mm of depth on a VISX Star S2 excimer laser. Corneas were treated topically with cacicol drops 1hour and 48hours after injury. Control groups received balanced salt solution (BSS) in the same dosage. Clinical and histopathological events were evaluated at 1, 2, 3 and 7 days after surgery. Sections obtained through the central region of the corneas were used to analyze the histopathological events of injured and healed corneas. αSMA (myofibroblast transformation), E cadherin (assembly of epithelial cells) and neuronal class III β-tubulin (innervation) were performed. RESULTS Corneas treated topically with cacicol for 7 days showed a greater degree of transparency compared to controls. cacicol treated corneas showed improved epithelial cytoarchitecture. Analysis of αSMA profiles in the stroma showed that cacicol reduced or delayed the presence of myofibroblasts in the stroma compared to BSS (P<0.001). Finally, a putative neuroregenerative effect of cacicol was found in corneas subjected to an experimental PRK lesion. In some cases some interindividual variability could be observed due to the design of the experimental model. This is a limitation to consider, despite the statistical significance of the data. CONCLUSIONS In a model of laser induced surgical lesions in the cornea, topical application of an RGTA (i.e. cacicol) could be involved in avoiding myofibroblast scarring formation and promoting nerve regeneration.
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Affiliation(s)
- I Alcalde
- Fundación de Investigación Oftalmológica, Oviedo, España; Universidad de Oviedo, Oviedo, España.
| | - A Íñigo-Portugués
- Fundación de Investigación Oftalmológica, Oviedo, España; Universidad de Oviedo, Oviedo, España
| | - N Carreño
- Instituto Oftalmológico Fernández-Vega, Oviedo, España
| | - A C Riestra
- Instituto Oftalmológico Fernández-Vega, Oviedo, España
| | - J M Merayo-Lloves
- Fundación de Investigación Oftalmológica, Oviedo, España; Instituto Oftalmológico Fernández-Vega, Oviedo, España; Universidad de Oviedo, Oviedo, España
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Kuffler DP. Platelet-Rich Plasma Promotes Axon Regeneration, Wound Healing, and Pain Reduction: Fact or Fiction. Mol Neurobiol 2015; 52:990-1014. [PMID: 26048672 DOI: 10.1007/s12035-015-9251-x] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Indexed: 11/25/2022]
Abstract
Platelet-rich plasma (PRP) has been tested in vitro, in animal models, and clinically for its efficacy in enhancing the rate of wound healing, reducing pain associated with injuries, and promoting axon regeneration. Although extensive data indicate that PRP-released factors induce these effects, the claims are often weakened because many studies were not rigorous or controlled, the data were limited, and other studies yielded contrary results. Critical to assessing whether PRP is effective are the large number of variables in these studies, including the method of PRP preparation, which influences the composition of PRP; type of application; type of wounds; target tissues; and diverse animal models and clinical studies. All these variables raise the question of whether one can anticipate consistent influences and raise the possibility that most of the results are correct under the circumstances where PRP was tested. This review examines evidence on the potential influences of PRP and whether PRP-released factors could induce the reported influences and concludes that the preponderance of evidence suggests that PRP has the capacity to induce all the claimed influences, although this position cannot be definitively argued. Well-defined and rigorously controlled studies of the potential influences of PRP are required in which PRP is isolated and applied using consistent techniques, protocols, and models. Finally, it is concluded that, because of the purported benefits of PRP administration and the lack of adverse events, further animal and clinical studies should be performed to explore the potential influences of PRP.
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Affiliation(s)
- Damien P Kuffler
- Institute of Neurobiology, University of Puerto Rico, Medical Sciences Campus, 201 Blvd. Del Valle, San Juan, 00901, Puerto Rico,
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Koulikovska M, Szymanowski O, Lagali N, Fagerholm P. Platelet-Rich Plasma Prolongs Myofibroblast Accumulation in Corneal Stroma with Incisional Wound. Curr Eye Res 2015; 40:1102-10. [PMID: 25848678 DOI: 10.3109/02713683.2014.978478] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this study was to determine whether platelet-rich plasma (PRP) has an effect on corneal stromal cells in a rat model of wound healing following corneal incision. MATERIALS AND METHODS The effect of PRP on corneal wound healing in vivo was investigated in a corneal incision wound model in rats. 40 rats were wounded by deep corneal incision, and treated with either topically administered PRP (20 rats) or sodium chloride (20 rats). At 4 h and 1, 3, and 5 days after incision, α-smooth muscle actin (α SMA), SMAD2 and SMAD3 expression and apoptosis in stromal cells were evaluated by immunohistochemistry, and IL-1β mRNA expression was evaluated by real time PCR. RESULTS PRP-treated corneas exhibited reduced stromal cell apoptosis at day 3 and day 5 (p = 0.038, and <0.001, respectively) relative to controls. Interleukin-1β mRNA expression, however, was unchanged in PRP-treated corneas relative to controls. Topical PRP treatment resulted in a higher proportion of αSMA-positive myofibroblasts recruited to the wound site relative to control corneas. PRP did not affect activation of SMAD2 but activation of SMAD3 was significantly reduced at day 1 (p = 0.001) and dramatically increased at day 5 (p = 0.032). CONCLUSIONS PRP treatment resulted in suppressed stromal cell apoptosis followed by SMAD3 activation and a greater proportion of myofibroblasts present at the wound site. Suppression of stromal cell apoptosis after corneal wounding by use of a growth factor-rich formulation may lead to myofibroblast accumulation by modulation of the TGF-β pathway.
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Affiliation(s)
- Marina Koulikovska
- a Division of Ophthalmology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden and
| | - Olena Szymanowski
- a Division of Ophthalmology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden and
| | - Neil Lagali
- a Division of Ophthalmology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden and.,b Division of Cell Biology, Department of Clinical and Experimental Medicine , Integrative Regenerative Medicine Centre (IGEN), Linköping University , Linköping , Sweden
| | - Per Fagerholm
- a Division of Ophthalmology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden and.,b Division of Cell Biology, Department of Clinical and Experimental Medicine , Integrative Regenerative Medicine Centre (IGEN), Linköping University , Linköping , Sweden
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Platelet recruitment promotes keratocyte repopulation following corneal epithelial abrasion in the mouse. PLoS One 2015; 10:e0118950. [PMID: 25775402 PMCID: PMC4361664 DOI: 10.1371/journal.pone.0118950] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/12/2015] [Indexed: 12/25/2022] Open
Abstract
Corneal abrasion not only damages the epithelium but also induces stromal keratocyte death at the site of injury. While a coordinated cascade of inflammatory cell recruitment facilitates epithelial restoration, it is unclear if this cascade is necessary for keratocyte recovery. Since platelet and neutrophil (PMN) recruitment after corneal abrasion is beneficial to epithelial wound healing, we wanted to determine if these cells play a role in regulating keratocyte repopulation after epithelial abrasion. A 2 mm diameter central epithelial region was removed from the corneas of C57BL/6 wildtype (WT), P-selectin deficient (P-sel-/-), and CD18 hypomorphic (CD18hypo) mice using the Algerbrush II. Corneas were studied at 6h intervals out to 48h post-injury to evaluate platelet and PMN cell numbers; additional corneas were studied at 1, 4, 14, and 28 days post injury to evaluate keratocyte numbers. In WT mice, epithelial abrasion induced a loss of anterior central keratocytes and keratocyte recovery was rapid and incomplete, reaching ~70% of uninjured baseline values by 4 days post-injury but no further improvement at 28 days post-injury. Consistent with a beneficial role for platelets and PMNs in wound healing, keratocyte recovery was significantly depressed at 4 days post-injury (~30% of uninjured baseline) in P-sel-/- mice, which are known to have impaired platelet and PMN recruitment after corneal abrasion. Passive transfer of platelets from WT, but not P-sel-/-, into P-sel-/- mice prior to injury restored anterior central keratocyte numbers at 4 days post-injury to P-sel-/- uninjured baseline levels. While PMN infiltration in injured CD18hypo mice was similar to injured WT mice, platelet recruitment was markedly decreased and anterior central keratocyte recovery was significantly reduced (~50% of baseline) at 4–28 days post-injury. Collectively, the data suggest platelets and platelet P-selectin are critical for efficient keratocyte recovery after corneal epithelial abrasion.
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Anitua E, de la Fuente M, Muruzabal F, Riestra A, Merayo-Lloves J, Orive G. Plasma rich in growth factors (PRGF) eye drops stimulates scarless regeneration compared to autologous serum in the ocular surface stromal fibroblasts. Exp Eye Res 2015; 135:118-26. [PMID: 25708868 DOI: 10.1016/j.exer.2015.02.016] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/29/2014] [Accepted: 02/13/2015] [Indexed: 11/26/2022]
Abstract
Autologous serum (AS) eye drops was the first blood-derived product used for the treatment of corneal pathologies but nowadays PRGF arises as a novel interesting alternative to this type of diseases. The purpose of this study was to evaluate and compare the biological outcomes of autologous serum eye drops or Plasma rich in growth factors (PRGF) eye drops on corneal stromal keratocytes (HK) and conjunctival fibroblasts (HConF). To address this, blood from healthy donors was collected and processed to obtain autologous serum (AS) eye drops and plasma rich in growth factors (PRGF) eye drops. Blood-derivates were aliquoted and stored at -80°C until use. PDGF-AB, VEGF, EGF, FGFb and TGF-β1 were quantified. The potential of PRGF and AS in promoting wound healing was evaluated by means of proliferation and migration assays in HK and HConF. Fibroblast cells were induced to myofibroblast differentiation after treatment with 2.5ng/mL of TGF-β1. The capability of PRGF and AS to prevent and inhibit TGF-β1-induced differentiation was evaluated. Results showed significant higher levels of all growth factors analyzed in PRGF eye drops compared to AS. Moreover, PRGF eye drops enhanced significantly the biological outcomes of both HK and HConF, and reduced TGF-β1-induced myofibroblast differentiation in contrast to autologous serum eye drops (AS). In summary, these results suggest that PRGF exerts enhanced biological outcomes than AS. PRGF may improve the treatment of ocular surface wound healing minimizing the scar formation compared to AS. Results obtained herein suggest that PRGF protects and reverses the myofibroblast phenotype while promotes cell proliferation and migration.
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Affiliation(s)
- E Anitua
- Biotechnology Institute (BTI), Vitoria, Spain
| | | | - F Muruzabal
- Biotechnology Institute (BTI), Vitoria, Spain
| | - A Riestra
- Fundación de Investigación Oftalmológica, Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
| | - J Merayo-Lloves
- Fundación de Investigación Oftalmológica, Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
| | - G Orive
- Biotechnology Institute (BTI), Vitoria, Spain.
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Anitua E, Pelacho B, Prado R, Aguirre JJ, Sánchez M, Padilla S, Aranguren XL, Abizanda G, Collantes M, Hernandez M, Perez-Ruiz A, Peñuelas I, Orive G, Prosper F. Infiltration of plasma rich in growth factors enhances in vivo angiogenesis and improves reperfusion and tissue remodeling after severe hind limb ischemia. J Control Release 2015; 202:31-9. [PMID: 25626084 DOI: 10.1016/j.jconrel.2015.01.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/21/2015] [Accepted: 01/23/2015] [Indexed: 01/03/2023]
Abstract
PRGF is a platelet concentrate within a plasma suspension that forms an in situ-generated fibrin-matrix delivery system, releasing multiple growth factors and other bioactive molecules that play key roles in tissue regeneration. This study was aimed at exploring the angiogenic and myogenic effects of PRGF on in vitro endothelial cells (HUVEC) and skeletal myoblasts (hSkMb) as well as on in vivo mouse subcutaneously implanted matrigel and on limb muscles after a severe ischemia. Human PRGF was prepared and characterized. Both proliferative and anti-apoptotic responses to PRGF were assessed in vitro in HUVEC and hSkMb. In vivo murine matrigel plug assay was conducted to determine the angiogenic capacity of PRGF, whereas in vivo ischemic hind limb model was carried out to demonstrate PRGF-driven vascular and myogenic regeneration. Primary HUVEC and hSkMb incubated with PRGF showed a dose dependent proliferative and anti-apoptotic effect and the PRGF matrigel plugs triggered an early and significant sustained angiogenesis compared with the control group. Moreover, mice treated with PRGF intramuscular infiltrations displayed a substantial reperfusion enhancement at day 28 associated with a fibrotic tissue reduction. These findings suggest that PRGF-induced angiogenesis is functionally effective at expanding the perfusion capacity of the new vasculature and attenuating the endogenous tissue fibrosis after a severe-induced skeletal muscle ischemia.
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Affiliation(s)
- Eduardo Anitua
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain
| | - Beatriz Pelacho
- Cell Therapy Program, Foundation for Applied Medical Research, University of Navarra, Spain
| | | | | | - Mikel Sánchez
- Arthroscopic Surgery Unit, Hospital Vithas San Jose, Vitoria, Spain
| | - Sabino Padilla
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain; BTI - Biotechnology Institute, Vitoria, Spain
| | - Xabier L Aranguren
- Cell Therapy Program, Foundation for Applied Medical Research, University of Navarra, Spain
| | - Gloria Abizanda
- Cell Therapy Program, Foundation for Applied Medical Research, University of Navarra, Spain
| | - María Collantes
- Department of Nuclear Medicine, MicroPET Research Unit CIMA-CUN, Clínica Universitaria, University of Navarra, Spain
| | - Milagros Hernandez
- Hematology and Cell Therapy Department, Clínica Universidad de Navarra, University of Navarra, Spain
| | - Ana Perez-Ruiz
- Cell Therapy Program, Foundation for Applied Medical Research, University of Navarra, Spain
| | - Ivan Peñuelas
- Department of Nuclear Medicine, MicroPET Research Unit CIMA-CUN, Clínica Universitaria, University of Navarra, Spain
| | - Gorka Orive
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain.
| | - Felipe Prosper
- Cell Therapy Program, Foundation for Applied Medical Research, University of Navarra, Spain; Hematology and Cell Therapy Department, Clínica Universidad de Navarra, University of Navarra, Spain.
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Roubelakis MG, Trohatou O, Roubelakis A, Mili E, Kalaitzopoulos I, Papazoglou G, Pappa KI, Anagnou NP. Platelet-rich plasma (PRP) promotes fetal mesenchymal stem/stromal cell migration and wound healing process. Stem Cell Rev Rep 2014; 10:417-28. [PMID: 24500853 DOI: 10.1007/s12015-013-9494-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Numerous studies have shown the presence of high levels of growth factors during the process of healing. Growth factors act by binding to the cell surface receptors and contribute to the subsequent activation of signal transduction mechanisms. Wound healing requires a complex of biological and molecular events that includes attraction and proliferation of different type of cells to the wound site, differentiation and angiogenesis. More specifically, migration of various cell types, such as endothelial cells and their precursors, mesenchymal stem/stromal cells (MSCs) or skin fibroblasts (DFs) plays an important role in the healing process. In recent years, the application of platelet rich plasma (PRP) to surgical wounds and skin ulcerations is becoming more frequent, as it is believed to accelerate the healing process. The local enrichment of growth factors at the wound after PRP application causes a stimulation of tissue regeneration. Herein, we studied: (i) the effect of autologous PRP in skin ulcers of patients of different aetiology, (ii) the proteomic profile of PRP, (iii) the migration potential of amniotic fluid MSCs and DFs in the presence of PRP extract in vitro, (iv) the use of the PRP extract as a substitute for serum in cultivating AF-MSCs. Considering its easy access, PRP may provide a valuable tool in multiple therapeutic approaches.
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Affiliation(s)
- Maria G Roubelakis
- Laboratory of Biology, University of Athens, School of Medicine, Michalakopoulou 176, Athens, 115 27, Greece,
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Lima AC, Mano JF, Concheiro A, Alvarez-Lorenzo C. Fast and Mild Strategy, Using Superhydrophobic Surfaces, to Produce Collagen/Platelet Lysate Gel Beads for Skin Regeneration. Stem Cell Rev Rep 2014; 11:161-79. [DOI: 10.1007/s12015-014-9548-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Goldschmidt E, Ielpi M, Loresi M, D'adamo M, Giunta D, Carrizo A, Ajler P, Yampolsky C, Argibay P. Assessing the role of selected growth factors and cytostatic agents in anin vitromodel of human dura mater healing. Neurol Res 2014; 36:1040-6. [DOI: 10.1179/1743132814y.0000000429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Luger MHA. March consultation #7. J Cataract Refract Surg 2014; 40:505-6; discussion 507. [PMID: 24581781 DOI: 10.1016/j.jcrs.2014.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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