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Lin YH, Hsu HS. Therapeutic efficacy of platelet-rich plasma in the management of rib fractures. J Chin Med Assoc 2024; 87:854-860. [PMID: 39017627 DOI: 10.1097/jcma.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND This study aimed to investigate the therapeutic efficacy of platelet-rich plasma (PRP) therapy in patients with rib fractures. METHODS This study retrospectively collected data from patients with acute rib fractures at Ming-Sheng General Hospital from 2020 to 2022 and excluded those who underwent surgical intervention or with severe extrathoracic injuries. PRP was extracted using the patient's blood and injected via ultrasound guidance near the fracture site. Patients self-assessed pain levels and medication usage at 0, 1, 2, 4, and 8 weeks. Pulmonary function tests were conducted at 4 weeks. RESULTS This study included 255 patients, with 160 and 95 patients in the conservative (only pain medications administered) and PRP groups (PRP and analgesics administered), respectively. The PRP group reported lower pain levels than the conservative group at 2 and 4 weeks. No substantial differences in medication usage were observed between the groups. The PRP group demonstrated lower pain levels and medication usage than the conservative group in severe rib fractures (≥3 ribs) and better lung function improvement at 4 weeks. After propensity score matching, the PRP group still had a better treatment outcome in pain control and lung function recovery. CONCLUSION PRP demonstrated considerable therapeutic efficacy in patients with severe rib fractures, resulting in reduced pain, decreased medication usage, and improved lung function but with no substantial benefits in patients with mild rib fractures.
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Affiliation(s)
- Yi-Han Lin
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Traumatology, Min-Sheng General Hospital, Taoyuan, Taiwan, ROC
| | - Han-Shui Hsu
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Karaborklu Argut S, Celik D. Reply to the Letter to the Editor: Does the Combination of Platelet-rich Plasma and Supervised Exercise Yield Better Pain Relief and Enhanced Function in Knee Osteoarthritis? A Randomized Controlled Trial. Clin Orthop Relat Res 2024; 482:1506-1507. [PMID: 38917050 PMCID: PMC11272292 DOI: 10.1097/corr.0000000000003164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024]
Affiliation(s)
- Sezen Karaborklu Argut
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Derya Celik
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Gunes D, Oksuz S, Koseoglu RD, Gokce E. Comparison of the Effect of Platelet-rich Plasma (PRP) and Fat Graft on Autologous Bone Grafting in a Randomized-controlled Experimental Skull Model. J Craniofac Surg 2024; 35:1298-1304. [PMID: 38710066 DOI: 10.1097/scs.0000000000010166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/20/2024] [Indexed: 05/08/2024] Open
Abstract
Gold standard method for the treatment of critical-sized bone defects is the autogenous bone grafting procedure. A number of new and potentially useful adjuncts currently are being investigated to enhance the success of bone grafting. We propose to evaluate the effect of the most known and easily obtained 2 biological materials, fat graft and platelet-rich plasma (PRP), on bone graft healing. Twenty-seven New Zealand male rabbits were included in this randomized, controlled study. Two-sided 15-mm diameter bone defects were created in the parietal bones and the bones taken were replaced right-to-left and vice versa with 1 control group, 1 fat graft applied group, and the last one PRP applied group. Histologic evaluation and 3-dimensional maxillofacial computerized tomography were performed and bone density was calculated. In radiologic analysis, bone density was significantly different in the PRP group compared with the control and fat graft group in the 12th week ( P <0.05). In histologic scoring analysis, the PRP group had a better score than the control and fat graft group, while the fat graft group was worse than the control group in the 6th week ( P <0.05). The addition of PRP had a positive effect whereas fat graft had a negative effect on bone graft healing compared with the control group.
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Affiliation(s)
- Deniz Gunes
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Aydin State Hospital, Aydin
| | - Sinan Oksuz
- Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Gulhane Medical School, Ankara
| | | | - Erkan Gokce
- Department of Radiology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
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Nunes B, Martins R, Linhares D, Azevedo L, Canadas R, Gutierres M. Effect of Platelet-Rich Plasma Dosing for Healing after Arthroscopic Cuff Repair Compared with Surgery Alone: A Systematic Review and Meta-Analysis. Med Sci Sports Exerc 2024; 56:796-804. [PMID: 38480490 DOI: 10.1249/mss.0000000000003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Platelet-rich plasma (PRP) has been used for arthroscopic rotator cuff repairs (aRCR), but no studies have addressed the impact of platelet concentration. The primary aim was to evaluate whether the PRP cell concentration has an effect on tendon healing after aRCR compared with surgery alone. The secondary aim was to assess the functional and pain outcomes. MATERIALS AND METHODS A systematic review was performed with searches in the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane (Central) databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Metanalytic procedures were performed for randomized controlled trials (RCTs), and a subgroup analysis was used for studies with target (approximately 10 6 cells·μL -1 ) or below-target PRP cellular concentrations (app. 5 × 10 5 cells·μL -1 ) regarding the primary outcome of tendon healing. RESULTS This review included 10 studies (8 RCTs) with 342 patients in the aRCR + PRP group and 344 patients with isolated aRCR. The risk of bias was low to intermediate (6/4, respectively). Meta-analysis of the RCT revealed that the aRCR + high-concentration PRP group had an approximately 3.9-fold higher chance of healing than the non-PRP group (odds ratio, 3.89; 95% confidence interval, 1.78-8.44; P = 0.0007). No significant difference in healing was found between the aRCR + low-concentration PRP and non-PRP groups (odds ratio, 2.21; 95% confidence interval, 0.66-7.45; P = 0.2). The Constant-Murley score and University of California Los Angeles scores were significantly improved in the aRCR + PRP groups with more than 12 months of follow-up, and no significant differences were found consistently for the American Shoulder and Elbow Society and visual analog scale scores. CONCLUSIONS This study highlights that a PRP cell concentration close to the target (10 6 cells·μL -1 ) of patients with aRCR may improve their healing and functional outcomes and that dosing may be potentially useful in therapy.
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Affiliation(s)
| | - Ricardo Martins
- Faculty of Medicine of the University of Porto, Porto, PORTUGAL
| | | | - Luís Azevedo
- CINTESIS@RISE-Center for Health Technology and Services Research at the Health Research Network, MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, PORTUGAL
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Ivanovski S, Lee RSB, Fernandez-Medina T, Pinto N, Andrade C, Quirynen M. Impact of autologous platelet concentrates on the osseointegration of dental implants. Periodontol 2000 2024. [PMID: 38647020 DOI: 10.1111/prd.12563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 04/25/2024]
Abstract
Osseointegration is defined as the direct deposition of bone onto biomaterial devices, most commonly composed from titanium, for the purpose of anchoring dental prostheses. The use of autologous platelet concentrates (APC) has the potential to enhance this process by modifying the interface between the host and the surface of the titanium implant. The rationale is to modify the implant surface and implant-bone interface via "biomimicry," a process whereby the deposition of the host's own proteins and extracellular matrix enhances the biocompatibility of the implant and hence accelerates the osteogenic healing process. This review of the available evidence reporting on the effect of APC on osseointegration explores in vitro laboratory studies of the interaction of APC with different implant surfaces, as well as the in vivo and clinical effects of APC on osseointegration in animal and human studies. The inherent variability associated with using autologous products, namely the unique composition of each individual's blood plasma, as well as the great variety in APC protocols, combination of biomaterials, and clinical/therapeutic application, makes it is difficult to make any firm conclusions about the in vivo and clinical effects of APC on osseointegration. The available evidence suggests that the clinical benefits of adding PRP and the liquid form of L-PRF (liquid fibrinogen) to any implant surface appear to be limited. The application of L-PRF membranes in the osteotomy site, however, may produce positive clinical effects at the early stage of healing (up to 6 weeks), by promoting early implant stability and reducing marginal bone loss, although no positive longer term effects were observed. Careful interpretation and cautious conclusions should be drawn from these findings as there were various limitations in methodology. Future studies should focus on better understanding of the influence of APCs on the biomaterial surface and designing controlled preclinical and clinical studies using standardized APC preparation and application protocols.
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Affiliation(s)
- Sašo Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Ryan S B Lee
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Tulio Fernandez-Medina
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
| | - Nelson Pinto
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Catherine Andrade
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Jia K, You J, Zhu Y, Li M, Chen S, Ren S, Chen S, Zhang J, Wang H, Zhou Y. Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization. Front Bioeng Biotechnol 2024; 12:1286035. [PMID: 38689760 PMCID: PMC11058865 DOI: 10.3389/fbioe.2024.1286035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
Platelet-rich fibrin, a classical autologous-derived bioactive material, consists of a fibrin scaffold and its internal loading of growth factors, platelets, and leukocytes, with the gradual degradation of the fibrin scaffold and the slow release of physiological doses of growth factors. PRF promotes vascular regeneration, promotes the proliferation and migration of osteoblast-related cells such as mesenchymal cells, osteoblasts, and osteoclasts while having certain immunomodulatory and anti-bacterial effects. PRF has excellent osteogenic potential and has been widely used in the field of bone tissue engineering and dentistry. However, there are still some limitations of PRF, and the improvement of its biological properties is one of the most important issues to be solved. Therefore, it is often combined with bone tissue engineering scaffolds to enhance its mechanical properties and delay its degradation. In this paper, we present a systematic review of the development of platelet-rich derivatives, the structure and biological properties of PRF, osteogenic mechanisms, applications, and optimization to broaden their clinical applications and provide guidance for their clinical translation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yanmin Zhou
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
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Anapu MP, Atluri KR, Chandra Tripuraneni S, Issrani R, Bader AK, Alkhalaf ZA, Sghaireen MG, Prabhu N, Rbea DH Alshammari R, Khalid G, Matab G, Khan FH. Evaluation of effect on stability of implants with and without platelet rich fibrin using a resonance frequency analyzer - An in-vivo study. Heliyon 2024; 10:e27971. [PMID: 38623195 PMCID: PMC11016576 DOI: 10.1016/j.heliyon.2024.e27971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024] Open
Abstract
Background Although the conventional replacement for lost teeth has been partial or full dentures, the need for a fixed, esthetic, and functional restoration makes dental implants a reliable alternative. Aim To evaluate the initial and final stability of platelet rich fibrin coated implants using resonance frequency analyzer. Method ology: Thirteen patients with two or more missing teeth were informed about the procedure, and a consent form was obtained after cone beam computer tomography evaluation. Blood was drawn from the anticubital area of the patient, which was centrifuged to obtain platelet-rich fibrin. In all, 26 implants were placed, among which 13 were platelet-rich fibrin-coated (test group) and 13 were without platelet-rich fibrin (control group), and implant stability quotient values were recorded. Results The mean age of the patients was 34.4 (SD = 4.28). Majority of the patients were males (9; 69.2%) whereas there were only four (30.8%) female patients. When comparison between overall primary implant stability with and without PRF was done, the mean difference was 5.12 and this difference was not statistically significant (p = 0.221) whereas a statistically significant difference (p = 0.019) was found when comparison between overall secondary implant stability was done with and without PRF. The primary and secondary stability values for the control group were 69.18 ± 7.45 and 73.84 ± 8.21 respectively, and the primary and secondary stability values for the test group were 64.06 ± 12.66 and 81.49 ± 7.61 respectively, which showed statistically significant differences among the groups. The difference in these values signify that primary stability is more in control group whereas secondary stability is more in case group. This signifies that PRF enhances the stability of implant. Conclusion Implants coated with platelet-rich fibrin exhibited better osseointegration than implants without platelet-rich fibrin.
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Affiliation(s)
- Mounica Priya Anapu
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Kaleswara Rao Atluri
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Sunil Chandra Tripuraneni
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Alzarea K. Bader
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Zainab A. Alkhalaf
- Department of Prosthetic Dental Sciences, Ministry of Health, Kingdom of Saudi Arabia
| | - Mohammed Ghazi Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Namdeo Prabhu
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Ghosoun Khalid
- College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Ghada Matab
- College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Farida Habib Khan
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
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Wang Y, Wang H, Xu J, Wang J, You L, Bai Y, Guo J. Exploration of the Clinical Effect of Different Autotransfusion Methods on Patients With Femoral Shaft Fracture Surgery. J Clin Lab Anal 2024; 38:e25018. [PMID: 38468395 PMCID: PMC10959180 DOI: 10.1002/jcla.25018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/30/2023] [Accepted: 02/02/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE To explore the clinical effect of predeposit, salvage, and hemodilution autotransfusion on patients with femoral shaft fracture (FSF) surgery. METHODS Selected patients with FSF were randomly divided into three groups: intraoperative blood salvage autotransfusion, preoperative hemodilution autohemotransfusion, and predeposit autotransfusion. Five days after the operation, the body temperature, heart rate, blood platelet (PLT), and hemoglobin (Hb) of patients were determined. The concentrations of EPO and GM-CSF in the three groups were calculated by ELISA. The content of CD14+ monocytes was calculated by FCM assay. The growth time and condition of the patient's callus were determined at the 30th, 45th, and 60th day after operation. Cox regression analysis was used to analyze the correlation between EPO, GM-CSF, CD14+ mononuclear content, callus growth, and autotransfusion methods. RESULTS There were no statistically significant differences in body temperature and heart rate between the three groups (p > 0.05). PLT and Hb in the Predeposit group were markedly increased compared with that in the Salvage and Hemodilution groups. The concentrations of EPO and GM-CSF in the Predeposit group were markedly increased compared with that in the Salvage and Hemodilution groups. The content of CD14+ monocytes in the Predeposit group was significantly higher than that in the Salvage and Hemodilution groups. Predeposit autotransfusion promotes callus growth more quickly. CONCLUSION Predeposit autotransfusion promoted the recovery of patients with FSF after the operation more quickly than salvage autotransfusion and hemodilution autotransfusion.
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Affiliation(s)
- Yujia Wang
- School of Gongli Hospital Medical TechnologyUniversity of Shanghai for Science and TechnologyShanghaiChina
| | - Huan Wang
- Department of Anesthesiology, Shanghai Gongli HospitalNaval Military Medical UniversityShanghaiChina
| | - Jiaming Xu
- Department of Anesthesiology, Shanghai Gongli HospitalNaval Military Medical UniversityShanghaiChina
| | - Jinhuo Wang
- Department of Anesthesiology, Shanghai Gongli HospitalNaval Military Medical UniversityShanghaiChina
| | - Laiwei You
- Department of Anesthesiology, Shanghai Gongli HospitalNaval Military Medical UniversityShanghaiChina
| | - Yu Bai
- Department of Anesthesiology, Shanghai Gongli HospitalNaval Military Medical UniversityShanghaiChina
| | - Jianrong Guo
- Department of Anesthesiology, Shanghai Gongli HospitalNaval Military Medical UniversityShanghaiChina
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Bacevich BM, Smith RDJ, Reihl AM, Mazzocca AD, Hutchinson ID. Advances with Platelet-Rich Plasma for Bone Healing. Biologics 2024; 18:29-59. [PMID: 38299120 PMCID: PMC10827634 DOI: 10.2147/btt.s290341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
Despite significant advances in the understanding and delivery of osteosynthesis, fracture non-union remains a challenging clinical problem in orthopaedic surgery. To bridge the gap, basic science characterization of fracture healing provides a platform to identify and target biological strategies to enhance fracture healing. Of immense interest, Platelet-rich plasma (PRP) is a point of care orthobiologic that has been extensively studied in bone and soft tissue healing given its relative ease of translation from the benchtop to the clinic. The aim of this narrative review is to describe and relate pre-clinical in-vitro and in-vivo findings to clinical observations investigating the efficacy of PRP to enhance bone healing for primary fracture management and non-union treatment. A particular emphasis is placed on the heterogeneity of PRP preparation techniques, composition, activation strategies, and delivery. In the context of existing data, the routine use of PRP to enhance primary fracture healing and non-union management cannot be supported. However, it is acknowledged that extensive heterogeneity of PRP treatments in clinical studies adds obscurity; ultimately, refinement (and consensus) of PRP treatments for specific clinical indications, including repetition studies are warranted.
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Affiliation(s)
- Blake M Bacevich
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Richard David James Smith
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Alec M Reihl
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Augustus D Mazzocca
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
- Medical Director, Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Brigham, Boston, MA, USA
| | - Ian D Hutchinson
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
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Mata M, Salvador-Clavell R, Ródenas-Rochina J, Sancho-Tello M, Gallego Ferrer G, Gómez Ribelles JL. Mesenchymal Stem Cells Cultured in a 3D Microgel Environment Containing Platelet-Rich Plasma Significantly Modify Their Chondrogenesis-Related miRNA Expression. Int J Mol Sci 2024; 25:937. [PMID: 38256011 PMCID: PMC10815493 DOI: 10.3390/ijms25020937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
The aim of this work is to study the effect of platelet factors on the differentiation of mesenchymal stem cells (MSCs) to hyaline cartilage chondrocytes in a three-dimensional environment. MSCs were cultured in a microgel environment with a chondrogenic medium. The microgel consisted of microspheres that combine gelatin and platelet-rich plasma (PRP). The gelatin/PRP microdroplets were produced by emulsion. The gelatin containing the microdroplets was enzymatically gelled, retaining PRP and, just before seeding the cells, platelets were activated by adding calcium chloride so that platelet growth factors were released into the culture media but not before. Platelet activation was analyzed before activation to rule out the possibility that the gelatin cross-linking process itself activated the platelets. The gene expression of characteristic chondrogenic markers and miRNA expression were analyzed in cells cultured in a differentiation medium and significant differences were found between gelation/PRP microgels and those containing only pure gelatin. In summary, the gelatin microspheres effectively encapsulated platelets that secreted and released factors that significantly contributed to cellular chondrogenic differentiation. At the same time, the microgel constituted a 3D medium that provided the cells with adherent surfaces and the possibility of three-dimensional cell-cell contact.
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Affiliation(s)
- Manuel Mata
- Departamento de Patología, Facultad de Medicina y Odontología, Universitat de València, 46010 Valencia, Spain; (R.S.-C.); (M.S.-T.)
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.R.-R.); (G.G.F.); (J.L.G.R.)
| | - Rubén Salvador-Clavell
- Departamento de Patología, Facultad de Medicina y Odontología, Universitat de València, 46010 Valencia, Spain; (R.S.-C.); (M.S.-T.)
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Joaquín Ródenas-Rochina
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.R.-R.); (G.G.F.); (J.L.G.R.)
| | - María Sancho-Tello
- Departamento de Patología, Facultad de Medicina y Odontología, Universitat de València, 46010 Valencia, Spain; (R.S.-C.); (M.S.-T.)
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Gloria Gallego Ferrer
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.R.-R.); (G.G.F.); (J.L.G.R.)
- Centre for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, 46022 Valencia, Spain
| | - José Luis Gómez Ribelles
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.R.-R.); (G.G.F.); (J.L.G.R.)
- Centre for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, 46022 Valencia, Spain
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Jhang JF, Jiang YH, Lin TY, Kuo HC. The Tumor Necrosis Factor-α Level in Platelet-Rich Plasma Might Be Associated with Treatment Outcome in Patients with Interstitial Cystitis/Bladder Pain Syndrome or Recurrent Urinary Tract Infection. Int J Mol Sci 2023; 25:163. [PMID: 38203334 PMCID: PMC10779330 DOI: 10.3390/ijms25010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Using platelet-rich plasma (PRP) injections to treat urological diseases has attracted great attention. This study investigated the impact of cytokine concentrations in PRP on the treatment outcome of patients with recurrent urinary tract infection (rUTI) and interstitial cystitis/bladder pain syndrome (IC/BPS). Forty patients with IC/BPS and twenty-one patients with rUTI were enrolled for four-monthly repeated PRP injections. PRP was collected at the first injection and analyzed with multiplex immunoassays for 12 target cytokines. In patients with IC/BPS, a Global Response Assessment (GRA) score ≥ 2 was defined as a successful outcome. In rUTI patients, ≤2 episodes of UTI recurrence during one year of follow-up was considered a successful outcome. Nineteen (47.5%) patients with IC/BPS and eleven (52.4%) patients with rUTI had successful outcomes. The IC/BPS patients with successful outcomes had significantly lower levels of tumor necrosis factor-α (TNF-α) in their PRP than those with unsuccessful outcomes (p = 0.041). The rUTI patients with successful outcomes also had a lower level of TNF-α (p = 0.025) and a higher level of epidermal growth factor (p = 0.035) and transforming growth factor-β2 (p = 0.024) in PRP than those with unsuccessful outcomes. A lower level of TNF-α in PRP might be a potentially predictive factor of treatment outcome.
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Affiliation(s)
- Jia-Fong Jhang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, Taiwan; (J.-F.J.); (Y.-H.J.)
| | - Yuan-Hong Jiang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, Taiwan; (J.-F.J.); (Y.-H.J.)
| | - Teng-Yi Lin
- Department of Laboratory Medicine, Hualien Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, Taiwan; (J.-F.J.); (Y.-H.J.)
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Chang CW, Lee CC, Liao JC. Using a developed co-culture device to evaluate the proliferation of bone marrow stem cells by stimulation with platelet-rich plasma and electromagnetic field. BMC Musculoskelet Disord 2023; 24:943. [PMID: 38053043 DOI: 10.1186/s12891-023-07042-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUNDS Bone marrow stem cell can differentiate to osteoblast by growth factors, pulsed low-intensity ultrasound and electric magnetic field. In the research, bone marrow stem cells were cultured; bone marrow stem cells in culture can be stimulated by platelet-rich plasma and electric field. METHODS The culture well of the co-cultivation device has a radius of 7.5 mm and a depth of 7 mm. It is divided into two sub-chambers separated by a 3 mm high and 1 mm wide barrier. The bone marrow stem cells were seeded at a density of 2 × 104 cells and the medium volume was 120μl. Platelet-rich plasma (PRP) or platelet-poor plasma (PPP) was added to the other sub-chamber at a volume of 10μl. The bone marrow stem cells were subjected to different electric fields (0 ~ 1 V/cm) at a frequency of 70 kHz for 60 min. RESULTS The highest osteogenic capacity of bone marrow stem cells was achieved by addition of PRP to electric field stimulation (0.25 V/cm) resulted in a proliferation rate of 599.78%. In electric field stimulation (0.75 V/cm) with PPP, the proliferation rate was only 10.46%. CONCLUSIONS Bone marrow stem cell with PRP in the co-culture device combined with electric field at 0.25 V/cm strength significantly promoted the growth of bone marrow stem cells.
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Affiliation(s)
- Chia-Wei Chang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Bone and Joint Research Center, Chang Gung University, Taoyuan City, Taiwan
| | - Chih-Chin Lee
- Department of Orthopedics Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, No._5, Fu-Shin Street, Kweishian, Taoyuan, 333, Taiwan
| | - Jen-Chung Liao
- Department of Orthopedics Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, No._5, Fu-Shin Street, Kweishian, Taoyuan, 333, Taiwan.
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13
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Sneed D, Wong C. Platelet-rich plasma injections as a treatment for Achilles tendinopathy and plantar fasciitis in athletes. PM R 2023; 15:1493-1506. [PMID: 36929699 DOI: 10.1002/pmrj.12965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 03/18/2023]
Abstract
Platelet-rich plasma (PRP) injections represent a growing interest in the use of biologic therapies for treatment of musculoskeletal injuries. One possible application of PRP is in the management of overuse injuries commonly experienced by athletes. The aim of this review is to evaluate and summarize existing evidence regarding the efficacy of PRP in the treatment of Achilles tendinopathy and plantar fasciitis in athletes. Although many lower quality single-armed studies have demonstrated clinical improvement in athletes treated for Achilles tendinopathy with PRP, higher quality randomized controlled trials (RCTs) have shown no clear benefit in athletes. Existing data suggest PRP significantly improves clinical outcomes for plantar fasciitis in the general population, but very few studies and no RCTs are available that specifically analyze outcomes in athletic populations. More research is needed to evaluate how platelet concentration, leukocyte and erythrocyte presence, and sport type may interact to affect clinical outcomes in athletes.
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Affiliation(s)
- Dustin Sneed
- Central Virginia VA Health Care System, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Carmen Wong
- Central Virginia VA Health Care System, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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14
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Li T, Wang YY, Liu C. The effectiveness of using platelet-rich concentrate with iliac bone graft in the repair of alveolar cleft: a meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg 2023; 52:1049-1056. [PMID: 36925370 DOI: 10.1016/j.ijom.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 12/28/2022] [Accepted: 01/06/2023] [Indexed: 03/18/2023]
Abstract
The purpose of this study was to review the existing evidence from randomized controlled trials (RCTs) on the effect of autogenous bone grafts combined with a platelet-rich concentrate on alveolar clefts. An electronic search was conducted in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases for studies published between January 2000 and April 2022. This study included six RCTs to evaluate bone quantity (bone formation ratio, %) and quality (bone density in Hounsfield units, HU), as well as complications as a way to assess the safety of the technique. Two independent reviewers assessed the risk of bias. There was no statistically significant difference in bone formation ratio at 6 months of follow-up between the use of autologous bone alone for alveolar bone grafting or adding platelet-rich plasma (PRP) (mean difference (MD) 14.33%, 95% confidence interval (CI) - 7.19% to 35.85%; P = 0.196) or platelet-rich fibrin (PRF) (MD 9.38%, 95% CI -2.36% to 21.12%; P = 0.123) to autologous bone. The MD for the change in bone density at 6 months was in favour of PRP added to autologous bone graft (MD 155.69 HU, 95% CI 99.29-212.09 HU; P < 0.001); however, this result was based on only two studies, one of which had a high risk of bias. Patients who received autologous bone graft with PRP were significantly less likely to experience complications (odds ratio (OR) 0.21, 95% CI 0.05-0.92; P = 0.038), but this was no longer statistically significant after a sensitivity test (OR 0.24, 95% CI 0.04-1.56; P = 0.138). In conclusion, this systematic review and meta-analysis appears to show no benefit to using a platelet-rich concentrate combined with autologous bone for alveolar cleft grafting in terms of bone volume, bone density, or complications.
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Affiliation(s)
- T Li
- Medical College of Nanchang University, Nanchang, Jiangxi Province, China; Department of Plastic Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China
| | - Y Y Wang
- Medical College of Nanchang University, Nanchang, Jiangxi Province, China; Department of Plastic Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China
| | - C Liu
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China; The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
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15
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Wang Z, Zhu P, Liao B, You H, Cai Y. Effects and action mechanisms of individual cytokines contained in PRP on osteoarthritis. J Orthop Surg Res 2023; 18:713. [PMID: 37735688 PMCID: PMC10515001 DOI: 10.1186/s13018-023-04119-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
Osteoarthritis (OA) is defined as a degenerative joint disease that can affect all tissues of the joint, including the articular cartilage, subchondral bone, ligaments capsule, and synovial membrane. The conventional nonoperative treatments are ineffective for cartilage repair and induce only symptomatic relief. Platelet-rich plasma (PRP) is a platelet concentrate derived from autologous whole blood with a high concentration of platelets, which can exert anti-inflammatory and regenerative effects by releasing multiple growth factors and cytokines. Recent studies have shown that PRP exhibits clinical benefits in patients with OA. However, high operational and equipment requirements greatly limit the application of PRP to OA treatment. Past studies have indicated that high-concentration PRP growth factors and cytokines may be applied as a commercial replacement for PRP. We reviewed the relevant articles to summarize the feasibility and mechanisms of PRP-based growth factors in OA. The available evidence suggests that transforming growth factor-α and β, platelet-derived growth factors, epidermal growth factor, insulin-like growth factor-1, and connective tissue growth factors might benefit OA, while vascular endothelial growth factor, tumor necrosis factor-α, angiopoietin-1, and stromal cell derived factor-1α might induce negative effects on OA. The effects of fibroblast growth factor, hepatocyte growth factor, platelet factor 4, and keratinocyte growth factor on OA remain uncertain. Thus, it can be concluded that not all cytokines released by PRP are beneficial, although the therapeutic action of PRP has a valuable potential to improve.
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Affiliation(s)
- Zhengchao Wang
- Department of Orthopedics, Wuhan Fourth Hospital, Wuhan, China
| | - Pengfei Zhu
- Department of Cardiovascular, Wuhan Fourth Hospital, Wuhan, China
- Department of Cardiovascular, Fujian Medical University Union Hospital, Fuzhou, China
| | - Bokai Liao
- School of Chemistry and Chemical Engineering, Guangzhou University, Guangzhou, China
| | - Hongbo You
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University and Technology, Jiefang Avenue No.1095, Qiaokou District, Wuhan, 430030, Hubei Province, China.
| | - Yu Cai
- Department of Rehabilitation, Wuhan Fourth Hospital, Hanzheng Street No.473, Qiaokou District, Wuhan, 430000, Hubei Province, China.
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16
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Otagiri T, Shiga Y, Hozumi T, Matsuura Y, Tajiri I, Takayama N, Alejandra M, Shiko Y, Orita S, Inage K, Eguchi Y, Suzuki T, Suzuki-Narita M, Mukai M, Mukaihata T, Tsuchiya R, Tokeshi S, Okuyama K, Arai T, Toshi N, Furuya T, Maki S, Aoki Y, Ohtori S. Combined effect of DBM, PRP, and bone marrow fluid on bone union in a rat posterolateral fusion model. Sci Rep 2023; 13:15041. [PMID: 37699916 PMCID: PMC10497499 DOI: 10.1038/s41598-023-41844-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Platelet-rich plasma (PRP) promotes bone union through osteoinduction. We investigated whether adding demineralized bone matrix (DBM), derived naturally from biomaterial and with various growth factors, for osteoconductivity and bone marrow fluid for osteogenesis results in different bone unions. Eight-week-old male Sprague-Dawley rats were divided into four groups of five based on transplantation material: sham control (C group); DBM alone (D group); DBM + PRP (DP group); and DBM + PRP + bone marrow fluid (DPB group). After posterolateral fusion at L3-5, postoperative weekly CT imaging determined average number of bone union in facet joints (4 joints × 5 animals = 20 joints) and bone formation. Pathological evaluation and bone strength were assessed using 3-point bending two weeks postoperatively. Facet joint bone union at four weeks postoperatively was 4/20 (20%, DP group) and 8/20 (40%, DPB group) joints. Six weeks postoperatively, it was 7/20 (35%, D group), 12/20 (60%, DP group), and 16/20 (80%, DPB group). Eight weeks postoperatively, it was 13/20 (65%, D group), 17/20 (85%, DP group), and 20/20 (100%, DPB group), suggesting that DPB > DP > D > C. Bone formation and bone strength showed a similar DPB > DP > D > C group trend. Adding PRP and bone marrow fluid to DBM promotes bone union and strength.
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Affiliation(s)
- Takuma Otagiri
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Takashi Hozumi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Matsuura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ikuko Tajiri
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoya Takayama
- Department of Regenerative Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Maria Alejandra
- Department of Regenerative Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Sumihisa Orita
- Chiba University Center for Frontier Medical Engineering, Chiba, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yawara Eguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Miyako Suzuki-Narita
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiaki Mukai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomohito Mukaihata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryuto Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Soichiro Tokeshi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kohei Okuyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahito Arai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Noriyasu Toshi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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17
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Mayoral Rojals V, Amescua Garcia C, Denegri P, Narvaez Tamayo MA, Varrassi G. The Invasive Management of Pain: Diagnosis and New Treatment Options. Cureus 2023; 15:e42717. [PMID: 37654942 PMCID: PMC10466260 DOI: 10.7759/cureus.42717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Both the diagnosis and treatment of pain are evolving, especially in interventional approaches. Diagnosis of low back pain combines old and new methodologies, in particular, it involves an expanded role for ultrasound. While low back pain is a common complaint, there are many etiologies to the condition which must be explored before a final diagnosis can be made and treatment planned. Tumors and infections are rarely involved in low back pain but should be ruled out in the initial phase itself since failing to address them early can have devastating consequences. Some invasive treatments seem promising in the management of low back pain. Treating musculoskeletal pain with regenerative medicine, such as platelet-rich plasma, holds great promise. Autologous blood products are safe and may help stimulate the body's own responses for regeneration. The so-called "orthobiologics" play a role in sports medicine and the treatment of musculoskeletal pain. Neuromodulation, especially spinal cord stimulation, is undergoing a renaissance with new waveforms, devices, and a greater albeit incomplete understanding of its mechanisms of action. Spinal cord stimulation is not a first-line therapy and not all patients or all back problems respond to this treatment. Nevertheless, the therapy can be safe, effective, and cost-effective with appropriate patient selection. Radiofrequency ablation of nerves in the form of neurotomy can be effective in reducing the pain of osteoarthritis. These procedures, including the newer cooled radiofrequency neurotomy, can restore function, reduce pain, and may potentially have an opioid-sparing effect. Technical expertise in nerve and anatomy is needed for the use of this technique. This review article aims to provide updated information on some invasive intervention techniques in pain management.
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Affiliation(s)
| | | | - Pasquale Denegri
- Anesthesia, Intensive Care, and Pain Medicine, Sant'Anna and San Sebastiano Hospital, Caserta, ITA
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18
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Liu J, Wang Y, Liang Y, Zhu S, Jiang H, Wu S, Ge X, Li Z. Effect of Platelet-Rich Plasma Addition on the Chemical Properties and Biological Activity of Calcium Sulfate Hemihydrate Bone Cement. Biomimetics (Basel) 2023; 8:262. [PMID: 37366857 DOI: 10.3390/biomimetics8020262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/04/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
Currently, platelet-rich plasma (PRP) is an attractive additive for bone repair materials. PRP could enhance the osteoconductive and osteoinductive of bone cement, as well as modulate the degradation rate of calcium sulfate hemihydrate (CSH). The focus of this study was to investigate the effect of different PRP ratios (P1: 20 vol%, P2: 40 vol%, and P3: 60 vol%) on the chemical properties and biological activity of bone cement. The injectability and compressive strength of the experimental group were significantly higher than those of the control. On the other hand, the addition of PRP decreased the crystal size of CSH and prolonged the degradation time. More importantly, the cell proliferation of L929 and MC3T3-E1 cells was promoted. Furthermore, qRT-PCR, alizarin red staining, and western blot analyses showed that the expressions of osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) genes and β-catenin protein were up-regulated, and mineralization of extracellular matrix was enhanced. Overall, this study provided insight into how to improve the biological activity of bone cement through PRP incorporation.
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Affiliation(s)
- Jingyu Liu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Yifan Wang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Yanqin Liang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Shengli Zhu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Hui Jiang
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Shuilin Wu
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
| | - Xiang Ge
- Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin 300354, China
| | - Zhaoyang Li
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Yaguan Road 135#, Tianjin 300072, China
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19
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Chung CS, Wei YF, Lin LS. Submucosal Injection of Activated Platelet-Rich Plasma for Treatment of Periodontal Disease in Dogs. J Vet Dent 2023; 40:19-27. [PMID: 36131537 DOI: 10.1177/08987564221124165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Periodontal disease is the most common oral disease seen in dogs, and its routine treatment usually involves dental scaling. Platelet-rich plasma (PRP) therapy may enhance the effectiveness of treatment of periodontal disease, delay the progression of the disease and decrease the time under anesthesia. However, its application in dogs is rarely discussed. The objective of this study was to evaluate the benefits of activated PRP for treatment of periodontal disease in dogs. 43 mL of whole blood was collected from six adult dogs and PRP extracted using the double centrifugation tube method. Subsequently, the PRP was activated using calcium chloride (A-PRP). Significantly elevated concentrations of PDGF-BB (7000.28 pg/mL), TGF-β (378.98 pg/mL), and VEGF (7.14 pg/mL) were detected in the A-PRP. Additionally, three of the dogs with stage 2-3 periodontal disease were enrolled in the clinical trial. Periodontal pocket depth, stage of periodontal disease, gingival index, horizontal bone loss, and alveolar bone density involving the maxillary third and fourth premolar and first molar teeth (107, 108, 109, 207, 208, and 209) were evaluated. Teeth were treated by dental scaling alone (control group) or by dental scaling followed by submucosal injection of 0.1 mL A-PRP per site. After 56 days, significant improvement in periodontal pocket depth, stage of periodontal disease, gingival index, and horizontal bone loss was observed in dogs injected with A-PRP. The high concentrations of growth factors in A-PRP likely contributed to this effect. The use of submucosal injections of A-PRP to treat canine stage 2-3 periodontal disease appears safe and effective for clinical practice.
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Affiliation(s)
- Cheng-Shu Chung
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan.,Division of Small Anival Surgery, Veterinary Medical Teaching Hospital, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Yi-Fang Wei
- Division of Small Anival Surgery, Veterinary Medical Teaching Hospital, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Lee-Shuan Lin
- Laboratory of Veterinary Diagnostic Imaging, Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan.,Division of Diagnostic Imaging, Veterinary Medical Teaching Hospital, National Pingtung University of Science and Technology, Pingtung, Taiwan.,School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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20
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Turajane T, Cheeva-Akrapan V, Saengsirinavin P, Lappaiwong W. Composition of Platelet-Rich Plasma Prepared From Knee Osteoarthritic Patients: Platelets, Leukocytes, and Subtypes of Leukocyte. Cureus 2023; 15:e36399. [PMID: 37090378 PMCID: PMC10114603 DOI: 10.7759/cureus.36399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION Platelet-rich plasma (PRP) has gained increasing popularity in the orthopedic field. There has been still no consensus on PRP preparation technique, thus providing a variety of final PRP products. Different preparation techniques lead to different compositions of PRP, which include platelet concentration, the number of leukocytes, and their subtypes. Here, we studied those compositions of PRP compared to whole blood samples. METHODS There were 335 participants who met the inclusion and exclusion criteria. Each participant underwent a blood drawing process to prepare PRP for their knee osteoarthritis treatment. We categorized baseline platelet concentration in whole blood samples into three groups: less than 2 x 105/µL (Group 1), between 2 x 105/µL and 2.99 x 105/µL (Group 2), and greater than 2.99 x 105/µL (Group 3). The primary outcome was reported as the platelet concentration in PRP and the ratio of platelet concentration in PRP compared to baseline whole blood samples. The secondary outcome was reported as the ratios of leukocyte, lymphocyte, and neutrophil in PRP compared to the baseline whole blood samples. RESULTS The average platelet concentration in PRP was 1.26 x 106/µL (6.3 times higher compared to baseline whole blood samples). The mean platelet concentration of PRP in Group 1, Group 2, and Group 3 was 1.08 x 106/µL, 1.38 x 106/µL, and 1.71 x 106/µL, respectively (p-value = 0.0001). The platelet concentration ratio of PRP condition to the baseline whole blood was 6.9, 5.8, and 4.2 in Group 1, Group 2, and Group 3, respectively (p-value = 0.0018). The average ratio of leukocytes in PRP to whole blood was 1.5. The average ratio of lymphocytes and neutrophils in PRP to whole blood was 2.0 and 0.5, respectively. Conclusion: Different baseline platelet concentrations in whole blood samples provided significantly different platelet concentrations in PRP. The baseline platelet concentration in whole blood also provided an inverse relation to the fold change of the platelet concentration in PRP. Subtypes of leukocytes changed from neutrophil-predominated in the baseline whole blood samples to lymphocyte-predominated in PRP.
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Affiliation(s)
- Thana Turajane
- Biotechnological Research and Development Center, Police General Hospital, Bangkok, THA
| | | | | | - Wanpen Lappaiwong
- Biotechnological Research and Development Center, Police General Hospital, Bangkok, THA
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Puricelli C, Boggio E, Gigliotti CL, Stoppa I, Sutti S, Giordano M, Dianzani U, Rolla R. Platelets, Protean Cells with All-Around Functions and Multifaceted Pharmacological Applications. Int J Mol Sci 2023; 24:4565. [PMID: 36901997 PMCID: PMC10002540 DOI: 10.3390/ijms24054565] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Platelets, traditionally known for their roles in hemostasis and coagulation, are the most prevalent blood component after erythrocytes (150,000-400,000 platelets/μL in healthy humans). However, only 10,000 platelets/μL are needed for vessel wall repair and wound healing. Increased knowledge of the platelet's role in hemostasis has led to many advances in understanding that they are crucial mediators in many other physiological processes, such as innate and adaptive immunity. Due to their multiple functions, platelet dysfunction is involved not only in thrombosis, mediating myocardial infarction, stroke, and venous thromboembolism, but also in several other disorders, such as tumors, autoimmune diseases, and neurodegenerative diseases. On the other hand, thanks to their multiple functions, nowadays platelets are therapeutic targets in different pathologies, in addition to atherothrombotic diseases; they can be used as an innovative drug delivery system, and their derivatives, such as platelet lysates and platelet extracellular vesicles (pEVs), can be useful in regenerative medicine and many other fields. The protean role of platelets, from the name of Proteus, a Greek mythological divinity who could take on different shapes or aspects, is precisely the focus of this review.
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Affiliation(s)
- Chiara Puricelli
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- Maggiore della Carità University Hospital, Corso Mazzini 18, 28100 Novara, Italy
| | - Elena Boggio
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- NOVAICOS s.r.l.s, Via Amico Canobio 4/6, 28100 Novara, Italy
| | - Casimiro Luca Gigliotti
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- NOVAICOS s.r.l.s, Via Amico Canobio 4/6, 28100 Novara, Italy
| | - Ian Stoppa
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Salvatore Sutti
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Mara Giordano
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- Maggiore della Carità University Hospital, Corso Mazzini 18, 28100 Novara, Italy
| | - Umberto Dianzani
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- Maggiore della Carità University Hospital, Corso Mazzini 18, 28100 Novara, Italy
| | - Roberta Rolla
- Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- Maggiore della Carità University Hospital, Corso Mazzini 18, 28100 Novara, Italy
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Sebbagh P, Cannone A, Gremion G, Gremeaux V, Raffoul W, Hirt-Burri N, Michetti M, Abdel-Sayed P, Laurent A, Wardé N, Applegate LA. Current Status of PRP Manufacturing Requirements & European Regulatory Frameworks: Practical Tools for the Appropriate Implementation of PRP Therapies in Musculoskeletal Regenerative Medicine. Bioengineering (Basel) 2023; 10:bioengineering10030292. [PMID: 36978683 PMCID: PMC10044789 DOI: 10.3390/bioengineering10030292] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/29/2023] Open
Abstract
Providing accurate and up-to-date practical tools enabling oversight of platelet-rich plasma (PRP) legislation and of the appropriate standards to be implemented for its manufacture and use in Europe is a demanding task. This is due to rapid medico-technological advancements, slowness and disparity in legislation updates and enforcement between member states, and many reported gray-zone practices, notably for autologous PRP use. The levels of risk associated with blood manipulation processes generally dictate the manufacturing requirements for PRP preparations, which have gradually shifted toward good manufacturing practices (GMP) for standardization and overall quality enhancement. This work firstly outlines Western European and Swiss legislation for PRP products/preparations, providing key simplified information and recommendations for medical doctors seeking to implement this biological-based therapy for safe use in hospital settings, clinics, or private offices. This work secondly shows the importance of PRP-based product manufacturing standardization, which subsequently enables sound clinical evaluation of therapeutic interventions. Although the applicable legal bases provide guidelines for GMP manufacturing infrastructure and basic process design, paramount importance is set on the definition of workflows, technical specifications, and key parameters for PRP preparation and delivery. Overall, the development of simple and robust technologies and processes for PRP preparation is critical for guaranteeing the high therapeutic quality of the intervention, in collaboration with qualified GMP manufacturing platforms. Importantly, this work aims to serve as a practical tool for clinicians based in Western Europe who are willing to appropriately (i.e., administratively and technically) implement autologous PRP treatments in musculoskeletal regenerative medicine workflows, to ensure they make informed and optimal regulatory or process-based decisions.
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Freitas NPP, Silva BDP, Bezerra MRL, Pescini LYG, Olinda RG, Salgueiro CCDM, Nunes JF, Martins JAM, Neto SG, Martins LT. Freeze-dried Platelet-rich Plasma and Stem Cell-conditioned Medium for Therapeutic Use in Horses. J Equine Vet Sci 2023; 121:104189. [PMID: 36464033 DOI: 10.1016/j.jevs.2022.104189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/19/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
This study investigated platelet-rich plasma (PRP) and adipose stem cell-conditioned medium (ASC-CM) use as a strategy to accelerate tissue healing. Platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) were quantified in fresh and freeze-dried PRP and ASC-CM, and a stability test was performed in the freeze-dried samples (90 and 180 days of storage). A cell proliferation test was performed using equine mesenchymal stem cell culture in reconstituted PRP gel mesh after freeze-drying. In vivo PRP, ASC-CM applications, or their association were performed in induced wounds at 15 and 9-day intervals, according to the treatments: saline solution (control), PRP, ASC-CM, or ASC-CM + PRP. Horses were monitored through photographs and wound area measurements on days 5, 7, 15, and 24 after lesion induction. Skin biopsies were obtained on days 15 and 24 of the experiment. PDGF and VEGF quantification did not differ between fresh or freeze-dried treatments, was similar after freeze-drying or 90 days of storage, but showed a significant reduction after 180 days of storage. Comparing all treatments, no differences were observed in the histopathological analyses. For inflammation, fibroplasia, and collagen formation, only the time effect between the first and second biopsies was significant. The cell proliferation test revealed intense multiplication in the PRP gel mesh. Healing time was similar among all treatments. In conclusion, our results showed the possibility to produce and maintain freeze-dried PRP and ASC-CM for 90 days. Further studies are needed to better explore the in vivo therapeutic PRP and ASC-CM effects.
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Affiliation(s)
- Natália P P Freitas
- Department of Veterinary Medicine, Graduate Program, Rede Nordeste de Biotecnologia (Renorbio), State University of Ceará (UECE), Fortaleza, Ceará, Brazil.
| | - Beatriz D'Almeida P Silva
- Department of Veterinary Medicine, Experimental Biology Unit (Nubex), University of Fortaleza (Unifor), Fortaleza, Ceará, Brazil
| | - Marcus R L Bezerra
- Department of Biotechnology, Graduate Program, Federal University of Ceará (UFC), Fortaleza, Ceará, Brazil
| | - Laura Y G Pescini
- Department of Veterinary Medicine, Experimental Biology Unit (Nubex), University of Fortaleza (Unifor), Fortaleza, Ceará, Brazil
| | - Roberio G Olinda
- Department of Pathology, Vetlab Veterinary Laboratory, Fortaleza, Ceará, Brazil
| | | | - José F Nunes
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, State University of Ceará (UECE), Fortaleza, Ceará, Brazil
| | - Jorge A M Martins
- Department of Veterinary Medicine, Federal University of Cariri (UFCA), Crato, Ceará, Brazil
| | - Saul G Neto
- Department of Veterinary Medicine, Experimental Biology Unit (Nubex), University of Fortaleza (Unifor), Fortaleza, Ceará, Brazil
| | - Leonardo T Martins
- Department of Veterinary Medicine, Experimental Biology Unit (Nubex), University of Fortaleza (Unifor), Fortaleza, Ceará, Brazil
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Matsubara T, Yamada K, Kanazawa T, Sato K, Yokosuka K, Shiba N. Improved intervertebral bone union in ALIF rat model with porous hydroxyapatite/collagen combined with platelet-rich plasma. Spine J 2023; 23:325-335. [PMID: 36064089 DOI: 10.1016/j.spinee.2022.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Platelet-rich plasma (PRP) can accelerate bone union in spinal fusion surgery with an autogenous bone graft. However, it is unclear whether bone union can be obtained by using artificial bone and PRP together in spinal interbody fusion surgery. PURPOSE This study aimed to determine whether interbody fusion can be achieved by transplanting porous hydroxyapatite/collagen(HAp/Col) which is an artificial bone material frequently used in spinal fusion surgery, together with PRP in the intervertebral disc space in rats. STUDY DESIGN AND SETTING A controlled laboratory study. METHODS A total of fourty 10-week old Sprague-Dawley rats were used in this study and assigned to three groups as follow: disc curettage only (control group, n=10), disc curettage + HAp/Col transplant (H group, n=10), and disc curettage + HAp/Col + PRP transplant (H+P group, n=10). The other 10 rats were sacrificed as blood donors for acquisition of PRP. Microcomputed tomography (μCT) examinations were performed to evaluate bone union, bone volume (BV), and bone mineral density (BMD) at 4, 8, and 12 weeks following surgery. Twelve weeks postoperatively, each group of three of L4-L5 spines was harvested to perform histological examination (hematoxylin & eosin stain) and the others were subjected to biomechanical testing (compression properties). RESULTS The platelet count in PRP was approximately 4.1 times greater than that in whole blood (260.6±26.2 × 104 mg/dL and 64.3±2.9 × 104 mg/dL in PRP and whole blood, respectively). All the L4-L5 lumbar discs were fused in the H+P group, whereas only one case was fused in the H group and none in the control group at 12 weeks after surgery. BV was significantly higher in the H+P group than in the H group or control groups (both p<.01), although BMD was not significantly different among the three groups. Upon histological analysis, mature bone formation was observed at the transplanted space in all cases in the H+P group, whereas fibrous tissue was observed at the location in the H and control groups. Regarding biomechanical properties, the ultimate load to failure was significantly higher in the H+P group than in the H group or control group (p=.021 and .013, respectively), although stiffness was not significantly different between the three groups. CONCLUSION The combination of porous HAp/Col and PRP at an appropriate concentration can promote bone union in the intervertebral disc space without using an autologous bone graft in the rat model. Bone tissue formation was histologically confirmed, and it was mechanically strong. CLINICAL SIGNIFICANCE This preclinical study showed that porous HAp/Col, when combined with PRP at an appropriate concentration, can induce bone union without autologous bone grafts. The results may eliminate the need for autologous bone collection for spinal fusion surgery in the future.
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Affiliation(s)
| | - Kei Yamada
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan.
| | | | - Kimiaki Sato
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
| | - Kimiaki Yokosuka
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
| | - Naoto Shiba
- Department of Orthopedic Surgery, Kurume University, Fukuoka, Japan
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Li C, Pan L, Yang L, Kong J, Zhang L. An umbrella review of the use of platelet-rich plasma in the treatment of androgenetic alopecia. J Cosmet Dermatol 2023; 22:1463-1476. [PMID: 36718799 DOI: 10.1111/jocd.15617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of androgenetic alopecia, as well as establish an effective treatment protocol and optimal PRP preparation procedure. METHODS We searched the PubMed, Scopus, Embase, Cochrane, CNKI, and Wanfang databases from inception to October 29, 2021, using PROSPERO's International Prospective Register of Systematic Reviews (registration ID: CRD42022295921). RESULTS The original literature search revealed 215 reviews; after duplication removal, 89 papers were eliminated, 95 were eliminated after reading the titles and abstracts, and eventually, 28 articles were included after reading the complete text. CONCLUSIONS PRP treatment for androgenetic alopecia is effective, and we recommend the following: (1) a PRP volume of at least 0.05 ml/cm2 , preferably 0.1 ml/cm2 ; (2) at least three consecutive treatments at an interval of 1 month; (3) intensive therapy is beneficial and can be provided from 3 to 6 months after continuous treatment; (4) objective indicators such as hair diameter, hair count; (5) long-term follow-up.
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Affiliation(s)
- Caihong Li
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Lingfeng Pan
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Liehao Yang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Jiao Kong
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Lianbo Zhang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
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Advances in the Clinical Application of Platelet-Rich Plasma in the Foot and Ankle: A Review. J Clin Med 2023; 12:jcm12031002. [PMID: 36769649 PMCID: PMC9917505 DOI: 10.3390/jcm12031002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
Autologous and recombinant biologic substances have been generated as a result of the research into the cellular features of the healing process. Orthobiologics are increasingly being used in sports medicine and musculoskeletal surgery. Nevertheless, clinical data are limited; consequently, further studies are required, particularly in foot and ankle pathologies. This review aims to provide evidence of the most recent literature results and ignite the interest of orthopedic specialists eager for an update about the most current discussion on platelet-rich plasma (PRP) clinical applications in the foot and ankle fields. Previous studies have shown that platelet-rich plasma can be beneficial in treating various conditions, such as chronic foot ulcers, osteoarthritis, Achilles tendinopathy, etc. Despite the positive effects of PRP on various musculoskeletal conditions, more prospective studies are needed to confirm its effectiveness at treating ankle and foot pathologies. In addition to clinical trials, other factors, such as the quality of the research and the procedures involved, must be considered before they can be used in patients. More long-term evaluations are needed to support or oppose its application in treating foot and ankle disorders. We present the most extensive review of PRP's clinical applications in the foot and ankle field.
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Desai A, Nambiar S, Unnikrishnan B, Rai S, Nayak S, Natarajan S. Effect of a Submucosal Injection of Platelet-Rich Plasma on the Rate of Orthodontic Tooth Movement - A Split-Mouth, Single-Blind Randomized Controlled Trial. Contemp Clin Dent 2023; 14:39-44. [PMID: 37250004 PMCID: PMC10209771 DOI: 10.4103/ccd.ccd_419_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/22/2021] [Accepted: 01/15/2022] [Indexed: 11/12/2022] Open
Abstract
Objective To investigate the effect of submucosal injection of platelet-rich plasma (PRP) on the rate of mini-implant-supported retraction, using a split-mouth randomized clinical design. Materials and Methods Twenty subjects of either gender between 16 and 25 years of age with bimaxillary dentoalveolar protrusion and crowding of <4 mm scheduled to undergo fixed mechanotherapy with the extraction of 1st premolars; were recruited for the study. Those with a periodontally compromised dentition, blood dyscrasias, smoking/alcoholism, or with a history of fixed orthodontic treatment were not considered. The intervention side received a submucosal injection of autologous PRP which was prepared using 10 ml of the patient's blood. The rate of extraction space closure on both sides was recorded and compared monthly for 3 months using a digital caliper. Results Mean overall retraction was faster on the intervention side as compared to the control side by 1.5 times and was statistically significant with a P value of 0.001. There was no influence of gender on the rate of retraction. There was no reported swelling or discomfort associated with the PRP injection. Conclusions Submucosal injection of PRP significantly accelerates orthodontic tooth movement and can therefore be used as an effective, safe, and minimally invasive method to expedite orthodontic treatment.
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Affiliation(s)
- Asavari Desai
- Associate Professor, Department of Orthodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Supriya Nambiar
- Professor and Head, Department of Orthodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Bhaskaran Unnikrishnan
- Professor and Dean, Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sharada Rai
- Professor and Head, Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sangeeta Nayak
- Associate Professor, Department of Periodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Srikant Natarajan
- Professor and Head, Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, India
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Oda H, Kaizawa Y, Franklin A, Sanchez Rangel U, Storaci H, Min JG, Wang Z, Abrams GD, Chang J, Fox PM. Assessment of a Synergistic Effect of Platelet-Rich Plasma and Stem Cell-Seeded Hydrogel for Healing of Rat Chronic Rotator Cuff Injuries. Cell Transplant 2023; 32:9636897231190174. [PMID: 37592455 PMCID: PMC10467370 DOI: 10.1177/09636897231190174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 08/19/2023] Open
Abstract
Outcomes after repair of chronic rotator cuff injuries remain suboptimal. Type-1 collagen-rich tendon hydrogel was previously reported to improve healing in a rat chronic rotator cuff injury model. Stem cell seeding of the tendon hydrogel improved bone quality in the same model. This study aimed to examine whether there was a synergistic and dose-dependent effect of platelet-rich plasma (PRP) on tendon-bone interface healing by combining PRP with stem cell-seeded tendon hydrogel. Human cadaveric tendons were processed into a hydrogel. PRP was prepared at two different platelet concentrations: an initial concentration (initial PRP group) and a higher concentration (concentrated PRP group). Tendon hydrogel was mixed with adipose-derived stem cells and one of the platelet concentrations. Methylcellulose, as opposed to saline, was used as a negative control due to comparable viscosity. The supraspinatus tendon was detached bilaterally in 33 Sprague-Dawley rats (66 shoulders). Eight weeks later, each detached tendon was repaired, and a hydrogel mixture or control was injected at the repair site. Eight weeks after repair, shoulder samples were harvested and assigned for biomechanical testing (n = 42 shoulders) or a combination of bone morphological and histological assessment (n = 24 shoulders). Biomechanical testing showed significantly higher failure load and stiffness in the concentrated PRP group than in control. Yield load in the initial and concentrated PRP groups were significantly higher than that in the control. There were no statistically significant differences between the initial and concentrated PRP groups. The addition of the highly concentrated PRP to stem cells-seeded tendon hydrogel improved healing biomechanically after chronic rotator cuff injury in rats compared to control. However, synergistic and dose-dependent effects were not seen.
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Affiliation(s)
- Hiroki Oda
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Yukitoshi Kaizawa
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Austin Franklin
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Uriel Sanchez Rangel
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Hunter Storaci
- Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - Jung Gi Min
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Zhen Wang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Geoffrey D. Abrams
- Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - James Chang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Paige M. Fox
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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Boksh K, Elbashir M, Thomas O, Divall P, Mangwani J. Platelet-Rich Plasma in acute Achilles tendon ruptures: A systematic review and meta-analysis. Foot (Edinb) 2022; 53:101923. [PMID: 36037774 DOI: 10.1016/j.foot.2022.101923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/13/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Platelet Rich Plasma (PRP) is known to exert multi-directional biological effects favouring tendon healing. However, conclusions drawn by numerous studies on its clinical efficacy for acute Achilles tendon rupture are limited. We performed a systematic review and meta-analysis to investigate this and to compare to those without PRP treatment. METHODS The Cochrane Controlled Register of Trials, Pubmed, Medline and Embase were used and assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms: ('plasma' OR 'platelet-rich' OR 'platelet-rich plasma' or 'PRP') AND ('Achilles tendon rupture/tear' OR 'calcaneal tendon rupture/tear' OR 'tendo calcaneus rupture/tear'). Data pertaining to biomechanical outcomes (heel endurance test, isokinetic strength, calf-circumference and range of motion), patient-reported outcome measures (PROMs) and incidence of re-ruptures were extracted. Meta-analysis was performed for same outcomes measured in at least three studies. Pooled outcome data were analysed by random- and fixed-effects models. RESULTS After abstract and full-text screening, 6 studies were included. In total there were 510 patients of which 256 had local PRP injection and 254 without. The average age was 41.6 years, mean time from injury to treatment 5.9 days and mean follow-up at 61 weeks. Biomechanically, there was similar heel endurance, isokinetic strength, calf circumference and range of motion between both groups. In general, there were no differences in patient reported outcomes from all scoring systems used in the studies. Both groups returned to their pre-injured level at a similar time and there were no differences on the incidence of re-rupture (OR 1.13, 95% CI, 0.46-2.80, p = 0.79). CONCLUSION PRP injections for acute Achilles tendon ruptures do not improve medium to long-term biomechanical and clinical outcomes. However, future studies incorporating the ideal application and biological composition of PRP are required to investigate its true clinical efficacy.
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Affiliation(s)
- Khalis Boksh
- Academic Team of Musculoskeletal Surgery, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - Mohamed Elbashir
- Academic Team of Musculoskeletal Surgery, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Owain Thomas
- Academic Team of Musculoskeletal Surgery, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Pip Divall
- Academic Team of Musculoskeletal Surgery, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Jitendra Mangwani
- Academic Team of Musculoskeletal Surgery, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
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Liu W, Huang Y, Liu D, Zeng T, Wang J, Li A, Wang D, Wang X. The Combination of Platelet Rich Plasma Gel, Human Umbilical Mesenchymal Stem Cells and Nanohydroxyapatite/polyamide 66 Promotes Angiogenesis and Bone Regeneration in Large Bone Defect. Tissue Eng Regen Med 2022; 19:1321-1336. [PMID: 36074328 PMCID: PMC9679130 DOI: 10.1007/s13770-022-00471-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/21/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the present study, a novel tissue engineering bone graft including platelet rich plasma gel (PRP gel), human umbilical mesenchymal stem cells (HUMSCs) and nanohydroxyapatite/polyamide 66 (nHA-PA66) was constructed. We explored whether the composite scaffolds could enhance the angiogenesis and bone repair capacity in rat femoral large bone defect (LBD). This study aimed to provide evidence for the clinical application of the composite scaffold in LBD treatment. METHODS PRP was prepared, the platelets and growth factors were measured. HUMSCs were isolated and identified. the osteogenic capacity of PRP in vitro was measured. Then HUMSCs-PRP-gel/nHA-PA66 composite scaffolds were synthesized and observed. The proliferation and osteogenesis differentiation of HUMSCs on the composite scaffold was measured. The angiogenic capacity of PRP in vitro was measured by capillary-like tube formation assay. Finally, the angiogenesis and bone repair capacity of the composite scaffolds was measured in rat LBD. RESULTS PRP contained high level of platelets and growth factors after activation, and promoted osteogenic and angiogenic differentiation in vitro. The HUMSCs-PRP-gel/nHA-PA66 composite scaffold was porosity and promoted the proliferation and osteogenesis differentiation of HUMSCs. At 12th weeks, more micro-vessels and new bone were formed around the composite scaffolds compared with other groups, the defect was almost repaired. CONCLUSION Our study for the first time identified that the combination of PRP gel, HUMSCs and nHA-PA66 scaffold could significantly promote angiogenesis and bone regeneration in rat LBD, which may have implications for its further application in clinical LBD treatment.
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Affiliation(s)
- Wei Liu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Yong Huang
- Department of Orthopedic Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Daqian Liu
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Teng Zeng
- Department of Orthopedic Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Jingzhe Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Ang Li
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dawei Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Xiaoyu Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China.
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Navya S, Prashantha G, Sabrish S, Roshan M, Mathew S. Evaluation of the effect of local administration of PRP vs vitamin D3 on the rate of orthodontic tooth movement and the associated external apical root resorption. J Oral Biol Craniofac Res 2022; 12:879-884. [PMID: 36250145 PMCID: PMC9563185 DOI: 10.1016/j.jobcr.2022.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/01/2022] [Accepted: 09/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background Increased orthodontic treatment duration is associated with iatrogenic risks such as root resorption, white spot lesions etc. Recent research using pharmacological agents to accelerate tooth movement has mostly been conducted on animals and there is no reported research conducted on humans comparing the effects of Vitamin D3 and Platelet Rich Plasma (PRP) in the same subjects using a split mouth technique. Objectives To determine and compare effects of local injection of PRP and Vitamin D3 on the rate of tooth movement. Also, to assess association of external apical root resorption with the use of PRP, Vitamin D3 and compare it to a control group. Materials & methods 11 subjects who diagnosed with Class I bi-maxillary malocclusion and who gave informed consent were recruited in the study. The patients were randomly divided using split mouth design and each quadrant served as either experimental or control group one. At the beginning of retraction phase, Vitamin D3 and PRP were injected to the randomly assigned quadrants while the contralateral side served as a control. The amount of space closure in 4 months was measured from distal surface of canine to mesial surface of 2nd premolar. Root resorption was assessed using CBCT taken at the beginning and at the closure of retraction phase. Results Mean rate of tooth movement was higher in PRP and Vitamin D3 groups compared to their controls. In the PRP group, the increased rate of tooth movement was observed throughout the study interval, but in the Vitamin D3 group it was only seen in first two months. Also, the PRP group demonstrated a higher rate of tooth movement compared to Vitamin D3 group. Root resorption was lesser in both experimental groups. Among the teeth assessed, lateral incisor showed maximum root resorption and canine the least. Conclusions PRP is a more efficient pharmacological agent compared to Vitamin D3 for accelerating tooth movement.
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Affiliation(s)
- S. Navya
- Department of Orthodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, New BEL road, MSR Nagar, Bangalore, 560054, Karnataka, India
| | - G.S. Prashantha
- Department of Orthodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, New BEL road, MSR Nagar, Bangalore, 560054, Karnataka, India
| | - S. Sabrish
- Department of Orthodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, New BEL road, MSR Nagar, Bangalore, 560054, Karnataka, India
| | - M.S. Roshan
- Faculty of Dental Sciences, Department of Orthodontics, Ramaiah University of Applied Sciences, New BEL road, MSR Nagar, Bangalore, 560054, Karnataka, India
| | - S. Mathew
- Department of Orthodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, New BEL road, MSR Nagar, Bangalore, 560054, Karnataka, India
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Tey RV, Haldankar P, Joshi VR, Raj R, Maradi R. Variability in Platelet-Rich Plasma Preparations Used in Regenerative Medicine: A Comparative Analysis. Stem Cells Int 2022; 2022:3852898. [PMID: 36311042 PMCID: PMC9613381 DOI: 10.1155/2022/3852898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/21/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2023] Open
Abstract
Background Platelet-rich plasma (PRP) and its derivatives are used in several aesthetic, dental, and musculoskeletal procedures. Their efficacy is primarily due to the release of various growth factors (GF), interleukins, cytokines, and white blood cells. However, the PRP preparation methods are highly variable, and studies lack consistency in reporting complete procedures to prepare PRP and characterize PRP and its derivatives. Also, all the tissue-specific (in vivo and in vitro) interactions and functional properties of the various derivatives/factors of the PRP have not been taken into consideration by any study so far. This creates a potential space for further standardization of the PRP preparation methods and customization of PRP/PRP derivatives targeted at tissue-specific/pathology specific requirements that would enable efficacious and widely acceptable usage of PRP as main therapy, rather than being used as adjuvant therapy. The main objective of our study was to investigate the variability in PRP preparation methods and to analyze their efficacy and reliability. Method This study considered articles published in the last 5 years, highlighting the variability in their PRP preparation methods and characterization of PRP. Following the PRISMA protocol, we selected 13 articles for the study. The selected articles were assessed using NHLBI quality assessment tool. Results We noted differences in (1) approaches to producing PRP, (2) extent of characterization of PRP, (3) small scale and large-scale preparation methods, (4) in vitro and in vivo studies. Conclusion We identified two studies describing the procedures which are simple, reproducible, economical, provide a good yield of platelets, and therefore can be considered methods for further tissue-specific and pathology-specific standardizations of PRP and its derivatives. We recommend further randomized studies to understand the full therapeutic potential of the constituents of PRP and its derivatives.
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Affiliation(s)
- Raghvendra Vikram Tey
- Department of Pathophysiology & Clinical Medicine, Western Atlantic University School of Medicine, Freeport, Grand Bahamas, Bahamas
| | - Pallavi Haldankar
- Department of Pathophysiology & Clinical Medicine, Western Atlantic University School of Medicine, Freeport, Grand Bahamas, Bahamas
| | - Vivek R. Joshi
- Department of Biochemistry, Department of Interprofessional Chronic Care, Drexel University College of Medicine, Wyomissing, Reading, PA, USA
| | - Rishi Raj
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Pikeville Medical Center, Pikeville, Kentucky, USA
| | - Ravindra Maradi
- Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, India
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Abrar M, Goyal M, Kumar M, Agarwal Y, Yadav E, Singh V. Comparative evaluation of platelet-rich plasma and micro-osteoperforation effect on orthodontic tooth movement rate in class II division 1 patients: A split mouth randomized trial. Int Orthod 2022. [DOI: 10.1016/j.ortho.2022.100694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Platelet-rich Plasma in the Management of Shoulder Disorders: Basic Science and Implications Beyond the Rotator Cuff. J Am Acad Orthop Surg 2022; 30:e1217-e1226. [PMID: 35947829 DOI: 10.5435/jaaos-d-22-00066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/22/2022] [Indexed: 02/01/2023] Open
Abstract
Platelet-rich plasma (PRP) is an autologous mixture produced by centrifugal separation of whole blood. Understanding the clinical efficacy of PRP remains a challenge in the field of sports medicine, including the treatment of various shoulder conditions. Animal studies have examined the biologic actions of PRP on the rotator cuff tendon and shoulder capsule. Human studies have reported the outcomes of PRP in the management of subacromial impingement syndrome, rotator cuff tears, frozen shoulder, and glenohumeral osteoarthritis. These studies highlight the role of PRP in the nonsurgical management of these conditions and its utilization in the perioperative setting to augment tissue healing and optimize the surgical outcomes. The role of PRP as an adjunct therapy in patients undergoing rotator cuff repair has been in the spotlight during the last decade; however, a limited number of studies have examined the role of PRP in the management of non-rotator cuff shoulder conditions. This article aims to provide an overview of the biologic actions of PRP on shoulder tissues and to summarize the outcomes of PRP injection in patients with rotator cuff and non-rotator cuff disease of the shoulder. We sought to organize the existing literature and to provide recommendations on the use of PRP in various shoulder conditions, based on the existing evidence.
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Dong C, Zhao C, Wang F. Clinical benefit of high tibial osteotomy combined with the intervention of platelet-rich plasma for severe knee osteoarthritis. J Orthop Surg Res 2022; 17:405. [PMID: 36064432 PMCID: PMC9446579 DOI: 10.1186/s13018-022-03304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The objective of present study was to investigate the therapeutic effects of high tibial osteotomy (HTO) combined with platelet-rich plasma (PRP) for severe knee osteoarthritis (KOA). METHODS This was a double-blinded, randomized, placebo-controlled trial. The participants were randomly divided by computerderived random charts into 3 groups: 24 participants in group A (24 knees) received a treatment option of HTO combined with PRP, 25 participants in group B (25 knees) received a treatment program of HTO combined with hyaluronic acid, and 25 participants in group C (25 knees) received a treatment method of HTO combined with normal saline (NS) (physiological control/placebo). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) were measured preoperatively and at the final follow-up. Status of articular cartilage was assessed according to the International Cartilage Repair Society grade and the presence of newly formed cartilaginous tissue by arthroscopy. MRI was completed of knee joint to measure the cartilaginous thickness. RESULTS Compared to Group B and C, the final follow-up results of knee function in Group A were significantly different (P < 0.001), such as the total WOMAC score 18.54 (SD 4.17), the VAS score 1.72 (SD 0.53). Cartilage regeneration of femur and tibia in Group A was observed in all patients. The cartilaginous thickness in Group A were significantly different (P < 0.001), such as the anterior patella femoral region 3.52 (SD 0.47), the anterior meniscal region 1.16 (SD 0.24), the posterior meniscal region 1.24 (SD 0.26) and the posterior condyle region 2.25 (SD 0.31). CONCLUSIONS The addition of combined PRP to HTO may be a more reasonable choice to relieve knee pain and decelerate the progression of the medial KOA.
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Affiliation(s)
- Conglei Dong
- grid.452209.80000 0004 1799 0194Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, Shijiazhuang, 050051 Hebei China
| | - Chao Zhao
- grid.452209.80000 0004 1799 0194Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, Shijiazhuang, 050051 Hebei China
| | - Fei Wang
- grid.452209.80000 0004 1799 0194Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, Shijiazhuang, 050051 Hebei China
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The effect of platelet-rich concentrates on orthodontic tooth movement: A review of randomized controlled trials. Heliyon 2022; 8:e10604. [PMID: 36164532 PMCID: PMC9508515 DOI: 10.1016/j.heliyon.2022.e10604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/10/2022] [Accepted: 09/07/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives Platelet-rich concentrates, namely platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have recently shown potential roles in accelerating orthodontic tooth movement (OTM) and reducing treatment duration. Our study aims to systematically evaluate the effect of platelet-rich concentrates on OTM. Materials and methods An electronic search of 11 databases, followed by a hand search of reference lists of eligible studies and related reviews, was conducted up to January 2022. Randomized controlled trials investigating OTM of patients with platelet-rich concentrates were included. Risk of bias was assessed by version 2 of Cochrane tool (RoB 2) for assessing risk of bias in randomized trials. Results Among 715 records initially identified, 9 studies were included, of which 3 used PRP and the other 6 applied PRF. 7 studies supported a positive relationship between platelet-rich concentrates and OTM, but the other 2 studies reported a null and a negative effect of PRF, respectively. The overall qualities of evidence were moderate to high. Conclusions Platelet-rich concentrates as PRP and PRF seem to be effective in accelerating OTM at early stages, while their long-term efficacy remains controversial. Repeated application of platelet concentrates may increase the accelerated stability of OTM.
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Gupta A, Jeyaraman M, Maffulli N. Common Medications Which Should Be Stopped Prior to Platelet-Rich Plasma Injection. Biomedicines 2022; 10:biomedicines10092134. [PMID: 36140235 PMCID: PMC9495905 DOI: 10.3390/biomedicines10092134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 01/22/2023] Open
Abstract
Osteoarthritis (OA) is an extremely prevalent joint condition in the United States, affecting over 30 million people [...]
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Affiliation(s)
- Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
- BioIntegrate, Lawrenceville, GA 30043, USA
- South Texas Orthopaedic Research Institute, STORI Inc., Laredo, TX 78045, USA
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow 110048, India
| | - Madhan Jeyaraman
- South Texas Orthopaedic Research Institute, STORI Inc., Laredo, TX 78045, USA
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow 110048, India
- Department of Orthopaedics, Faculty of Medicine, Sri Lalithambigai Medical College and Hospital, Dr. MGR Educational and Research Institute University, Chennai 600095, India
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, 84084 Fisciano, Italy
- San Giovanni di Dio e Ruggi D’Aragona Hospital “Clinica Ortopedica” Department, Hospital of Salerno, 84124 Salerno, Italy
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, London E1 4DG, UK
- School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent ST5 5BG, UK
- Correspondence:
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Yadav A, Ramasamy TS, Lin SC, Chen SH, Lu J, Liu YH, Lu FI, Hsueh YY, Lin SP, Wu CC. Autologous Platelet-Rich Growth Factor Reduces M1 Macrophages and Modulates Inflammatory Microenvironments to Promote Sciatic Nerve Regeneration. Biomedicines 2022; 10:biomedicines10081991. [PMID: 36009539 PMCID: PMC9406033 DOI: 10.3390/biomedicines10081991] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022] Open
Abstract
The failure of peripheral nerve regeneration is often associated with the inability to generate a permissive molecular and cellular microenvironment for nerve repair. Autologous therapies, such as platelet-rich plasma (PRP) or its derivative platelet-rich growth factors (PRGF), may improve peripheral nerve regeneration via unknown mechanistic roles and actions in macrophage polarization. In the current study, we hypothesize that excessive and prolonged inflammation might result in the failure of pro-inflammatory M1 macrophage transit to anti-inflammatory M2 macrophages in large nerve defects. PRGF was used in vitro at the time the unpolarized macrophages (M0) macrophages were induced to M1 macrophages to observe if PRGF altered the secretion of cytokines and resulted in a phenotypic change. PRGF was also employed in the nerve conduit of a rat sciatic nerve transection model to identify alterations in macrophages that might influence excessive inflammation and nerve regeneration. PRGF administration reduced the mRNA expression of tumor necrosis factor-α (TNFα), interleukin-1β (IL-1β), and IL-6 in M0 macrophages. Increased CD206 substantiated the shift of pro-inflammatory cytokines to the M2 regenerative macrophage. Administration of PRGF in the nerve conduit after rat sciatic nerve transection promoted nerve regeneration by improving nerve gross morphology and its targeted gastrocnemius muscle mass. The regenerative markers were increased for regrown axons (protein gene product, PGP9.5), Schwann cells (S100β), and myelin basic protein (MBP) after 6 weeks of injury. The decreased expression of TNFα, IL-1β, IL-6, and CD68+ M1 macrophages indicated that the inflammatory microenvironments were reduced in the PRGF-treated nerve tissue. The increase in RECA-positive cells suggested the PRGF also promoted angiogenesis during nerve regeneration. Taken together, these results indicate the potential role and clinical implication of autologous PRGF in regulating inflammatory microenvironments via macrophage polarization after nerve transection.
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Affiliation(s)
- Anjali Yadav
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan
| | - Thamil Selvee Ramasamy
- Stem Cell Biology Laboratory, Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Sheng-Che Lin
- Division of Plastic and Reconstructive Surgery, Tainan Municipal An-Nan Hospital-China Medical University, Tainan 709, Taiwan
| | - Szu-Han Chen
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan 701, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Jean Lu
- Genomics Research Center, Academia Sinica, Taipei 115, Taiwan
| | - Ya-Hsin Liu
- Department of Life Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 701, Taiwan
| | - Fu-I Lu
- Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 701, Taiwan
| | - Yuan-Yu Hsueh
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan 701, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Shau-Ping Lin
- Institute of Biotechnology, College of Bio-Resources and Agriculture, National Taiwan University, Taipei 106, Taiwan
| | - Chia-Ching Wu
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 5327); Fax: +886-6-209-3007
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Bajaj S, Orbuch D, Wang JV, Geronemus RG. Preparation and Utility of Platelet-Rich Plasma (PRP) for Facial Aging: A Comprehensive Review. Adv Ther 2022; 39:4021-4036. [DOI: 10.1007/s12325-022-02239-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
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Rurus Suryawan IG, Devi Anggaraeni A, Agita A, Adrian Nugraha R. The Role of Human Platelet-Rich Plasma to Enhance the Differentiation of Adipose derived Mesenchymal Stem Cells into Cardiomyocyte: An Experimental Study. Cardiovasc Hematol Agents Med Chem 2022:CHAMC-EPUB-123353. [PMID: 35538825 DOI: 10.1101/2020.12.10.420679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/17/2022] [Accepted: 03/11/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Several studies showed that Adipose derived mesenchymal stem cells (AMSCs) can differentiate into mesenchymal lineages, including cardiac cell types, but complete differentiation into cardiomyocytes is challenging. . Unfortunately, the optimal method to maximize AMSCs differentiation has not yet established. Platelet rich plasma (PRP) which contains rich growth factors, is believed could stimulate stem cell proliferation and differentiation in the context of cardiac tissue regeneration. OBJECTIVE To analyze the effect of PRP administration to enhance the differentiation of AMSCs into cardiomyocytes. METHODS This study used arandomized post-test only controlled group design. AMSCs were isolated from adipose tissues and cultured until 4 passages. The samples were divided into 3 groups, negative control group (α-MEM), positive control group (differentiation medium), and treatment group (PRP). The assessment of GATA-4 expression was conducted using flowcytometry on day-5. The assessment oftroponin expression was conducted using immunocytochemistry on day-10. Data analysis was conducted using T-test and One-Way ANOVA. RESULTS Flowcytometry of GATA-4 expression revealed a significant improvement in PRP group compared to negative and positive control group (67.04 4.49 vs 58.15 1.23 p < 0.05; 67.04 4.49 vs 52.96 2.02 p < 0.05). This was supported by the results of immunocytochemistry on troponin expression, which revealed significant improvement in the PRP group compared to negative and positive controls (38.13 5.2 vs 10.73 2.39 p < 0.05; 38.13 5.2 vs 26.00 0.4 p < 0.05). CONCLUSION PRP administration in the AMSCs culture could significantly improve the differentiation of AMSCs into cardiomyocytes measured by GATA-4 and troponin expressions. This was concordant with our hypothesis, which stated that there was an effect of PRP administration on AMSCs differentiation into cardiomyocytes.
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Affiliation(s)
- I Gde Rurus Suryawan
- Division of Interventional Cardiology, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Arifta Devi Anggaraeni
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Arisya Agita
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
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Carr BJ. Platelet-Rich Plasma as an Orthobiologic: Clinically Relevant Considerations. Vet Clin North Am Small Anim Pract 2022; 52:977-995. [PMID: 35562219 DOI: 10.1016/j.cvsm.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Platelet-rich plasma (PRP) is an autologous blood-derived product processed to concentrate platelets and the associated growth factors. PRP has been shown to be relatively well-tolerated and safe to use for a number of conditions in humans, equines, and canines. There are multiple commercial systems that have been validated for canine use. These systems use a variety of methodologies to produce a PRP product. However, PRP products have been shown to differ greatly between systems. Further study is needed to fully elucidate optimal component concentrations for various indications.
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Affiliation(s)
- Brittany Jean Carr
- The Veterinary Sports Medicine and Rehabilitation Center, 4104 Liberty Highway, Anderson, SC 29621, USA.
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Liu G, Zhang B, Wan T, Zhou C, Fan Y, Tian W, Jing W. A 3D-printed biphasic calcium phosphate scaffold loaded with platelet lysate/gelatin methacrylate to promote vascularization. J Mater Chem B 2022; 10:3138-3151. [PMID: 35352743 DOI: 10.1039/d2tb00006g] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
3D-printed biphasic calcium phosphate (BCP) scaffolds show great clinical application potential in bone tissue engineering; however, vascularization of the scaffold is a crucial step for bone regeneration and is still difficult to be controlled. To enhance scaffold vascularization, a novel bioactive scaffold loaded with platelet lysate/gelatin methacrylate (PL/GelMA) in a BCP scaffold was proposed for promoting vascularization. The PL/GelMA/BCP scaffold was successfully prepared via digital light processing (DLP) printing and filled with PL/GelMA to promote the vascularization effect. In vitro evaluation indicated that human umbilical vein endothelial cells (HUVECs) adhered well on the PL/GelMA/BCP scaffold, and cell proliferation was significantly promoted by coculture with the scaffold. Moreover, a variety of growth factors (GFs) in the PL were detected which were slowly released from the scaffold to modulate the cell behaviour and promote the formation of blood vessel-like structures. Co-culturing with the PL/GelMA/BCP scaffold upregulated the expression of angiogenesis-related genes in cells. In vitro results showed that a higher capillary formation was also observed in PL/GelMA/BCP scaffolds implanted subcutaneously on the back of the rats. These results indicated that the vascularization ability of BCP was enhanced by filling it with PL/GelMA. The PL/GelMA/BCP scaffold has the potential to promote vascularization in tissue engineering.
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Affiliation(s)
- Gang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China. .,Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd., Chengdu, Sichuan 610041, China
| | - Boqing Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Ting Wan
- Affiliated Hospital of Sichuan Nursing Vocational College (The Third People's Hospital of Sichuan Province), Chengdu 610071, China
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China. .,Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd., Chengdu, Sichuan 610041, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China. .,Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Rd., Chengdu, Sichuan 610041, China
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Kao DS, Zhang SW, Vap AR. A Systematic Review on the Effect of Common Medications on Platelet Count and Function: Which Medications Should Be Stopped Before Getting a Platelet-Rich Plasma Injection? Orthop J Sports Med 2022; 10:23259671221088820. [PMID: 35434168 PMCID: PMC9008823 DOI: 10.1177/23259671221088820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/21/2022] [Indexed: 01/22/2023] Open
Abstract
Background: Platelet-rich plasma (PRP) exerts its effect through the release of growth
factors and cytokines from the platelet concentrate. Certain medications may
affect platelet count or function, resulting in decreased efficacy of PRP
injections. Purpose: To systematically review the literature regarding common medications and
their effects on platelets to establish guidelines for which medications
should be stopped before obtaining a PRP injection. Study Design: Systematic review; Level of evidence, 2. Methods: This review was performed in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA) statement. A search for
studies assessing the effect of common medications on platelet count or
platelet function was performed of the PubMed, Cochrane Library, Web of
Science, and OpenGrey databases. Inclusion criteria were as follows: drug
studied was aspirin, acetaminophen, a nonsteroidal anti-inflammatory drug
(NSAID), a statin, or gabapentin; human participants; and article in the
English language. Risk of bias was assessed using the Cochrane Risk of Bias
tool and the Risk of Bias in Non-randomised Studies—of Interventions
tool. Results: A total of 1711 studies were identified through the initial search, with 20
studies meeting all inclusion criteria. No studies involving gabapentin met
all inclusion criteria. Patients treated with aspirin (268 patients) or
acetaminophen (13 patients) showed a significant decrease in platelet
aggregation. Statin therapy (73 patients) did not result in a significant
decrease in platelet aggregation. Patients who took NSAIDs (172 patients)
demonstrated significantly decreased platelet aggregation only when treated
with nonselective formulations. Those treated with cyclooxygenase
(COX)-2–selective NSAIDs showed no significant difference in platelet
aggregation. Treatment with aspirin, acetaminophen, statins, or NSAIDs did
not lead to a significant decrease in platelet count. Conclusion: Aspirin, acetaminophen, and nonselective NSAIDs should be considered for
suspension before a PRP injection because of their potential to diminish the
effects of the injection. COX-2–selective NSAIDs and statins do not need to
be withheld before a PRP injection.
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Affiliation(s)
- David S. Kao
- Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | | | - Alexander R. Vap
- Virginia Commonwealth University Health System, Richmond, Virginia, USA
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Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther 2022; 16:635-645. [PMID: 35300222 PMCID: PMC8922312 DOI: 10.2147/dddt.s356858] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Platelet rich plasma (PRP) was described as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia. To date, it was discovered that there are several growth factors and cytokines that can accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical field, such as in sport medicine, regenerative medicine, and aesthetic medicine. Several studies have shown that PRP can be used effectively for treatment of hair loss. Although it has been widely used, the exact mechanism of action of PRP is still not fully elucidated. In this article, we aim to review and update current information on the definition, classification, mechanism of action, clinical efficacy in hair regrowth, and adverse events of PRP.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
- Correspondence: Anon Paichitrojjana, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, 36/87-88 PS Tower 25Fl, Asoke Road, Sukhumvit 21, Klong Toey Nua, Wattana, Bangkok, 10110, Thailand, Tel +66 81-9343050, Email
| | - Anand Paichitrojjana
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Muthu S, Jeyaraman M, Ganie PA, Khanna M. Is Platelet-Rich Plasma Effective in Enhancing Spinal Fusion? Systematic Overview of Overlapping Meta-Analyses. Global Spine J 2022; 12:333-342. [PMID: 33472410 PMCID: PMC8907645 DOI: 10.1177/2192568220988278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVES We performed this systematic overview on overlapping meta-analyses that analyzed the role of platelet-rich plasma(PRP) in enhancing spinal fusion and identify which study provides the current best evidence on the topic and generate recommendations for the same. MATERIALS AND METHODS We conducted independent and duplicate electronic database searches in PubMed, Web of Science, Embase, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects till October-2020 for meta-analyses that analyzed the role of PRP in spinal fusion procedures. Methodological quality assessment was made using Oxford Levels of Evidence, AMSTAR scoring, and AMSTAR 2 grades. We then utilized the Jadad decision algorithm to identify the study with highest quality to represent the current best evidence to generate recommendations. RESULTS 3 meta-analyses fulfilling the eligibility criteria were included. The AMSTAR scores of included studies varied from 5-8(mean:6.3) and all included studies had critically low reliability in their summary of results due to their methodological flaws according to AMSTAR 2 grades. The current best evidence showed that utilization of PRP was not associated with significant improvement in patient-reported outcomes such as Visual Analog Score for pain compared to the standard fusion procedure. Moreover, PRP was found to be associated with lower fusion rates. CONCLUSION Based on this systematic overview, the effectiveness of PRP as a biological agent in augmenting spinal fusion is limited. Current evidence does not support the use of PRP as an adjuvant to enhance spinal fusion.
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Affiliation(s)
- Sathish Muthu
- Indian Stem Cell Study Group,
Lucknow, India
- Sathish Muthu, Member, Indian Stem Cell
Study Group, Lucknow, India.
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Yoshitake T, Rosen S, Cahill LC, Lamothe S, Ward A, Fujimoto JG. Rapid histological imaging of bone without microtome sectioning using nonlinear microscopy. Bone 2022; 154:116254. [PMID: 34743041 PMCID: PMC9832301 DOI: 10.1016/j.bone.2021.116254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/06/2021] [Accepted: 11/02/2021] [Indexed: 02/07/2023]
Abstract
Tissue preparation for histologic evaluation of bone is particularly lengthy, limiting its use in intraoperative or intraprocedural histological evaluation. Nonlinear microscopy (NLM) is an optical sectioning microscopy method that can visualize pathology in freshly excised tissue without requiring physical microtome sectioning. This study describes a rapid protocol for NLM imaging of bone and associated cartilage. NLM imaging was performed on 71 specimens of normal bone as well as arthritic, malignant and inflammatory bone tissue from 40 patients who underwent joint replacement, amputation, bone marrow biopsy or autopsy. Specimens ranged in size from core needle biopsies to transections of entire femoral heads. Specimens were stained with acridine orange and sulforhodamine 101, nuclear and cytoplasmic/stromal fluorescent dyes, for 5 min, then rinsed for 30 s. NLM fluorescent images were displayed using colors analogous to hematoxylin and eosin (H&E) to facilitate interpretation. Pathologists examined NLM images of the specimens in real time by rapidly translating the specimen to areas of interest, similar to a standard transmission light microscope. By adjusting the NLM focus depth, images from a few-μm-thick layer could be obtained down to ~100 μm below the tissue surface, analogous to serial sectioning. Following real-time NLM imaging, the tissue was processed for conventional paraffin histology, and H&E slides were compared to recorded NLM images. Similarities and differences between NLM and paraffin H&E were assessed. NLM enabled visualization of normal bone architecture, including the lamellar matrix and osteocytes of trabecular bone, articular cartilage, as well as pathological bone features such osteoarthritis, osteomyelitis, and malignancy with an appearance resembling the paraffin H&E. Differences such as changes in cell border sharpness, cellular and nucleolar size, and color patterns were noted, suggesting that training is required for accurate evaluation of bone pathology with NLM. Irregular surface contours and debris generated by gross tissue preparation of bone can make some regions difficult to evaluate with NLM, but the ability to perform rapid three-dimensional translation and sub-surface imaging reduced these problems. NLM is a promising technique for rapid evaluation of bone pathology. Further studies assessing diagnostic performance are warranted.
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Affiliation(s)
- Tadayuki Yoshitake
- Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Seymour Rosen
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Lucas C Cahill
- Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA; Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School and Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Simon Lamothe
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ashley Ward
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - James G Fujimoto
- Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.
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Karthik VC, Prabhu K, Bharath N, Shobana P, Indhu K, Abraham S, Arunalakshmi K. Randomized controlled study on effect of concentrated growth factors on crestal bone levels and peri-implant bone density in dental implants. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S68-S77. [PMID: 36110820 PMCID: PMC9469271 DOI: 10.4103/jpbs.jpbs_552_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: Modern dentistry aims to restore the comfort and health of the stomatognathic system. Dental implants have emerged as a promising option for this purpose. Concentrated growth factors (CGFs) have been suggested to enhance the healing of bone grafts and enhance the integration of implants into the bone. Growth factors are proteins which regulate the complex process of wound healing. They play an important role in cell migration, cell proliferation, and angiogenesis in the tissue regeneration phase. CGF was first developed by Sacco in 2006. It can be used as a barrier membrane to accelerate soft-tissue healing. CGF does not require any chemical or anticoagulants, and hence, it is free from viral transmission diseases. Crestal bone levels, peri-implant bone density, bleeding, probing depth, mobility, occlusion factors, restoration adequacy, radiographic images, oral hygiene, and patient health status are some of the important parameters for determining longevity of success rates in implant dentistry. This study will assess the peri-implant bone density and crestal bone levels with and without the use of CGF. Aim: To evaluate the effect of CGFs on peri-implant bone density and in the preservation of crestal bone levels around dental implants. Materials and Methods: Sampling procedure: Random selection of population (Sealed envelope method) Number of groups: Two-Control group (Group 1) and Experimental group (Group 2) Sample size: 20
For Group 2, implants were placed with CGF. For Group 1, implants were placed without CGF. The peri-implant bone density and bone levels were measured by Digora and signora software. Results: The mean crestal bone loss on the mesial aspect of implants placed in Group 2 is 0.294 mm and Group 1 is 0.345 mm, and the mean crestal bone loss on the distal aspect of implants placed in Group 2 is 0.320 mm and in Group 1 is 0.331 mm. There are no many significant differences on mesial and distal aspects around implants between the two groups Intragroup comparison of bone density values in Group 1 shows the mean difference from baseline to 1 month is 0.6, and after three and 6 months periods are 1.1 and 1.1, respectively, which indicates not much significant improvement in bone density values in Group 1. Intergroup comparison shows a significant difference between both the groups starting from as early as the 1st month. Conclusion: The results of this study indicate that CGF is significantly better in the regeneration of bone around the implants when comparing with nonCGF groups. Although CGF showed improvement in bone formation, there are no many differences in crestal bone level changes on mesial and distal sides of the implants between the two groups.
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Appraisal of Experimental Methods to Manage Menopause and Infertility: Intraovarian Platelet-Rich Plasma vs. Condensed Platelet-Derived Cytokines. MEDICINA (KAUNAS, LITHUANIA) 2021; 58:medicina58010003. [PMID: 35056311 PMCID: PMC8779970 DOI: 10.3390/medicina58010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 12/20/2022]
Abstract
The first published description of intraovarian platelet-rich plasma (PRP) appeared in mid-2016, when a new experimental technique was successfully used in adult human ovaries to correct the reduced fertility potential accompanying advanced maternal age. Considering the potential therapeutic scope of intraovarian PRP would likely cover both menopause and infertility, the mainstream response has ranged from skeptical disbelief to welcome astonishment. Indeed, reports of intraovarian PRP leading to restored menses in menopause (as an alternative to conventional hormone replacement therapy) and healthy term livebirths for infertility patients (from IVF or as unassisted conceptions) continue to draw notice. Yet, any proper criticism of ovarian PRP applications will be difficult to rebut given the heterogenous patient screening, varied sample preparations, wide differences in platelet incubation and activation protocols, surgical/anesthesia techniques, and delivery methods. Notwithstanding these aspects, no adverse events have thus far been reported and ovarian PRP appears well tolerated by patients. Here, early studies guiding the transition of ‘ovarian rejuvenation’ from experimental to clinical are outlined, with mechanisms to explain results observed in both veterinary and human ovarian PRP research. Current and future challenges for intraovarian cytokine treatment are also discussed.
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Tülek F, Kahraman A. The effects of intra-ovarian autologous platelet rich plasma injection on IVF outcomes of poor responder women and women with premature ovarian insufficiency. J Turk Ger Gynecol Assoc 2021; 23:14-21. [PMID: 34866374 PMCID: PMC8907433 DOI: 10.4274/jtgga.galenos.2021.2021.0134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: There are controversial results regarding the administrations of platelet rich plasma (PRP) to increase in-vitro fertilization (IVF) success rates in the current literature. The aim of this study was to evaluate the effects of intra-ovarian PRP injections on IVF outcomes of poor responder women and women with premature ovarian insufficiency (POI). Material and Methods: The medical history and outcome of women receiving intra-ovarian PRP injections performed in a single tertiary center between 2018 and 2021 was retrospectively reviewed. Results: In total 71 women were included, of whom 21 were diagnosed with POI according to European Society of Human Reproduction and Embryology criteria and 50 were poor responders according to Bologna criteria. Number of retrieved oocytes, number of 2 pronuclear embryos and number of cleavage stage embryos were significantly higher in poor responder women after PRP injections. However clinical pregnancy rates and live birth delivery rates were similar before and after PRP injections in poor responders. In women with POI, 8 embryos were obtained in cycles commenced after PRP injections but no clinical pregnancies were achieved in this group of patients. Conclusion: Intra-ovarian PRP injections do not appear to increase live birth rates or clinical pregnancy rates in poor responder women or in those with POI, in this cohort.
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Affiliation(s)
- Fırat Tülek
- Department of Midwifery, Üskudar University Faculty of Health Sciences, İstanbul, Turkey.,Department of Obstetrics and Gynecology, Memorial Atasehir Hospital, İstanbul, Turkey
| | - Alper Kahraman
- Department of Obstetrics and Gynecology, Haseki Training and Research Hospital, İstanbul, Turkey
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