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Pal D, Das P, Mukherjee P, Roy S, Chaudhuri S, Kesh SS, Ghosh D, Nandi SK. Biomaterials-Based Strategies to Enhance Angiogenesis in Diabetic Wound Healing. ACS Biomater Sci Eng 2024; 10:2725-2741. [PMID: 38630965 DOI: 10.1021/acsbiomaterials.4c00216] [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] [Indexed: 04/19/2024]
Abstract
Amidst the present healthcare issues, diabetes is unique as an emerging class of affliction with chronicity in a majority of the population. To check and control its effects, there have been huge turnover and constant development of management strategies, and though a bigger part of the health care area is involved in achieving its control and the related issues such as the effect of diabetes on wound healing and care and many of the works have reached certain successful outcomes, still there is a huge lack in managing it, with maximum effect yet to be attained. Studying pathophysiology and involvement of various treatment options, such as tissue engineering, application of hydrogels, drug delivery methods, and enhancing angiogenesis, are at constantly developing stages either direct or indirect. In this review, we have gathered a wide field of information and different new therapeutic methods and targets for the scientific community, paving the way toward more settled ideas and research advances to cure diabetic wounds and manage their outcomes.
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Affiliation(s)
- Debajyoti Pal
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Pratik Das
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Prasenjit Mukherjee
- Department of Veterinary Clinical Complex, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Subhasis Roy
- Department of Veterinary Clinical Complex, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Shubhamitra Chaudhuri
- Department of Veterinary Clinical Complex, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Shyam Sundar Kesh
- Department of Veterinary Clinical Complex, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Debaki Ghosh
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
| | - Samit Kumar Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata 700037, India
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Lang X, Li L, Li Y, Feng X. Effect of Diabetes on Wound Healing: A Bibliometrics and Visual Analysis. J Multidiscip Healthc 2024; 17:1275-1289. [PMID: 38524865 PMCID: PMC10961066 DOI: 10.2147/jmdh.s457498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/14/2024] [Indexed: 03/26/2024] Open
Abstract
Objective The quality of life of diabetic patients is seriously affected by wound healing difficulty, which can lead to increased infection, skin deep tissue injury and continuous pain. By analyzing the research trends and hot spots in this field, the visualization analysis map is constructed. Methods The contents of the selected articles were sorted out and analyzed by bibliometrics. We use CiteSpace, Vosviewer and HistCite to visualize literature information, including national publication statistics, institutions, authors, journal partnerships, and citations of published articles. Results Among the 2942 articles, the United States and China ranked first in both article circulation and TGCS, and many countries also cooperated. The collaboration between schools and research institutions is a core part of dissertation research institution collaboration, with most authors coming from the same institution. Most of the literature studies on the mechanisms and methods of promoting diabetic wound healing. Improving cell function or making innovative attempts in local treatment are the fruits of researchers' efforts to promote diabetic wound healing in recent years. Conclusion Through the metrology method, the time distribution, author institution, cooperation network, research status, research hotspot and development trend of the literature on the influence of diabetes on wound healing were intuitively displayed, which provided a reference for further research and development direction.
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Affiliation(s)
- Xiaona Lang
- Pharmacy Department, Tianjin Hospital, Tianjin, People’s Republic of China
| | - Lu Li
- Pharmacy Department, Tianjin Hospital, Tianjin, People’s Republic of China
| | - Yuntao Li
- Integrative Chinese and Western Medicine Department, Tianjin Hospital, Tianjin, People’s Republic of China
| | - Xin Feng
- Pharmacy Department, Tianjin Hospital, Tianjin, People’s Republic of China
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Blanquer A, Kostakova EK, Filova E, Lisnenko M, Broz A, Mullerova J, Novotny V, Havlickova K, Jakubkova S, Hauzerova S, Heczkova B, Prochazkova R, Bacakova L, Jencova V. A novel bifunctional multilayered nanofibrous membrane combining polycaprolactone and poly (vinyl alcohol) enriched with platelet lysate for skin wound healing. NANOSCALE 2024; 16:1924-1941. [PMID: 38170860 DOI: 10.1039/d3nr04705a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Skin wound healing is a complex physiological process that involves various cell types, growth factors, cytokines, and other bioactive compounds. In this study, a novel dual-function multilayered nanofibrous membrane is developed for chronic wound application. The membrane is composed of five alternating layers of polycaprolactone (PCL) and poly (vinyl alcohol) (PVA) nanofibers (PCL-PVA) with a dual function: the PCL nanofibrous layers allow cell adhesion and growth, and the PVA layers enriched with incorporated platelet lysate (PCL-PVA + PL) serve as a drug delivery system for continuous release of bioactive compounds from PL into an aqueous environment. The material is produced using a needleless multi-jet electrospinning approach which can lead to homogeneous large-scale production. The bioactive PCL-PVA + PL membranes are cytocompatible and hemocompatible. A spatially compartmented co-culture of three cell types involved in wound healing - keratinocytes, fibroblasts and endothelial cells - is used for cytocompatibility studies. PCL-PVA + PL membranes enhance the proliferation of all cell types and increase the migration of both fibroblasts and endothelial cells. The membranes are also hemocompatible without any deleterious effect for thrombogenicity, hemolysis and coagulation. Thus, the beneficial effect of the PCL-PVA + PL membrane is demonstrated in vitro, making it a promising scaffold for the treatment of chronic wounds.
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Affiliation(s)
- Andreu Blanquer
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, 08193, Spain.
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 00 Prague 4-Krc, Czech Republic
| | - Eva Kuzelova Kostakova
- Technical University of Liberec, Faculty of Science, Humanities and Education, Studentska 1402/2, Liberec, 46117, Czech Republic
| | - Elena Filova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 00 Prague 4-Krc, Czech Republic
| | - Maxim Lisnenko
- Technical University of Liberec, Faculty of Science, Humanities and Education, Studentska 1402/2, Liberec, 46117, Czech Republic
| | - Antonin Broz
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 00 Prague 4-Krc, Czech Republic
| | - Jana Mullerova
- Technical University of Liberec, Faculty of Science, Humanities and Education, Studentska 1402/2, Liberec, 46117, Czech Republic
- The Institute for Nanomaterials, Advanced Technologies and Innovation, Bendlova 1409/7, Liberec, 460 01, Czech Republic
| | - Vit Novotny
- The Institute for Nanomaterials, Advanced Technologies and Innovation, Bendlova 1409/7, Liberec, 460 01, Czech Republic
| | - Kristyna Havlickova
- Technical University of Liberec, Faculty of Science, Humanities and Education, Studentska 1402/2, Liberec, 46117, Czech Republic
| | - Sarka Jakubkova
- Regional Hospital Liberec, Husova 357/28, Liberec, 460 01, Czech Republic
| | - Sarka Hauzerova
- Technical University of Liberec, Faculty of Science, Humanities and Education, Studentska 1402/2, Liberec, 46117, Czech Republic
| | - Bohdana Heczkova
- Regional Hospital Liberec, Husova 357/28, Liberec, 460 01, Czech Republic
| | - Renata Prochazkova
- Regional Hospital Liberec, Husova 357/28, Liberec, 460 01, Czech Republic
- Faculty of Health, Technical University of Liberec, Studentska 1402/2, Liberec, 461 17, Czech Republic
| | - Lucie Bacakova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 00 Prague 4-Krc, Czech Republic
| | - Vera Jencova
- Technical University of Liberec, Faculty of Science, Humanities and Education, Studentska 1402/2, Liberec, 46117, Czech Republic
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Role of Innate Immune Cells in Chronic Diabetic Wounds. J Indian Inst Sci 2023. [DOI: 10.1007/s41745-022-00355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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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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Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120817. [PMID: 36551023 PMCID: PMC9774306 DOI: 10.3390/bioengineering9120817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022]
Abstract
Several musculoskeletal conditions are triggered by inflammatory processes that occur along with imbalances between anabolic and catabolic events. Platelet-rich plasma (PRP) is an autologous product derived from peripheral blood with inherent immunomodulatory and anabolic properties. The clinical efficacy of PRP has been evaluated in several musculoskeletal conditions, including osteoarthritis, tendinopathy, and osteonecrosis. When used in combination with hyaluronic acid (HA), a common treatment alternative, the regenerative properties of PRP are significantly enhanced and may provide additional benefits in terms of clinical outcomes. Recently, a new PRP-derived product has been reported in the literature and is being referred to as "plasma gel". Plasma gels are obtained by polymerizing plasmatic proteins, which form solid thermal aggregates cross-linked with fibrin networks. Plasma gels are considered to be a rich source of growth factors and provide chemotactic, migratory, and proliferative properties. Additionally, clot formation and the associated fibrinolytic reactions play an additional role in tissue repair. There are only a few scientific articles focusing on plasma gels. Historically, they have been utilized in the fields of aesthetics and dentistry. Given that the combination of three products (PRP, HA, and plasma gel) could enhance tissue repair and wound healing, in this technical note, we propose a novel regenerative approach, named "PRP-HA cellular gel matrix" (PRP-GM), in which leukocyte-rich PRP (LR-PRP) is mixed with a plasma gel (obtained by heating the plasma up) and HA in one syringe using a three-way stopcock. The final product contains a fibrin-albumin network entangled with HA's polymers, in which the cells and biomolecules derived from PRP are attached and released gradually as fibrinolytic reactions and hyaluronic acid degradation occur. The presence of leukocytes, especially monocytes and macrophages, promotes tissue regeneration, as type 2 macrophages (M2) possess an anti-inflammatory feature. In addition, HA promotes the viscosuplementation of the joint and induces an anti-inflammatory response, resulting in pain relief. This unique combination of biological molecules may contribute to the optimization of regenerative protocols suitable for the treatment of degenerative musculoskeletal diseases.
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Biopolymer-Based Wound Dressings with Biochemical Cues for Cell-Instructive Wound Repair. Polymers (Basel) 2022; 14:polym14245371. [PMID: 36559739 PMCID: PMC9783382 DOI: 10.3390/polym14245371] [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: 10/13/2022] [Revised: 11/25/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Regenerative medicine is an active research sphere that focuses on the repair, regeneration, and replacement of damaged tissues and organs. A plethora of innovative wound dressings and skin substitutes have been developed to treat cutaneous wounds and are aimed at reducing the length or need for a hospital stay. The inception of biomaterials with the ability to interact with cells and direct them toward desired lineages has brought about innovative designs in wound healing and tissue engineering. This cellular engagement is achieved by cell cues that can be biochemical or biophysical in nature. In effect, these cues seep into innate repair pathways, cause downstream cell behaviours and, ultimately, lead to advantageous healing. This review will focus on biomolecules with encoded biomimetic, instructive prompts that elicit desired cellular domino effects to achieve advanced wound repair. The wound healing dressings covered in this review are based on functionalized biopolymeric materials. While both biophysical and biochemical cues are vital for advanced wound healing applications, focus will be placed on biochemical cues and in vivo or clinical trial applications. The biochemical cues aforementioned will include peptide therapy, collagen matrices, cell-based therapy, decellularized matrices, platelet-rich plasma, and biometals.
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Li W, Wang QY, Bai XG, Xu J. Autologous platelet-rich gel in the treatment of diabetic foot ulcers: A retrospective study. Medicine (Baltimore) 2022; 101:e31701. [PMID: 36401364 PMCID: PMC9678626 DOI: 10.1097/md.0000000000031701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This study retrospectively investigated the effectiveness and safety of autologous platelet-rich gel (APRG) for the treatment of diabetic foot ulcers (DFU). In this retrospective study, we reviewed the electronic medical records (EMR) of 72 patients with DFU. The patients were allocated to a treatment group (n = 36) or a control group (n = 36). The patients in both groups received standard care (SC) and dressing change. In addition, patients in the treatment group also received APRG. Patients in both groups were treated for 12 weeks. The outcomes were DFU healing time (days), length of hospital stay (days), healing rate of DFU, DFU surface area reduction (cm2), and adverse events. We assessed and analyzed the outcomes before and after the 12-week treatment period. After treatment, there were significant differences in DFU healing time (P = .04), length of hospital stay (P = .04), DFU healing rate, and DFU surface area reduction (P < .01). Regarding safety, no EMR reported adverse events in this study. The results of this study showed that the APRG may benefit patients with DFU. However, high-quality prospective randomized controlled trials are required to verify these findings.
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Affiliation(s)
- Wei Li
- Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, Yan’an, China
| | - Qiao-Yun Wang
- Department of Ultrasound Diagnosis, Yanan University Affiliated Hospital, Yan’an, China
| | - Xiao-Gang Bai
- Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, Yan’an, China
| | - Jie Xu
- Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, Yan’an, China
- *Correspondence: Jie Xu, Department of Endocrine and Metabolism, Yanan University Affiliated Hospital, No. 43 North Street, Baota District, Yan’an, 716000, China (e-mail: )
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Chakraborty R, Borah P, Dutta PP, Sen S. Evolving spectrum of diabetic wound: Mechanistic insights and therapeutic targets. World J Diabetes 2022; 13:696-716. [PMID: 36188143 PMCID: PMC9521443 DOI: 10.4239/wjd.v13.i9.696] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/12/2022] [Accepted: 08/18/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus is a chronic metabolic disorder resulting in an increased blood glucose level and prolonged hyperglycemia, causes long term health conse-quences. Chronic wound is frequently occurring in diabetes patients due to compromised wound healing capability. Management of wounds in diabetic patients remains a clinical challenge despite many advancements in the field of science and technology. Increasing evidence indicates that alteration of the biochemical milieu resulting from alteration in inflammatory cytokines and matrix metalloproteinase, decrease in fibroblast and keratinocyte functioning, neuropathy, altered leukocyte functioning, infection, etc., plays a significant role in impaired wound healing in diabetic people. Apart from the current pharmacotherapy, different other approaches like the use of conventional drugs, antidiabetic medication, antibiotics, debridement, offloading, platelet-rich plasma, growth factor, oxygen therapy, negative pressure wound therapy, low-level laser, extracorporeal shock wave bioengineered substitute can be considered in the management of diabetic wounds. Drugs/therapeutic strategy that induce angiogenesis and collagen synthesis, inhibition of MMPs, reduction of oxidative stress, controlling hyperglycemia, increase growth factors, regulate inflammatory cytokines, cause NO induction, induce fibroblast and keratinocyte proliferation, control microbial infections are considered important in controlling diabetic wound. Further, medicinal plants and/or phytoconstituents also offer a viable alternative in the treatment of diabetic wound. The focus of the present review is to highlight the molecular and cellular mechanisms, and discuss the drug targets and treatment strategies involved in the diabetic wound.
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Affiliation(s)
- Raja Chakraborty
- Institute of Pharmacy, Assam Don Bosco University, Kamrup 782402, Assam, India
| | - Pobitra Borah
- School of Pharmacy, Graphic Era Hill University, Dehradun 248002, Uttarakhand, India
| | - Partha Pratim Dutta
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati 781026, Assam, India
| | - Saikat Sen
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati 781026, Assam, India
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Khan QI, Baig H, Al Failakawi A, Majeed S, Khan M, Lucocq J. The Effect of Platelet-Rich Plasma on Healing Time in Patients Following Pilonidal Sinus Surgery: A Systematic Review. Cureus 2022; 14:e27777. [PMID: 36106230 PMCID: PMC9450803 DOI: 10.7759/cureus.27777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/05/2022] Open
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Leme KC, Neri GM, Biscaro GG, Bulgareli AA, Duran N, Parisi MCR, Luzo ÂCM. Full Diabetic Foot Ulcer Healing and Pain Relief Based on Platelet-Rich-Plasma gel Formulation Treatment and the Involved Pathways. INT J LOW EXTR WOUND 2022:15347346221109758. [PMID: 35786036 DOI: 10.1177/15347346221109758] [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: 11/16/2022]
Abstract
Diabetic foot ulcer is a severe Diabetic Mellitus-associated complication. It is induced by poor glycemic control, which leads to peripheral neuropathy and vascular diseases. Platelet-rich plasma could be beneficial for healing processes due to its active biomolecules that promotes immunomodulation, angiogenesis, cell proliferation and analgesia.
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Affiliation(s)
- Krissia Caroline Leme
- Transfusion Medicine Service, Stem Cell Processing Laboratory, Umbilical Cord Blood Bank, Haematology Hemotherapy Center, University of Campinas (UNICAMP), Campinas, Brazil
| | - Guilherme Martins Neri
- Transfusion Medicine Service, Stem Cell Processing Laboratory, Umbilical Cord Blood Bank, Haematology Hemotherapy Center, University of Campinas (UNICAMP), Campinas, Brazil
| | - Gabriel Gaspar Biscaro
- Transfusion Medicine Service, Stem Cell Processing Laboratory, Umbilical Cord Blood Bank, Haematology Hemotherapy Center, University of Campinas (UNICAMP), Campinas, Brazil
| | - Andreia Afaz Bulgareli
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Brazil
| | - Nelson Duran
- Laboratory of Urogenital Carcinogenesis and Immunotherapy, Department of Structural and Functional Biology, Institute of Biology University of Campinas (UNICAMP), Campinas, SP, Brazil
- Nanomedicine Research Unit (Nanomed), Center for Natural and Human Sciences (CCNH), 425753Federal University of ABC (UFABC), Santo André, Brazil
| | | | - Ângela Cristina Malheiros Luzo
- Transfusion Medicine Service, Stem Cell Processing Laboratory, Umbilical Cord Blood Bank, Haematology Hemotherapy Center, University of Campinas (UNICAMP), Campinas, Brazil
- Laboratory of Urogenital Carcinogenesis and Immunotherapy, Department of Structural and Functional Biology, Institute of Biology University of Campinas (UNICAMP), Campinas, SP, Brazil
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Leg Ulcer Therapy by Local Injection of Autologous Growth Factors: Results of a Pilot Study. Dermatol Ther (Heidelb) 2022; 12:1615-1622. [PMID: 35737217 PMCID: PMC9276895 DOI: 10.1007/s13555-022-00753-7] [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: 04/16/2022] [Accepted: 06/01/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Population ageing has led to an increase in the prevalence of many chronic diseases that occur in elderly patients including chronic wounds of various aetiologies, especially leg ulcers. The treatment of these wounds is lengthy and associated with health, economic and social problems. The aim of our study was to compare the outcomes of local injections of autologous growth factors with standard dressings for leg ulcer treatment. METHODS The study included 25 patients with leg ulcers treated with autologous growth factors, and 15 patients treated with standard wet dressings only. The area and depth of ulcers were measured on days 0, 5, 28, 84 and 168, and statistically processed using the chi-square test, the Fischer exact test, the Wilcoxon two-sample test, the non-parametric paired Wilcoxon test and the Friedman analysis of variance (ANOVA) test at a significance level of 5%. RESULTS Area and depth did not significantly differ between the two groups before initiation of the treatment (p = 0.472 and p = 0.242, respectively). During the study period, the average leg ulcer area decreased in both the study and control groups by 72% and 40%, respectively. The paired Wilcoxon test showed that this decrease was significant in the study group (p < 0.001), but not in the control group (p = 0.075). CONCLUSION Leg ulcers heal better when treated with autologous growth factor injections than when treated with standard dressings alone. A further study with a larger number of patients is needed to confirm the presented results. However, this method seems to be a promising way to treat ulcers of the lower extremities.
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Preparation of Ion 2+-COS/SA Multifunctional Gel Films for Skin Wound Healing by an In Situ Spray Method. Mar Drugs 2022; 20:md20060401. [PMID: 35736204 PMCID: PMC9227795 DOI: 10.3390/md20060401] [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] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 12/15/2022] Open
Abstract
The rapid preparation of safe and efficient wound dressings that meet the needs of the entire repair process remains a major challenge for effective therapeutic wound healing. Natural, sprayable Ion2+-COS/SA multifunctional dual-network gel films created by the in situ coordination of chitooligosaccharide (COS), metal ions and sodium alginate (SA) using casting and an in-situ spray method were synthesized. The gel films exhibited excellent physicochemical properties such as swelling, porosity and plasticity at a COS mass fraction of 3%. Furthermore, at this mass fraction, the addition of bimetallic ions led to the display of multifunctional properties, including significant antioxidant, antibacterial and cytocompatibility properties. In addition, experiments in a total skin defect model showed that this multifunctional gel film accelerates wound healing and promotes skin regeneration. These results suggest that the sprayable Ion2+-COS/SA multifunctional pro-healing gel film may be a promising candidate for the clinical treatment of allodermic wounds.
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14
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Delivery systems for platelet derived growth factors in wound healing: A review of recent developments and global patent landscape. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Gawdat HI, El-Hadidy YA, Allam RSHM, Abdelkader HA. Autologous platelet-rich plasma 'fluid' versus 'gel' form in combination with fractional CO 2 laser in the treatment of atrophic acne scars: a split-face randomized clinical trial. J DERMATOL TREAT 2022; 33:2654-2663. [PMID: 35435087 DOI: 10.1080/09546634.2022.2067816] [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: 10/18/2022]
Abstract
BACKGROUND The treatment of atrophic acne scars represents a therapeutic challenge. Recently, plasma gel has been introduced among treatment modalities. OBJECTIVE To compare the efficacy of platelet-rich-plasma 'fluid' versus 'gel' form combined with fractional CO2 laser in the treatment of atrophic acne scars. METHODS Twenty-seven patients with atrophic acne scars were included. Treatment with fractional CO2 laser plus plasma fluid/gel was randomly assigned to the right/left sides of the face. Clinical and Optical Coherence Tomography (OCT) assessments were scheduled at baseline, one month, and three months after the last session. RESULTS There was a significant improvement in clinical assessment scores at third-month follow-up on the plasma gel- and plasma fluid-treated sides compared to those at the first-month follow-up (p < .001). Scar depth decreased significantly at third-month follow-up when compared to baseline on both plasma gel- and plasma fluid-treated sides (p < .001). The numerical pain score was significantly lower on the plasma fluid-treated side compared to the plasma gel-treated side (p = .004). CONCLUSION The use of platelet-rich plasma in combination with fractional CO2 laser, both in fluid and gel form, produced significant results in the treatment of atrophic acne scars. Patients reported an immediate more noticeable effect with plasma gel. However, the fluid injection was less painful.
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Affiliation(s)
- Heba I Gawdat
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Riham S H M Allam
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Mirhaj M, Labbaf S, Tavakoli M, Seifalian AM. Emerging treatment strategies in wound care. Int Wound J 2022; 19:1934-1954. [PMID: 35297170 DOI: 10.1111/iwj.13786] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 12/20/2022] Open
Abstract
Wound healing is a complex process in tissue regeneration through which the body responds to the dissipated cells as a result of any kind of severe injury. Diabetic and non-healing wounds are considered an unmet clinical need. Currently, different strategic approaches are widely used in the treatment of acute and chronic wounds which include, but are not limited to, tissue transplantation, cell therapy and wound dressings, and the use of an instrument. A large number of literatures have been published on this topic; however, the most effective clinical treatment remains a challenge. The wound dressing involves the use of a scaffold, usually using biomaterials for the delivery of medication, autologous stem cells, or growth factors from the blood. Antibacterial and anti-inflammatory drugs are also used to stop the infection as well as accelerate wound healing. With an increase in the ageing population leading to diabetes and associated cutaneous wounds, there is a great need to improve the current treatment strategies. This research critically reviews the current advancement in the therapeutic and clinical approaches for wound healing and tissue regeneration. The results of recent clinical trials suggest that the use of modern dressings and skin substitutes is the easiest, most accessible, and most cost-effective way to treat chronic wounds with advances in materials science such as graphene as 3D scaffold and biomolecules hold significant promise. The annual market value for successful wound treatment exceeds over $50 billion US dollars, and this will encourage industries as well as academics to investigate the application of emerging smart materials for modern dressings and skin substitutes for wound therapy.
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Affiliation(s)
- Marjan Mirhaj
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran.,Nanotechnology & Regenerative Medicine Commercialization Centre (NanoRegMed Ltd), London BioScience Innovation Centre, London, UK
| | - Sheyda Labbaf
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Mohamadreza Tavakoli
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Alexander Marcus Seifalian
- Nanotechnology & Regenerative Medicine Commercialization Centre (NanoRegMed Ltd), London BioScience Innovation Centre, London, UK
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17
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Cecerska-Heryć E, Goszka M, Serwin N, Roszak M, Grygorcewicz B, Heryć R, Dołęgowska B. Applications of the regenerative capacity of platelets in modern medicine. Cytokine Growth Factor Rev 2021; 64:84-94. [PMID: 34924312 DOI: 10.1016/j.cytogfr.2021.11.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023]
Abstract
Platelets produce platelet growth factors such as PDGF, IGF-1, EGF-, HGF, TGFβ, bFGF, and VEGF, which are crucial in regulating all stages of the wound healing process. The source of these substances is platelet-rich plasma (PRP). Over the past five decades, the interest and use of the regenerative properties of platelets have increased significantly in many different fields of medicine around the world. PRP and PRF plate preparations are used in: 1. Dentistry (they reduce bleeding, facilitate and accelerate soft tissue healing and bone regeneration - FGF 2, IGF-1, IGF-2, TGF-β1, and PDGF); 2. Sports medicine - IGF-1, IGF-2, TGF-β, VEGF, PDGF and bFGF, EGF); 3. dermatology and cosmetology (treatment of alopecia, hair reconstruction - FGF-7, HGF, acne scars, skin rejuvenation and regeneration, treatment of chronic and poorly healing wounds, burns, and acquired vitiligo); 4. Gynecology and reproductive medicine (treatment of infertility, erectile dysfunction - PDGF-β, TGF-β, IGF-1, in sexual dysfunction - PDGF, in vaginal atrophy); 5 Ophthalmology (in the healing of corneal epithelial wounds, in the treatment of dormant corneal ulcers, dry eye syndrome and the reconstruction of the corneal surface; 6. Neurology (regeneration of neurons, pain alleviation, and clinical symptoms - TGF-β 1, IGF-1, PDGF, VEGF) and FGF). Platelet-rich plasma therapy is a very interesting alternative and complement to traditional methods of treatment. However, the potential for using platelets is still not fully understood. The composition of platelet-rich plasma depends on many factors that may affect its use's efficacy and clinical benefits. Further research is necessary to standardize PRP delivery's preparation procedures and methods for a specific disease entity or clinical case.
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Affiliation(s)
- Elżbieta Cecerska-Heryć
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland.
| | - Małgorzata Goszka
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Natalia Serwin
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Marta Roszak
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Bartłomiej Grygorcewicz
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Rafał Heryć
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
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18
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Farimani M, Nazari A, Mohammadi S, Anvari Aliabad R. Evaluation of intra-ovarian platelet-rich plasma administration on oocytes-dependent variables in patients with poor ovarian response: A retrospective study according to the POSEIDON criteria. Reprod Biol Endocrinol 2021; 19:137. [PMID: 34496887 PMCID: PMC8425058 DOI: 10.1186/s12958-021-00826-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/02/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Poor ovarian response (POR) is among the common findings in infertile women with no significant underlying condition. The aim of this study was to investigate the intra-ovarian potential of platelet-rich plasma (PRP) administration on oocytes-dependent variables in the POR women grouped according to the POSEIDON criteria. METHODS This retrospective study was performed on POR women with no underlying condition who have undergone intra-ovarian PRP injection. As well as patients' age, the number of total and MI, MII, and GV oocytes were extracted from the files. The laboratory variables including anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol were also gathered. In order to reduce any bias due to the possible differences in kits or devices, a single laboratory with the highest number of cases was selected and others were excluded from the study. Then, the included cases were grouped into four according to the POSEIDON criteria and analyzed for the mentioned variables by SPSS, version 25. The statistical significance level was set as P-value < 0.05. RESULTS From 383 cases, a total number of 96 women were enrolled in this study. According to the POSEIDON criteria, group 4 (Age ≥ 35 years, AMH < 1.2 ng/mL) with the ratio of 56/96 (58.3%) had the highest prevalence among others. As the analyses showed, changes in the laboratory variables (LH, FSH, AMH, and estradiol) were not significant in almost all the groups following the intervention. Regarding the total oocytes number, PRP administration caused a significant increase in the total number in all the groups (all P < 0.05). Also, the number of MII oocytes was significantly increased following the treatment in all groups except for group 2 (Age ≥ 35 years, AMH ≥ 1.2 ng/mL; all P < 0.05). Of 96 cases, 14 (14.6%) got clinically pregnant following assisted reproductive techniques which this number were significantly differed among the groups (P = 0.002). CONCLUSION This study showed that PRP treatment was effective on total and MII oocyte numbers in the patients with POR, however, further studies are required.
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Affiliation(s)
- Marzieh Farimani
- Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arash Nazari
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Roghayeh Anvari Aliabad
- Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
- Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
- Endometrium and Endometriosis Research Center, Fatemieh Hospital, Pasdaran Street, P.O. Box, 89971-65177, Hamadan, Iran.
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19
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Norooznezhad AH, Mansouri K. Endothelial cell dysfunction, coagulation, and angiogenesis in coronavirus disease 2019 (COVID-19). Microvasc Res 2021; 137:104188. [PMID: 34022205 PMCID: PMC8135191 DOI: 10.1016/j.mvr.2021.104188] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/08/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been led to a pandemic emergency. So far, different pathological pathways for SARS-CoV-2 infection have been introduced in which the excess release of pro-inflammatory cytokines (such as interleukin 1 β [IL-1β], IL-6, and tumor necrosis factor α [TNFα]) has earned most of the attentions. However, recent studies have identified new pathways with at least the same level of importance as cytokine storm in which endothelial cell (EC) dysfunction is one of them. In COVID-19, two main pathologic phenomena have been seen as a result of EC dysfunction: hyper-coagulation state and pathologic angiogenesis. The EC dysfunction-induced hypercoagulation state seems to be caused by alteration in the levels of different factors such as plasminogen activator inhibitor 1 (PAI-1), von Willebrand factor (vWF) antigen, soluble thrombomodulin, and tissue factor pathway inhibitor (TFPI). As data have shown, these thromboembolic events are associated with severity of disease severity or even death in COVID-19 patients. Other than thromboembolic events, pathologic angiogenesis is among the recent findings. Furthermore, over-expression/higher levels of different proangiogenic factors such as vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1 α (HIF-1α), IL-6, TNF receptor super family 1A and 12, and angiotensin-converting enzyme 2 (ACE2) have been found in the lung biopsies/sera of both survived and non-survived COVID-19 patients. Also, there are some hypotheses regarding the role of nitric oxide in EC dysfunction and acute respiratory distress syndrome (ARDS) in SARS-CoV-2 infection. It has been demonstrated that different pathways involved in inflammation are generally common with EC dysfunction and angiogenesis. Altogether, considering the common possible upstream pathways in cytokine storm, pathologic angiogenesis, and EC dysfunction, it seems that targeting these molecules (such as nuclear factor κB) could be more effective in the management of patients with COVID-19.
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Affiliation(s)
- Amir Hossein Norooznezhad
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Kamran Mansouri
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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20
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Kuffler DP. Eliminating non-healing wounds: a review. Regen Med 2021; 16:391-404. [PMID: 33876695 DOI: 10.2217/rme-2020-0163] [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: 11/21/2022] Open
Abstract
Non-healing cutaneous wounds, including pressure, diabetic and venous ulcers, are wounds where the skin and underlying tissues die due to ischemia, infection, metabolic conditions, immunosuppression or radiation. Some can be eliminated with relatively straightforward techniques, although they may continue to grow in diameter and depth, becoming increasingly painful and never heal. Others respond more slowly or poorly to treatment, while others are recalcitrant to treatments. This review examines the etiology of non-healing wounds and different wound management treatments. In addition, it examines the efficacy of platelet-rich plasma in promoting wound healing and its potential mechanisms of action. It is concluded that platelet-rich plasma alone, but more effectively when combined with another technique(s), has the greatest potential for promoting complete wound healing. However, further studies are required to determine whether the efficacy of wound healing induced by each of these techniques is enhanced by applying the techniques simultaneously.
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Affiliation(s)
- Damien P Kuffler
- Institute of Neurobiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00901, USA
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21
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Filova E, Blanquer A, Knitlova J, Plencner M, Jencova V, Koprivova B, Lisnenko M, Kostakova EK, Prochazkova R, Bacakova L. The Effect of the Controlled Release of Platelet Lysate from PVA Nanomats on Keratinocytes, Endothelial Cells and Fibroblasts. NANOMATERIALS 2021; 11:nano11040995. [PMID: 33924537 PMCID: PMC8070234 DOI: 10.3390/nano11040995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 01/13/2023]
Abstract
Platelet lysate (PL) provides a natural source of growth factors and other bioactive molecules, and the local controlled release of these bioactive PL components is capable of improving the healing of chronic wounds. Therefore, we prepared composite nanofibrous meshes via the needleless electrospinning technique using poly(vinyl alcohol) (PVA) with a high molecular weight and with a high degree of hydrolysis with the incorporated PL (10% w/w). The morphology, wettability and protein release from the nanofibers was then assessed from the resulting composite PVA–PL nanomats. The bioactivity of the PVA–PL nanomats was proved in vitro using HaCaT keratinocytes, human saphenous endothelial cells (HSVECs) and 3T3 fibroblasts. The PVA–PL supported cell adhesion, proliferation, and viability. The improved phenotypic maturation of the HaCaT cells due to the PVA–PL was manifested via the formation of intermediate filaments positive for cytokeratin 10. The PVA–PL enhanced both the synthesis of the von Willebrand factor via HSVECs and HSVECs chemotaxis through membranes with 8 µm-sized pores. These results indicated the favorable effects of the PVA–PL nanomats on the three cell types involved in the wound healing process, and established PVA–PL nanomats as a promising candidate for further evaluation with respect to in vivo experiments.
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Affiliation(s)
- Elena Filova
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, 1083, 142 20 Prague, Czech Republic; (A.B.); (J.K.); (M.P.); (L.B.)
- Correspondence: ; Tel.: +420-2944-3742
| | - Andreu Blanquer
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, 1083, 142 20 Prague, Czech Republic; (A.B.); (J.K.); (M.P.); (L.B.)
| | - Jarmila Knitlova
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, 1083, 142 20 Prague, Czech Republic; (A.B.); (J.K.); (M.P.); (L.B.)
| | - Martin Plencner
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, 1083, 142 20 Prague, Czech Republic; (A.B.); (J.K.); (M.P.); (L.B.)
| | - Vera Jencova
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic; (V.J.); (B.K.); (M.L.); (E.K.K.)
| | - Barbora Koprivova
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic; (V.J.); (B.K.); (M.L.); (E.K.K.)
| | - Maxim Lisnenko
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic; (V.J.); (B.K.); (M.L.); (E.K.K.)
| | - Eva Kuzelova Kostakova
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic; (V.J.); (B.K.); (M.L.); (E.K.K.)
| | - Renata Prochazkova
- Regional Hospital Liberec, Husova 357/10, 460 63 Liberec, Czech Republic;
- Faculty of Health Studies, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic
| | - Lucie Bacakova
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, 1083, 142 20 Prague, Czech Republic; (A.B.); (J.K.); (M.P.); (L.B.)
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22
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GAMAL WM, OMAR MA, RASHWAN AH, MOHAMED AF. Role of autologous platelet rich plasma in management of chronic wounds. Chirurgia (Bucur) 2021. [DOI: 10.23736/s0394-9508.20.05119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Wang S, Yang J, Zhao G, Liu R, Du Y, Cai Z, Luan J, Shen Y, Chen B. Current applications of platelet gels in wound healing-A review. Wound Repair Regen 2021; 29:370-379. [PMID: 33749992 DOI: 10.1111/wrr.12896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/27/2020] [Accepted: 01/13/2021] [Indexed: 12/21/2022]
Abstract
Human platelets play important roles in several physiologic and pathologic processes. Platelet concentrates are activated with thrombin or calcium, resulting in a viscous coagulum (platelet gel [PG]), composed of 95% platelets at least. PG is increasingly used for the treatment of a variety of soft and hard tissue defects, most notably in the management of chronic non-healing wounds. During wound healing, platelets not only play a critical role in primary hemostasis and thrombosis, but also release growth factors and cytokines to promote tissue regeneration, enhance collagen synthesis, and trigger an immune response. This review addresses a variety of aspects relevant to the functions of well-known platelet growth factors, animal and clinical studies of PG in the last decade, and different sources of platelets for PG. PG is used for non-healing chronic wounds, such as oral ulcerations related to epidermolysis bullosa and chronic graft-versus-host disease, for those, the traditional treatment effect is poor. PG maybe provide a new therapeutic direction for these diseases. Nevertheless, some uncertainty is present, the number of clinical studies is not enough. Hence, randomized controlled trials are still required to study the potential of the use of PG in the near future.
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Affiliation(s)
- Shujun Wang
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Jinling Hospital Department Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Jie Yang
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Guangchao Zhao
- Jinling Hospital Department Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Ran Liu
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ying Du
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Zhimei Cai
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Jianfeng Luan
- Jinling Hospital Department Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Yanfei Shen
- School of Medicine, Southeast University, Nanjing, China
| | - Baoan Chen
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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24
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Malekpour Alamdari N, Shafiee A, Mirmohseni A, Besharat S. Evaluation of the efficacy of platelet-rich plasma on healing of clean diabetic foot ulcers: A randomized clinical trial in Tehran, Iran. Diabetes Metab Syndr 2021; 15:621-626. [PMID: 33740736 DOI: 10.1016/j.dsx.2021.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Diabetic foot ulcers (DFUs) are among challenging hurdles both for the patient and the physician. There is a recent trend toward finding novel and clinically efficient modalities to treat this potentially hazardous complication of diabetes mellitus in a timely manner. Herein, we aim to appraise the efficacy of platelet-rich plasma (PRP) in healing of clean DFUs. METHODS 90 patients with clean DFUs consisting of 56 (62.2%) males and 34 (37.8%) females with mean age (±standard deviation) of 56.52 (±7.14) years were enrolled in this study between June 2017 and December 2018. They were randomly allocated into control group (47 patients who received conventional dressing along with silver sulfadiazine ointment twice daily), and case group (43 patients who received PRP gel twice weekly for 3 weeks). All the patients were followed up for 6 months. RESULTS Our study showed that PRP significantly increased the healing rate of DFUs regardless of the age (p-value: 0.0), gender (p-value: 0.0), or smoking (p-value: 0.0) and blood pressure (p-value: 0.0) status of patients, but it did not have a significant impact on the need for amputation (p-value: 0.11), level of amputation (p-value: 0.16), or the need for further treatments such as graft or angioplasty (p-value: 0.52). CONCLUSION Regardless of the age, gender, or smoking and blood pressure status of patients, PRP can be efficiently used in diabetic patients to accelerate the healing rate of foot ulcers.
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Affiliation(s)
- Nasser Malekpour Alamdari
- Critical Care Quality Improvement Research Center at Shahid Modarres Hospital, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Clinical Research and Development Center at Shahid Modarres Hospital, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Shafiee
- Clinical Research and Development Center at Shahid Modarres Hospital, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Mirmohseni
- Clinical Research and Development Center at Shahid Modarres Hospital, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Besharat
- Clinical Research and Development Center at Shahid Modarres Hospital, Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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25
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Shao S, Pan R, Chen Y. Autologous Platelet-Rich Plasma for Diabetic Foot Ulcer. Trends Endocrinol Metab 2020; 31:885-890. [PMID: 33199085 DOI: 10.1016/j.tem.2020.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 12/28/2022]
Abstract
Application of autologous platelet-rich plasma (PRP), especially leukocyte- and platelet-rich fibrin (L-PRF), has emerged as a promising adjuvant therapy for the treatment of diabetic foot ulcers (DFUs). Conflicting results of PRP efficacy can be attributed to the lack of standardization in the PRP preparation process in addition to a paucity of well-designed randomized clinic trials (RCTs).
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Affiliation(s)
- Shiying Shao
- Division of Endocrinology, Internal Medicine, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China, 430030
| | - Ruping Pan
- Department of Nuclear Medicine, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China, 430030
| | - Yong Chen
- Division of Endocrinology, Internal Medicine, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China, 430030; Laboratory of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China, 430030.
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26
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Bayer A, Höntsch G, Kaschwich M, Dell A, Siggelkow M, Berndt R, Rusch R, Harder J, Gläser R, Cremer J. Vivostat Platelet-Rich Fibrin ® for Complicated or Chronic Wounds-A Pilot Study. Biomedicines 2020; 8:biomedicines8080276. [PMID: 32781647 PMCID: PMC7459803 DOI: 10.3390/biomedicines8080276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022] Open
Abstract
Vivostat Platelet-Rich Fibrin® (PRF) is an autologous platelet concentrate used for the local treatment of chronic or complicated wounds. Still, its application for this indication is not evidence-based. Therefore, we performed this monocentric retrospective pilot study investigating the clinical outcome of a local treatment of chronic or complicated wounds in 35 patients (23 male, 12 female, mean age 68.7 years) treated with Vivostat PRF®. This study population is the largest among published studies analyzing the clinical efficacy of Vivostat PRF® on chronic wounds so far. Using the perpendicular method we divided the wounds into three sizes (<10, 10–30, and >30 cm2). The clinical efficacy of the Vivostat PRF treatment was the primary endpoint and was divided into three groups of increasing degrees of wound improvement: (1) no improvement of the wound (wound area was not reduced > 10% under Vivostat PRF® treatment), (2) improvement of the wound (reduced area > 10% under Vivostat PRF® treatment) and (3) complete epithelialization (wounds that were completely re-epithelialized after Vivostat PRF® treatment). We included patients’ diagnosis and concomitant diseases (peripheral arterial occlusive disease (PAOD)), chronic venous insufficiency (CVI)), diabetic foot syndrome (DFS)) in our data analysis in order to investigate their potential impact on the wound healing capacity of Vivostat PRF®. Our results show that in the entire study population, 13 out of 35 (37.1%) patients experienced wound improvement and 14 out of 35 (40%) patients showed complete epithelialization of their wound under Vivostat PRF® treatment. In summary, 77.1% of the treated patients benefited from the Vivostat PRF® therapy. These positive wound healing effects were all observed within the first three to six Vivostat PRF® applications. Subgroup analyses showed that Vivostat PRF® appeared to be more efficient in patients without CVI in comparison to patients with CVI (p = 0.02). Moreover, Vivostat PRF® treatment seems to be particularly efficient in PAOD-related wounds with a reduced crural arterial blood supply (p = 0.01). Additionally, we performed an experimental human in vivo study on ten male students where we artificially generated bilateral gluteal wounds and analyzed the influence of the Vivostat PRF® treatment on the expression of two genes (human beta Defensin-2, ((hBD-2) and human beta-Defensin-3 (hBD-3)) in keratinocytes of resected wound specimens that are induced during wound healing. Interestingly, this analysis revealed that only seven of out ten individuals showed a relevant hBD-2 and hBD-3 gene induction after Vivostat PRF® treatment. This led to the novel “key-lock-hypothesis”. With the goal of an individualized precision medicine approach with optimized wound treatment strategies in the future, this is an important observation that demands further experimental and clinical studies.
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Affiliation(s)
- Andreas Bayer
- Institute of Anatomy, Kiel University, Olshausenstr. 40, 24098 Kiel, Germany
- Correspondence:
| | - Gesa Höntsch
- Department of Heart and Vascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus C, 24105 Kiel, Germany; (G.H.); (R.B.); (R.R.); (J.C.)
| | - Mark Kaschwich
- Department of Surgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.K.); (A.D.)
| | - Annika Dell
- Department of Surgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.K.); (A.D.)
| | - Markus Siggelkow
- Department of Vascular and Thoracic Surgery, Imland Clinic Rendsburg, Lilienstraße 20–28, 24768 Rendsburg, Germany;
| | - Rouven Berndt
- Department of Heart and Vascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus C, 24105 Kiel, Germany; (G.H.); (R.B.); (R.R.); (J.C.)
| | - Rene Rusch
- Department of Heart and Vascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus C, 24105 Kiel, Germany; (G.H.); (R.B.); (R.R.); (J.C.)
| | - Jürgen Harder
- Department of Dermatology, Kiel University, Rosalind-Franklin-Str. 9, 24105 Kiel, Germany; (J.H.); (R.G.)
| | - Regine Gläser
- Department of Dermatology, Kiel University, Rosalind-Franklin-Str. 9, 24105 Kiel, Germany; (J.H.); (R.G.)
| | - Jochen Cremer
- Department of Heart and Vascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus C, 24105 Kiel, Germany; (G.H.); (R.B.); (R.R.); (J.C.)
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Dai J, Jiang C, Sun Y, Chen H. Autologous platelet-rich plasma treatment for patients with diabetic foot ulcers: a meta-analysis of randomized studies. J Diabetes Complications 2020; 34:107611. [PMID: 32402839 DOI: 10.1016/j.jdiacomp.2020.107611] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/17/2020] [Accepted: 04/19/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study will explore the effectiveness and safety of autologous PRP in the treatment of patients with DFU. METHODS The electronic databases of PubMed, EMBASE, BIOSIS, Cochrane central, and Google Scholar internet were searched updated on Jan 30, 2020. Evaluated outcomes included rate of complete ulcer healing, time to healing and adverse events. Statistical analysis was performed with RevMan 5.0 software and STATA 10.0 software. RESULTS Ten RCTs with 456 patients were included in this study. The meta-analysis showed a higher complete ulcer healing rate (RR = 1.32, 95% CI 1.06 to 1.65, P = 0.01, I2 = 57%), a shorter healing time (MD = -23.42, 95% CI -37.33 to -9.51, P = 0.01, I2 = 78%), with no increasing the incidence of adverse events (RR = 0.48, 95% CI 0.22 to 1.05, P = 0.75, I2 = 0%) in PRP group compared with control. Mixed evidence was seen for publication bias, but analyses by using the trim-and-fill method did not appreciably alter results. CONCLUSION Our findings suggest that autologous PRP may improve the complete ulcer healing rate, shorten the healing time, with no increasing the incidence of adverse events.
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Affiliation(s)
- Jiezhi Dai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China
| | - Chaoyin Jiang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China
| | - Yangbai Sun
- Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer center, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Hua Chen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China.
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Mallis P, Alevrogianni V, Sarri P, Velentzas AD, Stavropoulos-Giokas C, Michalopoulos E. Effect of Cord Blood Platelet Gel on wound healing capacity of human Mesenchymal Stromal Cells. Transfus Apher Sci 2020; 59:102734. [PMID: 32005441 DOI: 10.1016/j.transci.2020.102734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/02/2020] [Accepted: 01/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Wound healing is a dynamic process, involving the recruitment of growth factors, cytokines, chemokines and cellular populations. Recently, the Cord Blood Platelet Gel (CBPG) has been applied successfully in wound closure and tissue regeneration. Moreover, its proper combination with stem cell populations such as Mesenchymal Stromal Cells (MSCs) may positively improve the wound healing process. Based on the above data, this study aimed to the evaluation of wound healing capacity of MSCs combined with CBPG under in vitro conditions. METHODS Initially, CBPG was developed from Cord Blood Units (CBUs). The determination of wound healing ability of MSCs was performed using the scratch wound assay. In addition, the morphological features, immunophenotypical characteristics and differentiation capacity of MSCs were evaluated. RESULTS Scratch wound assay results showed, that CBPG could positively stimulate the MSCs migration. Moreover, MSCs cultured in presence of CBPG were characterized by elongated shape and improved stemness properties as it was indicated by flow cytometric analysis and differentiation process. CONCLUSION These results clearly showed the beneficial effect of CBPG in combination with MSCs in wound healing. The proper combination of CBPG with stem cells strategy may enhance the healing process in patients with skin erosions.
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Affiliation(s)
- Panagiotis Mallis
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Greece.
| | - Vivian Alevrogianni
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Greece
| | - Phaedra Sarri
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Greece
| | - Athanassios D Velentzas
- Department of Biology, Section of Cell Biology and Biophysics, School of Science, National and Kapodistrian University of Athens, Greece
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Jaseem M, Alungal S, Dhiyaneswaran, Shamsudeen J. Effectiveness of autologous PRP therapy in chronic nonhealing ulcer: A 2-year retrospective descriptive study. J Family Med Prim Care 2020; 9:2818-2822. [PMID: 32984132 PMCID: PMC7491759 DOI: 10.4103/jfmpc.jfmpc_177_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 01/25/2023] Open
Abstract
CONTEXT Chronic nonhealing ulcer is a troublesome condition in patients especially with diabetes. Autologous PRP therapy can safely and effectively heal a chronic nonhealing ulcer in such patients. AIMS To study the effectiveness of autologous PRP therapy in a chronic nonhealing ulcer. SETTINGS AND DESIGN A retrospective descriptive study from previous case records of chronic nonhealing ulcer patients who were treated with autologous PRP therapy at a specialty orthopedic hospital from September 2017 to August 2019. METHODS AND MATERIALS Data on patients who presented with chronic nonhealing ulcers of >4 weeks duration who were treated with autologous PRP therapy and followed up for 20 weeks. STATISTICAL ANALYSIS USED Statistical Package for the Social Sciences (SPSS) version 20 was used to calculate mean. Microsoft Excel was used for preparing the chart. RESULTS The mean age of patients treated with autologous PRP therapy was 61.24 years, and the follow-up period was 20 weeks. The mean duration of ulcer healing following PRP therapy was 11.25 weeks, 80% of the patient showed ulcer size reduction of >75% following therapy. CONCLUSIONS In this retrospective descriptive study, it has demonstrated the effectiveness and safety of autologous PRP therapy in the healing of chronic nonhealing ulcers.
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Affiliation(s)
- Muhammed Jaseem
- Department of Orthopedics, Department of General Medicine, Asten Specialty Orthopedic Hospital, Pantheerankav, Calicut, Kerala, India
| | - Shana Alungal
- Department of Orthopedics, Department of General Medicine, Asten Specialty Orthopedic Hospital, Pantheerankav, Calicut, Kerala, India
| | - Dhiyaneswaran
- Department of Orthopedics, Department of General Medicine, Asten Specialty Orthopedic Hospital, Pantheerankav, Calicut, Kerala, India
| | - Jaseem Shamsudeen
- Department of Orthopedics, Department of General Medicine, Asten Specialty Orthopedic Hospital, Pantheerankav, Calicut, Kerala, India
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Yin S, Yang X, Bi H, Zhao Z. Combined Use of Autologous Stromal Vascular Fraction Cells and Platelet-Rich Plasma for Chronic Ulceration of the Diabetic Lower Limb Improves Wound Healing. INT J LOW EXTR WOUND 2020; 20:135-142. [PMID: 32131655 DOI: 10.1177/1534734620907978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The discovery of stromal vascular fraction cells and platelet-rich plasma in promoting tissue regeneration has prompted a new idea for the treatment of chronic diabetic ulcer of the lower limb. The study aim was to evaluate the clinical efficacy of a new method that applied stromal vascular fraction cells and platelet-rich plasma together in the treatment of recalcitrant chronic diabetic ulcer. We conducted a single-center, prospective, open, noncontrolled study. Four patients (5 ulcers in total) who had received standard treatment for diabetic ulcer for at least 3 months that failed to heal was enrolled. All patients were treated with surgical debridement, cell suspension (stromal vascular fraction cells suspended by platelet-rich plasma) injection into the wound, and platelet-rich plasma gel coverage. Wounds were measured every week after treatment using a 2-dimensional digital camera and a 3-dimensional wound measurement device. All patients were followed-up for 4 months after the treatment. Four of the 5 ulcers healed completely within a mean of 71.75 ± 29.57 days. The average proportion of granulation tissue achieved 100% within 4 weeks for all cases. The wound size decreased to less than half of the original size for all cases 4 weeks after the treatment. Findings revealed that the new treatment is efficient to achieve wound healing in patients with recalcitrant chronic diabetic ulcer of lower limb.
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Affiliation(s)
- Shilu Yin
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Xin Yang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Hongsen Bi
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Zhenmin Zhao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
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Aurix Gel Is an Effective Intervention for Chronic Diabetic Foot Ulcers: A Pragmatic Randomized Controlled Trial. Adv Skin Wound Care 2020; 32:416-426. [PMID: 31436621 PMCID: PMC7328869 DOI: 10.1097/01.asw.0000577140.19174.9e] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Supplemental digital content is available in the text. BACKGROUND Autologous platelet-rich plasma products can significantly vary with respect to platelet concentration, the presence of additional cellularity, and the use of additives. Therefore, the utility of each formulation for treating chronic wounds needs to be established. OBJECTIVE To establish the efficacy of up to 12 weeks of treatment with Aurix hematogel for healing diabetic foot ulcers against usual and customary care including any wound modality in 129 patients using a Medicare Coverage with Evidence Development paradigm. METHODS This pragmatic randomized controlled trial was conducted in 28 real-world outpatient wound care sites using an inclusive design that included participants with various health risks, comorbidities (eg, peripheral arterial disease, smoking), and any wound severity (Wagner 1–4). RESULTS Kaplan-Meier analysis showed a significant (log-rank P = .0476) time-to-heal advantage, with 48.5% of wounds healing with Aurix hematogel compared with 30.2% with usual and customary care. A higher percentage of healing was observed for Aurix across all wound severities (Wagner grade 1–4). Subgroup analysis revealed a significant healing advantage for Aurix when treating wounds accompanied by peripheral arterial disease and a demonstrated advantage for smokers. CONCLUSIONS This first Coverage with Evidence Development study in wound care demonstrates the effectiveness of Aurix for treating diabetic foot ulcers in Medicare beneficiaries.
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Rezazadeh D, Anvari Aliabad R, Norooznezhad AH. Autologous amniotic membrane: An accelerator of wound healing for prevention of surgical site infections following Cesarean delivery. Med Hypotheses 2019; 137:109532. [PMID: 31901609 DOI: 10.1016/j.mehy.2019.109532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/29/2019] [Accepted: 12/15/2019] [Indexed: 02/04/2023]
Abstract
Cesarean delivery (CD) has been known as the most common surgery in the United States. This procedure might associate with different complications, the most important of which is surgical site infection (SSI). Among the major SSI categories, incisional type is more common than the others. Regardless of its notable expense, the use of prophylactic wound healing technics (such as negative pressure therapy) has been advised for the patients with high SSI risk. Herein, use of patient's own human amniotic membrane in an autologous form (as a free of charge treatment) would be suggested for prevention of SSI in CD wounds. Human amniotic membrane (hAM) has been used for treatment of acute and chronic wounds and shown to be able to reduce the infection and the pain along with accelerating the healing process. Moreover, it has been shown in a systematic review and meta-analysis that hAM could significantly improve the treatment rate in comparison to the standard of care dressing (RR 2.057-3.665, P < 0.001) during a set time of six weeks. Wound duration on the other hand, has been shown to negatively associate with SSI. Furthermore, there is data supporting the critical role of tissue perfusion in the acceleration of wound healing along with decreasing the rate of wound infection. Angiogenesis, the formation of new blood vessels from their existing capillaries, is among the most crucial pathways involved in increasing tissue perfusion and wound healing. Interestingly, hAM is a rich source of pro-angiogenic and other tissue growth factors with the ability of inducing angiogenesis as well as strong antibacterial peptides. Taken together, authors suggest autologous application of hAM in the high (even low) risk patients undergoing CD in order to decrease wound related complications such as SSI and accelerate the healing time as a free wound healer. However, further randomized clinical trials are necessary.
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Affiliation(s)
- Davood Rezazadeh
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roghayeh Anvari Aliabad
- Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Hossein Norooznezhad
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Regenerative Medicine Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Mohamadi S, Norooznezhad AH, Mostafaei S, Nikbakht M, Nassiri S, Safar H, Moghaddam KA, Ghavamzadeh A, Kazemnejad A. A randomized controlled trial of effectiveness of platelet-rich plasma gel and regular dressing on wound healing time in pilonidal sinus surgery: Role of different affecting factors. Biomed J 2019; 42:403-410. [PMID: 31948604 PMCID: PMC6963006 DOI: 10.1016/j.bj.2019.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/02/2018] [Accepted: 05/02/2019] [Indexed: 12/16/2022] Open
Abstract
Background The aim of this study was to assess the possible association between different factors such as age, sex, antibiotic consumption duration, angiogenesis and pain and “acceleration of wound healing” in pilonidal sinus patients after treating with platelet-rich plasma (PRP). Methods In this clinical trial, 110 patients were randomly divided into treatment arm and control group. After surgery, control group underwent classic wound dressing and the treatment arm experienced PRP gel therapy. Before achieving complete healing, wound incisional biopsy was performed in order to evaluate angiogenesis. During the study, other data such as pain and antibiotic consumption duration were also collected. Wound healing time of pilonidal sinus disease was analyzed using Extended and Stratify Cox model. Data were analyzed using R and STATA software. p<0.05 were considered statistically significant. Results The average wound volume was calculated 41.9 ± 8.01 cc in the controls and 42.35 ± 10.81 in the treatment arm group. The mean of healing time was 8.7 ± 1.18, 4.8 ± 0.87 weeks for control and treatment arm, respectively. There was a significant and strong negative association between healing time and wound volume (p<0.01). Moreover, a significant negative association was found between pain duration and angiogenesis (p<0.001), a strong positive significant association was found between healing time of the treatment arms (p<0.01), and the rate of wound healing for participants treated with PRP gel was 37.2 times more than that of controls. Conclusion Authors hope for these finding to help the future researches to more thoroughly focus on the mentioned factors in order to find a suitable strategy for wound healing using PRP.
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Affiliation(s)
- Saeed Mohamadi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Norooznezhad
- Regenerative Medicine Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shayan Mostafaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Nikbakht
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirzad Nassiri
- Surgery Ward, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hiva Safar
- Pathology Ward, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Ali Moghaddam
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Ghavamzadeh
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Tian J, Cheng L, Cui X, Lei X, Tang J, Cheng B. Investigating the effect of age on platelet ultrastructure using transmission electron microscopy. Int Wound J 2019; 16:1457-1463. [PMID: 31486290 PMCID: PMC7949169 DOI: 10.1111/iwj.13214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/17/2019] [Accepted: 08/18/2019] [Indexed: 12/15/2022] Open
Abstract
In the present study, the age- and sex-related differences in platelet ultrastructure were investigated using transmission electron microscopy (TEM). A total of 15 healthy volunteers were grouped according to age, with 5 people in each of the following groups: young group (25-45 years), middle-aged group (46-65 years), and old-aged group (> 65 years). In the TEM micrographs, the internal components, specifically the α-granules, dense granules, and lysosomal granules, of 20 platelets were counted for each group. Two-way analysis of variance of age and sex variance was used to compare the results. The ultrastructure of the platelets in the old-aged group was observed to be quite different from those of the young and middle-aged groups. Specifically, with ageing, the platelet membrane becomes more irregular in shape and non-smooth, and multiple platelet membrane ruptures are observed. Furthermore, the pseudopodia and protuberances become more numerous and slender, and the number of α-granules is significantly reduced. These morphological changes indicate that ageing may affect the function of platelets, which in turn affects the efficacy of platelet concentrates. Thus, the effects of age should be considered when using platelet concentrates prepared from elderly autologous blood.
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Affiliation(s)
- Ju Tian
- Department of Plastic SurgeryZhongshan City People's HospitalZhongshanGuangdongChina
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
| | - Liu‐Hang‐Hang Cheng
- Key Laboratory of Tissue Repair and Regeneration of PLA, and Beijing Key Research Laboratory of Skin Injury, Repair and RegenerationThe Fourth Medical Center of General Hospital of PLABeijingChina
- Institute of Basic Medical SciencesGeneral Hospital of PLABeijingChina
| | - Xiao Cui
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouGuangdongChina
| | - Xiao‐Xuan Lei
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
| | - Jian‐Bing Tang
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
| | - Biao Cheng
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
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Xu J, Wang QY, Li W. Autologous platelet-rich gel and continuous vacuum sealing drainage for the treatment of patients with diabetic foot ulcer: Study Protocol. Medicine (Baltimore) 2019; 98:e17928. [PMID: 31725645 PMCID: PMC6867736 DOI: 10.1097/md.0000000000017928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Research focusing on the efficacy of autologous platelet-rich gel (APRG) and continuous vacuum sealing drainage (CVSD) for diabetic foot ulcer (DFU) is increasing. Despite increasing knowledge on this theme, its results remain inconsistent. Thus, we will provide insight into the efficacy of APRG and CVSD for patients with DFU. METHODS We will search electronic databases of MEDILINE, EMBASE, Cochrane Library, CINAHL, AMED, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to October 1, 2019. No language limitation is utilized to these databases. Two authors will independently perform study selection, data extraction, and risk of bias assessment. Disagreements between 2 authors will be solved through discussion with a third author. RESULTS The efficacy and safety of APRG and CVSD for patients with DFU will be assessed by the time to complete healing, proportion of ulcers healed within trial period, change of size of ulcer, health-related quality of life, patient length of hospital stay, and adverse events. CONCLUSION The results of this study will provide helpful evidence of APRG and CVSD for patients with DFU. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019153289.
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Affiliation(s)
- Jie Xu
- Department of Endocrine and Metabolism
| | - Qiao-Yun Wang
- Department of Ultrasound Diagnosis, Yan’an University Affiliated Hospital, Yan’an, China
| | - Wei Li
- Department of Endocrine and Metabolism
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Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments. Antibiotics (Basel) 2019; 8:antibiotics8040193. [PMID: 31652990 PMCID: PMC6963879 DOI: 10.3390/antibiotics8040193] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022] Open
Abstract
Diabetic foot ulcers (DFUs) are very important diabetes-related lesions that can lead to serious physical consequences like amputations of limbs and equally severe social, psychological, and economic outcomes. It is reported that up to 25% of patients with diabetes develop a DFU in their lifetime, and more than half of them become infected. Therefore, it is essential to manage infection and ulcer recovery to prevent negatives outcomes. The available information plays a significant role in keeping both physicians and patients aware of the emerging therapies against DFUs. The purpose of this review is to compile the currently available approaches in the managing and treatment of DFUs, including molecular and regenerative medicine, antimicrobial and energy-based therapies, and the use of plant extracts, antimicrobial peptides, growth factors, ozone, devices, and nano-medicine, to offer an overview of the assessment of this condition.
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Zhong Z, Huang H, Han Y, Dong W. Efficacy of continuous intravenous pumping of insulin for patients with diabetes complicated with perianal abscess and the effect on inflammatory cytokines. Exp Ther Med 2019; 18:1539-1544. [PMID: 31410107 PMCID: PMC6676185 DOI: 10.3892/etm.2019.7773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/10/2019] [Indexed: 12/27/2022] Open
Abstract
Efficacy of insulin with different administrations for patients with diabetes complicated with perianal abscess and the effect on serum inflammatory cytokines were investigated. One hundred and sixty-seven patients with type 2 diabetes who underwent radical operation of perianal abscess in Jinhua Hospital of Zhejiang University from January 2014 to December 2016 were analyzed. Before and after the operation, 89 patients who received continuous intravenous pumping of insulin for blood glucose control were set as an observation group, and 78 patients who received intermittent subcutaneous injection of insulin as a control group. The operative efficacy, wound healing time and 1-week postoperative growth of the granulation tissue were scored and compared. Fasting blood glucose (FBG) and 2 h postprandial blood glucose (2hPBG) before and after treatment were recorded and compared. Fasting venous blood was extracted before and on the 3rd and 7th days after operation to detect and compare serum inflammatory cytokines including tumor necrosis factor (TNF-α) and interleukin-6 (IL-6). Patients in the observation group had significantly higher total effective rate of the operation than that in the control group (P<0.05), and significantly shorter wound healing time and significantly lower growth score of the granulation tissue (P<0.05). Before treatment, there was no significant difference between the two groups in FBG and 2hPBG (P>0.05). After treatment, FBG and 2hPBG were significantly lower than those before treatment (P<0.050), and FBG and 2hPBG after treatment in the observation group were significantly lower than those in the control group (P<0.05). In conclusion, insulin pumps for injection during the perioperative period of patients with diabetes complicated with perianal abscess can better control the patients' blood glucose, improve the operative efficacy and promote the patients' postoperative healing. Moreover, continuous intravenous pumping of insulin is significantly better than traditional intermittent subcutaneous injection of it in controlling inflammation, so it is worthy of application.
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Affiliation(s)
- Zhifeng Zhong
- Department of Colorectal and Anal Surgery, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, P.R. China
| | - Huaying Huang
- Department of Endocrinology and Metabolism, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, P.R. China
| | - Yuejun Han
- Department of Colorectal and Anal Surgery, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, P.R. China
| | - Wuzhen Dong
- Department of Colorectal and Anal Surgery, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang 321000, P.R. China
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Platelet-rich plasma and its utility in medical dermatology: A systematic review. J Am Acad Dermatol 2019; 81:834-846. [PMID: 31009668 DOI: 10.1016/j.jaad.2019.04.037] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/09/2019] [Accepted: 04/14/2019] [Indexed: 02/06/2023]
Abstract
The field of dermatology has seen numerous therapeutic innovations in the past decade with platelet-rich plasma (PRP), recently garnering significant interest in alopecia, acne scarring, and skin rejuvenation. In other conditions of dermatology, such as chronic wounds and vitiligo, PRP has been investigated but has received less attention. The objective of this literature review was to focus on conditions of medical dermatology and to consolidate the available evidence on PRP for the practicing dermatologist. This review evaluates the literature up to October 31, 2018, and a search was conducted in the PubMed database for "platelet-rich plasma," "platelet releasate," "platelet gel," "platelet-rich fibrin" or "PRP" and "dermatology," "skin," "cutaneous," "wound," or "ulcer." In total, 14 articles met the inclusion criteria for this review. In studies representing Levels of Evidence 1b-4 according to the Centre for Evidence-Based Medicine, Oxford, PRP significantly improved wound healing in chronic diabetic ulcers, venous ulcers, pressure ulcers, leprosy ulcers, acute traumatic wounds, and ulcers of multifactorial etiologies. Two studies also documented benefits of adjunctive PRP in stable vitiligo. In chronic wounds of multiple etiologies and vitiligo, PRP warrants further investigation because it represents a potential therapeutic adjunct or alternative with a favorable side effect profile.
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Samaie Nouroozi A, Alyasin A, Malek Mohammadi A, Mehrdad N, Mousavi SA, Vaezi M, Gharib A, Ghavamzadeh A, Mohammadi S. Autologous Platelet-Released Growth Factor and Sexual Dysfunction Amendment: A Pilot Clinical Trial of Successful Improvement Sexual Dysfunction after Pelvic Irradiation. Asian Pac J Cancer Prev 2019; 20:817-823. [PMID: 30911301 PMCID: PMC6825769 DOI: 10.31557/apjcp.2019.20.3.817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sexual dysfunction (SDF) is a common sequel to cancer treatment which affects the quality of life in women treated with pelvic radiotherapy. The aim of this study was to evaluate the safety, symptom resolution and objective improvement the injection of autologous platelet released growth factor (APRGF) for treatment of SDF in cited patients. This prospective pilot study enrolled 10 cancer-free patients with SDF who underwent pelvic radiotherapy at least 5 years ago, randomly. Each patient was received 1-2 cc APRGF within four weeks and all patients were re-evaluated at eight weeks and six months. CD34 immuno histochemistry and Masson’s trichrome staining were performed on vaginal biopsy section for angiogenesis and fibrosis assay respectively. Sexual satisfaction after the injection of APRFG was clinically difference and the entire patient had sexual satisfaction. In the patient’s follow-up, none of them needs to repeat the treatment. Our results declared that APRGF injection was effective and symptoms were disappeared in the entire patients. Significant objective improvements in vaginal diameter (mean before injection, 6.5 cm vs 7.1 cm after injection) (p-value = 0.001) and vaginal flexibility (mean before treatment, 0.72 cm vs 1.85 cm after injection) (P-value = 0.026) were observed. Characteristics of discharge before the injection in 60% of patients were included dry vagina and 40% had mild discharge but after injection 40% of patients had moderate and also 60% had mild and sufficient discharge (P-value= 0.190). Overally, our patients reported better sexual function and showed better vaginal function indexes, after APRFG injection.
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Affiliation(s)
- Atefeh Samaie Nouroozi
- Department of Gynecology and Obstetrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Alyasin
- Department of Gynecology and Obstetrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Malek Mohammadi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nili Mehrdad
- Department of Gynecology and Obstetrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Asadollah Mousavi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,
| | - Mohammad Vaezi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,
| | - Atoosa Gharib
- Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ardeshir Ghavamzadeh
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,
| | - Saeed Mohammadi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,
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Nazari L, Salehpour S, Hosseini MS, Hashemi Moghanjoughi P. The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial. HUM FERTIL 2019; 23:209-213. [DOI: 10.1080/14647273.2019.1569268] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Leila Nazari
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saghar Salehpour
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadat Hosseini
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Hashemi Moghanjoughi
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhang C, Zhu Y, Lu S, Zhong W, Wang Y, Chai Y. Platelet-Rich Plasma with Endothelial Progenitor Cells Accelerates Diabetic Wound Healing in Rats by Upregulating the Notch1 Signaling Pathway. J Diabetes Res 2019; 2019:5920676. [PMID: 31559315 PMCID: PMC6735213 DOI: 10.1155/2019/5920676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/15/2019] [Indexed: 12/28/2022] Open
Abstract
Diabetic wounds, as a kind of refractory wound, are very difficult to heal. Both endothelial progenitor cell (EPC) transplantation and platelet-rich plasma (PRP) can improve diabetic wound healing to some extent. However, PRP application cannot provide reparative cells, while EPC transplantation cannot replenish the required growth factors for wound healing. Thus, when applied alone, neither of these factors is sufficient for effective wound healing. Furthermore, the proliferation, differentiation, and fate of the transplanted EPCs are not well known. Therefore, in this study, we examined the efficacy of combined PRP application with EPC transplantation in diabetic wound healing. Our results indicated that PRP application improved EPC proliferation and migration. The Notch signaling pathway plays a key role in the regulation of the proliferation and differentiation of stem cells and angiogenesis in wound healing. The application of PRP upregulated the Notch pathway-related gene and protein expression in EPCs. Furthermore, experiments with shNotch1-transfected EPCs indicated that PRP enhanced the function of EPCs by upregulating the Notch1 signaling pathway. In vivo studies further indicated that the combination of PRP and EPC transplantation increased neovascularization, reduced wound size, and improved healing in rat wound models. Thus, PRP application can provide the necessary growth factors for wound healing, while EPC transplantation offers the required cells, indicating that the combination of both is a potent novel approach for treating diabetic wounds.
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Affiliation(s)
- Cheng Zhang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd. 600, Shanghai 200233, China
| | - Yu Zhu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd. 600, Shanghai 200233, China
| | - Shengdi Lu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd. 600, Shanghai 200233, China
| | - Wanrun Zhong
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd. 600, Shanghai 200233, China
| | - Yanmao Wang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd. 600, Shanghai 200233, China
| | - Yimin Chai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd. 600, Shanghai 200233, China
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Hirase T, Ruff E, Surani S, Ratnani I. Topical application of platelet-rich plasma for diabetic foot ulcers: A systematic review. World J Diabetes 2018; 9:172-179. [PMID: 30364787 PMCID: PMC6198285 DOI: 10.4239/wjd.v9.i10.172] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/15/2018] [Accepted: 06/28/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To determine if topical application of platelet-rich plasma (PRP) to diabetic foot ulcers (DFUs) results in superior healing rates. METHODS A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Level I-IV investigations of topical PRP application in DFUs were sought in multiple databases including: MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials. The search terms used were "platelet rich plasma", "diabetes", "ulcers", and "wound". The Modified Coleman Methodology Score (MCMS) was used to analyze study methodological quality. Study heterogeneity and a mostly non-comparative nature of evidence precluded meta-analysis. Only the outcome measurements used by more than 50% of the studies were included in the data synthesis to increase power of the measurement over that of individual studies. A weighted mean of healing rate per week between PRP group vs controls were compared using two-sample z-tests using P-value of less than 0.05 for significance. RESULTS One thousand two hundred and seventeen articles were screened. Eleven articles (322 PRP subjects, 126 controls, PRP subject mean age 58.4 ± 7.2 years, control mean age 58.7 ± 5.9 years) were analyzed. Six articles were level II evidence, four were level III, and one article was level IV. The mean MCMS was 61.8 ± 7.3. Healing rate was significantly faster with PRP application compared to controls (0.68 ± 0.56 cm2/wk vs 0.39 ± 0.09 cm2/wk; P < 0.001). Mean heal time to > 90% of the original ulcer area was 7.8 ± 2.7 wk and 8.3 ± 3.7 wk for patients in the PRP group and control groups, respectively (P = 0.115). There were significantly lower adverse effects reported with PRP application compared to controls (7 wound infections, 1 contact dermatitis vs 14 wound infections, 1 maceration; P < 0.001). CONCLUSION The topical application of PRP for DFUs results in statistically superior healing rates and lower complication rates compared to controls.
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Affiliation(s)
- Takashi Hirase
- Department of Orthopaedic Surgery, Houston Methodist Hospital, Houston, TX 77030, United States
| | - Eric Ruff
- Department of Plastic and Reconstructive Surgery, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Salim Surani
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Texas A and M University, Corpus Christi, TX 77807, United States
| | - Iqbal Ratnani
- Department of Anesthesiology and Critical Care, Houston Methodist Hospital, Houston, TX 77030, United States
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Tian J, Lei XX, Xuan L, Tang JB, Cheng B. The effects of aging, diabetes mellitus, and antiplatelet drugs on growth factors and anti-aging proteins in platelet-rich plasma. Platelets 2018; 30:773-792. [PMID: 30252623 DOI: 10.1080/09537104.2018.1514110] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
As the aged population continues to markedly increase worldwide, the incidences of diabetes mellitus (DM) and cardiovascular disease (CVD) are increasing. In this study, we investigated the effects of aging, DM, and antiplatelet drugs on growth factors and anti-aging proteins in platelet-rich plasma (PRP). The study participants were classified into the following four groups: Group A, healthy individuals aged ≤45 years; Group B, healthy individuals aged >45 years; Group C, DM patients aged >45 years; and Group D, CVD patients aged >45 years taking antiplatelet drugs. The concentrations of epidermal growth factor (EGF), fibroblast growth factor (FGF)-2, platelet-derived growth factor (PDGF)-AA, PDGF-AB/BB, vascular endothelial growth factor (VEGF)-A, tissue inhibitor of metalloproteinase 2 (TIMP2), insulin-like growth factor 1 (IGF-1), growth differentiation factor (GDF)11, and clusterin in PRP samples were determined to analyze the effects of aging, DM, and antiplatelet drugs. Overall, the concentrations of IGF-1, TIMP2, and clusterin did not vary significantly between the four groups. The concentrations of PDGF-AB/BB (P = 0.010), VEGF-A (P = 0.000), and GDF11 (P = 0.026) were significantly different between Group A and Group B. Further, the concentrations of EGF (P = 0.000) and GDF11 (P = 0.000) were significantly different between Groups B and C. The concentrations of EGF (P = 0.001), VEGF-A (P = 0.000), and GDF11 (P = 0.002) significantly differed between Groups A and C. The concentrations of FGF-2 (P = 0.048), PDGF-AA (P = 0.03), and GDF11 (P = 0.001) were significantly different between Groups B and D. The concentrations of PDGF-AB/BB (P = 0.032), VEGF-A (P = 0.010), and GDF11 (P = 0.02) significantly differed between Groups A and D. We found that PRP contains high concentrations of the growth factors, TIMP2 and GDF11. Aging, DM, and antiplatelet drugs can decrease the concentration of some growth factors and GDF11, which weakens the regenerative capacity and anti-aging effects of PRP and reduces the quality of PRP.
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Affiliation(s)
- Ju Tian
- a Guangzhou School of Clinical Medicine , Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region) , Guangzhou , Guangdong , China.,b The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area , PLA , Guangzhou , Guangdong , China.,c Department of Plastic Surgery , People's Hospital of Zhongshan City , Zhongshan , Guangdong , China
| | - Xiao Xuan Lei
- a Guangzhou School of Clinical Medicine , Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region) , Guangzhou , Guangdong , China.,b The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area , PLA , Guangzhou , Guangdong , China
| | - Li Xuan
- d Department of Human Resources , Guangzhou General Hospital of People's Liberation Army , Guangzhou , Guangdong , China
| | - Jian Bing Tang
- b The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area , PLA , Guangzhou , Guangdong , China
| | - Biao Cheng
- a Guangzhou School of Clinical Medicine , Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region) , Guangzhou , Guangdong , China.,b The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area , PLA , Guangzhou , Guangdong , China
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Mostafaei S, Norooznezhad F, Mohammadi S, Norooznezhad AH. Effectiveness of platelet-rich plasma therapy in wound healing of pilonidal sinus surgery: A comprehensive systematic review and meta-analysis. Wound Repair Regen 2018; 25:1002-1007. [DOI: 10.1111/wrr.12597] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Shayan Mostafaei
- Department of Biostatistics, Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
- Rheumatology Research Center; Tehran University of Medical Sciences; Iran
| | - Fatemeh Norooznezhad
- Regenerative Medicine Research Center; Kermanshah University of Medical Sciences; Kermanshah Iran
| | - Saeed Mohammadi
- Hematology, Oncology and Stem Cell Transplantation Research Center; Tehran University of Medical Sciences; Tehran Iran
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45
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Factor XIII Subunit A in the Skin: Applications in Diagnosis and Treatment. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3571861. [PMID: 28894750 PMCID: PMC5574300 DOI: 10.1155/2017/3571861] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/26/2017] [Accepted: 06/21/2017] [Indexed: 01/09/2023]
Abstract
The role of factor XIII subunit A (FXIII-A) is not restricted to hemostasis. FXIII-A is also present intracellularly in several human cells and serves as a diagnostic marker in a wide range of dermatological diseases from inflammatory conditions to malignancies. In this review, we provide a guide on the still controversial interpretation of dermal cell types expressing FXIII-A and assess the previously described mechanisms behind their accumulation under physiological and pathological conditions of the human skin. We summarize the intracellular functions of FXIII-A as well as its possible sources in the extracellular space of the dermis with a focus on its relevance to skin homeostasis and disease pathogenesis. Finally, the potential role of FXIII-A in wound healing, as a field with long-term therapeutic implications, is also discussed.
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Evaluation of platelet-rich plasma gel potential in acceleration of wound healing duration in patients underwent pilonidal sinus surgery: A randomized controlled parallel clinical trial. Transfus Apher Sci 2017; 56:226-232. [DOI: 10.1016/j.transci.2016.12.032] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/25/2016] [Accepted: 12/27/2016] [Indexed: 11/19/2022]
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47
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Liu J, Lu F, Chen H, Bao R, Li Z, Lu B, Yu K, Dai F, Wu D, Lan G. Healing of skin wounds using a new cocoon scaffold loaded with platelet-rich or platelet-poor plasma. RSC Adv 2017. [DOI: 10.1039/c6ra27021b] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The cocoons of the silkwormBombyx moriare widely used as biofunctional materials.
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Affiliation(s)
- Jiawei Liu
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
| | - Fei Lu
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
- Chongqing Engineering Research Center of Biomaterial Fiber and Modern Textile
| | - HongLei Chen
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
| | - Rong Bao
- The Ninth People's Hospital of Chongqing
- Chongqing 400715
- China
| | - Zhiquan Li
- The Ninth People's Hospital of Chongqing
- Chongqing 400715
- China
| | - Bitao Lu
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
| | - Kun Yu
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
| | - Fangying Dai
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
- Chongqing Engineering Research Center of Biomaterial Fiber and Modern Textile
| | - Dayang Wu
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
- Chongqing Engineering Research Center of Biomaterial Fiber and Modern Textile
| | - Guangqian Lan
- College of Textile and Garments
- Southwest University
- Chongqing 400715
- China
- Chongqing Engineering Research Center of Biomaterial Fiber and Modern Textile
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