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Kulkarni RS, Kulkarni SR, Kulkarni RA, Kulkarni RR. Does Platelet-Rich Plasma Deserve a Role in Accelerating the Recovery of Reflex Sympathetic Dystrophy Following Distal Radius Fracture? Indian J Orthop 2024; 58:914-921. [PMID: 38948381 PMCID: PMC11208391 DOI: 10.1007/s43465-024-01171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/24/2024] [Indexed: 07/02/2024]
Abstract
Introduction This study was to evaluate the efficacy of multiple platelet-rich plasma injections in reflex sympathetic dystrophy following distal radius fracture after previous various treatments have failed. Materials and methods This comparative prospective study was designed for 64 patients of reflex sympathetic dystrophy developed following distal radius fracture, from January 2009 to December 2020 were enrolled in this study. This cohort of patient was given either four multiple subcutaneous platelet-rich plasma injections at weekly interval (n = 32) or two injections in a month with 15 days interval (n = 32). The primary outcome measure assessed with patient rated wrist evaluation questionnaire score. The secondary outcome was a visual analogue scale pain score. The final follow up was at 2 years. p ≤ 0.05 is considered statistically. Results The patient rated wrist evaluation score for usual and specific activities and EQ-VAS for pain level showed statistically significant greater improvement in group A (42 ± 21%) compared to group B (19 ± 24%), (p = 0.37). Patients also had improvement in wrist movements with no statistically significant differences in both groups. The standard difference in means of all three functional scores was almost similar between both groups A and B (standard difference in means = 0.032; 95% CI 0.236-0.830; p = 0.495), considered clinically meaningful. Conclusion This study results suggest autologous platelet-rich plasma injections seem to be safe, cost effective, efficacious algorithm treatment for reflex sympathetic dystrophy following distal radius fracture patients where previous treatments have failed.
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Affiliation(s)
- Raghavendra S. Kulkarni
- Government Hospital Devgad, Kudal Sindhudurg, India
- District Hospital, Oros Sindhudurg, India
- Present Address: SSPM Medical College and Lifetime Hospital Campus, Padve Sindhudurg, 415634 Maharashtra India
| | - SriRam R. Kulkarni
- Government Medical College and District Hospital, Oros Sindhudurg, India
- Present Address: Department of Orthopaedics, ACPM Medical College and Hospital, Dhule Sindhudurg, India
| | - Rachana A. Kulkarni
- District Hospital, Oros Sindhudurg, 416812 India
- Present Address: Department of Anatomy, Jawaharlal Nehru Medical College, Belgavi, India
| | - Ranjani R. Kulkarni
- ECHS, Government Polyclinic, Oros Sindhudurg, 416812 India
- Present Address: Department of Physiology, CDSIMER Medical College, Dayanand Sagar University, Bangalore, India
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Marín Fermín T, Calcei JG, Della Vedova F, Martinez Cano JP, Arias Calderon C, Imam MA, Khoury M, Laupheimer MW, D'Hooghe P. Review of Dohan Eherenfest et al. (2009) on "Classification of platelet concentrates: From pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF)". J ISAKOS 2024; 9:215-220. [PMID: 37562572 DOI: 10.1016/j.jisako.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/28/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
This classic discusses the original publication of Dohan Eherenfest et al. on "Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF)", in which the authors propose four categories of platelet concentrates depending on their leucocyte and fibrin content (P-PRP, leucocyte- and platelet-rich plasma (L-PRP), pure platelet-rich fibrin (P-PRF), and L-PRF) to group a "jungle" of products in which the term platelet-rich plasma (PRP) was used indistinctly. They were able to identify common factors such as: (1) the use of anticoagulants and immediate centrifugation of the blood after its collection; (2) most preparation techniques allowed platelet concentrate preparation within an hour; (3) the centrifugation aimed to separate the blood in layers that would allow the extraction of specific fractions; and (4) the product was activated with thrombin or calcium chloride. The reviewed manuscript has been listed among the most cited PRP articles in regenerative medicine, with more than 800 citations, driving current scientific research and clinical practise by categorising L-PRP and P-PRP (now, leucocyte-poor PRP). The classification has also opened the door to understanding intrinsic biological mechanisms between platelets, leukocytes, fibrin, and growth factors, which will later be considered for studying the proliferation and differentiation of cells in different tissues affected by PRP. Since the initial classification of platelet concentrates, several other classification systems have been proposed and published in the current literature such as platelet, activation, white blood cell (PAW), Mishra, platelet, leucocyte, red blood cells, and activation (PLRA), dose of platelet, efficiency, purity, and activation (DEPA), method, activation, red blood cells, spin, platelets, image guidance, leukocytes, and light activation (MARSPILL), etc. These classifications have identified important aspects of PRP that affect the biological composition and, ultimately, the indications and outcomes. To date, there is still a lack of standardisation in sample preparation, cohort heterogeneity, and incomplete reporting of sample preparation utilised, leading to a lack of clarity and challenging researchers and clinicians.
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Affiliation(s)
- Theodorakys Marín Fermín
- Centro Médico Profesional Las Mercedes, Las Mercedes 1060, Caracas, Venezuela; Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Inside Aspire Zone, Al Buwairda St, 29222, Doha, Qatar.
| | - Jacob G Calcei
- University Hospitals Drusinsky Sports Medicine Institute, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | | | | | - Claudia Arias Calderon
- Department of Trauma and Orthopedic Surgery, Hospital Nacional Edgardo Rebagliati Martins, Jesús María 15072, Peru
| | - Mohamed A Imam
- Smart Health Centre, University of East London, London E16 2RD, UK; Rowley Bristow Orthopaedic Unit, Ashford and St Peter's Hospital, Ashford TW15 3AA, UK
| | - Miguel Khoury
- Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Inside Aspire Zone, Al Buwairda St, 29222, Doha, Qatar
| | - Markus W Laupheimer
- Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Inside Aspire Zone, Al Buwairda St, 29222, Doha, Qatar
| | - Pieter D'Hooghe
- Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Inside Aspire Zone, Al Buwairda St, 29222, Doha, Qatar
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Berrigan WA, Bailowitz Z, Park A, Reddy A, Liu R, Lansdown D. A Greater Platelet Dose May Yield Better Clinical Outcomes for Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review. Arthroscopy 2024:S0749-8063(24)00206-8. [PMID: 38513880 DOI: 10.1016/j.arthro.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/09/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To determine whether the platelet dose administered during a platelet-rich plasma (PRP) injection for knee osteoarthritis (OA) affects clinical outcomes. METHODS A systematic review was performed by searching PubMed, Cochrane Library, and Embase for randomized controlled trials with at least 1 study arm using PRP for knee OA. Only studies that provided a platelet count, concentration, or dose with a minimum of 6-month outcome scores were included. Studies in which the PRP group had statistically significant positive outcomes were separated from those without statistical significance. The average platelet doses for studies with positive outcomes in the PRP group were compared with those without positive outcomes. RESULTS After exclusion criteria were applied, 29 studies were analyzed. Of the 29, there were 31 arms that used PRP as a treatment method, of which 28 had statistically significant positive outcomes at 6 months compared with the control group. The mean platelet dose in the 28 with a positive outcome was 5,500 ± 474 × 106, whereas the 3 that had no positive difference had a mean platelet dose of 2,302 ± 437 × 106 (P < .01). There were 18 studies with 12-month outcomes, with 16 of 18 having positive outcomes. The positive studies had an average platelet dose of 5,464 ± 511, whereas the studies that had no statistical difference had an average platelet dose of 2,253 ± 753 × 106 (P < .05). CONCLUSIONS Improved clinical outcomes from PRP injections for knee OA may be related to a greater platelet dose. LEVEL OF EVIDENCE Level II, systematic review of Level I and II studies.
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Affiliation(s)
- William A Berrigan
- Department of Orthopaedics, University of California San Francisco, San Francisco, California, U.S.A..
| | - Zach Bailowitz
- Department of Orthopedics, Kaiser Permanente Oakland, Oakland, California, U.S.A
| | - Anna Park
- University of California San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Aakash Reddy
- University of California Berkeley, Berkeley, California, U.S.A
| | - Ryan Liu
- University of California Berkeley, Berkeley, California, U.S.A
| | - Drew Lansdown
- Department of Orthopaedics, University of California San Francisco, San Francisco, California, U.S.A
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Prost D, Bardot T, Baud A, Calvo A, Aumont S, Collado H, Borne J, Rajon O, Ponsot A, Malaterre A, Dahak Y, Magalon G, Sabatier F, Magalon J. Long term improvement of knee osteoarthritis after injection of single high/very high volume of very pure PRP: A retrospective analysis of patients optimally managed in dedicated centers. Regen Ther 2024; 25:203-212. [PMID: 38234679 PMCID: PMC10792744 DOI: 10.1016/j.reth.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction PRP is gaining increasing interest for pain relief and improvement of joint function in patients with knee osteoarthritis (KOA) but practices and results remain heterogeneous limiting its adoption as standard of care. Current international recommendations are to collect real-life evidence of efficacy with a systematic monitoring of PRP quality and patients' outcomes. We aimed to analyze the response of patients presenting KOA and treated with standardized PRP injection in routine care. We also investigated the potential contributing factors including patient's phenotype and PRP characteristics. Methods Patients with symptomatic KOA and that failed first-line therapy received a single injection of a qualified PRP prepared using medical devices allowing to recover a high/very high volume of very pure PRP. Visual analogue scale (VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded at baseline and during 18 months follow-up. Results 431 patients had available follow-up data at 3 months, 291 at 6 months, 137 at 12 months and 44 at 18 months. PRP induced a significant decrease of WOMAC score at all follow up endpoints (29.2 ± 19.2 at 3 months, p < 0.001 and 25.9 ± 19.7 at 12 months, p < 0.01, compared to 39.7 ± 18.9 at baseline). Similar results were observed for pain VAS (38.9 ± 23.3 at 3 months, p < 0.001 and 35.3 ± 24.1 at 12 months, p < 0.05, compared to 56.0 ± 20.7 at baseline). Changes at 12 months were correlated to baseline scores and to the level of improvement at 3 months. The proportion of OMERACT OARSI responders reached 56.2 % for the total cohort and 60.4 % for severe patients at 6 months. Treatment failure occurred for 8.4 % of patients. Age, BMI or Kellgren-Lawrence grade did not impact on efficacy. Conclusion This real-life study evidences the clinical benefit of a standardized high or very high-volume injection of very pure PRP in patients with KOA, including those with a severe grade. It opens perspectives in the positioning of such strategy to delay arthroplasty and provide insights on factors able to anticipate long term efficacy.
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Affiliation(s)
- Didier Prost
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Thomas Bardot
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Alexandre Baud
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Anthony Calvo
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Stephane Aumont
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Herve Collado
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Julien Borne
- Regenerative Medicine Department of Excellence, Lyon, France
| | - Olivier Rajon
- Regenerative Medicine Department of Excellence, Lyon, France
| | - Antoine Ponsot
- Regenerative Medicine Department of Excellence, Lyon, France
| | | | - Yannis Dahak
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Guy Magalon
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Florence Sabatier
- Regenerative Medicine Department of Excellence, Marseille, France
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Jeremy Magalon
- Regenerative Medicine Department of Excellence, Marseille, France
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
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Su L, Xie S, Li T, Jia Y, Wang Y. Pretreatment with platelet-rich plasma protects against ischemia-reperfusion induced flap injury by deactivating the JAK/STAT pathway in mice. Mol Med 2024; 30:18. [PMID: 38302877 PMCID: PMC10835983 DOI: 10.1186/s10020-024-00781-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Ischemia-reperfusion (I/R) injury is a major cause of surgical skin flap compromise and organ dysfunction. Platelet-rich plasma (PRP) is an autologous product rich in growth factors, with tissue regenerative potential. PRP has shown promise in multiple I/R-induced tissue injuries, but its effects on skin flap injury remain unexplored. METHODS We evaluated the effects of PRP on I/R-injured skin flaps, optimal timing of PRP administration, and the involved mechanisms. RESULTS PRP protected against I/R-induced skin flap injury by improving flap survival, promoting blood perfusion and angiogenesis, suppressing oxidative stress and inflammatory response, and reducing apoptosis, at least partly via deactivating Janus kinase (JAK)-signal transducers and activators of transcription (STAT) signalling pathway. PRP given before ischemia displayed overall advantages over that given before reperfusion or during reperfusion. In addition, PRP pretreatment had a stronger ability to reverse I/R-induced JAK/STAT activation and apoptosis than AG490, a specific inhibitor of JAK/STAT signalling. CONCLUSIONS This study firstly demonstrates the protective role of PRP against I/R-injured skin flaps through negative regulation of JAK/STAT activation, with PRP pretreatment showing optimal therapeutic effects.
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Affiliation(s)
- Linlin Su
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, No.127 Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi, China.
| | - Songtao Xie
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, No.127 Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi, China
| | - Ting Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, No.127 Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi, China
| | - Yanhui Jia
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, No.127 Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi, China
| | - Yunchuan Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, No.127 Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi, China.
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Bacevich BM, Smith RDJ, Reihl AM, Mazzocca AD, Hutchinson ID. Advances with Platelet-Rich Plasma for Bone Healing. Biologics 2024; 18:29-59. [PMID: 38299120 PMCID: PMC10827634 DOI: 10.2147/btt.s290341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
Despite significant advances in the understanding and delivery of osteosynthesis, fracture non-union remains a challenging clinical problem in orthopaedic surgery. To bridge the gap, basic science characterization of fracture healing provides a platform to identify and target biological strategies to enhance fracture healing. Of immense interest, Platelet-rich plasma (PRP) is a point of care orthobiologic that has been extensively studied in bone and soft tissue healing given its relative ease of translation from the benchtop to the clinic. The aim of this narrative review is to describe and relate pre-clinical in-vitro and in-vivo findings to clinical observations investigating the efficacy of PRP to enhance bone healing for primary fracture management and non-union treatment. A particular emphasis is placed on the heterogeneity of PRP preparation techniques, composition, activation strategies, and delivery. In the context of existing data, the routine use of PRP to enhance primary fracture healing and non-union management cannot be supported. However, it is acknowledged that extensive heterogeneity of PRP treatments in clinical studies adds obscurity; ultimately, refinement (and consensus) of PRP treatments for specific clinical indications, including repetition studies are warranted.
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Affiliation(s)
- Blake M Bacevich
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Richard David James Smith
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Alec M Reihl
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Augustus D Mazzocca
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
- Medical Director, Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Brigham, Boston, MA, USA
| | - Ian D Hutchinson
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
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Fermín TM, Laupheimer M, Khoury M. Improving Injectable Orthobiologics Reporting Guidelines Adherence: Letter to the Editor. Am J Sports Med 2023; 51:NP66. [PMID: 38031746 DOI: 10.1177/03635465231203205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
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Anitua E, Troya M, Falcon-Pérez JM, López-Sarrio S, González E, Alkhraisat MH. Advances in Platelet Rich Plasma-Derived Extracellular Vesicles for Regenerative Medicine: A Systematic-Narrative Review. Int J Mol Sci 2023; 24:13043. [PMID: 37685849 PMCID: PMC10488108 DOI: 10.3390/ijms241713043] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
The use of platelet-rich plasma (PRP) has gained increasing interest in recent decades. The platelet secretome contains a multitude of growth factors, cytokines, chemokines, and other biological biomolecules. In recent years, developments in the field of platelets have led to new insights, and attention has been focused on the platelets' released extracellular vesicles (EVs) and their role in intercellular communication. In this context, the aim of this review was to compile the current evidence on PRP-derived extracellular vesicles to identify the advantages and limitations fortheir use in the upcoming clinical applications. A total of 172 articles were identified during the systematic literature search through two databases (PubMed and Web of Science). Twenty publications met the inclusion criteria and were included in this review. According to the results, the use of PRP-EVs in the clinic is an emerging field of great interest that represents a promising therapeutic option, as their efficacy has been demonstrated in the majority of fields of applications included in this review. However, the lack of standardization along the procedures in both the field of PRP and the EVs makes it extremely challenging to compare results among studies. Establishing standardized conditions to ensure optimized and detailed protocols and define parameters such as the dose or the EV origin is therefore urgent. Further studies to elucidate the real contribution of EVs to PRP in terms of composition and functionality should also be performed. Nevertheless, research on the field provides promising results and a novel basis to deal with the regenerative medicine and drug delivery fields in the future.
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Affiliation(s)
- Eduardo Anitua
- BTI-Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain; (M.T.); (M.H.A.)
- University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria-Gasteiz, Spain
| | - María Troya
- BTI-Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain; (M.T.); (M.H.A.)
- University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria-Gasteiz, Spain
| | - Juan Manuel Falcon-Pérez
- Exosomes Laboratory, Center for Cooperative Research in Biosciences, Basque Research and Technology Alliance, 48160 Derio, Spain; (J.M.F.-P.); (S.L.-S.); (E.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas Y Digestivas, 28029 Madrid, Spain
- Metabolomics Platform, Center for Cooperative Research in Biosciences, Basque Research and Technology Alliance, 48160 Derio, Spain
- IKERBASQUE, Basque Foundation for Science, 48009 Bilbao, Spain
| | - Silvia López-Sarrio
- Exosomes Laboratory, Center for Cooperative Research in Biosciences, Basque Research and Technology Alliance, 48160 Derio, Spain; (J.M.F.-P.); (S.L.-S.); (E.G.)
| | - Esperanza González
- Exosomes Laboratory, Center for Cooperative Research in Biosciences, Basque Research and Technology Alliance, 48160 Derio, Spain; (J.M.F.-P.); (S.L.-S.); (E.G.)
| | - Mohammad H. Alkhraisat
- BTI-Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain; (M.T.); (M.H.A.)
- University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria-Gasteiz, Spain
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Everts PA, Lana JF, Onishi K, Buford D, Peng J, Mahmood A, Fonseca LF, van Zundert A, Podesta L. Angiogenesis and Tissue Repair Depend on Platelet Dosing and Bioformulation Strategies Following Orthobiological Platelet-Rich Plasma Procedures: A Narrative Review. Biomedicines 2023; 11:1922. [PMID: 37509560 PMCID: PMC10377284 DOI: 10.3390/biomedicines11071922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Angiogenesis is the formation of new blood vessel from existing vessels and is a critical first step in tissue repair following chronic disturbances in healing and degenerative tissues. Chronic pathoanatomic tissues are characterized by a high number of inflammatory cells; an overexpression of inflammatory mediators; such as tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1); the presence of mast cells, T cells, reactive oxygen species, and matrix metalloproteinases; and a decreased angiogenic capacity. Multiple studies have demonstrated that autologous orthobiological cellular preparations (e.g., platelet-rich plasma (PRP)) improve tissue repair and regenerate tissues. There are many PRP devices on the market. Unfortunately, they differ greatly in platelet numbers, cellular composition, and bioformulation. PRP is a platelet concentrate consisting of a high concentration of platelets, with or without certain leukocytes, platelet-derived growth factors (PGFs), cytokines, molecules, and signaling cells. Several PRP products have immunomodulatory capacities that can influence resident cells in a diseased microenvironment, inducing tissue repair or regeneration. Generally, PRP is a blood-derived product, regardless of its platelet number and bioformulation, and the literature indicates both positive and negative patient treatment outcomes. Strangely, the literature does not designate specific PRP preparation qualifications that can potentially contribute to tissue repair. Moreover, the literature scarcely addresses the impact of platelets and leukocytes in PRP on (neo)angiogenesis, other than a general one-size-fits-all statement that "PRP has angiogenic capabilities". Here, we review the cellular composition of all PRP constituents, including leukocytes, and describe the importance of platelet dosing and bioformulation strategies in orthobiological applications to initiate angiogenic pathways that re-establish microvasculature networks, facilitating the supply of oxygen and nutrients to impaired tissues.
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Affiliation(s)
- Peter A Everts
- Research & Education Division, Gulf Coast Biologics, Fort Myers, FL 33916, USA
- OrthoRegen Group, Max-Planck University, Indaiatuba, São Paulo 13334-170, Brazil
| | - José Fábio Lana
- OrthoRegen Group, Max-Planck University, Indaiatuba, São Paulo 13334-170, Brazil
- Department of Orthopaedics, The Bone and Cartilage Institute, Indaiatuba, São Paulo 13334-170, Brazil
| | - Kentaro Onishi
- Department of PM&R and Orthopedic Surgery, University of Pittsburg Medical Center, Pittsburgh, PA 15213, USA
| | - Don Buford
- Texas Orthobiologics, Dallas, TX 75204, USA
| | - Jeffrey Peng
- Stanford Health Care-O'Connor Hospital Sports Medicine, Stanford University School of Medicine, San Jose, CA 95128, USA
| | - Ansar Mahmood
- Department of Trauma and Orthopaedic Surgery, University Hospitals, Birmingham B15 2GW, UK
| | - Lucas F Fonseca
- Department of Orthopaedics, The Federal University of São Paulo, São Paulo 04024-002, Brazil
| | - Andre van Zundert
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane and the University of Queensland, Brisbane 4072, Australia
| | - Luga Podesta
- Bluetail Medical Group & Podesta Orthopedic Sports Medicine, Naples, FL 34109, USA
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10
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Gutierrez-Ontalvilla P, Vidal L, Ruiz-Valls A, Iborra M. Letter to the Editor on The Effect of Lipofilling and Platelet-Rich Plasma on Patients with Moderate-Severe Vulvar Lichen Sclerosus who were Non-Responders to Topical Clobetasol Propionate: A Randomized Pilot Study. Aesthetic Plast Surg 2023; 47:66-68. [PMID: 35689103 DOI: 10.1007/s00266-022-02960-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/01/2022]
Affiliation(s)
- P Gutierrez-Ontalvilla
- Department of Plastic and Reconstructive Surgery, Hospital University La Fe, Avda Fernando Abril Martorell 106, 46026, Valencia, Spain.
| | - L Vidal
- Fidia Farmacéutica S.L.U, Barcelona, Spain
| | - A Ruiz-Valls
- Department of Plastic and Reconstructive Surgery, Hospital University La Fe, Avda Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - M Iborra
- Unit of Inflammatory Bowel Disease, Department of Digestive Medicine, Hospital University La Fe, Valencia, Spain
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Sebbagh P, Hirt-Burri N, Scaletta C, Abdel-Sayed P, Raffoul W, Gremeaux V, Laurent A, Applegate LA, Gremion G. Process Optimization and Efficacy Assessment of Standardized PRP for Tendinopathies in Sports Medicine: Retrospective Study of Clinical Files and GMP Manufacturing Records in a Swiss University Hospital. Bioengineering (Basel) 2023; 10:bioengineering10040409. [PMID: 37106596 PMCID: PMC10135571 DOI: 10.3390/bioengineering10040409] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Platelet-rich plasma (PRP) preparations have recently become widely available in sports medicine, facilitating their use in regenerative therapy for ligament and tendon affections. Quality-oriented regulatory constraints for PRP manufacturing and available clinical experiences have underlined the critical importance of process-based standardization, a pre-requisite for sound and homogeneous clinical efficacy evaluation. This retrospective study (2013–2020) considered the standardized GMP manufacturing and sports medicine-related clinical use of autologous PRP for tendinopathies at the Lausanne University Hospital (Lausanne, Switzerland). This study included 48 patients (18–86 years of age, with a mean age of 43.4 years, and various physical activity levels), and the related PRP manufacturing records indicated a platelet concentration factor most frequently in the range of 2.0–2.5. The clinical follow-up showed that 61% of the patients reported favorable efficacy outcomes (full return to activity, with pain disappearance) following a single ultrasound-guided autologous PRP injection, whereas 36% of the patients required two PRP injections. No significant relationship was found between platelet concentration factor values in PRP preparations and clinical efficacy endpoints of the intervention. The results were in line with published reports on tendinopathy management in sports medicine, wherein the efficacy of low-concentration orthobiologic interventions appears to be unrelated to sport activity levels or to patient age and gender. Overall, this study confirmed the effectiveness of standardized autologous PRP preparations for tendinopathies in sports medicine. The results were discussed in light of the critical importance of protocol standardization for both PRP manufacturing and clinical administration to reduce biological material variability (platelet concentrations) and to enhance the robustness of clinical interventions (comparability of efficacy/patient improvement).
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Affiliation(s)
- Patrick Sebbagh
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
| | - Nathalie Hirt-Burri
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - Corinne Scaletta
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - Philippe Abdel-Sayed
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland
- DLL Bioengineering, STI School of Engineering, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
| | - Wassim Raffoul
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - Vincent Gremeaux
- Sport Medicine Unit, Division of Physical Medicine and Rehabilitation, Swiss Olympic Medical Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland;
| | - Alexis Laurent
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Manufacturing Department, LAM Biotechnologies SA, CH-1066 Epalinges, Switzerland
| | - Lee Ann Applegate
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland
- Center for Applied Biotechnology and Molecular Medicine, University of Zurich, CH-8057 Zurich, Switzerland
- Correspondence: ; Tel.: +41-21-314-35-10
| | - Gerald Gremion
- Regenerative Therapy Unit, Plastic, Reconstructive & Hand Surgery Service, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (P.S.); (N.H.-B.); (C.S.); (P.A.-S.); (W.R.); (A.L.); (G.G.)
- Sport Medicine Unit, Division of Physical Medicine and Rehabilitation, Swiss Olympic Medical Center, Lausanne University Hospital, University of Lausanne, CH-1011 Lausanne, Switzerland;
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12
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Sebbagh P, Cannone A, Gremion G, Gremeaux V, Raffoul W, Hirt-Burri N, Michetti M, Abdel-Sayed P, Laurent A, Wardé N, Applegate LA. Current Status of PRP Manufacturing Requirements & European Regulatory Frameworks: Practical Tools for the Appropriate Implementation of PRP Therapies in Musculoskeletal Regenerative Medicine. Bioengineering (Basel) 2023; 10:bioengineering10030292. [PMID: 36978683 PMCID: PMC10044789 DOI: 10.3390/bioengineering10030292] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/29/2023] Open
Abstract
Providing accurate and up-to-date practical tools enabling oversight of platelet-rich plasma (PRP) legislation and of the appropriate standards to be implemented for its manufacture and use in Europe is a demanding task. This is due to rapid medico-technological advancements, slowness and disparity in legislation updates and enforcement between member states, and many reported gray-zone practices, notably for autologous PRP use. The levels of risk associated with blood manipulation processes generally dictate the manufacturing requirements for PRP preparations, which have gradually shifted toward good manufacturing practices (GMP) for standardization and overall quality enhancement. This work firstly outlines Western European and Swiss legislation for PRP products/preparations, providing key simplified information and recommendations for medical doctors seeking to implement this biological-based therapy for safe use in hospital settings, clinics, or private offices. This work secondly shows the importance of PRP-based product manufacturing standardization, which subsequently enables sound clinical evaluation of therapeutic interventions. Although the applicable legal bases provide guidelines for GMP manufacturing infrastructure and basic process design, paramount importance is set on the definition of workflows, technical specifications, and key parameters for PRP preparation and delivery. Overall, the development of simple and robust technologies and processes for PRP preparation is critical for guaranteeing the high therapeutic quality of the intervention, in collaboration with qualified GMP manufacturing platforms. Importantly, this work aims to serve as a practical tool for clinicians based in Western Europe who are willing to appropriately (i.e., administratively and technically) implement autologous PRP treatments in musculoskeletal regenerative medicine workflows, to ensure they make informed and optimal regulatory or process-based decisions.
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13
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Lai F, Dai S, Zhao Y, Sun Y. Combination of PDGF-BB and adipose-derived stem cells accelerated wound healing through modulating PTEN/AKT pathway. Injury 2023:S0020-1383(23)00123-7. [PMID: 37028952 DOI: 10.1016/j.injury.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 04/09/2023]
Abstract
Adipose-derived stem cells (ADSCs) have been widely proven to facilitate wound healing. Our study aimed to estimate the influence of combined ADSCs and platelet-derived growth factor-BB (PDGF-BB) on wound healing. We utilized 4 healthy SD rats to isolate ADSCs. Platelet-rich plasma (PRP) was acquired utilizing a two-step centrifugation technology. The role of PRP, PDGF-BB, and PDGF-BB combined with a PI3k inhibitor LY294002 on the viability, migration, and PTEN/AKT pathway in ADSCs were examined utilizing CCK-8, Transwell, and western blot assays. Then, we constructed an open trauma model in SD rats. Effects of ADSCs treated with PDGF-BB on pathological changes, CD31, and PTEN/AKT pathway of wound closure were assessed by hematoxylin & eosin (H&E) staining, Masson staining, immunohistochemical, and western blot assays, respectively. PRP and PDGF-BB intensified the viability and migration of ADSCs by modulating the PTEN/AKT pathway. Interestingly, LY294002 reversed the role of PDGF-BB on ADSCs. In vivo experiments, combined intervention with ADSCs plus PDGF-BB/PRP facilitated wound closure and ameliorated histological injury. Moreover, combined intervention with ADSCs and PDGF-BB attenuated the PTEN level and elevated the CD31 level as well as the ratio of p-AKT/AKT in the skin tissues. A combination of ADSCs and PDGF-BB facilitated wound healing might associate with the regulation of the PTEN/AKT pathway.
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Affiliation(s)
- Fangyuan Lai
- Center for Plastic & Reconstructive Surgery, Department of Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Shijie Dai
- College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ye Zhao
- Center for Plastic & Reconstructive Surgery, Department of Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Yi Sun
- Center for Plastic & Reconstructive Surgery, Department of Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
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14
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Sasaki GH. Response to: The Emperor Has No Platelets: Minimal Effects in an Alopecia Split-Scalp Study Unsurprising as Platelet-Rich Plasma Was Actually Platelet-Poor. Aesthet Surg J 2022; 42:NP802-NP803. [PMID: 35921665 DOI: 10.1093/asj/sjac213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Indexed: 12/30/2022] Open
Affiliation(s)
- Gordon H Sasaki
- cosmetic plastic surgeon in private practice in Pasadena, CA, USA
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15
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Everts PA, Mazzola T, Mautner K, Randelli PS, Podesta L. Modifying Orthobiological PRP Therapies Are Imperative for the Advancement of Treatment Outcomes in Musculoskeletal Pathologies. Biomedicines 2022; 10:biomedicines10112933. [PMID: 36428501 PMCID: PMC9687216 DOI: 10.3390/biomedicines10112933] [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: 09/19/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
Autologous biological cellular preparations have materialized as a growing area of medical advancement in interventional (orthopedic) practices and surgical interventions to provide an optimal tissue healing environment, particularly in tissues where standard healing is disrupted and repair and ultimately restoration of function is at risk. These cellular therapies are often referred to as orthobiologics and are derived from patient's own tissues to prepare point of care platelet-rich plasma (PRP), bone marrow concentrate (BMC), and adipose tissue concentrate (ATC). Orthobiological preparations are biological materials comprised of a wide variety of cell populations, cytokines, growth factors, molecules, and signaling cells. They can modulate and influence many other resident cells after they have been administered in specific diseased microenvironments. Jointly, the various orthobiological cell preparations are proficient to counteract persistent inflammation, respond to catabolic reactions, and reinstate tissue homeostasis. Ultimately, precisely delivered orthobiologics with a proper dose and bioformulation will contribute to tissue repair. Progress has been made in understanding orthobiological technologies where the safety and relatively easy manipulation of orthobiological treatment tools has been demonstrated in clinical applications. Although more positive than negative patient outcome results have been registered in the literature, definitive and accepted standards to prepare specific cellular orthobiologics are still lacking. To promote significant and consistent clinical outcomes, we will present a review of methods for implementing dosing strategies, using bioformulations tailored to the pathoanatomic process of the tissue, and adopting variable preparation and injection volume policies. By optimizing the dose and specificity of orthobiologics, local cellular synergistic behavior will increase, potentially leading to better pain killing effects, effective immunomodulation, control of inflammation, and (neo) angiogenesis, ultimately contributing to functionally restored body movement patterns.
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Affiliation(s)
- Peter A. Everts
- Education & Research Division, Gulf Coast Biologics, Fort Myers, FL 33916, USA
- Correspondence: ; Tel.: +1-239-961-6457
| | - Timothy Mazzola
- Breakthrough Regenerative Orthopedics, Boulder, CO 80305, USA
| | - Kenneth Mautner
- Department of Physical Medicine and Rehabilitation, Emory University, Atlanta, GA 30329, USA
| | - Pietro S. Randelli
- Instituto Orthopedico Gaetano Pini, Milan University, 20122 Milan, Italy
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16
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Keene DJ, Alsousou J, Harrison P, O’Connor HM, Wagland S, Dutton SJ, Hulley P, Lamb SE, Willett K. Platelet-rich plasma injection for acute Achilles tendon rupture : two-year follow-up of the PATH-2 randomized, placebo-controlled, superiority trial. Bone Joint J 2022; 104-B:1256-1265. [PMID: 36317349 PMCID: PMC9621093 DOI: 10.1302/0301-620x.104b11.bjj-2022-0653.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims To determine whether platelet-rich plasma (PRP) injection improves outcomes two years after acute Achilles tendon rupture. Methods A randomized multicentre two-arm parallel-group, participant- and assessor-blinded superiority trial was undertaken. Recruitment commenced on 28 July 2015 and two-year follow-up was completed in 21 October 2019. Participants were 230 adults aged 18 years and over, with acute Achilles tendon rupture managed with non-surgical treatment from 19 UK hospitals. Exclusions were insertion or musculotendinous junction injuries, major leg injury or deformity, diabetes, platelet or haematological disorder, medication with systemic corticosteroids, anticoagulation therapy treatment, and other contraindicating conditions. Participants were randomized via a central online system 1:1 to PRP or placebo injection. The main outcome measure was Achilles Tendon Rupture Score (ATRS) at two years via postal questionnaire. Other outcomes were pain, recovery goal attainment, and quality of life. Analysis was by intention-to-treat. Results A total of 230 participants were randomized, 114 to PRP and 116 to placebo. Two-year questionnaires were sent to 216 participants who completed a six-month questionnaire. Overall, 182/216 participants (84%) completed the two-year questionnaire. Participants were aged a mean of 46 years (SD 13.0) and 25% were female (57/230). The majority of participants received the allocated intervention (219/229, 96%). Mean ATRS scores at two years were 82.2 (SD 18.3) in the PRP group (n = 85) and 83.8 (SD 16.0) in the placebo group (n = 92). There was no evidence of a difference in the ATRS at two years (adjusted mean difference -0.752, 95% confidence interval -5.523 to 4.020; p = 0.757) or in other secondary outcomes, and there were no re-ruptures between 24 weeks and two years. Conclusion PRP injection did not improve patient-reported function or quality of life two years after acute Achilles tendon rupture compared with placebo. The evidence from this study indicates that PRP offers no patient benefit in the longer term for patients with acute Achilles tendon rupture. Cite this article: Bone Joint J 2022;104-B(11):1256–1265.
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Affiliation(s)
- David J. Keene
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK,Correspondence should be sent to David J. Keene. E-mail:
| | - Joseph Alsousou
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Paul Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Heather M. O’Connor
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan Wagland
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan J. Dutton
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Philippa Hulley
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E. Lamb
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK,College of Medicine and Health, University of Exeter, Exeter, UK
| | - Keith Willett
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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17
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Coulange Zavarro A, De Girolamo L, Laver L, Sánchez M, Tischer T, Filardo G, Sabatier F, Magalon J. The Top 100 Most Cited Articles on Platelet-Rich Plasma Use in Regenerative Medicine-A Bibliometric Analysis-From the ESSKA Orthobiologic Initiative. Bioengineering (Basel) 2022; 9:580. [PMID: 36290547 PMCID: PMC9598782 DOI: 10.3390/bioengineering9100580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 08/12/2023] Open
Abstract
Over the past few decades, more and more articles about platelet-rich plasma (PRP) use in regenerative medicine have been published. The aim of this study was to determine which articles have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles. Articles on the use of PRP in regenerative medicine were identified via the Thomson ISI Web of Science database. A majority of the articles originated from the USA (36%). The top journal in terms of number of articles was American Journal of Sports Medicine (12%). Musculoskeletal system and orthopedics (54%) were the most popular fields of applications. Preclinical studies were the most represented study type, from which only 8 from 46 (17.4%) provided a complete numerical description of the injected product. Analysis showed a time-dependent trend of increasing quality of the clinical studies (p = 0.004), although none of them provided a complete biological characterization of the injected PRP. This study demonstrated that the use of PRP in regenerative medicine is a growing and popular area of research, mainly focused on orthopedic applications. Studies on PRP-derived exosomes, biological characterization, and correlation with clinical results might be areas of future trends.
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Affiliation(s)
- Anouck Coulange Zavarro
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005 Marseille, France
| | - Laura De Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Lior Laver
- Department of Orthopaedics, Hillel Yaffe Medical Center (HYMC), Hadera 38100, Israel
- Arthrosport Clinic, Tel-Aviv, Israel
- Rappaport Faculty of Medicine, Technion University Hospital, Israel Institute of Technology, Haifa 32000, Israel
| | - Mikel Sánchez
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain
| | - Thomas Tischer
- Department of Orthopaedic Surgery, University of Rostock, 18051 Rostock, Germany
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Florence Sabatier
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005 Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, 13005 Marseille, France
- SAS Remedex, 13008 Marseille, France
| | - Jérémy Magalon
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005 Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, 13005 Marseille, France
- SAS Remedex, 13008 Marseille, France
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18
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Basic Science of Autologous Orthobiologics Part 1. Platelet-Rich Plasma. Phys Med Rehabil Clin N Am 2022; 34:1-23. [DOI: 10.1016/j.pmr.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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19
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Marín Fermín T, Scarlat MM, Laupheimer MW. Would you have an injection without knowing its formula? New challenges in platelet-rich plasma therapy. INTERNATIONAL ORTHOPAEDICS 2022; 46:2179-2180. [PMID: 36109372 PMCID: PMC9483503 DOI: 10.1007/s00264-022-05566-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Theodorakys Marín Fermín
- Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Inside Aspire Zone, Al Buwairda St, 29222, Doha, Qatar
| | | | - Markus Wilhelm Laupheimer
- Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Inside Aspire Zone, Al Buwairda St, 29222, Doha, Qatar
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20
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Anitua E, Padilla S, Prado R, Alkhraisat MH. Platelet-rich plasma: are the obtaining methods, classification and clinical outcome always connected? Regen Med 2022; 17:887-890. [PMID: 36169230 DOI: 10.2217/rme-2022-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Eduardo Anitua
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain.,Regenerative Medicine Laboratory, BTI Biotechnology Institute ImasD, Vitoria, Spain
| | - Sabino Padilla
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain.,Regenerative Medicine Laboratory, BTI Biotechnology Institute ImasD, Vitoria, Spain
| | - Roberto Prado
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain.,Regenerative Medicine Laboratory, BTI Biotechnology Institute ImasD, Vitoria, Spain
| | - Mohammad H Alkhraisat
- Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain.,Regenerative Medicine Laboratory, BTI Biotechnology Institute ImasD, Vitoria, Spain
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21
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Fernández-Fuertes J, Arias-Fernández T, Acebes-Huerta A, Álvarez-Rico M, Gutiérrez L. Clinical Response After Treatment of Knee Osteoarthritis With a Standardized, Closed-System, Low-Cost Platelet-Rich Plasma Product: 1-Year Outcomes. Orthop J Sports Med 2022; 10:23259671221076496. [PMID: 35387363 PMCID: PMC8977725 DOI: 10.1177/23259671221076496] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Intra-articular infiltration of platelet-rich plasma (PRP) is an alternative
therapeutic option to classic hyaluronic acid for the treatment of
symptomatic knee osteoarthritis (KOA). However, variation in preparation
methods and quality assessment of PRP makes the study of its real clinical
efficacy difficult. Purpose: To (1) evaluate the clinical efficacy of a characterized PRP product prepared
in a standardized manner and in a closed-system for the treatment of KOA and
to (2) evaluate the association of the clinical response to PRP-related
variables. Study Design: Case series; Level of evidence, 4. Methods: We recruited 130 patients with nonoperative KOA and evaluated them for 1
year. PRP was prepared from a donation of autologous blood, obtaining 3
aliquots of approximately 10mL of product, which were frozen, allowing
platelet disruption, platelet factor release, and long-term storage, until
administration. Patients were treated 3 consecutive times every 4 weeks with
an intra-articular PRP knee injection under sterile conditions. Complete
blood count was performed on the whole-blood sample and the processed PRP
before freezing it, for product quality assessment. Patients were assessed
using the Western Ontario and McMaster Universities Osteoarthritis Index
(WOMAC) and basic satisfaction scale at 3 months, 6 months, and 1 year after
intervention. Results: Quality assessment confirmed a leukocyte-poor PRP product (white blood cell
count, 0.09 ± 0.09 × 109/L) with a high platelet purity (platelet
count, 630.86 ± 191.75 × 109/L). WOMAC scores improved, and basic
satisfaction was achieved in 70% of patients. No adverse events were
reported. No correlations were observed between PRP quality parameters and
clinical results. PRP complete treatment production costs were €108/US$125
(€36/US$41.6 per injection). Conclusion: This standardized PRP production method resulted in improved WOMAC scores at
1 year postoperatively in 70% of patients with KOA. This technique was safe
and affordable and ensured consecutive infiltrations with the same product
to each patient.
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Affiliation(s)
- Judit Fernández-Fuertes
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Orthopedics and Trauma Surgery, Hospital Universitario de Cabueñes (CAHU), Gijón, Asturias, Spain
| | - Tamara Arias-Fernández
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Marlene Álvarez-Rico
- Department of Orthopedics and Trauma Surgery, Hospital Universitario de Cabueñes (CAHU), Gijón, Asturias, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
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22
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Magalon J, Frey A, Kaux JF. Intra-articular Platelet-Rich Plasma vs Placebo Injection and Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis. JAMA 2022; 327:1185-1186. [PMID: 35315896 DOI: 10.1001/jama.2022.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, Marseille, France
| | - Alain Frey
- Sports Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Jean-Francois Kaux
- Physical, Rehabilitation, and Sports Trauma Department, University Hospital of Liège, Liège, Belgium
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23
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Barber MS, Manning T, Desai R. Platelet-Rich Plasma Injections vs Placebo for Patients With Ankle Osteoarthritis. JAMA 2022; 327:777-779. [PMID: 35191931 DOI: 10.1001/jama.2021.24751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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24
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Charnay T, Silvestre A, Magalon J. Platelet-Rich Plasma Injections vs Placebo for Patients With Ankle Osteoarthritis. JAMA 2022; 327:780. [PMID: 35191935 DOI: 10.1001/jama.2021.24736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Theo Charnay
- Cell Therapy Laboratory, Hôpital de la Conception, Marseille, France
| | - Alain Silvestre
- Osteoarticular Medical Imaging Center, Bordeaux Sports Clinic, Mérignac, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, Marseille, France
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25
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Mallone F, Marenco M, Giustolisi R, Plateroti R, Lambiase A. Platelet-Rich Plasma (PRP) to promote corneal healing in firework-related ocular burn and total limbal stem cell deficiency (LSCD). Eur J Ophthalmol 2022; 33:NP18-NP22. [PMID: 35139684 DOI: 10.1177/11206721221080004] [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: 11/15/2022]
Abstract
PURPOSE To report the case of persistent corneal epithelial defect in total limbal stem cell deficiency (LSCD) after severe firework-related ocular burn treated with autologous Platelet-Rich Plasma (PRP). CASE DESCRIPTION A young patient, victim of fireworks trauma, presented with a large persistent epithelial defect affecting the central cornea of his left eye and progressing to stromal melting, in the context of grade VI ocular surface burn with 12 h limbal involvement. Impression cytology to the cornea confirmed a complete LSCD. Assessment of corneal sensitivity by Cochet Bonnet esthesiometer revealed complete corneal anesthesia. Based on progressive clinical worsening under conventional therapy, the patient was started on very pure autologous PRP eye drops obtained using the Hy-Tissue PRP® technology. Six times a day eye drops administration for 30 days was scheduled in the affected eye. At the end of treatment, the epithelial defect had disappeared being replaced by advancing conjunctiva. CONCLUSION Our findings provide information on management of ocular burns from fireworks, a subject of current interest and concern. Autologous PRP eye drops prepared using the Hy-Tissue PRP® system and administered in the presence of total LSCD and complete corneal anesthesia, prevented corneal stromal melting to progress and allowed the ocular surface epithelial coverage to re-establish. This paved the way for later successful restorative and reconstructive intervention. Also, first description of the Hy-tissue PRP procedure for ophthalmological use is reported.
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Affiliation(s)
- Fabiana Mallone
- Department of Sense Organs, 9311Sapienza University of Rome, Rome, Italy
| | - Marco Marenco
- Department of Sense Organs, 9311Sapienza University of Rome, Rome, Italy
| | - Rosalia Giustolisi
- Department of Sense Organs, 9311Sapienza University of Rome, Rome, Italy
| | - Rocco Plateroti
- Department of Sense Organs, 9311Sapienza University of Rome, Rome, Italy
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26
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Yam PK. The Emperor Has No Platelets: Minimal Effects in an Alopecia Split-Scalp Study Unsurprising as Platelet-Rich Plasma Was Actually Platelet-Poor. Aesthet Surg J 2021; 42:NP365-NP367. [PMID: 35037939 PMCID: PMC9005452 DOI: 10.1093/asj/sjab401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Patrick K Yam
- Faculty of Medicine, University of British Columbia, Vancouver, Canada,Corresponding Author: Dr Patrick K. Yam, 6051 Gilbert Rd., Richmond BC, V7C 3V3, Canada. E-mail: ; Twitter: @drpatrickyam
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27
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Capion SC, Jørgensen HBL, Ågren MS, Daugaard H, Ribel-Madsen S, Marando D, Johansson PI, Salado J, Halschou-Jensen PM, Borgwardt A, Andersen JR. The wound healing effect of local leukocyte platelet-rich plasma after total hip arthroplasty: A randomized controlled trial. Wound Repair Regen 2021; 29:988-995. [PMID: 34546614 DOI: 10.1111/wrr.12967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/17/2021] [Accepted: 09/02/2021] [Indexed: 12/12/2022]
Abstract
Rapid wound closure is important after arthroplasty procedures to prevent postoperative complications. Platelets are rich in growth factors and leukocytes contribute to innate immunity. We hypothesized that topical leukocyte platelet-rich plasma (L-PRP) derived from the blood of patients would be beneficial to wound healing. In this randomized controlled trial, patients subjected to elective total hip arthroplasty (THA) were assigned by concealed allocation either L-PRP application onto the sutured fascia or no application (control) after the THA intervention. In addition, all patients received 1.5 g protein/kg, 5 g L-arginine, 500 mg vitamin C and 44 mg zinc daily over the 4-week postoperative period to obtain optimal nutrition. The primary endpoint was complete healing of the skin incision. The secondary endpoints were blood transfusions, length of hospital stay, pain and wound infections. Sixteen patients in the L-PRP group and 17 patients in the control group completed the trial. L-PRP treatment accelerated complete wound healing after 3 weeks (seven in the L-PRP group vs. zero in the control group, p = 0.003) and after 4 weeks (12 in the L-PRP group vs. six in the control group, p = 0.037). No postoperative superficial wound infections occurred within 4 weeks, and there were no significant differences in the other secondary outcomes. L-PRP generated in 10 sex-matched healthy volunteers revealed increased concentrations of platelets (5.8-fold) and leukocytes (2.3-fold) compared with those in whole blood. Furthermore, the concentration of keratinocyte mitogen epidermal growth factor in L-PRP (380 ± 130 pg/ml, mean ± SD) was higher (p < 0.001) than that in serum (130 ± 26 pg/ml). In conclusion, a single intraoperative local application of L-PRP promoted wound healing after THA, possibly mediated by EGF receptor agonists.
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Affiliation(s)
- Susanne Clemen Capion
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Henrietta B L Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Magnus S Ågren
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Dermatology and Copenhagen Wound Healing Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Daugaard
- Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Søren Ribel-Madsen
- Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Debora Marando
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - José Salado
- Blood Bank, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Arne Borgwardt
- Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Jens Rikardt Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
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28
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Autologous Platelet-Rich Plasma Efficacy in the Field of Regenerative Medicine: Product and Quality Control. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4672959. [PMID: 34368346 PMCID: PMC8346315 DOI: 10.1155/2021/4672959] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022]
Abstract
Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combined mainly with stem cells, autologous fat grafts, hyaluronic acid, and biomaterials in a variety of medical fields, especially in hair regrowth, wound healing, and sports and rehabilitation medicine. However, the results obtained with this biologic therapy are heterogeneous and conflicting. The observed disparities in the effectiveness of PRP therapies may be due to a lack of standardization in blood processing and preparation. This article is aimed at reviewing the main biological parameters that need to be documented for a thorough reporting of quantitative and qualitative characteristics of the PRP injected, to allow a comparison between the quality of samples and the clinically obtained results and advance the efforts towards treatment standardization.
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29
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Orive G, Anitua E. Platelet-rich therapies as an emerging platform for regenerative medicine. Expert Opin Biol Ther 2021; 21:1603-1608. [PMID: 34043484 DOI: 10.1080/14712598.2021.1936495] [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: 10/21/2022]
Abstract
INTRODUCTION The combination of human plasma components with the multiple secretome from platelets has provided a new biological tool that is shaping a new future for its direct application in tissue regeneration as well as in cell culture and advanced therapy by means of its use as a clinical-grade supplement. AREAS COVERED Some relevant aspects related to the biology, growth factor delivery and molecular pathways driving the biological effects of platelet-rich therapies are summarized. Their use as clinical-grade cell supplements and advanced therapies is also carefully described. EXPERT OPINION Platelet-rich plasma therapies, and especially PRGF, contain an incredible number of biologically active agents that may exert regenerative and therapeutic potential. Here, we highlight the latest advances in this biological approach for the delivery of autologous growth factors with some of the recent new applications including the development of a clinical-grade supplement for advanced therapy.
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Affiliation(s)
- Gorka Orive
- BTI Biotechnology Institute, Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology - UIRMI (Upv/ehu-fundación Eduardo Anitua), Vitoria, Spain.,Department of Pharmacy, NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo De La Universidad 7, Vitoria-Gasteiz, Spain
| | - Eduardo Anitua
- BTI Biotechnology Institute, Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology - UIRMI (Upv/ehu-fundación Eduardo Anitua), Vitoria, Spain
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Bec C, Rousset A, Brandin T, François P, Rabarimeriarijaona S, Dumoulin C, Heleu G, Grimaud F, Veran J, Magalon G, Dignat-George F, Sabatier F, Louis ML, Magalon J. A Retrospective Analysis of Characteristic Features of Responders and Impaired Patients to a Single Injection of Pure Platelet-Rich Plasma in Knee Osteoarthritis. J Clin Med 2021; 10:jcm10081748. [PMID: 33920633 PMCID: PMC8073986 DOI: 10.3390/jcm10081748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 12/13/2022] Open
Abstract
(1) Background: The emergence of injectable “biologic” medication creates a new approach to treat osteoarthritis (OA). Among them, the use of intra-articular injection of PRP became widespread despite the absence of consensus regarding its optimal composition. The aim of this study was to retrospectively correlate an extensive biological characterization of injected PRP to the clinical responses of patients presenting knee OA. (2) Methods: This retrospective study included 75 patients with knee OA. Cartilage lesions were assessed using magnetic resonance imaging and the International Cartilage Regeneration Society (ICRS) classification. PRP extensive biological characterization was performed and patients’ subjective symptoms were recorded before injection and 3 and 6 months after injection using the Knee injury and Osteoarthritis Outcome Score (KOOS). Responders were defined by an improvement of 10 points on KOOS. (3) Results: At 6 months, 63.0% of the patients were responders. Impairment was characterized by a significantly higher proportion of patients with three compartments altered at baseline MRI and receiving a significantly higher dose of platelets compared to responders. (4) Conclusions: Single injection of pure PRP resulted in significant clinical improvement in the management of knee OA. Both baseline MRI and PRP biological features may be predictive factors of the clinical response, highlighting that a better understanding of action mechanism of PRP is still required.
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Affiliation(s)
- Cécilia Bec
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Axelle Rousset
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Thibault Brandin
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Pauline François
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
| | - Sitraka Rabarimeriarijaona
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Chloé Dumoulin
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Gaëlle Heleu
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Fanny Grimaud
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Julie Veran
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | | | - Françoise Dignat-George
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, 13005 Marseille, France
| | - Florence Sabatier
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
- Remedex SAS, 13008 Marseille, France;
| | - Marie-Laure Louis
- Orthopedic Department, Hopital Nord, AP-HM, 13015 Marseille, France;
- ICOS, Sport and Orthopedics Surgery Institute, 13008 Marseille, France
- Orthopedic Department, Clinique Juge, Almaviva, 13008 Marseille, France
| | - Jérémy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
- Remedex SAS, 13008 Marseille, France;
- Correspondence:
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31
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Bec C, Francois P, Rousset A, Magalon J. Response to P. Harrison et al : Characteristics of L-PRP preparations for treating Achilles tendon rupture within the PATH-2 study. Platelets 2021; 32:850-851. [PMID: 33818256 DOI: 10.1080/09537104.2021.1902968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Cecilia Bec
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
| | - Pauline Francois
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Inserm, INRA, C2VN, Aix Marseille Univ, Marseille, France
| | - Axelle Rousset
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Inserm, INRA, C2VN, Aix Marseille Univ, Marseille, France.,Sas Remedex, Marseille, France
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32
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Harrison P, Alsousou J. The state of the art and future of PRP therapy. Platelets 2021; 32:150-151. [PMID: 33463374 DOI: 10.1080/09537104.2020.1869718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Paul Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Joseph Alsousou
- Kadoorie Centre for Critical Care Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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