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Wang F, Zhang XL, Zhang J, Gong S, Tao J, Xiang H, Fu XQ, Bian XN, Yu XF, Xu AH, Yi CL, Shao SY. Therapeutic Effectiveness of Leukocyte- and Platelet-rich Fibrin for Diabetic Foot Ulcers: A Retrospective Study. Curr Med Sci 2024; 44:568-577. [PMID: 38789818 DOI: 10.1007/s11596-024-2874-2] [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: 01/15/2024] [Accepted: 03/13/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE Diabetic foot ulcer (DFU) is one of the most serious complications of diabetes. Leukocyte- and platelet-rich fibrin (L-PRF) is a second-generation autologous platelet-rich plasma. This study aims to investigate the clinical effects of L-PRF in patients with diabetes in real clinical practice. METHODS Patients with DFU who received L-PRF treatment and standard of care (SOC) from 2018 to 2019 in Tongji Hospital were enrolled. The clinical information including patient characteristics, wound evaluation (area, severity, infection, blood supply), SOC of DFU, and images of ulcers was retrospectively extracted and analyzed. L-PRF treatment was performed every 7±2 days until the ulcer exhibited complete epithelialization or an overall percent volume reduction (PVR) greater than 80%. Therapeutic effectiveness, including overall PVR and the overall and weekly healing rates, was evaluated. RESULTS Totally, 26 patients with DFU were enrolled, and they had an ulcer duration of 47.0 (35.0, 72.3) days. The severity and infection of ulcers varied, as indicated by the Site, Ischemia, Neuropathy, Bacterial Infection, and Depth (SINBAD) scores of 2-6, Wagner grades of 1-4, and the Perfusion, Extent, Depth, Infection and Sensation (PEDIS) scores of 2-4. The initial ulcer volume before L-PRF treatment was 4.94 (1.50, 13.83) cm3, and the final ulcer volume was 0.35 (0.03, 1.76) cm3. The median number of L-PRF doses was 3 (2, 5). A total of 11 patients achieved complete epithelialization after the fifth week of treatment, and 19 patients achieved at least an 80% volume reduction after the seventh week. The overall wound-healing rate was 1.47 (0.63, 3.29) cm3/week, and the healing rate was faster in the first 2 weeks than in the remaining weeks. Concurrent treatment did not change the percentage of complete epithelialization or healing rate. CONCLUSION Adding L-PRF to SOC significantly improved wound healing in patients with DFU independent of the ankle brachial index, SINBAD score, or Wagner grade, indicating that this method is appropriate for DFU treatment under different clinical conditions.
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Affiliation(s)
- Fen Wang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Xiao-Ling Zhang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Jing Zhang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Song Gong
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Jing Tao
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Hui Xiang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Xiao-Qing Fu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Xu-Na Bian
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - Xue-Feng Yu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China
| | - An-Hui Xu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Cheng-la Yi
- Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shi-Ying Shao
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, 430030, China.
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Wu Y, Peng G, Wang Y, Chen J, Zhang B, Tang J, Cheng B. Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta-analysis. Int Wound J 2024; 21:e14622. [PMID: 38158884 PMCID: PMC10961890 DOI: 10.1111/iwj.14622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024] Open
Abstract
This study aims to evaluate the clinical effects of different blood derivatives on wound healing using network meta-analysis. PubMed, Embase, OVID, Web of Science, SCOPUS and Cochrane Central were searched to obtain studies about blood derivatives on wound healing until October 2023. R 4.2.0 and Stata 15.0 softwares were used for data analysis. Forty-four studies comprising 5164 patients were included. The results of network meta-analysis showed that the healing area from high to low was GF + ORCCB, ORCCB, GF, PRF, Unnas paste dressing, APG, PRP injection, PRP, PRP + thrombin gel, PPP, HPL, CT. The healing time from low to high was PRP + thrombin gel, GF, PRP, PC + K, PC, APG, PRF, CT, Silver sulfadiazine ointment. The number of patients cured from high to low was APG, PRP injection, PRP, Aurix, PRF, Leucopatch, HPL, Antimicrobial Ointment Dressing, CT, 60 μg/cm2 repifermin, 120 μg/cm2 repifermin, AFG, PPP. The order of analgesic effect from high to low was AFG, Aminogam gel, PRF, PRP, Oxidised oil, APG, GF, CT. The order of the number of wound infection cases from low to high is APG, 20 μg/cm2 repifermin, 60 μg/cm2 repifermin, PRP, LeucoPatch, CT, PPP, Antiseptic ointment dressing. Healing area: GF + ORCCB had the best effect; Healing time: PRP + thrombin gel took the shortest time. The number of cured patients and the reduction of wound infection: APG has the best effect. Analgesic effect: AFG has the best effect. More studies with large sample sizes are needed to confirm the above findings.
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Affiliation(s)
- Yanhong Wu
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
| | - Guang Peng
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
| | - Yuzhi Wang
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
| | - Jianwu Chen
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
| | - Bin Zhang
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
| | - Jianbing Tang
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
| | - Biao Cheng
- Department of Burns and Plastic SurgeryGeneral Hospital of Southern Theater Command of PLAGuangzhouGuangdongChina
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Aghajanova L, Zhang A, Lathi RB, Huddleston HG. Platelet-rich plasma infusion as an adjunct treatment for persistent thin lining in frozen embryo transfer cycles: first US experience report. J Assist Reprod Genet 2024; 41:483-491. [PMID: 37996549 PMCID: PMC10894781 DOI: 10.1007/s10815-023-02993-8] [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: 08/10/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE To study effect of intrauterine infusion of platelet-rich plasma (PRP) on endometrial growth in the setting of thin endometrial lining in patients with prior cancelled or failed frozen embryo transfer (FET) cycles. MATERIALS AND METHODS Single-arm cohort study of forty-six patients (51 cycles) with endometrial lining thickness (EMT) < 6 mm in prior cancelled or failed FET cycles requesting intrauterine PRP treatment in upcoming FET cycle. The primary outcomes were final EMT in FET cycle and change in EMT after PRP. The secondary outcomes were overall pregnancy rate, clinical pregnancy rate, miscarriage rate, ongoing pregnancy, and live birth rates. RESULTS The mean pre-PRP EMT in all FET cycles was 4.0 ± 1.1 mm, and mean post-PRP EMT (final) was 7.1 ± 1.0 mm. Of 51 cycles, 33 (64.7%) reached ≥ 7 mm after PRP administration. There was a significant difference between pre-PRP EMT and post-PRP EMT in all FET cycles, with mean difference of 3.0 ± 1.5 mm. Three cycles were cancelled for failure to reach adequate lining. Total pregnancy rate was 72.9% in our cohort of 48 cycles that proceeded to transfer. Clinical pregnancy rate was 54.2% (26/48 FET cycles); clinical miscarriage rate was 14.3% (5/35 pregnancies). Twenty six women had live birth (18 with EMT ≥ 7 mm and 8 with EMT < 7 mm). Response to PRP was not correlated with any pre-cycle characteristics. CONCLUSION We demonstrate a significant improvement in lining thickness and pregnancy rates in this challenging cohort of women after PRP infusion, with no adverse events. Cost-effectiveness of PRP with benefits and alternatives should be carefully considered.
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Affiliation(s)
- Lusine Aghajanova
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford School of Medicine, 1195 West Fremont Avenue, MC 7717, Sunnyvale, CA, 94087, USA.
| | - Amy Zhang
- Quantitative Sciences Unit, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Ruth B Lathi
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford School of Medicine, 1195 West Fremont Avenue, MC 7717, Sunnyvale, CA, 94087, USA
| | - Heather G Huddleston
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
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Huang J, Sun J, Wang Q, Mo J, Nong Y, Zhai Z, Huang X, Mo J, Lu W. A Novel Wound Therapy Modality: Autologous Wound Edge Dotted Full-Thickness Skin Grafting Improving Diabetic Foot Ulcer Healing. Int J Gen Med 2023; 16:3815-3827. [PMID: 37662508 PMCID: PMC10473433 DOI: 10.2147/ijgm.s427401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023] Open
Abstract
Aim To explore the therapeutic efficacy of autologous wound edge-dotted full-thickness skin grafting in improving diabetic foot ulcer healing. Methods Sixty-three patients were divided into three groups: conventional wound therapy (CWT) (n = 23), platelet-rich plasma (PRP) (n = 20), and graft (n = 20). All participants were followed up for 12 weeks. The therapeutic efficacy of the three different wound treatment modalities was analyzed. Results After follow-up, 37 (58.7%) patients showed complete wound re-epithelialization, of which 10 (43.5%) occurred in the CWT group, 14 (70.0%) in the PRP group, and 13 (65.0%) in the graft group. Multivariate Cox analysis showed that the independent predictive factors for ulcer healing were different treatment modalities (graft: HR = 3.214, 95% CI=1.300-7.945, P < 0.05; platelet-rich plasma: HR = 3.075, 95% CI=1.320-7.161, P < 0.01), ABI (HR = 9.917, 95% CI=2.675-36.760, P < 0.01), and TcPO2 (HR = 1.040; 95% CI=1.005-1.076; P < 0.05). Stratified analysis showed that higher ABI in graft group or PRP group had higher wound healing rate (graft group: HR = 3.748, 95% CI=1.210-11.607, P < 0.05; PRP group: HR = 5.029, 95% CI=1.743-14.509, P < 0.05); higher TcPO2 in the graft group had higher wound healing rate (HR = 15.805, 95% CI=4.414-56.594, P < 0.01). Additionally, the wound healing time (P < 0.0167) and cumulative healing rate (P < 0.05) in both the PRP group and graft group were more advantageous. The graft group promotes wound re-epithelialization earlier and faster than in the CWT group and PRP group (P < 0.05). Meanwhile, the graft group had lower medical costs (P < 0.0167). Conclusion Autologous wound edge dotted full-thickness skin grafting has a higher cost-performance ratio than traditional diabetic foot ulcer wound care and is worthy of further clinical application.
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Affiliation(s)
- Jianhao Huang
- The Department of Endocrinology and Metabolism, Jinan University, Guangzhou, Guangdong, 510632, People’s Republic of China
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Jingxia Sun
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Qiu Wang
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Jianming Mo
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Yuechou Nong
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Zhenwei Zhai
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Xiuxian Huang
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Jiacheng Mo
- Information Network Center of Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
| | - Wensheng Lu
- The Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China
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Zhou T, Wu Z, Gou X, Xia H, Ding J, Ai S. Local injection therapy for carpal tunnel syndrome: a network meta-analysis of randomized controlled trial. Front Pharmacol 2023; 14:1140410. [PMID: 37693911 PMCID: PMC10484596 DOI: 10.3389/fphar.2023.1140410] [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: 01/10/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Objective: Clinical research has shown that local injections for carpal tunnel syndrome reduce the symptoms of patients and enhance their quality of life considerably. However, there are several therapy options, and the optimal choice of regimen remains uncertain. Therefore, we comprehensively evaluated the variations in clinical efficacy and safety of several medications for treating carpal tunnel syndrome. Methods: Computer searches of Embase, PubMed, Cochrane Library, and Web of Science databases were used to collect articles of randomized controlled trials on local injections for treating carpal tunnel syndrome from database creation till 10 June 2023. Two researchers independently screened the literature, extracted information, evaluated the risk of bias in the included studies, and performed network Meta-analysis using Stata 17.0 software. Drug efficacy was assessed using symptom severity/function and pain intensity. Surface under the cumulative ranking curve (SUCRA) ranking was used to determine the advantage of each therapy. Results: We included 26 randomized controlled trials with 1896 wrists involving 12 interventions, such as local injections of corticosteroids, platelet-rich plasma, 5% dextrose, progesterone, and hyaluronidase. The results of the network meta-analysis showed the following: (i) symptom severity: at the 3-month follow-up, D5W combined with splinting (SUCRA = 95%) ranked first, and hyaluronidase (SUCRA = 89.6%) at 6 months; (ii) functional severity: either at the 3-month follow-up (SUCRA = 89.5%) or 6 months (SUCRA = 83.6%), iii) pain intensity: 5% dextrose in water combined with splinting was the most effective at the 3-month (SUCRA = 85%) and 6-month (SUCRA = 87.6%) follow-up. Conclusion: Considering the combination of symptoms/function and pain intensity, combining 5% dextrose in water with splinting is probably the treatment of choice for patients with carpal tunnel syndrome. It is more effective than glucocorticoids and no adverse effects have been observed. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022370525.
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Affiliation(s)
- TianQi Zhou
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - ZhuoRao Wu
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - XingYun Gou
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - HaiSha Xia
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - JiLin Ding
- Department of Rehabilitation Medicine, Mianyang Hospital, Chengdu University of Traditional Chinese Medicine, Mianyang, China
| | - ShuangChun Ai
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Rehabilitation Medicine, Mianyang Hospital, Chengdu University of Traditional Chinese Medicine, Mianyang, China
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Huang Q, Wu T, Guo Y, Wang L, Yu X, Zhu B, Fan L, Xin JH, Yu H. Platelet-rich plasma-loaded bioactive chitosan@sodium alginate@gelatin shell-core fibrous hydrogels with enhanced sustained release of growth factors for diabetic foot ulcer healing. Int J Biol Macromol 2023; 234:123722. [PMID: 36801280 DOI: 10.1016/j.ijbiomac.2023.123722] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
The ability of autologous platelet-rich plasma (PRP) gel to promote rapid wound healing without immunological rejection has opened new avenues for the treatment of diabetic foot wounds. However, PRP gel still suffers from the quick release of growth factors (GFs) and requires frequent administration, thus resulting in decreased wound healing efficiency, higher cost as well as greater pain and suffering for the patients. In this study, the flow-assisted dynamic physical cross-linked coaxial microfluidic three-dimensional (3D) bio-printing technology, combined with the calcium ion chemical dual cross-linking method was developed to design PRP-loaded bioactive multi-layer shell-core fibrous hydrogels. The prepared hydrogels exhibited outstanding water absorption-retention capacity, good biocompatibility as well as a broad-spectrum antibacterial effect. Compared with clinical PRP gel, these bioactive fibrous hydrogels displayed a sustained release of GFs, reducing the administration frequency by 33 % availably during the wound treatment, but more prominent therapeutic effects such as effective reduced inflammation, in addition to promoting the growth of granulation tissue and angiogenesis, the formation of high-density hair follicles, and the generation of regular ordered and high-density collagen fiber network, which suggested great promise as exceptional candidates for treatment of diabetic foot ulcer in clinical settings.
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Affiliation(s)
- Qiwei Huang
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China
| | - Tingbin Wu
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China
| | - Yongshi Guo
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China
| | - Lihuan Wang
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China
| | - Xi Yu
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China
| | - Bo Zhu
- Department of Heapatobiliary Surgery, Jiangmen Central Hospital, Jiangmen, 529020, China
| | - Longfei Fan
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China
| | - John H Xin
- Institute of Textiles & Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Hui Yu
- Guangdong-Hong Kong Joint Laboratory for New Textile Materials, School of Textile Materials and Engineering, Wuyi University, Jiangmen, 529020, China.
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Li X, Gao J, Zheng H, Zou C, Yu Z, Wu Z, Zhang J. Study of platelet-rich plasma application for skin and plastic surgery in recent 20 years: A bibliometric analysis. J Cosmet Dermatol 2023; 22:1852-1862. [PMID: 36762408 DOI: 10.1111/jocd.15653] [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: 08/22/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND In recent years, platelet-rich plasma (PRP) has been used in plastic surgery, dermatology, and other treatment procedures worldwide. Since the number of scientific writings has been significantly increasing, it is challenging to generate a manual compilation and systematic review of PRP's therapeutic applications in dermatology and plastic surgeries. This study aimed to make a bibliometric analysis of the literature in the field and evaluate research hotspots and frontiers in this field in the past 20 years. METHODS Using the Academic Search Premier and ScienceDirect defined search terms, we searched the Web of Science Core Collection (WoSCC) and Scopus databases. All data were analyzed using CiteSpace 5.8.R3 and VOSviewer, including countries, institutions, authors, keywords, cited authors, cited journals, cited references, discovered research hotspots, and frontiers. RESULTS A total of 1931 studies were retrieved. The number of publications on PRP application in dermatology and plastic surgeries showed a yearly increase. The United States was the most significant contributor to this field, while Italy's contribution was noteworthy. The journal with the highest number of relevant articles in dermatology and plastic surgery included the Journal of Cosmetic Dermatology. However, the Wound Repair and Regeneration and International Journal of Molecular Sciences were the leading journals that should be paid attention to in the future. Author Anitua E from the Tor Vergata University of Rome published the most publications in this field. In the keyword co-occurrence analysis, all keywords were divided into six clusters, and the most common one in recent years was "PRP for facial beauty." Facial rejuvenation, scar, and alopecia were the main hotspots and research trends in this field. CONCLUSIONS Based on the current global trends, the use of PRP in cosmetics and skin care is receiving increasing attention from researchers and clinicians. Recently, an increasing number of articles on PRP's application in skin tissue repair have been published in the United States and Italy. The number of studies on hair loss, facial rejuvenation, and scar management is increasing, suggesting that these subjects may become research hotspots for PRP in dermatology and cosmetic surgeries in recent years.
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Affiliation(s)
- Xianhui Li
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junqing Gao
- Affiliated Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, China
| | - Haishan Zheng
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chengyou Zou
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhuoan Yu
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zouping Wu
- The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiasheng Zhang
- Affiliated Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, China
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Gong F, Zhang Y, Gao J, Li X, Zhang H, Ma G, Huang Y, Zhang B, Zhao F. Effect of platelet-rich plasma vs standard management for the treatment of diabetic foot ulcer wounds: A meta-analysis. Int Wound J 2022; 20:155-163. [PMID: 35751432 PMCID: PMC9797932 DOI: 10.1111/iwj.13858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 01/07/2023] Open
Abstract
We performed a meta-analysis to evaluate the effect of platelet-rich plasma vs standard management for the treatment of diabetic foot ulcer wounds. A systematic literature search up to March 2022 was performed and 1435 subjects with diabetic foot ulcer wounds at the baseline of the studies; 723 of them were treated with platelet-rich plasma, and 712 used control. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated to assess the effect of platelet-rich plasma vs standard management for the treatment of diabetic foot ulcer wounds using the dichotomous method with a random or fixed-effect model. The use of autologous platelet-rich plasma resulted in significantly higher complete-healed diabetic foot ulcer wounds compared with control (OR, 1.95; 95% CI, 1.49-2.56, P < 0.001). The use of allogeneic platelet-rich plasma resulted in significantly higher complete-healed diabetic foot ulcer wounds compared with control (OR, 6.19; 95% CI, 2.32-16.56, P < 0.001). The use of autologous and allogeneic platelet-rich plasma resulted in significantly higher complete-healed diabetic foot ulcer wounds compared with control. Though, the analysis of outcomes should be with caution because of the low number of studies in certain comparisons, for example, allogeneic platelet-rich plasma compared with control.
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Affiliation(s)
- Fan Gong
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Yun Zhang
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Jian Gao
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Xiaoliang Li
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Hanlin Zhang
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Guoxu Ma
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Yonglu Huang
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Bowen Zhang
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
| | - Fei Zhao
- Department of OrthopedicsPeople's Hospital of Ningxia Hui Autonomous RegionNingxiaChina
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Chueh KS, Huang KH, Lu JH, Juan TJ, Chuang SM, Lin RJ, Lee YC, Long CY, Shen MC, Sun TW, Juan YS. Therapeutic Effect of Platelet-Rich Plasma Improves Bladder Overactivity in the Pathogenesis of Ketamine-Induced Ulcerative Cystitis in a Rat Model. Int J Mol Sci 2022; 23:ijms23105771. [PMID: 35628581 PMCID: PMC9147926 DOI: 10.3390/ijms23105771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 12/15/2022] Open
Abstract
The present study attempted to elucidate whether intravesical instillation of platelet-rich plasma (PRP) could decrease bladder inflammation and ameliorate bladder hyperactivity in ketamine ulcerative cystitis (KIC) rat model. Female Sprague Dawley (S-D) rats were randomly divided into control group, ketamine-treated group, ketamine with PRP treated group, and ketamine with platelet-poor plasma (PPP) treated group. Cystometry and micturition frequency/volume studies were performed to investigate bladder function. The morphological change of bladder was investigated by Mason’s trichrome staining. Western blotting analysis were carried out to examine the protein expressions of inflammation, urothelial differentiation, proliferation, urothelial barrier function, angiogenesis and neurogenesis related proteins. The results revealed that treatment with ketamine significantly deteriorated bladder capacity, decreased voiding function and enhanced bladder overactivity. These pathological damage and interstitial fibrosis may via NF-κB/COX-2 signaling pathways and muscarinic receptor overexpression. PRP treatment decreased inflammatory fibrotic biosynthesis, attenuated oxidative stress, promoted urothelial cell regeneration, and enhanced angiogenesis and neurogenesis, thereafter recovered bladder dysfunction and ameliorate the bladder hyperactivity in KIC rat model. These findings suggested that the PRP therapy may offer new treatment options for those clinical KIC patients.
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Affiliation(s)
- Kuang-Shun Chueh
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (C.-Y.L.)
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Kuan-Hua Huang
- Divisions of Urological Oncology, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Jian-He Lu
- Emerging Compounds Research Center, Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan;
| | - Tai-Jui Juan
- Department of Medicine, National Defense Medical College, Taipei 11490, Taiwan;
| | - Shu-Mien Chuang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Rong-Jyh Lin
- Department of Parasitology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Chen Lee
- Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Cheng-Yu Long
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (C.-Y.L.)
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 80708, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Mei-Chen Shen
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Ting-Wei Sun
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Yung-Shun Juan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (C.-Y.L.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
- Correspondence: ; Tel.: +886-7-3121101
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Jiang J, Xing F, Luo R, Liu M. Effectiveness of Platelet-Rich Plasma for Patients With Carpal Tunnel Syndrome: A Systematic Review and meta-Analysis of Current Evidence in Randomized Controlled Trials. Front Pharmacol 2022; 13:834213. [PMID: 35571114 PMCID: PMC9092282 DOI: 10.3389/fphar.2022.834213] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/11/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Recently, there was a series of clinical studies focusing on local injection of platelet-rich plasma (PRP) for treatment of patients with carpal tunnel syndrome (CTS). However, the safety and efficacy of PRP in these CTS patients remains controversial. Therefore, we performed a systematic review to compare PRP with other conservative treatments in treatment of CTS patients. Methods: We systematically searched from electronic databases (Cochrane, PubMed, Web of Science, and EMBASE) up to 10 December 2021. The data of clinical results were extracted and analyzed by RevMan Manager 5.4. Results: Finally, eight randomized controlled studies, involving 220 CTS patients undergoing local injection of PRP were enrolled in this systematic review. All enrolled trials were considered to be of high quality. In the short-term efficacy, the PRP group was significantly lower in symptom severity scale (SSS) compared with the control group (MD = −2.00; 95% CI, −3.15 to −0.85; p = 0.0007; I2 = 0%). In the mid-term efficacy, the PRP group was significantly effective than the control group in the visual analogue scale (MD = −0.63; 95% CI, −1.22 to −0.04; p = 0.04; I2 = 61%), SSS (MD = −3.56; 95% CI, −4.93 to −2.18; p < 0.00001; I2 = 0%), functional status scale (MD = −2.29; 95% CI, −3.03 to −1.56; p < 0.00001; I2 = 45%), sensory peak latency (MD = −0.39; 95% CI, −0.58 to −0.19; p = 0.0001; I2 = 0%) and cross-sectional area of median nerve (MD = -0.20; 95% CI, −0.31 to −0.10; p = 0.0002; I2 = 0%). In the mid-long-term efficacy, the PRP group was only significantly lower in SSS compared with the control group (MD = −2.71; 95% CI, −4.33 to −1.10; p = 0.001; I2 = 38%). Conclusion: Local PRP injection is more effective than other conservative treatments in terms of mid-term efficacy in relieving pain, improving wrist function and symptoms, reducing MN swelling, and partially improving electrophysiological indicators. However, the long-term adverse side and consensus on standardization of PRP in CTS patients still need further large-scale trials.
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Affiliation(s)
- Jiabao Jiang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Xing
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Luo
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Liu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
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11
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Mastrogiacomo M, Nardini M, Collina MC, Di Campli C, Filaci G, Cancedda R, Odorisio T. Innovative Cell and Platelet Rich Plasma Therapies for Diabetic Foot Ulcer Treatment: The Allogeneic Approach. Front Bioeng Biotechnol 2022; 10:869408. [PMID: 35586557 PMCID: PMC9108368 DOI: 10.3389/fbioe.2022.869408] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/14/2022] [Indexed: 12/15/2022] Open
Abstract
Cutaneous chronic wounds are a major global health burden in continuous growth, because of population aging and the higher incidence of chronic diseases, such as diabetes. Different treatments have been proposed: biological, surgical, and physical. However, most of these treatments are palliative and none of them can be considered fully satisfactory. During a spontaneous wound healing, endogenous regeneration mechanisms and resident cell activity are triggered by the released platelet content. Activated stem and progenitor cells are key factors for ulcer healing, and they can be either recruited to the wound site from the tissue itself (resident cells) or from elsewhere. Transplant of skin substitutes, and of stem cells derived from tissues such as bone marrow or adipose tissue, together with platelet-rich plasma (PRP) treatments have been proposed as therapeutic options, and they represent the today most promising tools to promote ulcer healing in diabetes. Although stem cells can directly participate to skin repair, they primarily contribute to the tissue remodeling by releasing biomolecules and microvesicles able to stimulate the endogenous regeneration mechanisms. Stem cells and PRP can be obtained from patients as autologous preparations. However, in the diabetic condition, poor cell number, reduced cell activity or impaired PRP efficacy may limit their use. Administration of allogeneic preparations from healthy and/or younger donors is regarded with increasing interest to overcome such limitation. This review summarizes the results obtained when these innovative treatments were adopted in preclinical animal models of diabetes and in diabetic patients, with a focus on allogeneic preparations.
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Affiliation(s)
- Maddalena Mastrogiacomo
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy
- *Correspondence: Maddalena Mastrogiacomo,
| | - Marta Nardini
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy
| | - Maria Chiara Collina
- Unità Operativa Semplice Piede Diabetico e Ulcere Cutanee, IDI-IRCCS, Roma, Italy
| | - Cristiana Di Campli
- Unità Operativa Semplice Piede Diabetico e Ulcere Cutanee, IDI-IRCCS, Roma, Italy
| | - Gilberto Filaci
- Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ranieri Cancedda
- Emeritus Professor, Università degli Studi di Genova, Genova, Italy
| | - Teresa Odorisio
- Laboratorio di Biologia Molecolare e Cellulare, IDI-IRCCS, Roma, Italy
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12
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Korovin AY, Popandopulo KI, Bazlov SB, Turkin DV. [Complex treatment of lower limb ulcers in patients with diabetes mellitus type 2]. Khirurgiia (Mosk) 2022:48-53. [PMID: 35477200 DOI: 10.17116/hirurgia202204148] [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: 11/17/2022]
Abstract
OBJECTIVE To estimate the efficiency of stimulation of reparative processes in patients with diabetes mellitus type 2 and trophic ulcers of the lower limbs. MATERIAL AND METHODS There were 94 patients with diabetes mellitus type 2 complicated by trophic ulcers of the lower limbs. Mean age of patients was 67.8±8.6 years. The main group consisted of 50 (53.2%) patients who underwent stimulation of reparative processes, control group - 44 (46.8%) patients with standard treatment and hydrocolloid dressings. Efficiency of treatment was analyzed every 5 days considering wound healing and cytological data. RESULTS We found significant reduction of neurotrophic ulcer volume by 29.9% after 10 days. Positive macroscopic data were accompanied by reduction of white blood cells count up to 40-50% and increase in the number of histiocytes and endothelial cells. Among patients with ischemic ulcers, we obtained significant reduction of ulcerative defect only after 15-20 days in 3 (60%) cases. Overall efficiency of original management way 96%, mean duration of treatment - 37.1±5.9 days. In the control group, overall efficiency of treatment was 70.5%, duration of treatment - 45.9±6.1 days. CONCLUSION The original method was valuable to improve the outcomes in patients with diabetes mellitus type 2 and trophic ulcers of the lower limbs. The best results were obtained for neurotrophic ulcers. In case of ischemic ulcers, these technologies should be combined with measures on improvement of pulsatile blood flow and microcirculation. This method does not require hospitalization and reduces treatment cost.
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Affiliation(s)
- A Ya Korovin
- Kuban State Medical University, Krasnodar, Russia
| | | | - S B Bazlov
- Kuban State Medical University, Krasnodar, Russia
| | - D V Turkin
- Kuban State Medical University, Krasnodar, Russia
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13
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Singh M, Akkaya S, Preuß M, Rademacher F, Tohidnezhad M, Kubo Y, Behrendt P, Weitkamp JT, Wedel T, Lucius R, Gläser R, Harder J, Bayer A. Platelet-Released Growth Factors Influence Wound Healing-Associated Genes in Human Keratinocytes and Ex Vivo Skin Explants. Int J Mol Sci 2022; 23:ijms23052827. [PMID: 35269967 PMCID: PMC8911300 DOI: 10.3390/ijms23052827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023] Open
Abstract
Platelet-released growth factors (PRGFs) or other thrombocyte concentrate products, e.g., Platelet-Rich Fibrin (PRF), have become efficient tools of regenerative medicine in many medical disciplines. In the context of wound healing, it has been demonstrated that treatment of chronic or complicated wounds with PRGF or PRF improves wound healing in the majority of treated patients. Nevertheless, the underlying cellular and molecular mechanism are still poorly understood. Therefore, we aimed to analyze if PRGF-treatment of human keratinocytes caused the induction of genes encoding paracrine factors associated with successful wound healing. The investigated genes were Semaphorin 7A (SEMA7A), Angiopoietin-like 4 (ANGPLT4), Fibroblast Growth Factor-2 (FGF-2), Interleukin-32 (IL-32), the CC-chemokine-ligand 20 (CCL20), the matrix-metalloproteinase-2 (MMP-2), the chemokine C-X-C motif chemokine ligand 10 (CXCL10) and the subunit B of the Platelet-Derived Growth Factor (PDGFB). We observed a significant gene induction of SEMA7A, ANGPLT4, FGF-2, IL-32, MMP-2 and PDGFB in human keratinocytes after PRGF treatment. The CCL20- and CXCL10 gene expressions were significantly inhibited by PRGF therapy. Signal transduction analyses revealed that the PRGF-mediated gene induction of SEMA7A, ANGPLT4, IL-32 and MMP-2 in human keratinocytes was transduced via the IL-6 receptor pathway. In contrast, EGF receptor signaling was not involved in the PRGF-mediated gene expression of analyzed genes in human keratinocytes. Additionally, treatment of ex vivo skin explants with PRGF confirmed a significant gene induction of SEMA7A, ANGPLT4, MMP-2 and PDGFB. Taken together, these results describe a new mechanism that could be responsible for the beneficial wound healing properties of PRGF or related thrombocytes concentrate products such as PRF.
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Affiliation(s)
- Michael Singh
- Institute of Anatomy, Kiel University, 24098 Kiel, Germany; (M.S.); (S.A.); (T.W.); (R.L.)
| | - Serhat Akkaya
- Institute of Anatomy, Kiel University, 24098 Kiel, Germany; (M.S.); (S.A.); (T.W.); (R.L.)
| | - Mark Preuß
- Department for Vascular Medicine, Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Franziska Rademacher
- Department of Dermatology, Venerology and Allergology, Kiel University, 24105 Kiel, Germany; (F.R.); (R.G.); (J.H.)
| | - Mersedeh Tohidnezhad
- Department of Anatomy and Cell Biology, RWTH Aachen University, 52074 Aachen, Germany; (M.T.); (Y.K.)
| | - Yusuke Kubo
- Department of Anatomy and Cell Biology, RWTH Aachen University, 52074 Aachen, Germany; (M.T.); (Y.K.)
| | - Peter Behrendt
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany;
| | - Jan-Tobias Weitkamp
- Department of Oral and Maxillofacial Surgery, University Medical Center of Schleswig-Holstein, Campus Kiel, 24015 Kiel, Germany;
| | - Thilo Wedel
- Institute of Anatomy, Kiel University, 24098 Kiel, Germany; (M.S.); (S.A.); (T.W.); (R.L.)
| | - Ralph Lucius
- Institute of Anatomy, Kiel University, 24098 Kiel, Germany; (M.S.); (S.A.); (T.W.); (R.L.)
| | - Regine Gläser
- Department of Dermatology, Venerology and Allergology, Kiel University, 24105 Kiel, Germany; (F.R.); (R.G.); (J.H.)
| | - Jürgen Harder
- Department of Dermatology, Venerology and Allergology, Kiel University, 24105 Kiel, Germany; (F.R.); (R.G.); (J.H.)
| | - Andreas Bayer
- Institute of Anatomy, Kiel University, 24098 Kiel, Germany; (M.S.); (S.A.); (T.W.); (R.L.)
- Correspondence:
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14
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Russo S, Landi S, Courric S. Cost-Effectiveness Analysis for the Treatment of Diabetic Foot Ulcer in France: Platelet-Rich Plasma vs Standard of Care. Clinicoecon Outcomes Res 2022; 14:1-10. [PMID: 35018103 PMCID: PMC8742138 DOI: 10.2147/ceor.s327191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/09/2021] [Indexed: 01/13/2023]
Abstract
Introduction Diabetic chronic foot ulcers (DFU) lead to pain, reduced quality of life and represent a severe economic burden for patients and health systems. The clinical results of PRP effectiveness in the treatment of DFU are promising; on the other hand, the costs associated with treating DFUs with PRP are higher than those using standard therapy. Therefore, this study aims to determine the cost-effectiveness of platelet-rich plasma (PRP) therapy compared to standard therapy from the French healthcare system perspective. Methods A cost-effectiveness analysis (CEA) was performed using a decision Markov model with a cohort of patients with chronic DFU (duration of >3 weeks) with high orthopaedic risk and with ulcers graded 3A according to University of Texas classification. The effectiveness outcomes are reported in terms of quality adjusted life year (QALY). The costs are reported in euro (€) currency evaluated in 2019. A micro-costing approach alongside a clinical study was used to assess resource use. Deterministic sensibility analyses are reported to evaluate the robustness of the results. The analyses were carried out in the French setting. Results The incremental cost-effectiveness ratio (ICER) of PRP treatment is –€613/ QALY, which, being lower than zero, indicates the dominance of the PRP therapy. Deterministic and probabilistic sensitivity analysis underlines the main parameter affecting CE results. Lowest number of standard of care weekly medications (from 5 to 3) leads to a €622/QALY while increasing PRP weekly medication (from 1 to 4) has an ICER of €732/QALY. Discussion PRP is a cost-effective or even a cost-saving alternative in the French setting. PRP has higher cost for the complete medication, but, in the absence of wound complications, has the potential to involve lower consumption of resources in the form of routine medication over a 1-year time horizon.
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Affiliation(s)
- Salvatore Russo
- Department of Management, University of Venice, Venezia, Italy
| | - Stefano Landi
- Department of Business Administration and Management, University of Verona, Verona, Italy
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15
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Healing of Chronic Wounds with Platelet-Derived Growth Factors from Single Donor Platelet-Rich Plasma following One Freeze-Thaw Cycle. A Cross-Sectional Study. J Clin Med 2021; 10:jcm10245762. [PMID: 34945062 PMCID: PMC8705371 DOI: 10.3390/jcm10245762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 12/29/2022] Open
Abstract
Chronic non-healing wounds (CNHWs) may be associated with trauma or idiopathic in nature and are difficult to treat. Our objective was to assess the use of platelet-derived growth factor (PDGF) from single-donor platelets (al-PRP), using one freeze-thaw cycle, for treating CNHWs. We conducted a cross-sectional study. A total of 23 CNHWs being treated with al-PRP. The al-PRP treatment can be considered successful in well over half (n = 13, 56.5%) of the wounds. We found that all the wounds treated for up to 7 weeks showed partial or complete healing, while those treated for between 8 and 12 weeks did not show healing, healing again being successful in cases in which treatment was extended to more than 13 weeks (85.7%). Using chi-square tests, this relationship was found to be highly significant (p < 0.001, chi2 = 19.51; p value = 0.00006). Notably, Cramer's V coefficient was very high (0.921), indicating that the effect size of PRP treatment duration on healing is very large (84.8%). We could suggest that the use of al-PRP in the healing of CNHWs is a promising approach. Further studies with larger sample sizes and long follow-ups are needed to obtain multivariate models to explain which factors favour the healing of ulcers treated with PRP.
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16
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He M, Guo X, Li T, Jiang X, Chen Y, Yuan Y, Chen B, Yang G, Fan Y, Liang Z, Armstrong DG, Deng W. Comparison of Allogeneic Platelet-rich Plasma With Autologous Platelet-rich Plasma for the Treatment of Diabetic Lower Extremity Ulcers. Cell Transplant 2021; 29:963689720931428. [PMID: 32510240 PMCID: PMC7563928 DOI: 10.1177/0963689720931428] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Autologous platelet-rich plasma (au-PRP) has been widely used for the management of refractory chronic wounds. However, patients with diabetic lower extremity ulcers (DLEUs) usually have complicated clinical conditions, and the utility of au-PRP is limited. In this study, the feasibility, effectiveness, and safety of allogeneic platelet-rich plasma (al-PRP) and au-PRP were investigated and compared in the treatment of DLEUs. A total of 75 in-patients with type 2 diabetes were assigned to the al-PRP group (n = 20), au-PRP group (n = 25), and conventional wound therapeutic (CWT) group (n = 30) matched by the ankle brachial index and ulcer size from December 2015 to August 2018. Based on metabolic and nutritional regulation, infective control, and topical wound management, al-PRP, au-PRP, and CWT were administered to each group, respectively. Evaluation of treatment outcomes was determined by the parameters of wound healing and adverse reactions. The therapeutic times and average concentration of platelets were not significantly different between the au-PRP and al-PRP groups. The wound healing times of the al-PRP group (56.9 ± 29.22 d) and au-PRP group (55.6 ± 33.8 d) were significantly shorter than those of the CWT group (88.0 ± 43.4 d) (P < 0.01), but there was no significant difference between the groups with PRP treatment. Although there was no significant difference in the daily healing area among all groups (P > 0.05), the trend of the healing rate in the al-PRP group (16.77 ± 12.85 mm2), au-PRP group (14.31 ± 18.28 mm2), and CWT group (9.90 ± 8.51 mm2) gradually decreased. No obvious adverse reactions (fever, edema, pain, skin itching, rash, or other sensory abnormalities) were observed in either the au-PRP or the al-PRP groups. Both al-PRP and au-PRP could effectively and safely promote wound healing in patients with DLEUs. Alternatively, al-PRP could be used for DLEUs as an off-the-shelf solution when au-PRP is limited.
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Affiliation(s)
- Min He
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China.,Department of Endocrinology, Chongqing Southwest Hospital, China.,These authors contributed equally to this article
| | - Xuewen Guo
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China.,Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, China.,These authors contributed equally to this article
| | - Tao Li
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China.,Department of Endocrinology, Chongqing Southwest Hospital, China.,These authors contributed equally to this article
| | - Xiaoyan Jiang
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
| | - Yan Chen
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
| | - Yi Yuan
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
| | - Bing Chen
- Department of Endocrinology, Chongqing Southwest Hospital, China
| | - Gangyi Yang
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, China
| | - Yahan Fan
- Department of Blood Transfusion, Southwest Hospital, Chongqing, China
| | - Ziwen Liang
- Department of Endocrinology, Chongqing Southwest Hospital, China
| | - David G Armstrong
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Wuquan Deng
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
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17
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A narrative review of platelet-rich plasma (PRP) in reproductive medicine. J Assist Reprod Genet 2021; 38:1003-1012. [PMID: 33723748 DOI: 10.1007/s10815-021-02146-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/07/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Platelet-rich plasma (PRP) has become a novel treatment in various aspects of medicine including orthopedics, cardiothoracic surgery, plastic surgery, dermatology, dentistry, and diabetic wound healing. PRP is now starting to become an area of interest in reproductive medicine more specifically focusing on infertility. Poor ovarian reserve, menopause, premature ovarian failure, and thin endometrium have been the main areas of research. The aim of this article is to review the existing literature on the effects of autologous PRP in reproductive medicine providing a summation of the current studies and assessing the need for additional research. METHODS A literature search is performed using PubMed, MEDLINE, and CINAHL Plus to identify studies focusing on the use of PRP therapy in reproductive medicine. Articles were divided into 3 categories: PRP in thin lining, PRP in poor ovarian reserve, and PRP in recurrent implantation failure. RESULTS In women with thin endometrium, the literature shows an increase in endometrial thickness and increase in chemical and clinical pregnancy rates following autologous PRP therapy. In women with poor ovarian reserve, autologous intraovarian PRP therapy increased anti-Mullerian hormone (AMH) levels and decreased follicle-stimulating hormone (FSH), with a trend toward increasing clinical and live birth rates. This trend was also noted in women with recurrent implantation failure. CONCLUSIONS Limited literature shows promise in increasing endometrial thickness, increasing AMH, and decreasing FSH levels, as well as increasing chemical and clinical pregnancy rates. The lack of standardization of PRP preparation along with the lack of large randomized controlled trials needs to be addressed in future studies. Until definitive large RCTs are available, PRP use should be considered experimental.
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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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Ding ZY, Tan Y, Peng Q, Zuo J, Li N. Novel applications of platelet concentrates in tissue regeneration (Review). Exp Ther Med 2021; 21:226. [PMID: 33603835 PMCID: PMC7851614 DOI: 10.3892/etm.2021.9657] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/03/2020] [Indexed: 12/11/2022] Open
Abstract
Numerous studies have explored the suitability of biocompatible materials in regenerative medicine. Platelet concentrates are derived from centrifuged blood and are named according to their biological characteristics, such as platelet-rich plasma, platelet-rich fibrin and concentrated growth factor. Platelet concentrates have gained considerable attention in soft and hard tissue engineering. Indeed, multiple components of autologous platelet concentrates, such as growth factors, fibrin matrix and platelets, serve essential roles in wound healing. Current studies are focused on cutting-edge strategies to meet the requirements for tissue restoration by improving the properties of autologous platelet concentrates. In the present review, applications of platelet concentrates for tissue engineering are discussed, presenting a selection of recent advances and novel protocols. In addition, several aspects of these strategies, such as the advantages of lyophilized platelet concentrates and the combination of platelet concentrates with biomaterials, stem cells or drugs are discussed. The present review aims to summarize novel strategies using platelet concentrates to improve the outcomes of wound healing.
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Affiliation(s)
- Zhen-Yu Ding
- Hunan Key Laboratory of Oral Health Research, Hunan 3D Printing Engineering Research Center of Oral Care, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, Hunan 410008, P.R. China
| | - Ying Tan
- Department of Blood Transfusion, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, Hunan 410008, P.R. China
| | - Qian Peng
- Hunan Key Laboratory of Oral Health Research, Hunan 3D Printing Engineering Research Center of Oral Care, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, Hunan 410008, P.R. China
| | - Jun Zuo
- Hunan Key Laboratory of Oral Health Research, Hunan 3D Printing Engineering Research Center of Oral Care, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha, Hunan 410008, P.R. China
| | - Ning Li
- Department of Blood Transfusion, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, Hunan 410008, P.R. China
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Qian Z, Wang H, Bai Y, Wang Y, Tao L, Wei Y, Fan Y, Guo X, Liu H. Improving Chronic Diabetic Wound Healing through an Injectable and Self-Healing Hydrogel with Platelet-Rich Plasma Release. ACS APPLIED MATERIALS & INTERFACES 2020; 12:55659-55674. [PMID: 33327053 DOI: 10.1021/acsami.0c17142] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Diabetic skin ulcer is one of the severe complications of diabetes mellitus, which has a high incidence and may cause death or disability. Platelet-rich plasma (PRP) is widely used in the treatment of diabetic wounds due to the effect of growth factors (GFs) derived from it. However, the relatively short half-life of GFs limits their applications in clinics. In addition, the presence of a large amount of proteases in the diabetic wound microenvironment results in the degradation of GFs, which further impedes angiogenesis and diabetic wound healing. In our study, we fabricated a self-healing and injectable hydrogel with a composite of chitosan, silk fibroin, and PRP (CBPGCTS-SF@PRP) for promoting diabetic wound healing. CBPGCTS-SF@PRP could protect PRP from enzymatic hydrolysis, release PRP sustainably, and enhance the chemotaxis of mesenchymal stem cells. The results showed that it could promote the proliferation of repair cells in vitro. Moreover, it could enhance wound healing by expediting collagen deposition, angiogenesis, and nerve repair in a type 2 diabetic rat model and a rat skin defect model. We hope that this study will offer a new treatment for diabetic nonhealing wounds in clinics.
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Affiliation(s)
- Zhiyong Qian
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Xue Yuan Road No. 37, Haidian District, Beijing 100191, People's Republic of China
| | - Haiping Wang
- Department of Transfusion, 307 Hospital of Chinese PLA, Beijing 100071, P. R. China
| | - Yating Bai
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Xue Yuan Road No. 37, Haidian District, Beijing 100191, People's Republic of China
| | - Yuqing Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Xue Yuan Road No. 37, Haidian District, Beijing 100191, People's Republic of China
| | - Lei Tao
- The Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Tsinghua University, Beijing 100084, P. R. China
| | - Yen Wei
- The Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Tsinghua University, Beijing 100084, P. R. China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Xue Yuan Road No. 37, Haidian District, Beijing 100191, People's Republic of China
| | - Ximin Guo
- Department of Neural Engineering and Biological Interdisciplinary Studies, Institute of Military Cognition and Brain Sciences, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, People's Republic of China
| | - Haifeng Liu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Xue Yuan Road No. 37, Haidian District, Beijing 100191, People's Republic of China
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Yao D, Feng G, Zhao F, Hao D. Effects of platelet-rich plasma on the healing of sternal wounds: A meta-analysis. Wound Repair Regen 2020; 29:153-167. [PMID: 33128501 DOI: 10.1111/wrr.12874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/08/2020] [Accepted: 10/26/2020] [Indexed: 01/13/2023]
Abstract
Sternal wound infection (SWI) is a devastating complication after cardiac surgery. Platelet-rich plasma (PRP) may have a positive impact on sternal wound healing. A systematic review with meta-analyses was performed to evaluate the clinical effectiveness of topical application of autologous PRP for preventing SWI and promoting sternal wound healing compared to placebo or standard treatment without PRP. Relevant studies published in English or Chinese were retrieved from the Cochrane Central Register of Controlled Trials (The Cochrane Library), PubMed, Ovid EMBASE, Web of Science, Springer Link, and the WHO International Clinical Trials Registry Platform (ICTRP) using the search terms "platelet-rich plasma" and "sternal wound" or "thoracic incision." References identified through the electronic search were screened, the data were extracted, and the methodological quality of the included studies was assessed. The meta-analysis was performed for the following outcomes: incidence of SWI, incidence of deep sternal wound infection (DSWI), postoperative blood loss (PBL), and other risk factors. In the systematic review, totally 10 comparable studies were identified, involving 7879 patients. The meta-analysis for the subgroup of retrospective cohort studies (RSCs) showed that the incidence of SWI and DSWI in patients treated with PRP was significantly lower than that in patients without PRP treatment. However, for the subgroup of randomized controlled trials (RCTs), there was no significant difference in the incidence of SWI or DSWI after intervention between the PRP and control groups. There was no significant difference in PBL in both RCTs and RSCs subgroups. Neither adverse reactions nor in-situ recurrences were reported. According to the results, PRP could be considered as a candidate treatment to prevent SWI and DSWI. However, the quality of the evidence is too weak, and high-quality RCTs are needed to assess its efficacy on preventing SWI and DSWI.
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Affiliation(s)
- Dan Yao
- No. 3 Department of Burns and Plastic Surgery and Wound Healing Center, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Guang Feng
- No. 3 Department of Burns and Plastic Surgery and Wound Healing Center, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fan Zhao
- No. 3 Department of Burns and Plastic Surgery and Wound Healing Center, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Daifeng Hao
- No. 3 Department of Burns and Plastic Surgery and Wound Healing Center, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
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de Miguel-Gómez L, López-Martínez S, Campo H, Francés-Herrero E, Faus A, Díaz A, Pellicer A, Domínguez F, Cervelló I. Comparison of different sources of platelet-rich plasma as treatment option for infertility-causing endometrial pathologies. Fertil Steril 2020; 115:490-500. [PMID: 32854930 DOI: 10.1016/j.fertnstert.2020.07.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To study the effect of human plasma from different sources, namely, umbilical cord blood and adult blood platelet-rich plasma (PRP), on the regeneration of endometrial damage. DESIGN Composition analysis, in vitro approaches, and a preclinical murine model using plasma to promote endometrial regeneration. SETTING Hospital and university laboratories. PATIENT(S)/ANIMAL(S) Adult plasma from four Asherman syndrome/endometrial atrophy patients and one fertile woman, commercial umbilical cord plasma, and uterine-damaged NOD/SCID mice model were used. INTERVENTION(S) Endometrial stromal cells from primary culture and an endometrial stem cell line were cultured in vitro, and uterine-damaged NOD/SCID mice were treated with plasma samples from several origins. MAIN OUTCOME MEASURE(S) To investigate the possible beneficial effects of PRP from Asherman syndrome/endometrial atrophy patients. To test if plasma from human umbilical cord blood had a stronger effect than adult PRP in endometrial regeneration. To demonstrate if PRP from Asherman syndrome/endometrial atrophy patients was as effective as PRP from a healthy woman and could therefore be used for autologous treatment. RESULT(S) All plasma samples contained molecules with a high potential for regeneration (stem cell factor, platelet-derived growth factor BB, thrombospondin-1, von Willebrand factor). Furthermore, the highest increase in in vitro proliferation and migration rate was found when endometrial stromal cells were treated with umbilical cord plasma; adult PRP also revealed a significant increment. In the mouse model, a higher expression of Ki67 and Hoxa10 in the endometrium was detected after applying adult PRP, and the proteomic analysis revealed a specific protein expression profile depending on the treatment. The damaged uterine tissue showed more proregenerative markers after applying umbilical cord plasma (Stat5a, Uba3, Thy1) compared with the other treatments (nonactivated umbilical cord plasma, activated adult PRP, and no treatment). CONCLUSION(S) Human PRP possesses regeneration properties usable for endometrial pathologies. Besides that, these regenerative effects seem to be more apparent when the source of obtaining is umbilical cord blood.
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Affiliation(s)
- Lucía de Miguel-Gómez
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; University of Valencia, Valencia, Spain
| | - Sara López-Martínez
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Hannes Campo
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Emilio Francés-Herrero
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; University of Valencia, Valencia, Spain
| | - Amparo Faus
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Ana Díaz
- University of Valencia, Valencia, Spain
| | | | - Francisco Domínguez
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Irene Cervelló
- Fundación Instituto Valenciano de Infertilidad, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.
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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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Platelet-Released Growth Factors and Platelet-Rich Fibrin Induce Expression of Factors Involved in Extracellular Matrix Organization in Human Keratinocytes. Int J Mol Sci 2020; 21:ijms21124404. [PMID: 32575800 PMCID: PMC7378768 DOI: 10.3390/ijms21124404] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023] Open
Abstract
Platelet-released growth factor (PRGF) is a thrombocyte concentrate lysate which, like its clinically equivalent variations (e.g., Vivostat PRF® (platelet-rich fibrin)), is known to support the healing of chronic and hard-to-heal wounds. However, studies on the effect of PRGF on keratinocytes remain scarce. This study aims to identify genes in keratinocytes that are significantly influenced by PRGF. Therefore, we performed a whole transcriptome and gene ontology (GO) enrichment analysis of PRGF-stimulated human primary keratinocytes. This revealed an increased expression of genes involved in extracellular matrix (ECM) organization. Real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) analysis confirmed the PRGF-mediated induction of selected ECM-related factors such as transforming growth factor beta-induced protein, fibronectin 1, matrix metalloproteinase-9, transglutaminase 2, fermitin family member 1, collagen type I alpha 1 and collagen type XXII alpha 1. PRGF-induced expression of the above factors was influenced by blockade of the epidermal growth factor receptor (EGFR), a receptor playing a crucial role in wound healing. A differential induction of the investigated factors was also detected in skin explants exposed to PRGF and in experimentally generated in vivo wounds treated with Vivostat PRF®. Together, our study indicates that the induction of ECM-related factors may contribute to the beneficial wound-healing effects of PRGF-based formulations.
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Xiang J, Shen L, Hong Y. Status and future scope of hydrogels in wound healing: Synthesis, materials and evaluation. Eur Polym J 2020. [DOI: 10.1016/j.eurpolymj.2020.109609] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Chen D, Wang C, Cui L, Ran X. Autologous Platelet-Rich Gel Treatment of Chronic Nonhealing Ulcerated Tophaceous Gout. Indian J Dermatol 2020; 65:141-144. [PMID: 32180603 PMCID: PMC7059477 DOI: 10.4103/ijd.ijd_157_18] [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] [Indexed: 02/05/2023] Open
Abstract
Ulcers resulting from tophaceous gout are uncommon and very difficult to heal. Here we report a case with chronic refractory tophaceous gout, not responding to conventional treatment modality for several months in a 39-year-old man with a 12-year history of gout with recurrent acute arthritis attacks. Two times after treatment with autologous platelet-rich gel (APG), the ulcer healed finally for 2 months. This is the first study to confirm that APG can improve tophus ulcer healing. Based on conventional medical therapy and standard debridement, APG might be a novel and effective method to stimulate tophus ulcer healing.
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Affiliation(s)
- Dawei Chen
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chun Wang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lina Cui
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingwu Ran
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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The effect of platelet-rich plasma on the achievement of pregnancy during frozen embryo transfer in women with a history of failed implantation. Heliyon 2020; 6:e03577. [PMID: 32195397 PMCID: PMC7075971 DOI: 10.1016/j.heliyon.2020.e03577] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 11/13/2019] [Accepted: 03/09/2020] [Indexed: 12/23/2022] Open
Abstract
Objective The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on the rate of implantation and pregnancy in women with repeated failed implantation during frozen embryo transfer. Methods This study was conducted on 50 infertile women candidates (who were referred to the Infertility Treatment Center of Besat Hospital in Sanandaj) with a history of failed implantation for the purpose of frozen embryo transfer. The participants were randomly divided into two groups (n = 25). In the first group (control), the intrauterine infusion of 0.5 ml of Ringer serum was done 48 h before embryo transfer. In the second group (treatment), the intrauterine infusion of 0.5 ml of PRP was performed 48 h before embryo transfer. Results In this study, there was no significant difference between the two groups in the rate of chemical and clinical pregnancy. The rate of chemical pregnancy was 28% in the treatment group and 36% in the control group, while the rate of clinical pregnancy was 28% in the treatment group and 24% in the control group. Conclusion The intrauterine infusion of PRP before frozen embryo transfer in infertile women with a history of failed implantation will not make any significant effect on the result of pregnancy.
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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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Trull-Ahuir C, Sala D, Chismol-Abad J, Vila-Caballer M, Lisón JF. Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial. Sci Rep 2020; 10:2085. [PMID: 32034241 PMCID: PMC7005701 DOI: 10.1038/s41598-020-59113-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/24/2020] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study is to evaluate the efficiency of local platelet-rich plasma (PRP) injection as an adjuvant treatment after carpal ligament release. We conducted a prospective randomized, triple-blinded, controlled trial. Fifty participants with mild to extreme carpal tunnel syndrome (CTS) were randomly assigned either to the PRP (n = 25) or the platelet-poor plasma (PPP, n = 25) group. After performing open surgical release of the carpal ligament, the inside of the carpal tunnel was irrigated with 3 mL of PRP or PPP according to each participant’s group allocation. The primary outcome was hand grip strength (HGS). Secondary outcomes were the time taken off work after surgery (in days) and scores on the Wong–Baker Faces Scale, Boston Carpal Tunnel Questionnaire, and Southampton Wound Assessment Scale. We evaluated patients before treatment and at 6-weeks. As expected, the pain levels, symptom severity, and functional status improved in all the patients after surgery. However, intragroup analysis revealed that only the participants in the PRP group had regained their pre-operative HGS levels at 6-weeks follow-up. These findings indicate that PRP is an effective adjuvant treatment in patients with mild to severe CTS who require surgery.
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Affiliation(s)
- Carmen Trull-Ahuir
- Department of Nursing, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Diego Sala
- Department of Orthopedic Surgery and Traumatology, Umivale MATEPSSN.15, Valencia, Spain
| | - Joaquín Chismol-Abad
- Department of Orthopedic Surgery and Traumatology, Umivale MATEPSSN.15, Valencia, Spain
| | - Marian Vila-Caballer
- Department of Biomedical Sciences, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.
| | - Juan Francisco Lisón
- Department of Medicine, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain. .,Centre of Physiopathology of Obesity and Nutrition (CIBERobn), CB06/03 Carlos III Health Institute, Valencia, Spain.
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Siah TW, Guo H, Chu T, Santos L, Nakamura H, Leung G, Shapiro J, McElwee KJ. Growth factor concentrations in platelet‐rich plasma for androgenetic alopecia: An intra‐subject, randomized, blinded, placebo‐controlled, pilot study. Exp Dermatol 2020; 29:334-340. [DOI: 10.1111/exd.14074] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/21/2019] [Accepted: 01/21/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Tee Wei Siah
- Watford General Hospital Watford Hertfordshire UK
| | - Hongwei Guo
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
| | - Thomas Chu
- Department of Dermatology Wayne State University School of Medicine Dearborn MI USA
- Department of Dermatology Far Eastern Memorial Hospital New Taipei Taiwan
| | - Leopoldo Santos
- Department of Medicine Santa Casa of São Paulo School of Medicine São Paulo SP Brazil
- Department of Dermatology and Alergology Municipal Public Servant Hospital of São Paulo São Paulo SP Brazil
- Department of Medicine University of Taubaté Taubaté SP Brazil
| | | | - Gigi Leung
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
| | - Jerry Shapiro
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
- The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York NY USA
| | - Kevin J. McElwee
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
- Centre for Skin Sciences University of Bradford Bradford West Yorkshire UK
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Sowa Y, Kishida T, Tomita K, Adachi T, Numajiri T, Mazda O. Involvement of PDGF-BB and IGF-1 in Activation of Human Schwann Cells by Platelet-Rich Plasma. Plast Reconstr Surg 2019; 144:1025e-1036e. [PMID: 31764650 DOI: 10.1097/prs.0000000000006266] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Platelet-rich plasma contains high concentrations of growth factors that stimulate proliferation and migration of various cell types. Earlier experiments demonstrated that local platelet-rich plasma administration activates Schwann cells to improve axonal regeneration at a transected peripheral nerve lesion. However, the optimal concentration of human platelet-rich plasma for activation of human Schwann cells has not been determined, and mechanisms by which platelet-rich plasma activates Schwann cells remain to be clarified. METHODS Human Schwann cells were cultured with various concentrations of platelet-rich plasma in 5% fetal bovine serum/Dulbecco's Modified Eagle Medium. Cell viability, microchemotaxis, flow cytometry, and quantitative real-time polymerase chain reaction assays were performed to assess proliferation, migration, cell cycle, and neurotrophic factor expression of the human Schwann cells, respectively. Human Schwann cells were co-cultured with neuronal cells to assess their capacity to induce neurite extension. Neutralizing antibodies for platelet-derived growth factor-BB (PDGF-BB) and insulin-like growth factor-1 (IGF-1) were added to the culture to estimate contribution of these cytokines to human Schwann cell stimulation by platelet-rich plasma. RESULTS An addition of platelet-rich plasma at 5% strongly elevated proliferation, migration, and neurotrophic factor production of human Schwann cells. Both PDGF-BB and IGF-1 may be involved in mitogenic effect of platelet-rich plasma on human Schwann cells, and PDGF-BB may also play an important role in the migration-inducing effect of platelet-rich plasma. Neutralization of both PDGF-BB and IGF-1 cancelled the promoting effect of platelet-rich plasma on neurite-inducing activity of human Schwann cells. CONCLUSION This study may suggest the optimal concentration of platelet-rich plasma for human Schwann cell stimulation and potential mechanisms underlying the activation of human Schwann cells by platelet-rich plasma, which may be quite useful for platelet-rich plasma therapy for peripheral nerve regeneration. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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Affiliation(s)
- Yoshihiro Sowa
- From the Departments of Plastic and Reconstructive Surgery, Immunology, and Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine; and the Department of Plastic Surgery, Graduate School of Medicine, Osaka University
| | - Tsunao Kishida
- From the Departments of Plastic and Reconstructive Surgery, Immunology, and Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine; and the Department of Plastic Surgery, Graduate School of Medicine, Osaka University
| | - Koichi Tomita
- From the Departments of Plastic and Reconstructive Surgery, Immunology, and Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine; and the Department of Plastic Surgery, Graduate School of Medicine, Osaka University
| | - Tetsuya Adachi
- From the Departments of Plastic and Reconstructive Surgery, Immunology, and Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine; and the Department of Plastic Surgery, Graduate School of Medicine, Osaka University
| | - Toshiaki Numajiri
- From the Departments of Plastic and Reconstructive Surgery, Immunology, and Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine; and the Department of Plastic Surgery, Graduate School of Medicine, Osaka University
| | - Osam Mazda
- From the Departments of Plastic and Reconstructive Surgery, Immunology, and Dental Medicine, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine; and the Department of Plastic Surgery, Graduate School of Medicine, Osaka University
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32
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Daradka M, Alardah MM, Ismail ZB. Effects of autologous platelet-rich plasma coated sutures on intestinal anastomotic healing in rabbits. Heliyon 2019; 5:e02713. [PMID: 31840125 PMCID: PMC6893086 DOI: 10.1016/j.heliyon.2019.e02713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/22/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022] Open
Abstract
The objective of this study was to investigate the intestinal anastomotic healing enhancing effect of platelets-rich plasma (PRP) using PRP-coated sutures in a rabbit model. A total of 30 mature male rabbits were divided into 3 groups (10 rabbits per group). Group 1 received uncoated sutures, group 2 received sodium acetate-coated sutures, and group 3 received PRP-coated sutures. Polyglactin 910 (Vicryl, USA), size 4-0 was used in all groups. Five rabbits of each group were euthanized on day 3 following the surgery while the remaining 5 rabbits were euthanized on day 10. Gross evaluation of the anastomotic site in PRP-coated sutures group demonstrated significantly (P < 0.05) lower adhesion formation scores on both days 3 and 10 of the study while in the control groups, evidence of leakage at the anastomotic site was present along with signs of haemorrhage and local inflammation. On day 10 in the control groups, there were strands of strong adhesions between the ileum, colon and cecum with large amount of fibrin deposited at the site of the anastomosis. Tissues of the anastomotic site revealed a significant level of hydroxyproline on day 10 in PRP-coated sutures group compared with control groups. Histopathological evaluation revealed significantly (P < 0.05) less inflammatory infiltration, and more angiogenesis and collagen deposition on day 10 in PRP-coated sutures group compared to the control groups. Results of this study clearly indicate promising healing enhancing effects of using PRP-coated sutures at intestinal anastomotic site with little to no obvious disadvantages.
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Affiliation(s)
- Mousa Daradka
- Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Mira M Alardah
- Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Zuhair Bani Ismail
- Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Azizi S, Kheirandish R, Salarpoor M. Topical effect of allogenous serum rich in growth factors (SRGF) on diabetic skin wound in rat. Transfus Apher Sci 2019; 58:498-504. [PMID: 31311752 DOI: 10.1016/j.transci.2019.05.014] [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: 11/27/2018] [Accepted: 05/20/2019] [Indexed: 01/27/2023]
Abstract
Diabetic foot ulcer is a major complication of diabetes mellitus with negative effects on the life quality. Management of diabetic foot ulcers is a big challenge with poor and low sufficient outcome management. Therefore, achievement to effective treatments may treat these ulcers. Nowdays, platelet products are used as an effective and safe agent for promotion of healing proposes in regenerative medicine. Serum rich in growth factors (SRGF) is a source of released growth factors from the platelets. In the present study, effect of allogenous SRGF was investigated on the streptozotocin (STZ)-induced diabetic wounds in rats. STZ (50 mg/kh, SC) caused significant increase in blood glucose and weight loss in rats. Full thickness cutaneous wounds (8 mm diameter) were created bilaterally on the dorsal of the diabetic rats. SRGF was injected at the edges of the wounds of one side only on the first day, and the contrary sides were considered as the control group. The percentage of wound contraction was demonstrared on day 3, 7, 11 after surgery. Tissue specimens were collected for microscopic study on days 7 and 14. Results showed a significant higher rate of wound contraction on days 5 and 7 in the treated group. Histopathologic findings displayed acceleration of re-epithelialization, increased angiogenesis and dense collagen fibers with better organization in the treated group. Current study suggests that SRGF was efficient because facilate wound healing and showed rapid re-epithelialization and increased angiogenesis.
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Affiliation(s)
- Shahrzad Azizi
- Department of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran.
| | - Reza Kheirandish
- Department of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Maryam Salarpoor
- Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
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Spruijt NE, Hoogbergen MM, Buijs SJE, Grosveld MJW, Buth J. Stratification of chronic and complex wounds according to healing characteristics: a retrospective study. J Wound Care 2019; 28:446-452. [PMID: 31295095 DOI: 10.12968/jowc.2019.28.7.446] [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: 11/11/2022]
Abstract
OBJECTIVE Wound risk-stratified analyses are clinically relevant as they can assist in identifying hard-to-heal wounds. The aim of the study is to develop risk categories for wound healing based on a limited number of reliably recordable clinical data. METHOD This retrospective study used observational data. The primary outcome measure was wound healing at the end of treatment and the secondary outcome measure was the time to wound healing. A stratification model using regression analyses was developed to assign the patients to risk categories for wound healing and the time-to-heal. RESULTS The study cohort comprised of 540 patients. The most common wound diagnoses were diabetic ulcers, wounds in irradiated areas and wound dehiscence after surgery. Average wound duration before starting treatment at the wound centre was 11.7 months. Healing was achieved in 382 (71%) wounds, after an average treatment time of 4.4 months. A total of four risk categories for wound healing were developed by combining wound diagnosis (favourable versus unfavourable) and duration (<3 months versus >3 months). These risk categories demonstrated healing percentages ranging from 69-97% (p=0.0004) and mean time-to-healing varying from 2.7-5.9 months (p=0.01). CONCLUSION Using two clinical wound variables, diagnosis and duration, stratification categories were identified with significant associations with wound healing outcomes. Longer wound duration and unfavourable diagnoses, when combined into unfavourable risk categories, were associated with a lower percentage of wound healing and a longer treatment time until healing.
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Affiliation(s)
| | - Maarten M Hoogbergen
- Da Vinci Clinic, Geldrop, the Netherlands.,Plastic Surgeon, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Marcel J W Grosveld
- Da Vinci Clinic, Geldrop, the Netherlands.,Bernhoven Hospital, Uden, the Netherlands
| | - Jaap Buth
- Da Vinci Clinic, Geldrop, the Netherlands
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Hu Z, Qu S, Zhang J, Cao X, Wang P, Huang S, Shi F, Dong Y, Wu J, Tang B, Zhu J. Efficacy and Safety of Platelet-Rich Plasma for Patients with Diabetic Ulcers: A Systematic Review and Meta-analysis. Adv Wound Care (New Rochelle) 2019; 8:298-308. [PMID: 31832277 DOI: 10.1089/wound.2018.0842] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 01/02/2019] [Indexed: 12/18/2022] Open
Abstract
Significance: Autologous platelet-rich plasma (PRP) has been suggested to be effective for wound healing. However, clinical evidence for its use in patients with diabetic ulcer remains inconsistent. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of PRP in patients with diabetic ulcer. Recent Advances: Relevant randomized controlled trials (RCTs) were identified via systematic search of PubMed, MEDLINE, EMBASE, the Cochrane Library, and Web of Knowledge databases. Results were pooled using a random-effects model. The primary outcome of the study was the healing rate of ulcers in patients with PRP, when compared with controls. Secondary outcomes included the percentage of ulcer area reduction, recurrence rate, and amputation rate. Critical Issues: Eight RCTs that involved 431 participants were included. Compared with controls, PRP was associated with a significantly increased ratio of complete ulcer healing (odds ratio [OR] = 3.77, 95% confidence interval [CI] = 1.91-7.45, I2 = 42.2%) and reduced areas of ulcers (standard mean difference = 0.86, 95% CI = 0.27-1.45, I2 = 0.0%). No differences were observed between patients allocated to PRP or controls, in terms of the outcomes of recurrence rate (OR = 3.32, 95% CI = 0.41-27.18, I2 = 66.3%) or amputation rate (OR = 0.15, 95% CI = 0.15-1.28). The results of the trial sequence analyses revealed that the cumulative Z-curve crossed both the traditional boundary (p = 0.05) and trial sequential monitoring boundary. Future Directions: Our findings suggest that PRP may improve ulcer healing without significant adverse effects for patients with diabetic ulcers.
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Affiliation(s)
- Zhicheng Hu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shanqiang Qu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jian Zhang
- Department of Plastic Surgery, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiaoling Cao
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Peng Wang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shaobin Huang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Fen Shi
- Department of Plastic Surgery, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yunxian Dong
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jun Wu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Bing Tang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jiayuan Zhu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
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Yassin GE, Dawoud MHS, Wasfi R, Maher A, Fayez AM. Comparative lyophilized platelet-rich plasma wafer and powder for wound-healing enhancement: formulation, in vitro and in vivo studies. Drug Dev Ind Pharm 2019; 45:1379-1387. [DOI: 10.1080/03639045.2019.1620269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Ghada E. Yassin
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al Azhar University, Cairo, Egypt
- Department of Pharmaceutics, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA University), Giza, Egypt
| | - Marwa H. S. Dawoud
- Department of Pharmaceutics, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA University), Giza, Egypt
| | - Reham Wasfi
- Department of Microbiology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA University), Giza, Egypt
| | - Ahmed Maher
- Department of Biochemistry, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA University), Giza, Egypt
| | - Ahmed M. Fayez
- Department of Pharmacology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA University), Giza, Egypt
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Berndt S, Turzi A, Pittet-Cuénod B, Modarressi A. Autologous Platelet-Rich Plasma (CuteCell PRP) Safely Boosts In Vitro Human Fibroblast Expansion. Tissue Eng Part A 2019; 25:1550-1563. [PMID: 30896295 DOI: 10.1089/ten.tea.2018.0335] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Nowadays autologous fibroblast application for skin repair presents an important clinical interest. In most cases, in vitro skin cell culture is mandatory. However, cell expansion using xenogeneic or allogenic culture media presents some disadvantages, such as the risk of infection transmission or slow cell expansion. In this study, we investigated an autologous culture system to expand human skin fibroblast cells in vitro with the patient's own platelet-rich plasma (PRP). Human dermal fibroblasts were isolated from patients undergoing abdominoplasty, and blood was collected to prepare nonactivated PRP using the CuteCell™ PRP medical device. Cultures were followed up to 7 days using a medium supplemented with either fetal bovine serum (FBS) or PRP. Fibroblasts cultured in medium supplemented with PRP showed dose-dependently significantly higher proliferation rates (up to 7.7 times with 20% of PRP) and initiated a faster migration in the in vitro wound healing assay compared with FBS, while chromosomal stability was maintained. At high concentrations, PRP changed fibroblast morphology, inducing cytoskeleton rearrangement and an increase of alpha-smooth muscle actin and vimentin expression. Our findings show that autologous PRP is an efficient and cost-effective supplement for fibroblast culture, and should be considered as a safe alternative to xenogeneic/allogenic blood derivatives for in vitro cell expansion. Impact Statement Autologous dermal fibroblast graft is an important therapy in skin defect repair, but in vitro skin cell culture is mandatory in most cases. However, cell expansion using xenogeneic/allogenic culture media presents some disadvantages, such as the risk of infection transmission. We demonstrated that an autologous culture system with the patient's own platelet-rich plasma is an efficient, cost-effective, and safe supplement for fibroblast culture. As it respects the good manufacturing practices and regulatory agencies standards, it should be considered as a potent alternative and substitute to xenogeneic or allogenic blood derivatives for the validation of future clinical protocols using in vitro cell expansion.
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Affiliation(s)
- Sarah Berndt
- Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland.,Regen Lab SA, Le Mont-sur-Lausanne, Switzerland
| | | | - Brigitte Pittet-Cuénod
- Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Ali Modarressi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
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Li Y, Gao Y, Gao Y, Chen D, Wang C, Liu G, Yang X, Ran X. Autologous platelet-rich gel treatment for diabetic chronic cutaneous ulcers: A meta-analysis of randomized controlled trials. J Diabetes 2019; 11:359-369. [PMID: 30182534 DOI: 10.1111/1753-0407.12850] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/07/2018] [Accepted: 08/31/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In recent years, many studies have reported that autologous platelet-rich gel (APG) is an effective adjuvant treatment for chronic cutaneous ulcers in diabetics. The aim of this study was to explore the efficacy and safety of APG for the topical treatment of diabetic chronic cutaneous ulcers. METHODS The China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), Chinese Wanfang database, PubMed, EMBASE, EBSCOhost, and Cochrane Library were systematically searched for relevant studies published up to 18 October 2017. Fixed- and random-effects models were used to calculate risk ratios (RR), odds ratios (ORs), and mean difference (MD) with 95% confidence intervals (95% CI). Subgroup analyses were conducted according to the Diabetic Foot Wagner Classification. RESULTS Fifteen randomized control trials (RCTs) with 829 patients were eligible for inclusion in this analysis. Compared with standard care or conventional treatment, APG significantly improved the healing rate (RR 1.39; 95% CI 1.29, 1.50; P < 0.00001), shortened the healing time (MD -9.18; 95% CI -11.32, -7.05; P < 0.00001), and reduced the incidence of infection (OR 0.34; 95% CI 0.15, 0.77; P = 0.009). CONCLUSIONS Current evidence suggests that APG is effective and safe, and is feasible for use as an adjuvant treatment for diabetic ulcers, especially chronic refractory ulcers. However, more RCTs with a good design and of a high quality are needed before the use of APG can be implemented widely.
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Affiliation(s)
- Yan Li
- Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Yunyi Gao
- Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Gao
- Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Dawei Chen
- Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Chun Wang
- Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | | | - Xin Yang
- Institute of Business Analytics, University of Alabama, Tuscaloosa, Alabama
| | - Xingwu Ran
- Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
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Ding H, Fu XL, Miao WW, Mao XC, Zhan MQ, Chen HL. Efficacy of Autologous Platelet-Rich Gel for Diabetic Foot Wound Healing: A Meta-Analysis of 15 Randomized Controlled Trials. Adv Wound Care (New Rochelle) 2019; 8:195-207. [PMID: 31737414 DOI: 10.1089/wound.2018.0861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 12/06/2018] [Indexed: 01/02/2023] Open
Abstract
Objectives: The meta-analysis was performed to summarize the available evidence and determine the healing effectiveness of autologous platelet-rich gel (APG) on diabetic foot (DF) wounds. Approach: PubMed and The Cochrane Library and CNKI databases were searched to identify prior randomized controlled trials. Methodological qualities of included studies were assessed using Cochrane Handbook for Systematic Reviews of Intervention. Healing rate was considered the primary outcome; the secondary outcomes included healing time and adverse events. Results: Fifteen studies involving a total of 827 subjects were analyzed in the meta-analysis. Considering the primary outcome, the average healing rate in APG group was 85.8% and ranged from 68.4% to 100%. Relatively, the control group was 57.4% and ranged from 18.2% to 75.0%. Eligible studies were compared with a fixed effects model (I 2 = 0.0%, p = 0.496), indicating a higher healing rate with APG (risk ratio [RR] 1.44, 95% confidence interval [CI]: 1.32-1.57, z = 8.50, p < 0.001). The leave-one-out sensitivity analysis is robust. Considering the secondary outcomes, APG therapy needed less time (weighted mean difference -10.75 days, 95% CI: -11.67 to 8.86 days, z = 14.34, p < 0.001) and had fewer adverse events (RR 0.44, 95% CI: 0.25-0.76, z = 2.94, p = 0.003). Innovation: APG therapy is an innovative and effective approach to promote DF wound healing and reduce healing time and adverse events. Conclusion: The meta-analysis demonstrates that APG therapy has a positive effect on the treatment of DF wounds. However, additional well-designed and high-quality studies are needed to reach a conclusion with more confidence.
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Affiliation(s)
- Hui Ding
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Xue-Lei Fu
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Wei-Wei Miao
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Xing-Chun Mao
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Min-Qi Zhan
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Hong-Lin Chen
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
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Tsachiridi M, Galyfos G, Andreou A, Sianou A, Sigala F, Zografos G, Filis K. Autologous Platelet-Rich Plasma for Nonhealing Ulcers: A Comparative Study. Vasc Specialist Int 2019; 35:22-27. [PMID: 30993104 PMCID: PMC6453601 DOI: 10.5758/vsi.2019.35.1.22] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The use of platelet-rich plasma (PRP) for the treatment of nonhealing ulcers is a relatively new technique. Although it seems to result in a satisfying level of healing and low complication rates, data regarding its effectiveness remain sparse. This study aims to evaluate the potential therapeutic effects of PRP on chronic nonhealing ulcers. Materials and Methods This was a prospectively designed study comparing outcomes between patients treated with PRP (Group A, n=15) and patients treated conventionally (Group B, n=12) for different types of nonhealing ulcers. In Group A, PRP was produced from the patients’ own peripheral blood samples and was applied on the ulcer once every week. In Group B, patients were treated conventionally, without applying PRP. The total treatment period was 5 weeks. Results Both groups were similar regarding age, sex, comorbidities, and time of treatment. In Group A, patients showed a nonsignificant reduction of 4.5 mm2 in ulcer area (P=0.190) and a reduction of more than 1 mm in depth (P=0.0006), while Group B showed an increase of 108±80.5 mm2 in ulcer area after 5 weeks (P=0.016). The healing rate (HR) in Group A was stable and positive throughout the treatment period, while HR in Group B was initially negative but became positive after the 3rd week. Conclusion PRP application once a week promotes the healing of chronic ulcers. It improves the ulcer’s depth and HR, although its effect on ulcer area seems to be nonsignificant. However, larger comparative series are still needed to confirm these findings.
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Affiliation(s)
- Maria Tsachiridi
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece.,Department of Upper Gastrointestinal Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
| | - George Galyfos
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Andreou
- Department of General Surgery, York Hospital, York Teaching Hospital NHS Trust, York, United Kingdom
| | - Argiri Sianou
- Department of Microbiology, Areteion University Hospital, Athens, Greece
| | - Fragiska Sigala
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - George Zografos
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
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Álvaro-Afonso FJ, Lázaro-Martínez JL, García-Álvarez Y, Papanas N. Management of hard-to-heal diabetic foot ulcers: local use of autologous leucocytes, platelets and fibrin multi-layered patches (LeucoPatch). ANNALS OF TRANSLATIONAL MEDICINE 2019; 6:S126. [PMID: 30740447 DOI: 10.21037/atm.2018.12.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Francisco Javier Álvaro-Afonso
- Diabetic Foot Unit, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jose Luis Lázaro-Martínez
- Diabetic Foot Unit, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Yolanda García-Álvarez
- Diabetic Foot Unit, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nikolaos Papanas
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
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42
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Li T, Ma Y, Wang M, Wang T, Wei J, Ren R, He M, Wang G, Boey J, Armstrong DG, Deng W, Chen B. Platelet-rich plasma plays an antibacterial, anti-inflammatory and cell proliferation-promoting role in an in vitro model for diabetic infected wounds. Infect Drug Resist 2019; 12:297-309. [PMID: 30774397 PMCID: PMC6357877 DOI: 10.2147/idr.s186651] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Aim This study was designed to examine the potential mechanism underlying these roles of platelet-rich plasma in treating diabetic foot ulcers (DFUs). Methods Staphylococcus aureus and HaCaT were co-cultured under high glucose conditions to serve as an in vitro model for infected cells in DFUs. Platelet-rich gel (PRG) or extract liquid of platelet-rich gel (EPG) were used to interfere with the model to observe the growth of HaCaT cells and S. aureus, and the effect of miR-21 changes in HaCaT cells on PDCD4, NF-κB activity and related inflammatory factors. Results Incubation of HaCaT cells with S. aureus promoted the decline of cell proliferation. Under this condition, the level of PDCD4 and the activity of NF-κB were increased in HaCaT cells with concomitant increased of IL-6, TNF-α and decreased IL-10, TGF-β1 in cultured supernatant. Both of PRG and EPG exhibited specific anti-S. aureus activity where they protect HaCaT cells from bacterial damage and promote cell proliferation. Meanwhile, EPG was observed to increase intracellular miRNA-21 while reduce PDCD4 expression and inhibit NF-κB activity to suppress the inflammation in HaCaT cells. Conclusion This in vitro model provides a valuable tool for study of wound healing in the treatment of DFUs. Our results suggest that miRNA-21 may regulate the expression of NF-κB through PDCD4 where it plays an anti-inflammatory role and promote proliferation in infected DFUs treated by PRP. These findings could provide novel therapeutic targets for refractory wounds.
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Affiliation(s)
- Tao Li
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China,
| | - Yu Ma
- Department of Endocrinology and Nephrology, Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Affiliated Central Hospital of Chongqing University, Chongqing, People's Republic of China,
| | - Min Wang
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China,
| | - Tao Wang
- Institute of Combined Injury, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing, People's Republic of China
| | - Jing Wei
- Department of Endocrinology, General Hospital of Xinjiang Military Region, The Chinese People's Liberation Army, Urumqi, People's Republic of China
| | - Rui Ren
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China,
| | - Min He
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China,
| | - Guixue Wang
- Department of Endocrinology and Nephrology, Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Affiliated Central Hospital of Chongqing University, Chongqing, People's Republic of China,
| | - Johnson Boey
- Department of Podiatry, Singapore General Hospital, Singapore
| | - David G Armstrong
- Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Wuquan Deng
- Department of Endocrinology and Nephrology, Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Affiliated Central Hospital of Chongqing University, Chongqing, People's Republic of China,
| | - Bing Chen
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China,
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Del Pino-Sedeño T, Trujillo-Martín MM, Andia I, Aragón-Sánchez J, Herrera-Ramos E, Iruzubieta Barragán FJ, Serrano-Aguilar P. Platelet-rich plasma for the treatment of diabetic foot ulcers: A meta-analysis. Wound Repair Regen 2018; 27:170-182. [PMID: 30575212 DOI: 10.1111/wrr.12690] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/22/2018] [Accepted: 11/12/2018] [Indexed: 12/18/2022]
Abstract
Foot ulcer is a major complication of diabetes mellitus and often precedes leg amputation. Among the different methods to achieve ulcer healing, the use of platelet-rich plasma, which is rich in multiple growth factors and cytokines and may have similarities to the natural wound healing process, is gaining in popularity. A systematic review with meta-analyses was performed to evaluate the safety and clinical effectiveness of platelet-rich plasma for the treatment of diabetic foot ulcers compared to standard treatment or any other alternative therapy. The electronic databases Medline, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials were consulted in March 2017 with no restrictions placed on the publication date. Predefined criteria were used to determine inclusion of studies and to assess their methodologic quality. Eight randomized clinical trials and two prospective longitudinal-observational studies with control group were included. Platelet-rich plasma treatment increased the likelihood of chronic wound healing (RR = 1.32; 95% CI: 1.11, 1.57, I2 = 15%) while the volume of the ulcer (MD = 0.12 cm2 ; 95% CI: 0.08, 0.16; p < 0.01; I2 = 0%) and time to complete wound healing (MD = -11.18 days; 95% CI: -20.69, -1.68; I2 = 53%) decreased. Regarding safety profile, platelet-rich plasma did not differ from standard treatment in terms of probability of occurrence of wound complications (RR = 0.57; 95% CI: 0.25, 1.28; I2 = 0%) or recurrences (RR = 2.76; 95% CI: 0.23, 33.36; p = 0.43; I2 = 82%) but it decreased the rate of adverse events (RR = 0.80; 95% CI: 0.66, 0.96; p = 0.02; I2 = 0%). Cumulative meta-analysis revealed that there is enough evidence to demonstrate a statistically significant benefit. However, studies included presented serious methodologic flaws. According to the results, platelet-rich plasma could be considered a candidate treatment for nonhealing of diabetic foot ulcers.
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Affiliation(s)
- Tasmania Del Pino-Sedeño
- Department of Clinic Psicology, Psicobiology and Methodoloy, La Laguna University, Santa Cruz de Tenerife, Spain.,Health Services and Chronic Diseases Research Network (REDISSEC), Spain
| | - María M Trujillo-Martín
- Health Services and Chronic Diseases Research Network (REDISSEC), Spain.,Canary Islands Foundation of Health Research (FUNCANIS), El Rosario, Santa Cruz de Tenerife, Spain.,Spanish Network of Health Technology Assessment (RedETS), Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Santa Cruz de Tenerife, Spain
| | - Isabel Andia
- BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Vizcaya, Spain
| | | | - Estefanía Herrera-Ramos
- Health Services and Chronic Diseases Research Network (REDISSEC), Spain.,Canary Islands Foundation of Health Research (FUNCANIS), El Rosario, Santa Cruz de Tenerife, Spain.,Spanish Network of Health Technology Assessment (RedETS), Spain
| | - Francisco J Iruzubieta Barragán
- Health Services and Chronic Diseases Research Network (REDISSEC), Spain.,Center for Biomedical Research of La Rioja (CIBIR), La Rioja Health Service, Logroño, Spain.,Pre-Departmental Nursing Unit, Nursing School, La Rioja University, Logroño, Spain
| | - Pedro Serrano-Aguilar
- Health Services and Chronic Diseases Research Network (REDISSEC), Spain.,Spanish Network of Health Technology Assessment (RedETS), Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Santa Cruz de Tenerife, Spain.,Evaluation Service of the Canary Islands Health Service (SESCS), Canary Islands Health Service, El Rosario, Santa Cruz de Tenerife, Spain
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44
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Game F, Jeffcoate W, Tarnow L, Jacobsen JL, Whitham DJ, Harrison EF, Ellender SJ, Fitzsimmons D, Löndahl M. LeucoPatch system for the management of hard-to-heal diabetic foot ulcers in the UK, Denmark, and Sweden: an observer-masked, randomised controlled trial. Lancet Diabetes Endocrinol 2018; 6:870-878. [PMID: 30243803 DOI: 10.1016/s2213-8587(18)30240-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND The LeucoPatch device uses bedside centrifugation without additional reagents to generate a disc comprising autologous leucocytes, platelets, and fibrin, which is applied to the surface of the wound. We aimed to test the effectiveness of LeucoPatch on the healing of hard-to-heal foot ulcers in people with diabetes. METHODS This was a multicentre, international, observer-masked, randomised controlled trial of people with diabetes and a hard-to-heal foot ulcer done in 32 specialist diabetic foot clinics in three countries (UK, Denmark, and Sweden). After a 4-week run-in period, those with a reduction in ulcer area of less than 50% were randomly allocated (1:1) by computer-generated, web-based randomisation (block sizes of two, four, and six) to either prespecified good standard care alone or care plus weekly application of LeucoPatch. The primary outcome was the proportion of ulcers that healed within 20 weeks assessed in the intention-to-treat population (all participants with post-randomisation data collected), defined as complete epithelialisation (confirmed by an observer who was masked to randomisation group), and remained healed for 4 weeks. This trial is registered with the ISRCTN registry, number 27665670, and ClinicalTrials.gov, number NCT02224742. FINDINGS Between Aug 30, 2013, and May 3, 2017, 269 participants were randomly allocated to receive treatment (137 to receive standard care and 132 to receive LeucoPatch). The mean age was 61·9 years (SD 11·6), 217 (82%) were men, and 222 (83%) had type 2 diabetes. In the LeucoPatch group, 45 (34%) of 132 ulcers healed within 20 weeks versus 29 (22%) of 134 ulcers in the standard care group (odds ratio 1·58, 96% CI 1·04-2·40; p=0·0235) by intention-to-treat analysis. Time to healing was shorter in the LeucoPatch group (p=0·0246) than in the standard care group. No difference in adverse events was seen between the groups. The most common serious adverse event (SAE) was diabetic foot infection (24 events in the LeucoPatch group [24% of all SAEs] and 20 in the standard care group [27% of all SAEs]. There were no device-related adverse events. INTERPRETATION The use of LeucoPatch is associated with significant enhancement of healing of hard-to-heal foot ulcers in people with diabetes. FUNDING Reapplix ApS.
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Affiliation(s)
- Frances Game
- Department of Diabetes and Endocrinology, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK.
| | - William Jeffcoate
- Department of Diabetes and Endocrinology, Nottingham University Hospitals Trust, Nottingham, UK
| | - Lise Tarnow
- Steno Diabetes Center Zealand, Holbaek Sygehus, Holbaek, Denmark; Department of Clinical Research, Nordsjaellands Hospital, Hillerød, Denmark
| | - Judith L Jacobsen
- Statcon ApS, Kokkedal, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Diane J Whitham
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Eleanor F Harrison
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sharon J Ellender
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Magnus Löndahl
- Department of Endocrinology, Skane University Hospital, Lund, Sweden; Department of Clinical Sciences, Lund, Lund University
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45
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Semenič D, Cirman T, Rožman P, Smrke DM. REGENERATION OF CHRONIC WOUNDS WITH ALLOGENEIC PLATELET GEL VERSUS HYDROGEL TREATMENT: A PROSPECTIVE STUDY. Acta Clin Croat 2018; 57:434-442. [PMID: 31168175 PMCID: PMC6536287 DOI: 10.20471/acc.2018.57.03.05] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
SUMMARY – The aim of the study was to evaluate the efficacy and safety of the new method of platelet-rich plasma activation in the form of platelet gel, used in the treatment of non-healing chronic lower leg ulcers. The study was prospectively randomized, double blind and placebo controlled. We treated 60 patients (42 males and 18 females, mean age 69.43 years, SD 14.74) with chronic lower leg ulcers of different etiologies. Thirty patients were treated with allogeneic platelet gel and 30 with hydrogel. Both groups were comparable for duration of ulcer and its size. Treatment was repeated once a week for three consecutive weeks and then the last examination was scheduled at 6 months of the first platelet gel application. The t-test was used to analyze independent samples. Healing of chronic wounds with platelet gel was statistically significantly more effective compared to the treatment with hydrogel (p<0.05). At 6 months of platelet gel application, the mean wound area in the experimental group decreased to 35.01% (SD 53.69) of the initial wound size. In the control group, the wound area decreased to 89.95% (SD 71.82) of the initial wound size (p=0.001). The circumference of the wounds diminished to 54.62% (SD 39.85) of the initial value in the experimental group, compared to 91.28% (SD 29.32) in the control group (p<0.001). Allogeneic platelet gel prepared by the new method used in this study was found to be a good treatment option for non-healing chronic wounds when other methods are ineffective.
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Affiliation(s)
| | - Tina Cirman
- 1Department of Surgical Infections, University Medical Centre Ljubljana, Ljubljana, Slovenia; 2Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - Primož Rožman
- 1Department of Surgical Infections, University Medical Centre Ljubljana, Ljubljana, Slovenia; 2Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - Dragica Maja Smrke
- 1Department of Surgical Infections, University Medical Centre Ljubljana, Ljubljana, Slovenia; 2Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
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46
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Andia I, Maffulli N. Some patients (and some of us) respond better to some biological therapies: the as yet unsolved conundrum. J Orthop Traumatol 2018; 19:1. [PMID: 30128775 PMCID: PMC6102158 DOI: 10.1186/s10195-018-0505-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/24/2018] [Indexed: 11/24/2022] Open
Abstract
Very often, treatment for many common musculoskeletal conditions is only palliative, or involves surgery with major shortcomings. Biological interventions—in particular, platelet-rich plasma (PRP) therapies—may well provide more effective treatments, but their actual efficacy is under scrutiny. PRP is biologically unique to each individual depending on endogenous and exogenous factors, including, but not limited to, demographic factors (i.e. age), immune status (i.e. microbiota), metabolic diseases and concomitant medications. All these potential modifiers of the ultimate effects of PRP have been poorly explored, and their relationship with efficacy has not been established.
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Affiliation(s)
- Isabel Andia
- Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, 48903, Barakaldo, Spain
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentistry, Salerno, Italy. .,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK.
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47
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Aust M, Pototschnig H, Jamchi S, Busch KH. Platelet-rich Plasma for Skin Rejuvenation and Treatment of Actinic Elastosis in the Lower Eyelid Area. Cureus 2018; 10:e2999. [PMID: 30515364 PMCID: PMC6260498 DOI: 10.7759/cureus.2999] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Treatment of the lower eyelid region to rejuvenate the skin or treat actinic elastosis often proves difficult. Established treatment options, such as hyaluronic acid injections, botulinum toxin injections, microneedling, skin resurfacing (microdermabrasion, chemical peel (exfoliation), laser treatment), as well as blepharoplasties and autologous fat transfers, can be associated with significant risks and increased patient burden. Furthermore, they may not be effective for treating the signs of skin aging or actinic elastosis, including dark rings under the eyes, a lack of volume and cutis laxa. A minimally invasive treatment approach which visibly improves the above-mentioned conditions and which involves minimal risk and patient burden would be a desirable alternative. Materials & methods Twenty patients were treated a total of three times at monthly intervals with PRP (platelet-rich plasma). The patients were examined on the days of treatment and one month after the third injection. The PRP was obtained directly prior to treatment using the Arthrex ACP double syringe at the point of care. The injections (2 ml PRP per side) were administered laterally using 27 G 38 mm cannulas. Accurate photographic documentation and skin elasticity measurements using a cutometer were performed to objectify the subjective assessments from the patient and practitioner questionnaires. Results A progressive improvement in the esthetic outcome and a high level of patient satisfaction were determined. The cutometer measurements showed a statistically significant higher level of skin firmness (due to increased collagen production) and a statistically significant increase in skin elasticity (thanks to increased elastin production). Other than the anticipated visible swelling directly after the PRP injection, no other undesirable side effects or complications occurred. The typical burning sensation during the injection had not been reported. Conclusion The results indicate that a series of PRP injections in the lower eyelid region is a safe, efficient, virtually pain-free, simple and rapid treatment option for an area with otherwise limited treatment alternatives.
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48
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Stone Ii R, Natesan S, Kowalczewski CJ, Mangum LH, Clay NE, Clohessy RM, Carlsson AH, Tassin DH, Chan RK, Rizzo JA, Christy RJ. Advancements in Regenerative Strategies Through the Continuum of Burn Care. Front Pharmacol 2018; 9:672. [PMID: 30038569 PMCID: PMC6046385 DOI: 10.3389/fphar.2018.00672] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/05/2018] [Indexed: 01/09/2023] Open
Abstract
Burns are caused by several mechanisms including flame, scald, chemical, electrical, and ionizing and non-ionizing radiation. Approximately half a million burn cases are registered annually, of which 40 thousand patients are hospitalized and receive definitive treatment. Burn care is very resource intensive as the treatment regimens and length of hospitalization are substantial. Burn wounds are classified based on depth as superficial (first degree), partial-thickness (second degree), or full-thickness (third degree), which determines the treatment necessary for successful healing. The goal of burn wound care is to fully restore the barrier function of the tissue as quickly as possible while minimizing infection, scarring, and contracture. The aim of this review is to highlight how tissue engineering and regenerative medicine strategies are being used to address the unique challenges of burn wound healing and define the current gaps in care for both partial- and full-thickness burn injuries. This review will present the current standard of care (SOC) and provide information on various treatment options that have been tested pre-clinically or are currently in clinical trials. Due to the complexity of burn wound healing compared to other skin injuries, burn specific treatment regimens must be developed. Recently, tissue engineering and regenerative medicine strategies have been developed to improve skin regeneration that can restore normal skin physiology and limit adverse outcomes, such as infection, delayed re-epithelialization, and scarring. Our emphasis will be centered on how current clinical and pre-clinical research of pharmacological agents, biomaterials, and cellular-based therapies can be applied throughout the continuum of burn care by targeting the stages of wound healing: hemostasis, inflammation, cell proliferation, and matrix remodeling.
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Affiliation(s)
- Randolph Stone Ii
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Shanmugasundaram Natesan
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Christine J Kowalczewski
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Lauren H Mangum
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States.,Extremity Trauma and Regenerative Medicine, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Nicholas E Clay
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Ryan M Clohessy
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Anders H Carlsson
- Dental and Craniofacial Trauma Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - David H Tassin
- Dental and Craniofacial Trauma Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Rodney K Chan
- Dental and Craniofacial Trauma Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Julie A Rizzo
- Burn Flight Team, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Robert J Christy
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
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49
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Instructive microenvironments in skin wound healing: Biomaterials as signal releasing platforms. Adv Drug Deliv Rev 2018; 129:95-117. [PMID: 29627369 DOI: 10.1016/j.addr.2018.03.012] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/16/2018] [Accepted: 03/27/2018] [Indexed: 12/16/2022]
Abstract
Skin wound healing aims to repair and restore tissue through a multistage process that involves different cells and signalling molecules that regulate the cellular response and the dynamic remodelling of the extracellular matrix. Nowadays, several therapies that combine biomolecule signals (growth factors and cytokines) and cells are being proposed. However, a lack of reliable evidence of their efficacy, together with associated issues such as high costs, a lack of standardization, no scalable processes, and storage and regulatory issues, are hampering their application. In situ tissue regeneration appears to be a feasible strategy that uses the body's own capacity for regeneration by mobilizing host endogenous stem cells or tissue-specific progenitor cells to the wound site to promote repair and regeneration. The aim is to engineer instructive systems to regulate the spatio-temporal delivery of proper signalling based on the biological mechanisms of the different events that occur in the host microenvironment. This review describes the current state of the different signal cues used in wound healing and skin regeneration, and their combination with biomaterial supports to create instructive microenvironments for wound healing.
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50
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Gasparro R, Qorri E, Valletta A, Masucci M, Sammartino P, Amato A, Marenzi G. Non-Transfusional Hemocomponents: From Biology to the Clinic-A Literature Review. Bioengineering (Basel) 2018; 5:bioengineering5020027. [PMID: 29614717 PMCID: PMC6027172 DOI: 10.3390/bioengineering5020027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 12/17/2022] Open
Abstract
Non-transfusional hemocomponents for surgical use are autogenous products prepared through the centrifugation of a blood sample from a patient. Their potential beneficial outcomes include hard and soft tissue regeneration, local hemostasis, and the acceleration of wound healing. Therefore, they are suitable for application in different medical fields as therapeutic options and in surgical practices that require tissue regeneration.
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Affiliation(s)
- Roberta Gasparro
- Department of Neuroscience, Reproductive Science and Dental Science, University of Naples Federico II, 80131 Naples, Italy.
| | - Erda Qorri
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Albanian University, 1000 Tirana, Albania.
| | - Alessandra Valletta
- Department of Neuroscience, Reproductive Science and Dental Science, University of Naples Federico II, 80131 Naples, Italy.
| | - Michele Masucci
- Department of Neuroscience, Reproductive Science and Dental Science, University of Naples Federico II, 80131 Naples, Italy.
| | - Pasquale Sammartino
- Multidisciplinary Department of medical-Surgical and Dental Specialities, University of Naples "Luigi Vanvitelli", 80136 Italy.
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dental Science, University of Naples Federico II, 80131 Naples, Italy.
| | - Gaetano Marenzi
- Department of Neuroscience, Reproductive Science and Dental Science, University of Naples Federico II, 80131 Naples, Italy.
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