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Amarase C, Tanavalee A, Ngarmukos S, Tanavalee C, Jaruthien N, Somrak P, Tantavisut S. Comparison of functional performance outcomes between oral patented crystalline glucosamine sulfate and platelet-rich plasma among knee osteoarthritis patients: a propensity score matching analysis. Aging Clin Exp Res 2024; 36:168. [PMID: 39126538 DOI: 10.1007/s40520-024-02814-7] [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: 05/11/2024] [Accepted: 07/20/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Among the medications used to treat knee osteoarthritis (OA), oral patented crystalline glucosamine sulfate (pCGS) and platelet-rich plasma (PRP) have become popular alternatives to painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs). Although studies have shown that pCGS and PRP improve clinical outcomes, no study has compared outcomes between these optional treatments. We compared functional performance outcomes from baseline to the 1-year follow-up (FU) between oral pCGS and PRP in patients with knee OA. MATERIALS AND METHODS Three hundred eighty-two patients receiving oral pCGS and 122 patients receiving PRP injections were enrolled for a review of functional performance outcomes, including a five-time sit-to-stand test (5xSST), time up-and-go test (TUGT), and 3-minute walk distance test (3MWDT). The patients were followed up for one year. The pCGS group received 1500 mg daily, whereas the PRP group received 2 cycles of intra-articular injections at week 0 and week 6. Using propensity score matching based on age, sex, height, weight, BMI, and Kellgren and Lawrence (KL) classification, all three functional performance outcomes were compared between the baseline (pretreatment), 6-week, 12-week, 24-week, and 1-year FUs. RESULTS With a ratio of 2:1 (pCGS: PRP), 204 patients in the pCGS group were matched with 102 patients in the PRP group. Compared with the baseline levels, the PRP group showed significant improvements in 5xSST and TUGT outcomes from 6 weeks and significant improvements in 3MWDT outcomes from 12 weeks, whereas the pCGS group showed significant improvements in TUGT outcomes from 6 weeks and significant improvements in 5xSST and 3MWDT outcomes from 12 weeks. At the 24-week and 1-year FU, both groups showed significant improvements in all three functional performance tests without adverse events. CONCLUSIONS Although the PRP group showed faster improvements in 5xSST outcomes at six weeks, from the 12-week to 1-year FU, both the pCGS and PRP groups showed significant improvements in 5xSST, TUGT, and 3MWDT outcomes. As the use of PRP is more complicated and invasive than the use of oral pCGS, the benefits and drawbacks of selecting PRP over pCGS in knee OA treatment should be examined.
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Affiliation(s)
- Chavarin Amarase
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Aree Tanavalee
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand.
| | - Srihatach Ngarmukos
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Chotetawan Tanavalee
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Nonn Jaruthien
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Pakpoom Somrak
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Saran Tantavisut
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Bangkok, 10330, Thailand
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Serdarogullari M, Raad G, Makieva S, Liperis G, Fraire-Zamora JJ, Celik-Ozenci C. Revitalizing female fertility: platelet-rich plasma - hype or hope? Reprod Biomed Online 2024; 49:103813. [PMID: 38852205 DOI: 10.1016/j.rbmo.2024.103813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 06/11/2024]
Abstract
Platelet-rich plasma (PRP) has gained popularity as an experimental tool in regenerative medicine, with potential applications in reproductive medicine. This review will assess the existing literature on the role of PRP in female fertility enhancement, focusing on ovarian rejuvenation and increased endometrial thickness. PRP is being explored as a treatment for recurrent implantation failure, primary ovarian insufficiency and poor ovarian response. While the influence of PRP on endometrial thickness and implantation success is postulated, its effectiveness remains the subject of debate due to protocol variability and unclear patient selection criteria. This narrative review includes 36 articles published before December 2022, and highlights the lack of comprehensive molecular studies examining the impact of PRP on reproductive capacity. This review underscores the importance of standardizing PRP preparation protocols in reproductive medicine. However, challenges persist, and there is a need for well-planned randomized controlled trials and a deeper understanding of the patient population that would gain the greatest benefit from PRP treatment. Clarifying these aspects is crucial to improve outcomes for low-prognosis patients undergoing assisted reproductive technology.
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Affiliation(s)
- Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Northern Cyprus via Mersin 10, Turkey
| | - Georges Raad
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon; Al Hadi Laboratory and Medical Centre, Beirut, Lebanon
| | - Sofia Makieva
- Kinderwunschzentrum, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, Zurich, Switzerland
| | - Georgios Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
| | | | - Ciler Celik-Ozenci
- Department of Histology and Embryology, School of Medicine, Koc University, Istanbul, Turkey; Koç University Research Centre for Translational Medicine, Istanbul, Turkey.
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Santos LC, Lana GL, Santos GS, Visoni SBC, Brigagão RJ, Santos N, Sobreiro R, da Cruz Silva Reis A, Rodrigues BL, Ferrari S, Tambeli CH, Lana JF. The Biological Role of Platelet Derivatives in Regenerative Aesthetics. Int J Mol Sci 2024; 25:5604. [PMID: 38891792 PMCID: PMC11172268 DOI: 10.3390/ijms25115604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Bioproducts derived from platelets have been extensively used across various medical fields, with a recent notable surge in their application in dermatology and aesthetic procedures. These products, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), play crucial roles in inducing blood vessel proliferation through growth factors derived from peripheral blood. PRP and PRF, in particular, facilitate fibrin polymerization, creating a robust structure that serves as a reservoir for numerous growth factors. These factors contribute to tissue regeneration by promoting cell proliferation, differentiation, and migration and collagen/elastin production. Aesthetic medicine harnesses these effects for diverse purposes, including hair restoration, scar treatment, striae management, and wound healing. Furthermore, these biological products can act as adjuvants with other treatment modalities, such as laser therapy, radiofrequency, and microneedling. This review synthesizes the existing evidence, offering insights into the applications and benefits of biological products in aesthetic medicine.
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Affiliation(s)
| | - Giselle Lobo Lana
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Gabriel Silva Santos
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Silvia Beatriz Coutinho Visoni
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Rayssa Junqueira Brigagão
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Napoliane Santos
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Rafaela Sobreiro
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Andreza da Cruz Silva Reis
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Bruno Lima Rodrigues
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | - Sabrina Ferrari
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
| | | | - José Fábio Lana
- Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, Brazil; (G.L.L.); (S.B.C.V.); (R.J.B.); (N.S.); (R.S.); (A.d.C.S.R.); (B.L.R.); (S.F.); (J.F.L.)
- Medical School, Max Planck University Center (UniMAX), Indaiatuba 13343-060, Brazil
- Regenerative Medicine, Orthoregen International Course, Indaiatuba 13334-170, Brazil
- Clinical Research, Anna Vitória Lana Institute (IAVL), Indaiatuba 13334-170, Brazil
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Zamanian MY, Golmohammadi M, Vadiyan FV, Almulla AA, Vadiyan DE, Morozova NS, Alkadir OKA, Kareem AH, Alijani M. A narrative review of the effects of vitamin D3 on orthodontic tooth movement: Focus on molecular and cellular mechanisms. Food Sci Nutr 2024; 12:3164-3176. [PMID: 38726436 PMCID: PMC11077251 DOI: 10.1002/fsn3.4035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 05/12/2024] Open
Abstract
Orthodontic tooth movement (OTM) is a critical process in dental alignment, driven by the application of calibrated orthodontic forces. This study delves into the intricate molecular and cellular mechanisms by which vitamin D3 influences OTM. Vitamin D3 is identified as a critical regulator in bone metabolism, enhancing osteoblast activity and bone formation while also modulating osteoclast quantity and RANKL expression, essential for the remodeling of the alveolar bone. The precise mechanisms through which vitamin D3 facilitates these processes are explored, highlighting its potential in accelerating bone remodeling and, consequently, tooth alignment. This comprehensive review underscores vitamin D3's anabolic impact on bone metabolism and its pivotal role in the synthesis and mineralization processes governed by osteoblasts. The findings illuminate vitamin D3's promise in augmenting orthodontic therapy, suggesting its utility in improving treatment efficiency and reducing duration. However, the need for further research into the optimal application of vitamin D3 in orthodontics is emphasized, particularly concerning dosage, timing, and delivery methods.
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Affiliation(s)
- Mohammad Yasin Zamanian
- Department of Physiology, School of MedicineHamadan University of Medical SciencesHamadanIran
- Department of Pharmacology and Toxicology, School of PharmacyHamadan University of Medical SciencesHamadanIran
| | | | - Filipp V. Vadiyan
- Department of Therapeutic Dentistry, Institute of DentistryI.M. Sechenov First Moscow State Medical UniversityMoscowRussia
| | | | - Diana E. Vadiyan
- Department of Pediatric, Preventive Dentistry and Orthodontics, Institute of DentistryI.M. Sechenov First Moscow State Medical UniversityMoscowRussia
| | - Natalia S. Morozova
- Department of Pediatric, Preventive Dentistry and Orthodontics, Institute of DentistryI.M. Sechenov First Moscow State Medical UniversityMoscowRussia
| | | | | | - Mojtaba Alijani
- Department of Orthodontics, School of DentistryHamadan University of Medical SciencesHamadanIran
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Maniaci A, Lavalle S, Masiello E, Lechien JR, Vaira L, Boscolo-Rizzo P, Musa M, Gagliano C, Zeppieri M. Platelet-Rich Plasma (PRP) in the Treatment of Long COVID Olfactory Disorders: A Comprehensive Review. Biomedicines 2024; 12:808. [PMID: 38672163 PMCID: PMC11048638 DOI: 10.3390/biomedicines12040808] [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: 03/13/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Long COVID has brought numerous challenges to healthcare, with olfactory dysfunction (OD) being a particularly distressing outcome for many patients. The persistent loss of smell significantly diminishes the affected individual's quality of life. Recent attention has been drawn to the potential of platelet-rich plasma (PRP) therapy as a treatment for OD. This comprehensive review aims to evaluate the effectiveness of PRP therapy in ameliorating OD, especially when associated with long-term COVID-19. Methods: We executed a comprehensive search of the literature, encompassing clinical trials and observational studies that utilized PRP in treating OD limited to COVID-19. We retrieved and comprehensively discussed data such as design, participant demographics, and reported outcomes, focusing on the efficacy and safety of PRP therapy for OD in COVID-19 patients. Results: Our comprehensive analysis interestingly found promising perspectives for PRP in OD following COVID-19 infection. The collective data indicate that PRP therapy contributed to a significant improvement in olfactory function after COVID-19 infection. Conclusions: The evidence amassed suggests that PRP is a promising and safe therapeutic option for OD, including cases attributable to Long COVID-19. The observed uniform enhancement of olfactory function in patients receiving PRP highlights the necessity for well-designed, controlled trials. Such studies would help to refine treatment protocols and more definitively ascertain the efficacy of PRP in a broader, more varied patient cohort.
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Affiliation(s)
- Antonino Maniaci
- Faculty of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, EN, Italy; (A.M.)
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), 13005 Paris, France
| | - Salvatore Lavalle
- Faculty of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, EN, Italy; (A.M.)
| | - Edoardo Masiello
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, MI, Italy
| | - Jerome R. Lechien
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), 13005 Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
| | - Luigi Vaira
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), 13005 Paris, France
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, SS, Italy
- Biomedical Science Department, Biomedical Science Ph.D. School, University of Sassari, 07100 Sassari, SS, Italy
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical, and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, TS, Italy
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Caterina Gagliano
- Faculty of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, EN, Italy; (A.M.)
- Eye Clinic Catania, University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, CT, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, UD, Italy
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Hengtrakool P, Leearamwat N, Sengprasert P, Wongphoom J, Chaichana T, Taweevisit M, Ngarmukos S, Tanavalee A, Palaga T, Reantragoon R. Infrapatellar fat pad adipose tissue-derived macrophages display a predominant CD11c+CD206+ phenotype and express genotypes attributable to key features of OA pathogenesis. Front Immunol 2024; 15:1326953. [PMID: 38361943 PMCID: PMC10867170 DOI: 10.3389/fimmu.2024.1326953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
Objectives In knee osteoarthritis (OA), macrophages are the most predominant immune cells that infiltrate synovial tissues and infrapatellar fat pads (IPFPs). Both M1 and M2 macrophages have been described, but their role in OA has not been fully investigated. Therefore, we investigated macrophage subpopulations in IPFPs and synovial tissues of knee OA patients and their correlation with disease severity, examined their transcriptomics, and tested for factors that influenced their polarization. Methods Synovial tissues and IPFPs were obtained from knee OA patients undergoing total knee arthroplasty. Macrophages isolated from these joint tissues were characterized via flow cytometry. Transcriptomic profiling of each macrophage subpopulations was performed using NanoString technology. Peripheral blood monocyte-derived macrophages (MDMs) were treated with synovial fluid and synovial tissue- and IPFP-conditioned media. Synovial fluid-treated MDMs were treated with platelet-rich plasma (PRP) and its effects on macrophage polarization were observed. Results Our findings show that CD11c+CD206+ macrophages were predominant in IPFPs and synovial tissues compared to other macrophage subpopulations (CD11c+CD206-, CD11c-CD206+, and CD11c-CD206- macrophages) of knee OA patients. The abundance of macrophages in IPFPs reflected those in synovial tissues but did not correlate with disease severity as determined from Mankin scoring of cartilage destruction. Our transcriptomics data demonstrated highly expressed genes that were related to OA pathogenesis in CD11c+CD206+ macrophages than CD11c+CD206-, CD11c-CD206+, and CD11c-CD206- macrophages. In addition, MDMs treated with synovial fluid, synovial tissue-conditioned media, or IPFP-conditioned media resulted in different polarization profiles of MDMs. IPFP-conditioned media induced increases in CD86+CD206+ MDMs, whereas synovial tissue-conditioned media induced increases in CD86+CD206- MDMs. Synovial fluid treatment (at 1:8 dilution) induced a very subtle polarization in each macrophage subpopulation. PRP was able to shift macrophage subpopulations and partially reverse the profiles of synovial fluid-treated MDMs. Conclusion Our study provides an insight on the phenotypes and genotypes of macrophages found in IPFPs and synovial tissues of knee OA patients. We also show that the microenvironment plays a role in driving macrophages to polarize differently and shifting macrophage profiles can be reversed by PRP.
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Affiliation(s)
- Patchanika Hengtrakool
- Medical Microbiology Interdisciplinary Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Nitigorn Leearamwat
- Medical Microbiology Interdisciplinary Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Panjana Sengprasert
- Immunology Division, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jutamas Wongphoom
- Department of Pathology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Thiamjit Chaichana
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Mana Taweevisit
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Srihatach Ngarmukos
- Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Aree Tanavalee
- Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanapat Palaga
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Rangsima Reantragoon
- Immunology Division, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Skeletal Disorders and Enzyme Reaction Mechanism, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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7
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Gharpinde MR, Pundkar A, Shrivastava S, Patel H, Chandanwale R. A Comprehensive Review of Platelet-Rich Plasma and Its Emerging Role in Accelerating Bone Healing. Cureus 2024; 16:e54122. [PMID: 38487114 PMCID: PMC10939108 DOI: 10.7759/cureus.54122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
This comprehensive review delves into the emerging role of platelet-rich plasma (PRP) in accelerating bone healing. PRP, a blood-derived product rich in platelets and growth factors, has garnered attention for its regenerative potential. The review begins by defining PRP and providing a historical background, highlighting its significance in expediting bone healing. PRP's composition and preparation methods, including centrifugation techniques and commercial kits, are explored. Mechanistically, PRP operates by releasing growth factors, chemotaxis, and angiogenesis, elucidating its cellular effects. Applications in fracture healing and orthopaedic surgeries, such as joint arthroplasty and spinal fusion, are discussed, emphasising the promising outcomes in clinical trials. Safety considerations, patient selection criteria, and the need for PRP preparation and application standardisation are underscored. The review outlines ongoing research trends, potential technological advancements, and unexplored areas in paediatric applications and inflammatory bone disorders. The implications for clinical practice involve informed decision-making, optimised protocols, and interdisciplinary collaboration. In conclusion, the future of PRP in bone healing holds exciting prospects, with the potential for precision medicine, integration with emerging therapies, expanded applications, and enhanced technological innovations shaping its trajectory in orthopaedics and regenerative medicine.
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Affiliation(s)
- Milind R Gharpinde
- Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Pundkar
- Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sandeep Shrivastava
- Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hardik Patel
- Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rohan Chandanwale
- Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Moffa A, Nardelli D, Giorgi L, Di Giovanni S, Carnuccio L, Mangino C, Baptista P, Vacca M, Casale M. Platelet-Rich Plasma for Patients with Olfactory Dysfunction: Myth or Reality? A Systematic Review. J Clin Med 2024; 13:782. [PMID: 38337476 PMCID: PMC10856510 DOI: 10.3390/jcm13030782] [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: 01/09/2024] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND With promising outcomes, platelet-rich plasma (PRP) has recently been suggested as a treatment for olfactory dysfunction (OD). METHODS Clinical studies utilizing PRP in OD caused by COVID-19, trauma, anesthetic exposure, viral infection, and chronic rhinosinusitis were included in a systematic review. RESULTS Ten clinical studies were qualitatively analyzed. Six of these studies used the PRP for OD caused by COVID-19, one on OD after functional endoscopic sinus surgery, and three on post-infectious or post-trauma OD. The population included 531 patients, ranging in age from 15 to 63. CONCLUSION The use of PRP may be a risk-free and efficient therapeutic option with very encouraging outcomes. Indeed, it enhances olfactory perception in patients who not only exhibit COVID-19 infection aftereffects, but also in those who have lost their sense of smell due to trauma, rhinosinusitis, rhinitis, or even surgery. To evaluate the PRP's therapeutic benefits in OD patients and to compare the efficacy of different therapeutic protocols with regard to treatment schedules, there is an urgent need for focused controlled trials.
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Affiliation(s)
- Antonio Moffa
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Domiziana Nardelli
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Lucrezia Giorgi
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Simone Di Giovanni
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Luca Carnuccio
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Carmen Mangino
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Peter Baptista
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
- ENT Department, Al Zahra Private Hospital Dubai, Dubai 23614, United Arab Emirates
| | - Michele Vacca
- Transfusion Medicine and Cell Therapy, Fondazione Policlinico Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Manuele Casale
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
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Legiawati L, Yusharyahya SN, Bernadette I, Novianto E, Priyanto MH, Gliselda KC, Iriyanty S, Mutiara R. Comparing Single-spin Versus Double-spin Platelet-rich Plasma (PRP) Centrifugation Methods on Thrombocyte Count and Clinical Improvement of Androgenetic Alopecia: A Preliminary, Randomized, Double-blind Clinical Trial. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2023; 16:39-44. [PMID: 38125672 PMCID: PMC10729807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective Platelet-rich plasma (PRP) is widely known as an alternative therapy for androgenetic alopecia (AGA); however, there is no standardized method for its preparation and application. This study aims to compare the thrombocyte count elevation and clinical AGA improvements between single- and double-spin PRP preparation methods. Methods This preliminary, double-blind, randomized clinical trial included 30 male subjects with AGA aged 25 to 59 years with Hamilton-Norwood stages III to VI. Subjects were divided into a single-spin group (3,000rpm for 15 minutes) and a double-spin group (first spinning at 1,500rpm for 6 minutes, continuing at 2,500rpm for 15 minutes). The study was conducted for six weeks, with a two-week visit interval. Baseline and PRP thrombocyte counts were assessed on the initial appointment. A total of 1cc of PRP was intradermally injected into a 6×4cm predetermined area, administered at Weeks 0, 2, and 4. At every visit, clinical progress was assessed by overall hair appearance, photography, trichoscopy, and trichoscan. All subjects were instructed to use minoxidil twice daily during the study. This study has been registered at clinicaltrials.gov (ID No. NCT05681897). Results Both groups increased thrombocyte counts by 4 to 5 times from their initial levels; however, the increase in the single-spin group was more significant. Significant improvements were observed in both groups, including hair density, hair rate, and hair count of anagen, telogen, vellus, and terminal hair. Limitations Limitations include lack of placebo or vehicle control. Conclusion Both PRP preparation methods significantly raise thrombocyte counts, substantially improve nearly all hair parameters, and have tremendous therapeutic promise for treating AGA. Clinicians may designate one of the two techniques.
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Affiliation(s)
- Lili Legiawati
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Shannaz Nadia Yusharyahya
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Irma Bernadette
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Endi Novianto
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Mufqi Handaru Priyanto
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Keneyzia Carla Gliselda
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Septiana Iriyanty
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Rizka Mutiara
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
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Hou Y, Wen X, Zhou L, Fang X. The value of platelet-rich plasma-derived extracellular vesicles in modern medicine. Ann Med 2023; 55:2287705. [PMID: 38065677 PMCID: PMC10880568 DOI: 10.1080/07853890.2023.2287705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Platelet-rich plasma (PRP) has been widely used in clinical practice. The mechanism by which PRP promotes tissue repair lies in the release of multiple growth factors upon platelet activation, which accelerates the proliferation and differentiation of repair cells and the synthesis of extracellular matrix. In recent years, as extracellular vesicles (EVs) research has increased and intensified, it has been found that EVs also play an important role in tissue repair. This article provides a comprehensive review of the role of PRP and PRP-derived extracellular vesicles (PRP-EVs) in tissue repair. It discusses the biological characteristics, extraction, identification, activation, and preservation of PRP-EVs. It also reviews their applications in orthopedics and wound repair. The article highlights the importance of PRP-EVs in modern medicine and suggests that they could be a promising natural nanocarrier.
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Affiliation(s)
- Ya Hou
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xiaoyun Wen
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Liang Zhou
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xiansong Fang
- Blood Transfusion Department, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
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Ansere VA, Bubak MP, Miller BF, Freeman WM. Heterochronic Plasma Transfer: Experimental Design, Considerations, and Technical Challenges. Rejuvenation Res 2023; 26:171-179. [PMID: 37551981 PMCID: PMC10611967 DOI: 10.1089/rej.2023.0035] [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] [Indexed: 08/09/2023] Open
Abstract
Experimental approaches such as Heterochronic Plasma Transfer (HPT) provide insights into the aging process and help identify the factors that impact aging, with the aim of developing anti-aging therapies. HPT involves the transfer of plasma from an animal of one age to an animal of a different age and highlights the effects of the systemic environment on aging. Despite its importance as an aging research tool, HPT is not without limitations and HPT experiments across various studies differ in key experimental designs considerations, presenting a challenge in obtaining comparable outcomes. In this review, we examine the caveats and experimental design considerations of HPT as a research tool. We provide insights into plasma preparation procedures, route of administration, dosing regimen, and appropriate controls to assist investigators in achieving their experimental goals.
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Affiliation(s)
- Victor A. Ansere
- Genes & Human Disease Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Matthew P. Bubak
- Aging and Metabolism Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
- Oklahoma City Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA
| | - Benjamin F. Miller
- Aging and Metabolism Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
- Oklahoma City Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA
| | - Willard M. Freeman
- Genes & Human Disease Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
- Oklahoma City Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA
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Velasquez Garcia A, Ingala Martini L, Franco Abache A, Abdo G. Role of platelet-rich plasma in the treatment of rotator cuff tendinopathy. World J Orthop 2023; 14:505-515. [PMID: 37485430 PMCID: PMC10359750 DOI: 10.5312/wjo.v14.i7.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023] Open
Abstract
Shoulder pain is a common musculoskeletal complaint, and rotator cuff (RC) pathologies are one of the main causes. The RC undergoes various tendinopathic and avascular changes during the aging process. Other degenerative changes affecting its healing potential make it an appealing target for biological agents. Platelet-rich plasma (PRP) has demonstrated the potential to deliver a high concentration of several growth factors and anti-inflammatory mediators, and its clinical use is mainly supported by experiments that demonstrated its positive effect on muscle, ligaments, and tendinous cells. This review aimed to specify the role of PRP and its future applications in RC tendinopathies based on the current clinical evidence. Due to the different characteristics and conflicting outcomes, clinicians should use PRP with moderate expectations until more consistent evidence is available. However, it is reasonable to consider PRP in patients with contraindications to corticosteroid injections or those with risk factors for inadequate healing. Its autologous origin makes it a safe treatment, and its characteristics make it a promising option for treating RC tendinopathy, but the efficacy has yet to be established.
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Affiliation(s)
| | - Liborio Ingala Martini
- Department of Orthopedic Surgery, Hospital IVSS Dr. Luis Ortega, Porlamar 6301, Venezuela
- Department of Orthopedic Surgery, Hospital Clinicas del Este, Los Robles 6301, Venezuela
| | - Andres Franco Abache
- Department of Orthopedic Surgery, Hospital de Especialidades Guayaquil MSP, Guayaquil 090101, Ecuador
| | - Glen Abdo
- Department of Graduate Medical Education, Internal Medicine Residence Program, New York Medical College at St. Mary’s and St. Clare’s, Passaic, NJ 07055, United States
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Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120817. [PMID: 36551023 PMCID: PMC9774306 DOI: 10.3390/bioengineering9120817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022]
Abstract
Several musculoskeletal conditions are triggered by inflammatory processes that occur along with imbalances between anabolic and catabolic events. Platelet-rich plasma (PRP) is an autologous product derived from peripheral blood with inherent immunomodulatory and anabolic properties. The clinical efficacy of PRP has been evaluated in several musculoskeletal conditions, including osteoarthritis, tendinopathy, and osteonecrosis. When used in combination with hyaluronic acid (HA), a common treatment alternative, the regenerative properties of PRP are significantly enhanced and may provide additional benefits in terms of clinical outcomes. Recently, a new PRP-derived product has been reported in the literature and is being referred to as "plasma gel". Plasma gels are obtained by polymerizing plasmatic proteins, which form solid thermal aggregates cross-linked with fibrin networks. Plasma gels are considered to be a rich source of growth factors and provide chemotactic, migratory, and proliferative properties. Additionally, clot formation and the associated fibrinolytic reactions play an additional role in tissue repair. There are only a few scientific articles focusing on plasma gels. Historically, they have been utilized in the fields of aesthetics and dentistry. Given that the combination of three products (PRP, HA, and plasma gel) could enhance tissue repair and wound healing, in this technical note, we propose a novel regenerative approach, named "PRP-HA cellular gel matrix" (PRP-GM), in which leukocyte-rich PRP (LR-PRP) is mixed with a plasma gel (obtained by heating the plasma up) and HA in one syringe using a three-way stopcock. The final product contains a fibrin-albumin network entangled with HA's polymers, in which the cells and biomolecules derived from PRP are attached and released gradually as fibrinolytic reactions and hyaluronic acid degradation occur. The presence of leukocytes, especially monocytes and macrophages, promotes tissue regeneration, as type 2 macrophages (M2) possess an anti-inflammatory feature. In addition, HA promotes the viscosuplementation of the joint and induces an anti-inflammatory response, resulting in pain relief. This unique combination of biological molecules may contribute to the optimization of regenerative protocols suitable for the treatment of degenerative musculoskeletal diseases.
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Muacevic A, Adler JR, Badhal S, Wadhwa R. Effects of Intra-articular Platelet Rich Plasma on Cartilage Thickness, Clinical and Functional Outcomes in Knee Osteoarthritis. Cureus 2022; 14:e32256. [PMID: 36620792 PMCID: PMC9815489 DOI: 10.7759/cureus.32256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Osteoarthritis of the knee is one of the most common degenerative diseases and the fourth leading cause of years lived with disability at the global level. This study assessed the efficacy of platelet-rich plasma (PRP) in osteoarthritis of knees as to changes in cartilage thickness and clinical and functional outcomes. METHODS Thirty participants with Kellgren-Lawrence grade two and grade three osteoarthritis knee who satisfied the inclusion and exclusion criteria were enrolled in this prospective interventional study after taking written informed consent. Each participant received three doses of two ml intraarticular platelet-rich plasma at an interval of seven days. Clinical assessment was determined using the Visual Analogue Scale (VAS) and Knee Osteoarthritis Outcome Score (KOOS) on Day 0, Day 90, and Day 180. Cartilage thickness (femoral and trochlear cartilage) was measured pre (Day 0) and post-PRP (Day 180) under ultrasound guidance. RESULTS The mean VAS score for pain was 7.4 before treatment which changed to 5.3 (p= <0.0001) on Day 90 and 3.37 (p= <0.0001) on Day 180 post-PRP. The mean total KOOS was 19.16 ± 10.73 before treatment which improved to 37.42 ± 9.88 (p= <0.0001) and 49.98 ± 8.82 (p= <0.0001) at 90 days, and 180 days post-injection, respectively. The mean cartilage thickness (femoral and trochlear cartilage) improved from baseline (day 0) to final follow-up on day 180, which was statistically significant and implied cartilage repair following PRP administration. CONCLUSION This study supports the efficacy of PRP in the management of osteoarthritis knee by improvement in pain, joint stiffness, and activities of daily living, as well as aids in the repair and regeneration of articular cartilage.
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15
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Basic Science of Autologous Orthobiologics Part 1. Platelet-Rich Plasma. Phys Med Rehabil Clin N Am 2022; 34:1-23. [DOI: 10.1016/j.pmr.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Muthu S, Krishnan A, Ramanathan KR. Standardization and validation of a conventional high yield platelet-rich plasma preparation protocol. Ann Med Surg (Lond) 2022; 82:104593. [PMID: 36268335 PMCID: PMC9577528 DOI: 10.1016/j.amsu.2022.104593] [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: 08/08/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Of late, numerous randomised controlled trials report platelet-rich plasma (PRP) to be ineffective with preparation protocols of low platelet yield despite using expensive commercial PRP kits. OBJECTIVE This study aims to identify and standardize a preparation protocol for PRP with maximum platelets yield and concentration to obtain favourable results without the use of commercial preparation kits. MATERIALS & METHODS Blood samples were collected from 40 healthy volunteers who signed informed consent for participation in the study. The double spin protocol of PRP preparation was analyzed for variables such as centrifugal acceleration, time, and volume of blood processed and final product utilized. The final PRP prepared was investigated for platelet recovery, concentration, integrity, and viability. Each protocol investigated with technical and biological duplicates to avoid reporting and sampling bias. RESULTS We noted maximum platelet recovery (86-99%) with a consistent 6.4 ± 0.8 times the baseline concentration of platelets with first centrifugation at 100g for 15 min followed by second centrifugation at 1600g for 20 min. We did not note a loss of integrity or viability of the platelets in the final product from the above-said protocol. We also validated the protocol among all the study participants demonstrating consistency. CONCLUSION The preparation of PRP by the double-spin protocol using 10 ml of blood at 100 g followed by 1600 g for 15 and 20 min respectively in a 15 ml tube and using the lower 1/3rd of the final product demonstrated consistent high platelet recovery (86-99%) and concentration (6x) without disturbing the platelet integrity or viability.
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Affiliation(s)
- Sathish Muthu
- Department of Orthopaedics, Government Medical College, Dindigul, Tamil Nadu, India
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Department of Biotechnology, School of Engineering and Technology, Sharda University, New Delhi, India
- Corresponding author. Department of Orthopaedics, Government Medical College, Dindigul, Tamil Nadu, India.
| | - Anand Krishnan
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Department of Chemical Pathology, School of Pathology, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa
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17
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The Evaluation of Various Biological Properties for Bismuth Oxychloride Nanoparticles (BiOCl NPs). INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2022.109850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Wang L, Zhao L, Shen L, Fang Q, Yang Z, Wang R, Wu Q, Xie Y. Comparison of the effects of autologous and allogeneic purified platelet-rich plasma on cartilage damage in a rabbit model of knee osteoarthritis. Front Surg 2022; 9:911468. [PMID: 35910465 PMCID: PMC9334772 DOI: 10.3389/fsurg.2022.911468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Purified platelet-rich plasma (P-PRP) is gradually being used in the treatment of osteoarthritis (OA), and its sources are mainly divided into autologous and allogeneic blood. However, it is unclear whether autologous PRP is more effective or allogeneic PRP is superior. Objective In this study, autologous and allogeneic P-PRP was injected at early stage of KOA in rabbits, and then the differences in the efficacy of the two P-PRPs against KOA were compared from several perspectives, including pathological histology and immunohistochemistry. Method Experimental rabbits were divided into normal group (n = 8), model group (n = 8), autologous P-PRP group (n = 8), and allogeneic P-PRP group (n = 8) using a random number table method. The normal and model groups did not receive any treatment, and the autologous P-PRP and allogeneic P-PRP groups received intra-articular injections of autologous and allogeneic P-PRP, respectively, to observe the changes in the gross specimens of the knee joints of the experimental rabbits in each group. The histopathological changes of chondrocytes were also observed by HE-stained sections of articular cartilage, and the expression of chondrocytes Bone morphogenetic protein-2 (BMP-2) and Sox9 were detected by immunohistochemistry. Results Compared with the allogeneic P-PRP group, the differences were statistically significant (P < 0.05) in the gross specimens and pathological histological findings in the autologous PRP group. Immunohistochemical results showed that the expression of BMP-2 and Sox9 was elevated in both the autologous P-PRP group and the allogeneic P-PRP group compared with the model group, and the expression of BMP-2 was higher in the autologous P-PRP group than in the allogeneic P-PRP group, with a statistically significant difference (P < 0.05), while there was no difference in the expression of Sox9 between the two groups (P > 0.05). Conclusion Intra-articular injection of autologous P-PRP activated the expression of BMP-2 and Sox9 in chondrocytes and effectively improved KOA cartilage repair and reduced bone redundancy and joint fluid formation, and its efficacy was superior to that of intra-articular injection of allogeneic P-PRP.
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Affiliation(s)
- Lingling Wang
- Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Luting Zhao
- Department of Rehabilitation Medicine, The First People’s Hospital of Ziyang, Ziyang, China
| | - Lianwei Shen
- Department of Rehabilitation Medicine, The Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
- Department of Rehabilitation Medicine, Shandong University Cheeloo College of Medicine, Jinan, China; Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qilin Fang
- Department of Rehabilitation Medicine, The First People’s Hospital of Ziyang, Ziyang, China
| | - Zhenglei Yang
- Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Rongrong Wang
- Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qing Wu
- Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Correspondence: Qing Wu Yulei Xie
| | - Yulei Xie
- Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Faculty of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Correspondence: Qing Wu Yulei Xie
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Mysore V, Alexander S, Nepal S, Venkataram A. Regenerative Medicine Treatments for Androgenetic Alopecia. Indian J Plast Surg 2022; 54:514-520. [PMID: 34984094 PMCID: PMC8719950 DOI: 10.1055/s-0041-1739257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/05/2021] [Indexed: 11/16/2022] Open
Abstract
Regenerative medicine and the role of stem cells are being studied for applications in nearly every field of medicine. The pluripotent nature of stem cells underlies their vast potential for treatment of androgenic alopecia. Several advances in recent years have heightened interest in this field, chief among them are the evolution of simpler techniques to isolate regenerative elements and stems cells. These techniques are easy, outpatient procedures with immediate injection, often single session with harvest, and minimal manipulation (usually physical). This paper seeks to critically review the existing data and determine the current evidence and their role in practice.
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Affiliation(s)
- Venkataram Mysore
- The Venkat Center for Skin ENT and Plastic Surgery, Bangalore, India
| | - Sajin Alexander
- Department of Dermatology, Sony Memorial Hospital, Erumely, Kottayam, Kerala, India
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Abo El Naga HA, El Zaiat RS, Hamdan AM. The potential therapeutic effect of platelet-rich plasma in the treatment of post-COVID-19 parosmia. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [PMCID: PMC9556146 DOI: 10.1186/s43163-022-00320-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background COVID-19-related olfactory dysfunction is an emerging problem with a significant impact on the quality of life of affected individuals. Different lines of treatment have been used with varying results. This study aimed to assess the potential therapeutic effect of PRP in the treatment of post-COVID olfactory dysfunction. This work aimed to assess the potential therapeutic effect of platelet-rich plasma (PRP) in treating post-COVID-19 parosmia. A pilot study was conducted on 60 patients with post-COVID parosmia without responding to a 3-month course of olfactory training, topical corticosteroids, omega-three, vitamin B12, and zinc supplementation. The patients were distributed randomly and equally among 2 groups. The case group was subjected to three PRP injections in the olfactory cleft at 3 weeks intervals. The control group continued the pre-study treatment protocol for 6 weeks. The degree of parosmia was assessed before and after treatment subjectively using a visual analog scale (VAS) from 0 to 10. Reaching 0–1 on the visual analog scale was a complete improvement. The primary outcome was assessing the post-treatment score for parosmia 1 month after the third injection in the case group. The second outcome was the comparison between both groups regarding the degree of improvement 1 month after cessation of treatment. Results There was a highly significant improvement in VAS for parosmia (p < 0.00001) in the case group and a significant improvement in VAS for parosmia in the control group (p = P = 0.00148). There was a significant difference between both groups regarding the degree of improvement favoring the case group (p = 0.002). Conclusion Platelet-rich plasma injection in the olfactory cleft offers a therapeutic option for treating patients with post-COVID-19 olfactory parosmia who failed to respond to traditional conservative treatment.
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Affiliation(s)
- Heba A. Abo El Naga
- grid.411775.10000 0004 0621 4712Otolaryngology Head & Neck Surgery Department, Faculty of Medicine, Menoufia University, Shebin El-kom, Egypt
| | - Reham S. El Zaiat
- grid.411775.10000 0004 0621 4712Clinical Pathology Department, Faculty of Medicine, Menoufia University, Shebin El-kom, Egypt
| | - Ahmad M. Hamdan
- grid.411775.10000 0004 0621 4712Otolaryngology Head & Neck Surgery Department, Faculty of Medicine, Menoufia University, Shebin El-kom, Egypt
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Ngarmukos S, Tanavalee C, Amarase C, Phakham S, Mingsiritham W, Reantragoon R, Leearamwat N, Kongkaew T, Tharakhet K, Honsawek S, Dechsupa S, Tanavalee A. Two or four injections of platelet-rich plasma for osteoarthritic knee did not change synovial biomarkers but similarly improved clinical outcomes. Sci Rep 2021; 11:23603. [PMID: 34880370 PMCID: PMC8654822 DOI: 10.1038/s41598-021-03081-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
We compared two and four intra-articular injections of platelet-rich plasma (PRP) in terms of changes of synovial cytokines and clinical outcomes. One hundred twenty-five patients having knee osteoarthritis (OA) underwent PRP injections at a 6-week interval. Before each PRP injection, synovial fluid aspiration was collected for investigation. Patients were divided into two or four intra-articular PRP injections (group A and B, respectively). Changes in synovial biomarkers were compared with the baseline levels of both groups, and clinical outcomes were evaluated until one year. Ninety-four patients who had completed synovial fluid collection were included for final evaluation, 51 in group A and 43 in group B. There were no differences in mean age, gender, body mass index (BMI), and radiographic OA grading. The average platelet count and white blood cell count in PRP were 430,000/µL and 200/ µL, respectively. There were no changes of synovial inflammatory cytokines (IL-1β, IL-6, IA-17A, and TNF-alpha), anti-inflammatory cytokines (IL-4, IL-10, IL-13, and IL-1RA), and growth factors (TGF-B1, VEGF, PDGF-AA, and PDGF-BB) between baseline levels and six weeks in group A, and 18 weeks in group B. Both groups had significantly improved clinical outcomes from six weeks including visual analog scale (VAS), patient-reported outcome measures [PROMs; Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and Short Form-12 (SF-12)], with a significant delayed improvement of performance-based measures [PBMs; time up and go (TUG), 5-time sit to stand test (5 × SST), and 3-min walk test (3-min WT)]. In conclusion, two- or four-PRP intra-articular injection at a 6-week interval for knee OA demonstrated no changes of synovial cytokines and growth factors but similarly improved clinical outcomes from 6 weeks until 1 year.
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Affiliation(s)
- Srihatach Ngarmukos
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand.,Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Chotetawan Tanavalee
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand.,Department of Orthopaedics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Chavarin Amarase
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand.,Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Suphattra Phakham
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Warayapa Mingsiritham
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand.,Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Rangsima Reantragoon
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand.,Immunology Division, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nitigorn Leearamwat
- Immunology Division, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thidarat Kongkaew
- Immunology Division, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kittipan Tharakhet
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sittisak Honsawek
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand.,Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sinsuda Dechsupa
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Aree Tanavalee
- Study Group of Biologics for Treatment of Knee Osteoarthritis, Chulalongkorn University, Bangkok, Thailand. .,Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand.
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22
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Yam PK. The Emperor Has No Platelets: Minimal Effects in an Alopecia Split-Scalp Study Unsurprising as Platelet-Rich Plasma Was Actually Platelet-Poor. Aesthet Surg J 2021; 42:NP365-NP367. [PMID: 35037939 PMCID: PMC9005452 DOI: 10.1093/asj/sjab401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Patrick K Yam
- Faculty of Medicine, University of British Columbia, Vancouver, Canada,Corresponding Author: Dr Patrick K. Yam, 6051 Gilbert Rd., Richmond BC, V7C 3V3, Canada. E-mail: ; Twitter: @drpatrickyam
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23
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White C, Brahs A, Dorton D, Witfill K. Platelet-Rich Plasma: A Comprehensive Review of Emerging Applications in Medical and Aesthetic Dermatology. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:44-57. [PMID: 34980960 PMCID: PMC8675348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Platelet-rich plasma (PRP) has been integrated into numerous treatment regimens for medical and aesthetic dermatology. While some of these approaches are well-established, many uses are underreported in the literature. We sought to identify and summarize the emerging dermatologic applications for PRP by conducting a comprehensive PubMed search of studies published between 2000 and 2020. These studies were reviewed to synthesize collection methods, treatment schedule, adverse effects, and the impact of therapy for new and emerging uses for PRP. In general, we identified positive treatment outcomes for skin rejuvenation, scar revision, alopecia, pigmentary disorders, lichen sclerosus, leprosy-induced peripheral neuropathy, plaque psoriasis, and nail disorders. Widely, therapy was well-tolerated and suitable for all reported phototypes. The variations in collection and application sequences make concrete recommendations difficult to discern, underscoring the need for a standardized approach to preparation and treatment methods. We hope this review serves as an outline for new and interesting uses for PRP and will help readers familiarize themselves with this exciting technology for comfortable integration into their practices.
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Affiliation(s)
- Christopher White
- Dr. White is with Dermatology Partners in Strongsville, Ohio
- Drs. Brahs, Dorton, and Witfill are with the Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine, Largo Medical Center, in Largo, Florida
| | - Allyson Brahs
- Dr. White is with Dermatology Partners in Strongsville, Ohio
- Drs. Brahs, Dorton, and Witfill are with the Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine, Largo Medical Center, in Largo, Florida
| | - David Dorton
- Dr. White is with Dermatology Partners in Strongsville, Ohio
- Drs. Brahs, Dorton, and Witfill are with the Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine, Largo Medical Center, in Largo, Florida
| | - Kristin Witfill
- Dr. White is with Dermatology Partners in Strongsville, Ohio
- Drs. Brahs, Dorton, and Witfill are with the Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine, Largo Medical Center, in Largo, Florida
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24
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Autologous Biological Vitamin-C-added (ABC) Filler for Facial Volume Restoration. Aesthetic Plast Surg 2021; 45:2328-2337. [PMID: 33973050 DOI: 10.1007/s00266-021-02297-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/01/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Face rejuvenation procedures with injectable agents continue to gain popularity. Nowadays, a variety of commercial products are available as filler material. Ideal fillers should be inexpensive, easily obtainable, nontoxic, and biocompatible. The aim of this study is to report a clinical perspective for an appropriate, feasible, and inexpensive protocol of a stable, autologous biological filler for facial volume restoring without any commercial kits. METHODS Eight patients were investigated who underwent facial injection with ABC filler. Eleven ml of whole blood was placed in standard tubes containing anticoagulant and for each patient, 8 tubes were prepared. After the centrifugation at 1630 xg for 5 minutes, the upper plasma was taken, calcium was added and cooled. After the addition of vitamin C, the syringes were incubated at 85 °C for 10 minutes. The autologous biological material obtained was used as filling material. For comparison, FACE-Q satisfaction questionnaires were used before and after the procedure. RESULTS All patients were followed up for a minimum of 4 months. No major complications were recorded. The patient-reported FACE-Q satisfaction and FACE-Q quality of life pre- and post-procedure results showed statistically significant improvement (p < 0.05). Overall satisfaction with the outcome was 89.12 ± 16.73 (range 55-100). CONCLUSIONS ABC filler can be seen as a reliable, inexpensive, and easily obtainable material to restore facial volume with increased patient satisfaction and quality of life scores. We believe that our study will be encouraging to the application of autologous biological fillers for further clinical and scientific studies. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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25
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Carr JB. Editorial Commentary: Platelet-Rich Plasma Shows Promise for Improving Shoulder Tendinopathy. Arthroscopy 2021; 37:2754-2755. [PMID: 34481617 DOI: 10.1016/j.arthro.2021.05.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 02/02/2023]
Abstract
Platelet-rich plasma (PRP) injections continue to be used at increasing rates to treat common musculoskeletal conditions. PRP has a low-risk profile and emerging in vitro evidence to support its positive effects on soft-tissue healing. PRP has been shown to be of benefit for knee osteoarthritis, but less has been published regarding the shoulder. PRP delivers a high concentration of growth factors, cytokines, and other important inflammatory modulators. Its use is appealing for treating partial-thickness rotator cuff tears, subacromial bursitis, and rotator cuff tendinopathy since rotator cuff tendons often have poor healing capacity due to intrinsic degeneration. PRP has been shown to increase cell proliferation and matrix synthesis in tenocytes, which may aid tendon regeneration and healing. Adult tendons also contain a small amount of tendon progenitor cells, which can be induced to an active state by PRP. In addition, PRP is an autologous biologic agent and easy to acquire and administer in an outpatient clinical setting. Clinical studies continue to lag and are often heterogenous in quality and in results. PRP can vary widely based on multiple intrinsic and extrinsic factors, including patient age, sex, activity level, centrifugation speed, and number of centrifugation cycles. Thus, quality research methods should include reporting using the PAW (platelets/activation/white blood cells) system. Clinicians should remain cautiously optimistic about the future role of PRP injections in the shoulder.
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26
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Božič D, Vozel D, Hočevar M, Jeran M, Jan Z, Pajnič M, Pađen L, Iglič A, Battelino S, Kralj-Iglič V. Enrichment of plasma in platelets and extracellular vesicles by the counterflow to erythrocyte settling. Platelets 2021; 33:592-602. [PMID: 34384320 DOI: 10.1080/09537104.2021.1961716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In order to prepare optimal platelet and extracellular vesicle (EV)-rich plasma for the treatment of chronic temporal bone inflammation, we studied effects of centrifugation parameters on redistribution of blood constituents in blood samples of 23 patients and 20 volunteers with no record of disease. Concentrations of blood cells and EVs were measured by flow cytometry. Sample content was inspected by scanning electron microscopy. A mathematical model was constructed to interpret the experimental results. The observed enrichment of plasma in platelets and EVs after a single spin of blood depended on the erythrocyte sedimentation rate, thereby indicating the presence of a flow of plasma that carried platelets and EVs in the direction opposite to settling of erythrocytes. Prolonged handling time correlated with the decrease of concentration of platelets and larger EVs in platelet and EV-rich plasma (PVRP), R = -0.538, p = 0.003, indicating cell fragmentation during the processing of samples. In further centrifugation of the obtained plasma, platelet and EV enrichment depended on the average distance of the sample from the centrifuge rotor axis. Based on the agreement of the model predictions with observations, we propose the centrifugation protocol optimal for platelet and EV enrichment and recovery in an individual sample, adjusted to the dimensions of the centrifuge rotor, volume of blood and erythrocyte sedimentation rate.[Figure: see text].
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Affiliation(s)
- Darja Božič
- University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, Ljubljana, Slovenia.,University of Ljubljana, Faculty of Electrical Engineering, Laboratory of Physics, Ljubljana, Slovenia
| | - Domen Vozel
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Ljubljana, Slovenia.,University of Ljubljana, Faculty of Medicine, Department of Otorhinolaryngology, Ljubljana, Slovenia
| | - Matej Hočevar
- Department of Physics and Chemistry of Materials, Institute of Metals and Technology, Ljubljana, Slovenia
| | - Marko Jeran
- University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, Ljubljana, Slovenia.,University of Ljubljana, Faculty of Electrical Engineering, Laboratory of Physics, Ljubljana, Slovenia
| | - Zala Jan
- University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, Ljubljana, Slovenia
| | - Manca Pajnič
- University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, Ljubljana, Slovenia
| | - Ljubiša Pađen
- University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, Ljubljana, Slovenia
| | - Aleš Iglič
- University of Ljubljana, Faculty of Electrical Engineering, Laboratory of Physics, Ljubljana, Slovenia.,University of Ljubljana, Faculty of Medicine, Chair of Orthopedics, Laboratory of Clinical Biophysics, Ljubljana, Slovenia
| | - Saba Battelino
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Ljubljana, Slovenia.,University of Ljubljana, Faculty of Medicine, Department of Otorhinolaryngology, Ljubljana, Slovenia
| | - Veronika Kralj-Iglič
- University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, Ljubljana, Slovenia
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27
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da Fonseca L, Santos GS, Huber SC, Setti TM, Setti T, Lana JF. Human platelet lysate - A potent (and overlooked) orthobiologic. J Clin Orthop Trauma 2021; 21:101534. [PMID: 34386346 PMCID: PMC8339333 DOI: 10.1016/j.jcot.2021.101534] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/25/2021] [Accepted: 07/25/2021] [Indexed: 01/03/2023] Open
Abstract
The knowledge of the essential role of platelets in tissue healing is gradually increasing and as regenerative medicine prompts new solutions, platelet-derived bioproducts have been proposed as a potential tool in this field. In orthopaedics and sports medicine, the use of PRP has been rapidly increasing in popularity as patients seek novel non-surgical approaches to acute and chronic musculoskeletal conditions. The concept of having platelets as a secretory organ other than a mere sponge-like coagulation component opens up new frontiers for the use of the platelet secretome. Platelet lysate is a solution saturated by growth factors, proteins, cytokines, and chemokines involved in crucial healing processes and is administered to treat different diseases such as alopecia, oral mucositis, radicular pain, osteoarthritis, and cartilage and tendon disorders. For this purpose, the abundant presence of growth factors and chemokines stored in platelet granules can be naturally released by different strategies, mostly through lyophilization, thrombin activation or ultrasound baths (ultrasonication). As a result, human platelet lysate can be produced and applied as a pure orthobiologic. This review outlines the current knowledge about human platelet lysate as a powerful adjuvant in the orthobiological use for the treatment of musculoskeletal injuries, without however failing to raise some of its most applicable basic science.
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Affiliation(s)
- Lucas da Fonseca
- Orthopaedic Department – UNIFESP/EPM, 715 Napoleão de Barros St – Vila Clementino, 04024-002, São Paulo, SP, Brazil
| | - Gabriel Silva Santos
- IOC – Instituto Do Osso e da Cartilagem/the Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – Cidade Nova I, 13334-170, Indaiatuba, SP, Brazil,Corresponding author. IOC – Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – 2nd floor, Room #29, Indaiatuba, São Paulo, 13334-170, Brazil. Tel.: +551930174366, +5519989283863.
| | - Stephany Cares Huber
- IOC – Instituto Do Osso e da Cartilagem/the Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – Cidade Nova I, 13334-170, Indaiatuba, SP, Brazil
| | - Taís Mazzini Setti
- Indolor - Centro Intervencionista de Controle da Dor, 583 Sul Brasil Avenue – Room #406 – Centro, 89814-210, Maravilha, SC, Brazil
| | - Thiago Setti
- Indolor - Centro Intervencionista de Controle da Dor, 583 Sul Brasil Avenue – Room #406 – Centro, 89814-210, Maravilha, SC, Brazil
| | - José Fábio Lana
- IOC – Instituto Do Osso e da Cartilagem/the Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – Cidade Nova I, 13334-170, Indaiatuba, SP, Brazil
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28
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Muthuprabakaran K, Pai VV, Ahmad S, Shukla P. A cross-sectional analysis of the effects of various centrifugation speeds and inclusion of the buffy coat in platelet-rich plasma preparation. Indian J Dermatol Venereol Leprol 2021; 87:792-799. [PMID: 34245527 DOI: 10.25259/ijdvl_1050_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/01/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Platelet-rich plasma is an autologous blood preparation which is used in various medical specialties because of its regenerative properties. There is a wide variation in platelet-rich plasma preparation protocols and attaining the ideal platelet yield (>1 million platelets/μL) in a clinic setting can be challenging. We aimed at analyzing the centrifuge spin rates at which to attain an ideal platelet-rich plasma yield and also to study the effect of inclusion of the buffy coat after the first spin on the final platelet concentration in platelet-rich plasma. METHODS Seventy-five whole blood samples were obtained and divided into two groups - (1) leukocyte-rich platelet-rich plasma group and (2) leukocyte-poor platelet-rich plasma group. Samples in both groups were centrifuged using the dual spin method, at one of three centrifugation speed combinations (initial "soft" spin and second "hard" spin speeds, respectively): (1) 100 g/400 g, (2) 350 g/1350 g and (3) 900 g/1800 g. Platelet, red blood cell (RBC) and white blood cell (WBC) counts in both groups were compared. RESULTS The 100 g/400 g spin gave a high platelet yield (increase of 395.4 ± 111.1%) in the leukocyte-poor-platelet-rich plasma group, while in the leukocyte-rich platelet-rich plasma group both 100 g/400 g and 350 g/1350 g spins resulted in significantly higher yields with an increase of 691.5 ± 316.3% and 738.6 ± 193.3%, respectively. LIMITATIONS The study was limited by a smaller sample size in the pure platelet-rich plasma (leukocyte-poor platelet-rich plasma) group. CONCLUSION Ideal platelet yields can be achieved with both the 100 g/400 g as well as the 350 g/1350 g spins using the buffy coat inclusion method while the 100 g/400 g spin for "pure" platelet-rich plasma accomplishes a near-ideal platelet count with significantly reduced contamination with other cells.
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Affiliation(s)
- K Muthuprabakaran
- Department of Dermatology, Goa Medical College, Bambolim, Goa, India
| | | | - Suhail Ahmad
- Department of Dermatology, Goa Medical College, Bambolim, Goa, India
| | - Pankaj Shukla
- Department of Dermatology, Goa Medical College, Bambolim, Goa, India
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29
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Görgü M, Gökkaya A, Karanfil E. What Is the Adequate PRP Dose for an Effective Treatment? An In Vitro Experimental Study on the Skin. Aesthet Surg J 2021; 41:NP887-NP901. [PMID: 33493280 DOI: 10.1093/asj/sjab043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The clinical results of many studies on platelet-rich plasma (PRP) differ due to a lack of standardization in PRP preparation and administration as well as many variables such as PRP preparation methods, platelet concentration, and platelet activation. OBJECTIVES The authors sought to investigate a different variable that will affect PRP application results. How much PRP should be injected into the unit area of tissue for an effective PRP treatment? METHODS The study was performed on fresh surplus tissues of 20 patients that were discarded in abdominoplasty and mammoplasty operations. Nine areas of 4 cm2 were marked on the skin. Fluorescein-stained PRP was injected intradermally with 3 different gauge needles at 3 different doses (0.01, 0.03, and 0.05 mL). After injections, spreads of the fluorescent dye-covered areas in horizontal and vertical planes were measured and compared. For the horizontal plane measurements, the dye spread was measured first from the surface of the skin and second from the dermal surface of the skin. In addition, the width and depth of the dye spread in the dermis were measured from vertical sections. RESULTS Changing the needle diameter does not affect the width or depth (thickness) of the PRP spread in the dermis. Increasing the applied dose to 0.03 mL increases the spread to the width and depth (thickness). CONCLUSIONS In research evaluating the effectiveness of PRP treatments, it is necessary to report the volume of PRP to be applied per unit of tissue.
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Affiliation(s)
- Metin Görgü
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Gölköy, Bolu, Turkey
| | - Ali Gökkaya
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Gölköy, Bolu, Turkey
| | - Ertuğrul Karanfil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Gölköy, Bolu, Turkey
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30
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Gökkaya A, Görgü M, Kızılkan J, Karanfil E, Doğan A. The measurement of wound tensile strength and the effect of PRP on wound tensile force: an experimental investigation on rabbits. J Plast Surg Hand Surg 2021; 56:38-46. [PMID: 34106813 DOI: 10.1080/2000656x.2021.1914637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Platelets in PRP are used for their functions in the initiation and regulation of the wound healing process and are used for the repair of injured tissues and the rejuvenation of healthy tissues. In this study, we evaluated the effect of a single dose platelet-rich plasma on skin wound healing and we demonstrated the effect of platelet-rich plasma on skin wound healing by measuring changes in the wound tensile strength.Material and methods: A total of 8 incisions, each 3 cm long, were made on the back skin on both sides of the vertebral column of 12 rabbits. After suturing their backs with staples, platelet rich plasma (PRP) was injected into the edges of the wounds on the left side and saline solution (saline) was injected into the edges of the wounds on the right side. The tensile force that causes wounds to rupture by applying tension was measured on the 7th, 14th, 21st, and 28th days with the help of a special home-designed device.Results: The mean PRP enrichment was 3.19 fold over peripheral blood. The saline to PRP tensile strength ratios on the 7th, 14th, 21st, and 28th days were calculated as 75.7%, 104.0%, 105.3% and 86.5%, respectively. Overall, the difference in the tensile strength for wounds that had received saline or PRP was in-significant.Conclusion: The application of PRP increases the tensile strength of the wound in the early period. It is possible to measure the tensile strength precisely in in vivo studies with economical home-designed devices.
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Affiliation(s)
- Ali Gökkaya
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Bolu, Turkey
| | - Metin Görgü
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Bolu, Turkey
| | - Jehat Kızılkan
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Bolu, Turkey
| | - Ertuğrul Karanfil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Bolu, Turkey
| | - Ali Doğan
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Bolu, Turkey
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31
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Mota MDL, Barreto RB, Leite BR, Cavalcante BCCD. Desenvolvimento de um dispositivo para obter plasma rico em plaquetas (PRP). Rev Bras Ortop 2021; 57:289-294. [PMID: 35652016 PMCID: PMC9142259 DOI: 10.1055/s-0040-1721835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/17/2020] [Indexed: 11/12/2022] Open
Abstract
Objective
To present an innovative device that applies the double centrifugation method to obtain platelet-rich plasma (PRP), assessing whether there was an effective increase in the concentration of platelets.
Method
Ten volunteers underwent blood collection. The samples were separated in 20 ml syringes, sealed and subjected to the double centrifugation protocol at 1,100 revolutions per minute (rpm) for 15 minutes, resulting in the separation of red blood cells, plasma with platelets, and leukocytes. Then, 10 ml syringes were added to remove 9 ml, respecting the “buffy coat” parameter, collecting 8 ml above and 1 ml below for the second centrifugation and transferring again to the 20 ml syringe. The plasma was again centrifuged at 1,550 rpm for 10 minutes; as a result, it was divided into two parts: at the top, consisting of low platelet plasma (LPP), and at the bottom, by the platelet button. Part of the LPP was discarded, leaving only 3 ml with the platelet button. The cells were then counted.
Results
This innovative device was able to increase the concentration of platelets by almost three times compared with the baseline. In addition, the preparation time for the PRP was adequate, lasting only 35 to 40 minutes.
Conclusions
Platelet-rich plasma was successfully obtained by the double centrifuge protocol, allowing its clinical use. In addition, obtaining through the presented device promotes greater applicability in the preparation of PRP in specific centers, furthermore, being a quick and economical way to obtain PRP.
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Affiliation(s)
| | - Ronald Bispo Barreto
- Faculdade de Medicina, Universidade Tiradentes, Murilo Dantas, Aracaju, SE, Brasil
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32
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Lana JFSD, da Fonseca LF, Macedo RDR, Mosaner T, Murrell W, Kumar A, Purita J, de Andrade MAP. Platelet-rich plasma vs bone marrow aspirate concentrate: An overview of mechanisms of action and orthobiologic synergistic effects. World J Stem Cells 2021; 13:155-167. [PMID: 33708344 PMCID: PMC7933989 DOI: 10.4252/wjsc.v13.i2.155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 02/06/2023] Open
Abstract
The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past decade. Currently, there are multiple alternatives available as suitable treatments; however, the use of autologous blood-derived products such as platelet-rich plasma (PRP), bone marrow aspirate (BMA) and BMA concentrate (BMAC), specifically, is expanding. Although many investigations attempted to demonstrate the effectiveness of these therapies, even with positive results, the literature lacks standardized protocols and overall accuracy in study designs, which leads to variance and difficulty in reproducibility of protocols. The efficacy of PRP for the treatment of cartilage, bone and muscle tissues is well known. Although BMAC has generated optimistic results for the same purposes, its applicability in clinical trials is still relatively recent when compared to PRP. Both products demonstrate the potential to set forth reparative processes, each in their own distinct mechanism. The combination of these biological products has been previously proposed, yet little is known about their synergism. Evidence indicates that growth factor, cytokine, and chemokine profiles seen in both PRP and BMAC vary but are likely to work synergistically to enhance musculoskeletal healing. BMAC products seem to work well without PRP; however, the addition of PRP to BMAC has been shown to act as a rich and natural source of culture medium for stem cells located either peripherally or in the bone marrow itself. Nevertheless, additional variables associated with the use of BMAC and PRP in orthopedics must be further evaluated in order to consolidate the efficacy of this therapeutic strategy.
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Affiliation(s)
| | | | - Rafael da Rocha Macedo
- Department of Orthopedics, Rede D’Or Unit IFOR Hospital, São Bernardo do Campo 09715-021, SP, Brazil
| | - Tomas Mosaner
- Department of Orthopedics, The Bone and Cartilage Institute, Indaiatuba 13334-170, SP, Brazil
| | - William Murrell
- Department of Orthopaedics, Healthpoint UAE, Abu Dhabi 00000, United Arab Emirates
| | - Ashok Kumar
- Department of Orthopaedics, My Doc Specialist Medical Centre, Dubai 00000, United Arab Emirates
| | - Joseph Purita
- Department of Orthopedics, Institute of Regenerative Medicine, Boca Raton, FL 33432, United States
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Kao YC, Lin DZ, Lee SL, Chen C, Wang HJ, Chiu WK. Assisted therapy with platelet-rich plasma for burn patients: A meta-analysis and systematic review. Burns 2020; 47:1012-1023. [PMID: 33962831 DOI: 10.1016/j.burns.2020.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/08/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Platelet-rich plasma (PRP) therapy has been used in different medical fields, but its effectiveness in burn wound healing remains debatable. In this study, we performed a systematic review and meta-analysis of the available evidence on burn patients treated with PRP to evaluate the safety and efficacy of the treatment. METHODS Randomized controlled trials evaluating the efficacy of PRP in patients with burn injuries were selected. Eligible retrospective studies were abstracted and assessed for the risk of bias by two reviewers and results of mean time to complete epithelization and wound closure rate in the included studies were analyzed. Studies on the correlation between PRP and burn wound healing published in English or Chinese before March 2020 were retrieved from PubMed. RESULTS Eight studies (including 449 patients) met our inclusion criteria. Qualitative analysis revealed that compared with the control group, the PRP group had significantly better wound closure rates at weeks 2 (mean difference (MD): 12.79 [95% confidence interval (CI): 7.08, 18.49]; I2: 0%; p < 0.0001) and 3 (MD: 12.66 [95% CI: 5.97, 19.34]; I2: 55%; p = 0.0002) and time to complete epithelialization (MD: -3.45 [95% CI: -4.87, -2.04] (days); I2: 0%; p < 0.00001). There was no significant difference in infection rate or graft take rate. CONCLUSIONS PRP application can accelerate wound closure, however, it has no effect on the rates of wound infection and graft take rate.
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Affiliation(s)
- Yu-Chien Kao
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Dai-Zhu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Lian Lee
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chiehfeng Chen
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
| | - Hsian-Jenn Wang
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wen-Kuan Chiu
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
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Abstract
Introduction: Platelet-rich plasma (PRP) is an autologous blood-derived product that contains platelet concentrations at least 2/3 times above the normal level and includes platelet-related growth factors. The concept of PRP began in the 1970s in the field of hematology to treat patients with thrombocytopenia. In the 1980s and 1990s, PRP began to be used in surgical procedures such as maxillofacial surgery and plastic surgery. Since then, PRP had been used in orthopedic procedures, cardiac surgery, sports injuries, plastic surgery, gynecology, urology, and more recently in medical esthetics. Areas covered: This review analyzes the mechanisms of action, current indications, clinical evidence, safety and future directions of PRP in the management of various medical conditions. The literature search methodology included using medical subject headings terms to search in PubMed. Articles used were screened and critically appraised by the coauthors of this review. Expert Opinion: Platelet-rich plasma is a therapeutic option used to treat many medical conditions. PRP could be used alone or in combination with other procedures. The effectiveness and safety of PRP has been demonstrated in many medical scenarios, however there is limited availability of large randomized clinical trials.
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Affiliation(s)
- Shyla Gupta
- Department of Medicine, Queen's University , Kingston, ON, Canada
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Pachito DV, Bagattini ÂM, de Almeida AM, Mendrone-Júnior A, Riera R. Technical Procedures for Preparation and Administration of Platelet-Rich Plasma and Related Products: A Scoping Review. Front Cell Dev Biol 2020; 8:598816. [PMID: 33363154 PMCID: PMC7759516 DOI: 10.3389/fcell.2020.598816] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Platelet-rich plasma is widely used for different types of clinical situations, but universal standardization of procedures for its preparation is still lacking. Methods Scoping review of comparative studies that have assessed at least two alternatives in one or more stages of preparation, storage and/or administration of PRP or its related products. A systematic search was conducted in MEDLINE, Embase, and LILACS. Two authors screened references independently. Data extraction was performed iteratively, and results were presented for each included comparison. Results Thirty-nine studies were included after assessing full texts, focusing on the comparison of PRP to a related product, types of anticoagulants, centrifugation protocols, commercial kits, processing time, methods for activation, and application concomitantly to other substances. Only laboratory outcomes were assessed, as platelet, leukocyte and growth factor concentrations. Conclusion Results showed great variability related to methods employed in different stages of PRP processing, which may explain the variability observed in clinical trials assessing the efficacy of PRP for different clinical situations.
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Affiliation(s)
- Daniela Vianna Pachito
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, São Paulo, Brazil.,Fundação Getúlio Vargas, São Paulo, Brazil
| | - Ângela Maria Bagattini
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, São Paulo, Brazil.,Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
| | - Adriano Marques de Almeida
- Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
| | - Alfredo Mendrone-Júnior
- Fundação Pro Sangue Hemocentro de São Paulo e Laboratório de Processamento Celular, Hospital Sírio Libanês, São Paulo, Brazil
| | - Rachel Riera
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, São Paulo, Brazil.,Disciplina de Medicina Baseada em Evidências, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Straum OK. The optimal platelet concentration in platelet-rich plasma for proliferation of human cells in vitro-diversity, biases, and possible basic experimental principles for further research in the field: A review. PeerJ 2020; 8:e10303. [PMID: 33240635 PMCID: PMC7668201 DOI: 10.7717/peerj.10303] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/14/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In the last decades, several in vitro studies have tested the effect of plate-rich plasma (PRP) on the proliferation of human cells in search of a wizard for the use of PRP in a clinical setting. However, the literature displays striking differences regarding this question despite the relatively similar experimental design. The aim of this review is twofold: describe and explain this diversity and suggest basic principles for further in vitro studies in the field. The optimal platelet concentration in vivo will also be discussed. METHODS A search in mainly EMBASE and PubMed was performed to identify in vitro studies that investigate the effect of different PRP concentrations on human cell proliferation. The assessment of bias was based on the principles of "Good Cell Culture Practice" and adapted. RESULTS In total, 965 in vitro studies were detected. After the initial screening, 31 studies remained for full-text screening. A total of 16 studies met the criteria of final inclusion and appeared relatively sound. In general, the studies state consistently that PRP stimulates the proliferation of the human cell. Two main types of experimental techniques were detected: 1. The Fixed PRP Concentration Group using a fixed PRP concentration throughout the experiment, which leads to a substantial decrease in nutrition available at higher concentrations. 2. The Fixed PRP Volume Group using a fixed PRP-to-media ratio (Vol/Vol) throughout the experiment. A general tendency was observed in both groups: when the PRP to media ratio increased (Vol/Vol), the proliferation rate decreased. Further, The Low Leukocyte group observed a substantial higher optimal PRP concentration than The High leukocyte group. No prominent tendencies was seen regarding anticoagulants, activation methods, and blood donor (age or sex). DISCUSSION Two major biases regarding optimal proliferation in vitro is pointed out: 1. Too high PRP volume. It is speculated that the techniques used by some studies led to an adverse growth condition and even cell starvation at higher concentrations. 2. High leukocyte levels. Reduced proliferation rate due to proinflammatory substances released during degranulation of leukocytes. CONCLUSIONS The two main biases may explain the bell-shaped effect of PRP and the detrimental effects at higher platelet concentrations observed in several studies. These biases may also explain the low optimal PRP concentration observed in some studies. Even if one universal optimal PRP concentration does not exist, the review indicates that PRP concentrations in the upper parts of the scale is optimal or at least beneficial. Finally, following basic experimental principles are suggested. 1: The PRP/media ratio (Vol/Vol) should be kept as constant. 2: The PRP/media ratio should provide a sufficient nutrition supply, that is, PRP ≤ 10% (Vol/Vol). 3: The cell density per well (cells/mL) should be defined. 4: Leukocyte level should be kept low, preferable depleted (< 0.1 PLT/µL).
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Affiliation(s)
- Olav K. Straum
- Faculty of Humanities, Social Sciences, and Education, UiT The Arctic University of Norway, Tromsø, Norway
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Spinal Reflex Recovery after Dorsal Rhizotomy and Repair with Platelet-Rich Plasma (PRP) Gel Combined with Bioengineered Human Embryonic Stem Cells (hESCs). Stem Cells Int 2020; 2020:8834360. [PMID: 33178285 PMCID: PMC7647752 DOI: 10.1155/2020/8834360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/20/2020] [Accepted: 09/30/2020] [Indexed: 02/07/2023] Open
Abstract
Dorsal root rhizotomy (DRZ) is currently considered an untreatable injury, resulting in the loss of sensitive function and usually leading to neuropathic pain. In this context, we recently proposed a new surgical approach to treat DRZ that uses platelet-rich plasma (PRP) gel to restore the spinal reflex. Success was correlated with the reentry of primary afferents into the spinal cord. Here, aiming to enhance previous results, cell therapy with bioengineered human embryonic stem cells (hESCs) to overexpress fibroblast growth factor 2 (FGF2) was combined with PRP. For these experiments, adult female rats were submitted to a unilateral rhizotomy of the lumbar spinal dorsal roots, which was followed by root repair with PRP gel with or without bioengineered hESCs. One week after DRZ, the spinal cords were processed to evaluate changes in the glial response (GFAP and Iba-1) and excitatory synaptic circuits (VGLUT1) by immunofluorescence. Eight weeks postsurgery, the lumbar intumescences were processed for analysis of the repaired microenvironment by transmission electron microscopy. Spinal reflex recovery was evaluated by the electronic Von Frey method for eight weeks. The transcript levels for human FGF2 were over 37-fold higher in the induced hESCs than in the noninduced and the wildtype counterparts. Altogether, the results indicate that the combination of hESCs with PRP gel promoted substantial and prominent axonal regeneration processes after DRZ. Thus, the repair of dorsal roots, if done appropriately, may be considered an approach to regain sensory-motor function after dorsal root axotomy.
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Arora G, Arora S. Platelet-rich plasma-Where do we stand today? A critical narrative review and analysis. Dermatol Ther 2020; 34:e14343. [PMID: 32979292 DOI: 10.1111/dth.14343] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/13/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022]
Abstract
"Sometimes you have to travel a long way to find what is near." This quote by Paulo Coelho stands true for platelet-rich plasma (PRP) as we know of it today. Large strides have been made to understand this "youth" in blood, but there still seems a long way to go in our understanding of it. Despite advances, clarity in its preparation, biology, and the properties of the final product still remains elusive. The concepts of an ideal number or concentration of platelets in the final enriched plasma, best devices to prepare PRP, an ideal hardware, standard parameters for its preparation, the need for its activation or buffering of the final preparation or whether anticoagulants should be used or not, have evolved, since it was first described. The authors present an analysis of PRP present day status and its usefulness in field of medicine with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar related to PRP, its biology, types, and classifications, preparation, and use.
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Affiliation(s)
- Gulhima Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
| | - Sandeep Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
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Yaw HP, Van Den Helm S, Linden M, Monagle P, Ignjatovic V. Whole blood flow cytometry protocol for the assessment of platelet phenotype, function, and cellular interactions. Platelets 2020; 32:786-793. [PMID: 32881599 DOI: 10.1080/09537104.2020.1810222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Platelets are a key component of the hemostatic system and their roles in inflammation via interactions with leukocytes have also gained attention in recent years. Changes in platelet phenotype and function can cause bleeding and/or thrombosis and, as such, monitoring platelet-specific changes is crucial to assessing hemostasis in the clinical setting. Currently, available platelet function tests such as platelet aggregometry and thromboelastography require a large volume of blood, which is a major limitation for the pediatric population. Whole blood flow cytometric analysis of platelets is increasingly utilized in recent years, primarily due to the sensitivity of this method, but also because it only requires a small amount of blood with minimal sample manipulation. We have developed a whole blood flow cytometry methodological approach that enables the assessment of platelet phenotype, function, and their interactions with monocytes and neutrophils.
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Affiliation(s)
- Hui Ping Yaw
- Haematology Research, Murdoch Children's Research Institute, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Suelyn Van Den Helm
- Haematology Research, Murdoch Children's Research Institute, Murdoch Children's Research Institute, Melbourne, Australia
| | - Matthew Linden
- School of Biomedical Sciences, The University of Western Australia, Perth, Australia
| | - Paul Monagle
- Haematology Research, Murdoch Children's Research Institute, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Department of Clinical Haematology, The Royal Children's Hospital, Melbourne, Australia
| | - Vera Ignjatovic
- Haematology Research, Murdoch Children's Research Institute, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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Comparison of Two Anticoagulants for Pain Associated with Platelet-Rich Plasma Injections. Aesthetic Plast Surg 2020; 44:955-961. [PMID: 31722064 DOI: 10.1007/s00266-019-01541-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/03/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Platelet-rich plasma (PRP) has long been used in skin rejuvenation and hair loss treatment. Some patients require multiple intradermal injections into the face and scalp, and the way in which these patients process and experience pain differs, depending on the patient. Minimizing pain and discomfort during nonsurgical procedures is essential for patient satisfaction. In our experience, the use of acid citrate dextrose-A (ACD-A) as an anticoagulant caused more patient discomfort than did sodium citrate (Na-citrate) among patients who underwent facial rejuvenation with PRP. The aim of the present study was to evaluate patient-related discomfort in PRP sessions using two different anticoagulants. MATERIALS AND METHODS This clinical trial included 10 patients who received facial PRP injections for facial rejuvenation and 10 patients who received PRP injections in their scalps for hair loss. On the application area, half the surface was treated with Na-citrate PRP injections, and the other half was treated with the same amount of ACD-A PRP injections. Neither the doctors who applied the treatment nor the patients were given information about which anticoagulant was used in each area. Immediately after the procedure, the patients were asked to score their pain on each side of the application area on a scale of 1-10 using a visual analog scale (VAS). RESULTS PRP injections using Na-citrate as an anticoagulant caused less discomfort on both the face and scalp as compared with that of ACD-A. The outcome was statistically significant. CONCLUSION Anticoagulants used in PRP preparation affected patients' pain perceptions during the injections. The sensation of pain with PRP prepared with Na-citrate as an anticoagulant was lower than that of PRP prepared with ACD-A. Further studies are required to evaluate the correlation between anticoagulants used for PRP preparation and pain feelings during injections. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Optimized centrifugation preparation of the platelet rich plasma: Literature review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:150-154. [DOI: 10.1016/j.jormas.2019.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/26/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022]
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Xu J, Gou L, Zhang P, Li H, Qiu S. Platelet-rich plasma and regenerative dentistry. Aust Dent J 2020; 65:131-142. [PMID: 32145082 PMCID: PMC7384010 DOI: 10.1111/adj.12754] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2020] [Indexed: 11/30/2022]
Abstract
Regenerative dentistry is an emerging field of medicine involving stem cell technology, tissue engineering and dental science. It exploits biological mechanisms to regenerate damaged oral tissues and restore their functions. Platelet‐rich plasma (PRP) is a biological product that is defined as the portion of plasma fraction of autologous blood with a platelet concentration above that of the original whole blood. A super‐mixture of key cytokines and growth factors is present in platelet granules. Thus, the application of PRP has gained unprecedented attention in regenerative medicine. The rationale underlies the utilization of PRP is that it acts as a biomaterial to deliver critical growth factors and cytokines from platelet granules to the targeted area, thus promoting regeneration in a variety of tissues. Based on enhanced understanding of cell signalling and growth factor biology, researchers have begun to use PRP treatment as a novel method to regenerate damaged tissues, including liver, bone, cartilage, tendon and dental pulp. To enable better understanding of the regenerative effects of PRP in dentistry, this review describes different methods of preparation and application of this biological product, and provides detailed explanations of the controversies and future prospects related to the use of PRP in dental regenerative medicine.
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Affiliation(s)
- J Xu
- Shenzhen Longgang Institute of Stomatology, Shenzhen, Guangdong, China.,Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| | - L Gou
- Center for Genetic Medicine, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - P Zhang
- Shenzhen Longgang Institute of Stomatology, Shenzhen, Guangdong, China.,Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| | - H Li
- Shenzhen Longgang Institute of Stomatology, Shenzhen, Guangdong, China.,Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| | - S Qiu
- Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
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Kim CJ, Ki DY, Park J, Sunkara V, Kim TH, Min Y, Cho YK. Fully automated platelet isolation on a centrifugal microfluidic device for molecular diagnostics. LAB ON A CHIP 2020; 20:949-957. [PMID: 31989123 DOI: 10.1039/c9lc01140d] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Platelets play crucial roles in hemostasis and immunity. Over the last decades, clinical evidence has revealed the significance of platelets as complementary biomarkers for the detection and treatment of various diseases, including cancer. Due to a lack of well standardized convenient isolation methods for platelets, pre-analytical factors such as complex handling procedures negatively impact the quality of the platelet samples, including overactivation, low purity, and poor reproducibility. This may lead to biased interpretation of various downstream analyses, such as proteomic and genomic analyses. Herein, we describe a fully automated lab-on-a-disc-based method of platelet isolation from a small volume of blood (<1 mL). This method provides higher yields (>4 folds) and purity (>99%) and lower platelet activation than the conventional method. Moreover, it was also superior in the detection of platelet-related RNAs CD41, PF4, and P2Y12 due to lower contamination with white blood cells.
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Affiliation(s)
- Chi-Ju Kim
- Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea. and Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
| | - Dong Yeob Ki
- Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea. and Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
| | - Juhee Park
- Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
| | - Vijaya Sunkara
- Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
| | - Tae-Hyeong Kim
- Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
| | - YooHong Min
- Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
| | - Yoon-Kyoung Cho
- Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea. and Center for Soft and Living Matter, Institute for Basic Science (IBS), Ulsan 44919, Republic of Korea
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Soraganvi P, Nagakiran KV, Raghavendra-Raju RP, Anilkumar D, Wooly S, Basti BD, Janakiraman P. Is Platelet-rich Plasma Injection more Effective than Steroid Injection in the Treatment of Chronic Plantar Fasciitis in Achieving Long-term Relief? Malays Orthop J 2020; 13:8-14. [PMID: 31890104 PMCID: PMC6915312 DOI: 10.5704/moj.1911.002] [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] [Indexed: 12/22/2022] Open
Abstract
Introduction: Plantar fasciitis is characterised by pain in the heel, which is aggravated on weight bearing after prolonged rest. Many modalities of treatment are commonly used in the management of plantar fasciitis including steroid injection. Many studies show that steroid injection provides pain relief in the short term but not long lasting. Recent reports show autologous platelet-rich plasma (PRP) injection promotes healing, resulting in better pain relief in the short as well as long term. The present study was undertaken to compare the effects of local injection of platelet-rich plasma and Corticosteroid in the treatment of chronic plantar fasciitis. Materials and methods: Patients with the clinical diagnosis of chronic plantar fasciitis (heel pain of more than six weeks) after failed conservative treatment and plantar fascia thickness more than 4mm were included in the study. Patients with previous surgery for plantar fasciitis, active bilateral plantar fasciitis, vascular insufficiency or neuropathy related to heel pain, hypothyroidism and diabetes mellitus were excluded from the study. In this prospective double-blind study, 60 patients who fulfilled the criteria were divided randomly into two groups. Patients in Group A received PRP injection and those in Group B received steroid injection. Patients were assessed with visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score. Assessment was done before injection, at six weeks, three months and six months follow-up after injection. Plantar fascia thickness was assessed before the intervention and six months after treatment using sonography. Results: Mean VAS in Group A decreased from 7.14 before injection to 1.41 after injection and in Group B decreased from 7.21 before injection to 1.93 after injection, at final follow-up. Mean AOFAS score in Group A improved from 54 to 90.03 and in Group B from 55.63 to 74.67 at six months' follow-up. The improvements observed in VAS and AOFAS were statistically significant. At the end of six months' follow-up, plantar fascia thickness had reduced in both groups (5.78mm to 3.35mm in Group A and 5.6 to 3.75 in Group B) and the difference was statistically significant. Conclusion: Local injection of platelet-rich plasma is an effective treatment option for chronic plantar fasciitis when compared with steroid injection with long lasting beneficial effect.
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Affiliation(s)
- P Soraganvi
- Department of Orthopaedics, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India.,Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
| | - K V Nagakiran
- Department of Orthopaedics, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India.,Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
| | - R P Raghavendra-Raju
- Department of Orthopaedics, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India.,Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
| | - D Anilkumar
- Department of Orthopaedics, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India.,Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
| | - S Wooly
- Department of Orthopaedics, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India.,Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
| | - B D Basti
- Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
| | - P Janakiraman
- Department of Community Medicine, PES Institute of Medical Sciences and Research Kuppam Campus, Kuppam, India
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Melville JC, Mañón VA, Blackburn C, Young S. Current Methods of Maxillofacial Tissue Engineering. Oral Maxillofac Surg Clin North Am 2019; 31:579-591. [DOI: 10.1016/j.coms.2019.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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47
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The role of biologic agents in the management of common shoulder pathologies: current state and future directions. J Shoulder Elbow Surg 2019; 28:2041-2052. [PMID: 31585784 DOI: 10.1016/j.jse.2019.07.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 07/28/2019] [Indexed: 02/01/2023]
Abstract
The field of orthopedic surgery has seen a rapid increase in the use of various biologic agents for the treatment of common musculoskeletal injuries. Most biologic agents attempt to harness or mimic naturally occurring growth factors, cytokines, and anti-inflammatory mediators to improve tissue healing and recovery. The most commonly used biologic agents are platelet-rich plasma and cells derived from bone marrow aspirate and adipose tissue. These agents have become increasingly popular despite a relative dearth of clinical data to support their use. Much confusion exists among patients and physicians in determining the role of these agents in treating common shoulder pathologies, such as glenohumeral osteoarthritis, rotator cuff tears, and tendinopathy. This article reviews the basic science and clinical evidence for the most commonly used biologic agents in the management of common shoulder pathology.
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Eche IJ, Nahas M, Dunn E, Eche IM, O'Brien KL. Transfusion Reactions: A Case Study of an Ocular Adverse Event During Autologous Transplantation. Clin J Oncol Nurs 2019; 23:509-513. [PMID: 31538971 DOI: 10.1188/19.cjon.509-513] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Transfusion of blood products is an integral part of hematopoietic stem cell transplantation. Because of the risk for myelotoxicity during conditioning regimens, adequate transfusion support is needed. Typical signs and symptoms of transfusion reactions include fever, chills, hives, and itching. Uncommon symptoms, such as conjunctival erythema, periorbital itching, erythema, and edema, can also occur. OBJECTIVES The purpose of this article is to describe atypical transfusion-related reactions in a patient undergoing stem cell transplantation. METHODS This article presents a case study of a patient with cancer undergoing autologous stem cell transplantation who experienced an adverse ocular reaction following platelet transfusion. FINDINGS Ensuring that oncology nurses are proactive in identifying and managing symptoms that can result from atypical transfusion reactions can reduce morbidity and mortality and improve overall patient care outcomes.
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Martins Shimojo AA, Santos Duarte ADS, Santos Duarte Lana JF, Malheiros Luzo ÂC, Fernandes AR, Sanchez-Lopez E, Barbosa Souto E, Andrade Santana MH. Association of Platelet-Rich Plasma and Auto-Crosslinked Hyaluronic Acid Microparticles: Approach for Orthopedic Application. Polymers (Basel) 2019; 11:polym11101568. [PMID: 31561615 PMCID: PMC6835642 DOI: 10.3390/polym11101568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 12/13/2022] Open
Abstract
Platelet-rich plasma (PRP) associated with high molecular weight hyaluronic acid (HA) has been clinically used for tissue regeneration in orthopedics. Despite the recognized beneficial clinical outcomes (e.g., early pain control, improvement of patients' functional limitation and longer-term effectiveness compared to PRP and HA alone in mild and moderate osteoarthritis treatments), its use is still challenging and controversial due to lack of standardization of association practical protocols. Moreover, most studies neglect the matrix structure, that generates the ultimate properties of the association among platelets, fibrin network and the microparticles. In the present work, we aimed to analyze the influence of the PRP/HA association with a controlled matrix structure on the stability, rheological behavior, release of growth factors and in vitro proliferation of human adipose-derived mesenchymal cells (h-AdMSCs). The attenuation of the negative charge of HA was also evaluated. Pure PRP (P-PRP) (i.e., plasma enriched with platelets and poor in leukocytes) was prepared by centrifugation and activated with serum and calcium chloride (AP-PRP). Autocrosslinked hyaluronic acid (AHA) was prepared by organocatalyzed auto-esterification and structured in microparticles (MPAHA) by shearing. The attenuation of the negative charge of MPAHA was performed with chitosan (CHT) by polyelectrolyte complexation yielding MPAHA-CHT. The results showed that microparticles (MPs) have viscoelastic properties, extrusion force and swelling ratio appropriate for injectable applications. The association of AP-PRP with the controlled structure of MPAHA and MPAHA-CHT formed a matrix composed of platelets and of a fibrin network with fibers around 160 nm located preferably on the surface of the MPs with an average diameter of 250 μm. Moreover, AP-PRP/MPAHA and AP-PRP/MPAHA-CHT associations were non-toxic and supported controlled growth factor (PDGF-AB and TGF-β1) release and in vitro proliferation of h-AdMSC with a similar pattern to that of AP-PRP alone. The best h-AdMSC proliferation was obtained with the AP-PRP/MPAHA-CHT75:25 indicating that the charge attenuation improved the cell proliferation. Thus, the association of AP-PRP with the controlled structure of HA can be a valuable approach for orthopedic applications.
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Affiliation(s)
- Andréa Arruda Martins Shimojo
- Department of Engineering of Materials and Bioprocesses, School of Chemical Engineering, University of Campinas, 13083-852 Campinas, SP, Brazil.
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal.
| | | | | | | | - Ana Rita Fernandes
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal
| | - Elena Sanchez-Lopez
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of pharmacy and Food Sciences, University of Barcelona, Institute of Nanoscience and Nanotechnology (IN2UB), 08028 Barcelona, Spain
- Centro de Investigación biomédica en red de enfermedades neurodegenerativas (CIBERNED), 08028 Barcelona, Spain
| | - Eliana Barbosa Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal.
- CEB-Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - Maria Helena Andrade Santana
- Department of Engineering of Materials and Bioprocesses, School of Chemical Engineering, University of Campinas, 13083-852 Campinas, SP, Brazil
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Al-Hamed FS, Mahri M, Al-Waeli H, Torres J, Badran Z, Tamimi F. Regenerative Effect of Platelet Concentrates in Oral and Craniofacial Regeneration. Front Cardiovasc Med 2019; 6:126. [PMID: 31552270 PMCID: PMC6733887 DOI: 10.3389/fcvm.2019.00126] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/12/2019] [Indexed: 01/11/2023] Open
Abstract
Platelet concentrates (PCs) are biological autologous products derived from the patient's whole blood and consist mainly of supraphysiologic concentration of platelets and growth factors (GFs). These GFs have anti-inflammatory and healing enhancing properties. Overall, PCs seem to enhance bone and soft tissue healing in alveolar ridge augmentation, periodontal surgery, socket preservation, implant surgery, endodontic regeneration, sinus augmentation, bisphosphonate related osteonecrosis of the jaw (BRONJ), osteoradionecrosis, closure of oroantral communication (OAC), and oral ulcers. On the other hand, no effect was reported for gingival recession and guided tissue regeneration (GTR) procedures. Also, PCs could reduce pain and inflammatory complications in temporomandibular disorders (TMDs), oral ulcers, and extraction sockets. However, these effects have been clinically inconsistent across the literature. Differences in study designs and types of PCs used with variable concentration of platelets, GFs, and leucocytes, as well as different application forms and techniques could explain these contradictory results. This study aims to review the clinical applications of PCs in oral and craniofacial tissue regeneration and the role of their molecular components in tissue healing.
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Affiliation(s)
| | - Mohammed Mahri
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Haider Al-Waeli
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Jesus Torres
- Faculty of Dentistry, Universidad Complutense, Madrid, Spain
| | - Zahi Badran
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Periodontology (CHU/Rmes Inserm U1229/UIC11), Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
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