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Perussolo J, Calciolari E, Dereka X, Donos N. Platelet-rich plasma and plasma rich in growth factors in extra-oral wound care. Periodontol 2000 2024. [PMID: 39056422 DOI: 10.1111/prd.12572] [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: 10/04/2023] [Revised: 02/23/2024] [Accepted: 04/15/2024] [Indexed: 07/28/2024]
Abstract
This narrative review evaluates the existing literature on the clinical efficacy and safety of platelet-rich plasma (PRP) and plasma rich in growth factors (PRGFs) in extra-oral wound care, considering their potential benefits and drawbacks. The review specifically focuses on the impact of these treatments on patients' quality of life, pain management, treatment costs, recurrence rates, and potential complications. Given the extensive literature and diverse range of extra-oral wound types in which these autologous platelet concentrates have been applied, this narrative review focuses on the most frequently described wound types, including diabetic foot ulcers, venous leg ulcers, pressure ulcers, surgical wounds, and burns. The use of PRP has been reported in various medical specialties, with a low risk of adverse events. While there is a growing interest in the use of PRGF with promising results, the available literature on this topic is still limited. Only a few studies evaluated patients' perception of the treatment and the relationship between treatment costs and clinical outcomes. Data on recurrence rates and complications also vary across studies. In conclusion, PRP and PRGF show promise as alternatives or as adjunctive therapies to conventional treatments for various extra-oral wounds and ulcers, leading to reduced wound size and accelerated healing time but should be considered on a case-by-case basis, taking into account the type and severity of the wound.
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Affiliation(s)
- Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Surgery, Dental School, University of Parma, Parma, Italy
| | - Xanthippi Dereka
- Department of Periodontology, School of Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Sharun K, Chandran D, Manjusha KM, Mankuzhy PD, Kumar R, Pawde AM, Dhama K, El-Husseiny HM, Amarpal. Advances and prospects of platelet-rich plasma therapy in veterinary ophthalmology. Vet Res Commun 2023; 47:1031-1045. [PMID: 36607500 DOI: 10.1007/s11259-022-10064-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023]
Abstract
In the recent decades, there has been a significant uptick on the use of platelet-rich plasma (PRP) as a better alternative for ophthalmologic therapies in pathologies, primarily of the ocular surface. PRP is a class of liquid platelet concentrate containing a supra-physiological concentration of platelets in a relatively small amount of plasma. Its potential to heal various tissues has piqued interest in its therapeutic application as a biomaterial in regenerative medicine. It is currently a popular therapeutic agent in plastic surgery, cardiothoracic surgery, reconstructive surgery, and even oral and maxillofacial surgery. Based on the data from in vitro and in vivo studies, it can be concluded that PRP possesses adequate therapeutic potential in ocular pathologies, especially those involving cornea. In addition, the high concentrations of growth factors (TGF-β, VEGF, EGF) present in the PRP accelerate the healing of the corneal epithelium. PRP has great therapeutic prospects in veterinary ophthalmology as a regenerative therapeutic modality. However, several variables are yet to be defined and standardized that can directly affect the efficacy of PRP application in different ophthalmic conditions. There is a shortage of research on the use of PRP in ocular surface defects compared to the number of studies and reports on the use of autologous and allogeneic serum eye drops. Therefore, a data-driven approach is required to generate consensus/guidelines for the preparation, characterization, and therapeutic use of PRP in veterinary ophthalmology. This review aims to inform readers of the latest research on PRP, including its preparation methods, physiological and biochemical properties, clinical applications in veterinary ophthalmology, and their safety and efficacy.
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Affiliation(s)
- Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India.
| | - Deepak Chandran
- Department of Veterinary Sciences and Animal Husbandry, Amrita School of Agricultural Sciences, Amrita Vishwa Vidyapeetham University, Coimbatore, Tamil Nadu, 642109, India
| | - K M Manjusha
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Pratheesh D Mankuzhy
- Department of Physiology, Kerala Veterinary and Animal Sciences University, Pookode, Wayanad, Kerala, India
| | - Rohit Kumar
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Abhijit M Pawde
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Hussein M El-Husseiny
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, Tokyo University of Agriculture and Technology (TUAT), Fuchu, Tokyo, 183-0054, Japan
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Benha University, 13736, Toukh, Egypt
| | - Amarpal
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
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3
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Koay SY, Larkin DFP. New Pharmacological Approaches for the Treatment of Neurotrophic Keratitis. Front Pharmacol 2022; 13:796854. [PMID: 35392574 PMCID: PMC8981034 DOI: 10.3389/fphar.2022.796854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Neurotrophic keratitis (NK) is a rare degenerative condition that is caused by damage to the trigeminal nerve, with partial or complete loss of corneal sensory innervation. The loss of innervation leads to impaired healing of corneal epithelium, which subsequently results in punctate epithelial erosions, persistent epithelial defects, corneal ulcers and corneal perforation. Management of NK is often supportive and aims to promote epithelial healing and prevent progression of disease. Multiple novel pharmacological approaches have been proposed to address the underlying pathophysiology of NK, which are discussed in this paper.
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Affiliation(s)
- Su Yin Koay
- Cornea and External Diseases Service, Moorfields Eye Hospital, London, United Kingdom
| | - Daniel F P Larkin
- Cornea and External Diseases Service, Moorfields Eye Hospital, London, United Kingdom
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4
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Roumeau S, Dutheil F, Sapin V, Baker JS, Watson SL, Pereira B, Chiambaretta F, Navel V. Efficacy of treatments for neurotrophic keratopathy: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2022; 260:2623-2637. [DOI: 10.1007/s00417-022-05602-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/13/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022] Open
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Fitriana PO, Pawiroranu S, Widayanti TW, Wirohadidjojo YW, Mahayana IT. Autologous platelet-rich plasma eye drop for moderate-to-severe bacterial corneal ulcers: Changes in interleukin-6 tear concentration and clinical outcomes. Taiwan J Ophthalmol 2021; 12:457-461. [PMID: 36660115 PMCID: PMC9843573 DOI: 10.4103/tjo.tjo_42_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/30/2021] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The objective of this study was to evaluate interleukin-6 (IL-6) tear concentration and clinical outcome in patients with moderate-to-severe bacterial corneal ulcers post autologous platelet-rich plasma (PRP) eye drop therapy. MATERIALS AND METHODS This was a pre-post designed study involving 21 moderate-severe corneal ulcer patients who got autologous PRP eye drop. Subjects were got autologous PRP eye drop as adjuvant therapy. Patients with moderate-to-severe infectious bacterial corneal ulcers were included in this study. Tear sampling was performed before therapy using sterile Schirmer paper from conjunctival inferior fornix. PRP therapy was performed for 7 days. Data recording and tear sampling were then performed at day 0 (pre-PRP), day 7 (D+7), and day 14 (D+14) after PRP therapy. Data recording included presence of pericorneal injection, blepharospasm, size of corneal defects, and hypopyon. RESULTS There was a decrease in IL-6 tear concentration by day 14 after PRP therapy (P < 0.001). IL-6 concentration at day 7 after therapy (7525.67 ± 7092 pg/mL) tended to be lower before therapy (10,599 ± 6158 pg/mL), but not statistically significant (P = 0.156). The size of corneal defects decreased significantly post PRP at day 7 (P = 0.035) and at day 14 (P = 0.001). There was a significant blepharospasm at day 7 (P = 0.012) and day 14 (P < 0.001). There was a significant pericorneal injection only at day 14 (P = 0.002). There was no significant decreased hypopyon. CONCLUSION There was a significant reduction in IL-6 tear concentration and clinical improvement in moderate-to-severe bacterial corneal ulcers which got autologous PRP eye drop as adjuvant therapy.
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Affiliation(s)
- Prili Olda Fitriana
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Suhardjo Pawiroranu
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Tri Wahyu Widayanti
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Yohanes Widodo Wirohadidjojo
- Department of Dermato and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Indra Tri Mahayana
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia,Address for correspondence: Dr. Indra Tri Mahayana, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Jl. Farmako, Sekip Utara, Yogyakarta, 55284, Indonesia. E-mail: ;
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Peláez P, Damiá E, Torres-Torrillas M, Chicharro D, Cuervo B, Miguel L, del Romero A, Carrillo JM, Sopena JJ, Rubio M. Cell and Cell Free Therapies in Osteoarthritis. Biomedicines 2021; 9:1726. [PMID: 34829953 PMCID: PMC8615373 DOI: 10.3390/biomedicines9111726] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/18/2022] Open
Abstract
Osteoarthritis (OA) is the most common articular disease in adults and has a current prevalence of 12% in the population over 65 years old. This chronic disease causes damage to articular cartilage and synovial joints, causing pain and leading to a negative impact on patients' function, decreasing quality of life. There are many limitations regarding OA conventional therapies-pharmacological therapy can cause gastrointestinal, renal, and cardiac adverse effects, and some of them could even be a threat to life. On the other hand, surgical options, such as microfracture, have been used for the last 20 years, but hyaline cartilage has a limited regeneration capacity. In recent years, the interest in new therapies, such as cell-based and cell-free therapies, has been considerably increasing. The purpose of this review is to describe and compare bioregenerative therapies' efficacy for OA, with particular emphasis on the use of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP). In OA, these therapies might be an alternative and less invasive treatment than surgery, and a more effective option than conventional therapies.
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Affiliation(s)
- Pau Peláez
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Elena Damiá
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Marta Torres-Torrillas
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Deborah Chicharro
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Belén Cuervo
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Laura Miguel
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Ayla del Romero
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Jose Maria Carrillo
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Joaquín J. Sopena
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Mónica Rubio
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (P.P.); (M.T.-T.); (D.C.); (B.C.); (L.M.); (A.d.R.); (J.M.C.); (J.J.S.); (M.R.)
- Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
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Attili AR, Iacoucci C, Serri E, Cuteri V, Cantalamessa A, Linardi M, Rifici C, Mazzullo G, Rossi G, Galosi L, Tambella AM. Antibacterial Properties of Canine Platelet-Rich Plasma and Other Non-Transfusional Hemo-Components: An in vitro Study. Front Vet Sci 2021; 8:746809. [PMID: 34671662 PMCID: PMC8520915 DOI: 10.3389/fvets.2021.746809] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/26/2021] [Indexed: 01/13/2023] Open
Abstract
This in vitro study was carried out to evaluate the potential antibacterial properties of canine non-transfusional hemo-components. Therapeutic formulations commonly used for regenerative medicine purposes (platelet-rich plasma, platelet gel, platelet lysate, fibrin glue), considering both leukocyte-rich and leukocyte-poor formulations, but also platelet-poor plasma and activating substances (thrombin, calcium gluconate), were tested to detect elements with potential antimicrobial properties. The antibacterial effect was tested on different bacterial strains (Staphylococcus aureus subspecies aureus, Staphylococcus cohnii subspecies cohnii, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae subspecies pneumoniae) isolated from canine wounds and classified as susceptible, multidrug-, extensively, and pandrug-resistant bacteria toward a known panel of human and veterinary antibiotics. The evaluation was carried out by agar gel diffusion method (Kirby-Bauer) and micro-inhibition in broth using microplates and spectrophotometer reading. The study findings confirmed the hypothesized antibacterial properties of canine non-transfusional hemo-components. A more effective bacteriostatic effect was found against Gram-negative bacteria, drug-resistant too. The presence of leukocytes or platelets does not appear to be essential for the antibacterial effect. Further studies should be conducted to evaluate the exact mechanism of action of the antimicrobial activity. However, non-transfusional hemo-components could be a useful natural aid in controlling bacterial infections in dogs.
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Affiliation(s)
- Anna-Rita Attili
- Laboratory of Medical Microbiology and Infectious Diseases, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Cristina Iacoucci
- Laboratory of Medical Microbiology and Infectious Diseases, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Evelina Serri
- Veterinary Teaching Hospital, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Vincenzo Cuteri
- Laboratory of Medical Microbiology and Infectious Diseases, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Andrea Cantalamessa
- Laboratory of Medical Microbiology and Infectious Diseases, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Martina Linardi
- Laboratory of Medical Microbiology and Infectious Diseases, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Claudia Rifici
- Pathology Laboratory, Department of Veterinary Sciences, University of Messina, Messina, Italy
| | - Giuseppe Mazzullo
- Pathology Laboratory, Department of Veterinary Sciences, University of Messina, Messina, Italy
| | - Giacomo Rossi
- Pathology Laboratory, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Livio Galosi
- Pathology Laboratory, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Adolfo Maria Tambella
- Veterinary Teaching Hospital, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
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Abdelghany AA, Bahrawy ME, Alio JL. Combined Platelet Rich Plasma and Amniotic membrane in the treatment of Perforated Corneal Ulcers. Eur J Ophthalmol 2021; 32:2148-2152. [PMID: 34623187 DOI: 10.1177/11206721211049100] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE To report the outcomes of using synthetic amniotic membrane with platelet rich plasma for the primary management of corneal perforations. SETTING Ophthalmology department. Faculty of Medicine, Minia University, Minia, Egypt. METHODS A case series of 10 patients diagnosed with corneal perforation underwent emergency surgical procedure for repair of the perforation through the implantation of synthetic amniotic membrane with platelet-rich plasma clot under it and the application of platelet-rich plasma eye drops, with a follow up period of up to 4 weeks. RESULTS All cases demonstrated formation of adequate intraocular pressure digitally, within the first 7 days, and all cases showed complete sealing of the corneal perforation within the 4 weeks follow up period, mild symptoms were reported only in the 1st postoperative week like foreign body sensation and lacrimation. 3 of the treated patients underwent penetrating keratoplasty after 6 months with satisfactory visual outcomes. CONCLUSION The combination of amniotic membrane implant and platelet rich plasma in both the clot and eye drop forms is an effective and easy accessible method for the primary management of corneal perforations.
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Affiliation(s)
- Ahmed A Abdelghany
- Ophthalmology department, 68877Faculty of Medicine, Minia University, Minia, Egypt
| | | | - Jorge L Alio
- VISSUM innovation of Ophthalmology, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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Sánchez-González JM, Alonso-Aliste F, Borroni D, Amián-Cordero J, De-Hita-Cantalejo C, Capote-Puente R, Bautista-Llamas MJ, Sánchez-González MC, Rodríguez-Calvo-de-Mora M, Rocha-de-Lossada C. Plasma Rich in Growth Factors (PRGF) in Transepithelial Photorefractive Keratectomy (TPRK). J Clin Med 2021; 10:jcm10091939. [PMID: 33946455 PMCID: PMC8124326 DOI: 10.3390/jcm10091939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/13/2023] Open
Abstract
To evaluate the usage of plasma rich in growth factor (PRGF) in transepithelial photorefractive keratectomy (TPRK) in low and moderate myopia, patients who underwent myopic and astigmatism TPRK with PRGF were involved in this retrospective, observational study. Subjects underwent a surgical procedure between February 2019 and June 2019. A three-month follow-up was recorded. Pain score was assessed with a visual analogue scale (0–10) and re-epithelialization time recorded. A total of 48 eyes from 24 patients were recruited. Mean uncorrected distance visual acuity (UDVA) was 20/20.31 (0.00 ± 0.02 LogMAR). A total of 98% of eyes did not change corrected distance visual acuity (CDVA) lines. Two percent of eyes lost one line of CDVA. Preoperative spherical equivalent was −2.67 ± 1.37 D and after three months changed to −0.21 ± 0.34 D, and 2% of eyes changed 0.50 D or more between one and three months. Pain score was 3.29 ± 0.61 (3 to 6) score points at day one and 0.08 ± 0.27 score points at day seven. Finally, re-epithelialization time was 2.50 ± 1.20 days. PRGF addition to conventional refractive treatment such as TPRK seems to alleviate immediate postoperative pain and positively contribute to corneal re-epithelization time.
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Affiliation(s)
- José-María Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
- Department of Ophthalmology, Tecnolaser Clinic Vision, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
- Correspondence:
| | - Federico Alonso-Aliste
- Department of Ophthalmology, Tecnolaser Clinic Vision, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - Davide Borroni
- The Veneto Eye Bank Foundation, 30174 Venice, Italy;
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia
| | - Jonatan Amián-Cordero
- Department of Ophthalmology, Tecnolaser Clinic Vision, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - Concepción De-Hita-Cantalejo
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | - Raúl Capote-Puente
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | - María-José Bautista-Llamas
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | - María Carmen Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | | | - Carlos Rocha-de-Lossada
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120 Almería, Spain;
- Department of Ophthalmology, University Hospital Virgen de las Nieves, 18014 Granada, Spain
- Department of Ophthalmology, Ceuta Medical Center, 51001 Ceuta, Spain
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Farghali HA, AbdElKader NA, AbuBakr HO, Ramadan ES, Khattab MS, Salem NY, Emam IA. Corneal Ulcer in Dogs and Cats: Novel Clinical Application of Regenerative Therapy Using Subconjunctival Injection of Autologous Platelet-Rich Plasma. Front Vet Sci 2021; 8:641265. [PMID: 33816586 PMCID: PMC8012907 DOI: 10.3389/fvets.2021.641265] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/28/2021] [Indexed: 02/03/2023] Open
Abstract
Background: Corneal ulcer could be a major source of distress in small animals, with many contributing agents. In recent years, few studies evaluated the efficacy of platelet-rich plasma (PRP) in healing corneal ulcers. Aim: This study aimed to assess the ability of subconjunctival injection of autologous PRP in the treatment of corneal ulcers in dogs and cats as well as estimate the expression of matrix metalloproteinase (MMP)-2, MMP-9, and oxidative stress biomarkers in these patients. Methods: A total number of 28 animals (16 cats and 12 dogs) were enrolled in this study. Each animal was subjected to clinical, neurologic, and ophthalmic examinations where the type of ulcer was documented. Tear samples were collected for evaluation of oxidative biomarkers and MMPs; conjunctival swabs were taken to identify the involved organism. PRP was prepared from each animal and given as subconjunctival injection; numbers of injections were done according to case response. Clinical follow-up was done and documented for each case. Results: In cat patients, female and Persian cats were most affected; unilateral and superficial ulcers were most recorded. In male dogs, unilateral, and superficial ulcers were most recorded. FHV-1 was most identified in cats, while Staphylococcus aureus was most identified in dogs. Numbers of injections needed to achieve healing were recorded, with 50% of dogs needing two injections with 1-week intervals and 50% of cats needed three injections with 1-week intervals. Alterations in both oxidative biomarkers and MMPs were recorded in affected animals. Conclusion: The use of autologous PRP as a subconjunctival injection in treating corneal ulcers in dogs and cats is effective. The number of injections is the case and corneal ulcer type-dependent. Clinical Significance: Autologous PRP as a subconjunctival injection in treating corneal ulcer is a relatively cheap, safe method and can be done in the clinical setting.
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Affiliation(s)
- Haithem A Farghali
- Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Naglaa A AbdElKader
- Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Huda O AbuBakr
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Eman S Ramadan
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Marwa S Khattab
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Noha Y Salem
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Ibrahim A Emam
- Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
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11
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Gumus K. On the Horizon: Biologics and Nutrients for Neurotrophic Keratitis. Eye Contact Lens 2021; 47:154-156. [PMID: 33156130 DOI: 10.1097/icl.0000000000000757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
ABSTRACT Neurotrophic keratitis (NK), a potentially sight-threatening corneal disease, still does not have a specific treatment. The reduction or complete loss of corneal sensation, the most important factor in its pathogenesis, is one of the most important factors that complicate the treatment of corneal wound healing. In addition, the visual outcome may be adversely affected because of aggressive stromal fibrosis in severe NK cases. Basically, the current management of NK aims to accelerate wound healing and prevent the progression. However, new therapeutic agents, particularly developed depending on cell type-specific healing mechanisms are required for better visual outcomes. In recent years, several studies have started to use new promising areas of translational research, including gene therapy, stem cell therapy, miRNA, and bioengineering. Evidence has emerged that future treatment strategies for NK will be designed by the results of these studies. In this review, it is aimed to summarize scientific data of new treatment modalities for NK.
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Affiliation(s)
- Koray Gumus
- Ophthalmology, Memorial Ankara Hospital, Eye Clinic, Ankara, Turkey
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12
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Comparison of Two Preparation Methods for Platelet-Rich Plasma Eye Drops for Release of Growth Factors and De-Epithelization Rabbit Model. J Ophthalmol 2020; 2020:6634744. [PMID: 35873527 PMCID: PMC9301758 DOI: 10.1155/2020/6634744] [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: 10/07/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To compare two platelet-rich plasma (PRP) preparation methods (double spin (D-PRP) and TriCell PRP (T-PRP)) for eye drops, concentration yields of platelets and other cells, release of growth factors, and efficacy of the de-epithelization rabbit model. Methods PRP was extracted by D-PRP and T-PRP from 30 ml blood from healthy adults. After extraction, platelets and leukocytes were counted. D-PRP and T-PRP were preserved during A: 1 h storage at room temperature, B: 1 h storage at −20°C, C: 24 h storage at 4°C, and D: 24 h storage at −20°C. Platelet-derived growth factor (PDGF) was measured. Freezing/thawing PRP eye drops and control were instilled in the de-epithelization rabbit model four times per day for 5 days. Histology was compared between eyes treated with control, D-PRP, and T-PRP. Results 14 ml of D-PRP and 4 ml of T-PRP were extracted from 30 ml whole blood samples. D-PRP and T-PRP had 41.36 ± 8.43 × 104 and 67.02 ± 13.55 × 104 platelets and 0.41 ± 0.24 × 103/ml and 10.09 ± 4.29 × 103/ml leucocytes, respectively. In the four storage methods, PDGF concentrations in T-PRP were higher than those in D-PRP eye drops. Freezing/thawing D-PRP and T-PRP increased PDGF concentrations. Histology showed corneal epithelium thickness in T-PRP-treated eyes after healing (38.41 ± 9.10 μm) was significantly higher than that in control-treated (27.77 ± 4.76 μm) and D-PRP-treated eyes (18.32 ± 3.14 μm) (P < 0.05). There was no corneal damage with inflammation in corneal stroma and epithelium of all tested groups. Electron microscopy revealed strong adhesion between cell junctions in T-PRP-treated eyes. Conclusions Freezing/thawing of PRP extracted with the T-PRP kit may result in high platelet and leukocyte concentration and produce high PDGF concentration. PRP eye drops including leucocytes could increase thickness of corneal epithelium without corneal inflammation.
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13
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You J, Hodge C, Hoque M, Petsoglou C, Sutton G. Human Platelets and Derived Products in Treating Ocular Surface Diseases - A Systematic Review. Clin Ophthalmol 2020; 14:3195-3210. [PMID: 33116370 PMCID: PMC7567560 DOI: 10.2147/opth.s265701] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/26/2020] [Indexed: 12/26/2022] Open
Abstract
Human platelet products have emerged as an alternative treatment for a range of ocular surface diseases such as dry eye and corneal ulceration. With significant therapeutic potential and increasing popularity, this study aimed to conduct a systematic review to detail the various production methods involved in generating platelet-derived products, compare and analyze clinical findings across available studies, and disseminate the relative advantages, limitations, and challenges of using platelet products to treat ocular surface disease. Thirty-eight clinical studies were identified, excluding studies conducted in animals and non-English language. Studies reported clinical outcomes, which included ocular surface disease index, best-corrected visual acuity, and corneal fluorescein staining. Most clinical studies reported improved patient signs and symptoms with an increasing variety of human platelet products including platelet rich plasma eye drops, human platelet lysate and platelet gels. However, due to variations in production methods, and study designs as well as confusing terminology, it was suggested that characterization of platelet products is needed for proper evaluation across studies.
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Affiliation(s)
- Jingjing You
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Chris Hodge
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Vision Eye Institute, Chatswood, Sydney, NSW, Australia.,NSW Tissue Bank, Sydney, NSW, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Constantinos Petsoglou
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,NSW Tissue Bank, Sydney, NSW, Australia
| | - Gerard Sutton
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Vision Eye Institute, Chatswood, Sydney, NSW, Australia.,NSW Tissue Bank, Sydney, NSW, Australia
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14
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Mastropasqua L, Lanzini M, Dua HS, D' Uffizi A, Di Nicola M, Calienno R, Bondì J, Said DG, Nubile M. In Vivo Evaluation of Corneal Nerves and Epithelial Healing After Treatment With Recombinant Nerve Growth Factor for Neurotrophic Keratopathy. Am J Ophthalmol 2020; 217:278-286. [PMID: 32387431 DOI: 10.1016/j.ajo.2020.04.036] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the renewal of corneal nerve structure and function in patients with neurotrophic keratopathy (NK) treated with recombinant human nerve growth factor (rhNGF) eye drops. DESIGN Prospective, interventional, before-and-after case series. METHODS This study included 18 patients with NK with a persistent epithelial defect or corneal ulcer, treated with topical rhNGF, and age-matched healthy controls. Patients underwent clinical examination with corneal fluorescein staining, Schirmer 1 tear test, assessment of corneal sensitivity with the Cochet-Bonnet esthesiometer, and morphologic examination of the nerves by in vivo confocal microscopy (IVCM) at baseline and at 4 and 8 weeks of treatment. IVCM analysis was used to assess corneal sub-basal nerve density, number of nerve branches, and the diameter of nerve fibers. RESULTS A complete resolution of the epithelial defect was observed in all patients within 8 weeks. Schirmer 1 test showed a significant improvement of tear film secretion. Change from baseline in corneal sensation was significant (P < .001) but did not approach that of healthy controls. After 8 weeks of treatment, there was a significant increase in the mean nerve density in affected eyes as compared to baseline (P = .007) as well as in the number of nerve branches (P = .008) and nerve fiber diameter (P = .007). CONCLUSIONS Topical treatment with rhNGF was effective in promoting complete corneal healing of persistent epithelial defects and corneal ulcers in patients with NK. This was associated with an improvement of corneal sensitivity and an increase of sub-basal nerve density, diameter, and number of nerve branches, indicating improvement in structure and function of corneal nerves.
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Affiliation(s)
| | - Manuela Lanzini
- Ophthalmic Clinic, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.
| | | | | | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Roberta Calienno
- Ophthalmic Clinic, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Jessica Bondì
- Ophthalmic Clinic, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Dalia G Said
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Mario Nubile
- Ophthalmic Clinic, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
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15
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Perego R, Spada E, Baggiani L, Martino PA, Proverbio D. Efficacy of a Semi Automated Commercial Closed System for Autologous Leukocyte- and Platelet-Rich Plasma (l-prp) Production in Dogs: A Preliminary Study. Animals (Basel) 2020; 10:ani10081342. [PMID: 32759643 PMCID: PMC7459512 DOI: 10.3390/ani10081342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To characterize the cellular composition (platelets, erythrocytes, and leukocytes) and determine platelet-derived growth factor isoform BB (PDGF-BB) concentration in canine leukocyte- and platelet rich plasma (L-PRP) produced using a commercial semi-automated closed system. METHODS Twenty milliliters of citrated whole blood were obtained from 30 healthy un-sedated canine blood donors and processed using a semi-automated completely closed commercial system (CPUNT 20, Eltek group, Casale Monferrato, Alessandria, Italy) according to the manufacturer's instructions. Erythrocyte, leukocyte, and platelet counts were determined in both whole blood (WB) and resultant L-PRP. The PDGF-BB concentration was evaluated after bovine thrombin activation of 10 L-PRP samples. RESULTS This commercial system produced on average 2.3 ± 0.7 mL of L-PRP containing a high concentration of platelets (767,633 ± 291,001 μL, p < 0.001), with a 4.4 fold increase in platelet count, lower concentration of erythrocytes (528,600 ± 222,773 μL, p < 0.001) and similar concentration of leukocytes (8422 ± 6346 μL, p = 0.9918) compared with WB. L-PRP had an average of 3442 ± 2061 pg/mL of PDGF-BB after thrombin activation. Neutrophils, lymphocytes and monocytes average percent content in L-PRP was 14.8 ± 13.2, 71.7 ± 18.5 and 10.7 ± 6.4, respectively. CONCLUSION Sterile canine L-PRP prepared using this semi-automated closed system is easy to obtain, produces a significant increase in platelet count compared to WB and contains a detectable concentration of PDGF-BB after activation. Additional in vitro and in vivo studies are needed to assess inflammatory markers concentration and the therapeutic efficacy of this L-PRP in dogs.
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Affiliation(s)
- Roberta Perego
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine (DIMEVET), University of Milan, via dell’Università 6, 26900 Lodi, Italy; (L.B.); (D.P.)
- Correspondence: (R.P.); (E.S.); Tel.: +39-0250334521 (R.P.); +39-0250334520 (E.S.)
| | - Eva Spada
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine (DIMEVET), University of Milan, via dell’Università 6, 26900 Lodi, Italy; (L.B.); (D.P.)
- Correspondence: (R.P.); (E.S.); Tel.: +39-0250334521 (R.P.); +39-0250334520 (E.S.)
| | - Luciana Baggiani
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine (DIMEVET), University of Milan, via dell’Università 6, 26900 Lodi, Italy; (L.B.); (D.P.)
| | - Piera Anna Martino
- Department of Veterinary Medicine (DIMEVET), University of Milan, via dell’Università 6, 26900 Lodi, Italy;
| | - Daniela Proverbio
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine (DIMEVET), University of Milan, via dell’Università 6, 26900 Lodi, Italy; (L.B.); (D.P.)
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16
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Daradka M, Alardah MM, Ismail ZB. Effects of autologous platelet-rich plasma coated sutures on intestinal anastomotic healing in rabbits. Heliyon 2019; 5:e02713. [PMID: 31840125 PMCID: PMC6893086 DOI: 10.1016/j.heliyon.2019.e02713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/22/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022] Open
Abstract
The objective of this study was to investigate the intestinal anastomotic healing enhancing effect of platelets-rich plasma (PRP) using PRP-coated sutures in a rabbit model. A total of 30 mature male rabbits were divided into 3 groups (10 rabbits per group). Group 1 received uncoated sutures, group 2 received sodium acetate-coated sutures, and group 3 received PRP-coated sutures. Polyglactin 910 (Vicryl, USA), size 4-0 was used in all groups. Five rabbits of each group were euthanized on day 3 following the surgery while the remaining 5 rabbits were euthanized on day 10. Gross evaluation of the anastomotic site in PRP-coated sutures group demonstrated significantly (P < 0.05) lower adhesion formation scores on both days 3 and 10 of the study while in the control groups, evidence of leakage at the anastomotic site was present along with signs of haemorrhage and local inflammation. On day 10 in the control groups, there were strands of strong adhesions between the ileum, colon and cecum with large amount of fibrin deposited at the site of the anastomosis. Tissues of the anastomotic site revealed a significant level of hydroxyproline on day 10 in PRP-coated sutures group compared with control groups. Histopathological evaluation revealed significantly (P < 0.05) less inflammatory infiltration, and more angiogenesis and collagen deposition on day 10 in PRP-coated sutures group compared to the control groups. Results of this study clearly indicate promising healing enhancing effects of using PRP-coated sutures at intestinal anastomotic site with little to no obvious disadvantages.
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Affiliation(s)
- Mousa Daradka
- Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Mira M Alardah
- Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Zuhair Bani Ismail
- Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
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17
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Di Zazzo A, Coassin M, Varacalli G, Galvagno E, De Vincentis A, Bonini S. Neurotrophic keratopathy: Pros and cons of current treatments. Ocul Surf 2019; 17:619-623. [DOI: 10.1016/j.jtos.2019.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/08/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022]
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18
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Bernabei F, Roda M, Buzzi M, Pellegrini M, Giannaccare G, Versura P. Blood-Based Treatments for Severe Dry Eye Disease: The Need of a Consensus. J Clin Med 2019; 8:E1478. [PMID: 31533289 PMCID: PMC6780616 DOI: 10.3390/jcm8091478] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 01/08/2023] Open
Abstract
The use of blood-based eye drops as therapy for various diseases of the ocular surface has become increasingly popular in ophthalmic practice during recent years. The rationale for their use is based on the promotion of cellular proliferation and migration thanks to the supply of metabolically active substances, in particular growth factors. Blood-derived eye drops have been used for the treatment of several ocular surface disorders, such as dry eye disease, corneal ulcer, persistent epithelial defect, neurotrophic keratitis, ocular surface burn, recurrent corneal erosion, and limbal stem-cell deficiency. Both autologous (from patients themselves) and heterologous (from adult donors or from cord blood sampled at birth)-derived products exist, and each source has specific pros and cons. Despite an extensive literature, several issues are still under debate and the aim of this manuscript is to review the indications, preparation methods and storage, characterization of content, rationale for clinical outcomes, patient stratification, length of treatment, and rationale for repeated treatments at disease relapse. A rationale based on a "5 Ws and 2 Hs" protocol is proposed as a way of thinking, with the attempt to clarify Who, Why, When, Where, What, and How to use these treatment options.
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Affiliation(s)
- Federico Bernabei
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, S.Orsola-Malpighi Teaching Hospital, 40138 Bologna, Italy.
| | - Matilde Roda
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, S.Orsola-Malpighi Teaching Hospital, 40138 Bologna, Italy.
| | - Marina Buzzi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, 40138 Bologna, Italy.
| | - Marco Pellegrini
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, S.Orsola-Malpighi Teaching Hospital, 40138 Bologna, Italy.
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
| | - Piera Versura
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, S.Orsola-Malpighi Teaching Hospital, 40138 Bologna, Italy.
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19
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Ding H, Fu XL, Miao WW, Mao XC, Zhan MQ, Chen HL. Efficacy of Autologous Platelet-Rich Gel for Diabetic Foot Wound Healing: A Meta-Analysis of 15 Randomized Controlled Trials. Adv Wound Care (New Rochelle) 2019; 8:195-207. [PMID: 31737414 DOI: 10.1089/wound.2018.0861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 12/06/2018] [Indexed: 01/02/2023] Open
Abstract
Objectives: The meta-analysis was performed to summarize the available evidence and determine the healing effectiveness of autologous platelet-rich gel (APG) on diabetic foot (DF) wounds. Approach: PubMed and The Cochrane Library and CNKI databases were searched to identify prior randomized controlled trials. Methodological qualities of included studies were assessed using Cochrane Handbook for Systematic Reviews of Intervention. Healing rate was considered the primary outcome; the secondary outcomes included healing time and adverse events. Results: Fifteen studies involving a total of 827 subjects were analyzed in the meta-analysis. Considering the primary outcome, the average healing rate in APG group was 85.8% and ranged from 68.4% to 100%. Relatively, the control group was 57.4% and ranged from 18.2% to 75.0%. Eligible studies were compared with a fixed effects model (I 2 = 0.0%, p = 0.496), indicating a higher healing rate with APG (risk ratio [RR] 1.44, 95% confidence interval [CI]: 1.32-1.57, z = 8.50, p < 0.001). The leave-one-out sensitivity analysis is robust. Considering the secondary outcomes, APG therapy needed less time (weighted mean difference -10.75 days, 95% CI: -11.67 to 8.86 days, z = 14.34, p < 0.001) and had fewer adverse events (RR 0.44, 95% CI: 0.25-0.76, z = 2.94, p = 0.003). Innovation: APG therapy is an innovative and effective approach to promote DF wound healing and reduce healing time and adverse events. Conclusion: The meta-analysis demonstrates that APG therapy has a positive effect on the treatment of DF wounds. However, additional well-designed and high-quality studies are needed to reach a conclusion with more confidence.
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Affiliation(s)
- Hui Ding
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Xue-Lei Fu
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Wei-Wei Miao
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Xing-Chun Mao
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Min-Qi Zhan
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
| | - Hong-Lin Chen
- School of Nursing, Nantong University, Nantong, Jiangsu, PR China
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