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Cetin C, Okten SB, Tok OE, Ozcan P, Karasu AFG, Tanoglu FB, Taha HS, Ates S. Treatment of ovarian damage induced by chemotherapeutic drugs in female rats with G-CSF and platelet-rich plasma(PRP): an immunohistochemical study correlation with novel marker INSL-3. Gynecol Endocrinol 2024; 40:2301551. [PMID: 38195404 DOI: 10.1080/09513590.2023.2301551] [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: 08/23/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE To assess the impacts of Platelet-Rich Plasma(PRP) and Granulocyte Colony-Stimulating Factor(G-CSF) on a rat model with induced ovarian follicular damage caused by cyclophosphamide(Cy). MATERIALS AND METHODS Forty-two Sprague-Dawley rats were randomly allocated into seven distinct groups as; Group 1(control): NaCl intraperitoneal (IP) injection was administered on days D1, D7, and D14. Group 2(Cy):Cy IP injection on D1 + NaCl IP injection on D7 and D14 were administered. Group 3(PRP): PRP IP injection on D1,D7 and D14 were administered. Group 4(Cy + PRP):Cy IP injection on D1 and PRP IP injection on D1, D7 and D14 were administered. Group 5(G-CSF): G-CSF IP injection on D1, D7 and D14 were administered. Group 6(Cy + G-CSF):Cy IP injection on D1+ G-CSF IP injection on D1, D7 and D14 were administered. Group 7(Cy + PRP + G-CSF):Cy IP injection on D1+ PRP IP injection on D1,D7 and D14+ G-CSF IP injection on D1,D7 and D14 were administered. Follicular number, histological scores of AMH and INSL3 stained follicles at different stages of follicular development, and serum Anti-Müllerian hormone(AMH) were evaluated. RESULTS The primary, secondary, and antral follicle intensity scores for AMH-positive staining were most prominent in Groups 3 and 5. There was no significant difference between groups 4, 6 and 7 compared to group 1 in terms of follicule counts and AMH staining. The intensity scores of AMH-positive staining follicles were notably reduced in group 2 compared to groups 4, 6, and 7, with a significant difference (p < .01). Among the groups, group 2 exhibited the least intense antral follicle staining for INSL3, displaying a significant difference(p < .01) compared to the remaining groups. CONCLUSIONS Autologous PRP and G-CSF might protect ovarian function in the face of ovarian damage caused by Cy-induced effects.
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Affiliation(s)
- Caglar Cetin
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey
| | - Sabri Berkem Okten
- Acıbadem Health Group, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Olgu Enis Tok
- Deparment of Histology and Embryology, Istanbul Medipol University, Istanbul, Turkey
| | - Pınar Ozcan
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Fatma Basak Tanoglu
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey
| | - Havva Sevde Taha
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey
| | - Seda Ates
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey
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Maged AM, Mohsen RA, Salah N, Ragab WS. The value of intraovarian autologous platelet rich plasma in women with poor ovarian reserve or ovarian insufficiency: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2024; 24:85. [PMID: 38280991 PMCID: PMC10821562 DOI: 10.1186/s12884-024-06251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/03/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVES To assess the value of intraovarian PRP in women with low ovarian reserve. SEARCH STRATEGY Screening of databases from inception to January 2023 using the keywords related to "Platelet-rich plasma" AND "poor ovarian reserve" OR "ovarian failure". SELECTION CRITERIA Fourteen studies (1632 participants) were included, 10 included women with POR, 1 included women with POI and 3 included both POR and POI women. DATA COLLECTION AND ANALYSIS Extracted data included study settings, design, sample size, population characteristics, volume, timing and preparation of PRP administration, and outcome parameters. MAIN RESULTS AMH level was evaluated in 11 studies (2099 women). The mean difference (MD) was 0.09 with 95% CI of - 0.06, 0.24 (P = 0.25). Antral follicular count level was assessed in 6 studies (1399 women). The MD was 1.73 with 95% CI of 0.81, 2.66 (P < 0.001). The number of oocytes retrieved was evaluated in 7 studies (1413 women). The MD was 1.21 with 95% CI of 0.48, 1.94 (P = 0.001). CONCLUSION This systematic review found a significant improvement of AFC, the number of retrieved oocytes, the number of cleavage embryos and the cancellation rate in women with POR. TRIAL REGISTRATION Registration number CRD42022365682.
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Affiliation(s)
- Ahmed M Maged
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
| | - Reham A Mohsen
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Noha Salah
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Wael S Ragab
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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3
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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] [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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Sills ES, Wood SH. Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives. MEDICINES (BASEL, SWITZERLAND) 2023; 10:40. [PMID: 37505061 PMCID: PMC10384573 DOI: 10.3390/medicines10070040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/15/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023]
Abstract
Platelet-rich plasma (PRP) is an 'orthobiologic' with recognized roles in plastic surgery, musculoskeletal disorders, dentistry, dermatology, and more recently, 'ovarian rejuvenation'. Intraovarian PRP involves a complex secretome discharged after platelet activation, comprising multiple cytokine mediators delivered surgically to older or inactive ovarian tissue. Loss of oocyte meiotic fidelity and impaired fertilization accompanying advanced maternal age are already managed by IVF, but only with eggs provided by younger donors. However, if the observed effect of rectifying embryo ploidy error can be proven beyond case reports and small series, activated PRP (or its condensed plasma cytokines) would deliver a welcome therapeutic disruption that is difficult to overstate. Because shortcomings in ovarian function are presently addressed mainly by pharmacological approaches (i.e., via recombinant gonadotropins, GnRH analogs, or luteal support), autologous PRP would represent an unusual departure from these interventions. Given the diversity of platelet cargo proteins, the target response of intraovarian PRP is probably not confined to oocytes or follicles. For example, PRP manipulates signal networks driving improved perfusion, HOX regulation, N-glycan post-translational modification, adjustment of voltage-gated ion channels, telomere stabilization, optimization of SIRT3, and ribosome and mitochondria recovery in older oocytes. While multichannel signals operating on various pathways are not unique to reproductive biology, in intraovarian PRP this feature has received little study and may help explain why its standardization has been difficult. Against this background, our report examines the research themes considered most likely to shape clinical practice.
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Affiliation(s)
- E Scott Sills
- Regenerative Biology Group, FertiGen CAG, San Clemente, CA 92673, USA
- Department of Obstetrics & Gynecology, Palomar Medical Center, Escondido, CA 92029, USA
| | - Samuel H Wood
- Department of Obstetrics & Gynecology, Palomar Medical Center, Escondido, CA 92029, USA
- Gen 5 Fertility Center, San Diego, CA 92121, USA
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5
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Saba AI, Elbakary RH, Afifi OK, Sharaf Eldin HEM. Effects of Platelet-Rich Plasma on the Oxymetholone-Induced Testicular Toxicity. Diseases 2023; 11:84. [PMID: 37366872 DOI: 10.3390/diseases11020084] [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: 05/04/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
Oxymetholone is one of the anabolic steroids that has widely been used among teenagers and athletes to increase their muscle bulk. It has undesirable effects on male health and fertility. In this study, the therapeutic effects of platelet-rich plasma (PRP) on oxymetholone-induced testicular toxicity were investigated in adult albino rats. During the experiments, 49 adult male albino rats were divided into 4 main groups: Group 0 (donor group) included 10 rats for the donation of PRP, Group I (control group) included 15 rats, Group II included 8 rats that received 10 mg/kg of oxymetholone orally, once daily, for 30 days, and Group III included 16 rats and was subdivided into 2 subgroups (IIIa and IIIb) that received oxymetholone the same as group II and then received PRP once and twice, respectively. Testicular tissues of all examined rats were obtained for processing and histological examination and sperm smears were stained and examined for sperm morphology. Oxymetholone-treated rats revealed wide spaces in between the tubules, vacuolated cytoplasm, and dark pyknotic nuclei of most cells, as well as deposition of homogenous acidophilic material between the tubules. Electron microscopic examination showed vacuolated cytoplasm of most cells, swollen mitochondria, and perinuclear dilatation. Concerning subgroup IIIa (PRP once), there was a partial improvement in the form of decreased vacuolations and regeneration of spermatogenic cells, as well as a reasonable improvement in sperm morphology. Regarding subgroup IIIb (PRP twice), histological sections revealed restoration of the normal testicular structure to a great extent, regeneration of the spermatogenic cells, and most sperms had normal morphology. Thus, it is recommended to use PRP to minimize structural changes in the testis of adult albino rats caused by oxymetholone.
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Affiliation(s)
- Amal I Saba
- Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Reda H Elbakary
- Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Omayma K Afifi
- Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Heba E M Sharaf Eldin
- Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
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Pellicer N, Cozzolino M, Diaz-García C, Galliano D, Cobo A, Pellicer A, Herraiz S. Ovarian rescue in women with premature ovarian insufficiency: facts and fiction. Reprod Biomed Online 2023; 46:543-565. [PMID: 36710157 DOI: 10.1016/j.rbmo.2022.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
The ovary has a comparatively short functional lifespan compared with other organs, and genetic and pathological injuries can further shorten its functional life. Thus, preserving ovarian function should be considered in the context of women with threats to ovarian reserve, such as ageing, premature ovarian insufficiency (POI) and diminished ovarian reserve (DOR). Indeed, one-third of women with POI retain resting follicles that can be reactivated to produce competent oocytes, as proved by the in-vitro activation of dormant follicles. This paper discusses mechanisms and clinical data relating to new therapeutic strategies using ovarian fragmentation, stem cells or platelet-rich plasma to regain ovarian function in women of older age (>38 years) or with POI or DOR. Follicle reactivation techniques show promising experimental outcomes and have been successful in some cases, when POI is established or DOR diagnosed; however, there is scarce clinical evidence to warrant their widespread clinical use. Beyond these contexts, also discussed is how new insights into the biological mechanisms governing follicular dynamics and oocyte competence may play a role in reversing ovarian damage, as no technique modifies oocyte quality. Additional studies should focus on increasing follicle number and quality. Finally, there is a small but important subgroup of women lacking residual follicles and requiring oocyte generation from stem cells.
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Affiliation(s)
| | | | - César Diaz-García
- IVI London, EGA Institute for Women's Health, UCL, London, UK; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | | | - Ana Cobo
- IVI RMA Valencia, Valencia, Spain
| | - Antonio Pellicer
- IVI RMA Rome, Rome, Italy; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Sonia Herraiz
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
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Bostanci MS, Budak Ö, Çakiroğlu H, Köse O, Erdoğan M, Yuvaci HU, Çokluk E. The Effectiveness of Granulocyte Colony-Stimulating Factor (G-CSF) Against Experimental Ischemia–Reperfusion Injury in Rat Ovaries and Its Effect on In Vitro Fertilization Outcomes. Reprod Sci 2022; 30:1660-1667. [PMID: 36414821 DOI: 10.1007/s43032-022-01132-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
Local ischemic damage resulting from ovarian torsion is a common cause of decreased follicular activity and infertility. It was aimed to evaluate the effect of granulocyte colony-stimulating factor (G-CSF) protection on in vitro fertilization (IVF) results against experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries. The study consisted of 35 adult female Sprague-Dawley albino rats (sham, ischemia, I/R, I + G-CSF, and I/R + G-CSF) randomly assigned to 5 groups, each containing 7 rats. While bilateral adnexal torsion was applied to the ischemia groups for 3 h, detorsion was applied to the reperfusion groups. Intraperitoneal 100 IU/kg G-CSF was administered 30 min prior to ischemia (I + G-CSF) or reperfusion (I/R + G-CSF). After ovulation induction (intraperitoneal 150-300 IU/kg PMSG), the oocytes were collected and IVF was applied. Statistically significant differences were observed between the collected oocyte numbers in I and I + G-CSF, I/R, and I/R + G-CSF groups (P values were P = 0.001 for the I-I + G-SCF groups and P = 0.003 for I/R-IR + G-CSF, respectively). An increase in the number of MII oocytes obtained was observed in the I + G-CSF and I/R + G-CSF groups compared to the I and I/R groups. Grade 1 and grade 2 embryo numbers were statically different between the I/R and I/R + G-CSF groups (P values were P = 0.023 for grade 1 embryos and P = 0.045 for grade 2 embryos, respectively). G-CSF treatment was found to be effective in reducing I- and I/R-induced ovarian damage.
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Affiliation(s)
- Mehmet Sühha Bostanci
- Department of Obstetrics and Gynecology and Artificial Reproductive Techniques, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
| | - Özcan Budak
- Department of Histology and Embryology and Artificial Reproductive Techniques, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Hüseyin Çakiroğlu
- Medical and Experimental Research Center, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Osman Köse
- Department of Urology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehtap Erdoğan
- Department of Anatomy, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Hilal Uslu Yuvaci
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Erdem Çokluk
- Department of Biochemistry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
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Varghese J, Acharya N. Platelet-Rich Plasma: A Promising Regenerative Therapy in Gynecological Disorders. Cureus 2022; 14:e28998. [PMID: 36249659 PMCID: PMC9549690 DOI: 10.7759/cureus.28998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/10/2022] [Indexed: 11/24/2022] Open
Abstract
Platelet-rich plasma (PRP) could be understood as a special preparation of plasma in which the concentration of platelet is immensely high. This rationale for plasma use has been in the medical science for many years with plenty of success in various fields where it was inculcated, bringing dramatically favorable and better outcomes in terms of disease management and prognosis. PRP has been widely used in orthopedics from the very beginning, but in the past few years its use has been extended to other fields too, such as obstetrics and gynecology. From the very onset of the introduction of platelet-rich plasma in gynecology, there had been constant research being carried out all around the globe in order to scientifically prove and confirm its exact role in the management of gynecological problems. Regenerative medicine in gynecology was among the first areas where the platelet-rich plasma was implemented and has substantially given great results, which encouraged further extensive research to be carried out in other spectrums of gynecology. The implications of such great struggles ultimately gave way to evidence suggesting the importance of platelet-rich plasma in managing gynecological disorders like Asherman’s syndrome, urinary incontinence, genital fistulas, thin endometrium, etc. This review article collectively summarizes the various use of platelet-rich plasma in gynecology.
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Aboutalebi H, Alipour F, Ebrahimzadeh-Bideskan A. The protective effect of co-administration of platelet-rich plasma (PRP) and pentoxifylline (PTX) on cyclophosphamide-induced premature ovarian failure in mature and immature rats. Toxicol Mech Methods 2022; 32:588-596. [PMID: 35379072 DOI: 10.1080/15376516.2022.2057264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cyclophosphamide (CP), as an antineoplastic agent, causes premature ovarian failure (POF) due to ovarian toxicity and subsequent infertility in women. Platelet-rich plasma (PRP) has accumulated significant attention in regenerative medicine. Pentoxifylline (PTX) as a methylxanthine derivative has been shown to have antioxidant and antiapoptotic properties. The aim of this study was to evaluate the protective effect of PRP and PTX on CP-induced POF. Fifty mature and immature female rats were assigned into five groups: control, CP (75 mg/kg, intraperitoneal [ip] on days 1 and 10 to induce POF), CP + PRP (200 μl, ip, half an hour after CP injection on day 1 and 10), CP + PTX (50 mg/kg, orally, half an hour after CP injection daily for 21 day), and CP + PRP + PTX. At the end of experiments on day 21, measurement of body weight, ovarian parameters (ovarian volume, follicular granulosa cell layers diameter, oocyte diameter, and the number of granulosa cells), measurement of ovarian hormone in sera for estradiol (E2), and anti-Mullerian hormone (AMH), as well as biochemical assessment were performed.The results showed that CP significantly reduced the ovarian parameters, E2, AMH, superoxide dismutase (SOD) activity and increased Malondialdehyde (MDA) levels compared to the control group (p < 0.001). Our results also indicated that all histomorphometric parameters and biochemical markers in CP-induced POF, were preserved close to normal by PRP and PTX treatments in both mature and immature rats (p < 0.001). Therefore, it is concluded that the co-administration of PRP and PTX can protect the ovary from CP-induced POF.
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Affiliation(s)
- Hamideh Aboutalebi
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Fatemeh Alipour
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Alireza Ebrahimzadeh-Bideskan
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Bostancı MS, Budak Ö, Çakiroğlu H, Gök K, Köse O, Çokluk E. The effect of protection of platelet-rich plasma against experimental ischemia/reperfusion injury in the rat ovary on in vitro fertilization outcomes. J Obstet Gynaecol Res 2022; 48:1390-1398. [PMID: 35322499 DOI: 10.1111/jog.15232] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/29/2022] [Accepted: 03/12/2022] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Ovarian torsion is a common cause of local ischemic damage, reduced follicular activity and infertility. This study aimed to investigate how well platelet-rich plasma (PRP) protects against experimental ischemic (I) and ischemia-reperfusion (I/R) injury in rat ovaries and its effect on in vitro fertilization (IVF) outcomes. METHOD Fifty-six adult female Sprague-Dawley albino rats were randomly assigned to six groups of eight animals each: Sham, Ischemia, I/R, Sham + PRP, I + PRP, and I/R + PRP. The remaining eight animals were used to prepare the PRP. The ischemia groups were subjected to bilateral adnexal torsion for 3 h, while the I/R and I/R + PRP groups received subsequent detorsion for 3 h. Intraperitoneal (i.p.) PRP was administered 30 min prior to ischemia (I + PRP) or reperfusion (I/R + PRP). The ovaries were stimulated through an intraperitoneal injection of 150-300 internal units of IU/kg PMSG. After ovulation induction, oocytes were taken from the ovaries, and IVF was performed. RESULTS The number of MII oocytes reached the highest number with 4.63 ± 0.74 in the S group and had the lowest number with 0.50 ± 0.53 in the I/R group. There were statistically significant differences for the number of embryos obtained on the second day between the I and I + PRP groups and the I/R and I/R + PRP groups (p = 0.000). In comparing anti-Müllerian hormone 1 (AMH1) and AMH2 values within the group, the highest decrease was observed in the I and I/R groups. CONCLUSION PRP is effective in minimizing ovarian damage and preserving ovarian reserves following ovarian torsion.
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Affiliation(s)
- Mehmet Sühha Bostancı
- Department of Obstetrics and Gynecology and Artificial Reproductive Techniques, Faculty of Medicine, Sakarya University, Serdivan, Sakarya, Turkey
| | - Özcan Budak
- Department of Histology and Embryology and Artificial Reproductive Techniques, Faculty of Medicine, Sakarya University, Serdivan, Sakarya, Turkey
| | - Hüseyin Çakiroğlu
- Medical and Experimental Research Center, Faculty of Medicine, Sakarya University, Serdivan, Sakarya, Turkey
| | - Koray Gök
- Department of Obstetrics and Gynecology, Sakarya Research and Education Hospital, Serdivan, Sakarya, Turkey
| | - Osman Köse
- Department of Obstetrics and Gynecology Faculty of Medicine, Sakarya University, Serdivan, Sakarya, Turkey
| | - Erdem Çokluk
- Department of Biochemistry, Faculty of Medicine, Sakarya University, Serdivan, Sakarya, Turkey
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Shehata AS, Zidan RA, El-Mahroky SM, Abd El-Baset SA. Efficacy of platelet rich plasma on pancreatic injury induced by renal ischemia reperfusion in adult male rats. Ultrastruct Pathol 2022; 46:188-203. [DOI: 10.1080/01913123.2022.2044945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Azza S. Shehata
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rania A. Zidan
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Samaa M. El-Mahroky
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Samia A. Abd El-Baset
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Budak Ö, Bostancı MS, Toprak V, Doğanay S, Köse O. Protective Effects of Platelet-rich plasma for in vitro Fertilization of Rats with Ovarian Failure Induced by Cyclophosphamide. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:161-168. [PMID: 35213914 PMCID: PMC9948130 DOI: 10.1055/s-0041-1741451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Premature ovarian insufficiency (POI) contributes significantly to female infertility. Cyclophosphamide (CYC has adverse effects on folliculogenesis. Platelet-rich plasma (PRP) is an autologous product rich in many growth factors. We evaluated the protective effect of PRP on in vitro fertilization in female rats with CYC-induced ovarian damage. METHODS Twenty-eight adult female Sprague-Dawley rats were randomly divided into four groups. Group 1 (control-sodium chloride 0.9%; 1 mL/kg, single-dose intraperitoneal [IP] injection); group 2 (CYC), 75 mg/kg, single-dose IP injection and sodium chloride 0.9% (1 mL/kg, single-dose IP injection); group 3 CYC plus PRP, CYC (75 mg/kg, single-dose and PRP (200 μl, single-dose) IP injection); and group 4 (PRP, 200 μl, single-dose IP injection). RESULTS In the comparisons in terms of M1 and M2 oocytes, it was observed that the CYC group presented a significantly lower amount than the control, CYC/PRP, and PRP groups. (for M1, p = 0.000, p = 0.029, p = 0.025; for M2, p = 0.009, p = 0.004, p = 0.000, respectively). The number of fertilized oocytes and two-celled good quality embryos was found to be statistically significant between the CYC and control groups, CYC + PRP and PRP groups (p = 0.009, p = 0.001, p = 0.000 for oocytes, respectively. For embryos; p = 0.016, p = 0.002, p = 0.000). CONCLUSION Platelet-rich plasma can protect the ovarian function against damage caused by CYC, and, in addition, it improves oocyte count and the development of embryos as a result of oocyte stimulation during the IVF procedure.
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Affiliation(s)
- Özcan Budak
- Department of Histology and Embryology and Artificial Reproductive Techniques, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehmet Sühha Bostancı
- Department of Obstetrics and Gynecology and Artificial Reproductive Techniques, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Veysel Toprak
- Department of Obstetrics and Gynecology, Private Tatvan Can Hospital, Bitlis, Turkey
| | - Songül Doğanay
- Department of Physiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Osman Köse
- Specialist of Gynecological Oncology, Department of Obstetrics and Gynecology Faculty of Medicine, Sakarya University, Sakarya, Turkey
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Huang QY, Chen SR, Chen JM, Shi QY, Lin S. Therapeutic options for premature ovarian insufficiency: an updated review. Reprod Biol Endocrinol 2022; 20:28. [PMID: 35120535 PMCID: PMC8815154 DOI: 10.1186/s12958-022-00892-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/15/2022] [Indexed: 11/16/2022] Open
Abstract
Primary ovarian insufficiency (POI) is a rare gynecological condition. This disease causes menstrual disturbances, infertility, and various health problems. Historically, hormone replacement therapy is the first-line treatment for this disorder. Women diagnosed with POI are left with limited therapeutic options. In order to remedy this situation, a new generation of therapeutic approaches, such as in vitro activation, mitochondrial activation technique, stem cell and exosomes therapy, biomaterials strategies, and platelet-rich plasma intra-ovarian infusion, is being developed. However, these emerging therapies are yet in the experimental stage and require precise design components to accelerate their conversion into clinical treatments. Thus, each medical practitioner bears responsibility for selecting suitable therapies for individual patients. In this article, we provide a timely analysis of the therapeutic strategies that are available for POI patients and discuss the prospects of POI therapy.
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Affiliation(s)
- Qiao-Yi Huang
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, 362000, Fujian Province, China
| | - Shao-Rong Chen
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, 362000, Fujian Province, China
| | - Jia-Ming Chen
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, 362000, Fujian Province, China
| | - Qi-Yang Shi
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, 362000, Fujian Province, China.
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, 362000, Fujian Province, China.
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
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Kuang X, Tang Y, Xu H, Ji M, Lai D. The Evaluation of Ovarian Function Recovery Following Treatment of Primary Ovarian Insufficiency: A Systematic Review. Front Endocrinol (Lausanne) 2022; 13:855992. [PMID: 35573993 PMCID: PMC9095968 DOI: 10.3389/fendo.2022.855992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Primary ovarian insufficiency (POI) is gaining awareness as its prevalence increases and its effect on patients is extremely negative. To date, several therapies have been designed to treat POI, but the conclusions are conflicting, in part, due to inconsistent evaluation methods. Thus, we explore a multi-index of ovarian function assessment methods to evaluate the recovery of ovarian function after various therapies in order to evaluate effectiveness in a more comprehensive manner. AIM The purpose of this review is to assess the effectiveness of various therapies to recover ovarian function in patients with POI. The primary outcome measures were anti-Müllerian hormone (AMH) levels, follicle stimulating hormone (FSH) levels, and antral follicle count (AFC). The secondary outcomes included the change of mean ovarian volume, menstruation recovery, and pregnancy rate. METHODS Our systematic searching including PubMed, Web of Science, Cochrane, and Embase databases was conducted to find all human clinical trial articles published from January 2000 to April 2021 and related to POI treatment, including the keywords: POI, AFC, and hormones. All prospective and retrospective studies exploring ovarian function recovery that include AFC, AMH levels, and FSH levels evolution throughout treatment were included. All patients included in the studies met the POI criteria described by the European Society for Human Reproductive Embryology (ESHRE) guideline. RESULTS Six studies were selected based on the criteria: one randomized controlled trial and five observational studies. Among them, two studies focused on the intraovarian platelet-rich plasma (PRP) infusion treatment, two studies focused on dehydroepiandrosterone (DHEA) supplements, one study focused on hormone replacement therapy (HRT), and one study focused on autologous adipose-derived stromal cells (ADSCs) treatment. There was insufficient scientific evidence that any approach could help ovarian function recovery in patients with POI because the ovarian function markers in each study had inconsistent changes with 26 patients (6.2%) reporting spontaneous pregnancy. CONCLUSION Serum AMH levels, FSH levels, and AFC are sensitive indicators and reflect the evolution of ovarian function. Large randomized controlled trials are necessary, and the data on ovarian function should be collected comprehensively to evaluate the effectiveness of a variety of treatments.
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Affiliation(s)
- Xiaojun Kuang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yongzhe Tang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Hong Xu
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Min Ji
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- *Correspondence: Min Ji, ; Dongmei Lai,
| | - Dongmei Lai
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- *Correspondence: Min Ji, ; Dongmei Lai,
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Aydogdu I, Karaca E, Coban G, Cay A, Guler EM, Kocyigit A, Uzun E, Aydoğdu YE, Metin H, Miçooğullari U, Ilbey YO, Keskin MZ. An investigation of the effects of amniotic fluid on experimental ischemia/reperfusion damage in rat testes. J Pediatr Urol 2021; 17:761.e1-761.e6. [PMID: 34518124 DOI: 10.1016/j.jpurol.2021.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/18/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Various agents have been tested as preventive treatments for ischemia/reperfusion (IR) damage. In this study, we have investigated for the first time in the literature the efficacy of injection of amniomax (AMX) into testicular parenchyma, which is a commercial medium of rat amniotic fluid, in preventing testicular IR damage related to testicular torsion. OBJECTIVE This study aims to evaluate whether or not amniomax has an effect on experimental IR damage in rat testes using biochemical and histopathological methods based on data in the literature. Even if testicular torsion is repaired surgically in early term injury because of de IR damage still occurs. Is it possible to reduce the ischemia reperfusion injury with amniotic fluid and increase the success of treatment? STUDY DESIGN 40 male Wistar albino rats were included. Four groups were formed with 10 rats in each group: Sham, Ischemia/Reperfusion (IR), injection 1 min before detorsion (AMX-BD), injection 1 min after detorsion (AMX-AD). Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) were computed for oxidative stress, and Total Antioxidant Status (TAS) levels were computed for the antioxidant system, for both serum and tissue. Necrosis and microcalcification levels were assessed in the evaluation of testicular histology. P < 0.05 was considered statistically significant. RESULTS AMX-AD group has low necrosis degree than IR, Mean serum and tissue levels of TAS, TOS, and OSI parameters were respectively determined as; for TAS: 0.64 ± 0.11 and 0.96 ± 0.25 mmol Trolox Equivalent/L; for TOS: 6.71 ± 0.87 and 9.40 ± 1.03 μmol H2O2 equivalent/L; for OSI: 11.94 ± 3.74 and 10.70 ± 4.23 arbitrary unit. DISCUSSION Our study has investigated for the first time in the literature the efficacy of amniotic fluid in preventing testicular IR damage, and used amniomax (AMX) for this purpose. The limitation of our study may be the small number of rat in the groups. CONCLUSION We think an injection after detorsion is more favorable considering that the AMX-AD group demonstrated significantly lower levels of TOS in serum and tissue and OSI in serum, and significantly higher serum levels of TAS compared to the AMX-BD group, as well as the fact that the morphological protection effect was only observed for injections performed immediately after detorsion.
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Affiliation(s)
- Ibrahim Aydogdu
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | - Erkin Karaca
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Ganime Coban
- Bezmialem Vakif University, School of Medicine, Department of Pathology, Istanbul, Turkey.
| | - Ali Cay
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | - Eray Metin Guler
- Bezmialem Vakif University, Medical Laboratory Techniques Program, Istanbul, Turkey.
| | - Abdurrahim Kocyigit
- Bezmialem Vakif University, School of Medicine, Department of Biochemistry, Istanbul, Turkey.
| | - Ersan Uzun
- Istanbul Medeniyet University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | | | - Hüseyin Metin
- Bezmialem Vakif University, Scgool of Medicine, Emergency Medicine, Istanbul, Turkey.
| | - Uygar Miçooğullari
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Yusuf Ozlem Ilbey
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Mehmet Zeynel Keskin
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
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Metformin reduces ovarian ischemia reperfusion injury in rats by improving oxidative/nitrosative stress. Taiwan J Obstet Gynecol 2021; 60:45-50. [PMID: 33495007 DOI: 10.1016/j.tjog.2020.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the preventive role of metformin on rat ovarian ischemia reperfusion injury. MATERIALS AND METHODS Forty rats were divided equally into five groups; Group 1: sham, Group 2: surgical control with 3-hr torsion and detorsion, Group 3: 50 mg/kg p.o. metformin 30 min before 3-hr torsion, Group 4; metformin just after detorsion, Group 5; metformin 30 min before torsion and just after detorsion. Bilateral ovaries and blood sample were obtained seven days after detorsion for biochemical and histopathological evaluation. RESULTS Ovarian tissue total anti-oxidant status (TAS) levels were significantly increased in group 4 when compared to group 1, 2 and 3 (all p < 0.01). In addition, there was a significant decrease in tissue oxidative stress index (OSI) level in group 4 with respect to group 2 (p < 0.01). Moreover, serum levels of OSI were significantly higher in group 2 with respect to group 1 and 5 (both p < 0.05). Similarly, there was significant increase in serum levels of peroxynitrite in group 2 as compared to serum levels in group 3 and 5 (p < 0.01 and 0.05, respectively). Furthermore, there were significant decrease in histopathological scores metformin and sham groups when compared to rats in the control group (Group 2). CONCLUSION Metformin reduces ischemia reperfusion injury in rat torsion detorsion model by improving histopathological and biochemical findings including TAS, OSI and peroxynitrite.
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Effects of Platelet Rich Plasma and Amniotic Cell Culture Medium on Wound Healing Following Experimental Animal Tracheal Injury Model: A Comparative Study. J Craniofac Surg 2021; 32:1937-1941. [PMID: 33741881 DOI: 10.1097/scs.0000000000007396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Prolonged inflammation after tracheal injury invariably results in a degree of stenosis. The topical application of platelet-rich plasma (PRP) and human amniotic fluid-derived cell culture medium (ACCM) have been shown to promote wound healing. The effects of PRP and amniotic cell culture medium (Gibco AmnioMAX - II ) were investigated in a rat model through morphometric, histological, and biochemical parameters. MATERIAL METHODS Thirty-two male Sprague Dawley rats were included in the study: 4 rats provided for the preparation of PRP. Three groups of 7 rats were divided into PRP and ACCM groups, a control and a sham group respectively. A transverse incision on the ventral aspect of the third trachea spanning half of the tracheal circumference was performed. The incision was repaired with 7/0 polypropylene in the sham group. In the control group, 0.5 ml saline solution was applied on to the repaired injury site. In the other two groups, 0.5 mL PRP or ACCM were applied topically on the tracheal repair. Tissue samples were harvested 30 days after surgery for morphometric measurements and biochemical analyses for oxidative stress markers, IL-1beta, IL-6, and VEGF. Connective tissue thickness was evaluated histologically. Statistical analysis included the Mann-Whitney U and Kruskal Wallis tests. RESULTS A notable difference was detected (P = 0,025) in cartilage segment length measurements of the trachea between the ACCM group and the sham and control groups (P < 0.03). A significant difference was found in the analysis of TAS, TOS, and OSI values between the study groups and the control and sham groups (P < 0.005). There were also differences in IL1-beta and IL-6 levels between ACCM and PRP groups (P < 0.05). For the same parameters, the differences were significant between the PRP and, sham and control groups (P = 0,004 and P = 0,002 respectively), and between the ACCM and, sham and control groups (P = 0,003 and P = 0,002 respectively).VEGF values demonstrated a significant difference between the PRP and sham group (P = 0,002), and between ACCM and sham/control groups (p=0,002 for both), the highest VEGF value was in ACCM group while the lowest value was in the sham group. In the histological assessment of connective tissue, a significant difference was observed between ACCM and the other groups. CONCLUSION Amniotic fluid-derived cell culture medium shows less oxidative stress status than the other applications. ACCM is more effective on inflammatory and angiogenetic processes. Connective tissue thickness results were consistent with those biochemical and morphologic results. Additionally, a significant difference was observed in histological data between ACCM and PRP. Overall, ACCM proved to be efficient on tracheal healing. These effects can be attributed to the abundance of growth factors in both PRP and amniotic fluid-derived cell culture medium (ACCM).
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Elkhouly NI, Elkilani OA, Kolaib HA, Elkhouly RM, Morsi DI. Does Autologous Platelet-Rich Plasma Improve Wound Healing and Pain Perception after Cesarean Section in High-Risk Patients? Gynecol Obstet Invest 2021; 86:336-342. [PMID: 34261076 DOI: 10.1159/000517117] [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: 01/18/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the effect of autologous platelet-rich plasma (PRP) on wound healing and pain perception after cesarean section in high-risk patients. DESIGN This was a prospective randomized controlled trial. Participants/Materials, Settings, and Methods: This was a randomized controlled trial of 200 patients who came to the outpatient clinic of Menoufia University Hospital for elective cesarean surgery. The women were randomly assigned to 2 equal groups. The intervention group received PRP subcutaneous injection in the wound after surgery; however, the control group received the usual care. Outcome variables included the redness, edema, ecchymosis, discharge, approximation (REEDA) scale, Vancouver scar scale (VSS), and in addition to the visual analog scale (VAS). RESULTS From April 2018 to July 2020, the PRP group showed a greater reduction in the REEDA score compared to the control group on day 1, day 7, and this was continued till 6 months (1.51 ± 0.90 vs. 2.49 ± 1.12, p < 0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VSS and VAS scores beginning on the seventh day (3.71 ± 0.99 vs. 4.67 ± 1.25, p < 0.001) and (5.06 ± 1.10 vs. 6.02 ± 1.15, p < 0.001), respectively, and continued till 6 months. LIMITATIONS Pain was not measured by the use of analgesics, and we did not investigate the effects of varying platelet concentrations, centrifuge duration, or speed. CONCLUSIONS PRP has positive effects on wound healing and pain reduction in high-risk patients undergoing cesarean section in low-resource settings.
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Affiliation(s)
- Nabih I Elkhouly
- Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Osama A Elkilani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Hend A Kolaib
- Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Reem M Elkhouly
- Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Dalia I Morsi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
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Atkinson L, Martin F, Sturmey RG. Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon? Hum Reprod 2021; 36:1737-1750. [PMID: 33963408 PMCID: PMC8366566 DOI: 10.1093/humrep/deab106] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/09/2021] [Indexed: 12/13/2022] Open
Abstract
The prospect of ovarian rejuvenation offers the tantalising prospect of treating age-related declines in fertility or in pathological conditions such as premature ovarian failure. The concept of ovarian rejuvenation was invigorated by the indication of the existence of oogonial stem cells (OSCs), which have been shown experimentally to have the ability to differentiate into functional follicles and generate oocytes; however, their clinical potential remains unknown. Furthermore, there is now growing interest in performing ovarian rejuvenation in situ. One proposed approach involves injecting the ovary with platelet rich plasma (PRP). PRP is a component of blood that remains after the in vitro removal of red and white blood cells. It contains blood platelets, tiny anucleate cells of the blood, which are responsible for forming athrombus to prevent bleeding. In addition, PRP contains an array of cytokines and growth factors, as well as a number of small molecules.The utility ofPRP has been investigatedin a range of regenerative medicine approaches and has been shown to induce differentiation of a range of cell types, presumably through the action of cytokines. A handful ofcasereports have described the use of PRP injections into the ovaryin the human, and while these clinical data report promising results, knowledge on the mechanisms and safety of PRP injections into the ovary remain limited.In this article, we summarise some of the physiological detail of platelets and PRP, before reviewing the existing emerging literature in this area. We then propose potential mechanisms by which PRP may be eliciting any effects before reflecting on some considerations for future studies in the area. Importantly, on the basis of our existing knowledge, we suggest that immediate use of PRP in clinical applications is perhaps premature and further fundamental and clinical research on the nature of ovarian insufficiency, as well as the mechanism by which PRP may act on the ovary, is needed to fully understand this promising development.
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Affiliation(s)
- Lloyd Atkinson
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Francesca Martin
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Roger G Sturmey
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK.,Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, St Mary's Hospital, Manchester, UK
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Resumed ovarian function and pregnancy in early menopausal women by whole dimension subcortical ovarian administration of platelet-rich plasma and gonadotropins. ACTA ACUST UNITED AC 2021; 28:660-666. [PMID: 33784262 DOI: 10.1097/gme.0000000000001746] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study was designed to investigate if whole dimension subcortical ovarian administration of platelet-rich plasma with gonadotropin, in proximity to most ovarian follicles, is effective in restoring ovarian functions in women during early menopause. METHODS Platelet-rich plasma, prepared from 40 mL of autologous peripheral blood using the buffy coat method, was injected into extended subcortical area of bilateral ovaries along with recombinant follicle-stimulating hormone (rFSH) (Gonal-F 300IU) under laparoscopic guidance. The posttreatment ovarian folliculogenesis and serum levels of FSH, luteinizing hormone (LH), and estradiol were followed up for 6 months at weekly to monthly intervals. IVF was carried out in women resuming ovulatory functions. RESULTS Twelve early menopausal women with mean age of 44.42 ± 2.84 were enrolled. After treatment, 11 women resumed their menstrual period in 37.1 ± 23.5 days. Their average serum FSH was 70.47 ± 20.92 and 26.22 ± 17.55 IU/L, luteinizing hormone was 34.81 ± 11.86 and 14.3 ± 12.8 IU/L, before and after treatment, respectively. The mid-cycle E2 was 251.1 ± 143.8 pg/mL. Ten oocyte retrievals were carried out among six participants, four of them received controlled ovarian stimulation and another two using natural ovulation cycles. Thirteen mature eggs were retrieved which were then ICSI fertilized to obtain 10 normally fertilized 2PN oocytes. Two participants had cleavage stage embryos transferred of which one achieved clinical pregnancy. CONCLUSIONS Whole dimension subcortical ovarian administration of platelet-rich plasma with gonadotropin was shown to restore ovarian functions, at least temporarily, and could increase the probability of pregnancy using autologous oocytes in women with early menopause.
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Hajipour H, Farzadi L, Latifi Z, Keyhanvar N, Navali N, Fattahi A, Nouri M, Dittrich R. An update on platelet-rich plasma (PRP) therapy in endometrium and ovary related infertilities: clinical and molecular aspects. Syst Biol Reprod Med 2021; 67:177-188. [PMID: 33632047 DOI: 10.1080/19396368.2020.1862357] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Administration of platelet-rich plasma (PRP) is one of the well-recommended strategies for the treatment of endometrium- and ovary-associated infertility. Due to the autologous source of PRP, minimal risks for disease transmission and immunogenic and allergic responses are expected in this method. Despite the extensive use of PRP in medicine, its precise mechanism of action in endometrial and ovarian tissues is still unknown. Nevertheless, the induction of cell proliferation, chemotaxis, regeneration, extracellular matrix synthesis, remodeling, angiogenesis, and epithelialization are the main pathways for PRP to affect female reproductive organs. Given the promising results of previous studies, it is necessary to standardize PRP preparation protocols for different therapeutic purposes and also clearly determine appropriate inclusion and exclusion criteria for recruiting patients. In the current review, we presented a summary of studies on PRP therapy for endometrium- and ovary-associated infertility with a focus on the possible mechanisms by which PRP enhances endometrial receptivity and regenerates ovarian function.Abbreviations: PRP: platelet-rich plasma; ART: assisted reproductive technology; POF: premature ovarian failure; TGF: transforming growth factors; PDGF: platelet-derived growth factors; IGF-I: insulin-like growth factor-1; HGF: hepatocyte growth factor; EGF: epidermal growth factor; FGF: fibroblast growth factor; VEGF: vascular endothelial growth factor; ADP: adenosine diphosphate, ATP: adenosine triphosphate; PDGF: platelet-derived growth factor; COX2: cyclooxygenase-2; TP53: tumor protein 53; ER-α: estrogen receptors alpha; ER-β: estrogen receptors beta; PR: progesterone receptor; RIF: recurrent implantation failure; G-CSF: granulocyte colony-stimulating factor; iNOS: inducible nitric oxide synthase; NF-kβ: nuclear factor kappa beta; MMPs: matrix metalloproteinases; Col1a1: collagen type I alpha 1; IL: interleukin; FSH: follicle-stimulating hormone; AMH: anti-Mullerian hormone; GDF-9: growth differentiation factor 9.
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Affiliation(s)
- Hamed Hajipour
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Laya Farzadi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Latifi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Keyhanvar
- Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazli Navali
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,OB/GYN, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ralf Dittrich
- OB/GYN, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
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Abstract
Advanced maternal age is associated with the natural oocyte depletion, leading to low oocyte yield, high infertility treatment cancellation rates, and eventual decreases in pregnancy rates. Various innovative interventions have been introduced to improve the outcome of infertility treatment for aging patients. Numerous published data demonstrated that early follicle development was regulated by intraovarian growth factors through autocrine or paracrine mechanisms. Platelet-rich plasma (PRP), a plasma fraction of peripheral blood with a high concentration of platelets, has been implemented in regenerative medicine in the last decade. The plasma contains a variety of growth factors that were suggested to be able to enhance angiogenesis regeneration and the cell proliferation process. The initial report showed that an intraovarian injection of PRP improved the hormonal profile and increased the number of retrieved oocytes in patients with diminished ovarian reserve. Subsequently, several studies with larger sample sizes have reported that this approach resulted in several healthy live births with no apparent complications. However, the use of ovarian PRP treatment needs to be fully investigated, because no randomized controlled trial has yet been performed to confirm its efficacy.
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Panda SR, Sachan S, Hota S. A Systematic Review Evaluating the Efficacy of Intra-Ovarian Infusion of Autologous Platelet-Rich Plasma in Patients With Poor Ovarian Reserve or Ovarian Insufficiency. Cureus 2020; 12:e12037. [PMID: 33457137 PMCID: PMC7797441 DOI: 10.7759/cureus.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The emergence of autologous platelet-rich plasma (PRP) therapy reflects a break-through for infertile patients with premature ovarian failure. To study the efficacy of intra-ovarian infusion of autologous PRP on the improvement of ovarian reserve parameters and the subsequent artificial reproductive technique (ART) cycle outcomes in infertile women with poor ovarian reserve or premature ovarian insufficiency, a systematic search in electronic databases like Medline (through PubMed), Embase, Scopus, Web of Science, and Cochrane was done using relevant search terms. Except for case series, case reports, and review articles, all other types of studies, those evaluated for the effects of intra-ovarian infusion of PRP in subfertile women for decreased ovarian reserve (DOR) or premature ovarian insufficiency (POI) were included in our systematic review. The data were extracted from each eligible study and cross-checked by two authors. Intra-ovarian PRP infusion appears to be effective in ovarian rejuvenation, and the results of the subsequent intracytoplasmic sperm injection (ICSI) cycle are encouraging. PRP intervention was found to be beneficial in terms of an improvement in ovarian reserve parameters (increase in serum anti-mullerian hormone or antral follicle count or decrease in serum follicular stimulating hormone). ICSI cycle performance in terms of the total number of oocytes retrieved, number of two-pronuclei embryos, fertilization rate, number of cleavage stage embryos, number of good quality embryos, and cycle cancellation rate were found to be improved after intra-ovarian PRP infusion as compared to their previous cycle without PRP infusion.
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Affiliation(s)
- Soumya R Panda
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Mangalagiri, Guntur, IND
| | - Shikha Sachan
- Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
| | - Smrutismita Hota
- Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Mangalagiri, Guntur, IND
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An experimental study on the long-term and short-term effects of PRP treatment on the endometrium and ovaries. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.824815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Kalyoncu S, Yilmaz B, Demir M, Tuncer M, Bozdag Z, Ince O, Akif Bozdayi M, Ulusal H, Taysi S. Octreotide and lanreotide decrease ovarian ischemia-reperfusion injury in rats by improving oxidative and nitrosative stress. J Obstet Gynaecol Res 2020; 46:2050-2058. [PMID: 32748523 DOI: 10.1111/jog.14379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 12/31/2022]
Abstract
AIM To investigate the protective effect of octreotide and lanreotide on ovarian damage in experimental ovarian ischemia-reperfusion injury. METHODS Fifty-six rats were separated into seven groups; group 1: sham group, group 2: surgical control group with 3-h torsion and detorsion, group 3: 0.02 mg/kg s.c. octreotide 30 min before 3-h torsion, group 4; octreotide just after detorsion for 7 days, group 5: octreotide 30 min before torsion and just after detorsion for 7 days, group 6: single time 20 mg/kg s.c. lanreotide before torsion, group 7: single time lanreotide just after detorsion. RESULTS All histopathological scores except congestion were significantly lower in group 1 than other groups. In addition, hemorrhage (group 2 vs 4: P < 0.05), degeneration (group 2 vs 4: P < 0.05, group 2 vs 5: P < 0.01 and group 2 vs 6: P < 0.05) and total damage score (group 2 vs 4: P < 0.05, group 2 vs 5: P < 0.05, group 2 vs 6: P < 0.05 and group 2 vs 7: P < 0.05) were significantly lower than other groups. Moreover, ovarian tissue total oxidant status and oxidative stress index levels were significantly decreased in groups 5 (both P < 0.05) and 7 (both P < 0.05) when compared to group 2. Furthermore, tissue levels of peroxynitrite were significantly higher in group 2 than groups 1, 3 and 5 (all P < 0.05). CONCLUSIONS Octreotide and lanreotide have a protective role against ischemia-reperfusion damage in rat torsion detorsion model by improving histopathological and biochemical findings including tissue levels of total oxidant status, oxidative stress index and peroxynitrite.
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Affiliation(s)
- Senol Kalyoncu
- Obstetrics and Gynecology Clinic, TOBB ETU University Hospital, Ankara, Turkey
| | - Bulent Yilmaz
- Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkey
| | - Mustafa Demir
- Obstetrics and Gynecology Clinic, ANKA Hospital, Gaziantep, Turkey
| | - Meltem Tuncer
- Department of Physiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Zehra Bozdag
- Department of Pathology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Onur Ince
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Faculty of Medicine, Kutahya, Turkey
| | - Mehmet Akif Bozdayi
- Department of Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Hasan Ulusal
- Department of Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Seyithan Taysi
- Department of Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Wood SH, Sills ES. Intraovarian vascular enhancement via stromal injection of platelet-derived growth factors: Exploring subsequent oocyte chromosomal status and in vitro fertilization outcomes. Clin Exp Reprod Med 2020; 47:94-100. [PMID: 32466629 PMCID: PMC7315860 DOI: 10.5653/cerm.2019.03405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022] Open
Abstract
The inverse correlation between maternal age and pregnancy rate represents a major challenge for reproductive endocrinology. The high embryo ploidy error rate in failed in vitro fertilization (IVF) cycles reflects genetic misfires accumulated by older oocytes over time. Despite the application of different follicular recruitment protocols during IVF, gonadotropin modifications are generally futile in addressing such damage. Even when additional oocytes are retrieved, quality is frequently poor. Older oocytes with serious cytoplasmic and/or chromosomal errors are often harvested from poorly perfused follicles, and ovarian vascularity and follicular oxygenation impact embryonic chromosomal competency. Because stimulation regimens exert their effects briefly and immediately before ovulation, gonadotropins alone are an ineffective antidote to long-term hypoxic pathology. In contrast, the tissue repair properties (and particularly the angiogenic effects) of platelet-rich plasma (PRP) are well known, with applications in other clinical contexts. Injection of conventional PRP and/or its components (e.g., isolated platelet-derived growth factors as a cell-free substrate) into ovarian tissue prior to IVF has been reported to improve reproductive outcomes. Any derivative neovascularity may modulate oocyte competence by increasing cellular oxygenation and/or lowering concentrations of intraovarian reactive oxygen species. We propose a mechanism to support intrastromal angiogenesis, improved follicular perfusion, and, crucially, embryo ploidy rescue. This last effect may be explained by mRNA upregulation coordinated by PRP-associated molecular signaling, as in other tissue systems. Additionally, we outline an intraovarian injection technique for platelet-derived growth factors and present this method to help minimize reliance on donor oocytes and conventional hormone replacement therapy.
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Affiliation(s)
| | - E Scott Sills
- Gen 5 Fertility Center, San Diego, CA, USA.,Applied Biotechnology Research Group, University of Westminster, London, UK
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27
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Platelet-inspired therapeutics: current status, limitations, clinical implications, and future potential. Drug Deliv Transl Res 2020; 11:24-48. [PMID: 32323161 DOI: 10.1007/s13346-020-00751-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recent research has been successful in demonstrating the importance of the addition of platelets to the field of cell-mediated therapeutics, by making use of different platelet forms to design modalities able to positively impact a wide range of diseases. A key obstacle hindering the success of conventional therapeutic interventions is their inability to produce targeted treatment, resulting in a number of systemic side effects and a longer duration for the onset of action to occur. An additional challenge facing current popular therapeutic interventions is biocompatibility of the system, resulting in the decline of patient compliance to treatment. In an attempt to address these challenges, the past few decades have been witness to the discovery and innovation of precision therapy, in order to achieve targeted treatment for an array of conditions, thereby superseding alternative mechanisms of treatment. Platelet-mediated therapeutics, as well as employing platelets as drug delivery vehicles, are key components in advancing precision therapy within research and in clinical settings. This novel approach is designed with the objective that the platelets retain their original structure and functions within the body, thereby mitigating biocompatibility challenges. In this article, we review the current significant impact that the addition of platelet-inspired systems has made on the field of therapeutics; explore certain limitations of each system, together with ideas on how to overcome them; and discuss the clinical implications and future potential of platelet-inspired therapeutics. Graphical abstract.
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KARAKAŞ S, KAYA C, GÜRASLAN H, SAKIZ D, SÜZEN ÇAYPINAR S, CENGİZ H, EKİN M, YAŞAR L. Effect of metformin and detorsion treatment on serum anti-Müllerian hormonelevels and ovarian histopathology in a rat ovarian torsion model. Turk J Med Sci 2020; 50:455-463. [PMID: 31999406 PMCID: PMC7164755 DOI: 10.3906/sag-1803-196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 01/29/2020] [Indexed: 12/31/2022] Open
Abstract
Background/aim Adnexal torsion is a common gynaecological emergency, and considered to be a problem mostly in reproductive-age women. To evaluatethe effect of metformin and detorsion treatment on reducing ovarian reserve in an ovarian torsion model. Materials and methods Twenty-four nonpregnant, Wistar Hannover rats were included in the study. Animals were divided into 3 groups: the control group, the detorsion only group, and the metformin + detorsion group. The first group received only laparotomy. In the second group, ovaries were fixed to the abdominal wall after performing 360° ovarian torsion, followed by detorsion after a 3-h period of ischemia. The third group underwent the same torsion and detorsion procedures as the second group, and received 50 mg/kg metformin by gavage for 14 days. Ovarian damage scores, follicle counts, and AMH levels were evaluated. Results The total damage score was significantly increased in the detorsion only group compared to the metformin+detorsion and control groups. Pre-operative/post-operative AMH decreases were statistically significant in negative direction in the detorsion only group when compared to the metformin+detorsion and control groups (P = 0.001). Conclusion Metformin+detorsion treatment may be effective in protecting the ovarian reserve after ovarian torsion.
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Affiliation(s)
- Sema KARAKAŞ
- Department of Obstetrics and Gynecology, University of Health Sciences,Gaziosmanpaşa Taksim Training and Research Hospital, İstanbulTurkey
| | - Cihan KAYA
- Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbulTurkey
| | - Hakan GÜRASLAN
- Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbulTurkey
| | - Damlanur SAKIZ
- Department of Pathology, University of Health Sciences,Bakirköy Dr Sadi Konuk Training and Research Hospital, İstanbulTurkey
| | - Sema SÜZEN ÇAYPINAR
- Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbulTurkey
| | - Hüseyin CENGİZ
- Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbulTurkey
| | - Murat EKİN
- Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbulTurkey
| | - Levent YAŞAR
- Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbulTurkey
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29
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Melo P, Navarro C, Jones C, Coward K, Coleman L. The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study. J Assist Reprod Genet 2020; 37:855-863. [PMID: 32030554 DOI: 10.1007/s10815-020-01710-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/30/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the impact of a 3-month course of intracortical injections of autologous platelet-rich plasma (PRP) upon ovarian reserve markers versus no intervention in women with low ovarian reserve prior to undergoing assisted reproductive technology (ART). METHODS Prospective controlled, non-randomized comparative study conducted in a private fertility clinic, in Venezuela. Women with abnormal ovarian reserve markers (FSH, AMH and AFC) who declined oocyte donation were allocated to one of the following groups according to patient choice: monthly intracortical ovarian PRP injections for three cycles, or no intervention. Primary outcomes were the change in FSH, AMH and AFC pre- and post-treatment. Secondary outcomes included the number of oocytes collected and fertilized, biochemical/clinical pregnancy rates and miscarriage and live birth rates. RESULTS Eighty-three women were included, of which 46 received PRP treatment and 37 underwent no intervention. Overall median age was 41 years (IQR 39-44). There were no demographic differences between the study groups. At the 3-month follow-up, women treated with PRP experienced a significant improvement in FSH, AMH and AFC, whereas there was no change in the control group. Furthermore, overall rates of biochemical (26.1% versus 5.4%, P = 0.02) and clinical pregnancy (23.9% versus 5.4%, P = 0.03) were higher in the PRP group, while there was no difference in the rates of first trimester miscarriage and live birth between groups. CONCLUSION PRP injections are effective and safe to improve markers of low ovarian reserve prior to ART, although further evidence is required to evaluate the impact of PRP on pregnancy outcomes.
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Affiliation(s)
- P Melo
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, OX3 9DU, UK.
| | - C Navarro
- Fertiaguerrevere Fertility Clinic, Caracas, 1012, Venezuela
| | - C Jones
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, OX3 9DU, UK
| | - K Coward
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, OX3 9DU, UK
| | - L Coleman
- Fertiaguerrevere Fertility Clinic, Caracas, 1012, Venezuela
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30
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Aniss NND, Zaazaa AM, Saleh MRA. Anti-arthritic Effects of Platelets Rich Plasma and Hyaluronic Acid on Adjuvant-induced Arthritis in Rats. INT J PHARMACOL 2019. [DOI: 10.3923/ijp.2020.33.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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31
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Saif-Elnasr M, Abdel Fattah SM, Swailam HM. Treatment of hepatotoxicity induced by γ-radiation using platelet-rich plasma and/or low molecular weight chitosan in experimental rats. Int J Radiat Biol 2019; 95:1517-1528. [PMID: 31290709 DOI: 10.1080/09553002.2019.1642538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/09/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
Background and aim: Platelet-rich plasma (PRP) is rich in growth factors and plays an important role in tissue healing and cytoprotection. Also, it has been proved that low molecular weight chitosan (LMC) possesses many outstanding health benefits. The aim of this study was to assess the possibility of using PRP and/or fungal LMC to treat hepatotoxicity induced by γ-radiation in albino rats.Materials and methods: Forty-eight adult male albino rats were randomly divided into eight groups. Group I (control), Group II (PRP alone), Group III (LMC alone), Group IV (PRP + LMC), Group V (γ-irradiated alone), Group VI (γ-irradiated + PRP), Group VII (γ-irradiated + LMC), and Group VIII (γ-irradiated + PRP + LMC). The irradiated rats were whole body exposed to γ-radiation (8 Gy) as fractionated doses (2 Gy) twice a week for 2 consecutive weeks. The treated groups received PRP (0.5 mL/kg body weight, s.c.) and/or LMC (10 mg/kg body weight, s.c.) 2 days a week 1 h after every dose of γ-radiation and continued for another week after the last dose of radiation. Serum alanine transaminase (ALT) and aspartate transaminase (AST) activities, as well as reduced glutathione (GSH) content, malondialdehyde (MDA), total antioxidant capacity (TAC), and nuclear factor erythroid 2-related factor 2 (Nrf2) levels in the liver tissue and relative expression of microRNA-21 (miR-21) in serum were measured, in addition to histopathological examination.Results: Exposure of rats to γ-radiation resulted in a significant increase in serum ALT and AST activities, hepatic MDA levels, and serum miR-21 relative expression, along with a significant decrease in hepatic GSH content, TAC, and Nrf2 levels. Treatment with PRP and/or fungal LMC after exposure to γ-radiation ameliorated these parameters and improved the histopathological changes induced by γ-radiation.Conclusions: The results demonstrated that PRP and/or LMC inhibited γ-radiation-induced hepatotoxicity and using both of them together seems more effective. They can be a candidate to be studied toward the development of a therapeutic strategy for liver diseases.
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Affiliation(s)
- Mostafa Saif-Elnasr
- Health Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Salma M Abdel Fattah
- Drug Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Hesham M Swailam
- Radiation Microbiology Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
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32
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Yim HE, Kim DS, Chung HC, Shing B, Moon KH, George SK, Kim MW, Atala Z, Kim JH, Ko IK, Yoo JJ. Controlled Delivery of Stem Cell-Derived Trophic Factors Accelerates Kidney Repair After Renal Ischemia-Reperfusion Injury in Rats. Stem Cells Transl Med 2019; 8:959-970. [PMID: 31144785 PMCID: PMC6708069 DOI: 10.1002/sctm.18-0222] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 03/04/2019] [Indexed: 12/20/2022] Open
Abstract
Renal disease is a worldwide health issue. Besides transplantation, current therapies revolve around dialysis, which only delays disease progression but cannot replace other renal functions, such as synthesizing erythropoietin. To address these limitations, cell‐based approaches have been proposed to restore damaged kidneys as an alternative to current therapies. Recent studies have shown that stem cell‐derived secretomes can enhance tissue regeneration. However, many growth factors undergo rapid degradation when they are injected into the body in a soluble form. Efficient delivery and controlled release of secreting factors at the sites of injury would improve the efficacy in tissue regeneration. Herein, we developed a gel‐based delivery system for controlled delivery of trophic factors in the conditioned medium (CM) secreted from human placental stem cells (HPSCs) and evaluated the effect of trophic factors on renal regeneration. CM treatment significantly enhanced cell proliferation and survival in vitro. Platelet‐rich plasma (PRP) was used as a delivery vehicle for CM. Analysis of the release kinetics demonstrated that CM delivery through the PRP gel resulted in a controlled release of the factors both in vitro and in vivo. In an acute kidney injury model in rats, functional and structural analysis showed that CM delivery using the PRP gel system into the injured kidney minimized renal tissue damage, leading to a more rapid functional recovery when compared with saline, CM, or vehicle only injection groups. These results suggest that controlled delivery of HPSC‐derived trophic factors may provide efficient repair of renal tissue injury. stem cells translational medicine2019;8:959&970
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Affiliation(s)
- Hyung Eun Yim
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA.,Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Doo Sang Kim
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA.,Department of Urology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyun Chul Chung
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA.,Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Brian Shing
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - Kyung Hyun Moon
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA.,Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sunil K George
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - Michael W Kim
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - Zachary Atala
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - Ji Hyun Kim
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - In Kap Ko
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
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Orhan E, Sapmaz-Metin M, Tarladaçalışır-Topçu Y, Gündüz Ö, Kaya O. The effect of platelet-rich plasma in inactive form on the burn zone of stasis in rats. J Plast Surg Hand Surg 2019; 53:301-308. [DOI: 10.1080/2000656x.2019.1614454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Erkan Orhan
- Department of Plastic Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Melike Sapmaz-Metin
- Department of Histology and Embryology, School of Medicine, Trakya University, Edirne, Turkey
| | | | - Özgür Gündüz
- Department of Medical Pharmacology, School of Medicine, Trakya University, Edirne, Turkey
| | - Oktay Kaya
- Department of Physiology, School of Medicine, Trakya University, Edirne, Turkey
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34
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Soliman AF, Saif-Elnasr M, Abdel Fattah SM. Platelet-rich plasma ameliorates gamma radiation-induced nephrotoxicity via modulating oxidative stress and apoptosis. Life Sci 2019; 219:238-247. [PMID: 30659793 DOI: 10.1016/j.lfs.2019.01.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 10/27/2022]
Abstract
AIMS As a source of growth factors and with its cytoprotective properties, platelet-rich plasma (PRP) received considerable attention in regenerative medicine. Thus, this study was designed to evaluate the protective efficacy of PRP against γ-radiation-induced nephrotoxicity. MAIN METHODS Forty male rats were distributed in four groups: 1) control, 2) PRP, 3) Radiation, and 4) PRP + radiation. Nephrotoxicity was examined in rats after a whole body γ-irradiation at a single dose of 8 Gy. Activated PRP (0.5 ml/kg BW) was injected subcutaneously twice weekly for three successive weeks prior to γ-irradiation. At the end of the experiment, creatinine, urea, albumin, and neutrophil gelatinase-associated lipocalin (NGAL) serum levels, as well as renal relative gene expression level of kidney injury molecule-1 (KIM-1) were estimated. Further, malondialdehyde level, nitric oxide content and reduced glutathione content in addition to superoxide dismutase and catalase activities were measured. Moreover, the expression levels of B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X (Bax), and caspase-3 proteins were assayed. KEY FINDINGS PRP pre-treatment significantly reduced the radiation-induced abnormalities in kidney histology and attenuated the induced cell injury. Furthermore, PRP notably ameliorated the state of oxidative stress and appeared to inhibit the induced apoptosis. SIGNIFICANCE This study lends a probable protective role of PRP against γ-radiation-induced nephrotoxicity which can highlight the possibilities of its application as a complementary procedure during radiotherapy.
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Affiliation(s)
- Ahmed F Soliman
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
| | - Mostafa Saif-Elnasr
- Health Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Salma M Abdel Fattah
- Drug Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
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35
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Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pappas A, Pantou A, Chronopoulou M, Deligeoroglou E, Koutsilieris M, Pantos K. Autologous Platelet-Rich Plasma Treatment Enables Pregnancy for a Woman in Premature Menopause. J Clin Med 2018; 8:jcm8010001. [PMID: 30577435 PMCID: PMC6352170 DOI: 10.3390/jcm8010001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 12/18/2022] Open
Abstract
This report presents the case of a woman aged 40 who has experienced premature menopause from the age of 35. Having rejected oocyte donation, she opted for intraovarian injection of autologous platelet-rich plasma with the aim to rejuvenate the ovarian tissue and enable the employment of her own gametes through in-vitro fertilization. Six weeks following the autologous platelet-rich plasma treatment, a significant reduction in the patient’s follicle-stimulating hormone (FSH) levels were noted. A natural in-vitro fertilization cycle led to a biochemical pregnancy, resulting in a spontaneous abortion at the 5th week of pregnancy. This is the first report of a successful autologous platelet-rich plasma application leading to pregnancy in menopause. This report uniquely contributes to the medical knowledge and challenges current practice in the context of infertility. The efficiency and safety of this treatment with regard to the reproductive system merits further investigation.
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Affiliation(s)
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Nikolaos Nitsos
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| | - Athanasios Pappas
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Agni Pantou
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Margarita Chronopoulou
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Efthymios Deligeoroglou
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| | - Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
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Abdel Fattah SM, Saif-Elnasr M, Soliman AF. Platelet-rich plasma as a potential therapeutic approach against lead nitrate- and/or gamma radiation-induced hepatotoxicity. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:34460-34471. [PMID: 30311112 DOI: 10.1007/s11356-018-3366-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/27/2018] [Indexed: 06/08/2023]
Abstract
Because of the potential regenerative and cytoprotective effects of its content of numerous bioactive growth factors and cytokines, platelet-rich plasma (PRP) became an attractive biomaterial for therapeutic purposes. Therefore, the current study was designed to investigate the potential therapeutic effect of PRP against lead nitrate- and/or γ-radiation-induced hepatotoxicity. To do so, hepatotoxicity was induced in rats by intraperitoneal administration of lead nitrate (7.5 mg/kg) thrice weekly for two consecutive weeks and/or a whole-body γ-irradiation at a single dose of 6 Gy. Activated PRP (0.5 ml/kg) was injected subcutaneously 24 h after the last dose of lead nitrate and/or γ-irradiation and continued twice weekly for three successive weeks. Lead nitrate intoxication and/or γ-irradiation resulted in a significant elevation of serum alanine transaminase and aspartate transaminase activities accompanied with a significant decrease in serum levels of total protein and albumin. Further, a significant increase in malondialdehyde level and nitric oxide content accompanied with a significant decrease in the reduced glutathione content and the enzyme activities of glutathione-S-transferase, superoxide dismutase, and catalase were observed. Additionally, hepatic extracellular signal-regulated kinase (ERK) and Akt signaling pathways were stimulated. PRP treatment notably ameliorated the induced cell injury, reduced the intracellular oxidative and interestingly increased the upregulation of phosphorylated ERK1/2 and Akt. Moreover, PRP treatment relieved lead nitrate and/or γ-radiation-induced hepatic histological damages. In conclusion, this study sheds the light on a probable therapeutic role of PRP against lead nitrate- and/or γ-radiation-induced hepatotoxicity which might attribute to its ability to activate ERK and Akt signaling pathways.
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Affiliation(s)
- Salma M Abdel Fattah
- Drug Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt.
| | - Mostafa Saif-Elnasr
- Health Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Ahmed F Soliman
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
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Dawood AS, Salem HA. Current clinical applications of platelet-rich plasma in various gynecological disorders: An appraisal of theory and practice. Clin Exp Reprod Med 2018; 45:67-74. [PMID: 29984206 PMCID: PMC6030616 DOI: 10.5653/cerm.2018.45.2.67] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 05/03/2018] [Accepted: 05/25/2018] [Indexed: 12/31/2022] Open
Abstract
The purpose of this paper is to review the current clinical uses of platelet-rich plasma (PRP) in the field of gynecology. All relevant articles published from January 2000 to December 2017 were reviewed and analyzed. The articles on PRP in the field of gynecology were mainly case series, pilot studies, or case reports. PRP is currently considered a new therapeutic modality for some disorders that are refractory to conventional drugs.
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Sekerci CA, Tanidir Y, Sener TE, Sener G, Cevik O, Yarat A, Alev-Tuzuner B, Cetinel S, Kervancioglu E, Sahan A, Akbal C. Effects of platelet-rich plasma against experimental ischemia/reperfusion injury in rat testis. J Pediatr Urol 2017; 13:317.e1-317.e9. [PMID: 28215833 DOI: 10.1016/j.jpurol.2016.12.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/13/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Testicular torsion is a common problem and, to date, there is no agent to preserve testicular function following detorsion. Platelet-rich plasma (PRP), with its rich growth factor composition, has proven beneficial in regenerative therapy. It is believed that PRP has not been studied in testis for ischemia/reperfusion (I/R) injury. OBJECTIVE This study investigated the effect of PRP in an I/R rat model 1 month after detorsion. STUDY DESIGN Of 24 adult male Sprague-Dawley rats, 18 were randomly assigned into three groups, with six in each: control, I/R and I/R + PRP. The PRP was prepared from the remaining six. Each group underwent right orchiectomy. Ischemia was performed by rotating the left testis 720° and fixing with a nylon suture for 4 h. Reperfusion occurred 4 h later by removing the suture, and PRP was administered at a dose of 10 μl (2000 × 109/l) into the left testis via the intraparenchymal route. Animals were sacrificed at the fourth week, and testes were taken for malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), myeloperoxidase (MPO), transforming growth factor β (TGF-β), and caspase-3 measurements. RESULTS Ischemia/reperfusion caused a significant increase in MDA, MPO and caspase-3 activity, and significant decrease in GSH levels and SOD activity. The PRP treatment helped correct the alterations in SOD, caspase-3, and MPO activities and MDA levels. However, the mean MDA level and MPO activity were not totally restored compared with the controls. Serum testosterone levels of the I/R group were significantly lower compared with the control and I/R + PRP groups. TGF-β and caspase-3 protein expressions were significantly higher in the I/R group compared with the control group and were low with PRP administration compared with I/R groups (summary Table). DISCUSSION The findings of the present study suggest that PRP, by inhibiting neutrophil infiltration and oxidative stress and increasing antioxidant defense, exerts protective effects on testicular tissues against I/R. This study had some limitations: a scoring system was not used in the assessment of spermatogenesis in the histopathological findings and specific testis cell types were not histologically assessed. CONCLUSIONS In light of the biochemical, histological and, especially, hormonal findings, intraparenchymal PRP injection may have a protective effect in testicular tissue against I/R injury.
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Affiliation(s)
- C A Sekerci
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Y Tanidir
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - T E Sener
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - G Sener
- Department of Pharmacology, School of Pharmacy, Marmara University, Istanbul, Turkey
| | - O Cevik
- Department of Biochemistry, School of Pharmacy, Cumhuriyet University, Sivas, Turkey
| | - A Yarat
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - B Alev-Tuzuner
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - S Cetinel
- Department of Histology & Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - E Kervancioglu
- Department of Histology & Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - A Sahan
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - C Akbal
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
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Rah DK, Min HJ, Kim YW, Cheon YW. Effect of Platelet-Rich Plasma on Ischemia-Reperfusion Injury in a Skin Flap Mouse Model. Int J Med Sci 2017; 14:829-839. [PMID: 28824320 PMCID: PMC5562190 DOI: 10.7150/ijms.19573] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/18/2017] [Indexed: 01/14/2023] Open
Abstract
Background: Ischemia-reperfusion (I/R) injury is a leading cause of surgical skin flap compromise and organ dysfunction. Platelet-rich plasma (PRP) is an abundant reserve of various growth factors. Activated platelets play a role in endothelial damage during I/R injury; however, exogenous PRP could inhibit the production of reactive oxygen species. The goal of this study was to investigate the effect of PRP on I/R injury. Methods: Four groups (n=30) of C57BL/6N mice with lateral thoracic artery island flaps were used. Group A, the control group, received flap elevation and repositioning. Group B received PRP and repositioning. Group C had 4 hours of ischemia and then were reperfused. Group D received PRP, had 4 hours of ischemia, and then were reperfused. The survival area of flap tissue and blood perfusion were assessed. Histological evaluation included neutrophil counts. Reactive oxygen species and proinflammatory cytokines were measured to evaluate I/R injury. Protein expression of phosphorylated apoptosis signaling regulating kinase-1 (pASK-1), p38MAPK, and pNF-κB was measured by western blot. Results: PRP treatment enhanced the survival area and perfusion of the flap, reduced neutrophil accumulation in mice subjected to I/R injury. PRP treatment also showed a protective effect, with decreases in nitric oxide, myeloperoxidase, malondialdehyde concentrations. Additionally, PRP suppresses monocyte chemotactic protein-1, TNF-α, IL-1β, and IL-6. Finally, PRP decreased ASK-1 and NF-κB expression in tissues with I/R injury. Conclusion: PRP acts as a protective factor during flap I/R injury by reducing reactive oxygen species level and proinflammatory cytokines via decreased expression of pASK-1 and pNF-κB.
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Affiliation(s)
- Dong Kyun Rah
- Department of Plastic and Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Hyung Jun Min
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yang Woo Kim
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Young Woo Cheon
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Martín-Solé O, Rodó J, García-Aparicio L, Blanch J, Cusí V, Albert A. Effects of Platelet-Rich Plasma (PRP) on a Model of Renal Ischemia-Reperfusion in Rats. PLoS One 2016; 11:e0160703. [PMID: 27551718 PMCID: PMC4994962 DOI: 10.1371/journal.pone.0160703] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/22/2016] [Indexed: 12/29/2022] Open
Abstract
Renal ischemia-reperfusion injury is a major cause of acute renal failure, causing renal cell death, a permanent decrease of renal blood flow, organ dysfunction and chronic kidney disease. Platelet-rich plasma (PRP) is an autologous product rich in growth factors, and therefore able to promote tissue regeneration and angiogenesis. This product has proven its efficacy in multiple studies, but has not yet been tested on kidney tissue. The aim of this work is to evaluate whether the application of PRP to rat kidneys undergoing ischemia-reperfusion reduces mid-term kidney damage. A total of 30 monorrenal Sprague-Dawley male rats underwent renal ischemia-reperfusion for 45 minutes. During ischemia, PRP (PRP Group, n = 15) or saline solution (SALINE Group, n = 15) was administered by subcapsular renal injection. Control kidneys were the contralateral organs removed immediately before the start of ischemia in the remaining kidneys. Survival, body weight, renal blood flow on Doppler ultrasound, kidney weight, kidney volume, blood biochemistry and histopathology were determined for all subjects and kidneys, as applicable. Correlations between these variables were searched for. The PRP Group showed significantly worse kidney blood flow (p = 0.045) and more histopathological damage (p<0.0001). Correlations were found between body weight, kidney volume, kidney weight, renal blood flow, histology, and serum levels of creatinine and urea. Our study provides the first evidence that treatment with PRP results in the deterioration of the kidney’s response to ischemia-reperfusion injury.
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Affiliation(s)
- Oriol Martín-Solé
- Unit of Pediatric Urology, Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | - Joan Rodó
- Unit of Pediatric Urology, Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Lluís García-Aparicio
- Unit of Pediatric Urology, Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Josep Blanch
- Department of Pediatric Radiology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Victoria Cusí
- Department of Pathology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Asteria Albert
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
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