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Pineda-Cortel MR, Suarez C, Cabrera JT, Daya M, Bernardo-Bueno MM, Vergara RC, Villavieja A. Biotherapeutic Applications of Platelet-Rich Plasma in Regenerative Medicine. Tissue Eng Regen Med 2023; 20:811-828. [PMID: 37651090 PMCID: PMC10519926 DOI: 10.1007/s13770-023-00560-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP), a blood-based product containing platelets and growth factors, is being utilized to treat numerous non-hemostatic disorders. Studies have explored the use of PRP to provide rapid repair, healing, and recovery from various injuries; some studies mentioned the effectiveness of PRP as compared with other forms of treatment like the use of hyaluronic acid. Commercially available PRP systems are available now, and each varies from one another depending on how it is prepared, thus causing variations in platelet concentration and growth factor content. These variations also implicated different therapeutic applications. METHODS The paper reviews the various applications of PRP, including factors to consider before using PRP therapy, and provides an extensive list of PRP applications. RESULTS The administration of PRP as a standalone treatment or as a co-therapy results in observed positive outcomes. However, there is a lack of standardization for PRP preparation, increasing the risks for heterogeneity and bias amongst results. CONCLUSION The use of PRP is indeed an option for regenerative therapy, but more research is needed before it can fully be recommended as a primary treatment modality.
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Affiliation(s)
- Maria Ruth Pineda-Cortel
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines
| | - Consuelo Suarez
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | - Jan-Tyrone Cabrera
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | - Minerva Daya
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | | | - Renz Cleve Vergara
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines
| | - Adrian Villavieja
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines.
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Basic Science of Autologous Orthobiologics Part 1. Platelet-Rich Plasma. Phys Med Rehabil Clin N Am 2022; 34:1-23. [DOI: 10.1016/j.pmr.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kheil MH, Bahsoun R, Sharara FI. Platelet-rich plasma: inconclusive evidence of reproductive outcomes in menopausal women. J Assist Reprod Genet 2022; 39:1987-1991. [PMID: 35731320 PMCID: PMC9474992 DOI: 10.1007/s10815-022-02554-5] [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: 05/02/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE The use of platelet-rich plasma is being investigated in reproductive medicine and clinically promoted as a fertility treatment for menopause. We aimed to review the literature on the impact of PRP on fertility in menopause. METHODS A literature search was performed using the PubMed and MEDLINE search engines. The search was limited to the English language. Articles studying PRP use in menopause were selected for the purpose of this review. RESULTS Limited case reports and case series studied fertility outcomes of PRP in menopause. Randomized controlled trials are lacking. Furthermore, no studies have been conducted to evaluate the effect of different PRP concentrations, injection techniques, or side effects on reproductive outcomes in menopausal women. CONCLUSION There is a dearth of data to support the routine implementation of intraovarian PRP injections for fertility restoration in menopausal women. Patients considering such therapy need to be well aware of the lack of adequate data for PRP use in menopause and should be counseled accordingly.
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Affiliation(s)
- Mira H Kheil
- Department of Pathology, Wayne State University, Detroit, MI, USA
| | - Reem Bahsoun
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Fady I Sharara
- Virginia Center for Reproductive Medicine, 11150 Sunset Hills Rd., Suite 100, Reston, VA, 20190, USA.
- Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC, USA.
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Dejnek M, Witkowski J, Moreira H, Płaczkowska S, Morasiewicz P, Reichert P, Królikowska A. Content of blood cell components, inflammatory cytokines and growth factors in autologous platelet-rich plasma obtained by various methods. World J Orthop 2022; 13:587-602. [PMID: 35949706 PMCID: PMC9244964 DOI: 10.5312/wjo.v13.i6.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/04/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The evaluation of the efficacy of platelet-rich plasma (PRP) in clinical practice yields conflicting results and raises numerous controversies. This may be due to different concentrations of biologically active components in PRP obtained with the use of different methods of gravity separation.
AIM To compare the content, repeatability and correlations between biologically active components in PRP obtained with four different commercial systems.
METHODS From a whole blood sample of each of 12 healthy male volunteers, 4 PRP samples were prepared using 4 different commercial kits [Arthrex Autologous Conditioned Plasma (ACP), Mini GPS III, Xerthra, Dr. PRP] in accordance with the instructions provided by the manufacturers. A comparative analysis of blood cell components - 13 selected inflammatory cytokines and 7 growth factors - in the obtained PRP samples was performed using the Kruskal-Wallis test by ranks. The repeatability of results in each method was evaluated by the estimation of the coefficient of variation. The Spearman correlation was used to estimate the relationship between blood cell content and cytokines.
RESULTS Significantly higher concentrations of platelets (PLT), white blood cells (WBC) and red blood cells (RBC) were found in PRP obtained with the use of Mini GPS III than in PRP obtained using other systems. Significant differences in the content of growth factors and cytokines in PRP were found. A positive correlation of the amount of PLT, RBC and WBC with the concentration of most of the growth factors was found but in only three inflammatory cytokines. The obtained correlations between blood cell components and cytokines differed between the systems in terms of statistical significance, which may be due to insufficient sample size. The repeatability of the obtained PLT concentration also varied between protocols with the lowest in Xerthra and the highest in Arthrex ACP.
CONCLUSION Significant differences in the content of biologically active components and their repeatability were found in PRP obtained by various methods, providing new data for further research.
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Affiliation(s)
- Maciej Dejnek
- Department of Trauma Surgery, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Jarosław Witkowski
- Department of Trauma Surgery, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Helena Moreira
- Department of Medical Science Foundation, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Sylwia Płaczkowska
- Teaching and Research Diagnostic Laboratory, Department of Laboratory Diagnostics, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Piotr Morasiewicz
- Institute of Medical Sciences, Department of Orthopaedic and Trauma Surgery, University of Opole, Opole 45-052, Poland
| | - Paweł Reichert
- Department of Trauma Surgery, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Wroclaw Medical University, Wroclaw 50-355, Poland
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López JF, Mikkola A, Sarkanen JR, Kaartinen IS, Kuokkanen HO, Ylikomi T. Adipose tissue as a source of growth factors to promote wound healing: a human study of skin graft donor sites. J Wound Care 2022; 31:282-292. [DOI: 10.12968/jowc.2022.31.4.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: In the microenvironment of wound sites, naturally occurring growth factors are crucial for cell migration, opsonisation, chemotaxis, differentiation and angiogenesis. Exogenous growth factors, such as platelet-rich plasma (PRP) and adipose tissue, also improve healing. Method: In the present within-subject study, we described the effects of PRP and adipose tissue extract (ATE) on skin graft donor site wound healing in patients requiring split-thickness skin grafts. Each patient, having at least two donor sites, received both control (no growth factor) and experimental (PRP or ATE) treatments. Wounds were evaluated on days 5, 7, 10, 15, 30 and 60. Digital photography and spectral images were used to analyse haemoglobin and melanin content, and re-epithelialisation area. Pain was assessed by visual analogue scale. Scar characteristics were scored on days 30 and 60. Biomaterial samples were analysed for growth factor and protein content. Results: The study included 24 patients (18 male and six female; mean age: 59.1 years). PRP was topically applied to wounds in 11 patients (13 donor sites) and ATE in 13 patients (15 sites). ATE-treated donor sites exhibited significantly accelerated wound re-epithelialisation on days 5 and 7 compared with control sites (p=0.003 and 0.04, respectively). PRP accelerated healing on day 7 compared with control sites (p=0.001). Additionally, the application of ATE improved scar quality on days 30 and 60 (p=0.0005 and 0.02, respectively). Pain scores did not differ significantly between treatments. Conclusion: In this study, both growth factor sources stimulated wound healing. ATE is an alternative source of growth factors that promote early wound healing and improve scar quality.
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Affiliation(s)
- Jenny F López
- Department of Cell Biology, School of Medicine (currently Faculty of Medicine and Health Technology), Tampere University, Tampere, Finland
- Department of Plastic Surgery, Unit of Musculoskeletal Diseases, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - Antti Mikkola
- Department of Plastic Surgery, Unit of Musculoskeletal Diseases, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - Jertta-Riina Sarkanen
- Department of Cell Biology, School of Medicine (currently Faculty of Medicine and Health Technology), Tampere University, Tampere, Finland
- FICAM, Finnish Centre for Alternative Methods, School of Medicine, University of Tampere, Tampere, Finland
- Science Center, Pirkanmaa Hospital District, Finland
| | - Ilkka S Kaartinen
- Department of Plastic Surgery, Unit of Musculoskeletal Diseases, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
- Science Center, Pirkanmaa Hospital District, Finland
| | - Hannu O Kuokkanen
- Department of Plastic Surgery, Unit of Musculoskeletal Diseases, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
- Science Center, Pirkanmaa Hospital District, Finland
| | - Timo Ylikomi
- Department of Cell Biology, School of Medicine (currently Faculty of Medicine and Health Technology), Tampere University, Tampere, Finland
- FICAM, Finnish Centre for Alternative Methods, School of Medicine, University of Tampere, Tampere, Finland
- Science Center, Pirkanmaa Hospital District, Finland
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Van Schaik KD, Lee KS. Orthobiologics: Diagnosis and Treatment of Common Tendinopathies. Semin Musculoskelet Radiol 2021; 25:735-744. [PMID: 34937114 DOI: 10.1055/s-0041-1735475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Orthobiologics, including platelet-rich plasma, prolotherapy, and mesenchymal stem cells, are seeing increasing use in the treatment of osteoarthritis (OA), muscle injury, and tendinopathy. This article reviews the biology and applications of orthobiologics in tendons, muscles, and joints, and focuses on platelet-rich plasma (PRP). Clinical evidence-based literature related to the use of PRP in the treatment of rotator cuff injury, lateral epicondylosis, Achilles tendinopathy, plantar fasciitis, knee OA, and acute muscle injury are discussed.
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Affiliation(s)
- Katherine D Van Schaik
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kenneth S Lee
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Whitney KE, Dornan GJ, King J, Chahla J, Evans TA, Philippon MJ, LaPrade RF, Huard J. The Effect of a Single Freeze-Thaw Cycle on Matrix Metalloproteinases in Different Human Platelet-Rich Plasma Formulations. Biomedicines 2021; 9:1403. [PMID: 34680520 PMCID: PMC8533272 DOI: 10.3390/biomedicines9101403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/27/2021] [Accepted: 10/01/2021] [Indexed: 01/17/2023] Open
Abstract
Storing platelet-rich plasma (PRP) for future use is a compelling approach, presuming the retention of biological properties is maintained. However, certain factors in PRP preparations have deleterious effects for the treatment of certain musculoskeletal conditions. The purpose of this study was to measure and compare matrix metalloproteinase protein (MMP) concentrations between fresh and freeze-thawed leukocyte-rich PRP (LR-PRP) inactivated (LR-I) and activated (LR-A) preparations, and leukocyte-poor PRP (LP-PRP) inactivated (LP-I) and activated (LP-A) preparations. A volume of 60 mL of whole blood was drawn from 19 healthy donors. LP-I and LR-I samples were processed using a manual extraction and centrifugation methodology. LP-A and LR-A products were activated with 10% CaCl2 and recombinant thrombin. Blood fractions were either immediately assayed and analyzed or stored at -80 °C for 24, 72 and 160 h. Multiplex immunoassay was used to measure MMP-1, MMP-2, MMP-3, MMP-9, MMP-10, and MMP-12. MMP-1 concentrations increased in LR-A (p < 0.05) and MMP-9 significantly increased in LR-I (p < 0.05), while MMP-2 significantly decreased in LR-I (p < 0.05) and MMP-3 concentrations significantly decreased in LR-A (p < 0.05). MMP-12 concentrations also significantly decreased in LR-I (p < 0.05) from baseline concentrations. There were no significant differences between LP-A and LP-I preparations and MMP concentrations. MMP-10 concentrations in all PRP samples compared to each freezing time point were also not significantly different. MMPs regulate components of the extracellular matrix (ECM) in the remodeling phase of musculoskeletal injury. In this study, we observed a significant increase and decrease in MMP concentrations in response to a single freeze-thaw cycle in inactivated PRP and activated PRP preparations. This evidence contributes to the growing body of literature on the optimization of PRP preparation and storage strategies prior to delivery. Our findings suggest that specific PRP preparations after a single freeze-thaw may be more advantageous for certain musculoskeletal applications based on the presence of MMP concentrations.
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Affiliation(s)
- Kaitlyn E. Whitney
- Steadman Philippon Research Institute, Vail, CO 81657, USA; (K.E.W.); (G.J.D.); (J.K.)
| | - Grant J. Dornan
- Steadman Philippon Research Institute, Vail, CO 81657, USA; (K.E.W.); (G.J.D.); (J.K.)
| | - Jillian King
- Steadman Philippon Research Institute, Vail, CO 81657, USA; (K.E.W.); (G.J.D.); (J.K.)
| | - Jorge Chahla
- Rush University Medical Center, Midwest Orthopaedics at Rush, Chicago, IL 60612, USA;
| | - Thos A. Evans
- The Steadman Clinic, Vail, CO 81657, USA; (T.A.E.); (M.J.P.)
| | | | | | - Johnny Huard
- Steadman Philippon Research Institute, Vail, CO 81657, USA; (K.E.W.); (G.J.D.); (J.K.)
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Ferrari AR, Cortrezzi S, Borges E, Braga D, Souza MDCBD, Antunes RDA. Evaluation of the Effects of Platelet-Rich Plasma on Follicular and Endometrial Growth: A Literature Review. JBRA Assist Reprod 2021; 25:601-607. [PMID: 34415119 PMCID: PMC8489815 DOI: 10.5935/1518-0557.20210036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Platelet-rich plasma (PRP) has been used in several areas of medicine due to its ability to promote tissue regeneration by growth factors and cytokines. This review addresses the use of PRP to rejuvenate ovarian follicles and increase the thickness of the endometrium to receive an embryo. PRP is obtained from the patient's own blood (autologous blood) - a fact that determines a lower chance of rejection reactions. Alpha granules of platelets provide and release supra physiological amounts of growth factors and cytokines, which provide a regenerative stimulus in tissues with low healing potential. In the ovary, PRP and its growth factors stimulate vascularization and recruitment of available primordial follicles that could no longer be otherwise stimulated. The rejuvenation of the ovary by PRP infusion aims to obtain new oocytes in ovaries with low numbers of follicles or low follicular reserve markers. In the preparation of the endometrium, PRP is used for its several growth factors that allow tissue proliferation and endometrial thickening, especially in cases of endometria that are difficult to prepare or that fail to reach an adequate minimum thickness (>7mm). To date, there are few studies of greater expression in the literature that support the use of PRP with the two purposes described above. Thus, although promising, the technique must still be validated by larger clinical trials.
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Affiliation(s)
| | - Sylvia Cortrezzi
- Fertility - Centro de Fertilização Assistida, São Paulo, SP, Brazil
| | - Edson Borges
- Fertility - Centro de Fertilização Assistida, São Paulo, SP, Brazil
| | - Daniela Braga
- Fertility - Centro de Fertilização Assistida, São Paulo, SP, Brazil
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de Andrade ALL, Sardeli AV, Garcia TA, Livani B, Belangero WD. PRP does not improve the objective outcomes of anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021; 29:3049-3058. [PMID: 33169180 DOI: 10.1007/s00167-020-06348-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Platelet rich plasma (PRP) has been used in association with anterior cruciate ligament resconstruction (ACLR) to improve rehabilitation. The purpose was to systematically review the literature to compare the effects of PRP on ACLR in its objective and subjective outcomes. METHODS A systematic review of the MEDLINE, Web of Science, Embase, Scopus, and Cochrane databases was performed. Two independent reviewers included all the English language literature of patients undergoing primary ACLR with autograft combined with PRP. The outcomes analyzed were graft ligamentization (MRI), tibial and femoral tunnel widening (MRI), knee laxity, IKDC, Lysholm, Tegner activity scale and visual analog scale. RESULTS Nine studies were included with a total of 525 patients. PRP did not improve ligamentization of graft (standardized mean difference (SMD): 0.01 [95% CI: - 0.37; 0.39]), did not lead to lesser tunnel widening (SMD: 0.71 [95% CI: - 0.12; 1.54]), or lead to lesser knee laxity (raw mean difference: 0.33 [95% CI: - 0.84; 0.19]). Although there was statistical significance for PRP effects on Lysholm score and VAS (p < 0.01), their magnitude was limited. CONCLUSION PRP showed no improvement in objective outcomes like ligamentization and less tunnel widening, while it showed just small improvements in terms of Lysholm, VAS and knee laxity. Therefore, there is not enough evidence to support a recommendation in favor of PRP and more research is needed. LEVEL OF EVIDENCE I.
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Affiliation(s)
| | - Amanda Veiga Sardeli
- Laboratory of Exercise Physiology-FISEX, University of Campinas-UNICAMP, Campinas, Brazil
| | - Thiago Alves Garcia
- Orthopaedic Biomaterials Laboratory, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil
| | - Bruno Livani
- Faculty of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil
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de Andrade ALL, Sardeli AV, Garcia TA, Livani B, Belangero WD. Time-Dependent Effect of Platelet-Rich Plasma in Reducing Donor-Site Pain After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2021; 49:2854-2858. [PMID: 33253008 DOI: 10.1177/0363546520968289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Anterior cruciate ligament reconstruction (ACLR) has a high incidence among sports players, and one important side effect of the surgery is graft donor site morbidity. Although some evidence suggests that application of platelet-rich plasma (PRP) during ACLR reduces pain and improves knee function, it is not a universal finding. PURPOSE To perform a meta-analysis of previous studies testing the effects of PRP on donor site morbidity after ACLR. STUDY DESIGN Systematic review and meta-analysis. METHODS We reviewed PubMed (Medline), Web of Science, Embase, Scopus, and Cochrane databases to find studies testing the effects of PRP on the donor site of ACLR autograft. After identifying 4 studies, we conducted 2 meta-analyses, 1 for the effects of PRP on pain, assessed by visual analog scale (VAS), and the other for the functional knee scores. We also tested the ability of time after ACLR to predict the PRP-related reduction of pain. RESULTS In the 4 studies identified, 157 patients were analyzed. Although the VAS score was lower with PRP at 6 months (raw mean difference [RMD], -0.97 [95% CI, -1.59 to -0.36]; P = .001) and 12 months (RMD, -0.61 [95% CI,-1.02 to -0.21]; P = .003), the effects of PRP disappeared at 24 months (RMD, -0.08 [95% CI,-0.38 to 0.22]; P = .586). A univariate regression analysis reinforced the ability of time after ACLR to predict the PRP-related reduction of VAS pain score (r2 = 0.98). However, knee function after ACLR was not improved by the use of PRP (standardized mean difference, 0.71 [95% CI,-0.17 to 1.60]; P = .114). CONCLUSION PRP applied to a bone-patellar tendon-bone donor site could reduce knee pain within a year, and this reduction had a correlation with time, meaning that the effect of PRP decreased with time after surgery. However, pain reduction did not reach clinical relevance and did not lead to better functional knee scores.
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Affiliation(s)
| | - Amanda Veiga Sardeli
- Laboratory of Exercise Physiology-FISEX, University of Campinas-UNICAMP, Campinas-SP, Brazil
| | - Thiago Alves Garcia
- Orthopaedic Biomaterials Laboratory, School of Medical Sciences, University of Campinas-UNICAMP, Campinas-SP, Brazil
| | - Bruno Livani
- Faculty of Medical Sciences, University of Campinas-UNICAMP, Campinas-SP, Brazil
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Oliveira-Filho MAD, Souza M, Tabushi FI, Almeida LE, Figueiredo FP, Lourenço ES, Giovanini AF, Malafaia O, Ribas Filho JM. Platelet-concentrated and platelet poor-plasma promote different pattern on immunohistochemical expression of TGF-β1, however they impairs the osteoneogensis in calvarial defects treated with autograft due suppression of osteocalcin. Acta Cir Bras 2021; 36:e360604. [PMID: 34287607 PMCID: PMC8291903 DOI: 10.1590/acb360604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose Herein we evaluated the effects of platelet concentrate (PC) and
platelet-poor plasma (PPP) on bone repair using noncritical defects in the
calvaria of rabbits and compared them to the presence of TGF-β1 and
osteocalcin on reparative sites. Methods Five noncritical defects of 8.7 mm in diameter were created on the calvaria
of 15 animals. Each defect was treated differently, using autograft (ABG),
ABG associated with PC (ABG + PC), ABG with PPP (ABG + PPP), isolated PPP,
and blood clot (control). The animals were submitted to euthanasia on the
second, fourth and sixth week post-surgery. Results The defects that received ABG+PC or PPP demonstrated lower bone formation
when compared to specimens that received ABG in the same period. These
results coincided to significant higher immunopositivity for TGF-β1 for
specimens that received PC, and lower presence of cytokine in the group PPP.
However, either higher or lower presence of TGF-β1 were also correlated to
lower presence of osteocalcin. Likewise, these results were similar to
findings in specimens treated only with PPP when compared to control. Conclusions PC and PPP were not effective when applied in association with ABG.
Similarly, isolated use of PPP was not beneficial in optimizing the bone
repair.
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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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13
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Liu B, Jeong HJ, Yeo JH, Oh JH. Efficacy of Intraoperative Platelet-Rich Plasma Augmentation and Postoperative Platelet-Rich Plasma Booster Injection for Rotator Cuff Healing: A Randomized Controlled Clinical Trial. Orthop J Sports Med 2021; 9:23259671211006100. [PMID: 34159208 PMCID: PMC8182201 DOI: 10.1177/23259671211006100] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/05/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Platelet-rich plasma (PRP) has been applied as an adjuvant treatment for
arthroscopic rotator cuff repair (ARCR) to enhance rotator cuff healing.
However, it remains debatable whether PRP enhances tendon-to-bone
healing. Purpose: To assess the efficacy of intraoperative augmentation and postoperative
injection of PRP that was prepared using the double-spin method and calcium
activation without thrombin in patients with ARCR. Study Design: Randomized controlled trial; Level of evidence, 1; and cohort study; Level of
evidence, 3. Methods: A total of 58 patients underwent ARCR using intraoperative PRP augmentation.
Half of the patients were randomly assigned to receive an additional
ultrasound-guided PRP injection at the repair site at 2 weeks
postoperatively (PRP-booster group); the other half did not receive the
booster injection (PRP-only group). A control group that did not receive any
PRP treatment was retrospectively matched using propensity score matching.
Structural integrity was assessed using magnetic resonance imaging at 1 year
postoperatively, and healing rates were compared between patients with tear
sizes ≤2 cm versus >2 cm. Functional outcomes were assessed using the
visual analog scale (VAS) for pain; VAS for satisfaction; shoulder range of
motion; and Constant, American Shoulder and Elbow Surgeons, and Simple
Shoulder Test scores at minimum 2-year follow-up. Results: In patients with tears >2 cm, the rate of healing failure at 1-year
follow-up was significantly less in the overall PRP group than in the
control group (12.9% vs 35.7%, respectively; P = .040),
however, the PRP-booster group did not present a better healing rate than
did the PRP-only group. The overall PRP group had lower VAS for pain scores
compared with the control group (0.5 ± 1.1 vs 1.3 ± 1.8, respectively;
P = .016) and higher VAS for satisfaction scores (9.2 ±
1.2 vs 8.6 ± 1.7; P = .023) at the final follow-up, whereas
no statistical difference was found between the PRP-only and PRP-booster
groups in functional outcomes. Conclusion: Intraoperative PRP augmentation during ARCR demonstrated superior anatomic
healing results in patients with rotator cuff tears >2 cm as well as
reduced pain and increased subjective satisfaction. PRP booster injection
provided no additional benefit to tendon integrity or functional
recovery.
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Affiliation(s)
- Bei Liu
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Hyeon Jang Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Ji Hyun Yeo
- Department of Orthopaedic Surgery, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyangsi, Republic of Korea
| | - Joo Han Oh
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
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Dawod A, Miro J, Elbaz HT, Fahmy H, Abdoon AS. Effect of Intrauterine Infusion of Equine Fresh Platelets-Rich Plasma (PRP) or Lyophilized PRP (L-GF equina) on Ovarian Activity and Pregnancy Rate in Repeat Breeder Purebred Arabian Mares. Animals (Basel) 2021; 11:ani11041123. [PMID: 33919901 PMCID: PMC8070911 DOI: 10.3390/ani11041123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Persistent endometritis is one of the major causes of infertility in mares and results in endometrium degeneration, namely, endometrosis. Platelets-rich plasma (PRP) is an emerging therapeutic application in tissue regeneration because of its high concentration of growth factors with a high mitogenic and anti-inflammatory potential, but reduced preservation time. L-GFequina is a freeze-dried, stabilized, platelet-rich plasma product (PP) that can be stored at 2 to 8 °C for several months. It can be easily used after reconstitution with sterile saline or water, eliminating the need for repeated blood product collection and special equipment. The intrauterine infusion of equine platelet-rich plasma or L-GFequina can be used indistinctly in repeat breeder mares, shortening the estrous cycle, with no significant effect on the follicular diameter, as well as increasing pregnancy rate in Arabian purebred mares. Abstract This study was designed to examine the effect of the intrauterine infusion of platelet-rich plasma (PRP) or equine lyophilized growth factor (L-GFequina) on the follicular growth, endometrial thickness, estrus cycle length, and pregnancy rate in purebred Arabian mares. A total of 73 purebred Arabian mares who experienced repeat breeding for three successive cycles were randomly divided into the following three groups: control group, without treatment; second Group (PRP group), in which mares were intrauterine infused with 20 mL of fresh PRP on the second day after the end of physic estrus phase; and the third group (L-GFequina Group), consisting of mares that were intrauterine infused with 20 mL of reconstituted lyophilized horse platelets growth factors (L-GFequina) on the second day after the estrus phase. The results showed no significant difference between control and treated groups in the diameter of the preovulatory follicles during the post treatment cycle. The endometrium thickness increased significantly in the L-GFequina and PRP groups ahead of the non-treated group. Intrauterine L-GFequina or PRP administration shortened the estrus cycle length. A higher pregnancy rate was recorded in the L-GFequina and PRP treated mares. In conclusion, the intrauterine infusion of L-GFequina or PRP increased the endometrial thickness and pregnancy rate and could be used to improve fertility in Arabian purebred mares who experienced from repeat breeding.
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Affiliation(s)
- Ahmed Dawod
- Husbandry and Animal Wealth Development Department, Faculty of Veterinary Medicine, University of Sadat City, Menofia 32897, Egypt
| | - Jordi Miro
- Department of Animal Medicine and Surgery, Veterinary Faculty, Autonomous University of Barcelona, E-08193 Barcelona, Spain
| | - Hamed T Elbaz
- Theriogenology Department, Faculty of Veterinary Medicine, University of Sadat City, Menofia 32897, Egypt
| | - Hossam Fahmy
- Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt
| | - Ahmed S Abdoon
- Department of Animal Reproduction and Artificial Insemination, National Research Center, Giza 12622, Egypt
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15
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Arora G, Arora S. Platelet-rich plasma-Where do we stand today? A critical narrative review and analysis. Dermatol Ther 2020; 34:e14343. [PMID: 32979292 DOI: 10.1111/dth.14343] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/13/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022]
Abstract
"Sometimes you have to travel a long way to find what is near." This quote by Paulo Coelho stands true for platelet-rich plasma (PRP) as we know of it today. Large strides have been made to understand this "youth" in blood, but there still seems a long way to go in our understanding of it. Despite advances, clarity in its preparation, biology, and the properties of the final product still remains elusive. The concepts of an ideal number or concentration of platelets in the final enriched plasma, best devices to prepare PRP, an ideal hardware, standard parameters for its preparation, the need for its activation or buffering of the final preparation or whether anticoagulants should be used or not, have evolved, since it was first described. The authors present an analysis of PRP present day status and its usefulness in field of medicine with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar related to PRP, its biology, types, and classifications, preparation, and use.
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Affiliation(s)
- Gulhima Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
| | - Sandeep Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
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16
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Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain. Neurol Sci 2020; 42:1977-1986. [PMID: 32990858 DOI: 10.1007/s10072-020-04710-0] [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: 05/07/2020] [Accepted: 09/04/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study. DESIGN Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection. RESULTS Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups. CONCLUSION The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03931824.
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Titan A, Schär M, Hutchinson I, Demange M, Chen T, Rodeo S. Growth Factor Delivery to a Cartilage-Cartilage Interface Using Platelet-Rich Concentrates on a Hyaluronic Acid Scaffold. Arthroscopy 2020; 36:1431-1440. [PMID: 31862290 DOI: 10.1016/j.arthro.2019.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine whether (1) human leukocyte-platelet-rich plasma (L-PRP) or (2) leukocyte-platelet-rich fibrin (L-PRF) delivered on a hyaluronic acid (HA) scaffold at a bovine chondral defect, a simulated cartilage tear interface, in vitro would improve tissue formation based on biomechanical, histologic, and biochemical measures. METHODS L-PRF and L-PRP were prepared from 3 healthy volunteer donors and delivered in conjunction with HA scaffolds to defects created in full-thickness bovine cartilage plugs harvested from bovine femoral condyle and trochlea. Specimens were cultured in vitro for up to 42 days. Treatment groups included an HA scaffold alone and scaffolds containing L-PRF or L-PRP. Cartilage repair was assessed using biomechanical testing, histology, DNA quantification, and measurement of sulfated glycosaminoglycan and collagen content at 28 and 42 days. RESULTS L-PRF elicited the greatest degree of defect filling and improvement in other histologic measures. L-PRF-treated specimens also had the greatest cellularity when compared with L-PRP and control at day 28 (560.4 μg vs 191.4 μg vs 124.2 μg, P = .15); at day 48, there remained a difference, although not significant, between L-PRF versus L-PRP (761.1 μg vs 589.3 μg, P = .219) . L-PRF had greater collagen deposition when compared with L-PRP at day 42 (40.1 μg vs 16.3 μg, P < .0001). L-PRF had significantly greater maximum interfacial strength compared with the control at day 42 (10.92 N vs 0.66 N, P = .015) but had no significant difference compared with L-PRP (10.92 N vs 6.58 N, P = .536). L-PRP facilitated a greater amount of sulfated glycosaminoglycan production at day 42 when compared with L-PRF (15.9 μg vs 4.3 μg, P = .009). CONCLUSIONS Delivery of leukocyte-rich platelet concentrates in conjunction with a HA scaffold may allow for improvements in cartilage healing through different pathways. L-PRF was not superior to L-PRP in its biomechanical strength, suggesting that both treatments may be effective in improving biomechanical strength of healing cartilage through different pathways. CLINICAL RELEVANCE The delivery of platelet-rich concentrates in conjunction HA scaffolds may augment healing cartilaginous injuries.
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Affiliation(s)
- Ashley Titan
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A
| | - Michael Schär
- Orthopaedic Soft Tissue Research Program, Sports Medicine and Shoulder Service, and the Department of Biomechanics, Hospital for Special Surgery, New York, New York, U.S.A; Department of Orthopaedic Surgery and Traumatology, University of Bern, Insel Hospital, Bern, Switzerland
| | - Ian Hutchinson
- Orthopaedic Soft Tissue Research Program, Sports Medicine and Shoulder Service, and the Department of Biomechanics, Hospital for Special Surgery, New York, New York, U.S.A; Department of Orthopaedic Surgery, University at Albany-State University of New York, Albany, New York, U.S.A
| | - Marco Demange
- Department of Orthopedic Surgery, University of São Paulo, São Paulo, Brazil
| | - Tony Chen
- Orthopaedic Soft Tissue Research Program, Sports Medicine and Shoulder Service, and the Department of Biomechanics, Hospital for Special Surgery, New York, New York, U.S.A
| | - Scott Rodeo
- Orthopaedic Soft Tissue Research Program, Sports Medicine and Shoulder Service, and the Department of Biomechanics, Hospital for Special Surgery, New York, New York, U.S.A.
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Kim JI, Bae HC, Park HJ, Lee MC, Han HS. Effect of Storage Conditions and Activation on Growth Factor Concentration in Platelet-Rich Plasma. J Orthop Res 2020; 38:777-784. [PMID: 31709604 DOI: 10.1002/jor.24520] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/03/2019] [Indexed: 02/06/2023]
Abstract
This study aimed to evaluate growth factor concentration in platelet-rich plasma (PRP) (leukocyte-rich PRP) based on storage temperature, duration of storage, and method of activation. PRP samples were stored at 24℃ (room temperature group), 4℃ (refrigerator group), and -70℃ (deep-freezer group). In each temperature, four aliquots were prepared based on the time of analysis (immediately, 1, 3, and 7 days after preparation). After storage, concentrations of platelet-derived growth factor-AA (PDGF-AA), transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), and fibroblast growth factor-basic (FGF-B) were assessed with/without activation using Quantikine colorimetric sandwich immunoassay kits. PRP was activated with 10% Triton-X for PDGF-AA, VEGF, FGF-B, IGF-1 measurement and sonication for TGF-β1 measurement. Without activation, PDGF-AA concentration was highest on day 7 in the room temperature group. With activation, the concentration of PDGF-AA was constant over the observation period at all temperatures. Without activation, the TGF-β1 concentration remained negligible over the observation period at all temperatures. However, with activation, TGF-β1 gradually increased to its highest concentration on day 7 at all temperatures. Over the observation period, VEGF and IGF-1 concentrations were constant with and without activation at all temperatures. Without activation, FGF-B concentration increased, with the highest concentration observed on day 7 in the deep-freezer group. With activation, FGF-B concentration decreased after day 1 in the room temperature group. Growth factor concentration in PRP differed significantly based on storage temperature, duration of storage, and method of activation. Appropriate storage conditions and activation are important to optimize its effects on desired clinical outcomes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:777-784, 2020.
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Affiliation(s)
- Joong Il Kim
- Department of Orthopaedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hyun Cheol Bae
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Hee Jung Park
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyuk Soo Han
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
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19
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Natural polymeric biomaterials in growth factor delivery for treating diabetic foot ulcers. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2019.101385] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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20
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Effects of specific pathogen-free porcine platelet-rich plasma activated by the novel activator ectoine on cell proliferation and biological function. Biochem Eng J 2020. [DOI: 10.1016/j.bej.2019.107424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Kim MH, Byeon HS. Review for good platelet-rich plasma procedure in cosmetic dermatology and surgery. ACTA ACUST UNITED AC 2019. [DOI: 10.25056/jcm.2019.3.1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Moon Hee Kim
- Department of Cosmetic Medicine, GC iMED, Seoul, Rep. of Korea
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22
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Smit Y, Marais HJ, Thompson PN, Mahne AT, Goddard A. Clinical findings, synovial fluid cytology and growth factor concentrations after intra-articular use of a platelet-rich product in horses with osteoarthritis. J S Afr Vet Assoc 2019; 90:e1-e9. [PMID: 31170778 PMCID: PMC6556911 DOI: 10.4102/jsava.v90i0.1721] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 02/04/2019] [Accepted: 02/19/2019] [Indexed: 01/06/2023] Open
Abstract
Osteoarthritis is a common cause of lameness in horses, resulting in poor performance. Intra-articular platelet-rich plasma can deliver a collection of bioactive molecules, such as autologous growth factors and proteins involved in the quality of tissue repair. Horses (n=5) with osteoarthritis affecting antebrachiocarpal, middle carpal or metacarpophalangeal joints, and horses (n=5) without osteoarthritis of the corresponding joints (radiographically free of osteoarthritis), were used for the production of platelet-rich plasma which was subsequently injected into selected joints. Clinical and synovial fluid changes after intra-articular injection of platelet-rich plasma as well as synovial platelet-derived growth factor-BB and transforming growth factor-beta 1 concentration changes were evaluated in these joints and compared between normal joints and joints with osteoarthritis. A gravity filtration system produced a moderately concentrated platelet-rich plasma, representing a 4.7-fold increase in baseline platelet concentration. The synovial effusion score was significantly different between the control joints and joints with osteoarthritis on Day 0 with a higher score in the group with osteoarthritis. Within the control group, the synovial effusion score was significantly higher on Days 1 and 2 compared to Day 0. For both groups, the synovial fluid nucleated cell count, predominantly intact neutrophils, was significantly increased on Days 1 and 2, with no significant difference between groups. The mean synovial platelet-derived growth factor-BB and transforming growth factor-beta 1 concentrations were increased for both groups but significantly lowered in the group with osteoarthritis on Day 1 compared to normal joints. Concentrations for platelet-derived growth factor-BB remained unchanged on Day 5, compared to Day 1, with no significant difference between groups. In conclusion, intra-articular treatment with platelet-rich plasma resulted in increased synovial growth factor concentrations in joints but with lower concentrations in joints with osteoarthritis. A transient inflammatory reaction was seen both clinically as an increase in synovial effusion and cytologically in both normal joints and joints with osteoarthritis.
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Affiliation(s)
- Yolandi Smit
- Department of Companion Animal Clinical Studies, University of Pretoria, Onderstepoort.
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Jayaram P, Yeh P, Patel SJ, Cela R, Shybut TB, Grol MW, Lee BH. Effects of Aspirin on Growth Factor Release From Freshly Isolated Leukocyte-Rich Platelet-Rich Plasma in Healthy Men: A Prospective Fixed-Sequence Controlled Laboratory Study. Am J Sports Med 2019; 47:1223-1229. [PMID: 30888847 DOI: 10.1177/0363546519827294] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The benefits of platelet-rich plasma (PRP) are believed to be in part dependent on growth factor release after platelet activation. Platelet activation is complex and involves multiple mechanisms. One important mechanism is driven by cyclooxygenase 1 (COX-1)-mediated conversion of arachidonic acid (AA) to precursor prostaglandins that then mediate proinflammatory responses that trigger growth factor release. Acetylsalicylic acid (ASA; also known as aspirin) is known to irreversibly inhibit COX-1, thereby blocking AA-mediated signaling; however, it is unclear whether ASA use alters growth factor release from freshly isolated PRP. PURPOSE To assess the effects of low-dose ASA use on activation of growth factor release from freshly isolated human PRP via AA and thrombin (TBN). STUDY DESIGN Controlled laboratory study. METHODS Twelve healthy men underwent blood collection and leukocyte-rich PRP (LR-PRP) preparation through a double-spin protocol to obtain baseline whole blood and PRP counts the same day. PRP was aliquoted into 3 groups: nonactivated, AA activated, and TBN activated. Immediately after activation, the concentrations of transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF), and platelet-derived growth factor AB (PDGF-AB) were measured using enzyme-linked immunosorbent assays (ELISAs). The same 12 participants were then placed on an 81-mg daily dose of oral ASA for 14 days. Repeat characterization of whole blood and PRP analyses was done on day 14, followed by repeat ELISAs of growth factors under the same nonactivated and activated settings as previously stated. RESULTS Fourteen days of daily ASA had no effect on the number of platelets and leukocytes measured in whole blood and LR-PRP. Compared with nonactivated LR-PRP, AA- and TBN-mediated activation led to significant release of VEGF and PDGF-AB. In contrast, release of TGF-β1 from LR-PRP was observed only with activation by AA, not with TBN. Consistent with its inhibitory role in AA signaling, ASA significantly inhibited AA-mediated release of all 3 growth factors measured in this study. Although ASA had no effect on TBN-mediated release of VEGF and TGF-β1 from LR-PRP, ASA did partially block TBN-mediated release of PDGF-AB, although the mechanism remains unclear. CONCLUSION Daily use of low-dose ASA reduces VEGF, PDGF-AB, and TGF-β1 expression in freshly isolated human LR-PRP when activated with AA. CLINICAL RELEVANCE Reduction in growth factor release attributed to daily use of low-dose ASA or other COX inhibitors can be mitigated when PRP samples are activated with TBN. Clinical studies are needed to determine whether activation before PRP injection is needed in all applications where ASA is in use and to what extent ASA may inhibit growth factor release in vivo at the site of injury.
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Affiliation(s)
- Prathap Jayaram
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.,Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Peter Yeh
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Shiv J Patel
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Racel Cela
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Theodore B Shybut
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew W Grol
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Brendan H Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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Berger DR, Centeno CJ, Steinmetz NJ. Platelet lysates from aged donors promote human tenocyte proliferation and migration in a concentration-dependent manner. Bone Joint Res 2019; 8:32-40. [PMID: 30800297 PMCID: PMC6359887 DOI: 10.1302/2046-3758.81.bjr-2018-0164.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives Platelet-rich plasma (PRP) is being used increasingly often in the clinical setting to treat tendon-related pathologies. Yet the optimal PRP preparations to promote tendon healing in different patient populations are poorly defined. Here, we sought to determine whether increasing the concentration of platelet-derived proteins within a derivative of PRP, platelet lysate (PL), enhances tenocyte proliferation and migration in vitro, and whether the mitogenic properties of PL change with donor age. Methods Concentrated PLs from both young (< 50 years) and aged (> 50 years) donors were prepared by exposing pooled PRP to a series of freeze-thaw cycles followed by dilution in plasma, and the levels of several platelet-derived proteins were measured using multiplex immunoassay technology. Human tenocytes were cultured with PLs to simulate a clinically relevant PRP treatment range, and cell growth and migration were assessed using DNA quantitation and gap closure assays, respectively. Results Platelet-derived protein levels increased alongside higher PL concentrations, and PLs from both age groups improved tenocyte proliferation relative to control conditions. However, PLs from aged donors yielded a dose-response relationship in tenocyte behaviour, with higher PL concentrations resulting in increased tenocyte proliferation and migration. Conversely, no significant differences in tenocyte behaviour were detected when increasing the concentration of PLs from younger donors. Conclusion Higher PL concentrations, when prepared from the PRP of aged but not young donors, were more effective than lower PL concentrations at promoting tenocyte proliferation and migration in vitro. Cite this article: D. R. Berger, C. J. Centeno, N. J. Steinmetz. Platelet lysates from aged donors promote human tenocyte proliferation and migration in a concentration-dependent manner. Bone Joint Res 2019;8:32–40. DOI: 10.1302/2046-3758.81.BJR-2018-0164.R1.
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Affiliation(s)
- D R Berger
- Interventional Orthopedics Foundation, Broomfield, Colorado, USA
| | - C J Centeno
- Centeno-Schultz Clinic, Broomfield, Colorado, USA; Board Chairman, Interventional Orthopedics Foundation, Broomfield, Colorado, USA; Chief Medical Officer, Regenexx, LLC, Broomfield, Colorado, USA
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da Silva LQ, Montalvão SADL, Justo-Junior ADS, Cunha Júnior JLR, Huber SC, Oliveira CC, Annichino-Bizzacchi JM. Platelet-rich plasma lyophilization enables growth factor preservation and functionality when compared with fresh platelet-rich plasma. Regen Med 2018; 13:775-784. [DOI: 10.2217/rme-2018-0035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aims: To compare levels and activity of the growth factors between fresh and lyophilized platelet-rich plasma (PRP). Methods: Analysis of platelet concentration using fibroblast and human umbilical vein endothelial cell cultures were compared between fresh and lyophilized PRP obtained from peripheral blood. Results: After lyophilization, 54% of platelets were intact whereas the fresh showed no aggregation with agonists (levels under 20%). The concentration of growth factors (VEGF, EGF, TGF-β and PDGF) in both products were similar. Fresh and lyophilized PRPs induced proliferation in the fibroblasts at 24 h (0.303 vs 0.300, respectively). Conclusion: Lyophilized PRP appears to be an alternative to fresh PRP and the results evidenced the role of growth factors as a key element in the activity of this product.
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Affiliation(s)
- Letícia Queiroz da Silva
- Hemocentro, Haemostasis Laboratory, State University of Campinas–UNICAMP. 13083-970, Campinas, São Paulo, Brazil
| | | | - Amauri da Silva Justo-Junior
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas–UNICAMP. 13083-970, Campinas, São Paulo, Brazil
| | | | - Stephany Cares Huber
- Hemocentro, Haemostasis Laboratory, State University of Campinas–UNICAMP. 13083-970, Campinas, São Paulo, Brazil
| | - Carolina Caliári Oliveira
- Faculty of Medical Sciences, State University of Campinas–UNICAMP. 13083-970, Campinas, São Paulo, Brazil
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Abstract
PURPOSE OF REVIEW To assess the utilization and efficacy of platelet-rich plasma (PRP), for the treatment of articular cartilage injury, most commonly characterized by progressive pain and loss of joint function in the setting of osteoarthritis (OA). RECENT FINDINGS PRP modulates the inflammatory and catabolic environment through a locally applied concentrate of platelets, leukocytes, and growth factors. Clinically, PRP has been shown to be possibly a viable treatment adjuvant for a variety of inflammatory and degenerative conditions. Recent efforts have focused on optimizing delivery methods that enable platelets to slowly degranulate their biological constituents, which may promote healing and improve OA symptoms for a longer duration. There are various factors that affect the progression of OA within joints, including inhibition of inflammatory cytokines and altering the level of enzymatic expression. PRP therapy aims to mediate inflammatory and catabolic factors in a degenerative environment through the secretion of anti-inflammatory factors and chemotaxic effects. There are a growing number of studies that have demonstrated the clinical benefit of PRP for non-operative management of OA. Additional randomized controlled trials with long-term follow-up are needed in order to validate PRP's therapeutic efficacy in this setting. Additionally, continued basic research along with well-designed pre-clinical studies and reporting standards are necessary in order to clarify the effectiveness of PRP for cartilage repair and regeneration for future clinical applications.
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Effects of Surface Nanotopography and Calcium Chemistry of Titanium Bone Implants on Early Blood Platelet and Macrophage Cell Function. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1362958. [PMID: 30069461 PMCID: PMC6057348 DOI: 10.1155/2018/1362958] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022]
Abstract
Early responses of blood platelets and immunoinflammatory cells (macrophages) to titanium (Ti) bone implants affect the subsequent biological healing of implants by modulating early tissue healing-microenvironments via the formation of temporary fibrin matrix scaffolds for stem cell migration and production of growth factors and cytokines. This study investigated the effects of nanoscale surface topography and calcium ion (Ca2+) modification of Ti surfaces on biocompatibility regulated by blood platelets and macrophages, for the future surface design of Ti bone implants with enhanced early osteogenic capacity. A nanostructured Ti surface with or without Ca2+ enrichment was prepared using the hydrothermal treatment. Immediate and early functions of platelets and macrophages modulated by modified Ti surfaces were investigated by morphological observation of platelet spreading and fibrin matrix formation, platelet growth factor release, immunostaining of macrophage phenotypes, and macrophage inflammatory cytokine production. The results showed that surface nanoscale topographical modification of Ti promotes blood platelet activation and suppresses the inflammatory response of macrophages. In addition, surface chemistry modifications with Ca2+ enhanced the platelet response-modulating function of the nanostructured Ti surface, which accelerated immediate fibrin matrix formation and platelet-derived growth factor-AB release. Thus, nanotopographical and Ca2+ modifications of implant surfaces are expected to be effective approaches that favor the initial phase of wound healing around the Ti bone implants through positive modulation of immediate blood platelet function and early macrophage immunoinflammatory response.
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28
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Biological Treatment for Osteoarthritis of the Knee: Moving from Bench to Bedside-Current Practical Concepts. Arthroscopy 2018; 34:1719-1729. [PMID: 29628381 DOI: 10.1016/j.arthro.2018.01.048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/08/2018] [Accepted: 01/26/2018] [Indexed: 02/02/2023]
Abstract
Biological-based therapies for cartilage pathology have gained considerable recognition in the last few decades due to their potential benefits including their minimal invasiveness, capacity for unprecedented healing, and potential for rapid recovery. Consequently, these therapies are likely to have the most noteworthy impact on patients with degenerative joint changes who want to remain active. Currently, the most researched treatments include platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and cell-based therapies. Although further basic science research and well-designed randomized clinical trials are needed to elucidate the long-term role of these therapies in the treatment of osteoarthritis, there is compelling evidence for their use for certain indications. This article aims to review the existing literature for biological-based treatment options for osteoarthritis, critically assessing the current evidence-based recommendations and identify potential avenues for development.
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Miao X, Rahman MFU, Jiang L, Min Y, Tan S, Xie H, Lee L, Wang M, Malmström RE, Lui WO, Li N. Thrombin-reduced miR-27b attenuates platelet angiogenic activities in vitro via enhancing platelet synthesis of anti-angiogenic thrombospondin-1. J Thromb Haemost 2018; 16:791-801. [PMID: 29442415 DOI: 10.1111/jth.13978] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Indexed: 12/29/2022]
Abstract
Essentials It is unclear if platelet micro-RNAs can regulate de novo protein synthesis of platelets. Platelet de novo protein synthesis of thrombospondin-1 (TSP-1) was induced by thrombin. Thrombin stimulation in vitro altered platelet microRNA profiles, including decreased miR-27b. Decreased miR-27b hampers platelet angiogenic activities via enhancing de novo TSP-1 synthesis. SUMMARY Background Platelets can synthesize proteins upon activation. Platelets contain a number of microRNAs (miRNA) and a fully functional miRNA effector machinery. It is, however, unclear if platelet miRNAs can regulate protein synthesis of platelets, and whether the regulation may produce a physiological impact. Objectives To investigate if and how platelet miRNAs regulate de novo syntheses of angiogenic regulators and subsequently modulate platelet angiogenic activities. Methods and Results Microarray-based miRNA profiling showed that thrombin stimulation in vitro down- or up-regulated a number of platelet miRNAs, both in the total platelet miRNAs and in Ago2-associated miRNAs. Among those altered miRNAs, miR-27b was down-regulated in both the total and Ago2-immunoprecipitated miRNA profiles of platelets, which was confirmed by reverse transcription-quantitative PCR (RT-qPCR). Using western blotting assays, we showed that thrombin induced platelet de novo synthesis of thrombospondin-1, and that the level of thrombospondin-1 synthesis could reach a level of 3-5-fold higher than that before thrombin stimulation. With either the platelet precursor megakaryocyte cell line MEG-01 cells or mature platelets, we demonstrated that transfection of miR-27b mimic, but not the negative control of miRNA mimic, markedly reduced thrombospondin-1 protein levels. The latter subsequently enhanced platelet-dependent endothelial tube formation on matrigel. Conclusions Thrombin stimulation in vitro reduces platelet miR-27b levels that may markedly enhance thrombin-evoked platelet de novo synthesis of thrombospondin-1. Elevation of platelet miR-27b by transfection inhibits thrombospondin-1 synthesis, and subsequently enhances platelet pro-angiogenic activities. Hence, platelet activation-dependent reduction of miR-27b levels may represent a novel negative regulatory mechanism of platelet angiogenic activities.
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Affiliation(s)
- X Miao
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
| | - M F-U Rahman
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
| | - L Jiang
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
- Department of Pathology, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University School of Medicine, Ningbo, China
| | - Y Min
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
| | - S Tan
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
| | - H Xie
- Department of Oncology-Pathology and Cancer Center Karolinska, Karolinska University Hospital-Solna, Stockholm, Sweden
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - L Lee
- Department of Oncology-Pathology and Cancer Center Karolinska, Karolinska University Hospital-Solna, Stockholm, Sweden
| | - M Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - R E Malmström
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital-Solna, Stockholm, Sweden
| | - W-O Lui
- Department of Oncology-Pathology and Cancer Center Karolinska, Karolinska University Hospital-Solna, Stockholm, Sweden
| | - N Li
- Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital-Solna, Stockholm, Sweden
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Karsten E, Breen E, Herbert BR. Red blood cells are dynamic reservoirs of cytokines. Sci Rep 2018; 8:3101. [PMID: 29449599 PMCID: PMC5814557 DOI: 10.1038/s41598-018-21387-w] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/24/2018] [Indexed: 01/06/2023] Open
Abstract
Red blood cells (RBCs) have been shown to affect immune function and can induce inflammatory responses after transfusion. The transfusion of washed RBCs can significantly reduce adverse effects, however, the soluble factors that may mediate these effects have not been identified. Previous studies have identified, but not quantified, a small number of chemokines associated with RBCs. We isolated RBCs from healthy volunteers and quantified of a panel of 48 cytokines, chemokines, and growth factors in the lysate, cytosol, and conditioned media of these cells using Luminex® technology. This analysis revealed that, after correcting for white blood cell and platelet contamination, 46 cytokines were detected in RBC lysates, and the median concentration in RBCs was 12-fold higher than in the plasma. In addition, extensive washing of RBCs, such as that performed in proteomics analyses or prior to some RBC transfusions, significantly attenuated the release of six cytokines following incubation at 37 °C. This supports the hypothesis that, alongside its gas exchange function, RBCs play a role in cytokine signalling. This discovery may help supplement disease biomarker research and may shed light on adverse inflammatory processes that can follow RBC transfusion.
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Affiliation(s)
- Elisabeth Karsten
- Translational Regenerative Medicine Laboratory, Kolling Institute, Royal North Shore Hospital, Sydney, Australia. .,Northern Clinical School, Faculty of Medicine, The University of Sydney, Sydney, Australia. .,Sangui Bio Pty Ltd, Sydney, Australia.
| | | | - Benjamin R Herbert
- Translational Regenerative Medicine Laboratory, Kolling Institute, Royal North Shore Hospital, Sydney, Australia.,Northern Clinical School, Faculty of Medicine, The University of Sydney, Sydney, Australia.,Sangui Bio Pty Ltd, Sydney, Australia
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31
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Whitney KE, Liebowitz A, Bolia IK, Chahla J, Ravuri S, Evans TA, Philippon MJ, Huard J. Current perspectives on biological approaches for osteoarthritis. Ann N Y Acad Sci 2018; 1410:26-43. [PMID: 29265418 DOI: 10.1111/nyas.13554] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/18/2017] [Accepted: 10/25/2017] [Indexed: 12/18/2022]
Abstract
Musculoskeletal injuries that disrupt the structure and function of diarthrodial joints can cause permanent biomechanical alterations and lead to a more severe, chronic condition. Despite advancements that have been made to restore tissue function and delay the need for joint replacement, there are currently no disease-modifying therapies for osteoarthritis (OA). To reduce the risk of OA, innovative preventive medicine approaches have been developed over the last decade to treat the underlying pathology. Several biological approaches are promising treatment modalities for various stages of OA owing to their minimally invasive nature and actively dynamic physiological mechanisms that attenuate tissue degradation and inflammatory responses. Individualized growth factor and cytokine therapies, tissue-engineered biomaterials, and cell-based therapies have revolutionary potential for orthopedic applications; however, the paucity of standardization and categorization of biological components and their counterparts has made it difficult to determine their clinical and biological efficacy. Cell-based therapies and tissue-engineered biologics have become lucrative in sports medicine and orthopedics; nonetheless, there is a continued effort to produce a biological treatment modality tailored to target intra-articular structures that recapitulates tissue function. Advanced development of these biological treatment modalities will potentially optimize tissue healing, regeneration, and joint preservation strategies. Therefore, the purpose of this paper is to review current concepts on several biological treatment approaches for OA.
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Affiliation(s)
- Kaitlyn E Whitney
- Steadman Philippon Research Institute, Vail, Colorado.,The Steadman Clinic, Vail, Colorado
| | | | | | - Jorge Chahla
- Steadman Philippon Research Institute, Vail, Colorado
| | | | - Thos A Evans
- Steadman Philippon Research Institute, Vail, Colorado.,The Steadman Clinic, Vail, Colorado
| | - Marc J Philippon
- Steadman Philippon Research Institute, Vail, Colorado.,The Steadman Clinic, Vail, Colorado
| | - Johnny Huard
- Steadman Philippon Research Institute, Vail, Colorado.,The University of Texas Health Science Center at Houston, Houston, Texas
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32
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Platelet-rich plasma: combinational treatment modalities for musculoskeletal conditions. Front Med 2017; 12:139-152. [DOI: 10.1007/s11684-017-0551-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/30/2017] [Indexed: 12/12/2022]
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Sermer C, Kandel R, Anderson J, Hurtig M, Theodoropoulos J. Platelet‐rich plasma enhances the integration of bioengineered cartilage with native tissue in an
in vitro
model. J Tissue Eng Regen Med 2017; 12:427-436. [DOI: 10.1002/term.2468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 03/16/2017] [Accepted: 05/04/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Corey Sermer
- Department of Surgery, Division of OrthopaedicsMt. Sinai and Women's College Hospital Toronto Ontario Canada
- Department of Pathology and Laboratory Medicine, Lunenfeld‐Tannenbaum Research InstituteMt. Sinai Hospital Toronto Ontario Canada
| | - Rita Kandel
- Department of Pathology and Laboratory Medicine, Lunenfeld‐Tannenbaum Research InstituteMt. Sinai Hospital Toronto Ontario Canada
| | - Jesse Anderson
- Department of Surgery, Division of OrthopaedicsMt. Sinai and Women's College Hospital Toronto Ontario Canada
| | - Mark Hurtig
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Canada
| | - John Theodoropoulos
- Department of Surgery, Division of OrthopaedicsMt. Sinai and Women's College Hospital Toronto Ontario Canada
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Shanbhag S, Stavropoulos A, Suliman S, Hervig T, Mustafa K. Efficacy of Humanized Mesenchymal Stem Cell Cultures for Bone Tissue Engineering: A Systematic Review with a Focus on Platelet Derivatives. TISSUE ENGINEERING PART B-REVIEWS 2017; 23:552-569. [PMID: 28610481 DOI: 10.1089/ten.teb.2017.0093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Fetal bovine serum (FBS) is the most commonly used supplement for ex vivo expansion of human mesenchymal stem cells (hMSCs) for bone tissue engineering applications. However, from a clinical standpoint, it is important to substitute animal-derived products according to current good manufacturing practice (cGMP) guidelines. Humanized alternatives to FBS include three categories of products: human serum (HS), human platelet derivatives (HPDs)-including platelet lysate (PL) or platelet releasate (PR), produced by freeze/thawing or chemical activation of platelet concentrates, respectively, and chemically defined media (serum-free) (CDM). In this systematic literature review, the in vitro and in vivo osteogenic potential of hMSCs expanded in humanized (HS-, HPD-, or CDM-supplemented) media versus hMSCs expanded in FBS-supplemented media, was compared. In addition, PL and PR were compared in terms of their growth factor (GF)/cytokine-content and cell-culture efficacy. When using either 10-20% autologous or pooled HS, 3-10% pooled HPDs or CDM supplemented with GFs, in comparison with 10-20% FBS, a majority of studies reported similar or superior in vitro proliferation and osteogenic differentiation, and in vivo bone formation in ectopic or orthotopic rodent models. Moreover, a trend for higher GF content was observed in PL versus PR, although evidence for cell culture efficacy is limited. In summary, humanized supplements seem at least equally effective as FBS for hMSC expansion and osteogenic differentiation. Although pooled HPDs appear to be the most favorable supplement for large-scale hMSC expansion, further efforts are needed to standardize the preparation and composition of these products in compliance with cGMP standards.
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Affiliation(s)
- Siddharth Shanbhag
- 1 Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Andreas Stavropoulos
- 2 Department of Periodontology, Faculty of Odontology, Malmö University , Malmö, Sweden
| | - Salwa Suliman
- 1 Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Tor Hervig
- 3 Department of Immunology and Transfusion Medicine, Haukeland University Hospital , Bergen, Norway
| | - Kamal Mustafa
- 1 Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen , Bergen, Norway
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35
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Badran Z, Abdallah MN, Torres J, Tamimi F. Platelet concentrates for bone regeneration: Current evidence and future challenges. Platelets 2017. [DOI: 10.1080/09537104.2017.1327656] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Zahi Badran
- Department of Periodontology (CHU/Rmes Inserm U1229/UIC11), Faculty of Dental Surgery, University of Nantes, Nantes, France
- Division of Biomedical Sciences, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Mohamed-Nur Abdallah
- Division of Biomedical Sciences, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Jesus Torres
- Faculty of Dentistry, Universidad Complutense, Madrid, Spain
| | - Faleh Tamimi
- Division of Biomedical Sciences, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Platelet-Rich Plasma Augmentation for Hip Arthroscopy. Arthrosc Tech 2017; 6:e763-e768. [PMID: 28706829 PMCID: PMC5495659 DOI: 10.1016/j.eats.2017.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/01/2017] [Indexed: 02/03/2023] Open
Abstract
Biological augmentation and therapeutics are being increasingly used in musculoskeletal and orthopaedic care. Platelet-rich plasma (PRP) is produced from centrifugation of peripheral blood, a process that concentrates platelets within autologous plasma. The process of PRP preparation is fundamental in controlling the contents, and it influences its therapeutic potential. Platelets contain alpha granules that store and release a variety of growth factors and other proteins that may augment the healing environment; PRP also has the added benefit of promoting postsurgical hemostasis. The purpose of this report was to detail our institutional preparation protocol and method of administration of PRP during hip arthroscopy.
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37
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Franklin SP, Birdwhistell KE, Strelchik A, Garner BC, Brainard BM. Influence of Cellular Composition and Exogenous Activation on Growth Factor and Cytokine Concentrations in Canine Platelet-Rich Plasmas. Front Vet Sci 2017; 4:40. [PMID: 28424777 PMCID: PMC5380674 DOI: 10.3389/fvets.2017.00040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 03/07/2017] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The purposes of this study were to (1) evaluate correlations among platelet, leukocyte, growth factor, and cytokine concentrations in canine platelet-rich plasmas (PRPs) produced from five different canine PRP-concentrating systems and (2) compare the effects of different activation protocols on platelet activation and growth factor release from one of these PRPs. METHODS PRP was made using blood from 15 dogs and each of 5 different PRP systems in a cross-over design. Complete blood counts were performed to quantify platelet and leukocyte concentrations. PRPs were activated, or not, according to manufacturer instructions, and transforming growth factor-β1 (TGF-β1), platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor, and tumor necrosis factor-alpha (TNF-α) were quantified. Differences among platelet, leukocyte, and growth factor concentration were compared among the different systems. Correlations between platelet and anabolic growth factor concentrations were assessed. Subsequently, PRP was made from 12 additional dogs using one of the devices. Each PRP was divided into three aliquots that were activated with calcium chloride (CaCl2), human γ-thrombin (HGT), or not activated. Expression of CD62P and platelet-bound fibrinogen (CAP1) was quantified for each activation group. Concentrations of TGF-β1, PDGF-BB, and TNF-α were also quantified for each activation group and a fourth group that was frozen/thawed. Differences among activation groups were assessed by a Friedman test. RESULTS There were statistically significant differences among the PRPs made with difference devices with regard to platelet, leukocyte, TGF-β1, and PDGF-BB concentrations (p < 0.0001). There were weak to moderate correlations (R2 = 0.07-0.58) between platelet and anabolic growth factor concentrations but it appeared that activation had a greater effect on growth factor concentration than did cellular composition. Intentional platelet activation significantly increased CD62P and CAP1 expression as well as TGF-β1 and PDGF-BB concentrations in the one PRP in which all activation methods were assessed. Activation with HGT resulted in the greatest platelet activation, and CaCl2 and freeze/thaw elicited moderate increases in either growth factor release or CD62P and CAP1 expression. CONCLUSION There are positive correlations between platelet and anabolic growth factor concentrations in canine PRPs. However, intentional platelet activation has a greater effect on growth factor delivery than platelet concentration. Thrombin provides more robust activation than CaCl2.
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Affiliation(s)
- Samuel P Franklin
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Kate E Birdwhistell
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Alena Strelchik
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Bridget C Garner
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Fernandes G, Yang S. Application of platelet-rich plasma with stem cells in bone and periodontal tissue engineering. Bone Res 2016; 4:16036. [PMID: 28018706 PMCID: PMC5153571 DOI: 10.1038/boneres.2016.36] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/19/2016] [Accepted: 08/23/2016] [Indexed: 12/17/2022] Open
Abstract
Presently, there is a high paucity of bone grafts in the United States and worldwide. Regenerating bone is of prime concern due to the current demand of bone grafts and the increasing number of diseases causing bone loss. Autogenous bone is the present gold standard of bone regeneration. However, disadvantages like donor site morbidity and its decreased availability limit its use. Even allografts and synthetic grafting materials have their own limitations. As certain specific stem cells can be directed to differentiate into an osteoblastic lineage in the presence of growth factors (GFs), it makes stem cells the ideal agents for bone regeneration. Furthermore, platelet-rich plasma (PRP), which can be easily isolated from whole blood, is often used for bone regeneration, wound healing and bone defect repair. When stem cells are combined with PRP in the presence of GFs, they are able to promote osteogenesis. This review provides in-depth knowledge regarding the use of stem cells and PRP in vitro, in vivo and their application in clinical studies in the future.
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Affiliation(s)
- Gabriela Fernandes
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Shuying Yang
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA
- Developmental Genomics Group, New York State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
- Department of Anatomy & Cell Biology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Muto T, Kokubu T, Mifune Y, Inui A, Sakata R, Harada Y, Takase F, Kurosaka M. Effects of platelet-rich plasma and triamcinolone acetonide on interleukin-1ß-stimulated human rotator cuff-derived cells. Bone Joint Res 2016; 5:602-609. [PMID: 27965219 PMCID: PMC5227058 DOI: 10.1302/2046-3758.512.2000582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 09/13/2016] [Indexed: 12/13/2022] Open
Abstract
Objectives Triamcinolone acetonide (TA) is widely used for the treatment of rotator cuff injury because of its anti-inflammatory properties. However, TA can also produce deleterious effects such as tendon degeneration or rupture. These harmful effects could be prevented by the addition of platelet-rich plasma (PRP), however, the anti-inflammatory and anti-degenerative effects of the combined use of TA and PRP have not yet been made clear. The objective of this study was to determine how the combination of TA and PRP might influence the inflammation and degeneration of the rotator cuff by examining rotator cuff-derived cells induced by interleukin (IL)-1ß. Methods Rotator cuff-derived cells were seeded under inflammatory stimulation conditions (with serum-free medium with 1 ng/ml IL-1ß for three hours), and then cultured in different media: serum-free (control group), serum-free + TA (0.1mg/ml) (TA group), serum-free + 10% PRP (PRP group), and serum-free + TA (0.1mg/ml) + 10% PRP (TA+PRP group). Cell morphology, cell viability, and expression of inflammatory and degenerative mediators were assessed. Results Exposure to TA significantly decreased cell viability and changed the cell morphology; these effects were prevented by the simultaneous administration of PRP. Compared with the control group, expression levels of inflammatory genes and reactive oxygen species production were reduced in the TA, PRP, and TA+PRP groups. PRP significantly decreased the expression levels of degenerative marker genes. Conclusions The combination of TA plus PRP exerts anti-inflammatory and anti-degenerative effects on rotator cuff-derived cells stimulated by IL-1ß. This combination has the potential to relieve the symptoms of rotator cuff injury. Cite this article: T. Muto, T. Kokubu, Y. Mifune, A. Inui, R. Sakata, Y. Harada, F. Takase, M. Kurosaka. Effects of platelet-rich plasma and triamcinolone acetonide on interleukin-1ß-stimulated human rotator cuff-derived cells. Bone Joint Res 2016;5:602–609. DOI: 10.1302/2046-3758.512.2000582.
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Affiliation(s)
- T Muto
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - T Kokubu
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - Y Mifune
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - A Inui
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - R Sakata
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - Y Harada
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - F Takase
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - M Kurosaka
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
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41
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Yilmaz I, Akkaya S, Isyar M, Batmaz AG, Guler O, Oznam K, Ugras A, Mahiroğullari M. Is there a treatment protocol in which platelet-rich plasma is effective? J Orthop 2016; 13:316-21. [PMID: 27408512 DOI: 10.1016/j.jor.2016.06.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 06/27/2016] [Indexed: 01/08/2023] Open
Abstract
AIM We aimed to reveal whether there are prospective suggestions for effective and standard platelet-rich plasma applications. METHODS We searched for clinical trials and traced all the references of incorporated documents. RESULTS In literature, there was no study indicating which disease is treated by which mechanism of action, how much dose and content are prepared and applied, when the treatment is applied and how many cures are applied. CONCLUSION Guides introducing which concentrations of PRP are used for which diseases are to be prepared immediately by a committee which is comprised of primarily orthopedists, clinical pharmacologists and toxicologists.
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Affiliation(s)
- Ibrahim Yilmaz
- Republic of Turkey Ministry of Health, State Hospital, Department of Pharmacovigilance, Materiovigilance and Rational Use of Drugs, 59100 Tekirdag, Turkey
| | - Semih Akkaya
- Pamukkale University School of Medicine, Department of Orthopaedic and Traumatology, 20070 Denizli, Turkey
| | - Mehmet Isyar
- Central Hospital Health Group, Department of Orthopaedic and Traumatology, 34742 Istanbul, Turkey
| | - Ahmet Güray Batmaz
- Istanbul Medipol University School of Medicine, Department of Orthopaedic and Traumatology, 34214 Istanbul, Turkey
| | - Olcay Guler
- Istanbul Medipol University School of Medicine, Department of Orthopaedic and Traumatology, 34214 Istanbul, Turkey
| | - Kadir Oznam
- Istanbul Medipol University School of Medicine, Department of Orthopaedic and Traumatology, 34214 Istanbul, Turkey
| | - Akin Ugras
- Istanbul Medipol University School of Medicine, Department of Orthopaedic and Traumatology, 34214 Istanbul, Turkey
| | - Mahir Mahiroğullari
- Memorial Health Group, Department of Orthopaedic and Traumatology, 34384 Istanbul, Turkey
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Affiliation(s)
- I R Murray
- Department of Orthopaedics, The University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, EH16 4SB, UK
| | - R F LaPrade
- Steadman Philippon Research Institute, Vail, Colorado, USA
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