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Melo-Ferraz A, Coelho C, Miller P, Criado MB, Monteiro MC. Comprehensive analysis of L-PRF exudate components and their impact on whole blood platelets. Clin Oral Investig 2024; 28:470. [PMID: 39110266 DOI: 10.1007/s00784-024-05868-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 07/31/2024] [Indexed: 09/18/2024]
Abstract
OBJECTIVE This study assessed the cellular composition and effects of leukocyte-platelet-rich fibrin (L-PRF) exudate on whole blood platelets from healthy volunteers. Key objectives included evaluating leukocyte subpopulations, platelet activation markers, platelet-leukocyte interactions and quantifying inflammatory cytokines within the L-PRF exudate. MATERIALS AND METHODS L-PRF was obtained from 20 healthy donors. Flow cytometry methodologies were used to assess intracellular calcium kinetics and activated GPIIbIIIa, and P-selectin expression. Leukocyte subpopulations and platelet-leukocyte interactions were characterized using monoclonal antibodies. Inflammatory cytokines (IL-8, IL-1β, IL-6, IL-10, TNF, IL-12p70) within L-PRF exudate were quantified using a cytometric bead array. RESULTS The expression of activated GPIIbIIIa, and P-selectin exhibited a significant increase (p < 0.001) when L-PRF exudate was added to platelets of whole blood. Regarding intracellular Ca2+ mobilization, the L-PRF exudate elicited significant responses (p < 0.001). L-PRF exudate contained different leukocytes populations, being TCD4 + the most representative of T cells. It was possible to stablish a profile of cytokines produced by the L-PRF exudate, with human IL-8 cytokine exhibiting the highest average (16.90 pg/mL). CONCLUSIONS Despite the study limitations, the research yielded important insights: 1- L-PRF exudate can stimulate platelet activation, essential in healing, tissue inflammation and remodeling. 2-The presence of leukocyte subpopulations within L-PRF exudate reflexes its complexity and potential to enhance immune responses. 3-The analysis of inflammatory cytokines within L-PRF exudate revealed its immunomodulatory potential. These findings are valuable evidences for understanding the potential role of L-PRF exudate in regenerative dentistry and medicine, offering innovative therapeutic strategies. CLINICAL RELEVANCE This research highlights crucial aspects that could significantly influence the clinical use of L-PRF exudate in the oral cavity. The findings support the application of L-PRF exudate in both surgical and regenerative dentistry, facilitating the development of innovative therapeutic strategies to enhance patient outcomes.
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Grants
- PAAALPRF_PI2RL_IINFACTS_2021 UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU and 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU
- PAAALPRF_PI2RL_IINFACTS_2021 UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU and 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU
- PAAALPRF_PI2RL_IINFACTS_2021 UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU and 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU
- PAAALPRF_PI2RL_IINFACTS_2021 UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU and 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU
- PAAALPRF_PI2RL_IINFACTS_2021 UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU and 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU
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Affiliation(s)
- António Melo-Ferraz
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, 4585-116, Portugal
| | - Cristina Coelho
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, 4585-116, Portugal
| | - Paulo Miller
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, 4585-116, Portugal.
| | - Maria Begoña Criado
- 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, 4585-116, Portugal
| | - Maria Céu Monteiro
- 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, 4585-116, Portugal
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Carvalho A, Ferreira AF, Soares M, Santos S, Tomé P, Machado-Simões J, Pais AS, Sousa AP, Paiva A, Almeida-Santos T. Optimization of Platelet-Rich Plasma Preparation for Regenerative Medicine: Comparison of Different Anticoagulants and Resuspension Media. Bioengineering (Basel) 2024; 11:209. [PMID: 38534483 DOI: 10.3390/bioengineering11030209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Platelet-rich plasma (PRP) has emerged as a promising therapy in regenerative medicine. However, the lack of standardization in PRP preparation protocols presents a challenge in achieving reproducible and accurate results. This study aimed to optimize the PRP preparation protocol by investigating the impact of two different anticoagulants, sodium citrate (SC) and ethylenediaminetetraacetic acid (EDTA), and resuspension media, plasma versus sodium chloride (NaCl). Platelet recovery rates were calculated and compared between groups, in addition to platelet activity and vascular endothelial growth factor (VEGF) released into plasma after PRP activation. The platelet recovery rate was higher with EDTA in comparison to SC (51.04% vs. 29.85%, p = 0.005). Platelet activity was also higher, with a higher expression of two platelet antibodies, platelet surface P-Selectin (CD62p) and PAC-1, in the EDTA group. The concentration of VEGF was higher with SC in comparison to EDTA (628.73 vs. 265.44 pg/mL, p = 0.013). Platelet recovery rates and VEGF levels were higher in PRP resuspended in plasma when compared to NaCl (61.60% vs. 48.61%, p = 0.011 and 363.32 vs. 159.83 pg/mL, p = 0.005, respectively). Our study reinforces the superiority of EDTA (as anticoagulant) and plasma (for resuspension) in obtaining a higher platelet recovery and preserving platelet functionality during PRP preparation.
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Affiliation(s)
- Alexandra Carvalho
- Reproductive Medicine Unit, Gynecology, Obstetrics, Reproduction and Neonatology Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Ana Filipa Ferreira
- Reproductive Medicine Unit, Gynecology, Obstetrics, Reproduction and Neonatology Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Maria Soares
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Doctoral Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Susana Santos
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, 3000-075 Coimbra, Portugal
| | - Patrícia Tomé
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, 3000-075 Coimbra, Portugal
| | - Juliana Machado-Simões
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Ana Sofia Pais
- Reproductive Medicine Unit, Gynecology, Obstetrics, Reproduction and Neonatology Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Paula Sousa
- Reproductive Medicine Unit, Gynecology, Obstetrics, Reproduction and Neonatology Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Artur Paiva
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, 3000-075 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Ciências Biomédicas Laboratoriais, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, 3046-854 Coimbra, Portugal
| | - Teresa Almeida-Santos
- Reproductive Medicine Unit, Gynecology, Obstetrics, Reproduction and Neonatology Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Albahrawy M, Abass M, Mosbah E, Karrouf G, Awadin W, Zaghloul A. Reinforcement of colon anastomosis healing with leukocyte platelet-rich fibrin in rabbit model. Life Sci 2023; 333:122146. [PMID: 37802197 DOI: 10.1016/j.lfs.2023.122146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
AIM This study investigated the regenerative efficacy of leukocyte platelet-rich fibrin (L-PRF) on colon anastomotic healing in rabbits. MAIN METHODS Thirty-six healthy male white New Zealand rabbits were subjected to complete transactions of the ascending colon. The rabbits were equally divided into two groups: the control group, where the transected colon ends were anastomosed by a simple interrupted suture pattern, and the L-PRF-treated group, in which L-PRF was wrapped entirely around the anastomotic line. The postoperative acute pain scale was assessed using the Bristol Rabbit Pain Scale before surgery and at each four-hour interval post-operatively. After euthanizing the rabbits, the adhesion degree score, anastomotic bursting pressure, and stenosis degree of the anastomotic colon were assessed, and histopathological examination at the 7th, 14th, and 28th days postoperatively. KEY FINDINGS Rabbits in both groups showed a significant increase in pain scores compared to baseline. Postoperatively, the L-PRF group exhibited significantly lower pain scores, adhesion scores, and stenosis degrees than the control group. However, the anastomotic bursting pressure was significantly higher in the L-PRF group. Re-epithelialization, polymorphonuclear neutrophil infiltration, granulation tissue formation, and collagen deposition scores were improved considerably in the L-PRF group compared to the control group. Immunostaining of growth factor expression was significantly lower in the control than in the L-PRF group. SIGNIFICANCE The L-PRF can augment collagen deposition, re-epithelialize the mucosa, promote angiogenesis, reduce adhesions, and diminish the stenosis degree scores. Therefore, it can be considered a promising aid in healing bowel anastomoses.
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Affiliation(s)
- Mohammed Albahrawy
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Marwa Abass
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Esam Mosbah
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Gamal Karrouf
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Walaa Awadin
- Department of Pathology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Adel Zaghloul
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
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Li A, Piao H, Zhang J, Cheng Q, Piao F, Cao C, Yan Y, Li J, Jin B. Clinical Effect of Platelet-Rich Fibrin Combined with BIO-GENE Artificial Bone Meal in Bone Defects After Jaw Cyst Surgery. Int J Gen Med 2023; 16:5225-5234. [PMID: 38021056 PMCID: PMC10644843 DOI: 10.2147/ijgm.s431638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose To compare the clinical repair effects of leaving the defect empty and using Platelet-Rich Fibrin (PRF) combined with BIO-GENE artificial bone powder in patients with bone defects 6 months after jaw cystectomy. Patients and Methods From June 2021 to June 2022, 70 patients who were admitted to the Department of Stomatology, Affiliated Hospital of Yanbian University, and were diagnosed with jaw cysts postoperatively were selected. All of the patients were divided into two groups according to random method, among which 35 patients who underwent cystectomy alone were recorded as group A, which served as blank control; 35 patients who underwent cystectomy and PRF combined with BIO-GENE artificial bone meal repaired bone defects during the same period were recorded as group B. 3D Slicer 5.0.3 software was used to reconstruct Cone Beam Computed Tomography (CBCT) after operation. In this study, the preoperative and postoperative CBCT data of the patients were analyzed using 3D Slicer 5.0.3 software in DICOM format to calculate the cleft volume before surgery and the newly formed bone volume after surgery. The osteogenesis rate was measured based on these calculations.The bone formation percentage in the bone defect area was recorded at 6 months, and the clinical curative effects of the two groups were compared. Results After 6 months of surgery, the patients showed varying degrees of restoration in the jaw cyst area.The osteogenesis rate at 6 months in group A was 76.06±13.38%, while group B had a rate of 92.87±5.72%.The CBCT values in group B were higher than those in group A at 6 months post-surgery (P<0.05), t=-6.84.Group A and Group B showed a statistically significant difference. Conclusion Compared with simple cystectomy, PRF combined with BIO-GENE artificial bone powder has a better effect on the speed of bone repair after cystectomy within 6 months and provides more favorable effects for the repair of postoperative dentition defects, and provides support to repair teeth after defects such as dental implants.
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Affiliation(s)
- An Li
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Huxiong Piao
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Jiamin Zhang
- Department of Periodontal Mucosal Disease, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, People’s Republic of China
| | - Qingtao Cheng
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Fangyu Piao
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Chang Cao
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Yuqi Yan
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Jingxu Li
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
| | - Bin Jin
- Stomatology, Affiliated Hospital of Yanbian University, Yanji, People’s Republic of China
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Skurska A, Chwiedosik M, Ślebioda Z. Adjunctive use of platelet-rich fibrin in surgical treatment of furcation defects: A systematic review. Adv Med Sci 2023; 68:366-371. [PMID: 37757664 DOI: 10.1016/j.advms.2023.09.009] [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: 05/08/2023] [Revised: 07/20/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Periodontitis is an infectious disease characterized by the inflammatory destruction of the tooth supporting tissues. In multi-rooted teeth, this process leads to periodontal destruction within furcations creating defects demanding in terms of treatment. Regeneration of class II furcation involvement, although possible, is considered an unpredictable procedure, especially in terms of the bone fill. The interest in wound healing improvement by additional use of autologous concentrates of growth factors remains high in many fields of dentistry. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate and biomaterial. PRF forms a solid fibrin matrix, which is slowly remodeled comparable to the natural blood clot. Its utilization is associated with release of growth factors and glycoproteins over a long period of time. PRF activates alkaline phosphates, which show osteoblastic activity and this activation influences the bone formation. The aim of this review of randomized controlled trials (RCTs) was to evaluate the adjunctive use of platelet-rich fibrin in surgical treatment of furcation defects.
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Affiliation(s)
- Anna Skurska
- Department of Integrated Dentistry, Medical University of Bialystok, Poland.
| | | | - Zuzanna Ślebioda
- Department of Oral Surgery, Periodontology and Oral Mucosa Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Kosmidis K, Ehsan K, Pitzurra L, Loos B, Jansen I. An in vitro study into three different PRF preparations for osteogenesis potential. J Periodontal Res 2023; 58:483-492. [PMID: 36942454 DOI: 10.1111/jre.13116] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To investigate the effect of Advanced Platelet-Rich Fibrin (A-PRF+), Leukocyte Platelet-Rich Fibrin (L-PRF), and injectable Platelet-Rich Fibrin (i-PRF) on osteogenesis of a human osteoblast-like cell line in vitro. BACKGROUND Different PRF protocols are used in clinical dentistry in the last years. Recent literature documented the positive impact of PRF derivatives in vivo and in vitro, on different types of cells. However, hardly any literature comparing the new protocols for PRF (the A-PRF+ and i-PRF) with the original protocol of PRF (L-PRF) is present for osteoblast-like cells. MATERIALS AND METHODS A-PRF+, L-PRF, and i-PRF were prepared from six male donors and pre-cultured with 10 mL culture medium for 6 days. 5 x 103 cells/ml osteoblasts from the osteoblast cell line (U2OS) were seeded and cultured either with conditioned medium derived from the different PRF conditions or with regular culture medium. At five different time points (0, 7, 14, 21, 28 days), the osteogenic capacity of the cells was assessed with Alizarin Red S to visualize mineralization. Also in these cells, the calcium concentration and alkaline phosphatase activity were investigated. Using qPCR, the expression of alkaline phosphatase, osteocalcin, osteonectin, ICAM-1, RUNX-2, and collagen 1a was assessed. RESULTS In osteoblast-like cells cultured with conditioned medium, the A-PRF+ conditioned medium induced more mineralization and calcium production after 28 days of culturing compared with the control (p < .05). No significant differences were found in the extent of cell proliferation between the different conditions. RUNX-2 and osteonectin mRNA expression in the cells were lower in all PRF-stimulated cultures compared with control at different time points. The i-PRF-conditioned medium induced more ALP activity (p < .05) compared with control and osteoblasts-like cells differentiated more compared with osteoblasts cultured with L-PRF. CONCLUSIONS The three PRF preparations seem to have the capacity to increase the osteogenic potential of osteoblast-like cells. A-PRF+ seems to have the highest potential for mineralization, while i-PRF seems to have the potential to enhance early cell differentiation.
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Affiliation(s)
- Kostantinos Kosmidis
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Karishma Ehsan
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruno Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ineke Jansen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Niemiec P, Szyluk K, Jarosz A, Iwanicki T, Balcerzyk A. Effectiveness of Platelet-Rich Plasma for Lateral Epicondylitis: A Systematic Review and Meta-analysis Based on Achievement of Minimal Clinically Important Difference. Orthop J Sports Med 2022; 10:23259671221086920. [PMID: 35425843 PMCID: PMC9003647 DOI: 10.1177/23259671221086920] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/10/2022] [Indexed: 12/19/2022] Open
Abstract
Background: The effectiveness of platelet-rich plasma (PRP) injection in the treatment of lateral epicondylitis remains debatable. Purpose: To evaluate the effectiveness of PRP in lateral epicondylitis treatment using minimal clinically important difference (MCID) values as a reference and to investigate if leukocyte content can influence the effectiveness of the therapy. Study Design: Systematic review; Level of evidence, 4. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors searched the Medline and Scopus databases for studies on lateral epicondylitis and PRP therapy that used the following patient-reported outcome measures (PROMs): visual analog scale (VAS) for pain; Disabilities of the Arm, Shoulder and Hand (DASH); Patient-Rated Tennis Elbow Evaluation (PRTEE); and Mayo Clinic Performance Index (MAYO). The weighted arithmetic means for the PROMs were calculated at baseline (week 0) and follow-up weeks 4, 8, 12, 24, 52, and 104. The mean differences in outcomes (ΔVAS, ΔDASH, ΔPRTEE, and ΔMAYO) were compared with the MCID values at each follow-up point. In addition, the effectiveness of leukocyte-rich PRP (LR-PRP) versus leukocyte-poor PRP (LP-PRP) was also compared. The Student t test was used in all analyses. Results: A total of 26 studies were included in the analysis. After PRP injection, all PROM scores improved with time. The scores improved significantly from baseline to each follow-up time ( P < .0001), with the exception of the PRTEE (no significant difference at follow-up weeks 12 and 52). The mean difference in scores from baseline exceeded the respective MCIDs from weeks 4 to 104 for the VAS and DASH, from weeks 4 to 52 for the MAYO, and from weeks 8 to 52 for the PRTEE. The MCID for each of the PROMs was exceeded at almost every observation period in both the LR-PRP and the LP-PRP systems. Conclusion: Based on comparisons with the MCID values of commonly used outcome scores, PRP seems to be an effective form of treatment for lateral epicondylitis. Both the LR- PRP and the LP- PRP systems were effective in the context of meeting the MCID.
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Affiliation(s)
- Pawel Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Karol Szyluk
- District Hospital of Orthopaedics and Trauma Surgery, Piekary Śląskie, Poland
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Alicja Jarosz
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
- Alicja Jarosz, MSc, Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 str, 40-752, Katowice, Poland (email )
| | - Tomasz Iwanicki
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Anna Balcerzyk
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
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Zhang Y, Xing F, Luo R, Duan X. Platelet-Rich Plasma for Bone Fracture Treatment: A Systematic Review of Current Evidence in Preclinical and Clinical Studies. Front Med (Lausanne) 2021; 8:676033. [PMID: 34414200 PMCID: PMC8369153 DOI: 10.3389/fmed.2021.676033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Recently, there is an increasing interest in the therapeutic potential of platelet-rich plasma (PRP) for bone fracture treatment. Nevertheless, the effect of PRP for bone fracture treatment remains controversial and is still a matter of discussion. Therefore, we performed a systematic review to evaluate the efficacy and safety of PRP injection for treatment of bone fracture. Methods: The main bibliographic databases, including Medline, PubMed, Embase, Web of Science, and the Cochrane library, were comprehensively searched for studies focusing on the application of platelet-rich plasma (PRP) on bone fracture treatment. All relevant articles were screened for eligibility and subdivided into the preclinical and clinical studies. Data were extracted and presented systematically. Results: Finally, twenty-six in vitro preclinical studies (basic studies), nine in vivo preclinical studies (animal studies), and nine clinical studies, met the selection criteria, and were included in the present systematic review. Preclinical studies showed an overall positive effect of PRP on osteoblast-like cells in vitro and bone healing in animal models. The most used treatment for bone fracture in animal and clinical studies is fixation surgery combined with PRP injection. The clinical studies reported PRP shortened bony healing duration, and had no positive effect on improving the healing rate of closed fractures. However, the results of functional outcomes are controversial. Additionally, compared with control group, PRP would not increase the rate of postoperative wound infection. Conclusion: The present systematic review confirmed the continuing interests of PRP as an additional treatment for bone fracture. Preclinical studies highlighted the potential value of PRP as promising therapy for bone fracture. However, the preclinical evidence did not translate into a similar result in the clinical studies. In addition, types of fractures and procedures of PRP preparation are heterogeneous in enrolled studies, which might result in controversial results. Meanwhile, characteristics of PRP, such as platelet concentration, the numbers of leukocytes, still need to be determined and further research is required.
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Affiliation(s)
- Yangming Zhang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Xing
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Luo
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Duan
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
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Melo-Ferraz A, Coelho C, Miller P, Criado MB, Monteiro MC. Platelet activation and antimicrobial activity of L-PRF: a preliminary study. Mol Biol Rep 2021; 48:4573-4580. [PMID: 34146200 DOI: 10.1007/s11033-021-06487-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/08/2021] [Indexed: 02/01/2023]
Abstract
Leukocyte and platelet rich fibrin (L-PRF) is one of the platelet concentrates used to support regeneration and healing process. Many studies showed possible immunological and antibacterial properties of L-PRF. We perform an in vitro study to analyze the effect of L-PRF on platelet activation, platelet-leukocytes interactions and antimicrobial activity, important components in the healing process. Molecular biomarkers related with platelet activation and platelet-leukocyte interactions were analyzed by means of flow cytometry when L-PRF exudate was added to whole blood platelets. L-PRF membrane was used to evaluate antimicrobial activity using Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853) and Candida albicans (ATCC 90028). Our experimental design allows to evaluate platelet activation and analyze molecular biomarkers of other immune cells and platelet-leukocyte interactions. From the results obtained we can conclude that L-PRF can be a valuable tool in healing process, efficient in activating platelets of whole blood and inhibiting microbial growth. In our opinion, the use of L-PRF exudate, in addition to L-PRF membrane, presents some advantages that have to be considered in clinical trials. Additional research on the characterization and quantification of cells and its products present in the L-PRF exudate, as well as on the temporal factor released. Also, further studies using strains isolated from clinical cases are needed.
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Affiliation(s)
- António Melo-Ferraz
- IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technology, CESPU-Cooperativa de Ensino Superior Politécnico e Universitário, Rua Central de Gandra 1317, 4585 116, Gandra, PRD, Portugal
| | - Cristina Coelho
- IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technology, CESPU-Cooperativa de Ensino Superior Politécnico e Universitário, Rua Central de Gandra 1317, 4585 116, Gandra, PRD, Portugal
| | - Paulo Miller
- IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technology, CESPU-Cooperativa de Ensino Superior Politécnico e Universitário, Rua Central de Gandra 1317, 4585 116, Gandra, PRD, Portugal
| | - Maria Begoña Criado
- IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technology, CESPU-Cooperativa de Ensino Superior Politécnico e Universitário, Rua Central de Gandra 1317, 4585 116, Gandra, PRD, Portugal
| | - Maria Céu Monteiro
- IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technology, CESPU-Cooperativa de Ensino Superior Politécnico e Universitário, Rua Central de Gandra 1317, 4585 116, Gandra, PRD, Portugal.
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Chen M, Xia W. Proteomic Profiling of Plasma and Brain Tissue from Alzheimer's Disease Patients Reveals Candidate Network of Plasma Biomarkers. J Alzheimers Dis 2021; 76:349-368. [PMID: 32474469 DOI: 10.3233/jad-200110] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most prevalent form of dementia with two pathological hallmarks of tau-containing neurofibrillary tangles and amyloid-β protein (Aβ)-containing neuritic plaques. Although Aβ and tau have been explored as potential biomarkers, levels of these pathological proteins in blood fail to distinguish AD from healthy control subjects. OBJECTIVE We aim to discover potential plasma proteins associated with AD pathology by performing tandem mass tag (TMT)-based quantitative proteomic analysis of proteins from peripheral and central nervous system compartments. METHODS We performed comparative proteomic analyses of plasma collected from AD patients and cognitively normal subjects. In addition, proteomic profiles from the inferior frontal cortex, superior frontal cortex, and cerebellum of postmortem brain tissue from five AD patients and five non-AD controls were compared with plasma proteomic profiles to search for common biomarkers. Liquid chromatography-mass spectrometry was used to analyze plasma and brain tissue labeled with isobaric TMT for relative protein quantification. RESULTS Our results showed that the proteins in complement coagulation cascade and interleukin-6 signaling were significantly altered in both plasma and brains of AD patients. CONCLUSION Our results demonstrate the relevance in immune responses between the peripheral and central nervous systems. Those differentially regulated plasma proteins are explored as candidate biomarker profiles that illustrate chronic neuroinflammation in brains of AD patients.
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Affiliation(s)
- Mei Chen
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - Weiming Xia
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA.,Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
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Akbarzadeh S, McKenzie MB, Rahman MM, Cleland H. Allogeneic Platelet-Rich Plasma: Is It Safe and Effective for Wound Repair? Eur Surg Res 2021; 62:1-9. [PMID: 33621973 DOI: 10.1159/000514223] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/04/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) and its derivatives are an emerging biotechnology whereby concentrated platelets provide damaged tissue with growth factors, cytokines, and other mediators to improve healing outcomes. Although there is strong evidence in the benefits of autologous PRP for both acute and chronic wounds, allogeneic PRP has been studied far less in comparison. SUMMARY In this mini-review, we discuss critical steps of allogenic PRP (and its derivatives) preparation. We performed a non-systematic review of the literature to identify animal and human subject studies testing allogenic PRP for wound treatment. We searched OVID Medline and PubMed for articles using the keywords "wound, ulcer, lesion, skin, and cutaneous" and "PRP, or platelet-rich plasma, or platelet-rich fibrin, or PRF, or platelet releasate" and "homologous, allogeneic or allogenic," which were limited to non-review articles and English language. Two studies in animal models and 8 studies in patients were reviewed. There were inconsistencies in preparation methods, treatment regimens, and some lacked a control group in their studies. Despite these variations, none of the studies identified any major side effects or adverse events. The treatment resulted in a reduced time to heal and/or reduced wound size in most cases. Key Messages: In situations where autologous PRP is not available or suitable, allogeneic PRP appears to provide a safe alternative. Its efficacy, however, requires larger-scale studies with appropriate controls. Standardization in PRP preparation and treatment regime are also needed to be able to interpret allogenic PRP efficacy.
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Affiliation(s)
- Shiva Akbarzadeh
- Victorian Adult Burns Service, Alfred Health, Melbourne, Victoria, Australia, .,Department of Surgery, Monash University, Melbourne, Victoria, Australia,
| | - Maxwell B McKenzie
- Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Md Mostafizur Rahman
- Victorian Adult Burns Service, Alfred Health, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Heather Cleland
- Victorian Adult Burns Service, Alfred Health, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
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Song D, Shujaat S, Huang Y, Van Dessel J, Politis C, Lambrichts I, Jacobs R. Effect of platelet-rich and platelet-poor plasma on 3D bone-to-implant contact: a preclinical micro-CT study. Int J Implant Dent 2021; 7:11. [PMID: 33598799 PMCID: PMC7889772 DOI: 10.1186/s40729-021-00291-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bone-to-implant contact ratio (BIC%) plays a critical role in secondary stability of osseointegrated dental implants. The aim of this study was to identify the correlation of 2D/3D micro-CT images with histology as a gold standard for evaluating BIC% and to investigate the influence of the platelet-rich plasma (PRP) and platelet-poor plasma (PPP) on 3D BIC% following delayed implant placement with delayed loading (DIP+DL). METHODS Nine beagle dogs were recruited. Following bilateral extraction of mandibular 3rd premolar, 4th premolar, and 1st molar, 54 screw-type titanium implants were inserted and randomly divided into one control and two test groups based on a split-mouth design. The control group involved DIP+DL (n = 18) and both test groups included DIP+DL with local application of PRP (n = 18) and PPP (n = 18). A BIC analysis was performed utilizing 2D histomorphometry and 2D/3D micro-CT. Following identification of correlation between histology and 2D/3D micro-CT images, a 3D micro-CT assessment of the 3D BIC% at three follow-up time-points (1, 3, and 6 months) was carried out for observing the influence of PRP and PPP on BIC. RESULTS The 2D micro-CT BIC% values revealed a strong positive correlation with histology (r = 0.98, p < 0.001) and a moderate correlation existed with 3D micro-CT (r = 0. 67, p = 0.005). BIC levels at 1 month and combined influence of PPP and PRP irrespective of time-points revealed significantly higher 3D BIC% compared to the control. However, a reduction in 3D BIC% was observed at the 3rd and 6th month. No significant difference was observed between both PRP and PPP. CONCLUSIONS Both 2D and 3D micro-CT demonstrated a potential to be utilized as a complimentary method for assessing BIC compared to the histological gold standard. Overall, both PRP and PPP significantly facilitated bone healing and osseointegration with a higher 3D BIC at follow-up. However, their influence was reduced as the observation period was increased.
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Affiliation(s)
- Dandan Song
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
- Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Yan Huang
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- West China College of Stomatology, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, Sichuan University, Chengdu, China
| | - Jeroen Van Dessel
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ivo Lambrichts
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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13
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The Effects of Platelet-Rich and Platelet-Poor Plasma on Biological Characteristics of BM-MSCs In Vitro. Anal Cell Pathol (Amst) 2020; 2020:8546231. [PMID: 32908815 PMCID: PMC7471809 DOI: 10.1155/2020/8546231] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/14/2020] [Accepted: 07/24/2020] [Indexed: 12/27/2022] Open
Abstract
Platelet-rich plasma (PRP) and its byproduct platelet-poor plasma (PPP) are rich sources of cytokines in tissue damage repair. Bone marrow-derived mesenchymal stem cells (BM-MSCs) have received more and more attention for their ability to treat multiple diseases. The purpose of our study was to investigate the biologic action of PPP and PRP on BM-MSCs. The adipogenic potential of BM-MSCs revealed no obvious change, but the osteogenic ability of BM-MSCs was enhanced after treated with PRP. CCK8 assays and cell colony formation assays showed that PRP promoted cell proliferation, while this effect of PPP was not obvious. No obvious difference was found in cell cycle and apoptosis of BM-MSCs between PRP and PPP treatment. Expression of β-galactosidase, a biological marker of senescence, was decreased upon PRP treatment which indicated that PRP provided significant protection against cellular senescence. The migratory capacity of BM-MSCs was detected by scratch and transwell assays. The results indicated that PRP could affect the migration ability of BM-MSCs. From immunofluorescence detection and western blot, we demonstrated that the level of epithelial-mesenchymal transition-related proteins was changed and several pluripotency marker genes, including Sox2, Sall4, Oct4, and Nanog, were increased. Finally, the expression of the key signal pathway such as PI3K/AKT was examined. Our findings suggested that PRP promoted cell migration of BM-MSCs via stimulating the signaling pathway of PI3K/AKT.
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The Platelet Concentrates Therapy: From the Biased Past to the Anticipated Future. Bioengineering (Basel) 2020; 7:bioengineering7030082. [PMID: 32751638 PMCID: PMC7552713 DOI: 10.3390/bioengineering7030082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022] Open
Abstract
The ultimate goal of research on platelet concentrates (PCs) is to develop a more predictable PC therapy. Because platelet-rich plasma (PRP), a representative PC, was identified as a possible therapeutic agent for bone augmentation in the field of oral surgery, PRP and its derivative, platelet-rich fibrin (PRF), have been increasingly applied in a regenerative medicine. However, a rise in the rate of recurrence (e.g., in tendon and ligament injuries) and adverse (or nonsignificant) clinical outcomes associated with PC therapy have raised fundamental questions regarding the validity of the therapy. Thus, rigorous evidence obtained from large, high-quality randomized controlled trials must be presented to the concerned regulatory authorities of individual countries or regions. For the approval of the regulatory authorities, clinicians and research investigators should understand the real nature of PCs and PC therapy (i.e., adjuvant therapy), standardize protocols of preparation (e.g., choice of centrifuges and tubes) and clinical application (e.g., evaluation of recipient conditions), design bias-minimized randomized clinical trials, and recognize superfluous brand competitions that delay sound progress. In this review, we retrospect the recent past of PC research, reconfirm our ultimate goals, and discuss what will need to be done in future.
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15
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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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16
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Mariani E, Pulsatelli L. Platelet Concentrates in Musculoskeletal Medicine. Int J Mol Sci 2020; 21:ijms21041328. [PMID: 32079117 PMCID: PMC7072911 DOI: 10.3390/ijms21041328] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/29/2020] [Accepted: 02/06/2020] [Indexed: 12/02/2022] Open
Abstract
Platelet concentrates (PCs), mostly represented by platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are autologous biological blood-derived products that may combine plasma/platelet-derived bioactive components, together with fibrin-forming protein able to create a natural three-dimensional scaffold. These types of products are safely used in clinical applications due to the autologous-derived source and the minimally invasive application procedure. In this narrative review, we focus on three main topics concerning the use of platelet concentrate for treating musculoskeletal conditions: (a) the different procedures to prepare PCs, (b) the composition of PCs that is related to the type of methodological procedure adopted and (c) the clinical application in musculoskeletal medicine, efficacy and main limits of the different studies.
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Affiliation(s)
- Erminia Mariani
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
- Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum-University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6366803
| | - Lia Pulsatelli
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
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Agarwal A, Manjunath RGS, Sethi P, Shankar GS. Platelet-rich fibrin in combination with decalcified freeze-dried bone allograft for the management of mandibular degree II furcation defect: A randomised controlled clinical trial. SINGAPORE DENTAL JOURNAL 2020; 39:33-40. [PMID: 32054425 DOI: 10.1142/s2214607519500032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Treatment of furcation involvement of molars with periodontal disease remains challenging and unpredictable. Platelet-rich fibrin (PRF) has received the attention of researchers due to its pleiotropic properties essential for periodontal wound healing. The osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully used in periodontal regeneration. Aim: The present study aimed to explore the effectiveness of PRF alone and with DFDBA in the treatment of mandibular degree II furcation defects in subjects with chronic periodontitis. Material and Methods: Patients treated were from the Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly. A total of 60 mandibular molars were treated with either open flap debridement (OFD) alone, [Formula: see text] combination or [Formula: see text] combination. The soft and hard tissue parameters such as vertical probing depth (VPD), vertical clinical attachment level (VCAL), gingival marginal level (GML), horizontal probing depth (HPD), vertical bone fill (VBF), horizontal bone fill (HBF) and furcation width (FW) were determined at baseline and 9 months postoperatively. A paired [Formula: see text]-test was conducted to assess the statistical significance between time period within each group for clinical and radiographic parameters. ANOVA and post-hoc Tukey's tests were also conducted for intergroup comparison of soft and hard tissue parameters. Statistical significance was set at [Formula: see text]. Results and Discussion: After 9 months, all treatment groups showed significant ([Formula: see text]) improvement in soft and hard tissue parameters, except GML in all the three groups and HBF and FW in the OFD group as compared to baseline. The mean VBF change was highest in the [Formula: see text] group ([Formula: see text]) mm, followed by that in the [Formula: see text] and OFD groups ([Formula: see text] and [Formula: see text][Formula: see text]mm, respectively). Conclusions: It was shown that both [Formula: see text] and [Formula: see text] combinations were significantly advantageous for the management of mandibular degree II furcation defects. However, the [Formula: see text] combination has significantly greater benefits than [Formula: see text] combination in terms of VBF.
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Affiliation(s)
- Ashish Agarwal
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - R G Shiva Manjunath
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Priyamwada Sethi
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - G Shiva Shankar
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Chou TM, Chang HP, Wang JC. Autologous platelet concentrates in maxillofacial regenerative therapy. Kaohsiung J Med Sci 2020; 36:305-310. [PMID: 32052598 DOI: 10.1002/kjm2.12192] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/19/2020] [Indexed: 01/23/2023] Open
Abstract
Platelet concentrates have emerged as innovative autologous blood products that enhance tissue healing and regeneration in regenerative therapy. A common feature of these products is their higher than baseline platelet concentration, which improves wound healing and tissue repair. Four main categories of products can be easily defined, based on their leukocyte content and fibrin architecture: pure platelet-rich plasma, such as Cell Separator PRP or Anitua' PRGF; leukocyte- and platelet-rich plasma (L-PRP), such as PCCS or Ace PRP; pure platelet-rich fibrin (P-PRF), such as Fibrinet PRFM; and leukocyte- and platelet-rich fibrin (L-PRF), such as Choukroun's PRF. Two families contain significant concentrations of leukocytes: L-PRP and L-PRF. These four families of products have different biological signatures and mechanisms and obviously different clinical applications. An L-PRF membrane releases growth factors and matrix proteins over a period longer than 7 days, whereas a PRP gel matrix releases and disperses its growth factors in a relatively quick download. In the near future, simple and inexpensive products such as L-PRF are expected to have applications in oral-maxillofacial surgery, periodontal surgery, plastic surgery, orthopedic surgery, and sports medicine. Leukocytes substantially affect the intrinsic biology and properties of platelet concentrates, not only because they enhance immune function and antibacterial potential, but also because they have essential roles in the wound healing process. Unfortunately, their impact has been almost completely neglected in the literature. Improved understanding of the effects of leukocytes in wound healing is essential for development of new clinical applications of platelet concentrates.
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Affiliation(s)
- Tsau-Mau Chou
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hong-Po Chang
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Jen-Chyan Wang
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Pitzurra L, Jansen IDC, de Vries TJ, Hoogenkamp MA, Loos BG. Effects of L-PRF and A-PRF+ on periodontal fibroblasts in in vitro wound healing experiments. J Periodontal Res 2019; 55:287-295. [PMID: 31782171 PMCID: PMC7154757 DOI: 10.1111/jre.12714] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/28/2019] [Accepted: 11/12/2019] [Indexed: 02/06/2023]
Abstract
Objective To determine whether leukocyte‐platelet‐rich fibrin (L‐PRF) and advanced platelet‐rich fibrin (A‐PRF+) differ in their in vitro capacity to induce proliferation and migration of periodontal fibroblasts. Background L‐PRF and A‐PRF + are autologous materials used in periodontal regenerative surgery. They derive from blood from patients, but have different characteristics. The literature is controversial regarding the effects of the two PRF preparations on periodontal tissue fibroblasts. Materials and methods L‐PRF and A‐PRF + membranes were prepared from eight patients and incubated in 3 mL of culture medium for 2 days. Gingival fibroblasts (G‐F) and periodontal ligament fibroblast (PDL‐F) primary cells were retrieved from 7 donors. These cells were pre‐cultured for 1 day in wound healing experiment plates leaving a gap of 500 ± 50 µm in a concentration of 3.3 x 105 cells/mL. 70 µL of the cell suspension was placed in each half of the well. Thereafter, the pre‐cultured L‐PRF and A‐PRF + supernatants were added to the experimental plates, and the fibroblasts were incubated for another 24 h. Medium alone (NEG) and fibroblast growth factor II (FGF) were used as controls. Subsequently, cell migration was registered for 24 h with live cell imaging in a time frame microscope at 5% CO2 in air at 37°C. Images were analyzed using ImageJ. Cell proliferation and cell viability were measured. Results L‐PRF and A‐PRF + induced higher cell proliferation than FGF and NEG. Both A‐PRF + and L‐PRF induced significant faster artificial wound closure than controls. Both PRF conditioned media induced faster cell migration in the initial phase (P < .01), but in the stoppage phase, the induced migration was higher for the A‐PRF+, compared with L‐PRF (P < .01). Conclusion L‐PRF and A‐PRF + have a stimulatory effect on migration and proliferation of periodontal fibroblasts, and artificial wound closure was longer sustained by A‐PRF + than L‐PRF.
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Affiliation(s)
- Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ineke D C Jansen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teun J de Vries
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michel A Hoogenkamp
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Univeristeit Amsterdam, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Abstract
Autologous fat grafting is increasingly being used as a method for the repair of facial soft tissue defects and facial rejuvenation, given its low risk of adverse effects and high efficacy. However, the unpredictability of graft retention is a limitation of this procedure. In addition, there is no standard procedure to date for autologous fat grafting. Different methods have been developed to increase the retention of grafted fat. For instance, platelet concentrates have been used to directly deliver bioactive factors to grafted fat. Platelet concentrates also provide incidental therapeutic benefits by enhancing the persistence of fat grafted in the face via the release of growth factors and cytokines. In this review, we describe current strategies for improving the survival of facial fat grafts, mainly focusing on the application of growth factors/cytokines and platelet concentrates to fat grafting.
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Nakornnoi T, Leethanakul C, Samruajbenjakun B. Effects of Leukocyte-Platelet-Rich Plasma on the Alveolar Bone Changes During Orthodontic Tooth Movement in Rabbits: A Micro-CT Study. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2019. [DOI: 10.1177/0301574219872608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To investigate the effects of leukocyte-platelet-rich plasma (L-PRP) on the alveolar bone changes at the compression and tension sides during orthodontic tooth movement. Materials and Methods: Around 20 New Zealand white rabbits were used in a split-mouth design. The maxillary first premolar was moved mesially with a nickel-titanium closed-coil spring. One side of the maxilla was randomly injected with L-PRP, while the contralateral side served as the control which received normal saline. The alveolar bone adjacent to the maxillary first premolar was scanned using microcomputed tomography at days 0, 7, 14, and 28. Microstructural parameters including bone volume fraction, trabecular thickness, and trabecular separation of alveolar bone were assessed on the compression and tension sides of the maxillary first premolar. Results: Compared between the groups, the L-PPR group showed a significantly decreased bone volume fraction on the compression side on days 7 and 14 but significantly increased bone volume fraction on the tension side on day 14. However, there were no statistically significant differences in the parameters of trabecular thickness and trabecular separation. Conclusion: Local administration of L-PRP may promote bone resorption on the compression side and bone formation on the tension side at the initial stage of orthodontic tooth movement.
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Affiliation(s)
- Theerasak Nakornnoi
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Chidchanok Leethanakul
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Bancha Samruajbenjakun
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
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Evaluation of Risk Parameters in Bone Regeneration Using a Customized Titanium Mesh. IMPLANT DENT 2019; 28:543-550. [DOI: 10.1097/id.0000000000000933] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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23
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Puidokas T, Kubilius M, Stumbras A, Juodzbalys G. Effect of leukocytes included in platelet concentrates on cell behaviour. Platelets 2019; 30:937-945. [DOI: 10.1080/09537104.2019.1646900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Tomas Puidokas
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mantas Kubilius
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arturas Stumbras
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Zhang W, Guo Y, Kuss M, Shi W, Aldrich AL, Untrauer J, Kielian T, Duan B. Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation. TISSUE ENGINEERING PART B-REVIEWS 2019; 25:225-236. [PMID: 30712506 DOI: 10.1089/ten.teb.2018.0309] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPACT STATEMENT The clinical application of platelet-rich plasma (PRP) has been widely studied for its effects on trauma or injury repair/regeneration, however the antibacterial property of PRP has been overlooked. Increasing evidence suggests PRP as a good antibacterial agent and that it could help prevent/treat tissue infection. This review emphasizes the importance of PRP's antibacterial property and summarizes the preclinical and clinical findings regarding the application of PRP in the prevention and treatment of wound and bone infection. The use of biocompatible PRP may be advantageous for tissue infection treatment due to its inherent antibacterial and healing promoting properties.
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Affiliation(s)
- Wenhai Zhang
- 1 Department of Orthopedics, Tianjin Hospital, Tianjin, People's Republic of China.,2 Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska
| | - Yue Guo
- 3 Tissue Engineering Labs of Orthopedics Institute, Tianjin Hospital, Tianjin, People's Republic of China
| | - Mitchell Kuss
- 2 Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska.,4 Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Wen Shi
- 2 Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska.,4 Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Amy L Aldrich
- 5 Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jason Untrauer
- 6 Division of Oral and Maxillofacial Surgery, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Tammy Kielian
- 5 Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Bin Duan
- 2 Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska.,4 Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska.,7 Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.,8 Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska
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25
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Oudelaar BW, Peerbooms JC, Huis In 't Veld R, Vochteloo AJH. Concentrations of Blood Components in Commercial Platelet-Rich Plasma Separation Systems: A Review of the Literature. Am J Sports Med 2019; 47:479-487. [PMID: 29337592 DOI: 10.1177/0363546517746112] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) has proven to be a very safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries. Currently, several commercial separation systems are available for the preparation of PRP. The concentrations of blood components in PRP among these separation systems vary substantially. PURPOSE To systematically review and evaluate the differences between the concentrations of blood components in PRP produced by various PRP separation systems. STUDY DESIGN Systematic review. METHODS MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE were searched for studies that compared the concentrations of blood components and growth factors in PRP between various separation systems and studies that reported on the concentrations of blood components and growth factors of single separation systems. The primary outcomes were platelet count, leukocyte count, and concentration of growth factors (eg, platelet-derived growth factor-AB [PDGF-AB], transforming growth factor-β1 [TGF-β1], and vascular endothelial growth factor [VEGF]). Furthermore, the preparation protocols and prices of the systems were compared. RESULTS There were 1079 studies found, of which 19 studies were selected for inclusion in this review. The concentrations of platelets and leukocytes in PRP differed largely between, and to a lesser extent within, the studied PRP separation systems. Additionally, large differences both between and within the studied PRP separation systems were found for all the growth factors. Furthermore, preparation protocols and prices varied widely between systems. CONCLUSION There is a large heterogeneity between PRP separation systems regarding concentrations of platelets, leukocytes, and growth factors in PRP. The choice for the most appropriate type of PRP should be based on the specific clinical field of application. As the ideal concentrations of blood components and growth factors for the specific fields of application are yet to be determined for most of the fields, future research should focus on which type of PRP is most suitable for the specific field.
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Affiliation(s)
- Bart W Oudelaar
- OCON Centre for Orthopaedic Surgery, Hengelo, the Netherlands
| | - Joost C Peerbooms
- Department of Orthopaedic Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
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Pichotano EC, de Molon RS, de Souza RV, Austin RS, Marcantonio E, Zandim-Barcelos DL. Evaluation of L-PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial. Clin Implant Dent Relat Res 2019; 21:253-262. [PMID: 30690860 DOI: 10.1111/cid.12713] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To investigate the effectiveness of adding leukocyte and platelet-rich fibrin (L-PRF) to deproteinized bovine bone mineral (DBBM) for early implant placement after maxillary sinus augmentation. MATERIALS AND METHODS Twelve patients requiring two-stage bilateral maxillary sinus augmentation were enrolled to the study. The elevated sinus cavities were randomly grafted with DBBM + L-PRF (test) or DBBM alone (control) in a split-mouth design. Implants were placed in the augmented sites after 4 months in the test group and 8 months in the control group. Bone biopsies were collected during implant placement for histomorphometric evaluation. Resonance frequency analysis was performed immediately after implant placement and at implant loading in both groups. Cone-beam computed tomography was obtained preoperatively and postoperatively for evaluation of graft volume changes. RESULTS Both procedures were effective for maxillary sinus augmentation. Cone-beam computed tomography analysis did not reveal differences in graft volume between test and control group at any of the evaluated time points (P > .05). Histological evaluation demonstrated increased percentage of newly formed bone for the test group (44.58% ± 13.9%) compared to the control group (30.02% ± 8.42%; P = .0087). The amount of residual graft in the control group was significantly higher (13.75% ± 9.99%) than in the test group (3.59 ± 4.22; P = .0111). Implant stability quotient (ISQ) immediately after implant placement was significantly higher in the control group (75.13 ± 5.69) compared to the test group (60.9 ± 9.35; P = .0003). The ISQ values at loading did not differ between the groups (P = .8587). Implant survival rate was 100% for both groups. CONCLUSION The addition of L-PRF to the DBBM into the maxillary sinus allowed early implant placement (4 months) with increased new bone formation than DBBM alone after 8 months of healing.
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Affiliation(s)
- Elton Carlos Pichotano
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Rupert S Austin
- Tissue Engineering and Biophotonics, King's College London Dental Institute, Guy's Hospital, London, United Kingdom
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
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Kitamura Y, Suzuki M, Tsukioka T, Isobe K, Tsujino T, Watanabe T, Watanabe T, Okudera H, Nakata K, Tanaka T, Kawase T. Spectrophotometric determination of platelet counts in platelet-rich plasma. Int J Implant Dent 2018; 4:29. [PMID: 30276491 PMCID: PMC6167270 DOI: 10.1186/s40729-018-0140-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/29/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) is widely used in regenerative dentistry and other medical fields. However, its effectiveness has often been questioned. For better evaluation, the quality of individual PRP preparations should be assured prior to use. We proposed a spectrophotometric method for determination of platelet counts and validated its applicability using two types of PRP preparations. METHODS Blood samples were obtained from healthy male volunteers and pure PRP (P-PRP) and leukocytes-rich PRP (L-PRP) were prepared using the double-spin method. In serial dilutions, platelet counts in P-PRP and L-PRP were determined using an automated hematology analyzer and a compact spectrophotometer. For validation, P-PRP and L-PRP independently prepared by three well-trained operators were used for comparison of the calculated and measured platelet counts. RESULTS In the two types of PRP samples evaluated, platelet counts were almost equal and greater amount of both white blood cells (WBCs) and red blood cells (RBCs) were included in L-PRP preparations. The calibration curve obtained from serially diluted P-PRP showed a strong correlation (R2 = 0.995), whereas that of L-PRP was relatively weaker (R2 = 0.975). In validation testing, the scatter plot of the calculated platelet counts versus the measured values showed a strong correlation in P-PRP (R2 = 0.671), whereas that of L-PRP showed a much weaker correlation (R2 = 0.0605). CONCLUSIONS This method can precisely determine platelet counts in PRP preparations when the inclusion of WBCs or RBCs is minimized. Therefore, we recommend that clinicians use this method for quality assurance of individual PRP preparations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Koh Nakata
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Takaaki Tanaka
- Department of Materials Science and Technology, Niigata University, Niigata, Japan
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry, Niigata University, Niigata, Japan.
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Tsukioka T, Hiratsuka T, Nakamura M, Watanabe T, Kitamura Y, Isobe K, Okudera T, Okudera H, Azuma A, Uematsu K, Nakata K, Kawase T. An on-site preparable, novel bone-grafting complex consisting of human platelet-rich fibrin and porous particles made of a recombinant collagen-like protein. J Biomed Mater Res B Appl Biomater 2018; 107:1420-1430. [PMID: 30270545 PMCID: PMC6585782 DOI: 10.1002/jbm.b.34234] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/13/2018] [Accepted: 08/18/2018] [Indexed: 12/17/2022]
Abstract
Platelet‐rich fibrin (PRF) is widely used in regenerative medicine. Nonetheless, major issues include its controversial effects on bone regeneration and a lack of quality‐assured glass tubes required for coagulation. We used porous particles (FBG) comprising a recombinant RGD motif‐enriched collagen I‐like protein to activate the coagulation pathway and examined the effects of the resulting PRF–FBG complex on bone regeneration. Human whole‐blood samples were mixed with FBG in plastic tubes and centrifuged to prepare a PRF–FBG complex. Platelet‐derived growth factor‐BB (PDGF‐BB) levels and cell growth activity were determined by ELISA and a bioassay using osteoblasts. Bone regenerative activity was assessed using a mouse model of calvarial bone defect. FBG facilitated PRF‐like matrix formation during centrifugation. In this PRF–FBG complex, the microstructure of fibrin fibers was similar to that of PRF prepared conventionally in glass tubes. PDGF‐BB levels and mitogenic action were not significantly influenced by FBG. In the bone defect model, although PRF did not exert any significant positive effects on its own, in combination with FBG, it synergistically stimulated new bone formation. This study demonstrated that incorporation of FBG into whole‐blood samples induces PRF formation without the aid of glass tubes. The resulting PRF–FBG complex could be a promising bone grafting material in clinical settings. © 2018 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1420–1430, 2019.
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Affiliation(s)
| | - Takahiro Hiratsuka
- Bioscience & Technology Development Center, FIJIFILM Corporation, Kanagawa, Japan
| | | | | | | | | | | | | | - Akihiko Azuma
- Bioscience & Technology Development Center, FIJIFILM Corporation, Kanagawa, Japan
| | - Kohya Uematsu
- Division of Implantology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Koh Nakata
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry, Niigata University, Niigata, Japan
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Frelinger AL, Gerrits AJ, Neculaes VB, Gremmel T, Torres AS, Caiafa A, Carmichael SL, Michelson AD. Tunable activation of therapeutic platelet-rich plasma by pulse electric field: Differential effects on clot formation, growth factor release, and platelet morphology. PLoS One 2018; 13:e0203557. [PMID: 30256831 PMCID: PMC6157860 DOI: 10.1371/journal.pone.0203557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/22/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Activation of platelet-rich plasma (PRP) by pulse electric field (PEF) releases growth factors which promote wound healing (e.g., PDGF, VEGF for granulation, EGF for epithelialization). AIMS To determine after PEF activation of therapeutic PRP: 1) platelet gel strength; 2) profile of released growth factors; 3) alpha- and T-granule release; 4) platelet morphology. METHODS Concentrated normal donor PRP was activated by 5 μsec (long) monopolar pulse, ~4000 V/cm (PEF A) or 150 nsec (short) bipolar pulse, ~3000 V/cm (PEF B) in the presence of 2.5 mM (low) or 20 mM (high) added CaCl2. Clot formation was evaluated by thromboelastography (TEG). Surface exposure of alpha granule (P-selectin) and T-granule (TLR9 and protein disulfide isomerase [PDI]) markers were assessed by flow cytometry. Factors in supernatants of activated PRP were measured by ELISA. Platelet morphology was evaluated by transmission electron microscopy (TEM). RESULTS Time to initial clot formation was shorter with thrombin (<1 min) than with PEF A and B (4.4-8.7 min) but clot strength (elastic modulus, derived from TEG maximum amplitude) was greater with PEF B than with either thrombin or PEF A (p<0.05). Supernatants of PRP activated with PEF A had higher EGF levels than supernatants from all other conditions. In contrast, levels of PF4, PDGF, and VEGF in supernatants were not significantly different after PEF A, PEF B, and thrombin activation. T-granule markers (TLR9 and PDI) were higher after thrombin than after PEF A or B with low or high CaCl2. By TEM, platelets in PEF-treated samples retained a subset of granules suggesting regulated granule release. CONCLUSION Pulse length and polarity can be modulated to produce therapeutic platelet gels as strong or stronger than those produced by thrombin, and this is tunable to produce growth factor profiles enhanced in specific factors important for different stages of wound healing.
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Affiliation(s)
- Andrew L. Frelinger
- Center for Platelet Research Studies, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (ALF); (VBN)
| | - Anja J. Gerrits
- Center for Platelet Research Studies, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - V. Bogdan Neculaes
- GE Global Research Center, Niskayuna, New York, United States of America
- * E-mail: (ALF); (VBN)
| | - Thomas Gremmel
- Center for Platelet Research Studies, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Andrew S. Torres
- GE Global Research Center, Niskayuna, New York, United States of America
| | - Anthony Caiafa
- GE Global Research Center, Niskayuna, New York, United States of America
| | - Sabrina L. Carmichael
- Center for Platelet Research Studies, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alan D. Michelson
- Center for Platelet Research Studies, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, United States of America
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Katagiri W, Watanabe J, Toyama N, Osugi M, Sakaguchi K, Hibi H. Clinical Study of Bone Regeneration by Conditioned Medium From Mesenchymal Stem Cells After Maxillary Sinus Floor Elevation. IMPLANT DENT 2018; 26:607-612. [PMID: 28727618 DOI: 10.1097/id.0000000000000618] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This clinical study was undertaken to evaluate the safety of use of the secretome of bone marrow-derived mesenchymal stem cells (MSC-CM) for maxillary sinus floor elevation (SFE). MATERIALS AND METHODS MSC-CM was prepared from conditioned medium from human bone marrow-derived MSCs. Six partially edentulous patients were enrolled in the study. MSC-CM was mixed with porous beta-tricalcium phosphate (β-TCP) and implanted in 4 patients (experimental group), whereas only β-TCP was implanted in the other 2 patients (control group). Six months after SFE, bone biopsies and histological assessments were performed. RESULTS Bone formation was clinically confirmed in all cases. Although Hounsfield units in computed tomography images were not significantly different between the groups, histological analysis revealed a significant difference in newly formed bone area between the groups. In particular, bone volume in the center of the augmented area was significantly greater in the MSC-CM group. Newly formed bone consisted of lamellar bone in the MSC-CM group but woven bone in the β-TCP group. CONCLUSION The secretome of bone marrow-derived mesenchymal stem cells (MSC-CM) was used safely and has great osteogenic potential for regenerative medicine of bone.
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Affiliation(s)
- Wataru Katagiri
- *Associate Professor, Division of Reconstructive Surgery and Oral and Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. †Graduate Student, Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. ‡Assistant Professor, Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. §Professor, Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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31
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Pichotano EC, de Molon RS, Freitas de Paula LG, de Souza RV, Marcantonio E, Zandim-Barcelos DL. Early Placement of Dental Implants in Maxillary Sinus Grafted With Leukocyte and Platelet-Rich Fibrin and Deproteinized Bovine Bone Mineral. J ORAL IMPLANTOL 2018; 44:199-206. [PMID: 29457934 DOI: 10.1563/aaid-joi-d-17-00220] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This case report aimed to describe the effects of leukocyte and platelet-rich fibrin (L-PRF) associated with demineralized bovine bone mineral (DBBM) and absorbable collagen membrane (CM) on bone regeneration in maxillary sinus augmentation. A 59-year-old male patient was referred to the Department of Periodontology for implant rehabilitation of his edentulous upper jaw. The treatment plan involved maxillary sinus augmentation followed by implant installations. A split-mouth design was employed in which the right maxillary sinus was filled using L-PRF, DBBM, and CM; the left side was filled with DBBM and CM. After 4 and 8 months postoperatively, 2 dental implants were installed in each of the right and left maxillary sinuses. Cone-beam computerized tomography (CBCT) was taken before and after sinus augmentation for evaluation of tridimensional bone volume alterations. Bone biopsies were harvested from the implant sites for histomorphometric evaluation. Resonance frequency analysis was employed immediately after implant placement and before prosthetic rehabilitation for evaluation of implant stability. Implants were loaded 10 months after sinus augmentation. CBCT analysis showed a higher resorption rate in the right side of the maxillary sinus (L-PRF + DBBM) compared to the left side (22.25% and 8.95%, respectively). Implant stability quotients were above 68 in all time-points for both groups. Histomorphometric analysis showed a high amount of newly formed bone when L-PRF was used compared with DBBM alone (2 118 102 and 975 535 mm3, respectively). Taken together, both techniques were effective for maxillary sinus augmentation, however the addition of L-PRF to the graft allowed early implant placement and accelerated bone healing in the conditions studied.
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Affiliation(s)
- Elton Carlos Pichotano
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Rafael Scaf de Molon
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | | | - Elcio Marcantonio
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Daniela Leal Zandim-Barcelos
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
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Dohle E, El Bagdadi K, Sader R, Choukroun J, James Kirkpatrick C, Ghanaati S. Platelet-rich fibrin-based matrices to improve angiogenesis in an in vitro co-culture model for bone tissue engineering. J Tissue Eng Regen Med 2017; 12:598-610. [PMID: 28509340 PMCID: PMC5888144 DOI: 10.1002/term.2475] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 12/19/2022]
Abstract
In the context of prevascularization strategies for tissue‐engineering purposes, co‐culture systems consisting of outgrowth endothelial cells (OECs) and primary osteoblasts (pOBs) have been established as a promising in vitro tool to study regeneration mechanisms and to identify factors that might positively influence repair processes such as wound healing or angiogenesis. The development of autologous injectable platelet‐rich fibrin (PRF), which can be generated from peripheral blood in a minimal invasive procedure, fulfils several requirements for clinically applicable cell‐based tissue‐engineering strategies. During this study, the established co‐culture system of OECs and pOBs was mixed with injectable PRF and was cultivated in vitro for 24 h or 7 days. The aim of this study was to analyse whether PRF might have a positive effect on wound healing processes and angiogenic activation of OECs in the co‐culture with regard to proinflammatory factors, adhesion molecules and proangiogenic growth factor expression. Histological cell detection revealed the formation of lumina and microvessel‐like structures in the PRF/co‐culture complexes after 7 days of complex cultivation. Interestingly, the angiogenic activation of OECs was accompanied by an upregulation of wound healing‐associated factors, as well as by a higher expression of the proangiogenic factor vascular endothelial growth factor, which was evaluated both on the mRNA level as well as on the protein level. Thus, PRF might positively influence wound healing processes, in particular angiogenesis, in the in vitro co‐culture, making autologous PRF‐based matrices a beneficial therapeutic tool for tissue‐engineering purposes by simply profiting from the PRF, which contains blood plasma, platelets and leukocytes.
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Affiliation(s)
- Eva Dohle
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Karima El Bagdadi
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Robert Sader
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Joseph Choukroun
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.,Pain Therapy Center, Nice, France
| | - C James Kirkpatrick
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.,Department of Biomaterials, Gothenburg, Sweden
| | - Shahram Ghanaati
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
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D’asta F, Halstead F, Harrison P, Zecchi Orlandini S, Moiemen N, Lord J. The contribution of leucocytes to the antimicrobial activity of platelet-rich plasma preparations: A systematic review. Platelets 2017; 29:9-20. [DOI: 10.1080/09537104.2017.1317731] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Federica D’asta
- Birmingham Children’s Hospital, Burns Centre, Steelhouse Lane, Birmingham, UK
| | - Fenella Halstead
- NIHR Surgical Reconstruction and Microbiology Research, CentreQueen Elizabeth Hospital, Birmingham, UK
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Paul Harrison
- NIHR Surgical Reconstruction and Microbiology Research, CentreQueen Elizabeth Hospital, Birmingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Sandra Zecchi Orlandini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
| | - Naiem Moiemen
- NIHR Surgical Reconstruction and Microbiology Research, CentreQueen Elizabeth Hospital, Birmingham, UK
- The Scar Free Foundation Centre for Burns Research, Queen Elizabeth Hospital, Birmingham, UK
| | - Janet Lord
- NIHR Surgical Reconstruction and Microbiology Research, CentreQueen Elizabeth Hospital, Birmingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Abstract
There is now good evidence that cytokines and growth factors are key factors in tissue repair and often exert anti-infective activities. However, engineering such factors for global use, even in the most remote places, is not realistic. Instead, we propose to examine how such factors work and to evaluate the reparative tools generously provided by 'nature.' We used two approaches to address these objectives. The first approach was to reappraise the internal capacity of the factors contributing the most to healing in the body, i.e., blood platelets. The second was to revisit natural agents such as whey proteins, (honey) bee venom and propolis. The platelet approach elucidates the inflammation spectrum from physiology to pathology, whereas milk and honey derivatives accelerate diabetic wound healing. Thus, this review aims at offering a fresh view of how wound healing can be addressed by natural means.
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Affiliation(s)
- Olivier Garraud
- GIMAP-EA3064, Faculty of medicine of Saint-Etienne, University of Lyon, 42023, Saint-Etienne, France.
- National Institute for Blood Transfusion, 75015, Paris, France.
| | - Wael N Hozzein
- Bioproducts Research Chair, Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
- Botany Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Gamal Badr
- Laboratory of Immunology and Molecular Physiology, Zoology Department, Faculty of Science, Assiut University, 71516, Assiut, Egypt
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ÖZEÇ İ, ŞİMŞEK S, BENLİDAYI E, Mehmet KÜRKÇÜ MKÜRKÇÜ. Trombosit Zengin Fibrin ve Rifamisinin Bir Allogreft ile Kombinasyonda Kemik Büyütme Üzerindeki Etkilerinin Tavşan Tibiasında Eşzamanlı İmplant Yerleştirmesiyle Histomorfometrik Olarak Değerlendirilmesi. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.307301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Choukroun J, Ghanaati S. Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients' own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept. Eur J Trauma Emerg Surg 2017; 44:87-95. [PMID: 28283682 PMCID: PMC5808086 DOI: 10.1007/s00068-017-0767-9] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/23/2017] [Indexed: 12/19/2022]
Abstract
Purpose The aim of this study was to analyze systematically the influence of the relative centrifugation force (RCF) on leukocytes, platelets and growth factor release within fluid platelet-rich fibrin matrices (PRF). Materials and methods Systematically using peripheral blood from six healthy volunteers, the RCF was reduced four times for each of the three experimental protocols (I–III) within the spectrum (710–44 g), while maintaining a constant centrifugation time. Flow cytometry was applied to determine the platelets and leukocyte number. The growth factor concentration was quantified 1 and 24 h after clotting using ELISA. Results Reducing RCF in accordance with protocol-II (177 g) led to a significantly higher platelets and leukocytes numbers compared to protocol-I (710 g). Protocol-III (44 g) showed a highly significant increase of leukocytes and platelets number in comparison to -I and -II. The growth factors’ concentration of VEGF and TGF-β1 was significantly higher in protocol-II compared to -I, whereas protocol-III exhibited significantly higher growth factor concentration compared to protocols-I and -II. These findings were observed among 1 and 24 h after clotting, as well as the accumulated growth factor concentration over 24 h. Discussion Based on the results, it has been demonstrated that it is possible to enrich PRF-based fluid matrices with leukocytes, platelets and growth factors by means of a single alteration of the centrifugation settings within the clinical routine. Conclusions We postulate that the so-called low speed centrifugation concept (LSCC) selectively enriches leukocytes, platelets and growth factors within fluid PRF-based matrices. Further studies are needed to evaluate the effect of cell and growth factor enrichment on wound healing and tissue regeneration while comparing blood concentrates gained by high and low RCF.
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Affiliation(s)
- J Choukroun
- Private Practice, Pain Therapy Center, Nice, France.
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Laboratory, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - S Ghanaati
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Laboratory, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
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Kieb M, Sander F, Prinz C, Adam S, Mau-Möller A, Bader R, Peters K, Tischer T. Platelet-Rich Plasma Powder: A New Preparation Method for the Standardization of Growth Factor Concentrations. Am J Sports Med 2017; 45:954-960. [PMID: 27903591 DOI: 10.1177/0363546516674475] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) is widely used in sports medicine. Available PRP preparations differ in white blood cell, platelet, and growth factor concentrations, making standardized research and clinical application challenging. PURPOSE To characterize a newly standardized procedure for pooled PRP that provides defined growth factor concentrations. STUDY DESIGN Controlled laboratory study. METHODS A standardized growth factor preparation (lyophilized PRP powder) was prepared using 12 pooled platelet concentrates (PCs) derived from different donors via apheresis. Blood samples and commercially available PRP (SmartPrep-2) served as controls (n = 5). Baseline blood counts were analyzed. Additionally, single PCs (n = 5) were produced by standard platelet apheresis. The concentrations of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived growth factor AB (PDGF-AB), transforming growth factor β1 (TGF-β1), insulin-like growth factor 1 (IGF-1), interleukin (IL)-1α, IL-1β, and IL-1 receptor agonist (IL-1RA) were analyzed by enzyme-linked immunosorbent assay, and statistical analyses were performed using descriptive statistics, mean differences, 95% CIs, and P values (analysis of variance). RESULTS All growth factor preparation methods showed elevated concentrations of the growth factors VEGF, bFGF, PDGF-AB, and TGF-β1 compared with those of whole blood. Large interindividual differences were found in VEGF and bFGF concentrations. Respective values (mean ± SD in pg/mL) for whole blood, SmartPrep-2, PC, and PRP powder were as follows: VEGF (574 ± 147, 528 ± 233, 1087 ± 535, and 1722), bFGF (198 ± 164, 410 ± 259, 151 ± 99, and 542), PDGF-AB (2394 ± 451, 17,846 ± 3087, 18,461 ± 4455, and 23,023), and TGF-β1 (14,356 ± 4527, 77,533 ± 13,918, 68,582 ± 7388, and 87,495). IGF-1 was found in SmartPrep-2 (1539 ± 348 pg/mL). For PC (2266 ± 485 pg/mL), IGF-1 was measured at the same levels of whole blood (2317 ± 711 pg/mL) but was not detectable in PRP powder. IL-1α was detectable in whole blood (111 ± 35 pg/mL) and SmartPrep-2 (119 ± 44 pg/mL). CONCLUSION Problems with PRP such as absent standardization, lack of consistency among studies, and black box dosage could be solved by using characterized PRP powder made by pooling and lyophilizing multiple PCs. The new PRP powder opens up new possibilities for PRP research as well as for the treatment of patients. CLINICAL RELEVANCE The preparation of pooled PRP by means of lyophilization may allow physicians to apply a defined amount of growth factors by using a defined amount of PRP powder. Moreover, PRP powder as a dry substance with no need for centrifugation could become ubiquitously available, thus saving time and staff resources in clinical practice. However, before transferring the results of this basic science study to clinical application, regulatory issues have to be cleared.
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Affiliation(s)
- Matthias Kieb
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany.,Center of Surgery, Ernst von Bergmann Hospital, Potsdam, Germany
| | - Frank Sander
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | | | - Stefanie Adam
- Department of Cell Biology, Rostock University Medical Center, Rostock, Germany
| | - Anett Mau-Möller
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Rainer Bader
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Kirsten Peters
- Department of Cell Biology, Rostock University Medical Center, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
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Platelet Rich Fibrin “PRF” and Regenerative Medicine: ‘The Low-Speed Concept’. STEM CELL BIOLOGY AND REGENERATIVE MEDICINE 2017. [DOI: 10.1007/978-3-319-55645-1_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Yasui Y, Wollstein A, Murawski CD, Kennedy JG. Operative Treatment for Osteochondral Lesions of the Talus: Biologics and Scaffold-Based Therapy. Cartilage 2017; 8:42-49. [PMID: 27994719 PMCID: PMC5154422 DOI: 10.1177/1947603516644298] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Numerous basic science articles have published evidence supporting the use of biologic augmentation in the treatment of osteochondral lesions of the talus (OLT). However, a comprehensive evaluation of the clinical outcomes of those treatment modalities in OLT has yet to be published. The purpose of this review is to provide an evidence-based overview of clinical outcomes following biologic augmentation to surgical treatments for OLT. DESIGN A comprehensive literature review was performed. Two commonly used surgical techniques for the treatment of OLT-bone marrow stimulation and osteochondral autograft transfer-are first introduced. The review describes the operative indications, step-by- step operative procedure, clinical outcomes, and concerns associated with each treatment. A review of the currently published basic science and clinical evidence on biologic augmentation in the surgical treatments for OLT, including platelet-rich plasma, concentrated bone marrow aspirate, and scaffold-based therapy follows. RESULTS Biologic agents and scaffold-based therapies appear to be promising agents, capable of improving both clinical and radiological outcomes in OLT. Nevertheless, variable production methods of these biologic augmentations confound the interpretation of clinical outcomes of cases treated with these agents. CONCLUSIONS Current clinical evidence supports the use of biologic agents in OLT cases. Nonetheless, well-designed clinical trials with patient-specific, validated and objective outcome measurements are warranted to develop standardized clinical guidelines for the use of biologic augmentation for the treatment of OLT in clinical practice.
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Affiliation(s)
- Youichi Yasui
- Hospital for Special Surgery, New York, NY, USA
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Adi Wollstein
- Hospital for Special Surgery, New York, NY, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christopher D. Murawski
- Hospital for Special Surgery, New York, NY, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Platelet-Rich Plasma and Concentrated Bone Marrow Aspirate in Surgical Treatment for Osteochondral Lesions of the Talus. Foot Ankle Clin 2016; 21:869-884. [PMID: 27871420 DOI: 10.1016/j.fcl.2016.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Platelet-rich plasma (PRP) and concentrated bone marrow aspirate (CBMA) have the potential to improve the quality of cartilage repair in osteochondral lesions of the talus (OLT). In this review, we describe the basic science and clinical evidence that has been published on the topic of PRP and CBMA on 2 commonly used surgical techniques for the treatment of OLT: bone marrow stimulation and osteochondral autograft transfer.
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Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. TISSUE ENGINEERING PART B-REVIEWS 2016; 23:83-99. [PMID: 27672729 DOI: 10.1089/ten.teb.2016.0233] [Citation(s) in RCA: 225] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of conditions caused by trauma, disease, and old age. One area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. This systematic review gathered all the currently available in vitro, in vivo, and clinical literature utilizing PRF for soft tissue regeneration, augmentation, and/or wound healing. In total, 164 publications met the original search criteria, with a total of 48 publications meeting inclusion criteria (kappa score = 94%). These studies were divided into 7 in vitro, 11 in vivo, and 31 clinical studies. In summary, 6 out of 7 (85.7%) and 11 out of 11 (100%) of the in vitro and in vivo studies, respectively, demonstrated a statistically significant advantage for combining PRF to their regenerative therapies. Out of the remaining 31 clinical studies, a total of 8 reported the effects of PRF in a randomized clinical trial, with 5 additional studies (13 total) reporting appropriate controls. In those clinical studies, 9 out of the 13 studies (69.2%) demonstrated a statistically relevant positive outcome for the primary endpoints measured. In total, 18 studies (58% of clinical studies) reported positive wound-healing events associated with the use of PRF, despite using controls. Furthermore, 27 of the 31 clinical studies (87%) supported the use of PRF for soft tissue regeneration and wound healing for a variety of procedures in medicine and dentistry. In conclusion, the results from the present systematic review highlight the positive effects of PRF on wound healing after regenerative therapy for the management of various soft tissue defects found in medicine and dentistry.
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Affiliation(s)
- Richard J Miron
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
| | - Masako Fujioka-Kobayashi
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida.,2 Cranio-Maxillofacial Surgery, Bern University Hospital , Inselspital, Bern, Switzerland .,3 Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School , Tokushima, Japan
| | - Mark Bishara
- 4 West Bowmanville Family Dental , Ontario, Canada
| | - Yufeng Zhang
- 5 Department of Oral Implantology, University of Wuhan , Wuhan, China
| | - Maria Hernandez
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
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Effect of Blood Component Coatings of Enosseal Implants on Proliferation and Synthetic Activity of Human Osteoblasts and Cytokine Production of Peripheral Blood Mononuclear Cells. Mediators Inflamm 2016; 2016:8769347. [PMID: 27651560 PMCID: PMC5019932 DOI: 10.1155/2016/8769347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 05/04/2016] [Accepted: 05/25/2016] [Indexed: 12/23/2022] Open
Abstract
The study monitored in vitro early response of connective tissue cells and immunocompetent cells to enosseal implant materials coated by different blood components (serum, activated plasma, and plasma/platelets) to evaluate human osteoblast proliferation and synthetic activity and inflammatory response presented as a cytokine profile of peripheral blood mononuclear cells (PBMCs) under conditions imitating the situation upon implantation. The cells were cultivated on coated Ti-plasma-sprayed (Ti-PS), Ti-etched (Ti-Etch), Ti-hydroxyapatite (Ti-HA), and ZrO2 surfaces. The plasma/platelets coating supported osteoblast proliferation only on osteoconductive Ti-HA and Ti-Etch whereas activated plasma enhanced proliferation on all surfaces. Differentiation (BAP) and IL-8 production remained unchanged or decreased irrespective of the coating and surface; only the serum and plasma/platelets-coated ZrO2 exhibited higher BAP and IL-8 expression. RANKL production increased on serum and activated plasma coatings. PBMCs produced especially cytokines playing role in inflammatory phase of wound healing, that is, IL-6, GRO-α, GRO, ENA-78, IL-8, GM-CSF, EGF, and MCP-1. Cytokine profiles were comparable for all tested surfaces; only ENA-78, IL-8, GM-CSF, and MCP-1 expression depended on materials and coatings. The activated plasma coating led to uniformed surfaces and represented a favorable treatment especially for bioinert Ti-PS and ZrO2 whereas all coatings had no distinctive effect on bioactive Ti-HA and Ti-Etch.
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Pavlovic V, Ciric M, Jovanovic V, Stojanovic P. Platelet Rich Plasma: a short overview of certain bioactive components. Open Med (Wars) 2016; 11:242-247. [PMID: 28352802 PMCID: PMC5329835 DOI: 10.1515/med-2016-0048] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 05/23/2016] [Indexed: 12/18/2022] Open
Abstract
Platelet rich plasma (PRP) represents a relatively new approach in regenerative medicine. It is obtained from patient’s own blood and contains different growth factors and other biomolecules necessary for wound healing. Since there are various protocols for PRP preparing, it usually results with PRP generation with different amounts of bioactive substances, which finally may modulate the intensity of wound healing. The reference data about potential effect of some PRP compounds on wound healing, in different tissues, are still controversial. This review summarizes recently known facts about physiological role of certain PRP components and guidance for further research. Also, this review discusses different procedure for PRP generation and potential effect of leukocytes on wound healing.
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Affiliation(s)
- Voja Pavlovic
- Institute of Physiology, Medical Faculty University of Nis, Bulevar Dr. Zorana Djindjica 81, Nis, Serbia
| | - Milan Ciric
- Institute of Physiology, Medical Faculty University of Nis, Nis, Serbia
| | | | - Predrag Stojanovic
- Predrag Stojanovic, Department of Microbiology and Immunology, Nis, Serbia
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Martínez CE, González SA, Palma V, Smith PC. Platelet-Poor and Platelet-Rich Plasma Stimulate Bone Lineage Differentiation in Periodontal Ligament Stem Cells. J Periodontol 2016; 87:e18-26. [DOI: 10.1902/jop.2015.150360] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Betancourt J, Murrell W. Leukocyte-poor platelet-rich plasma to treat degenerative meniscal tear: A case report. J Clin Orthop Trauma 2016; 7:106-109. [PMID: 28018086 PMCID: PMC5167441 DOI: 10.1016/j.jcot.2016.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 01/30/2023] Open
Abstract
A traumatic and/or degenerative meniscus lesion is thought to be a clinical manifestation of early-onset osteoarthritis (OA), which is a chronic progressive condition that can cause substantial pain and disability. Platelet-rich plasma (PRP) is an emerging treatment option that has been reported to improve healing. Here, we present a case of a 29-year-old woman, with left anterior and medial knee pain, without history of trauma or injury. The patient was managed with leukocyte-poor PRP injections derived from her peripheral blood with high concentrations of platelets, platelet-derived growth factors, and bioactive proteins, with a total follow-up of 30 months. Post-treatment patient was evaluated at every follow-up for improvement using three independent measures, VAS, GROC, and KOOS. There was considerable improvement in the pain symptoms from baseline (VAS: 70 mm; GROC: n/a; and KOOS: 39) to 30 months (VAS: 40 mm; GROC: 5; and KOOS: 63.1) indicating that PRP injections can serve as therapeutic intervention for treatment of pain associated with early onset of OA. To further validate these results, more longitudinal and evidence-based studies are recommended, which may further guide the clinicians to manage early-onset OA with PRP.
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Affiliation(s)
- J.P. Betancourt
- Department of Internal Medicine, University of Puerto Rico, San Juan, PR, USA
| | - W.D. Murrell
- Dr. Humeira Badsha Medical Center, Dubai, United Arab Emirates,Orthopaedics, Rehabilitation, and Podiatry Department, Ft. Belvoir Community Hospital, Ft. Belvoir, VA, USA,Corresponding author at: Dr. Humeira Badsha Medical Center, Dubai, United Arab Emirates. Tel.: +971 508921587; fax: +1 8779943500.Dr. Humeira Badsha Medical CenterDubaiUnited Arab Emirates
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Oryan A, Alidadi S, Moshiri A. Platelet-rich plasma for bone healing and regeneration. Expert Opin Biol Ther 2015; 16:213-32. [DOI: 10.1517/14712598.2016.1118458] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Jo CH, Shin JS, Shin WH, Lee SY, Yoon KS, Shin S. Platelet-rich plasma for arthroscopic repair of medium to large rotator cuff tears: a randomized controlled trial. Am J Sports Med 2015; 43:2102-10. [PMID: 26015443 DOI: 10.1177/0363546515587081] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Two main questions about the use of platelet-rich plasma (PRP) for regeneration purposes are its effect on the speed of healing and the quality of healing. Despite recent numerous studies, evidence is still lacking in this area, especially in a representative patient population with medium to large rotator cuff tears. PURPOSE To assess the efficacy of PRP augmentation on the speed and quality of healing in patients undergoing arthroscopic repair for medium to large rotator cuff tears. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS A total of 74 patients scheduled for arthroscopic repair of medium to large rotator cuff tears were randomly assigned to undergo either PRP-augmented repair (PRP group) or conventional repair (conventional group). In the PRP group, 3 PRP gels (3 × 3 mL) were applied to each patient between the torn end and the greater tuberosity. The primary outcome was the Constant score at 3 months after surgery. Secondary outcome measures included the visual analog scale (VAS) for pain, range of motion (ROM), muscle strength, overall satisfaction and function, functional scores, retear rate, and change in the cross-sectional area (CSA) of the supraspinatus muscle. RESULTS There was no difference between the 2 groups in the Constant score at 3 months (P > .05). The 2 groups had similar results on the VAS for pain, ROM, muscle strength, overall satisfaction and function, and other functional scores (all P > .05) except for the VAS for worst pain (P = .043). The retear rate of the PRP group (3.0%) was significantly lower than that of the conventional group (20.0%) (P = .032). The change in 1-year postoperative and immediately postoperative CSAs was significantly different between the 2 groups: -36.76 ± 45.31 mm(2) in the PRP group versus -67.47 ± 47.26 mm(2) in the conventional group (P = .014). CONCLUSION Compared with repairs without PRP augmentation, the current PRP preparation and application methods for medium to large rotator cuff repairs significantly improved the quality, as evidenced by a decreased retear rate and increased CSA of the supraspinatus, but not the speed of healing. However, further studies may be needed to investigate the effects of PRP on the speed of healing without risking the quality.
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Affiliation(s)
- Chris Hyunchul Jo
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Ji Sun Shin
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Won Hyoung Shin
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Yeon Lee
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Kang Sup Yoon
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sue Shin
- Department of Laboratory Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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Picard F, Hersant B, Bosc R, Meningaud JP. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: A review and a proposal for a new standard care. Wound Repair Regen 2015; 23:638-43. [PMID: 26019054 DOI: 10.1111/wrr.12317] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 05/22/2015] [Indexed: 01/29/2023]
Abstract
Nonhealing chronic wounds and exposed tendons, bones and joints are very challenging to cure specially for diabetic patients. Plastic surgeons have a new weapon to enhance wound healing with the use of autologous growth factors. Recently, the process of fabrication of platelet-rich plasma (PRP) has been simplified. The goal of this literature review is to summarize the evidenced-based body of knowledge regarding the treatment of diabetic chronic wounds by PRP. A PubMed and Cochrane search (1978-2015) was performed and all studies assessing the clinical effect of PRP on the healing of diabetic chronic wounds were included. The screening retrieved 7,555 articles and 12 studies were included. On six randomized studies included, five found significant benefits for the use of PRP on diabetic chronic foot ulcers and the sixth randomized study did not publish a statistical analysis but found favorable outcomes. The two other controlled studies included found significant benefits regarding the healing rate and the four uncontrolled studies included showed high rates of healing with the adjunction of PRP. Regarding the method of use, PRP was applied on the wound as a gel twice a week (41.7% of studies) or once a week (33.3% of studies). In conclusion, 87.5% of controlled studies found a significant benefit for the adjunction of PRP to treat chronic diabetic wounds. As PRP may be beneficial, we suggest using PRP on diabetic ulcers which remain unhealed after standard treatment.
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Affiliation(s)
- Frédéric Picard
- Department of Plastic & Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Barbara Hersant
- Department of Plastic & Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Romain Bosc
- Department of Plastic & Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Jean-Paul Meningaud
- Department of Plastic & Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
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Kuffler DP. Platelet-Rich Plasma Promotes Axon Regeneration, Wound Healing, and Pain Reduction: Fact or Fiction. Mol Neurobiol 2015; 52:990-1014. [PMID: 26048672 DOI: 10.1007/s12035-015-9251-x] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Indexed: 11/25/2022]
Abstract
Platelet-rich plasma (PRP) has been tested in vitro, in animal models, and clinically for its efficacy in enhancing the rate of wound healing, reducing pain associated with injuries, and promoting axon regeneration. Although extensive data indicate that PRP-released factors induce these effects, the claims are often weakened because many studies were not rigorous or controlled, the data were limited, and other studies yielded contrary results. Critical to assessing whether PRP is effective are the large number of variables in these studies, including the method of PRP preparation, which influences the composition of PRP; type of application; type of wounds; target tissues; and diverse animal models and clinical studies. All these variables raise the question of whether one can anticipate consistent influences and raise the possibility that most of the results are correct under the circumstances where PRP was tested. This review examines evidence on the potential influences of PRP and whether PRP-released factors could induce the reported influences and concludes that the preponderance of evidence suggests that PRP has the capacity to induce all the claimed influences, although this position cannot be definitively argued. Well-defined and rigorously controlled studies of the potential influences of PRP are required in which PRP is isolated and applied using consistent techniques, protocols, and models. Finally, it is concluded that, because of the purported benefits of PRP administration and the lack of adverse events, further animal and clinical studies should be performed to explore the potential influences of PRP.
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Affiliation(s)
- Damien P Kuffler
- Institute of Neurobiology, University of Puerto Rico, Medical Sciences Campus, 201 Blvd. Del Valle, San Juan, 00901, Puerto Rico,
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Kawase T. Platelet-rich plasma and its derivatives as promising bioactive materials for regenerative medicine: basic principles and concepts underlying recent advances. Odontology 2015; 103:126-35. [DOI: 10.1007/s10266-015-0209-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/16/2015] [Indexed: 11/29/2022]
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