Experimental model for the study of the effects of platelet-rich plasma on the early phases of muscle healing. Blood Transfus. 2014;12 Suppl 1:s221-s228. [PMID: 23867182 DOI: 10.2450/2013.0275-12]

Platelet-rich plasma (PRP) therapy: An approach in reproductive medicine based on successful animal models

Platelet-rich plasma (PRP) has been fully studied for different clinical applications in veterinary medicine for many years with promising results. As a result, therapeutic studies to elucidate pathways for PRP use in human reproduction have been performed. PRP applications in human reproductive medicine are recent, but the role of platelet growth factors in improving the endometrial environment is well known. Indications for PRP therapy show its positive effects in promoting endometrial and follicular growth and gestation in assisted reproduction cycles, as has been proven in animals. We summarized the putative role of PRP on endometrial receptivity with a brief history of promising results in research and clinical therapies.

Intramuscular Injection of Combined Calf Blood Compound (CFC) and Homeopathic Drug Tr14 Accelerates Muscle Regeneration In Vivo

Skeletal muscle injuries in competitive sports cause lengthy absences of athletes from tournaments. This is of tremendous competitive and economic relevance for both the athletes and their respective clubs. Therapy for structural muscle lesions aims to promote regeneration and fast-track return-to-play. A common clinical treatment strategy for muscle injuries is the intramuscular injection of calf blood compound and the homeopathic drug, Tr14. Although the combination of these two agents was reported to reduce recovery time, the regulatory mechanism whereby this occurs remains unknown. In this in vivo study, we selected a rat model of mechanical muscle injury to investigate the effect of this combination therapy on muscle regeneration. Gene expression analysis and histological images revealed that this combined intramuscular injection for muscle lesions can enhance the expression of pro-myogenic genes and proteins and accelerate muscle regeneration. These findings are novel and depict the positive effects of calf blood compound and the homeopathic drug, Tr14, which are utilized in the field of Sports medicine.

Rectus femoris myotendinous lesion treated with PRP: a case report

BACKGROUND AND AIM OF WORK

Musculoskeletal injuries are the most common cause of severe, chronic pain and physical disability for the majority of all sport-related injuries. Platelet-rich plasma is being used more frequently to promote healing of muscle injuries. We report a case of 39 years old non professional soccer player who came to our attention for a quadriceps muscle pain onset after kicking the ball during a match.

METHODS

Clinical and instrumental evaluation revealed a myotendinous junction rupture of the rectus femoris with retraction of 1.5 cm from the anterior inferior iliac spine. We decided to treat the patient with PRP ultrasound guided injections and a specific rehabilitation protocol.

RESULTS

Clinical evaluation 45 days following the end of the treatment showed the resolution of the pain and the full recovery of strength and range of motion. Muscle healing was documented by magnetic resonance imaging.

CONCLUSIONS

Even if the role of PRP in muscle injury is not still clear, the result observed confirms that it could be used in the treatment of muscle lesions.

Platelet-rich plasma for muscle injuries: A systematic review of the basic science literature

BACKGROUND

Platelet-rich plasma (PRP) is an increasingly used biologic adjunct for muscle injuries, as it is thought to expedite healing. Despite its widespread use, little is known regarding the mechanisms by which PRP produces its efficacious effects in some patients.

AIM

To clarify the effects of PRP on muscular pathologies at the cellular and tissue levels by evaluating the basic science literature.

METHODS

A systematic review of PubMed/MEDLINE and EMBASE databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. Level III in vivo and in vitro studies examining PRP effects on muscles, myocytes and/or myoblasts were eligible for inclusion. Extracted data included PRP preparation methods and study results.

RESULTS

Twenty-three studies were included (15 in vivo, 6 in vitro, 2 in vitro/in vivo). Only one reported a complete PRP cytology (platelets, and red and white blood cell counts). Five in vitro studies reported increased cellular proliferation, four reported increased gene expression, and three reported increased cellular differentiation. Five in vivo studies reported increased gene expression, three reported superior muscle regeneration, and seven reported improved histological quality of muscular tissue.

CONCLUSION

The basic science literature on the use of PRP in muscle pathology demonstrates that PRP treatment confers several potentially beneficial effects on healing in comparison to controls. Future research is needed to determine optimal cytology, dosing, timing, and delivery methods of PRP for muscle pathologies.

Influence of Platelet-Rich and Platelet-Poor Plasma on Endogenous Mechanisms of Skeletal Muscle Repair/Regeneration

The morpho-functional recovery of injured skeletal muscle still represents an unmet need. None of the therapeutic options so far adopted have proved to be resolutive. A current scientific challenge remains the identification of effective strategies improving the endogenous skeletal muscle regenerative program. Indeed, skeletal muscle tissue possesses an intrinsic remarkable regenerative capacity in response to injury, mainly thanks to the activity of a population of resident muscle progenitors called satellite cells, largely influenced by the dynamic interplay established with different molecular and cellular components of the surrounding niche/microenvironment. Other myogenic non-satellite cells, residing within muscle or recruited via circulation may contribute to post-natal muscle regeneration. Unfortunately, in the case of extended damage the tissue repair may become aberrant, giving rise to a maladaptive fibrotic scar or adipose tissue infiltration, mainly due to dysregulated activity of different muscle interstitial cells. In this context, plasma preparations, including Platelet-Rich Plasma (PRP) and more recently Platelet-Poor Plasma (PPP), have shown advantages and promising therapeutic perspectives. This review focuses on the contribution of these blood-derived products on repair/regeneration of damaged skeletal muscle, paying particular attention to the potential cellular targets and molecular mechanisms through which these products may exert their beneficial effects.

Platelet-rich plasma and skeletal muscle healing: a molecular analysis of the early phases of the regeneration process in an experimental animal model

Platelet-rich plasma (PRP) has received increasing interest in applied medicine, being widely used in clinical practice with the aim of stimulating tissue healing. Despite the reported clinical success, there is still a lack of knowledge when considering the biological mechanisms at the base of the activity of PRP during the process of muscle healing. The aim of the present study was to verify whether the local delivery of PRP modulates specific molecular events involved in the early stages of the muscle regeneration process. The right flexor sublimis muscle of anesthetized Wistar rats was mechanically injured and either treated with PRP or received no treatment. At day 2 and 5 after surgery, the animals were sacrificed and the muscle samples evaluated at molecular levels. PRP treatment increased significantly the mRNA level of the pro-inflammatory cytokines IL-1β, and TGF-β1. This phenomenon induced an increased expression at mRNA and/or protein levels of several myogenic regulatory factors such as MyoD1, Myf5 and Pax7, as well as the muscular isoform of insulin-like growth factor1 (IGF-1Eb). No effect was detected with respect to VEGF-A expression. In addition, PRP application modulated the expression of miR-133a together with its known target serum response factor (SRF); increased the phosphorylation of αB-cristallin, with a significant improvement in several apoptotic parameters (NF-κB-p65 and caspase 3), indexes of augmented cell survival. The results of the present study indicates that the effect of PRP in skeletal muscle injury repair is due both to the modulation of the molecular mediators of the inflammatory and myogenic pathways, and to the control of secondary pathways such as those regulated by myomiRNAs and heat shock proteins, which contribute to proper and effective tissue regeneration.