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Nakagawa HF, Kim J, Rinaldi J, Rabinowitz J, Mautner K, DeMers A, Sherman S, Borg-Stein J, Sussman WI. Systematic Review of Randomized Controlled Trials Evaluating the Use of Platelet-Rich Plasma for Knee Osteoarthritis: Adherence to Minimum Information for Studies Evaluating Biologics in Orthopaedics. Am J Sports Med 2025; 53:1241-1253. [PMID: 39754417 DOI: 10.1177/03635465241249996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
Abstract
BACKGROUND The Minimum Information for Studies Evaluating Biologics in Orthopedics (MIBO) guidelines were developed in May 2017 to encourage improved reporting standards, promote increased transparency and reproducibility, and enhance clinical evaluation capabilities. The MIBO guidelines consist of 23 checklist items considered necessary to critically appraise clinical studies evaluating platelet-rich plasma (PRP). PURPOSE To assess randomized controlled trials that evaluated PRP for the treatment of knee osteoarthritis in order to systematically review their adherence to the MIBO guidelines. STUDY DESIGN Systematic review. Level 1a. METHODS A search was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The inclusion criteria were randomized controlled trials reporting on knee osteoarthritis treated with intra-articular PRP. The studies were categorized into pre-, peri-, and post-MIBO groups based on the start date of data collection. The overall MIBO scores, defined as percentage of checklist items out of the 23 checklist items reported in 1 study, individual item scores, defined as percentage of studies reporting the checklist item within a specified group, and overall item score defined as the average of the individual item scores from all the included studies were calculated. RESULTS The review included 87 studies (7925 patients; 8118 knees). Of these, 51 studies were assigned to the pre-MIBO group, 19 studies to the peri-MIBO group, and 17 studies to the post-MIBO group. The overall MIBO score was 72%. No statistically significant differences in MIBO scores were found among the 3 MIBO groups (P = .345). The majority of the studies (62 studies; 71%) had MIBO scores <80%. MIBO items with particularly low item scores included reporting of whole-blood characteristics (20%), platelet recovery rate (22%), PRP analysis (30%), and PRP activation (47%). No significant difference among the 3 MIBO groups was found for the item scores except for the reporting of the recipient details (P = .012). CONCLUSION This study highlights the deficiencies in adherence to the MIBO guidelines, particularly in reporting key variables such as whole-blood characteristics, platelet recovery rate, PRP analysis, and PRP activation. These findings suggest that the publication of the MIBO guidelines has not resulted in improved reporting practices in studies investigating intra-articular PRP for the treatment of knee osteoarthritis.
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Affiliation(s)
- Hirotaka F Nakagawa
- Department of Orthopedics and Rehabilitation, Tufts Medical Center, Boston, Massachusetts, USA
| | - James Kim
- Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Joseph Rinaldi
- Department of Orthopedics and Rehabilitation, Tufts Medical Center, Boston, Massachusetts, USA
| | - Judy Rabinowitz
- Hirsch Health Sciences Library, Tufts University, Boston, Massachusetts, USA
| | - Ken Mautner
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ariana DeMers
- Restore Orthopedics and Sports Medicine, Sonora, California, USA
| | - Seth Sherman
- Department of Orthopaedic Surgery, Stanford Medicine, Redwood City, California, USA
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Walter I Sussman
- Department of Orthopedics and Rehabilitation, Tufts Medical Center, Boston, Massachusetts, USA
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Odložilová Š, Paral J, Sirovy M, Zajak J, Fibír A. Platelet-Rich Plasma: Characteristics and Current Review of its Use in Surgery. POLISH JOURNAL OF SURGERY 2024; 96:66-74. [PMID: 39465631 DOI: 10.5604/01.3001.0054.6750] [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] [Indexed: 10/29/2024]
Abstract
Platelet-rich plasma (PRP) is presently employed across various medical disciplines, including surgical specialties. It is primarily used in the healing of chronic wounds, burn medicine, tissue regeneration support, and scar correction as well as in other surgical and orthopedic indications. Wounds, in general, possess a pro-inflammatory biochemical environment characterized by high protease activity that diminishes the effective concentration of growth factors. In contrast, PRP serves as a source of growth factors and exhibits mitogenic, angiogenic, and chemotactic properties. PRP is a biological product defined as a portion of the autologous blood's plasma fraction with a higher than physiological platelet concentration. PRP is obtained through the centrifugation of blood samples collected from patients. The insights into the biology, mechanism of action, and classification of PRP presented in this review can assist medical professionals in orienting themselves and comprehending the possibilities of the clinical application of this therapy, which remains a subject of investigation and validation. This review summarizes up-to-date information regarding the use of PRP, primarily in burn and reconstructive surgery, plastic surgery, traumatology, and general surgery.
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Affiliation(s)
- Šárka Odložilová
- Department of Military Surgery, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic, Department of Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jiri Paral
- Department of Military Surgery, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic, Department of Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic, Department of Surgery, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Miroslav Sirovy
- Department of Military Surgery, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic, Department of Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jan Zajak
- Department of Military Surgery, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic, Department of Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Aleš Fibír
- Department of Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic, Department of Surgery, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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Park SH, Kim DY, Lee WJ, Jang M, Jeong SM, Ku SK, Kwon YS, Yun S. Effect of platelet-rich plasma in Achilles tendon allograft in rabbits. J Vet Sci 2024; 25:e22. [PMID: 38568824 PMCID: PMC10990913 DOI: 10.4142/jvs.23281] [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: 11/13/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Achilles tendon is composed of dense connective tissue and is one of the largest tendons in the body. In veterinary medicine, acute ruptures are associated with impact injury or sharp trauma. Healing of the ruptured tendon is challenging because of poor blood and nerve supply as well as the residual cell population. Platelet-rich plasma (PRP) contains numerous bioactive agents and growth factors and has been utilized to promote healing in bone, soft tissue, and tendons. OBJECTIVE The purpose of this study was to evaluate the healing effect of PRP injected into the surrounding fascia of the Achilles tendon after allograft in rabbits. METHODS Donor rabbits (n = 8) were anesthetized and 16 lateral gastrocnemius tendons were fully transected bilaterally. Transected tendons were decellularized and stored at -80°C prior to allograft. The allograft was placed on the partially transected medial gastrocnemius tendon in the left hindlimb of 16 rabbits. The allograft PRP group (n = 8) had 0.3 mL of PRP administered in the tendon and the allograft control group (n = 8) did not receive any treatment. After 8 weeks, rabbits were euthanatized and allograft tendons were transected for macroscopic, biomechanical, and histological assessment. RESULTS The allograft PRP group exhibited superior macroscopic assessment scores, greater tensile strength, and a histologically enhanced healing process compared to those in the allograft control group. CONCLUSIONS Our results suggest administration of PRP on an allograft tendon has a positive effect on the healing process in a ruptured Achilles tendon.
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Affiliation(s)
- Seok-Hong Park
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Dong-Yub Kim
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Won-Jae Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Min Jang
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Seong Mok Jeong
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon 34134, Korea
| | - Sae-Kwang Ku
- Department of Anatomy and Histology, College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Korea
| | - Young-Sam Kwon
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Sungho Yun
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea.
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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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Zhang QD, Duan QY, Tu J, Wu FG. Thrombin and Thrombin-Incorporated Biomaterials for Disease Treatments. Adv Healthc Mater 2024; 13:e2302209. [PMID: 37897228 DOI: 10.1002/adhm.202302209] [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: 07/12/2023] [Revised: 10/20/2023] [Indexed: 10/29/2023]
Abstract
Thrombin, a coagulation-inducing protease, has long been used in the hemostatic field. During the past decades, many other therapeutic uses of thrombin have been developed. For instance, burn treatment, pseudoaneurysm therapy, wound management, and tumor vascular infarction (or tumor vasculature blockade therapy) can all utilize the unique and powerful function of thrombin. Based on their therapeutic effects, many thrombin-associated products have been certificated by the Food and Drug Administration, including bovine thrombin, human thrombin, recombinant thrombin, fibrin glue, etc. Besides, several thrombin-based drugs are currently undergoing clinical trials. In this article, the therapeutic uses of thrombin (from the initial hemostasis to the latest cancer therapy), the commercially available drugs associated with thrombin, and the pros and cons of thrombin-based therapeutics (e.g., adverse immune responses related to bovine thrombin, thromboinflammation, and vasculogenic "rebounds") are summarized. Further, the current challenges and possible future research directions of thrombin-incorporated biomaterials and therapies are discussed. It is hoped that this review may provide a valuable reference for researchers in this field and help them to design safer and more effective thrombin-based drugs for fighting against various intractable diseases.
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Affiliation(s)
- Qiong-Dan Zhang
- State Key Laboratory of Digital Medical Engineering, School of Biological Science and Medical Engineering, Southeast University, 2 Southeast University Road, Nanjing, Jiangsu, 211189, P. R. China
| | - Qiu-Yi Duan
- State Key Laboratory of Digital Medical Engineering, School of Biological Science and Medical Engineering, Southeast University, 2 Southeast University Road, Nanjing, Jiangsu, 211189, P. R. China
| | - Jing Tu
- State Key Laboratory of Digital Medical Engineering, School of Biological Science and Medical Engineering, Southeast University, 2 Southeast University Road, Nanjing, Jiangsu, 211189, P. R. China
| | - Fu-Gen Wu
- State Key Laboratory of Digital Medical Engineering, School of Biological Science and Medical Engineering, Southeast University, 2 Southeast University Road, Nanjing, Jiangsu, 211189, P. R. China
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Wang Z, Feng C, Chang G, Liu H, Li S. The use of platelet-rich plasma in wound healing and vitiligo: A systematic review and meta-analysis. Skin Res Technol 2023; 29:e13444. [PMID: 37753680 PMCID: PMC10444946 DOI: 10.1111/srt.13444] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/13/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE To critically assess the effect and safety of platelet-rich plasma (PRP) in chronic wounds and vitiligo. METHODS A systematic literature searching was performed. Results were expressed as weight mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Pooled estimates were performed using a fixed-effects model or random-effects model, depending on the heterogeneity among studies. RESULTS A total of 27 studies were included in this meta-analysis. In patients with chronic diabetic ulcers, PRP significantly increased proportion of complete wound healing, percentage of wound area healed, and shortened the complete wound healing. In venous ulcers, PRP improved the epithelialized area and percentage of wound area healed. In vitiligo, PRP had better results in degree of improvement and mean repigmentation than controls. Regarding the safety profile, PRP did not increase the risk of infection in patients with chronic diabetic ulcers. Meta-regression revealed that source of PRP and preparation method of PRP significantly affected the proportion of complete wound healing, whereas age, gender, country, duration of wound, and wound size had no impact on this outcome. CONCLUSION PRP is effective and safe, and can be used as a potential therapeutic adjunct or alternative treatment in chronic wounds of multiple etiologies and vitiligo.
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Affiliation(s)
- Zhi Wang
- Department of Plastic & Cosmetic SurgeryPeking Union Medical College HospitalBeijingChina
| | - Cheng Feng
- Department of Plastic & Cosmetic SurgeryPeking Union Medical College HospitalBeijingChina
| | - Guojing Chang
- Department of Plastic & Cosmetic SurgeryPeking Union Medical College HospitalBeijingChina
| | - Hao Liu
- Department of Plastic & Cosmetic SurgeryPeking Union Medical College HospitalBeijingChina
| | - Shuo Li
- Department of Plastic & Cosmetic SurgeryPeking Union Medical College HospitalBeijingChina
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Uyeki CL, Perry NP, Farina EM, Wang C, Nascimento RJ, Mazzocca AD. Biologic Adjuvants for Rotator Cuff Augmentation. OPER TECHN SPORT MED 2023. [DOI: 10.1016/j.otsm.2023.150988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Shelesko EV, Doronina VA, Sharipov OI, Kvan OK, Chernikova NA, Strunina YV, Zinkevich DN. [Autologous fibrin glue for endoscopic skull base repair in patients with cerebrospinal fluid leakage]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2023; 87:49-54. [PMID: 36763553 DOI: 10.17116/neiro20238701149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The main stages of endoscopic skull base repair in patients with cerebrospinal fluid (CSF) leakage are identification of bone boundaries of the fistula and its closure by auto- and allografts. Fibrin glue can be used to fix plastic materials and additionally seal skull base defect. OBJECTIVE To analyze efficacy and safety of Vivostat autologous fibrin glue for endoscopic skull base repair in patients with nasal CSF leakage and to compare postoperative outcomes after defect closure by Vivostat fibrin glue and allogeneic fibrin glue. MATERIAL AND METHODS A retro- and prospective analysis included 56 patients with nasal CSF leakage who were treated at the Burdenko Neurosurgery Center between January 2021 and June 2022. Patients were divided into 2 groups: Vivostat fibrin glue (n=27, 48.2%) and allogeneic fibrin glue (n=29, 51.8%). Demographic and clinical perioperative data were analyzed. RESULTS No early postoperative recurrence of CSF leakage was registered in both groups, whereas meningitis occurred in 2 cases in each group. Recurrent CSF leakage in delayed postoperative period occurred in 1 patient (3.4%) of the control group (p>0.05). Incidence of perioperative complications, subfebrile temperature in early postoperative period, surgery time and hospital-stay were similar. CONCLUSION Vivostat autologous fibrin glue is a safe and effective method for fixing the grafts in endoscopic skull base repair. The advantages of this approach are easy application, elimination of the risk of allergic, immunological and infectious complications, as well as acceleration of tissue regeneration.
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Affiliation(s)
| | | | | | - O K Kvan
- Burdenko Neurosurgery Center, Moscow, Russia
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Zhao F, Hao L, Jin X. Clinical observation and evaluation of CGF in the treatment of androgenic alopecia. J Cosmet Dermatol 2022; 21:5723-5729. [PMID: 35608516 DOI: 10.1111/jocd.15109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/08/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the efficacy of concentrated growth factor (CGF) injections in patients with androgenic alopecia. METHODS Venous blood of 60 patients (aged 18-55 years old with a mean age of 38 years) with androgenic alopecia who were treated from September 2017 to September 2019 were collected to prepare CGF. 0.1 ml CGF was injected into the alopecia area with an interval of 30-35 days for a total of 6 times. The evaluation was performed before treatment and at 1, 3, and 6 months after the first injection and 3 and 6 months after the last injection. RESULTS Among the 60 patients, 58 cases received 6 treatments completely, 52 cases showed significant improvement, 8 cases improved, and no ineffective or worsening cases were found. Among the 58 patients, hair density, hair follicle density, and hair diameter increased significantly. Furthermore, the hair status of all patients was improved to varying degrees during the 6-month follow-up from the digital photographs. No complications such as redness, swelling, infection, and ulceration were found in the injection area, and the patient satisfaction was 93% (56/60). CONCLUSION Concentrated growth factor treatment can significantly improve the symptoms of hair loss and increase hair diameter in patients with androgenic alopecia. It is effective, safe, and worth popularizing.
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Affiliation(s)
- Fangning Zhao
- The 16th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Lijun Hao
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaolei Jin
- The 16th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Bajaj S, Orbuch D, Wang JV, Geronemus RG. Preparation and Utility of Platelet-Rich Plasma (PRP) for Facial Aging: A Comprehensive Review. Adv Ther 2022; 39:4021-4036. [DOI: 10.1007/s12325-022-02239-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
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Saurav S, Aggarwal AN, Shahi P, Kamal S, Bansal K, Singla S. Efficacy of Single Injection of Platelet-Rich Plasma in Shoulder Impingement Syndrome. Cureus 2022; 14:e25727. [PMID: 35812631 PMCID: PMC9270084 DOI: 10.7759/cureus.25727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction To analyze the change in Visual Analog Scale (VAS), QuickDASH score, and the range of motion at the shoulder joint following a single injection of platelet-rich plasma (PRP) in shoulder impingement syndrome. Methods Twenty patients (21 shoulders) of either sex above the age of 18 years with a clinical diagnosis of shoulder impingement having a positive shoulder impingement test (positive Hawkins-Kennedy impingement test and/or positive Neer's impingement sign), ultrasonographic confirmation of shoulder impingement, and a failure to respond to standard non-operative methods for a minimum period of four weeks were included in this prospective interventional study. PRP was injected at the proposed site. At three months after the injection, the changes in the VAS, QuickDASH score, and the range of motion at the shoulder joint were analyzed. Results There were significant changes in the VAS, QuickDASH score, and range of motion at the shoulder joint following a single injection of PRP. Conclusions Platelet-rich plasma (PRP) injection results in a significant decrease in pain and improvement in the range of motion and an overall excellent functional outcome in shoulder impingement syndrome. However, future studies with a bigger sample size and longer follow-up are needed.
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Luo G, Wang C, Li J, Zhang X, Sun Z, Song S, Fan C. Thrombin improves diabetic wound healing by ERK dependent and independent Smad2/3 linker region phosphorylation. Curr Pharm Des 2022; 28:1433-1443. [PMID: 35546767 DOI: 10.2174/1381612828666220511125237] [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: 11/03/2021] [Accepted: 03/22/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Impaired wound healing is one of the most noteworthy features and troublesome complications of diabetes mellitus, which arouse a rising global health concern but without potent remedies. Thrombin is the major hemostatic agent applied at wound healing initiation and recently gained therapeutic credits in later phases. However, a rare investigation achieved prolonged use of thrombin and probed the detailed mechanism. OBJECTIVE To investigate the effects and mechanism of thrombin on diabetic skin wound healing. METHODS The effect of thrombin on fibroblast proliferation, α-SMA, and Collagen I expression was firstly studied in vitro by Cell Counting Kit 8 (CCK8) and western blotting. Then, the specific phosphorylation site of SMAD2/3 and their ERK1/2 dependence during thrombin treatment were assessed by western blotting for mechanism exploration. After that, full-thickness wound defects were established in diabetic male SD rats and treated with thrombin in the presence or absence of PD98059 to observe the in vivo effects of thrombin and to confirm its ERK dependence. RESULTS We found that thrombin promoted fibroblast proliferation and their α-SMA and Collagen I production. Mechanistically, thrombin induced phosphorylation of Smad2 linker region (Ser245/250/255) through ERK1/2 phosphorylation but promoted phosphorylation of Smad3 linker region (Ser204) independent of ERK1/2. Histological results showed that thrombin facilitated wound healing by promoting α-SMA and Collagen I expression, which was not abolished by inhibiting ERK phosphorylation. CONCLUSION Collectively, this study validated the therapeutic efficacy of thrombin on diabetic wound healing and identified both ERK-dependent and -independent Smad2/3 linker region phosphorylation as the essential signaling events in this process.
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Affiliation(s)
- Gang Luo
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China
| | - Chongyang Wang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China
| | - Juehong Li
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China
| | - Xuancheng Zhang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China
| | - Ziyang Sun
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China
| | - Sa Song
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China
| | - Cunyi Fan
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People\'s Hospital, 600 Yishan Rd, Shanghai 200233, PR China.,Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Building 3, Langu Science and Technology Park, Lane 70, Haiji 6th Road, Shanghai, China
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An Evaluation of the Effect of Activation Methods on the Release of Growth Factors from Platelet-Rich Plasma. Plast Reconstr Surg 2022; 149:404-411. [PMID: 35077415 DOI: 10.1097/prs.0000000000008772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Activation of platelets in platelet-rich plasma may improve growth factor release, thus enhancing regenerative properties. The authors investigated whether different methods of platelet-rich plasma activation affected growth factor release kinetics over time. METHODS Platelet-rich plasma from 20 healthy volunteers was processed by six different methods: (1) control (nonactivated); (2) activation with calcium chloride; (3) activation with calcium chloride and ethanol; (4) activation with calcium chloride and ethanol at 4°C; (5) activation with calcium chloride and ethanol with vitamin C; (6) activation with calcium chloride and ethanol with vitamin C at 4°C. Concentration of secreted vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and insulin-like growth factor over 24 hours was measured by immunoassay. RESULTS Calcium chloride-activated platelet-rich plasma produced significantly more insulin-like growth factor at 1 hour compared to cold and vitamin C platelet-rich plasma, and calcium chloride plus ethanol produced significantly more at 24 hours compared to vitamin C platelet-rich plasma. The addition of vitamin C reduced release of PDGF over time. Activation with calcium chloride and ethanol with or without cold temperature produced a gradual PDGF release as opposed to calcium chloride alone, which caused higher PDGF within 4 hours. There were no significant differences between groups for VEGF, although calcium chloride and cooled platelet-rich plasma approached significance for producing more than vitamin C platelet-rich plasma. CONCLUSIONS Activation of platelet-rich plasma does not significantly improve growth factor secretion, which is made worse by the addition of vitamin C, a platelet inhibitor. Ethanol does not negatively impact growth factor production and may offer a more gradual release. CLINICAL RELEVANCE STATEMENT These findings will help guide platelet-rich plasma preparation methods where therapeutic growth factors are used. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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Sneha K, Rani A, Chandra R, Kumar S, Jannu R, Muppirala S. The G-Force conundrum in platelet-rich fibrin generation: Management of a problem hidden in plain sight. Contemp Clin Dent 2022; 13:150-155. [PMID: 35846586 PMCID: PMC9285831 DOI: 10.4103/ccd.ccd_830_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/01/2020] [Accepted: 12/04/2020] [Indexed: 11/20/2022] Open
Abstract
Aim: A force of 400 g at 2700 revolutions per minute (RPM) results in an optimum leukocyte and platelet-rich fibrin (L-PRF). Most of centrifuges with varying characteristics generate a g-force in excess of 700 g at 2700 RPM. In this context, the study explores the effect of the original centrifugation protocol and a modified protocol tailor-made to lower the RPM to generate a g-force of ~ 400 g on platelet concentration, clot size and growth factors release in L-PRF prepared in two different commercially available centrifuges. Materials and Methods: Twenty five subjects each were assigned to the following groups; R1 and R2 where L-PRF was obtained from two laboratory swing-out centrifuges (Remi 8C® and Remi C854®, Mumbai, India), respectively. PRF was obtained from each subject within a group using two protocols; Original (O) protocol: conforming to the original centrifugation cycle (2700 RPM for 12 min) and Modified (M) protocol. Clot size, growth factor estimation, and platelet counts were measured at 20, 40, and 60 min from all the L-PRF clots, respectively. Results: At the third time period (40–60 min), there were no significant differences in clot sizes with the original protocol (P = 0.09), but a highly significant difference was noticed with the modified protocol in both the centrifuges (P = 0.001). Our results showed an increased concentration of vascular endothelial growth factor and epidermal growth factor with modified protocol than with original protocol with both the centrifuges (P = 0.001). By the end of second and third time periods, more platelet concentration was observed with modified protocol than with the original protocol in both the centrifuges (P = 0.001). Conclusion: This study infers that the centrifuge type and relative centrifugal force can affect the quality and quantity of cells and growth factors and an optimum relationship between g-force and RPM should be maintained to obtain L-PRF with adequate cell viability and optimum growth factor release.
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15
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Alexander S, Horo I, Johnson S, Daniel S. Platelet-rich plasma in hair loss-Mechanism, preparation, and classification. J Cosmet Dermatol 2021; 21:970-978. [PMID: 34897939 DOI: 10.1111/jocd.14662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022]
Abstract
Platelet-rich plasma is the autologous plasma containing platelet concentration more than the baseline separated after centrifugation. It has become a very popular option for the treatment of hair loss in the past few decades. Used alone or in combination with other treatment options it has found a place as a hair restoration procedure throughout the world. However, evidence supporting its credibility is quite ambiguous with contradictory reports available in the literature. In this article, we try to analyze the available data regarding its mechanism of action, preparation protocols, and classification, with regard to hair loss.
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Affiliation(s)
- Sajin Alexander
- Schieffelin Institute of Health-Research and Leprosy Center (SIH-R &LC), Karigiri, Vellore, India
| | - Ilse Horo
- Schieffelin Institute of Health-Research and Leprosy Center (SIH-R &LC), Karigiri, Vellore, India
| | - Sobha Johnson
- Schieffelin Institute of Health-Research and Leprosy Center (SIH-R &LC), Karigiri, Vellore, India
| | - Sheela Daniel
- Schieffelin Institute of Health-Research and Leprosy Center (SIH-R &LC), Karigiri, Vellore, India
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Ferrari AR, Cortrezzi S, Borges E, Braga D, Souza MDCBD, Antunes RDA. Evaluation of the Effects of Platelet-Rich Plasma on Follicular and Endometrial Growth: A Literature Review. JBRA Assist Reprod 2021; 25:601-607. [PMID: 34415119 PMCID: PMC8489815 DOI: 10.5935/1518-0557.20210036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Platelet-rich plasma (PRP) has been used in several areas of medicine due to its ability to promote tissue regeneration by growth factors and cytokines. This review addresses the use of PRP to rejuvenate ovarian follicles and increase the thickness of the endometrium to receive an embryo. PRP is obtained from the patient's own blood (autologous blood) - a fact that determines a lower chance of rejection reactions. Alpha granules of platelets provide and release supra physiological amounts of growth factors and cytokines, which provide a regenerative stimulus in tissues with low healing potential. In the ovary, PRP and its growth factors stimulate vascularization and recruitment of available primordial follicles that could no longer be otherwise stimulated. The rejuvenation of the ovary by PRP infusion aims to obtain new oocytes in ovaries with low numbers of follicles or low follicular reserve markers. In the preparation of the endometrium, PRP is used for its several growth factors that allow tissue proliferation and endometrial thickening, especially in cases of endometria that are difficult to prepare or that fail to reach an adequate minimum thickness (>7mm). To date, there are few studies of greater expression in the literature that support the use of PRP with the two purposes described above. Thus, although promising, the technique must still be validated by larger clinical trials.
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Affiliation(s)
| | - Sylvia Cortrezzi
- Fertility - Centro de Fertilização Assistida, São Paulo, SP, Brazil
| | - Edson Borges
- Fertility - Centro de Fertilização Assistida, São Paulo, SP, Brazil
| | - Daniela Braga
- Fertility - Centro de Fertilização Assistida, São Paulo, SP, Brazil
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Sharun K, Pawde AM, Manjusha KM, Banu S A, Kalaiselvan E, Kumar R, Kinjavdekar P, Amarpal, Verma MR. Classification and coding of platelet-rich plasma derived from New Zealand white rabbits for tissue engineering and regenerative medicine applications. Expert Opin Biol Ther 2021; 21:1473-1482. [PMID: 34264158 DOI: 10.1080/14712598.2021.1955099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE Platelet-rich plasma (PRP) is a category of platelet concentrate that has been widely used as a therapeutic modality in musculoskeletal medicine. The present study was conducted to classify and code the non-activated platelet-rich plasma (nPRP) derived from New Zealand white rabbits for tissue engineering and other regenerative medicine applications. METHODS PRP was prepared from the whole blood by double centrifugation protocol using a laboratory centrifuge. The prepared nPRP was characterized using the parameters such as platelet dose, the relative composition of platelets, WBC, and RBC. The production protocol was described using the parameters such as platelet enrichment factor, factor increase in WBC concentration, platelet capture efficiency, WBC-reducing efficiency, and RBC-reducing efficiency. The nPRP was also classified and coded using the most recent and universally accepted classification and coding systems. RESULTS The non-activated leukocyte-poor red cell-rich PRP had an average platelet count of 1875.75 × 109/L, which is higher than the basal platelet concentration in the whole blood. Furthermore, the protocol used in this study has a mean platelet capture efficiency of 47.43 ± 6.42%. CONCLUSION The protocol described in this study can be used to prepare non-activated leukocyte-poor red cell-rich PRP (Red-PRP IC1) from rabbits that can be coded as 318-00-00.
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Affiliation(s)
- Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Abhijit M Pawde
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - K M Manjusha
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Amitha Banu S
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - E Kalaiselvan
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Rohit Kumar
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Prakash Kinjavdekar
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Amarpal
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Med Ram Verma
- Division of Livestock Economics, Statistics and Information Technology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
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18
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Understanding the GERD Barrier. J Clin Gastroenterol 2021; 55:459-468. [PMID: 33883513 DOI: 10.1097/mcg.0000000000001547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gastroesophageal reflux disease (GERD) is steadily increasing in incidence and now affects 18% to 28% of the population in the United States. A thorough understanding of the pathophysiology underlying this disease is necessary to improve the current standard of care. Most GERD pathophysiology models focus on the lower esophageal sphincter (LES) as the key element which prevents esophageal reflux. More recent research has highlighted the crural diaphragm (CD) as an additional critical component of the GERD barrier. We now know that the CD actively relaxes when the distal esophagus is distended and contracts when the stomach is distended. Crural myotomy in animal models increases esophageal acid exposure, highlighting the CD's vital role. There are also multiple physiological studies in patients with symptomatic hiatal hernia that demonstrate CD dysfunction is associated with GERD. Finally, computer models integrating physiological data predict that the CD and the LES each contribute roughly 50% to the GERD barrier. This more robust understanding has implications for future procedural management of GERD. Specifically, effective GERD management mandates repair of the CD and reinforcement of the LES. Given the high rate of hiatal hernia recurrences, it seems that novel antireflux procedures should target this essential component of the GERD barrier. Future research should focus on methods to maintain crural integrity, decrease hiatal hernia recurrence, and improve long-term competency of the GERD barrier.
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Rushing CJ, Rathnayake VR, Oxios AJ, Spinner SM, Hardigan P. Patient-Perceived Recovery and Outcomes after Bipolar Radiofrequency Controlled Ablation with Platelet-Rich Plasma Injection for Refractory Plantar Fasciosis. J Foot Ankle Surg 2021; 59:673-678. [PMID: 32600560 DOI: 10.1053/j.jfas.2019.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/14/2019] [Accepted: 07/18/2019] [Indexed: 02/03/2023]
Abstract
Previous studies have documented persistent postoperative symptoms and limitations following plantar fasciotomy using patient-reported outcome measures (PROMs). The incomplete recovery (resolution) has been theorized to occur from altered foot biomechanics, and alternative treatment methods have continued to gained popularity for addressing refractory plantar fasciosis (RPF). The purpose of the present study was to assess patient-perceived recovery (PPR) and outcomes after bipolar radiofrequency controlled ablation (BRC) with platelet-rich plasma (PRP) injection for RPF. From July 2006 to July 2016, 43 patients (52 procedures) were enrolled. PROMS were prospectively obtained and compared between patients who perceived themselves as recovered without/residual deficits (recovered-resolved, recovered-not resolved) and those not recovered. Holistic satisfaction, procedure-specific satisfaction, complications, reoperations, and failure were recorded. Overall, 67.4% perceived themselves as recovered-resolved, 23.3% as recovered-not resolved, and 9.3% as not recovered. Holistic and procedure specific satisfaction were high (90.7% and 88.4%), with a mean modified Foot Function Index of 11.65, visual analog scale for pain 1.5, and failure rate of 9.3% at a median of 53 months (interquartile range 33 to 83). In the present study, outcomes with BRC with PRP injection compared favorably to the long-term outcomes reported for partial and complete plantar fasciotomy. Although 14 patients (32.6%) continued to have some postoperative symptoms, 71% indicated that they were satisfied with their symptoms, and 64% would undergo a similar procedure again. Therefore, despite the study's shortcomings, a patient's ability to cope appears to have a role in recovery from RPF.
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Affiliation(s)
- Calvin J Rushing
- Resident, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL.
| | | | - Adam J Oxios
- Resident, Westside Regional Medical Center, Plantation, FL
| | - Steven M Spinner
- Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL; Residency Director, Westside Regional Medical Center, Plantation, FL
| | - Patrick Hardigan
- Director, Statistical Consulting Center, Nova Southeastern University, Ft. Lauderdale, FL
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20
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Does Platelet-Rich Plasma (PRP) Improve Colonic Anastomotic Healing in Rats Undergoing Cisplatin-Paclitaxel-Based HIPEC? Indian J Surg 2021. [DOI: 10.1007/s12262-021-02871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Plantar fasciitis has been considered an acute inflammatory disorder. However, the local histologic findings represent a more chronic, degenerative state without inflammation. Patients may be stuck in a chronic state of cyclical inflammation leading to tissue degeneration, refractory symptoms, and disability. This idea process has influenced the treatment approach of some practitioners who have implemented the idea of regenerative medicine and use of biologic adjuvants in the treatment of plantar heel pain. Biologic therapies provide many different cellular components, growth factors, and proteins to restore normal tissue biology and are a useful adjunct in the treatment of recalcitrant plantar fasciitis.
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Affiliation(s)
- Alan Ng
- Advanced Orthopedic and Sports Medicine Specialists, Denver, CO, USA; Highlands-Presbyterian, St. Luke's Podiatric Medicine and Surgery Residency Program, 1719 East 19th Avenue, Denver, CO 80218, USA.
| | - Robert Cavaliere
- Highlands-Presbyterian, St. Luke's Podiatric Medicine and Surgery Residency Program, 1719 East 19th Avenue, Denver, CO 80218, USA
| | - Lauren Molchan
- Highlands-Presbyterian, St. Luke's Podiatric Medicine and Surgery Residency Program, 1719 East 19th Avenue, Denver, CO 80218, USA
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22
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Bhettani MK, Rehman M, Altaf HN, Altaf OS. Effectiveness of Topical Insulin Dressings in Management of Diabetic Foot Ulcers. World J Surg 2021; 44:2028-2033. [PMID: 31820059 DOI: 10.1007/s00268-019-05321-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Infected diabetic foot ulcers are always a problem for the surgeon, as well as, an economic burden upon the patient and state, in terms of increased hospital stay and cost of medications and dressings. Various methods have been devised for the treatment of infected wounds in history with varying results in different patients groups. The purpose of this study is to compare the effectiveness of topical insulin on the healing of diabetic foot ulcers with the conventional Pyodine® povidone iodine dressing. Our objective was to compare effectiveness of topical insulin with conventional Pyodine® povidone iodine dressings in frequency of healing of diabetic foot ulcers. MATERIALS AND METHODS It was a quasi-experimental study done at Pakistan Institute of Medical Sciences Islamabad over a period of 20 months from January 2015 to September 2016. One hundred ten patients were included in the study. Sampling technique used was non-probability consecutive. Patients were assigned into two groups, group A receiving treatment with solution of 30 International Units Insulin Regular in 30 ml of normal saline and group B receiving conventional dressing with normal saline. The wound were compared for both groups at the days 7, 14 and 21 for wound healing. Complete healing time of diabetic foot ulcers was determined from patients' followup visits in outpatient department. Data was by analyzed by SPSS 20. RESULTS A total of 110 patients were enrolled in the study. Patients were divided equally into both control and experimental groups. The mean age of the patients was 53.23 ± 6.21 years. The mean pre-treatment wound diameter was 4.81 ± 0.85 cm in the placebo group, while it was 4.84 ± 0.81 cm in the topical insulin group (CI 0.29-0.35, P = 0.875). The mean post-treatment wound diameter was 3.90 ± 0.76 cm in the placebo group, while it was 2.46 ± 0.57 cm in the topical insulin group (CI 0.44-0.58, P = 0.022). The mean wound difference was 0.91 ± 0.25 cm in the placebo group, while it was 2.4 ± 0.34 cm in the topical insulin group (CI 0.40-0.20, P = 0.041). The mean percent reduction in wound diameter was 19.2 ± 4.6% in the placebo group, while it was 49.7 ± 5.2% cm in the topical insulin group (CI 10.6-6.1, P = 0.001). CONCLUSION There was significant contraction seen in the size of the ulcer in both the study groups depicting the healing process.
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Affiliation(s)
| | - Mubarik Rehman
- Shifa College of Medicine, Shifa Tameer-e-Millat University, Pitrus Bokhari Road H-8/4, Islamabad, 44000, Pakistan
| | - Humera N Altaf
- Shifa College of Medicine, Shifa Tameer-e-Millat University, Pitrus Bokhari Road H-8/4, Islamabad, 44000, Pakistan.
| | - Omar S Altaf
- Tehsil Headquarter Hospital Hazro, Hazro Tehsil, Attock District, 43440, Pakistan
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De La Pena A, Mukhtar M, Yokosawa R, Carrasquilla S, Simmons CS. Quantifying cellular forces: Practical considerations of traction force microscopy for dermal fibroblasts. Exp Dermatol 2021; 30:74-83. [PMID: 32767472 PMCID: PMC7769991 DOI: 10.1111/exd.14166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/12/2020] [Accepted: 07/30/2020] [Indexed: 12/28/2022]
Abstract
Traction force microscopy (TFM) is a well-established technique traditionally used by biophysicists to quantify the forces adherent biological cells exert on their microenvironment. As image processing software becomes increasingly user-friendly, TFM is being adopted by broader audiences to quantify contractility of (myo)fibroblasts. While many technical reviews of TFM's computational mechanics are available, this review focuses on practical experimental considerations for dermatology researchers new to cell mechanics and TFM who may wish to implement a higher throughput and less expensive alternative to collagen compaction assays. Here, we describe implementation of experimental methods, analysis using open-source software and troubleshooting of common issues to enable researchers to leverage TFM for their investigations into skin fibroblasts.
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Affiliation(s)
| | | | | | | | - Chelsey S. Simmons
- Department of Mechanical and Aerospace Engineering
- J. Crayton Pruitt Department of Biomedical Engineering
- Division of Cardiovascular Medicine, University of Florida
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van der Bijl I, de Korte D, Middelkoop E. Variation in platelet-rich plasma compositions used for wound healing indications. Wound Repair Regen 2020; 29:284-287. [PMID: 33368809 DOI: 10.1111/wrr.12886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/19/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022]
Abstract
At present, the role of platelet-rich plasma (PRP) in burn and wound management is undefined. We present some of the evidence for PRP in wound healing and other medical fields. Currently, the high variation in product composition, mode and timing of application prevent a clear definition of the position of PRP in wound healing. Perspectives on solving these issues are described.
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Affiliation(s)
- Ivo van der Bijl
- Department of Blood Cell Research, Sanquin Research, Amsterdam, the Netherlands.,Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
| | - Dirk de Korte
- Department of Blood Cell Research, Sanquin Research, Amsterdam, the Netherlands.,Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centers, Beverwijk, the Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Chen TL, Zhang XH, Wang XM, Chen J, Liu J. Does platelet-rich plasma really need to be activated in fat grafts? A critical comment. J Plast Reconstr Aesthet Surg 2020; 74:1355-1401. [PMID: 33250389 DOI: 10.1016/j.bjps.2020.10.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Tie-Lou Chen
- Department of Periodontal, Oral Center of PLA, Affiliated Changhai Hospital, Second Military Medical University, Shanghai 200081, China.
| | - Xin-Hai Zhang
- Department of Orthodontics, Oral Center of PLA, Affiliated Changhai Hospital, Second Military Medical University, China.
| | - Xiao-Man Wang
- Department of Orthodontics, Oral Center of PLA, Affiliated Changhai Hospital, Second Military Medical University, China
| | - Jun Chen
- Department of General Dentistry, Affiliated Changhai Hospital, Second Military Medical University, Shanghai 200081, China
| | - Jin Liu
- Department of General Dentistry, Affiliated Changhai Hospital, Second Military Medical University, Shanghai 200081, China
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Arora G, Arora S. Platelet-rich plasma-Where do we stand today? A critical narrative review and analysis. Dermatol Ther 2020; 34:e14343. [PMID: 32979292 DOI: 10.1111/dth.14343] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/13/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022]
Abstract
"Sometimes you have to travel a long way to find what is near." This quote by Paulo Coelho stands true for platelet-rich plasma (PRP) as we know of it today. Large strides have been made to understand this "youth" in blood, but there still seems a long way to go in our understanding of it. Despite advances, clarity in its preparation, biology, and the properties of the final product still remains elusive. The concepts of an ideal number or concentration of platelets in the final enriched plasma, best devices to prepare PRP, an ideal hardware, standard parameters for its preparation, the need for its activation or buffering of the final preparation or whether anticoagulants should be used or not, have evolved, since it was first described. The authors present an analysis of PRP present day status and its usefulness in field of medicine with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar related to PRP, its biology, types, and classifications, preparation, and use.
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Affiliation(s)
- Gulhima Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
| | - Sandeep Arora
- Mehektagul Dermaclinic, New Delhi, India.,Department of Dermatology, Command Hospital Air Force, Bengaluru, India
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27
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Li FL, Wu CB, Sun HJ, Zhou Q. Comparison of Autologous Platelet-Rich Plasma and Chitosan in the Treatment of Temporomandibular Joint Osteoarthritis: A Retrospective Cohort Study. J Oral Maxillofac Surg 2020; 79:324-332. [PMID: 33045183 DOI: 10.1016/j.joms.2020.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this article is to study the effect of autologous platelet-rich plasma (PRP) injected into the upper cavity of the temporomandibular joint (TMJ) on the treatment of TMJ osteoarthritis. PATIENTS AND METHODS We retrospectively analyzed the data of 27 patients with TMJ osteoarthritis treated at the China Medical University Hospital of Stomatology from September 2018 to September 2019. Maximal interincisal opening, pain intensity, and TMJ sounds were recorded and compared before treatment and at the 3rd and 6th months after the treatment. SPSS 24.0 software was used to analyze the data of each group, and the imaging changes in the condylar bone were compared before and 6 months after the treatment. The P-value was set at .05. RESULTS Better results were observed in the group treated with PRP on maximal interincisal opening and pain intensity than in the group receiving chitosan treatment. Regarding TMJ sounds, relief was observed in both groups, with no significant difference. CONCLUSIONS The effect of PRP on the improvement of the maximal interincisal opening and pain intensity of patients with TMJ osteoarthritis is better than that of chitosan. However, it should be noted that the incidence of complications associated with the injection of PRP may be higher than that with injection of chitosan.
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Affiliation(s)
- Fu-Long Li
- Resident, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China
| | - Chuan-Bin Wu
- Attending Doctor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China
| | - Hai-Jiang Sun
- Attending Doctor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China
| | - Qing Zhou
- Professor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China.
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Zhang L, Miao H, Wang D, Qiu H, Zhu Y, Yao X, Guo Y, Wang Z. Pancreatic extracellular matrix and platelet-rich plasma constructing injectable hydrogel for pancreas tissue engineering. Artif Organs 2020; 44:e532-e551. [PMID: 32671848 DOI: 10.1111/aor.13775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/11/2020] [Accepted: 07/06/2020] [Indexed: 12/13/2022]
Abstract
The development of pancreatic extracellular matrices enriched with insulin-secreting β-cells is a promising tissue engineering approach to treat type 1 diabetes. However, its long-term therapeutic efficacy is restricted by the defensive mechanism of host immune response and the lack of developed vascularization as appropriate after transplantation. Platelet-rich plasma (PRP), as an autologous platelet concentrate, contains a large number of active factors that are essential for the cell viability, vascularization, and immune regulation. In this study, we have incorporated pancreatic extracellular matrix (PEM) with PRP to develop a three-dimensional (3D) injectable PEM-PRP hydrogel to coculture and transplant rat insulinoma cells (INS-1) and human umbilical vein endothelial cells (HUVECs). Results from this study demonstrated that PEM-PRP hydrogel mimicked the biochemical compositions of native extracellular matrices, and possessed the enhanced elastic modulus and resistance to enzymatic degradation that enabled biomaterials to maintain its volume and slowly degrade. Additionally, PEM-PRP hydrogel could release growth factors in a sustained manner. In vitro, PEM-PRP hydrogel significantly promoted the viability, insulin-secreting function, and insulin gene expression of gel encapsulated INS-1 cells. Moreover, HUVECs encapsulated in PEM-PRP hydrogel were found to constitute many lumen-like structures and exhibited high expression of proangiogenic genes. In vivo transplantation of PEM-PRP hydrogel encapsulated with INS-1 cells and HUVECs improved the viability of INS-1 cells, promoted vascularization, inhibited the host inflammatory response, and reversed hyperglycemia of diabetic rats. Our study suggests that the PEM-PRP hydrogel offers excellent biocompatibility and proangiogenic property, and may serve as an effective biomaterial platform to maintain the long-term survival and function of insulin-secreting β cells.
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Affiliation(s)
- Liang Zhang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R. China.,Department of General Surgery, Tengzhou Central People's Hospital, Tengzhou, P.R. China
| | - Haiyan Miao
- Department of General Surgery, The Sixth People's Hospital, Nantong, P.R. China
| | - Dongzhi Wang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R. China.,Research Center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Hongquan Qiu
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R. China.,Research Center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Yi Zhu
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R. China.,Research Center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Xihao Yao
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R. China.,Research Center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Yibing Guo
- Research Center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Zhiwei Wang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R. China
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Zhang L, Qiu H, Wang D, Miao H, Zhu Y, Guo Q, Guo Y, Wang Z. Enhanced vascularization and biocompatibility of rat pancreatic decellularized scaffolds loaded with platelet-rich plasma. J Biomater Appl 2020; 35:313-330. [PMID: 32567485 DOI: 10.1177/0885328220933890] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The ultimate goal of pancreatic tissue engineering is to create a long-lived substitute organ to treat diabetes. However, the lack of neovascularization and the occurrence of immune response limit the efficacy of tissue-engineered pancreas after in vivo transplantation. Platelet-rich plasma (PRP) is an autologous platelet concentrate containing a large number of growth factors and immunoregulatory factors. The aim of this study was to evaluate rat pancreatic decellularized scaffold (PDS) loaded with PRP for vascularization, host inflammatory response and macrophage polarization in an animal model. The study results indicated that compared to PDS, PRP-loading PDS exhibited the enhanced mechanical properties and released growth factors in a slow and sustained manner to supplement the loss of growth factors during decellularization. In vitro, human umbilical vein endothelial cells (HUVECs) were seeded in PDS and PRP-loading PDS, and cultured in the circular perfusion system. When compared with PDS, PRP-loading PDS significantly promoted the colonization, proliferation and pro-angiogenic genes expression of cells on scaffolds. In vivo, PDS loaded with PRP then re-endothelialized with HUVECs were implanted subcutaneously in rats, which enhanced the angiogenesis of scaffolds, inhibited the host inflammatory response, and induced the polarization dominated by pro-regenerative M2 macrophages that also facilitated tissue vascular regeneration. Thus, the re-endothelialized PRP-loading PDS may represent a promising bioengineered pancreas with sustained vascularization and excellent biocompatibility.
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Affiliation(s)
- Liang Zhang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
- Department of General Surgery, Tengzhou Central People’s Hospital, Tengzhou, P.R. China
| | - Hongquan Qiu
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
- Research center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R China
| | - Dongzhi Wang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
- Research center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R China
| | - Haiyan Miao
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
- Department of General Surgery, The Sixth People’s Hospital, Nantong, P.R China
| | - Yi Zhu
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
- Research center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R China
| | - Qingsong Guo
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
| | - Yibing Guo
- Research center of Clinical Medical, Affiliated Hospital of Nantong University, Nantong, P.R China
| | - Zhiwei Wang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, P.R China
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A Comprehensive Review of Concentrated Growth Factors and Their Novel Applications in Facial Reconstructive and Regenerative Medicine. Aesthetic Plast Surg 2020; 44:1047-1057. [PMID: 31970453 DOI: 10.1007/s00266-020-01620-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Concentrated growth factors (CGFs) are the latest generation of platelet concentrates. The objective of developing CGF is to increase therapeutic efficacy. However, few studies have supported the superiority of CGF in composition and efficacy. The reconstruction and regeneration process is complicated and long term, whereas bioactivity of CGF is not durable. The purpose of this review is threefold. The first is to recommend more comparative studies between CGF and other platelet concentrates. The second is to constitute a continuous drug delivery system by combining CGF with other biomaterials. Finally, the novel use of CGF in facial regenerative and reconstructive medicine will be highlighted. METHODS A comprehensive review of literature regarding the use of CGF in facial regenerative and reconstructive medicine was performed. Based on the inclusion and exclusion criteria, a total of 135 articles were included. RESULTS The use of CGF involving facial rejuvenation, cartilage grafting, facial bone defects, facial peripheral nerve injury and wounding is reviewed. The reconstructive and regenerative principles lie in firm fibrin scaffolds and continuous in situ delivery of multiple growth factors. CONCLUSIONS CGF represents an advance in personalized medicine concept. However, the current scientific evidences about the use of CGF are limited. More basic and clinical studies should be conducted to understand the characteristics and clinical application of CGF. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Gruber RP. Invited Discussion on: Concentrated Growth Factors Extracted from Blood Plasma used to Repair Nasal Septal Mucosal Defect After Rhinoplasty. Aesthetic Plast Surg 2020; 44:517-518. [PMID: 31624893 DOI: 10.1007/s00266-019-01504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/22/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Ronald P Gruber
- Departments of Plastic and Reconstructive Surgery, Stanford University, Stanford, USA.
- University of California (SF), San Francisco, USA.
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Beyzadeoglu T, Pehlivanoglu T, Yildirim K, Buldu H, Tandogan R, Tuzun U. Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases. Orthop J Sports Med 2020; 8:2325967120902013. [PMID: 32128315 PMCID: PMC7036517 DOI: 10.1177/2325967120902013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 09/28/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) reconstruction performed with growth factors and activated platelets has been suggested to accelerate tendon ligamentization, leading to earlier return to daily activities and sports. HYPOTHESES Platelet-rich fibrin (PRF) will result in improved graft maturation and healing as evaluated by magnetic resonance imaging (MRI) in patients undergoing hamstring ACL reconstruction. Hemostatic and analgesic properties of PRF will lead to less postoperative blood loss and pain. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS A total of 44 patients with isolated ACL injuries who underwent arthroscopic all-inside anatomic single-bundle ACL reconstruction with semitendinosus tendon graft were enrolled. Group 1 included 23 patients who had PRF sprayed to the surface of the graft; group 2 included 21 patients for whom no PRF was used. Patients were discharged after 24 hours and examined for hemarthrosis that needed to be aspirated. MRI was performed at the fifth postoperative month. A blinded radiologist evaluated graft maturation according to its signal intensity and the presence of synovial fluid at the tunnel-graft interface. RESULTS PRF-treated grafts demonstrated lower MRI signal intensity and less fluid in the graft-tunnel interface as compared with controls for the entire length of the graft. The mean full-length MRI signal intensities were 9.19 versus 16.59 (P = .047) for groups 1 and 2, respectively. Subgroup analysis of the semitendinosus grafts demonstrated a signal intensity of 11.57 versus 23.98 (P = .044) for the proximal third, 9.53 versus 13.83 (P = .237) for the midbody, and 6.48 versus 11.98 (P = .087) for the distal third. Synovial fluid at the graft-tunnel interface was detected in 1 patient in group 1 (4.3%) and 3 patients in group 2 (14.3%; P < .001). Patients in group 1 had significantly less hemarthrosis that needed to be aspirated (P = .003), while postoperative analgesia requirements were similar in both groups (P = .08). No clinical benefit of PRF could be demonstrated in clinical outcomes. CONCLUSION Application of PRF led to superior graft integration and maturation in the proximal third of the ACL graft. There was no significant difference in MRI signal intensity in the midbody or distal tibial graft. Application of PRF also resulted in significantly lower rates of postoperative hemarthrosis that needed to be aspirated.
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Affiliation(s)
- Tahsin Beyzadeoglu
- Beyzadeoglu Clinic, Department of Orthopaedics and Traumatology,
Istanbul, Turkey
- Department of Sports Medicine, Faculty of Health Sciences, Halic
University, Istanbul, Turkey
| | - Tuna Pehlivanoglu
- Department of Orthopaedic Surgery and Traumatology, Istanbul
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey
| | - Kerem Yildirim
- Beyzadeoglu Clinic, Department of Orthopaedics and Traumatology,
Istanbul, Turkey
| | - Halil Buldu
- Beyzadeoglu Clinic, Department of Orthopaedics and Traumatology,
Istanbul, Turkey
- Department of Sports Medicine, Faculty of Health Sciences, Halic
University, Istanbul, Turkey
| | - Reha Tandogan
- Cankaya Ortopedi, Department of Orthopaedics and Traumatology,
Istanbul, Turkey
| | - Umit Tuzun
- Department of Radiology, Sonomed Imaging Center, Istanbul,
Turkey
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Jeong W, Kim YS, Roh TS, Kang EH, Jung BK, Yun IS. The effect of combination therapy on critical-size bone defects using non-activated platelet-rich plasma and adipose-derived stem cells. Childs Nerv Syst 2020; 36:145-151. [PMID: 30879128 DOI: 10.1007/s00381-019-04109-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 02/27/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Non-activated platelet-rich plasma (nPRP) slowly releases growth factors that induce bone regeneration. Adipose tissue-derived stem cells (ASCs) are also known to induce osteoblast differentiation. In this study, we investigated the combined effect of nPRP and ASC treatment compared with single therapy on bone regeneration. METHODS Thirty New Zealand white rabbits with 15 × 15 mm2 calvarial defects were randomly divided into four treatment groups: control, nPRP, ASC, or nPRP + ASC groups. For treatment, rabbits received a collagen sponge (Gelfoam®) saturated with 1 ml normal saline (controls), 1 ml non-activated PRP (nPRP group), 2 × 106 ASCs (ASCs group), or 2 × 106 ASCs plus l ml nPRP (nPRP + ASCs group). After 16 weeks, bone volume and new bone surface area were measured, using three-dimensional computed tomography and digital photography. Bone regeneration was also histologically analyzed. RESULTS Bone surface area in the nPRP group was significantly higher than both the control and ASC groups (p < 0.001 and p < 0.01, respectively). The percentage of regenerated bone surface area in the nPRP + ASC group was also significantly higher than the corresponding ratios in the control group (p < 0.001). The volume of new bone in the nPRP group was increased compared to the controls (p < 0.05). CONCLUSION Our results demonstrate that slow-releasing growth factors from nPRP did not influence ASC activation in this model of bone healing. PRP activation is important for the success of combination therapy using nPRP and ASCs.
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Affiliation(s)
- Woonhyeok Jeong
- Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, South Korea
| | - Young Seok Kim
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonjoo-ro, Gangnam-gu, Seoul, 135-720, South Korea
| | - Tai Suk Roh
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonjoo-ro, Gangnam-gu, Seoul, 135-720, South Korea
| | - Eun Hye Kang
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Severance Hospital, Seoul, South Korea
| | - Bok Ki Jung
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonjoo-ro, Gangnam-gu, Seoul, 135-720, South Korea
| | - In Sik Yun
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonjoo-ro, Gangnam-gu, Seoul, 135-720, South Korea.
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Losi P, Barsotti MC, Foffa I, Buscemi M, De Almeida CV, Fabbri M, Gabbriellini S, Nocchi F, Ursino S, Urciuoli P, Mazzoni A, Soldani G. In vitro human cord blood platelet lysate characterisation with potential application in wound healing. Int Wound J 2019; 17:65-72. [PMID: 31665826 DOI: 10.1111/iwj.13233] [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] [Received: 05/21/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 01/19/2023] Open
Abstract
Platelets contain abundant growth factors and cytokines that have a positive influence on the migration and proliferation of different cell types by modulating its physiopathological processes. As it is known that human umbilical cord blood platelet lysate (UCB-PL) contains a supraphysiological concentration of growth factors, in the present study, we investigated its effectiveness in wound-healing processes. Human UCB-PL was obtained by the freeze/thaw of platelet concentrate (1.1 × 109 platelets/L), and its effect was evaluated on human or mouse endothelial cells, monocytes, fibroblasts, and keratinocytes in different concentrations. Human UCB-PL was observed to have high levels of pro-angiogenic growth factor than peripheral blood platelet-rich plasma. Among the cell lines, different concentrations of human UCB-PL were necessary to influence their viability and proliferation. For L929 cells, 5% of total volume was necessary, while for human umbilical vein endothelial cell, it was 10%. Cell migration on monocytes was increased with respect to the positive control, and scratch closure on keratinocytes was increased with respect to serum-free medium with only 10% of human UCB-PL. We concluded that the human UCB-PL may be useful to produce a large amount of standard platelet concentrates sufficient for several clinical-scale expansions avoiding inter-individual variability, which can also be used as a functional tool for clinical regenerative application for wound healing.
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Affiliation(s)
- Paola Losi
- Laboratorio di Medicina Rigenerativa, Biomateriali e terapie avanzate, Institute of Clinical Physiology, National Research Council, Massa, Italy
| | - Maria C Barsotti
- Laboratorio di Medicina Rigenerativa, Biomateriali e terapie avanzate, Institute of Clinical Physiology, National Research Council, Massa, Italy
| | - Ilenia Foffa
- Laboratorio di Medicina Rigenerativa, Biomateriali e terapie avanzate, Institute of Clinical Physiology, National Research Council, Massa, Italy
| | - Marianna Buscemi
- Laboratorio di Medicina Rigenerativa, Biomateriali e terapie avanzate, Institute of Clinical Physiology, National Research Council, Massa, Italy
| | - Carolina V De Almeida
- Laboratorio di Medicina Rigenerativa, Biomateriali e terapie avanzate, Institute of Clinical Physiology, National Research Council, Massa, Italy
| | - Marco Fabbri
- Laboratorio di Immunogenetica, Medicina Trasfusionale e Biologia dei Trapianti, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Sabrina Gabbriellini
- Laboratorio di Immunogenetica, Medicina Trasfusionale e Biologia dei Trapianti, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Francesca Nocchi
- Laboratorio di Immunogenetica, Medicina Trasfusionale e Biologia dei Trapianti, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Silvia Ursino
- Laboratorio di Immunogenetica, Medicina Trasfusionale e Biologia dei Trapianti, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Patrizia Urciuoli
- Laboratorio di Immunogenetica, Medicina Trasfusionale e Biologia dei Trapianti, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Alessandro Mazzoni
- Medicina Trasfusionale e Biologia dei Trapianti, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Giorgio Soldani
- Laboratorio di Medicina Rigenerativa, Biomateriali e terapie avanzate, Institute of Clinical Physiology, National Research Council, Massa, Italy
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Bijl I, Vlig M, Middelkoop E, Korte D. Allogeneic platelet‐rich plasma (PRP) is superior to platelets or plasma alone in stimulating fibroblast proliferation and migration, angiogenesis, and chemotaxis as relevant processes for wound healing. Transfusion 2019; 59:3492-3500. [DOI: 10.1111/trf.15535] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/16/2019] [Accepted: 08/01/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Ivo Bijl
- Department of Blood Cell Research Sanquin Research Amsterdam The Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres, Red Cross Hospital Beverwijk The Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centres, Red Cross Hospital Beverwijk The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic, Reconstructive and Hand Surgery Amsterdam Movement Sciences Amsterdam The Netherlands
| | - Dirk Korte
- Department of Blood Cell Research Sanquin Research Amsterdam The Netherlands
- Department of Product and Process Development Sanquin Blood Bank Amsterdam The Netherlands
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Do the Fibrin Scaffold and Growth Factors in Platelet-Rich Fibrin Play the Most Vital Roles in Bone Regeneration? A Critical Comment. J Craniofac Surg 2019; 30:1923-1926. [DOI: 10.1097/scs.0000000000005487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
There is good scientific rationale to support the use of growth factors to promote musculoskeletal tissue regeneration. However, the clinical effectiveness of platelet-rich plasma (PRP) and other blood-derived products has yet to be proven. Characterization and reporting of PRP preparation protocols utilized in clinical trials for the treatment of musculoskeletal disease is highly inconsistent, and the majority of studies do not provide sufficient information to allow the protocols to be reproduced. Furthermore, the reporting of blood-derived products in orthopaedics is limited by the multiple PRP classification systems available, which makes comparison of results between studies challenging. Several attempts have been made to characterize and classify PRP; however, no consensus has been reached, and there is lack of a comprehensive and validated classification. In this annotation, we outline existing systems used to classify preparations of PRP, highlighting their advantages and limitations. There remains a need for standardized universal nomenclature to describe biological therapies, as well as a comprehensive and reproducible classification system for autologous blood-derived products. Cite this article: Bone Joint J 2019;101-B:891–896.
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Affiliation(s)
- L. A. Rossi
- Department of Orthopaedic Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I. R. Murray
- Resident in Orthopaedic Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK
- Department of Trauma and Orthopaedics, University of Edinburgh, Edinburgh, UK
| | - C. R. Chu
- Department of Orthopedic Surgery, Stanford University, Stanford, California, USA
- VA Palo Alto, Palo Alto, California, USA
| | - G. F. Muschler
- Director of the Joint Preservation Center, and Director of the Regenerative Medicine Laboratory, Cleveland Clinic, Cleveland, Ohio, USA
| | - S. A. Rodeo
- Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, New York, USA
- Orthopaedic Surgery, Weill Medical College of Cornell University, New York, New York, USA
- The Hospital for Special Surgery, New York, New York, USA
- New York Giants Football, New York, New York, USA
| | - N. S. Piuzzi
- Cleveland Clinic, Cleveland, Ohio, USA
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Huber SC, Junior JLRC, Silva LQ, Montalvão SAL, Annichino-Bizzacchi JM. Freeze-dried versus fresh platelet-rich plasma in acute wound healing of an animal model. Regen Med 2019; 14:525-534. [PMID: 31115259 DOI: 10.2217/rme-2018-0119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: To compare freeze-dried and fresh platelet-rich plasma (PRP) preparations, in a pre-clinical study. Materials & methods: 30 Wistar male rats were used to compare and characterize human PRP which was applied at the perilesional area in an acute wound model, evaluated by macroscopical and histological analysis. Results: Despite the increased growth factor concentration after the freeze-drying process, no change in the healing kinetics was observed in vivo. Nevertheless, a significant increased number of myofibroblasts was demonstrated in comparison with the fresh PRP group. We also demonstrated a significant increased percentage of blood vessels in comparison with controls in both the superficial and deep epidermis. Conclusion: These results encourage randomized clinical trials to evaluate the effectiveness of freeze-dried PRP for skin ulcer treatment.
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Affiliation(s)
- Stephany C Huber
- Hemocentro, Haemostasis Laboratory, State University of Campinas - UNICAMP, 13083-970, Campinas, São Paulo, Brazil
| | - José Luiz R C Junior
- Hemocentro, Haemostasis Laboratory, State University of Campinas - UNICAMP, 13083-970, Campinas, São Paulo, Brazil
| | - Letícia Q Silva
- Hemocentro, Haemostasis Laboratory, State University of Campinas - UNICAMP, 13083-970, Campinas, São Paulo, Brazil
| | - Silmara A L Montalvão
- Hemocentro, Haemostasis Laboratory, State University of Campinas - UNICAMP, 13083-970, Campinas, São Paulo, Brazil
| | - Joyce M Annichino-Bizzacchi
- Hemocentro, Haemostasis Laboratory, State University of Campinas - UNICAMP, 13083-970, Campinas, São Paulo, Brazil
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Atashi F, André-Lévigne D, Colin DJ, Germain S, Pittet-Cuénod B, Modarressi A. Does non-activated platelet-rich plasma (PRP) enhance fat graft outcome? An assessment with 3D CT-scan in mice. J Plast Reconstr Aesthet Surg 2019; 72:669-675. [DOI: 10.1016/j.bjps.2018.12.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/23/2018] [Accepted: 12/21/2018] [Indexed: 12/25/2022]
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Kia C, Baldino J, Bell R, Ramji A, Uyeki C, Mazzocca A. Platelet-Rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology. Curr Rev Musculoskelet Med 2018; 11:566-572. [PMID: 30203334 PMCID: PMC6220011 DOI: 10.1007/s12178-018-9515-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Platelet-rich plasma (PRP) contains numerous growth factors and cytokines that potentially offer an alternative treatment modality to assist in the healing of multiple musculoskeletal issues. The purpose of this review was to examine the latest literature on the use of PRP for various ligament and tendon pathologies. RECENT FINDINGS Recent literature has shown moderate- to high-quality evidence that PRP can have positive clinical effects in certain conditions such as lateral epicondylitis and rotator cuff tendinopathy. Prospective studies have shown that it can also be useful in the treatment of patella tendinopathy. In summary, we found PRP to have variable success in ligament and tendon pathology; however, it should be considered a viable option in chronic musculoskeletal disease that has failed other treatments. Patient selection, duration of symptoms, and combining with other modalities such as physical therapy should all be taken into consideration in treatment with PRP.
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Affiliation(s)
- Cameron Kia
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, USA.
| | - Joshua Baldino
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, USA
| | - Ryan Bell
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, USA
| | - Alim Ramji
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, USA
| | - Colin Uyeki
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, USA
| | - Augustus Mazzocca
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, USA
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Biological Treatment for Osteoarthritis of the Knee: Moving from Bench to Bedside-Current Practical Concepts. Arthroscopy 2018; 34:1719-1729. [PMID: 29628381 DOI: 10.1016/j.arthro.2018.01.048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/08/2018] [Accepted: 01/26/2018] [Indexed: 02/02/2023]
Abstract
Biological-based therapies for cartilage pathology have gained considerable recognition in the last few decades due to their potential benefits including their minimal invasiveness, capacity for unprecedented healing, and potential for rapid recovery. Consequently, these therapies are likely to have the most noteworthy impact on patients with degenerative joint changes who want to remain active. Currently, the most researched treatments include platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and cell-based therapies. Although further basic science research and well-designed randomized clinical trials are needed to elucidate the long-term role of these therapies in the treatment of osteoarthritis, there is compelling evidence for their use for certain indications. This article aims to review the existing literature for biological-based treatment options for osteoarthritis, critically assessing the current evidence-based recommendations and identify potential avenues for development.
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Hersant B, Bouhassira J, SidAhmed-Mezi M, Vidal L, Keophiphath M, Chheangsun B, Niddam J, Bosc R, Nezet AL, Meningaud JP, Rodriguez AM. Should platelet-rich plasma be activated in fat grafts? An animal study. J Plast Reconstr Aesthet Surg 2018; 71:681-690. [PMID: 29477267 DOI: 10.1016/j.bjps.2018.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/22/2017] [Accepted: 01/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The adjunction of platelet-rich plasma with graft fat has been the subject of a few clinical trials which have demonstrated its value in adipocyte survival. The aim of this study was to assess the different efficacies between activated and non-activated PRP on adipose cells in vitro and for adipose tissue graft survival in vivo. METHODS The in vitro study assessed the effects of PRP on both the proliferation and adipocyte differentiation of adipose cells. For the in vivo study, 8 nude rats received 3 human fat injections as follows: 0.8 mL of fat + 0.2 mL of normal saline; 0.8 mL of fat + 0.2 mL of non-activated PRP; and 0.8 mL of fat + 0.2 mL of PRP activated with calcium chloride (CaCl2). The quantitative assessment of adipocyte survival was implemented after 3 months using histomorphometric analysis. Histological and immunohistochemical analysis were also performed to evaluate angiogenesis, inflammation and quality of adipocytes in the grafted tissue. RESULTS We showed that activated PRP stimulated, in vitro, proliferation and differentiation of adipose cells. In vivo experiments indicated that CaCl2-activated PRP was more efficient than non-activated to prolong the survival of fat grafts in nude rats. The mean percentage areas occupied by viable adipocytes in the PRP-free group, non-activated PRP group and activated PRP group were 13%, 14% and 24% (p = 0.05%), respectively. Histological and immunohistochemical analysis revealed protective effect of activated PRP on inflammation and adipocyte death. CONCLUSION This study showed that activation by CaCl2 improves the beneficial effects of PRP for fat graft maintenance.
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Affiliation(s)
- Barbara Hersant
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France; INSERM U955, Equipe 12, Creteil, France
| | - Jonathan Bouhassira
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France; INSERM U955, Equipe 12, Creteil, France.
| | - Mounia SidAhmed-Mezi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France; INSERM U955, Equipe 12, Creteil, France
| | - Luciano Vidal
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France
| | - Mayoura Keophiphath
- DIVA expertise, 1 place Pierre Potier BP 50624, 31106 Cedex 1, Toulouse, France
| | - Barbara Chheangsun
- DIVA expertise, 1 place Pierre Potier BP 50624, 31106 Cedex 1, Toulouse, France
| | - Jeremy Niddam
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France
| | - Romain Bosc
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France
| | | | - Jean-Paul Meningaud
- Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue de Lattre de Tassigny 94000, Creteil, France; UPEC, University Paris Est Creteil, Val de Marne, France; INSERM U955, Equipe 12, Creteil, France
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Scaffold Free Bone Regeneration Using Platelet-Rich Fibrin in Calvarial Defect Model. J Craniofac Surg 2018; 29:251-254. [DOI: 10.1097/scs.0000000000004210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Agrawal AA. Evolution, current status and advances in application of platelet concentrate in periodontics and implantology. World J Clin Cases 2017; 5:159-171. [PMID: 28560233 PMCID: PMC5434315 DOI: 10.12998/wjcc.v5.i5.159] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/29/2017] [Accepted: 02/28/2017] [Indexed: 02/05/2023] Open
Abstract
Platelet concentrates (PC) [platelet-rich plasma (PRP) and platelet-rich fibrin (PRF)] are frequently used for surgical procedures in medical and dental fields, particularly in oral and maxillofacial surgery, plastic surgery and sports medicine. The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration. Although leukocyte rich and leukocyte poor PRP's have their own place in literature, the importance of non-platelet components in a platelet concentrate remains a mystery. PC have come a long way since its first appearance in 1954 to the T-PRF, A-PRF and i-PRF introduced recently. These PC find varied applications successfully in periodontics and implant dentistry as well. However, the technique of preparation, standing time, transfer process, temperature of centrifuge, vibration, etc., are the various factors for the mixed results reported in the literature. Until the introduction of a proper classification of terminologies, the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion. This review intends to clarify all these confusion by briefing the exact evolution of PC, their preparation techniques, recent advances and their various clinical and technical aspects and applications.
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Jeong WH, Roh TS, Kim YS, Kang EH, Jung BK, Lee WJ, Lew DH, Yun IS. Acceleration of osteogenesis by platelet-rich plasma with acellular dermal matrix in a calvarial defect model. Childs Nerv Syst 2016; 32:1653-9. [PMID: 27444291 DOI: 10.1007/s00381-016-3150-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/12/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE The effects of platelet-rich plasma (PRP) on improvement of bone regeneration have been widely investigated. However, use of a proper scaffold is also important to the delivery of bioactive materials. The aim of this study was to analyze the effects of PRP with acellular dermal matrix (ADM) as a bone substitute in a cranial defect model. METHODS Twenty-nine New Zealand white rabbits were randomly divided into four groups including control, PRP, ADM, and PRP with ADM. A 15 × 15-mm(2) bony defect was carefully created in the cranium. The experimental materials were applied in each group. After 16 weeks, the volume and surface area of new bone were measured using three-dimensional computed tomography and digital photography, and the new bone was analyzed histologically. RESULTS The PRP with ADM group exhibited a statistically significant increase in volume and surface area of newly formed bone compared with the other groups (p < 0.05). Histological findings revealed compact lamellar bone in the PRP with ADM group. In contrast, scattered bone islands were detected within the fibrous connective tissue in the other groups. CONCLUSIONS The regeneration of mature and augmented bone was achieved following the application of PRP mixed with ADM. The results indicated that the PRP combined with ADM could be a potentially useful substitute for bone and may aid in the elimination of additional donor-site harvest procedures.
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Affiliation(s)
- Woon Hyeok Jeong
- Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea
| | - Tai Suk Roh
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea
| | - Young Seok Kim
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea
| | - Eun Hye Kang
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Severance Hospital, Seoul, Korea
| | - Bok Ki Jung
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Severance Hospital, Seoul, Korea
| | - Won Jai Lee
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Severance Hospital, Seoul, Korea
| | - Dae Hyun Lew
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Severance Hospital, Seoul, Korea
| | - In Sik Yun
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University Health System, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea.
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Platelet gel: a new therapeutic tool with great potential. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 15:333-340. [PMID: 27483482 DOI: 10.2450/2016.0038-16] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/09/2016] [Indexed: 12/31/2022]
Abstract
Chronic wounds, such as diabetic foot ulcers, represent a serious clinical problem for patients and clinicians. Management of these wounds has a strong economic impact worldwide. Complications resulting from injuries are a frequent cause of morbidity and mortality. Chronic wounds lead to infections, painful dressings and prolonged hospitalisation. This results in poor patient Quality of Life and in high healthcare costs. Platelet concentrates (PC) are defined as autologous or allogeneic platelet derivatives with a platelet concentration higher than baseline. PC are widely used in different areas of Regenerative Medicine in order to enhance wound healing processes; they include platelet-rich plasma (PRP), platelet gel (PG), platelet-rich fibrin (PRF), serum eye drops (E-S), and PRP eye drops (E-PRP). This review highlights the use of platelet-rich plasma (PRP) and platelet gel (PG) preparation for clinical use.
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Murray IR, LaPrade RF, Musahl V, Geeslin AG, Zlotnicki JP, Mann BJ, Petrigliano FA. Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 2: Rotator Cuff. Orthop J Sports Med 2016; 4:2325967116636586. [PMID: 27099865 PMCID: PMC4820026 DOI: 10.1177/2325967116636586] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Rotator cuff tears are common and result in considerable morbidity. Tears within the tendon substance or at its insertion into the humeral head represent a considerable clinical challenge because of the hostile local environment that precludes healing. Tears often progress without intervention, and current surgical treatments are inadequate. Although surgical implants, instrumentation, and techniques have improved, healing rates have not improved, and a high failure rate remains for large and massive rotator cuff tears. The use of biologic adjuvants that contribute to a regenerative microenvironment have great potential for improving healing rates and function after surgery. This article presents a review of current and emerging biologic approaches to augment rotator cuff tendon and muscle regeneration focusing on the scientific rationale, preclinical, and clinical evidence for efficacy, areas for future research, and current barriers to advancement and implementation.
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Affiliation(s)
| | | | - Volker Musahl
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Andrew G Geeslin
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Jason P Zlotnicki
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Barton J Mann
- Author deceased.; American Orthopaedic Society for Sports Medicine, Rosemont, Illinois, USA
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Comparing the Effect of Nonactivated Platelet-Rich Plasma, Activated Platelet-Rich Plasma, and Bone Morphogenetic Protein-2 on Calvarial Bone Regeneration. J Craniofac Surg 2016; 27:317-21. [DOI: 10.1097/scs.0000000000002349] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Roh YH, Kim W, Park KU, Oh JH. Cytokine-release kinetics of platelet-rich plasma according to various activation protocols. Bone Joint Res 2016; 5:37-45. [PMID: 26862077 PMCID: PMC4852788 DOI: 10.1302/2046-3758.52.2000540] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives This study was conducted to evaluate the cytokine-release kinetics of platelet-rich plasma (PRP) according to different activation protocols. Methods Two manual preparation procedures (single-spin (SS) at 900 g for five minutes; double-spin (DS) at 900 g for five minutes and then 1500 g for 15 minutes) were performed for each of 14 healthy subjects. Both preparations were tested for platelet activation by one of three activation protocols: no activation, activation with calcium (Ca) only, or calcium with a low dose (50 IU per 1 ml PRP) of thrombin. Each preparation was divided into four aliquots and incubated for one hour, 24 hours, 72 hours, and seven days. The cytokine-release kinetics were evaluated by assessing PDGF, TGF, VEGF, FGF, IL-1, and MMP-9 concentrations with bead-based sandwich immunoassay. Results The concentration of cytokine released from PRP varied over time and was influenced by various activation protocols. Ca-only activation had a significant effect on the DS PRPs (where the VEGF, FGF, and IL-1 concentrations were sustained) while Ca/thrombin activation had effects on both SS and DS PRPs (where the PDGF and VEGF concentrations were sustained and the TGF and FGF concentrations were short). The IL-1 content showed a significant increase with Ca-only or Ca/thrombin activation while these activations did not increase the MMP-9 concentration. Conclusion The SS and DS methods differed in their effect on cytokine release, and this effect varied among the cytokines analysed. In addition, low dose of thrombin/calcium activation increased the overall cytokine release of the PRP preparations over seven days, relative to that with a calcium-only supplement or non-activation. Cite this article: Professor J. H. Oh. Cytokine-release kinetics of platelet-rich plasma according to various activation protocols. Bone Joint Res 2016;5:37–45. DOI: 10.1302/2046-3758.52.2000540
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Affiliation(s)
- Y H Roh
- Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - W Kim
- Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - K U Park
- Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - J H Oh
- Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
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