Utilità clinica dei fattori di crescita nel plasma ricco di piastrine (PRP). Analisi dell'efficacia di differenti metodi di preparazione

Abstract

Background and aim Over the past few years, the use of blood components for non-infusion or non-transfusion procedure has rapidly expanded to various clinical applications in different speciality fields. PRP has a high concentration of platelets that make it functional for the repair and regeneration processes of damaged tissues. These effects depend on the fact that growth factors are present in the alpha granules of the platelets, able not only to stimulate tissue regeneration, but also to field a striking local anti-inflammatory response, called chemotaxis. The main identified growth factors that trigger and promote tissue regeneration processes are TGF-β (Transforming Growth Factor beta), VEGF (Vascular Endothelial Growth Factor) and PDGF (Platelet Derived Growth Factor). The purpose of this study is to compare the characteristic parameters of the blood components for non-infusion use obtained with the various possible preparation methods: this study will be able to identify the parameters for the best therapeutic effect on the patients treated, in terms of effectiveness and durability. Materials and methods The type of blood component to prepare, for the treatment of patients, is chosen by the transfusion doctor, based on their clinical characteristics, such as age, venous access and concomitant pathologies, choosing between the PRP Single Device (PRP-SD), the PRP by apheresis (PRP-AFE), the PRP homologous (PRP-OMO) and the Leuco-platelet apheresis (L-PRP). Results Control blood count was performed on all patients treated with the PRP before sampling and subsequently, on the blood component. The results has been compared with the data reported in literature, in order to identified the most effective PRP preparation method, in terms of platelet yield and of leukocyte. Conclusions The literature’s data show that the number of platelets and leukocytes present in the PRP greatly influences the patient's outcome. The results obtained have showed a variety of platelets and leukocytes contained in the PRP prepared with the various processing methods. The PRP-SD is the blood component capable of guaranteeing the best therapeutic effect, in terms of efficacy and durability. Keywords: PRP, Growth factors, Platelets, Leukocytes.