Allogeneic Platelet-rich Plasma Research Articles

Allogeneic platelet-rich plasma for knee osteoarthritis in patients with primary immune thrombocytopenia: A randomized clinical trial

Allogeneic platelet-rich plasma for knee osteoarthritis in patients with primary immune thrombocytopenia: A randomized clinical trial

Formation of osteoconductive biograft with bioorganic scaffold, human mesenchymal stromal cells, and platelet-rich plasma with its evaluation in vitro

BackgroundComplex graft bioengineering is an actual topic in bone defects’ repair. For those, different scaffolds may be seeded with mesenchymal stromal cells and growth / differentiation factors. The natural role of platelet factors in reparative processes justifies the possibility of its usage for mesenchymal stromal cell proliferation and differentiation into osteoblasts in vitro in terms of the scaffold-based bioengineering. To develop and evaluate in vitro biocompatibility and osteoconductivity of a complex biograft based on a bioorganic scaffold seeded with human bone marrow mesenchymal stromal cells and saturated with growth and differentiation factors of allogeneic platelet-rich plasma. ResultsThe properties of viability and adhesion of human bone marrow mesenchymal stromal cells in four types of bioorganic scaffolds were evaluated with biochemical and immunomorphological methods. Scaffold with the least cytotoxicity was used as a basis for complex biograft formation, so as a carrier for cells and platelet-derived factors. Then, cell proliferation activity and osteogenic differentiation were estimated with biochemical, morphological, histochemical and molecular-biological methods. The study showed high viability of cells in all bioorganic scaffolds but the least cytotoxicity was the one based on xenogeneic collagen sponge. We also found that allogeneic platelet-rich plasma positively affects the proliferation and osteogenic differentiation of bone marrow mesenchymal stromal cells in a complex biograft in vitro. ConclusionsThe properties of the developed complex biograft characterize its biocompatibility and osteoconductivity and make it potentially suitable for regenerative medicine, particularly for reconstructive surgery of bone defects.How to cite: Danilkovich NN, Kosmacheva SM, Ionova AG, et al. Formation of osteoconductive biograft with bioorganic scaffold, human mesenchymal stromal cells, and platelet rich plasma with its evaluationin vitro. Electron J Biotechnol 2024;69. https://doi.org/10.1016/j.ejbt.2024.01.004.

Management of rotator cuff injuries using allogenic platelet-rich plasma

Rotator cuff injuries are a major cause of shoulder pain, affecting the quality of life and producing a significant burden on healthcare systems. Conservative management modalities are prioritized, resorting to surgery only when required. The field of regenerative medicine involving the use of biologics, such as platelet-rich plasma (PRP), has evolved and shown potential for managing rotator cuff injuries. Nonetheless, limitations including subpar outcomes have led clinicians to question the efficacy of autologous PRP. To circumvent this, the possibility of utilizing a standardized and well-characterized allogenic PRP for RCI has been explored. In this manuscript, we qualitatively present the evidence from in vitro, pre-clinical, clinical and ongoing studies investigating the applications of allogenic PRP in the context of rotator cuff disorders. Administration of allogenic PRP is safe and potentially efficacious to manage rotator cuff injuries, though more adequately powered randomized controlled trials with longer follow-ups are warranted to further establish the efficacy of allogenic PRP and justify its routine clinical use.

Allogeneic platelet-rich plasma inhibits ferroptosis in promoting wound repair of type 2 diabetic ulcers

Increasing evidence has revealed the emerging role of ferroptosis in the pathophysiology of type 2 diabetes mellitus (T2DM) and its complications. Platelet-rich plasma (PRP) has been demonstrated to facilitate the healing of T2DM ulcers. However, the mechanism by which PRP repairs T2DM ulcers remains unclear. Here, we sought to investigate the interaction between PRP and ferroptosis in repairing T2DM ulcers. The results showed that the cellular activity, proliferation, and migration of fibroblasts were down-regulated, and the cellular activity and normal function of vascular endothelial cells were impaired in the high glucose environment or under RSL3 conditions (a GSH peroxidase 4 inhibitor and ferroptosis inducer). Additionally, both cells experienced over-activation of multiple forms of reactive oxygen species (ROS) and lipid peroxidation. In the T2DM rat model, we observed a decreased rate of ulcer wound healing, impaired proliferative capacity, diminished vascular regeneration, and marked inflammation and hyperfibrosis. More importantly, there was typical damage to mitochondria, increased levels of iron ions, and consistent alterations in protein expression of ferroptosis-related factors. These factors include cyclooxygenase-2 (COX2), glutathione peroxidase 4 (GPX4), transferrin receptor (TFRC), and Solute Carrier Family 7 Member 11 (SLC7A11), among others. Due to the strong association between ferroptosis and T2DM ulcers, the use of allogeneic platelet-rich plasma (Al-PRP) exhibited physiological effects similar to those of the ferroptosis inhibitor Ferrostatin-1 (Fer-1). In vivo experiments, both drugs inhibited a range of impediments to wound healing caused by T2DM and ameliorated the adverse effects associated with ferroptosis. Moreover, Al-PRP attenuated the impairment of normal cellular function, activation of ROS and lipid peroxidation induced by high glucose or RSL3. These results suggested that ferroptosis was involved in the development of T2DM ulcers, which could be treated with Al-PRP by inhibiting ferroptosis, and inhibition of ferroptosis may be a suitable treatment strategy for T2DM ulcers.

Underlying factors that may affect the treatment of Platelet-rich plasma in chronic wounds

Platelet-rich plasma (PRP) has gained widespread usage in the treatment of various chronic wounds due to its ease of preparation and high safety profile. But not every treatment can achieve satisfactory results. The quality of PRP is based on individual biological characteristics. Autologous PRP technology is greatly affected by the patient himself. Individual responses to PRP treatment are different and will produce different therapeutic effects. Especially in patients with uncontrollable factors such as aging, diabetes, and coronary heart disease, the use of antiplatelet drugs may potentially reduce the quality of autologous platelet-rich plasma (PRP). When treating related diseases, it is important to consider the impact of factors such as age, gender, and the specific disease. Currently, many researchers are focusing on the development of allogeneic PRP technology to avoid the inconvenience of collecting autologous blood and reduce potential negative effects that may exist in the patient's disease itself. In this review, we explore the factors generally recognized in current research which influence the efficacy of PRP.

A Comparative Study on Platelet-Rich Plasma From Elderly Individuals and Young Adults to Treat Pressure Ulcers in Mice

ObjectiveThe aim of the present study was to compare the therapeutic effects of activated platelet-rich plasma (PRP) prepared from elderly individuals and young adults to treat pressure ulcers (PUs), and to accumulate a theoretical basis for allogeneic PRP treatment of PUs in elderly patients. Materials and methodsWhole blood was extracted from elderly individuals aged >65 y and young adult volunteers for PRP preparation, and platelet concentrations in whole blood and PRP were compared. Growth factors released from activated PRP were assayed using the enzyme-linked immunosorbent assay. C57BL/6 mice were divided into three groups: the control saline, elderly-PRP (Group A), and young adult-PRP (Group B). Ischemia-reperfusion injury-induced PUs were established on the backs of mice. PUs were photographed on days 0, 5, and 10 to assess their sizes. Specimens were collected on day 10 and subjected to hematoxylin and eosin and Masson's staining. Immunohistochemical staining for CD31 was conducted to evaluate vascular formation, and cell invasion was assessed using a Transwell assay. The action of PRP on transforming growth factor-beta (TGF-β)-dependent fibroblast activity and epithelial-mesenchymal transition was analyzed using immunofluorescence and Western blotting in vitro. ResultsThe platelet concentrations in whole blood and PRP of young adults were significantly higher than that in elderly individuals. The two PRP treatment groups had similar platelet enrichment coefficients of PRP. After activation, PRP from young adults produced significantly higher levels of platelet-derived growth factor, TGF-β, and vascular endothelial growth factor than PRP from elderly individuals (P < 0.05). The concentrations of platelet-derived growth factor, TGF-β, and vascular endothelial growth factor were positively correlated with the platelet concentrations in whole blood and PRP. The effects of PRP in regulating the expressions of TGF-β, α-smooth muscle actin, vimentin, and E-cadherin were observed in vivo and in vitro. The two PRP treatment groups exhibited better wound healing than the control group, as evidenced by more re-epithelialization, higher collagen content, skin fibrosis, and more blood vessel formation over time. Group B exhibited better wound healing than Group A (P < 0.05). ConclusionPRP exhibits potent wound healing ability in PU therapy, and PRP from young adults is seemingly superior to that from elderly individuals because of a higher concentration of platelets and increased production of growth factors.

Allogenic Platelet-Rich Plasma for the Treatment of Adhesive Capsulitis.

Adhesive capsulitis (AC) is a common shoulder disorder leading to pain and restricted range of motion (ROM) and affects the patient's activities of daily living (ADL) and overall quality of life (QoL). Conservative therapies are prioritized, resorting to surgical intervention only when necessary. Unfortunately, these modalities have limitations and do not address the underlying pathological cause of AC. The use of autologous biologics, such as platelet-rich plasma (PRP), has evolved and shown promise for managing musculoskeletal (MSK) injuries, including AC. However, subpar functional outcomes have led clinicians to question the long-term efficacy of autologous PRP. To circumvent this, the possibility of utilizing a standardized and well-characterized allogenic PRP for AC has been explored. In this manuscript, we qualitatively present in vitro, pre-clinical, clinical, and ongoing studies investigating the varied applications of allogenic PRP for the management of AC. The results demonstrated that allogenic PRP acts ina pleiotropic manner and decreases pro-inflammatorycytokines only in the inflammatory condition. In addition, the administration of allogenic PRP is safe and potentially efficacious, in terms of reducing pain and improving range of motion, shoulder strength, and function,in non-surgical management of AC. Nonetheless, more pre-clinical studies and adequately powered, multicenter, prospective, non-randomized, and randomized controlled trials with longer follow-up are warranted to further establish the safety and efficacy of allogenic PRP and justify its routine clinical use.

Effect of allogeneic platelet-rich plasma on the healing of ulcer wound surface in streptozotocin-induced diabetic rats

Purpose: To evaluate the effect of allogeneic platelet-rich plasma (PRP) on ulcer wound surface in streptozotocin-induced diabetic rats.Methods: A total of 20 male Sprague-Dawley (SD) rats were procured as skin ulcer as well as diabetes models, and randomly divided into control and PRP groups, respectively. Their wound surfaces were smeared with 0.9 % normal saline or an equal concentration of allogeneic PRP, respectively, and the pathological changes in the wound tissues were examined with the aid of hematoxylin-eosin (H&amp;E) staining. Also, the expression levels of transforming growth factor-β1 (TGF-β1), matrix metalloproteinase-2 (MMP-2), and tissue inhibitor of metalloproteinase-2 (TIMP-2) in wound tissues were determined using enzyme-linked immunosorbent assay (ELISA).Results: Both purulent exudation and swelling of the wound surface were milder in the PRP group than in the control group, and the PRP group showed greater redness on the wound surface and more pronounced signs of epithelialization of the wound surface and its margins (p &lt; 0.05). Wound healing rate in PRP group was higher than in the control group while the number of fibroblasts and new microvessels in the wound surface in the PRP group were greater than in the control group, accompanied by slighter inflammatory response compared to the control group. Furthermore, the PRP group expressed lower MMP-2, MMP-2/TIMP-2 ratio, and higher TGF-β1 and TIMP-2 levels than in the control group (p &lt; 0.05).Conclusion: Allogeneic PRP treatment contributes to the healing of ulcer wound surface in diabetic rats, a process mediated by TGF-β1/MMP-2/TIMP-2 signaling pathway. Thus, PRP is a potential therapeutic agent for the management of diabetic ulcer wounds.

Use of allogeneic platelet-rich plasma for the treatment of autoimmune ocular surface disorders: case series

PurposeTo assess the effectiveness of topical allogeneic platelet-rich plasma (PRP) eye drops for the treatment of symptoms and clinical signs in patients with severe dry eye disease as a secondary condition caused by Sjögren’s syndrome (SS).DesignCase series and literature review.MethodsSix eyes from three consecutive patients with severe dry eye from SS were evaluated. The eyes were treated with allogeneic topical PRP eye drops, with one drop applied six times daily for 3 months. A post-treatment follow-up evaluation was conducted 3 months after treatment suspension. We evaluated subjective symptoms, visual acuity, tear breakup time, the results of Schirmer’s I test, fluorescein corneal and conjunctival staining, and corneal sensitivity.ResultsThe symptoms and visual acuity improved significantly in all patients. There was a significant improvement in corneal sensitivity and a decrease or disappearance of fluorescein corneal staining.ConclusionThe treatment with allogenic PRP eye drops of patients with SS-related severe dry eye disease has proven to be very effective, with an improvement in symptoms and main clinical signs.

Allogenic platelet-rich plasma for treatment of knee and hip osteoarthritis.

Osteoarthritis (OA) induces tremendous amounts of stress and financial burden on patients and healthcare systems worldwide. Current treatments have limitations and do not address the etiopathogenetic cause of OA. Regenerative medicine may circumvent limitations posed by traditional modalities and relies on the utilization of biologics including platelet-rich plasma (PRP). Several peer-reviewed studies have documented the safety and efficacy of autologous PRP in mitigating symptoms in knee and hip OA patients. Nonetheless, only few studies investigated the safety and efficacy of allogenic PRP. This mini review summarizes the outcomes of preclinical and clinical studies using allogenic PRP for treatment of knee or hip OA. We identified 3 preclinical and 1 clinical study using allogenic PRP for treatment of knee OA, and only 1 clinical study using allogenic PRP for treatment of hip OA. Administration of allogenic PRP is safe and probably efficacious in patients with knee or hip OA. However, more pre-clinical studies and high-powered, multi-center, non-randomized and randomized controlled trials with extended follow-up are warranted to further establish the safety and efficacy of allogenic PRP to justify its clinical use.

BDNF and Krox20 as Indicators of Platelet-rich Plasma-Induced Nerve Regeneration in a Neuropathic Orofacial Pain Model.

Various growth factors contained in PRP can increase angiogenesis and cell proliferation, which plays an essential role in the process of neuroregeneration and peripheral nerve injury recovery. This study analyzed PRP effects in the neuro-regeneration of axonotmesis through brain-derived neurotrophic factor (BDNF) and Krox20 expressions. Freeze-dried allogeneic platelet-rich plasma (PRP) were prepared from allogeneic sources. Forty-two Rattus norvegicus were divided into three groups: negative control group, positive control group (crushing infraorbital nerve) and treatment group (crushing infraorbital nerve without PRP injection). Each group was observed for fourteen and twenty-one days after injury. Infraorbital nerve tissue is isolated for indirect immunohistochemistry examination with BDNF and Krox20 antibodies. Data analysis was performed using One-Way ANOVA and Mann-Whitney tests with significant value as p < 0.05. The PRP group showed BDNF expression significantly higher than control positive groups, both observation days (p = 0.00). A higher Korx20 expression showed by the PRP group after 21 days than in the control positive groups (p = 0.002). PRP can potentially improve neuroregeneration of axonotmesis through increased BDNF and Krox20 expression on the twenty-one days after injury.

Clinical manifestations of allergic reactions and immunoglobulin E levels on allogeneic freeze-dried platelet-rich plasma (PRP) application

Link of Video Abstract: https://youtu.be/yS431sCL3VQ Background: Several studies have reported that modern wound dressings offer better results. Allogeneic PRP products in the form of injections and gels are available in the market, which helps accelerate wound healing without triggering an immunological reaction. Meanwhile, this study was carried out to investigate the Allogeneic Freeze-Dried PRP form, which is more practical, efficient, and safer. This study aims to determine the effect of Allogeneic Freeze-Dried PRP on human split-thickness skin graft donor wounds on clinical manifestations of allergic reactions and levels of Immunoglobulin E (IgE). Methods: A randomized Pre- and Post-test Control-Trial Group Design was conducted on patients with split-thickness skin graft donor wounds using Allogeneic Freeze-Dried PRP dressings at Dr. Soetomo General Hospital, Surabaya. Allergic manifestations were reviewed during the observation period of up to 4 days, and IgE levels were measured pre-test and 60 minutes post-application. A statistical comparison of results was carried out between the trial and control groups that used paraffin dressings. Results: A total of 36 patients were used as subjects, with 19 (52.78%) in the trial group and 17 (47.22%) in the control group, and their parameters were generally homogeneous. There were no clinical manifestations of allergic, changes in vital signs, and significant differences in IgE levels before and after application statistically in all study subjects (p&gt;0.05). Conclusion: Application of Allogeneic Freeze-Dried PRP to human split-thickness skin graft donor wounds did not generate clinical manifestations of allergic reactions and an increase in IgE.

Comparison of single and double centrifugation methods for preparation of Platelet-Rich Plasma (PRP).

To compare the platelet count, platelet concentration/yield, residual Red blood cells (RBCs) and White blood cells (WBCs) counts in platelet-rich plasma (PRP) samples prepared from the single- and the double-centrifugation protocols. It was a Cross-Sectional study, conducted at the Department of Hematology & Transfusion Medicine, The Children's Hospital and UCHS, Lahore from October 2021 to January 2022 including 50 voluntary, healthy individuals of age 20-45 years of both genders, after taking informed consent. Complete blood count analysis of all participants was done initially by drawing 3ml blood in EDTA vial. From all the participants, 20 ml venous blood sample was taken in syringes containing tri-sodium citrate and then shifted to harvest tubes. Group-I comprised of PRP samples prepared by single- centrifugation method. While Group-II samples were prepared by Double-centrifugation method consisting of soft and hard spin. The platelet, RBC and WBC counts in prepared PRP samples were determined by using automated SYSMEX XP-100 hematology analyzer. Platelet yield or Platelet concentration (%) was calculated for samples using formula. The data analysis was done using SPSS version 23. The mean PRP platelet count in Group-I was 594.6±157.4×103/μl whereas in Group-II was 923.06 ± 127.58×103/μl. In Group-I, the mean platelet concentration/yield in PRP was 175.75 ± 55.08% while in Group-II, it was 276.78 ± 112.7%. Significant difference was observed between the platelet counts and platelet concentration/yields from the PRP samples of two Group-s (p < 0.01). Significant difference between the WBCs count was also observed (p < 0.01) with higher WBCs in Group- I PRP. Residual RBCs were almost same among two Group-s. The double centrifugation protocol resulted in higher platelet quantity and yield with less contamination by red and white blood cells than did the single centrifugation protocol for PRP preparation. So, double centrifugation method is beneficial in preparation of autologous as well as allogenic PRP.

The effects of several forms of platelet concentrates combined with biomaterial collapan on segmental tibial bone defect regeneration

Objective: the purpose of the study was to evaluate the effects of three forms of allogeneic platelet concentrates on segmental tubular bone defect osseous regeneration.Material and Methods. In 145 laboratory rats tibial shaft segment was resected and stable osteosynthesis of the bone ends was performed. In group 1 animals the bone defect was left graftless, in group 2 animals biomaterial Collapan and shattered orthotopic autologous bone mixture into the bone defect site was placed. In group 3 animals as part of Collapan-autobone mixture defect filling fresh allogeneic platelet rich plasma was added, in group 4 animals allogeneic cryodestructed platelet rich plasma to the Collapan-bone mixture was added and group 5 animals received Collapan-bone mixture with allogeneic platelet rich fibrin added.Results. According to gross dissection data in 23 of the 32 group 3 rats, in 25 of the 37 group 4 rats and in 19 of the 27 group 5 rats complete visual tibial shaft defect healing occurred. In group 2 on visual inspection of tibial bone in 5 of the 10 rats defect healing was noted and in group 1 rats the defect healed in 15 of the 39 animals only. Bone defect healing rates in groups 3, 4 and 5 differed from group 1 healing rate significantly with χ2 = 7,889, χ2 = 6,452 and χ2 = 6,504 respectively, group 2 bone defect healing rate did not differ from that of group 1 (χ2 = 0,439). Histological analysis of specimens from groups 3, 5 and especially from group 4, at 3 weeks after plasty demonstrated active intermediary callus formation at bonesaw-line and neoformed osteoid bone on Collapan-bone chips aggregations surfaces; no intermediary callus formation in specimens from group 2 was found. At 6 to 12 weeks after plasty the most mature osseous tissue in specimens from group 4 was observed, the least mature neoformed osseous tissue amount was common to specimens from group 2.Conclusion. All three allogeneic Collapan-immobilized platelet concentrates studied promoted bone formation and healing of considerable segmental tibial shaft bone defect in rat model. The most evident osteogenesis activating effect was histologically confirmed in cases where cryodestructed platelet rich plasma to Collapan-bone chips mixture was added.

Comparıson of the effect of the autogenıc and xenogenıc use of platelet-rıch plasma on rabbıt chondrocutaneous composıte graft survıval

The platelet-rich plasma (PRP) has become popular in the medical world due to its content of growth factors and numerous studies are experimental. In experimental studies, the preparation and application of PRP are problematic and allogenic PRP transfers have been preffered, because of the difficulties in preparation of autogenic PRP in animal experiments. Xenogenic transfers and their effects have not been studied in this topic. This study aimed to investigate the effect of autogenic and xenogenic use of PRP on composite graft viability. Methods: Two composite grafts are prepared for each ear of nine rabbits. Each ear was randomly divided into three groups. After the procedure, the wound edges and base were injected with 1 cc serum physiologic, autogenic PRP or 1 cc human-derived xenogenic PRP. At 3 weeks, samples were taken, photographic and histopathological evaluations were made. Results: The graft viability was better in autogenic and xenogenic group compared to the control group. In comprasion of autogenic and xenogenic groups, although the macroscopic evaluation revealed better graft viability and less necrosis in the group which had been treated with autogenic PRP, the difference was not statistically significant. The three groups did not significantly differ in terms of inflammation. Vascularization examined histopathologically. CD31 staining, which was used to evaluate angiogenesis, was significantly higher in the autogenic PRP group than the remaining two groups. Conclusion: Although autogenic PRP has better results histopathologically, the xenogenic use of PRP may be an alternative for studies, when macroscopic evaluation is necessary.

Efficacy of intra-articular injection of allogeneic platelet-rich plasma for knee osteoarthritis combined with hematologic blood dyscrasias with platelet dysfunction: protocol of a randomized, double-blind, placebo-controlled trial

BackgroundAutologous platelet-rich plasma (PRP) has been shown to alleviate the symptoms of patients suffering from knee osteoarthritis (KOA), but for certain patients with hematologic diseases with platelet dysfunction and patients receiving anti-platelet medications, autologous PRP is not an optimum solution. Allogeneic PRP has been proven to be safe and effective in the treatment of osteoarthritis, rotator cuff disease, refractory wounds and other medical fields. However, a well-designed and long-term follow-up prospective randomized controlled trial (RCT) to evaluate the effect of allogeneic PRP intra-articular injections for KOA combined with hematologic blood dyscrasias has not yet been performed.Methods/ designWe will conduct an allogeneic PRP injection for KOA combined with hematologic blood dyscrasias with platelet dysfunction study: a prospective, randomized, double-blind, placebo-controlled trial. One hundred participants with KOA combined with hematologic blood dyscrasias with platelet dysfunction will be randomly allocated to receive either one allogeneic PRP injection or one saline injection into the knee joint. The primary outcome will be a 12-month change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Secondary outcomes will be the 36-Item Short-Form General Health Survey (SF-36) score, Lysholm score, overall knee pain score and MRI assessment at 1-, 3-, 6- and 12-month.DiscussionThe results of this study will help determine whether allogeneic PRP could be used as a non-surgical intervention to treat patients with knee OA combined with hematologic blood dyscrasias with platelet dysfunction.Trial registrationChinese Clinical Trials Registry reference: ChiCTR2100048624. Prospectively registered 11th of July 2021.

Allogeneic Solid Platelet-Rich Plasma for Persistent Epithelial Neurotrophic Defects: A Protocol and Pilot Study

Here, we present the procedure to obtain allogeneic solid platelet-rich plasma (PRP) and its use in a pilot study of patients with persistent neurotrophic epithelial defects. We included 4 eyes of 4 patients with persistent neurotrophic epithelial defects unresponsive to other therapies from a single institution. PRP and thrombin were produced by the Department of Transfusion Medicine from healthy blood donors. PRP was activated in its solid form in the operating room with addition of thrombin and calcium gluconate 10% and applied on the cornea with fibrin glue and soft contact lens. Corneal healing time, corneal esthesiometry, visual acuity, Oxford staining score, Ocular Surface Disease Index questionnaire, and Schirmer I test were recorded. Anterior segment optical coherence tomography and in vivo confocal microscopy were also evaluated over the 4-month follow-up period. The persistent epithelial defect healed in all patients in the first 10 days. During the follow-up, there was an absence of recurrences. For all patients, there was a reduction in Ocular Surface Disease Index questionnaire score (case 1: -55 points, -73.3%; case 2: -26.3 points, -58.4%; case 3: -56 points, -69.1%; case 4: -20 points, -26.6%; mean reduction: 39.3 points, 56.85%) and Oxford staining score (case 1, 2, and 3: 3 points decrease; case 4: 2 points decrease; mean reduction: -2.75 points). Allogeneic solid PRP in combination with fibrin glue may facilitate wound healing in neurotrophic persistent epithelial defects. Further prospective studies are needed to quantify its efficacy.

The role of allogeneic platelet-rich plasma in patients with diabetic foot ulcer: Current perspectives and future challenges.

The frequency of chronic cutaneous wounds are sharply increasing in aging populations. Patients with age-related diseases, such as diabetes, tumors, renal failure and stroke are prone to soft tissue and skin injury, compounded by slowed healing in aging. Imbalance of wound inflammation, loss of growth factor secretion, and impairment of tissue repair abilities are all possible reasons for failed healing. Therefore, it is vital to explore novel approaches to accelerate wound healing. Platelet-rich plasma (PRP) as a cell therapy has been widely applied for tissue repair and regeneration. PRP promotes wound healing by releasing antimicrobial peptides, growth factors and micro-RNAs. Medical evidence indicates that autologous platelet-rich plasma (au-PRP) can promote wound healing effectively, safely and rapidly. However, its clinical application is usually restricted to patients with chronic cutaneous wounds, generally because of other severe complications and poor clinical comorbidities. Allogeneic platelet-rich plasma (al-PRP), with abundant sources, has demonstrated its superiority in the field of chronic wound treatment. Al-PRP could overcome the limitations of au-PRP and has promising prospects in clinical applications. The aim of this review is to summarize the current status and future challenges of al-PRP in chronic cutaneous wound management. We also summarized clinical cases to further describe the application of al-PRP for chronic wounds in clinical practice.

Platelet-derived growth factors from a single donor by apheresis and one freeze-thaw cycle for treating medication-related osteonecrosis of the jaw.

Aim: To assess whether the use of allogeneic platelet-derived growth factors could serve as a feasible, effective and safe biological therapy for the treatment of medication-related osteonecrosis of the jaw (MRONJ). Materials & methods: Patients with multiple myeloma and MRONJ were included and treated with allogeneic platelet-rich plasma, continued for between 6 and 18weeks (mean: 9). Results: We observed a treatment success rate of 87.5% (p<0.05). Assessing the association between healing and treatment duration, we observed a statistically significant relationship (χ2=8.00; p= 0.018; Cramer's V = 1), confirming that healing was very closely related to the duration of the treatment. Conclusion: Allogeneic platelet-rich plasma could be a recommended treatment for MRONJ. Future research with a large sample to validate our findings is required.

Effect of platelet-rich plasma vs standard management for the treatment of diabetic foot ulcer wounds: A meta-analysis.

We performed a meta-analysis to evaluate the effect of platelet-rich plasma vs standard management for the treatment of diabetic foot ulcer wounds. A systematic literature search up to March 2022 was performed and 1435 subjects with diabetic foot ulcer wounds at the baseline of the studies; 723 of them were treated with platelet-rich plasma, and 712 used control. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated to assess the effect of platelet-rich plasma vs standard management for the treatment of diabetic foot ulcer wounds using the dichotomous method with a random or fixed-effect model. The use of autologous platelet-rich plasma resulted in significantly higher complete-healed diabetic foot ulcer wounds compared with control (OR, 1.95; 95% CI, 1.49-2.56, P < 0.001). The use of allogeneic platelet-rich plasma resulted in significantly higher complete-healed diabetic foot ulcer wounds compared with control (OR, 6.19; 95% CI, 2.32-16.56, P < 0.001). The use of autologous and allogeneic platelet-rich plasma resulted in significantly higher complete-healed diabetic foot ulcer wounds compared with control. Though, the analysis of outcomes should be with caution because of the low number of studies in certain comparisons, for example, allogeneic platelet-rich plasma compared with control.