Growth Factor Concentrations Research Articles

The growth factor content as an indicator of platelet counts in platelet-rich plasma

BackgroundPlatelet contains growth factors that enhance tissue repair mechanisms, including epidermal growth factor (EGF), platelet-derived growth factor (PDGF-AA and −AB), and transforming growth factor (TGF)-β. Autologous platelet-rich plasma (PRP) has been shown to significantly improve the treatment of tendon injuries compared with hyaluronic acid and placebo. The topic of agreement between platelet concentrations and growth factors has been covered in some previous studies, but growth factor levels did not correlate well with platelet concentrations. MethodIn this study, autologous PRP was prepared by concentrating platelets through a J6-MI centrifuge. The automatic hematology analyzer Sysmex XN-20 was used to analyze the platelet concentration in PRP, and the PRP growth factors were determined by ELISA, including PDGF, transforming growth factor- β1 (TGF-β1), and EGF. Statistical analysis was conducted on data from 107 patients who received autologous PRP using Pearson correlation analysis. ResultsPearson correlation analysis revealed PDGF, TGF, and EGF had a strong positive correlation with the platelet concentration of the final PRP product (r = 0.697, p < 0.0001; r = 0.488, p < 0.0001; r = 0.572, p < 0.0001, respectively) ConclusionsThere was a strong positive correlation between the concentration of platelets in the final PRP product and the levels of PDGF-AB, TGF-β, and EGF. These results suggested straightforward and cost-effective growth factor tests can provide valuable information about platelet content in PRP.

Clinical and Epidemiological Profile of Deep Second Degree Burn Patients Treated with Platelet Lysate

The wound healing process in burn victims is still a problem today despite the advances made in the management of these patients with the different resuscitation regimens, the advent of antibiotic therapy as well as the different local treatments used. The local application of a high concentration of growth factor through the use of halogenic platelet concentrates lyzed by freezing- thawing has been done in the past with the aim of accelerating the healing process of the various wounds. The aim of this work is to describe Clinical and epidemiological profile of deep second degree burn patients treated with platelet lysate. A longitudinal and prospective study was carried out in 30 adult patients with deep second-degree burns with boiling water with a burned body surface area ≤ 5%, treated locally with allogeneic platelet lysate in the Burn centre and Plastic Surgery Service of the General Hospital “Dr. Juan Bruno Zayas Alfonso” in Santiago de Cuba, during the period of February 2015 to February 2016.A total of 30 adult patients have been studied. The mean age was 33.93. Female sex predominated with a male/female ratio of 1/2. The most frequent location of burns was in the lower limbs accounting for 36.6% of patients, followed by the upper limbs and anterior trunk at 26.7% in both cases. For the study group, the epitelization time was less than 21 days and in the majority of cases (66.7%) this time was 7-13 days. Non-relevant side effects were observed in 80% of patients and included pruritus (50%), perilesional erythema (8.3%) and pain in 29.2% of patients. Apart from these side effects, no complications have been observed in our patients. The promising results reported in this study and in the literature warn that platelet lysate may become a potential therapeutic candidate for deep second- degree burns from boiling water.

Skin Telocytes Could Fundament the Cellular Mechanisms of Wound Healing in Platelet-Rich Plasma Administration.

For more than 40 years, autologous platelet concentrates have been used in clinical medicine. Since the first formula used, namely platelet-rich plasma (PRP), other platelet concentrates have been experimented with, including platelet-rich fibrin and concentrated growth factor. Platelet concentrates have three standard characteristics: they act as scaffolds, they serve as a source of growth factors and cytokines, and they contain live cells. PRP has become extensively used in regenerative medicine for the successful treatment of a variety of clinical (non-)dermatological conditions like alopecies, acne scars, skin burns, skin ulcers, muscle, cartilage, and bone repair, and as an adjuvant in post-surgery wound healing, with obvious benefits in terms of functionality and aesthetic recovery of affected tissues/organs. These indications were well documented, and a large amount of evidence has already been published supporting the efficacy of this method. The primordial principle behind minimally invasive PRP treatments is the usage of the patient's own platelets. The benefits of the autologous transplantation of thrombocytes are significant, representing a fast and economic method that requires only basic equipment and training, and it is biocompatible, thus being a low risk for the patient (infection and immunological reactions can be virtually disregarded). Usually, the structural benefits of applying PRP are attributed to fibroblasts only, as they are considered the most numerous cell population within the interstitium. However, this apparent simplistic explanation is still eluding those different types of interstitial cells (distinct from fibroblasts) that are residing within stromal tissue, e.g., telocytes (TCs). Moreover, dermal TCs have an already documented potential in angiogenesis (extra-cutaneous, but also within skin), and their implication in skin recovery in a few dermatological conditions was attested and described ultrastructurally and immunophenotypically. Interestingly, PRP biochemically consists of a series of growth factors, cytokines, and other molecules, to which TCs have also proven to have a positive expression. Thus, it is attractive to hypothesize and to document any tissular collaboration between cutaneous administered PRP and local dermal TCs in skin recovery/repair/regeneration. Therefore, TCs could be perceived as the missing link necessary to provide a solid explanation of the good results achieved by administering PRP in skin-repairing processes.

Prospective Outcomes After Serial Platelet-Rich Plasma (PRP) Injection in Vocal Fold Scar and Sulcus.

Vocal fold scar and sulcus pose significant treatment challenges with no current optimal treatment. Platelet-rich plasma (PRP), an autologous concentration of growth factors, holds promise for regenerating the superficial lamina propria. This study aims to evaluate the potential benefits of serial PRP injections on mucosal wave restoration and vocal function. In a prospective clinical trial across two institutions, patients with vocal fold scar underwent four serial PRP injections, one month apart. Blinded independent laryngologists and expert listeners used pretreatment and one-month post-fourth injection videostroboscopy and CAPE-V assessments to evaluate mucosal wave and voice quality changes, respectively. Additionally, patient reported outcome measures (PROMs) were evaluated. In the study, 15 patients received 55 PRP injections without adverse effects. Eight patients (53.3%) had mild, three patients (20%) had moderate, and four patients (26.7%) had severe scar. There was an average reduction of 8.7 points in post-treatment VHI-10 scores (p = 0.007). The raters observed an improvement in post-treatment voice in 73.4% of cases, and CAPE-V scores showed a reduction of 18.8 points on average (p = 0.036). The videostroboscopic VALI ratings showed an improvement in mucosal wave rating from 2.0 to 4.0. On average, the raters perceived the post-PRP exams to be better in 56.7% of cases. PRP has been validated as a safe autologous option for treatment of vocal fold scar. While results for mucosal wave and voice quality varied, there was a consistent improvement in PROMs. Level 3: Prospective cohort study, with blinded analysis Laryngoscope, 2024.

Clinical Efficacy of Concentrated Growth Factors for the Management of Marginal Tissue Recession: A Systematic Review and Meta-Analysis.

To systematically review existing scientific literature to determine, compare, and evaluate whether concentrated growth factors (CGF) or connective tissue grafts (CTG) is a better treatment alternative for patients with marginal tissue recession (MTR). Electronic databases like PubMed, Embase, Scopus, and Google Scholar were screened from the last 20 years reporting treatment of MTR using CGF or CTG and other techniques. Periodontal parameters like probing depth, clinical attachment level, recession depth, recession width, keratinized tissue width, root coverage, increase in gingival thickness and plaque index, and gingival index were compared. Standardized mean difference was used as a summary statistic measure with a random effect model and P value <0.05 as statistically significant. Six studies fulfilled eligibility criteria and were included in qualitative synthesis, of which only 4 studies were suitable for meta-analysis. The pooled estimate through standardized mean difference signifies that CGF was superior to CTG in the reduction of probing depth, gingival index, and plaque index and gain in clinical attachment level while CTG was superior in reducing the recession depth and recession width. Both the procedures had an overall equal effect on keratinized tissue width and root coverage, but these differences were statistically insignificant ( P >0.05). Publication bias through the funnel plot showed symmetric distribution without systematic heterogeneity. The present study suggests that treatment of MTR with CTG or CGF resulted in clinically favorable outcomes, but no statistically significant differences was observed between these 2 procedures regarding the outcome.

Impact of different formulations of platelet lysate on proliferative and immune profile of equine mesenchymal stromal cells.

Platelet lysate (PL) is investigated as a potential replacement for fetal bovine serum (FBS) in cell culture. However, there is limited research on its impact on the immune profile of equine mesenchymal stromal cells (eMSCs). This study aimed to evaluate the effects of different PL formulations on the proliferative capacity, multipotentiality, and immune profile of equine adipose tissue-derived MSCs (eAD-MSCs). In vitro growth kinetics and trilineage differentiation of eAD-MSCs (n = 7) were assessed under three culture conditions: medium-concentration PL (MPL), high-concentration PL (HPL), and FBS as a control. The immune profile was evaluated by studying the expression of immunogenic receptors such as MHC I, MHC II, and immunomodulatory molecules IL-6, IL-10, and TNF-α, determined by gene expression, surface marker expression, and cytokine quantification. Both PL formulations, pooled from 5 donors, exhibited 3.3 and 6.5-fold higher platelet counts than baseline plasma for MPL and HPL, respectively. Higher concentrations of TGF-β and PDGF were found in both PL formulations compared to baseline. Furthermore, MPL and HPL subcultures demonstrated proliferative, clonogenic, and multipotent capacities similar to FBS. The immune profile of PL-cultured cells exhibited gene expression levels related to immunogenicity and immunomodulation similar to the reference condition, and the surface antigen presence of MHC II was also similar. However, HPL media exhibited higher IL-6, IL-10, and TNF-α concentrations in the culture supernatant. In conclusion, both PL media contained higher concentrations of growth factors compared to FBS, supporting the in vitro culture of eAD-MSCs with proliferative, clonogenic, and multipotent capacity similar to the reference medium. Nonetheless, PL usage led to a variation in the immunomodulatory cytokine microenvironment, with higher concentrations of IL-6, IL-10, and TNF-α in HPL media compared to MPL and FBS.

The effects of mineral trioxide aggregate and second-generation autologous growth factor on pulpotomy via TNF-α and NF-kβ/p65 pathways

This study aims to investigate the effect of Mineral Trioxide Aggregate (MTA), a bioactive endodontic cement, and Concentrated Growth Factor (CGF), a second-generation autologous growth factor, on pulpotomy-induced pulp inflammation. The study utilized the maxillary anterior central teeth of thirty-six young male Sprague Dawley rats. Forty-eight teeth were randomly assigned to two groups (12 rats/group; 24 teeth/group) based on the capping material (MTA or CGF). Subsequently, two subgroups (MTAG and CGFG) were formed per group (12 teeth/group) based on the time following pulpotomy (2-weeks and 4-weeks). The central teeth of the 12 animals assigned to the control group (CG) were not manipulated in any way, both in the 2-week group and in the 4-week group. Tissue samples extracted from rats at the end of the experiment were stained with H&E for histopathological analysis. For immunohistochemical analysis, primary antibodies for TNF-α and NF-kβ/65 were incubated. Data obtained from semi-quantitative analysis were assessed for normal distribution using Skewness-Kurtosis values, Q-Q plot, Levene’s test, and the Shapiro-Wilk test on statistical software. A P value < 0.05 was considered significant. When compared with the control group, both MTAG and CGFG showed increased edematous and inflammatory areas. In MTAG, edematous and inflammatory areas decreased significantly from the 2nd week (2(2–2), 2(1–2)) to the 4th week (1(1–1), 1(0–1)), while in CGFG, edematous areas decreased (2(2–3), 1.5(1–2)), and inflammatory areas increased significantly (2(2–3), 3(2-2.5)). When compared with the control group, TNF-α and NF-kβ/p65 positivity were higher in both MTAG and CGFG. In MTAG, TNF-α [2(1.5-2)] and NF-kβ/p65 [1.5(1–2)] positivity decreased significantly from the 2nd week to the 4th week [TNF-α: 1(1–1), NF-kβ/p65: 1(1–2)], while no significant change was observed in CGFG. In conclusion, this study revealed a reduction in cells showing TNF-α and NF-kβ/p65 positivity in the MTA treatment group compared to the CGF group. Although MTA demonstrated more favorable results than CGF in mitigating pulpal inflammation within the scope of this study, further experimental and clinical investigations are warranted to obtain comprehensive data regarding CGF.

Application of Concentrated Growth Factors in Combination with Bio-Oss for Extraction of Mandibular Proximal Impacted Wisdom Teeth

In this study, we investigate the combined application of concentrated growth factor (CGF) and Bio-Oss (BO) for the treatment of periodontal bone defect (BD) after extraction of impacted wisdom teeth. Firstly, we assess the osteogenic properties of CGF in periodontal ligament stem cells (PDLSCs). The concentration-dependent effect of CGF on enhancing the activity of PDLSCs has been demonstrated. Furthermore, CGF effectively promotes differentiation and enhances the osteogenic function of PDLSCs, leading to improved expression of related osteogenic proteins. Subsequently, a total of 64 patients with loss of alveolar bone in the second molar, who received treatment at our hospital between July 2020 and July 2023, are included. They are randomly divided into a BO group (treated with BO) and a CGF/BO group (treated with CGF+BO). We observe that the combined application of CGF and BO demonstrated superior efficacy in alleviating pain, reducing swelling, and preventing dry socket incidence. In addition, it exhibited enhanced effectiveness in restoring periodontal tissue, including reducing probing depth, gingival depth, and clinical attachment loss. It also displayed better inhibition of gingival inflammatory response and gingival bleeding. Furthermore, it could enhance the restoration of periodontal BD, such as increasing the width of the alveolar bone and root depth, reducing the vertical distance from the apex of the alveolar ridge, as well as improving dental function. Therefore, the combined application of CGF and BO holds great potential in periodontal BD therapy for promoting the regeneration of periodontal bone, thus restoring dental function.

Adipose-derived stem cells transplantation improves survival and alleviates contraction of skin grafts via promoting macrophages M2 polarization.

Full-thickness skin grafts are widely used in plastic and reconstructive surgery. The main limitation of skin grafting is the poor textural durability and associated contracture, which often needs further corrective surgery. Excessive inflammation is the main reason for skin graft contractions, which involve overactivation of myofibroblasts. These problems have prompted the development of new therapeutic approaches, including macrophage polarization modulation and stem cell-based therapies. Currently, adipose-derived stem cells (ASCs) have shown promise in promoting skin grafts survival and regulating macrophage phenotypes. However, the roles of ASCs on macrophages in decreasing skin grafts contraction remain unknown. Rat adipose-derived stem cells (rASCs) were isolated from rat inguinal adipose tissues. Full-thickness skin graft model was constructed on male rats divided into control group and rASCs treatment group. Skin graft was assessed for concentration, elasticity modulus and stiffness. Rat bone marrow-derived macrophages (rBMDMs) were isolated from rat femurs, and subsequent RT-qPCR and coculture assays were carried out to explore the cellular mechanisms. Immunohistochemical and immunofluorescence staining were used to verify mechanisms in vivo. In vivo results showed that after injection of ASCs, improved texture, increased survival and inhibited contraction of skin grafts were seen. Vascularization was also improved as illustrated by laser perfusion image and vascular endothelial growth factor (VEGF) concentration. Histological analysis revealed that ASCs injection significantly reduced expression of pro-inflammatory cytokines (TNF-a, IL-1β) and increased expression of anti-inflammatory (IL-10) and pro-healing cytokines (IGF-1). At cellular level, after co-culturing with rASCs, rat bone marrow derived macrophages (rBMDMs) favored M2 polarization even under inflammatory stimulus. ASCs treatment enhanced vascularization via angiogenic cytokines secretion and alleviated inflammatory environment in skin grafts by driving M2 macrophages polarization, which improved survival and decreased skin grafts contraction. Our work showed that ASCs transplantation can be harnessed to enhance therapeutic efficacy of skin grafting in cutaneous defects treatment.

Influence of haematological parameters on size of the advanced platelet-rich fibrin+ (A-PRF+) in the horse

The advanced-PRF+ (A-PRF+) is a platelet concentrate, showing a higher concentration of growth factors, an increased number of cells and looser structure of the fibrin clot than leukocyte-PRF. A high variability in the size of PRF associated with patients, haematological features and centrifugation protocols was reported. The aims of this study were to evaluate the feasibility of A-PRF+ production in the field and the correlation between haematological parameters, macroscopic and microscopic features in equine A-PRF+. Samples from twenty Standardbred horses (3–7 years) were harvested with glass tubes without anticoagulants, previously heated at 37 °C. Blood samples were centrifugated at 1300 rpm for 8 min with a fixed-angle centrifuge and a horizontal centrifuge in the field, at a temperature of 15–17 °C. Clots were measured and placed on the Wound Box® for a 2-min compression. Membranes were measured and fixed in 10% formalin for histological examination. Clot and membrane surface did not differ between sex and centrifuge. Haematological parameters did not show a significant correlation to clot and membrane size. Membranes obtained from both centrifugation protocols showed a loose fibrin structure and cells evenly distributed throughout the clot. Tubes' warming was effective to obtain A-PRF+ clots from all samples, regardless the environmental temperature. Further studies are needed to evaluate the influence of other blood molecules on the A-PRF+ structure and size.

Forward osmosis zwitterionic membranes for platelet concentration – Evaluation of the feasibility of the concept

This study focuses on the development of forward osmosis (FO) membranes tailored for platelet and growth factor enrichment applications while maintaining minimal activation throughout the process. The FO membrane structure comprises a polyacrylonitrile (PAN) layer, fabricated using vapor-induced phase separation (VIPS), atop a polyethylene terephthalate (PET) substrate. Then, a polyamide (PA) layer was formed through interfacial polymerization (IP) at the PAN layer interface. The PET side of the membrane was further enhanced with coatings of antifouling copolymers, based on poly(ethylene glycol) methyl ether methacrylate (PEGMA) alone or both PEGMA and zwitterionic sulfobetaine methacrylate (SBMA). In a first step, the formation of each layer was optimized. The structure of the PAN layer was adjusted through the polymer concentration (15 wt%) and the exposure time to vapors (15 min) during the VIPS step. The PA layer was optimized by adjusting the curing temperature to 70 °C. The antifouling copolymer was selected by conducting protein adsorption tests. Subsequently, these tailored FO membranes were employed in the enrichment of plasma proteins, growth factors, and platelets from platelet-rich plasma. It is shown that the membrane modified with a copolymer made of butyl methacrylate (BMA), PEGMA and SBMA, referred to as poly(BMA-r-PEGMA-r-SBMA), enabled to reach a Human Serum Albumin concentration factor of 1.32 and a platelet concentration using PRP of 2.4. Despite partial platelet activation (12 %) due to the high cell concentration, the platelet content is much higher than in PRP or whole blood, which could benefit platelet-based therapies. In addition, the system can be applied to the concentration of growth factors, with PDGF and VEGF concentration factors of 1.92 and 2.58, respectively, which could contribute to the advancement of regenerative medicine.

Concentrated growth factor intradermal injection assisted super-thin flap expansion for repairing skin defects: A randomized, single blinded, split-site study.

The super-thin skin flap formed by skin and soft tissue expansion has large area and good ductility, so it can be used to repair skin defects. However, because the flap is thin, the blood flow in the dermis of the super-thin expanded flap is weakened, and flap rupture and necrosis after secondary flap transfer may occur. To compare the skin thickness difference between the expanded ultrathin flaps injected with concentrated growth factor (CGF) and the blank group or saline group. From June 2021 to December 2023, 10 patients (44 sites) with large-area scars or skin tumors were treated, and a single center half randomized controlled trial was conducted. The test site of expander implantation was divided into three groups: intradermal injection of CGF group, normal saline group and blank group. The same amount of expansion was performed every 1-2 weeks, and CGF or normal saline was injected into the dermis every 4 weeks, a total of three times. After 2-3 months of expansion, color Doppler ultrasound was used to measure the skin thickness of each group. Compared with the blank group, the skin thickness of CGF group was 1.75 ± 0.08 mm, and that of BLA blank group was 1.42 ± 0.07 mm, with statistically significant difference (p < 0.0001); In the other group, compared with the saline group, the skin thickness of the CGF group was 1.54 ± 0.08 mm, and the average skin thickness of the saline group was 1.40 ± 0.08 mm, with significant difference between the two groups (p = 0.0067). CGF intradermal injection can increase the skin thickness of super-thin skin flap in the process of soft tissue expansion, which is a safe and effective auxiliary method of skin expansion.

Revealing the Potency of Growth Factors in Bovine Colostrum.

Colostrum is a nutritious milk synthesized by mammals during the postpartum period, and its rich bioactive components has led to a global increase in the consumption of bovine colostrum as a supplement. Bovine colostrum contains key components such as immunoglobulins, oligosaccharides, lactoferrin and lysozyme. It is a special supplement source due to its natural, high bioavailability and high concentrations of growth factors. Growth factors are critical to many physiological functions, and considering its presence in the colostrum, further research must be conducted on its safe application in many bodily disorders. Growth factors contribute to wound healing, muscle and bone development, and supporting growth in children. Additionally, the molecular mechanisms have been explored, highlighting the growth factors roles in cell proliferation, tissue regeneration, and the regulation of immune responses. These findings are crucial for understanding the potential health effects of bovine colostrum, ensuring its safe use, and forming a basis for future clinical applications. This review article examines the growth factors concentration in bovine colostrum, their benefits, clinical studies, and molecular mechanisms.

Whole Body Vibration Training Has No Effect on Vascular Endothelial and Inflammatory Markers in Young Healthy Women.

Background: The aim of the study was to comparatively assess the impact of single and repeated whole body vibration training (WBVT) and training without vibration on changes in the concentration of vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), and high-sensitivity C-reactive protein (hsCRP) in healthy, young, non-training women. Methods: The study involved 46 women (age 20.48 ± 1.72 years), who were divided into three groups: the experimental group participating in WBVT (EVG, n = 17); the comparison group performing the same exercises but without the vibration factor (EXG, n = 12); and the control group, which did not participate in any training (CON, n = 17). The program included participation in 36 training sessions conducted over 12 weeks, with a frequency of 3 times per week. In the EVG and EXG groups, venous blood was collected before and after the first and last training sessions, while in the CON group, blood was collected twice at a 3-month interval. Results: No significant changes were observed in the concentrations of the studied markers either after a single or repeated training session in both experimental groups (p > 0.05). Conclusions: The proposed WBVT protocol appears to be a safe form of exercise that does not induce negative inflammatory reactions. The applied vibration stimulus combined with physical exercises did not initiate pro-angiogenic processes or stimulate eNOS activity in healthy women, suggesting that similar studies should be conducted in individuals with circulatory problems or chronic inflammatory diseases.

Fentanyl Overdose Causes Prolonged Cardiopulmonary Dysregulation in Male SKH1 Mice.

Fentanyl overdose is a survivable condition that commonly resolves without chronic overt changes in phenotype. While the acute physiological effects of fentanyl overdose, such as opioid-induced respiratory depression (OIRD) and Wooden Chest Syndrome, represent immediate risks of lethality, little is known about longer-term systemic or organ-level impacts for survivors. In this study, we investigated the effects of a single, bolus fentanyl overdose on components of the cardiopulmonary system up to one week post. SKH1 mice were administered subcutaneous fentanyl at the highest non-lethal dose (62 mg/kg), LD10 (110 mg/kg), or LD50 (135 mg/kg), before euthanasia at 40 min, 6 h, 24 h, or 7 d post-exposure. The cerebral cortex, heart, lungs, and plasma were assayed using an immune monitoring 48-plex panel. The results showed significantly dysregulated cytokine, chemokine, and growth factor concentrations compared to time-matched controls, principally in hearts, then lungs and plasma to a lesser extent, for the length of the study, with the cortex largely unaffected. Major significant analytes contributing to variance included eotaxin-1, IL-33, and betacellulin, which were generally downregulated across time. The results of this study suggest that cardiopulmonary toxicity may persist from a single fentanyl overdose and have wide implications for the endurance of the expanding population of survivors.

An Approach to Improve Endometrial Receptivity: Is It Beneficial to Flush The Uterine Cavity with Follicular Fluid and Granulosa Cells? A Phase III Randomised Clinical Trial.

The follicular fluid (FF) of mature oocytes contains a high concentration of growth factors and cytokines that have the potential to influence implantation in either a paracrine or autocrine manner. During the physiological processes of ovulation, FF enters the fallopian tubes in conjunction with the oocyte. The purpose of this study is to evaluate implantation and clinical pregnancy rates following uterine flushing with FF and granulosa cells in infertile women with moderate male factor infertility after ovum retrieval for intracytoplasmic sperm injection (ICSI). This phase III randomised clinical trial enrolled 140 women with moderate male factor infertility who intended to undergo ICSI at Royan Infertility Clinic (Tehran, Iran). A computer-generated program and opaque sealed envelopes were used to randomly allocate patients to either an intervention group (n=70) or a control group (n=70). Participants in the intervention group received 2 ml of clear FF (without blood contamination) from 2 to 3 dominant follicles after oocyte retrieval. The control group only underwent uterine cavity catheterisation. The intervention group had a clinical pregnancy rate of 38.5% (25/65) compared to the control group [42.9% (27/63); P=0.719] and an implantation rate of 24.1% compared to the control group (27%; P=0.408). These rates did not differ between the groups. There were no statistically significant differences between the intervention and control groups in terms of pregnancy-related complications-ectopic pregnancy, blighted ovum or anembryonic pregnancy, and abortion. Uterine cavity flushing with FF from mature follicles following oocyte retrieval had no effect, either positively or negatively, on clinical pregnancy or implantation rates in women with moderate male factor infertility (registration number: NCT04077970).

Impact of concentrated growth factor (CGF) injection on acceleration of orthodontic tooth movement in rabbits

BackgroundThe present study aimed to assess how a concentrated growth factor (CGF) injection affects the rate of orthodontic tooth movement in rabbits.MethodsThis experimental investigation employed a split-mouth configuration. Before orthodontic mesialization of the maxillary first molars, CGF was prepared and administered using submucosal injections on the buccal and palatal sides of the maxillary first molars in one randomly assigned quadrant. The opposite quadrant was used as a control. The study examined four time points:1, 2, 3, and 4 weeks. The measurement of tooth movement was conducted at each follow-up point using a digital caliper. The rabbits were euthanized, and their maxillary segments, specifically the maxillary first molars, were studied histologically to identify any alterations occurring on both the tension and compression sides.ResultsSignificant tooth movement was observed in the experimental sides versus control sides in the second, third, and fourth week of follow-up periods (p ≤ 0.05). Histologically, on the compression side, the CGF group showed bone resorption and periodontal ligament active reactions from the first week and continued throughout the next three weeks. Also, on the tension side, the CGF group depicted cementoblastic and osteoblastic activities from the first week followed by fibroblastic activities from the second week and all activities continued till the fourth week.ConclusionsCGF has the potential to effectively enhance orthodontic tooth movement without adverse clinical or histological effects.

Platelet-Rich Plasma: Characteristics and Current Review of its Use in Surgery.

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&apos;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.

P-329 Evaluating Implansera, autologous platelet-derived growth factors, to improve clinical pregnancy and live birth rates in frozen embryo transfer for women with recurrent implantation failure

Abstract Study question Can Implansera, Autologous Platelet-Derived Growth Factors, serve as a promising adjuvant therapy in assisted reproductive techniques to enhance endometrial thickness and implantation rates? Summary answer Use of Implansera significantly increased clinical pregnancy and Live Birth Rate In Patients With repeated implantation failure during FET cycles. What is known already Insufficient endometrial thickness and receptivity contribute to Recurrent Implantation Failure (RIF), prompting consideration of surrogacy. Despite global rise in Frozen Embryo Transfer (FET), quest for an optimal implantation protocol persists. Recent research highlights platelet-rich plasma (PRP) as promising solution for thin endometrium and RIF cases, attributing positive outcomes to PRP’s high growth factor concentration. Recognizing the need for precise platelet and growth factor concentrations, Implansera—a specialized platelet-derived growth factor concentrate—was developed. This innovation addresses the challenge of unresponsive endometrium, offering tailored solution to maximize therapeutic efficacy and improve pregnancy outcomes for patients facing RIF issues. Study design, size, duration Conducted from May 2021 to December 2023, this prospective interventional self-controlled study focused on 21 women (aged 30-48) experiencing recurrent IVF failure due to stubborn thin endometrium. Selected after negative hysteroscopic and bacteriologic screenings, and unsuccessful pregnancies despite multiple immune therapy regimens, such as intralipid and granulocyte colony-stimulating factor infusions, steroids, and endometrial scratching. The subjects underwent Implansera treatment, aiming to address refractory thin endometrium and potentially enhance their chances of successful conception. Participants/materials, setting, methods After obtaining informed consent women with at least two previous unexplained RIF, who were candidates for frozen-thawed embryo transfer were treated with intrauterine infusion of 0.8 ml of Implansera was infused into uterine cavity in addition to standard HRT protocols 2 days before ET. Clinical pregnancy was determined by positive serum β-HCG, 2weeks after ET and presence of fetal heart beat in trans-vaginal ultrasound 5weeks after ET. Main results and the role of chance Among 21 women, 10 achieved pregnancy (47.6%), while 11 did not conceive (52.4%). Clinical outcomes varied: 1 woman (4.8%) experienced chemical pregnancy, 3 (14.3%) miscarried before 6-12 weeks, 3 (14.3%) delivered healthy full-term babies, and 3 (14.3%) are in the 24th week of uneventful gestation accounts for 28.6% cumulative successful pregnancy outcomes. Implansera treatment yielded no reported adverse effects.Implansera, prepared through a patented proprietary process, standardized to contain 6-9 times higher growth factors than peripheral blood, particularly implantation-friendly and anti-inflammatory cytokines, addresses the crucial angiogenic and anti-inflammatory requirements for successful implantation. Tailored for the cyclical demands of endometrial proliferation, secretion, and implantation phases, it efficiently restores impaired uterine environments.Beyond efficacy, Implansera’s safety, reproducibility, and effectiveness in emulating natural tissue repair and regeneration processes are noteworthy. Studies underscore the significance of creating an environment conducive to successful implantation, and Implansera’s composition aligns with these requirements. Its capacity to mimic natural processes positions it as a promising solution, offering a comprehensive approach to enhancing endometrial receptivity, thus optimizing conditions for successful pregnancies. Limitations, reasons for caution This self-controlled prospective study, albeit with small sample size and lacking randomized control group, aligns with published data in demonstrating Implansera’s benefits. Proposing larger studies, particularly with unexplained RIF, to establish Implansera as routine IVF adjuvant. Further investigations aim to identify active molecules influencing implantation and suggest targeted recommendations. Wider implications of the findings Implansera improved implantation, pregnancy, and live birth rates (LBR) in unexplained RIF patients which indicates clearly endometrial thickness and receptivity improvement and motivated us to plan randomized controlled studies to confirm the results and provide opportunity for women with unexplained RIF to conceive and deliver in lesser number of cycles. Trial registration number Not applicable

O-151 Endometrial preparation using CONCEIVF algorithm with intrauterine and sub-endometrial endosera administration for enhanced pregnancy rates in women with thin endometrium

Abstract Study question Could personalized regenerative medicine based strategies promote endometrial growth and receptivity in women with refractory thin endometrium resulting in successful implantation and live births? Summary answer Personalized regenerative medicine based strategies remarkably promote endometrial growth and receptivity in women with refractory thin endometrium resulting in successful implantation and live births What is known already Thin endometrium (&amp;lt;7mm) is considered sub-optimal for embryo transfer and associated with reduced pregnancy chances. Regenerative medicine based strategies utilizing stem cells, growth factors alone or in combination for endometrial regeneration have been proposed as futuristic clinical therapies. Data-intensive biomedical technologies in research studies reveals that humans vary widely at genetic, biochemical, physiological, exposure and behavioral levels, especially with respect to disease processes and treatment responsiveness. Hence there is a need to deeply ‘personalize,’ interventional strategies at clinical and dosage level for individual patients. Study design, size, duration In this self- controlled study, 60 women with history of more than 3 failed IVF cycles due to persistent refractory thin endometrium (&amp;lt;7mm) were enrolled between July 21-December 23. 42 women were treated with intrauterine administration of Endosera and 18 patients were treated with sub-endometrial administration of Endosera as suggested by CONCEIVF - Proprietary Algorithm from Seragen.. Endosera is Autologous platelet derived implantation friendly anti-inflammatory cytokines and concentrated growth factors and progenitor cells. Participants/materials, setting, methods CONCEIVF-Algorithm classifies patients (High, Moderate, Poor responders) based on age, BMI, clinical history, guiding standardized dosage routines for proliferative, secretory, implantation phases including CD 33/CD34 cells minimal threshold, are specified. Intrauterine Endosera administration, 2 or 3 times from menstrual cycle day 5 during FET, precedes embryo transfer. Sub-endometrial administration involves Endosera with endothelial progenitor cell support on cycle days 5-7, followed by embryo transfer two days after the final Endosera infusion in the subsequent cycle. Main results and the role of chance Clinical pregnancy rate was 77%(46/60), no pregnancy in 10 patients accounting for 17%. 50% (30/60) delivered healthy babies and 17%(10/60) of uneventful pregnancies are progressing. 3 patients (5%) had miscarriage between 6-8 weeks. Improvement in endometrium thickness (EMT) was 90% with mean difference of 1.9mm improvement in 54 patients. No adverse effects reported. 33 patients out of 42 conceived and 6 out of 42 patients did not conceive and 3 out of 42 patients are yet to undergo embryo transfer in the intra-uterine group. 13 patients out of 18 conceived and 4 out of 18 patients did not conceive and 1 out of 18 patient is yet to undergo embryo transfer in the sub-endometrial group. Live birth rate and on-going pregnancies are indicators of overall endometrial quality (thickness and receptivity) improvement and validates that personalization helps to achieve maximum success rate. 15 out of 60 patients who were referred to surrogacy have conceived. In women with a history of cycle cancellations due to thin endometrium, CONCEIVF algorithm recommended personalized Endosera dosages resulted in improved endometrial thickness, clinical pregnancy and live birth. Personalization holds the key for precision because now two patients are alike! Limitations, reasons for caution This prospective self-control study, contains small sample size and lacks randomized controlgroup. Our results are encouraging but large cohort of patients is needed to establish efficacy. of protocols and positive patient predictors score to strengthen Conceivf personalized recommendations. Wider implications of the findings Despite global rise in FET for diverse indications, ongoing efforts to find the optimal endometrial preparation protocol persist. Our personalized approach achieved cumulative 74% pregnancy rate (40/54 ETs done), inspiring planned randomized trials to validate results and help women with resistant thin endometrium to conceive without surrogacy. Trial registration number Not applicable