Conclusion Platelet-rich Plasma Research Articles

Comparison of the Effectiveness of Platelet-Rich Plasma Injection Versus Plantar-Specific Calf Stretching Exercises in Patients With Plantar Fasciitis: A Randomized Controlled Trial.

Background Plantar fasciitis is a common foot condition with multifactorial etiology. It is the most frequent cause of heel pain and has been categorized as an overuse syndrome. A clinical examination and history are crucial for diagnosis. There are several different forms of treatment available, two of which are frequently used: physical therapy and steroid injections. Recent research on platelet-rich plasma (PRP) has demonstrated encouraging outcomes and fewer side effects when compared to steroid injections. Methods A randomized controlled trial was conducted and randomization was done of indoor patients into two groups. Group 1, ending with odd numbers, was given PRP injections, and Group 2, ending with even numbers, was advised plantar-specific calf stretching exercises. Visual analog scale (VAS) scores were evaluated before and after the intervention and follow-up was done on the second, sixth, and 12th weeks. Results Comparing the VAS scores between the two groups, we found that in the pre-intervention phase, the VAS score of Group 1 was 5.4±0.56 and that of Group 2 was 5.4±0.59. In the post-intervention phase, the VAS score in Group 1 was 4.6±0.89, while in Group 2 it was 5.2±0.62. In the second week after intervention, the VAS score was observed to be 3.3±0.97 in Group 1, while in Group 2, it was 3.3±0.80. After the sixth week of intervention, the observed VAS score was 2.7±0.78, while in Group 2 it was 2.9±0.82. The mean VAS score after 12weeks of intervention was observed to be 2.3±0.91 in Group 1, while in Group 2, it was 2.2±0.80. Conclusion PRP injections and plantar-specific calf stretching exercises are equally effective in providing pain relief in plantar fasciitis. PRP injections have complications and problems which have been discussed. Exercises are devoid of such complications. No recurrences occurred in the exercise group and four cases had recurrence in the PRP group.

Platelet rich plasma injection in knee osteoarthritis: results after four years.

Background Knee osteoarthritis (KOA) is a progressive degenerative disease and a leading cause of disability worldwide. Intra-articular injection of platelet-rich plasma (PRP) is still a debatable symptomatic treatment and has provided multiple publications in literature with mixed results. Aim of the work To evaluate the short and long term effects of intra-articular injection of PRP on pain and functional status of the knee joint as measured by the Lysholm questionnaire and visual analogic pain scale (VAS). Patients and methods Twenty-one patients with primary Kellgren-Lawrence grade 3 KOA were assessed using the Lysholm questionnaire and the visual analogue scale for pain (VAS). A single PRP injection was administered, followed by reassessment of VAS at the first, fourth and eighth weeks after the injection. After eight weeks, patients were assessed with VAS and Lysholm questionnaire. In order to evaluate the long term effect of this single injection, we reassessed the patients four years after the injection using the same method. Results Fifteen females (71%) and six males (29%) with mean age 60 years (ranging from 44 to 76 years) were enrolled. After a single PRP injection, there was significant improvement in Lysholm and VAS. Before the injection, VAS medium score was 7 (ranging from 5 to 9) and we observed improvements in all assessments at the first (medium VAS 2), fourth (medium VAS 2) and eighth week (medium VAS 2) post injection and was still better than the pre injection score after 4 years (medium VAS 4). This was also observed in Lysholm score. The pre injection score was 41; at 8 weeks, 84; at 4 years, 66. Conclusion PRP injection achieves good results in the symptomatic treatment of Kellgren-Lawrence grade 3 KOA. This study confirmed that a single PRP injection can provide a long-term effect in pain reduction and functional status improvement in KOA, despite the progression of the disease. Further studies with more patients and randomized double blinded controlled studies are recommended to confirm these results.

The potency and safety of platelet-rich plasma and its therapy protocol for erectile dysfunction: A systematic review and meta-analysis of randomized controlled trials

Abstract* Background Platelet-rich plasma (PRP) is a novel treatment for erectile dysfunction (ED) that is considered to be a cost-effective option. It has demonstrated positive outcomes and minimal adverse effects. By injecting PRP into the intracavernous tissue, it has the potential to promote angiogenesis and neuroregeneration, leading to a potential permanent improvement in erectile performance. The potency and safety as well as the variety of PRP administration protocols in the treatment of ED are the objectives of this paper. Method Using certain terms, a systematic search was done on three different databases: Science Directs, Scielo, and PubMed. Papers about PRP therapy for EDs within the last decade, be randomized controlled trials (RCTs), and be original studies with freely available full-text content were included in this study. This article omitted letters to the editor, reviews, and editorials regarding PRP and ED. Results Three RCT were included in this studies. The improvement is observed at one month, three months, and six months after the treatment, compared to the baseline. PRP group participants met the Minimal Clinically Important Difference (MCID) in the International Index of Erectile Function-Erectile Function (IIEF-EF) at a higher percentage than those in the placebo group at both one month and six months. Injection of PRP leads to a superior enhancement in the IIEF-EF score, compared to a placebo, in patients suffering from ED at one month, three months, six months. Conclusion PRP is a proven therapeutic technique that has been shown to greatly enhance ED. Yet, to establish uniform guidelines for PRP in treating erectile dysfunction, further investigation into PRP, particularly in protocol development, is imperative.

The Role of Intra-Articular Injection of Autologous Platelet Rich Plasma versus Corticosteroids in Treatment of Synovitis in Lumbar Facet Joint Disease

Abstract Background Low back pain (LBP) is an extremely common health problem and lumbar facet joint (FJ) disease is one of its main causes. Intra-articular injection of FJ is one of the vital therapeutic methods for FJ disease. Corticosteroids (CS) are the most commonly used injected drugs; however, previous studies have indicated that it has limited ability in long-term relief of LBP. Aim of the Work to compare the efficacy of intra-articular injection of platelet rich plasma (PRP) versus CS in improving MRI detected synovitis in correlation to clinical complaints of the patients with lumbar FJ syndrome. Patients and Methods Thirty patients with lumbar FJ syndrome divided into two equal groups: Group ‘I’ injected with PRP and Group ‘II’ with CS. The patients were comparatively assessed pre and post the intervention according to; number of tender lumbar FJs on palpation, maximum active lumbar extension range of motion, LBP visual analogue score (VAS), functional disability questionnaires - Roland Morris disability questionnaire (RMQ) and Oswestry disability index (ODI) - and MRI lumbar FJ detected synovitis and their grading. Results Both study groups showed statistical significant improvement in all mentioned parameters at 3 month follow up, there was no statistically significant difference between the results of both groups, however, PRP injected joints showed better performance regarding MRI synovitis grade in all lumbar FJ levels as compared to those injected with CS. Conclusion Both PRP and CS injections were determined to be effective in improvement of MRI detected FJ synovitis concurrently with improving clinical parameters, pain and functional activities of the patients at 3 months follow-up. However, PRP showed superior effect in improving MRI detected synovitis grade, therefore may be a better treatment option for longer duration efficacy and fewer side effects. TRN NCT04860531- 1/3/2021

Comparison of the Efficacy Between Regional Nerve Block and Ring Block as Local Anesthetic Techniques for Platelet-Rich Plasma Treatment.

Introduction Platelet-rich plasma (PRP), a solution of concentrated platelets, has been widely used to promote wound repair and tissue regeneration. In the treatment of pattern hair loss, platelets in PRP secrete an abundance of growth factors, including platelet-derived growth factor (PDGF), fibroblast growth factor(FGF), and many more, which stimulate and increase signaling molecules and accelerate cell proliferation. In the PRP treatment for hair regrowth, the supratrochlear nerve (STN) block and supraorbital nerve (SON) block are given to anesthetize the scalp up to the vertex except for the temporal region. The ring block is the common local anesthetic technique usedby infiltrating local anesthetic agents around the target area. The primary objectives were to compare the pain and anesthetic success rates produced by regional nerve blocks and ring blocks. Materials and methods A sample size of 100 patients undergoing PRP treatment for hair regrowth were taken as the subjects for the study. Patients were allotted into two groups by randomization. Group 1 was given regional nerve blocks as the anesthetic technique used for local anesthesia, and group 2 was given ring blocks. In the study group, STN and SON blocks as the regional nerve blocks were given 2% lignocaine with 1:80000 adrenaline to anesthetize the area, and the PRP was injected from the anterior hairline up to the vertex of the scalp, not involving the occipital and temporal regions. In the control group, a ring block was given for the same procedure. Participants from both groups were assessed for the pain and analgesia caused by ring block and regional nerve blocks using the visual analog scale (VAS). Results A mean rank of 30.28 was observed for the regional nerve block technique, and a mean rank of 70.72 was observed for the ring block technique. A p-value of 0.00 that is <0.05 was observed, which shows there is a significant difference in the pain and the analgesia experienced by the subjects between the two groups, during and three hours after the procedure. Conclusion PRP is one of the most commonly used treatments for hair regrowth. The ring block is the common local anesthetic technique used for producing anesthesia, while regional nerve blocks are more effective in producing local anesthesia. This study proves that STN and SON blocks are better anesthetic techniques than the ring block technique for PRP treatment in hair growth.

Efficacy of Platelet Rich Plasma in Erectile Dysfunction: A Clinical Trial

Background: Platelet-rich plasma (PRP) is a treatment that uses a patient's own blood, processed to concentrate platelets and growth factors, to treat erectile dysfunction (ED). Erectile dysfunction (ED) is a common condition that affects men of all ages and can have a significant impact on quality of life. Platelet rich plasma (PRP) is a newer treatment option that involves injecting a concentrated solution of platelets into the affected area to promote healing and tissue regeneration. Objective: The purpose of the present study was to evaluate the efficacy of platelet-rich plasma (PRP) in treating erectile dysfunction (ED). Methodology: A prospective study was conducted to evaluate the efficacy of platelet-rich plasma (PRP) in treating erectile dysfunction (ED) with a sample of 50 patients in Dhaka, Bangladesh during the period of January 2022 to June 2022. The patients received PRP treatment and the improvement in erectile function was measured through standardized questionnaires and scales. Data were collected predesigned data collection sheet. Results: The average age of the study subjects is 53.70 years. The mean scores of the IIEF-EF domain showed a statistically significant improvement from 18.50 ± 3.60 before the procedure to 20.71 ± 3.71 after 6th months (p = 0.002). Sexual satisfaction also showed a statistically significant improvement, with a mean score increasing from 6.00 ± 0.57 before the procedure to 8.00 ± 0.85 after 6th months (p = 0.016). However, there were no statistically significant changes in the mean scores for orgasmic function and sexual desire (p = 0.113 and p = 0.389, respectively). The mean score for general satisfaction showed a small but statistically significant increase from 5.00 ± 0.29 before the procedure to 5.38 ± 0.24 after the 1st month (p = 0.027). Conclusion: In conclusion platelet-rich plasma (PRP) application provides short-term improvement in erectile function. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):71-75

A Comparative Study of Topical Procapil With Platelet-Rich Plasma Therapy Versus Topical Redensyl, Saw Palmetto, and Biotin With Platelet-Rich Plasma Therapy in the Treatment of Androgenetic Alopecia.

Background and aim Androgenetic alopecia (AGA) is a well-known hair loss disorder in both men and women affecting approximately 80% and 50% of the population, respectively. Various treatment options for AGA are available with varying efficacy. Combination therapy is a new dictum to combat AGA. Hence, this study aimed to compare the efficacy of commonly used topical therapies such as Procapil with platelet-rich plasma (PRP) and redensyl, saw palmetto (SP), and biotin (RSB) with PRP. Materials and methods This was a randomized controlled trial conducted on 54 male patients with AGA attending the outpatient department in a tertiary care hospital. Participants were randomly assigned into two equal groups (A and B). Group A participants were treated with Procapil with PRP, and group B participants were treated with redensyl, saw palmetto, and biotin with PRP at three weeks intervals for a total period of four sessions. Clinical improvement was assessed by serial hair photography by a third blinded observer and was recorded. Results A total of 54 individuals were included and were distributed into 27 each in group A and group B. AGA grading score was found significant between the groups with P< 0.05. Conclusion PRP with adjuvants redensyl, saw palmetto, and biotin can be a better alternative to the current therapies of PRP.

Comparative study between platelet-rich plasma intraarticular injection versus hyaluronic acid in knee osteoarthritis

Background Osteoarthritis (OA) is a major public health problem that causes pain and disability in one-third of all affected patients. It primarily affects the elderly populations. This study aimed to evaluate the efficacy of intraarticular injections of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in knee OA. Patients and methods This was a prospective study that included 40 adult patients with knee OA grades II and III, where 20 patients were treated with PRP intraarticular injection two injections 1 month apart (group A), and 20 patients were treated with HA injections generally administered as a weekly injection for 3 weeks (group B). Data were collected from January 2017 till February 2018. In group A, the age of patients ranged from 45.0 to 67.0 years; five (25%) patients were males and 15 (75%) patients were females; unilateral side was affected in four (20%) patients, and bilateral side was affected in 16 (80%) patients; and grade II OA cases were 12 patients, and grade III OA cases were seven (40%) patients. In group B, the age of patients ranged from 49 to 75 years; five (25%) patients were males and 15 (75%) patients were females; unilateral side was affected in eight (40%) patients, and bilateral side was affected in 12 (60%) patients; and grade II OA cases were 11 (55%) patients, and grade III OA patients were nine (45%) patients. The procedure was done on an outpatient basis and under complete aseptic technique. PRP or HA was injected intraarticularly through an anterolateral or anteromedial portal. Follow-up with the patients was for at least 6 months, and the results of treatment were assessed by the knee injury and osteoarthritis outcome score (KOOS). Results At the end of the follow-up period, which was 6 months, the KOOS in group A had improved to a mean score of 64.89 ± 17.97 points, as compared with the pre-injection score, which was 49.95 ± 14.21 points. In group B, at end of follow-up, the period score was 58.60 ± 19.10 points and the pre-injection score was 49.39 ± 19.97 points. Conclusion Both PRP and HA injections show significant improvement in grades II and III OA. The KOOS symptom subscale showed that PRP injections were more effective than HA injections in patients with grade II arthritis.

Efficacy of autologous platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: a randomized open-label trial

BackgroundPlatelet-rich plasma (PRP) is an adjunctive treatment in androgenetic alopecia (AGA). Its role as a monotherapy, when compared to FDA-approved therapies in moderate grades of androgenetic alopecia is not established.ObjectivesWe sought to study the efficacy and safety of standardized non-activated PRP preparation against topical minoxidil in AGA.MethodsMen aged 20–50 with Grade III and IV (Modified Hamilton-Norwood) AGA were randomized to receive 5% Minoxidil (×6 months) or PRP injections (monthly ×3). The primary endpoints were global photographic assessment at week 24, change in target area hair counts, density, and anagen hair at week 12. Other outcomes were subjects’ satisfaction and adverse events.ResultsIn total, 64 participants were randomized. At week 24, 56% responded to Minoxidil arm and 38% to PRP (p = 0.124). There was a significant increase in target area hair count and density at week 12 within the groups. The difference between the groups was not statistically significant. Adverse events occurred in 53% and 37% of the PRP and minoxidil groups, respectively. Patient satisfaction was better with Minoxidil.ConclusionPRP is effective in the treatment of moderate grades of androgenetic alopecia in men, although perhaps not different from minoxidil. Side effects occur more frequently with PRP.

Extracorporeal Shockwave Therapy Versus Platelet Rich Plasma Injection in Patients of Chronic Plantar Fasciitis: A Randomized Controlled Trial From a Tertiary Center of Eastern India.

Introduction Plantar fasciitis is a degenerative condition of the plantar fascia that leads to heel and sole pain. Physical modalities, physiotherapy, medication, and orthoses have been tried before as treatments. Extracorporeal shockwave therapy (ESWT) and the injection of autologous platelet-rich plasma (PRP) are generally effective in the treatment of plantar fasciitis, which might be resistant to other conservative measures. The present study compares the efficacy of ESWT and PRP injection in respect of symptomatic relief, functional improvement, and change in plantar fascia thickness (PFT). Methods Seventy-two patients were enrolled and randomized into two groups. Patients in the first group received ESWT, whereas patients in the second group received PRP injections. Patients were evaluated using the Visual Analog Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) score, along with PFTmeasurement (using ultrasonography) before the treatment and at days 15, 30, and 90 after the treatment. The X2 test was used to compare qualitative variables, and the paired T-test was used to evaluate quantitative data. Quantitative variables had a normal distribution with a standard deviation, and the significance level was set at P-value=0.05. Results On day 0, the mean VAS of the ESWT and PRP groups were 6.44±1.11 and 6.78±1.17, respectively (p=0.237). On day 15, the mean VAS of the ESWT and PRP groups were 4.67±1.45 and 6.67±1.35, respectively (p<0.001). At day 30, the mean VAS of the ESWT and PRP groups were 4.97±1.46 and 4.69±1.39, respectively (p=0.391). On day 90, the mean VAS of the ESWT and PRP groups were 5.47±1.63 and 3.36±0.96 (p<0.001). On day 0, the mean PFTs of the ESWT and PRP groups were 4.73±0.40 and 5.19±0.51, respectively (p<0.001). At day 15, the mean PFT of the ESWT and PRP groups were 4.64±0.46 and 5.11±0.62, respectively (p<0.001) which changed to 4.52±0.53 and 4.40±0.58 at day 30 (p<0.001), and to 4.40±0.50 and 3.82±0.45 at day 90 (p<0.001). The mean AOFAS of the ESWT and PRP groups were 68.39±5.88 and 64.86±8.95 on day 0 (p=0.115), 72.58±6.26 and 67.22±10.47 on day 15 (p=0.115), 73.22±6.92 and 74.72±7.52 on day 30 (p=0.276), and 72.75±7.90 and 81.08±6.01 on day 90, respectively (p<0.001). Conclusion Both PRP injection and ESWT are very effective methods to improve pain and cause reduced plantar fascia thickness in patients with chronic plantar fasciitis non-responsive to other conservative measures. PRP injection is more effective at a longer duration as compared to ESWT.

Platelet-rich plasma protects human keratinocytes from UVB-induced apoptosis by attenuating inflammatory responses and endoplasmic reticulum stress.

Although the role of platelet-rich plasma (PRP) in ultraviolet light B (UVB)-induced photoaging has been confirmed in many studies, the specific mechanism is still not clear. Therefore, we attempted to investigate the effect and mechanism of PRP on UVB-induced human keratinocyte (HaCaT cells) apoptosis. HaCaT cells were collected to construct UVB-induced photoaging models. Then, the cells were divided into Sham group, 5% PRP group, UVB group, and UVB + 5% PRP group. Next, MTT assay was used to detect the level of cell proliferation; flow cytometry to check the level of apoptosis; ELISA to determine the TNF-α, IL-18, IL-6, and IL-1β levels in the supernatant; and Western blot to test Bax, Bcl-2, cytochrome c (Cyt.c), GRP78, CHOP, and ATF4 protein expression levels. Briefly, 5% PRP intervention could relieve the inhibition of UVB on HaCaT cell proliferation, inhibit the promotion of UVB to cell apoptosis, up-regulate UVB-induced Bcl-2 protein expression, and decrease Bax and Cyt.c protein level. In addition, 5% PRP significantly down-regulated the inflammatory factor levels of TNF-α, IL-18, IL-6, and IL-1βin UVB-induced cells and reduced the inflammatory response. Moreover, 5% PRP also greatly reduced the protein expression levels of GRP78, CHOP, and ATF4 in UVB-induced cells and alleviated endoplasmic reticulum (ER) stress. PRP may protect HaCaT cells from UVB-induced apoptosis by alleviating inflammatory response and ER stress.

PRP from Personal Blood Relieves Joint Fluid-Inducing Synovial Injury through NF-κB Pathway and Mitochondrial Apoptosis in Human Synovial Fibroblast Cells.

Background Platelet-rich plasma (PRP) therapy is a new kind of biological therapy to retune the plasma concentrator into the patient's body for the treatment of osteoarthritis diseases. The present research aimsed to confirm the treatment effects of PRP against osteoarthritis injury and elucidate its potential mechanism via constructing a kind of cellular injury model of human synovial fibroblast cells (HSF cells) induced by synovial fluid from osteoarthritis patients. Materials and Methods HSF cells wereas firstly treated with the different doses of synovial fluid from osteoarthritis patients, and evaluated for the cellular injury via cell morphology and MTT assay. And then, the protective effect of PRP against cellular injury were examined by cell morphology and MTT assay. Following, flow cytometry and western blot assay were employed to evaluate the effect of PRP on mitochondrial apoptosis. Finally, the effect of PRP on NF-κB pathway-associated inflammation wasere examined by Elisa ELISA assay and western blot. Results The dilution ratio 1 : 5 of synovial fluid displayed an excellent injury effect against HSF cells and selected as the model condition. The data from cellular image and MTT assay showed that PRP with the doses 1 : 5 and 1 : 10 could alleviate the cellular mounts decrease in the damaged HSF cells. Flow cytometry, western blot, and Elisa ELISA assay displayed that PRP could relieve the cellular mitochondrial apoptosis and NF-κB pathway-associated inflammation in the damaged HSF cells. Conclusion PRP might relieve HSF cells injury induced by synovial fluid from osteoarthritis patients through alleviating the mitochondrial apoptosis and NF-κB pathway-associated inflammation.

Single versus Three Doses of Intraarticular Platelet-Rich Plasma Injection in Treatment of Early Osteoarthritis Knee Joint—A Prospective Comparative Study

Background Autologous platelet-rich plasma (PRP), which contains a pool of growth factors, appears to offer an easy solution for delivering multiple growth factors needed for tissue repair. The objective of the study is to compare between single versus three doses of intraarticular platelet-rich plasma injection in the treatment of early osteoarthritis knee joint. Materials and Methods A prospective comparative study was done on 100 patients with early osteoarthritis knee who were randomized into two groups in an alternating fashion—single-dose injection and triple-dose injection groups. PRP (5 mL) obtained by double-spin method was injected per knee and followed up at 1, 3, and 6 months and outcomes measured using WOMAC (Western Ontario and McMaster universities osteoarthritis index) and VAS (visual analog scale) scores. Results VAS scores showed a statistically significant difference in triple-dose group at all follow-ups. In WOMAC, such a difference was observed for stiffness subscore at all the follow-ups, but the pain subscore and total score showed an improvement only at the final follow-up with the functional assessment subscore showing no statistical difference at any follow-ups. Conclusion PRP injection appears to be effective in early symptomatic osteoarthritis with better clinical results using a triple-dose regimen.

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review.

ObjectiveThis paper reviews the research of platelet-rich plasma (PRP) in articular cartilage injury repair, to assess the mechanism, utilization, and efficacy of PRP in the treatment of articular cartilage injury, hoping to provide a theoretical basis for the clinical application of PRP in the future.Materials and MethodsA comprehensive database search on PRP applications in cartilage repair was performed. Among them, the retrieval time range of PRP in clinical trials of repairing knee cartilage injury was from January 1, 2021 to January 1, 2022. Non-clinical trials and studies unrelated to cartilage injury were excluded.ResultPRP can affect inflammation, angiogenesis, cartilage protection, and cellular proliferation and differentiation after articular cartilage injury through different pathways. In all, 13 clinical trials were included in the analysis.ConclusionPRP is an emergent therapeutic approach in tissue engineering. Most studies reported that PRP has a positive effect on cartilage injury, improving the joint function, meanwhile there is a lack of standardized standards. The technology of PRP in the repair and treatment of articular cartilage injury is worthy of further research.

Efficacy of Platelet-Rich Plasma in the Treatment of Fractures: A Meta-Analysis.

Background Although numerous studies have reported the effectiveness of platelet-rich plasma (PRP) in promoting and enhancing bone healing, many orthopedic physicians remain skeptical of platelet-rich plasma in the treatment of fractures. The objective of this meta-analysis was to assess the efficacy of PRP in the treatment of fractures. Methods We search for research on PRP treatment of fractures in Pubmed, Embase, Medline, and Cochrane libraries. Two independent reviewers assessed included studies and met to develop a consensus on included studies. We also assessed the risk of bias using Review Manager 5.3 software. Results The present meta-analysis included 10 randomized controlled trials (RCT) containing 652 patients. In the fixed-effect meta-analysis of 10 RCTs, 8 RCTs found that fracture patients benefited from PRP treatment. The use of PRP reduced the time of fracture healing in 4 RCTs. Three RCTs found that PRP adjuvant therapy enhanced bone mineral density in the fracture trace and reduced the time of bone regeneration in mandibular fractures patients (standardized mean difference (SMD) = −1.99, 95%confidence interval (CI) = −2.64–−1.35). And 3 RCTs found that PRP adjuvant therapy decreased the risk of revision surgery in fracture patients (SMD = 1.83, 95%CI = 1.10–3.04). Conclusion PRP adjuvant therapy is beneficial for the treatment of fracture patients, particularly those with mandibular fractures, and decreased the risk of revision surgery in fracture patients.

Nrf2/HO-1 pathway is involved the anti-inflammatory action of intrauterine infusion of platelet-rich plasma against lipopolysaccharides in endometritis

Objective(s) Endometritis is the inflammatory response of the uterine lining which is linked to infertility. Administration of platelet-rich plasma (PRP) represents a well-recommended strategy for the treatment of endometrium-associated infertility. In this study, we set to characterize the role and molecular mechanism of PRP intrauterine infusion in mice with endometritis. Methods A mouse model of endometritis was established using lipopolysaccharide (LPS). Mouse endometrial epithelial cells were obtained in primary culture. PRP-treated cells were assayed for proliferative and apoptotic activities. Moreover, iNOS expression and chemokine and inflammatory factor contents in cells were assessed using RT-qPCR and ELISA. The mice were subjected to PRP intrauterine infusion. The expression of genes related to uterine development was analyzed by qPCR and the ki-67 content and caspase-3 activation in endometrial tissues were examined by immunohistochemistry. Finally, the Nrf2/HO-1 pathway activity in tissues was examined by Western blot. Results LPS induced inflammatory cell recruitment and tissue damage in the endometrium of mice, along with significantly increased levels of inflammatory and chemokine factors. PRP significantly enhanced endometrial epithelial cell activity, decreased apoptosis, and reduced inflammatory factor secretion. In addition, PRP intrauterine infusion significantly increased the expression of genes related to uterine development, promoted tissue proliferation, decreased apoptosis, and diminished inflammatory response in endometrial tissues of mice. PRP intrauterine infusion significantly elevated Nrf2/HO-1 pathway activity in endometrial epithelial cells and tissues. Conclusion PRP intrauterine infusion significantly inhibited endometrial cell injury and alleviated the inflammatory response through activating the Nrf2/HO-1 pathway.

Platelet-rich plasma inhibits inflammation, apoptosis, and the NLRP3/Caspase-1 pathway and induces matrix metalloproteinases and proliferation of IL-1β-induced articular chondrocytes by downregulating T-box transcription factor 3

ObjectivesOsteoarthritis (OA) is a chronic joint disease characterized by osteoproliferation and the degeneration and destruction of articular cartilage. Platelet-rich plasma (PRP) is rich in various growth factors that have been reported to promote bone defect repair. This study examined the specific role and mechanism of PRP in OA.MethodsOA model cells were created by treating articular chondrocytes with IL-1β. After treatment of the model cells with PRP or/and a T-box transcription factor 3 (TBX3)-overexpression plasmid, TBX3 expression was monitored via RT-qPCR, western blotting, and immunofluorescence assays. IL-1β, IL-33, and Caspase-3 levels were detected with ELISA kits. Levels of NLRP3, Caspase-1, MMP9, MMP13, and COL2A1 expression were evaluated by western blotting, and cell proliferation was assessed by the CCK-8 assay.ResultsOur results showed that TBX3 expression was upregulated in IL-1β-induced articular chondrocytes. IL-1β stimulation induced inflammation and the production of matrix metalloproteinases, activated Caspase-3 and the NLRP3/Caspase-1 pathway, inhibited the proliferation of articular chondrocytes; however, all those affects mediated by IL-1β could be markedly reversed by PRP. We also found that PRP alleviated IL-1β-induced inflammation, apoptosis, and extracellular matrix degradation in articular chondrocytes by inhibiting TBX3. Our findings suggest that PRP alleviates OA progression in vitro by downregulating TBX3.ConclusionPRP suppressed OA progression in vitro by inhibiting TBX3, which may be its mechanism of action in treating OA.

The Effect of Calcium Gluconate on Platelet Rich Plasma Activation for VEGF-A Expression of Human Dental Pulp Stem Cells.

Objective Platelet-rich plasma (PRP) activation is an important factor in triggering the initial release of blood-derived growth factors from platelets. Vascular endothelial growth factor-A (VEGF-A) can be expressed by human dental pulp stem cells (hDPSCs) and plays an important role in dental pulp angiogenesis. The aim of this study is to analyze the effects of calcium gluconate on PRP activation in hDPSC VEGF-A expression. Materials and Methods Two types of PRP and their corresponding activators were analyzed in this study: PRP (activated using calcium chloride/CaCl 2 ) and PRP-T (activated using CaCl 2 with the addition of 10% calcium gluconate). hDPSCs were obtained by using an out-growth method (DPSCs-OG), and harvest between the fifth and sixth passages, then cultured in three different media groups: control, PRP, and PRP-T, which were planted in 96 wells (5 × 10 3 each well). The VEGF-A expression of hDPSCs was analyzed by using an ELISA test and observed at 24, 48, and 72 hours. Statistical Analysis This study was performed by using one-way ANOVA ( p < 0.05) test. Results There were significant differences between all groups ( p < 0.05) at 48 and 72 hours of observations, and no significant differences in the PRP and PRP-T groups at 48 and 72 hours of observations ( p > 0.05). Conclusion PRP and PRP-T were equally effective in inducing VEGF-A expression of hDPSCs.

Platelet-Rich Plasma versus Corticosteroid Injection for the Treatment of Lateral Epicondylitis: A Systematic Review of Systematic Reviews.

BackgroundLateral epicondylitis (LE) is one of the most commonly reported musculoskeletal disorders in the upper extremity. The mechanism of LE is repetitive motion that causes a strain of the extensor tendons. This consequently causes pain and tendinosis at the tendinous attachment site on the lateral epicondyle. Most cases of LE are treated nonoperatively with a variety of interventions, such as injections.PurposeThe aim of this systematic review (SR) is to synthesize the current evidence on the efficacy of platelet rich plasma (PRP) injections versus corticosteroid (CS) injections as treatment interventions for LE.Study DesignSystematic ReviewMethodsOnline databases were searched from database inception to February 24th, 2020 for relevant SR’s evaluating PRP vs. CS injections as treatment methods for LE. Two independent researchers searched and screened for articles that were systematic reviews that directly compared PRP to CS injections for LE.ResultsA total of five SR’s were included in this review that were published between 2016 and 2020. CS injections were more efficacious for short-term pain relief, and PRP injections were more efficacious for long-term pain relief and improved function.ConclusionPRP injections appear to be a more effective long-term treatment option than CS injections for those with LE who did not respond to conservative management.Level of evidence1

Evaluation of autologus platelet-rich plasma versus silver nitrate in the treatment of cervical erosion

Background Cervical erosion is identified by the existence of columnar cells on the ectocervix rather than on the squamous epithelium. Adolescent age, pregnancy, and hormonal contraception are all causes of erosion. Some doctors think erosion is a typical asymptomatic variation, while others believe it is caused by persistent cervicitis. Metaplastic columnar epithelium may cause a variety of symptoms such as vaginal discharge, leukorrhea, postcoital bleeding, pelvic discomfort, and dyspareunia. Laser ablation, microwave ablation, platelet-rich plasma (PRP) injections, herbal treatments, and cryosurgery have all been reported as therapeutic options. Aim Evaluating the therapeutic effect of applying an autologous PRP in cervical erosion versus chemical cautery with silver nitrate. Patients and methods Randomized controlled clinical study on 100 patients at the outpatient clinic of the Obstetrics and Gynecology Department, Faculty of Medicine, Tanta University Hospitals. A total of 50 patients was assigned as the PRP group), the study group, while the other was the silver nitrate group. Follow-up visits occurred on the 1st, 2nd, 4th, 6th, 8th, 10tht, and 12th week posttreatment for the lesion size changes, symptom relief, postprocedure discomfort, pain, and long-term complications. Results PRP and silver nitrate are now being used to treat symptomatic patients with cervical erosion. Because it resulted in a faster tissue healing time and fewer complications, autologous PRP has the potential to replace alternative unpleasant treatment options such as cautery, with promising results for inflamed and injured cervical tissue with erosion repair. Conclusion PRP shows no immunogenic difficulty or ethical matters as autologous. It stops damage to the cervix and hence prevention from cervical cancer.