Effect Of Platelet-rich Plasma Research Articles

Platelet-rich plasma for the treatment of erectile dysfunction: a systematic review of preclinical and clinical studies.

There has been tremendous growth in regenerative medicine during the last decade. For erectile dysfunction (ED), after the inclusion of low-intensity shockwave therapy as a treatment modality for ED management by the European Association of Urology sexual health guidelines, intracavernosal injection of platelet-rich plasma (PRP) has gained popularity between urologists and patients as a novel ED therapeutic modality with initial promising results. However, limited clinical data exist regarding efficacy and safety in patients with ED. Furthermore, despite numerous preclinical studies in other tissues and organs, the mechanism of action for restoring erectile function remains undetermined. This systematic review aims to present the current status of preclinical and clinical evidence regarding the use of PRP as treatment option for ED. A systematic literature search was conducted using PubMed, Cochrane, and ScienceDirect databases, until February 2023 for studies exploring the effect of PRP on ED. We identified 517 articles, 23 of which were included in this review. These were 7 preclinical (of which 1 was a comparative trial and 6 were placebo-controlled randomized controlled trials) and 16 clinical studies (of which 1 was a comparative trial, 5 were randomized trials, and 2 were placebo-controlled randomized controlled trials). Preclinical data support the regenerative role of PRP in erectile tissue, in accordance with existing evidence in other tissues. Randomized clinical studies, as well as the first 2 available randomized, placebo-controlled clinical trials, showed promising efficacy and a lack of any adverse events. As PRP for ED is widely used worldwide, there is an urgent need for high-quality studies with long-term follow-up. Standardization of research protocols, especially on the quality of PRP preparation, is also needed.

Platelet-rich plasma alleviates knee arthritis in rats by inhibiting p65.

Knee osteoarthritis (KOA) is a chronic joint disease characterized by the degeneration of articular cartilage. In this study, we explored the potential therapeutic effects of platelet-rich plasma (PRP) and identified molecular targets for treating KOA. A rat model of KOA was established via the Hulth method and primary knee joint chondrocytes were isolated to evaluate the effects of PRP and shRNA targeting p65 (sh-p65). ELISA was used to detect inflammatory factors, including IL-6, IL-1β, and TNF-α. HE staining, Safranin O/Fast Green staining and Masson staining were performed to evaluate the morphology of articular cartilage, followed by detection of p65, COL2A1, ACAN, MMP13, and ADAMTS5 expression. The proliferation and apoptosis of primary knee chondrocytes were detected by the CCK-8 assay and TUNEL staining, respectively. Treatment with either PRP or sh-p65 decreased IL-6, IL-1β, and TNF-α levels in the peripheral blood of KOA rats and chondrocyte culture supernatants, increased COL2A1 and ACAN levels, and decreased MMP13 and ADAMTS5 expression. Furthermore, administration of PRP or sh-p65 exerted protective effects on articular cartilage, enhanced the vitality of knee joint chondrocytes, and inhibited apoptosis. Collectively, PRP inhibited inflammation, promoted chondrocyte proliferation and cartilage matrix secretion, and induced cartilage regeneration by suppressing p65 expression; these effects allow PRP to alleviate KOA progression. P65-based targeted therapy administered in combination with PRP might be a promising strategy for treating KOA.

Systematic review: Impact of stem cells-based therapy, and platelet-rich plasma in hair loss and telogen effluvium related to COVID-19

BackgroundThe incidence of hair loss (HL) and telogen effluvium (TE) in COVID-19 patients has been reported in several studies. ObjectivesEvaluate both the increased incidence of HL and TE in COVID-19 and the effectiveness of Platelet-Rich Plasma (PRP), Adipose-derived Mesenchymal Stem Cells (AD-MSCs), and Human Follicle Stem Cells (HFSCs) in these patients. MethodsThe protocol was developed by the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. A multistep search of PubMed, MEDLINE, Embase, Clinicaltrials. gov, Scopus, and Cochrane databases has been performed to identify papers focusing on HL and TE COVID-19 related, and papers focusing on AD-MSCs, HFSC, and PRP use. ResultsOf the 404 articles initially identified focusing on HL and TE, 44 were related to COVID-19, and finally, only 6 were analyzed. On the other way, 331 articles focusing on AD-MSCs, HFSC, and PRP were initially identified. Of these, only 6 articles PRP (n = 3), AD-MSCs, and HFSCs (n = 3) have been analyzed. ConclusionCollected data confirmed both an increased incidence of HL and TE in COVID-19 patients, preliminarily, the related effectiveness of AD-MSCs, HFSCs, and PRP without major side effects.

Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis

Background: Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit. No studies have evaluated the effect of PRP from 6 to 12 months in ankle osteoarthritis. Purpose: To assess the efficacy of PRP injections in ankle osteoarthritis over the course of 52 weeks. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In this 52-week follow-up trial, 100 patients with ankle osteoarthritis were randomized to a PRP group or placebo (saline) group. Patients received 2 intra-articular talocrural injections: at inclusion and after 6 weeks. Patient-reported outcome measures were used to assess pain, function, quality of life, and indirect costs over 52 weeks. Results: Two patients (2%) were lost to follow-up. The adjusted between-group difference for the patient-reported American Orthopaedic Foot & Ankle Society score over 52 weeks was −2 points (95% CI, −5 to 2; P = .31) in favor of the placebo group. No significant between-group differences were observed for any of the secondary outcome measures. Conclusion: For patients with ankle osteoarthritis, PRP injections did not improve ankle symptoms and function over 52 weeks compared with placebo injections. Registration: NTR7261 (Netherlands Trial Register).

(219) AUTOLOGOUS PLATELET-RICH PLASMA IMPROVES ENDOTHELIAL AND TADALAFIL-INDUCED RELAXATIONS IN CORPUS CAVERNOSUM FROM PATIENTS WITH ERECTILE DYSFUNCTION

Abstract Objectives Available clinical evidence suggests the potential therapeutic use of intracavernosal injections of platelet-rich plasma (PRP) to treat erectile dysfunction (ED). However, the effects of PRP on human cavernosal function have not been elucidated. Our aim was to evaluate the effects of acute exposure to autologous PRP on relaxant capacity of human corpus cavernosum (HCC) from patients with ED. Methods HCC strips were obtained from four ED patients undergoing penile prosthesis insertion and giving informed consent. Previous to intervention, PRP and platelet-poor plasma (PPP) were obtained from patients by apheresis and stored at -20°C until functional procedures. Endothelial relaxation to acetylcholine (ACh) was evaluated before and after 60 min exposure to PRP or PPP (1% v/v) in organ chamber. Relaxant response to the PDE5 inhibitor, tadalafil, was also evaluated in PRP or PPP (1%) treated HCC from the same patient. Results Average age of patients was 67-years-old (range 61-71) while hypertension and smoking history was present in 3/4, diabetes in 2/4, and obesity in 1/4. Mean platelet content in PRP was 1,096x10 9 /L (range 786 to 1,284 x109/L) while negligible platelet content was obtained in any PPP. Exposure to autologous PRP but not PPP significantly enhanced (p<0.0001 by two-factors ANOVA) ACh-induced endothelial relaxations (pEC50 5.75±0.65 vs. 7.16±0.50; Emax 57.3±14.8% vs. 88.5±2.0%; before and after 1%PRP, respectively). Additionally, HCC treated with autologous PRP displayed augmented relaxant responses to tadalafil (p=0.0018 by two-factors ANOVA) with respect to those treated with PPP (pEC50 6.08±0.5 vs. 6.82±0.51 for PPP and PRP, respectively). Conclusions Acute exposure to autologous PRP improves endothelial function and functional response to PDE5 inhibition. These results support the reported clinical improvement of erectile function in patients with ED and suggest that PRP injection might induce a functional effect on cavernosal tissue in addition to the claimed restorative/regenerative effect. Conflicts of Interest None

Clinical evaluation of autologous platelet-rich plasma therapy for intrauterine adhesions: a systematic review and meta-analysis.

This meta-analysis aims to evaluate the efficacy and safety of autologous platelet-rich plasma (PRP) administration in reducing adhesion recurrence and improving pregnancy outcomes in patients with intrauterine adhesion (IUA). We conducted a comprehensive search of Pubmed, Embase, the Cochrane Library, Web of Science, Scopus, and China National Knowledge Internet (CNKI) from inception to February 10, 2023, without any language or regional restrictions. We used random-effects models to assess odds ratios (OR) and weight mean differences (WMD) with 95% confidence intervals (CI). Our meta-analysis included a total of 730 patients from 10 clinical studies (6 RCTs and 4 non-RCTs). The results showed that PRP administration significantly increased endometrial thickness (WMD = 0.79, 95% CI: 0.40-1.19; P < 0.001; I2 = 0.0%), menstrual volume (WMD = 2.96, 95% CI = 2.30-3.61; P < 0.001; I2 = 0.0%), and days of menstruation (WMD = 1.13, 95% CI = 0.86-1.41; P < 0.001; I2 = 0.0%). Additionally, the clinical pregnancy rate was also improved (OR = 1.82, 95% CI: 1.19-2.78; P = 0.006; I2 = 0.0%). However, there was insufficient evidence to reach a conclusion regarding the effects of PRP on the recurrence rate of moderate to severe IUA, changes in AFS scores, miscarriage rate, and live birth rate. Our analysis confirms that autologous PRP is an effective treatment for IUA. However, the limited sample size suggests that the results should be interpreted with caution. Therefore, larger and well-designed studies are necessary in the future to confirm these findings and explore the optimal PRP dosing regimens further. https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023391115.

Assessment of the Effect of Phototherapy and PRP on the Immediate Implants: An Original Research.

Immediate implants have been gaining popularity in recent times. There are many adjuvant techniques that are followed before implant placement, which have recently shown hopeful results. For this reason, the current comparative study analyzes the effectiveness of platelet-rich plasma (PRP) and photofunctionalization (PF) at a tertiary care dental hospital. In the current clinical trial, 30 subjects were grouped equally to receive immediate dental implants, with one group in which pretreatment of the extraction site was done with the auto-PRP and PF, while the control group received no pretreatment. For 12 months after the placement of the implant, the subjects were observed for alterations in the parameters. The variables analyzed were survival, esthetics, biological integration, and finally the success of the implants in each group. Values were noted and compared using the appropriate statistical tools, while keeping the level of significance at P < 0.05. For the variables of esthetics and survival, no substantial differences were observed in the PRP and PF groups. There was no difference between these experimental groups and the control group. However, there were significant differences for the biological variable as there was more marginal bone loss in the experimental groups. On the whole, the success was greater for the experimental groups than the control group, though not significant. The pretreatment protocols using PRP and PF have shown to improve some characteristics of the immediate implants in the anterior regions. However, further studies are suggested.

Light and scanning electron microscopic study of the effects of platelet-rich plasma on dexamethasone-induced osteoporosis in adult male albino rats

Abstract Background Osteoporosis may occur by using glucocorticoids for a long time. Recently, platelet-rich plasma (PRP) is used in treating a wide variety of musculoskeletal problems. Aim This work aimed to study the effect of PRP against dexamethasone-induced osteoporosis in adult male albino rats. Materials and methods This study was carried out on 40 adult male albino rats that were divided into two main groups: control group I: included 10 rats and experimental group II included 30 rats, which were subdivided into three subgroups. Subgroup IIa received PRP, subgroup IIb was injected with dexamethasone intramuscularly, and subgroup IIc received the same dose of dexamethasone and then injected with PRP. At the end of the experiment, upper ends of femur bones of all animals were obtained and processed for histological study using light and scanning electron micrograph studies. Results Light microscopic examination revealed osteoporotic histological changes in group IIb where cancellous bone trabeculae appeared thin and discontinuous. Scanning electron micrograph studies confirmed the results of the light microscopic study. Group IIc revealed partial preservation of the normal histological picture. Statistical analysis showed that group IIb and untreated left femur of group IIc revealed a highly significant decrease in the mean thickness of trabeculae and a highly significant increase in the width of intertrabecular spaces as compared with the control group, while group IIa and treated right femur of group IIc revealed nonsignificant changes as compared with the control group. Conclusion Osteoporosis resulted from glucocorticoids in adult male albino rats could be partially treated with PRP injection.

Poster 374: Patient knowledge of and willingness to pay for platelet-rich plasma injections: A prospective survey study on orthopedic sports medicine patients

Objectives: The efficacy of platelet-rich plasma (PRP) injections for sports-related injuries is a hotly- debated topic. PRP is a cash-pay procedure that is not covered by insurance, and it is actively advertised for a number of different indications, some without supporting evidence. Yet, an increasing number of patients are asking their physicians for PRP injections. The aim of this study is to better understand patients’ knowledge of PRP and willingness to pay out of pocket. Methods: This ongoing Institutional Review Board-approved prospective study included patients presenting with a new chief complaint at a sports medicine orthopedic office in a large urban academic health system. Patients completed an anonymous survey prior to evaluation by an orthopedic surgeon. The survey collected demographic information, clinical information, knowledge of PRP, willingness to pay for PRP based on expected percentage pain reduction, and motivators behind willingness to pay. Two cohorts included: 1) patients who had heard of PRP and 2) patients who had not. The latter group was given a short educational excerpt on PRP. Two-tailed Mann-Whitney U and Kruskal-Wallis tests evaluated pain scores and willingness to pay for PRP between the cohorts. Spearman rank correlation tests evaluated correlations between household income and willingness to pay. Results: To date, we have enrolled 32 patients of which 37.5% had previous orthopedic surgery, 43.75% had seen another medical provider for their current symptoms and 37.5% had previously heard of PRP. Patients who had heard of PRP (versus those that had not) reported lower median pain scores (median 4.75 versus 5.0 out of 10), the same hindrance of daily activities (median 3.0 out of 5), and longer duration of symptoms (median 5.0 months versus 1.0 month), although not statistically significant. Patients were willing to pay more for a greater anticipated reduction in pain: median of $50, $250, and $500 for 25%, 50% and 100% reduction in pain, respectively (Table 1) (p&lt;0.05). Patients who had heard of PRP were willing to pay more for PRP (median $500 versus $200; Table 1); this was not statistically significant. There was no correlation between patients’ income and willingness to pay. Finally, regarding willingness to pay for a given percent reduction in pain, patients reported their top three motivators to be symptoms affecting their day-to-day life, desire to try non-surgical interventions, and desire to return to normal activity (Table 1). For patients who had not heard of PRP, after being informed of PRP these patients reported physician trust as the greatest motivator behind their willingness to pay (Table 1). Conclusions: This ongoing study demonstrates the correlation between willingness to pay and perceived effectiveness of PRP while also noting motivators to pay. Moreover, we were also able to demonstrate some differences between patients who had heard of PRP versus those that had not. These data may be further refined with ongoing enrollment and will provide important insights into patients’ knowledge and how this impacts decision-making in the context of PRP injections. [Table: see text]

Effect of Submucosal Injection of Platelet-rich Plasma on the Rate of Canine Retraction – A Split-mouth Randomized Clinical Study

Abstract Introduction: The use of platelet-rich plasma (PRP) has gained popularity in orthodontics in the past decade. PRP is an autologous concentration of platelets rich in growth factors and is hypothesized to play a role in orthodontic tooth movement (OTM) due to its bone remodeling capacity. Objective: The aim of this study was to determine the effect of PRP on the rate of tooth movement in humans. Materials and Methods: Fourteen patients requiring bilateral extraction of upper first premolars were included in the study. PRP (×4) was prepared and injected in the alveolar mucosa, distal to canine on experimental sides. Canine retraction was initiated on the same day of PRP injection using NiTi closed coil springs on both sides. The amount of canine retraction was measured and compared between both sides at the 4th, 8th, 12th, and 16th weeks by measuring the distance between lateral incisor and canine on the cast. Results: Results showed mean displacement of 1.355 mm, 1.232 mm, 1.191 mm, and 1.085 mm on experimental side and 1.265 mm, 1.126 mm, 1.031 mm, and 0.879 mm on control side at the 4th, 8th, 12th, and 16th weeks, respectively. Although increased OTM (13.85% or 1.1 times faster) was observed on experimental side at all time intervals compared to the control group, the result was not statistically significant. Conclusion: 4× concentration of PRP does not accelerate OTM significantly.

A systematic review of the therapeutic effect of platelet-rich plasma for treating traumatic brain injury

Abstract Traumatic brain injury (TBI) is the leading cause of death and disability worldwide and thus a significant public health concern. It can result in a range of physical, cognitive, and emotional impairments, which can significantly impact the quality of life of affected individuals and their families. Despite advances in the management of TBI, no effective treatment fully restores neurological function. Platelet-rich plasma (PRP) is a promising therapeutic approach for the treatment of TBI that has gained increasing attention in recent years. PRP is a blood product containing high concentration of platelets rich in growth factors and other bioactive molecules that can promote tissue repair and regeneration. PRP has been used in various clinical settings to accelerate healing and reduce inflammation, and there is growing evidence that it may have therapeutic benefits for TBI. This study seeks to gather evidence-based information on the therapeutic effect of PRP in the treatment of TBI. This protocol will follow the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis [PRISMA] guideline 2020. In this review, we determined four primary central databases as sources of information: PubMed, EMBASE, SCOPUS, and Cochrane Central Register of Controlled Trails. This Project was registered on the International Prospective Register of Systematic Reviews [PROSPERO]. Ethics and dissemination: Ethical approval for this study was not needed as we used alread y published studies to run this current study. Study findings will be published in journals and presented at conferences for broader dissemination. PROSPERO Registration N°: CRD42023426358.

Platelet-rich plasma influence on the sternal wounds healing: A meta-analysis.

A meta-analysis research was executed to appraise the effect of platelet-rich plasma (PRP) on sternal wound healing (SWH). Inclusive literature research till April 2023 was done and 1098 interconnected researches were revised. The 11 picked researches, enclosed 8961 cardiac surgery (CS) persons were in the utilised researchers' starting point, 3663 of them were utilising PRP, and 5298 were control. Odds ratio (OR) and 95% confidence intervals (CIs) were utilised to appraise the effect of PRP on the SWH by the dichotomous approach and a fixed or random model. PRP had significantly lower sternal wound infection (SWI) (OR, 0.11; 95% CI, 0.03-0.34, p < 0.001), deep SWI (OR, 0.29; 95% CI, 0.16-0.51, p < 0.001), and superficial SWI (OR, 0.20; 95% CI, 0.13-0.33, p < 0.001), compared to control in CS persons. PRP had significantly lower SWI, deep SWI, and superficial SWI, compared to control in CS persons. However, caution must be taken when interacting with its values since there was a low sample size of some of the nominated research found for the comparisons in the meta-analysis.

O-065 A multi-center randomized controlled trial of intraovarian injection of platelet rich plasma for women with poor ovarian response

Abstract Study question Does intraovarian injection of autologous platelet-rich plasma (PRP) improve oocyte yield in young patients with poor ovarian response (POR)? Summary answer Intra-ovarian PRP injection did not result in increased number of oocytes retrieved or improvement of any other relevant measured outcomes. What is known already POR is one of the major hurdles to overcome in patients undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF). Several methods have recently emerged to attempt follicular reactivation in these patients with a poor prognosis. One of them, the intra-ovarian injection of autologous PRP, demonstrated promising results in retrospective and prospective cohort studies. Study design, size, duration This was a multi-center, randomized controlled trial (RCT) to evaluate the efficacy of PRP in improving IVF outcomes in women with POR. Patients who met inclusion criteria (&amp;lt;38 years, two or more prior cycles with &amp;lt; 3 oocytes retrieved, and without single gene disorders, prior ovarian surgery, endometriomas, BMI &amp;gt;35, or severe male factor infertility) were randomized to either receive an autologous intra-ovarian PRP injection (PRP group) or no intervention (control group) prior to COH. Participants/materials, setting, methods A total of 83 patients were randomized to PRP group (n = 41) or control group (n = 42). After treatment, patients underwent COH, oocyte retrieval, intracytoplasmic sperm injection (ICSI), preimplantation genetic testing for aneuploidy (PGT-A), and single frozen euploid embryo transfer. Number of MII oocytes obtained was the primary outcome. Secondary outcomes included ovarian reserve tests (antral follicle count [AFC] and anti-Mullerian hormone [AMH]), blastocyst and euploid blastocyst yields, and sustained implantation. Main results and the role of chance No significant differences were observed in number of MII oocytes retrieved (3.1 ± 3.3 vs 2.8 ± 2.4 in PRP vs control, respectively; p = 0.9), blastocysts (1.3 ± 2.1 vs 1.0 ± 1.3, p = 0.8), or euploid blastocysts (0.9 ± 1.6 vs 0.8 ± 1.1; p = 0.5) per cycle. Similarly, no differences were observed in the likelihood of obtaining at least one euploid blastocyst (37 vs 45%, p = 0.4; relative risk [RR], 95% confidence interval [CI] 0.9, 0.6-1.2) or the rate of sustained implantation (29 vs 31%, p = 0.9; RR 1.0, 0.7-1.3). Pre- and post-treatment AFC in both groups (PRP: from 5.2 ± 3.2 to 7.9 ± 4.5, p &amp;lt; 0.0001; control: from 5.6 ± 3.3 to 6.8 ± 4.8, p = 0.02) were statistically significantly different, whereas AMH was different in the PRP group only (PRP: 0.73 ± 0.46 to 0.99 ± 0.98, p = 0.02; control: 0.70 ± 0.59 to 0.73 ± 0.57, p = 0.59). Limitations, reasons for caution Oocyte retrieval took place the cycle immediately following treatment; therefore, we could not evaluate long-term effects of PRP on ovarian reserve or response. Lack of a placebo group would limit interpretability had a difference between groups been observed. The effect of PRP on patients &amp;gt;38 years old was not studied. Wider implications of the findings Intra-ovarian PRP injection did not improve reproductive outcomes by any relevant measure. Our findings do not support wide utilization of PRP to improve IVF outcomes in women with POR. Trial registration number NCT04163640

P-692 Effect of intra-ovarian instillation of autologous platelet rich plasma on live birth rate in POSEIDON 3 versus POSEIDON 4 group: A prospective follow-up study

Abstract Study question What is the effect of intra-ovarian platelet rich plasma(PRP) on live birth rate(LBR) in POSEIDON-3 versus POSEIDON-4 group? Summary answer Intra-ovarian PRP improves the live birth rate in low prognosis patients irrespective of age, this giving them hope of their own biological child. What is known already With the emerging regenerative medicine promising various treatment modalities, PRP is considered a novel therapeutic option. Various anecdotal cases have been reported, demonstrating successful pregnancy outcomes after the PRP treatment. But the data still remains elusive, especially for women of Asian ethnicity, who have a rapid decline in ovarian reserve when compared to the Caucasian population. Consequently, we attempt to compare the effects of autologous PRP on LBR in POSEIDON-3 versus POSEIDON-4 groups. Study design, size, duration After ethical approval, a prospective interventional study was conducted at ART Centre, Department of Obstetrics and Gynaecology of a tertiary care institute during a period from July 2020 to April 2022. 72 women between the ages of 20 and 40 years with idiopathic poor ovarian reserve (AMH 1.2&amp;lt;ng/ml; AFC&amp;lt;5) and a normal adequate uterine cavity were enrolled, and those with a history of radiotherapy, chemotherapy, endometriosis, or ovarian/tubal surgery were excluded. Participants/materials, setting, methods Women between 20-40 years of age with low ovarian reserve received 1.5 ml-PRP prepared from 30 ml venous-blood, was instilled in each ovarian stroma between day 6-10 of menses. Patients were followed up for 3-consecutive months to assess ovarian-reserve parameters (FSH, AMH, AFC). Patients showing significant improvement (AFC&amp;gt;5) were enrolled in antagonist-IVF cycles and categorised into two groups: POSEIDON-3 vs 4 groups. Paired/signrank test and Independent/ranksum test compared clinical parameters between the two groups. Main results and the role of chance The mean age and BMI of the recruited women were 31.7 + 4.2 years and 24.89 + 3.73 kg/m2. Out of 72 participants, 16.67% responded in 1st month of follow-up(AFC: 5 vs 3,p&amp;lt;0.001), 43% in 2nd month(AFC: 6 vs 3,p&amp;lt;0.001)(AMH: 1.02 vs 0.99,p=0.02) and 12.5% in 3rd month(AFC:4 vs 3,p&amp;lt;0.001)(AMH:0.89 vs 0.85,p=0.01). 20 participants showed no improvement in AFC, AMH, or FSH. Excluding one, 43 underwent antagonist cycle. Despite the evident age-difference between the POSEIDON-3 and 4 groups(29.6 vs 36.6 years), the POSEIDON-4 group women were more obese (27.4 + 1.30 vs 23.3 + 0.49,p=0.0007). Although the number of oocytes retrieved was similar (6.35 + 1.83 vs 5.75 + 1.35,p=0.21), the E2 levels on the day of trigger were significantly low in POSEIDON-4 patients (1082.33 + 273.03 vs 1727.16 + 867.79,p=0.01). Also, the dose of HMG requirement was higher in POSEIDON-4 (1450 + 96.53 vs 1190.3 + 66.49,p=0.04) thus depicting the effect of advanced age. Otherwise, there was no significant difference in dose of rFSH requirement (2705.6 + 48.93 vs 2737 + 54.74,p=0.71), fertilisation rate (60.86% vs 57.86%,p=0.66), biochemical pregnancy rate (30.7% vs 29.03%,p=0.78), CPR (25% vs 25.8%,p=0.95) and LBR (22.6% vs 16.66%,p=0.66) between the two-groups. No adverse events reported. Limitations, reasons for caution Our study was a non-randomized study with no control/sham, arm as doing so would be unethical and impose a financial burden on the patients with no guaranteed clinical success. Wider implications of the findings With the impetus to provide a biological child to the women with poor ovarian reserve, ovarian-rejuvenation with PRP seems to be a promising treatment. It can be concluded that PRP improves the ovarian reserve which translates into better reproductive outcomes in women who were planned and counselled for donor-oocyte IVF. Trial registration number Not applicable

Platelet-rich plasma ameliorates neurotoxicity induced by silver nanoparticles in male rats via modulation of apoptosis, inflammation, and oxidative stress.

The widespread use of silver in various forms raises concerns about its potential adverse effects. Silver nanoparticles (AgNPs) can enter the brain and subsequently induce neurotoxicity. As a source of diverse growth factors and for its cytoprotective properties, platelet-rich plasma (PRP) has received considerable attention in regenerative medicine. Our aim was to estimate the toxic effects of AgNPs on the rat brain and assess the possible protective effects of PRP against AgNPs induced neurotoxicity. A total of 40 adult male rats were divided into four groups (n = 10), namely the control, AgNPs, AgNPs+PRP, and auto-recovery groups. AgNPs were given intraperitoneally (i.p.) at a 10 mg/kg dose.bw daily for 28 days. PRP was given (a day after AgNPs treatment) i.p. at a dose of 0.5 mL/kg.bw twice weekly for 3 weeks. Rats in the auto-recovery group were left without treatment for 3 weeks after AgNP toxicity. Serum and brain tissue samples were collected for assessment of proinflammatory cytokines, oxidative stress markers, as well as the expression levels of apoptotic markers. Brain histopathological and immunohistochemistry examinations were done. AgNPs significantly increased oxidative stress markers and proinflammatory cytokines, decreased antioxidant defense markers, and induced apoptosis and histopathological brain injuries. However, PRP treatment restored brain oxidant/antioxidant balance, attenuated the inflammatory state, prevented apoptosis, and improved the brain histopathological lesions induced by AgNPs, with no significant improvements shown by auto-recovery group. Our data provided a novel protective effect for PRP against AgNPs-induced neurotoxicity due to its antioxidant, anti-inflammatory, and antiapoptotic effects.

Injections of platelet-rich plasma prepared by automatic blood cell separator combined with topical 5% minoxidil in the treatment of male androgenetic alopecia.

Platelet-rich plasma (PRP) has been increasingly accepted as a potential therapy in the treatment of androgenetic alopecia (AGA), However, there remains a dearth of data on the effectiveness of PRP prepared by automatic blood cell separator with a combination of topical minoxidil for the treatment of AGA. To evaluate the efficacy and safety of PRP prepared by automatic blood cell separator combined with topical 5% minoxidil therapy in male AGA. Thirty male patients with mild/moderate AGA were enrolled in a randomized double-blind controlled study. Patients were randomly divided into two treatment arms: (group A) PRP prepared by automatic blood cell separator combined with topical 5% minoxidil group; (group B) PRP prepared by automatic blood cell separator combined with a topical placebo group. Trichoscopic assessments regarding hair density/quantity and mean hair diameter were performed at baseline and follow-up. Clinical efficacy of global photography and patient satisfaction were conducted to verify the therapeutic efficacy of the treatment, and the occurrence of adverse reactions was recorded. We detected a significant increase in all patients in hair density and quantity after PRP treatment (p < 0.05), and there was no significant difference in mean hair diameter. Although hair density/quantity was more pronounced in group A than in group B, the difference between groups was not statistically significant (p > 0.05). In terms of clinical efficacy and patient satisfaction, group A was superior to group B, and no serious adverse reactions occurred. We hereby conclude that the injections of PRP prepared by an automated method are effective and safe in the treatment of mild-to-moderate male AGA patients, and its combination with topical 5% minoxidil therapy was superior to PRP monotherapy with better clinical efficacy and higher patient satisfaction.

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.

Pulsed Radiofrequency and Platelet Rich Plasma in Degenerative Joint Arthritis: Two Case Reports and Literature Analyses.

(1) Background: Osteoarthritis (OA) is a debilitating joint disease. The are several therapies available for OA. According to current knowledge, the combination of Platelet-Rich Plasma (PRP) and Pulsed Radiofrequency (PRF) can be applied in the treatment of pain of nociceptive origin due to peripheral tissue damage. (2) Methods: We performed a narrative review identifying the articles by searching electronic databases. A retrospective analysis of patients with OA treated with PRF and PRP in "Vito Fazzi" Hospital (Lecce, Italy) was performed. (3) Results: A total of four publications on the use of PRP and PRF in degenerative joint arthritis were included in our review. In our experience, two patients with OA were treated with PRP and PRF after unsuccessful conservative treatment. Patient pain score, daily activity ability, active range of activity, and muscle strength improved after treatment. Patients reported a higher level of satisfaction. No major adverse events were reported. (4) Conclusions: The goal of the combined application of the two treatments is to make full use of the analgesic effect of PRF and the repairing effect of PRP. At present, the therapeutic potential of PRP and PRF in OA remains unmet.

Comparison of the effects of platelet-rich plasma and corticosteroid injection in rotator cuff disease treatment: a systematic review and meta-analysis.

Platelet-rich plasma (PRP) and corticosteroids are used to treat rotator cuff diseases. However, few reviews have compared the effects of these 2 treatments. In this study, we compared the effects of PRP and corticosteroid injection on the prognosis of rotator cuff diseases. According to the Cochrane Manual of Systematic Review of Interventions, the PubMed, Embase, and Cochrane databases were searched comprehensively. Two independent authors screened suitable studies and performed data extraction and risk of bias assessment. Only randomized controlled trials comparing the effects of PRP and corticosteroid in the treatment of rotator cuff injuries were included, as measured by clinical function and pain during different follow-up periods. Nine studies with 469 patients were included in this review. In short-term treatment, corticosteroids were superior to PRP in the improvement of Constant, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (mean difference [MD] -5.08, 95% confidence interval [CI] -10.26, 0.06; P = .05 and MD -0.97, 95% CI -1.68, -0.07; P = .03 and MD -6.67, 95% CI -12.85, -0.49; P= .03, respectively). No statistically significant difference was observed between the 2 groups at midterm (P > .05), and the recovery of the Simple Shoulder Test and American Shoulder and Elbow Surgeons scores in PRP treatment was significantly better than that in corticosteroid treatment in the long term (MD: 1.21, 95% CI: 0.68, 1.74; P < .00001 and MD: 6.96, 95% CI: 3.90, 9.61; P < .00001, respectively). In pain reduction based on visual analog scale score, corticosteroids led to better pain reduction (MD: 0.84, 95% CI: 0.03, 1.64; P = .04), but no significant difference was observed in pain reduction between the 2 groups in the any term (P > .05). However, these differences did not reach the minimum clinically important difference. Current analysis showed that corticosteroids have better efficacy in short term, whereas PRP is more beneficial for long-term recovery. However, no difference was observed in the mid-term efficacy between the 2 groups. Randomized controlled trials with longer follow-up periods and larger sample sizes are also needed to determine the optimal treatment.

Protective and Therapeutic Effect of Platelet-Rich Plasma on Experimental Cisplatin Ototoxicity.

Cisplatin is a chemotherapeutic agent with an ototoxic effect that is frequently used in head and neck cancers. There are studies in the literature conducted with various antioxidant substances to protect and/or prevent ototoxicity. This study aims to investigate whether platelet-rich plasma (PRP) has a protective and therapeutic effect on cisplatin ototoxicity. A total of 40 Sprague Dawley albino rats were divided into six groups as control group (n=6), PRP-only group (n=6), cisplatin group (n=6), cisplatin + PRP group (n=6), PRP + cisplatin group (n=6), and donor group (n=10). At the beginning of the study and the 8th day, they were tested with distortion product otoacoustic emission (DPOAE). Assessment of DPOAE results was based on the signal-to-noise ratio in 2000, 3000, 4000, 6000, and 8000 Hz frequency bands. On the 8th day, the rats were sacrificed. For histological examinations, the temporal bones were dissected and fixed. After hematoxylin and eosin staining, the tissues were evaluated by light microscopy. In the DPOAE tests performed on the 0th and 8th days of the cisplatin group, it was observed that cisplatin caused hearing loss in the rat ears. It was determined that the cisplatin group at 2000 Hz, 3000 Hz and 4000 Hz had a significant decrease in hearing compared to all groups (p<0.015), while the cisplatin group at 6000 and 8000 Hz was characterized by hearing loss at a higher rate than all groups (p<0.001). At the end of the study, negative effects of cisplatin on both cellular dimensions (cytoplasmic vacuolization, cell degeneration, dilatation, apoptotic cells, nerve degeneration) and hearing function were observed. No protective or therapeutic effect of PRP on cisplatin ototoxicity was observed. Our study showed that platelet-rich plasma did not have a significant effect in the treatment of hearing loss due to cisplatin ototoxicity and in preventing hearing loss in rats.