High Concentrations Of Growth Factors Research Articles

Autologous leucocyte and platelet rich in fibrin (L-PRF) - is it a competitive solution for bone augmentation in maxillary sinus lift? A 6-month radiological comparison between xenografts and L-PRF.

Much of the research published involves using artificial products, like xenografts and resorbable collagen membranes, after a prior Cone Beam Computer Tomography (CBCT) investigation. Nowadays, more accessible access, less financial costs, a biological approach, and faster healing are objectives that surround this procedure. Leucocytes and platelets rich in Fibrin (L-PRF) are a natural component with a high concentration of growth factors. Due to its regenerative properties and lack of complications, it is used in several medical fields, like orthopedics, dermatology, and oral surgery. This retrospective study aims to compare results in bone height and volume obtained through external sinus lift, either by using xenografts or autologous plasma rich in fibrin, by evaluating the quantity of new bone formation from a radiological point of view. Fifty-eight Caucasian patients were included in this retrospective study; 48 were submitted to xenograft procedure, and 10 were selected for L-PRF grafting material with simultaneous implant placement. Lack of clinical and histological studies performed on patients with L-PRF surgeries limited us in choosing a larger group for the radiological analysis. CBCT evaluation was performed before surgery and 6 months after. All patients selected for the study presented good general and oral health, acute oral and sinus infections excluded; smoking and periodontal disease were also criteria of exclusion. Two operators performed the measurements in pre-established landmarks in different time frames. The two independent groups were compared with the Wilcoxon rank-sum test for quantitative data. Qualitative characteristics were described as counts and percentages. All analyses were performed in an R environment for statistical computing and graphics. Mean bone height gain in the xenograft group in the regions was as follows: 7.44 for the anterior landmark, 12.14 for the median and 8.28 for the distal. The mean group height gained for the L-PRF group was 0.1 anteriorly, -0.18 for the median measurement, and 0.23 distally. We obtained excellent overall reliability for all the height measurements between the two operators. Further studies must be conducted to establish new sets of surgical protocols in case L-PRF alone is found to be a reliable, stable, biological alternative to the well-documented xenografts in external sinus lifts. Radiological results, although promising, must be further applied in long term clinical survival of the implants in the grafted sites. Also, studies combining L-PRF in conjunction with xenograft might bring improved clinical results in terms of reduced postoperative complications and accelerated healing.

Immunomodulation of Cancer Cells Using Autologous Blood Concentrates as a Patient-Specific Cell Culture System: A Comparative Study on Osteosarcoma and Fibrosarcoma Cell Lines.

The understanding that tumor cells might evade immunity through various mutations and the potential of an augmented immune system to eliminate abnormal cells led to the idea of utilizing platelet-rich fibrin (PRF), a blood concentrate containing the body's immune elements as an adjunctive therapy for localized tumors. This study is the first that evaluated the effect of PRF generated with different relative centrifugal forces (RCFs) on osteoblastic and fibroblastic tumor cell lines MG63 and HT1080 with regard to cell viability, cytokine and growth factor release, and the gene expression of factors related to the cell cycle and apoptosis. Our findings could demonstrate decreased cell proliferation of MG63 and HT1080 when treated indirectly with PRF compared to cell cultures without PRF. This effect was more distinct when the cells were treated with low-RCF PRF, where higher concentrations of growth factors and cytokines with reduced RCFs can be found. Similar patterns were observed when assessing the regulation of gene expression related to the cell cycle and apoptosis in both MG63 and HT1080 cells treated with PRF. Despite variations, there was a consistent trend of an up-regulation of tumor-suppressive genes and a down-regulation of anti-apoptotic genes in both cell types following treatment with high- and, particularly, low-RCF PRF formulations.

Do Intraoperative Platelet-Rich Plasma Injections Influence the Final Appearance of Vertical Scars after Breast Reduction? Spectrophotometric Analysis

Background: Platelet-rich plasma (PRP) has been shown to support wound healing and tissue regeneration due to its high concentration of growth factors and cytokines. This study aims to investigate the effect of intraoperative PRP injections on the final appearance of vertical scars after breast reduction, as well as to identify potential predictors of a scar’s aesthetic assessment using spectrophotometric parameters. Methods: In this prospective, randomized trial, 82 scars from 41 women who underwent bilateral breast reduction with an inverted T pattern were analyzed. PRP or a placebo substance (0.9% sodium chloride solution) was injected intraoperatively into the edges of vertical wounds. Spectrophotometric measurements of scar pigmentation were performed 3 and 6 months after surgery; additionally, two independent observers evaluated the aesthetic appearance of scars based on photographs. Results: The results showed that the use of intraoperative PRP injections did not significantly influence the final appearance of vertical scars after breast reduction. Conclusions: We indicated spectrophotometric variables (b) in the early stages of wound healing (after 3 months) that can be predictors of the final scar’s aesthetic outcome. This can be helpful in detecting scars that may need additional interventions to optimize the healing process.

A Comparison of Efficacy of Autologous Platelet-rich Plasma and Conventional Sutures in Anchoring Split Skin Graft on Wounds

Abstract Context: Split thickness skin grafting (STSG) restores cutaneous cover over wounds thus protecting the underlying surface from contamination, fluid loss and stimulates healing. Autologous platelet rich plasma (PRP) provides a large number of platelets and high concentration of growth factors which promote overall uptake of STSG. Aims: The aim of this study was to assess the immediate, subsequent adhesion and final take of STSG with application of PRP over recipient site. Methods and Material: 1 year Randomised Control Trial where 80 wounds of various aetiologies were randomised into intervention group (n=40) which received PRP before placing STSG on recipient site and control group (n=40) in which the graft was fixed in place with sutures alone. Immediate graft adhesion and subsequent graft uptake were compared between the two groups and statistical analysis was done with: SPSS Version 20. Results: Irrespective of aetiology, and size, among a total of 80 wounds 87.5% grafts had adhered by 1st minute of application in the intervention group compared to nil in control group (p< 0.0001). Graft uptake was assessed on first three consecutive dressings. There was significantly better graft uptake in intervention group compared to control group [third dressing uptake (98.29%, 93%, p< 0.0001) respectively].Difference in seroma and haematoma formation were also compared between the two groups and found to be not significant. (p>0.05) Conclusions: Application of topical PRP facilitates STSG uptake. It decreases operative time by decreasing mobility of graft over the wound bed. Thus, use of PRP improves outcome of split thickness skin graft in wounds of various aetiologies and we recommend use of the same at recipient site of STSG. CTRI/2021/06/034401

Enhanced Diabetic Rat Wound Healing by Platelet-Rich Plasma Adhesion Zwitterionic Hydrogel.

The skin is the largest organ in the human body and serves as a barrier for protective, immune, and sensory functions. Continuous and permanent exposure to the external environment results in different levels of skin and extracellular matrix damage. During skin wound healing, the use of good dressings and addition of growth factors to the wound site can effectively modulate the rate of wound healing. A dressing containing bioactive substances can absorb wound exudates and reduce adhesion between the wound and dressing, whereas growth factors, cytokines, and signaling factors can promote cell motility and proliferation. We prepared a functional wound dressing by combining platelet-rich plasma (PRP) and zwitterionic hydrogels. Functional wound dressings are rich in various naturally occurring growth factors that can effectively promote the healing process in various types of tissues and absorb wound exudates to reduce adhesion between wounds and dressings. Furthermore, PRP-incorporated zwitterionic hydrogels have been used to repair full-thickness wounds in Sprague-Dawley rats with diabetes (DM SD). Fibroblasts and keratinocytes were cultured with PRP, zwitterionic hydrogels, and PRP-incorporated zwitterionic hydrogels to assess cell proliferation and specific gene expression. Furthermore, PRP-incorporated zwitterionic hydrogels were used to repair full-thickness skin defects in DM SD rats. The swelling ratio of hydrogel, hydrogel + PRP1000 (108 platelets/mL), and hydrogel + PRP1000 (109 platelets/mL) groups were similar (~07.71% ± 1.396%, 700.17% ± 1.901%, 687.48% ± 4.661%, respectively) at 144 hours. The tensile strength and Young modulus of the hydrogel and hydrogel + PRP10000 groups were not significantly different. High concentrations of PRP (approximately 108 and 109 platelets/mL) effectively promoted the proliferation of fibroblasts and keratinocytes. The zwitterionic hydrogels were not cytotoxic to any cell type. High PRP concentration-incorporated zwitterionic hydrogels increased the rate of cell proliferation and significantly increased the expression of characteristic genes such as collagen, fibronectin, involucrin, and keratin. Subsequently, zwitterionic hydrogels with high PRP concentrations were used to repair full-thickness skin defects in DM SD rats, and a wound healing rate of more than 90% was recorded on day 12. PRP contains high concentrations of growth factors that promote cell viability, enhance specific gene expression, and have a high medical value in cell therapy. Zwitterionic hydrogels have a 3-dimensional interconnected microporous structure and can resist cell adhesion without causing cytotoxicity. Platelet-rich plasma-incorporated zwitterionic hydrogels further enhance the cellular properties and provide an effective therapeutic option for wound healing.

An Exosome-Rich Conditioned Medium from Human Amniotic Membrane Stem Cells Facilitates Wound Healing via Increased Reepithelization, Collagen Synthesis, and Angiogenesis.

Tissue regeneration is an essential requirement for wound healing and recovery of organs' function. It has been demonstrated that wound healing can be facilitated by activating paracrine signaling mediated by exosomes secreted from stem cells, since exosomes deliver many functional molecules including growth factors (GFs) and neurotrophic factors (NFs) effective for tissue regeneration. In this study, an exosome-rich conditioned medium (ERCM) was collected from human amniotic membrane stem cells (AMSCs) by cultivating the cells under a low oxygen tension (2% O2 and 5% CO2). The contents of GFs and NFs including keratinocyte growth factor, epidermal growth factor, fibroblast growth factor 1, transforming growth factor-β, and vascular endothelial growth factor responsible for skin regeneration were much higher (10-30 folds) in the ERCM than in normal conditioned medium (NCM). In was found that CM-DiI-labeled exosomes readily entered keratinocytes and fibroblasts, and that ERCM not only facilitated the proliferation of keratinocytes in normal condition, but also protected against H2O2 cytotoxicity. In cell-migration assay, the scratch wound in keratinocyte culture dish was rapidly closed by treatment with ERCM. Such wound-healing effects of ERCM were confirmed in a rat whole skin-excision model: i.e., the wound closure was significantly accelerated, remaining minimal crusts, by topical application of ERCM solution (4 × 109 exosome particles/100 μL) at 4-day intervals. In the wounded skin, the deposition of collagens was enhanced by treatment with ERCM, which was supported by the increased production of collagen-1 and collagen-3. In addition, enhanced angiogenesis in ERCM-treated wounds was confirmed by increased von Willebrand factor (vWF)-positive endothelial cells. The results indicate that ERCM from AMSCs with high concentrations of GFs and NFs improves wound healing through tissue regeneration not only by facilitating keratinocyte proliferation for skin repair, but also activating fibroblasts for extracellular matrix production, in addition to the regulation of angiogenesis and scar tissue formation.

Platelet Therapy and Ovarian Rejuvenation in Women with Premature Ovarian Failure

Introduction: Premature Ovarian Failure (POF) is a disease that occurs before the age of 40 due to dysfunction of the ovaries. In these women، the production and secretion of estrogen hormone is not done properly. Such a situation causes irregular or interrupted periods، disturbances in the ovulation process and occurrence of menopausal symptoms. Premature ovarian failure makes it difficult for women to get pregnant، so more research in this field is necessary.
 Conclusion: The results showed that one of the recommended ways to repair and regenerate the failing ovarian tissue was the use of platelet-rich plasma (PRP). The positive effects of PRP were dependent on the high concentration of growth factors in the alpha granules of platelets. The results of this review article showed that the use of platelet-rich plasma in restoring ovarian function could be considered as a treatment method in these patients.

Activated platelet-rich plasma accelerate endometrial regeneration and improve pregnancy outcomes in murine model of disturbed endometrium.

Platelet Rich Plasma (PRP) contains high concentrations of growth factors, therefore, PRP activation results in their release, stimulating the process of healing and regeneration. The study was conducted to check whether activated platelet-rich plasma (aPRP) treatment can improve regeneration of the endometriumin an experimental model of ethanol-induced disturbed endometrium. Seventy-two female Wistar rats were randomly assigned into the control group, disturbed endometrium (DE) group and aPRP treated group. Activation of PRP was performed by adding thrombin. All the animals were sacrificed on day 1, day 3, day 6 and day 9 and samples were taken from the miduterine horn. Quantification of Cytokine and chemokine profiles of activated and non-activated PRP for CCL2, TNF- α, IL-1β, CXCL8, CXCL10, IL2, IL4, IL-6 IL-10, IL-12, IL-17A, TGF- β, IFN-γ was carried out. Functional and structural recovery of the endometrium was analyzed by hematoxylin-eosin (HE) and immunohistochemical (IHC) analyses. HE confirmed proliferated epithelial lining and stromal reconstruction with decreased fibrosis in PRP treated group compared to the DE group. Epithelial thickness in aPRP treated on day 1, day 3, day 6 and day 9 revealed an significant increase (p ≤ 0.05). Significantly stronger IHC expression of alpha smooth muscle actin, Cytokeratin 18, Cytokeratin 19, Connexin-40, E-Cadherin, Claudin-1, Zona Occludin-1was found in the aPRP treated group compared to the DE group. Furthermore, aPRP treatment was associated with birth of live pups. Our results suggest that intrauterine administration of aPRP stimulated and accelerated the regeneration of endometrium in the murine model of disturbed endometrium.

P-350 Evaluation of EndoSERA Autologous Platelet Derived Growth Factors for improving clinical pregnancy and live birth rate in FET cycles for women with refractory thin endometrium

Abstract Study question Can Autologous Platelet Derived Growth Factors (hereafter EndoSERA) be used as promising coadjuvant therapy in assisted reproductive techniques to improve endometrial thickness and implantation rate? Summary answer Use of EndoSERA significantly increased endometrial growth, clinical pregnancy and Live Birth Rate In Patients With refractory thin endometrium during FET cycles. What is known already Inadequate endometrial thickness and receptivity are major causes for RIF and surrogacy is reasonable option when endometrium remains unresponsive to conventional treatments. Recent studies demonstrated platelet-rich plasma (PRP) improves pregnancy outcomes in thin endometrium and RIF patients. The mechanisms of PRP have not been completely elucidated, but laboratory studies have shown that the high concentration of growth factors in PRP can potentially speed up the healing process. Need for an optimized method to ensure right concentration of platelets and growth factors to maximize the therapeutic outcomes formed the basis for developing EndoSERA-implantation friendly platelet derived growth factors concentrate. Study design, size, duration In this prospective interventional self-controlled study, 55 women in the age group of 25-45 years from July 2018 to July 2022 with > 3 failed FET due to refractory thin endometrium, negative hysteroscopic screening for endometrial pathology, and negative bacteriologic screening and failed to get pregnant with multiple immune therapy regimens like intralipid infusions, granulocyte colony-stimulating factor infusions, steroid therapy, endometrial scratching were selected to undergo Endo-SERA treatment. Participants/materials, setting, methods After obtaining informed consent subjects were treated with intrauterine infusion of EndoSERA 3 times (Day7 and Day 12 of their menstrual cycle day and 2 days before ET). 54 patients underwent FET. Intrauterine infusion of 0.8 ml of EndoSERA was infused into uterine cavity in addition to standard HRT protocols. 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 Post EndoSERA administration endometrial thickness(ET) was significantly thicker (7.86 ± 0.22 vs 6.22 ± 0.31 mm; P <.05) in 98% of patients and optimal response to EndoSERA was considered to reach ET ≥ 7mm after 2nd EndoSERA dose administration. Only one patient’s cycle got canceled due to ET < 7mm. Out of 55 women, 42 became pregnant (76%) and 12 patients did not conceive (22%). 39 women (70.9%) had a clinical pregnancy and 5 women (9.1%) miscarried before 6-12 wks and 3 women (5%) had biochemical pregnancy. 33 women (60%) had delivered healthy full-term babies and one patient (2%) is in her 24th week of uneventful gestation. There were no adverse effects reported by the patients who were treated with EndoSERA. There are studies highlighting the need for an angiogenic and anti-inflammatory environment for successful implantation. EndoSERA is standardized to contain 6-9 folds higher amounts of growth factors than peripheral blood majorly implantation friendly and anti-inflammatory cytokines which restore impaired uterine environments and optimized for cyclical requirements of proliferation, secretion & Implantation phases of Endometrium. It has also been shown to be safe, reproducible, and effective in mimicking the natural processes of tissue repair and regeneration. Limitations, reasons for caution This prospective self-controlled study with small sample size lacks a randomized control group. While the beneficial effects observed in this study are improved than published data, larger study with patients recruited based on inclusion criteria of refractory thin endometrium is proposed for recommending EndoSERA as routine adjuvant during IVF procedures. Wider implications of the findings EndoSERA improved implantation, pregnancy, and live birth rates (LBR) in refractory thin endometrium patients which indicates clearly endometrial thickness and receptivity improvement and cumulative 62% has motivated us to plan randomized controlled studies to confirm the results and provide opportunity for women with refractory thin endometrium to conceive without surrogacy. Trial registration number Not Applicable

Use of platelet-rich fibrin (PRF) in the periodontology: A Review

Platelets play an essential role in wound healing and periodontal regeneration, so using platelet concentrates can speed up wound healing after periodontal treatment. Platelet-rich fibrin (PRF), an autogenous concentrated blood product, is a fibrin matrix comprising molecular and cellular elements that allow for optimum improvement and PRF also increases the production of osteoprotegerin, which causes osteoblast proliferation and acts as an osteoconductive and osteoinductive material, initiating bone regeneration. Platelet-rich plasma (PRP) and PRF are platelet concentrates prepared from the patient's own blood. Recent studies have focused on the development of therapeutic alternatives that are simple to prepare, non-toxic or biocompatible to living tissues, and inexpensive, with the potential to result in the local release of growth factors that accelerate hard and soft tissue healing. PRP is a plasma fraction that contains a high concentration of growth factors. PRF is a natural fibrin-based biomaterial derived from an anticoagulant-free blood harvest without any artificial biochemical modification, allowing fibrin membranes enriched with platelets and growth factors to be obtained. It facilitates the application of growth factors to the surgical area in a concentrated form, thereby accelerating wound improvement and regeneration. Platelet concentrates are used in many areas of dentistry, including soft tissue improvement, plastic periodontal surgery, gingival enlargement, ridge preservation, regeneration of bone defects, drug-related osteonecrosis of the jawbone, sinus augmentation, immediate implant placement, and implant osseointegration. Their use is preferred due to their ease of application and low cost. This paper reviews the current literature concerning the utilization of platelet-rich fibrin in periodontology. How to cite this article: Sağsöz A, Acun Kaya F. Use of platelet-rich fibrin (PRF) in periodontology: A review. J Med Dent Invest 2023;4:e230317. https://doi.org/10.5577/jomdi.e230317 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Comparative evaluation of the effectiveness of Titanium platelet rich fibrin (T-PRF) membrane and collagen membrane combined with xenograft in the treatment of mandibular class II furcation defects – A study protocol of randomized controlled trial

BACKGROUND Class II furcation is a significant clinical problem in dentistry. Its presence indicates advanced periodontitis. Different xenografts are available for the treatment of furcation involvement. Platelet concentrates that have been assimilated have a high concentration of growth factors, which has the added benefit of improving and accelerating healing. This study aims to compare the evaluation of effectiveness of T-PRF with xenograft and collagen membrane with xenograft in class II furcation defects. METHODS A one-year timeframe is going to be utilized to carry out the planned protocol, which is a randomised clinical trial. According to the inclusion criteria, 26 systemically healthy patients with class II furcation defects in mandibular molars will be included in the study. In Group I, xenograft and T-PRF (test group) will be condensed and in Group II, xenograft and collagen membrane (control group) will be condensed after the complete debridement of the furcation defect. Plaque index (PI), papillary bleeding index (PBI), Periodontal pocket depth (PPD), relative attachment level (R-CAL) and relative gingival marginal level (R-GML) will be evaluated as the clinical parameters. Cone-beam computed tomography (CBCT) will be performed to measure furcation height (FH), furcation width (FW), and furcation depth (FD) defects of mandibular molars. Data from each group will be evaluated at the time of surgery (baseline), and three and six months after the surgery. EXPECTED OUTCOMES Using xenograft (FIX OSS) combined with T-PRF, the authors anticipate better outcomes for class II mandibular furcation defects (test group). Improved clinical and radiographic outcomes in terms of PPD, R-CAL, R-GML and FH, FW, FD, are anticipated. CONCLUSIONS Using xenograft in combination with the T-PRF procedure is anticipated to have a better combined effect on periodontal parameters, including hard tissues and soft tissue outcomes. Registration: CTRI REF/2023/03/064367.

Pilot study on the effect of autologous activated platelet-rich plasma on diabetic foot ulcer wound healing and serum HbA1c levels

Context: Autologous activated platelet-rich plasma (aaPRP) is a platelet-based therapy with high concentrations of growth factors that enhance the process of wound healing and glucose normalization. Aims: To evaluate the safety and efficacy of systemic and local administration of autologous activated platelet-rich plasma in diabetic foot ulcer wound healing and patients’ serum hemoglobin A1C. Methods: Ten subjects were equally randomized to placebo and aaPRP treatment. The aaPRP was administered locally and intravenously. Wound surface area and serum HbA1c levels were recorded on days 0, 7, and 14. Results: Injection of aaPRP for two weeks shows better clinical outcomes in reducing wound surface area non-significantly (40.11 ± 43.22 vs. -8.29 ± 49%; p = 0.136) and serum HbA1c levels non-significantly compared to the control group (2.16 ± 0.54 vs. 1.64 ± 2.218%; p = 0.635). However, patients in the aaPRP group had significantly better control of HbA1c within the first week of treatment (1.39 ± 0.84 vs. -0.08 ± 0.92; p = 0.030). Conclusions: aaPRP could be considered a potential therapeutic strategy in patients with diabetic foot ulcers.

Role for platelet rich plasma as an adjuvant therapy in wound healing and burns

Abstract Background Platelet rich plasma (PRP) contains high concentrations of growth factors. Intuitively, these were thought to be of potential benefit in healing of chronic wounds, skin grafts and graft donor sites. This was echoed in retrospective studies and an individual case basis but had not been randomized. Methods A systematic search was carried out by two individuals, independently, on the MEDLINE, EMBASE and COCHRANE databases, according to PRISMA guidelines. All data analysis and statistics was pooled and analysed using the Cochrane RevMan Software. Results Split thickness grafts have been described by numerous authors, but PRP use did not offer a significant advantage in graft take in pooled results (MD 5.83, 95% CI − 0.69 to 12.25, random-effects, p = 0.08). The analysis of included randomized controlled trials has shown favourable split-thickness skin graft donor site healing in the PRP group (MD − 5.55, 95% CI − 7.40 to − 3.69, random-effects, p = < 0.00001) compared to the control group. For carpal tunnel syndrome, the pooled results showed no difference in functional scores vs steroid injections (SMD − 0.68, 95% CI − 1.47 to 0.10, randomeffects, p = 0.09) or indeed splinting groups. Conclusions With the current body of evidence, we conclude that the use of PRP as an adjuvant therapy in skin grafts, burns, carpal tunnel surgery or scars cannot be rationalised. A potential use of PRP is in donor site management but the cost of this would be difficult to justify. Level of evidence: Not ratable.

Advances and prospects of platelet-rich plasma therapy in veterinary ophthalmology.

In the recent decades, there has been a significant uptick on the use of platelet-rich plasma (PRP) as a better alternative for ophthalmologic therapies in pathologies, primarily of the ocular surface. PRP is a class of liquid platelet concentrate containing a supra-physiological concentration of platelets in a relatively small amount of plasma. Its potential to heal various tissues has piqued interest in its therapeutic application as a biomaterial in regenerative medicine. It is currently a popular therapeutic agent in plastic surgery, cardiothoracic surgery, reconstructive surgery, and even oral and maxillofacial surgery. Based on the data from in vitro and in vivo studies, it can be concluded that PRP possesses adequate therapeutic potential in ocular pathologies, especially those involving cornea. In addition, the high concentrations of growth factors (TGF-β, VEGF, EGF) present in the PRP accelerate the healing of the corneal epithelium. PRP has great therapeutic prospects in veterinary ophthalmology as a regenerative therapeutic modality. However, several variables are yet to be defined and standardized that can directly affect the efficacy of PRP application in different ophthalmic conditions. There is a shortage of research on the use of PRP in ocular surface defects compared to the number of studies and reports on the use of autologous and allogeneic serum eye drops. Therefore, a data-driven approach is required to generate consensus/guidelines for the preparation, characterization, and therapeutic use of PRP in veterinary ophthalmology. This review aims to inform readers of the latest research on PRP, including its preparation methods, physiological and biochemical properties, clinical applications in veterinary ophthalmology, and their safety and efficacy.

Platelet-rich plasma (PRP) as an alternative to fetal bovine serum (FBS) in the culture of mesenchymal stem cells in cell therapy

Stem cells (SC) are defined by having proliferation and differentiation properties, with cellular self-renewal capacity, due to these characteristics they are widely studied in the cell therapy field. The Mesenchymal Stem Cells (MSCs) represent the most studied population of SC, due to their capacity to originate cardiomyocytes, skeletal muscle, neural precursors, among other cells. To culture MSCs in the laboratory, culture medium supplemented with fetal bovine serum (FBS) must be used. Despite its extensive use in protocols for cell expansion, FBS presents potential risks that cannot be neglected and are difficult to eliminate from serum. An alternative to the use of SFB is platelet-rich plasma (PRP), which contains high concentration of growth factors (GFs) assisting in cell proliferation in vitro. The main objective of the study is to analyze the feasibility of replacing FBS with PRP from umbilical cord blood to supplement the cell culture medium.

Submucosal Injection of Activated Platelet-Rich Plasma for Treatment of Periodontal Disease in Dogs.

Periodontal disease is the most common oral disease seen in dogs, and its routine treatment usually involves dental scaling. Platelet-rich plasma (PRP) therapy may enhance the effectiveness of treatment of periodontal disease, delay the progression of the disease and decrease the time under anesthesia. However, its application in dogs is rarely discussed. The objective of this study was to evaluate the benefits of activated PRP for treatment of periodontal disease in dogs. 43 mL of whole blood was collected from six adult dogs and PRP extracted using the double centrifugation tube method. Subsequently, the PRP was activated using calcium chloride (A-PRP). Significantly elevated concentrations of PDGF-BB (7000.28 pg/mL), TGF-β (378.98 pg/mL), and VEGF (7.14 pg/mL) were detected in the A-PRP. Additionally, three of the dogs with stage 2-3 periodontal disease were enrolled in the clinical trial. Periodontal pocket depth, stage of periodontal disease, gingival index, horizontal bone loss, and alveolar bone density involving the maxillary third and fourth premolar and first molar teeth (107, 108, 109, 207, 208, and 209) were evaluated. Teeth were treated by dental scaling alone (control group) or by dental scaling followed by submucosal injection of 0.1 mL A-PRP per site. After 56 days, significant improvement in periodontal pocket depth, stage of periodontal disease, gingival index, and horizontal bone loss was observed in dogs injected with A-PRP. The high concentrations of growth factors in A-PRP likely contributed to this effect. The use of submucosal injections of A-PRP to treat canine stage 2-3 periodontal disease appears safe and effective for clinical practice.

Comparing the immunomodulatory properties of equine BM-MSCs culture expanded in autologous platelet lysate, pooled platelet lysate, equine serum and fetal bovine serum supplemented culture media.

Joint injury often leads to cartilage damage and posttraumatic inflammation, which drives continued extracellular matrix degradation culminating in osteoarthritis. Mesenchymal stem cells (MSCs) have been proposed as a biotherapeutic to modulate inflammation within the joint. However, concerns have been raised regarding the immunogenicity of MSCs cultured in traditional fetal bovine serum (FBS) containing media, and the potential of xenogenic antigens to activate the immune system causing rejection and destruction of the MSCs. Xenogen-free alternatives to FBS have been proposed to decrease MSC immunogenicity, including platelet lysate (PL) and equine serum. The objective of this study was to compare the immunomodulatory properties of BM-MSCs culture-expanded in media supplemented with autologous PL (APL), pooled PL (PPL), equine serum (ES) or FBS. We hypothesized that BM-MSCs culture expanded in media with xenogen-free supplements would exhibit superior immunomodulatory properties to those cultured in FBS containing media. Bone marrow-derived MSCs (BM-MSCs) were isolated from six horses and culture expanded in each media type. Blood was collected from each horse to isolate platelet lysate. The immunomodulatory function of the BM-MSCs was assessed via a T cell proliferation assay and through multiplex immunoassay quantification of cytokines, including IL-1β, IL-6, IL-8, IL-10, and TNFα, following preconditioning of BM-MSCs with IL-1β. The concentration of platelet-derived growth factor BB (PDGF-BB), IL-10, and transforming growth factor-β (TGF-β) in each media was measured via immunoassay. BM-MSCs cultured in ES resulted in significant suppression of T cell proliferation (p = 0.02). Cell culture supernatant from preconditioned BM-MSCs cultured in ES had significantly higher levels of IL-6. PDGF-BB was significantly higher in APL media compared to FBS media (p = 0.016), while IL-10 was significantly higher in PPL media than ES and FBS (p = 0.04). TGF-β was highest in APL media, with a significant difference in comparison to ES media (p = 0.03). In conclusion, expansion of equine BM-MSCs in ES may enhance their immunomodulatory abilities, while PL containing media may have some inherent therapeutic potential associated with higher concentrations of growth factors. Further studies are needed to elucidate which xenogen-free supplement optimizes BM-MSC performance.

Effectiveness of Lateral Elbow Tendinopathy Treatment Depends on the Content of Biologically Active Compounds in Autologous Platelet-Rich Plasma.

Autologous platelet-rich plasma (PRP) injection is an alternative treatment option for patients with lateral elbow tendinopathy. The treatment is supposed to accelerate tissue regeneration by providing high concentrations of growth factors derived from platelets. The aim of the study was to assess the relationship between the content of biologically active compounds in PRP and the clinical effect of the treatment. Thirty patients with lateral elbow tendinopathy treated with a single PRP injection, were evaluated. The pain intensity (measured by a visual analogue scale (VAS)), the pressure pain threshold (PPT), the grip strength and strength of the main arm and forearm muscle groups, and the functional outcome (measured by the Disability of Arm, Shoulder and Hand (DASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaires), were assessed before PRP injection and at one- and three-months follow-up. Flow cytometry measurements of the growth factors and inflammatory cytokines in PRP were performed, and the results were used to establish the relationship between those molecules and the clinical outcome. After three months from the intervention, the minimal clinically important difference in pain reduction and functional improvement was observed in 67% and 83% of patients, respectively. Positive correlations were found between the extent of pain reduction after three months and concentrations in the PRP of platelets, epidermal growth factor (EGF), vascular endothelial growth factor, and platelet-derived growth factors. The concentration of EGF in the PRP significantly correlated with an improvement in grip strength, strength of wrist extensors, and the size of functional improvement measured by the PRTEE. The local injection of PRP is a safe and effective treatment option for lateral elbow tendinopathy, and the clinical outcome is correlated with concentrations of its biologically active compounds.

The role of platelet-rich plasma in the mild and severe stages of atherosclerotic disease in mice.

Background: Platelet-rich plasma (PRP) has a high concentration of growth factors (GFs), which present a therapeutic wound healing effect. Despite having been correlated with an immunomodulatory function, the administration of PRP has not yet been investigated in atherosclerosis models. Aim: Evaluate the effect of lyophilized PRP on atherosclerosis in mice models through serum analysis. Methods: Animals received a high-fat diet for disease induction and a weekly PRP retro-orbital application. Effectiveness was evaluated by measuring inflammatory markers in plasma following the treatment of mice with either PRP or saline solution. Results: PRP was well characterized for platelet and GF concentrations; the atherosclerotic profile was established. Cytokine concentrations were altered after PRP applications. Conclusion: PRP could modulate the inflammatory pattern in the early stages of atherosclerosis.

Applications of Platelet Rich Plasma in Urology

Platelet rich plasma is a product obtained from vein whole blood sample, with a high concentration of growth factors, which have been reported to be beneficial for tissue regeneration. In the last few years, several assays that pretend to demonstrate the efficacy of platelet rich plasma in many disciplines, including urology, have been published. The aim of this assay is to develop a bibliographic review of the publications available about platelet rich plasma and urology. The search was based on PubMed database. Platelet rich plasma has demonstrated to be a safe and easy to obtain product, and it has also shown promising results in terms of efficacy in urology. However, it is necessary to conduct large, placebo-controlled, studies that can confirm or deny the effectiveness of platelet rich plasma before it can be used on urological conditions.