Local Administration Of Platelet-rich Plasma Research Articles

Clinical efficacy of Platelet-Rich Plasma versus local Methylprednisolone Injection in Lateral Epicondylitis.

To compare the results of local administration of platelet-rich plasma (PRP) with methylprednisolone in the treatment of tennis elbow. This retrospective cohort was conducted at Jinnah Postgraduate Medical Center (JPMC) during January 2017 to April 2018. Patients conservatively managed for lateral epicondylitis with local methylprednisolone injection or PRP injection were approached for possible inclusion in the study at 12 months of treatment. The primary outcome of the study was to determine the Numerical Pain Rating Score (NPRS) on resisted wrist extension. Whereas, the secondary outcomes were quick disability arm, shoulder, and hand score (qDASH), the grip strength and VAS for satisfaction. The baseline, six weeks and three month data on Grip strength, NPRS, and qDASH were extracted from the patients' medical records maintained at the hospital. The data were analyzed by using SPSS software. A total of 91 patients were approached, of them 81 (89.01%) agreed to participate. There were 46 (56.79%) who received local methylprednisolone injection and 35 (43.20%) received PRP. At 12 months follow up, there was no difference in NPRS pain scores between the two groups (p=0.691); pain decreased in both groups at six weeks and at 12 months. There was no significant difference in the functional outcome (qDASH score) in both groups. Both groups were equally satisfied with the treatment they had received. The study concluded that there is no difference between outcome and efficacy of both treatment modalities used for the treatment of tennis elbow in alleviating pain at 12 months.

OVARIAN TOXICITY OF FAC CHEMOTHERAPY IN RATS AND POSSIBILITY OF ITS CORRECTION WITH PLATELET-RICH PLASMA.

To compare thedynamics of changes in thehormonal status of female rats in thesetting of theFAC (5-fluorouracil, doxorubicin and cyclophosphamide) chemotherapy and after local administration of platelet-rich plasma (PRP). Thestudy was carried out on female Wistar rats treated according to theFAC chemotherapy scheme (4courses with a 3-week interval). Theovariotoxic effect of theFAC chemotherapy was assessed by thelevels of anti-Mullerian hormone, estradiol (E2) and follicle-stimulating hormone in theproestrus phase. Three weeks after thelast course of chemotherapy, 5rats were administered with local intra- and periovarian injection of PRP (triply with a 1-week interval). Thedynamics of all investigated hormonal markers of theovarian reserve in experimental animals was characterized by a progressive decrease in anti-Mullerian hormone and E2levels and an increase in follicle-stimulating hormone level. Thedynamics of thestudied parameters after theserial administration of PRP demonstrated an improvement in thehormonal status. FAC chemotherapy in theexperiment causes premature ovarian failure, and local administration of PRP improves thehormonal parameters of theovarian reserve.

The retrospective analysis of platelet-rich plasma and corticosteroid injection under epiduroscopic guidance for radiculopathy in operated or unoperated patients for lumbar disc herniation.

Epiduroscopy is a treatment method that can be applied to operated or non-operated patients with lumbar disc pathology. The aim of our study was to investigate and compare the efficacy of corticosteroid and platelet-rich plasma (PRP) therapy that we have injected in epidural and foraminal spaces under the guidance of epiduroscopy in the operated or unoperated patients with radicular pain. The retrospective study was conducted with 62 patients (40 females, 22 males; mean age: 48±12.3 years; range, 20 to 75 years) between January 2014 and September 2020. Of the patients, 32 were unoperated, whereas 30 were operated. All the patients had radicular pain. All the patients were evaluated by the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) at the start, on the 10th day, and at one and six months after the procedure by polyclinic control and by a phone call for their last follow-up. The VAS and ODI scores of patients treated with corticosteroid and PRP were decreased on the 10th day, at one and six months and the last follow-up, and this decrease was statistically significant. Both PRP and corticosteroid injections were effective in pain scores during short-term and long-term follow-ups owing to the contribution of epiduroscopic intervention by allowing local administration of PRP or corticosteroids and analgesic agents as well as its mechanical adhesiolysis effect.

Growth Factor Roles in Soft Tissue Physiology and Pathophysiology.

Repair and healing of injured and diseased tendons has been traditionally fraught with apprehension and difficulties, and often led to rather unsatisfactory results. The burgeoning research field of growth factors has opened new venues for treatment of tendon disorders and injuries, and possibly for treatment of disorders of the aorta and major arteries as well. Several chapters in this volume elucidate the role of transforming growth factor β (TGFß) in pathogenesis of several heritable disorders affecting soft tissues, such as aorta, cardiac valves, and tendons and ligaments. Several members of the bone morphogenetic group either have been approved by the FDA for treatment of non-healing fractures or have been undergoing intensive clinical and experimental testing for use of healing bone fractures and tendon injuries. Because fibroblast growth factors (FGFs) are involved in embryonic development of tendons and muscles among other tissues and organs, the hope is that applied research on FGF biological effects will lead to the development of some new treatment strategies providing that we can control angiogenicity of these growth factors. The problem, or rather question, regarding practical use of imsulin-like growth factor I (IGF-I) in tendon repair is whether IGF-I acts independently or under the guidance of growth hormone. FGF2 or platelet-derived growth factor (PDGF) alone or in combination with IGF-I stimulates regeneration of periodontal ligament: a matter of importance in Marfan patients with periodontitis. In contrast, vascular endothelial growth factor (VEGF) appears to have rather deleterious effects on experimental tendon healing, perhaps because of its angiogenic activity and stimulation of matrix metalloproteinases-proteases whose increased expression has been documented in a variety of ruptured tendons. Other modalities, such as local administration of platelet-rich plasma (PRP) and/or of mesenchymal stem cells have been explored extensively in tendon healing. Though treatment with PRP and mesenchymal stem cells has met with some success in horses (who experience a lot of tendon injuries and other tendon problems), the use of PRP and mesenchymal stem cells in people has been more problematic and requires more studies before PRP and mesenchymal stem cells can become reliable tools in management of soft tissue injuries and disorders.

Effects of local administration of platelet-rich plasma and guided tissue regeneration on bone healing in early inserted dental implants - a histomorphometric analysis

Introduction. In order to provide the most favorable conditions for bone healing following implant loading, new techniques such as the use of growth factors to directly or indirectly regulate cell and tissue growth are becoming increasingly popular. Simplicity in producing concentrated thrombocytes derived from platelet-rich plasma has led to increasing application of growth factors derived from thrombocytes, such as PDGF, TGF-?, IGF and VEGF, in order to increase the percentage of bone-to-implant contact that provides better implant stability and possibly earlier functional loading. The aim of the study was to determine the effects of platelet-rich plasma and guided tissue regeneration on bone regeneration in the case of bone defects in early dental implant insertion. Materials and Methods. This experimental study was conducted on 10 study dogs that received 40 BCT implants, i.e., 4 implants per dog. The study included early dental implant placement in the sites of the extracted premolars. Artificial bone defects, resembling peri-implantitis defects, were made on the mesial side of each site, and the defects were filled using suitable guided tissue regeneration protocols with platelet-rich plasma derived from each experimental animal an hour before surgery. Histopathologic and histomorphometric evaluations were performed 10 months following the implantation. Results and Conclusion. The applied protocols had different effects on bone healing. According to the results obtained, the use of platelet-rich plasma combined with deproteinized bovine bone and bovine-derived resorptive membrane provided superior bone defect ossification

Efficiency of local injections of platelet-rich plasma in shoulder impingement syndrome

Chronic shoulder pain caused by shoulder impingement syndrome (SIS) is a common pathology that leads to worse quality of life and disability. The local administration of platelet-rich plasma (PRP) is a promising treatment for SIS.Objective: to evaluate the efficiency of subacromial injection of PRP in chronic shoulder pain caused by SIS.Patients and methods. The investigation enrolled 30 patients (13 women and 17 men; mean age, 45.8±14.1 years) with chronic shoulder pain lasting ≥3 months after rotator tendons injury confirmed by ultrasound and/or magnetic resonance imaging and inefficiency of previously medical therapy. All the patients received three subacromial injections of 5 ml of PRP at a 7-day interval. The investigators assessed the course of pain during movement (100-mm visual analogue scale (VAS)) and functional ability according to the ASES and CSC questionnaires at baseline and 1, 3 and 6 months after treatment.Results and discussion. During the treatment, there was a considerable improvement in all indicators. At baseline and 1 and 3 months, the mean pain severity measured on VAS was 49.3±10.3, 32.4±21.3, and 20.6±21.3 mm, respectively; in this case, the positive effect persisted at 6-month follow-up: 10 [0; 30] mm (p<0.001). The mean ASES values were 59.5±11.5, 75.9±17.4, 82.6±17.6, and 86.7±17.1 (p<0.001) and the mean CSC scores were 72.3±14.1, 81.0±16.2, 88.5±16.1, and 92.8±16.2 (p<0.001), respectively. There were no serious adverse reactions.Conclusion. Subacromial injection of PRP is an effective and safe treatment for chronic shoulder pain associated with SIS.

Successful pregnancy and live birth after intrauterine administration of autologous platelet-rich plasma in a woman with recurrent implantation failure: A case report

Platelets contain a significant amount of growth factors that have positive effects on local tissue repair and endometrial receptivity. Here we present a 45-yr-old woman with primary infertility and two failed in vitro fertilization (IVF) cycles who was candidate to receive donor eggs. Five consecutive frozen-thawed embryo transfer cycles with good quality embryos were performed within 2 yr. With the diagnosis of recurrent implantation failure (RIF), the patient was treated for improving endometrial receptivity with intrauterine administration of autologous platelet-rich plasma (PRP), 24 hr before embryo transfer. The patient gave birth to a healthy baby boy weighing 2350 gr in the cesarean section. Extensive literature search suggests that this is the first successful pregnancy after administration of PRP in a woman with RIF. Local administration of PRP before embryo transfer may play a vital role in successful implantation .

Effects of insulin-like growth factor–I and platelet-rich plasma on sciatic nerve crush injury in a rat model

Local administration of insulin-like growth factor-I (IGF-I) has been shown to increase the rate of axon regeneration in crush-injured and freeze-injured rat sciatic nerves. Local administration of platelet-rich plasma (PRP) has been also shown to have a measurable effect on facial nerve regeneration after transection in a rat model. The objective of the study was to compare the effects of locally administered IGF-I and PRP on the parameters of the Sciatic Function Index (SFI), sensory function (SF), axon count, and myelin thickness/axon diameter ratio (G-ratio) in a rat model of crush-injured sciatic nerves. The right sciatic nerve of Wistar albino rats (24 animals) was crushed using a Yasargil-Phynox aneurysm clip for 45 minutes. All animals were randomly divided into 3 groups: Group 1 (control group) was treated with saline, Group 2 was treated with IGF-I, and Group 3 was treated with PRP. Injections were performed using the tissue expander's injection port with a connecting tube directed at the crush-injured site. Functional recovery was assessed with improvement in the SFI. Recovery of sensory function was using the pinch test. Histopathological examination was performed 3 months after the injury. The SFI showed an improved functional recovery in the IGF-I-treated animals (Group 2) compared with the saline-treated animals (Group 1) 30 days after the injury. In IGF-I-treated rats, sensory function returned to the baseline level significantly faster than in saline-treated and PRP-treated rats as shown in values between SF-2 and SF-7. The G-ratios were found to be significantly higher in both experimental groups than in the control group. This study suggests that the application of IGF-I to the crush-injured site may expedite the functional recovery of paralyzed muscle by increasing the rate of axon regeneration.

Immunohistochemical study of angiogenesis after local administration of platelet-rich plasma in a patellar tendon defect

A full thickness defect was made in the central portion of the patellar tendon of 48 New Zealand white rabbits. Platelet-rich plasma (PRP) gel was then applied and filled the tendon defect. The same procedure was performed in the control group, without the application of PRP. Animals were sacrificed after one, two, three, and four weeks. Histological and immunohistochemical analyses using a monoclonal antibody against CD31 were performed. The histological examination showed a superior healing process in the PRP group compared with the control group. Especially in the third week, the tissue formed in the PRP group was more mature and dense with less elastic fibres remaining. Neovascularisation was significantly higher in the PRP group during the first two weeks and significantly lower in the third and fourth weeks (p < 0.0001). Histological examination and study of angiogenesis showed that the application of PRP enhances and accelerates the tendon healing process.

Effect of local administration of platelet-rich plasma and guided tissue regeneration on the level of bone resorption in early dental implant insertion

Osseointegration is a result of cellular migration, differentiation, bone formation, and bone remodeling on the surface of an implant. Each of these processes depends on platelets and blood coagulum. Platelet-rich plasma (PRP) is used to improve osseointegration and stability of implants. The aim of the research was to test the influence that PRP and guided tissue regeneration in bone defects have on bone defect filling and the level of bone resorption in early implant insertion. This experimental study included 10 dogs. A total of 40 BCT implants were inserted, 4 in each dog (two on the left side and two on the right side), with guided tissue regeneration. Radiologic analyses were done immediately after the insertion and 10 weeks after the insertion. Bone defect filling was measured by a graduated probe 10 weeks after the implant insertion. The following protocols were tested: I - PRP in combination with bovine deproteinized bone (BDB) and resorptive membrane of bovine origin (RBDM), II - BDB + RBDM, III - PRP + RBDM and IV - RBDM. The applied protocols affected differently the bone defect filling and the level of bone resorption. Significantly better results (the lowest bone resorption) were achieved with protocol I (PRP + BDB + RBDM) in comparison with protocols III (PRP + RBDM) and IV (RBDM), but not with protocol II (BDB + RBDM). On the other hand, no significant difference was found among protocols II (BDB + RBDM), III (PRP + RBDM) and IV (RBDM) in the level of bone tissue resorption. The bone defect filling was largest and the level of bone resorption was lowest in the protocol with PRP applied in combination with BDB and RBDM.

Platelet-Rich Plasma (PRP) Stimulates the Extracellular Matrix Metabolism of Porcine Nucleus Pulposus and Anulus Fibrosus Cells Cultured in Alginate Beads

In vitro assessment of the effects of platelet-rich plasma on the extracellular matrix metabolism of porcine intervertebral disc cells. To determine whether platelet-rich plasma is effective in stimulating cell proliferation and extracellular matrix metabolism by porcine disc cells cultured in alginate beads. Platelet-rich plasma is used to accelerate wound healing and tissue regeneration. Activated platelets release multiple growth factors that regulate cell proliferation, differentiation, and morphogenesis. Individual growth factors present in platelet-rich plasma have been demonstrated to affect the metabolism of intervertebral disc cells. Platelet-poor and platelet-rich plasma was isolated from fresh porcine blood using a commercially available platelet concentration system. After preculture for 7 days and serum starvation for 24 hours, the beads containing nucleus pulposus and anulus fibrosus cells were then cultured for another 72 hours in serum-free medium, 10% fetal bovine serum, 10% platelet-poor plasma, or 10% platelet-rich plasma. The synthesis of proteoglycans and collagen, the accumulation of proteoglycans, and the DNA content were biochemically assessed. Platelet-rich plasma had a mild stimulatory effect on cell proliferation of intervertebral disc cells. Platelet-rich plasma treatment significantly upregulated proteoglycan and collagen synthesis and proteoglycan accumulation when compared with platelet-poor plasma. Platelet-rich plasma was effective in stimulating cell proliferation and extracellular matrix metabolism. The response to platelet-rich plasma was greater in the case of anulus fibrosus cells than of nucleuspulposus cells. The local administration of platelet-rich plasma might stimulate intervertebral disc repair. In addition, given the risks of using animal serum for tissue engineering, autologous blood may gain favor as a source of growth factors and serum supplements needed for stimulating cells to engineer intervertebral disc tissues.