Plasma Rich In Growth Factors Research Articles

Recovery of Corneal Innervation after Treatment in Dry Eye Disease: A Confocal Microscopy Study

To analyze the changes in corneal innervation by means of in vivo corneal confocal microscopy (IVCM) in patients diagnosed with Evaporative (EDE) and Aqueous Deficient Dry Eye (ADDE) and treated with a standard treatment for Dry Eye Disease (DED) in combination with Plasma Rich in Growth Factors (PRGF). Eighty-three patients diagnosed with DED were enrolled in this study and included in the EDE or ADDE subtype. The primary variables analyzed were the length, density and number of nerve branches, and the secondary variables were those related to the quantity and stability of the tear film and the subjective response of the patients measured with psychometric questionnaires. The combined treatment therapy with PRGF outperforms the standard treatment therapy in terms of subbasal nerve plexus regeneration, significantly increasing length, number of branches and nerve density, as well as significantly improving the stability of the tear film (p < 0.05 for all of them), and the most significant changes were located in the ADDE subtype. the corneal reinnervation process responds in a different way depending on the treatment prescribed and the subtype of dry eye disease. In vivo confocal microscopy is presented as a powerful technique in the diagnosis and management of neurosensory abnormalities in DED.

Effectiveness of Hyaluronic Acid Gel Injection with and without PRGF for Management of Interdental Papillary Loss: A Randomized Clinical Trial.

To evaluate the effectiveness of hyaluronic acid (HA) gel injection with and without plasma rich in growth factors (PRGF) for the management of interdental papillary loss. A single blinded randomized clinical trial was carried out on 21 subjects with 34 sites. Patients within the age group 18-45 years who had Class I and II papillary recession in the maxillary anterior region were selected. The sites involved were randomly assigned to Group HA alone and Group HA + PRGF. The patients were recalled 4 weeks after receiving supragingival and subgingival instrumentation. HA or HA + PRGF was injected into the defective papilla at baseline and at 3 and 6 weeks. Image based measurements of Papillary Width (PW), Papillary Deficient Height (PDH), Deficient Area (DA), Deficient Volume (DV) were registered at baseline, 3 weeks, 6 weeks and 12 weeks. A vernier caliper was used to measure the papillary depth in the impression made using additional silicone impression material pre- and post-intervention. There was a significant improvement in the within-group comparison of PW, PDH, DA and DV in both the groups. Group HA + PRGF showed significantly greater improvement in comparison to Group HA alone in terms of PDH, DA and DV at 6 and 12 weeks. Even though HA gel has already been established as a promising injectable agent in the minimally invasive treatment of interdental papillary deficiency, PRGF may also have a significant adjuvant effect when used along with HA. Further clinical studies with longer follow up duration, larger sample size and standardization of the tooth shape are required for a better understanding of the adjuvant effect of PRGF when used along with HA.

Beneficial Effects of Plasma Rich in Growth Factors (PRGF) Versus Autologous Serum and Topical Insulin in Ocular Surface Cells

Purpose In the last few decades, several blood derived products such as platelet-rich plasma (PRP), plasma rich in growth factors (PRGF) and autologous serum (AS) have been used for the treatment of ocular surface disorders. Recently, insulin has been proposed to be used as an alternative for the treatment of ocular surface diseases. The aim of this study was to evaluate the biological potential of PRGF eye drops in comparison with AS and insulin on ocular surface cells. Methods Blood from three healthy young donors was collected to obtain autologous serum (AS) eye drops and plasma rich in growth factors (PRGF) eye drops. Insulin (Actrapid®) was diluted at 1 and 0.2 IU/mL. The biological potential of PRGF, AS and insulin was assessed by proliferation in HCE, HK and HConF cells. Wound healing assay was performed in HCE cells after incubation with the different treatments. HConF and HK cells were differentiated to myofibroblast after treatment with 2.5 ng/mL of TGF-β1 and then incubated with all treatments. Results PRGF eye drops induced significantly higher proliferation rate compared to AS or insulin in HConF and HK cells, but not in HCE cells. In addition, the percentage of wound healing area was significantly reduced after PRGF treatment in comparison with AS or insulin treatment. Furthermore, PRGF significantly reduced the number of myodifferentiated cells compared to AS and insulin at both concentrations analyzed. Conclusion The results obtained in the present study show that PRGF increases the biological activity of the ocular surface cells and reduces the expression of fibrosis marker compared to insulin or AS. Translational relevance The present study suggests that plasma rich in growth factors eye drops are a more effective therapy than insulin and autologous serum eye drops for the treatment of ocular surface diseases.

Restoring Study PRGF: a randomized clinical trial on plasma rich in growth factors for knee osteoarthritis

BackgroundA randomized clinical trial assessing plasma rich in growth factors (PRGF) versus hyaluronic acid for knee osteoarthritis was published in 2012 (sponsor trial ID BTI-01-EC/07/ART). Evidence of misreporting was discovered following access to unpublished materials. In accordance with the principles of the Restoring Invisible and Abandoned Trials (RIAT) initiative, we sought to re-analyse Study PRGF based on the unpublished trial materials.MethodsReanalysis was made possible primarily based on two unpublished study documents (original trial protocol and final report) obtained from the authors of the original publication. A call to action, calling on the authors to correct the original publication, was publicly issued. The involved ethics committee was repeatedly approached and extensive discussion with the authors ensued. After no agreement to correct the paper was reached, we embarked on this restoration. Reanalysis was focused on providing updated analyses for efficacy and safety.ResultsThe efficacy of PRGF was not statistically different from hyaluronic acid for any prespecified primary or secondary efficacy outcomes. For the primary endpoint, the percent of patients on PRGF compared to hyaluronic acid with a decrease >40% in WOMAC pain subscale score was 5.4% higher; 95% confidence interval (CI) −10.4% to 21.3%; p = 0.505. This differs from the original publication that reported a non-prespecified primary endpoint (decrease >50% in WOMAC pain subscale score) which was 14.1% higher; 95% CI 0.5 to 27.6%; p=0.044. Furthermore, in contrast to the article statement that all the adverse events disappeared in 48 h, at least two patients in the hyaluronic arm and five patients in the PRGF arm reported persistent adverse events. Inadequate disclosure of conflicts of interest in the original publication was also noted.ConclusionsThis reanalysis of Study PRGF found no clinically or statistically significant benefit from PRGF compared to hyaluronic acid. The restoration of Study PRGF shows the urgency of important changes to trial reporting and oversight practices. In the future, timely access to all clinical trial documents is needed to minimize the risk of reporting bias. Similarly, ethics committees should be ready to intervene whenever a case of potential misconduct arises.Trial registrationThis is a RIAT project, whose original trial was approved and registered on 19 December 2007 by the Ethics Committee of the Basque Country, Spain, as BTI-01-EC/07/ART.

Cost-utility analysis and net monetary benefit of Platelet Rich Plasma (PRP), intra-articular injections in compared to Plasma Rich in Growth Factors (PRGF), Hyaluronic Acid (HA) and ozone in knee osteoarthritis in Iran

PurposeTo evaluate the cost-effectiveness of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factors (PRGF), Hyaluronic Acid (HA) and ozone as effective treatment approaches in knee osteoarthritis management from Iran Health care perspective.MethodsA decision tree model was conducted to assess the cost-effectiveness of four common intra-articular treatment approaches in patients with mild and moderate knee osteoarthritis. The data on clinical effectiveness was obtained from a randomized controlled trial (RCT) conducted in Iran and used to estimate utility values. The direct medical costs were estimated according to tariffs for public medical centers and hospitals, approved by the Iran Ministry of Health and Medical Education in 2021. The incremental cost-effectiveness ratio (ICER) and the net monetary benefit (NMB) were used to evaluate the cost-utility analysis. Deterministic and probabilistic sensitivity analyses are performed to investigate the robustness of the results and account for the different sources of uncertainty.ResultsIn this study, HA intra-articular injection-related costs ($581.67/patient) were defined as the highest cost, followed by PRGF ($328.10/patient), PRP (318.58/patient), and Ozone (103.20/patient). According to the utility value, PRP and PRGF (0.68) have the same and the most utility among Intra-articular injections in knee osteoarthritis management. However, the PRP injection method was identified as the most cost-effective intervention due to its high NMB and ICER estimates. Based on the Monte Carlo Simulation, PR intervention, compared to other ones, was introduced as the dominant strategy regarding knee OA management, with a WTP of $10,000 for 100% of cases.ConclusionThe study result demonstrated that intra-articular injection of PRP, compare to other injections, is a cost-effective treatment option for patients with mild and moderate knee osteoarthritis. In addition, intra-articular injection of PRP was identified as the best injection, with the highest level of net monetary benefit, for knee OA management.

Clinical, histological, and histomorphometrical comparison of CenoBone® with and without plasma rich in growth factor for edentulous ridge preservation in the dental sockets.

The aim of this study was to compare the clinical, histological, and histomorphometrical outcomes of CenoBone® allograft with and without plasma rich in growth factor (PRGF) for the preservation of edentulous ridge in the dental sockets. This study is experimental clinical trial that 14 dental sockets were included the sockets required ridge preservation followed by implant placement in the premolar and molar of the mandible. After extraction of the teeth, the CenoBone® allograft and PRGF were used in the test group and CenoBone® allograft was used alone in the control group. During the first stage of surgery and 5 months later, in the second stage of surgery (implant placement), the vertical changes of the ridge were measured. Furthermore, using Core-Biopsy in the second stage of surgery, criteria of histologic and histomorphometric were determined. Data were analyzed with t-test, Mann-Whitney U-test, and Fisher's exact test at the level of significance of P < 0.05. The mean trabecular thickness in the test group (52.18 ± 5.53) was significantly higher than that in the control group (41.53 ± 10.40) (P = 0.344). However, there were no significant differences in the mean values of vertical bone absorption, bone percentage, remaining biomaterials, inflammation, and blood vessels between the two groups. There was no case of foreign body reaction and the bone was vital in all the cases and in direct contact with the biomaterial. Although CenoBone® allograft with PRGF was effective in some histomorphometric factors such as trabecular thickness, it did not lead to significant clinical changes.

CBCT assessment of the integration of xenograft mixed with plasma rich in growth factors (PRGF) in direct maxillary sinus lift surgery: Case series study

CBCT assessment of the integration of xenograft mixed with plasma rich in growth factors (PRGF) in direct maxillary sinus lift surgery: Case series study

Intra-osseous infiltration of adipose mesenchymal stromal cells and plasma rich in growth factors to treat acute full depth cartilage defects in a rabbit model: Serum osteoarthritis biomarkers and macroscopical assessment.

Intra-articular infiltration of plasma rich in growth factors (PRGF) and adipose mesenchymal stromal cells (AMSCs) are known to inhibit osteoarthritis progression. However, in severely affected patients, the treatment cannot reach the deeper layers of the articular cartilage; thus, its potential is limited. To overcome this limitation, intra-osseous infiltrations have been suggested. The purpose of this study is to assess the impact of intra-osseous infiltration therapies on serum biomarkers of osteoarthritis and to assess cartilage regeneration macroscopically. A total of 80 rabbits were divided into four groups based on the intra-osseous treatment administered on the day of surgery: control, PRGF, AMSCs and a combination of PRGF + AMSCs. In addition, all groups received a single intra-articular administration of PRGF on the same day. Serum biomarker levels were measured before infiltration and 28-, 56-, and 84-days post infiltration, and macroscopical assessment was conducted at 56- and 84-days follow-up post infiltration. In the PRGF + AMSCs group, significantly lower concentrations of hyaluronic acid and type II collagen cleavage neoepitope were recorded at all time points during the study, followed by PRGF, AMSCs and control groups. Regarding macroscopical assessment, lower scores were obtained in PRGF + AMSCs group at all study times. The results suggest that the combination of intra-articular PRGF with intra-osseous PRGF or AMSCs achieves better results in rabbits with acute chondral defects and that intra-osseous infiltration is a safe procedure.

Plasma rich in growth factors as an adjuvant agent in non‐penetrating deep sclerectomy

AbstractPurpose: To evaluate the utility and safety of plasma rich in growth factors (PRGF) eye drops in the postoperative treatment of non‐penetrating deep sclerectomy (NPDS).Methods: Retrospective case–control study, including open‐angle glaucoma patients. Cases were consecutively recruited, and used topical PRGF for 4 months after NPDS. Historical controls were patients who had undergone the same technique immediately before the start of the study (without PRGF). Prior to surgery, intraocular pressure (IOP), the number of topical hypotensive medications, and visual field mean deviation (MD) were registered. Postoperatively (1 week, 3 and 6 months), those three variables were also analysed, as well as complications, manipulations and reinterventions.Results: Preoperatively, the PRGF group (n = 37) and the control group (n = 49) were similar in age (70.9 ± 10.0 vs. 71.5 ± 10.7 years; p = 0.68), IOP (23.0 ± 9.0 vs. 20.6 ± 10.2 mmHg; p = 0.26), MD (−15.0 ± 8.8 vs. −15.9 ± 7.8 dB; p = 0.76) and the number of hypotensive medications (2.8 ± 0.9 vs. 2.7 ± 0.8; p = 0.40). IOP significantly decreased at all follow‐up visits in both groups, compared to preoperative values. That reduction was greater at 6 months with PRGF (p &lt; 0.01): 10.9 ± 4.3 mmHg (−52.6%) versus 15.0 ± 8.0 mmHg (−27.2%). In the final analysis, the number of drugs similarly reduced in both groups (p = 0.32). MD showed no significant differences. Surgical complications were observed in 12 control eyes (25%) and 5 eyes (14%) treated with PRGF (p = 0.06). No complications related to the use of PRGF were identified. The needling rates were 9.4% and 5.9% in PRGF and controls, respectively (p = 0.58). Three eyes (6.3%) required further glaucoma surgery in the control group, and 1 (2.7%) in the PRGF‐group (p = 0.78). The final complete success rate was higher with PRGF: 83.8% vs 60.4%.Conclusions: Postoperative PRGF reduced IOP and complications rate in the mid‐term after NPDS, thus it may be considered as a possible safe adjuvant agent to achieve surgical success.

The Effect of an Autologous Protein-Based Topical Serum on Cutaneous Burns.

Burns are skin lesions that can be life-threatening. Platelet-rich plasma (PRP) is growing as an effective alternative for the management of burns. The objective of this study was to assess the use of a storable topical serum based on plasma rich in growth factors (PRGF) in promoting burn wound healing, called Endoret-Serum (ES). 3D skin models were used to assess thermal burn injury. Extracellular matrix remodeling, tissue damage, and metabolic activity of explants were analyzed, and a histomorphometric examination was carried out. Silver sulfadiazine cream (SC) was used as control ointment for burn management. Three patients suffering from skin burns were also treated with ES and clinically assessed. Endoret-Serum was based on an enriched platelet fraction with neutral pH and containing a high load of growth factors. Both ES and SC reduced tissue damage after burn, with ES being more effective. ES treatment maintained the metabolic activity of explants at a healthy level, and increased collagen and elastin deposition. Both treatments preserved the cutaneous connective tissue and induced newly synthesized matrix, with ES being more effective. Both treatments induced an intense collagenization, but ES showed better results as it restored the basal layer network with reduced signs of fibrosis. ES decreased the apoptotic cell number. Patients suffering from skin burns showed complete healing after ES treatment. Endoret-Serum might promote cutaneous healing and may be useful for accelerating the regeneration of skin burns. J Drugs Dermatol. 2022;21(12):1330-1339. doi:10.36849/JDD.6763.

Histological and biochemical evaluation of plasma rich in growth factors treatment for grade II muscle injuries in sheep

The purpose of this study was to perform a histological and biochemical evaluation of the influence of plasma rich in growth factors (PRGF) on muscle regeneration process after a surgically induced grade II muscle laceration. A randomized, single blind, controlled experimental research was conducted including twenty-one adult healthy sheep, randomly divided in three groups (n = 7). A grade II surgical section was performed in the biceps femoris muscle of both hindlimbs. After two days (basal time), intralesional infiltration of autologous PRGF or Saline solution was randomly administered in both hindlimbs. Treatment was repeated once a week. Animal groups were euthanized at 1 (T1), 2 (T2) or 4 (T4) weeks. Histological assessment showed that PRGF intralesional injection induced a significant decrease of inflammatory cells density, significant higher centrally nucleated fibers percentage and significantly smaller fibrotic areas compared to Saline-treated muscles at T1, T2 and T4. Also, lower vascular density, with lower capillaries cross-sectional area, in PRGF group compared to Saline was observed. Biochemical analysis revealed a significant higher expression level of MYOD1, MYF5 and MYOG genes in PRGF groups at T1 compared to Saline treated muscles. At ultrastructural level, PRGF groups presented scarce edema and loss of connective tissue structure, as well as higher mitochondrial density adequately associated to the sarcomere unit in contrast to the Saline group. In conclusion, histological, biochemical, and ultrastructural results showed that PRGF treatment improved muscle regeneration process leading to more mature histological aspect in newly formed muscle tissue after a surgically induced grade II muscle injury.

Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy-A Systematic Review of the Literature.

Back pain with radicular symptoms is associated with detrimental physical and emotional functioning and economic burden. Conservative treatments including physical, pharmacologic and injection therapy may not provide clinically significant or long-standing relief. Regenerative medicine research including Platelet rich plasma (PRP), Platelet lysate (PL) or Plasma rich in growth factors (PRGF) continues to develop, however evidence appraisal for treatment of radicular pain remains lacking. Thus, we performed a systematic review to evaluate the effectiveness of epidural steroid injections containing PRP or related products to treat radicular pain. Embase, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were queried. Twelve studies were included in qualitative analysis, consisting of three randomized controlled trials and nine observational studies. The primary outcome was pain intensity, and secondary outcomes included functional improvement, anatomical changes on advanced imaging, and adverse events. All studies identified improved pain intensity and functional outcomes after epidural injection of PRP, PRGF and/or PL. Similar or longer lasting pain relief was noted in the PRP cohort compared to the cohort receiving epidural steroid injections with effects lasting up to 12-24 months. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis revealed a very-low certainty of evidence due to risk of bias, indirectness, and imprecision.

Bone-Regenerative Ability of Platelet-Rich Plasma Following Sinus Augmentation with Anorganic Bovine Bone: A Systematic Review with Meta-Analysis.

Background: The objective of this systematic review is to assess the effect of the adjuvant use of platelet-rich plasma (PRP) and its type on new bone formation by anorganic bovine bone during maxillary sinus floor augmentation procedure. Methods: PubMed, Cochrane Central Register of Controlled Trials, and Ovid databases were searched for relevant studies published up to 16 September 2021. Randomized clinical trials (RCTs) and non-randomized controlled clinical trials (CCTs) that reported data on the new bone formation (measured by histomorphometric analysis) were considered. Risk of bias and quality assessment of included studies were evaluated following the Cochrane Handbook for Systematic Reviews of Interventions and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool. Strength of evidence was assessed following the approach of the Agency for Healthcare Research and Quality (AHRQ) through its evidence-based practice center (AHRQ EPC). The meta-analysis was based on the primary outcome of newly formed bone, for which the standard mean difference was calculated. Results: After the application of eligibility criteria, six clinical trials (three RCTs and three CCTs) covering 85 maxillary sinus floor elevation procedures were included. The pooled new bone formation value for PRP was 1.67 (95% CI: −0.15 to 3.49; I2: 86%), indicating the absence of significant effect. Plasma rich in growth factors (PRGF) was the pure PRP tested in five of the included studies. When sub-group (type of PRP) meta-analysis was performed, significantly higher new bone formation was observed in the PRGF group [2.85 (95% CI: 0.07 to 5.64; I2: 88%)] in comparison to the control group. Conclusions: A beneficial effect on new bone formation after maxillary sinus floor elevation can be obtained when anorganic bovine bone is mixed with PRGF.

Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: 3-Dimensional Analysis Using Cone-Beam Computed Tomography on the Outcomes of Non-Surgical Endodontic Treatment Using A-PRF+ and Calcium Hydroxide: A Retrospective Cohort Study.

The study presents results of periapical lesion healing after one-visit root canal treatment (RCT) with Advanced Platelet Rich Fibrin plus (A-PRF+) application compared to a two-visit RCT with an inter-appointment calcium hydroxide filling. The comparison was made based on CBCT-Periapical Index (PAI) lesion volume changes and the occurrence of post endodontic pain. The results of 3D radiographic healing assessments based on volume reduction criteria were different from the CBCT-PAI. Based on volume changes, the healing assessment criteria-9 cases from the Study Group and six cases in the Control Group were defined as healed. Based on the CBCT-PAI healing assessment criteria, 8 cases from the Study Group and 9 cases from the Control Group were categorized as healed. The volumes of apical radiolucency were, on average, reduced by 85.93% in the Study Group and by 72.31% in the Control Group. Post-endodontic pain occurred more frequently in the Control than in the Study Group. The highest score of pain in the Study Group was five (moderate pain, n = 1), while in the Control Group, the highest score was eight (severe pain, n = 2). In the 6-month follow-up, CBCT scans showed a better healing tendency for patients in the Study Group.

Plasma rich in growth factors (PRGF) and leukocyte-platelet rich fibrin (L-PRF): comparative release of growth factors and biological effect on osteoblasts

PurposeTo compare the release of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-I) and interleukin 1β (IL-1β) of plasma rich in growth factors (PRGF) and leucocyte platelet-rich fibrin (L-PRF) and to evaluate their biological implication in osteoblasts.MethodsBlood from 3 healthy volunteers was processed into PRGF, immediate L-PRF (L-PRF 0ʹ) and L-PRF 30 min after collection (L-PRF-30ʹ) and a control group. Growth factors release were analyzed at 7 times by ELISA. Cell proliferation, collagen-I synthesis and alkaline phosphatase activity were assessed in primary cultures of human osteoblasts.ResultsA slower controlled release of IGF-I, VEGF and PDGF was observed in the PRGF group at day 14. A higher synthesis of type I collagen was also quantified in PRGF. L-PRF released significantly higher amounts of IL-1β, that was almost absent in the PRGF.ConclusionsThe addition of leukocytes dramatically increases the secretion of proinflammatory cytokines, which are likely to negatively influence the synthesis of type I collagen and alkaline phosphatase (ALP) by osteoblasts.

Rheumatoid Forefoot Reconstruction Following Minimally Invasive Surgery and Hoffmann-Clayton Procedure with Administration of Plasma Rich in Growth Factors - A 3-Year Follow-Up: A Retrospective Study

From 80 % to 90 % of foot deformities in adults are due to rheumatoid arthritis. Despite various surgical approaches, early functional and cosmetic results have been the greatest concern among patients. Thus, optimal surgical choice in rheumatoid forefoot correction is of vital importance for better subjective and clinical results. Thus, optimal surgical choice in rheumatoid forefoot correction is of vital importance for better subjective and clinical results. Our work evaluates the results of minimally invasive surgery (MIS) and resection arthroplasty per Hoffmann-Clayton along with the administration of Plasma Rich in Growth Factors (PRGF) in rheumatoid-affected forefoot patients.

Pathogenesis and treatment of wound healing in patients with diabetes after tooth extraction.

Diabetes mellitus is a common systematic chronic disease amongst dental patients. The elevated glucose microenvironment can prolong the healing of tooth extraction sockets. Therefore, the promotion of healing up tooth extraction sockets is of great clinical importance to the patients with diabetes mellitus. The current evidence indicates the mechanism of the recovery period of extraction sockets in hyperglycaemia conditions from physiological, inflammation, immune, endocrine and neural aspects. New advancements have been made in varied curative approaches and drugs in the management of wound healing of tooth extraction sockets in diabetes. However, most of the interventions are still in the stage of animal experiments, and whether it can be put into clinical application still needs further explorations. Specifically, our work showed topical administration of plasma-rich growth factor, advanced platelet-rich fibrin, leukocyte- and platelet-rich fibrin and hyaluronic acid as well as maxillary immediate complete denture is regarded as a promising approach for clinical management of diabetic patients requiring extractions. Overall, recent studies present a blueprint for new advances in novel and effective approaches for this worldwide health ailment and tooth extraction sockets healing.

Autologous Platelet Rich Plasma (PRGF) Preserves Genomic Stability of Gingival Fibroblasts and Alveolar Osteoblasts after Long-Term Cell Culture

Plasma rich in growth factors (PRGF) has several applications in dentistry that may require repeated applications of PRGF. Furthermore, it has been used for ex vivo expansion of human origin cells for their clinical application. One of the most relevant issues in these applications is to guarantee the genetic stability of cells. In this study, the chromosomal stability of gingival fibroblasts and alveolar osteoblasts after long-term culture was evaluated. Cells were expanded with PRGF or foetal bovine serum (FBS) as a culture medium supplement until passage 7 or 8 for gingival fibroblast or alveolar osteoblasts, respectively. A comparative genomic hybridization (CGH) array was used for the genetic stability study. This analysis was performed at passage 3 and after long-term culture with the corresponding culture medium supplements. The cell proliferative rate was superior after PRGF culture. Array CGH analysis of cells maintained with all the three supplements did not reveal the existence of alterations in copy number or genetic instability. The autologous PRGF technology preserves the genomic stability of cells and emerges as a safe substitute for FBS as a culture medium supplement for the clinical translation of cell therapy.

Initial experiences using plasma rich in growth factors to treat keratoneuralgia.

Keratoneuralgia, a clinical diagnosis of sensitized corneal pain without visible ocular surface damage, generally has minimal response to conventional therapies. Causes include refractive surgery and chronic dry eye. We evaluated the efficacy of Plasma Rich in Growth Factors (PRGF), a novel treatment prepared using a commercially available kit, in patients with keratoneuralgia. A retrospective chart review identified patients who had the clinical diagnosis of keratoneuralgia and were treated with PRGF for at least 3 months from October 2015 to April 2020 at a single academic institution. Both objective eye exam findings and concurrent treatments were obtained at baseline, 3 months, and final visit (if available). A questionnaire was administered to identified patients, including symptoms scores measured with a visual analog scale. The results of this survey and other objective findings were compared before and after PRGF treatment. 16 out of 32 patients (50%) with a mean follow-up period of 33 ± 26 months answered the questionnaire. Refractive surgeries were the cause of keratoneuralgia in 14 patients (87.5%), with LASIK the most common procedure (11 patients, 69%). There were no adverse events recorded or reported. Symptom scored by VAS in a modified Symptoms Assessment in Dry Eye questionnaire significantly decreased after PRGF use (85 ± 16 to 45 ± 33, p = 0.0002). Ten patients (63%) reported PRGF is superior to other therapy and would recommend to others. There were no significant trends in visual acuity, objective exam findings, or concurrent treatments after PRGF treatment. PRGF is safe and can potentially alleviate symptoms in patients with keratoneuralgia, a rare but devastating complication after refractive surgery. Prospective trial is indicated to explore PRGF as a potentially useful treatment for keratoneuralgia.

The Effectiveness of Plasma Rich in Growth Factors (PRGF) in the Treatment of Nerve Compression Syndromes of the Upper Extremity: A Retrospective Observational Clinical Study.

Background: Nerve compression syndromes of the upper extremity are a common cause of neuropathic pain and functional impairment. Recently, platelet-rich plasma (PRP) infiltrations have emerged as an effective biological approach to the treatment of this type of injury. The objectives of this retrospective observational study were to assess clinical improvement in patients with median and ulnar nerve entrapment syndrome after undergoing biologically-assisted nerve release surgery with plasma-rich-in-growth-factors (PRGF) technology. Methods: Participants (n = 39) with moderate-to-severe nerve compression syndrome of the upper limb diagnosed by both electromyography and clinical examination, and who were treated with PRGF, were identified from the center’s medical records. The evaluation was based on patient-reported outcomes. Pre- and post-treatment differences in the Visual analog scale (VAS), the Boston carpal tunnel questionnaire (BCTQ), and the Quick-DASH score were assessed. Results: Three study groups were conducted: patients with carpal tunnel syndrome (n = 16), with recurrent carpal tunnel syndrome (n = 8), and with ulnar nerve entrapment (n = 15). The median follow-up was 12 months (interquartile range (IQR), 9–16). In comparison to pre-treatment values, all three study groups obtained statistically significant improvements for the three analyzed scales at the end of the follow-up, with p < 0.001 for all scales in the carpal tunnel syndrome and ulnar nerve entrapment groups and p < 0.01 for all scales in the recurrent carpal tunnel syndrome group. There were no serious adverse effects in the analyzed patients. Conclusion: PRGF-assisted open surgical nerve release treatment (intraneural and perineural liquid PRGF infiltrations and nerve wrapping with PRGF membrane) exerts long-term beneficial effects on pain reduction and functional improvement in the nerve and nerve–muscle unit in patients with upper extremity compression syndromes.