Application Of Platelet-rich Plasma Research Articles

Efficacy of Autologous Platelet Rich Plasma For Treatment of Diabetic Foot Ulcer

Background: Diabetic foot ulcer (DFU) is a common complication of long standing uncontrolled diabetes mellitus. There are different types of treatment commonly practiced among the clinicians to treat DFU. Among them, autologous platelet rich plasma (PRP) application is getting popularity day by day throughout the western world. Methodology: It was a prospective, randomized, controlled study that was carried out among 40 DFU patients in the Department of Surgery, Dhaka Medical College Hospital. Among them, 20 patients were treated by autologous PRP and another 20 patients were treated by conventional method. They were followed up for 12 weeks period. Data collected from the participants were analyzed to compare the healing rate among two groups. Result: In PRP treated ulcers, healing rate was significantly faster and better in comparison to conventionally treated ulcers. After 10th weeks follow up, in PRP group 14 ulcers were completely healed whereas in control group,4 ulcers were completely healed. On the contrary, 3 ulcers in control group showed further deterioration. At the end of 12th weeks follow up, 19 ulcers in PRP group were completely healed whereas 13 ulcers in control group were completely healed. In PRP group no patient showed any complication during treatment, whereas in control group 7 patients experienced local complications. Conclusion: Treatment of diabetic foot ulcer with autologous platelet rich plasma results in faster and better ulcer healing in comparison to conventional treatment. PRP accelerates the healing rate and keep the ulcer area safe from external pathogens. Hence, autologous PRP is a better selection for DFU treatment. J Dhaka Med Coll. 2023; 32(1) : 38-42

Platelet-rich plasma applications in the larynx: snake oil or stupendous?

To explore and summarize recent work examining the use of platelet-rich plasma (PRP) applications for vocal fold disorder. Intrachordal PRP injections have recently emerged as a treatment option for patients with damage to the lamina propria of the vocal fold (scar, atrophy, sulcus and inflammatory lesions). Studies support significant improvements in patient-reported and clinician-reported outcomes, and objective phonatory parameters. PRP demonstrates a good safety profile, absence of immune reactions, affordable cost model and improvement in mucosal wave features with resultant improved voice quality up to 12 months following treatment. PRP injection of the vocal folds is a novel repurposing of a previously validated technique, and emerging data shows consistent results across multiple centres, increasing confidence in use of this freely available material. Current published studies confirm improved voice outcomes compared with pretreatment measures and high patient satisfaction. Further research is required to properly assign the role of and ideal candidate for PRP applications, and to delineate durability of treatment.

Platelet-rich plasma for treatment of female stress urinary incontinence.

Stress urinary incontinence (SUI) poses a significant burden on affected individuals, impairing their quality of life and causing embarrassment due to involuntary urine leakage during activities such as sneezing or coughing. While conservative and surgical treatments exist, a subset of patients experiences persistent symptoms despite these interventions. This review provides insights into the potential role of platelet-rich plasma (PRP) as a therapeutic adjunct for patients with SUI that does not respond to conventional non-surgical or surgical treatments. We conducted a literature review of studies in English to evaluate PRP efficacy in managing SUI. The studies conducted on PRP therapy suggest that it is an effective and safe treatment option for SUI in women. PRP injections, when used alone or in combination with other therapies, have shown significant improvements in SUI symptoms. Moreover, these studies indicate that PRP injections offer a less invasive and low-risk alternative to surgical procedures for managing SUI, which could lead to shorter recovery times. The efficacy of PRP therapy is evidenced by significant reductions in SUI symptoms, as well as improvements in bladder function variables, without significant adverse effects reported. However, further research is necessary to establish the long-term effectiveness and safety of PRP therapy for managing SUI in diverse patient populations. Additionally, ongoing evaluations of PRP therapy in combination with other interventions will be essential for optimizing treatment outcomes and broadening the potential applications of PRP in the management of SUI.

Duramater Healing Following Decompression And Posterior Stabilization Using Platelet Rich Plasma And Platelet Rich Fibrin: A Systematic Review

Background: Platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade. This systematic review evaluates the efficacy of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in enhancing duramater healing and reducing complications, particularly cerebrospinal fluid (CSF) leaks, following spinal surgeries. Incidental dural tears are a common complication in lumbar spine surgeries, leading to significant postoperative challenges. Methods: The review included randomized controlled trials comparing PRP and PRF with conventional treatments, sourced from databases such as PubMed, ScienceDirect, ProQuest, and Cochrane Library. Results: PRP and PRF are rich in growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β), all of which play crucial roles in wound healing. Conclusion: Both PRP and PRF significantly improve duramater healing, with PRF offering a more sustained release of growth factors, thereby enhancing watertight dura closure and reducing CSF leakage.

Clinical Effects of Additional Platelet-Rich Plasma Application to Exercise Therapy in Patients with Subacromial Impingement Syndrome: A Double-Blind Randomized Controlled Trial.

Exercise therapy (ET) is the main and initial treatment modality for treating subacromial impingement syndrome (SIS). The isolated or combined use of platelet-rich plasma (PRP) applications in treating SIS is increasing and promising. A comparison was made on the effectiveness of ET alone and in combination with PRP on pain, functionality, and quality of life (QoL) in patients with SIS. The purposes of this study were to (1) investigate the possible positive effects of PRP injections combined with ET in treating SIS on pain, functionality, and QoL and (2) propose an alternative treatment protocol. It was hypothesized that the group receiving PRP applications in addition to ET would have a better QoL due to less pain and higher functionality 6 months after treatment. Randomized controlled trial; Level of evidence, 2. Volunteer patients diagnosed with SIS were included based on history and physical examination findings. All participants underwent magnetic resonance imaging to confirm the diagnosis and exclude possible accompanying pathologies. The patients were randomly divided into 2 groups. The first group underwent ET at home for 8 weeks (ET group), and the second group received the same ET program and an additional 2 PRP injections, at the beginning of the study and the end of the fourth week (PRP group). Patients were evaluated initially and 6 months after the treatment using the visual analog scale (VAS) for pain score, Constant-Murley Score (CMS), and the 36-Item Short Form Health Survey (SF-36). The Kolmogorov-Smirnov test determined the conformity of the data to a normal distribution, chi-square analysis was used to compare categorical variables between groups, and the Mann-Whitney U test was used to compare continuous and intergroup variables. Intragroup changes before and after treatment were evaluated with the Wilcoxon signed-rank test. P < .05 was considered statistically significant. A total of 67 patients were initially enrolled; 5 were excluded and 6 were lost to follow-up (1 because of a COVID diagnosis). Thus, 56 patients (56 shoulders) were included for analysis. There were 28 patients in the ET group and 28 patients in the PRP group. There were no statistical differences between groups regarding participant characteristics and clinical evaluations before treatment. A statistically significant improvement was observed in pain (VAS subgroups), functionality (CMS subgroups), and QoL (SF-36 subgroups) evaluations of patients in both the ET and the PRP groups compared with before the treatment and 6 months after treatment (P < .05). At the 6-month posttreatment evaluation, the PRP group was statistically significantly superior to isolated ET in terms of VAS rest (P = .001) and night (P = .004) scores. This superiority was also in favor of the PRP group in flexion strength (P = .001), abduction strength (P = .046), and abduction degree (P = .041) measurements. There was no significant difference between ET and PRP groups regarding VAS activity, CMS, and SF-36 scores (P > .05) at 6 months. Our study showed that both isolated ET and additional PRP application to ET are effective methods in SIS treatment regarding pain, function, and QoL. Combining ET with PRP was superior in reducing pain and improving abduction degree and strength.

Autologous platelet concentrates as adjuvant in the surgical management of medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therapies for the surgical management of MRONJ include autologous platelet concentrates (APCs). These APCs serve as a source of various cells and growth factors that aid tissue healing and regeneration. This review evaluated the use of platelet-rich plasma (PRP), plasma-rich in growth factors (PRGF), and leukocyte- and platelet-rich fibrin (L-PRF) as adjuvant therapies for the surgical management of MRONJ by conducting analyses on the results of 58 articles. Compared to surgical treatment alone, the application of PRP and L-PRF after surgery appears to increase healing in the management of patients with MRONJ. No studies have reported unhealed lesions as a result of surgical treatment of MRONJ with PRGF application or compared it with surgical treatment alone. The overall results of this review have shown favorable healing rates of MRONJ lesions managed with the application of APCs after surgical treatment; however, significant methodological limitations may limit the scientific evidence supporting their use. Further randomized controlled trials with strict criteria are needed to establish the extent to which APCs can improve wound healing and quality of life in patients with MRONJ requiring surgical treatment.

Effect of Freeze-Thawing Treatment on Platelet-Rich Plasma Purified with Different Kits.

Osteoarthritis of the knee (OAK), a progressive degenerative disease affecting quality of life, is characterized by cartilage degeneration, synovial inflammation, and osteophyte formation causing pain and disability. Platelet-rich plasma (PRP) is an autologous blood product effective in reducing OAK-associated pain. PRP compositions depend on their purification. In clinical practice, PRP is typically administered immediately after purification, while cryopreserved PRP is used in research. Platelets are activated by freezing followed by release of their humoral factors. Therefore, PRP without any manipulation after purification (utPRP) and freeze-thawed PRP (fPRP) may differ in their properties. We purified leukocyte-poor PRP (LPPRP) and autologous protein solution (APS) to compare the properties of utPRPs and fPRPs and their effects on OAK target cells. We found significant differences in platelet activation and humoral factor content between utPRPs and fPRPs in both LPPRP and APS. Freeze-thawing affected the anti-inflammatory properties of LPPRP and APS in chondrocytes and synovial cells differed. Both utPRPs and fPRPs inhibited polarization toward M1 macrophages while promoting polarization toward M2 macrophages. Freeze-thawing specifically affected humoral factor production in macrophages, suggesting that evaluating the efficacy of PRPs requires considering PRP purification methods, properties, and conditions. Understanding these variations may enhance therapeutic application of PRPs in OAK.

Enhancing wound healing in cattle through the application of vitreous humour fluid and platelet-rich plasma

The aim of this work: to examine the impact of applying vitreous humour fluid as well as platelet-rich plasma (PRP) on cattle's wound healing. Twelve dairy cows, randomly divided into three groups, constituted the subjects for this research. Those cows consumed standard quantities—grains; alfalfa; straw—with ad libitum clean water. We collected Vitreous humour fluid from slaughtered cows, storing it at 4°C. Through withdrawing blood from the same cows and separating PRP from plasma, we prepared Autologous PRP. Furthermore, we prepared a mixture of PRP with vitreous humour fluid which has been subsequently applied to wound site. At 7, 14, and 21 weeks, we performed biopsies on the cows for histopathological examination. On day 7, the histopathological examination revealed improved tissue reorganization and proliferation in wounds treated with PRP and vitreous humour fluid. Furthermore, in comparison with the control group--at this same time point--collagen organization has been notably superior. Moving onto day 14: a complete or partial union of wound margins manifested in the two groups treated with PRP and vitreous humour fluid; also, better granulation tissue formation stood out significantly—an indicator that healing progress had been robustly effective. By day 21; complete epithelialization—alongside dense collagen bundles filling the wound site—signified successful healing of wounds treated specifically with the use of vitreous humor fluid. The findings of the presented work indicate that the utilization of vitreous humour fluid and PRP could facilitate the process of wound healing in cattle. Improvements in tissue reorganization, proliferation, and collagen organization were all found. In the process of developing wound healing therapies for cattle, such findings offer useful insights that can be further developed.

Preliminary results of acute Achilles tendon rupture treated with platelet-rich plasma and immobilization

Objective: Evaluate preliminary functional results, return to sport, re-rupture rate of acute Achilles rupture treated with one applicationof platelet-rich plasma (PRP), and immobilization.Methods: A prospective analytical study was performed in patients with acute Achilles tendon rupture treated conservatively, associatedwith a single local application of PRP within 10 days of injury. The sample comprised 28 patients diagnosed and monitored by the sameteam for a minimum of 12 months. The American Foot and Ankle Society Functional Rating Scale (AOFAS), Achilles tendon totalrupture score (ATRS), visual analog scale (VAS), and Achilles tendon resting angle (ATRA) were evaluated, the time of return to sportsactivities and isokinetic strength were evaluated at the different follow-up times and injury site using magnetic resonance imaging.Results: The variance analysis of the AOFAS, ATRA, and VAS scores showed a significant difference at six and 12 months regardingthe initial score and according to the injury site. The mean time to return to sports activities was 197 days, 85.7% had homogeneoustendons, and heel-rise type 2 was achieved in 28.6% at six months and 60.7% at 12 months.Conclusion: The protocol proposed by our study for Achilles tendon rupture significantly improved all the scores evaluated comparedto the initial condition and the isokinetic evaluations, obtaining even better results in proximal injuries. Level of Evidence IV; Therapeutic studies investigating the results of treatment; Case series.

The combined application of pulsed electromagnetic fields and platelet-rich plasma in the treatment of early-stage knee osteoarthritis: A randomized clinical trial.

This study aims to evaluate the therapeutic efficacy of combined treatment with pulsed electromagnetic fields (PEMFs) and platelet-rich plasma (PRP) injection in improving pain and functional mobility among patients with early-stage knee osteoarthritis (KOA). We hypothesize that this combined therapy can yield superior treatment outcomes. Based on the different treatment regimens, we divided 48 patients diagnosed with Kellgren-Lawrence grades I-III KOA into 3 groups: the PRP group, the PEMFs group, and the PRP + PEMFs group. Each subtype of KOA patients was randomly assigned to different treatment groups. In the PRP group, patients received intra-articular injections of leukocyte-rich platelet-rich plasma once a month for 3 consecutive months. In the PEMFs group, patients receive low-frequency PEMFs irradiation therapy with a frequency of 30 Hz and intensity of 1.5 mT, once daily, 5 times a week, for a consecutive treatment period of 12 weeks. In the PRP + PEMFs group, patients receive both of the aforementioned treatment protocol. The treatment effects on patients are evaluated at baseline and at weeks 4, 8, and 12 post-treatment. Assessment parameters include visual analog scale for pain, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne Index score, and knee joint range of motion. From the 4th to the 12th week of treatment, the visual analog scale scores, Western Ontario and McMaster Universities Osteoarthritis Index scores, and Lequesne index scores of patients in all 3 groups gradually decreased, while knee joint mobility gradually increased (P < .05). At weeks 4, 8, and 12 after treatment, the PRP combined with PEMFs group showed significantly better scores compared to the PRP group and the PEMFs group, with statistically significant differences (P < .05). A total of 7 patients experienced adverse reactions such as knee joint swelling, low-grade fever, and worsening knee joint pain after treatment, all of which disappeared within 1 week after treatment. The incidence of complications did not differ significantly among the 3 groups (P = .67). PRP, PEMFs, and the combination of PRP and PEMFs therapy all effectively alleviate knee joint pain and improve joint function. However, compared to single treatment modalities, the combined therapy of PRP and PEMFs demonstrates more pronounced efficacy.

Efficacy of platelet rich plasma for acceleration of healing in chronic wounds.

To compare the standard dressing with normal saline with platelet-rich plasma for acceleration of healing in patients with chronic wounds. The study was conducted at the Department of Plastic and Reconstructive Surgery, Dow University of Health Sciences and Dr K.M. Ruth Pfau Civil Hospital, Karachi, from April 1, 2019, to March 31, 2020, and comprised patients of either gender aged 18-60 years with arterial ulcers on the lower limb with dimension of wound <10 cm2, haemoglobin >10g/dl and platelet count >150x109/L. The patients were randomised into control group A, which received conventional treatment of dressing with normal saline, and intervention group B, which received daily dressings with normal saline and weekly application of platelet-rich plasma. The procedure was repeated every week for 3 weeks. Bates Jensen wound assessment tool was used to assess the final outcome. Data was analysed using SPSS 20. Of the 98 patients, with mean age 41.68±11.03 years, there were 49(50%) in group A; 45(91.8%) males and 4(8.2%) females with overall mean age 40.10±10.8 years. The other 49(50%) patients were in group B; 39(79.6%) males and 10(20.4%) females with overall mean age 43.27±11.1 years (p>0.05). Mean wound assessment score of group B patients decreased significantly compared to group A (p=0.002). Platelet-rich plasma treatment showed better performance in accelerating healing of chronic arterial wounds compared to the standard treatment of daily dressing with normal saline.

Systematic Review of Platelet-Rich Plasma in Medical and Surgical Specialties: Quality, Evaluation, Evidence, and Enforcement.

Background: Platelet-rich plasma (PRP) is widely used in various medical and surgical specialties for its regenerative properties, including aesthetics (facial rejuvenation, hair restoration, and skin tightening) and orthopedics (treatment of tendinitis and osteoarthritis). However, the inconsistent literature on PRP's efficacy and safety leads to critical knowledge gaps. This systematic review evaluates quality control measures in PRP preparation and application and explores the regulatory environment governing its clinical use. Methods: Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, EMBASE, and Web of Science, for studies published from January 2020 to April 2024. The review included randomized controlled trials (RCTs) involving human participants undergoing PRP treatment for aesthetic or regenerative purposes. Key parameters such as the PRP preparation methods, platelet concentration, and quality control measures were analyzed. The study protocol was registered with PROSPERO (ID: CRD42024557669). Results: Out of 75 RCTs involving 5726 patients, the review identified significant variability in PRP preparation methods and application techniques, including differences in centrifugation protocols and platelet concentration levels. A new evidence-based scoring system, the William-Eqram Scoring System for PRP Quality Reporting (WESS-PQR), was proposed to address these inconsistencies. Correlation analysis revealed a strong positive correlation (r = 0.79) between proper temperature control during preparation and PRP efficacy. Initial platelet count assessment showed a moderate positive correlation (r = 0.57) with efficacy. Conclusions: Standardized PRP preparation protocols and robust regulatory frameworks are urgently needed to ensure the safety and efficacy of PRP treatments. The proposed WESS-PQR scoring system can serve as a valuable tool for clinicians and researchers, promoting consistency and reliability in PRP applications.

Platelet-Rich Plasma in Aesthetic Dermatology: Current Evidence and Future Directions.

Platelet-rich plasma (PRP) has emerged as a promising treatment in aesthetic dermatology. This systematic review aims to evaluate the current evidence for PRP applications in skin rejuvenation, hair restoration, wound healing, and fat grafting. FollowingPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across multiple databases and 13 studies meeting the inclusion criteria were selected for review. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of included studies. The reviewed studies consistently reported positive outcomes for PRP across various applications. In skin rejuvenation, significant improvements in collagen density and overall skin appearance were observed. For hair restoration, studies showed mean increases of 18-27.7 hairs/cm² in treated areas. PRP demonstrated efficacy in accelerating wound healing across various wound types, including chronic ulcers. In fat grafting, PRP was associated with improved graft survival and integration. Patient satisfaction was generally high across all applications. However, there was significant heterogeneity in PRP preparation methods and treatment protocols among studies. This systematic review provides evidence supporting the efficacy of PRP in aesthetic dermatology, particularly in skin rejuvenation, hair restoration, wound healing, and fat grafting. PRP demonstrates a favorable safety profile across applications. However, the variability in study designs and PRP protocols highlights the need for standardization. Future research should focus on large-scale randomized controlled trials with standardized protocols and longer follow-up periods to solidify the evidence base for PRP in aesthetic dermatology.

The Use of Platelet-Rich Plasma (PRP) in Surgery: Antibiotic Effects and PostSurgical Rehabilitation Benefits

Platelet-Rich Plasma (PRP) therapy has emerged as a promising adjunct in various surgical disciplines. This paper explores the multifaceted applications of PRP in surgery, focusing on its antibiotic effects and benefits during post-surgical rehabilitation. Comprehensive review and analysis of peer-reviewed studies reveal PRP’s potential in enhancing wound healing, reducing infection rates, and improving rehabilitation outcomes. The paper consolidates current evidence, addressing both the advantages and limitations of PRP therapy.

Platelet-Rich Therapies in Hernia Repair: A Comprehensive Review of the Impact of Platelet Concentrates on Mesh Integration in Hernia Management.

Mesh-augmented hernia repair is the gold standard in abdominal wall and hiatal/diaphragmatic hernia management and ranks among the most common procedures performed by general surgeons. However, it is associated with a series of drawbacks, including recurrence, mesh infection, and adhesion formation. To address these weaknesses, numerous biomaterials have been investigated for mesh coating. Platelet-rich plasma (PRP) is an autologous agent that promotes tissue healing through numerous cytokines and growth factors. In addition, many reports highlight its contribution to better integration of different types of coated meshes, compared to conventional uncoated meshes. The use of PRP-coated meshes for hernia repair has been reported in the literature, but a review of technical aspects and outcomes is missing. The aim of this comprehensive review is to report the experimental studies investigating the synergistic use of PRP and mesh implants in hernia animal models. A comprehensive literature search was conducted across PubMed/Medline, Web of Science, and Scopus without chronological constraints. In total, fourteen experimental and three clinical studies have been included. Among experimental trials, synthetic, biologic, and composite meshes were used in four, nine, and one study, respectively. In synthetic meshes, PRP-coating leads to increased antioxidant levels and collaged deposition, reduced oxidative stress, and improved inflammatory response, while studies on biological meshes revealed increased neovascularization and tissue integration, reduced inflammation, adhesion severity, and mechanical failure rates. Finally, PRP-coating of composite meshes results in reduced adhesions and improved mechanical strength. Despite the abundance of preclinical data, there is a scarcity of clinical studies, mainly due to the absence of an established protocol regarding PRP preparation and application. To this point in time, PRP has been used as a coating agent for the repair of abdominal and diaphragmatic hernias, as well as for mesh fixation. Clinical application of conclusions drawn from experimental studies may lead to improved results in hernia repair.

The Biological Effect of Platelet-Rich Plasma on Rotator Cuff Tears: A Prospective Randomized In Vivo Study.

The positive effect of platelet-rich plasma (PRP) on tendon metabolism has been extensively investigated and proven in vitro. Additionally, in vivo animal studies have correlated the application of PRP with the enhancement of tenocyte anabolic activity in the setting of tendon degeneration. However, less is known about its in vivo effect on human tendon biology. The purpose of the current prospective randomized comparative study was to evaluate the effect of PRP on torn human supraspinatus tendon. Twenty consecutive eligible patients with painful and magnetic resonance imaging (MRI)-confirmed degenerative supraspinatus tendon tears were randomized in a one-to-one ratio into two groups. The patients in the experimental group (n = 10) underwent an ultrasound-guided autologous PRP injection in the subacromial space 6 weeks before the scheduled operation. In the control group (n = 10), no injection was made prior to surgery. Supraspinatus tendon specimens were harvested from the lateral end of the torn tendon during shoulder arthroscopy and were evaluated under optical and electron microscopy. In the control group, a mixed cell population of oval and rounded tenocytes within disorganized collagen and sites of accumulated inflammatory cells was detected. In contrast, the experimental group yielded abundant oval-shaped cells with multiple cytoplasmic processes within mainly parallel collagen fibers and less marked inflammation, simulating the intact tendon structure. These findings indicate that PRP can induce microscopic changes in the ruptured tendon by stimulating the healing process and can facilitate a more effective recovery.

610 The Effectiveness of Adipose Tissue Derived Mesenchymal Stem Cells Mixed with Platelet Rich Plasma in the Healing of Inflammatory Bowel Anastomoses: A Pre-Clinical Study in Rats

Abstract Aim Anastomotic leak is a detrimental complication following bowel surgery leading to prolonged hospital stay, increased healthcare costs and significant increase in morbidity and mortality. The aim of this study is to investigate the effect of adipose derived mesenchymal stem cells (MSCs) mixed with platelet rich plasma (PRP) in the healing of bowel anastomoses, in an inflammatory environment . Method Thirty-five male Wistar rats were divided into five groups of seven animals: normal controls, colitis controls, PRP, MSCs, and PRP + MSCs. All groups underwent laparotomy, segmental colectomy and anastomosis in situ. Colitis was previously established by transrectal administration of 2,4,6-trinitrobenzene sulfonic acid (TNBS) except for the normal controls. Post-mortem histopathological, tissue hydroxyproline and anastomotic bursting pressure (ABP) assessments were performed. Results Tissue hydroxyproline and ABP were significantly increased in the group of PRP+MSCs compared to colitis controls (p=0.0151 and p=0.0104, respectively). Inflammatory cell infiltration was lower and fibroblast activity higher in PRP + MSCs group, but not statistically significant. Neoangiogenesis (p=0.0073) and anastomotic area epithelialization (p=0.0182) were significantly higher in PRP + MSCs group compared to colitis controls. Conclusions The synergic effect of the PRP and MSCs is shown to significantly improve healing in bowel anastomoses even on a background of inflammation. These results give hope for primary anastomosis and potentially avoiding stoma and its complications, especially in immunocompromised or malnourished patients undergoing bowel resection. Clinical studies should follow in order to support the clinical application of PRP and MSCs combination in gastrointestinal anastomoses.

Application of cord blood-derived platelet-rich plasma in the treatment of diseases.

Platelet-rich plasma (PRP), a blood product containing high concentrations of platelets, has been increasingly used for the treatment of a number of diseases because of its anti-inflammatory and regenerative properties. PRP is generally obtained from the patient's own peripheral blood when used in clinical applications, but allogeneic PRP extracted from umbilical cord blood has also attracted attention due to its unique advantages. The main purpose of this narrative review was to summarize the research and clinical application of cord blood-derived PRP (CB-PRP) in the treatment of diseases up to April 2024. This review also discusses the differences between CB-PRP and autologous PRP (A-PRP). A thorough search of PubMed® and Clinicaltrials.gov identified 13 articles and four clinical trials. To date, CB-PRP has been primarily studied in the fields of orthopaedics, dermatology, neurology, obstetrics/gynaecology and ophthalmology. This is likely to be because this research is relatively novel. Considering the differences between the characteristics of A-PRP and CB-PRP, it is thought that CB-PRP might hold more promise for broader applications in the future.

Mechanisms, Efficacy, and Clinical Applications of Platelet-Rich Plasma in Tendinopathy: A Comprehensive Review.

Tendinopathy poses a significant clinical challenge characterized by chronic tendon pain, swelling, and impaired function, affecting athletes and the general population. Current treatments often provide limited success, necessitating exploration into regenerative therapies such as platelet-rich plasma (PRP). PRP harnesses the regenerative potential of autologous platelets and growth factors to promote tendon healing. This review aims to comprehensively examine the mechanisms, efficacy, and clinical applications of PRPin tendinopathy. We discuss the pathophysiology of tendinopathy, highlighting collagen disorganization, increased ground substance, and inflammatory changes. PRP's action mechanism involves releasing bioactive molecules that stimulate cellular proliferation, collagen synthesis, and tissue remodeling. Clinical studies and trials evaluating PRP in various tendinopathies, including Achilles, patellar, and rotator cuff tendinopathy, are reviewed to assess its efficacy and effectiveness compared to traditional therapies. Practical aspects, such as preparation methods, injection techniques, and safety considerations, are discussed to provide insights into optimal PRP administration. Challenges, including protocol variability and evidence gaps, are addressed, and future research and clinical practice directions are proposed. By synthesizing current knowledge, this review aims to guide clinicians in enhancing treatment strategies and advancing the field of tendon regenerative medicine.

Ultrasound-Guided PRP and SVF Therapy Shows Sustained Improvement in Severe Knee Osteoarthritis: A 12-Month Retrospective Study.

BACKGROUND Knee osteoarthritis (OA) is a chronic disease caused by cartilage degeneration in the joint accompanied by joint deformities, pain, and stiffness. This study assessed the changes over time in the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS) values of patients after the combined application of stromal vascular fraction (SVF) and platelet-rich plasma (PRP). MATERIAL AND METHODS A retrospective clinical study was designed. Thirty-four patients (8 males, 26 females, mean age 65.21±10.71, range 30-83 years) with pain due to knee osteoarthritis received SVF and PRP between 2019 and 2020. During and after the procedure, ultrasound-guided intra-articular spread was checked. RESULTS PRP+SVF injection provided significant improvement in the clinical symptoms of the patients measured according to their VAS and WOMAC scores, and this improvement continued until the twelfth month. The change in VAS scores of the patients was 1.76±1.18 (P=0.000) in the first month, 1.50±1.46 (P=0.000) in the sixth month, and 1.53±1.41 (P=0.000) in the twelfth month. VAS scores decreased 6.6 to 1.6 point at the end of the twelfth month. The WOMAC scores of the patients were 23.20±12.12 (P=0.000) in the first month, 19.48±12.0 (P=0.000) in the sixth month, and 20.01±10.48 (P=0.000) in the twelfth month. WOMAC scores decreased 51.99 to 20.48 point at the end of the twelfth month. CONCLUSIONS Applying ultrasound-guided PRP+SVF injection into the knee joint once in OA patients improved VAS and WOMAC scores.