Platelet-rich Plasma Products Research Articles

Arthroscopic rotator cuff repair combined with platelet-rich plasma products can reduce the rate of retearing and improve clinical outcomes: A meta-analysis of randomized controlled trials.

Although several studies on the potential benefits of protein-rich plasma (PRP) therapy for rotator cuff injuries have been published, the results have been conflicting. Therefore, this study aimed to determine whether PRP is beneficial for the prevention of retears after arthroscopic rotator cuff repair (ARCR). Two reviewers conducted independent literature searches based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) comparing a PRP treatment group with a control group were included. The quality of evidence was assessed using the Cochrane Collaboration Risk of Bias Tool. Clinical outcomes were compared using the risk ratio (RR) for dichotomous variables and weighted mean difference (WMD) for continuous variables. Statistical significance was set at P < .05. This review included 21 RCTs (1359 patients). Significant results were noted in favor of PRP treatment compared with controls based on retearing rates (16.5% vs 23.6%, respectively; P = .002) and the Constant score in the short term (WMD: 1.98; 95% confidence interval [CI], 0.27-3.70; I2 = 0%; P = .02), medium term and long term (WMD: 2.56 [95% CI: 1.57-3.55]; I2 = 2%; P < .001); the University of California, Los Angeles score in the short term (WMD: 1.14 [95% CI: 0.43-1.85]; I2 = 25%; P = .002) but not in the medium and long term (WMD: 0.66 [95% CI: -0.16 to 1.48]; I2 = 57%; P = .11); and the visual analog scale score in the short term (WMD: -0.63 [95% CI: -0.83 to-0.43]; I2 = 41%; P < .001), medium and long term (WMD: -0.12 [95% CI: -0.19 to-0.05]; I2 = 0%; P = .008). There was no significant difference in American Shoulder and Elbow Surgeons scores between the treatment and control groups in the short term (WMD: -0.48 [95% CI: -2.80 to 1.85]; I2 = 22%; P = .69) or medium and long term (WMD: 0.92 [95% CI: -1.56 to 3.39]; I2 = 40%; P = .47). Intraoperative use of PRP reduces the risk of rotator cuff repair failure, improves clinical outcomes, and reduces recurrence rates.

The effect of calcium chloride on the release of platelet-derived growth factor-BB in the platelet-rich plasma products

The effect of calcium chloride on the release of platelet-derived growth factor-BB in the platelet-rich plasma products

Literature review details and supports the application of platelet-rich plasma products in canine medicine, particularly as an orthobiologic agent for osteoarthritis.

Platelet-rich plasma (PRP) and other platelet-derived products represent a subset of regenerative medicine and have been researched in the veterinary community for the treatment of osteoarthritis, soft tissue wounds, tendinopathies, periodontitis, and fracture repairs. PRP is simple to produce, relatively affordable, safe, and can be delivered on site, making it an appealing therapeutic agent in veterinary medicine. As an orthobiologic for the treatment of osteoarthritis, it is one of few interventions with clinical study support that possess anabolic potential. Platelet product variability is wide ranging and often described in terms of cellular content or platelet enrichment. Growth factors associated with platelet activation and subsequent degranulation may mediate inflammation, modulate cellular immune response, and promote tissue repair. Product composition, dosage, and application likely influence treatment outcomes depending on the classification of the disease targeted. Sufficient canine data regarding the formulation and clinical application of canine PRP exist to warrant review. The aim of this narrative is to provide scientific background and clinical insight for veterinarians regarding platelet product content/formulation, mechanisms of action, considerations for use, and clinical application in dogs.

Platelet-Rich Plasma: Advances and Controversies in Hair Restoration and Skin Rejuvenation.

Platelet-rich plasma (PRP) and its combined therapeutic modalities have catalyzed new possibilities in dermatology; however, limitations in evidence and lack of consensus remain among clinicians regarding optimal composition, protocol, technique, and application. To provide an update and analysis of the evidence for PRP in hair restoration and skin rejuvenation through review of recent available data, highlighting controversies and expert insights to guide future studies, and stimulate discourse and innovations benefitting patients. A structured review and expert analysis of PubMed publications before October 2023, with a focus on recent literature from January 2020 through October 2023. Growing literature supports the utility and benefits of PRP and related autologous products for applications for skin and hair, with strongest evidence for androgenetic alopecia and skin rejuvenation. However, this is limited by lack of consensus regarding best practices and protocols. Randomized, controlled trials with uniform metrics comparing outcomes of various compositions of autologous blood products, preparation methods, dosimetry, and frequency of treatments are still required. This will allow the medical discourse to grow beyond the realm of expert opinion into consensus, standardization, and more wide spread adoption of best practices that will benefit patients.

Does the Combination of Platelet-rich Plasma and Supervised Exercise Yield Better Pain Relief and Enhanced Function in Knee Osteoarthritis? A Randomized Controlled Trial.

Knee osteoarthritis is a leading cause of disability with substantial healthcare costs, and efficient nonsurgical treatment methods are still needed. Platelet-rich plasma (PRP) injections and exercise therapy are used frequently in clinical practice. Whether PRP or PRP combined with exercise is more effective than exercise alone is unclear. (1) Which treatment relieves knee osteoarthritis pain better: PRP alone, exercise, or PRP combined with exercise? (2) Does PRP alone, exercise, or PRP combined with exercise yield better results in terms of the WOMAC score, performance on the 40-m fast-paced walk test and stair climbing test, and the SF-12 health-related quality of life score? In this randomized, controlled, three-arm clinical trial, we recruited patients with mild-to-moderate (Kellgren-Lawrence Grade II or III) knee osteoarthritis with a minimum of 3 points on the 11-point numeric rating scale for pain. During the study period, 157 patients with a diagnosis of knee osteoarthritis were screened and 84 eligible volunteers were enrolled in the study. Patients were randomly allocated (1:1:1) into either the exercise group (28), PRP group (28), or PRP + exercise group (28). Follow-up proportions were similar between the groups (exercise: 89% [25], PRP: 86% [24], PRP + exercise: 89% [25]; p = 0.79). All patients were analyzed in an intention-to-treat manner. There were no between-group differences in age, gender, arthritis severity, and baseline clinical scores (pain, WOMAC, functional performance tests, and health-related quality of life). The exercise group underwent a 6-week structured program consisting of 12 supervised individual sessions focused on strengthening and functional exercises. Meanwhile, the PRP group received three weekly injections of fresh, leukocyte-poor PRP. The PRP + exercise group received a combined treatment with both interventions. The primary outcome was knee pain over 24 weeks, measured on an 11-point numeric rating scale for pain (ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain, with a minimum clinically important difference [MCID] of 2). The secondary outcome measures included the WOMAC index (ranging from 0 to 100, with lower scores indicating a lower level of disability and an MCID of 12), the durations of the 40-meter fast-paced walk test and stair climbing test, and the SF-12 health-related quality of life score. For the a priori sample size calculation, we used the numeric rating scale score for pain at 24 weeks as the primary outcome variable. The MCID for the numeric rating scale was deemed to be 2 points, with an estimated standard deviation of 2.4. Based on sample size calculations, a sample of 24 patients per group would provide 80% power to detect an effect of this size between the groups at the significance level of p = 0.05. We found no clinically important differences in improvements in pain-defined as ≥ 2 points of 10-at 24 weeks when comparing exercise alone to PRP alone to PRP + exercise (1.9 ± 0.7 versus 3.8 ± 1.8 versus 1.4 ± 0.6; mean difference between PRP + exercise group and exercise group -0.5 [95% confidence interval -1.2 to 0.4]; p = 0.69). Likewise, we found no differences in WOMAC scores at 24 weeks of follow-up when comparing exercise alone to PRP alone to PRP + exercise (10 ± 9 versus 26 ± 20 versus 7 ± 6; mean difference between PRP + exercise group and exercise group -3 [95% CI -12 to -5]; p = 0.97). There were no differences in any of the other secondary outcome metrics among the PRP + exercise and exercise groups. PRP did not improve pain at 24 weeks of follow-up in patients with mild-to-moderate knee osteoarthritis compared with exercise alone. Moreover, exercise alone was clinically superior to PRP alone, considering function and the physical component of health-related quality of life. Despite the additional costs and endeavors related to PRP products, the combination of PRP and exercise did not differ from exercise alone. The results of this randomized controlled trial do not support the use of PRP injections in the treatment of patients diagnosed with mild-to-moderate knee osteoarthritis. Consequently, exercise alone is the recommended treatment for reducing pain and enhancing function throughout this timeframe. Level I, therapeutic study.

Not all platelet-rich plasma are created equal.

This review aims to elucidate potential variations in clinical outcomes resulting from the use of different types of platelet-rich plasma (PRPs) in reproductive medicine. It seeks to explore the reasons behind the diverse results reported in various studies and assess the general features distinguishing different PRP formulations. PRPs have found applications across diverse medical fields, generating controversy due to the variability in outcomes. The field of reproductive medicine, despite its limited published studies, is encountering a similar challenge as it integrates these treatments. The multitude of PRP product brands in the market, coupled with 'home-made' PRPs, poses a significant barrier to establishing a common protocol for the preparation of standardized PRP products. This impediment hinders widespread adoption by clinicians, particularly in endometrial or ovarian treatments. Drawing from evidence in other medical disciplines, this review endeavors to compile essential characteristics that PRPs must possess, aiming to mitigate the impact of variables affecting results in forthcoming studies.

A systematic review and meta-analysis of the efficacy of platelet-rich plasma products for treatment of equine joint disease.

Equine joint disease including septic arthritis (SA) and osteoarthritis (OA) is a critical cause of equine lameness. Platelet-rich plasma (PRP) is one of the most popular regenerative therapies to treat equine OA, even SA, but the evidence in support of the treatment is conflicting. The aim of the study was to systematically review the current evidence on PRP products used for SA and OA, as well as the efficacy of PRP products as treatment for OA on the basis of a meta-analysis of the available literature. Systematic review and meta-analysis. A systematic search of relevant databases (PubMed, Web of Science, Scopus) was performed to identify studies published from 2013 to 2023, in accordance with the PRISMA guidelines. Randomised controlled trials, non-randomised trials and controlled laboratory studies that used at least one type of PRP products were included. Dichotomous outcomes were presented using odds ratios (ORs) and 95% confidence intervals (95% CIs). A total of 21 publications were identified in the systematic review and 5 of them in the meta-analysis. These publications involved various types of PRP products and reported different outcomes. Although most of the studies were associated with a high risk of bias, the overall estimated effect was consistent with a significant improvement in the PRP products treatment group compared with the control group (OR: 15.32; 95% CI: 3.00-78.15; p < 0.05). There was a significant improvement in clinical performance outcomes between the groups (OR: 36.64; 95% CI: 3.69-364.30; p < 0.05). PRP products as intra-articular treatment are likely efficacious for treatment of equine OA and have potential for treating SA. These conclusions might be affected by the limited number of randomised controlled studies and high variability of different types of PRP products. To better evaluate the efficacy of PRP, a widely recognised classification system and the utilisation of randomised, blinded, equivalency or non-inferiority trials are required.

Evaluation of a membrane filter and platelet-rich plasma (PRP) product obtained from a prototype PRP kit that works through a new method for separating PRP based on cell dimensions

The harvesting of platelet-rich plasma (PRP) from whole blood based on cell density is a standard procedure that is currently applied to commercially available PRP kits. Leukocytes and erythrocytes, which are closer in density, contaminate a significant amount of PRP products, mostly commercial PRP kits. In this study, we tested membrane filters and PRP products from our prototype PRP kit. We did this by putting a membrane filter with pores of 2 μm in the middle of the tube, which is a new way to separate things based on the cell dimension method (CDM). The evaluations were performed for membrane filter use, hematology analysis, blood smears, viability and cytotoxicity assays, and fibrin structure by scanning electron microscopy (SEM). Compared to the density method (DM), the CDM enables the elimination of a significant number of leukocytes and erythrocytes from the PRPs (CDM-PRP) and a significant increase in the number of platelets compared to the whole blood and DM-PRP. Furthermore, both DM-PRP and CDM-PRP increased the cell viability in L929 cells by adding them at 5% in the culture medium. In addition to CDM-PRP having the lowest cytotoxicity based on the LDH assay, the fibrin structure of CDM-PRP blood clots is characterized by thickness and firmness with a network structure. Thus, we believe that the PRP from the prototype PRP kit meets the requirements as a biomaterial for medical treatments.

Does Platelet-Rich Plasma Treatment Increase In Vitro Fertilization (IVF) Success in the Infertile Population?

Platelet-rich plasma (PRP) is obtained by centrifuging the platelet-rich portion of the patient's own blood. The objective of our study is to retrospectively examine the impact of intraovarian PRP injection on infertile women with diminished ovarian reserve, specifically focusing on the oocyte count, oocyte quality, and endometrial thinning. A retrospective assessment was conducted on cases who had intraovarian PRP injection at the in vitro fertilization (IVF) unit of the Obstetrics and Gynecology Department of Gazi University School of Medicine hospital. The review encompasses the period from 1 January 2015 to 30 June 2020. The endometrial thickness, follicle count of greater than 14 millimeters, estradiol levels, follicle-stimulating hormone (FSH) levels, and antral follicle count were assessed during the menstrual cycle both prior to and within a period of 1-6 months following the PRP procedure. Twenty nonpregnant patients who had IVF before and 4-6 months after PRP were admitted to the post-PRP IVF cycle. The quantification of oocytes and M2 oocytes was conducted both prior to and subsequent to PRP treatment. Among 120 cases, only 60 cases who fulfilled inclusion criteria were analyzed.The basal endometrial thickness, basal follicle number (>14 mm), estradiol value, oocyte count, and M2 oocyte count exhibited a statistically significant increase following the administration of PRP injection (p<0.001). The basal FSH value exhibited a notable drop following the administration of PRP injection, with a statistically significant difference(p=0.002). In the pregnant group, the number of oocytes obtained with oocyte pick-up (OPU) increased by 300%, and in the nonpregnant group, the increase was 125% only. The number of M2 oocytes obtained with OPU increased by 250% in the pregnant group, while it was 93% in the nonpregnant group. Ultimately, the affordability of PRP production and its considerable theoretical efficacy have the potential to substantially decrease the expenses associated with assisted reproductive technology procedures. In the present scenario, the administration of an intraovarian PRP injection may be contemplated as a therapeutic intervention for women exhibiting diminished ovarian reserve.

Creating 2 Unique Platelet-rich Plasma Products From a Single Batch of Whole Blood With a Single Processing Kit

Introduction: Platelet-rich plasma (PRP) is effective for knee osteoarthritis (OA) and certain tendinopathies. Current recommendations support the use of leukocyte-poor PRP for OA and leukocyte-rich PRP for tendinopathy. If a patient presents with both OA and tendinopathy, very few systems can create multiple PRP products in the same treatment session. The Angel device processes multiple cycles to produce different PRP products. Methods: Ten healthy volunteers donated 156 mL whole blood (WB) that was mixed with 24 mL of anticoagulant citrate dextrose solution, solution A. The first PRP was produced by processing 120 mL at the 0% hematocrit setting and the second PRP was created by processing the remaining 60 mL at the 15% hematocrit setting. WB and PRP underwent complete blood counts and growth-factor analysis. Results: Ten patients donated WB for processing. The 0% setting yielded 3.7 ± 0.15 mL PRP, whereas the 15% setting produced 4.7 ± 0.33 mL. The 0% and 15% settings both concentrated platelets significantly more than WB (1101.5 ± 281.7 K/uL and 1357.8 ± 363.7 vs 184.3 ± 39.1 K/uL, P = 0.000). The 0% setting reduced total leukocytes, but this was not statistically significant. The 15% setting concentrated total leukocytes to 24 ± 8.72 K/uL, which was significantly higher than WB (P = 0.000). Neutrophil concentration was significantly reduced in the 0% PRP compared with 15% (0.032 ± .02 vs 6.75 ± 5.76 K/uL, P = 0.000). Discussion: Two unique PRP products were created from the same batch of WB using a single commercial kit by processing aliquots at different settings.

Factors affecting the features of platelet-rich plasma in patients with knee osteoarthritis.

The aim of this study was to present an analysis of platelet-rich plasma obtained from patients with knee osteoarthritis and reveal the factors affecting its features. A total of 62 patients (mean age: 56.68 ± 7.13 years) with symptomatic knee osteoarthritis were included in this study. Age (years), gender, height (m), weight (kg), body mass index (kg/m2), duration of symptoms, smoking status, smoking index, general health status, and physical activity scores were recorded. Whole blood and platelet-rich plasma cell counts were performed with a hematology analyzer. White blood cell, red blood cell, and platelet counts were recorded. According to the dose of injected platelets, efficiency of the procedure, purity of platelet-rich plasma, and activation classification, dose of platelets, efficiency of the procedure (platelet recovery rate, %), and purity of the obtained platelet-rich plasma product (relative composition in platelets, %) were calculated. Correlation analysis between the features of platelet-rich plasma and the patient-related variables, including age, gender, body mass index, smoking status, smoking index, presence of other health conditions, physical activity scores, duration of symptoms, and pain levels, was performed. Dose of injected platelets, efficiency of the procedure, purity of platelet-rich plasma, and activation analysis showed that the dose of injected platelets was 3.25 billion, the efficiency of the process was 77%, and the purity rate of the platelet-rich plasma was 98.4%. Platelet-rich plasma platelet count was correlated with whole blood platelet count (r = 0.81, P < .001), whole blood white blood cell count (r = 0.39, P = .002), smoking status (r = 0.56, P = .03), smoking index (r = -0.63, P = .002), and the presence of hypertension (r = -0.31, P=.04). Platelet-rich plasma white blood cell and purity of platelet-rich plasma were correlated with the smoking status of the patients (r = 0.52, P = .01; r = 0.64, P = .003, respectively). This study has demonstrated that high dose and very pure platelet-rich plasma with medium efficiency was yielded with this platelet-rich plasma preparation procedure; whole blood platelet count, the presence of hypertension, and the smoking status of patients affect the features of the obtained platelet-rich plasma. Level IV, Diagnostic Study.

Angiogenesis and Tissue Repair Depend on Platelet Dosing and Bioformulation Strategies Following Orthobiological Platelet-Rich Plasma Procedures: A Narrative Review.

Angiogenesis is the formation of new blood vessel from existing vessels and is a critical first step in tissue repair following chronic disturbances in healing and degenerative tissues. Chronic pathoanatomic tissues are characterized by a high number of inflammatory cells; an overexpression of inflammatory mediators; such as tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1); the presence of mast cells, T cells, reactive oxygen species, and matrix metalloproteinases; and a decreased angiogenic capacity. Multiple studies have demonstrated that autologous orthobiological cellular preparations (e.g., platelet-rich plasma (PRP)) improve tissue repair and regenerate tissues. There are many PRP devices on the market. Unfortunately, they differ greatly in platelet numbers, cellular composition, and bioformulation. PRP is a platelet concentrate consisting of a high concentration of platelets, with or without certain leukocytes, platelet-derived growth factors (PGFs), cytokines, molecules, and signaling cells. Several PRP products have immunomodulatory capacities that can influence resident cells in a diseased microenvironment, inducing tissue repair or regeneration. Generally, PRP is a blood-derived product, regardless of its platelet number and bioformulation, and the literature indicates both positive and negative patient treatment outcomes. Strangely, the literature does not designate specific PRP preparation qualifications that can potentially contribute to tissue repair. Moreover, the literature scarcely addresses the impact of platelets and leukocytes in PRP on (neo)angiogenesis, other than a general one-size-fits-all statement that "PRP has angiogenic capabilities". Here, we review the cellular composition of all PRP constituents, including leukocytes, and describe the importance of platelet dosing and bioformulation strategies in orthobiological applications to initiate angiogenic pathways that re-establish microvasculature networks, facilitating the supply of oxygen and nutrients to impaired tissues.

Human platelet lysate improves the growth and survival of cultured human pre-antral follicles

Research questionHow do platelet-rich plasma products like human platelet lysate (HPL) and umbilical cord plasma (UCP) affect the growth and survival of isolated human pre-antral follicles in vitro? DesignHuman pre-antral follicles (n = 724; mean diameter: 75 µm; range: 46–237 µm) were isolated from ovarian medulla donated by 14 patients undergoing unilateral oophorectomy for ovarian tissue cryopreservation. Follicles were encapsulated in 0.5% alginate and cultured for 8 days in media supplemented with 5% fetal bovine serum (FBS) (n = 171), 2.5% human serum albumin (HSA) (n = 159), 5% HPL (n = 223) or 5% UCP (n = 171). ResultsThe survival probability was significantly higher in the group supplemented with HPL (80%) compared with the other three groups: FBS (54%, P < 0.001); HSA (63%, P = 0.004) and UCP (29%, P < 0.001). Surviving follicles in the UCP group had less defined follicular membranes and decompacted granulosa cell layers. The median growth of surviving follicles was significantly (P < 0.001) larger in the HPL group (73 µm) compared with any of the other three groups: HSA (43 μm); FBS (40 μm) UCP (54 μm). A descriptive analysis of follicular secretion of anti-Müllerian hormone and oestradiol did not reveal any difference between the groups. The detectability of follicular genes was high for AR (100%), AMHR2 (100%) and FSHR (76%), whereas few follicles expressed LHR (20%). ConclusionHuman platelet lysate significantly improved survival and growth of cultured human pre-antral follicles compared with FBS, HSA and UCP. The use of HPL is a valuable improvement to culture human pre-antral follicles but further studies will have to prove whether the superiority of HPL translates into better quality oocytes.

Comparative evaluation of autologous platelet-rich plasma and platelet lysate in patients with knee osteoarthritis

Autologous platelet-rich plasma (PRP) and platelet lysate (PL) are nowadays promising candidates in the treatment of articular cartilage lesions. We aimed to compare PRP and PL injection effectiveness in patients with knee osteoarthritis (KOA). A total of fifty women with KOA were included in the study. Patients were treated with intra-articular injections of PRP and PL. Clinical outcomes were evaluated using the comparison of VAS, WOMAC, and ROM scores. The concentration levels of growth factors and cytokines were measured by ELISA. All patients showed significant improvements in pain and function following treatment of KOA with PL and PRP compared to baseline. Moreover, PL's concentration of growth factors was significantly higher than PRP. A significant increase was also observed in all of the aforementioned mediators in both PRP and PL products compared to control. These results can introduce PL as a promising and alternative option for KOA therapy in the future.

Changes in Lacrimation in experimentally induced Corneal Ulcers in Rabbits, treated with Third Eyelid Flap, Hyaluronic Acid and Platelet-Rich Plasma products

Changes in Lacrimation in experimentally induced Corneal Ulcers in Rabbits, treated with Third Eyelid Flap, Hyaluronic Acid and Platelet-Rich Plasma products

Two manual non-commercial preparation methods for platelet-rich plasma in donkeys (Equus asinus)

Platelet-rich plasma (PRP) is a biologic, whole blood (WB) derived, immunomodulatory therapeutic that has gained popularity in brood mares for its potential to mitigate post-breeding uterine inflammation/infection and enhance fertility rates. In jennies, increased susceptibility to post-breeding endometritis and poor fertility rates have been associated with insemination using frozen-thawed jack semen. Because many donkey breeds are threatened with extinction, frozen semen technology offers a viable chance at recovery. Thus, PRP has potential in similarly benefitting donkey breeding programs. However, the majority of PRP protocols previously described in donkeys have not undergone critical assessment. Commercial and noncommercial PRP production methods exist, but the latter confers advantages (e.g., field applicability and decreased cost) for a species more likely to receive veterinary care in resource-limited settings. The objective of this study was to evaluate two manual noncommercial methods of producing PRP (double centrifugation [DC] and single centrifugation [SC]) in six healthy adult donkeys (n=3 jennies; n=3 johns; ages 4-8 years old) undergoing three blood collections two weeks apart. For DC-PRP, WB collected into a 150 mL blood transfusion bag containing citrate-phosphate-dextrose solution with adenine was split into 50 mL tubes, centrifuged at 400 × g/15 min, then plasma transferred into 15 mL conical tubes and centrifuged at 1000 × g/10 min. Afterwards, the bottom 2.5 mL of plasma per tube waspreserved as DC-PRP with the above supernatant as DC platelet-poor plasma (PPP). For SC-PRP, WB was collected into 2.7 mL sodium citrate vacutainer tubes, then centrifuged at 120 × g/10 min. Post-centrifugation, the top third layer of plasma was deemed SC-PPP with the remaining portion as SC-PRP. Concentrations of platelets, leukocytes (WBC), and erythrocytes (RBC), and platelet-derived growth factor-BB (PDGF-BB) were assessed in the WB, and extracted PRP and PPP. Data was analyzed by Friedman and Dunn's as a post hoc test with significance as P<0.05. Both protocols concentrated platelets 1.7–5.2-fold, reduced WBC 1.1–50.4-fold, and decreased RBC at least 829-fold compared to WB (P<0.0001). Activity of PDGF-BB in DC-PRP and SC-PRP increased by 1.2–7.0-fold in comparison to WB (P=0.0003). Platelet concentration and PDGF-BB activity rose 3-fold (P<0.0001) and 5.8-fold (P=0.0007), respectively, in DC-PRP than SC-PRP. Leukocyte concentration was wider in DC-PRP than SC-PRP (P<0.0001), but did not differ between WB and DC-PRP (P=0.61). Reduction in WBC and RBC was 42-fold and 22-fold greater, respectively, in SC-PRP than DC-PRP (P<0.0001). These results indicate that noncommercial methods of PRP preparation described in horses are applicable in donkeys. Double centrifugation yielded higher platelet concentration and PDGF-BB activity despite greater WBC and RBC contamination than PRP processing via SC. Future studies are needed to determine in vivo efficacy of PRP in donkeys.

Mitigation of post breeding endometritis in mares treated with platelet rich plasma

Persistent breeding-induced endometritis (PBIE) is one of the major causes of infertility in mares, characterized by a lingering inflammatory response in the uterus, which leads to accumulation of uterine fluid and polymorphonuclear cells (PMN), harming the reproductive efficiency of the animal. The aim of this study was to determine if the presence and volume of intrauterine fluid and the percent of endometrial neutrophils decreased after intrauterine application of blood platelet-rich plasma (PRP) in mares with post-mating endometritis. Healthy estrous crossbreed mares (n = 9) aged between 6 to 12 years, with optimal body condition and under the same nutritional management, had two cycles randomly assigned to a crossover trial. Each received either intrauterine infusions of lactate ringer solution (LRS) or autologous PRP 4h after artificial insemination (AI) with fresh semen of low sperm quality from the same stallion. All the animals went through all the treatments. A total of 100 mL of citrated whole blood was collected for PRP production and was centrifuged at 2315g for 15 minutes then 579g for 10 minutes. The presence of intrauterine fluid (IUF) was analyzed by ultrasonographic examination and the percentage of endometrial neutrophils was determined through endometrial cytology, both before insemination (in the presence ofa preovulatory follicle ≥35mm and endometrial edema) and 24h after treatment application. Statistical analysis was performed by a Mixed model (SAS, 2023) for repeated measures with treatment and time as between subject factors. The presence of intrauterine fluid had an effect of time (p ≤ 0.049), where fluid size was smaller before AI than 24h after treatment; however, there was no treatment effect (p ≥ 0.264) over intrauterine fluid. The percentage of endometrial neutrophils had an effect of time (p ≤0.001), less inflammatory cells were found before AI than 24 hours after treatment; there was an effect of treatment (p ≤0.001) as well, where PRP decreased the number of endometrial polymorphonuclear cells compared to the control group infused with LRS. The increase in intrauterine fluid with time suggests that semen itself increases blood perfusion that generates intrauterine fluid accumulation. After induction of physiological endometritis, endometrial polymorphonuclear cell numbers were reduced successfully with PRP treatment. PRP is rich in peptides and signaling proteins that suppress the expression of proinflammatory cytokines such as IL-1 and TNF, inhibits polymorphonuclear neutrophil migration, and thus regulates intrauterine inflammation through decreased endometrial COX-2 expression.

Comparison of Resuspension Techniques on the Cellular and Cytokine Characteristics of Platelet Rich Plasma: A Pilot Study

Background: Platelet Rich Plasma (PRP) is increasingly used for a variety of musculoskeletal ailments such as tendinopathy and arthritis. There are numerous protocols for preparing PRP, but to our knowledge there have been no studies to assess the impact that re-suspension techniques may have on the cellular characteristics and growth factor expression of the final PRP product. Hypothesis: The type of re-suspension technique used will alter the platelet characteristics and growth factor expression of PRP. Study Design: Descriptive laboratory study. Methods: Blood was collected from nine healthy volunteer donors between ages 26-60. Informed consent and ethics approval was obtained. A double spin technique was used resulting in a concentrated PRP product. Three commonly employed re-suspension techniques were utilized to re-suspend the final PRP product and the cellular characteristics and growth factor expression were analyzed using a reproducible protocol. This study was completed over a single day. Results: All three re-suspension techniques resulted in a 4.6-5.2-fold increase in platelet concentration with no difference between groups (p=0.31). This is consistent with the recommended PRP concentration in published literature. Each re-suspension technique also demonstrated in increase in concentration of PDGF and VEGF with no difference between groups (p=0.81 and p=0.97). Conclusion: This pilot study suggests that the re-suspension techniques may be equivalent and do not result in altered cellular or growth factor characteristics within the study limitations. Clinical Relevance: The mixing method can be labor and time intensive and prolong patient wait times. The vortex method can shorten the overall patient encounter time while still providing an optimal PRP product. Previously, there were only theoretical assumptions regarding how the re-suspension techniques may modify PRP characteristics.

Clinical manifestations of allergic reactions and immunoglobulin E levels on allogeneic freeze-dried platelet-rich plasma (PRP) application

Link of Video Abstract: https://youtu.be/yS431sCL3VQ Background: Several studies have reported that modern wound dressings offer better results. Allogeneic PRP products in the form of injections and gels are available in the market, which helps accelerate wound healing without triggering an immunological reaction. Meanwhile, this study was carried out to investigate the Allogeneic Freeze-Dried PRP form, which is more practical, efficient, and safer. This study aims to determine the effect of Allogeneic Freeze-Dried PRP on human split-thickness skin graft donor wounds on clinical manifestations of allergic reactions and levels of Immunoglobulin E (IgE). Methods: A randomized Pre- and Post-test Control-Trial Group Design was conducted on patients with split-thickness skin graft donor wounds using Allogeneic Freeze-Dried PRP dressings at Dr. Soetomo General Hospital, Surabaya. Allergic manifestations were reviewed during the observation period of up to 4 days, and IgE levels were measured pre-test and 60 minutes post-application. A statistical comparison of results was carried out between the trial and control groups that used paraffin dressings. Results: A total of 36 patients were used as subjects, with 19 (52.78%) in the trial group and 17 (47.22%) in the control group, and their parameters were generally homogeneous. There were no clinical manifestations of allergic, changes in vital signs, and significant differences in IgE levels before and after application statistically in all study subjects (p&gt;0.05). Conclusion: Application of Allogeneic Freeze-Dried PRP to human split-thickness skin graft donor wounds did not generate clinical manifestations of allergic reactions and an increase in IgE.

Platelet Rich Plasma : A Boon To Periodontics

Platelet-rich plasma (PRP), a recently developed autologous cellular therapy, has the potential to perform new functions in an array of regenerative pharmacological treatment plans. Platelet growth factors (PGFs) promote the three stages of the wound recovery and repair cascade, which is the cornerstone of PRP therapy (inflammation, proliferation, remodelling). In vitro, in vivo, and animal experiments were used to test a wide range of PRP formulations. Yet, because it is difficult to apply the findings and technique recommendations from non-clinical studies to human clinical treatment protocols, recommendations from in vitro and animal research frequently result in various clinical manifestations. In this study, we addressed recent advancements in PRP production and composition, applications in periodontics, and PRP mechanisms relating to tissue inflammation and angiogenesis.