PRP Group Research Articles

Positive effect on spinal fusion by the combination of platelet-rich plasma and collagen-mineral scaffold using lumbar posterolateral fusion model in rats

BackgroundPlatelet-rich plasma (PRP) is autologous in origin and contains a high concentration of platelets which is a source of various growth factors. Previous studies have suggested that PRP has a positive effect in accelerating fusion by an autologous bone graft in a lumbar fusion. The role of PRP on artificial bone grafts in spinal fusion remains controversial. In this study, positive effect on spinal fusion by PRP was hypothesized; in vitro and in vivo studies were designed to test this hypothesis.MethodsPRP was produced from peripheral blood of Sprague-Dawley (SD) rats. A lumbar posterolateral arthrodesis model was used to test the efficacy of PRP on spinal fusion. Thirty SD rats were divided into three groups by different implants: the PRP group, PRP plus collagen-mineral carrier; the platelet-poor plasma (PPP) group, PPP plus collagen-mineral carrier; and the control group, collagen-mineral only. Spinal fusion was examined using plain radiographs, micro-computed tomography (micro-CT), manual palpation, and histological analysis. The fusion rate by micro-CT and that by manual palpation in groups were compared.ResultsIn the micro-CT results, 16 fused segments were observed in the PRP group (80%, 16/20), 2 in the PPP group (10%, 2/20), and 2 in the control group (10%, 2/20). The fusion rate, determined by manual palpation, was 60% (6/10) in the PRP group, 0% (0/10) in the PPP group, and 0% (0/10) in the control group. Histology showed that the PRP group had more new bone and matured marrow formation.ConclusionsThe results of this study demonstrated that PRP on an artificial bone carrier had positive effects on lumbar spinal fusion in rats. In the future, this composite could be potentially used as a bone graft in humans.

Evaluation of the Hydroxyproline Content in the Frozen Allograft Tendon Impregnated with the Mesenchymal Cells & PRP in Lamb

Background: Tendon grafting is mostly required to repair an injury to flexor tendon and due to the importance of this tendon; it needs methods to speed up the re-vitality of the tendon allograft. OBJECTIVES: The aim was to investigate the efficacy of the mesenchymal cells and platelet rich plasma on the hydroxyproline content of frozen allograft tendons after grafting in lamb. METHODS: In this experimental study, mid portion (five cm) of SDFT of fifteen lambs, from both forelimbs were removed and replaced with frozen allografts tendon. Animals were divided into 3 subgroups of 5 lambs each: control, PRP and MSCs. The hydroxyproline concentration was measured by after 60 days. Data was analyzed using student t test at P<0.05%. RESULTS: The normal mean values of hydroxyproline content was 137.171±5.291 mg/g dry matter which 87.694±6.502 in control group but 99.694±1.839 in PRP group and in group treated with MSC was recorded 134.322±2.123 mg/g dry matter (P<0.05%) it was quite significantly different between control tendons with that of normal one of the same animal. There was marked increase in hydroxyproline content of MSC group when compare with that of control and PRP groups. CONCLUSIONS: The results of this study showed that MSCs could enhance HP content in the frozen grafted tendon in lamb.

Comparative Study of Hamstring Graft Healing Time after Anterior Cruciate Ligament Reconstruction with Augmentation of Platelet-Rich Plasma

Aim: To Compare hamstring graft healing time after anterior cruciate ligament (ACL) reconstruction with the use of augmentation of platelet-rich plasma. Methods: 30 patients between age group of 18 to 40 years with complete ACL tear were randomly divided into two groups the control group in which only ACL reconstruction was done and second group in which acl reconstruction was performed along with augmentation with Platelet rich plasma. For the PRP group, 3 ml of PRP was obtained in the operation room and was injected into femoral tunnel just before after portal suture. MRI was obtained post operatively 3 month, 6 month and 9th month for both the groups. Graft healing time was defined as the time taken for the graft to reach ligamentization phase when the graft became hyperintense or was visualised similar to PCL or the remnant which was preserved during reconstruction. Results: Patients in PRP augmented group achieved ligamentization phase significantly earlier as compared to those in the control group, with mean time of 3.4 months as compared to 8.1 months in the control group. Conclusion: PRP helps in faster healing of the Hamstring graft. However further studies are required to correlate graft healing time with return to previous activity.

ANALISA GEL KOMBINASI PLATELET RICH PLASMA DAN CHITOSAN TERHADAP PENINGKATAN JUMLAH OSTEOBLAS SEBAGAI BONE REGENERATION PADA LUKA PASCA EKSTRAKSI GIGI TIKUS WISTAR

Background: Extraction has been known as a method for removing the tooth from its socket. Although extraction is frequent, the incidence of post extraction complication are commonly found, about 2,6-30,9%. Complications can inhibit wound healing and bone regeneration of socket. PRP is Platelet Rich Plasma containing growth factors that plays an important role in wound healing, induces bone regeneration and stimulates osteoprogenitor cell into osteoblast cell. Chitosan is a chitin derivate that extracted from the crab shells through deacetylation stage. Chitosan properties are osteoinductive, biocompatible, biodegradable, cell proliferation, antimicrobial, antioxidant, antitumor, and stimulates growth factors capabilities. Purpose: To analyze the combination of PRP and Chitosan gel to increase the number of osteoblast in post extraction wound of wistar rat teeth.Method: True experimental post-test only control group design was done in 28 wistar rats. Sample were divided into 4 groups: PRP gel, combination PRP and Chitosan gel, Chitosan gel and control group Povidone Iodine. Dextra Mandible incisors were extracted and treated accordingly. Number of osteoblast in post extraction socket was observed microscopically after 14 days using IHC staining. Data analyzed by using One Way ANOVA parametric test followed by Post Hoc LSD test.Results: There were statically signifcant di?erence between number of osteoblast in combination PRP and Chitosan gel group compare to PRP gel group (p=0,736), Chitosan gel group (p=0,402) and Povidone Iodine group (p=0,613).Conclusion: Combination PRP and Chitosan gel has a good e?ect in increasingnumber of osteoblast in wound healing post dental extraction

Clinical and radiological effects of platelet-rich plasma on interstitial supraspinatus lesion: A randomized, double-blind, controlled trial

Aim To assess effectiveness of ultra-sound guided platelet-rich plasma infiltrations (PRP) on the supraspinatus interstitial tear healing. Background Symptomatic interstitial superior rotator cuff tear management remains challenging, as conservative management is rarely fully effective, and surgical management requires a long recovery period of 6 months. PRP infiltration might thus represent a valuable alternative. Methods We conducted a randomized, double-blind, controlled trial involving 80 patients suffering from a symptomatic isolated supraspinatus tendon interstitial tear. Patients received two intratendinous injections separated by 1 month, of either PRP (n = 41) or saline solution (n = 39). The primary outcome was tear size evolution, measured on magnetic-resonance arthrogram performed at baseline and at month 7. Results The tendon tear volume did not change between groups : 0 mm3 (range : −84 to +41) for PRP group and 9.8 mm3 (range : −264 to +270 mm3) for saline group (P = 0.175). Comparison between baseline and month 7 on the whole cohort showed a statistically significant decrease in median lesion size from 29 mm3 (range : 4–301) to 19 mm3 (range : 0–292) (P = 0.0293), and a significant improvement for all the clinical scores (VAS, SANE, Constant, and ASES scores) (P > 0.001). There were no between-group significant differences with respect to the clinical scores evolution. Main side effects identified were present on 26/80 patients (PRP : 18/41 ; control : 8/39 ; P = 0.0256), and consisted of : significant pain following injections (PRP : 11/41 ; control : 6/39), frozen shoulder (PRP : 8/41 ; control : 3/39), development of bursal- or articular-tear pattern at month 7 (PRP : 4/41 ; control : 1/39). Nine patients had to benefit a surgical rotator cuff repair after month 7 (PRP : 7/41 ; control : 2/40 ; P = 0.182). Conclusions PRP was not superior to saline injection regarding supraspinatus interstitial tear healing and clinical outcomes improvement. We observed a clinical and radiological improvement on the merged PRP and placebo groups between months 0 and 7. More side effects were observed on the PRP group. The potential costs of two PRP infiltrations are estimated as EURO 1100.

The comparative and prospective study on efficacy and functional outcome of autologous platelet rich plasma injection vs hydrodissection in adhesive capsulitis of shoulder

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Adhesive capsulitis of should is also called frozen shoulder which describes a chronic, indolent pathological process in which the body forms excessive adhesions across the glenohumeral joint which in turn leads to pain, stiffness, and loss of range of movements which compromises the quality of life. The objective of the study was to evaluate the efficacy and functional outcome of autologous PRP injection and hydrodissection in adhesive capsulitis of shoulder.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; After excluding the patients who failed to satisfy the study protocol, the remaining 100 patients are divided equally into two groups namely group A (n=50) who receive autologous PRP injection and group B (n=50) who receive hydrodissection for adhesive capsulitis of shoulder. Both group participants are followed up pre-procedurally and post-procedurally at the end of 1&lt;sup&gt;st&lt;/sup&gt;, 6&lt;sup&gt;th&lt;/sup&gt; and 12&lt;sup&gt;th&lt;/sup&gt; month for pain relief and range of movements. The improvements in pain and range of movements are charted in terms of VAS and DASH scoring system.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The statistical analysis were done for 46 patients in group A and 45 patients in group B which showed a statistical improvement in pain and range of movements (p&amp;lt;0.001 for VAS score and p&amp;lt;0.01 for DASH score) in group A who received autologous platelet rich plasma therapy. Autologous PRP therapy improves the functional quality of life with a long term outcome.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; For adhesive capsulitis of shoulder, autologous PRP therapy remains functionally superior than hydrodissection as autologous PRP is a constructive procedure by rejuvenating the degenerative tissues.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Clinical and Radiological Evaluation of Transplanted Fresh Ear Cartilage Impregnated With the Mesenchymal Cells & PRP in Treatment of Growth Plate Injury in Lamb

Background: Growth plate is responsible for bone elongation and its injury could result in severe orthopedic problems. OBJECTIVES: This study was aimed to investigate the radiographic changes after transplanting the fresh autogenous ear cartilage impregnated with PRP and MSc in treatment of growth plate injury in lamb. METHODS: Cranial half (½) in length in full depth of the right hind limb growth plate was resected with bone oscillator and was transplanted with autogenous fresh harvested ear cartilage at the time of surgery in all of the 15 male lambs. Subsequently they were divided into 3 subgroups of 5 lambs in each group, control, PRP and MSCs. Radiographs were obtained from operated limbs at surgery time and 60 post-operative. RESULTS: Clinically, all lambs showed same lameness degree and mostly apparent after cast removal but gradually improved in the treated group which showed normal weight bearing after one month. Early physeal closure was seen in growth plate injured site only in control group without limb shortening or angular deformity. Lambs with MSCs showed mild bone bridge formation (1.4b ± 0.4b) as compared with PRP group (1.8 ± 0.37ab) and control group (2.8 ± 0.2 a) (P<0.05).On 60 days postoperatively control group showed significant mineralization (by 2.8±0.2a) while less mineralization was detected in MSCs and PRP groups (by 1.4± 0.4b and 2.4± o.4 ab). CONCLUSIONS: This study showed that MSCs & PRP can quite effective in preventing bone bridge formation and mineralization besides convergence of the transplanted tissue into growth plate cartilage. Keywords:

Effect of adding platelet-rich plasma to fat grafts in myringoplasty

BackgroundPlatelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP, with growth factors up to 8 times that of normal serum, has been shown to be safe and effective in promoting natural processes of wound healing. Our study aims to examine the effect of combining the fat graft with PRP in myringoplasty procedures indicated for TMP secondary to chronic suppurative otitis media (CSOM) and whether it can significantly promotes Tympanic membrane (TM) healing.MethodsThis prospective study included forty patients, presenting with dry tympanic membrane secondary to tubo-tympanic CSOM. Half the patients underwent fat graft Myringoplasty with PRP application (group A), while others served as control and received the fat graft only, without PRP (group B).ResultsIn group A, eighteen cases (90%) significantly showed an intact tympanic membrane, while Eleven cases (55%) were successful in group B. P=0.044.ConclusionTopical autologous PRP application during fat plug Myringoplasty is highly successful with no reported postoperative infections and minimal morbidity.

A clinical study of platelet rich plasma versus conventional dressing in management of diabetic foot ulcers

Background: Diabetic foot ulcers continue to pose significant global issue despite the advances made in the management of diabetes. It causes major foot complications if they are not addressed properly. It needs multidisciplinary approach for its care. While several advancements has taken place in wound care management, platelet rich plasma and stem cell therapy promises to offer a new hope in its management, aiding in cellular and tissue regeneration. The purpose of the present study was to compare Platelet-Rich Plasma versus conventional dressing in the management of diabetic foot ulcers.Methods: This prospective study was focused on 20 diabetic foot ulcers, carried out in a surgical unit of ACS Medical College and Hospital, Chennai, Tamil Nadu, from January 2018 to June 2018. Patients were divided into two groups; Group A received conventional ordinary dressing (N=10, 50%) and Group B received PRP dressing (N = 10, 50%). The mean follow-up period was 8 weeks.Results: The estimated time of wound healing was 8 weeks and healing was found to be more effective for patients in group B compared to patients in group A; the PRP group was found to be more effective in wound healing with fewer complications, less infection, exudates and pain.Conclusions: There have been considerable advances in the use of PRP in therapeutic processes in recent years in tissue regeneration therapy. PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds; PRP enables healing, and reduces amputation rates, infection and exudates.

Fractal dimension in the evaluation of different treatments of muscular injury in rats.

To evaluate alterations from different therapies in muscular injury using the Fractal Dimension (FD) method. 35 animals were allocated in Control Group (C), Injury Control Group (IC), Injury Low Level Laser Therapy Group (ILT), Injury Platelet Rich Plasma Group (IP), and Injury LLLT and PRP Group (ILP). The animals suffered a stretch injury in gastrocnemius muscle and after that IP and ILP groups received PRP application. The ILT and ILP groups received daily LLLT applications for seven days. After seven days the animals were euthanized and the gastrocnemius muscle removed and frozen. The muscles were stained with Hematoxylin and Eosin (HE) and Picrosirius Red, for observation of the morphology of the injury and semi-quantitative and quantitative analysis through the Fractal Dimension (FD) method. In the qualitative and semi-quantitative analysis, in relation to IC group, the ILT presented a reduction in rounded fibers and the IP in angular fibers. The ILP group demonstrated a reduction in both polymorphic fibers and inflammatory infiltrate. The FD of the muscles stained with HE was higher in the groups that suffered the injury when compared to the C group (p < 0.05); the FD of the collagen demonstrated no statistical difference between the groups. Both treatments were able to accelerate injury repair, and the association of both presented better results than the isolated applications. However, the FD method showed no sensitivity to differentiate the treatments, either in the histological aspects or the injury in collagen.

Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.&lt;/p&gt;

Volumetric findings of MRI after platelet rich plasma injection in knee osteoarthritis (A randomized clinical trial)

Most of studies have focused on subjective and clinical symptoms effect of PRP and fewer papers have studied its objective effect on cartilage. In this study, we investigated the effect of PRP on cartilage characteristics by special MRI sequencings. In the double blind randomized clinical trial, patients with grades 1, 2 and 3 of osteoarthritis were included in this study. All of the knees divided to groups randomly and exercise was prescribed for all of knees. Beside, PRP was injected 2 courses with 4 weeks interval in PRP group. For all of patients before and 6 months after treatment VAS (visual analogue scale) and WOMAC (Western Ontario and McMaster Universities Arthritis Index) were fulfilled and MRI was performed. Sequencings of MRI were PD fat saturated (coronal and sagittal) and transverse TRUFISP 3D. Imaging was scored according to 4 cartilage's characteristics including, Patellofemoral cartilage volume, Subarticular bone marrow abnormality, Medial and lateral meniscal disintegrity and Synovitis. Twenty-three knees in case group and 23 knees in control group were studied. All of patients were female with mean age 57.57 ± 5.9 years old and mean BMI 28.49 ± 3.24 (Kg/m 2 ). Mean total WOMAC and VAS changes before and after treatment in control group were 11.61 ± 1.3 and 8.5 ± 1.1 respectively. In PRP group, mean total of WOMAC and VAS changes showed better improvement with 20 ± 3.2 and 12.3 ± 1.6 respectively ( P -value < 0.05). In PRP group all of the radiologic variables except subarticular bone marrow abnormality had significantly improvement ( P -value < 0.05). In comparison between 2 groups, Patellofemoral cartilage volume and synovitis had significantly changes in PRP group ( P -value < 0.05). In this study, in addition to the effect of PRP on VAS and WOMAC, there is effect on radiologic characteristics (Patellofemoral cartilage volume and synovitis) significantly. For more evaluation, study with more sample size is recommended.

Does intraarticular PRP injection improve function, pain and quality of life in patients with OA of knee? Case control study of 50 patients

Knee osteoarthritis (OA) is a common debilitating chronic disease. Up to one in 5 people over the age of 45 suffer from knee OA and typical symptoms include significant pain, restricted mobility and difficulty to indulge in activities of daily living. Other than knee replacement, no other reliable treatment exists to manage symptomatic knee OA.Platelet Rich Plasma (PRP) is a form of Prolotherapy and is increasingly used to manage OA patients, although the evidence is largely anecdotal. We conducted a case-control study to assess efficacy of PRP comparing it for pain relief in OA Knee.We studied two groups of 25 patients each. One group of 25 patients was given therapeutic exercises and Acetaminophen for pain relief (control group). Second group of 25 patients (PRP group) was injected with two courses of intra-articular injection of Leucocyte rich PRP with interval of 6 weeks. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) was recorded pre-intervention, at six months & one year post-intervention in both the groups. Change scores were assessed for statistical significance.No compilations were noted in both groups and none of the cases needed further surgical intervention during the follow up period. Mean changes of total WOMAC, in PRP group showed significantly better improvement than control group (P<0.05) at all time intervals.This study showed that intra articular PRP knee injection combined with therapeutic exercise can be more effective in pain reduction and improvement of stiffness and quality of life, compared with therapeutic exercise alone.

Influence of 4-week multi-strain probiotic administration on resting-state functional connectivity in healthy volunteers

PurposeExperimental investigations in rodents have contributed significantly to our current understanding of the potential importance of the gut microbiome and brain interactions for neurotransmitter expression, neurodevelopment, and behaviour. However, clinical evidence to support such interactions is still scarce. The present study used a double-blind, randomized, pre- and post-intervention assessment design to investigate the effects of a 4-week multi-strain probiotic administration on whole-brain functional and structural connectivity in healthy volunteers.MethodsForty-five healthy volunteers were recruited for this study and were divided equally into three groups (PRP: probiotic, PLP: placebo, and CON: control). All the participants underwent resting-state functional MRI and diffusion MRI brain scans twice during the course of study, at the beginning (time point 1) and after 4 weeks (time point 2). MRI data were acquired using a 3T whole-body MR system (Magnetom Skyra, Siemens, Germany).ResultsFunctional connectivity (FC) changes were observed in the default mode network (DMN), salience network (SN), and middle and superior frontal gyrus network (MFGN) in the PRP group as compared to the PLP and CON groups. PRP group showed a significant decrease in FC in MFGN (in frontal pole and frontal medial cortex) and in DMN (in frontal lobe) as compared to CON and PLP groups, respectively. Further, significant increase in FC in SN (in cingulate gyrus and precuneus cortex) was also observed in PRP group as compared to CON group. The significance threshold was set to p < 0.05 FWE corrected. No significant structural differences were observed between the three groups.ConclusionsThis work provides new insights into the role of a multi-strain probiotic administration in modulating the behaviour, which is reflected as changes in the FC in healthy volunteers. This study motivates future investigations into the role of probiotics in context of major depression and stress disorders.

Autologous Matrix-Induced Chondrogenesis vs Microfracture with PRP for Chondral Lesions of the Knee in a Rabbit Model

Currently, microfracturing is the most commonly used cartilage repair procedure in cartilage defects. Our aim was to study the mechanism of in vivo cartilage repair in case of full-thickness articular cartilage damage of the knee using a three-dimensional matrix implanted without any preseeded cells in the defect. We also investigated whether platelet-rich plasma application after microfracture procedure of the knee is associated with improved outcome compared with traditional microfracture treatment alone in a rabbit model. Histological examination of the chondral defects, revealed the largest amount of new tissue with hyaline-like cartilage features in Hyalofast group. At 12 weeks from implantation of the Hyalofast scaffold demonstrated complete filling of the defect with hyaline cartilage in admixture with the scaffold and bone metaplasia in the deepest areas. In the PRP group, complete filling of the defect with an admixture of fibrous and hyaline-like cartilage tissue appeared with a discreet tendency of endochondral ossification. We confirmed the superiority of the autologous matrix-induced chondrogenesis compared to microfracture and PRP or microfracture alone in case of full-thickness articular cartilage damage of the knee.

Platelet-rich Plasma Protects HUVECs against oX-LDL-induced Injury.

Platelet-rich plasma (PRP) contains a variety of cytokines, some of which ameliorate oX-LDL (oxidized low-density lipoprotein)-induced endothelial cell (EC) injury. Therefore, we hypothesized that PRP might alleviate oX-LDL-induced injury.MethodologyHuman umbilical vein endothelial cells (HUVECs) were divided into four groups: a PPP (platelet-poor plasma) group, an oX-LDL group, an oX-LDL+PRP group and a PRP group. CCK-8 (Cell Counting Kit) assay, Annexin V-FITC/7-AAD and Hochest 33342 staining were performed to assess cell proliferation and apoptosis. Tube formation and cell migration assays were performed to evaluate HUVEC-mediated vasculogenesis and migration. Expression levels of Bcl-2, Bax, caspase-3, cleaved caspase-3, PI3K, Akt, eNOS p-Akt, p-eNOS, IL-6 and IL-1 were detected by western blotting or immunofluorescence.Principal findingsPRP promoted HUVEC proliferation in a non-linear pattern, protected HUVECs against oX-LDL-induced apoptosis and attenuated oX-LDL-mediated inhibition of HUVEC migration and vasculogenesis. Additionally, compared to the PPP group, PRP downregulated pro-apoptotic proteins (ratio of Bax/Bcl-2, caspase-3 and cleaved caspase-3) as well as IL-6 and IL-1. Moreover, the PI3K/Akt/eNOS pathway was activated by PRP and inactivated by oX-LDL.ConclusionsIt was demonstrated that PRP protected HUVECs against oX-LDL-induced injury and that the PI3K/Akt/eNOS pathway was activated in this process.

Intra-articular injections of expanded mesenchymal stem cells with and without addition of platelet-rich plasma are safe and effective for knee osteoarthritis.

To compare the effectiveness and safety of intra-articular injections of autologous expanded mesenchymal stromal stem cells alone (MSCs), or in combination with platelet-rich plasma (MSCs + PRP), in patients with knee osteoarthritis. Eighteen patients (57.6 ± 9.6years) with radiographic symptomatic knee osteoarthritis (Dejour grades II-IV) were randomized to receive intra-articular injections of MSCs (n = 9) or MSCs + PRP (n = 9). Injections were performed 2-3 weeks after bone marrow aspiration (± 80-100ml) which was obtained from both posterior iliac crests. The Knee Injury and Osteoarthritis Outcome Score (KOOS) improved significantly throughout the 12 months for both groups (p < 0.05). No statistically significant differences between groups were found in KOOS subscales and global score improvements at 12-month end-point (n.s.). The MSCs group showed significant improvements in the pain, function and daily living activities, and sports and recreational activities subscales (p < 0.05). Similarly, the MSCs + PRP group showed significant improvements in the pain, function and daily living activities and quality of life subscales (p < 0.05). The average number of fibroblast colony forming units (CFU-F) was 56.8 + 21.9 for MSCs group and 50.7 ± 21.7 for MSCs + PRP group. Minimal adverse effects were seen in both groups (10 adverse events, in 5 patients). Intra-articular injections of expanded MSCs alone or in combination with PRP are safe and have a beneficial effect on symptoms in patients with symptomatic knee osteoarthritis. Adding PRP to the MSCs injections did not provide additional benefit. These results are encouraging and support the recommendation of this minimally invasive procedure in patients with knee osteoarthritis, without requiring hospitalization. The CFU-F results may be used as reference for future research. Prospective cohort study, Level II.

Should platelet-rich plasma be activated in fat grafts? An animal study

The adjunction of platelet-rich plasma with graft fat has been the subject of a few clinical trials which have demonstrated its value in adipocyte survival. The aim of this study was to assess the different efficacies between activated and non-activated PRP on adipose cells in vitro and for adipose tissue graft survival in vivo. The in vitro study assessed the effects of PRP on both the proliferation and adipocyte differentiation of adipose cells. For the in vivo study, 8 nude rats received 3 human fat injections as follows: 0.8 mL of fat + 0.2 mL of normal saline; 0.8 mL of fat + 0.2 mL of non-activated PRP; and 0.8 mL of fat + 0.2 mL of PRP activated with calcium chloride (CaCl2). The quantitative assessment of adipocyte survival was implemented after 3 months using histomorphometric analysis. Histological and immunohistochemical analysis were also performed to evaluate angiogenesis, inflammation and quality of adipocytes in the grafted tissue. We showed that activated PRP stimulated, in vitro, proliferation and differentiation of adipose cells. In vivo experiments indicated that CaCl2-activated PRP was more efficient than non-activated to prolong the survival of fat grafts in nude rats. The mean percentage areas occupied by viable adipocytes in the PRP-free group, non-activated PRP group and activated PRP group were 13%, 14% and 24% (p = 0.05%), respectively. Histological and immunohistochemical analysis revealed protective effect of activated PRP on inflammation and adipocyte death. This study showed that activation by CaCl2 improves the beneficial effects of PRP for fat graft maintenance.

Platelet-rich plasma stimulates angiogenesis in mice which may promote hair growth

BackgroundPlatelet-rich plasma (PRP) is an autologous concentration of human platelets in plasma. In this paper, we aimed to investigate the effect of PRP on hair growth.MethodsPlatelet-rich plasma and platelet-poor plasma were prepared by sterile centrifugation and injected into shaved dorsal skin of mice (n = 10). Saline injection was used in the control group. The length of randomly plucked hairs was measured at 8, 13, 18 days after PRP injection. Histological examination was preformed to observe the histologic changes of skins. The immunohistochemistry analysis of CD31 was performed to detect the changes of hair length and formation of new vessels.ResultsAt 13 and 18 days after the last injection, the hair length of mice in PRP group (4.24 ± 0.60 and 8.29 ± 0.48 mm, respectively) was significantly longer compared with the control group (3.70 ± 0.52 and 7.21 ± 0.64 mm, p < 0.05). No significant difference in the hair length was found between the PPP group and the control (p > 0.05). In addition, the number of CD31-positive vessel in the PRP group (9.90 ± 0.60) was more than that in the control group (8.60 ± 2.34, p < 0.05).ConclusionPlatelet-rich plasma might promote hair length growth and increase the number of hair follicles by inducing angiogenesis.

Autologous Platelet Rich Plasma Injection Improves Early Tendon Repair in Rabbits: A Histopathological and Biomechanical Study

Objective- The aim of this study was to investigate the PRP effects on the early time-period during tendon healing in rabbits DDF tendon. Design-Experimental study Animals- Twenty male New Zealand white rabbits Procedure-PRP samples were prepared using twice centrifugation method of modification of the Cuarsan technique. Animals were randomly assigned into two equal treatment and control groups. The injury model was unilateral complete transection through the middle one third of deep digital flexor tendon. Immediately after primary repair, either 0.5 cc PRP or placebo was injected intratendiously into the suture site in the treatment and control groups, respectively. Operated limbs were immobilized for two weeks. Animals were sacrificed at the third week and the tendons underwent histopathological (H&E and MT staining) and biomechanical evaluation. Results- The histopathological (H&E) observation showed significant increase in percentage of fibrillar linearity, fibrillar contiuity, number of capillaries in epitenon and epitenon thickness in PRP treated group compared to the control group (p<0.05). Results from MT staining revealed more collagen deposition, in treatment group in comparison to the control. Results of mechanical testing revealed the significant improvement of force at failure and energy absorption capacity of repaired in the PRP group in comparison to the control (p<0.05). Conclusion and clinical relevance-The present study findings suggest that PRP is a simple, safe, quick and cost effective way to obtain a natural concentration of autologous growth factors which reduce the risk of rupture after tendon primary repair and improve functional outcomes.