Platelet-rich Plasma Treatment Research Articles

A model-based quantitative analysis of efficacy and associated factors of platelet rich plasma treatment for osteoarthritis.

While platelet rich plasma (PRP) has been extensively studied in treating osteoarthritis (OA), there has been an ongoing debate regarding the efficacy of PRP and the optimal subpopulation for PRP treatment remains unknown. The authors hereby aim to establish a pharmacodynamic model-based meta-analysis to quantitatively evaluate PRP efficacy, comparing with hyaluronic acid (HA) and identify relevant factors that significantly affect the efficacy of PRP treatment for OA. The authors searched for PubMed and the Cochrane Library Central Register of Controlled Trials of PRP randomized controlled trials (RCTs) for the treatment of symptomatic or radiographic OA from the inception dates to 15 July 2022. Participants' clinical and demographic characteristics and efficacy data, defined as Western Ontario and McMaster Universities Osteoarthritis Index and visual analog scale pain scores at each time point were extracted. A total of 45 RCTs (3829 participants) involving 1805 participants injected with PRP were included in the analysis. PRP reached a peak efficacy at ~ 2-3 months after injection in patients with OA. Both conventional meta-analysis and pharmacodynamic maximal effect models showed that PRP was significantly more effective than HA for joint pain and function impairment (additional decrease of 1.1, 0.5, 4.3, and 1.1 scores compared to HA treatment at 12 months for Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness, function, and visual analog scale pain scores, respectively). Higher baseline symptom scores, older age (≥60 years), higher BMI (≥30), lower Kellgren-Lawrence grade (≤2) and shorter OA duration (<6 months) were significantly associated with greater efficacy of PRP treatment. These findings sugges t that PRP is a more effective treatment for OA than the more well-known HA treatment. The authors also determined the time when the PRP injection reaches peak efficacy and optimized the targeting subpopulation of OA. Further high-quality RCTs are required to confirm the optimal population of PRP in the treatment of OA.

Comparison of the effects of platelet-rich plasma and corticosteroid injection in rotator cuff disease treatment: a systematic review and meta-analysis.

Platelet-rich plasma (PRP) and corticosteroids are used to treat rotator cuff diseases. However, few reviews have compared the effects of these 2 treatments. In this study, we compared the effects of PRP and corticosteroid injection on the prognosis of rotator cuff diseases. According to the Cochrane Manual of Systematic Review of Interventions, the PubMed, Embase, and Cochrane databases were searched comprehensively. Two independent authors screened suitable studies and performed data extraction and risk of bias assessment. Only randomized controlled trials comparing the effects of PRP and corticosteroid in the treatment of rotator cuff injuries were included, as measured by clinical function and pain during different follow-up periods. Nine studies with 469 patients were included in this review. In short-term treatment, corticosteroids were superior to PRP in the improvement of Constant, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (mean difference [MD] -5.08, 95% confidence interval [CI] -10.26, 0.06; P = .05 and MD -0.97, 95% CI -1.68, -0.07; P = .03 and MD -6.67, 95% CI -12.85, -0.49; P= .03, respectively). No statistically significant difference was observed between the 2 groups at midterm (P > .05), and the recovery of the Simple Shoulder Test and American Shoulder and Elbow Surgeons scores in PRP treatment was significantly better than that in corticosteroid treatment in the long term (MD: 1.21, 95% CI: 0.68, 1.74; P < .00001 and MD: 6.96, 95% CI: 3.90, 9.61; P < .00001, respectively). In pain reduction based on visual analog scale score, corticosteroids led to better pain reduction (MD: 0.84, 95% CI: 0.03, 1.64; P = .04), but no significant difference was observed in pain reduction between the 2 groups in the any term (P > .05). However, these differences did not reach the minimum clinically important difference. Current analysis showed that corticosteroids have better efficacy in short term, whereas PRP is more beneficial for long-term recovery. However, no difference was observed in the mid-term efficacy between the 2 groups. Randomized controlled trials with longer follow-up periods and larger sample sizes are also needed to determine the optimal treatment.

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.

Orthobiologic Treatment of Throwing Related Injuries in Sport: A Focused Review of the Published Literature.

Because of the growth and development of orthobiologics, in particular platelet-rich plasma, as a potential treatment modality in sports related injuries, it is imperative that providers are aware of the up-to-date published data on the usage of this treatment. While some data are promising, prospective studies are needed to determine the effectiveness of platelet-rich plasma treatment for throwing related injuries. There are limitations with all of the published data that include their retrospective nature, heterogeneity between study designs, and platelet-rich plasma characteristics if reported. While platelet-rich plasma may be used as a likely safe adjuvant to conservative and surgical treatments, prospective randomized controlled studies using appropriately reported platelet-rich plasma concentrations and characteristics will help physicians make more definitive recommendations in regard to platelet-rich plasma treatment. Based on the currently available published data, this treatment may be trialed in the right setting and based on severity and location of injury.

Combinatorial Influence of Bone Marrow Aspirate Concentrate (BMAC) and Platelet-Rich Plasma (PRP) Treatment on Cutaneous Wound Healing in BALB/c Mice.

Bone marrow, a soft spongy tissue, is containing mesenchymal stem cells, that are well-recognized according to their self-renewability and stemness. Therefore, we hypothesized that bone marrow aspirate concentrate (BMAC) could have a pivotal influence on the process of wound healing in particular when it is combined with platelet-rich plasma (PRP). Thirty-six albino mice (BALB/c) were used in the study and they were grouped as negative-control, PRP treated, BMAC treated and BMAC plus PRP treated. An incisional wound (1 cm2) was made at the back of mouse and their wounds were treated according to their treatment plan and group allocations. Later, the skin at the treated wound sites was collected on days 7, 14, and 21 for histopathological investigation. The results showed that there was a statistically significant difference in BMAC+PRP-treated wounds over the rest of the treated groups in the acceleration of wound healing throughout the experiment by increasing the rate of wound contraction, re-epithelization process, and granulation tissue intensity with fluctuated infiltration in the number of the neutrophils, macrophages, and lymphocytes, also restoration of the epidermal and dermal thickness with less scarring and hair follicle regeneration vs to the negative-control, PRP and BMAC only treated groups. Our findings indicated that BMAC containing mesenchymal stem cells is an efficient approach, which can be used to enhance a smooth and physiopathological healing process, especially when it is used in combination with PRP.

OncoTherad immunotherapy plus platelet rich plasma as potential therapeutic strategy for ovarian cancer: The role of toll-like receptors 2 and 4 signaling pathways.

e17602 Background: Ovarian cancer (OC) has the most devastating death rate of gynecological cancers with only 44% of women surviving 5 years after diagnosis. Toll-like receptors (TLRs) signaling can play an important role in the OC treatment. TLR activation in immune cells can help activate an effective antitumor response. In this scenario, a new perspective is represented by combined OncoTherad (MRB-CFI-1) immunotherapy and Platelet Rich Plasma (PRP). OncoTherad (MRB-CFI-1) leads to the distinct stimulation of the innate immune system mediated by TLR2 and TLR4, resulting in an increased activation of the IFN signaling pathway. Also, PRP acts on immune activation and exerts antitumor effects. This study characterized the histopathological and molecular effects of the OncoTherad associated with PRP in the treatment of OC chemically induced in rats and described the possible mechanisms of action of this association involving the TLRs 2 and 4 signaling pathways. Methods: Fischer 344 female rats were divided into 5 groups (n = 7 animals per group): Control (Sham surgery) group; Cancer (7,12 dimethylbenzoanthracene – DMBA injection in the ovarian bursa, 1.25 mg/kg) group; OncoTherad (20mg/kg) group; PRP (328.103 – 549.103 platelets/mm3) group and; OncoTherad+PRP (same doses of the isolated treatments) group. Intraperitoneal doses were administered twice a week for 4 weeks. Immunohistochemistry was analyzed as total immunoreactivity and intensity of immunoreaction. Results: Our results showed serous type ovarian carcinoma, follicular atresia, absence of corpora lutea and hyperplasia of the germinal epithelium and tunica albuginea in the Cancer group. The histopathological changes in the PRP group were similar as Cancer group. In contrast, the animals treated with OncoTherad singly or in combination with PRP showed decrease of ovarian neoplastic lesions and histopathological recovery. TLR4 and IL-6 immunoreactivities were significantly lower (p &lt; 0.05) in the Cancer group. PRP treatment reduced (p &lt; 0.05) TLR2. In the Oncotherad+PRP group, the immunoreactivities of TLR4, MyD88, IRF-3 and TNF-α were lower. OncoTherad treatment alone led to stimulation of the innate immune system mediated by TLR2 and TLR4, resulting in an increased activation of the MyD88 signaling pathway (intensified IL-6 and TNF-α immunoreactivities). Conclusions: OncoTherad immunotherapy was able to reduce ovarian lesions and stimulated the TLR2 and 4 signaling pathways in the OC microenvironment, leading to antitumor effects by activating the production of inflammatory cytokines. Thus, OncoTherad immunotherapy could be considered an important therapeutic strategy for OC.

Effects of heterologous platelet-rich plasma on liver enzymes, oxidative stress biomarkers and pancreatic microarchitecture in diabetic mice

Diabetes Mellitus (DM) is a chronic metabolic disorder associated with inflammation and oxidative stress. Platelet-rich plasma (PRP) has an established role in alleviating DM. The current study aimed to evaluate the effect of heterologous PRP on liver functioning, oxidative stress, and microarchitecture of pancreatic islets in diabetic mice. Twenty-four (24) healthy male (4–5 weeks old) albino mice were selected and grouped as G1, G2, G3, and G4 (n ​= ​6). G1 was control group and remained untreated while G2 (PRP group) was given a subcutaneous dose of PRP (0.5 ​mL/kg body weight) twice a week for four weeks. G3 and G4 were first given a single dose of alloxan intraperitoneally (150 ​mg/kg) to induce diabetes. PRP treatment (0.5 ​mL/kg body weight) was given to G4 only for four weeks (twice a week). Completion of experimentation was followed by blood collection through the retro-orbital puncture and dissection for pancreas excision. Sera were isolated and liver functioning and oxidative stress were assessed. ALT (P ​= ​0.0022) and AST (P ​= ​0.0010) level were found higher in G3 compared to control (G1). Conversely, PRP treatment reduced it significantly in G4. MDA (P ​< ​0.0001) and GSH (P ​< ​0.0001) also showed a statistically significant difference while CAT (P ​= ​0.5288) showed no significant difference among all groups. Furthermore, histological analyses revealed the deformation in the microarchitecture of the pancreas in G3 as it displayed vacuolated cytoplasm, damaged islets, and collagen deposition. PRP treatment restored the islets as it was observed in G4. Results revealed that PRP restored transaminases and oxidative stress biomarkers in DM and ameliorate pancreatic microarchitecture.

Pseudoseptic reaction to an intra-articular platelet-richplasma injection into the knee: a case report.

A variety of intra-articular injections are used for the management of osteoarthritis. A rare complication of intra-articular injections is acute pseudoseptic arthritis, which mimics true septic arthritis. To the authorsknowledge, pseudosepsis has not been reported as a complication after platelet-rich plasma (PRP) injections. We present a case report of pseudoseptic arthritis resulting in acute postinjection pain and a joint effusion after an intra-articular PRP injection into the knee. Clinically, pseudosepsis can occur after PRP treatment with significantly elevated white blood cell counts in the synovial fluid, and should be a consideration in cases of post-PRP injection flares.

The Potency of Platelet-Rich Plasma for Chronic Low Back Pain: A Systematic Review and Metaanalysis of Randomized Controlled Trial.

Low back pain is one of the leading causes of disability in the world. Regenerative medicine can be one of the novel treatment breakthroughs in patients with low back pain, yet its use is still debatable. We performed a systematic evaluation and meta-analysis to determine the efficacy of platelet-rich plasma (PRP) treatment for patients with chronic low back pain. Comprehensive database searches were performed in four databases. This study was conducted and reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses Guideline and registered to PROSPERO. We included and examined randomized controlled trials that looked into research employing PRP for patients with chronic low back pain. Outcomes of interest include clinical enhancement of pain, which is demonstrated in pain scores. Three studies were included comprising 138 patients with chronic low back pain. After 1, 3, and 6 months after injection, there was a substantial reduction in the pain score difference between the PRP and control groups, demonstrating PRP's superiority over the control group in the treatment of chronic low back pain. PRP injection significantly enhances chronic low back pain in the first, third, and sixth months after injection compared to controls.

Platelet-rich plasma treatment for talar cartilage repair: a systematic review and meta-analysis

PurposeTo systematically review the studies regarding to the safety, efficacy and application methods of PRP in promoting the talar cartilage repair.MethodsA systematic review was performed by searching PubMed, Web of Science, OVID and EMBASE to identify studies that compared the clinical efficacy of PRP for talar cartilage repair. Main outcome was the American Orthopedic Foot and Ankle Society (AOFAS) score for function and Visual Analog Scale (VAS) for pain was the second outcome.ResultsA total of 10 studies were included in this systematic review, including 4 randomized controlled trials, 1 controlled trial, 3 case series and 2 cohort studies. Four RCTs were analyzed using meta-analysis. For all outcomes, statistical results favored PRP group (AOFAS: MD = 7.84; 95% CI= [-0.13, 15.80], I2 = 83%, P < 0.01; VAS: MD = 1.86; 95% CI= [0.68, 3.04], I2 = 85%, P < 0.01). There were almost no reports of adverse events related to PRP intervention. Subgroup analysis showed that whether PRP was used alone or combined with other treatments could result in high heterogeneity but no more specific factors were identified to contribute to this.ConclusionPRP is safe and effective for talar cartilage repair. In addition to the standardization of PRP preparation and application, it is necessary to distinguish the effects of PRP used alone or in combination with other treatments. In PRP studies, surgical treatment of talar cartilage repair remains the mainstream. The regulation of PRP in surgical applications are worth exploring. The most relative component is the mesenchymal stem cell because it is the only exposed chondrocyte precursor in the articular cavity whether it is microfracture or cell transplantation.Trial registrationThe study was registered in the PROSPERO International prospective register of systematic reviews (CRD42022360183).

Efficacy Differences of Platelet Rich Plasma for Treatment of Androgenetic Alopecia between Men and Women

Background: Almost 50% males face a health issue called androgenic alopecia and even almost 21 million women are affected too. Aim: To determine the efficacy difference of platelet rich plasma for treatment of androgenic alopecia among patients. Study design: Quasi experimental method. Methodology: In order to collect the data, the purposive sampling technique was used. Enrolled patients (n=102) were divided into two groups. Each group received PRP infections after every 1 month for 3 months. Follow up was done at 3 and 6 months. Results were assessed by standard photographs and Hamilton Norwood scale for men and Ludwig scale for women. SPSS v 23 evaluated data. Chi-square test was used to compare the efficacy of Platelet Rich Plasma for treatment of androgenic alopecia between genders. Results: Mean age of the study participants was 27.1±4.5 years. Independent sample t test revealed that the mean age of the female participants was significantly higher than male participants (p &lt; 0.001). There was 100% response rate of PRP treatment for androgenic alopecia in both genders. Practical Implication: This study helped researchers in exploring the efficacy of PRP as a remedy for hair re-growth as it is cheap and safe. Secondly, it added to local literature regarding androgenic alopecia. Conclusion: It was concluded that sub-dermal PRP injections were effective among both genders with androgenic alopecia. Keywords: Efficacy, Androgenic alopecia, Response Rate, Treatment Options and Plasma Rich Proteins.

“Platelet-Rich Plasma” epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial

BackgroundLumbar herniated disc (HNP) is mainly treated by conservative management. Epidural steroid injection (ESI) has been an option to treat failed cases prior to surgery. Triamcinolone has been widely used due to its efficacy in bringing about pain reduction for up to three months. However, several reports have shown some severe adverse events. Platelet-rich plasma (PRP) is made from blood through centrifugation. Several studies supported the potential short to long-term effects, and safety of PRP injection in treating HNP. The study objective was to evaluate the efficacy of PRP in treatment of single-level lumbar HNP in comparison to triamcinolone.MethodsThirty patients were treated by transforaminal epidural injections. PRP was obtained from 24 ml venous blood through standardized double-spin protocol. Participants included fifteen patients each being in triamcinolone and PRP groups. The same postoperative protocols and medications were applied. The visual analogue scale of leg (LegVAS), collected at baseline, 2, 6, 12, and 24 weeks, was the primary outcome. The BackVAS, Oswestry Disability Index (ODI), adverse event, and treatment failure were the secondary endpoints.ResultsPlatelet ratio of PRP in fifteen patients was 2.86 ± 0.85. Patients treated by PRP injections showed statistically and clinically significant reduction in LegVAS at 6, 12, and 24 weeks, and in ODI at 24 weeks. It demonstrated comparable results on other aspects. No adverse event occurred in either group.ConclusionNoncommercial epidural double-spin PRP yielded superior results to triamcinolone. Due to its efficacy and safety, the procedure is recommended in treating single level lumbar HNP.Trial registrationNCT, NCT05234840. Registered 1 January 2019, https://clinicaltrials.gov/ct2/show/record/NCT05234840.

Comperative study between effect of hyalouronic acid and platelet rich plasma in treatment of knee osteoarthritis

comperative study between effect of hyalouronic acid and platelet rich plasma in treatment of knee osteoarthritis

Platelet Rich Plasma and Adipose-Derived Mesenchymal Stem Cells Mitigate Methotrexate-Induced Nephrotoxicity in Rat via Nrf2/Pparγ/HO-1 and NF-Κb/Keap1/Caspase-3 Signaling Pathways: Oxidative Stress and Apoptosis Interplay.

the nephrotoxicity of methotrexate (MTX) is observed in high-dose therapy. Moreover, low-dose MTX therapy for rheumatic diseases is debatable and claimed to cause renal impairment. This study aimed at studying the effect of methotrexate in repeated low doses on rat kidneys and assessing the efficacy of adipose-derived mesenchymal stem cells (AD-MSCs) and platelet rich plasma (PRP) for attenuating this effect. Forty-two male Wistar rats were used, 10 rats were donors of AD-MSCs and PRP, 8 rats served as control, and the remaining rats were subjected to induction of nephrotoxicity by MTX intraperitoneal injection once weekly for successive 8 weeks and then assigned into 3 groups of 8 animals each: Group II: received MTX only. Group III: received MTX + PRP. Group IV: received MTX + AD-MSCs. After one month, rats were anaesthetized, serum-sampled, and renal tissue removed for biochemical, histological, and ultrastructural evaluation. there was significant tubular degeneration, glomerulosclerosis, fibrosis, decreased renal index, along with increased levels of urea and creatinine in the MTX group compared to the control group. Immunohistochemical expression of caspase-3 and iNOS in the renal tissue was significantly increased in group II compared to groups III and IV. Biochemical results revealed higher tissue malondialdehyde (MDA) concentration in the MTX-injected group which decreased significantly in co-treatment with either AD-MSC or PRP + MTX. MSC promoted the activation of the Nrf2/PPARγ/HO-1 and NF-κB/Keap1/caspase-3 pathways, increased antioxidant enzyme activities, reduced lipid peroxidation levels, and alleviated oxidative damage and apoptosis. PRP showed therapeutic effects and molecular mechanisms similar to MSC. Furthermore, MSC and PRP treatment significantly reduced MTX-induced upregulation of the pro-inflammatory (NF-κB, interleukin-1ß, and TNF-α), oxidative stress (Nrf-2, hemoxygenase-1, glutathione, and malondialdehyde), and nitrosative stress (iNOS) markers in the kidney. repeated administration of low-dose MTX resulted in massive renal tissue toxicity and deterioration of renal function in rats which proved to be attenuated by PRP and AD-MSCs through their anti-inflammatory, anti-apoptotic and anti-fibrotic properties.

Biological injection therapy with leukocyte-poor platelet-rich plasma induces cellular alterations, enhancement of lubricin, and inflammatory downregulation in vivo in human knees: A controlled, prospective human clinical trial based on mass spectrometry imaging analysis.

To investigate the in vivo biological effects of leukocyte-poor platelet-rich plasma (LpPRP) treatment in human synovial layer to establish the cellular basis for a prolonged clinical improvement. Synovial tissues (n = 367) were prospectively collected from patients undergoing arthroscopic surgery. Autologous-conditioned plasma, LpPRP, was injected into the knees of 163 patients 1-7 days before surgery to reduce operative trauma and inflammation, and to induce the onset of regeneration. A total of 204 patients did not receive any injection. All samples were analyzed by mass spectrometry imaging. Data analysis was evaluated by clustering, classification, and investigation of predictive peptides. Peptide identification was done by tandem mass spectrometry and database matching. Data analysis revealed two major clusters belonging to LpPRP-treated (LpPRP-1) and untreated (LpPRP-0) patients. Classification analysis showed a discrimination accuracy of 82%-90%. We identified discriminating peptides for CD45 and CD29 receptors (receptor-type tyrosine-protein phosphatase C and integrin beta 1), indicating an enhancement of musculoskeletal stem cells, as well as an enhancement of lubricin, collagen alpha-1-(I) chain, and interleukin-receptor-17-E, dampening the inflammatory reaction in the LpPRP-1 group following LpPRP injection. We could demonstrate for the first time that injection therapy using "autologic-conditioned biologics" may lead to cellular changes in the synovial membrane that might explain the reported prolonged beneficial clinical effects. Here, we show in vivo cellular changes, possibly based on muscular skeletal stem cell alterations, in the synovial layer. The gliding capacities of joints might be improved by enhancing of lubricin, anti-inflammation by activation of interleukin-17 receptor E, and reduction of the inflammatory process by blocking interleukin-17.

Stem-Cell, Shockwave, and Platelet Rich Plasma Therapy for the Treatment of Erectile Dysfunction and Peyronie’s Disease: A Survey of Clinics Across the USA

To identify clinics offering off-label therapies for erectile dysfunction (ED) and Peyronie's disease (Pyd) including stem cell, platelet-rich plasma (PRP), and shockwave therapy and to determine the transparency they provided to patients inquiring about these treatment modalities. Clinics were identified in different regions in the US using a systematic search on online website directories and were approached by asking a series of standardized questions regarding the cost of treatment, duration of therapy, the medical staff involved, and patient outcome data. A total of 26 clinics were surveyed for stem cell therapy, 26 for PRP treatment, and 27 for shockwave therapy. Of the 79 clinics contacted, 93.7% provided some answers to the questions we asked, with a majority offering treatments for both ED and Pyd. The cost of treatment varied widely between clinics. The average cost per stem cell therapy injection was $5291, PRP per injection was $1336, and shockwave therapy per session was $413. A physician was involved in 67% of treatments, and only 6 of 79 clinics reported that a urologist was involved. Over 75% of the clinics reported patient satisfaction following treatment. Durability of benefits to patients ranged from months to years according to the clinics' reports. Our data not only demonstrate the widespread use of off-label therapies for ED and PyD across the United States but also the lack of scientific data to support the claims made to patients. This study highlights the need for more oversight and standardization in novel regenerative therapies for ED and PyD.

Platelet-rich plasma in the treatment of alopecia areata: A retrospective evaluation of 17 patients

Background: Alopecia areata (AA) is a disease of unknown etiology which is thought to be autoimmune, that presents challenges in terms of treatment. Platelet-rich plasma (PRP) can induce the development of new hair follicles through various growth factors it contains. PRP could be a treatment option for patients with AA. Objectives: We aim to evaluate the effectiveness and safety of PRP treatment in patients with patch-type AA. Methods: The study included 17 patients diagnosed with patch-type AA who received PRP treatment at least 3 sessions every 4 weeks. Treatment response was evaluated by calculating the severity of alopecia tool (SALT) scores. Results: The mean age of patients was 29.70 ± 10.09, and the mean disease duration was 18.17 ± 39.46 months. The mean SALT score of 17 patients was 6.82 ± 4.96 and 4.35 ± 4.58 before treatment and at the end of the 3rd month, respectively. The reduction in SALT scores was statistically significant (P = 0.01). At the end of the 3rd month, six patients (35.3%) had an excellent response, one patient (5.9%) had a good response, one patient (5.9%) had a partial response, and nine patients (52.9%) showed no response. The mean SALT scores of four patients who received six sessions of PRP of treatment were 6.00 ± 2.94 and 1.75 ± 2.06 at the end of the 6th month. No serious side effects were noted. Relapse was observed in one patient within 1 year of follow-up. Conclusion: As a result of our study, PRP treatment was found to be an effective and reliable treatment method in patients with mild AA.

Effects of Stromal Vascular Fraction and Platelet-Rich Plasma Treatment on Capillary Histopathology During Anal Trauma Healing in Rats: An in Vivo Study

INTRODUCTION: Anal traumas, such as blunt and penetrating injuries to the perineum, can disrupt the anal sphincter and cause considerable morbidity. Non-invasive anal trauma therapies have been widely developed, including growth factors administered as platelet-rich plasma (PRP) and stromal vascular fraction (SVFs) containing adipose[1]derived stem cells (ASCs) and limited growth factor. This study aimed to assess PRP and SVF effects on capillary histopathology in the anal trauma Wistar rat model. MATERIALS AND METHODS: This experimental study used a rat model. Rats were divided into three groups: Group A (n=12) was treated with PRP and SVFs; Group B (n=12) was treated with normal saline (placebo); Group C (n=4) was sacrificed on day 0 to obtain baseline capillary counts. Groups A and B were further divided into three subgroups, sacrificed on days 1, 7, and 14 post-treatment. RESULTS: Capillary counts significantly showed higher density between Groups A and B (p=0.037, analysis of variance). On day 7, there was a significant difference between Groups A and B (p=0.001). CONCLUSION: Mean capillary density significantly improved in anal trauma treated with a combination of PRP and SVFs compared to control. Our findings support the use of PRP and SVFs to aid recovery of patients with anal trauma.

Platelet-Rich Plasma (PRP) As A New Approach And Promising Therapy In Patients With Alopecia Areata

Background: Alopecia areata (AA) is a non-scarring, autoimmune, inflammatory condition that causes well-defined areas of hair loss on the scalp and/or body. A new biotechnology called platelet-rich plasma (PRP) was developed as a result of increased interest in tissue engineering and cell-based therapies. This therapy is defined as an autologous, non-allergic preparation of platelets in concentrated plasma. Study aimed to evaluate the effect of PRP treatment in alopecia areata. Case: This study included 3 patients complaining of multiple patchy alopecia areata. They were treated with combination of PRP therapy, topical fluocinolone acetonide 0.025% cream, minoxidil 2 and 5%, and ketoconazole 2% scalp solution. One patient was also treated with intralesional triamcinolone acetonide injections. PRP was injected intradermally every 4 weeks and final monitoring was conducted after 4-6 sessions. Evaluation and follow up results were determined using photographic monitoring as well as patient’s satisfaction. Results: Administration of autologous PRP had significance hair regrowth in all three patients in this study. PRP treatment sessions varied from 3 to 6 sessions. However, significance outcomes in these patients were established after 3 sessions of PRP treatment, while the best results were obtained after 4-6 sessions of PRP treatment. No major side effects was reported. Conclusion: PRP is effective in promoting hair growth. PRP treatment for alopecia areata is safe, easy to perform, and can achieve patient’s satisfaction, without any major adverse effects. However, further research on standardized protocol of PRP methods are needed.

The Possible Role of Platelet Rich Plasma in treatment of the Induced surgical Corneal Injury in rabbits: Histomorphometric and Electron Microscopic studies.

The Possible Role of Platelet Rich Plasma in treatment of the Induced surgical Corneal Injury in rabbits: Histomorphometric and Electron Microscopic studies.