Clinical utility of growth factors in platelet rich plasma (PRP). Analysis of the effectiveness of different preparation methods
Main Article Content
Abstract
Background and aim
Over the past few years, the use of blood components for non-infusion or non-transfusion procedure has rapidly expanded to various clinical applications in different speciality fields.
PRP has a high concentration of platelets that make it functional for the repair and regeneration processes of damaged tissues.
These effects depend on the fact that growth factors are present in the alpha granules of the platelets, able not only to stimulate tissue regeneration, but also to field a striking local anti-inflammatory response, called chemotaxis.
The main identified growth factors that trigger and promote tissue regeneration processes are TGF-β (Transforming Growth Factor beta), VEGF (Vascular Endothelial Growth Factor) and PDGF (Platelet Derived Growth Factor).
The purpose of this study is to compare the characteristic parameters of the blood components for non-infusion use obtained with the various possible preparation methods: this study will be able to identify the parameters for the best therapeutic effect on the patients treated, in terms of effectiveness and durability.
Materials and methods
The type of blood component to prepare, for the treatment of patients, is chosen by the transfusion doctor, based on their clinical characteristics, such as age, venous access and concomitant pathologies, choosing between the PRP Single Device (PRP-SD), the PRP by apheresis (PRP-AFE), the PRP homologous (PRP-OMO) and the Leuco-platelet apheresis (L-PRP).
Results
Control blood count was performed on all patients treated with the PRP before sampling and subsequently, on the blood component.
The results has been compared with the data reported in literature, in order to identified the most effective PRP preparation method, in terms of platelet yield and of leukocyte.
Conclusions
The literature’s data show that the number of platelets and leukocytes present in the PRP greatly influences the patient's outcome.
The results obtained have showed a variety of platelets and leukocytes contained in the PRP prepared with the various processing methods. The PRP-SD is the blood component capable of guaranteeing the best therapeutic effect, in terms of efficacy and durability.
Keywords: PRP, Growth factors, Platelets, Leukocytes.
Downloads
Article Details
The authors agree to transfer the right of their publication to the Journal, simultaneously licensed under a Creative Commons License - Attribution that allows others to share the work indicating intellectual authorship and the first publication in this magazine.
References
[2] Tsay RC, Vo J, Burke A,, Eisig SB, Lu HH, Landesberg R (2005) Differrential growth factor retension by platelet-rich plasma composites. J Oral Maxillofac Surg 63:521-528.
[3] Anitua E., Sånchez M., del Mar Zalduendo M., de la Fuente M., Prado R., Orive G., Andia 1.: Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif 2009; 42: 162-170.
[4] Carmeliet P., Storkebaum E.: Vascular and neuronal effects of VEGF in the nervous system: implications for neurological disorders. Semin Cell Dev Biol 2002; 13:39-53.
[5] Borzini P, Mazzucco L: Platelet-rich plasma (PRP) and platelet derivatives for topical therapy. What is true from the biological view point? ISBT Science Series 2007; 2:272-281.
[6] Browning S.R., Weiser A.M., Woolf N., Golish R., SanGiovanni T.P., Scuderi G.J., Carballo C., Hanna L.S.: Platelet-rich plasma increases matrix metalloproteinases in cultures of human synovial fibroblasts. J Bone Joint Surg Am 2012; 94:1-7.
[7] Assirelli E., Filardo G, Mariani E, Kon E, Roffi A, Vaccaro F, Marcacci M, Facchini A, Pulsatelli L. Effect of two different preparations of platelet-rich plasma on synoviocytes. Knee surg sports traumatol arthrose. 2015; 9:2690-703.
[8] Barrientos S., Stojadinovic 0., Golinko M.S., Brem H., Tomic-Canic M.: Growth factors and cytokines in wound healing. Wound Repair. Regen 2008; 16:585-601.
[9] Haseeb A, Haqqi TM (2013) Immunophatogenesis of Osteoarthritis. Clin Immunol 146:185-196.
[10] Whitman, D. H; Berry, R. L.; Green, D. M. Platelet gel: An autologous alternative to fibrin glue with appli-cations in oral and maxillofacial surgery. J. Oral. Maxillofac. surg., 55:1294-9, 1997.
[11] Garcia-Martinez 0., Reyes-Botella C., Diaz-Rodriguez L., De Luna-Bertos E., RamosTorrecillas J., Val-lecillo-Capilla M.F., Ruiz C.: Effect of platelet-rich plasma on growth and antigenic profile of human osteo-blasts and its clinical impact. J Oral Maxillofac Surg 2012; 70:1558-1564.
[12] Borzini P., Mazzucco L.: Tissue regeneration and in-loco administration of platelet derivatives. Clinical outcome, heterogeneous products, heterogeneity of the effector mechanisms. Transfusion 2005; 35:1759-1767.
[13] Carter M.J., Fylling C.P., Parnell L.K.: Use of platelet rich plasma on wound healing:"a sistematic review and meta-analisys." Eplasty 2011; 11:38.
[14] DECRETO 2 novembre 2015 : Disposizioni relative ai requisiti di qualità e sicurezza del sangue e degli emo-componenti.
[15] Cho H.S., Song I.H., Park S. Y., Sung M.C., Ahn M.W., Song K.E.: Individual variation in growth factor concentrations in platelet-rich plasma and its influence on human mesenchymal stem cells. Korean J Lab Med 2011; 31 :212-218.
[16] Drengk A., Zapf A., Stürmer E.K., Stürmer K.M., Frosch K.H.: Influence of platelet-rich plasma on chon-drogenic differentiation and proliferation of chondrocytes and mesenchymal stem cells. Cells Tissues Or-gans. 2009; 189:317-326.
[17] Graziani F., Ivanovski S., Cei S., Ducci F., Tonetti M., Gabriele M.: The in vitro effect of different concen-trations on osteoblasts and fibroblasts. Clin Oral Implants Res 2005; 17:212-219.
[18] Hilary J. Braun, Hyeon Joo Kim, Constance R. Chu, Jason L. Dragoo The effect of Platelet-Rich plasma formulation and blood products on human synoviocytes.
[19] Jackson S.P.: The growing complexity of platelet aggregation. Blood 2007; 109:5087-5095.
[20] Goldring MB, Otero M (2011) Inflammation in osteoarthritis. Curr Opin Rheumatol 23:471-478.
[21] Jurk K., Kehrel B.E.: Platelets: physiology and biochemistry. Semin Thromb Hemost 2005; 31:381-392.
[22] Macaulay l.c., Carr P., Gusnanto A., Ouwehand W.H., Fitzgerald D., Watkins N.A. Platelet genomics and proteomics in human health and disease. J Clin Invest 2005; 1 15:3370-3377.
[23] Park SI, Lee HR, Kim S, Ahn MW, Do SH (2012) Time sequential modulation in expression of growth factors from platelet-rich plasma (PRP) on the chondrocyte cultures. Moll Cell Biochem 361:9-17.
[24] Tschon M, Fini M, Giardino R, Filiardo G, Dallari D, Torricelli P, Martini L, Giavaresi G, Kon E, Maltarello MC, Nicolini A, Carpi A (2011) Lights and shadow concerning platelet products for muscoloskeletal regene-ration. Front Biosci (Elite Ed) 3:96-107.
[25] Werner S, Grose R.: Regulation of wound healing by growth factors and cytokines. Physiol Rev. 2003; 83:835-870.
[26] Cole BJ, Seroyer ST, Filiardo G, Bajaj S, Fortier LA (2010) Platelet-Rich Plasma: where are we now and where are we going? Sports Health 2:203-210.