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Chen CF, Wang PF, Liao HT. Platelet-Rich Plasma Lysate Enhances the Osteogenic Differentiation of Adipose-Derived Stem Cells. Ann Plast Surg 2024; 92:S12-S20. [PMID: 38285990 DOI: 10.1097/sap.0000000000003765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
ABSTRACT Adipose-derived stem cells (ADSCs) have become an accepted source of cells in bone tissue engineering. This study aimed to investigate whether platelet-rich plasma (PRP) lysate can replace traditional fetal bovine serum as a culture medium with the enhanced proliferation and osteogenic potential of ADSCs. We divided the experiment into 5 groups where the ADSCs were cultured in an osteogenic medium containing 2.5%, 5%, 7.5%, and 10% PRP lysate with 10% fetal bovine serum as the control group. The cell proliferation, alkaline phosphatase (ALP) activity, ALP stain, alizarin red stain, osteocalcin (OCN) protein expression, and osteogenic-specific gene expression were analyzed and compared among these groups. The outcome showed that all PRP lysate-treated groups had good ALP stain and ALP activity performance. Better alizarin red stains were found in the 2.5%, 5%, and 7.5% PRP lysate groups. The 2.5% and 5% PRP lysate groups showed superior results in OCN quantitative polymerase chain reaction, whereas the 5% and 7.5% PRP lysate groups showed higher OCN protein expressions. Early RUNX2 (Runt-related transcription factor 2 () genes were the most expressed in the 5% PRP lysate group, followed by the 2.5% PRP lysate group, and then the 7.5% PRP lysate group. Thus, we concluded that 5% PRP lysate seemed to provide the optimal effect on enhancing the osteogenic potential of ADSCs. Platelet-rich plasma lysate-treated ADSCs were considered to be a good cell source for application in treating nonunion or bone defects in the future.
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Affiliation(s)
- Chia-Fang Chen
- Division of Trauma Plastic Surgery, Department of Plastic and Reconstructive Surgery
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Xie Y, Xing Q, Wang S, Yang Z, Hu A, Wu Q. Can platelet-rich plasma enhance the effect of meniscus repair? A meta-analysis of randomized controlled trials Platelet-rich plasma and meniscus repair. J Orthop Surg (Hong Kong) 2022; 30:10225536221131483. [PMID: 36278428 DOI: 10.1177/10225536221131483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. PURPOSE To determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. METHODS By searching PubMed, EMBASE, Cochrane Library databases, clinicaltrials.gov, and the CNKI database from their inception till December 1, 2020, we performed a meta-analysis of RCTs reporting the results of the Pain Visual Analog Scale (VAS), the pain of Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, the International Knee Documentation Committee (IKDC), healing rate, and adverse events. The risk of bias is assessed using Cochrane's collaborative tools. The summary results are expressed with effect size and 95% confidence interval, and sensitivity were performed. RESULTS The meta-analysis included 9 RCTs and 345 patients. In general, compared with the control group, used of PRP during meniscus surgery significantly improved the pain (SMD: -0.95, p < 0.00001,95% CI: -1.22 to -0.69, I2 = 42%) and knee joint function (SMD: 1.00, p = 0.01.95% CI: 0.22 to 1.79, I2 = 89%) of patients with meniscus injury at 6 months after treatment. However, both PRP and non-PRP showed improvements in the pain and knee joint function, with no significant difference between the groups at 1 months and beyond 12 months. The PRP enhancement technique showed benefit in improving the cure rate of meniscus repair (RR:1.44; p < 0.0001, 95% CI: 1.20-1.73). No serious adverse events were reported in any study. CONCLUSION As an enhancement program for meniscus repair, PRP is worthy of further consideration in improving the function and pain of patients during the mid-term follow-up after surgery, and PRP can further improve the healing rate of meniscus repair. However, the evidence still needs to be interpreted carefully because of the quantity and quality of the included studies.
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Affiliation(s)
- Yulei Xie
- Department of Rehabilitation Medicine, 117913Affiliated Hospital of North Sichuan Medical College, Sichuan, China
- School of Rehabilitation, Capital Medical University, China Rehabilitation Research Center, Sichuan, China
| | - Qijia Xing
- 117913Department of Pain Medicine,Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | - Shan Wang
- Department of Rehabilitation Medicine, 117913Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | - Zhenglei Yang
- Department of Rehabilitation Medicine, 117913Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | - Anli Hu
- 56710Hubei University Of Economics, Hubei, China
| | - Qing Wu
- Department of Rehabilitation Medicine, 117913Affiliated Hospital of North Sichuan Medical College, Sichuan, China
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Hetz SP, Martin J, Pototschnig H. Patient Satisfaction and Clinical Effects of Platelet-Rich Plasma on Pattern Hair Loss in Male and Female Patients. Cureus 2022; 14:e28801. [PMID: 36225399 PMCID: PMC9534340 DOI: 10.7759/cureus.28801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Hair loss is a widespread condition in both genders. Over the past decade, platelet-rich plasma (PRP) has become a common treatment for hair loss. Our goal was to analyze patient satisfaction and the clinical effects of PRP on male and female pattern hair loss. Methods Over a period of 12 months, we treated a total of 56 patients for androgenetic alopecia with PRP. All of these patients were included in this study; 15 cc of whole blood was spun in an ACP double syringe (Arthrex Inc., Naples, Forida) for five minutes. The yielded 5 to 6 cc of PRP were then injected into the scalp. Forty-nine patients were treated with a series of three injections at monthly intervals, three patients with a series of four injections, two patients with a series of five injections, one patient was treated with a series of seven injections, and one patient with a series of eight injections. Follow-ups were conducted one month after the last treatment. A self-drawn questionnaire was used to assess the satisfaction and clinical results from the patient's and the clinician's perspectives. Results The average age was 41 years (20-68 years). Fifty-seven percent of all patients were male and 43% female. In total, the patients were satisfied with the treatment results. The average score was 7.29 on a scale from 0 to 10. The clinician's rating was similar (6.46). Moreover, with an average score of 8 on a scale from 0 to 10, it is very likely that the patients will recommend PRP treatments to friends. The probability of occurrence of clinical effects among the entire study population was reported as follows: improvement in hair density (patient‘s rating: 64%; clinician's rating: 46%), thickness (38%; 45%), quality (46%; 54%), sheen/lustre (27%; 21%), new hair growth (57%; 68%), less hair loss (48%; 20%), other positive effects (5%, 2%), no effects (4%; 4%), negative effects (0%; 0%). Conclusion Our study revealed encouraging results for the treatment of male and female pattern hair loss with PRP. The autologous treatment was rated with high satisfaction scores and can be considered a safe and effective treatment modality.
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Xie YL, Jiang H, Wang S, Hu AL, Yang ZL, Mou Z, Wang Y, Wu Q. Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2022; 101:e30002. [PMID: 35984172 PMCID: PMC9388038 DOI: 10.1097/md.0000000000030002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. Therefore, a meta-analysis was conducted to determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. METHODS PubMed, EMBASE, Cochrane Library Databases, clinicaltrials.gov, and the CNKI Database were searched from their inception till December 1, 2020. The RCTs reporting the outcomes of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events were included. The risk of bias was assessed using Cochrane collaborative tools. The simulated results were expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed. RESULTS The meta-analysis included 8 RCTs and 431 participants. Compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: -0.40, P = .002, 95%CI: -0.66 to -0.15) and Lysholm score (MD: 3.06, P < .0001, 95%CI: 1.70-4.42) of meniscus injury, but the PRP showed no benefit in improving the healing rate of meniscus repair (RR: 1.22, P = .06, 95%CI: 0.99-1.51). No serious adverse events were reported in any study. CONCLUSIONS PRP is safe and effective in improving the effect of meniscus repair as augment. High quality RCTs with long follow-up and definitive results are needed in the future to confirm the use and efficacy of PRP in meniscus tears.
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Affiliation(s)
- Yu-lei Xie
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Hong Jiang
- Department of Rehabilitation Medicine, Xichong County People’s Hospital, Nanchong, Sichuan, People’s Republic of China
| | - Shan Wang
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - An-li Hu
- Accounting Institute, Hubei University of Economics, Wuhan, Hubei, People’s Republic of China
| | - Zheng-lei Yang
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Zhao Mou
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Yinxu Wang
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
| | - Qing Wu
- Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China
- *Correspondence: Qing Wu, Rehabilitation Medicine Department, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, People’s Republic of China (e-mail: )
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Emerging Delivery Strategies of Platelet-Rich Plasma with Hydrogels for Wound Healing. ADVANCES IN POLYMER TECHNOLOGY 2022. [DOI: 10.1155/2022/5446291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Platelet-rich plasma (PRP), a platelet-rich plasma concentrate obtained from whole blood, has been widely used to treat wounds due to its high contents of growth factors that can not only play a role in the hemostasis, repair, and anti-infection of wounds but also promote cell proliferation, maturation, and angiogenesis. However, after PRP activation, its clinical effect was limited because of burst and uncontrolled release of growth factors and poor mechanical properties of PRP gels. In recent years, increasing attention has been moved to the loading and sustained release of growth factors in PRP by polymeric carriers. Hydrogels, as an interesting carrier, enable controlled delivery of growth factors by structural designs. Moreover, using hydrogels to encapsulate PRP is favorable to controlling the mechanical properties and water maintenance of PRP gels, which can provide a stable and moist wound repair environment to promote coordinated operations of skin tissue cells and cytokines as well as wound healing. In this review, the state of the art of hydrogels that have been used to load PRP for wound treatments is introduced, and further prospects in the research area are proposed.
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Platelet-Rich Plasma as an Alternative to Xenogeneic Sera in Cell-Based Therapies: A Need for Standardization. Int J Mol Sci 2022; 23:ijms23126552. [PMID: 35742995 PMCID: PMC9223511 DOI: 10.3390/ijms23126552] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/12/2022] Open
Abstract
There has been an explosion in scientific interest in using human-platelet-rich plasma (PRP) as a substitute of xenogeneic sera in cell-based therapies. However, there is a need to create standardization in this field. This systematic review is based on literature searches in PubMed and Web of Science databases until June 2021. Forty-one studies completed the selection criteria. The composition of PRP was completely reported in less than 30% of the studies. PRP has been used as PRP-derived supernatant or non-activated PRP. Two ranges could be identified for platelet concentration, the first between 0.14 × 106 and 0.80 × 106 platelets/µL and the second between 1.086 × 106 and 10 × 106 platelets/µL. Several studies have pooled PRP with a pool size varying from four to nine donors. The optimal dose for the PRP or PRP supernatant is 10%. PRP or PRP-derived supernatants a have positive effect on MSC colony number and size, cell proliferation, cell differentiation and genetic stability. The use of leukocyte-depleted PRP has been demonstrated to be a feasible alternative to xenogeneic sera. However, there is a need to improve the description of the PRP preparation methodology as well as its composition. Several items are identified and reported to create guidelines for future research.
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Kauhl W, Pototschnig H, Paasch U. Can Platelet-Rich Plasma Reduce the Burden of Inflammatory Skin Diseases Such as Psoriasis and Atopic Dermatitis? Cureus 2021; 13:e18472. [PMID: 34754637 PMCID: PMC8565102 DOI: 10.7759/cureus.18472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/05/2022] Open
Abstract
Objective In this study, our aim was to investigate the clinical effects of platelet-rich plasma (PRP) on the skin of patients suffering from plaque psoriasis or atopic dermatitis. Methods Over a period of 53 months, we treated a total of 40 patients for inflammatory skin diseases with PRP. All of these patients were included in this study; 5-6 ml of PRP were prepared with the autologous-conditioned plasma (ACP) double syringe and injected subdermally. Follow-ups were conducted at three, six, nine, and 12 weeks after treatment. Besides the lesion size, Psoriasis Area and Severity Index (PASI) and Eczema Area and Severity Index (EASI) were also calculated. Data were evaluated statistically at a significance level of p≤0.05. Results A total of 30 patients were treated for plaque psoriasis. The elbow area represented the most common area of treatment (17 cases). The average lesion size decreased from 8.2 cm² to 0.3 cm² (p<0.00001). Of note, 80% of all patients achieved complete remission (PASI100) at the last follow-up. The remaining 20% reached at least PASI70. Ten patients were treated for atopic dermatitis. In six cases, efflorescences on patients' arms were treated, and in four cases, patients' legs were treated. The average lesion size decreased from 8 cm² to 0.155 cm² (p<0.00001). Notably, 50% of all patients achieved complete remission (EASI100) at the last follow-up. The other half reached at least EASI70. In all cases, the lesion size decreased progressively. No adverse events were reported. Conclusion Our study revealed encouraging results for both psoriasis and atopic dermatitis. The autologous treatment was safe and effective in all patients. Further studies are required to validate these initial findings.
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Affiliation(s)
- Winfried Kauhl
- Plastic and Reconstructive Surgery, Gemeinschaftspraxis Dr. med. Kauhl Dr. med. Cymorek, Moenchengladbach, DEU
| | | | - Uwe Paasch
- Department of Dermatology, Venereology, and Allergology, University of Leipzig Medical Center, Leipzig, DEU
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Surowiecka A, Pototschnig H. Can hydrogel dressings reduce patients' discomfort and side effects of facial platelet-rich plasma injections? Dermatol Ther 2020; 33:e13906. [PMID: 32594637 DOI: 10.1111/dth.13906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/15/2020] [Accepted: 06/20/2020] [Indexed: 11/26/2022]
Abstract
The literature shows that facial injection of platelet-rich plasma (PRP) is a safe and effective treatment modality. Serious adverse effects have not been reported so far. Nevertheless, side effects such as redness, edema, bruising, pain, pruritus, and heat sensation have been reported. Our goal was to assess the potential effects of hydrogel dressing after injection of PRP. PRP was prepared using an ACP double-syringe system and applied on face by intradermal microdeposit injections. One half of the face was covered with a cooled (20°C) hydrogel dressing for 20 minutes before and after PRP injection. Patients rated the levels of pain separately for both sides. Physician and patient rated the overall appearance of the skin, redness, swelling, bruising, and number of bruises straight after the procedure. At 6-month follow-up, the physician rated the global aesthetic outcome. Needle prick-induced pain and edema were rated less on the hydrogel side. Our results demonstrate a significant reduction of patient's discomfort and side effects through application of hydrogel dressings. Recovery has been accelerated and the overall appearance of the skin straight after the procedure has been rated significantly better than without dressing application. At 6-month follow-up, the global aesthetic improvement was rated equally on both sides.
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Affiliation(s)
- Agnieszka Surowiecka
- Department of Gastroenterological Surgery and Transplantation, Central Clinical Hospital of the Ministry of the Interior in Warsaw, Warsaw, Poland
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9
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Griffin MF, Naderi N, Kalaskar DM, Seifalian AM, Butler PE. Argon plasma surface modification promotes the therapeutic angiogenesis and tissue formation of tissue-engineered scaffolds in vivo by adipose-derived stem cells. Stem Cell Res Ther 2019; 10:110. [PMID: 30922398 PMCID: PMC6440049 DOI: 10.1186/s13287-019-1195-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 01/09/2023] Open
Abstract
Background Synthetic implants are being used to restore injured or damaged tissues following cancer resection and congenital diseases. However, the survival of large tissue implant replacements depends on their ability to support angiogenesis that if limited, causes extrusion and infection of the implant. This study assessed the beneficial effect of platelet-rich plasma (PRP) and adipose-derived stem cells (ADSCs) on synthetic biomaterials in combination with argon plasma surface modification to enhance vascularisation of tissue-engineered constructs. Methods Non-biodegradable polyurethane scaffolds were manufactured and modified with plasma surface modification using argon gas (PM). Donor rats were then used to extract ADSCs and PRP to modify the scaffolds further. Scaffolds with and without PM were modified with and without ADSCs and PRP and subcutaneously implanted in the dorsum of rats for 3 months. After 12 weeks, the scaffolds were excised and the degree of tissue integration using H&E staining and Masson’s trichrome staining, angiogenesis by CD31 and immune response by CD45 and CD68 immunohistochemistry staining was examined. Results H&E and Masson’s trichrome staining showed PM+PRP+ADSC and PM+ADSC scaffolds had the greatest tissue integration, but there was no significant difference between the two scaffolds (p < 0.05). The greatest vessel formation after 3 months was shown with PM+PRP+ADSC and PM+ADSC scaffolds using CD31 staining compared to all other scaffolds (p < 0.05). The CD45 and CD68 staining was similar between all scaffolds after 3 months showing the ADSCs or PRP had no effect on the immune response of the scaffolds. Conclusions Argon plasma surface modification enhanced the effect of adipose-derived stem cells effect on angiogenesis and tissue integration of polyurethane scaffolds. The combination of ADSCs and argon plasma modification may improve the survival of large tissue implants for regenerative applications. Electronic supplementary material The online version of this article (10.1186/s13287-019-1195-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M F Griffin
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, UK. .,Royal Free London NHS Foundation Trust Hospital, London, UK. .,Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK. .,Plastic and Reconstructive Surgery Department, Royal Free Hospital, University College London, Pond Street, London, UK.
| | - N Naderi
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, UK.,Royal Free London NHS Foundation Trust Hospital, London, UK
| | - D M Kalaskar
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, UK.,UCL Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Stanmore, Middlesex, HA7 4LP, UK
| | - A M Seifalian
- Nanotechnology and Regenerative Medicine Commercialization Centre (Ltd), The London Bioscience Innovation Centre, London, NW1 0NH, UK
| | - P E Butler
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, UK.,Royal Free London NHS Foundation Trust Hospital, London, UK.,Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK
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Kuffler DP. Differing efficacies of autologous platelet-rich plasma treatment in reducing pain following rotator-cuff injury in a single patient. J Pain Res 2018; 11:2239-2245. [PMID: 30349350 PMCID: PMC6186771 DOI: 10.2147/jpr.s169647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rotator-cuff tears (RCTs) are typically associated with chronic pain. The most common treatment for reducing pain is the injection of cortisone into the injury site. An alternative and increasingly used technique is the injection of autologous platelet-rich plasma (PRP). A limitation of cortisone is its pain relief is short-lived, while PRP has the limitation of providing pain relief to only about 50% of patients, making its efficacy questioned, although when it is effective, its efficacy is longer than cortisone. Little is known about what accounts for these limitations. This paper presents results from a patient with RCTs causing excruciating pain who received an injection of PRP into that shoulder resulting in complete pain elimination that was ongoing at 2 years and 2 months. When 7-month severe posttrauma pain associated with the RCT developed in the contralateral shoulder, PRP prepared the same way and injected by the same person who performed the first injection provided no pain relief. However, a subsequent single cortisone injection resulted in complete pain elimination, which was ongoing at >15 months. These observations indicate that PRP can have inconsistent effects in reducing pain, not only between patients but also within the same patient. Further, although the pain relief induced by cortisone is normally not long-lasting, when given following a PRP injection, it can induce complete pain relief lasting >15 months. This paper discusses possible reasons for the variability in PRP efficacy on pain relief and addresses the possibility that when administered together, PRP and cortisone may act in a complementary manner, leading to significantly greater and longer-lasting pain relief.
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Affiliation(s)
- Damien P Kuffler
- Institute of Neurobiology, Medical Sciences Campus, University of Puerto Rico, San Juan 00901, Puerto Rico,
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Aust M, Pototschnig H, Jamchi S, Busch KH. Platelet-rich Plasma for Skin Rejuvenation and Treatment of Actinic Elastosis in the Lower Eyelid Area. Cureus 2018; 10:e2999. [PMID: 30515364 PMCID: PMC6260498 DOI: 10.7759/cureus.2999] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Treatment of the lower eyelid region to rejuvenate the skin or treat actinic elastosis often proves difficult. Established treatment options, such as hyaluronic acid injections, botulinum toxin injections, microneedling, skin resurfacing (microdermabrasion, chemical peel (exfoliation), laser treatment), as well as blepharoplasties and autologous fat transfers, can be associated with significant risks and increased patient burden. Furthermore, they may not be effective for treating the signs of skin aging or actinic elastosis, including dark rings under the eyes, a lack of volume and cutis laxa. A minimally invasive treatment approach which visibly improves the above-mentioned conditions and which involves minimal risk and patient burden would be a desirable alternative. Materials & methods Twenty patients were treated a total of three times at monthly intervals with PRP (platelet-rich plasma). The patients were examined on the days of treatment and one month after the third injection. The PRP was obtained directly prior to treatment using the Arthrex ACP double syringe at the point of care. The injections (2 ml PRP per side) were administered laterally using 27 G 38 mm cannulas. Accurate photographic documentation and skin elasticity measurements using a cutometer were performed to objectify the subjective assessments from the patient and practitioner questionnaires. Results A progressive improvement in the esthetic outcome and a high level of patient satisfaction were determined. The cutometer measurements showed a statistically significant higher level of skin firmness (due to increased collagen production) and a statistically significant increase in skin elasticity (thanks to increased elastin production). Other than the anticipated visible swelling directly after the PRP injection, no other undesirable side effects or complications occurred. The typical burning sensation during the injection had not been reported. Conclusion The results indicate that a series of PRP injections in the lower eyelid region is a safe, efficient, virtually pain-free, simple and rapid treatment option for an area with otherwise limited treatment alternatives.
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Lang S, Herrmann M, Pfeifer C, Brockhoff G, Zellner J, Nerlich M, Angele P, Prantl L, Gehmert S, Loibl M. Leukocyte-reduced platelet-rich plasma stimulates the in vitro proliferation of adipose-tissue derived mesenchymal stem cells depending on PDGF signaling. Clin Hemorheol Microcirc 2018; 67:183-196. [PMID: 28922143 DOI: 10.3233/ch-170246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Platelet-rich Plasma (PRP) is suggested as xenoprotein-free cell-culture medium replacement for animal-derived supplements. OBJECTIVE The aim of this study was to investigate PRP-triggered signaling in adipose derived mesenchymal stem cells (ASCs). METHODS PRP was obtained from 4 male patients. We incubated ASCs in α-MEM with different Platelet derived growth factor (PDGF) subtypes or 10% or 20% pooled PRP or 20% fetal calf serum (FCS) prior to determination of the S-phase fraction (SPF). To investigate the influence of PDGF signaling on ASCs, PDGF receptor β inhibitor was added, and protein expression of ASCs was measured. RESULTS ASCs exposed to 20% PRP, PDGF-AB and - BB demonstrated significant higher SPF in comparison to PDGF-AA and 20% FCS after 48 hours (all P < 0.05). PDGF receptor β inhibition diminished the PRP-induced SPF increase of ASCs significantly after 48 hours (P < 0.01). ASCs with PDGF receptor β inhibition showed significant higher PDGF receptor β and significant lower c-MYC expression compared to untreated cells in presence of 20% PRP after 48 hours (both P < 0.05). CONCLUSIONS The proliferation promoting effect of PRP on ASCs is mediated by PDGF signaling and is associated with c-MYC overexpression.
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Affiliation(s)
- Siegmund Lang
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Marietta Herrmann
- AO Research Institute, Davos, Switzerland.,IZKF Group Tissue Regeneration in Musculoskeletal Diseases, Orthopedic Center for Musculoskeletal Research, University Würzburg, Würzburg, Germany
| | - Christian Pfeifer
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Gero Brockhoff
- Department of Obstetrics and Gynecology, University Medical Center Regensburg, Regensburg, Germany
| | - Johannes Zellner
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Michael Nerlich
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Peter Angele
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Lukas Prantl
- Center of Plastic, Hand and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Sebastian Gehmert
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany.,Center of Plastic, Hand and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany.,Department of Orthopedic Surgery, University Hospital Basel, Basel, Switzerland
| | - Markus Loibl
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
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Blocki A, Löper F, Chirico N, Neffe AT, Jung F, Stamm C, Lendlein A. Engineering of cell-laden gelatin-based microgels for cell delivery and immobilization in regenerative therapies. Clin Hemorheol Microcirc 2017; 67:251-259. [DOI: 10.3233/ch-179206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Anna Blocki
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin and Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Farina Löper
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin and Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Nino Chirico
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Axel T. Neffe
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin and Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Friedrich Jung
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin and Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Christof Stamm
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin and Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany
| | - Andreas Lendlein
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin and Helmholtz-Zentrum Geesthacht, Teltow, Germany
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Hilber F, Loibl M, Lang S, Kerschbaum M, Brockhoff G, Angele P, Zellner J, Schmitz P, Nerlich M, Worlicek M. Leukocyte-reduced platelet-rich plasma increases proliferation of tenocytes treated with prednisolone: a cell cycle analysis. Arch Orthop Trauma Surg 2017; 137:1417-1422. [PMID: 28815297 DOI: 10.1007/s00402-017-2771-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The purpose of this study was to evaluate the effect of allogenic leukocyte-reduced platelet-rich plasma on human tenocytes after treatment with prednisolone and to develop a standardization of its application for clinical practice. METHODS A leukocyte-reduced PRP was produced using the Arthrex Double Syringe (Arthrex, Inc., Naples, FL, USA), in a modified single-spin separation method. Human tenocytes were isolated from discarded rotator cuff segments. Tenocytes were cultured in the presence of PRP and prednisolone, both alone and in combination. Control samples were treated in media containing 2% FCS for 72 h. After 72 h of incubation, cell cycle kinetics of tenocytes were analyzed to assess proliferation. RESULTS Incubation of the tenocytes with PRP alone for 48 h led to high proliferation rate (10% PRP, 28.0 ± 10.5%; 20% PRP, 40.9 ± 3.3%). Incubation in the presence of prednisolone led to a significant decrease of the proliferation rate (5.2 ± 3.1%; p < 0.05). Treatment with PRP for 48 h significantly increased the proliferation of tenocytes in a dose-dependent manner (10% PRP, 28.0 ± 10.5%; 20% PRP, 40.9 ± 3.3%; p < 0.05). The presence of prednisolone resulted in a decreased tenocyte proliferation (5.2 ± 3.1%; p < 0.05), whereas addition of PRP for 24 and 48 h after prednisolone exposure did not show any compensating effect independent of PRPs concentration (10% PRP, 3.7 ± 3.0%; 20% PRP, 2.5 ± 2.5%). However, a significantly increased cell proliferation of tenocytes was evident when PRP was applied 24 h after prednisolone incubation for 48 h (31.0 ± 3.4 and 34.3 ± 4.7%). CONCLUSION The use of leukocyte-reduced PRP stimulates the proliferation of tenocytes and antagonizes the negative effect of prednisolone 24 h after treatment. Addition of PRP 48 h after treatment with prednisolone has no positive effect on the proliferation rate of tenocytes.
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Affiliation(s)
- Franz Hilber
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Markus Loibl
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Siegmund Lang
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Maximilian Kerschbaum
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Gero Brockhoff
- Department of Obstetrics and Gynecology, University Medical Center Regensburg, Regensburg, Germany
| | - Peter Angele
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Johannes Zellner
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Paul Schmitz
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Michael Nerlich
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Michael Worlicek
- Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
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Platelet-Rich Plasma as an Autologous and Proangiogenic Cell Delivery System. Mediators Inflamm 2017; 2017:1075975. [PMID: 28845088 PMCID: PMC5563430 DOI: 10.1155/2017/1075975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 06/20/2017] [Indexed: 12/18/2022] Open
Abstract
Angiogenesis is a key factor in early stages of wound healing and is crucial for the repair of vascularized tissues such as the bone. However, supporting timely revascularization of the defect site still presents a clinical challenge. Tissue engineering approaches delivering endothelial cells or prevascularized constructs may overcome this problem. In the current study, we investigated platelet-rich plasma (PRP) gels as autologous, injectable cell delivery systems for prevascularized constructs. PRP was produced from human thrombocyte concentrates. GFP-expressing human umbilical vein endothelial cells (HUVECs) and human bone marrow-derived mesenchymal stem cells (MSCs) were encapsulated in PRP gels in different proportions. The formation of cellular networks was assessed over 14 days by time-lapse microscopy, gene expression analysis, and immunohistology. PRP gels presented a favorable environment for the formation of a three-dimensional (3D) cellular network. The formation of these networks was apparent as early as 3 days after seeding. Networks increased in complexity and branching over time but were only stable in HUVEC-MSC cocultures. The high cell viability together with the 3D capillary-like networks observed at early time points suggests that PRP can be used as an autologous and proangiogenic cell delivery system for the repair of vascularized tissues such as the bone.
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Leukocyte-Reduced Platelet-Rich Plasma Alters Protein Expression of Adipose Tissue-Derived Mesenchymal Stem Cells. Plast Reconstr Surg 2017; 138:397-408. [PMID: 27064225 DOI: 10.1097/prs.0000000000002388] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Application of platelet-rich plasma and stem cells has become important in regenerative medicine. Recent literature supports the use of platelet-rich plasma as a cell culture media supplement to stimulate proliferation of adipose tissue-derived mesenchymal stem cells. The underlying mechanism of proliferation stimulation by platelet-rich plasma has not been investigated so far. METHODS Adipose tissue-derived mesenchymal stem cells were cultured in α-minimal essential medium supplemented with platelet-rich plasma or fetal calf serum. Cell proliferation was assessed with cell cycle kinetics using flow cytometric analyses after 48 hours. Differences in proteome expression of the adipose tissue-derived mesenchymal stem cells were analyzed using a reverse-phase protein array to quantify 214 proteins. Complementary Ingenuity Pathways Analysis and gene set enrichment analysis were performed using protein data, and confirmed by Western blot analysis. RESULTS A higher percentage of adipose tissue-derived mesenchymal stem cells in the S phase in the presence of platelet-rich plasma advocates the proliferation stimulation. Ingenuity Pathways Analysis and gene set enrichment analysis confirm the involvement of the selected proteins in the process of cell growth and proliferation. Ingenuity Pathways Analysis revealed a participation in the top-ranked canonical pathways PI3K/AKT, PTEN, ILK, and IGF-1. Gene set enrichment analysis identified the authors' protein set as being part of significantly regulated protein sets with the focus on cell cycle, metabolism, and the Kyoto Encyclopedia of Genes and Genomes transforming growth factor-β signaling pathway. CONCLUSIONS The present study provides evidence that platelet-rich plasma stimulates proliferation and induces a unique change in the proteomic profile of adipose tissue-derived mesenchymal stem cells. The interpretation of altered expression of regulatory proteins represents a step forward toward achieving good manufacturing practice-compliant criteria for cell-based strategies.
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Di Matteo B, Loibl M, Andriolo L, Filardo G, Zellner J, Koch M, Angele P. Biologic agents for anterior cruciate ligament healing: A systematic review. World J Orthop 2016; 7:592-603. [PMID: 27672573 PMCID: PMC5027015 DOI: 10.5312/wjo.v7.i9.592] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/22/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma (PRP) and stem cells to promote anterior cruciate ligament (ACL) healing.
METHODS A systematic review of the literature was performed on the use of biologic agents (i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair. Exclusion criteria were articles written in other languages, reviews, or studies analyzing other applications of PRP/stem cells in knee surgery not related to promoting ACL healing.
RESULTS The database search identified 394 records that were screened. A total of 23 studies were included in the final analysis: In one paper stem cells were applied for ACL healing, in one paper there was a concomitant application of PRP and stem cells, whereas in the remaining 21 papers PRP was used. Based on the ACL injury pattern, two papers investigated biologic agents in ACL partial tears whereas 21 papers in ACL reconstruction. Looking at the quality of the available literature, 17 out of 21 studies dealing with ACL reconstruction were randomized controlled trials. Both studies on ACL repair were case series.
CONCLUSION There is a paucity of clinical trials investigating the role of stem cells in promoting ACL healing both in case of partial and complete tears. The role of PRP is still controversial and the only advantage emerging from the literature is related to a better graft maturation over time, without documenting beneficial effects in terms of clinical outcome, bone-graft integration and prevention of bony tunnel enlargement.
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Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9262909. [PMID: 27478842 PMCID: PMC4949344 DOI: 10.1155/2016/9262909] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/29/2016] [Accepted: 06/05/2016] [Indexed: 01/08/2023]
Abstract
A positive effect of intra-articular platelet-rich plasma (PRP) injection has been discussed for osteoarthritic joint conditions in the last years. The purpose of this study was to evaluate PRP injection into the trapeziometacarpal (TMC) joint. We report about ten patients with TMC joint osteoarthritis (OA) that were treated with 2 intra-articular PRP injections 4 weeks apart. PRP was produced using the Double Syringe System (Arthrex Inc., Naples, Florida, USA). A total volume of 1.47 ± 0.25 mL PRP was injected at the first injection and 1.5 ± 0.41 mL at the second injection, depending on the volume capacity of the joint. Patients were evaluated using VAS, strength measures, and the Mayo Wrist score and DASH score after 3 and 6 months. VAS significantly decreased from 6.2 ± 1.6 to 5.4 ± 2.2 at six-month follow-up (P < 0.05). The DASH score was unaffected; however, the Mayo Wrist score significantly improved from 46.5 ± 18.6 to 67.5 ± 19.0 at six-month follow-up (P = 0.05). Grip was unaffected, whereas pinch declined from 6.02 ± 2.99 to 3.96 ± 1.77 at six-month follow-up (P < 0.05). We did not observe adverse events after the injection of PRP, except one occurrence of a palmar wrist ganglion, which resolved without treatment. PRP injection for symptomatic TMC OA is a reasonable therapeutic option in early stages TMC OA and can be performed with little to no morbidity.
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Tobita M, Tajima S, Mizuno H. Adipose tissue-derived mesenchymal stem cells and platelet-rich plasma: stem cell transplantation methods that enhance stemness. Stem Cell Res Ther 2015; 6:215. [PMID: 26541973 PMCID: PMC4635588 DOI: 10.1186/s13287-015-0217-8] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Because of their ease of isolation and relative abundance, adipose-derived mesenchymal stem cells (ASCs) are a particularly attractive autologous cell source for various therapeutic purposes. ASCs retain a high proliferation capacity in vitro and have the ability to undergo extensive differentiation into multiple cell lineages. Moreover, ASCs secrete a wide range of growth factors that can stimulate tissue regeneration. Therefore, the clinical use of ASCs is feasible. However, the potential of ASCs differs depending on the donor's medical condition, including diseases such as diabetes. Recent studies demonstrated that ASCs from diabetic donors exhibit reduced proliferative potential and a smaller proportion of stem cell marker-positive cells. Therefore, to ensure the success of regenerative medicine, tissue engineering methods must be improved by the incorporation of factors that increase the proliferation and differentiation of stem/progenitor cells when autologous cells are used. Platelet-rich plasma (PRP), which contains high levels of diverse growth factors that can stimulate stem cell proliferation and cell differentiation in the context of tissue regeneration, has recently been identified as a biological material that could be applied to tissue regeneration. Thus, co-transplantation of ASCs and PRP represents a promising novel approach for cell therapy in regenerative medicine. In this review, we describe the potential benefits of adding PRP to ASCs and preclinical and clinical studies of this approach in various medical fields. We also discuss the mechanisms of PRP action and future cell-based therapies using co-transplantation of ASCs and PRP.
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Affiliation(s)
- Morikuni Tobita
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 1138421, Japan
| | - Satoshi Tajima
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 1138421, Japan
| | - Hiroshi Mizuno
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 1138421, Japan.
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