The applications of the plasma matrix in the treatments of dental pulp and periapical diseases / 口腔疾病防治

@#The plasma matrix is a kind of autologous blood conduct. It has been widely used in maxillofacial tissue regeneration, skin cosmetology and some other fields. Recently, to preserve the dental pulp as well as the teeth, pulp regeneration therapy and apical surgery have become increasingly important as well as the applications of bioactive materials. As a kind of autologous bioactive material, the plasma matrix has some natural advantages as it is easy to obtain and malleable. The plasma matrix can be used in the following cases: ①pulp revascularization of young permanent teeth with open apical foramina that cannot stimulate apical bleeding; ② apical barrier surgery with bone defects and large area perforation repair with bone defects or root sidewall repair surgery; ③ apical surgeries of teeth with large area of apical lesions, with or without periodontal diseases. The plasma matrix is a product derived from our blood, and there are no obvious contraindications for its use. Several systematic reviews have shown that the plasma matrix can effectively promote the regenerative repair of dental pulp in patients with periapical diseases. However, the applications of plasma matrix are different because its characteristics are affected by different preparation methods. In addition, there is still a lack of long-term clinical researches on the plasma matrix, and the histological evidences are difficult to obtain, so a large number of in vitro and in vivo experimental studies are still needed. This article will describe the applications of different kinds of plasma matrix for dental pulp regeneration and bone tissue regeneration in apical surgeries to provide references for clinicians in indication selection and prognosis evaluation.

THE ROLE OF PLATELET-RICH PLASMA IN ANDROGENETIC ALOPECIA: A COMPREHENSIVE NARRATIVE REVIEW

Platelet-rich plasma (PRP) is a promising treatment in regenerative medicine for androgenetic alopecia (AGA). PRP, derived from the patient's blood, contains a concentrated platelet fraction rich in growth factors and bioactive molecules that aid in tissue repair and wound healing. When PRP is administered, these factors are released, stimulating hair growth and regeneration. PRP's mechanism of action involves the release of growth factors like PDGF, TGF-β, VEGF, and IGF, which promote cell proliferation, activate dormant hair follicles, and induce hair cycle growth. PRP also reduces inammation, promotes angiogenesis, and may inhibit 5-alpha reductase activity, which contributes to AGA. By understanding these mechanisms, PRP can be optimized for effective hair restoration therapies in AGA

Histological effect of platelet-rich plasma on temporomandibular joint osteoarthritis: systematic review in animal models

SUMMARY: The aim of this systematic review was to assess the histological effects of platelet-rich plasma (PRP) on temporomandibular joint osteoarthritis (TMJ-OA) in animal models. A systematic search was performed using PubMed, WoS, EMBASE, Science Direct and SCOPUS databases. The inclusion criteria were experimental studies in animal models that evaluated the use of PRP as a treatment for TMJ-OA with or without arthrocentesis/arthroscopy. Comparison was made to a healthy control group or to other treatment. The variables evaluated were the histological effects of the treatments, characteristics of the primary articles, characteristics of the sample studied and the risk of bias. The systematic search identified 120 studies. Eventually 5 studies were included in the analysis. Four of the studies showed a statistically significant repair in joint tissues and improvement of cartilage thickness in animals treated with PRP. The global risk of bias was unclear. The results of this systematic review suggest that PRP treatment in TMJ-OA has benefits at the histological level in cartilage, articular disc and articular bone tissue in animal models. However, due to the low number of studies and the risk of bias, further research is needed to recommend its use.

El objetivo de esta revisión sistemática fue evaluar los efectos histológicos del plasma rico en plaquetas (PRP) en la osteoartritis de la articulación temporomandibular (ATM-OA) en modelos animales. Se realizó una búsqueda sistemática en las bases de datos PubMed, WoS, EMBASE, Science Direct y SCOPUS. Los criterios de inclusión fueron estudios experimentales en modelos animales que evaluaran el uso de PRP como tratamiento para la ATM-OA con o sin artrocentesis/ artroscopia. La comparación se realizó con un grupo de control sano o con otro tratamiento. Las variables evaluadas fueron los efectos histológicos de los tratamientos, las características de los artículos primarios, las características de la muestra estudiada y el riesgo de sesgo. La búsqueda sistemática identificó 120 estudios. Finalmente se incluyeron 5 estudios en el análisis. Cuatro de los estudios mostraron una reparación estadísticamente significativa en los tejidos articulares y una mejora del grosor del cartílago en los animales tratados con PRP. El riesgo global de sesgo fue incierto. Los resultados de esta revisión sistemática sugieren que el tratamiento con PRP en la ATM-OA tiene beneficios a nivel histológico en el cartílago, el disco articular y el tejido óseo articular en modelos animales. Sin embargo, debido al escaso número de estudios y al riesgo de sesgo, se necesitan investigaciones adicionales para recomendar su uso.

Evaluation of the safety and efficacy of platelet-rich plasma in the treatment of female patients with chronic telogen effluvium: A randomised, controlled, double-blind, pilot clinical trial

Background: Chronic telogen effluvium is characterised by diffuse loss of hair of the scalp. One of the emerging lines of treatment is platelet-rich plasma. However, not much of published data exist. Aims: A pilot study was conducted on chronic telogen effluvium patients to evaluate the efficacy and safety of platelet-rich plasma, and to compare two different methods of platelet-rich plasma preparation. Methods: The study included 30 female patients with chronic telogen effluvium. Patients were randomised into three groups: Group (1): Special platelet-rich plasma tubes centrifuged at 3500 rpm; Group (2): Ordinary laboratory tubes centrifuged at 1000 rpm; Group (3): Normal saline as a placebo. Patients' evaluation was done with visual analog scale, hair pull test, trichoscopy, photos, satisfaction questionnaire, and safety. All patients received four monthly sessions. Patients were evaluated one month and three months after the last session. Results: The hair pull test,visual analogue scale, and patient satisfaction results showed a statistically significant difference between group 1 vs. group 3 and group 2 vs.group 3 at one and three months after the sessions, while there was no difference between group1 vs. group 2. Trichoscopy results (baseline, one and three months after treatment) showed a significant increase in hair density and thickness in the frontal area, temporal area, and the vertex in groups 1 and 2 only. There was no statistically significant difference between the three groups with regards to side effects. Limitations: The sample size was small with ten patients in each group. Furthermore, the follow-up of patients was for only three months. Conclusions: Platelet-rich plasma could be considered as a promising therapy for patients with chronic telogen effluvium with an excellent safety profile. The ordinary laboratory low-cost tubes might be a reliable alternative to the expensive special platelet-rich plasma kits tubes. The trial registry number is PACTR202006539654415

Plasma rico en plaquetas, regenerador en alteraciones corneales / Platelet-rich plasma, regenerative in corneal disorders

En los últimos años, múltiples investigaciones han mostrado la participación de los factores de crecimiento en la regeneración de diferentes tejidos, lo que ha llevado a la utilización de los derivados hemáticos. Se considera este tratamiento una herramienta viable y efectiva para favorecer la epitelización en enfermedades de la superficie ocular. Es necesario encontrar una terapia eficaz en las alteraciones de la superficie ocular rebeldes a tratamientos convencionales. El objetivo del estudio es demostrar que la terapia celular es una novedosa disciplina científica a aplicar en nuestro medio. Se presentan tres casos atendidos en el servicio de córnea del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" con enfermedades de la superficie ocular. Caso clínico 1, paciente con úlcera corneal bacteriana grave que evolucionó a adelgazamiento en los 360°. Caso clínico 2, paciente con diagnóstico de melting corneal post de displasia conjuntival. Caso clínico 3, paciente con defecto epitelial post úlcera corneal. En los tres casos, se indicó plasma rico en plaquetas como único tratamiento, con una duración variable según respuesta al tratamiento. En todos los casos se logró regeneración epitelial en menor tiempo y rápida mejoría de las manifestaciones clínicas. No presentaron complicaciones, los pacientes mejoraron la agudeza visual tras lograr la cicatrización corneal. Es una terapia eficaz y de fácil obtención. Tiene impacto en la calidad de vida del paciente, con rápida reincorporación laboral y social, por lo que reduce los gastos sociales y económicos por tiempo de enfermedad y recuperación(AU)

In recent years, multiple investigations have shown the participation of growth factors in the regeneration of different tissues, which has led to the use of hematic derivatives. This treatment is considered a viable and effective tool to promote epithelialization in diseases of the ocular surface. It is necessary to find an effective therapy in alterations of the ocular surface that are resistant to conventional treatments, the objective of the study being to show cell therapy as a novel scientific discipline to be applied in our environment. Three cases treated in the cornea service of the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" with diseases of the ocular surface are presented. Clinical case 1, patient with severe bacterial corneal ulcer that progressed to 360° thinning. Clinical case 2, patient diagnosed with corneal melting after conjunctival dysplasia and clinical case 3, patient with epithelial defect post corneal ulcer. In all three cases, platelet-rich plasma (PRP) was indicated as the only treatment, with a variable duration depending on the response to treatment. In all cases, the following was achieved: epithelial regeneration in less time and rapid improvement of clinical manifestations, no complications, patients improved visual acuity at the end of achieving corneal healing. Is an effective and easily obtained therapy. It has an impact on the patient's quality of life, with rapid work and social reintegration, thus reducing social and economic expenses due to illness and recovery time(AU)

Use of platelet concentrates in oral surgery of patients with osteonecrosis: a scoping review

Abstract The objective of this study was to map, through a scoping review, the evidence available in the literature on the use of platelet concentrates in compromised patients undergoing oral surgeries. Searches were performed in electronic databases for clinical studies with compromised patients undergoing oral surgery who used platelet concentrates. Only studies published in English were included. Two independent researchers carried out the selection of studies. The study design and objective, surgical procedure and platelet concentrate used, systemic involvement, analyzed outcome, and main results were extracted. A descriptive analysis of the data was performed. Twenty-two studies met the eligibility criteria and were included. Case series was the most frequent study design among the included studies (41.0%). In terms of systemic disability, 19 studies reported patients with cancer and related to surgical treatment 16 studies reported patients underwent treatment for osteonecrosis related to the use of the drug. The most used platelet concentrate was pure platelet-rich fibrin (P-PRF). In general, most studies recommend the use of platelet concentrates. Thus, the results of this study suggest that the evidence related to the use of platelet concentrates in compromised patients when undergoing oral surgeries is still initial. Also, most studies assessed the use of platelet concentrates in patients with osteonecrosis.

Resumo O objetivo do estudo foi mapear, através de uma revisão de escopo, as evidências disponíveis na literatura sobre o uso de agregrantes plaquetários em pacientes comprometidos e que realizaram cirurgias odontológicas. Pesquisas foram realizadas em bases de dados por estudos clínicos com pacientes comprometidos que realizaram cirurgia odontológica e usaram agragantes plaquetários. Apenas estudos em inglês foram incluídos. Dois pesquisadores independentes realizaram a seleção dos estudos. Os seguintes dados foram extraídos: desenho do estudo, objetivo, procedimento cirúrgico, agregante plaquetário usado, envolvimento sistêmico, desfecho analisado e principais resultados. Uma análise descritiva dos dados foi realizada. Vinte e dois estudos preencheram os critérios de elegibilidade e foram incluídos. Série de casos foi o desenho de estudo mais frequente entre os estudos incluídos (41,0%). Em relação ao comprometimento sistêmico, 19 estudos reportaram pacientes com câncer e em relação ao tratamento cirúrgico, 16 estudos reportaram pacientes que realizavam tratamento para osteonecrose relacionada ao uso de medicamentos. O agregante mais utilizado foi o plasma rico em fribina (P-PRF). Em geral, maioria dos estudos recomendou o uso dos agregantes plaquetários. Assim, os resultados desse estudo sugerem que a evidência relacionada ao uso de agregantes plaquetários em pacientes comprometidos que realizam cirurgia odontológica é ainda inicial. Ainda, a maioria dos estudos avaliaram o uso de agregantes plaquetários em pacientes com osteonecrose.

Úlceras de pie diabético y plasma rico en plaquetas / Healing of diabetic foot ulcers with platelet-rich plasma

Introducción: El plasma rico en plaquetas (PRP) se encuentra en desarrollo desde los años 80, asociado con aplicaciones en medicina cardíaca, traumatológica y dermatológica. El PRP es una preparación autóloga, con una concentración de plaquetas por sobre el valor normal en sangre periférica, que se obtiene a partir de su centrifugación siguiendo diferentes protocolos que fueron valorados en distintas revisiones sistemáticas. El plasma luego se activa con trombina o cloruro cálcico, o por lisis física (ultrasonido o frizado). El PRP contiene factores de crecimiento, citoquinas y proteínas de adhesión que, al aplicarse en la lesión, favorecen la hemostasia, la síntesis de tejido conectivo y la revascularización. El producto se aplica en solución o gel. Se intentaron diferentes clasificaciones del PRP para estandarizarlo, sin éxito. Se conceptualizó la receta del PRP para aplicación clínica, que presentó las siguientes características: valores altos de plaquetas, disminución de la contaminación de glóbulos rojos, presencia de neutrófilos y leucocitos para el éxito terapéutico. Protocolo y casos: Se presenta el protocolo de preparación de PRP de centrifugación única de 7 minutos a 1400 rpm, con activación por medio de gluconato de calcio según la siguiente proporción: 3 ml plasma/0.4 ml gluconato cálcico. Además, se informan tres casos de úlceras de pie diabético de nuestra institución. Conclusión: El PRP no presenta complejidad en su preparación y aplicación, por lo que es factible de realizar en el primer nivel de atención que cuente con los recursos materiales y profesionales con conocimiento en el abordaje de heridas crónicas.

Introduction: Platelet-rich plasma (PRP) has been under development since the 1980s, associated with applications in cardiac, traumatological, and dermatological medicine. PRP is an autologous preparation with a platelet concentration above the normal value in peripheral blood that is obtained from its centrifugation following different protocols that were evaluated in different systematic reviews. The plasma is then activated with thrombin or calcium chloride, or by physical lysis (ultrasound or friz). PRP contains growth factors, cytokines, and adhesion proteins that, when applied to the lesion, favor hemostasis, connective tissue synthesis, and revascularization. The product is applied in solution or gel. Different classifications of the PRP were used with the intention of standardizing the procedure without success. The PRP recipe for clinical application was conceptualized. It presented the following characteristics: high platelet values, decreased red blood cell contamination, presence of neutrophils and leukocytes for therapeutic success. Protocol and cases: The PRP preparation protocol for single centrifugation for 7 minutes at 1400 rpm with activation through calcium gluconate is presented according to the following ratio: 3 ml plasma/0.4 ml of calcium gluconate. Three cases of diabetic foot ulcers from our institution are reported. Conclusion: The PRP does not present complexity in its preparation and application, so it is feasible to perform it in the first level of care that has the material and professional resources with knowledge in the approach to chronic wounds.

Bienestar psicológico y ansiedad en adultos mayores con osteoartrosis de rodilla / Psychological well-being and anxiety in older adults with knee osteoarthritis

Introducción: El envejecimiento poblacional en Cuba ha incrementado los casos de osteoartrosis de rodilla. Como alternativa terapéutica se utiliza el plasma rico en plaquetas autólogo, en aras de potenciar el bienestar físico y psicológico de los pacientes. Objetivo: Caracterizar la relación entre el bienestar psicológico y la ansiedad de los adultos mayores con osteoartrosis de rodilla tratados con plasma rico en plaquetas autólogo. Métodos: Se utilizó un enfoque cuantitativo, con un alcance descriptivo-correlacional, y un diseño expost-facto retrospectivo simple. El muestreo fue intencional, no probabilístico, y quedó conformado por 300 pacientes. Se aplicó la Adaptación de la Escala de Bienestar Psicológico de Ryff y el Inventario de Ansiedad Rasgo-Estado. Para el análisis de los datos se realizaron tres cortes: antes del tratamiento regenerativo y a los tres y seis meses de evolución. Resultados: Hubo cambios de niveles medio-bajo a niveles altos de bienestar psicológico. Disminuyeron los niveles de ansiedad estado, pero no los de ansiedad rasgo. El bienestar psicológico no se correlacionó con la ansiedad rasgo y la relación estadística positiva fue muy débil con la ansiedad estado. Conclusiones: Se identificaron cambios favorables del bienestar psicológico y de la ansiedad estado, con persistencia de niveles altos de ansiedad rasgo(AU)

Introduction: The population aging in Cuba has caused the increase of osteoarthrosis of the knee in the elderly. As a therapeutic alternative, it was used the clinical use of autologous platelet-rich plasma, in order to promote well-being, not only physical, but also psychological. Objective: To characterize the relationship between psychological well-being and anxiety state and feature of elderly adults with osteoarthrosis of the knee, who are subjected to regenerative treatment with autologous platelet-rich plasma. Methods: A quantitative research approach was used, with a descriptive-correlational scope, and a simple retrospective expost-fact design. Sampling was intentional, non-probabilistic and consisted of 300 older adults. The Adaptation of the Ryff Psychological Well-Being Scale and the Trait-State Anxiety Inventory were applied. For the analysis of the data, three cuts were made: before the regenerative treatment, and after three and six months of evolution. Results: There were changes from medium-low levels to high levels of psychological well-being. Levels of state anxiety decreased, but trait anxiety did not. Psychological well-being did not correlate with trait anxiety and there was a weak positive statistical relationship with state anxiety. Conclusions: Changes were identified that favor psychological well-being and trait anxiety, with persistent high levels of trait anxiety(AU)

Plasma rico en plaquetas autólogo en la cicatrización de heridas por cirugía electiva, ¿mito o realidad? Estudio prospectivo experimental / Autologous platelet rich plasma in the healing of wounds by elective surgery, myth or reality? Experimental prospective study

El plasma rico en plaquetas es un producto biológico definido como parte de la fracción plasmática de sangre autóloga con concentración plaquetaria por encima de la línea de base, considerándose como tecnología terapéutica endógena con potencial para estimular y acelerar la cicatrización de los tejidos.Objetivo : Evaluar el uso del plasma rico en plaquetas autólogo en la cicatrización de heridas quirúrgicas de pacientes intervenidos por colecistectomía convencional electiva en el Hospital General Nacional "Dr. Ángel Larralde".Métodos : Estudio cohorte, observacional y analítico, con diseño experimental, prospectivo, de corte longitudinal. Muestra no probabilística, intencional, conformada por pacientes ajustados a criterios de inclusión. Ficha de Recolección de Datos diseñada con las escalas de Vancouver y de Evaluación Objetiva de Paciente y Observador. Los resultados obtenidos se tabularon en una matriz de datos realizada con Microsoft®Excel y, posteriormente, presentados por medio de tablas de distribución de frecuencias y gráficos. Para el análisis e interpretación de los resultados, se recurrió al programa SPSS 26®, de licencia libre. Se utilizó el estadístico Chi Cuadrado.Resultados : Total de 26 pacientes: grupo de estudio con 11 pacientes, grupo control con 15 pacientes. Se calculó valor de p para ambas escalas, resultando˂ 0.05 en todas las observaciones. Conclusión : Se observó una evolución satisfactoria evidente en los pacientes a los cuales se les aplicó el PRP respecto al grupo control, de manera que apoya la premisa de que el PRP contribuye a una cicatrización rápida, sin complicaciones y de fácil obtención(AU)

Platelet-rich plasma is a biological product defined as part of the plasmatic fraction of autologous blood with platelet concentration above the baseline, being considered as an endogenous therapeutic technology with the potential to stimulate and accelerate tissue healing.Objective : To evaluate the use of autologous platelet-rich plasma in the healing of surgical wounds in patients undergoing elective conventional cholecystectomy at the National General Hospital "Dr. Angel Larralde.Methods : Cohort, observational and analytical study, with an experimental, prospective design, longitudinal cut. Non-probabilistic, intentional sample, made up of patients adjusted to inclusion criteria. Data Collection Sheet designed with the Vancouver scales and the Objective Assessment of Patient and Observer. The results obtained were tabulated in a data matrix made with Microsoft®Excel and, later, presented by means of frequency distribution tables and graphs. For the analysis and interpretation of the results, the free license program SPSS 26® was used. The Chi Square statistic was used.Results : Total of 26 patients: study group with 11 patients, control group with 15 patients. The p value was calculated for both scales, resulting in˂ 0.05 in all observations. Conclusion : An evident satisfactory evolution was observed in the patients to whom the PRP was applied compared to the control group, so that it supports the premise that the PRP contributes to rapid healing, without complications and easy to obtain(AU)

Effectiveness of platelet-rich plasma on post-COVID chronic olfactory dysfunction

SUMMARY OBJECTIVE: The aim of this study was to investigate the efficacy of platelet-rich plasma injection on the olfactory cleft of patients with post-COVID olfactory dysfunction lasting over 1 year, who were unresponsive to common treatments. METHODS: Patients over 18 years of age with post-COVID olfactory dysfunction over 1 year whose complaints did not improve with intranasal steroids and D-panthenol/vitamin A combination nasal sprays with olfactory rehabilitation training for 1 month were prospectively collected and randomized into two groups: intranasal platelet-rich plasma group and control group. At the end of 1 month, Connecticut Chemosensory Clinical Research Center olfaction test scores of smell detection threshold and smell identification test were compared accordingly. RESULTS: A total of 25 patients were randomized into platelet-rich plasma (n=12) and control (n=13) groups. In the platelet-rich plasma group, the mean smell detection threshold score increased from 5.63 (SD 0.68) to 6.46 (SD 0.45), and the mean smell identification test score increased from 11.42 (SD 1.17) to 15.17 (SD 0.39). In the control group, the mean smell detection threshold score changed from 5.69 (SD 0.66) to 5.77 (SD 0.70), and the mean smell identification test score changed from 11.20 (SD 1.12) to 11.85 (SD 1.57). Post-hoc analysis revealed that similar mean smell detection threshold (mean difference 0.07; p=0.994) and smell identification test (mean difference −0.50; p=0.703) scores were transformed into a significant difference between groups (smell detection threshold mean difference 0.69; p=0.037; smell identification test mean difference 3.32; p<0.001). CONCLUSION: At the end of the first month, there was a significant improvement in olfactory threshold values in the platelet-rich plasma group compared to the control group. No side effect or adverse event related to platelet-rich plasma injection was observed.

Estabilidad del plasma rico en plaquetas obtenido en sistema abierto / Stability of platelet-rich plasma obtained in an open system

Introducción: Para proteger la actividad biológica y evitar la degradación de un producto se deben mantener estrictas condiciones de obtención y almacenamiento. La información que avala el tiempo y las condiciones de almacenamiento debe partir de estudios de estabilidad realizados a largo plazo, en tiempo y condiciones de almacenamiento reales. Objetivo: Evaluar la estabilidad en vida de estante y condiciones de estrés del plasma rico en plaquetas obtenido en sistema abierto. Métodos: Se diseñó un estudio de estabilidad siguiendo las normas descritas por el Centro para el Control Estatal de los Medicamentos. Se evaluaron las principales propiedades fisicoquímicas y biológicas del plasma rico en plaquetas. Las pruebas para demostrar estabilidad del producto se realizaron con una duración de tres días y una frecuencia de ensayo en las horas 0, 4, 8, 12, 24, 48 y 72. Resultados: Los ensayos de pH mostraron que se mantiene estable con independencia del tiempo y la temperatura con un 95 % de confiabilidad. El 100 % de las muestras estudiadas no presentó variación en relación con las características organolépticas y el volumen. La esterilidad tampoco mostró variaciones. Las concentraciones del plasma rico en plaquetas según tiempo y temperaturas arrojaron una significación mayor de 0,05 con variación en función del tiempo y las temperaturas con una confiabilidad del 95 %. Conclusiones: Se demostró que el proceso de elaboración del plasma rico en plaquetas se lleva a cabo de forma controlada y segura. El plasma rico en plaquetas obtenido mantiene sus propiedades físicas, químicas y biológicas tras someterlo a diferentes tiempos y temperaturas de almacenamiento.

Introduction: To maintain biological activity and avoid degradation of a product, strict conditions of collection and storage must be maintained, the information that supports the time and storage conditions must be based on long-term stability studies carried out in real time and storage conditions. Objective: To evaluate the shelf life stability and stress conditions of the platelet rich plasm obtained in an open system. Methods: A stability study was designed following the standards described by the Center for State Control of Medicines, where the main physicochemical and biological properties of platelet rich plasm were evaluated, the tests to demonstrate product stability were carried out with a duration of three days. and a test frequency at 0, 4, 8, 12, 24, 48 and 72 hours. Results: The pH tests showed that it remains stable regardless of time and temperature with 95% reliability, 100% reliability. The samples studied did not present variation in relation to the organoleptic characteristics and volume, sterility in general did not show variations either, platelet rich plasm concentrations according to time and temperatures showed a significance greater than 0.05 with variation depending on time and temperatures with a reliability of 95%. Conclusions: The present work shows that the platelet rich plasm elaboration process is carried out in a controlled and safe way, the platelet rich plasm obtained maintains its physical, chemical and biological properties after subjecting it to different storage times and temperatures.

Beneficios del plasma rico en plaquetas en el tratamiento de las úlceras crónicas por pie diabético / Benefits of Platelet-Rich Plasma in the Treatment of Chronic Diabetic Foot Ulcers

La Diabetes Mellitus es una enfermedad crónica que afecta a millones de personas en todo el mundo causando problemas socioeconómicos y emocionales; una de las complicaciones más temidas de la enfermedad son las úlceras crónicas por pie diabético (UCPD), ya que constituyen una de las principales causas de amputación de miembros inferiores, la prevalencia más alta se halló en Norteamérica (13%), en Bolivia la diabetes tipo 2 tuvo una prevalencia nacional para adultos de 6,5% y de ellos aproximadamente el 20% desarrollaron las UCPD. Por ello, fue indispensable contar con un tratamiento efectivo que evite la cronicidad, infección y amputación del miembro afectado por las úlceras. El Plasma rico en plaquetas es un producto derivado de la sangre con varios elementos que intervienen en la regeneración de tejidos y con efectos antiinflamatorios en varias lesiones; por tal motivo, surge como una opción promisoria para el tratamiento de las UCPD sin importar el grado de lesión (grados de Wagner).Para exponer sus beneficios y considerarlo como tratamiento de primera línea, se efectuó una revisión sistemática, con objetivos de carácter descriptivo-exploratorio; la recolección de la literatura se realizó de fuentes primarias (últimos 5 años), secundarias y terciarias. Finalmente, tras el análisis de los resultados se concluye indicando que el PRP como tratamiento disminuye el tiempo de curación de las úlceras del pie diabético, riesgo de infección, etc.

Diabetes Mellitus is a chronic disease that affects millions of people around the world, causing socioeconomic and emotional problems; one of the most feared complications of the disease are chronic diabetic foot ulcers (UCPD), since they constitute one of the main causes of lower limb amputation, the highest prevalence was found in North America (13%), in Bolivia the Type 2 diabetes had a national adult prevalence of 6.5%, and approximately 20% of them developed UCPD. Therefore, it was essential to have an effective treatment that prevents chronicity, infection and amputation of the limb affected by ulcers. Platelet-rich plasma (PRP) is a blood-derived product with several elements involved in tissue regeneration and with anti-inflammatory effects on various lesions; For this reason, it emerges as a promising option for the treatment of UCPD regardless of the degree of injury (Wagner grades). To expose its benefits and consider it as first-line treatment, a systematic review was carried out, with descriptive-exploratory objectives; the literature was collected from primary (last 5 years), secondary and tertiary sources. Finally, after analyzing the results, it is concluded that PRP as a treatment decreases the healing time of diabetic foot ulcers, the risk of infection, etc.

Platelet-rich Plasma Induces M2 Macrophage Polarization via Regulating AMPK Singling Pathway / 中国实验血液学杂志

OBJECTIVE@#To investigate the role of platelet-rich plasma (PRP) in inducing the M2 macrophage polarization via regulating AMPK singling pathway.@*METHODS@#The expressions of M1 marker CD11c and M2 marker CD206 in macrophages of blank control group, LPS group, LPS+PRP group, and LPS+PRP+Compound C group were detected by flow cytometry. Western blot was used to observe the effects of PRP on the expression of AMPK-mTOR signaling pathway-related proteins at different times (12 h, 18 h and 24 h) after LPS treatment. RNA interference technology was used to silence the expression of AMPK in macrophages, and the expression of TGF-β protein was subsequently examined by Western blot.@*RESULTS@#LPS significantly reduced the expression of CD206 and increased the expression of CD11c (P <0.05). After the addition of PRP, the expression of CD206 was significantly increased (P <0.05), while the expression of CD11c was significantly decreased (P <0.05). Compared with LPS group, PRP treatment significantly increased the expressions of p-AMPK and p-ULK1 proteins at 12 h, 18 h and 24 h, while significantly decreased the expression of p-mTOR protein (P <0.05). After the addition of AMPK inhibitor Compound C, the expression of CD206 was significantly reduced (P <0.05) and the expression of CD11c was significantly increased compared with LPS+PRP group (P <0.05). After silencing the expression of AMPK in macrophages, the promotion effect of PRP on TGF-β was significantly reduced (P <0.05).@*CONCLUSION@#PRP can stimulate the transformation of macrophages to M2 type via AMPK signalling pathway.

Progress and prospect of biological treatment for rotator cuff injury repair / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress in biotherapy of rotator cuff injury in recent years, in order to provide help for clinical decision-making of rotator cuff injury treatment.@*METHODS@#The literature related to biotherapy of rotator cuff injury at home and abroad in recent years was widely reviewed, and the mechanism and efficacy of biotherapy for rotator cuff injury were summarized from the aspects of platelet-rich plasma (PRP), growth factors, stem cells, and exosomes.@*RESULTS@#In order to relieve patients' pain, improve upper limb function, and improve quality of life, the treatment of rotator cuff injury experienced an important change from conservative treatment to open surgery to arthroscopic rotator cuff repair. Arthroscopic rotator cuff repair plus a variety of biotherapy methods have become the mainstream of clinical treatment. All kinds of biotherapy methods have ideal mid- and long-term effectiveness in the repair of rotator cuff injury. The biotherapy method to promote the healing of rotator cuff injury is controversial and needs to be further studied.@*CONCLUSION@#All kinds of biotherapy methods show a good effect on the repair of rotator cuff injury. It will be an important research direction to further develop new biotherapy technology and verify its effectiveness.

Research progress on platelet rich plasma in management of patients with knee osteoarthritis / 中国输血杂志

Knee osteoarthritis (KOA) is a common chronic degenerative disease of cartilage, which often occurs in middle-aged and elderly patients. It can cause joint swelling, pain and limited movement. With the aging population gradually increasing in China, the prevalence of KOA is also increasing, imposing burdens on patients, families and society. At present, the clinical treatment methods for KOA mainly include physical exercise therapy, non-steroidal analgesic drug therapy, intra-articular hormone injection therapy and surgical treatment, which can improve symptoms and reduce pain but cannot effectively cure KOA. With the development of medicine, platelet-rich plasma (PRP) therapy, as a new treatment method, has the effects of nerve repair and pain relief, and has become a new choice for the treatment of KOA. This article reviews the application of PRP in KOA, so as to provide a new perspective for clinical treatment of knee osteoarthritis KOA.

Protective effect of platelet-rich plasma on LPS-induced neuroinflammation in BV2 microglia through NRF2/HO-1 pathway / 中国输血杂志

【Objective】 To investigate the protective effect and mechanism of platelet-rich plasma (PRP) on lipopolysaccharide (LPS) -induced inflammatory response in BV2 cells. 【Methods】 BV2 microglia were divided into normal control group, 10%PRP control group, LPS group (LPS induction), 3%PRP+ LPS group (LPS induction, 3%PRP pretreatment), 5%PRP+ LPS group (LPS induction, 5%PRP pretreatment), 10%PRP+ LPS group (LPS induction, 10%PRP pretreatment), and the proliferation of BV2 cells was measured by CCK-8. The mitochondrial membrane potential of BV2 cells was measured by confocal microscopy, ROS was measured by fluorescence method, and NO was measured by Griess method. The protein expressions of IL-6, TNF-α, BACH1, GPX4, NRF2 and HO-1 were detected by Western blot. In addition, BV2 microglia were treated with HO-1 inhibitor and divided into normal control group, LPS group, ZnPP+ LPS group, 10%PRP+ LPS group, ZnPP+ LPS+ 10%PRP group, and the protein expressions of HO-1, IL-6 and TNF-α were detected by Western blot. 【Results】 Compared with normal control group, PRP promoted the proliferation of BV2 cells (P<0.01). The mitochondrial membrane potential decreased, ROS production increased, the levels of NO, IL-6, TNF-α and BACH1 increased (P<0.01). However, the expression levels of GPX4, NRF2 and HO-1 decreased (P<0.01) in LPS group. Compared with LPS group, the proliferation activity and mitochondrial membrane potential of BV2 cells in 3%PRP+ LPS, 5%PRP+ LPS and 10%PRP+ LPS groups significantly increased. The levels of ROS, NO, IL-6, TNF-α and BACH1 significantly decreased (P<0.01). The expressions of GPX4, NRF2 and HO-1 in different concentrations of PRP (3%, 5% and 10%) increased (P<0.01). Moreover, the expression of IL-6 and TNF-α in ZnPP+ LPS group was significantly higher than that in LPS group after HO-1 inhibitor treatment. Compared with 10%PRP+ LPS+ ZnPP group, HO-1 inhibitor could reverse the effect of PRP on the expression of IL-6 and TNF-α in LPS-induced BV2 cells (P<0.01). 【Conclusion】 PRP inhibits the inflammatory response of BV2 microglia induced by LPS by activating the NRF2/HO-1 signaling pathway.

Bioactive ingredients in activated platelet-rich plasma derived from cord blood and adult blood via Luminex technology: a comparative study / 中国输血杂志

【Objective】 To compare the bioactive ingredients in activated platelet-rich plasma (PRP) from cord blood and adult blood, explore its reasonable indicators reflecting the inflammatory regulation ability, in order to guide the preparation. 【Methods】 PRP was prepared and activated from 63 healthy adults (31 males, 32 females) and 61 neonates (30 males, 31 females), and 20 cytokines were measured using Luminex technology for assessing the age- and sex-based bioactive differences of PRP. High-sensitivity C-reactive protein(hs-CRP), procalcitonin and MMPs/TIMPs from each sample were measured for their correlations with the 10 inflammation-related cytokines. 【Results】 The activated cord blood PRP released 10 growth factors and chemokines more than the adult blood PRP, whereas IGF-1, HGF and 8 pro-inflammatory cytokines lower than the latter. Most cytokines of adult PRP were more in females than in males (P<0.05), except for IGF-1 and HGF, which showed no difference by gender. Compared with hs-CRP and PCT, MMPs/TIMPs ratio was more closely related with the inflammation-related cytokines, which can reflect the inflammatory regulation of PRP. 【Conclusion】 Due to the lower immunocompetence and no age or gender disturbance, cord blood PRP has the rational MMPs/TIMPs ratio and more cytokines which promote the inflammation and wound healing.

Effects of autologous platelet-rich plasma combined with negative pressure wound therapy for chronic refractory wounds: a Meta-analysis / 中国输血杂志

【Objective】 To systematically evaluate the therapeutic efficacy of autologous platelet-rich plasma combined with negative pressure wound therapy on chronic refractory wounds, and to provide reference for clinical treatment. 【Methods】 Randomized controlled trials of autologous platelet-rich plasma combined with negative pressure wound therapy for the treatment of chronic refractory wounds were included in the databases of CNKI, Wan fang, VIP, PubMed, Embase and Cochrane Library from the time of database construction to November 2022. After literature screening, data extraction and quality evaluation, Meta analysis was performed using Stata 15.1 software. 【Results】 After screening, a total of 11 Chinese literatures that met the criteria of this paper were retrieved, involving a total of 359 patients with chronic refractory wounds. The observation group was treated with autologous platelet-rich plasma combined with negative pressure wound therapy, and the control group was treated with negative pressure wound therapy alone. Meta-analysis suggested that compared with negative pressure wound therapy alone, autologous platelet-rich plasma combined with negative pressure wound therapy shortened wound healing time [WMD=-6.08, 95%CI (-7.77, -4.40), P<0.05]. The hospitalization was shortened [WMD=-8.24, 95%CI (-11.55, -4.94), P<0.05], the pain score was decreased [WMD=-1.73, 95%CI (-2.06, -1.40), P<0.05], and the positive rate of bacterial culture on the wound was decreased [RR=0.28, 95%CI(0.16, 0.49), P<0.05], the wound treatment effect was good [RR=1.28, 95%CI(1.17, 1.41), P<0.05]. 【Conclusion】 Based on current studies, compared with the negative pressure wound therapy alone, autologous platelet-rich plasma combined with negative pressure wound therapy can effectively promote the healing of chronic refractory wounds, shorten the hospital stay, reduce pain and infection, and the clinical treatment effect is better.

Preparation and preliminary evaluation of sodium alginate/agarose/carboxymethyl chitosan spray film dressing carrying platelet rich plasma for wound repair / 中国输血杂志

【Objective】 To develop a spray-on membrane dressing for wound repair containing platelet rich plasma (PRP) sodium alginate (SA)/agarose(AG)/carboxymethyl chitosan (CMCS). 【Methods】 SA/AG/ CMCS were mixed in different proportions to prepare biodegradable quick setting spray (BQSS) by blending film method, and the film-forming time, moisture retention and compression resistance of the prepared BQSS were tested. Then PRP and BQSS were mixed in the proportion of 3∶7, 4∶6, 5∶5, 6∶4 and 7∶3 to prepare PRP-BQSS spray film dressings. The film-forming time, moisture retention, compressive strength, porosity and slow-release effect of growth factors of PRP-BQSS spray film dressings were studied. 【Results】 In the preparation of BQSS compound spray film solution, when SA, AG, CMCS and sterile distilled water were 0.6∶0.6∶0.6∶98.2g, the film-forming time (7.73±0.31) s, moisture retention (75. 54±3.03) % and compression resistance (791.00±68.02) g of the spray-film dressing were the best. The basic properties of PRP-BQSS spray-on film dressings and the release of growth factors show that PRP-BQSS spray-on film dressings can exist in different forms, and with the decrease of PRP concentration percentage, its film-forming time, moisturizing performance and compressive strength showed an upward trend. When the PRP content is 30%, the porosity of the dressing is the highest, about(84.34±0.90)%. The release of platelet-derived growth factor-AA(PDGF-AA), platelet factor-4(PF-4) and transforming growth factor beta (TGF-β) was in a slow upward trend, and the release of the three growth factors was higher than that of PRP group in 48 hours. 【Conclusion】 The preparation method of PRP-BQSS spray film dressing designed in this study is simple and mild, and can form a film quickly, with good biological properties and better growth factor inhibition and sustained-release effect.

Secondary herpes zoster wound cured by allogeneic platelet-rich plasma: a case report / 中国输血杂志

【Objective】 To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of herpes zoster wounds secondary to systemic lupus erythematosus (SLE), especially large ulcer wounds. 【Methods】 The treatment process of a patient with massive herpes zoster wounds in perineum and hip accompanied by extensive soft tissue necrosis secondary to SLE was retrospectively analyzed. The clinical efficacy of allogeneic PRP was explored combined with treatment key points and literature review. 【Results】 The patient′s wound bed was prepared until the wound was fresh, then treated externally with allogeneic PRP 3 times a week. The wound was healed completely after 42 days. 【Conclusion】 In the case of autologous PRP unavailable or unsuitable, allogeneic PRP is a safe alternative, which can effectively promote tissue regeneration, and this patient achieved curative effect in a short period of time.