Platelet-rich plasma in sinus augmentation procedures: a systematic literature review: Part II.

BACKGROUND: Although platelet-rich plasma (PRP) has been extensively studied for over a decade, there are no definitive reports, which prove the benefit of using PRP in sinus augmentation procedures. In addition, no systematic literature review has been done to report the benefit of treatment outcome in patients who received PRP in conjunction with bone/bone substitutes in maxillary sinus augmentation procedures. Therefore, it can be rightly stated that evidence for an adjunctive benefit of using PRP with bone grafts in sinus augmentation procedures is equivocal and inconclusive. AIM: : The objective of this systematic literature review was to examine this literature in determining whether PRP with bone and bone substitutes leads to more rapid and effective bone regeneration clinically, radiographically, and histologically with sinus augmentation procedures and was there any clinical data parallel to animal experiments providing clinical evidence in sinus augmentation procedures? METHODS: A systematic review of randomized clinical trials of at least 6 months duration was conducted comparing PRP and bone/bone substitutes (test group) to bone/bone substitutes (control group) alone. Electronic databases such as MEDLINE and CENTRAL (Cochrane central register of controlled clinical trials) were searched for relevant articles. The reference list of all included articles was searched along with unpublished clinical trials whose abstracts were available. RESULTS: Although, there is a lack of human studies, which show benefit of using PRP in conjunction with bone grafting materials, it can be stated that use of PRP does lead to early regeneration and reduction in healing time of soft and hard tissues. However, no significant statistical or clinical benefit was reported from studies that would satisfy the inclusion criteria. This study answers the question very clearly that at this point of time, there is no human study that strongly supports the benefit of using PRP in sinus augmentation procedures. CONCLUSION: There is a paucity of clinically controlled trials regarding benefits of PRP in sinus augmentation procedures. Theoretically, it seems to have significant beneficial effects on the soft and hard tissue healing; however, the disparity in study design, surgical techniques, and different outcome assessment variables used, makes it difficult to assess the practical benefit of its clinical use. Although no obvious positive effects of PRP on healing of bone graft material in maxillary sinus augmentation procedures were noted, the handling of the particulate bone grafts was improved.

Platelet-rich plasma: a literature review.

Platelet-rich plasma (PRP) is an autologous concentration of platelets in concentrated plasma, which is extensively used to promote soft and hard tissue healing. The significance behind its use refers to the abundance of growth factors present in a well-prepared PRP concentrate. These growth factors enhance the rate and quality of wound healing by different mechanisms. The objective of this review article is to explain the biological aspect of hard and soft tissue healing by application of PRP in conjunctions with its molecular basis.

Diversity of the FcR- and KIR-related genes in an amphibian Xenopus.

Receptors subdivided into inhibitory and activating forms play important roles in the regulation of leukocyte development and effector functions. Two prototypic examples of paired receptors are Fc-receptors (FcR) and Killer cell Immunoglobulin-like receptors (KIR). FcRs are cell surface proteins that bind to the constant regions of IgG and IgE. Classical KIRs recognize MHC class I molecules and regulate natural killer (NK) cell cytotoxic functions. The evolution of these proteins and the time of their origin remain enigmatic. So far, molecules unequivocally related to mammalian FcRs and KIRs have been identified in chicken and an amphibian Xenopus. The lineage-specific evolution of the FcR and KIR families apparently led to the generation of unique sets of receptors in all species studied. Members of both families show extraordinary diversity of domain architectures. This structural diversity makes elusive the functional relationships between the highly specialized mammalian FcR and KIR genes and their homologs in nonmammalian species.

The Xenopus FcR family demonstrates continually high diversification of paired receptors in vertebrate evolution.

BACKGROUND: Recent studies have revealed an unexpected diversity of domain architecture among FcR-like receptors that presumably fulfill regulatory functions in the immune system. Different species of mammals, as well as chicken and catfish have been found to possess strikingly different sets of these receptors. To better understand the evolutionary history of paired receptors, we extended the study of FcR-like genes in amphibian representatives Xenopus tropicalis and Xenopus laevis. RESULTS: The diploid genome of X. tropicalis contains at least 75 genes encoding paired FcR-related receptors designated XFLs. The allotetraploid X. laevis displays many similar genes primarily expressed in lymphoid tissues. Up to 35 domain architectures generated by combinatorial joining of six Ig-domain subtypes and two subtypes of the transmembrane regions were found in XFLs. None of these variants are shared by FcR-related proteins from other studied species. Putative activating XFLs associate with the FcRgamma subunit, and their transmembrane domains are highly similar to those of activating mammalian KIR-related receptors. This argues in favor of a common origin for the FcR and the KIR families. Phylogenetic analysis shows that the entire repertoires of the Xenopus and mammalian FcR-related proteins have emerged after the amphibian-amniotes split. CONCLUSION: FcR- and KIR-related receptors evolved through continual species-specific diversification, most likely by extensive domain shuffling and birth-and-death processes. This mode of evolution raises the possibility that the ancestral function of these paired receptors was a direct interaction with pathogens and that many physiological functions found in the mammalian receptors were secondary acquisitions or specializations.

Phylogenetic conservation of glycoprotein 96 ability to interact with CD91 and facilitate antigen cross-presentation.

Although the ability of gp96 to activate APCs and generate CD8 CTLs against peptides they chaperone through interaction with the endocytic receptors CD91 is supported by solid evidence, its biological relevance in immune surveillance is debated. We have used an evolutionary approach to determine whether gp96 interacts with receptors expressed on APCs and promotes MHC class I cross-presentation of minor histocompatibility Ags (H-Ags) to CTLs in the frog Xenopus. We show that in Xenopus gp96 binds the CD91 homolog at the surface of peritoneal leukocytes, and that this binding is inhibited by molar excess of unlabeled gp96 or the CD91 ligand alpha2-macroglobulin, by anti-CD91 Ab and by the specific CD91 antagonist receptor-associated protein. Surface binding followed by internalization of gp96 was confirmed by fluorescent microscopy. Furthermore, adoptive transfer of peritoneal leukocytes pulsed with as little as 800 ng of gp96 chaperoning minor H-Ags, but not minor H-Ag-free gp96, induces potent CD8 T cell infiltration and Ag-specific accelerated rejection of minor H-locus disparate skin grafts. Inhibition of gp96-CD91 interaction by pretreatment with anti-CD91 Ab and receptor-associated protein impairs both CD8 T cell infiltration and acute skin graft rejection. These data provide evidence of the conserved ability of gp96 to facilitate cross-presentation of chaperoned Ags by interacting with CD91. The persistence of this biological process for >350 million years that separate mammals and amphibians from a common ancestor strongly supports the proposition that gp96 and CD91 are critically involved in immune surveillance.

In vivo study of T-cell responses to skin alloantigens in Xenopus using a novel whole-mount immunohistology method.

BACKGROUND: The African clawed frog, Xenopus, is a widely used comparative model for studying the immune response to transplantation antigens. METHODS: To better define the effector cells involved in the immune response to skin alloantigens of the frog Xenopus laevis, we have adapted a whole-mount immunohistology procedure used in mice that enables us to visualize leukocyte infiltration into unfixed transplanted skin tissues using fluorescent antibodies. We characterized the leukocyte populations present in donor skin at different times after transplantation using anti-class II and CD8 monoclonal antibodies. RESULTS: In autografts, only class II Langerhans or dendritic-like cells and very few CD8 T cells were detected. In contrast, major histocompatibility complex (MHC) disparate skin grafts at the peak of acute rejection (seven days posttransplantation, 50% rejection of pigment cells) were infiltrated with a large number of bright class II leukocytes, the majority of which were CD8 T cells. Most of these cells were located outside blood vessels and often near areas lacking pigmentation. Compared to MHC-disparate skin grafts, skin differing from the host only by minor histocompatibility antigens undergoes slower (i.e., chronic) rejection; interestingly, however, it was infiltrated by similar numbers of class II and CD8 T cell effectors, but with delayed kinetics (i.e., peaked around 15 days posttransplantation). CONCLUSIONS: Our data provide direct in vivo evidence of marked infiltration of effector leukocytes, a majority of which are CD8 T cells that occurs at the onset of tissue destruction of skin allografts.