Factores de crecimiento en el plasma: herramienta terapéutica en dermatología / Growth factors in plasma: therapeutic tool in dermatology

Las plaquetas contienen una gran cantidad de factores de crecimiento que participan en los procesos de cicatrización tisular. Entre ellos, el factor de crecimiento derivado de las plaquetas (PDGF), el factor de crecimiento transformante (TGF), el factor plaquetario 4 (PF4), la interleucina (IL)-1, el factor angiogénico derivado de las plaquetas (PDAF), el factor de crecimiento endotelial (VEGF), el factor de crecimiento epidérmico (EGF), el factor de crecimiento endotelial derivado de las plaquetas (PDEGF), el factor de crecimiento de células epiteliales (ECGF) y el factor de crecimiento similar a la insulina (IGF). El plasma rico en plaquetas (PRP) es un derivado sanguíneo concentrado de la sangre total con una alta concentración de plaquetas. Otro componente esencial del PRP son las proteínas que actúan a nivel de la adhesión celular (fibrina, fibronectina y vitronectina), que proporcionan el soporte estructural necesario para la migración celular y para la proliferación y crecimiento tridimensional de los tejidos sobre los que actúa. La fibrina es la forma activada del fibrinógeno, sustrato final de todas las reacciones de coagulación, se transforma en fibrina insoluble por acción de la trombina. El gel de fibrina polimerizado constituye la primera matriz cicatricial de las heridas. Tanto el plasma rico en plaquetas como las mallas de fibrina varían en la composición y concentración de factores de crecimiento, proteínas y citocinas. En este trabajo se revisan las características de estos productos biológicos, su aplicación en dermatología así como los principales requisitos para su preparación(AU)

Platelets contain a large amount of growth factors involved in the processes of tissue healing. Among them, plateletderived growth factor (PDGF), transforming growth factor (TGF), platelet factor 4 (PF4), interleukin (IL) -1, angiogenic factor derived from platelets (PDAF) , the endothelial growth factor (VEGF), the epidermal growth factor (EGF), the plateletderived endothelial growth factor (PDEGF), the epithelial cell growth factor (ECGF) and the Insulin like growth factor (IGF). Platelet-rich plasma (PRP) is a concentrated whole blood derivate with a high concentration of platelets. Another essential component of PRP are proteins acting on cell adhesion (fibrin, fibronectin and vitronectin), which provide the structural support necessary for cell migration and proliferation as well as three-dimensional growth of the tissues on which they act. Fibrin is the activated form of fibrinogen, the final substrate of all coagulation reactions. It is transformed into insoluble fibrin by the action of thrombin. The polymerized fibrin gel constitutes the first cicatricial matrix of wounds. Both plateletrich plasma and fibrin meshes vary in the composition and concentration of growth factors, proteins and cytokines. In this work we review the characteristics of these biological products, their application in dermatology as well as main requirements for their preparation(AU)

Clinical factors affecting the efficacy of melasma treatment using the Q-switched 1064 Nd: YAG laser mode in a group of Venezuelan female patients.

The influence of melasma risk factors on the effectiveness of laser toning treatment in Venezuelan females was investigated. Clinical evaluation was performed (n = 64) including ultrasound and thyroid hormone profile. All patients underwent face exposure with laser toning, eight sessions weekly. VISIA percentiles corresponding to dark brown spots determined before and after treatment were compared by ANOVA. Differences between percentile values before and after treatment for each patient were calculated and expressed as percentages. An improvement of ≥30% was considered as significant. Spearman rank correlations between improvement and clinical parameters were determined. A significant increase (p > .005) of the median of the percentiles in the overall group was observed. However, only 62.5% of the patients exhibited an improvement of ≥30% at the right malar, 73.4% at the frontal and 71.8% at the left malar areas. Hormonal contraception during treatment (right malar: p < .0001 left malar: p = .0035), thyroid disorders (right malar: p < .0001; frontal: p = .011; left malar: p < .0001) and photoaging (right malar: p = .0235; frontal: p = .0237; left malar: p = .0137) were inversely associated to melasma improvement after treatment. Prolonged use of sunscreen improved significantly (right malar: p < .001; frontal: p = .016 and left malar: p = .025) treatment effectiveness.