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1.
Medicine (Baltimore) ; 100(41): e27526, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731144

RESUMO

BACKGROUND: The effect of platelet-rich plasma (PRP) on patients with acute Achilles tendon rupture is still controversial. The purpose of this systematic review is to assess the efficacy of PRP injections treating acute Achilles tendon rupture. METHODS: A comprehensive electronic literature search was performed in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant studies that were published prior to April 29, 2021. Randomized controlled trials evaluating the efficacy of PRP injections in treating patients with acute Achilles tendon rupture were included. Statistical analyses were conducted using RevMan software. RESULTS: Five randomized controlled trials were included in this systematic review. The results of the meta-analysis showed that PRP has positive effects on ankle dorsiflexion angle, dorsal extension strength of the ankle, and calf circumference compared with that in controls. However, the current evidence failed to show that PRP effectively improves ankle plantar flexion angle, plantar flexion strength of the ankle, and pain. CONCLUSIONS: PRP injections for the treatment of acute Achilles tendon rupture significantly improved ankle dorsiflexion angle, dorsal extension strength of the ankle, and calf circumference compared with that in controls. Additional studies with larger sample sizes, more rigorous designs and standardized protocols are needed to draw more reliable and accurate conclusions.


Assuntos
Tendão do Calcâneo/patologia , Plasma Rico em Plaquetas/fisiologia , Ruptura/diagnóstico , Ruptura/terapia , Tendão do Calcâneo/lesões , Doença Aguda , Adulto , Tornozelo/fisiologia , Estudos de Casos e Controles , Feminino , Humanos , Injeções/métodos , Masculino , Pessoa de Meia-Idade , Plasma Rico em Plaquetas/química , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular/fisiologia , Traumatismos dos Tendões/epidemiologia , Traumatismos dos Tendões/patologia , Resultado do Tratamento
2.
PLoS One ; 16(9): e0251166, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34529657

RESUMO

Platelet-rich plasma (PRP) is a widely used autologous treatment for tendon injuries in clinics. Platelets (PLTs) are a major source of high mobility group box1 (HMGB1) that is gaining attention as a chemoattractant that can recruit stem cells to the wound area to enhance healing of injured tissues; however, the contribution of PLT HMGB1 in wounded tendon healing remains unexplored. This study investigated the effect of PLT HMGB1 within PRP on tendon healing using PLT HMGB1 knockout (KO) and GFP mice. A window defect was created in the patellar tendons of both groups of mice, and wounds were treated with either saline, PRP isolated from PLT HMGB1-KO mice, or PRP isolated from GFP mice. Seven days post-treatment, animals were sacrificed and analyzed by gross inspection, histology, and immunostaining for characteristic signs of tendon healing and repair. Our results showed that in comparison to mice treated with PRP from PLT HMGB1-KO mice, wounds treated with PRP from GFP mice healed faster and exhibited a better organization in tendon structure. Mice treated with PRP from PLT HMGB1-KO mice produced tendon tissue with large premature wound areas and low cell densities. However, wounds of PLT HMGB1-KO mice showed better healing with PRP from HMGB1-KO mice compared to saline treatment. Moreover, wounds treated with PRP from GFP mice had increased extracellular HMGB1, decreased CD68, increased stem cell markers CD146 and CD73, and increased collagen III protein expression levels compared to those treated with PRP from PLT HMGB1-KO mice. Thus, PLT HMGB1 within PRP plays an important role in tendon wound healing by decreasing inflammation, increasing local HMGB1 levels, and recruiting stem cells to the wound area in the tendon. Our findings also suggest that the efficacy of PRP treatment for tendon injuries in clinics may depend on PLT HMGB1 within PRP preparations.


Assuntos
Proteína HMGB1/genética , Proteína HMGB1/metabolismo , Plasma Rico em Plaquetas/fisiologia , Traumatismos dos Tendões/terapia , Cicatrização , 5'-Nucleotidase/metabolismo , Animais , Antígeno CD146/metabolismo , Colágeno Tipo III/metabolismo , Modelos Animais de Doenças , Feminino , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Camundongos , Camundongos Knockout , Camundongos Transgênicos , Plasma Rico em Plaquetas/metabolismo , Traumatismos dos Tendões/genética , Traumatismos dos Tendões/metabolismo , Fatores de Tempo , Resultado do Tratamento , Regulação para Cima
3.
Int J Mol Sci ; 22(17)2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34502364

RESUMO

Platelet-rich fibrin (PRF) is an autologous blood concentrate obtained without anticoagulants by centrifugation of patients' peripheral venous blood. PRF is considered to enhance the formation of new bone. The aim of this manuscript was to present two case reports of permanent teeth with closed apexes with periapical lesions, treated endodontically with the use of PRF. The root canals were mechanically cleaned and shaped with NiTi files and irrigated with 5.25% sodium hypochlorite (NaOCl), 40% citric acid (CA), and triple distillated water. Before the canal systems were obturated, A-PRF was used as a scaffold and was placed below the cementodentinal junction with hand pluggers. Cone beam computerized tomography (CBCT) was used to assess the resolutions of periapical radiolucencies. After 6 months, the measurements of both periapical lesions were significantly reduced. Although the performed root canal treatments (RCTs) can definitely be recognized as successful, it must be emphasized that mechanical shaping and cleaning of the root canals with special disinfecting solutions significantly affect the clinical efficacy of RCT. It seems impossible to state that PRF played a leading role in the healing process of the presented periapical lesions. Further studies must be performed to assess whether RCT of mature teeth with an additional PRF application is superior to RCT performed alone.


Assuntos
Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Endodontia Regenerativa/métodos , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibrina Rica em Plaquetas/metabolismo , Fibrina Rica em Plaquetas/fisiologia , Plasma Rico em Plaquetas/metabolismo , Plasma Rico em Plaquetas/fisiologia , Tratamento do Canal Radicular/métodos
4.
Int J Mol Sci ; 22(18)2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34576225

RESUMO

Despite the fact that different biomaterials are widely used in many biomedical applications, they can still cause side effects. Therefore, our aim was to assess neutrophil activity during the inflammatory phase of the repair process and long-term interactions between circulating neutrophils and Titanium (Ti) implants. Additionally, neutrophil in vitro response after stimulation by the extract of antimicrobial peptides (AMP extract), pentoxifylline (PTX) and some platelet-rich (L-PRP and PURE PRP) and platelet-poor (PPP) concentrates were tested. The study was conducted on eight sheep after Ti implant insertion into the tibia and revealed that the Ti implant did not cause any side effects during the course of experiment. After addition of L-PRP into neutrophils, culture activity of these cells significantly increased (p < 0.01), whereas treatment with AMP extract, PURE PRP, PPP or PTX caused decrease in neutrophil enzymatic response (on the basis of elastase, myeloperoxidase and alkaline phosphatase release) and free radical generation. These effects were observed in neutrophils isolated during the inflammatory phase as well as 4 and 10 months after implantation. Obtained results will be useful in regulation of inflammatory response during implantation of biomaterial and create possibility to modulate the cells response towards pro- or anti-inflammatory to reduce host tissue damage.


Assuntos
Leucócitos/efeitos dos fármacos , Neutrófilos/efeitos dos fármacos , Titânio/química , Animais , Anti-Inflamatórios , Peptídeos Catiônicos Antimicrobianos/farmacologia , Materiais Biocompatíveis/metabolismo , Plaquetas/metabolismo , Feminino , Inflamação , Neutrófilos/fisiologia , Pentoxifilina/farmacologia , Plasma Rico em Plaquetas/metabolismo , Plasma Rico em Plaquetas/fisiologia , Próteses e Implantes , Ovinos
5.
Rev. cuba. anestesiol. reanim ; 20(1): e683, ene.-abr. 2021.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1156368

RESUMO

Introducción: La enfermedad degenerativa discal es una entidad frecuente y uno de los principales motivos de consulta. Genera altas tasas de discapacidad, años útiles perdidos, así como altos costos económicos por asistencia médica y grandes pérdidas monetarias. Su tratamiento es generalmente conservador, aunque en la actualidad se incluyen terapias biológicas novedosas. Objetivo: Describir las principales propiedades biológicas que hacen del plasma rico en plaquetas una terapéutica efectiva para la enfermedad degenerativa discal. Métodos: Se realizó una revisión no sistemática de la bibliografía basada en artículos que se publicaron en bases de datos indexadas en Infomed como Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, Scopus, LILACS; en idioma español, inglés y portugués, durante los últimos diez años. Desarrollo: Se expusieron características clínico epidemiológicas de la enfermedad degenerativa discal, así como las propiedades biológicas que le permiten al plasma rico en plaqueta tener una función activa en la regeneración del disco intervertebral o el retraso de la cascada de degradación de este. Se resaltan los principales estudios de acuerdo a la vía de administración del plasma rico en plaquetas y sus resultados. Conclusiones: De acuerdo con lo publicado por los autores, el plasma rico en plaquetas es una alternativa efectiva en el tratamiento de la enfermedad degenerativa discal por la producción de factores derivados de las plaquetas, que intervienen en la degeneración del disco intervertebral, siendo la vía intradiscal la que más se emplea(AU)


Introduction: Degenerative disc disease is a frequent condition and one of the main reasons to attend the consultation. It generates high rates of disability, useful years lost, as well as high economic costs for medical assistance and large monetary losses. Its treatment is generally conservative, although novel biological therapies are currently included. Objective: To describe the main biological properties that make platelet-rich plasma an effective therapy against degenerative disc disease. Methods: A nonsystematic review of the bibliography was carried out based on articles published, during the last ten years, in databases indexed in Infomed, such as Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, Scopus, and LILACS, in Spanish, English and Portuguese. Development: Clinical-epidemiological characteristics of degenerative disc disease were presented, as well as the biological properties that allow platelet-rich plasma to have an active function in the regeneration of the intervertebral disc or the delay of its degradation cascade. The main studies are highlighted, according to the route of administration of platelet-rich plasma and their results. Conclusions: According to what has been published by authors, platelet-rich plasma is an effective alternative in the treatment of degenerative disc disease, due to the production of factors derived from platelets, which intervene in the degeneration of the intervertebral disc, being the intradiscal pathway the most used(AU)


Assuntos
Humanos , Plasma Rico em Plaquetas/fisiologia , Degeneração do Disco Intervertebral/terapia , Degeneração do Disco Intervertebral/epidemiologia , Degeneração do Disco Intervertebral/cirurgia
6.
J Tissue Viability ; 30(2): 183-189, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33712331

RESUMO

Cutaneous autoimmune and inflammatory diseases are a major burden of global disease and many lack effective treatments that can derive in different dermatoses like atopic dermatitis. Despite the increase prevalence and the high health-care costs worldwide, the heterogeniety and multifactoriality of these diseases mean that effective treatment options are scarce. Plasma rich in growth factors (PRGF) technology could be an alternative approach that may help in the management of this cutaneous condition. The aim of this study was to assess the effect of two different PRGF formulations (just activated and autologous topical serum (ATS)) for the management of skin inflammation. Additionally, ATS was assessed over two patients suffering from radiotherapy induced dermatitis. Human organotypic skin explant cultures (hOSECs) were used as human skin models. To induce atopic dermatitis-like conditions, skin explants were treated with both interleukin-4 (IL-4) and interleukin-13 (IL-13). PRGF and ATS were intradermally and topically applied, respectively. Metabolic activity, reactive oxigen species (ROS), necrosis and inflammatory cytokine production were determined. Both PRGF formulations increased tissue viability and significantly reduced the excessive free radical accumulation and the cutaneous cytokine production such as TNF-α and IL-1ß. Case reports showed a positive response after ATS treatment in terms of skin quality improvement, local erythema decrease and burning and itching amelioration. The oedema, swelling and desquamation caused by radiation induced dermatitis was also reduced and the patients referred ceased pruritus and pain. This preliminary study suggests that PRGF might aid in the management of inflammatory skin conditions.


Assuntos
Anti-Inflamatórios/análise , Peptídeos e Proteínas de Sinalização Intercelular/análise , Plasma Rico em Plaquetas/fisiologia , Pele/efeitos dos fármacos , Administração Cutânea , Anti-Inflamatórios/química , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/química , Oxazinas/uso terapêutico , Xantenos/uso terapêutico
7.
J Assist Reprod Genet ; 38(5): 1003-1012, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33723748

RESUMO

PURPOSE: Platelet-rich plasma (PRP) has become a novel treatment in various aspects of medicine including orthopedics, cardiothoracic surgery, plastic surgery, dermatology, dentistry, and diabetic wound healing. PRP is now starting to become an area of interest in reproductive medicine more specifically focusing on infertility. Poor ovarian reserve, menopause, premature ovarian failure, and thin endometrium have been the main areas of research. The aim of this article is to review the existing literature on the effects of autologous PRP in reproductive medicine providing a summation of the current studies and assessing the need for additional research. METHODS: A literature search is performed using PubMed, MEDLINE, and CINAHL Plus to identify studies focusing on the use of PRP therapy in reproductive medicine. Articles were divided into 3 categories: PRP in thin lining, PRP in poor ovarian reserve, and PRP in recurrent implantation failure. RESULTS: In women with thin endometrium, the literature shows an increase in endometrial thickness and increase in chemical and clinical pregnancy rates following autologous PRP therapy. In women with poor ovarian reserve, autologous intraovarian PRP therapy increased anti-Mullerian hormone (AMH) levels and decreased follicle-stimulating hormone (FSH), with a trend toward increasing clinical and live birth rates. This trend was also noted in women with recurrent implantation failure. CONCLUSIONS: Limited literature shows promise in increasing endometrial thickness, increasing AMH, and decreasing FSH levels, as well as increasing chemical and clinical pregnancy rates. The lack of standardization of PRP preparation along with the lack of large randomized controlled trials needs to be addressed in future studies. Until definitive large RCTs are available, PRP use should be considered experimental.


Assuntos
Fertilização In Vitro , Indução da Ovulação , Plasma Rico em Plaquetas/metabolismo , Medicina Reprodutiva , Hormônio Antimülleriano/metabolismo , Feminino , Humanos , Infertilidade Feminina/tratamento farmacológico , Infertilidade Feminina/genética , Reserva Ovariana/genética , Plasma Rico em Plaquetas/fisiologia , Gravidez
8.
Medicine (Baltimore) ; 100(7): e24680, 2021 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607808

RESUMO

BACKGROUND: To explore the effectiveness of platelet-rich plasma (PRP) injection regarding functional recovery, pain relief, and range of motion (ROM) of shoulder compared with the corticosteroid injection in patients with rotator cuff lesions treated non-operatively. METHODS: An electronic literature search was performed by 2 authors in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant randomized controlled trial (RCTs) that were published up to July 20, 2020. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect sizes. RESULTS: Six RCTs were included in this systematic review. Meta-analysis revealed that corticosteroid injection yielded statistically significant superior functional recovery (SMD = -0.80; 95% CI, -1.42 to -0.18; P = .01) and pain relief (MD = 1.59; 95% CI, 0.30-2.89; P = .02) compared with PRP injection for rotator cuff lesions during the short-term follow-up period. However, at the medium-term and long-term follow-up, no statistically significant difference was identified between the 2 groups. Regarding the ROM of shoulder, no statistically significant difference was found between the 2 groups during the whole follow-up period. CONCLUSIONS: The current clinical evidence revealed short-term efficacy of corticosteroid injection and no significant medium- to long-term difference between corticosteroid and PRP injection in the treatment of rotator cuff lesions. Additional studies with longer follow-ups, larger sample sizes, and more rigorous designs are needed to draw more reliable and accurate conclusions.


Assuntos
Corticosteroides/administração & dosagem , Tratamento Conservador/métodos , Plasma Rico em Plaquetas/fisiologia , Lesões do Manguito Rotador/terapia , Corticosteroides/uso terapêutico , Adulto , Estudos de Casos e Controles , Gerenciamento de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Plasma Rico em Plaquetas/química , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Resultado do Tratamento
9.
Adipocyte ; 10(1): 80-90, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33525977

RESUMO

Stem cells could form the basis of a novel, autologous treatment for chronic wounds like diabetic foot ulcers. Fat grafts contain adipose-derived stem cells (ADSC) but low survival of cells within the grafts is a major limitation. Platelet-rich plasma (PRP) may increase graft survival. This review examines the histology from animal studies on fat grafting, ADSC and PRP in wound healing. A literature review of major electronic databases was undertaken, and narrative synthesis performed. Data from 30 animal studies were included. ADSC increase angiogenesis over 14 days and often clinically accelerated wound healing. ADSC had a greater effect in animals with impaired wound healing (e.g. diabetes). Activated PRP increased viability of fat grafts. Despite the high number of studies, the quality is variable which weakens the evidence. It does suggest there is a benefit of ADSC, particularly in impaired wound healing. High-quality evidence in humans is required, to establish its clinical usefulness.


Assuntos
Tecido Adiposo/transplante , Plasma Rico em Plaquetas/fisiologia , Cicatrização/fisiologia , Adipócitos/metabolismo , Adipócitos/transplante , Tecido Adiposo/metabolismo , Animais , Proliferação de Células/fisiologia , Humanos , Modelos Animais , Plasma Rico em Plaquetas/metabolismo , Transplante de Células-Tronco/métodos , Células-Tronco , Transplante/métodos , Transplantes/metabolismo
10.
Dis Colon Rectum ; 64(6): 714-723, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33399410

RESUMO

BACKGROUND: Anal fissure is one of the most common benign anal disorders, and medical treatments play an important role in its management. OBJECTIVE: The purpose of this study was to investigate the short-term effects and success of platelet-rich plasma in the treatment of chronic anal fissure. DESIGN: The study is a 2 parallel group, randomized, controlled clinical trial. SETTINGS: The study was performed in 2 tertiary university hospitals. PATIENTS: Forty-four patients with chronic anal fissure were randomly assigned to platelet-rich plasma treatment or control group. Presenting symptoms and pain scores were recorded on enrollment. The control patient self-administered topical glyceryl trinitrate. Platelet-rich plasma was injected locally in the intervention group followed by self-administered glyceryl trinitrate. MAIN OUTCOME MEASURES: The primary outcome measure is a reduction in pain scores. RESULTS: On day 10 and 1 month after treatment, the mean pain score was significantly lower in the patients treated with platelet-rich plasma than in the controls (p = 0.005 and p < 0.005). By 1 month after treatment, the mean pain score declined by 5.7 points in the platelet-rich plasma-treated group compared with a 4.1 mean pain score decline in the control group (mean difference:1.6 points (95% CI, 0.3-2.9)). According to the repeated-measures analyses, pain scores decreased in both groups, but the decrease in the treatment group was statistically higher than in the control group (p < 0.001). Complete epithelialization and recovery rates were significantly higher in the platelet-rich plasma group than in controls at all follow-up times, with p values ranging from 0.034 to <0.001. The observed difference in complete epithelialization after 2 months of treatment between the platelet-rich plasma group and the control group was 56.2% with a 95% CI of 14.03% to 98.4%. LIMITATIONS: This study was limited by its small sample size, and long-term follow-up of the patients was not presented. CONCLUSIONS: Platelet-rich plasma reduced concerns and accelerated epithelialization and healing in patients with chronic anal fissures. See Video Abstract at http://links.lww.com/DCR/B461.RESULTADOS A CORTO PLAZO DEL PLASMA RICO EN PLAQUETAS EN EL TRATAMIENTO DE LA FISURA ANAL CRÓNICA: ESTUDIO CLÍNICO CONTROLADO ALEATORIZADO. ANTECEDENTES: La fisura anal es uno de los trastornos anales benignos más comunes y los tratamientos médicos juegan un papel importante en su manejo. OBJETIVO: El propósito de este estudio fue investigar los efectos a corto plazo y el éxito del plasma rico en plaquetas en el tratamiento de la fisura an33al crónica. DISEO: El estudio es un ensayo clínico controlado, aleatorizado y de dos grupos paralelos. ESCENARIO: El estudio se llevó a cabo en dos hospitales universitarios terciarios. PACIENTES: Cuarenta y cuatro pacientes con fisura anal crónica fueron asignados aleatoriamente al grupo de tratamiento con plasma rico en plaquetas o al grupo control. Los síntomas de presentación y las puntuaciones de dolor se registraron en la inscripción. Los pacientes de control se autoadministraron trinitrato de glicerilo tópico. El plasma rico en plaquetas se inyectó localmente en el grupo de intervención seguido de trinitrato de glicerilo autoadministrado. PRINCIPALES MEDIDAS DE RESULTADO: La principal medida de resultado es una reducción en las puntuaciones de dolor. RESULTADOS: El día 10 y un mes después del tratamiento, la puntuación media de dolor fue significativamente menor en los pacientes con plasma rico en plaquetas que en los controles (p = 0.005 y p <0.005, respectivamente). Un mes después del tratamiento, la puntuación media de dolor disminuyó 5.7 puntos en el grupo tratado con plasma rico en plaquetas en comparación con una disminución de la puntuación media de dolor de 4.1 en el grupo de control (diferencia media: 1.6 puntos [intervalo de confianza del 95%; 0.3-2.9] Según los análisis de medidas repetidas, las puntuaciones de dolor disminuyeron en ambos grupos, pero la disminución en el grupo de tratamiento fue estadísticamente mayor que en el grupo de control (p <0.001). Las tasas de epitelización completa y recuperación fueron significativamente más altas en los pacientes con plasma rico en plaquetas que en los controles en todos los tiempos de seguimiento, con valores de p que van desde 0.034 a <0.001. La diferencia observada en la epitelización completa después de dos meses de tratamiento entre el grupo de plasma rico en plaquetas y el grupo de control fue del 56.2% con un intervalo de confianza del 95% del 14.03% al 98.4%. LIMITACIONES: Este estudio estuvo limitado por el pequeño tamaño de la muestra y porque no se proporcionó un seguimiento a largo plazo de los pacientes. CONCLUSIONES: El plasma rico en plaquetas redujo las molestias y aceleró la epitelización y la curación en pacientes con fisuras anales crónicas. Consulte Video Resumen en http://links.lww.com/DCR/B461. (Traducción-Dr. Jorge Silva Velazco).


Assuntos
Fissura Anal/terapia , Medição da Dor/estatística & dados numéricos , Plasma Rico em Plaquetas/química , Reepitelização/efeitos dos fármacos , Inibidores da Liberação da Acetilcolina/administração & dosagem , Inibidores da Liberação da Acetilcolina/normas , Inibidores da Liberação da Acetilcolina/uso terapêutico , Adulto , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/normas , Toxinas Botulínicas/uso terapêutico , Estudos de Casos e Controles , Doença Crônica , Feminino , Fissura Anal/diagnóstico , Fissura Anal/patologia , Seguimentos , Humanos , Esfincterotomia Lateral Interna/normas , Esfincterotomia Lateral Interna/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Nitroglicerina/administração & dosagem , Nitroglicerina/efeitos adversos , Plasma Rico em Plaquetas/fisiologia , Reepitelização/fisiologia , Resultado do Tratamento , Vasodilatadores/administração & dosagem , Vasodilatadores/efeitos adversos
11.
Eur J Ophthalmol ; 31(2): NP33-NP38, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32141311

RESUMO

INTRODUCTION: Mooren's ulcer is a painful, inflammatory chronic keratitis that affects corneal periphery, progressing centripetally, ultimately ending in perforation. The first line of treatment includes systemic immunomodulators, with surgery being the last option. We present a case of bilateral Boston keratoprosthesis implantation for severe Mooren's ulcer that responded differently in each eye. CLINICAL CASE: A 32-year-old male with corneal opacification, anterior staphylomas, vision of hand movement, was started on systemic immunosuppression with cyclosporine. After two failed penetrating keratoplasties in each eye, high intraocular pressure despite diode cyclophotocoagulation, and cystic macular edema, we performed Boston keratoprosthesis type 1 in both eyes. The right eye responded initially well, with a best-corrected visual acuity of 20/80 and normal intraocular pressure. The left eye presented high intraocular pressure, which required cyclophotocoagulation, ultimately resulting in hypotony. Boston keratoprosthesis was performed but had peripheral corneal necrosis that progressed despite amniotic membrane transplantation and aggressive intensive treatment with medroxyprogesterone, autologous platelet-rich-in-growth-factors eye drops, and oral doxycycline. Thus, replacement of the semi-exposed Boston keratoprosthesis with tectonic penetrating keratoplasty was necessary. However, both eyes developed phthisis bulbi with final visual acuity of perception of light with poor localization. CONCLUSION: Mainstay treatment of Mooren's ulcer is systemic immunomodulation. Surgical treatment must be considered only when risk of perforation, preferably with inflammation under control. Penetrating keratoplasty frequently fails, and Boston keratoprosthesis may be a viable option. However, postoperative complications, especially uncontrolled high intraocular pressure, corneal necrosis, and recurrence of Mooren's ulcer may jeopardize the outcomes and need to be addressed promptly with intensive topical and systemic treatment.


Assuntos
Órgãos Artificiais , Córnea , Úlcera da Córnea/cirurgia , Próteses e Implantes , Adulto , Antibacterianos/uso terapêutico , Terapia Combinada , Anticoncepcionais Orais Hormonais/uso terapêutico , Doxiciclina/uso terapêutico , Seguimentos , Humanos , Ceratoplastia Penetrante , Masculino , Medroxiprogesterona/uso terapêutico , Soluções Oftálmicas/uso terapêutico , Plasma Rico em Plaquetas/fisiologia , Recidiva , Úlcera , Acuidade Visual
12.
Plast Reconstr Surg ; 147(1): 219-230, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33370070

RESUMO

BACKGROUND: The use of platelet-rich plasma has emerged as one of the most desired nonsurgical treatments for facial rejuvenation and hair restoration. It has grown to encompass a wide variety of applications within the field of plastic surgery, including its use in combination with microneedling, laser, and fat-grafting procedures. METHODS: In this article, the authors aim to (1) describe the preparation process of platelet-rich plasma; (2) discuss the proposed science behind platelet-rich plasma with regard to its evolving role in hair restoration and facial rejuvenation; and (3) highlight the recent literature examining its widespread use. RESULTS: Based on the available literature, there is a therapeutic advantage to the use of platelet-rich plasma as a single treatment modality for alopecia and skin rejuvenation and in combination with laser skin treatment and fat grafting. There is, however, a considerable amount of variability in the processing, preparation, and treatment modalities. CONCLUSIONS: Despite a lack of standardized protocols for platelet-rich plasma preparation and a scarcity of large-scale studies with long-term follow-up, there is convincing evidence with objective measurement modalities that display positive outcomes after treatment for skin rejuvenation, hair regrowth, wound healing, and fat graft take.


Assuntos
Alopecia/terapia , Transfusão de Sangue Autóloga/métodos , Técnicas Cosméticas , Plasma Rico em Plaquetas/fisiologia , Rejuvenescimento/fisiologia , Humanos , Envelhecimento da Pele/fisiologia , Resultado do Tratamento , Cicatrização/fisiologia
13.
Probl Radiac Med Radiobiol ; 25: 338-352, 2020 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-33361845

RESUMO

OBJECTIVE: To determine in experiment the quality of healing of skin radiation ulcers infected with Staphylococcusaureus (S. aureus) under the photodynamic therapy (PDT) administration and the use of platelet-rich plasma (PRP). MATERIALS AND METHODS: The experiment was performed on 95 male WAG rats of 6 months of age, which were divided into three groups. Group 1 included animals in whom a skin radiation ulcers in the thigh area was simulated, followed by application of a 0.2 ml suspension of reference strain of S. aureus to its surface on the 7th day after irradiation. Group 2 included animals with S. aureus-infected skin radiation ulcers, in whom the PET was administered aday after infection contamination. Group 3 included animals with S. aureus-infected skin radiation ulcers, in whomthe PDT was administered a day after infection in the morning, and the PRP was manifold injected in periwound areain the afternoon. The skin with underlying soft tissues from the area of radiation damage were the material for morphological examination. The hematoxylin and eosin, picrofuxin according to van Gizon, Mallory staining wereapplied to micropreparations. A morphometric study was conducted. RESULTS: In animals with skin radiation ulcers, in whom the PDT was administered upon infection with S. aureus(group 2), compared with animals with simulated infected skin radiation ulcers without treatment (group 1), Theactivation (i.e. accelerating) of the healing occurred for the period from the 14th to the 52nd day of experiment dueto the active processes of wound cleansing from necrotized tissues, less pronounced inflammatory changes in thelesion, and active of appearance and maturation of granulation tissue, less pronounced hemodynamic, ischemic andalternative disorders in the dermis, hypodermis, muscle tissue surrounding the wound cavity, activation of proliferative processes in epithelial layer localized in the marginal parts of the wound. Formation of pathological (hypertrophic or keloid) scar of the skin was the result of healing of skin radiation ulcer infected with S. aureus. In animalswith radiation ulcers infected with S. aureus, in the case of PDT and PRP (group 3) the regenerative process wasdirected not only at accelerating the rate of healing, but also on restoration of original structure of the lost parts ofthe skin compared with only PDT administration (group 2). Acceleration of the healing of the infected skin radiation ulcer in animals of groups 2 and 3 was due to similar processes. CONCLUSIONS: Photodynamic therapy activates and accelerates the healing process of skin radiation ulcers infectedwith S. aureus and leads to formation of a pathological scar (hypertrophic or keloid). Healing of the infected S. aureusradiation ulcers occurs more actively upon the photodynamic therapy administration in combination with multipleperiwound injections of the platelet-enriched plasma, compared with only photodynamic therapy administration,and finishes with an organotypic regeneration and almost complete skin recovery.


Assuntos
Fotoquimioterapia/métodos , Plasma Rico em Plaquetas/fisiologia , Lesões Experimentais por Radiação/terapia , Úlcera Cutânea/terapia , Infecções Estafilocócicas/terapia , Cicatrização/fisiologia , Infecção dos Ferimentos/terapia , Animais , Humanos , Queloide/prevenção & controle , Masculino , Azul de Metileno/farmacologia , Fármacos Fotossensibilizantes/farmacologia , Plasma Rico em Plaquetas/química , Lesões Experimentais por Radiação/microbiologia , Lesões Experimentais por Radiação/patologia , Ratos , Pele/efeitos dos fármacos , Pele/microbiologia , Pele/patologia , Úlcera Cutânea/microbiologia , Úlcera Cutânea/patologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/patologia , Staphylococcus aureus , Resultado do Tratamento , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/patologia
14.
Int J Mol Sci ; 21(24)2020 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-33352749

RESUMO

The expansion of nanotechnology for drug delivery applications has raised questions regarding the safety of nanoparticles (NPs) due to their potential for interacting at molecular and cellular levels. Although polymeric NPs for drug delivery are formulated using FDA-approved polymers such as lactide- and glycolide-based polymers, their interactions with blood constituents, remain to be identified. The aim of this study was to determine the impact of size-selected Poly-lactide-co-glycolide-polyethylene glycol (PLGA-PEG) NPs on platelet activity. The NPs of 113, 321, and 585 nm sizes, were formulated and their effects at concentrations of 0-2.2 mg/mL on the activation and aggregation of platelet-rich plasma (PRP) were investigated. The results showed that NPs of 113 nm did not affect adenosine diphosphate (ADP)-induced platelet aggregation at any NP concentration studied. The NPs of 321 and 585 nm, at concentrations ≥0.25 mg/mL, reduced ADP-activated platelet aggregation. The platelet activation profile remained unchanged in the presence of investigated NPs. Confocal microscopy revealed that NPs were attached to or internalised by platelets in both resting and activated states, with no influence on platelet reactivity. The results indicate minimal risks of interference with platelet function for PLGA-PEG NPs and that these NPs can be explored as nanocarriers for targeted drug delivery to platelets.


Assuntos
Plaquetas/efeitos dos fármacos , Sistemas de Liberação de Medicamentos , Nanopartículas/administração & dosagem , Agregação Plaquetária/efeitos dos fármacos , Plasma Rico em Plaquetas/efeitos dos fármacos , Polietilenoglicóis/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Plaquetas/fisiologia , Portadores de Fármacos/química , Humanos , Nanopartículas/química , Agregação Plaquetária/fisiologia , Plasma Rico em Plaquetas/fisiologia
15.
Biomed Res Int ; 2020: 3432987, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33145346

RESUMO

Introduction: Literature shows platelet-rich plasma (PRP) to improve overall outcomes in orthopedics, dermatology, ophthalmology, gynecology, and plastic surgery. Data on oncological patients is very limited. Only one publication is available on PRP in breast cancer patients. This work evaluated PRP in sentinel node biopsy procedures for breast cancer patients in terms of complication rates and oncological short-term follow-up. Methods: The evaluated PRP was ACP®, i.e., autologous conditioned plasma by Arthrex®. Between 2015 and 2018, 163 patients were offered to receive an ACP®/PRP injection in their lymph node biopsy site. Recruitment resulted in an approximate one-to-one ratio for analysis. Endpoints were major (revision) and minor (seroma, hematoma, and infection) complications rates as well as distant metastases, local recurrence, and overall survival. Median follow-up was 30 months. Results: Complication rates and oncological follow-up showed PRP to be applicable to use in a sentinel node biopsy scenario in breast cancer patients. There were 0 revisions in the ACP®/PRP group and 1.2% revisions in the control group (not significant). Oncological follow-up showed zero (0) distant metastases and local recurrences as well as a 100% 30-month overall survival. Conclusions: This is the first analysis of ACP®/PRP used in breast cancer patients in a sentinel node biopsy setting worldwide. PRP does not seem to increase rates of local recurrence within this 30-month follow-up time frame. Also, trend towards decreasing complication rates could be shown.


Assuntos
Neoplasias da Mama/cirurgia , Excisão de Linfonodo/métodos , Recidiva Local de Neoplasia/prevenção & controle , Plasma Rico em Plaquetas/fisiologia , Linfonodo Sentinela/cirurgia , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Feminino , Humanos , Metástase Linfática/prevenção & controle , Pessoa de Meia-Idade , Linfonodo Sentinela/patologia , Biópsia de Linfonodo Sentinela , Análise de Sobrevida
16.
Int J Mol Sci ; 21(20)2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33096812

RESUMO

Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.


Assuntos
Analgésicos/farmacologia , Indutores da Angiogênese/farmacologia , Transfusão de Plaquetas/métodos , Plasma Rico em Plaquetas , Imunidade Adaptativa , Envelhecimento , Anti-Inflamatórios não Esteroides/farmacologia , Senescência Celular , Humanos , Imunidade Inata , Técnicas In Vitro , Osteoartrite/terapia , Plasma Rico em Plaquetas/citologia , Plasma Rico em Plaquetas/fisiologia , Reabilitação , Serotonina/metabolismo , Terminologia como Assunto
17.
Int J Mol Sci ; 21(18)2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32899959

RESUMO

Platelet-rich plasma (PRP) therapy has been considered as a promising treatment for androgenetic alopecia (AGA). The aim of the study was comparative evaluation of the clinical efficacy of PRP-therapy, minoxidil, and their combination in the treatment of men with AGA and to evaluate the effects of PRP on the proliferation of hair follicle (HF) cells in skin biopsy. MATERIALS AND METHODS: The study involved 69 men who were divided into 3 groups who received PRP therapy, minoxidil, and their combination. The clinical efficacy of the therapy was evaluated by the dynamics of morphometric of hairs. To assess cell proliferation antibodies to ß-catenin, CD34, Ki67, and to Dkk-1 were used. RESULTS: PRP treatment was more effective than minoxidil therapy (p = 0.005). Complex therapy turned out to be more effective than minoxidil monotherapy (p < 0.0001) and PRP monotherapy (p = 0.007). After applying PRP the absolute and relative values of the ß-catenin and CD34 expression area increased; an increase in Ki67+ index was also significant. CONCLUSIONS: PRP can be considered as a treatment option for AGA. Combined PRP and minoxidil use seems promising for the treatment of AGA. PRP increase in the proliferative activity of HF cells and improves hair morphology in patients with AGA.


Assuntos
Alopecia/terapia , Proliferação de Células , Folículo Piloso/fisiologia , Minoxidil/administração & dosagem , Plasma Rico em Plaquetas/fisiologia , Adulto , Alopecia/tratamento farmacológico , Alopecia/patologia , Biópsia , Contagem de Células , Proliferação de Células/efeitos dos fármacos , Terapia Combinada , Cabelo/efeitos dos fármacos , Cabelo/metabolismo , Cabelo/patologia , Folículo Piloso/efeitos dos fármacos , Folículo Piloso/patologia , Humanos , Imuno-Histoquímica , Masculino , Transfusão de Plaquetas/métodos , Couro Cabeludo/efeitos dos fármacos , Couro Cabeludo/patologia , Resultado do Tratamento , Adulto Jovem
18.
Int J Mol Sci ; 21(18)2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32900003

RESUMO

BACKGROUND: Platelet-rich plasma (PRP) is an autologous blood product that contains a high concentration of platelets and leucocytes, which are fundamental fibroblast proliferation agents. Literature has emerged that offers contradictory findings about leucocytes within PRP. Herein, we elucidated the effects of highly concentrated leucocytes and platelets on human fibroblasts. METHODS: Leucocyte-rich, PRP (LR-PRP) and leucocyte-poor, platelet-poor plasma (LP-PPP) were compared to identify their effects on human fibroblasts, including cell proliferation, wound healing and extracellular matrix and adhesion molecule gene expressions. RESULTS: The LR-PRP exhibited 1422.00 ± 317.21 × 103 platelets/µL and 16.36 ± 2.08 × 103 white blood cells/µL whilst the LP-PPP demonstrated lower concentrations of 55.33 ± 10.13 × 103 platelets/µL and 0.8 ± 0.02 × 103 white blood cells/µL. LR-PRP enhanced fibroblast cell proliferation and cell migration, and demonstrated either upregulation or down-regulation gene expression profile of the extracellular matrix and adhesion molecules. CONCLUSION: LR-PRP has a continuous stimulatory anabolic and ergogenic effect on human fibroblast cells.


Assuntos
Matriz Extracelular/fisiologia , Fibroblastos/fisiologia , Leucócitos/fisiologia , Plasma Rico em Plaquetas/fisiologia , Cicatrização/fisiologia , Adulto , Movimento Celular/fisiologia , Proliferação de Células , Células Cultivadas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
Reprod Biol Endocrinol ; 18(1): 78, 2020 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-32758249

RESUMO

Premature Ovarian Insufficiency (POI) is viewed as a type of infertility in which the menopausal status occurs before the physiological age. Several therapeutic strategies have been introduced in clinic for POI treatment, although the outputs are not fully convincing. Platelet-rich plasma (PRP) is a unique blood product widely applied in regenerative medicine, which is based on the releasing of the growth factors present in platelets α-granules. In the current investigation, we examined the effectiveness of PRP as a therapeutic alternative for POI animals. POI in Wistar albino rats was induced by daily intraperitoneal (IP) administration of gonadotoxic chemical agent, 4-vinylcyclohexene dioxide (VCD) (160 mg/ kg) for 15 consecutive days. After POI induction, the PRP solution was directly injected intra-ovarian in two concentrations via a surgical intervention. Every two weeks post-injection, pathological changes were monitored in the ovaries using Hematoxylin-Eosin staining method, until eight weeks. Follicle Stimulating Hormone (FSH) content in serum was measured, together with the expression of the angiogenic-related transcripts ANGPT2 and KDR by real-time qPCR. Furthermore the fertility status of the treated rats was evaluated by mating trials. Histopathological examination revealed successful POI induction via the depletion of morphologically normal follicles in rats following VCD treatment compared to the control rats. The injection of PRP at two concentrations reduced the number and extent of the follicular atresia and inflammatory responses (p < 0.05). The expression of both ANGPT2 and KDR transcripts were significantly increased in POI rats due to enhanced inflammation, while these values were modulated after PRP administration (p < 0.05) compared to POI rats. FSH showed a decreased trend in concentration eight weeks after PRP treatment, but not statistically significant (p > 0.05). Nevertheless, a clear improvement in litter counts was found in POI rats receiving PRP compared to the non-treated POI group, being able to consider PRP as a facile, quick, accessible, safe and relatively cheap alternative therapeutic strategy to revert POI-related pathologies.


Assuntos
Ovário , Ovulação/fisiologia , Plasma Rico em Plaquetas/fisiologia , Insuficiência Ovariana Primária/terapia , Rejuvenescimento/fisiologia , Moduladores da Angiogênese/administração & dosagem , Animais , Modelos Animais de Doenças , Feminino , Injeções Intralesionais , Neovascularização Fisiológica/fisiologia , Ovário/irrigação sanguínea , Ovário/patologia , Ovário/fisiologia , Insuficiência Ovariana Primária/patologia , Insuficiência Ovariana Primária/fisiopatologia , Ratos , Ratos Wistar , Recuperação de Função Fisiológica
20.
Acta Orthop Traumatol Turc ; 54(4): 438-444, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32812877

RESUMO

OBJECTIVE: The aim of this study was to compare the effects of local administrations of platelet-rich plasma (PRP) with autologous conditioned serum (ACS) on Achilles tendon healing in a rat model. METHODS: In this study, 40 male Sprague-Dawley rats, aged 12 months and weighing 350 to 400 g were used. The rats were divided into three groups (n=10 in each group): a control group and two treatment groups (PRP vs ACS). A standardized procedure was applied for the complete rupture and repair of the Achilles tendon in each group. The PRP group received one dose of PRP on the operative area, and ACS group received ACS at 24, 48, and 72 hours after the surgery. The control group received no injection. Animals were sacrificed 30 days after the operation, and tendon healing in each group was assessed histopathologically based on Bonar's semi-quantitative score and Movin's semi-quantitative grading scale. For the biomechanical analyses, unoperated Achilles tendons of all rats in the control and ACS groups were also harvested, and pulling tests were applied to the specimen to measure the longitudinal axis strength. The highest force value among the data obtained was defined as the maximum strength value (Fmax). RESULTS: The mean Bonar's score was significantly lower in the PRP group (3.8±0.8) than in the ACS (4.8±0.45) and control groups (5.2±0.837) (p=0.0028). The mean Movin's score was significantly lower in the PRP group (7.80±1.49) than in the ACS (9.8±1) and control groups (11.2±2.4) (p=0.029). The ratio of type I collagen was significantly higher in the PRP group (60±6) than in the ACS (52±4.5) and control groups (42±9) (p=0.005). Biomechanical results obtained from operated sites were comparable in terms of Fmax among groups (PRP, 33.93±2.61; ACS, 35.24±3.26; control, 35.69±3.62) (p=0.674). Similarly, the results obtained from unoperated sites were comparable among groups (PRP, 47.71±1.21; ACS, 48.14±2; control, 49.14.69±1.88) (p=0.395). CONCLUSION: In terms of histopathological results, PRP seems to be more effective than ACS for Achilles tendon healing in rats.


Assuntos
Tendão do Calcâneo , Plasma Rico em Plaquetas/fisiologia , Ruptura/terapia , Soro/fisiologia , Cicatrização/fisiologia , Tendão do Calcâneo/lesões , Tendão do Calcâneo/fisiopatologia , Animais , Fenômenos Biomecânicos , Modelos Animais de Doenças , Injeções Intralesionais/métodos , Masculino , Ratos , Ratos Sprague-Dawley , Resultado do Tratamento
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