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Congenital hair loss, also known as androgenetic alopecia, has a significant impact on a person's self-confidence and quality of life and can even lead to depression. The miniaturization of hair follicles is the histological feature of AGA. This process does not progress synchronously and therefore differs from other forms of hair loss. Therapies only show effectiveness when intact hair follicles are still present! Therefore, an early diagnosis and initiation of AGA treatment are crucial for success. Although Minoxidil and Finasteride are mainly used for AGA treatment nowadays, current studies suggest that biological treatments with PRP, exosomes, and low-level laser therapy (e.g. Lasercaps) are effective alternatives with fewer side effects. Their effectiveness can be further improved through combination therapy. The issue of varying efficiency with the same therapeutic approach is not always due to the patient, but often to an improperly executed treatment concept by the physician. A prerequisite for successful AGA treatment is standardized procedures based on evidence-based medicine. [ABSTRACT FROM AUTHOR]

Breast cancer treatment encompasses various therapeutic modalities, including surgery, radiotherapy, and chemotherapy. Breast-conserving surgery has been an integral part of breast cancer management. However, radiotherapy, an important component of breast cancer management, can lead to complications, particularly fibrosis, affecting reconstructive surgery outcomes. We conducted an in vivo study using 48 female Wistar Albino rats, employing segmental mastectomy and radiotherapy to simulate post-mastectomy conditions. The rats were divided into six groups: control, mastectomy, mastectomy + radiotherapy, mastectomy + platelet-rich plasma (PRP) + radiotherapy, mastectomy + infliximab + radiotherapy, and mastectomy + infliximab + PRP + radiotherapy. Edema, hyperemia, inflammation, and fibrosis were assessed as indicators of tissue response. Histopathological analysis revealed that mastectomy + infliximab and mastectomy + infliximab + PRP groups showed significant reductions in fibrosis compared to other groups. Edema, hyperemia, and inflammation were also less severe in these groups compared to the control group. Radiotherapy-induced fibrosis is a major concern in breast reconstruction. Our study suggests that local PRP application and systemic infliximab administration, either alone or in combination, could mitigate the adverse effects of radiotherapy. This approach has the potential to improve reconstructive outcomes in patients undergoing or having the possibility to undergo radiotherapy. This is the first study showing the effectiveness of infliximab and PRP combination on wound healing. The provided experimental rat model might offer guidance for further research. This study provides insights into optimizing outcomes in reconstructive breast surgery, paving the way for further research and clinical studies. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich plasma (PRP) treatment for knee osteoarthritis has grown exponentially over the past decade; however, its scientific evaluation is highly variable. The American Academy of Orthopaedic Surgeons addressed the need for the standardization of orthobiologics studies by publishing the Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines in May 2017. In total, the MIBO guidelines are divided into 12 categories, encompassing 23 checklist items. Hypothesis/Purpose: The purpose of this study was to analyze how well randomized controlled trials (RCTs) on PRP interventions for knee osteoarthritis adhered to the MIBO guidelines. We hypothesized that most articles would report <80% of the MIBO criteria. Study Design: Systematic review; Level of evidence, 1. Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to perform a systematic review in the PubMed/MEDLINE and Web of Science databases. Inclusion criteria included English-language RCTs that assessed PRP interventions for knee osteoarthritis and reported beginning patient enrollment in June 2017 or later. The original 23 MIBO checklist items were separated and modified into a 44-point checklist. Adherence was determined by calculating the total percentage of checklist items that each article adequately and clearly reported from the 44-point checklist. Results: A total of 25 RCTs (2356 patients) were included in this study. The weighted mean age was 57.7 ± 4.4 years, with 42.9% being male. On average, only 53.1% ± 10.4% (range, 31.8%-77.3%) of the 44-point MIBO checklist items were reported per article. No articles had adherence rates ≥80%, 5 (20.0%) had rates between 60% and 79.9%, and 20 (80.0%) had rates ≤59.9%. Categories fluctuated in adherence, with "Intervention" having the greatest adherence (100.0%) and "Activation" having the lowest (14.0%). Additionally, 4 (33.3%) categories had adherence rates ≥80%, 0 had rates from 60% to 79.9%, and 8 (66.7%) had rates ≤59.9%. Conclusion: The overall mean adherence to MIBO guidelines by RCTs on PRP interventions for knee osteoarthritis was 53.1%. To increase the reproducibility, improve transparency, and assess the treatment efficacy of future PRP studies, reporting of MIBO guidelines should be improved. [ABSTRACT FROM AUTHOR]

This study was done to estimate the testicular histological alterations induced by Busulfan (BUS) and compare the possible protective effects of melatonin (MT) and platelet rich plasma (PRP) in a rat model. Sixty-four male rats were dispersed into: control group, BUS group, melatonin group, and PRP group. Blood samples were processed for biochemical analysis. Tissue specimens were managed for light and electron microscopic studies. Immunohistochemical expression of vimentin and proliferating cell nuclear antigen (PCNA) was performed. Busulfan induced severe testicular damage in all studied methodologies. It showed a statistically significant decrease in serum testosterone and elevation of MDA when compared to the control group. Abnormal testicular cytostructures suggesting defective spermatogenesis were observed: distorted seminiferous tubules, deformed spermatogenic cells, low germinal epithelium height, few mature spermatozoa, and also deformed barrier. Vimentin and PCNA expressions were reduced. Ultrastructurally, Sertoli cells and the blood testis barrier were deformed, spermatogenic cells were affected, and mature spermatozoa were few and showed abnormal structure. Both melatonin and PRP induced improvement in all the previous parameters and restoration of spermatogenesis as confirmed by improvement of Johnsen's score from 2.6 ± .74 to 7.6 ± .92. In conclusion, melatonin and PRP have equal potential to ameliorate the testicular toxicity of BUS. Melatonin can provide a better noninvasive way to combat BUS induced testicular injury. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is a common yet difficult-to-treat condition, which is an important psychosocial problem. Platelet-rich plasma (PRP) therapy has been considered as a promising treatment for AGA. However, the current evidence on the efficacy of PRP for treating AGA is still controversial. This study evaluated the efficacy of PRP monotherapy in the treatment of AGA. Methods: We searched PubMed, Embase, Cochrane Library and Web of Science to collect randomized controlled trials on use of PRP in AGA for a meta-analysis. Results: Ten trials with a total 555 treatment units were identified. The hair density in PRP group was significantly higher than control group [MD = 25.09, 95%CI: 9.03–41.15, p = 0.002], but there was no significant difference in hair diameter between two groups [SMD = 0.57, 95%CI: − 0.23 to 1.38, p = 0.16]. Subgroup analyses indicated that hair density was significantly higher among the male-only trials than in the mixed-sex samples (p = 0.02). In addition, neither the split-head design nor the year of publication affected hair density (p = 0.05, p = 0.06). However, hair density was significantly higher in trials with a sample size less than 30 (p = 0.0004). Conclusions: PRP treatment increased hair density in participants with AGA, but not hair diameter. In terms of hair density, PRP elicits stronger effects in male patients. There was a trend toward differed treatment effect by gender with PRP injection, which warrants further investigation. Especially in the case of female. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266. [ABSTRACT FROM AUTHOR]

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Abstract Purpose The treatment of cartilage lesions remains a challenge. Matrix‐associated autologous chondrocyte implantation has evolved to become the gold standard procedure. However, this two‐step procedure has crucial disadvantages, and the one‐step minced cartilage procedure has gained attention. This retrospective study aimed to evaluate the clinical and radiological outcome of an all‐autologous minced cartilage technique in cartilage lesions at the knee joint. Methods In this retrospective cohort study, 71 patients (38.6 years ± 12.0, 39,4% female) with a magnetic resonance imaging (MRI) confirmed grade III–IV cartilage defect at the medial femur condyle (n = 20), lateral femur condyle (n = 2), lateral tibia plateau (n = 1), retropatellar (n = 28) and at the trochlea (n = 20) were included. All patients were treated with an all‐autologous minced cartilage procedure (AutoCart™). Clinical knee function was evaluated by the Tegner score, visual analogue scale, the subjective and objective evaluation form of the International Knee Documentation Committee and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI analyses were performed by magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 knee score. Follow‐up examination was 13.7 ± 4.2 (12–24) months postoperative. Results All clinical scores significantly improved after surgical intervention (p

Introduction: Sports injuries are a significant health problem for both professional and recreational athletes. Standard treatment methods, including physiotherapy, pharmacotherapy, and surgical interventions, often fall short in cases of severe soft tissue damage. This has led to a growing interest in alternative therapies, such as platelet-rich plasma (PRP). In recent years, there has been growing interest in platelet-rich plasma (PRP) therapy due to its potential regenerative properties. PRP is increasingly used in the treatment of sports injuries, with the aim of accelerating tissue regeneration and facilitating a return to full physical fitness. This paper attempts to analyze available scientific studies to assess the effectiveness of PRP in the treatment of sports injuries. Purpose of the work: The aim of this study is to assess the effectiveness and safety of platelet-rich plasma (PRP) therapy in treating sports-related muscle, tendon, ligament, and joint injuries, and to compare its efficacy with other established treatment modalities, such as physiotherapy and pharmacotherapy. Results: Platelet-rich plasma (PRP) therapy has been shown to be highly effective in treating sports injuries, particularly muscle and tendon injuries. PRP accelerates tissue regeneration and shortens the time to return to physical activity, but the effectiveness of the therapy depends on the proper preparation protocol and individual patient characteristics. Compared to other treatment methods, PRP has a favorable safety profile and a lower risk of complications. Despite promising results, further studies are needed to better determine the long-term effectiveness and optimal conditions for using this therapy.

Introduction: Lichen sclerosus (LS) is a chronic inflammatory dermatosis predominantly affecting the anogenital area, with potential systemic implications. Objective: Our aim is to elucidate its clinical characteristics and management strategies. Methods: We conducted a retrospective observational study on adult patients with LS referred to our center between January 2022 and December 2023. Results: Forty-six adult subjects affected by LS were enrolled in the present study. The majority of patients presented with genital involvement, but a significant subset exhibited extragenital LS and concomitant immune-mediated disorders. Common symptoms included itching, soreness, and dyspareunia, with characteristic skin findings of erythema and atrophy. Topical corticosteroids were the mainstay of therapy, complemented by alternative treatments in refractory cases. Alternative therapeutic approaches, such as platelet rich plasma or adipose-tissue derived stromal/stem cell-based strategies, were effectively employed in refractory cases, in the absence of major adverse events. Conclusions: Our findings underscore the importance of alternative approaches in the management of LS and highlight the need for further research to elucidate its pathogenesis and optimize therapeutic interventions.

Introductionβ-TCP ceramics are bone replacement materials that have recently been tested as a drug delivery system that can potentially be applied to endogenous substances like growth factors found in blood platelets to facilitate positive attributes.MethodsIn this work, we used flow chamber loading to load β-TCP dowels with blood suspensions of platelet-rich plasma (PRP), platelet-poor plasma (PPP), or buffy coat (BC) character. PRP and BC platelet counts were adjusted to the same level by dilution. Concentrations of TGF-β1, PDGF-AB, and IGF-1 from dowel-surrounding culture medium were subsequently determined using ELISA over 5 days. The influence of alginate was additionally tested to modify the release.ResultsConcentrations of TGF-β1 and PDGF-AB increased and conclusively showed a release from platelets in PRP and BC compared to PPP. The alginate coating reduced the PDGF-AB release but did not reduce TGF-β1 and instead even increased TGF-β1 in the BC samples. IGF-1 concentrations were highest in PPP, suggesting circulating levels rather than platelet release as the driving factor. Alginate samples tended to have lower IGF-1 concentrations, but the difference was not shown to be significant.DiscussionThe release of growth factors from different blood suspensions was successfully demonstrated for β-TCP as a drug delivery system with release patterns that correspond to PRP activation after Ca2+-triggered activation. The release pattern was partially modified by alginate coating.

Abstract Introduction Previable premature rupture of membrane (PV‐PROM) is a complex clinical situation posing considerable risks to the foetus. There is an extreme paucity of management options and clear guidelines in the literature for this dismal situation. This is the first report on usage of a novel combination of cellular therapeutic agents in a case of PROM. This study reports the earliest gestational age at which a case of spontaneous PV‐PROM (sPV‐PROM) has been successfully dealt by active management and, the longest period of continuation of pregnancy in a singleton sPV‐PROM for a total of 149 days. Objective To study the benefit of Intraamniotic Injection of PRF and PRP (IFPRP) in an index case of PV‐PROM. Design This is a case report of a 26‐year‐old woman with a recurrent, sPV‐PROM at 14 weeks 2 days with a previous pregnancy loss due to PV‐PROM at 18 weeks managed in a private reproductive health hospital in Mysore, India. Methods Our subject underwent an elective cervical stitch at 14 weeks. She had confirmed, repeated episodes of leak after 30 h of the procedure. Apart from aggressive management to control infection with vaginal asepsis, an Intraamniotic injection of 9 mL of autologous PRF and 4.5 mL of PRP was done under ultrasound guidance. The pregnancy was monitored closely for signs of infection and foetal wellbeing. Results The amniotic fluid leak stopped immediately after IFPRP for 36 h. After two more bouts of small leak, it stopped completely. She delivered a healthy baby of 3.4 kg at 35 weeks 4 days. The mother and baby did well postnatally. Conclusion Our protocol for fixing the leak is simple, easy to use, and can be done in resource‐poor settings which we consider is a big advantage. Further studies are needed to explore its potential in treating PROM.

Background: The process of curing and regaining the integrity of damaged tissues is known as healing. An autologous concentration of platelets embedded in plasma is known as platelet-rich plasma (PRP). Aim: This study was conducted to evaluate the role of PRP in the fast healing of wounds and complications in oral surgical procedures. Materials and Methods: A total of 60 patients who underwent different oral surgical procedures were included in this study. PRP was placed in the surgical area after surgical procedures and recalled at the 2nd, 4th, and 6th month postoperatively. There was the assessment of soft tissue healing by measuring the probing depth in teeth adjacent to the surgical area and hard tissue healing in the form of alveolar bone density and alveolar bone height. The assessment of postoperative complications was also conducted. Results: The decrease in the probing depth at different follow-ups was greater in PRP patients showing better and fast soft tissue healing. The increase in alveolar height and alveolar bone density at different follow-ups was greater in the PRP group showing better and fast hard tissue healing. The frequency of complications, such as trismus and pain, was lesser in patients with PRP. Conclusion: The wound healing was at increased rate with reduced complications on using PRP in oral surgical procedures.

It is worth considering the regenerative capacity of platelet-rich plasma (PRP) and laser for challenging skin wounds. Therefore, this study aimed to investigate the healing potential of a single dose of inactivated autologous PRP, Laser, and PRP/Laser on full-thickness skin defects in dogs. Three mongrel dogs were subjected to 4 circular full-thickness skin defects on the thoracic region. Hence, 4 groups were evaluated: The control group (conventional treatment); the PRP group (single subcutaneous infiltration of inactivated autologous PRP); the laser group (laser for one session), and the PRP/laser group (single subcutaneous infiltration of autologous PRP followed by laser for one session). Measured variables were the percentage of wound size, catalase activity, malondialdehyde concentration, and expression of vascular endothelial growth factor A and collagen I alpha 2 genes. Tissue biopsies were also harvested for histopathologic and immunohistochemistry assessments. The percentage of wound size was significantly lower in all groups than in the control group with a greater reduction in the PRP group. Histopathologic findings were better in PRP and PRP/laser groups with superiority for PRP. Other variables were significantly different among groups at some time points. In conclusion, PRP has a greater potential than laser and PRP/laser for accelerating and improving the quality of healing of acute full-thickness skin wounds in dogs.

Abstract Rotator cuff injuries are a major cause of shoulder pain, affecting the quality of life and producing a significant burden on healthcare systems. Conservative management modalities are prioritized, resorting to surgery only when required. The field of regenerative medicine involving the use of biologics, such as platelet-rich plasma (PRP), has evolved and shown potential for managing rotator cuff injuries. Nonetheless, limitations including subpar outcomes have led clinicians to question the efficacy of autologous PRP. To circumvent this, the possibility of utilizing a standardized and well-characterized allogenic PRP for RCI has been explored. In this manuscript, we qualitatively present the evidence from in vitro, pre-clinical, clinical and ongoing studies investigating the applications of allogenic PRP in the context of rotator cuff disorders. Administration of allogenic PRP is safe and potentially efficacious to manage rotator cuff injuries, though more adequately powered randomized controlled trials with longer follow-ups are warranted to further establish the efficacy of allogenic PRP and justify its routine clinical use.

Introduction: PRP is gaining increasing interest for pain relief and improvement of joint function in patients with knee osteoarthritis (KOA) but practices and results remain heterogeneous limiting its adoption as standard of care. Current international recommendations are to collect real-life evidence of efficacy with a systematic monitoring of PRP quality and patients' outcomes. We aimed to analyze the response of patients presenting KOA and treated with standardized PRP injection in routine care. We also investigated the potential contributing factors including patient's phenotype and PRP characteristics. Methods: Patients with symptomatic KOA and that failed first-line therapy received a single injection of a qualified PRP prepared using medical devices allowing to recover a high/very high volume of very pure PRP. Visual analogue scale (VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded at baseline and during 18 months follow-up. Results: 431 patients had available follow-up data at 3 months, 291 at 6 months, 137 at 12 months and 44 at 18 months. PRP induced a significant decrease of WOMAC score at all follow up endpoints (29.2 ± 19.2 at 3 months, p

Introduction Non-surgical treatment of osteoarthritis is aimed at managing joint degeneration and inflammation to prolong the life of the original joint and delay total joint replacement. The objective was to pathomorphologically substantiate preclinical effectiveness of PRP in OA using comparative analysis of depleted plasma and serum. Material and methods The experiment was performed in 120 Wistar rats, divided into 4 groups. Osteoarthritis was simulated using an original method. Knee joint injection given to the animals after skin dissection under inhalation anesthesia and visual control two weeks later contained 0.05 ml PRP in group 1, 0.05 ml plasma in groups 2 and 0.05 ml blood serum in groups 3. The same volume of physiological saline solution was used for the injections produced for control animals. Injections were administered three times at 2-week intervals. Animals were sacrificed in groups of 10 at 2 weeks of each injection. Results The median MANKIN value scored 2.0 (1.0; 2.0) in group 1, 6.0 (5.0; 7.0) in group 2 and 7.0 (6.0; 7.0) in group 3 at 6 weeks. The median MANKIN value scored 7.5 (7.0, 8.0) in the control group. Statistically significant differences were determined between the groups at p < 0.001. Discussion Literature data on preclinical evaluation of the effectiveness of PRP therapy in biological models of OA are controversial. An original, low-traumatic functional method was used for simulating knee OA to reproduce major pathogenetic mechanisms in rats. Conclusion The findings suggested a pronounced therapeutic effect with improved morphofunctional features of the hyaline cartilage and MANKIN score of 2 at 6 days of intra-articular administration of modified PRP as compared with plasma and serum.

Background and objectives: Due to the regeneration potential of growth factors (GFs) and platelet concentrates (PCs), facial rejuvenation has been a major area of attention in esthetic medicine. The effectiveness and safety of PCs and GFs in promoting face rejuvenation are examined in this systematic review, which is complemented by a case series. GFs are essential for collagen production and dermal matrix remodeling, while PCs, like Platelet-Rich Plasma (PRP), are abundant in bioactive chemicals that promote tissue healing and cellular regeneration. Materials and Methods: A comprehensive literature search was performed on PubMed, Web of Science, and Scopus, focusing on human clinical trials published between February 2019 and February 2024 related to PRP and facial esthetics. Results: Thirteen studies met the inclusion criteria and were analyzed. Conclusions: The review summarizes the most recent data on patient outcomes, treatment regimens, and possible hazards. The case series that goes with it shows real-world examples of how to improve skin elasticity, texture, and general facial appearance with little negative side effects. These results highlight the potential use of PCs and GFs as minimally invasive procedures.

Chronic nonhealing wounds pose a serious challenge to regaining skin function and integrity. Platelet-derived extracellular vesicles (PEVs) are nanostructured particles with the potential to promote wound healing since they can enhance neovascularization and cell migration and reduce inflammation and scarring. This work provides an innovative overview of the technical laboratory issues in PEV production, PEVs' role in chronic wound healing and the benefits and challenges in its clinical translation. The article also explores the challenges of proper sourcing, extraction techniques and storage conditions, and discusses the necessity of further evaluations and combinational therapeutics, including dressing biomaterials, M2-derived exosomes, mesenchymal stem cells-derived extracellular vesicles and microneedle technology, to boost their therapeutic efficacy as advanced strategies for wound healing. [ABSTRACT FROM AUTHOR]

Individual differences in the response to platelet-rich plasma (PRP) therapy can be observed among patients. The genetic background may be the cause of this variability. The current study focused on the impact of genetic variants on the effectiveness of PRP. The aim of the present study was to analyze the impact of single nucleotide polymorphisms (SNP) of the platelet-derived growth factor receptor alpha (PDGFRA) gene on the effectiveness of treating lateral elbow tendinopathy (LET) with PRP. The treatment's efficacy was analyzed over time (2, 4, 8, 12, 24, 52 and 104 weeks after the PRP injection) on 107 patients using patient-reported outcome measures (PROM) and achievement of a minimal clinically important difference (MCID). Four SNPs of the PDGFRA gene (rs7668190, rs6554164, rs869978 and rs1316926) were genotyped using the TaqMan assay method. Patients with the AA genotypes of the rs7668190 and the rs1316926 polymorphisms, as well as carriers of the T allele of rs6554164 showed greater effectiveness of PRP therapy than carriers of other genotypes. Moreover, the studied SNPs influenced the platelets' parameters both in whole blood and in PRP. These results showed that PDGFRA gene polymorphisms affect the effectiveness of PRP treatment. Genotyping the rs6554164 and the rs1316926 SNPs may be considered for use in individualized patient selection for PRP therapy. [ABSTRACT FROM AUTHOR]

Osteochondral lesions of the talus are common in patients suffering even minor trauma; timely diagnosis and treatment can prevent the development of early osteoarthritis. The objectives of this systematic review and meta-analysis were to evaluate the effects of additional procedures on arthroscopic ankle microperforations for osteochondral lesions. A systematic literature search was conducted using PubMed-Medline, Cochrane Central, and Google Scholar to select clinical studies analyzing the efficacy of platelet-rich plasma (PRP), hyaluronic acid (HA), and bone marrow concentrate (BMC) procedures. Ten articles following PRISMA guidelines with a total of 464 patients were included in this review. Quality assessment using MINORS was performed, and all studies demonstrated high quality. The results of the systematic review showed benefits in all patients undergoing infiltrative therapy with PRP, hyaluronic acid, and BMC. The best results in terms of AOFAS score and VAS scale were found in patients undergoing PRP injection. The meta-analysis showed improvements in pain relief and return to daily activities in patients undergoing arthroscopic microperforations and PRP, although not reporting statistically significant results (p = 0.42). All treatment strategies reported better scores compared to the control groups. Among the various treatments analyzed, the addition of PRP appears to be the most valuable probably for the larger population receiving this treatment, showing excellent outcomes in pain reduction, clinical outcomes, and return to daily activities. II [ABSTRACT FROM AUTHOR]

Muscle and tendon injuries encompass a wide range of conditions, including both acute and chronic ailments, and are common among athletes, representing a significant cause of injuries in various sports. Frequently affected areas include the hamstrings, quadriceps, gastrocnemius, and hip flexors. Concurrently, tendinopathy presents a complex clinical challenge, affecting a majority of athletes due to high load demands and repetitive movements, with its incidence in sports practice increasing over the last decades to account for up to 30% of all injuries. The substantial costs, both in terms of time away from competition and financial loss, have spurred growing scientific interest in therapies that can enhance the healing process of these injuries. In this context, innovative orthobiologic approaches, particularly platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs), have been explored for their potential to facilitate the return-to-play phase and reduce the risk of reinjury by modulating inflammation and promoting tissue regeneration. This narrative review aims to summarize the current evidence regarding the role of orthobiologics in the management of sports-related muscle and tendon injuries. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Does platelet-rich plasma (PRP) intraovarian injection increase the number of retrieved oocytes in successive ovarian punctions among patients with poor ovarian reserve (POR)? SUMMARY ANSWER The injection of PRP increases the number of retrieved oocytes without increasing the quality of developed blastocysts. WHAT IS KNOWN ALREADY Management of women with reduced ovarian response to stimulation is one of the significant challenges in reproductive medicine. Recently, PRP treatment has been proposed as an adjunct in assisted reproduction technology, with controversial results. STUDY DESIGN, SIZE, DURATION This placebo-controlled, double-blind, randomized trial included 60 patients with POR stratified according to the POSEIDON classification groups 3 and 4. It was conducted to explore the efficacy and safety of intraovarian PRP injection. Patients were proposed to undergo three consecutive ovarian stimulations to accumulate oocytes and were randomized to receive either PRP or placebo during their first oocyte retrieval. Randomization was performed using computer-generated randomization codes. Double blinding was ensured so that neither the participant nor the investigators knew of the treatment allotted. All patients underwent three ovarian stimulations and egg retrieval procedures. ICSI was performed after a third ovarian puncture. The primary endpoint was the number of mature oocytes retrieved after PRP or placebo injection in successive ovarian punctures. PARTICIPANTS/MATERIALS, SETTING, METHODS Sixty women (30–42 years) fulfilling inclusion criteria were randomized in equal proportions to the treatment or control groups. MAIN RESULTS AND THE ROLE OF CHANCE The baseline demographic and clinical characteristics [age, BMI, anti-Müllerian hormone (AMH) levels] were comparable between the groups. Regarding the primary endpoint, the cumulative number (mean ± SEM) of retrieved mature oocytes was slightly higher in the treatment group: 10.45 ± 0.41 versus 8.91 ± 0.39 in the control group, respectively (95% CI of the difference 0.42–2.66; P  = 0,008). The number of mature oocytes obtained among all patients increased in successive egg retrievals: 2.61 ± 0.33 (mean ± SEM) in punction 1 (P1), 3.85 ± 0.42 in P2, and 4.73 ± 0.44 in P3. However, the increase was higher among patients receiving the assessed PRP treatment. In P2, the number of retrieved mature oocytes was 4.18 ± 0.58 versus 3.27 ± 0.61 in controls (95% CI of the difference: −0.30 to 2.12; P  = 0.138) and in P3, 5.27 ± 0.73 versus 4.15 ± 0.45 (95% CI of the difference: 0.12–2.12; P  = 0.029). The mean ± SEM number of developed and biopsied blastocysts was 2.43 ± 0.60 in the control group and 1.90 ± 0.32 in the treatment group, respectively (P  = 0.449). The mean number of euploid blastocysts was 0.81 ± 0.24 and 0.81 ± 0.25 in the control and treatment groups, respectively (P  = 1.000). The percentages of patients with euploid blastocysts were 53.33% (16 out of 30) and 43.33% (13 out of 30) for patients in the control and treatment groups, respectively (Fisher's exact test P  = 0.606). The overall pregnancy rate per ITT was 43% (26 out of 60 patients). However, the percentage of clinical pregnancies was higher in the control group (18 out of 30, 60%) than in the treatment group (8 out of 30, 27%) (P  = 0.018). There was also a trend toward poorer outcomes in the treatment group when considering full-term pregnancies (P  = 0.170). There were no differences between control and treatment groups regarding type of delivery, and sex of newborns. LIMITATIONS, REASONS FOR CAUTION The mechanism of the potential beneficial effect of PRP injection on the number of retrieved oocytes is unknown. Either delivered platelet factors or a mechanical effect could be implicated. Further studies will be needed to confirm or refute the data presented in this trial and to specify the exact mechanism of action, if any, of PRP preparations. WIDER IMPLICATIONS OF THE FINDINGS The increasing number of women with a poor response to ovarian stimulation supports the exploration of new areas of research to know the potential benefits of therapies capable of increasing the number of oocytes available for fertilization and improving the quality of developed blastocysts. An increase in the retrieved oocytes in both arms of the trial suggests that, beyond the release of growth factor from platelets, a mechanical effect can play a role. However, neither improvement in euploid blastocyst development nor pregnancy rates have been demonstrated. STUDY FUNDING/COMPETING INTEREST(S) This trial was supported by Basque Government and included in HAZITEK program, framed in the new Euskadi 2030 Science and Technology Plan (PCTI 2030). These aids are co-financed by the European Regional Development Fund (FEDER). The study funders had no role in the study design, implementation, analysis, manuscript preparation, or decision to submit this article for publication. No competing interests are declared by all the authors. TRIAL REGISTRATION NUMBER Clinical Trial Number EudraCT 2020-000247-32. TRIAL REGISTRATION DATE 3 November 2020. DATE OF FIRST PATIENT'S ENROLLMENT 16 January 2021. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome (CTS) is one of the most diagnosed disabling conditions of the upper extremities. Corticosteroid local injection is one of the traditional treatments. Platelet-Rich Plasma (PRP) local injection has emerged as a new treatment, promoting nerve regeneration. Objectives: Comparison of the effectiveness of a single PRP local injection to a single corticosteroid local injection for treating idiopathic CTS using nerve conduction studies and Visual Analog Scale. Patients and method: 40 patients with mild idiopathic CTS were diagnosed clinically and selected according to Padua's Neurophysiologic Severity Scale (PNSS) started the study. They were divided into 2 equal groups; the first group of patients received a single local corticosteroid injection, and the second group received a single local PRP injection. Nerve conduction studies (NCS) in the form of median nerve sensory conduction velocity and the Visual Analogue Scale (VAS) were compared in both groups before and three months after injection. Results: Our study included 40 patients randomly grouped into two equal main categories. Group I (corticosteroid group) included 20 patients with a mean age of 41.50±11.26 years, while Group II (PRP group) included 20 patients with a mean age of 39.10±11.24 years. VAS and median nerve sensory conduction velocity were significantly reduced in group II compared to group I. Conclusions: PRP single local injection in the wrist proved to be better than corticosteroids single local injection for managing mild idiopathic CTS. [ABSTRACT FROM AUTHOR]

Platelet-rich fibrin (PRF) represents the second generation of platelet concentrates, which has attracted increasing attention in recent years due to its ability to accelerate wound healing and promote tissue regeneration. Over the past few decades, various forms of platelet concentrates have appeared with different properties of each product in terms of its structure, concentration of growth factors and other biomolecules necessary for wound healing, widely used in dentistry and maxillofacial surgery. New generations, including fibrin rich in leukocytes and platelets (L-PRF) and advanced fibrin rich in platelets (A-PRF), have demonstrated superior biological properties in healing and regeneration than those of first-generation concentrates such as platelet-rich plasma (PRP). These biological products are completely autologous, easy to prepare, have minimal costs and have a prolonged release of growth factors, as well as a number of other advantages compared to traditionally prepared platelet concentrates. The purpose of the study is to summarize, analyze and systematize the available data on platelet concentrates and their modifications. A systematic review of the literature data was conducted, 67253 publications were found, presented in international electronic databases: PubMed, Google Search, Ebsco, Embase, Web of Science, ScienceDirect, SciELO and eLibrary. 99 publications were selected based on the selection criteria. The methodology of this study meets the requirements for systematic reviews and meta-analyses of PRISMA. The study systematized the available data on the evolution of platelet concentrates, preparation protocols, nature, properties and biological effects of various modifications of PRF. [ABSTRACT FROM AUTHOR]

Persistent pneumothorax is a life-threatening complication that can occur after congenital cardiac surgery. Traditional treatment such as chest tube drainage may not be effective in managing this condition. This study presents a new minimally invasive method for treating persistent pneumothorax using platelet-rich plasma–fibrin glue (PRP–FG). The method has been successful in treating postoperative chylothorax in previous studies, and its use has decreased morbidity, mortality, and hospital stay in chylothorax patients. Ten patients with persistent pneumothorax following cardiothoracic surgery (3 TAPVC, 2 d-TGA, 2 VSD + IAA,1 TRUNCUS + TAPVC, 1 VSD + COA, 1 GLENN), who did not respond to conservative management, underwent treatment with PRP–FG. Follow-up was done for a period of 1–4 years. The age and diagnoses of pneumothorax after surgery were 85.5 ± 36.0 days and 62.4 ± 34.3 h, respectively. Persistent pneumothorax of 8 patients (80%) was cured completely after PRP–FG injection. PRP–FG therapy was failed in two patients who died. All cured patients had a normal life without any complications during follow-up. After PRP–FG injection, 3 patients stopped bubbling at one-time injection, 3 patients stopped bubbling at two-time injection, and 2 patients stopped bubbling at three-time injection. Two patients died during treatment; in these cases, one-time injections were done which was not successful. Persistent pneumothorax after congenital–cardiac surgery can be treated successfully with PRP–FG. This bedside minimal-invasive procedure may significantly decrease the morbidity and mortality rate. Further research is needed to confirm the efficacy of this promising treatment through multicentre clinical trials. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the effects of different intra-articular injections using a mixture of hyaluronic acid (HA) and platelet-rich plasma (PRP) versus hyaluronic acid and corticosteroid in the management of TMJ internal derangement with reduction. Materials and Methods: Sixty patients were randomly divided into two equal groups. Group I was injected with hyaluronic acid and PRP, while group II was injected with hyaluronic acid and corticosteroid. Pain intensity according to the visual analogue scale, maximum inter-incisal opening (MIO), lateral movement, and joint sound were measured pre-operatively and at 1 week, 1 month, and 6 months post-operatively. Results: MIO and lateral movements were improved in both groups, with a reduction in the number of patients suffering from clicking sounds along the follow-up periods with no significant difference between the studied groups. However, regarding pain, the group injected with HA and PRP achieved the best results after 6 months, while patients treated with HA and corticosteroids obtained the best results at the end of the 1st week. Conclusion: Hyaluronic acid and platelet-rich plasma mixture performed better than hyaluronic acid and corticosteroid in the treatment of TMJ internal derangement with reduction at the long-term follow-up regarding pain intensity. [ABSTRACT FROM AUTHOR]

Skin wound healing is a complex biological process in which the replacement of dead tissue by a vital one takes place. The aim of this study was to assess the clinical and histopathological modalities of Curcumin nanoparticles and (Platelet-rich plasma) application on excisional skin wound healing activity. Under complete aseptic conditions full-thickness (10 mm) artificial uniform skin wounds were created on the back of twenty anaesthetized male rats (divided into four groups; Control (Group A), Curcumin treatment (Group B), Platelet-rich plasma treatment (Group C), and Curcumin - Platelet-rich plasma treatment (Group D). Tissue sections were stained by hematoxylin and eosin, PAS, and Crossman trichrome for histopathological evaluation of the wound healing properties following the curcumin and PRP topical treatment. Significant skin regeneration including wound closure and histopathological healing was better in Curcumin nanoparticles and PRP treated groups compared to the control untreated one through better reepithelization and coaptation between the epidermis and dermal layers, more vascular angiogenesis, less inflammatory reactions, healthy granulation tissue and better collagen fibers density in the dermal layer. The obtained results proved an effective external therapeutic use of both Curcumin and PRP on cutaneous wound healing progression. [ABSTRACT FROM AUTHOR]

The aim of this research is to explore the therapeutic efficacy of platelet‐rich plasma (PRP) on the cutaneous ulceration of diabetes mellitus (DM). From the beginning of the database until January 2024, we looked through several databases to obtain randomised, controlled PRP studies to treat the wound healing of DM in adult patients. The Cochrane Collaboration's Risk‐Of‐Bias Instrument was used to evaluate the risk of bias in randomised, controlled studies. Funnel plots, sensitivity analyses and Egger regression tests were employed to determine the reliability and effectiveness of the meta‐analyses. Depending on the degree of heterogeneity, a fixed or random effect model has been used. The statistical significance was determined to be below 0.05. Altogether 281 trials were collected from the database and entered into Endnote Software for screening, and 15 trials were analysed. It was found that PRP was associated with a higher rate of wound healing (OR, 3.23; 95% CI, 2.42, 4.31 p < 0.0001). PRP was associated with a reduction in the risk of post‐operative wound infection (OR, 0.46; 95% CI, 0.21, 0.99 p = 0.05). PRP was associated with a reduction in the risk of amputations amongst those with DM (OR, 0.50; 95% CI, 0.30, 0.84 p = 0.009). Overall, PRP treatment for DM is expected to improve the rate of wound healing, decrease the risk of wound infection and decrease the risk of amputations. [ABSTRACT FROM AUTHOR]

Rotator cuff injuries are a major cause of shoulder pain, affecting the quality of life and producing a significant burden on healthcare systems. Conservative management modalities are prioritized, resorting to surgery only when required. The field of regenerative medicine involving the use of biologics, such as platelet-rich plasma (PRP), has evolved and shown potential for managing rotator cuff injuries. Nonetheless, limitations including subpar outcomes have led clinicians to question the efficacy of autologous PRP. To circumvent this, the possibility of utilizing a standardized and well-characterized allogenic PRP for RCI has been explored. In this manuscript, we qualitatively present the evidence from in vitro, pre-clinical, clinical and ongoing studies investigating the applications of allogenic PRP in the context of rotator cuff disorders. Administration of allogenic PRP is safe and potentially efficacious to manage rotator cuff injuries, though more adequately powered randomized controlled trials with longer follow-ups are warranted to further establish the efficacy of allogenic PRP and justify its routine clinical use. [ABSTRACT FROM AUTHOR]

Rotator cuff (RC) injuries include a wide range of pathologic states. Athletes are perhaps the most susceptible to RC injuries ranging from tendinopathy to partial or full-thickness tears, due to functional overload and repetitive movements, causing abstention from sports for long periods. Regenerative medicine keeps giving us multiple choices to fight the disability caused by these pathologies. A literature search was performed, and findings related to the structure-function of rotator cuff units, pathophysiology of injuries, regenerative medicine treatments, and future strategies were outlined. Platelet-rich plasma (PRP) has a greater number of articles and clinical trials, accompanied by stem cells progenitor, prolotherapy, and new approaches such as microfragmented adipose tissue and exosomes. RC injuries in athletes can cause pain, functional impotence, and the risk of recurrence, and can lead them to stop playing sports. Regenerative medicine offers a range of treatments, but some of them need further studies to underline their actual validity. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to investigate the effects of autologous intrauterine platelet-rich plasma (IU-PRP) infusion during ovulation induction with clomiphene citrate (CC) on endometrial thickness (EMT) and clinical pregnancy in patients with polycystic ovary syndrome (PCOS) and thin endometrium. The secondary outcome was to detect possible transformations in oligomenorrheic cycles after PRP. Methods: This study was conducted on 35 anovulatory PCOS patients aged between 22 and 29 years who applied for infertility treatment. The patients had a thin endometrium in their past history. EMT 7 mm was considered thin endometrium. The diagnosis of PCOS was made according to the revised Rotterdam criteria. A total of 35 patients were divided into two groups according to whether they received PRP or not. Twenty patients received CC plus PRP treatment, whereas 15 patients received CC treatment alone. Patients in both groups were administered CC at a dose of 100 mg/day for 5 days, starting from the 3rd day of progesterone-related withdrawal bleeding. Follicular development and EMT were recorded using transvaginal ultrasonography. In cases with EMT <7 mm, approximately 0.5-1 mL of autologous PRP was infused with the IUI catheter, four days after CC treatment, i.e., on the ninth day of the cycle. EMT was measured and recorded again 3 and 6 days after PRP. Timed intercourse was recommended for cases with a follicle with a mean diameter of at least 16-18 mm. The biochemical and clinical pregnancy rates of both groups were recorded. Results: Both groups were similar in terms of participant age and body mass index. All participants in the CC plus PRP group were successfully infused with autologous PRP on the ninth day of the cycle. The serum estradiol, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratios of both groups were similar. Biochemical pregnancy and clinical pregnancy rates of the CC plus PRP group were significantly higher than those of the CC alone group (p<0.03 and p<0.02, respectively). Although clinical pregnancy was detected in 5 individuals in the PRP group (25%), clinical pregnancy was recorded in 2 individuals in the CC alone group (13.3%). There was no significant change in the oligo/anovulatory cycle patterns of patients with and without PRP. EMT values on the sixth (4.96±2.11 mm vs. 4.68±2.47 mm, p<0.37) and eighth days were similar between the two groups (5.11±3.10 mm vs. 5.29±3.01 mm, p<0.51). Compared with the CC alone group, the EMT values measured both at day 12 (6.34±1.09 mm vs. 5.47±3.90 mm, p<0.02) and at day 15 (7.44±2.60 mm vs. 6.23±2.70 mm, p<0.01) in the PRP group were found to be significantly higher. Conclusion: IU-PRP infusion in PCOS patients with thin endometrium who underwent ovulation stimulation with CC significantly increased both EMT and clinical pregnancy rates. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff injuries are among the most common causes of shoulder pain and dysfunction. The present study was conducted to assess management outcome of rotator cuff injuries using allogenic platelet-rich plasma. Materials & Methods: 60 cases of rotator cuff injuries of both genders were selected. Patients were given dual PRP injection into the rotator cuff. Patients were divided into 4 groups. Group I were cases of Tendinitis, group II were partial tear < 50 %, group III were partial tear >50 % and group IV were full thickness tear. Parameters such as Global improvement score, Quick DASH scores were collected at pre- treatment, 6months and 1 year after treatment. Results: Out of 58 patients, males were 38 and females were 20. Global improvement score at pre- treatment, 6 months and 1 year was 58.2, 60.7 and 57.4 in group I respectively. It was 65.3, 68.4, and 62.1 in group II respectively. It was 64.9, 70.3, and 74.6 in group III respectively. It was 61.2, 60.8, and 62.4 in group IV respectively. The difference was significant (P< 0.05). Q-DASH score in group I was 38.4, 20.3 and 18.5 at pre- treatment, at 6 months and at 1 year. In group II was 37.4, 24.2 and 30.4 at pre- treatment, at 6 months and at 1 year. In group III, it was 38.6, 18.4 and 10.2 at pre- treatment, at 6 months and at 1 year. In group IV, it was 18.4, 24.2. and 22.7 at pre- treatment, at 6 months and at 1 year respectively. The difference was significant (P< 0.05). Conclusion: For patients with RC cuff injuries who have not improved with conservative treatment such as physical therapy and activity modification, platelet-rich plasma injection is a safe and efficient alternative. [ABSTRACT FROM AUTHOR]

Despite the development of surgical technologies, intraabdominal adhesions are one of the most important problems for infertility, abdominopelvic pain, and intestinal obstruction. This study was aimed the efficiency of PRP (Platelet Rich Plasma) on preventing postoperative intraabdominal adhesions. In this study, 25 male Sprak Dawley breed rats of 4 months old were used. They were divided into 2 groups equally. Five rats were used as donor and obtained PRP. Following general anesthesia and under routine procedures, all groups were traumatized 1 cm² area on the ileocecal region while group 1 was served as control with no chemical, the group 2 was locally applied PRP. Relaparatomy was made on the 14 days after surgery The results were evaluated macroscopically and histopathologically. Adhesion and fibrosis scores of PRP group were observed to have significantly decreased compared to the control (p<0.05). There was no significant difference in inflamation between the PRP and control groups (p>0.05). In conclusion, it was determined that PRP was nore effective on the preventive of intraabdominal adhesions. [ABSTRACT FROM AUTHOR]

Introduction: The health of the ocular surface that is important for visual acuity is dependent on the corneal epithelial integrity. Platelet-rich plasma is considered a therapeutic approach to corneal wounds because of its content of growth factors. These growth factors help to promote and accelerate wound healing in different tissues including the cornea Aim of the Work: To evaluate the effect of PRP on corneal wound healing in surgically induced corneal injury in rabbits. Material and Methods: Eighteen rabbits each weighing 2.5-3 kg were used in this experiment. Blood from the marginal vein of the ear was obtained from Rabbits assigned to be donors for PRP. The center of the cornea was marked, and the epithelium was scrabbed by an ophthalmic blade, then four incisions were made in the center of the corneal stroma. Rabbits were assigned into one of three groups: group I represented the control group that didn't receive any treatment. Group II represented the saline group that received one drop of sodium chloride. Group III received PRP as single subconjunctival injection. Animals of all the groups were then euthanized one week after the surgery. The Cornea of all groups was extracted, processed and subjected to light, and Scanning electron microscopic examination Results: Platelet rich plasma led to restoration of the regular arrangement of stromal collagen fibers and regular surface epithelium of the corneal wound that showed a good amount of microvilli. Conclusion: Platelet-Rich plasma led to a more regular pattern of wound healing with better quality in induced corneal injury. [ABSTRACT FROM AUTHOR]