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Purpose of reviewThis study aims to systematically review platelet dosage in platelet rich plasma (PRP) injections for common musculoskeletal conditions.Recent findingsNotable heterogeneity exists in the literature regarding platelet dosage. Clinical studies indicate that a higher dosage may lead to improved outcomes concerning pain relief, functional improvement, and chondroprotection in knee osteoarthritis (OA). However, the impact of dosing on other musculoskeletal pathologies remains uncertain. Our investigation identifies a potential dose-response relationship between platelet dose and PRP effectiveness for knee OA treatment, pinpointing an optimal threshold of greater than 10 billion platelets for favorable clinical outcomes. Notably, this effect appears more pronounced for functional outcomes than for pain relief. For other conditions, a lower dosage may suffice, although the existing literature lacks clarity on this matter. PRP dosage may significantly influence treatmentoutcomes, particularly in knee OA. Further research is warranted to elucidate optimal dosages for varying conditions.

Colorectal cancer (CRC) is a prevalent malignant tumor worldwide, with a high mortality rate due to its complex etiology and limited early screening techniques. This study aimed to identify potential biomarkers for early detection of CRC utilizing targeted metabolite profiling of platelet‐rich plasma (PRP). Based on multiple reaction monitoring (MRM) mode, liquid chromatography tandem mass spectrometry (LC–MS/MS) analysis identified metabolites in PRP collected from patients with CRC (n = 70) and healthy controls (n = 30). A total of 302 metabolites were identified and quantified in this study, including various categories such as lipids, lipid mediators, amino acids, and derivatives, organic acids and derivatives, nucleotides and derivatives, alkaloids, carbohydrates, vitamins and derivatives, and others. The differential analysis revealed that five carbohydrates and organic acids (lactose, glycerol‐3‐phosphate, 2−hydroxyglutaric acid, isocitric acid, and citric acid) involved in the carbohydrate metabolism pathway displayed consistent upregulation within PRP derived from patients with CRC. To further validate the abundance of differential metabolites, 10 pairs of CRC tissues, adjacent tissues, and matched PRP were collected. Ultimately, five carbohydrate metabolites were validated in PRP, and compared with carcinoembryonic antigen (CEA) and cancer antigen 19‐9 (CA199), the five carbohydrate metabolites significantly improved the specificity of differentiating patients with CRC from healthy controls. Furthermore, the diagnostic efficacy of the combined five‐carbohydrate metabolite panel was superior to that of individual metabolites, CEA and CA199. The sensitivity, specificity, and AUC of the metabolite panel in distinguishing patients with CRC from healthy controls were 90.00%, 96.67%, and 0.961 (95% CI 0.922–0.998), respectively. Collectively, metabolomics was used to identify and validate differential metabolites in the PRP of CRC, which may serve as potential early screening markers for patients with CRC. [ABSTRACT FROM AUTHOR]

Knee osteoarthritis is a common chronic joint disease worldwide, representing a significant public health problem because of its impact on pain, functionality, and quality of life. Current treatment options, including pharmacological and physical therapies, aim to manage symptoms in the early and middle stages and delay surgical interventions. Platelet-rich plasma (PRP), an orthobiological treatment, has emerged as a promising treatment offering potential benefits, such as inflammation modulation, cartilage regeneration, and symptom relief. This review evaluates the role of PRP in the management of knee osteoarthritis by analyzing recent literature and consensus reports. The therapeutic effects of PRP are attributed to its bioactive components, including growth factors and cytokines, which promote tissue healing and regulate inflammatory processes. Clinical studies have demonstrated the efficacy of PRP for pain reduction and functional improvement, particularly in patients with mild-to-moderate knee osteoarthritis. However, variability in preparation protocols, dosage, and patient characteristic influence outcomes, highlighting the need for standardized protocols. Key factors such as centrifugation technique, activation method, and leukocyte concentration significantly affect the efficacy of PRP. Consensus reports have recommended PRP as an effective and safe option for the management of knee osteoarthritis, especially in the early and middle stages, and under certain conditions, has potential application in advanced cases. Although PRP shows promise as an innovative treatment, further high-quality, long-term studies are needed to optimize the protocol. This review highlights the efficacy of PRP among conservative treatments and its potential to improve outcomes in patients with knee osteoarthritis. Keywords:Knee osteoarthritis, platelet rich plasma, PRP therapy, orthobiological treatments, cartilage regeneration, ınflammation modulation: [ABSTRACT FROM AUTHOR]

Background Current guidelines advocate a shared decision-making process approach to erectile dysfunction management, and while there is growing interest in regenerative therapies such as stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy for erectile dysfunction, comparative data on the efficacy of these modalities are limited. Aim This systematic review and network meta-analysis aims to compare stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy for managing erectile dysfunction and quantify their impact on the International Index of Erectile Function (IIEF). Methods In January 2024, a systematic search of online databases was performed to identify randomized clinical trials related to stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy in erectile dysfunction. Eligible articles reported outcomes using the IIEF score. Data were inputted into Review Manager 5.4 for pairwise meta-analysis. Data were then used to build a network in R Studio. These networks were used to model 200 000 Markov Chains via MonteCarlo sampling. The results are expressed as standardized mean difference (SMD) with 95% credible intervals (CrI). Meta-regression was used to adjust for PDE5is use. Outcomes Impact on the International Index of Erectile Function. Results A total of 16 studies involving 907 patients were analyzed. The standardized mean difference (SMD) vs control for stem cell therapy was 0.92 [95% CrI –0.49, 2.3]. For platelet-rich plasma, the SMD vs control was 0.83 [95% CrI 0.15, 1.5], and for low-intensity shockwave therapy, the SMD vs control was 0.84 [95% CrI 0.49, 1.2]. When stratifying low-intensity shockwave therapy by dose, the SMD vs control at 0.15 mJ/mm2 was 1.1 [95% CrI 0.36, 1.9], while at 0.09 mJ/mm2, it was 0.75 [95% CrI 0.26, 1.2]. Meta-regression adjusting for the administration of PDE5 inhibitors yielded non-significant results. Clinical implications The findings suggest that stem cells, platelet-rich plasma, and low intensity shockwave therapy, particularly at 0.15 and 0.09 mJ/mm2, may offer improvements in erectile function. Strengths and limitations The strength is the robust statistical methods. Limitations are in heterogeneity in control groups and follow-up durations among included studies. Conclusion Shockwave therapy and platelet-rich plasma demonstrated statistically significant improvements, though the clinical relevance and extent of their impact remain questionable. Further research is necessary to determine the efficacy of stem cell therapies for erectile function. [ABSTRACT FROM AUTHOR]

Background: Erectile dysfunction (ED) is a common issue among males, and the use of platelet-rich plasma (PRP) therapy for treating ED has gained increasing attention, but there is still no conclusive evidence regarding its efficacy. Aim: To evaluate the efficacy of PRP therapy for ED. Methods: We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases up to November 2023 to identify randomized controlled trials (RCTs) on PRP therapy for ED. We used Review Manager version 5.4 for data analysis and management. Result: After applying inclusion and exclusion criteria for screening, a total of 4 studies involving 413 patients were finally included in our meta-analysis. According to our analysis, the PRP group showed significant advantages over the placebo group in terms of MCID at the first month (p = 0.03) and sixth months (p = 0.008), while there was no significant difference between the two groups at the third month (p = 0.19). Additionally, in terms of IIEF, PRP showed significantly better efficacy than placebo at the first, third, and sixth months (p < 0.00001). Conclusions: PRP shows more effectiveness in treating ED compared to placebo, offering hope as a potential alternative treatment for ED. [ABSTRACT FROM AUTHOR]

Sudden Sensorineural Hearing Loss (SSNHL) is a distressing condition with limited treatment options. This prospective study aimed to investigate the effectiveness of intratympanic Platelet Rich Plasma (PRP) as a salvage treatment for SSNHL. 56 consecutive patients with unilateral SSNHL, unresponsive to conventional treatments, were administered two intratympanic injections of autologous PRP 10 days apart and hearing threshold evaluated after one month. Audiometric data before and after PRP injections revealed a significant mean hearing gain of 11.99 dB which was more in lower frequencies (250, 500, 1000 Hz) reaching upto 13.88dB. Notably, improvement was observed in patients with amino glycoside-induced hearing loss, even after prolonged symptom duration. Additionally, 8 out of 17 patients reported subjective improvement in tinnitus. No serious adverse events were noted, and patients tolerated the procedure well. Intratympanic PRP holds promise as a salvage treatment for SSNHL, particularly in cases where conventional treatments have failed. Further research with larger sample sizes and comparative studies is warranted to establish PRP's role as a primary therapy for SSNHL and explore its long-term benefits. Its role in treatment of tinnitus also needs to be explored. [ABSTRACT FROM AUTHOR]

Studies evaluating the results of platelet-rich plasma (PRP) for the treatment of rotator cuff tendinopathy have demonstrated conflicting results and have been confounded by small patient samples, the absence of a control group, the combined analysis of isolated tendinopathies and rotator cuff tears, and insufficient reporting of PRP preparations. The purpose of this study was to perform a randomized controlled trial (RCT) comparing PRP with standard corticosteroid injections in providing pain relief and improved function in patients with rotator cuff tendinopathy. This was a double-blind RCT at a single center. We evaluated patients between 18 and 50 years old who had both a clinical and magnetic resonance imaging diagnosis of supraspinatus tendinopathy refractory to conservative treatment. A total of 50 patients received PRP treatment, whereas 50 patients received a corticosteroid, as a control group. Patients completed patient-reported outcome assessments at baseline and at 1, 3, 6 and 12 months after injection. The primary outcome was improvement in the visual analog scale (VAS) score for pain. Secondary outcomes included changes in American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and the Pittsburgh Sleep Quality Index (PSQI). Treatment failure was defined as persistent pain at 3 months that required a subsequent injection. The mean age was 27.7 years (±7.4). All the patients completed 12 months of clinical follow-up. At 12 months, patients in the PRP group showed a significantly greater improvement in the VAS score than patients in the corticosteroid group: 1.68 (0.6) vs. 2.3 (1.0) (P <.001). As well, at the 12-month follow-up, the 3 scores evaluated were significantly higher in patients treated with PRP than in patients treated with corticosteroid: ASES, 89.8 (6.3) vs. 78.0 (8.6) (P <.001); SANE, 89.2 (6.3) vs. 80.5 (9.6) (P <.001); and PSQI, 2.72 (0.6) vs. 4.02 (1.7) (P <.001). The overall failure rate was significantly higher in the corticosteroid group (30%) than in the PRP group (12%) (P <.01). One subacromial PRP injection in patients with rotator cuff tendinopathy showed significantly superior and sustained pain-relieving and functional improvements compared with one corticosteroid subacromial injection assessed by 4 patient-reported outcome scales at the 12-month follow-up. Moreover, the overall failure rate was significantly higher in the corticosteroid group than in the PRP group. [ABSTRACT FROM AUTHOR]

The present study was designed to assess the possible effects of platelet rich plasma (PRP) when used individually and in combination with nitazoxanide (NTZ) on experimental Cryptosporidium parvum (C. parvum) infection. It was conducted on 100 male albino mice, laboratory bred in Theodore Bilharz Research Institute. Starting from the 7th day post infection (p.i), therapeutics were given to immunosuppressed infected mice, which were divided as follows; oral NTZ treated group (0.2 mg/g/day for 6 consecutive days), six-PRP-treated groups (0.5 μl/g/week) to be administered intravenously (IV) in 1st, 2nd, 3rd week as PRP alone in (3 groups) and combined with oral NTZ (0.2 mg/g/day for 6 consecutive days) in (3 groups). Parasitological, histopathological and immunohistochemical assessments of therapeutics under study were done. Fecal pellets collected from groups at different intervals were stained using modified Ziehl–Neelsen and examined under microscope. Among PRP-treated groups, the highest significant percentage of oocyst reduction (89.96%) was observed in the group received 3 doses of PRP in combination with NTZ on the 35th day post infection. Likewise, the histopathological examination of small intestinal tissue sections showed improvement in villous architecture with mild to moderate stunting and moderate inflammatory infiltrates in lamina propria. Immunohistochemical staining of small intestinal tissue sections showed moderate increase in the expression of TGF-β1. Therefore, PRP can be a novel strategy in the treatment of cryptosporidiosis particularly when combined with NTZ. [ABSTRACT FROM AUTHOR]

Background: Intervertebral disc degeneration (IDD) was the most common cause of low back pain. Platelet rich plasma (PRP) has the potential to repair IDD, however, there is still no conclusion on whether Leukocyte-poor platelet rich plasma (Lp-PRP) or Leukocyte-rich platelet rich plasma (Lr-PRP) is better for the treatment of IDD. Methods: First, we conducted an in vitro study to compare the effects of autologous Lp-PRP and Lr-PRP on human degenerated nucleus pulposus (NP) cells. Then we verified the in vivo effects of autologous Lp-PRP and Lr-PRP in treating disc degeneration through a rabbit IDD model. Results: The in vitro study showed both autologous Lp-PRP and Lr-PRP can promote the cell proliferation, the synthesis of COL II and Aggrecan of human degenerated NP cells, while Lp-PRP are better than Lr-PRP (P<0.05). In addition, only Lp-PRP can inhibit the apoptosis of human degenerated NP cells (P<0.05), whereas Lr-PRP activates the catabolism on the contrary (P<0.05). Further, the in vivo study through the rabbit IDD model verified that autologous Lp-PRP has better effects than autologous Lr-PRP in repairing IDD according to X-ray, MRI, histological, and immunohistochemical assessment (P<0.05, respectively). And the caspase-3 IHC results also showed that only autologous Lp-PRP treatment could inhibit apoptosis of NP cells in the rabbit IDD model (P<0.05). Conclusion: Combining in vivo and in vitro studies, the present study confirmed that autologous Lp-PRP has a better effect than autologous Lr-PRP in repairing IDD, which may be due to the inflammatory factors (TNFα, IL-1β, etc.) in Lr-PRP antagonizing part of the repair effects and promoting the catabolism additionally. Therefore, our findings suggest that Lp-PRP may provide better results than Lr-PRP for treating IDD. Further randomized clinical trials will provide evidence to guide practice. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome (CTS) is the most frequent peripheral nerve entrapment neuropathy, accounting for about 90% of cases. CTS arises because of the median nerve compression in the carpal tunnel on the wrist, as the median nerve passes through the tunnel from the forearm to the hand. The available evidence regarding therapy for CTS, reveals that splinting therapy, corticosteroid injection, and surgery are not 100% effective in curing CTS so there is a need to search for other alternative therapies. One of the pain therapies currently being developed in the medicine sector is platelet rich plasma (PRP). PRP refers to platelet concentrations in plasma higher than normal platelets circulating in the body. PRP has been extensively utilized as new secure therapy in dentistry, bone surgery, ophthalmology, neurosurgery, and plastic surgery for three decades. PRP contains several growth factors that can enhance the process of wound healing, angiogenesis, and regeneration of axons. Regarding the use of PRP therapy in CTS there is still a lot of debate and the benefits of these therapies have been still questioned. However, there are currently numerous studies on the utilization of PRP therapy in CTS. In vitro and in vivo studies show that PRP has neuroprotective, neurogenic, and neuroinflammatory modulators on nerves. Recent studies have shown satisfactory results from the administration of PRP therapy in CTS cases. PRP is a promising alternative therapy for mild to moderate CTS cases, but it is not recommended for treatment of severe CTS cases. There are no studies that conduct long-term follow-up after the administration of PRP therapy, so there is no documentation related to the long-term impact of PRP therapy in CTS cases. [ABSTRACT FROM AUTHOR]

Background: Not only do damaged tissues exhibit reduced vascularity and degenerative changes, but cicatricial alopecia makes hair transplantation an extremely difficult process. Regenerating damaged tissue may be possible with platelet-rich plasma (PRP) because of its effects on angiogenesis, tissue remodeling, and regeneration. The present work aimed to determine if PRP has a role in improving the result of follicular unit extraction (FUE) in nonandrogenic alopecia. Methods: In a prospective clinical study, twenty-four patients with nonandrogenic alopecia, were split into two equal groups (n=12): Group A: patients were administered two injections of local intradermal PRP one week before hair transplantation and again two weeks and four weeks after the hair transplantation. Group B: (Control group): No local injections of any type were administered to individuals undergoing hair transplantation. Applying a trichoscope to manually tally the transplanted follicular units per cm2, digital photography, and patients' satisfaction were assessed 6 to 12 months after hair transplantation. Results: Non-significant differences were found between the two groups as regards patient satisfaction, hair survival rate, as well as blind evaluation by the other surgeons. In group A, there were 3 patients (25%) with mild satisfaction, 6 patients (50%) with moderate satisfaction and 3 patients (25%) with high satisfaction. In group B, there were 6 patients (50%) with mild satisfaction, 4 patients (33.3%) with moderate satisfaction and 2 patients (16.7%) with high satisfaction. Conclusions: Incorporating platelet-rich plasma (PRP) into FUE improves scar tissue texture and quality more than FUE alone, however there is no significant difference in the clinical results of hair restoration in terms of density of newly grown hair. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a prevalent musculoskeletal disease affecting middle-aged and elderly individuals, with knee pain as a common complaint. Standard therapy approaches generally attempt to alleviate pain and inflammation, using various pharmacological and non-pharmacological options. However, the efficacy of these therapies in long-term tissue repair remains debated. As an alternative, regenerative medicine offers a promising strategy, with decreased adverse event rates and increasing evidence of safety and efficacy. This review will outline current advances in regenerative medicine for knee OA, emphasizing outpatient clinic-based therapies that use orthobiological and non-biological products. Different strategies based on orthobiologics are discussed as potential regenerative options for the management of knee OA. Cell-free therapies including platelet-rich plasma, autologous anti-inflammatories, exosomes, human placenta extract, and mitochondrial transplantation are discussed, focusing on their potential for cartilage regeneration. Additionally, cell-based therapies with regenerative properties including bone marrow aspirate concentrate, adipose stromal vascular fraction, microfat, nanofat, stem cell therapy, and genetically modified cells as part of orthobiologics, are being investigated. Also, this study is looking into non-biological approaches such as using gold-induced cytokines, extracorporeal shockwave therapy, and ozone therapy. The mechanisms of action, effectiveness, and clinical applications of each therapy are being explored, providing insights into their role in the management of knee OA. [ABSTRACT FROM AUTHOR]

Introduction Osteoarthritis (OA), including that of the knee joint, represents a significant proportion of musculoskeletal injuries in the Canadian Armed Forces (CAF) due to the frequent, high-stress physical activity for which member participation is necessary. Platelet-rich plasma (PRP) is a conservative, autologous treatment that has the potential to relieve symptoms and improve functionality of military members to decrease the impact of the disease and ultimately strengthen the CAF. Materials and Methods A search of systematic reviews and meta-analyses was conducted to determine the efficacy of PRP injections in treating knee OA. The Scopus database, PubMed database, and Omni academic search tools were scoped for relevant publications. English literature, published up to and including March 2023, that investigated only clinically randomized controlled trials (RCTs) was eligible for inclusion. The results of network meta-analyses were investigated and summarized independent of reviews and non-network meta-analyses. Results A total of 225 unique systematic reviews and meta-analyses were initially identified, of which 39 publications, including 7 network meta-analyses, adhered to the defined inclusion and exclusion criteria. PRP was found to significantly alleviate symptoms of pain based on the visual analog scale and Western Ontario and McMaster Universities Arthritis Index pain scores within the 12-month follow-up. Function, activity, sport, quality of life, and stiffness were additionally determined to generally improve to a greater extent from PRP treatment compared to controls, while adverse effects were minor and temporary. PRP placed in the top 3 in 9 reported surface under the cumulative ranking curves, while individually reported rankings of leukocyte-poor and leukocyte-rich PRP both placed in the top 4. The clinical recommendations made were generally positive, with 17 publications acknowledging the benefits of PRP, 3 supporting possible efficacy, and an additional 8 recommending that it be an option for the conservative treatment of knee OA. Conclusion The results of this review support the efficacy of PRP for relieving symptoms of pain and improving function, stiffness, and quality of life for patients experiencing knee OA within 12 months. As a result, leukocyte-poor-PRP could be considered for members of the CAF with mild to moderate knee OA (Kellgren–Lawrence grades 1–3) to slow the progression of OA and extend the military careers of CAF members. There continues to be a need for future studies to investigate the longer-term effects of PRP to verify sustained benefits at follow-up points greater than 12 months, including findings of improvement in a delayed fashion at the 3- and 6-month timeframe compared to hyaluronic acid treatment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the platelet-rich plasma (PRP) effectiveness in patients with a long-lasting postviral olfactory dysfunction (LPOD). Methods: Forty-three consecutive patients with a long-lasting postviral OD were prospectively recruited. The injection of 1 mL of PRP was carried out in both olfactory clefts. The pre- to 6-month post-PRP injection change in olfaction was assessed with the olfactory disorder questionnaire (ODQ) and the threshold, discrimination, and identification (TDI) tests. Results: Forty-three patients received bilateral PRP injections (24 females). The mean age of patients was 58.9 ± 16.8 years. The mean duration of LPOD was 8.7 years. The pre to 6-month post-injection mean TDI significantly improved from 10.3 ± 10.2 to 20.12 ± 12.07 (p = 0.001). The mean ODQ significantly decreased from 29.8 ± 13.0 to 23.4 ± 11.3 (p = 0.013). The average change of the TDI and the ODQ were 9.8 and 6.4, respectively. Age was inversely associated with the 6-month threshold score. Conclusion: PRP appears to be a promising therapeutic strategy for long-lasting postviral OD. Our findings support the conduction of controlled randomized trial in this population of patients. [ABSTRACT FROM AUTHOR]

Objective: Platelet rich plasma (PRP) is an autologous substance widely used to stimulate dermal collagen synthesis. This study aimed to investigate the efficacy of a single PRP treatment for facial rejuvenation. Materials and Methods: This study was conducted at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand from August 2020 to March 2021. Enrolled patients underwent a single intradermal injection treatment of 0.1 mL PRP at 30 locations on the face. Outcomes were assessed at 1, 2, and 4 weeks post-intervention using the patient-perceived age visual analog scale (VAS), FACE-Q assessment, and elasticity index (EI) with a Cutometer. Results: Forty Thai patients with an average age of 36.4 years, Fitzpatrick skin type 3-4 were enrolled. The mean Patient-perceived Age VAS significantly decreased one month after treatment (-2.71±2.42, p<0.001). FACE-Q satisfaction with facial skin was 74.29±14.49, and satisfaction with the outcome was 73.41±16.26 (scale 0-100). The PRP significantly affected skin EI, with the peak improvement observed at 1-2 weeks post-injection, predominantly at the cheek, crow’s feet, and perioral area (all p<0.05). All patients had an overall improvement in satisfaction scores throughout the study. Conclusion: A single treatment of PRP injection resulted in overall satisfaction in facial skin rejuvenation as measured by patient-perceived age VAS and FACE-Q assessment. The PRP showed positive outcomes in EI with peak performance at 1-2 weeks post-treatment. [ABSTRACT FROM AUTHOR]

Lateral sprains have been commonly seen in ankle injuries and have been the leading cause of chronic pain, disability, and posttraumatic ankle osteoarthritis. Other than conventional conservative measures, platelet-rich plasma (PRP) therapy has gained a lot of success in achieving complete healing along with pain relief and improvement in functional outcomes. Its use in the pediatric population has also shown promising results. Here, we report the case of a 12-year-old child who had a partial tear of the anterior talofibular ligament (ATFL) and had tried conservative measures for 2 years with no relief. The pain continued to worsen limiting any sports activities. We performed two PRP injections in ATFL 4 weeks apart under direct visualization of ultrasonography. This case report adds to the current evidence of the beneficial effects of PRP on old ligament injury and its utility in the pediatric population.

Introduction: In recent years, biotherapy in orthopedics has become widespread, and platelet-rich plasma (PRP) has been readily used to treat sports injuries and osteoarthritis. Production of freeze-dried PRP (PRP-FD) results in PRP that is in powder form, allowing it to be stored for long periods at room temperature. Using this technology, we have developed Valuable Platelet-Derived Factor Concentrate Freeze Dry (VFD). However, whether VFD contains sufficient levels of bioactive substances (BS) remains unknown and retains the same levels of BS during long-term storage. In this study, we examined whether VFD contains sufficient amounts of BS and whether they retain these BS levels during long-term storage. Methods: Peripheral blood was collected from 10 healthy men (mean ± SD: 46.5 ± 15 years old) and various BS, including transforming growth factor β (TGF-β), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), tissue inhibitors of metalloproteinases-1 (TIMP-1), interleukin-1 receptor antagonist (IL-1ra), matrix metallopeptidase-9 (MMP-9), and interleukin-6 (IL-6), were compared between VFD and normal PRP samples, including both leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP). VFD was prepared using two rounds of centrifugation. LP-PRP and LR-PRP were activated by freezing and thawing before measurement. To evaluate the effects of long-term storage, the BS of VFD purified from five professional football players was compared between baseline and 1 year after storage. Results: In terms of the growth factors, the TGF-β and EGF levels were higher in LR-PRP than in VFD and LP-PRP (p

Abstract Background Intervertebral disc degeneration (IDD) was the most common cause of low back pain. Platelet rich plasma (PRP) has the potential to repair IDD, however, there is still no conclusion on whether Leukocyte-poor platelet rich plasma (Lp-PRP) or Leukocyte-rich platelet rich plasma (Lr-PRP) is better for the treatment of IDD. Methods First, we conducted an in vitro study to compare the effects of autologous Lp-PRP and Lr-PRP on human degenerated nucleus pulposus (NP) cells. Then we verified the in vivo effects of autologous Lp-PRP and Lr-PRP in treating disc degeneration through a rabbit IDD model. Results The in vitro study showed both autologous Lp-PRP and Lr-PRP can promote the cell proliferation, the synthesis of COL II and Aggrecan of human degenerated NP cells, while Lp-PRP are better than Lr-PRP (P

Purpose: Cartilage repair necessitates adjunct therapies such as cell-based approaches, which commonly use MSCs and chondrocytes but is limited by the formation of fibro-hyaline cartilage. Articular cartilage-derived chondroprogenitors(CPs) offer promise in overcoming this, as they exhibit higher chondrogenic and lower hypertrophic phenotypes. The study aimed to compare the efficacy of various cell types derived from adult and foetal cartilage suspended in platelet-rich plasma(PRP) in repairing chondral defects in an Ex-vivo Osteochondral Unit(OCU) model. Methods: In-vitro characterization of the cells included growth kinetics, FACS, qRT-PCR, and multilineage differentiation potential using histology and GAG analysis. Ex-vivo human OCUs with chondral defects containing the different cells in PRP were cultured and subjected to analysis for matrix and collagen staining. Results: The ex-vivo OCU analysis, in terms of defect repair, showed that adult chondrocytes, sorted-CPs, and foetal MCPs displayed better host integration and filling. The In-vitro analysis of adult chondrocytes displayed greater chondrogenic genes ACAN and COL2A1 expression, with sorted-CPs also showing higher levels of ACAN. In terms of accumulation of extracellular matrix uptake evident by Safranin O staining and collagen type II fibrillar uptake, the AD-MSCs, BM-MSCs, and sorted CPs outperformed the other groups. BM-MSCs also showed corroborative higher CD146 levels, however, the gene analysis of the AD-MSCs showed a high hypertrophic tendency in terms of its COL1A1 and RUNX2 expression. Conclusion: Sorted chondroprogenitors outperformed both in terms of filling and hyaline-like repair, with AD-MSC and BM-MSC groups also achieving functional cartilage of a hyaline nature, warranting further evaluation using in-vivo and clinical studies. [ABSTRACT FROM AUTHOR]

Ryan S D’Souza,1 Yeng F Her,1 Nasir Hussain,2 Jay Karri,3 Michael E Schatman,4 Aaron K Calodney,5 Christopher Lam,6 Thomas Buchheit,7 Brennan J Boettcher,8 George C Chang Chien,9 Scott G Pritzlaff,10 Christopher Centeno,11 Shane A Shapiro,12 Johana Klasova,1 Jay S Grider,13 Ryan Hubbard,14 Eliana Ege,15 Shelby Johnson,8 Max H Epstein,16 Eva Kubrova,8 Mohamed Ehab Ramadan,17 Alexandra Michelle Moreira,18 Swarnima Vardhan,19 Yashar Eshraghi,20 Saba Javed,21 Newaj M Abdullah,22 Paul J Christo,17 Sudhir Diwan,23 Leslie C Hassett,24 Dawood Sayed,6 Timothy R Deer25 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA; 2Department of Anesthesiology, The Ohio State Wexner Medical Center, Columbus, OH, USA; 3Departments of Orthopedic Surgery and Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA; 4Department of Anesthesiology, Perioperative Care, & Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA; 5Precision Spine Care, Tyler, TX, USA; 6Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA; 7Department of Anesthesiology, Duke University, Durham, NC, USA; 8Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA; 9Department of Regenerative Medicine, GCC Institute, Torrance, CA, USA; 10Department of Anesthesiology and Pain Medicine, University of California, Davis, Sacramento, CA, USA; 11Centeno-Schultz Clinic, Broomfield, CO, USA; 12Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA; 13Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA; 14Department of Sports Medicine, Anderson Orthopedic Clinic, Arlington, VA, USA; 15Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA; 16Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA, USA; 17Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA; 18Department of Physical Medicine & Rehabilitation, University of Miami/Jackson Memorial Hospital, Miami, FL, USA; 19Department of Internal Medicine, Yale New Haven Health – Bridgeport Hospital, Bridgeport, CT, USA; 20Department of Anesthesiology & Critical Care Medicine, Ochsner Health System, New Orleans, LA, USA; 21Department of Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA; 22Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA; 23Department of Pain Medicine, Advanced Spine on Park Avenue, New York City, NY, USA; 24Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA; 25Department of Anesthesiology and Pain Medicine, West Virginia University School of Medicine, Charleston, WV, USACorrespondence: Ryan S D’Souza, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA, Tel +1-(507)-284-9696, Fax +1-(507)-266-7732, Email dsouza.ryan@mayo.eduPurpose: Injectable biologics have not only been described and developed to treat dermal wounds, cardiovascular disease, and cancer, but have also been reported to treat chronic pain conditions. Despite emerging evidence supporting regenerative medicine therapy for pain, many aspects remain controversial.Methods: The American Society of Pain and Neuroscience (ASPN) identified the educational need for an evidence-based guideline on regenerative medicine therapy for chronic pain. The executive board nominated experts spanning multiple specialties including anesthesiology, physical medicine and rehabilitation, and sports medicine based on expertise, publications, research, and clinical practice. A steering committee selected preliminary questions, which were reviewed and refined. Evidence was appraised using the United States Preventive Services Task Force (USPSTF) criteria for evidence level and degree of recommendation. Using a modified Delphi approach, consensus points were distributed to all collaborators and each collaborator voted on each point. If collaborators provided a decision of “disagree” or “abstain”, they were invited to provide a rationale in a non-blinded fashion to the committee chair, who incorporated the respective comments and distributed revised versions to the committee until consensus was achieved.Results: Sixteen questions were selected for guideline development. Questions that were addressed included type of injectable biologics and mechanism, evidence in treating chronic pain indications (eg, tendinopathy, muscular pathology, osteoarthritis, intervertebral disc disease, neuropathic pain), role in surgical augmentation, dosing, comparative efficacy between injectable biologics, peri-procedural practices to optimize therapeutic response and quality of injectate, federal regulations, and complications with mitigating strategies.Conclusion: In well-selected individuals with certain chronic pain indications, use of injectable biologics may provide superior analgesia, functionality, and/or quality of life compared to conventional medical management or placebo. Future high-quality randomized clinical trials are warranted with implementation of minimum reporting standards, standardization of preparation protocols, investigation of dose–response associations, and comparative analysis between different injectable biologics.Keywords: regenerative medicine, injectable biologics, platelet-rich plasma, mesenchymal stem cell, bone marrow aspirate concentrate, pain medicine

Background: Knee osteoarthritis (OA) affects approximately 260 million people worldwide and is a common cause of disability. Effective and safe medical treatments are needed. Currently, no approved disease-modifying drugs exist, and non-operative therapies are associated with only small to moderate benefits and may have serious adverse effects. Platelet-rich plasma (PRP) is a safe autologous blood product containing high levels of growth factors and cytokines with potential to alter biological processes implicated in OA pathogenesis and symptoms. Objective: The aim of this study is to determine the clinical efficacy of Intraarticular PRP injection in early osteoarthritis of knee joint. Materials and Methods: A prospective, single blinded, randomized control trial in 100 Patients of Karnataka Medical College & Research Institute, Hubballi with early (Grade 1 and 2 Kellgren-Lawrence classification) osteoarthritis of knee joint in patients between 40 - 65 years of age treated with platelet rich plasma injection. Demographic data, history, Clinical examination and details of investigations will be recorded in the study proforma. Results: Intraarticular PRP was injected into 100 patients. The most common age group involved in study is 56-60 years (28%) with 54 (54%) patients were male and M:F ratio of 1.17. There is a statistically significant difference between the mean values of VAS, KOOS, WOMAC and OK Scores at 6 months compared to baseline scores without any serious adverse effect. Conclusion: The outcomes of this study showed that the use of PRP injections for treating OA (Grade 1 and 2 Kellgren-Lawrence classification) were shown to be successful in terms of improving functional results and diminishing pain intensity. PRP holds a promising, effective, better solution in the management in OA knee. [ABSTRACT FROM AUTHOR]

Cadmium is a heavy metal with wide industrial applications. Humans are exposed to cadmium through different ways. Cadmium demonstrates a low excretion rate and accumulates in liver, kidney, and testes. Platelet rich plasma (PRP) contains various biologically active factors. This study aims at investigating the effect of PRP on incubated rat sperm parameters exposed to cadmium chloride. In this study, epididymal sperms were collected from 20 Wistar rats. The sperm suspension was divided into four groups: group 1 (control), group 2 (treated with cadmium chloride (Cd Cl2)), group 3 (treated with PRP and Cd Cl2), and group 4 (treated with PRP). The samples were incubated in room temperature for 1 h, and the assessments were made at 60 min after incubation. Sperm parameters including viability, abnormal morphology rate, membrane integrity, and chromatin condensation were evaluated. The results showed that viability and membrane integrity of sperms treated with CdCl2 (group 2) was significantly decreased compared to other groups. Supplementation of sperms with PRP improved viability of sperms in group 3. Abnormal morphology rate and chromatin condensation of sperms were decreased in group 3 in comparison to group 2. These results suggest beneficial effect of PRP on viability, morphology, membrane, and DNA integrity of sperms exposed to CdCl2. [ABSTRACT FROM AUTHOR]

Purpose: There are few options for treatment of dysphonia secondary to vocal pathology related to lamina propria scar, atrophy, sulcus, or inflammatory disorders. Platelet rich plasma (PRP) may provide anti-inflammatory and regenerative properties seen with other tissue engineering therapies without the risks associated with these treatments. We evaluated vocal fold (VF) injection of PRP for feasibility, phonatory effects, patient satisfaction and durability. Methods: Patients with dysphonia secondary to vocal fold scar, atrophy, sulcus and inflammatory lesions were included. PRP injections were administered in office, to bilateral vocal folds. Patients were followed up at 1 week, 1 month, 3 months and 6 months to assess outcomes (GRBAS scale, maximum phonation time, vocal fatigue index (VFI), voice handicap index (VHI-10) and stroboscopy). Results: 75 intracordal PRP injections were administered to 48 patients. All injections were completed, and no adverse reactions were experienced. Improvements in VHI-10 scores at 1,3,6 months were seen (mean VHI 21.73 at baseline, 15.62 at six months, p < 0.001). 72.3% rated improvement at 7 or above on Likert scale. 95.7% of patients would consider a future PRP injection. Secondary outcomes VFI, MPT, and GRBAS also demonstrated significant improvements over time. Patients receiving a single PRP injection (n = 26) still demonstrated significant VHI-10 improvements at 1,3 and 6 months. Conclusions: VF office PRP injections are feasible and safe and can provide phonatory benefit and reduce vocal effort in benign VF disorders. A single PRP injection is sufficient to provide sustained benefit in some cases. Level of evidence: Level III: prospective cohort study. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus (DM) is associated with a high risk of chronic degenerative Achilles (AT) and Patellar (PT) tendinopathies and ruptures. Growth factors (GFs) synthesis in diabetics is substantially decreased in human connective tissues, including in tendons. Platelet Rich Plasma (PRP), which is enriched in GFs, might prove of great help in tendon healing. The aim of the study was to assess whether pre-existent DM or Impaired Glucose Tolerance (IGT) could influence the clinical outcome in subjects undergoing PRP treatment. Methods: Sixty subjects with diabetes/pre-diabetes and sixty euglycemic controls, matched for sex and age, were enrolled. Patients suffering from proximal insertional PT and mid-portion AT, treated with PRP therapy, were included in the study. To assess the basal status and the efficacy of the therapy after 3 and 6 months, the Victorian Institute of Sport Assessment (VISA) questionnaire and the Ultrasound methodology study were used. Patient satisfaction was assessed by means of the Likert Scale. Results: In the population study at 6 months, the mean VISA-score increased (8.92 ± 0.67; p-value < 0.001). The improvement in the diabetic group was less evident compared to the controls (−2.76 ± 0.95; p-value = 0.003). Even though the improvement was poor, it was still significant. MCID analysis revealed that diabetics had higher risk of therapeutic unsuccess. Logistic regression analysis was applied to assess factors associated with unsatisfactory results (Likert-scale) of PRP treatment: AT (O.R.: 3.05; 95%CI: 1.40–6.64; p-value = 0.005), higher BMI values (O.R.: 1.02; 95%CI: 1.01–1.04; p-value = 0.01), and lower VISA score values at baseline (O.R.: 0.95; 95%CI: 0.90–0.99; p-value = 0.04). Conclusions: PRP treatment in AT and PT chronic tendinopathies resulted in less favorable results in subjects with diabetes compared with euglycemic subjects. Moreover, the subjects with PT showed better results than those with AT. [ABSTRACT FROM AUTHOR]

The plantar heel pain is very common complaint that causes significant discomfort. Plantar fasciitis is due to degenerative change of the plantar fascia at attachment site. Corticosteroids and autologous PRP injections are effective in the treatment of plantar fasciitis. We compared the local corticosteroid (methyl prednisolone acetate) injection and platelet-richplasma in terms of patient outcome in chronic plantar fasciitis. Materials and methods: The study was conducted at Pain clinic and in Department of Orthopaedics, Government District hospital Chitradurga, Karnataka from November 2022 to October 2023. Forty patients were enrolled in this study. The patients were selected randomly and were divided in two groups of 20 patients each (PRP and Steroid groups). Follow up done at 2 weeks, 6 weeks, 3 months and 6 months. Results: Significant pain relief after 6 weeks of platelet rich plasma therapy and after at 3 months and 6 months follow up. Significant improvement in both groups with respect to AOFAS score and VAS scores. This improvement was significantly more in PRP group. Conclusion: PRP injection is more effective in resulting pain relief and function as compared to corticosteroid injection in the treatment of plantar fasciitis. [ABSTRACT FROM AUTHOR]

Lateral sprains have been commonly seen in ankle injuries and have been the leading cause of chronic pain, disability, and posttraumatic ankle osteoarthritis. Other than conventional conservative measures, platelet-rich plasma (PRP) therapy has gained a lot of success in achieving complete healing along with pain relief and improvement in functional outcomes. Its use in the pediatric population has also shown promising results. Here, we report the case of a 12-year-old child who had a partial tear of the anterior talofibular ligament (ATFL) and had tried conservative measures for 2 years with no relief. The pain continued to worsen limiting any sports activities. We performed two PRP injections in ATFL 4 weeks apart under direct visualization of ultrasonography. This case report adds to the current evidence of the beneficial effects of PRP on old ligament injury and its utility in the pediatric population. [ABSTRACT FROM AUTHOR]

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Background and Objectives: Regulatory requirement of fixed holding time (6 h) of whole blood (WB) at room temperature, that is, 22–24°C (RT) results in sub‐optimal component separation. The aim was to evaluate the platelet concentrates (PC) prepared by both platelet rich plasma (PRP) and buffy coat (BC) methods after overnight hold (18–24 h) at RT. Materials and Methods: A prospective experimental study was performed. A total of 48 WB units collected were divided into four groups (12 each) control‐1 (C1) and test‐1 (T1) for PRP and control‐2 (C2) and test‐2 (T2) for the BC method. Control groups were processed within 6 h, and in test groups, components were prepared after overnight hold, followed by evaluation of quality parameters. Results: Irrespective of the method used, all PCs had similar volume, platelet yield, swirling, no bacterial contamination, RBC contamination, PaO2 and PaCO2 levels. PCs in the T1 group had significant differences in glucose and MPV values on d1, which were resolved by d5 of storage. PCs in T2 has significant differences in pH, glucose, and MPV levels throughout storage. PRBC in test and control groups had similar quality parameters till d42 of storage. FFPs in all tests were noninferior to the concurrent control groups till 3 months of storage. Conclusion: Overnight holding of WB had no lasting deleterious changes. Though a few biochemical parameters in the test groups were significantly different, they can be accepted to improve the logistics of component separation. Overall PRP method seemed to have a better result than the BC method after an overnight hold. [ABSTRACT FROM AUTHOR]

Complex fracture reconstruction, malunion, delayed and nonunion are challenging problems often require special attention. Autogenous bone graft for osseous healing has been considered gold standard for decades. It contains viable osteoprogenitor cells, cytokines and growth factors with appropriate tissue matrix resulting in osteogenesis, osteoinduction and osteoconduction. Orthobiologics are biological materials used to augment bone and soft tissue cure, with multifactorial effects. In our study, three orthobiologics i.e., Bone Marrow Aspirate (BMA), Platelet Rich Plasma (PRP) and Decellularized Fish Scale (DFS) were used in conjunction to autogenous bone graft. Objective was to transplant as many cells as possible with osteogenic potential along with the graft. These three regimens were evaluated in terms of clinical vital parameters, hematology, serum analysis, bone biomarkers, mechanical assessment, radiographic evaluation and histomorphometry. We concluded that Bone-BMA combination showed best results in fracture healing and bone remodeling while Bone-PRP combination was below par than Bone-BMA but was superior to Bone-DFS combination. More clinical research may be required before widespread use of these regimens. Furthermore, it is paramount that veterinary orthopedic surgeons must have contemporary knowledge regarding autogenous grafts and orthobiologics, so they can utilize them correctly. [ABSTRACT FROM AUTHOR]

Background Platelet-rich plasma (PRP) is a therapeutic approach that is gaining attention for its potential in the treatment of poor ovarian response. This meta-analysis aimed to systematically review and analyze clinical studies to evaluate the impact of PRP on poor responders undergoing ovarian stimulation for IVF.Methods A comprehensive search was conducted in electronic databases, including PubMed, Embase, Scopus, Web of Science, and the Cochrane Library to identify relevant studies published in English. The pooled data, such as pregnancy outcome, number of MII oocytes, number of transferable embryos, and ovarian reserve markers were analyzed using R version 4.2.3.Results A total of 10 trials were enrolled in the present meta-analysis. Following PRP treatment, live birth rate was found to be 16.6% (95% CI 8.8%-26.1%), while clinical pregnancy rate was observed to be 25.4% (95% CI 13.1%-39.9%). PRP pretreatment resulted in a higher number of MII oocytes (MD 1.073, 95% CI 0.720 to 1.427), a higher number of embryos (MD 0.946, 95% CI 0.569 to 1.323), a higher antral follicle count (MD 1.117; 95% CI 0.689 to 1.544), and the change of hormone levels.Conclusions Among the studies evaluated in this review, PRP showed promising results in poor responder. Further research is required to clarify the potential role of PRP in female reproductive health.

Background Erectile dysfunction (ED) is a common issue among males, and the use of platelet-rich plasma (PRP) therapy for treating ED has gained increasing attention, but there is still no conclusive evidence regarding its efficacy.Aim To evaluate the efficacy of PRP therapy for ED.Methods We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases up to November 2023 to identify randomized controlled trials (RCTs) on PRP therapy for ED. We used Review Manager version 5.4 for data analysis and management.Result After applying inclusion and exclusion criteria for screening, a total of 4 studies involving 413 patients were finally included in our meta-analysis. According to our analysis, the PRP group showed significant advantages over the placebo group in terms of MCID at the first month (p = 0.03) and sixth months (p = 0.008), while there was no significant difference between the two groups at the third month (p = 0.19). Additionally, in terms of IIEF, PRP showed significantly better efficacy than placebo at the first, third, and sixth months (p

Introduction: Platelet-rich plasma (PRP) has become an increasingly popular therapeutic tool across various medical specialties since its introduction in 1958. Defined as a concentrated solution of platelets and growth factors derived from autologous blood, PRP supports tissue repair and regeneration processes. PRP’s composition includes high concentrations of platelets and growth factors that facilitate angiogenesis, connective tissue remodeling, and cellular repair, making PRP a promising treatment option for complex urological conditions and beyond. Purpose of the study: This review aims to summarize the applications and efficacy of PRP in treating specific urological conditions such as erectile dysfunction, Peyronie's disease, urethral stricture, hypospadias, interstitial cystitis and urinary incontinence. Materials and Methods: To provide a comprehensive summary of current knowledge on this topic, a literature review of English-language articles, with an emphasis on recent publications, was conducted. The review utilized the PubMed database and included 51 studies accessed prior to October 2024. Conclusions: PRP therapy appears to be a promising, safe, and minimally invasive treatment option for several urological conditions. Studies suggest that PRP may benefit erectile function, reduce symptoms in Peyronie's disease, and improve outcomes in conditions related to the urethra and bladder, with minimal reported adverse effects. However, the lack of standardized PRP preparation protocols and large placebo-controlled trials poses a challenge to fully establishing its efficacy. Further research is necessary to confirm PRP’s effectiveness, optimize preparation and administration methods, and develop guidelines for its clinical application in urology.

Background: Ozone can enhance the expression of some growth factors (GFs) in platelet rich plasma (PRP), recent study showed oxygen-rich PRP (ozonized PRP) have better therapeutic effects on bone and joint diseases. PRP injection has been widely used in the treatment of facial rejuvenation, but the efficacy of sufficient oxygen-rich PRP in facial rejuvenation has not been studied. Objective: Firstly, we examined whether ozone treatment can increase the concentration of GFs of PRP in vitro. And then a variety of subjective and objective detection methods were used to evaluate the effect of sufficient(10–12 mL each time for the injection of face and neck) oxygen-rich (ozonized PRP) PRP injection in facial rejuvenation by follow-up for 6 months. At last, we investigated the satisfaction, side effects and pain score of the treatment through a questionnaire survey. Methods: The concentration of main GFs in PRP treated with different dose of ozone in vitro was measured by ELISA. Clinical picture, the collagen thickness of dermis by reflectance confocal microscope(RCM), skin conditions (including spots, ultraviolet (UV) spots, brown spots, red area, pores, wrinkles, texture and porphyrin) by VISIA were collected before treatment and each month follow-up visit after treatment until 6-month follow-up period was finished. Patients’ satisfaction, side effects and pain score were collected at the end of follow-up period. Results: PRP treated by high-dose ozone (57 μg/mL, ozone/PRP volume ratio:1/1) in vitro showed a significant increase in endothelial growth factor (EGF) and transforming growth factor-β (TGF-β) compared to baseline(P

Abstract Background Masquelet membrane induction technology is one of the treatment strategies for large bone defect (LBD). However, the angiogenesis ability of induced membrane decreases with time and autologous bone grafting is associated with donor site morbidity. This study investigates if the PRP-FG-nHA/PA66 scaffold can be used as a spacer instead of PMMA to improve the angiogenesis ability of induced membrane and reduce the amount of autologous bone graft. Methods Platelet rich plasma (PRP) was prepared and PRP-FG-nHA/PA66 scaffold was synthesized and observed. The sustained release of VEGFA and porosity of the scaffold were analyzed. We established a femur LBD model in male SD rats. 55 rats were randomly divided into four groups depending on the spacer filled in the defect area. “Defect only” group (n = 10), “PMMA” group (n = 15), “PRP-nHA/PA66” group (n = 15) and “PRP-FG-nHA/PA66” group (n = 15 ). At 6 weeks, the spacers were removed and the defects were grafted. The induced membrane and bone were collected and stained. The bone formation was detected by micro-CT and the callus union was scored on a three point system. Results The PRP-FG-nHA/PA66 scaffold was porosity and could maintain a high concentration of VEGFA after 30 days of preparation. The induced membrane in PRP-FG-nHA/PA66 group was thinner than PMMA, but the vessel density was higher.The weight of autogenous bone grafted in PRP-FG-nHA/PA66 group was significantly smaller than that of PMMA group. In PRP-FG-nHA/PA66 group, the bone defect was morphologically repaired. Conclusion The study showed that PRP-FG-nHA/PA66 scaffold can significantly reduce the amount of autologous bone graft, and can achieve similar bone defect repair effect as PMMA. Our findings provide some reference and theoretical support for the treatment of large segmental bone defects in humans.

Statement of the Problem: Treatment of immature necrotic teeth is a problematic situation. Conventional root canal therapy is challenging and leaves a weak, fragile and undeveloped tooth for lifetime.Purpose: This review was aimed to assess the outcome of available randomized clinical tr-ials (RCTs) on the efficacy of platelet concentrates (PC) in dentine-pulp complex regeneration.Materials and Method: An electronic search was conducted on MEDLINE, EMBASE, Cochrane, and Google scholar databases. A further manual search was performed on the list of related articles in order to ensure inclusion of potentially missed articles in earlier electronic search. Those proved RCTs matched with the standard criteria were included following an initial assessment of abstracts and the text independently by the reviewers.Results: From the total 602 harvested articles, only 13 met the criteria and were evaluated with 11 having parallel design and 2 split mouth. Only one study featured low risk of bias, while three had moderate risk and the rest were at high risk of bias. Six studies had used platelet rich plasma (PRP), 4 employed platelet rich fibrin (PRF), one utilized injectable platelet rich fibrin (I-PRF), and three used both PRF and PRP for their experimental groups while blood clot (BC) was used as the control group for all. The success rate was reported at 87.3% judged by the absence of pathologic signs and symptoms.Conclusion: Dentin wall thickening, root lengthening and apex closure were higher in PC groups, however, these differences were not statistically significant in reported studies. It can be concluded that PCs promote the pulp tissue revitalization and continuation of root development. However, a consensus on its potency for true pulp regeneration is yet to be reached.

Introduction: Extracellular vesicles from mesenchymal stromal cells (MSC-EVs) are potent stimulators of naïve cartilage and their injection is studied in clinical trials for cartilage lesions, since often cartilage repaired with conventional approaches is incomplete or less performant leading to joint degeneration. The main pitfall of these innovative approaches is the high EVs dispersion into the joint cavity and consequent low concentration at lesion site. Thus, biological scaffolds for concentration of EVs where needed might be a promising option. This work aimed at producing an enhanced platelet-derived fibrin gel loaded with adipose-derived MSCs (ASCs)-EVs. Methods: EVs’ embedment efficiency in platelet gel, their release and incorporation in OA chondrocytes and cartilage explants were monitored by flow cytometry, microfluidic approaches, scansion electron microscopy and real-time quantitative multimodal nonlinear optics imaging. The effect of released EVs was tested in OA chondrocytes by gene expression studies. Results: A protocol ensuring high incorporation EVs efficiency in platelet gels was defined, relying on a one-step modification of the standard procedure used in current clinical practice. Trapped EVs were released continuously for up to 4 weeks and uptaken in pathologic chondrocytes and cartilage explants. The release of the EVs-loaded platelet gel had stronger and synergic anti-inflammatory/matrix remodelling effects with respect to both EVs per se and unloaded gel released products. Conclusions: These results suggest the feasibility of producing a platelet gel loaded with MSC-EVs at high efficiency that can be used as an enhanced tool to foster chondrocyte homeostasis, a key requisite for proper cartilage healing.

Platelet rich plasma (PRP) is increasingly used in various fields of medicine, aiming to regeneration and repair damaged tissues, cells and organs. High concentration of bioactive molecules including growth factors, cytokines and chemokines are the rationale of using PRP. The aim of this study is to analyze the effect of frozen on the levels of growth factors. In our study, PRP samples were isolated from 50 healthy volunteers using the Trima Accel blood cell separator. The concentration of growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), insulin-like growth factor (IGF-1) and platelet factor 4 (PF-4) were assessed in fresh PRP and frozen PRP stored at −80 °C for one to twelve months. The study found that count of platelet in all fresh and frozen PRP samples was significantly increased compared to whole blood baseline. There was no significant difference in the concentrations of PDGF-BB, bFGF, VEGF, and PF-4 between fresh and frozen samples. The concentrations of EGF and IGF in Frozen-PRP group were significantly higher than those in Fresh-PRP group. And the storage condition of −80 °C is suitable for PRP, which will not lead to a decrease in growth factors concentration for at least 6 months.

Relevance. Proximal humerus fractures account for up to 75 % of all humerus fractures in patients over 60 years of age. The number of such patients is constantly growing, but there is no consensus on the treatment of this injury.Target. To determine the effectiveness of using platelet-rich lysate in patients with proximal humerus fractures.Object and methods. A randomized prospective study was conducted. All operated patients (n = 34) were divided into 3 groups. The first group (main 1) included patients who were administered platelet-rich plasma lysate at the end of surgery – 13 patients. The second (main 2) included patients who used platelet-rich plasma on the 14th day from the moment of surgery. The third (comparison group) included patients who didn`t use platelet-rich plasma lysate. To objectify the effect of platelet-rich plasma used the ultrasound method of research.Results. An intergroup comparison at different times after surgery showed that in the Main 1 group, in which PRP was started intraoperatively, the relative thickness of the supraspinatus muscle on the side of the operation was significantly lower than in other groups. In a pairwise comparison in the group of patients without PRP and in patients of the 2nd main group (who were administered PRP n the 14th day), the relative thickness of the supraspinatus muscle on the side of surgery after 1 month and after 1,5–2,5 months didn`t differ significantly from surgery.Conclusions. Intraoperative use of platelet-rich plasma can reduce inflammatory changes in the tendons of the supraspinatus and subscapularis muscles, which is reliably confirmed by ultrasound data.

Background Female pattern hair loss (FPHL) is one of the most common chronic problems seen by dermatologists worldwide. Hair loss has a significant influence on the quality of life and is associated with low self-esteem and depression. The treatment modalities vary from medical approaches to surgical interventions. However, limited perceived efficacy of a therapeutic regimen may lead to premature stoppage of treatment. Objective To evaluate the efficacy of platelet rich plasma (PRP), fractional CO2 laser and combination of both in treatment of FPHL. Patients and methods This is a split-scalp prospective interventional study in which thirty patients presenting with FPHL received PRP in one area, fractional CO2 in another one, combined fractional CO2 and PRP in a third one and saline intradermal injection in the fourth area in frontal and mid scalp region of scalp. The sessions were scheduled every 2 weeks for 4 sessions, then monthly for 2 months. Patients were evaluated after each session and 3months after the last session. The results were evaluated by trichoscopic and folliscopic examination in the four examined areas. Assessment of treatment response was done according to the count of terminal and vellus hair, the thickness and density of hair shafts and the percentage of change, determined by folliscopic examination. Patients’ satisfaction and side effects were evaluated. Results There was significant difference between the studied groups as regards percentage of change of terminal hair, vellus hair, hair thickness and hair density after treatment. Pairwise comparisons showed that the combined group was statistically better than either PRP, fractional CO2, or saline group as regards all studied parameters (P value was

Abstract Background Islet transplantation is an effective treatment for diabetes or even its complications. Aim of this study is to investigate efficacy of biomaterial treated islet transplantation on treating diabetic nephropathy. Methods Male rats were randomly divided into 6 groups; Control, diabetic control, diabetic transplanted with untreated islets, with platelet rich plasma treated islets, with pancreatic islets homogenate treated islets, or with these biomaterials combination treated islets. Islets cultured with biomaterials and transplanted to diabetic rats. After 60 days, biochemical, oxidative stress, and stereological parameters were assessed. Results Serum albumin and BUN concentration, decreased and increased respectively, Oxidative stress of kidney impaired, kidney weight, volume of kidney, cortex, medulla, glomerulus, proximal and distal tubules, collecting ducts, vessels, inflammatory, necrotic and fibrotic tissue in diabetic group increased compared to control group (p

Background: Macrophages are innate immune cells that display remarkable phenotypic heterogeneity and functional plasticity. Due to their involvement in the pathogenesis of several human conditions, macrophages are considered to be an attractive therapeutic target. In line with this, platelet derivatives have been successfully applied in many medical fields and as active participants in innate immunity, cooperation between platelets and macrophages is essential. In this context, the aim of this review is to compile the current evidence regarding the effects of platelet derivatives on the phenotype and functions of macrophages to identify the advantages and shortcomings for feasible future clinical applications. Methods: A total of 669 articles were identified during the systematic literature search performed in PubMed and Web of Science databases. Results: A total of 27 articles met the inclusion criteria. Based on published findings, platelet derivatives may play an important role in inducing a dynamic M1/M2 balance and promoting a timely M1-M2 shift. However, the differences in procedures regarding platelet derivatives and macrophages polarization and the occasional lack of information, makes reproducibility and comparison of results extremely challenging. Furthermore, understanding the differences between human macrophages and those derived from animal models, and taking into account the peculiarities of tissue resident macrophages and their ontogeny seem essential for the design of new therapeutic strategies. Conclusion: Research on the combination of macrophages and platelet derivatives provides relevant information on the function and mechanisms of the immune response. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy of intra-articular PRP injections in patients with knee osteoarthritis. Study Design: Cross Sectional. Setting: Orthopedic Department of Mardan Medical Complex. Period: 13th August to 14th December 2023. Methods: Involving 50 diagnosed osteoarthritis patients at demographic data, grades of osteoarthritis, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded pre-treatment. Patients received PRP injections at three intervals, and post-treatment WOMAC scores were assessed. Statistical analysis included mean, standard deviations, and a paired t-test. Results: The study comprised 66% female patients, with a mean age of 50.08±5.82 and mean BMI of 27.16±3.53. Regarding grades of osteoarthritis, grade 1, grade 2 and grade 3 comprised of n=14(28%), 19(38%), 17(34%) respectively PRP treatment significantly reduced WOMAC scores from a pre-treatment mean of 56.62±5.70 to 27.54±4.79 (p < 0.001). Conclusion: The significant reduction in WOMAC scores post-treatment suggests that intra-articular PRP injections may serve as a valuable intervention in the short term management of knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: For many years, diced-cartilage grafts have been utilized successfully to enhance the tip of the nose with exception of some cases which have skin irregularities deformities and graft resorption. This technique combining diced cartilage grafts, Platelet Rich Plasma (PRP) in a chrysalis manner allows correct nasal tip augmentation with no major complications and minimal graft resorption due to the regenerative properties of the PRP. This study aimed to compare the outcome of using diced cartilage only or diced cartilage with PRP technique in nasal tip augmentation. Methods: The study was conducted on 24 patients at Otolaryngology Department, Zagazig University Hospitals. Patients were divided into 2 groups: group 1: 12 patients underwent tip augmentation by diced cartilage only and group 2: 12 patients underwent tip augmentation by diced cartilage and PRP. Results: There was significant difference between both groups regarding visual analogue scale (VAS) score. Conclusions: Diced cartilage with PRP technique for nasal tip augmentation may lead to improved postoperative outcomes with less pain and higher patient satisfaction without impacting graft integrity or resorption rates compared to diced cartilage only. [ABSTRACT FROM AUTHOR]

Background: Micronized acellular dermal matrix (mADM) can induce tissue regeneration and repair, and filling. Objectives: The efficacy and safety of (mADM) were evaluated in the treatment of atrophic acne scar. Methods: In this single‐blinded, self‐controlled, split‐face study, 16 patients (48 scar sites) were divided into treatment group (24 scar sites) and control group (24 scar sites). One side of the affected area was treated with mADM combined with platelet rich plasma (PRP) injection as the treatment group; the other side of the affected area was treated with PRP injection as the control group. The efficacy was evaluated by the Acne scar assessment scale (ASAS) and Acne Scar Weight Rating Scale (ECCA) 3 months after treatment. Results: After 3‐month treatment in 16 patients, the atrophic acne scars in both groups were all improved. The ASAS score and ECCA weight score in the treatment group was significantly lower than that in the control group (2.50 ± 0.51 vs. 3.62 ± 0.77 and 14.17 ± 10.18 vs. 31.88 ± 13.25; p < 0.001). Limitations: Short‐term 3‐month treatment period. Small sample size limits generalizability of results. Conclusion: The curative effect of mADM combined with PRP is significantly better than that of PRP alone. [ABSTRACT FROM AUTHOR]

Introduction: Orthodontic tooth movement results from a biological response to external forces, disrupting the dentofacial complex's balance. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have shown potential in accelerating tooth movement, and this study compared their effectiveness in canine retraction through repeated submucosal administration. Aim: To evaluate and compare the effects of repeated submucosally administered platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) on canine retraction. Study Design: A sample comprising 20 adult patients with well-aligned arches, indicating 1st premolar extraction was selected. The study randomly assigned PRP and PRF treatments into two groups for canine retraction. In Group 1, PRP was used, while Group 2 employed PRF. The maxillary arch was divided into right and left sides for equal distribution, using Microsoft Excel for random allocation. After leveling and alignment with a stainless-steel wire, bilateral first premolar extractions were performed. Mini screws were inserted between the second premolars and first molars for anchorage, and NiTi closed-coil springs were used to apply retraction force. 20 ml of blood was drawn for PRP and PRF preparation. PRP and PRF were administered submucosally around the canines at 15-day intervals until space closure. Analysis of canine retraction was done through study models taken at pre-extraction and each subsequent appointment till complete space closure using IC Measure software. Results: Paired t-test was used to analyze the obtained data. Linear movement of space closure with the intervention of PRF revealed a mean value of 9.88±0.65mm and PRP revealed an overall average linear measurement of 9.61±0.66 mm. The mean difference between linear measurements of PRF and PRP at time difference T0-T9 was significant at a value of 0.27±0.03 mm (p value-0.004) with greater linear movement shown by PRF. There was an insignificant difference (p-value =0.981) between the mean difference in interval T0-T9 in angular measurements of PRF and PRP. Conclusion: Canine retraction by PRF was 1.02 times faster than PRP. The findings of this study showed that the linear measurement of PRF was greater than that of PRP by 0.27±0.03mm. PRF showed increased variation in rotation of canine than PRP. Further research can be carried out on the comparative analysis of variants of PRF and PRP, such as L-PRF, A-PRF, etc. in determining their efficacy in accelerating orthodontic tooth movement [ABSTRACT FROM AUTHOR]

Background: Treatment for post-traumatic greater occipital neuralgia (GON) includes serial injections of steroid/anesthetic. While these injections can alleviate pain, effects can be transient, frequently lasting only 1 month. As a potential alternative, platelet-rich plasma (PRP) injections are an emerging biological treatment with beneficial effects in peripheral nerve disorders. We investigated the feasibility, safety, and effectiveness of a single PRP injection for post-traumatic GON in comparison to saline or steroid/anesthetic injection. Methods: In this pilot randomized, double-blinded, placebo-controlled trial, 32 adults with post-traumatic GON were allocated 1:1:1 to receive a single ultrasound-guided injection of (1) autologous PRP (2) steroid/anesthetic or (3) normal saline. Our primary outcome was feasibility (recruitment, attendance, retention) and safety (adverse events). Exploratory measures included headache intensity and frequency (daily headache diaries) and additional questionnaires (headache impact, and quality of life) assessed at pre-injection, 1 week, 1 month, and 3 months post-injection. Results: We screened 67 individuals, 55% were eligible and 95% of those participated. Over 80% of daily headache diaries were completed with 91% of participants completing the 3-month outcome questionnaires. No serious adverse events were reported. There were no significant differences between groups for headache intensity or frequency. Headache impact on function test-6 scores improved at 3 month in the PRP (β = -9.7, 95% CI [-15.6, -3.74], p = 0.002) and saline (β = -6.7 [-12.7, -0.57], p = 0.033) groups but not steroid/ anesthetic group (p = 0.135). Conclusion: PRP is a feasible and safe method for treating post-traumatic GON with comparable results to saline and steroid/anaesthetic. Further trials with larger sample sizes are required. [ABSTRACT FROM AUTHOR]

Background: Masquelet membrane induction technology is one of the treatment strategies for large bone defect (LBD). However, the angiogenesis ability of induced membrane decreases with time and autologous bone grafting is associated with donor site morbidity. This study investigates if the PRP-FG-nHA/PA66 scaffold can be used as a spacer instead of PMMA to improve the angiogenesis ability of induced membrane and reduce the amount of autologous bone graft. Methods: Platelet rich plasma (PRP) was prepared and PRP-FG-nHA/PA66 scaffold was synthesized and observed. The sustained release of VEGFA and porosity of the scaffold were analyzed. We established a femur LBD model in male SD rats. 55 rats were randomly divided into four groups depending on the spacer filled in the defect area. "Defect only" group (n = 10), "PMMA" group (n = 15), "PRP-nHA/PA66" group (n = 15) and "PRP-FG-nHA/PA66" group (n = 15). At 6 weeks, the spacers were removed and the defects were grafted. The induced membrane and bone were collected and stained. The bone formation was detected by micro-CT and the callus union was scored on a three point system. Results: The PRP-FG-nHA/PA66 scaffold was porosity and could maintain a high concentration of VEGFA after 30 days of preparation. The induced membrane in PRP-FG-nHA/PA66 group was thinner than PMMA, but the vessel density was higher.The weight of autogenous bone grafted in PRP-FG-nHA/PA66 group was significantly smaller than that of PMMA group. In PRP-FG-nHA/PA66 group, the bone defect was morphologically repaired. Conclusion: The study showed that PRP-FG-nHA/PA66 scaffold can significantly reduce the amount of autologous bone graft, and can achieve similar bone defect repair effect as PMMA. Our findings provide some reference and theoretical support for the treatment of large segmental bone defects in humans. [ABSTRACT FROM AUTHOR]

Introduction: In veterinary medicine there are few readily available products for platelet transfusion to patients with thrombocytopenia. Commercial tabletop platelet concentrating systems have recently become available to veterinarians, primarily directed towards uses associated with regenerative medicine. These systems could potentially be used to produce fresh concentrated platelets for use in transfusion medicine. This study evaluated the concentration, activation, and sterility of a double centrifugation platelet concentrate (PC) produced by a commercial benchtop system. Methods: Ten healthy dogs were studied. Whole blood was collected and mixed with ACD-A in a 1:7.6 ratio of ACD-A to whole blood. 12 mL of this mixture was processed into PC via single centrifugation, while 60 mL of the anticoagulated whole blood was processed via a commercial double centrifugation system. Both types of PC were evaluated for platelet concentration, CD62P expression with and without thrombin stimulation, and for sterility. Results: Mean platelet count in the double centrifuged PC was 863 ± 352 × 10³/µL, with very low white blood cell contamination (median of 0.47 × 10³ leukocyte/µL (range 0.15-2.18 × 10³/µL)). The double-centrifuged PC had similar baseline activation characteristics (as determined by P-selectin expression) as the single centrifuge PC (0.76% vs. 0.72% unstimulated, 30.5% vs. 34.9% stimulated, p = 0.432). Discussion: The benchtop PC system studied here did not cause activation of platelets during production and produced a sterile product that can be further investigated as a source of fresh platelet concentrates for transfusion purposes. [ABSTRACT FROM AUTHOR]

Background: To evaluate the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064‐nm Q‐switched Nd:YAG laser in reducing nanofat treated dark circles and wrinkles under the eyes. Method: This study was a single‐blinded randomized clinical trial conducted on patients with suborbital darkening under the eyes that randomly divided into control and case groups. In the control group, 15 patients were treated with one session of nanofat injection only, and five patients of each intervention groups received one session of nanofat+SVF injection, nanofat+PRP injection, and nanofat injection+Nd:YAG laser, respectively. Assessments methods were (1) evaluation of the degree of darkness and repair under the eyes by a blinded dermatologist based on clinical photographs, (2) investigating patient satisfaction, (3) using biometric variables for color, thickness, and density of the skin (only 3 months after the treatment), and (4) recording the possible adverse effects. Conclusion: In terms of the extent of reduction in the intensity of darkness under the eyes, the combined treatment of nanofat injection together with SVF, PRP, and Nd:YAG laser had a much greater therapeutic effect than nanofat injection alone. In all three groups of combined treatments, patients were 100% satisfied. In terms of biometric variables, amount of changes in colorimeter, complete and dermal thickness, complete and dermal density, between the different groups was statistically significant. The use of combined treatments including nanofat with SVF injection, PRP, and 1064 Q‐switched Nd:YAG laser may be more effective than nanofat alone, in reducing infraorbital dark circles and wrinkles. [ABSTRACT FROM AUTHOR]