Thursday, November 23, 2017

Use of Platelet-Rich Plasma (PRP) in Regenerative Therapies

Platelet-Rich Plasma (PRP) treatment is one of the most cutting-edge and potentially beneficial types of prolotherapy available today.

What's Prolotherapy

Prolotherapy is short for "proliferation therapy", which can be described as follows:
  • Is an alternative medicine practice
  • Is a nonsurgical treatment which stimulates healing
  • Is also known as regenerative (injection) therapy
  • Works by stimulating the body's own natural healing mechanisms to repair injured musculoskeletal, skin or connective tissues
Types of Prolotherapy include:

In this article, we will focus on the use of PRP in regenerative medicine.

Use of PRP in Regenerative Therapies

Regenerative therapy uses a patient's own tissues to initiate the healing process. With PRP, it uses our platelet-rich plasma to initiate the healing in different treatments:

Growth Factors Released from PRP

Platelets constitute a reservoir of critical growth factors (GFs) and cytokines which may govern and regulate the tissue healing process. The bioactive molecules secreted by platelet α-granules are involved in several cellular activities such as stem cell trafficking, proliferation, and differentiation, with a complex effect on pro/anti-inflammatory and anabolic/catabolic processes.[26]

Moreover, with respect to purified individual GFs, platelets have the theoretical advantage of containing various bioactive molecules with a natural balance of anabolic and catabolic functions, possibly optimizing the tissue environment and favoring the healing process.[26]

Based on this rationale, PRP is an easy, low-cost, and minimally invasive procedure to deliver high concentrations of autologous GFs and cytokines into injured tissues in physiological proportions. This blood-derived product, placed directly into the damaged tissue, either surgically or through injections, has been widely experimented in different fields of medicine.[27-34]

A variety of growth factors can be released from PRP, which could include:[11,12]

Harvesting Platelets

Platelets are very rare as they take up only 0.4% of our blood cells. With the process of PRP harvesting, we can concentrate those platelets in plasma, which we then put platelet-rich plasma in the areas that need regeneration and rejuvenation. Below are the steps of harvesting PRP:
  1. Collecting blood 
  2. Separating the platelets 
    • By using a centrifuge with proprietary tubes 
    • Separate the contents of our blood from the plasma and the platelets. Among the platelets, which areas are higher concentration or lower concentration 
  3. Extracting platelet-rich plasma
There are different techniques that can be used in the process:[11,12]
  • One spin technique
  • Two spin technique
  • Platelet rich fibrin matrix[23]

Activating Platelets

Among the several variables affecting PRP  lysates (or releasates), platelet activation is a crucial step that might influence the availability of bioactive molecules and therefore tissue healing.[35-36]

The term “activation” refers to 2 key processes that are initiated during PRP preparation:
  1. Degranulation of platelets to release GFs from α-granules
  2. Fibrinogen cleavage to initiate matrix formation
    • A clotting process which allows the formation of a platelet gel, and therefore to confine the secretion of molecules to the chosen site.[26]
In our body, platelets will be activated by the injuries or surgeries. Outside our body, platelets can be exogenously activated by:
  • CaCl2 (or Calcium Gluconate)
  • Thrombin
  • Or a mixture of the above

An activation step before PRP administration is included in many of the protocols used, commonly by adding thrombin and/or calcium chloride (CaCl2), but some physicians prefer to inject PRP in its resting form, relying on the spontaneous platelet activation occurring after exposure to the native collagen present in the connective tissues.[37]


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  12. To Fill or Not to Fill: Aesthetic Surgery of the Aging Midface | UCLAMDCHAT Webinars
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    • When talking about PLTs and their products, a great number of variables have to be considered. 
    • These variables are mainly related to PRP preparation methodsthe type of activatorsintra- and inter-species variabilitytypes of pathology to be treatedthe ways and times of administration and the association of PRP or PG with other treatments
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    • On the basis of this most recent Level I evidence review, PRP results in “significant clinical improvements” in patients with symptomatic osteoarthritis of the knee.
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  42. Autologous serum eye drops reduce ocular surface disease symptoms
  43. Hair Loss Got You Down? Platelet-Rich Plasma May Regrow It

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