Platelet-rich plasma - a revolutionary therapeutic option in multi-disciplinary indications
DOI:
https://doi.org/10.12775/JEHS.2024.51.011Keywords
Platelet-Rich Plasma, Orthopedics, Dermatology, DentistryAbstract
Background: Platelet-rich plasma (PRP) was originally described as a small volume of plasma that contains higher concentrations of platelets, compared to peripheral blood. Although currently the use of PRP in most indications is off-label, it is not prohibited. Initially, PRP was used for wound healing and tissue regeneration in fields such as orthopaedics, dermatology, maxillofacial surgery and dentistry.
Aim of the study: The aim of this article was to present and summarise the modern production methods, the mechanism of action at the molecular and biochemical level and the most important uses and indications of PRP in present-day medicine.
Material and methods: A cross-sectional search of relevant literature was performed in databases using accepted wording. Publications from 2003-2023 were included. The entire process has been supplemented with additional procedures to increase the reliability of this publication.
Results: Orthopaedics has gained many minimally invasive therapeutic solutions thanks to PRP. Its effects on ligament and tendon tissues have been studied, where promising data have been proven. Also in aesthetic medicine and dermatology, many treatment strategies have been developed using PRP, mainly for the treatment of acne, androgenic alopecia and delaying tissue ageing as much as possible.
Conclusion: Platelet-rich plasma has found application in the treatment of many conditions in orthopaedics, dermatology, aesthetic medicine and dentistry. It is characterised by good therapeutic efficacy, with relatively low risk. However, high-quality studies are still lacking to provide more reliable data.
References
Shahid M, Kundra R. Platelet-rich plasma (PRP) for knee disorders. EFORT Open Rev. 2017 Mar 13;2(1):28-34.
https://doi.org/10.1302/2058-5241.2.160004
Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther. 2022 Mar 10;16:635-645. https://doi.org/10.2147/DDDT.S356858
Zhang Q, Liu T, Gu Y, Gao Y, Ni J. Efficacy and safety of platelet-rich plasma combined with hyaluronic acid versus platelet-rich plasma alone for knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res. 2022 Nov 19;17(1):499. https://doi.org/10.1186/s13018-022-03398-6
Justicz N, Derakhshan A, Chen JX, Lee LN. Platelet-Rich Plasma for Hair Restoration. Facial Plast Surg Clin North Am. 2020 May;28(2):181-187. https://doi.org/10.1016/j.fsc.2020.01.009
Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004 Apr;62(4):489-96.
https://doi.org/10.1016/j.joms.2003.12.003
Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009 Nov;37(11):2259-72. https://doi.org/10.1177/0363546509349921
Lei X, Xu P, Cheng B. Problems and Solutions for Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Review. Aesthetic Plast Surg. 2019 Apr;43(2):457-469. https://doi.org/10.1007/s00266-018-1256-1
Fallouh L, Nakagawa K, Sasho T, Arai M, Kitahara S, Wada Y, Moriya H, Takahashi K. Effects of autologous platelet-rich plasma on cell viability and collagen synthesis in injured human anterior cruciate ligament. J Bone Joint Surg Am. 2010 Dec 15;92(18):2909-16. https://doi.org/10.2106/JBJS.I.01158
Dhillon MS, Karna SK, Dhatt SS, Behera P, Bhatia A. Can Platelet rich plasma stimulate human ACL growth in culture? A preliminary experience. Muscles Ligaments Tendons J. 2015 Oct 20;5(3):156-61.
https://doi.org/10.11138/mltj/2015.5.3.156
Krismer AM, Cabra RS, May RD, Frauchiger DA, Kohl S, Ahmad SS, Gantenbein B. Biologic response of human anterior cruciate ligamentocytes on collagen-patches to platelet-rich plasma formulations with and without leucocytes. J Orthop Res. 2017 Dec;35(12):2733-2739. https://doi.org/10.1002/jor.23599
Anitua E, Troya M, Orive G. An autologous platelet-rich plasma stimulates periodontal ligament regeneration. J Periodontol. 2013 Nov;84(11):1556-66. https://doi.org/10.1902/jop.2013.120556
Cross JA, Cole BJ, Spatny KP, Sundman E, Romeo AA, Nicholson GP, Wagner B, Fortier LA. Leukocyte-Reduced Platelet-Rich Plasma Normalizes Matrix Metabolism in Torn Human Rotator Cuff Tendons. Am J Sports Med. 2015 Dec;43(12):2898-906. https://doi.org/10.1177/0363546515608157
Zhang J, Li F, Augi T, Williamson KM, Onishi K, Hogan MV, Neal MD, Wang JH. Platelet HMGB1 in Platelet-Rich Plasma (PRP) promotes tendon wound healing. PLoS One. 2021 Sep 16;16(9):e0251166.
https://doi.org/10.1371/journal.pone.0251166
Han L, Fang WL, Jin B, Xu SC, Zheng X, Hu YG. Enhancement of tendon-bone healing after rotator cuff injuries using combined therapy with mesenchymal stem cells and platelet rich plasma. Eur Rev Med Pharmacol Sci. 2019 Oct;23(20):9075-9084. https://doi.org/10.26355/eurrev_201910_19310
Arshdeep; Kumaran MS. Platelet-rich plasma in dermatology: boon or a bane? Indian J Dermatol Venereol Leprol. 2014 Jan-Feb;80(1):5-14. doi: 10.4103/0378-6323.125467.
Tan JK, Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol. 2015 Jul;172 Suppl 1:3-12.
https://doi.org/10.1111/bjd.13462
Makrantonaki E, Ganceviciene R, Zouboulis C. An update on the role of the sebaceous gland in the pathogenesis of acne. Dermatoendocrinol. 2011 Jan;3(1):41-9. https://doi.org/10.4161/derm.3.1.13900
Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016 Dec;15(4):434-443. https://doi.org/10.1111/jocd.12207
Bienenfeld A, Nagler AR, Orlow SJ. Oral Antibacterial Therapy for Acne Vulgaris: An Evidence-Based Review. Am J Clin Dermatol. 2017 Aug;18(4):469-490.
https://doi.org/10.1007/s40257-017-0267-z
Abdel Aal AM, Ibrahim IM, Sami NA, Abdel Kareem IM. Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars. J Cosmet Laser Ther. 2018 Apr;20(2):106-113.
Intravia J, Allen DA, Durant TJ, McCarthy MB, Russell R, Beitzel K, Cote MP, Dias F, Mazzocca AD. In vitro evaluation of the anti-bacterial effect of two preparations of platelet rich plasma compared with cefazolin and whole blood. Muscles Ligaments Tendons J. 2014 May 8;4(1):79-84.
Gómez, L. A., Casas, V., & Merchán, W. H. (2017). The use of platelet‐rich plasma in the treatment of acne and its scars: A pilot study. Surgical and Cosmetic Dermatology, 9(2), 156-159.
https://doi.org/10.5935/scd1984‐8773.201792932
Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N. Platelet-rich plasma in androgenic alopecia: myth or an effective tool. J Cutan Aesthet Surg. 2014 Apr;7(2):107-10. https://doi.org/10.4103/0974-2077.138352
Singh S. Role of platelet-rich plasma in chronic alopecia areata: Our centre experience. Indian J Plast Surg. 2015 Jan-Apr;48(1):57-9.
https://doi.org/10.4103/0970-0358.155271
Gkini MA, Kouskoukis AE, Tripsianis G, Rigopoulos D, Kouskoukis K. Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period. J Cutan Aesthet Surg. 2014 Oct-Dec;7(4):213-9.
https://doi.org/10.4103/0974-2077.150743
Abuaf OK, Yildiz H, Baloglu H, Bilgili ME, Simsek HA, Dogan B. Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study. Ann Dermatol. 2016 Dec;28(6):718-724. https://doi.org/10.5021/ad.2016.28.6.718
Pendsey SP. Understanding diabetic foot. Int J Diabetes Dev Ctries. 2010 Apr;30(2):75-9. https://doi.org/10.4103/0973-3930.62596
Babaei V, Afradi H, Gohardani HZ, Nasseri F, Azarafza M, Teimourian S. Management of chronic diabetic foot ulcers using platelet-rich plasma. J Wound Care. 2017 Dec 2;26(12):784-787.
https://doi.org/10.12968/jowc.2017.26.12.784
Cervelli V, Lucarini L, Spallone D, Palla L, Colicchia GM, Gentile P, De Angelis B. Use of platelet-rich plasma and hyaluronic acid in the loss of substance with bone exposure. Adv Skin Wound Care. 2011 Apr;24(4):176-81. https://doi.org/10.1097/01.ASW.0000396302.05959.d3
Gentile P, Scioli MG, Bielli A, Orlandi A, Cervelli V. Concise Review: The Use of Adipose-Derived Stromal Vascular Fraction Cells and Platelet Rich Plasma in Regenerative Plastic Surgery. Stem Cells. 2017 Jan;35(1):117-134.
https://doi.org/10.1002/stem.2498
Azzena B, Mazzoleni F, Abatangelo G, Zavan B, Vindigni V. Autologous platelet-rich plasma as an adipocyte in vivo delivery system: case report. Aesthetic Plast Surg. 2008 Jan;32(1):155-8; discussion 159-61.
https://doi.org/10.1007/s00266-007-9022-9
Saad Setta H, Elshahat A, Elsherbiny K, Massoud K, Safe I. Platelet-rich plasma versus platelet-poor plasma in the management of chronic diabetic foot ulcers: a comparative study. Int Wound J. 2011 Jun;8(3):307-12.
https://doi.org/10.1111/j.1742-481X.2011.00797.x
Li L, Chen D, Wang C, Yuan N, Wang Y, He L, Yang Y, Chen L, Liu G, Li X, Ran X. Autologous platelet-rich gel for treatment of diabetic chronic refractory cutaneous ulcers: A prospective, randomized clinical trial. Wound Repair Regen. 2015 Jul-Aug;23(4):495-505. https://doi.org/10.1111/wrr.12294
Ahmed M, Reffat SA, Hassan A, Eskander F. Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers. Ann Vasc Surg. 2017 Jan;38:206-211. https://doi.org/10.1016/j.avsg.2016.04.023
Mohammadi MH, Molavi B, Mohammadi S, Nikbakht M, Mohammadi AM, Mostafaei S, Norooznezhad AH, Ghorbani Abdegah A, Ghavamzadeh A. Evaluation of wound healing in diabetic foot ulcer using platelet-rich plasma gel: A single-arm clinical trial. Transfus Apher Sci. 2017 Apr;56(2):160-164.
https://doi.org/10.1016/j.transci.2016.10.020
Ramos-Torrecillas J, García-Martínez O, De Luna-Bertos E, Ocaña-Peinado FM, Ruiz C. Effectiveness of platelet-rich plasma and hyaluronic acid for the treatment and care of pressure ulcers. Biol Res Nurs. 2015 Mar;17(2):152-8. https://doi.org/10.1177/1099800414535840
Alissa R, Esposito M, Horner K, Oliver R. The influence of platelet-rich plasma on the healing of extraction sockets: an explorative randomised clinical trial. Eur J Oral Implantol. 2010 Summer;3(2):121-34.
Robiony M, Polini F, Costa F, Politi M. Osteogenesis distraction and platelet-rich plasma for bone restoration of the severely atrophic mandible: preliminary results. J Oral Maxillofac Surg. 2002 Jun;60(6):630-5.
https://doi.org/10.1053/joms.2002.33107
Simonpieri A, Del Corso M, Vervelle A, Jimbo R, Inchingolo F, Sammartino G, Dohan Ehrenfest DM. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery. Curr Pharm Biotechnol. 2012 Jun;13(7):1231-56.
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Copyright (c) 2024 Aleksandra Kiełkowicz, Piotr Pisera, Filip Pactwa, Zuzanna Popińska, Bartłomiej Żmuda, Daniel Ślusarczyk, Wiktoria Jakubowska, Michał Żuberek
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