Allogeneic Platelet-Rich Plasma Therapy as an Effective and Safe Adjuvant Method for Chronic Wounds

Liao, Xuan; Liang, Jun-Xian; Li, Shenghong; Huang, Su; Yan, Jianxin; Xiao, Ling; Song, Jianxing; Liu, Hongwei

doi:10.1016/j.jss.2019.09.019

Cited by 57 publications

(43 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The latter have shown low immunogenicity as confirmed in a recent randomised controlled study, in which allogeneic PRP was used as an adjuvant in the management of chronic wounds. 22 The clinical safety of allogeneic PRP was also corroborated in a randomised controlled trial encompassing 75 patients injected with allogeneic PRP in plantar fasciitis. 23 PRPs contain a supraphysiological concentration of platelets, and optionally leukocytes, in a limited volume of plasma.…”

Section: The Blood-derived Product Familymentioning

confidence: 89%

Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis

Andı́a

Atilano

Maffulli

2021

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

Intra-articular injections of platelet-rich plasma (PRP) and other novel blood-derived products developed specifically for osteoarthritis (OA) can provide pain relief and potential benefits in disease progression. Meta-analyses show the clinical superiority of PRP compared with other intra-articular injections, but results are modest and the effect sizes are small. PRP injections in knee OA are performed indiscriminately, but the clinical response varies enormously between patients because of an array of mixed OA phenotypes. Subgroup analyses are scarce; some studies stratify patients according to radiographic severity and found better results in early OA, without consensus for more advanced stages of the condition. Parallel identification of soluble and imaging biomarkers is essential to personalise and leverage PRP therapies. The inflammatory phenotype is most interesting from the PRP perspective because PRPs modulate inflammation by releasing a large pool of chemokines and cytokines, which interact with synovial fibroblasts and macrophages; in addition, they can modulate the innate immune response. No soluble biomarkers have been discovered that have implications for OA research and PRP interventions. Clinical examination of patients based on their inflammatory phenotype and imaging identification of pain sources and structural alterations could help discern who will respond to PRP. Synovial inflammation and bone marrow lesions are sources of pain, and intra-articular injections of PRP combined with subchondral bone injection can enhance clinical outcomes. Further refining ultrasound phenotypes may aid in personalising PRP therapies. Intra-articular delivery combined with injections in altered ligamentous structures, medial and coronal ligaments or premeniscal pes anserinus showed positive clinical outcomes. Although the evidence supporting these approaches are weak, they merit further consideration to refine PRP protocols and target the right OA phenotypes.

show abstract

Section: The Blood-derived Product Familymentioning

confidence: 89%

Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis

Andı́a

Atilano

Maffulli

2021

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

show abstract

“…PRP is an autologous blood product, so there is no immune rejection and no risk of disease transmission when treated with PRP; moreover, PRP has the advantages of the simple preparation process, small patient wound surface, low treatment cost, and biological therapeutic potential, and has been widely used in various clinical fields (33)(34)(35). Studies have shown that PRP injection can promote functional improvement and relieve pain by inhibiting the inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma improves chronic inflammatory pain by inhibiting PKM2-mediated aerobic glycolysis in astrocytes

Wei¹,

Jin²,

Meng³

et al. 2020

Ann Transl Med

View full text Add to dashboard Cite

Background: Astrocytes are highly glycolytic cells that play a crucial role in chronic pain. Recently it has been found that inflammation and metabolism are related to the inflammatory stimuli closely that cause cellular metabolic changes. Pyruvate kinase M2 (PKM2) is a critical metabolic kinase in aerobic glycolysis or the Warburg effect. Besides, it also plays a crucial role in cell proliferation and signal transduction, but its role in astrocytes is still unclear. Methods:The chronic inflammatory pain model was set up by intraplantar injection of complete Freund's adjuvant (CFA) in Sprague Dawley (SD) rats as well as the cell model was constructed by lipopolysaccharidetreated primary astrocytes. Von Frey filament stimulation was used to continuously observe the changes of pain behavior in rats after modeling. Then, immunofluorescence staining and Western blot tests were used to observe the expression levels of glial fibrillary acidic protein (GFAP), pyruvate kinase (PKM2), signal transducers and activators of transcription 3 (STAT3) and high mobility group box-1 protein (HMGB1).After that, specific kits measured lactate contents. Finally, we observed the platelet-rich plasma's (PRP) effect on mechanical hyperalgesia in rats with inflammatory pain induced by CFA and its effect on related signal molecules.Results: We found that in the CFA-induced inflammatory pain model, astrocytes were significantly activated, GFAP was increased, PKM2 was significantly up-regulated, and the glycolytic product lactate was increased. Also, intrathecal injection of PRP increased the pain threshold, inhibited the activation of astrocytes, and decreased the expression of PKM2 and aerobic glycolysis; in LPS-activated primary astrocytes as an in vitro model, we found PKM2 translocation activationSTAT3 signaling resulted in sustained activation of astrocyte marker GFAP, and the expression level and localization of p-STAT3 were correlated with PKM2. PRP could inhibit the activation of astrocytes, reduce the expression of PKM2 and the expression levels of glycolysis and GFAP, GLUT1, and p-STAT3 in astrocytes.Conclusions: Our findings suggest PKM2 not only plays a glycolytic role in astrocytes, but also plays a crucial role in astrocyte-activated signaling pathways, and PRP attenuates CFA induced inflammatory pain by inhibiting aerobic glycolysis in astrocytes, providing a new therapeutic target for the treatment of inflammatory pain.

show abstract

“…A randomized trial of 60 patients with chronic wounds treated with either allogeneic single-donor PRP (activated by calcium gluconate prior to gelation) as a single dose injection prior to skin grafting or standard skin grafting showed significantly faster healing in the allogeneic cohort at the first- and third-week time points. On examination of the wounds, increased granulation and decreased inflammatory exudate was noted among the PRP group and no ulcers had recurred in the treatment group in periods of 6 months to 4 years of follow-up [44]. In contrast, a randomised trial allocated 16 participants with venous ulcers into either allogeneic PRF-treated (pooled from volunteers) or a hydrocolloid dressing-treated group for the treatment of venous ulcers.…”

Section: Allogeneic Prp In Chronic Wounds and Difficult To Heal Ulcersmentioning

confidence: 99%

Allogeneic Platelet-Rich Plasma: Is It Safe and Effective for Wound Repair?

et al. 2021

View full text Add to dashboard Cite

Background: Platelet-rich plasma (PRP) and its derivatives are an emerging biotechnology whereby concentrated platelets provide damaged tissue with growth factors, cytokines, and other mediators to improve healing outcomes. Although there is strong evidence in the benefits of autologous PRP for both acute and chronic wounds, allogeneic PRP has been studied far less in comparison. Summary: In this mini-review, we discuss critical steps of allogenic PRP (and its derivatives) preparation. We performed a non-systematic review of the literature to identify animal and human subject studies testing allogenic PRP for wound treatment. We searched OVID Medline and PubMed for articles using the keywords “wound, ulcer, lesion, skin, and cutaneous” and “PRP, or platelet-rich plasma, or platelet-rich fibrin, or PRF, or platelet releasate” and “homologous, allogeneic or allogenic,” which were limited to non-review articles and English language. Two studies in animal models and 8 studies in patients were reviewed. There were inconsistencies in preparation methods, treatment regimens, and some lacked a control group in their studies. Despite these variations, none of the studies identified any major side effects or adverse events. The treatment resulted in a reduced time to heal and/or reduced wound size in most cases. Key Messages: In situations where autologous PRP is not available or suitable, allogeneic PRP appears to provide a safe alternative. Its efficacy, however, requires larger-scale studies with appropriate controls. Standardization in PRP preparation and treatment regime are also needed to be able to interpret allogenic PRP efficacy.

show abstract

Allogeneic Platelet-Rich Plasma Therapy as an Effective and Safe Adjuvant Method for Chronic Wounds

Cited by 57 publications

References 25 publications

Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis

Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis

Platelet-rich plasma improves chronic inflammatory pain by inhibiting PKM2-mediated aerobic glycolysis in astrocytes

Allogeneic Platelet-Rich Plasma: Is It Safe and Effective for Wound Repair?

Contact Info

Product

Resources

About