Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF)

Abstract

BackgroundThe development of platelet-rich fibrin (PRF) drastically simplified the preparation procedure of platelet-concentrated biomaterials, such as platelet-rich plasma (PRP), and facilitated their clinical application. PRF’s clinical effectiveness has often been demonstrated in pre-clinical and clinical studies; however, it is still controversial whether growth factors are significantly concentrated in PRF preparations to facilitate wound healing and tissue regeneration. To address this matter, we performed a comparative study of growth factor contents in PRP and its derivatives, such as advanced PRF (A-PRF) and concentrated growth factors (CGF).MethodsPRP and its derivatives were prepared from the same peripheral blood samples collected from healthy donors. A-PRF and CGF preparations were homogenized and centrifuged to produce extracts. Platelet and white blood cell counts in A-PRF and CGF preparations were determined by subtracting those counts in red blood cell fractions, supernatant acellular serum fractions, and A-PRF/CGF exudate fractions from those counts of whole blood samples. Concentrations of growth factors (TGF-β1, PDGF-BB, VEGF) and pro-inflammatory cytokines (IL-1β, IL-6) were determined using ELISA kits.ResultsCompared to PRP preparations, both A-PRF and CGF extracts contained compatible or higher levels of platelets and platelet-derived growth factors. In a cell proliferation assay, both A-PRF and CGF extracts significantly stimulated the proliferation of human periosteal cells without significant reduction at higher doses.ConclusionsThese data clearly demonstrate that both A-PRF and CGF preparations contain significant amounts of growth factors capable of stimulating periosteal cell proliferation, suggesting that A-PRF and CGF preparations function not only as a scaffolding material but also as a reservoir to deliver certain growth factors at the site of application.

Regenerative surgical treatment of peri‐implantitis using either a collagen membrane or concentrated growth factor: A 12‐month randomized clinical trial

“…16,17 Concentrated growth factors (CGF) were introduced by Sacco as a therapeutic protocol obtained by separation from centrifuged venous blood using a special device in the same manner as PRF. 21 It has been stated that CGF forms rich layers of growth factors including transforming growth factor-beta 1 (TGF-β1), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), insulinlike growth factor (IGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), and bone morphogenic protein (BMP) 20 and deliver these specific growth factors at the site of application. 20 Furthermore, CGF has been found to be almost identical to self-clotted advanced-PRF (A-PRF) in respect of mechanical and degradation properties.…”

“…18 While CGF has been stated to be an improved formulation of PRF, 19 it has also been proposed that a different term is used for CGF because of the use of a different centrifuge machine (MEDIFUGE, Silfradent srl, S. Sofia, Italy) and centrifugation speed (2400 to 3000 rpm). 21 Previous studies have indicated that CGF accelerates new bone formation related to guided bone regeneration. 21 It has been stated that CGF forms rich layers of growth factors including transforming growth factor-beta 1 (TGF-β1), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), insulinlike growth factor (IGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), and bone morphogenic protein (BMP) 20 and deliver these specific growth factors at the site of application.…”

Study of a Two-Step Centrifugation Protocol for Concentrating Cells and Growth Factors in Bovine Platelet-Rich Plasma

“…Unfortunately, the WBC concentration was not reported for the techniques used for producing PRPs in cattle [11, 12, 29], which prevents us from comparing our findings with those reports.…”

Platelet-rich plasma for regeneration of neural feedback pathways around dental implants: a concise review and outlook on future possibilities

“…27, 28, 29 Ehrenfest et al suggested that the various platelet concentrates can be classified into four main categories, depending on the known leukocyte content and fibrin architecture: 30, 31, 32 pure platelet-rich plasma (P-PRP), leukocyte- and platelet-rich plasma (L-PRP), pure platelet-rich fibrin (P-PRF), and leukocyte- and platelet-rich fibrin (L-PRF). Given this variety of preparations and applications of platelet concentrates, 32 studies do not always adhere to the proposed classification, which leads to inconsistent results and confusion in comparing the efficacy of PRP products.…”