Leucocyte-Rich Platelet-Rich Plasma Enhances Fibroblast and Extracellular Matrix Activity: Implications in Wound Healing

Abstract

Background: Platelet-rich plasma (PRP) is an autologous blood product that contains a high concentration of platelets and leucocytes, which are fundamental fibroblast proliferation agents. L iterature has emerged that offers contradictory findings about leucocytes within PRP. Herein, we elucidated the effects of highly concentrated leucocytes and platelets on human fibroblasts. Methods: Leucocyte-rich, PRP (LR-PRP) and leucocyte-poor, platelet-poor plasma (LP-PPP) were compared to identify their effects on human fibroblasts, including cell proliferation, wound healing and extracellular matrix and adhesion molecule gene expressions. Results: The LR-PRP exhibited 1422.00 ± 317.21 × 103 platelets/µL and 16.36 ± 2.08 × 103 white blood cells/µL whilst the LP-PPP demonstrated lower concentrations of 55.33 ± 10.13 × 103 platelets/µL and 0.8 ± 0.02 × 103 white blood cells/µL. LR-PRP enhanced fibroblast cell proliferation and cell migration, and demonstrated either upregulation or down-regulation gene expression profile of the extracellular matrix and adhesion molecules. Conclusion: LR-PRP has a continuous stimulatory anabolic and ergogenic effect on human fibroblast cells.

Pilot Study on the Use of the “Monocyte-Rich” Platelet-Rich Plasma in Combination with 1927 nm Fractional and 308 nm Excimer Lasers for the Treatment of Vitiligo

“…L-PRP has a 6-fold platelet concentration and increases PDGF-AB and TGF-β1 concentrations compared with whole blood, and also strongly activates the NF-κB pathway and contains a high amount of leukocytes, TNF-α and IL-1β [ 57 ]. The secretion of these factors correlates with the hypothesis of some authors, who consider that L-PRP contributes to inflammation and premature apoptosis [ 58 ]. Furthermore, one study argued that L-PRP may intensify the over-expression of MMP and consequently activate extracellular matrix (ECM) catabolic pathways and excessive inflammation [ 59 ].…”

“…Furthermore, one study argued that L-PRP may intensify the over-expression of MMP and consequently activate extracellular matrix (ECM) catabolic pathways and excessive inflammation [ 59 ]. This concept was also accentuated in another study [ 60 ], which reported that leukocytes in PRP initiate a greater activation of the nuclear factor kappa-light-chain-enhancer of the activated B cells pathway, subsequently resulting in significantly less fibroblast proliferation and a higher concentration of pro-inflammatory cytokines [ 58 , 59 , 60 ]. However, the PRP of these studies contained a high concentration of RBCs and therefore could be the source of this reaction and bias [ 58 ].…”

“…A more complete classification is the DEPA ( Dose of injected platelets; Efficiency of the production; Purity of the PRP obtained; Activation process), proposed by Magalon et al, which is based on the quantity of platelets obtained by the PRP devices, on product purity and on platelet activation before the injection. The parameters considered by the DEPA are exhaustive but cannot be measured by clinicians, so they should be declared in the characteristics of each medical device [ 49 , 54 , 55 , 56 , 57 , 58 ].…”

“…Then, according to the data provided by the manufacturer, the monocyte-rich PRP kit is able to obtain a platelet-rich plasma with a high concentration of peripheral blood mononuclear cells (with a proportionately lower amount of lymphocytes), a low concentration of neutrophils and an almost complete depletion of red blood cells. We decided to test monocyte-rich PRP in vitiligo, since peripheral monocytes demonstrated regenerative effects in the skin through the activation of macrophage colony-stimulating factors and because at the same time, as L-PRP, it may influence epidermal pigmentation, through a direct activity on melanin distribution/degradation and through activation of keratinocytes for the production of melanogenic factors [ 58 ].…”

Local injection of leukocyte rich platelet rich plasma produced higher radius union scoring system than local injection of pure platelet rich plasma in conservative therapy of intra-articular closed distal radius fractures

“…WBC levels in L-PRP are more than 100% levels in WB. 9 In Kenmochi's study, almost the same results were obtained, namely that the PLT concentration increased by 4.8 and WBC increased by 2.6 times in L-PRP. 10 In this study, the results obtained were that the group of research subjects who received P-PRP injection showed that the mean RUSS score was significantly higher than placebo in the 6 week post-injury period (p value =0.012, CI 95% =0.25-1.91).…”