Platelet lysate promotes the healing of long-standing diabetic foot ulcers: A report of two cases and in vitro study

Abstract

Long-standing foot ulcers present a great challenge in diabetes care. Platelet products have been suggested as a possible therapeutic option. However, nor the effect of an injectable form of platelet lysate on the healing of ulcers nor that on primary cells of the epidermis have been studied. In the current study, we present two cases of an ongoing clinical trial showing the positive effect of autologous platelet lysate injected perilesional. Both clinical cases treated with injections of hPL showed complete healing of previously un-healed within 8 weeks of treatment. Further, we describe the in vitro effect of human platelet lysate (hPL) on primary human epidermal keratinocytes (HEK) in terms of chemotaxis, migration and proliferation. In vitro, HEK showed enhanced chemotaxis towards the hPL compared to keratinocyte-defined media (p < 0.0001). Their migration was also stimulated especially at hPL concentration of 10%V/V (p < 0.0001). In contrast, hPL significantly inhibited HEK proliferation measured through MTT assay (p < 0.0001). In conclusion, the findings presented here provide preliminary evidence of an explanatory mechanism for the effect of hPL on primary keratinocytes and therefore of their potential use in a clinical setting. hPL promotes keratinocyte migration and therefore closure of foot ulcers.

Evaluation of the Regenerative Potential of Platelet-Lysate and Platelet-Poor Plasma Derived from the Cord Blood Units in Corneal Wound Healing Applications: An In Vitro Comparative Study on Corneal Epithelial Cells

“…Conversely, accumulating evidence from the literature indicated that CB derivatives are characterized by a great content of biomolecules [ 18 , 19 ]. For this reason, the CB products have been used with success in patients suffering from skin lesions and extended wounds [ 23 , 24 , 25 , 26 , 27 , 28 ].…”

“…It is known that the interplay between PDGF, FGF, TGF, and VEGF can promote the proliferation of cells and angiogenesis, resulting in advanced regeneration of the damaged tissue [ 20 , 21 , 22 ]. Currently, CB derivatives, such as the platelet rich plasma (PRP) and PL, have been applied with great success in several approaches involving skin lesions, occurring due to infection of Epidermolysis bullosa and also in patients suffering from diabetic ulcers [ 23 , 24 , 25 , 26 , 27 , 28 ]. Additionally, it has been reported that the CB-PPP contains a significant amount of growth factors, which may also exert wound healing properties [ 23 ].…”

Developing a Glyoxal-Crosslinked Chitosan/Gelatin Hydrogel for Sustained Release of Human Platelet Lysate to Promote Tissue Regeneration

“…HPL contains lots of well-known platelet growth factors, which have been considered to play an essential role in cell-mediated angiogenesis and skin fibroblast behavior [ 33 , 34 ]. Previous publications have shown that HPL can be utilized for the restoration of corneal lesions [ 35 ], diabetic ulcers [ 36 ] and other soft tissue pathologies [ 37 ]. Apart from the soft tissue, HPL can be successfully applied for the local treatment of osteoarthritis, which is attributed to the growth factors released from platelet granules after intra-articular activation [ 38 ].…”

PLCL/PCL Dressings with Platelet Lysate and Growth Factors Embedded in Fibrin for Chronic Wound Regeneration

“… 8 , 10 , 11 Exogenous addition of hPL has shown significant effects on cell migrations and proliferations both in vitro and in vivo. 12 However, the incorporation, stability, and gradual release of the hPL component from nanofiber membranes remains challenging.…”