The Combined Use of Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells Promotes Healing. A Review of Experimental Models and Future Perspectives

Abstract

Wound healing and tissue regeneration are a field of clinical medicine presenting high research interest, since various local and systematic factors can inhibit these processes and lead to an inferior result. New methods of healing enhancement constantly arise, which, however, require experimental validation before their establishment in everyday practice. Platelet-rich plasma (PRP) is a well-known autologous factor that promotes tissue healing in various surgical defects. PRP derives from the centrifugation of peripheral blood and has a high concentration of growth factors that promote healing. Recently, the use of adipose-derived mesenchymal stem cells (ADMSCs) has been thoroughly investigated as a form of wound healing enhancement. ADMSCs are autologous stem cells deriving from fat tissue, with a capability of differentiation in specific cells, depending on the micro-environment that they are exposed to. The aim of the present comprehensive review is to record the experimental studies that have been published and investigate the synergistic use of PRP and ADMSC in animal models. The technical aspects of experimentations, as well as the major results of each study, are discussed. In addition, the limited clinical studies including humans are also reported. Future perspectives are discussed, along with the limitations of current studies on the long-term follow up needed on efficacy and safety.

How to Enhance the Effects of Platelet Rich Plasma on Tissue Regeneration: AMPLEX PLUS Technology, a New Strategy

“…As can be seen from numerous studies [68,69], for many applications of PRP the results obtained have not been satisfactory, and also for those applications for which the effects of treatment with PRP have been judged positively, the results obtained are clearly susceptible to further notable improvements. An attempt has therefore been made to enhance the effect of PRP by using them in combination with adult stem cells taken from the same patient, antibiotics, anti-inflammatories, vitamins, etc., however the increase in efficacy obtained with these combinations, compared to the use of PRP from alone, it was quite modest [70,71]. It was therefore assumed that the limited effectiveness of the various preparations was due to a low platelet concentration and, consequently, to a low concentration of the factors contained in the platelet granules.…”

Research trends of platelet-rich plasma therapy on knee osteoarthritis from 2011 to 2021: A review

“…[36][37][38][39] The combination of PRP and MSCs appears to be more beneficial for bone healing than PRP alone. [40,41] According to Meta-analysis, at 6-month follow-up, adipose mesenchymal stem cells provided better pain relief than PRP, HA, and saline, and LP-PRP was most effective for functional improvement. At the 12-month follow-up, both adipose mesenchymal stem cells and LP-PRP provided clinical pain relief, and knee function improved better with LP-PRP.…”

Efficacy of autologous mesenchymal stromal cell treatment for chronic degenerative musculoskeletal conditions in dogs: A retrospective study

“…In addition to their reparative potential, they possess anti-inflammatory and immune-modulating properties that allow them to control inflammation and pain (23)(24)(25)(26)(27). Furthermore, several canine RM studies have included platelet rich plasma (PRP) with MSCs, as the combination is considered to be synergistic in terms of regenerative effects (22,28).…”