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SUMMARY: The aim of this systematic review was to assess the histological effects of platelet-rich plasma (PRP) on temporomandibular joint osteoarthritis (TMJ-OA) in animal models. A systematic search was performed using PubMed, WoS, EMBASE, Science Direct and SCOPUS databases. The inclusion criteria were experimental studies in animal models that evaluated the use of PRP as a treatment for TMJ-OA with or without arthrocentesis/arthroscopy. Comparison was made to a healthy control group or to other treatment. The variables evaluated were the histological effects of the treatments, characteristics of the primary articles, characteristics of the sample studied and the risk of bias. The systematic search identified 120 studies. Eventually 5 studies were included in the analysis. Four of the studies showed a statistically significant repair in joint tissues and improvement of cartilage thickness in animals treated with PRP. The global risk of bias was unclear. The results of this systematic review suggest that PRP treatment in TMJ-OA has benefits at the histological level in cartilage, articular disc and articular bone tissue in animal models. However, due to the low number of studies and the risk of bias, further research is needed to recommend its use.
El objetivo de esta revisión sistemática fue evaluar los efectos histológicos del plasma rico en plaquetas (PRP) en la osteoartritis de la articulación temporomandibular (ATM-OA) en modelos animales. Se realizó una búsqueda sistemática en las bases de datos PubMed, WoS, EMBASE, Science Direct y SCOPUS. Los criterios de inclusión fueron estudios experimentales en modelos animales que evaluaran el uso de PRP como tratamiento para la ATM-OA con o sin artrocentesis/ artroscopia. La comparación se realizó con un grupo de control sano o con otro tratamiento. Las variables evaluadas fueron los efectos histológicos de los tratamientos, las características de los artículos primarios, las características de la muestra estudiada y el riesgo de sesgo. La búsqueda sistemática identificó 120 estudios. Finalmente se incluyeron 5 estudios en el análisis. Cuatro de los estudios mostraron una reparación estadísticamente significativa en los tejidos articulares y una mejora del grosor del cartílago en los animales tratados con PRP. El riesgo global de sesgo fue incierto. Los resultados de esta revisión sistemática sugieren que el tratamiento con PRP en la ATM-OA tiene beneficios a nivel histológico en el cartílago, el disco articular y el tejido óseo articular en modelos animales. Sin embargo, debido al escaso número de estudios y al riesgo de sesgo, se necesitan investigaciones adicionales para recomendar su uso.
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Animales , Osteoartritis/terapia , Articulación Temporomandibular/anatomía & histología , Trastornos de la Articulación Temporomandibular/terapia , Plasma Rico en Plaquetas/fisiología , Modelos Animales de EnfermedadRESUMEN
OBJECTIVE: Adequate endometrial thickness has been considered an important parameter for hormonal response and blastocyst implantation in assisted reproduction therapies. While there is no consensus on the exact thickness of the endometrium considered 'adequate,' a thin endometrium (<7mm) has been associated with compromised outcomes in assisted reproduction therapies. Platelet-rich plasma (PRP), which is a concentrate obtained from peripheral blood, is a rich source of growth factors that play important roles in various cellular processes. The objective is to utilize lyophilized PRP (LPRP) to increase the thickness of the endometrium and enhance the outcomes of embryo transfer in women with poor response to previous in-vitro fertilization procedures. METHODS: This study enrolled nine women between 23 and 42 years of age, with a thin endometrium, who had undergone multiple previous unsuccessful assisted reproduction procedures. All patients underwent intrauterine infusion of LPRP, followed by frozen-thawed embryo transfer after 2-3 days. RESULTS: Endometrial thickness was assessed by ultrasound 2 weeks after LPRP infusion, which showed improved thickness in all patients (range, 0.7-2.2mm). Clinical pregnancy occurred in all patients and eight out of nine patients are currently between 9 weeks and 27 weeks of gestation. Twin fetal heartbeats were not detected at the eighth week in one patient. CONCLUSION: Infusion of LPRP was found to be beneficial to increase endometrium thickness in all patients. This regenerative technique could be considered to enhance the outcomes of assisted reproduction techniques in a minimally-invasive manner, without any side effects.
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Fertilización In Vitro , Plasma Rico en Plaquetas , Embarazo , Humanos , Femenino , Índice de Embarazo , Fertilización In Vitro/métodos , Endometrio , Plasma Rico en Plaquetas/fisiología , FertilizaciónRESUMEN
OBJECTIVE: Premature ovarian insufficiency (POI) contributes significantly to female infertility. Cyclophosphamide (CYC has adverse effects on folliculogenesis. Platelet-rich plasma (PRP) is an autologous product rich in many growth factors. We evaluated the protective effect of PRP on in vitro fertilization in female rats with CYC-induced ovarian damage. METHODS: Twenty-eight adult female Sprague-Dawley rats were randomly divided into four groups. Group 1 (control-sodium chloride 0.9%; 1 mL/kg, single-dose intraperitoneal [IP] injection); group 2 (CYC), 75 mg/kg, single-dose IP injection and sodium chloride 0.9% (1 mL/kg, single-dose IP injection); group 3 CYC plus PRP, CYC (75 mg/kg, single-dose and PRP (200 µl, single-dose) IP injection); and group 4 (PRP, 200 µl, single-dose IP injection). RESULTS: In the comparisons in terms of M1 and M2 oocytes, it was observed that the CYC group presented a significantly lower amount than the control, CYC/PRP, and PRP groups. (for M1, p = 0.000, p = 0.029, p = 0.025; for M2, p = 0.009, p = 0.004, p = 0.000, respectively). The number of fertilized oocytes and two-celled good quality embryos was found to be statistically significant between the CYC and control groups, CYC + PRP and PRP groups (p = 0.009, p = 0.001, p = 0.000 for oocytes, respectively. For embryos; p = 0.016, p = 0.002, p = 0.000). CONCLUSION: Platelet-rich plasma can protect the ovarian function against damage caused by CYC, and, in addition, it improves oocyte count and the development of embryos as a result of oocyte stimulation during the IVF procedure.
OBJETIVO: A insuficiência ovariana prematura (POI) contribui significativamente para a infertilidade feminina. A ciclofosfamida (CYC) tem efeitos adversos na foliculogênese. O plasma rico em plaquetas (PRP) é um produto autólogo rico em muitos fatores de crescimento. Avaliamos o efeito protetor do PRP na fertilização in vitro em ratas com lesão ovariana induzida por CYC. MéTODOS: Vinte e oito ratas Sprague-Dawley adultas foram divididas aleatoriamente em quatro grupos. Grupo 1 (controle - cloreto de sódio 0,9%; 1 mL/kg, injeção intraperitoneal [IP] em dose única); grupo 2 (CYC), 75 mg/kg, injeção IP de dose única e cloreto de sódio 0,9% (1 mL/kg, injeção ip de dose única); grupo 3 CYC + PRP, CYC (75 mg/kg, dose única e PRP (200 µl, dose única) injeção IP); e grupo 4 (PRP, 200 µl, injeção IP de dose única). RESULTADOS: Nas comparações em termos de ovócitos M1 e M2, observou-se que o grupo CYC apresentou uma quantidade significativamente menor que os grupos controle, CYC/PRP, e PRP. (Para M1, p = 0,000, p = 0,029, p = 0,025; para M2, p = 0,009, p = 0,004, p = 0,000, respectivamente). O número de oócitos fertilizados e embriões bicelulares de boa qualidade foi considerado estatisticamente significativo entre os grupos CYC e controle, CYC + PRP e grupos PRP (p = 0,009, p = 0,001, p = 0,000 para oócitos, respectivamente. Para embriões, p = 0,016, p = 0,002, p = 0,000). CONCLUSãO: O PRP pode proteger a função ovariana contra os danos causados pelo CYC e, além disso, proporciona melhora na contagem de oócitos e no desenvolvimento de embriões como resultado da estimulação ovariana durante o procedimento de fertilização in vitro.
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Enfermedades del Ovario , Plasma Rico en Plaquetas , Animales , Ciclofosfamida/toxicidad , Femenino , Fertilización In Vitro , Enfermedades del Ovario/inducido químicamente , Enfermedades del Ovario/prevención & control , Plasma Rico en Plaquetas/fisiología , Ratas , Ratas Sprague-DawleyRESUMEN
Introducción: La enfermedad degenerativa discal es una entidad frecuente y uno de los principales motivos de consulta. Genera altas tasas de discapacidad, años útiles perdidos, así como altos costos económicos por asistencia médica y grandes pérdidas monetarias. Su tratamiento es generalmente conservador, aunque en la actualidad se incluyen terapias biológicas novedosas. Objetivo: Describir las principales propiedades biológicas que hacen del plasma rico en plaquetas una terapéutica efectiva para la enfermedad degenerativa discal. Métodos: Se realizó una revisión no sistemática de la bibliografía basada en artículos que se publicaron en bases de datos indexadas en Infomed como Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, Scopus, LILACS; en idioma español, inglés y portugués, durante los últimos diez años. Desarrollo: Se expusieron características clínico epidemiológicas de la enfermedad degenerativa discal, así como las propiedades biológicas que le permiten al plasma rico en plaqueta tener una función activa en la regeneración del disco intervertebral o el retraso de la cascada de degradación de este. Se resaltan los principales estudios de acuerdo a la vía de administración del plasma rico en plaquetas y sus resultados. Conclusiones: De acuerdo con lo publicado por los autores, el plasma rico en plaquetas es una alternativa efectiva en el tratamiento de la enfermedad degenerativa discal por la producción de factores derivados de las plaquetas, que intervienen en la degeneración del disco intervertebral, siendo la vía intradiscal la que más se emplea(AU)
Introduction: Degenerative disc disease is a frequent condition and one of the main reasons to attend the consultation. It generates high rates of disability, useful years lost, as well as high economic costs for medical assistance and large monetary losses. Its treatment is generally conservative, although novel biological therapies are currently included. Objective: To describe the main biological properties that make platelet-rich plasma an effective therapy against degenerative disc disease. Methods: A nonsystematic review of the bibliography was carried out based on articles published, during the last ten years, in databases indexed in Infomed, such as Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, Scopus, and LILACS, in Spanish, English and Portuguese. Development: Clinical-epidemiological characteristics of degenerative disc disease were presented, as well as the biological properties that allow platelet-rich plasma to have an active function in the regeneration of the intervertebral disc or the delay of its degradation cascade. The main studies are highlighted, according to the route of administration of platelet-rich plasma and their results. Conclusions: According to what has been published by authors, platelet-rich plasma is an effective alternative in the treatment of degenerative disc disease, due to the production of factors derived from platelets, which intervene in the degeneration of the intervertebral disc, being the intradiscal pathway the most used(AU)
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Humanos , Plasma Rico en Plaquetas/fisiología , Degeneración del Disco Intervertebral/terapia , Degeneración del Disco Intervertebral/epidemiología , Degeneración del Disco Intervertebral/cirugíaRESUMEN
OBJECTIVES: to analyze the evidence on the cost and effectiveness of Plaque Rich Plasma in the treatment of venous ulcers compared to other topical therapies. METHODS: systematic review, with search in the databases: COCHRANE, EMBASE, MEDLINE via PubMed, LILACS, CINAHL, SCOPUS, without temporal cut and in the English, Portuguese and Spanish languages. RESULTS: fifteen articles were included, a cost-minimization analysis showed that the cost of Plaque Rich Plasma is 163.00 ± 65.90, slightly higher than the cost of standard dressing. Regarding effectiveness, the results of the studies associated with the meta-analysis suggest a tendency that Plaque Rich Plasma is effective in the healing of venous ulcers. CONCLUSIONS: it is concluded that there are few studies about the cost of Platelet Rich Plasma and this product tends to be effective in the healing of venous ulcers. However, more controlled and randomized clinical studies are necessary in order to establish a stronger recommendation.
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Plasma Rico en Plaquetas/metabolismo , Plasma Rico en Plaquetas/fisiología , Úlcera Varicosa/terapia , Análisis Costo-Beneficio , Humanos , Úlcera Varicosa/fisiopatología , Cicatrización de Heridas/fisiologíaRESUMEN
Los defectos óseos alrededor de los implantes dentales son considerados enfermedades que afectan el soporte y estabilidad del implante dental lo que limita la oseointegración. El tratamiento de estos defectos involucra procedimientos de regeneración ósea guiada que se define como la reproducción o reconstitución de una parte perdida o dañada del tejido óseo periimplantario con el fin de restaurar su arquitectura y función. El plasma rico en plaquetas y el plasma rico en fibrina son concentrados de plaquetas autólogos ampliamente usados en la regeneración periodontal y regeneración ósea guiada; sin embargo, sus resultados clínicos, histológicos y radiográficos son discutidos cuando se tratan defectos óseos alrededor de implantes dentales. En la presente revisión se realizó una búsqueda de la información mediante las bases de datos de diferentes buscadores (PubMed, SciELO, Redalyc y ScienceDirect) para encontrar artículos que traten sobre el uso de los concentrados plaquetarios (plasma rico en plaquetas y plasma rico en fibrina) en la terapia de la regeneración ósea guiada. Clínicamente, los concentrados plaquetarios otorgan resultados favorables en la reducción de la profundidad de sondaje y ganancia de nivel de inserción clínica en el tratamiento de defectos infraóseos periodontales. Histológicamente, los concentrados plaquetarios favorecen la neoformación ósea aumentando la velocidad de regeneración. Radiográficamente, los concentrados plaquetarios favorecen el aumento de densidad ósea, relleno óseo y tejido mineralizado. Con ello, se logra una reducción significativa del tamaño del defecto óseo(AU)
Bone defects around dental implants are considered to be diseases affecting the support and stability of the implant, thus limiting osseointegration. Treatment of these defects involves guided bone regeneration procedures, defined as the reproduction or reconstitution of a part lost or damaged of the peri-implant bone tissue with the purpose of restoring its architecture and function. Platelet-rich plasma and fibrin-rich plasma are autologous platelet concentrates widely used in guided bone regeneration and periodontal regeneration. However, their clinical, histological and radiographic results are debated when bone defects around dental implants are dealt with. The present review included a search for information in the databases of various search engines (PubMed, SciELO, Redalyc and ScienceDirect) to find papers about the use of platelet concentrates (platelet-rich plasma and fibrin-rich plasma) in guided bone regeneration therapy. Clinically, platelet concentrates yield favorable results in reducing probing depth and raising the level of clinical insertion in the treatment of periodontal intraosseous defects. Histologically, platelet concentrates enhance bone neoformation, speeding up regeneration. Radiographically, platelet concentrates lead to an increase in bone density, bone filler and mineralized tissue. A significant reduction is thus achieved in the size of the bone defect(AU)
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Humanos , Plasma Rico en Plaquetas/fisiología , Regeneración Ósea/fisiología , Densidad Ósea/genética , Fibrina Rica en Plaquetas/fisiologíaRESUMEN
ABSTRACT Objectives: to analyze the evidence on the cost and effectiveness of Plaque Rich Plasma in the treatment of venous ulcers compared to other topical therapies. Methods: systematic review, with search in the databases: COCHRANE, EMBASE, MEDLINE via PubMed, LILACS, CINAHL, SCOPUS, without temporal cut and in the English, Portuguese and Spanish languages. Results: fifteen articles were included, a cost-minimization analysis showed that the cost of Plaque Rich Plasma is € 163.00 ± 65.90, slightly higher than the cost of standard dressing. Regarding effectiveness, the results of the studies associated with the meta-analysis suggest a tendency that Plaque Rich Plasma is effective in the healing of venous ulcers. Conclusions: it is concluded that there are few studies about the cost of Platelet Rich Plasma and this product tends to be effective in the healing of venous ulcers. However, more controlled and randomized clinical studies are necessary in order to establish a stronger recommendation.
RESUMEN Objetivos: analizar las evidencias acerca del costo y de la efectividad del Plasma Rico en Plaquetas en el tratamiento de úlceras venosas comparado a las otras terapias tópicas. Métodos: revisión sistemática con la búsqueda en bases de datos: Cochrane Library, EMBASE, MEDLINE vía PubMed, LILACS, CINAHL, SCOPUS, hay un tiempo y en inglés, portugués y español. Resultados: se incluyeron 15 artículos, un análisis de costo-minimización demostró que el costo del Plasma Rico en Plaquetas es de € 163,00 ± 65,90, poco superior al costo del vendaje estándar. En cuanto a la efectividad, los resultados de los estudios asociados al metaanálisis sugieren una tendencia de que el Plasma Rico en Plaquetas es efectivo en la cicatrización de las úlceras venosas. Conclusiones: se concluye que hay pocos estudios acerca del costo del Plasma Rico en Plaquetas y que ese tiende a ser efectivo en la cicatrización de úlceras venosas. Todavía, son necesarios más estudios clínicos controlados y aleatorizados para que se pueda establecer una recomendación más fuerte.
RESUMO Objetivos: analisar as evidências acerca do custo e da efetividade do Plasma Rico em Plaquetas no tratamento de úlceras venosas comparado às outras terapias tópicas. Métodos: revisão sistemática, com busca nas bases de dados COCHRANE, EMBASE, MEDLINE via PubMed, LILACS, CINAHL, SCOPUS, sem recorte temporal e nos idiomas inglês, português e espanhol. Resultados: foram incluídos 15 artigos. Uma análise de custo-minimização demonstrou que o custo do Plasma Rico em Plaquetas é de €163,00 ± 65,90, pouco superior ao custo do curativo padrão. Quanto à efetividade, os resultados dos estudos associados à metanálise sugerem uma tendência de que o Plasma Rico em Plaquetas é efetivo na cicatrização das úlceras venosas. Conclusões: conclui-se que há poucos estudos acerca do custo do Plasma Rico em Plaquetas e esse produto tende a ser efetivo na cicatrização de úlceras venosas. Entretanto, são necessários mais estudos clínicos controlados e randomizados para que se possa estabelecer uma recomendação mais forte.
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Humanos , Úlcera Varicosa/terapia , Plasma Rico en Plaquetas/fisiología , Plasma Rico en Plaquetas/metabolismo , Úlcera Varicosa/fisiopatología , Cicatrización de Heridas/fisiología , Análisis Costo-BeneficioRESUMEN
Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) are orthobiologic therapies considered as an alternative to the current therapies for muscle, bone and cartilage. Different formulations of biomaterials have been used as carriers for PRP and BMAC in order to increase regenerative processes. The most common biomaterials utilized in conjunction with PRP and BMAC clinical trials are organic scaffolds and natural or synthetic polymers. This review will cover the combinatorial strategies of biomaterial carriers with PRP and BMAC for musculoskeletal conditions (MsCs) repair and regeneration in clinical trials. The main objective is to review the therapeutic use of PRP and BMAC as a treatment option for muscle, bone and cartilage injuries.
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Materiales Biocompatibles/farmacología , Medicina Regenerativa/métodos , Células de la Médula Ósea/fisiología , Ensayos Clínicos como Asunto , Humanos , Plasma Rico en Plaquetas/fisiologíaRESUMEN
OBJECTIVE: To evaluate whether or not one should use a new Protocol for Endometrial Receptivity Improvement (PRIMER) based on platelet-rich plasma (PRP) and granulocyte colony-stimulation factor (G-CSF) to enhance ongoing pregnancy rates in patients with recurrent implantation failure (RIF). METHODS: Women undergoing IVF/ICSI were prospectively divided into two groups: - PRIMER/RIF group (n:33): patients with RIF (defined as ≥2embryo transfers (ETs) and at least 5 morphologically good embryos transferred) in which intrauterine PRP injection and subcutaneous G-CSF-injection were performed. - Control group (n:33): patients in their first IVF/ICSI attempt/cycle (without PRP or G-CSF injection). The PRP was prepared using autologous fresh-whole blood processed to increase platelet-concentration in 2 to 4 fold. All patients undergoing the PRP-treatment received 0.7ml of it through intrauterine-injection 48 hours before the ET. G-CSF (300mg/0.5ml) started simultaneously to PRP and was administered subcutaneously every week. RESULTS: Regarding implantation, clinical pregnancy and miscarriage rates, we found no statistically significant difference (18.2% versus 17.6%, p=0.90; 36.4% versus 30.3%, p=0.61 and 25.0% versus 9.0%, p=0.43, respectively). The use of PRIMER enabled RIF patients (previous ET µ: 4.0±1.5) to reach similar ongoing pregnancy and live birth rates like those patients who had their first IVF/ICSI cycle attempt (27.3% versus 27.3%, p=0.99). CONCLUSIONS: Our results showed, for the first time, evidence that this therapeutic protocol (PRIMER) could be used as a feasible treatment based on biological rationale for patients with RIF, considering its promising outcomes, it is a simple procedure and not associated with patient complications.
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Aborto Habitual/terapia , Transfusión de Componentes Sanguíneos/métodos , Implantación del Embrión , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Plasma Rico en Plaquetas/fisiología , Terapias en Investigación/métodos , Aborto Habitual/patología , Adulto , Implantación del Embrión/efectos de los fármacos , Implantación del Embrión/fisiología , Transferencia de Embrión/métodos , Endometrio/efectos de los fármacos , Endometrio/patología , Femenino , Fertilización In Vitro/métodos , Humanos , Recién Nacido , Nacimiento Vivo , Masculino , Persona de Mediana Edad , Proyectos Piloto , Embarazo , Índice de Embarazo , Insuficiencia del TratamientoRESUMEN
INTRODUCTION: Central graft ulceration is a rare complication of an orbital dermal fat graft caused by diminished blood supply to the implant. This study reports on the efficacy and safety of the use of a single subconjunctival injection of autologous platelet-rich plasma to rescue an ulcerated orbital dermal fat graft. METHODS: Three patients, who had undergone autologous dermal fat graft to treat their anophthalmic socket, were given a 2-mL subconjunctival platelet-rich plasma injection in the exposed graft margins. Demographic and clinical features, treatment protocol, clinical course, complications and follow-up time are reported. In the preoperative examination, all the patients presented a primary epithelial defect of the dermal fat graft. RESULTS: There were no major complications such as necrosis or infection. One patient presented a small conjunctival granuloma at 1-month follow up. Mean postoperative follow-up duration was 13 (range: 10-16) months. By 1 month, the chronic epithelial defect had resolved with the graft integrated within the orbital tissues in all cases. All patients were referred for artificial prosthesis placement. CONCLUSION: Although further work is needed, our findings suggest that a single subconjunctival platelet-rich plasma injection could be an effective, safe and economic alternative to surgery to rescue an ulcerated orbital dermal fat graft.
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Tejido Adiposo/trasplante , Enfermedades Orbitales/terapia , Implantes Orbitales/efectos adversos , Plasma Rico en Plaquetas/fisiología , Úlcera/terapia , Anciano , Autoinjertos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Orbitales/etiología , Implantación de Prótesis , Úlcera/etiología , Adulto JovenRESUMEN
BACKGROUND: There is evidence showing that human mesenchymal stromal cells (MSC) seeded on collagen microspheres (CM) and incorporated into platelet rich plasma (PRP) clots induce bone formation. For clinical trials it is very important to establish standardization of storage and shipment conditions to ensure the viability and functionality of cellular products. We investigate the effect of storage temperature and time on the viability and functionality of human MSC seeded on CM and included into PRP clots for using in the further clinical application for bone regeneration. METHODS: MSC/CM/PRP clots were stored at room temperature (RT), 4⯰C and 37⯰C for 12â¯h, 24â¯h and 48â¯h. At each period of time, MSC were evaluated for their viability and functionality. RESULTS: MSC from MSC/CM/PRP clots maintained at RT and 37⯰C for 24â¯h showed a high viability (90%) and maintained their capacity of proliferation, migration and osteogenic differentiation. In contrast, MSC/CM/PRP maintained to 4⯰C showed a significant reduction in their viability and migration capacity. MSC from MSC/CM/PRP clots maintained at RT for 24â¯h induce osteogenesis in the subcutaneous tissues of mice, after four months of transplantation. DISCUSSION: Our results show that MSC incorporated into CM/PRP clots and maintained at RT can be utilized in bone regeneration protocols during the first 24â¯h after their processing.
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Conservación de la Sangre/métodos , Supervivencia Celular/fisiología , Células Madre Mesenquimatosas/citología , Plasma Rico en Plaquetas/fisiología , Animales , Regeneración Ósea/fisiología , Colágeno/farmacología , Femenino , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/fisiología , Ratones , Ratones Endogámicos C57BL , Microesferas , Modelos Animales , Osteogénesis , Temperatura , Factores de TiempoRESUMEN
OBJECTIVE: To improve endometrial quality and implantation rates after the administration of platelet-rich plasma in patients with refractory endometrium. METHODS: 19 patients undergoing in vitro fertilization, aged between 33 and 45 years with a history of refractory endometrium, to whom platelet rich plasma was given by infusion with a catheter into the uterine cavity on the tenth day of the hormone replacement therapy, and then 72 hours after the first administration. RESULTS: Endometrial thicknesses >7mm was reported with the first use; and in all cases, endometrial thicknesses >9mm were evident after the second administration. The entire study group qualified for Embryo Transfer at the blastocyst stage. We had 73.7% of positive pregnancy tests, of which 26.3% yielded live births; 26.3% ongoing pregnancies; 10.5% biochemical pregnancies; 5.3% anembryonic pregnancies and 5.3% had fetal death (16 weeks). CONCLUSIONS: Platelet-rich plasma and its biostimulation effects on the endometrial microvasculature seems to be beneficial to patients with refractory endometrium, providing an increase in endometrial receptivity and a consequent increase in implantation rates. As an autologous resource, they are easy to obtain and inexpensive. Thus, we recommend it to be included in the different protocols for endometrial preparation, including those in which a natural cycle is preferred.
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Aborto Habitual/prevención & control , Aborto Espontáneo/prevención & control , Implantación del Embrión/fisiología , Transferencia de Embrión/métodos , Endometrio/patología , Plasma Rico en Plaquetas/fisiología , Técnicas Reproductivas Asistidas , Aborto Habitual/epidemiología , Aborto Espontáneo/epidemiología , Adulto , Terapia Combinada , Femenino , Fertilización In Vitro/métodos , Humanos , Recién Nacido , Nacimiento Vivo/epidemiología , Persona de Mediana Edad , Embarazo , Índice de Embarazo , Insuficiencia del Tratamiento , Resultado del TratamientoRESUMEN
Reconstructive surgery to craniofacial deformities caused by tumor ressections, traumas or congenital malformation are frequent in medicine practice. It aims to provide the patients with better quality of life and functional improvement of speech, breathing, chewing, and swallowing. Many are the techniques described in the literature to recover bone defects. This study evaluated a vascularized galeal and periosteum flap in rabbits, which could possibly substitute the bone graft in reconstructive surgery, especially for facial defects. It involved rabbits, divided into 12 groups, submitted to a surgical procedure to construct the galea and periosteum cranial flap filled with fragments of cranial bone, platelet-rich plasma, mesenchimal stem cells, and hyaluronic acid. The evaluation methods included image examinations and histological analysis.The results demonstrated bone formation with the use of platelet-rich plasma, mesenchimal stem cells, and bone fragments. The use of several enrichment materials of osseous cellular stimulation improved the quality and bone tissue organization. The more enrichment factor used, the better the tissue quality result was.Much research should be done to improve the methods and to analyze if results in human have the same bone formation as it happened in rabbits.
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Ácido Hialurónico/metabolismo , Células Madre Mesenquimatosas/citología , Periostio , Plasma Rico en Plaquetas/fisiología , Colgajos Quirúrgicos/cirugía , Animales , Osteogénesis , Periostio/citología , Periostio/cirugía , Conejos , Procedimientos de Cirugía PlásticaRESUMEN
OBJECTIVE: Muscle injuries are common, and their treatment requires costs and time off. Platelet rich plasma and low level laser therapy have been shown to be affordable and easy to use. The aim of this study was to evaluate the associated effects of low level laser therapy and platelet rich plasma on the treatment of the soleus muscle injured by strain in rats. METHODS: Thirty-five rats were randomly allocated into five groups: Control (C), Injury Control (IC), injury PRP (IP), injury LLLT (ILT) and injury LLLT and PRP (ILTP). The strain injury was induced in the soleus muscle and the IP group received application of platelet rich plasma immediately after the lesion, while the ILT group received low level laser therapy. After seven days, all animals were euthanized and the soleus muscle removed for further histological analysis. RESULTS: The association of both treatments (ILTP) resulted in better histological aspects than the low level laser therapy and platelet rich plasma alone, when compared with the injury group (IC). The collagen analysis exhibited a significant increase in the ILT group (2.99 SD=1.13) compared to the C (1.88 SD=0.41, p=0.012) and IP (2.04 SD=0.44, p=0.018). CONCLUSION: The association of low level laser therapy with platelet rich plasma produced better results on muscle injury compared to the isolated use of these therapies. Furthermore, none of the treatments could modulate the collagen deposition in relation to injury group.
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Colágeno/fisiología , Terapia por Luz de Baja Intensidad/métodos , Músculo Esquelético/lesiones , Plasma Rico en Plaquetas/fisiología , Regeneración/fisiología , Cicatrización de Heridas/fisiología , Animales , Colágeno/metabolismo , Músculo Esquelético/patología , Ratas , Ratas WistarRESUMEN
OBJECTIVES:: Previous reports have revealed that several cytokines (including platelet-derived growth factor-BB, transforming growth factors-ß1 and insulin-like growth factor-1) can enhance the rate of bone formation and synthesis of extracellular matrix in orthopaedics or periodontology. This study aimed to determine the concentration of cytokines within platelet-rich fibrin microstructures and investigate whether there are differences in the different portions of platelet-rich fibrin, which has implications for proper clinical use of platelet-rich fibrin gel. METHODS:: Whole blood was obtained from six New Zealand rabbits (male, 7 to 39 weeks old, weight 2.7-4 kg); it was then centrifuged for preparation of platelet-rich fibrin gels and harvest of plasma. The resultant platelet-rich fibrin gels were used for cytokine determination, histological analyses and scanning electron microscopy. All plasmas obtained were subject to the same cytokine determination assays for the purpose of comparison. RESULTS:: Cytokines platelet-derived growth factor-BB and transforming growth factor-ß1 formed concentration gradients from high at the red blood cell end of the platelet-rich fibrin gel (p=1.88×10-5) to low at the plasma end (p=0.19). Insulin-like growth factor-1 concentrations were similar at the red blood cell and plasma ends. The porosities of the platelet-rich fibrin samples taken in sequence from the red blood cell end to the plasma end were 6.5% ± 4.9%, 24.8% ± 7.5%, 30.3% ± 8.5%, 41.4% ± 12.3%, and 40.3% ± 11.7%, respectively, showing a gradual decrease in the compactness of the platelet-rich fibrin network. CONCLUSION:: Cytokine concentrations are positively associated with platelet-rich fibrin microstructure and portion in a rabbit model. As platelet-rich fibrin is the main entity currently used in regenerative medicine, assessing cytokine concentration and the most valuable portion of PRF gels is essential and recommended to all physicians.
Asunto(s)
Plaquetas/fisiología , Citocinas/fisiología , Plasma Rico en Plaquetas/fisiología , Animales , Línea Celular , Centrifugación , Modelos Animales de Enfermedad , Geles/química , Masculino , Plasma Rico en Plaquetas/química , ConejosRESUMEN
Opinions about the clinical utility of platelet-rich plasma (PRP) vary, as a large number of experimental studies have questioned its efficacy. The purpose of this study was to evaluate the effects of PRP on experimental alveolar wound healing in rats. Fifty young adult male Wistar rats were divided in control and PRP groups and submitted to extraction of the right maxillary incisor. In the PRP group, blood was collected by cardiac puncture, and the socket was filled with a PRP gel. Animals were euthanized after 1, 3, 7, 14 and 30 days. Histological and histomorphometric analyses were performed at each experimental time point. Semiquantitative histological analysis showed that the PRP group exhibited significantly more collagen-matrix deposition and less bone-matrix formation in the socket than did the control group from 7 to 30 days. Histomorphometric analyses showed that the PRP group also exhibited lower bone-tissue areas than the control group at 7 (p=0.0250) and 14 days (p<0.0001), but at 30 days, no significant difference between the groups was observed. In the present study, PRP did not enhance alveolar wound healing, and PRP-treated rats exhibited low rates of bone deposition during the intermediate phases of alveolar socket repair.
Las opiniones sobre la utilidad clínica del plasma rico en plaquetas (PRP) varían, ya que un gran número de estudios experimentales han cuestionado su eficacia. El propósito de este estudio fue evaluar los efectos del PRP sobre la cicatrización experimental de heridas alveolares en ratas. Cincuenta ratas Wistar adultas fueron divididas en grupos control y PRP, y fueron sometidas a extracción del incisivo maxilar derecho. En el grupo de PRP, la sangre se recogió por punción cardiaca, y el alvéolo se llenó con un gel de PRP. Los animales se sacrificaron después de 1, 3, 7, 14 y 30 días. Se realizaron análisis histológicos e histomorfométricos en cada momento experimental. El análisis histológico semicuantitativo mostró que el grupo de PRP exhibió significativamente más deposición de matriz de colágeno y menos formación de matriz ósea en el receptáculo que el grupo control de 7 a 30 días. Los análisis histomorfométricos mostraron que el grupo PRP también exhibió áreas de tejido óseo inferiores al grupo control a 7 (p = 0,0250) y 14 días (p <0,0001), pero a los 30 días no se observó diferencia significativa entre los grupos. En el presente estudio, el PRP no mejoró la cicatrización de las heridas alveolares, y las ratas tratadas con PRP mostraron bajas tasas de deposición ósea durante las fases intermedias de la reparación de los receptáculos alveolares.
Asunto(s)
Animales , Masculino , Ratas , Plasma Rico en Plaquetas/fisiología , Alveolo Dental/patología , Cicatrización de Heridas/fisiología , Ratas WistarRESUMEN
OBJECTIVES: Previous reports have revealed that several cytokines (including platelet-derived growth factor-BB, transforming growth factors-β1 and insulin-like growth factor-1) can enhance the rate of bone formation and synthesis of extracellular matrix in orthopaedics or periodontology. This study aimed to determine the concentration of cytokines within platelet-rich fibrin microstructures and investigate whether there are differences in the different portions of platelet-rich fibrin, which has implications for proper clinical use of platelet-rich fibrin gel. METHODS: Whole blood was obtained from six New Zealand rabbits (male, 7 to 39 weeks old, weight 2.7-4 kg); it was then centrifuged for preparation of platelet-rich fibrin gels and harvest of plasma. The resultant platelet-rich fibrin gels were used for cytokine determination, histological analyses and scanning electron microscopy. All plasmas obtained were subject to the same cytokine determination assays for the purpose of comparison. RESULTS: Cytokines platelet-derived growth factor-BB and transforming growth factor-β1 formed concentration gradients from high at the red blood cell end of the platelet-rich fibrin gel (p=1.88×10-5) to low at the plasma end (p=0.19). Insulin-like growth factor-1 concentrations were similar at the red blood cell and plasma ends. The porosities of the platelet-rich fibrin samples taken in sequence from the red blood cell end to the plasma end were 6.5% ± 4.9%, 24.8% ± 7.5%, 30.3% ± 8.5%, 41.4% ± 12.3%, and 40.3% ± 11.7%, respectively, showing a gradual decrease in the compactness of the platelet-rich fibrin network. CONCLUSION: Cytokine concentrations are positively associated with platelet-rich fibrin microstructure and portion in a rabbit model. As platelet-rich fibrin is the main entity currently used in regenerative medicine, assessing cytokine concentration and the most valuable portion of PRF gels is essential and recommended to all physicians.
Asunto(s)
Animales , Masculino , Conejos , Plaquetas/fisiología , Citocinas/fisiología , Plasma Rico en Plaquetas/fisiología , Línea Celular , Centrifugación , Modelos Animales de Enfermedad , Geles/química , Plasma Rico en Plaquetas/químicaRESUMEN
O gel de plasma rico em plaquetas (PRP) é uma concentração autóloga de plaquetas em um pequeno volume de plasma com potencial de melhorar a integração dos enxertos. Foram utilizados oito equinos adultos, realizando-se enxertos de pele com largura de 2,5 x 2,5 centímetros em cada lado do pescoço, sendo um lado o tratamento, com o uso do gel de PRP e do outro lado o controle. Os animais foram avaliados nos dias 0, 7, 14, 21 e 28 após a cirurgia por meio de avaliação clínica, histológica, morfométrica e cultura bacteriana dos enxertos. As avaliações clínicas, morfométricas e bacteriológicas dos tecidos enxertados não revelaram diferenças significativas entre o grupo controle e o grupo tratamento com PRP. A avaliação histológica revelou um aumento da inflamação aguda no momento 7 e de concentração de colágeno no momento 14 no grupo tratamento, decorrente da liberação de fatores de crescimento pelas plaquetas presentes no gel, que não diferiu nos demais momentos. De acordo com as condições experimentais utilizadas neste estudo, pode-se concluir que não houve diferenças significativas entre o lado tratado com PRP e o lado controle em enxertos cutâneos em equinos.
The platelet-rich plasma (PRP) gel is an autologous platelet concentration in a small plasma volume with the potential to improve the integration of the grafts. Eight adult equines were used, performing skin grafts, with 2.5x2.5 centimeters, on both sides of the neck, in which one was the treatment side, using the PRP gel, and the other side was the control. The animals were assessed after the surgery on days 0, 7, 14, 21, and 28, by clinical, histological, morphometric, and culture analysis of the grafts. The clinical, morphological, and biological analysis of tissue grafts revealed no significant differences between the control group and the treatment group with PRP. Histologic evaluation revealed an increase in acute inflammation on day 7 and collagen concentration on day 14, resulting from the release of growth factors by the platelets present in the gel, which did not differ in further moments. According to the experimental conditions used in this study, we concluded there were no significant differences between the side treated with PRP and the control side in skin grafts in horses.
Asunto(s)
Animales , Caballos/cirugía , Cicatrización de Heridas/fisiología , Plasma Rico en Plaquetas/fisiología , Trasplante de Piel/veterinariaRESUMEN
O gel de plasma rico em plaquetas (PRP) é uma concentração autóloga de plaquetas em um pequeno volume de plasma com potencial de melhorar a integração dos enxertos. Foram utilizados oito equinos adultos, realizando-se enxertos de pele com largura de 2,5 x 2,5 centímetros em cada lado do pescoço, sendo um lado o tratamento, com o uso do gel de PRP e do outro lado o controle. Os animais foram avaliados nos dias 0, 7, 14, 21 e 28 após a cirurgia por meio de avaliação clínica, histológica, morfométrica e cultura bacteriana dos enxertos. As avaliações clínicas, morfométricas e bacteriológicas dos tecidos enxertados não revelaram diferenças significativas entre o grupo controle e o grupo tratamento com PRP. A avaliação histológica revelou um aumento da inflamação aguda no momento 7 e de concentração de colágeno no momento 14 no grupo tratamento, decorrente da liberação de fatores de crescimento pelas plaquetas presentes no gel, que não diferiu nos demais momentos. De acordo com as condições experimentais utilizadas neste estudo, pode-se concluir que não houve diferenças significativas entre o lado tratado com PRP e o lado controle em enxertos cutâneos em equinos.(AU)
The platelet-rich plasma (PRP) gel is an autologous platelet concentration in a small plasma volume with the potential to improve the integration of the grafts. Eight adult equines were used, performing skin grafts, with 2.5x2.5 centimeters, on both sides of the neck, in which one was the treatment side, using the PRP gel, and the other side was the control. The animals were assessed after the surgery on days 0, 7, 14, 21, and 28, by clinical, histological, morphometric, and culture analysis of the grafts. The clinical, morphological, and biological analysis of tissue grafts revealed no significant differences between the control group and the treatment group with PRP. Histologic evaluation revealed an increase in acute inflammation on day 7 and collagen concentration on day 14, resulting from the release of growth factors by the platelets present in the gel, which did not differ in further moments. According to the experimental conditions used in this study, we concluded there were no significant differences between the side treated with PRP and the control side in skin grafts in horses.(AU)
Asunto(s)
Animales , Caballos/cirugía , Plasma Rico en Plaquetas/fisiología , Trasplante de Piel/veterinaria , Cicatrización de Heridas/fisiologíaRESUMEN
Treatment of muscle injuries usually results in the interruption of sports practice; thus, studies aimed at accelerating the return to activity, with proper tissue repair, are important. Therefore, this study aimed to evaluate the effects of photobiomodulation (PBM), associated or not with platelet-rich plasma (PRP), on the treatment of muscle injury. Thirty-five animals were used and divided into five groups (n = 7): control (C), control lesion (CL), lesion treated with low-level laser therapy (LLLT) (LLt), lesion treated with PRP (LP), and lesion treated with both techniques, LLLT and PRP (LLtP). Muscle injury was induced by stretching the gastrocnemius muscle, and the animals in the LLtP and LP groups received the application of PRP immediately following the injury. The LLLT was applied daily for 7 days. The animals were euthanized 7 days after the injury. Analysis of the NADH/NAD ratio and collagen was performed by Raman spectroscopy; in addition to which, histological analysis of the gastrocnemius muscle was performed. The LLtP group demonstrated a reduction in the area of injury, regenerating cells and a healthy appearance of muscle fibers. The Raman analyses showed a reduction in the NADH/NAD ratio in the CL group, demonstrating oxidative stress, and the collagen presented a reduction in the CL and LLt groups, when compared with the C group. It is concluded that either PBM or PRP, and the association of both, was able to reduce the oxidative stress promoted by injury and modulate collagen production at the site of the injury. Furthermore, although both treatments individually were effective for repairing the damage caused by muscle injury, the association of both demonstrated a better histological aspect.