Platelet-rich plasma injections for chronic plantar fasciopathy: a systematic review
F. Franceschi, R. Papalia, E. Franceschetti, M. Paciotti, N. Maffulli …
in British Medical Bulletin
British Medical Bulletin, Volume 112, Issue 1, 1 December 2014, Pages 83–95, https://doi.org/10.1093/bmb/ldu025
Published: 19 September 2014
… 2 Aksahin E Dogruyol D Yuksel HY The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis Arch Orthop Trauma Surg 2012 132 781 5 3 Barrett SJ O’Malley R Plantar fasciitis and other causes of heel…
Introduction
There is an increasing interest in platelet-rich plasma (PRP) injection as a treatment for chronic plantar fasciopathy (PF). We wished to evaluate the evidence for the use of PRP in PF/fasciitis.
Sources of data
We performed a systematic review on the effects of PRP in PF. In June 2014, we searched Medline, Cochrane, CINAHL and Embase databases using various combinations of the commercial names of each PRP preparation and ‘plantar’ (with its associated terms). We only included prospectively designed studies in humans.
Areas of agreement
Eight articles met the inclusion criteria, three of them were randomized. All studies yielded a significantly greater improvement in symptoms between baseline and last follow-up assessment. None of the papers recorded major complications.
Areas of controversy
Only three randomized studies were identified; none of them had a true controlled group treated with placebo and one of the three studies had a very short (6 week) follow-up. A non-randomized study evaluating PRP versus corticosteroids (CCS) injections, and a randomized controlled trial comparing PRP and dextrose prolotherapy reported no statistical significant differences at 6 months. Most studies did not have a control group and imaging evaluation.
Growing points and areas for research
Evidence for the use of PRP in PF shows promising results, and this therapy appears safe. However, the number of studies available is limited and randomized placebo-controlled studies are required. Characterizing the details of the intervention and standardizing the outcome scores would help to better document the responses and optimize the treatment.
Journal Article
Inefficacy of ultrasound-guided local injections of autologous conditioned plasma for recent epicondylitis: results of a double-blind placebo-controlled randomized clinical trial with one-year follow-up
Bernard Montalvan, Patrick Le Goux, Shahnaz Klouche, Delphine Borgel, Philippe Hardy …
in Rheumatology
Rheumatology, Volume 55, Issue 2, 1 February 2016, Pages 279–285, https://doi.org/10.1093/rheumatology/kev326
Published: 08 September 2015
…. The aim was to assess the efficacy of two intra-tendinous injections of platelet-rich plasma (PRP) on epicondylitis of recent evolution (≤3 months). Methods. Our study was a double-blind placebo-controlled randomized trial. Two US-guided injections of either PRP (autologous conditioned plasma…
Abstract
Objectives. The aim was to assess the efficacy of two intra-tendinous injections of platelet-rich plasma (PRP) on epicondylitis of recent evolution (≤3 months).
Methods. Our study was a double-blind placebo-controlled randomized trial. Two US-guided injections of either PRP (autologous conditioned plasma) or saline solution were performed with an interval of 4 weeks. The exclusion criterion was previous CS infiltration. Patients were monitored by an independent evaluator blinded to treatment at baseline and 1, 3, 6 and 12 months of follow-up. The primary evaluation criterion was the relative improvement from baseline to 6 months in pain score on visual analog scale (0–10). Secondary criteria were the Roles–Maudsley score and the assessment of pain on isometric contraction of extensor carpi radialis brevis and extensor digitorum communis.
Results. Twenty-five patients were randomly assigned to each group. Three patients in each arm dropped out before 6 months. In both groups, the pain score [mean (s.d.)] decreased significantly between two consecutive visits from 6.8 (0.8) (PRP) and 7 (1) (saline) at baseline to 2.5 (1.6) and 1.6 (1.5) (PRP) and to 2.1 (1.6) and 1.8 (2.1) (saline) at 6 and 12 months, respectively. At 6 months, no statistically significant difference was found between groups for relative improvement in pain score [autologous conditioned plasma: −63.2 (22.4%); saline: −69.7 (25.1%); P = 0.24]. No significant difference was found for the secondary criteria.
Conclusion. Two US-guided PRP injections for epicondylitis of recent evolution were not more efficacious than saline injections, until 6- and 12-months follow-up.
Trial Registration: ClinicalTrials.gov; https://clinicaltrials.gov/; NCT02378285.
Journal Article
Gender and Age Differences in Growth Factor Concentrations From Platelet-Rich Plasma in Adults
J. Richard Evanson, MC USA, M. Kelly Guyton, MS USA, David L. Oliver, MC USA, Justin M. Hire, MD, Richard L. Topolski, PhD …
in Military Medicine
Military Medicine, Volume 179, Issue 7, 1 July 2014, Pages 799–805, https://doi.org/10.7205/MILMED-D-13-00336
Published: 01 July 2014
… of platelet-rich plasma (PRP) to facilitate healing of orthopedic-related injuries has gained popularity; however, the clinical benefits are not consistent. Differences may result from variations in growth factor (GF) levels in normal populations. The purpose of this study was to determine if GF levels…
Abstract
The use of platelet-rich plasma (PRP) to facilitate healing of orthopedic-related injuries has gained popularity; however, the clinical benefits are not consistent. Differences may result from variations in growth factor (GF) levels in normal populations. The purpose of this study was to determine if GF levels present in activated PRP preparations differed by gender and age (≤25 versus >25 years) in a healthy population (N = 102). All GFs analyzed (epidermal growth factor [EGF], hepatocyte growth factor [HGF], insulin growth factor-1 [IGF-1], platelet-derived growth factor-AB [PDGF-AB], platelet-derived growth factor-BB [PDGF-BB], transforming growth factor beta-1 [TGFβ-1], and vascular endothelial growth factor) had higher levels for females and for those ≤25 years old. Of the GFs tested, four of seven were significantly higher (p < 0.05) for females (EGF, HGF, IGF-1, PDGF-BB), the most significant being IGF-1 (female, 85.0; male, 69.3 ng/mL; p < 0.01). Five of seven GFs achieved significance (p < 0.05) for people ≤25 years old (EGF, IGF-1, PDGP-AB, PDGF-BB, and TGFβ-1), with IGF and PDGF-AB achieving p < 0.001 (≤25 years, 85.1; >25 years, 56.8, and ≤25 years, 7.66; >25 years, 5.77 ng/mL, respectively). Finally, for both genders, most of the GFs were positively correlated with all GFs. This study demonstrated that both age and gender account for variations in specific GFs present in PRP, and this may partially explain some of the inconsistent results of PRP clinical trials.
Platelet-rich plasma in the conservative treatment of painful tendinopathy: a systematic review and meta-analysis of controlled studies
I. Andia, P. M. Latorre, M. C. Gomez, N. Burgos-Alonso, M. Abate …
in British Medical Bulletin
British Medical Bulletin, Volume 110, Issue 1, 1 June 2014, Pages 99–115, https://doi.org/10.1093/bmb/ldu007
Published: 02 May 2014
… fibrin matrices: a potential source of biological mediators that modulate tendon cell activities J Biomed Mater Res A 2006 77 285 93 9 Andia I Sánchez M Maffulli N Tendon healing and platelet rich plasma therapies Expert Opin Biol Ther 2010 10 1415 26 10 Andia I…
Abstract
Background
Platelet-rich plasma (PRP) seeks to meet the multifaceted demand of degenerated tendons providing several molecules capable of boosting healing.
Areas timely for developing research
PRP is used for managing tendinopathy, but its efficacy is controversial.
Sources of data
Electronic databases were searched for clinical studies assessing PRP efficacy. Methodological quality was evaluated using the methods described in the Cochrane Handbook for systematic reviews.
Areas of agreement
Thirteen prospective controlled studies, comprising 886 patients and diverse tendons were included; 53.8% of studies used identical PRP protocol.
Areas of controversy
Sources of heterogeneity included different comparators, outcome scores, follow-up periods and diverse injection protocols, but not PRP formulation per se.
Growing points
Pooling pain outcomes over time and across different tendons showed that L-PRP injections ameliorated pain in the intermediate-long term compared with control interventions, weighted mean difference (95% CI): 3 months, −0.61 (−0.97, −0.25); 1 year, −1.56 (−2.27, −0.83). However, these findings cannot be applied to the management of individual patients given low power and precision.
Research
Further studies circumventing heterogeneity are needed to reach firm conclusions. Available evidence can help to overcome hurdles to future clinical research and bring forward PRP therapies.
Considerations on the Use of Platelet-Rich Plasma, Specifically for Burn Treatment
Rose E. Marck, MD, Esther Middelkoop, PhD, Roelf S. Breederveld, MD, PhD
in Journal of Burn Care & Research
Journal of Burn Care & Research, Volume 35, Issue 3, 1 May 2014, Pages 219–227, https://doi.org/10.1097/BCR.0b013e31829b334e
Published: 01 May 2014
…Rose E. Marck, MD; Esther Middelkoop, PhD; Roelf S. Breederveld, MD, PhD ** Address correspondence to Rose E. Marck, MD, Burn Center, Red Cross Hospital, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands. Copyright © 2013 by the American Burn Association 2013 Abstract Platelet-rich plasma (PRP…
Abstract
Journal Article
Comparative effectiveness of autologous blood-derived products, shock-wave therapy and corticosteroids for treatment of plantar fasciitis: a network meta-analysis
Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Kuo-Liong Chien, Yu-Kang Tu …
in Rheumatology
Rheumatology, Volume 54, Issue 9, 1 September 2015, Pages 1735–1743, https://doi.org/10.1093/rheumatology/kev010
Published: 06 April 2015
… controlled trials and three quasi-experimental studies that included 604 patients were enrolled. Pair-wise meta-analysis indicated a trend favouring ABPs over CSs regarding VAS reduction at 3 months; this benefit was significant in a subgroup analysis of platelet-rich plasma (PRP) vs CSs. There were…
Abstract
Objective. To compare the efficacy of autologous blood-derived products (ABPs), CSs and shock-wave (SW) therapy in the treatment of plantar fasciitis.
Methods. Electronic databases were searched for studies that compared ABPs, CSs and SW therapy for the treatment of plantar fasciitis, published up to June 2014. The primary and secondary outcomes were reduction in visual analogue scale (VAS) score at 3 and 6 months and odds ratio of treatment success, respectively. Groups were compared by traditional pair-wise meta-analysis and by network meta-analysis.
Results. Seven randomized controlled trials and three quasi-experimental studies that included 604 patients were enrolled. Pair-wise meta-analysis indicated a trend favouring ABPs over CSs regarding VAS reduction at 3 months; this benefit was significant in a subgroup analysis of platelet-rich plasma (PRP) vs CSs. There were no significant between-group differences in VAS reduction at 6 months and in treatment success. Network meta-analysis showed that ABPs had the highest probability of being the best treatment at 3 months, but ABPs were slightly inferior to SW for VAS reduction at 6 months. Although SW therapy had the highest likelihood of treatment success, the between-group differences in probabilities were less remarkable than those for pain reduction at 3 and 6 months.
Conclusion. ABPs, followed by CSs, were best in providing relief from pain at 3 months. SW therapy and ABPs had similar probabilities of providing pain relief at 6 months, and were better than CSs at that time. Subgroup analysis indicated that an ABP regimen consisting of platelet-rich plasma improves treatment efficacy.
Journal Article
Platelet micro-RNA expression in type 2 diabetes mellitus
C. Stratz, T.G. Nuehrenberg, B. Fiebich, M. Amann, H. Binder …
in European Heart Journal
European Heart Journal, Volume 34, Issue suppl_1, 1 August 2013, P3251, https://doi.org/10.1093/eurheartj/eht309.P3251
Published: 01 August 2013
… of platelets in patients with diabetes mellitus. Methods: Platelet miRNA profiles were assessed in clinically stable diabetic and nondiabetic patients (each n=30). Platelet miRNA was isolated from leucocyte-depleted platelet-rich plasma, and miRNA profiling was performed using LNA micro-array technology…
Abstract
Background: Diabetes mellitus as a major contributor to cardiovascular disease burden induces dysfunctional platelets. Platelets contain abundant miRNAs, which recently have been linked to inflammatory responses and, thus, may play a role in the development of atherosclerosis. While plasma miRNAs are affected by diabetes mellitus, no data exist on platelet miRNA profiles in this disease. Therefore, this study sought to explore the miRNA profile of platelets in patients with diabetes mellitus.
Methods: Platelet miRNA profiles were assessed in clinically stable diabetic and nondiabetic patients (each n=30). Platelet miRNA was isolated from leucocyte-depleted platelet-rich plasma, and miRNA profiling was performed using LNA micro-array technology (miRBase 18.0, containing 1,917 human miRNAs). Effects of diabetes mellitus were explored by univariate statistical tests for each miRNA, adjusted for potential confounders, and by developing a multivariable signature, which was evaluated by resampling techniques.
Results: Platelets in non-diabetic patients demonstrated miRNA expression profiles comparable to previously published data. The miRNA expression profiles of platelets in diabetics were similar. Statistical analysis unveiled only three miRNAs (miR-377-5p, miR-628-3p, miR-3137) with high reselection probabilities in resampling techniques, corresponding to signatures with only modest discriminatory performance. Functional annotation of predicted targets for these miRNAs pointed towards an influence of diabetes mellitus on mRNA processing.
Conclusions: We did not find any major differences in platelet miRNA profiles between diabetics and non-diabetics. Minor differences pertained to miRNAs associated with mRNA processing. Thus, previously described differences in plasma miRNAs between diabetic and nondiabetic patients cannot be explained by plain changes in the platelet miRNA profile.
Journal Article
Differential effects of P2Y1 versus P2Y12 receptor antagonism on thrombosis and bleeding in rabbits
P. Wong, E. Crain, C. Watson, W. Yang, R. Wexler …
in European Heart Journal
European Heart Journal, Volume 34, Issue suppl_1, 1 August 2013, P1431, https://doi.org/10.1093/eurheartj/eht308.P1431
Published: 01 August 2013
…. Bleeding time (BT) was measured for up to 20 min following cuticle incision. Ex vivo inhibition of peak platelet aggregation to ADP, arachidonic acid and collagen were determined in citrated platelet-rich plasma by optical aggregometry. BMS-884775 was infused i.v. starting 30 min before and maintained…
Abstract
Journal Article
Platelet rich plasma improves the healing process after airway anastomosis,
Abel Gómez-Caro, Pilar Ausin, Marc Boada
in Interactive CardioVascular and Thoracic Surgery
Interactive CardioVascular and Thoracic Surgery, Volume 13, Issue 6, 1 December 2011, Pages 552–556, https://doi.org/10.1510/icvts.2011.273995
Published: 01 December 2011
…). 6 4 2011 4 7 2011 12 7 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved. 2011 Abstract This study investigated whether platelet-rich plasma (PRP) promotes healing and reduces anastomotic complications following airway surgery in a pig model. PRP…
Abstract
This study investigated whether platelet-rich plasma (PRP) promotes healing and reduces anastomotic complications following airway surgery in a pig model. PRP was obtained by spinning down the animal’s own blood (60 ml) and collecting the buffy coat containing platelets and white blood cells. Fifteen adult pigs were randomized into three groups: (1) sham treatment (cervicotomy), (2) non-PRP group (50% tracheal resection and end-to-end anastomosis), and (3) PRP group (50% tracheal resection, end-to-end anastomosis and PRP application). Blood samples were taken at baseline and at one, six and 24 . Animals were monitored for anastomotic complications, infection and local reactivity. Laser Doppler flowmetry was performed intraoperatively and at 30 days to assess differences in pre- and post-anastomotic blood flow. The tensile strength of the anastomosis was also tested. The platelet level was higher in PRP fluid than in the baseline blood sample (P<0.002). Vascular endothelial growth factor, transforming growth factor β-1 and epidermal growth factor immunoassay readings peaked at one and six hours in the animals that had received PRP (P<0.03); these also showed significantly increased transanastomotic flow and stress–strain resistance (P<0.04) at 30 days than the animals that had not received PRP. PRP therefore, accelerates the onset of healing in airway surgery by promoting an earlier release of platelet-derived growth factors that stimulate transanastomotic angiogenesis. Journal Article
Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip
Mikel Sánchez, Jorge Guadilla, Nicolás Fiz, Isabel Andia in Rheumatology Rheumatology, Volume 51, Issue 1, 1 January 2012, Pages 144–150, https://doi.org/10.1093/rheumatology/ker303 Published: 09 November 2011 … by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2011 Abstract Objective. To assess the safety and symptomatic changes of IA injections of platelet-rich plasma (PRP) in patients with OA of the hip. Methods. Forty… Abstract Objective. To assess the safety and symptomatic changes of IA injections of platelet-rich plasma (PRP) in patients with OA of the hip. Methods. Forty patients affected by monolateral severe hip OA were included in the study. Each joint received three IA injections of PRP, which were administered once a week. The primary end point was meaningful pain relief, which was described as a reduction in pain intensity of at least 30% from baseline levels as evaluated by the WOMAC subscale at 6-months post-treatment. The visual analogue scale (VAS) and Harris hip score subscale for pain were used to verify the results. Secondary end points included changes in the level of disability of at least 30% and the percentage of positive responders, i.e. the number of patients that achieved a >30% reduction in pain and disability.
Results. Statistically significant reductions in VAS, WOMAC and Harris hip subscores for pain and function were reported at 7 weeks and 6 months (P < 0.05). Twenty-three (57.5%) patients reported a clinically relevant reduction of pain (45%, range 30–71%) as assessed by the WOMAC subscale. Sixteen (40%) of these patients were classified as excellent responders who showed an early pain reduction at 6–7 weeks, which was sustained at 6 months, and a parallel reduction of disability. Side effects were negligible and were limited to a sensation of heaviness in the injection site.
Conclusions. This preliminary non-controlled prospective study supported the safety, tolerability and efficacy of PRP injections for pain relief and improved function in a limited number of patients with OA of the hip.
Journal Article
Manufacture of Pooled Platelets in Additive Solution and Storage in an ELX Container After an Overnight Warm Temperature Hold of Platelet-Rich Plasma
Hiba Alhumaidan, MD, Tracey Cheves, MT, Stein Holme, PhD, Joseph D. Sweeney, MD, FACP, FRCPath
in American Journal of Clinical Pathology
American Journal of Clinical Pathology, Volume 136, Issue 4, 1 October 2011, Pages 638–645, https://doi.org/10.1309/AJCPFD87THDWCSVA
Published: 10 January 2011
… The processing of whole blood–derived platelet-rich plasma (PRP) to a platelet concentrate and platelet-poor plasma is currently performed within 8 hours to comply with the requirements to manufacture fresh frozen plasma. Maintaining PRP at room temperature for a longer period can have the advantage of shifting…
Abstract
The processing of whole blood–derived platelet-rich plasma (PRP) to a platelet concentrate and platelet-poor plasma is currently performed within 8 hours to comply with the requirements to manufacture fresh frozen plasma. Maintaining PRP at room temperature for a longer period can have the advantage of shifting the completion of component manufacture onto day shifts. Pairs of ABO-identical prepooled platelets were manufactured by the PRP method, using the current approach with platelet storage in a CLX HP container (Pall Medical, Covina, CA) and plasma, or a novel approach with an 18- to a 24-hour room temperature hold of the PRP and the manufacture of pooled platelets in a glucose-containing additive solution (AS) and storage in a new ELX container (Pall Medical). Standard in vitro assays were performed on days 2, 5, and 7. The results showed that the AS platelets in ELX have in vitro characteristics that are equivalent or superior to those of the standard product.
Journal Article
Randomized prospective trial of saphenous vein harvest site infection after wound closure with and without topical application of autologous platelet-rich plasma
Sven M. Almdahl, Terje Veel, Per Halvorsen, Mona Bekken Vold, Per Mølstad
in European Journal of Cardio-Thoracic Surgery
European Journal of Cardio-Thoracic Surgery, Volume 39, Issue 1, 1 January 2011, Pages 44–48, https://doi.org/10.1016/j.ejcts.2010.06.007
Published: 01 January 2011
… © 2010 European Association for Cardio-Thoracic Surgery 2010 Abstract Objective: Wound infection is still a common problem after open long saphenous vein harvesting. Platelets are important for the healing process. The hypothesis was that spraying of the wounds with platelet-rich plasma might reduce…
Abstract
Objective: Wound infection is still a common problem after open long saphenous vein harvesting. Platelets are important for the healing process. The hypothesis was that spraying of the wounds with platelet-rich plasma might reduce the frequency of harvest site infections. Methods: From January to October 2008, 140 patients undergoing first-time coronary artery bypass grafting were randomized into two groups of 70 patients. Both groups had standard surgical leg wound closure and care except topical application of platelet-rich plasma as adjunctive treatment in the active treatment group. End points were wound infection and cosmetic result at 6 weeks. Results: The follow-up was 100% complete. Nine patients (13%) in the treatment group and eight (11%) in the control group experienced harvest site infection (p = 0.80). The overall cosmetic result was also similar between the groups (p = 0.34), but the top score was borderline and more frequent in the treatment group (p = 0.050). Conclusion: Topical application of autologous platelet-rich plasma on vein harvest wounds did not reduce the rate of surgical site infection.
Journal Article
Autologous platelet-rich plasma: effect on sternal healing in the sheep model
Ignacio Gallo, Alberto Sáenz, Edurne Artiñano, Javier Esquide
in Interactive CardioVascular and Thoracic Surgery
Interactive CardioVascular and Thoracic Surgery, Volume 11, Issue 3, 1 September 2010, Pages 223–225, https://doi.org/10.1510/icvts.2010.237776
Published: 01 September 2010
… Abstract Postcardiotomy sternal wound complications remain challenging. We looked at the effects of plasma rich in growth factors (PRGF) as an agent on sternal bone healing. In 24 female sheep, a median sternotomy was surgically created. In 12 of them (group control) the sternum was closed with three…
Abstract
Postcardiotomy sternal wound complications remain challenging. We looked at the effects of plasma rich in growth factors (PRGF) as an agent on sternal bone healing. In 24 female sheep, a median sternotomy was surgically created. In 12 of them (group control) the sternum was closed with three figure-of-eight wires. In 12 (group PRGF) three clots of autologous PRGF were applied over the sternum after its closure in the same manner as the control group. All sheep were killed at the nine-week follow-up. The sternum and the surrounding soft tissue was removed and fixed in formaldehyde. Transversal sections of the bone were obtained, decalcified and stained with hematoxylin and eosin. In the control group, we found extensive cartilaginous areas. In the PRGF group, the presence of trabecular bone tissue was common, with formation of hematopoietic medullary tissue. The process of new bone formation was accelerated in the PRGF group at the nine-week follow-up. In contrast, in the control group, the presence of cartilaginous tissue was the most common finding.
Journal Article
L -amino acid oxidase from Naja atra venom activates and binds to human platelets
Rui Li, Shaowen Zhu, Jianbo Wu, Wanyu Wang, Qiumin Lu …
in Acta Biochimica et Biophysica Sinica
Acta Biochimica et Biophysica Sinica, Volume 40, Issue 1, 1 January 2008, Pages 19–26, https://doi.org/10.1111/j.1745-7270.2008.00372.x
Published: 01 January 2008
…-LAAO, was purified from the venom of Naja atra. Its N-terminal sequence shows great similarity with LAAOs from other snake venoms. NA-LAAO dose-dependently induced aggregation of washed human platelets. However, it had no activity on platelets in platelet-rich plasma. A low concentration of NA-LAAO…
Abstract
Journal Article
Platelet Aggregation Testing in Platelet-Rich Plasma: Description of Procedures With the Aim to Develop Standards in the Field
Lan Zhou, MD, Alvin H. Schmaier, MD
in American Journal of Clinical Pathology
American Journal of Clinical Pathology, Volume 123, Issue 2, 1 February 2005, Pages 172–183, https://doi.org/10.1309/Y9EC63RW3XG1V313
Published: 02 January 2005
… of these studies. The present report describes one laboratory’s methods and interpretations of platelet aggregation and secretion studies of platelet-rich plasma using each of the common platelet agonists. Diagnostic categories for the evaluation of the platelet function testing are presented. The diagnostic…
Abstract
Platelet function testing consisting of platelet aggregation and secretion often is requested in the clinical evaluation of patients with bleeding problems. At present, there are no uniform clinical laboratory standards for the performance or interpretation of these studies. The present report describes one laboratory’s methods and interpretations of platelet aggregation and secretion studies of platelet-rich plasma using each of the common platelet agonists. Diagnostic categories for the evaluation of the platelet function testing are presented. The diagnostic categories then are applied to the evaluation of 61 patients referred to our medical center for these studies. The aims of this report are to present clinical platelet aggregation and secretion studies and to provide a working schema to evaluate these results. Our intent is to stimulate interest in the development of professional guidelines for platelet function testing in the clinical laboratory.
Journal Article
ICVTS on-line discussion A1 Reply to Kan
Bansi Koul, Faleh Al-Rashidi, Misha Bhat, Leif Pierre
in Interactive CardioVascular and Thoracic Surgery
Interactive CardioVascular and Thoracic Surgery, Volume 6, Issue 5, 1 October 2007, Pages 622, https://doi.org/10.1510/icvts.2007.155523A1
Published: 01 October 2007
…Bansi Koul; Faleh Al-Rashidi; Misha Bhat; Leif Pierre Published by European Association for Cardio-Thoracic Surgery. All rights reserved. 2007 eResponse : Our study [1] has shown that acute intraoperative plateletpheresis (APP), harvesting platelet-rich plasma equivalent to 25% of the estimated…
Extract
Journal Article
Autologous Platelet Concentrate for the Production of Platelet Gel
Carol A. Jameson, CP, MT(ASCP)SBB
in Laboratory Medicine
Laboratory Medicine, Volume 38, Issue 1, 1 January 2007, Pages 39–42, https://doi.org/10.1309/3UA5HWYVKNCE01AR
Published: 01 January 2007
…× the baseline level accelerates the healing process. When platelet rich plasma is mixed with an activator, a platelet gel will form. Clinical applications of platelet gel are numerous. Some benefits include a marked decrease in post-surgical swelling and bruising, reduction in surgical site pain, elimination…
Abstract
Platelets are attracted to a wound or injury site stimulating the clotting and healing cascades. Degranulated platelets release numerous substances including proteins known as growth factors. Growth factors signal undifferentiated stem cells to the site, promote cell mitosis, and stimulate osteogenesis and angiogenesis. Cytokines, which attract neutrophils, are also released from platelet granules. Concentrating platelets 4× to 5× the baseline level accelerates the healing process. When platelet rich plasma is mixed with an activator, a platelet gel will form. Clinical applications of platelet gel are numerous. Some benefits include a marked decrease in post-surgical swelling and bruising, reduction in surgical site pain, elimination of drains, and acceleration of bone growth and soft tissue healing. Scientific publications support that autologous biomaterial accelerates the healing process.
Journal Article
Effect of lipoprotein (a) on platelet activation induced by platelet-activating factor: role of apolipoprotein (a) and endogenous PAF-acetylhydrolase
Loukas D Tsironis, John V Mitsios, Haralampos J Milionis, Moses Elisaf, Alexandros D Tselepis
in Cardiovascular Research
Cardiovascular Research, Volume 63, Issue 1, 1 July 2004, Pages 130–138, https://doi.org/10.1016/j.cardiores.2004.03.005
Published: 01 July 2004
…. Reduced Lp(a) [Lp(a-)] was prepared by incubation of Lp(a) with dithiothreitol (DTT), whereas inactivation of Lp(a)-associated PAF-AH was performed by incubation of Lp(a) with pefabloc [pefa-Lp(a)]. Platelet-rich plasma (PRP) or washed platelets were prepared from peripheral venous blood samples…
Abstract
Objective: Lipoprotein (a) [Lp(a)] is considered an atherogenic lipoprotein, which is also implicated in thrombosis. Lp(a) binds to platelets and modulates the effects of various platelet agonists. Platelet activating factor (PAF) is a potent platelet agonist degraded and inactivated by PAF-acetylhydrolase (PAF-AH), which in plasma is associated with lipoproteins. Lp(a) is enriched in PAF-AH, thus a functional characteristic of this lipoprotein is its capability to hydrolyze and inactivate PAF. In the present study, we investigated the effect of Lp(a) on PAF-induced platelet activation. The potential roles of the apo(a) moiety and especially of the PAF-AH content of Lp(a) on the above effect were also addressed. Methods: Lp(a) was isolated by affinity chromatography from plasma of apparently healthy fasting donors with serum Lp(a) concentrations ≥20 mg/dl. Reduced Lp(a) [Lp(a-)] was prepared by incubation of Lp(a) with dithiothreitol (DTT), whereas inactivation of Lp(a)-associated PAF-AH was performed by incubation of Lp(a) with pefabloc [pefa-Lp(a)]. Platelet-rich plasma (PRP) or washed platelets were prepared from peripheral venous blood samples of normolipidemic, apparently healthy fasting donors with their serum Lp(a) levels lower than 0.8 mg/dl. The surface expression of the platelet integrin-receptor αIIbβ3 and the fibrinogen binding to the activated αIIbβ3 was studied by flow cytometry. Results: Lp(a), at doses higher than 20 μg/ml, inhibits PAF-induced platelet activation in a dose-dependent manner. Pefa-Lp(a), lacking PAF-AH activity, exhibited a similar to Lp(a) inhibitory effect. Importantly, the Lp(a) inhibitory effect was not influenced by the apo(a) isoform size, whereas Lp(a-) was a more potent inhibitor compared to Lp(a). Similarly to PAF, Lp(a) inhibits platelet aggregation induced by ADP or Calcium ionophore A23187. Lp(a), pefa-Lp(a) or Lp(a-) effectively inhibited PAF- or ADP-induced surface expression of αIIbβ3, the Lp(a-) being more potent compared to Lp(a) or to pefa-Lp(a). Finally, Lp(a) significantly inhibited fibrinogen binding to platelets activated with PAF. Conclusions: Lp(a) inhibits PAF-induced platelet activation in a non-specific manner. The Lp(a)-associated PAF-AH does not play any important role in this effect, whereas the apo(a) moiety of Lp(a) significantly reduces its inhibitory effect. The inhibition of αIIbβ3 activation and fibrinogen binding to the activated platelets may represent the major mechanism by which Lp(a) inhibits PAF-induced platelet aggregation.
Journal Article
Platelet Serotonin Levels in Hyperactive Children
Janice O. Goldman, Roger J. Thibert, Byron P. Rourke
in Journal of Pediatric Psychology
Journal of Pediatric Psychology, Volume 4, Issue 3, 1 September 1979, Pages 285–296, https://doi.org/10.1093/jpepsy/4.3.285
Published: 01 September 1979
…) and in platelet-rich plasma. Platelets were isolated as a pellet and analyzed for protein and 5-HT concentrations. Free and total plasma tryptophan concentrations were also determined. Statistical analyses of the data indicated that Croup 2 children had significantly higher levels of5-HT. In all groups, WBPC…
Abstract
A group of reportedly hyperactive children, who were outpatients in a treatment center for children with behavioral disorders, were divided into three subgroups on the basis of clinical symptoms: I, hyperactive; 2, borderline hyperactive; and 3, nonhyperactive. Blood samples were drawn from the children when they had been drug-free for 48 hours and fasting overnight. Percent eosinophils [EOS] from a routine differential were reported. Platelets were counted in the whole blood specimens (WBPC) and in platelet-rich plasma. Platelets were isolated as a pellet and analyzed for protein and 5-HT concentrations. Free and total plasma tryptophan concentrations were also determined. Statistical analyses of the data indicated that Croup 2 children had significantly higher levels of5-HT. In all groups, WBPC was inversely related to 5-HT. In Groups I and 3, there was a statistically significant inverse correlation between age and WBPC; in Group 2, age was correlated inversely with 5-HT in whole blood. In Group 1 children, EOS correlated positively with WBPC and negatively with STBP; age correlated directly with STBP. These correlations in Group I support the possibility that some hyperactive children may have allergic responses which are related to maturation, changes in 5-HT metabolism, and symptoms of hyperactivity. The increased platelet 5-HT concentrations in Group 2, if extrapolated to the neuronal level, indicate the possibility of raised neuronal levels of 5-HT which may lead to increased activity in serontonergic pathways and, possibly, to decreased activity in other biogenie amine pathways through “false” neurotransmission by 5-HT. The increased 5-HT levels could also indicate defective release or binding of 5-HT, in which case activity in the serotonergic pathways would be decreased. Levels of TRY did not vary significantly among the three groups of children, nor did they relate in any meaningful way to 5-HT levels.
Journal Article
In a Patient One Year After an Intradiscal Platelet–Rich Plasma Injection
Gregory E. Lutz, MD
in Pain Medicine
Pain Medicine, Volume 18, Issue 6, 1 June 2017, Pages 1197–1199, https://doi.org/10.1093/pm/pnw299
Published: 22 February 2017
…Gregory E. Lutz, MD © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2017 Dear Editor, Rich in fibrin, platelets, and anabolic growth factors that play central roles in IVD homeostasis, platelet-rich plasma (PRP) has been…
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Journal Article
HPLC Determination of Serotonin and Its Metabolites From Human Platelet-Rich Plasma; Shift to 5-Hydroxytryptophol Formation Following Alcohol Consumption
Kornélia Tekes
in Journal of Chromatographic Science
Journal of Chromatographic Science, Volume 46, Issue 2, 1 February 2008, Pages 169–173, https://doi.org/10.1093/chromsci/46.2.169
Published: 01 February 2008
… human platelet-rich plasma (PRP) using N -methylserotonin as internal standard. Separation of serotonin (5HT), 5-hydroxytryptophan (5HTP), 5-hydroxytryptophol (5HTOL), and 5-hydroxyindole-acetic acid (5HIAA) is carried out on Supelcosil LC-18DB stationary phase. A mixture of 48mM citric acid, 28mM…
Abstract
A sensitive, simple, and reliable high-performance liquid chromatographic method with electrochemical detection is developed for the measurement of four natural products, the serotonin-related indols from human platelet-rich plasma (PRP) using N-methylserotonin as internal standard. Separation of serotonin (5HT), 5-hydroxytryptophan (5HTP), 5-hydroxytryptophol (5HTOL), and 5-hydroxyindole-acetic acid (5HIAA) is carried out on Supelcosil LC-18DB stationary phase. A mixture of 48mM citric acid, 28mM sodium phosphate dibasic, 0.027mM Na2EDTA, and 3% methanol (pH 3.18) serves as the mobile phase. Measurements are carried out at 25°C at Eox = 0.65 V. The calibration curves are linear through the range of 10-200 pg/mL. Method validation is performed according to internationally accepted criteria. Blood is collected from healthy controls and schizophrenic subjects. Significantly higher PRP serotonin is measured in schizophrenics; patients with recent alcohol consumption could be characterized with significantly elevated 5HTOL/5HIAA ratio.
Journal Article
A novel treatment of radiation induced xerostomia by autologous platelet-rich-plasma and peripheral stem cells
A. Taghizadeh Kermani, P. Izadpanahi, K. Khazaeni, M. Pezeshki Rad M, R. Asadi …
in Annals of Oncology
Annals of Oncology, Volume 27, Issue suppl_6, 1 October 2016, 1009P, https://doi.org/10.1093/annonc/mdw376.61
Published: 11 October 2016
…@oup.com. 2016 Background: There are 30000 to 40000 head and neck cancers cases in United States each year. Radiotherapy is one of the best treatment options in these patients. Unfortunately, Xerostomia is one of most common side effects. This study aimed to evaluate effect of autologous platelet rich…
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Background: There are 30000 to 40000 head and neck cancers cases in United States each year. Radiotherapy is one of the best treatment options in these patients. Unfortunately, Xerostomia is one of most common side effects. This study aimed to evaluate effect of autologous platelet rich plasma (PRP) and PRP along with peripheral blood cells (PC) application in treatment of radiation induced xerostomia for the first time in the world.
Methods: 21 patients with head and neck cancers who suffered from post radiation xerostomia were selected regard to inclusion criteria. Patients were divided into PRP or PRP + PC group randomly. They were followed up for 6 months. Data was analyzed by SPSS version 20 and parametric and nonparametric tests
Results: 21 patients with…
Journal Article
eComment. Platelet-rich plasma and cardiac tissue regeneration
Michael Spartalis, Eleni Tzatzaki, Antonios Athanasiou, Eleftherios Spartalis
in Interactive CardioVascular and Thoracic Surgery
Interactive CardioVascular and Thoracic Surgery, Volume 26, Issue 1, 1 January 2018, Pages 154, https://doi.org/10.1093/icvts/ivx321
Published: 19 December 2017
… (ECM) is the only promising new therapeutic approach to regenerate cardiac tissue [ 1 ]. However, is this the whole picture? We performed a thorough search of the literature which resulted in a significant number of recent studies demonstrating the emerging role of platelet-rich plasma (PRP…
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We read with great interest the article by Kislitsina et al [1] titled “Unlocking the secrets to regenerating cardiac tissue: an update”. The authors present an article that is focused on cardiac tissue regeneration, a research field which has attracted considerable interest over the past years. The authors conclude that extracellular matrix (ECM) is the only promising new therapeutic approach to regenerate cardiac tissue [1]. However, is this the whole picture?
…
We performed a thorough search of the literature which resulted in a significant number of recent studies demonstrating the emerging role of platelet-rich plasma (PRP) in repairing myocardial tissue [2–4].
…
PRP is a volume of fractionated plasma from the patient’s own blood that contains platelet concentrate. PRP is rich in…
