Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

International Journal of Molecular Sciences - Tập 21 Số 20 - Trang 7794
Peter A. Everts1, Kentaro Onishi2, Prathap Jayaram3, José Fábio Lana4, Kenneth Mautner5
1Gulf Coast Biologics, Research and Science Division, Fort Myers, FL 33916, USA
2Department of PM&R and Orthopedic Surgery, University of Pittsburg Medical Center, Pittsburgh, PA 15213, USA;
3Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA;
4The Bone and Cartilage Institute, Indaiatuba, Sao Paulo, Brazil;
5Emory Sports Medicine and Primary Care Sports Medicine, Emory University, Atlanta, GA 30329, USA;

Tóm tắt

Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

Từ khóa


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