The potential therapeutic effect of platelet-rich plasma in the treatment of post-COVID-19 parosmia

The Egyptian Journal of Otolaryngology - Tập 38 - Trang 1-6 - 2022
Heba A. Abo El Naga1, Reham S. El Zaiat2, Ahmad M. Hamdan1
1Otolaryngology Head & Neck Surgery Department, Faculty of Medicine, Menoufia University, Shebin El-kom, Egypt
2Clinical Pathology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt

Tóm tắt

COVID-19-related olfactory dysfunction is an emerging problem with a significant impact on the quality of life of affected individuals. Different lines of treatment have been used with varying results. This study aimed to assess the potential therapeutic effect of PRP in the treatment of post-COVID olfactory dysfunction. This work aimed to assess the potential therapeutic effect of platelet-rich plasma (PRP) in treating post-COVID-19 parosmia. A pilot study was conducted on 60 patients with post-COVID parosmia without responding to a 3-month course of olfactory training, topical corticosteroids, omega-three, vitamin B12, and zinc supplementation. The patients were distributed randomly and equally among 2 groups. The case group was subjected to three PRP injections in the olfactory cleft at 3 weeks intervals. The control group continued the pre-study treatment protocol for 6 weeks. The degree of parosmia was assessed before and after treatment subjectively using a visual analog scale (VAS) from 0 to 10. Reaching 0–1 on the visual analog scale was a complete improvement. The primary outcome was assessing the post-treatment score for parosmia 1 month after the third injection in the case group. The second outcome was the comparison between both groups regarding the degree of improvement 1 month after cessation of treatment. There was a highly significant improvement in VAS for parosmia (p < 0.00001) in the case group and a significant improvement in VAS for parosmia in the control group (p = P = 0.00148). There was a significant difference between both groups regarding the degree of improvement favoring the case group (p = 0.002). Platelet-rich plasma injection in the olfactory cleft offers a therapeutic option for treating patients with post-COVID-19 olfactory parosmia who failed to respond to traditional conservative treatment.

Tài liệu tham khảo

Giacomelli A, Pezzati L, Conti F et al (2020) Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study. Clin Infect Dis 53(9):1689–1699 Whitcroft KL, Hummel T (2020) Olfactory Dysfunction in COVID-19: Diagnosis and Management. JAMA 323(24):2512–2514 Sungnak W, Huang N, Bécavin C, Berg M, Queen R, Litvinukova M et al (2020) SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med 26(5):681–687 Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S (2008) Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 82(15):7264–7275 Yan CH, Mundy DC, Patel ZM (2020) The use of platelet-rich plasma in treatment of olfactory dysfunction: A pilot study. Laryngoscope Investig Otolaryngol 5(2):187–193 Lee CH, Jeon SW, Seo BS, Mo JH, Jeon EH, Choi AR et al (2010) Transplantation of neural stem cells in anosmic mice. Clin Exp Otorhinolaryngol 3(2):84 Nota J, Takahashi H, Hakuba N, Hato N, Gyo K (2013) Treatment of Neural Anosmia by Topical Application of Basic Fibroblast Growth Factor– Gelatin Hydrogel in the Nasal Cavity: An Experimental Study in Mice. JAMA Otolaryngol Head Neck Surg 139(4):396–400 Yasak AG, Yigit O, Araz Server E, DurnaDastan S, Gul M (2018) The effectiveness of platelet-rich plasma in an anosmia-induced mice model. Laryngoscope 128(5):E157–E162 Perez AG, Lana JF, Rodrigues AA, Luzo AC, Belangero WD, Santana MH (2014) Relevant aspects of centrifugation step in the preparation of platelet-rich plasma. ISRN Hematol 2014:176060 Stenner M, Vent J, Hüttenbrink KB, Hummel T, Damm M (2008) Topical therapy in anosmia: relevance of steroid-responsiveness. Laryngoscope 118(9):1681–1686 Butowt R, von Bartheld CS (2020) Anosmia in COVID-19: underlying mechanisms and assessment of an olfactory route to brain infection. Neuroscientist 11:107385842095690 Gane SB, Kelly C, Hopkins C (2020) Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome Rhinology 58:289–294 Beites CL, Kawauchi S, Crocker CE, Calof AL (2005) Identification and molecular regulation of neural stem cells in the olfactory epithelium. Exp Cell Res 306(2):309–316 Leung CT, Coulombe PA, Reed RR (2007) Contribution of olfactory neural stem cells to tissue maintenance and regeneration. Nat Neurosci 10(6):720 Iwai N, Zhou Z, Roop DR, Behringer RR (2008) Horizontal basal cells are multipotent progenitors in normal and injured adult olfactory epithelium. Stem Cells 26(5):1298–1306 Duggan CD, Ngai J (2007) Scent of a stem cell. Nat Neurosci 10(6):673 Schwob JE, Jang W, Holbrook EH, Lin B, Herrick DB, Peterson JN et al (2017) Stem and progenitor cells of the mammalian olfactory epithelium: Taking poietic license. J Comp Neurol 525(4):1034–1054 Kim HY, Kim JH, Dhong HJ, Kim KR, Chung SK, Chung SC et al (2012) Effects of statins on the recovery of olfactory function in a 3- methylindole–induced anosmia mouse model. Am J Rhinol Allergy 26(2):e81–e84 Farrag TY, Lehar M, Verhaegen P, Carson KA, Byrne PJ (2007) Effect of platelet rich plasma and fibrin sealant on facial nerve regeneration in a rat model. Laryngoscope 117(1):157–165 Oppenheim RW, Qin-Wei Y, Prevette D, Yan Q (1992) Brain-derived neurotrophic factor rescues developing avian motoneurons from cell death. Nature 360(6406):755 Shirley DM, Williams SA, Santos PM (1996) Brain-derived neurotrophic factor and peripheral nerve regeneration: a functional evaluation. Laryngoscope 106(5):629–632 Elgazzar RF, Mutabagani MA, Abdelaal SE, Sadakah AA (2008) Platelet rich plasma may enhance peripheral nerve regeneration after cyanoacrylate reanastomosis: a controlled blind study on rats. Int J Oral Maxillofac Surg 37(8):748–755 Sariguney Y, Yavuzer R, Elmas C, Yenicesu I, Bolay H, Atabay K (2008) Effect of platelet-rich plasma on peripheral nerve regeneration. J Reconstr Microsurg 24(03):159–167 Lee AC, Yu VM, Lowe JB 3rd, Brenner MJ, Hunter DA, Mackinnon SE et al (2003) Controlled release of nerve growth factor enhances sciatic nerve regeneration. Exp Neurol 184:295 Mligiliche NL, Tabata Y, Ide C (1999) Nerve regeneration through biodegradable gelatin conduits in mice. East Afr Med J 76:400 Yu W, Wang J, Yin J (2011) Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci 121(4):176–180 Ogata T, Yamamoto S, Nakamura K, Tanaka S (2006) Signaling axis in Schwann cell proliferation and differentiation. Mol Neurobiol 33:51 Monje PV, Rendon S, Athauda G, BatesM WPM, Bunge MB (2009) Non-antagonistic relationship between mitogenic factors and cAMP in adult Schwann cell re-differentiation. Glia 57:947 Oya T, Zhao YL, Takagawa K, Kawaguchi M, Shirakawa K, Yamauchi T et al (2002) Platelet-derived growth factor-b expression induced after rat peripheral nerve injuries. Glia 38:303 Tohill M, Mantovani C, Wiberg M, Terenghi G (2004) Rat bone marrow mesenchymal stem cells express glial markers and stimulate nerve regeneration. Neurosci Lett 362:200 Kalbermatten DF, Kingham PJ, Mahay D, Mantovani C, Pettersson J, Raffoul W et al (2008) Fibrin matrix for suspension of regenerative cells in an artificial nerve conduit. J Plast Reconstr Aesthet Surg 61:669 Mantovani C, Terenghi G, Shawcross SG (2012) Isolation of adult stem cells and their differentiation to Schwann cells. Methods Mol Biol 916:47 Tomita K, Madura T, Mantovani C, Terenghi G (2012) Differentiated adipose-derived stem cells promote myelination and enhance functional recovery in a rat model of chronic denervation. J Neurosci Res 90:1392 Takeuchi M, Kamei N, Shinomiya R, Sunagawa T, Suzuki O, Kamoda H et al (2012) Human platelet-rich plasma promotes axon growth in brain-spinal cord coculture. Neuroreport 23:712 Shen YX, Fan ZH, Zhao JG, Zhang P (2009) The application of platelet-rich plasma may be a novel treatment for central nervous system diseases. Med Hypotheses 73:1038 Mavrogeni P, Kanakopoulos A, Maihoub S, Krasznai M, Szirmai A (2017) Anosmia treatment by platelet rich plasma injection. Int Tinnitus J 20(2):102–105 Yan CH, Mundy DC, Patel ZM (2020) The use of platelet-rich plasma in treatment of olfactory dysfunction: A pilot study. Laryngoscope Investig Otolaryngol 5(2):187–193 GoljanianTabrizi A, Asadi M, Mohammadi M, AbediYekta A, Sohrabi M (2021) Efficacy of Platelet-Rich Plasma as an Adjuvant Therapy to Endoscopic Sinus Surgery in Anosmia Patients with Sinonasal Polyposis: A Randomized Controlled Clinical Trial. Med J Islam Repub Iran 35(1):1159–1165 Aboelmagd EA, Mohamed EF, Abdelmegeed EM, Eltahan AA (2021) Platelet-rich plasma in the management of anosmia. EJNSO 7(1):10–19