DOI: https://doi.org/10.22263/2312-4156.2022.6.18
P.A. Erashov1, V.L. Denisenko2
Platelet-reach plasma (PRP). Its classification, obtaining and current clinical application (review)
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Specialized Center, Vitebsk, Republic of Belarus
Vestnik VGMU. 2022;21(6):18-28.
Abstract.
Platelet-reach plasma (PRP) has been used in medicine for more than 30 years. A large amount of data concerning the efficiency of its use in different fields of medicine were collected during this period. PRP-products are undoubtedly safe and effective tissue regeneration stimulants. But, nevertheless, there are certain controversies regarding PRP clinical application. This situation is caused by significant differences in methods of its preparation and approaches to its clinical use.
Objectives. To summarize the available literature data concerning the preparation methods, composition, mechanisms of action and application fields of different PRP-products. We also made an attempt to create their unified classification.
Material and methods. To get necessary information a review of literature data (mostly reviews) on this topic was made by us.
Results. The action of different varieties of PRP is based on the release of bioactive substances from platelets’ α-granules. Additionally, some other components, such as leucocytes, fibrin and hyaluronic acid, may make a certain contribution to the PRP action. Activated PRP has a grater biological activity in comparison with the non-activated one. PRP-products are widely used in the field of traumatology, cosmetology and trichology, surgery and proctology, gynecology and urology. As a result of this work our own synthetic classification of PRP has been created by us.
Conclusions. PRP-products can be used as a safe and effective injured tissue regeneration stimulant. The use of different types of PRP should be based on the specificity of the pathology treated. To expand the range of indications for PRP and to develop preparation methods of PRP with specific characteristics further studies are needed.
Keywords: platelet-reach plasma, PRP, PRF, growth factors, stimulation of tissue regeneration.
References
1. Golebiewska EM, Poole AW. Platelet secretion: From haemostasis to wound healing and beyond. Blood Rev. 2015 May;29(3):153-62. doi: http://dx.doi.org/10.1016/j.blre.2014.10.003
2. Thon JN, Italiano JE. Platelets: production, morphology and ultrastructure. Handb Exp Pharmacol. 2012;(210):3-22. doi: http://dx.doi.org/10.1007/978-3-642-29423-5_1
3. Holinstat M. Normal platelet function. Cancer Metastasis Rev. 2017 Jun;36(2):195-198. doi: http://dx.doi.org/10.1007/s10555-017-9677-x
4. Knighton DR, Ciresi KF, Fiegel VD, Austin LL, Butler EL. Classification and treatment of chronic nonhealing wounds. Successful treatment with autologous platelet-derived wound healing factors (PDWHF). Ann Surg. 1986 Sep;204(3):322-30. doi: http://dx.doi.org/10.1097/00000658-198609000-00011
5. Rossi LA, Murray IR, Chu CR, Muschler GF, Rodeo SA, Piuzzi NS. Classification systems for platelet-rich plasma. Bone Joint J. 2019 Aug;101-B(8):891-896. doi: http://dx.doi.org/10.1302/0301-620X.101B8.BJJ-2019-0037.R1
6. Magalon J, Bausset O, Serratrice N, Giraudo L, Aboudou H, Veran J, et al. Characterization and Comparison of 5 Platelet-Rich Plasma Preparations in a Single-Donor Model. Arthroscopy. 2014 May;30(5):629-38. doi: http://dx.doi.org/10.1016/j.arthro.2014.02.020
7. Medvedev VL, Kogan MI, Mihailov IV, Lepetunov SN. Platelet-rich autologous plasma: what is it and for what? Urology Herald. 2020;8(2):67-77. doi: http://dx.doi.org/10.21886/2308-6424-2020-8-2-67-77
8. Cohn CS, Lockhart E. Autologous platelet-rich plasma: evidence for clinical use. Curr Opin Hematol. 2015 Nov;22(6):527-32. doi: http://dx.doi.org/10.1097/MOH.0000000000000183
9. Mussano F, Genova T, Munaron L, Petrillo S, Erovigni F, Carossa S. Cytokine, chemokine, and growth factor profile of platelet-rich plasma. Platelets. 2016 Jul;27(5):467-71. doi: http://dx.doi.org/10.3109/09537104.2016.1143922
10. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009 Mar;27(3):158-67. doi: http://dx.doi.org/10.1016/j.tibtech.2008.11.009
11. Dos Santos RG, Silva Santos G, Alkass N, Chiesa TL, Azzini GO, da Fonseca LF, et al. The regenerative mechanisms of platelet-rich plasma: A review. Cytokine. 2021 Aug;144:155560. doi: http://dx.doi.org/10.1016/j.cyto.2021.155560
12. Orive G, Anitua E. Platelet-rich therapies as an emerging platform for regenerative medicine. Expert Opin Biol Ther. 2021 Dec;21(12):1603-1608. doi: http://dx.doi.org/10.1080/14712598.2021.1936495
13. Samadi P, Sheykhhasan M, Khoshinani HM. The Use of Platelet-Rich Plasma in Aesthetic and Regenerative Medicine: A Comprehensive Review. Aesthetic Plast Surg. 2019 Jun;43(3):803-814. doi: http://dx.doi.org/10.1007/s00266-018-1293-9
14. Leitner GC, Gruber R, Neumüller J, Wagner A, Kloimstein P, Höcker P, Körmöczi GF, et al. Platelet content and growth factor release in platelet-rich plasma: a comparison of four different systems. Vox Sang. 2006 Aug;91(2):135-9. doi: http://dx.doi.org/10.1111/j.1423-0410.2006.00815.x
15. Gupta S, Paliczak A, Delgad D. Evidence-based indications of platelet-rich plasma therapy. Expert Rev Hematol. 2021 Jan;14(1):97-108. doi: http://dx.doi.org/10.1080/17474086.2021.1860002
16. Kobayashi E, Flückiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016 Dec;20(9):2353-2360. doi: http://dx.doi.org/10.1007/s00784-016-1719-1
17. Irmak G, Demirtaş TT, Gümüşderelioğlu M. Sustained release of growth factors from photoactivated platelet rich plasma (PRP). Eur J Pharm Biopharm. 2020 Mar;148:67-76. doi: http://dx.doi.org/10.1016/j.ejpb.2019.11.011
18. Frelinger AL, Torres AS, Caiafa A, Morton CA, Berny-Lang MA, Gerrits AJ, et al. Platelet-rich plasma stimulated by pulse electric fields: Platelet activation, procoagulant markers, growth factor release and cell proliferation. Platelets. 2016;27(2):128-35. doi: http://dx.doi.org/10.3109/09537104.2015.1048214
19. Arora G, Arora S. Platelet-rich plasma-Where do we stand today? A critical narrative review and analysis. Dermatol Ther. 2021 Jan;34(1):e14343. doi: http://dx.doi.org/10.1111/dth.14343
20. Shin H-S, H Woo -M, Kang B-J. Optimisation of a double-centrifugation method for preparation of canine platelet-rich plasma. BMC Vet Res. 2017 Jun;13(1):198. doi: http://dx.doi.org/10.1186/s12917-017-1123-3
21. Marques LF, Stessuk T, Cherici Camargo IC, Sabeh Junior N, dos Santos L, Ribeiro-Paes JT. Platelet-rich plasma (PRP): methodological aspects and clinical applications. Platelets. 2015;26(2):101-13. doi: http://dx.doi.org/10.3109/09537104.2014.881991
22. Sharun K, Pawde AM, Manjusha KM, Banu SA, Kalaiselvan E, Kumar R, et al. Classification and coding of platelet-rich plasma derived from New Zealand white rabbits for tissue engineering and regenerative medicine applications. Expert Opin Biol Ther. 2021 Nov;21(11):1473-1482. doi: http://dx.doi.org/10.1080/14712598.2021.195509
23. DeLong JM, Russell RP, Mazzocca AD. Platelet-Rich Plasma: The PAW Classification System. Arthroscopy. 2012 Jul;28(7):998-1009. doi: http://dx.doi.org/10.1016/j.arthro.2012.04.148
24. Gentile P, Calabrese C, De Angelis B, Dionisi L, Pizzicannella J, Kothari A, et al. Impact of the Different Preparation Methods to Obtain Autologous Non-Activated Platelet-Rich Plasma (A-PRP) and Activated Platelet-Rich Plasma (AA-PRP) in Plastic Surgery: Wound Healing and Hair Regrowth Evaluation. Int J Mol Sci. 2020 Jan;21(2):431. doi: http://dx.doi.org/10.3390/ijms21020431
25. Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020 Oct;21(20):7794. doi: http://dx.doi.org/10.3390/ijms21207794
26. Wang L, Zhao L, Shen L, Fang Q, Yang Z, Wang R, et al. Comparison of the effects of autologous and allogeneic purified platelet-rich plasma on cartilage damage in a rabbit model of knee osteoarthritis. Front Surg. 2022 Jul;9:911468. doi: http://dx.doi.org/10.3389/fsurg.2022.911468
27. Wang Y, Yao C, Yang Z, Guo W. Clinical efficacy of platelet-rich plasma as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury. J Int Med Res. 2020 Sep;48(9):300060520955059. doi: http://dx.doi.org/10.1177/0300060520955059
28. Sheean AJ, Anz AW, Bradley JP. Platelet-Rich Plasma: Fundamentals and Clinical Applications. Arthroscopy. 2021 Sep;37(9):2732-2734. doi: http://dx.doi.org/10.1016/j.arthro.2021.07.003
29. Ghai B, Gupta Vasudha, Jain A, Goel N, Chouhan D, Yatinder Kumar Batra. Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study. Braz J Anesthesiol. 2019 Sep-Oct;69(5):439-447. doi: http://dx.doi.org/10.1016/j.bjan.2019.06.003
30. Xu Z, Yin W, Zhang Y, Qi X, Chen Y, Xie X, et al. Comparative evaluation of leukocyte- and platelet-rich plasma and pure platelet-rich plasma for cartilage regeneration. Sci Rep. 2017 Mar;7:43301. doi: http://dx.doi.org/10.1038/srep43301
31. O’Connell B, Wragg NM, Wilson SL. The use of PRP injections in the management of knee osteoarthritis. Cell Tissue Res. 2019 May;376(2):143-152. doi: http://dx.doi.org/10.1007/s00441-019-02996-x
32. Jeong W, Kim YS, Roh TS, Kang EH, Jung BK, Yun IS. The effect of combination therapy on critical-size bone defects using non-activated platelet-rich plasma and adipose-derived stem cells. Childs Nerv Syst. 2020 Jan;36(1):145-151. doi: http://dx.doi.org/10.1007/s00381-019-04109-z
33. Mehrabania D, Seghatchiane J, Acker JP. Platelet rich plasma in treatment of musculoskeletal pathologies. Transfus Apher Sci. 2019 Dec;58(6):102675. doi: http://dx.doi.org/10.1016/j.transci.2019.102675
34. Borrione P, Di Gianfrancesco A, Pereira MT, Pigozzi F. Platelet-rich plasma in muscle healing. Am J Phys Med Rehabil. 2010 Oct;89(10):854-61. doi: http://dx.doi.org/10.1097/PHM.0b013e3181f1c1c7
35. Fang J, Wang X, Jiang W, Zhu Y, Hu Y, Zhao Y, Song X, et al. Platelet-rich plasma therapy in the treatment of diseases associated with orthopedic injuries. Tissue Eng Part B Rev. 2020 Dec;26(6):571-585. doi: http://dx.doi.org/10.1089/ten.TEB.2019.0292
36. Slapnicka J, Fassmann A, Strasak L, Augustin P, Vanek J. Effects of Activated and Nonactivated Platelet-Rich Plasma on Proliferation of Human Osteoblasts In Vitro. J Oral Maxillofac Surg. 2008 Feb;66(2):297-301. doi: http://dx.doi.org/10.1016/j.joms.2007.05.022
37. Wang C, Xu M, Guo W, Wang Y, Zhao S, Zhong L. Clinical efficacy and safety of platelet-rich plasma in arthroscopic full-thickness rotator cuff repair: A meta-analysis. PLoS One. 2019 Jul;14(7):e0220392. doi: http://dx.doi.org/10.1371/journal.pone.0220392
38. Gentile P, Garcovich S. Autologous Activated Platelet-Rich Plasma (AAPRP) and Non-activated (A-PRP) in Hair Growth: a retrospective, blinded, randomized evaluation in Androgenetic Alopecia. Expert Opin Biol Ther. 2020 Mar;20(3):327-337. doi: http://dx.doi.org/10.1080/14712598.2020.1724951
39. Butt G, Hussain I, Ahmed FJ, Choudhery MS. Efficacy of platelet-rich plasma in androgenetic alopecia patients. J Cosmet Dermatol. 2019 Aug;18(4):996-1001. doi: http://dx.doi.org/10.1111/jocd.12810
40. Gentile P, Dionisi L, Pizzicannella J, de Angelis B, de Fazio D, Garcovich S. A Randomized Blinded Retrospective Study: the combined use of Micro-needling Technique, Low-Level Laser Therapy and Autologous NonActivated Platelet-Rich Plasma improves Hair ReGrowth in patients with Androgenic Alopecia. Expert Opin Biol Ther. 2020 Sep;20(9):1099-1109. doi: http://dx.doi.org/10.1080/14712598.2020.1797676
41. Mastrogiacomo M, Nardini M, Collina MC, Di Campli C, Filaci G, Cancedda R, et al. Plasma Therapies for Diabetic Foot Ulcer Treatment: The Allogeneic Approach. Front Bioeng Biotechnol. 2022 May;10:869408. doi: http://dx.doi.org/10.3389/fbioe.2022.869408
42. Stilhano RS, Andrade Denapoli PM, Gallo CC, Samoto VY, McNeill Ingham SJ, Abdalla RJ, et al. Regenerative effect of platelet-rich plasma in the murine ischemic limbs. Life Sci. 2021 Nov;284:119934. doi: http://dx.doi.org/10.1016/j.lfs.2021.119934
43. Smith OJ, Wicaksana A, Davidson D, Spratt D, Mosahebi A. An evaluation of the bacteriostatic effect of platelet-rich plasma. Int Wound J. 2021 Aug;18(4):448-456. doi: http://dx.doi.org/10.1111/iwj.13545
44. Hersant B, Bouhassira J, SidAhmed-Mezi M, Vidal L, Keophiphath M, Chheangsun B, et al. Should platelet-rich plasma be activated in fat grafts? An animal study. J Plast Reconstr Aesthet Surg. 2018 May;71(5):681-690. doi: http://dx.doi.org/10.1016/j.bjps.2018.01.005
45. Kurt F, Sözen S, Hakan Kanat B, Kutluer N, Sakalli O, Gençtürk M, et al. Effect of platelet-rich plasma on healing in laser pilonidoplasty for pilonidal sinus disease. Lasers Med Sci. 2021 Jul;36(5):1015-1021. doi: http://dx.doi.org/10.1007/s10103-020-03137-5
46. Dawood AS, Salem HA. Current clinical applications of platelet-rich plasma in various gynecological disorders: An appraisal of theory and practice. Clin Exp Reprod Med. 2018 Jun;45(2):67-74. doi: http://dx.doi.org/10.5653/cerm.2018.45.2.67
47. Poulios E, Mykoniatis I, Pyrgidis N, Zilotis F, Kapoteli P, Kotsiris D, et al. Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double- Blind, Randomized, Placebo-Controlled Clinical Trial. J Sex Med. 2021 May;18(5):926-935. doi: http://dx.doi.org/10.1016/j.jsxm.2021.03.008
48. Kuffler DP. Platelet-Rich Plasma and the Elimination of Neuropathic Pain. Mol Neurobiol. 2013 Oct;48(2):315-32. doi: http://dx.doi.org/10.1007/s12035-013-8494-7
49. Wang S, Liu X, Wang Y. Evaluation of Platelet-Rich Plasma Therapy for Peripheral Nerve Regeneration: A Critical Review of Literature. Front Bioeng Biotechnol. 2022 Mar;10:808248. doi: http://dx.doi.org/10.3389/fbioe.2022.808248
50. Salarinia R, Sadeghnia HR, Alamdari DH, Hoseini SJ, Mafinezhad A, Hosseini M. Platelet rich plasma: Effective treatment for repairing of spinal cord injury in rat. Acta Orthop Traumatol Turc. 2017 May;51(3):254-257. doi: http://dx.doi.org/10.1016/j.aott.2017.02.009
51. Bailey E, Kashbour W, Shah N, Worthington HV, Renton TF, Coulthard P. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2020 Jul;7(7):CD004345. doi: http://dx.doi.org/10.1002/14651858.CD004345
52. Altaii M, Kaidonis X, Koblar S, Cathro P, Richards L. Platelet rich plasma and dentine effect on sheep dental pulp cells regeneration/revitalization ability (in vitro). Aust Dent J. 2017 Mar;62(1):39-46. doi: http://dx.doi.org/10.1111/adj.12426
53. Attia S, Narberhaus C, Schaaf H, Streckbein P, Pons-Kühnemann J, Schmitt C, et al. Long-Term Influence of Platelet-Rich Plasma (PRP) on Dental Implants after Maxillary Augmentation: Retrospective Clinical and Radiological Outcomes of a Randomized Controlled Clinical Trial. J Clin Med. 2020 Jan;9(2):355. doi: http://dx.doi.org/10.3390/jcm9020355
Information about authors:
P.A. Erashov– lecturer of the Chair of General Surgery, Vitebsk State Order of Peoples’ Friendship Medical University,
E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Pavel A. Erashov;
V.L. Denisenko – Doctor of Medical Sciences, associate professor, chief physician of the Vitebsk Regional Clinical Specialized Center.
