Platelet-rich plasma (PRP)

Abstract

The platelets contain three types of secretion granules: α-granules, dense granules, and lysosomes. Recent proteomic analyzes showed that 3,000 bioactive proteins are released from activated platelets. Among the three types of granules, α-granules are the main storage organs for employed proteins, containing adhesion proteins, coagulation factors and inhibitors, fibrinolytic factors and their inhibitors, proteins and anti-proteins, growth factors and mitogenic factors. , chemicals and cytokines, antimicrobial proteins, and anti-microbial proteins. Proteins are known to be in gases, such as cathepsins and elastas, and other enzymes, including phosphate and glycosidases.

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Once platelets are activated, these bioactive proteins are generated and released to the damaged tissues, and control vigorously genetically, including cell proliferation, cellularxis chemistry, angiogenesis, cell differentiation and ECM synthesis.

PRP is classified according to these classifications based on the number of leukocytes and fibrin materials and includes four types of PRP preparation. Plasma (P-PRP) is rich in platelets of Leukocyte (P-PRP) containing low leukocytes and low fibrin density. Leukocyte and platelet-rich plasma (L-PRP) have a high number of leococytes and low fiber density. Pure-rich platelets (P-PRF) contain a low number of leococytes and high fibrin density. Leukocyte-and platelet-rich fibers have a high number of leococytes and high-fibrin density. developed the PAW classification based on the number of platelets (P), the activation system (A), and the presence of white blood cells (leukocytes), as described. It is very important to include this information to assess the effect of PRP and in clinical trials. Unfortunately, this comprehensive information comprises only 10% of the articles published. The type of PRP prepared by commercially available equipment is well summarized in the original papers classified and in the chapter on a review book. .

PRP activation

The activation of PRP is one of the major factors influencing the outcome of the studies. In studies, it is important to activate and use soluble components for culture, unless the cultures are in contact with collagen matrix, for example, which stimulates endogenous activation. For in studies and clinical studies, exogenous or endogenous activation techniques were used. Activation will result in platelet deductions and the release of α granules with growth factors. Encourages the activation of fibrinogen cleavage that promotes matrix formation. PRP activation is generally encouraged through calcium chloride and / or thrombin, freezing and melting, or exposure to collagen. For studies, a freezing and melting (> six times recommended) procedure is appropriate as no additional component is required. The activation of collagen does not require an additional ingredient, such as thrombin, but the amount of release of growth factors may differ. These differences in the method of activation for clinical trials make it difficult to estimate the results of the studies accurately.

PRP for IVD repair

The use of PRP where multiple growth factors are targeted at high levels has grown in orthopedic practice although its biological mechanisms require further investigation. Currently, biological molecules that are prepared in an autologous way for clinical use. However, PRP was prepared through various appliances for separation of the patient himself. Blood in the operating room is regulated as a   cleaning device. Alternatively, local blood banks can produce PRP.

However, the preparation of PRP varies greatly and could cause the various biological activities described among the studies. It was reported that different PRP activation methods are affected by its physical form and that it can release molecules. changing bioactive A systematic review by   of PRP literature from 2006 to 2016 suggested that the preparation and composition of PRP needed to be standardized so that studies could be reproduced and different studies compared. Overall, the majority of studies have significant biological effects focusing on PRP effects in IVD tissues.

In PRP effects on cells

The studies that focus on the in   effects of PRP appear on IVD cells, suggesting that PRP may be a major therapeutic agent for IVD degeneration. The effects of PRP (growth factors) are also summarized in a number of revised sections.

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