scholarly journals Platelet rich plasma enhancement of skin regeneration in an ex vivo human experimental model

2020 ◽  
Author(s):  
Giovanni Nicoletti ◽  
Marco Saler ◽  
Laura Villani ◽  
Agnese Rumolo ◽  
Marco Mario Tresoldi ◽  
...  
Keyword(s):  
Wound Repair ◽  
Ex Vivo ◽  
Platelet Rich Plasma ◽  
Skin Wound ◽  
Elastic Fibres ◽  
Antiinflammatory Action ◽  
Autologous Platelet Rich Plasma ◽  
Plasma Enhancement ◽  
Autologous Platelet ◽  
Culture Protocol

An original ex vivo wounded skin culture protocol using autologous Platelet Rich Plasma (PRP) and enriched Dulbecco’s Modified Eagle’s Medium demonstrated a favourable modulation of the epithelial cells and fibroblasts proliferation, a relevant antiinflammatory action and a favourable modulation of the re-organization of collagen and elastic fibres. The step by step regenerative effects of PRP on human skin wound repair and regeneration process was observed over a period of 10 days.

Reversal Strategy For Antagonizing The P2Y12-Inhibitor Ticagrelor By Platelet Concentrates

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1153-1153
Author(s):  
Hobl Eva-Luise ◽  
Petra Jilma-Stohlawetz ◽  
Ulla Derhaschnig ◽  
Schoergenhofer Christian ◽  
Michael Schwameis ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Whole Blood ◽  
Ex Vivo ◽  
Platelet Reactivity ◽  
Platelet Rich Plasma ◽  
Loading Dose ◽  
Platelet Concentrates ◽  
P2y12 Inhibitor ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Abstract Background Patients on anti-platelet therapy have a higher incidence of bleeding complications and reversal of anti-platelet drug effects is an important issue in emergency situations. For old and conventional anti-coagulants, reversal strategies are established. However, there is no experience or recommendation how to antagonize the reversible and highly effective P2Y12-inhibitor ticagrelor and how to restore platelet function following ticagrelor dosing. The aim of this study was to investigate an ex vivo model to reverse the effects of ticagrelor and to estimate the optimal quantity of platelet transfusions required to normalize platelet aggregation. Methods Healthy volunteers (n=20) ingested a loading dose of 180 mg ticagrelor. Blood samples were obtained at baseline to gain autologous platelet rich plasma and to perform aggregation studies after 3h, i.e. at the time of expected maximal ticagrelor concentrations and maximimal platelet inhibition. To normalize platelet aggregation, increasing amounts of autologous platelet rich plasma (PRP) were added ex vivo to hirudin anti-coagulated blood, by spiking PRP into blood at ratios of 1:10, 1:5 and 1:3. Platelet aggregation was assessed by whole blood multiple electrode aggregometry (MEA; Multiplate). For interpretation of aggregation, we defined a cutoff level of 40 U (Units) as the lower limit of the normal range. Volunteers above this level were considered to exhibit normal platelet reactivity. Nonparametric tests were used and statistical comparisons were performed with the Friedman ANOVA, and the Wilcoxon test for post-hoc comparisons. A two-tailed p-value of less than 0.05 was considered significant. Results Ingestion of 180 mg ticagrelor reduced average aggregation responses from 71 to 16 A.U. (p<0.001) and the platelet reactivity index in the VASP-assay from 88 to 22 units (p<0.001) A clear dose-response was obtained after spiking whole blood with increasing amounts of PRP. After addition of PRP at a ratio of 1:10, platelet aggregation increased to 31±14 U. When assuming that one apheresis platelet concentrate (200 mL) typically contains a minimum of 2 x1011 platelets, the ratio of 1:10 corresponds to 0.5 units of apheresis platelet concentrates. A ratio of 1:5 – equivalent to 1 unit of platelet concentrates – increased ADP induced platelet aggregation to 41±14 U. Platelet aggregation increased further to 48±18 U following the addition of PRP at a ratio of 1:3, which corresponds to 1.5 units of platelet concentrates (figure 1). All comparisons were significant at p<0.01. Conclusion Platelets dose-dependently improved ex vivo platelet aggregation of subjects after a loading dose of 180 mg of ticagrelor. It is estimated that > 2 units of apheresis platelet concentrates will be necessary to completely restore baseline platelet aggregation in the majority of patients. Point-of-care platelet function tests may be suitable tools to verify this concept in emergency patients and to estimate the extent of the reversal and de-risk on an individual patient’s level. Disclosures: No relevant conflicts of interest to declare.

scholarly journals P303 Local Application of Autologous Platelet-rich Plasma leads to Sustained Healing of Crohn’s Perianal Fistulae – One Year follow-up Results from a Single Center Pilot Study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S331-S332
Author(s):  
D Podmanicky ◽  
M Jezberova ◽  
J Lucenicova ◽  
V Bak ◽  
B Kadleckova ◽  
...  
Keyword(s):  
Wound Repair ◽  
Platelet Rich Plasma ◽  
Complete Healing ◽  
End Point ◽  
Perianal Fistulae ◽  
Autologous Platelet Rich Plasma ◽  
One Year ◽  
Mri Score ◽  
Autologous Platelet

Abstract Background Failure of wound repair and dysregulated inflammation in considered to play a key role in the persistence of Crohn’s perianal fistulae (pCD). Few preliminary reports suggest that autologous platelet-rich plasma (PRP) can enhance wound repair and may be effective in treating pCD. Therefore, the aim of our study was to determine the efficacy of autologous PRP in the treatment of pCD. Methods A prospective, uncontrolled, single center study in a referral IBD center was conducted between July 2018 and March 2021. Adult Crohn′s disease patients with pCD failing on antibiotics, immune suppression and/or biologics were eligible for the study. All patients had non-cutting setons for a minimal period of 6 weeks prior study intervention. Autologous PRP was separated by centrifugation 60 ml of peripheral blood in Harvest SmartPrep© System at the time of operation. After the seton removing, internal openings were closed by PDS 2/0 single suture and PRP was injected close to internal openings and fistula tracts. Patients were examined at outpatient clinic at week 1, month 1, 3, 6 and 12. Any suspected side-effects of the treatment were noted. Treatment effect was assessed by perianal Crohn Disease Activity Index (PCDAI assessed at baseline, month 1, 3, 6, 12) and van Assche MRI score (assessed at baseline and month 6 and 12). The primary end-point was complete healing at month 6 defined as closure of all external fistula openings and absence of abscess on MRI. The secondary end-point was sustained response at month 12. Results In total, 25 patients (pts) with pCD were included (mean age 36 years, range 21-61; 15 men). The majority of pts were using antiTNF biologics (9 adalimumab, 9 infliximab), 4 pts were treated by ustekinumab, one by vedolizumab, two patients were on immunomodulators monotherapy. By March 2021, 24 patients finished the 6 months and 21 patients the 12 months follow-up. The primary end-point of complete healing at month 6 was reached by 18 out of 24 pts (75%). All but one patients with complete healing had persistent complete healing at 12 months follow-up. Baseline PCDAI (median 5, range 2-15) decreased significantly as early as at month 1 (median 1, range 0-8; p&lt;0.001) and remained further stable over 12 months. Van Assche MRI score decreased significantly from median of 9 (range 3-18) at baseline to 5 (range 0-18) and 5.5 (range 0-18) at month 6 (p=0.001) and 12 (p=0.03); respectively. Conclusion Local application of autologous platelet-rich plasma leads to rapid healing of difficult-to-treat Crohn’s perianal fistulae in 75% of patients and this effect is sustained up to minimal period of one year.

Autologous platelet-rich plasma for assisted reproduction

2021 ◽  
Author(s):  
Dennis Vaidakis ◽  
Eleni Sertedaki ◽  
Vasilios Karageorgiou ◽  
Charalampos S Siristatidis
Keyword(s):  
Assisted Reproduction ◽  
Platelet Rich Plasma ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet
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