Il Platelet Rich Plasma (PRP) is a therapy commonly used in different medical fields such as plastic surgery, pediatric surgery, cardiac surgery, maxillofacial surgery, ophthalmology, orthopedics, dermatology, gynecology and urology due to its ability to promote tissue regeneration.
Platelet Rich Plasma: what it is and its history
Il Platelet Rich Plasma (PRP) is a therapy that has its origins in the field of hematology. The term was born in the 70s to describe plasma with a platelet content higher than that present in peripheral blood. In transfusion medicine, platelet concentrates were mainly used for hemostatic treatment in cases of bleeding. In recent decades, research has explored in depth the use of platelet concentrates as an aid in tissue regeneration.
In the last twenty years, therapies based on the use of PRP have aroused more and more interest for their potential in regenerative medicine, finding use in a wide range of chronic and acute pathologies.
The use of Autologous PRPthat is to say derived from the same patient, it is especially popular for its simple manipulation and broad characterization. Furthermore, various techniques of preparation of the product allow to measure the quantity of growth factors and proteins released during the platelet degranulation phase. The latter are the protagonists who, thanks to their content in growth factors, chemokines and cytokines, play an important role in tissue regeneration.
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How is Platelet Rich Plasma prepared?
There are various manual and commercial techniques for preparing Platelet Rich Plasma. May be fit liquid o in the form the gel. Healthcare personnel collect the blood sample in test tubes containing an anticoagulant to avoid the formation of clots and the activation of platelets. The anticoagulant of choice is the citrate salt as it does not interfere with platelet biology.
PRP manufacturing methods include:
use of fresh venipuncture blood subjected to a first low-speed centrifugation which separates the plasma with the platelets in suspension from the other figurative elements of the blood. A second centrifugation of the plasma at high speed allows to obtain a platelet concentrate; use of buffy coat (a blood component derived from the processing of blood bags) derived from whole blood and stored at laboratory temperature. Il buffy coat undergoes high-speed centrifugation to obtain three layers: red blood cells, white blood cells and platelets, platelet-poor plasma (PPP). The healthcare professional removes the PPP and collects the middle layer which may or may not be deprived of white blood cells.
What is Platelet Rich Plasma used for?
PRP is a widely used technology for tissue regeneration. Depending on the needs, the characteristics of PRP can be varied, for example by modifying the presence or absence of leukocytes to obtain different immunomodulatory properties. PRP acts in synergy with physical, pharmacological and surgical therapies enhancing the physiological healing response.
PRP is a treatment that has multiple uses in the medical field. In orthopedics, for example, it is often used in the treatment of degenerative joint diseases and tendinopathies. Studies have shown that it has a superior therapeutic effect compared to other treatments such as hyaluronic acid or cortisone infiltrations. Athletes can also benefit from PRP for the recovery of tendon structures subjected to intense stresses and microtraumas.
He comes also used to treat chronic pain, such as sports injuries, thanks to the analgesic effect of chemical mediators released by activated platelets. The first results on its analgesic activity were obtained in a study on shoulder surgery, with a reduction in the use of pain-relieving drugs and an improvement in post-surgical rehabilitation.
PRP has properties that counteract skin aging,acne and for the treatment of alopecia, therefore it is used in aesthetic medicine. In dermatology it has been shown to play an important role in the treatment of chronic lesions such as venous and diabetic ulcers as well as for the treatment of psoriasis, acne and scars. In ophthalmology it finds its use in the treatment of tear film pathologies, such as dry eyes, keratopathies and alterations in tear density.
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References
Alves R, & Grimalt R, 2018. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage Disord. 2018 Jan;4(1):18-24. (Free)Dohan Ehrenfest DM, Rasmusson L, & Albrektsson T, 2009. 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.Leitner GC, Gruber R, et al., 2006. Platelet content and growth factor release in platelet-rich plasma: a comparison of four different systems. Vox Sang. 2006 Aug;91(2):135-9. Andia I, Sanchez M, & Maffulli N, 2010. Tendon healing and platelet-rich plasma therapies. Expert Opin Biol Ther. 2010 Oct;10(10):1415-26.Everts P, Onishi K, et al.2020. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020 Oct 21;21(20):7794. (Free)