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Hersant B, SidAhmed-Mezi M, Aboud C, Niddam J, Levy S, Mernier T, La Padula S, Meningaud JP. Synergistic Effects of Autologous Platelet-Rich Plasma and Hyaluronic Acid Injections on Facial Skin Rejuvenation. Aesthet Surg J 2021; 41:NP854-NP865. [PMID: 33534905 DOI: 10.1093/asj/sjab061] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Many therapeutic options are currently available for facial skin rejuvenation, but little evidence exists about the efficacy of combining such procedures. OBJECTIVES The aim of this study was to assess and investigate the synergistic effect of hyaluronic acid (HA) and autologous platelet-rich plasma (a-PRP) injections on facial skin rejuvenation. METHODS For this randomized controlled prospective study, 93 eligible patients were enrolled and randomized into 3 intervention groups to undergo a series of 3 treatment sessions with either a-PRP, HA, or a mixture of a-PRP and HA (Cellular Matrix; Regen Lab) injected into facial cheeks. RESULTS A total of 93 patients were included. Treatment with Cellular Matrix led to a very significant improvement in the overall facial appearance compared with treatment with a-PRP or HA alone (P < 0.0001). Participants treated with Cellular Matrix showed a 20%, 24%, and 17% increase in FACE-Q score at 1, 3, and 6 months posttreatment, respectively. For the HA group, the improvement in FACE-Q score was 12%, 11%, and 6% at 1, 3, and 6 months posttreatment, respectively, whereas for the a-PRP group the improvement was 9%, 11%, and 8% at 1, 3, and 6 months posttreatment, respectively. Biophysical measurements showed significantly improved skin elasticity for the Cellular Matrix group compared with the groups receiving a-PRP or HA alone. No serious adverse events were reported. CONCLUSIONS Combining a-PRP and HA seems to be a promising treatment for facial rejuvenation with a highly significant improvement in facial appearance and skin elasticity compared with a-PRP or HA alone. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Barbara Hersant
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Mounia SidAhmed-Mezi
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Celine Aboud
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Jeremy Niddam
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Samuel Levy
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Thibaud Mernier
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Simone La Padula
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Jean-Paul Meningaud
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
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Devereaux J, Dargahi N, Fraser S, Nurgali K, Kiatos D, Apostolopoulos V. Leucocyte-Rich Platelet-Rich Plasma Enhances Fibroblast and Extracellular Matrix Activity: Implications in Wound Healing. Int J Mol Sci 2020; 21:ijms21186519. [PMID: 32900003 PMCID: PMC7556022 DOI: 10.3390/ijms21186519] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Platelet-rich plasma (PRP) is an autologous blood product that contains a high concentration of platelets and leucocytes, which are fundamental fibroblast proliferation agents. Literature has emerged that offers contradictory findings about leucocytes within PRP. Herein, we elucidated the effects of highly concentrated leucocytes and platelets on human fibroblasts. Methods: Leucocyte-rich, PRP (LR-PRP) and leucocyte-poor, platelet-poor plasma (LP-PPP) were compared to identify their effects on human fibroblasts, including cell proliferation, wound healing and extracellular matrix and adhesion molecule gene expressions. Results: The LR-PRP exhibited 1422.00 ± 317.21 × 103 platelets/µL and 16.36 ± 2.08 × 103 white blood cells/µL whilst the LP-PPP demonstrated lower concentrations of 55.33 ± 10.13 × 103 platelets/µL and 0.8 ± 0.02 × 103 white blood cells/µL. LR-PRP enhanced fibroblast cell proliferation and cell migration, and demonstrated either upregulation or down-regulation gene expression profile of the extracellular matrix and adhesion molecules. Conclusion: LR-PRP has a continuous stimulatory anabolic and ergogenic effect on human fibroblast cells.
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Affiliation(s)
- Jeannie Devereaux
- College of Health and Biomedicine, Victoria University, Melbourne, VIC 3011, Australia;
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia; (N.D.); (S.F.); (K.N.)
- Correspondence: (J.D.); (V.A.); Tel.: +613-83958218 (J.D.); +613-99192025 (V.A.)
| | - Narges Dargahi
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia; (N.D.); (S.F.); (K.N.)
| | - Sarah Fraser
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia; (N.D.); (S.F.); (K.N.)
| | - Kulmira Nurgali
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia; (N.D.); (S.F.); (K.N.)
| | - Dimitrios Kiatos
- College of Health and Biomedicine, Victoria University, Melbourne, VIC 3011, Australia;
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia; (N.D.); (S.F.); (K.N.)
- Correspondence: (J.D.); (V.A.); Tel.: +613-83958218 (J.D.); +613-99192025 (V.A.)
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Aizawa H, Kawabata H, Sato A, Masuki H, Watanabe T, Tsujino T, Isobe K, Nakamura M, Nakata K, Kawase T. A Comparative Study of The Effects of Anticoagulants on Pure Platelet-Rich Plasma Quality and Potency. Biomedicines 2020; 8:biomedicines8030042. [PMID: 32106422 PMCID: PMC7148468 DOI: 10.3390/biomedicines8030042] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 01/25/2023] Open
Abstract
It is generally accepted that citrate or the A-form of acid-citrate-dextrose (ACD-A) are suitable for preparing platelet-rich plasma (PRP) for regenerative therapy. However, this is based on evidence from blood transfusions and not from regenerative medicine. Thus, we examined the effects of anticoagulants, such as ACD-A, ethylenediaminetetraacetic acid (EDTA), and heparin, on the regenerative quality of PRP to address this gap. The blood samples were collected in the presence of anticoagulants and were processed to prepare pure-PRP. Platelet size, activation status, and intra-platelet free Ca2+ concentration were determined while using a hematology analyzer and flow cytometer. Platelet-derived growth factor-BB (PDGF-BB) was quantified while using an ELISA. In pure-PRP samples, EDTA caused platelet swelling and activation, but yielded the highest number of platelets. Heparin aggregated platelets and disturbed the overall counting of blood cells. However, no significant differences in PDGF-BB levels were observed among the anticoagulants tested. Moreover, when considering the easy preparation of platelet suspensions, without the need for high-level pipetting skills, these findings suggest the comparable potency of EDTA-derived pure-PRP in tissue regeneration and support the use of EDTA in the preparation of pure-PRP. Further in vivo studies are required in animal models to exclude the possible negative effects of including EDTA in pure-PRP preparations.
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Affiliation(s)
- Hachidai Aizawa
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Hideo Kawabata
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Atsushi Sato
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Hideo Masuki
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Taisuke Watanabe
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Tetsuhiro Tsujino
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Kazushige Isobe
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Masayuki Nakamura
- Tokyo Plastic Dental Society, Kita-ku, Tokyo 114-0002, Japan; (H.A.); (H.K.); (A.S.); (H.M.); (T.W.); (T.T.); (K.I.); (M.N.)
| | - Koh Nakata
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan;
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry, Niigata University, Niigata 951-8514, Japan
- Correspondence: ; Tel.: +81-25-262-7559
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In vitro evidence supporting applications of platelet derivatives in regenerative medicine. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 18:117-129. [PMID: 31657710 DOI: 10.2450/2019.0164-19] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/05/2019] [Indexed: 11/21/2022]
Abstract
The role of platelets in haemostasis has long been known, but understanding of these cells' involvement in wound healing/tissue repair is more recent and has given rise to a multitude of translational studies. Tissue repair processes consist of complex, regulated interactions between cells modulated by biologically active molecules, most of which are growth factors released by activated platelets: this aspect represents the rationale on which the use of platelet derivatives for clinical purposes is based. In the last years, many in vitro studies have focused on the mechanisms of action by which these growth factors affect the biological activities of cells, thus supporting tissue healing. Although limited by some drawbacks (two-dimensional in vitro monocultures cannot replicate the tissue architecture and organisation of organs or the continuous interplay between different cell types), in vitro studies do have the advantages of giving rapid results and allowing precise control of platelet concentrations and other parameters.This review offers an updated overview of the data obtained from the most recent bench-top studies focused on the effects of platelet derivatives on a wide variety of human cells, highlighting their possible impact for in vivo applications. The heterogeneity of the data obtained so far is very evident. This can be explained by the different experimental settings used in each study, which may be the cause of the variability in clinical outcomes. In fact, in vitro studies suggest that the composition of platelet derivatives and the method used for their production and activation (or not) and the platelet concentration used can have profound effects on the final results.
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Bijl I, Vlig M, Middelkoop E, Korte D. Allogeneic platelet‐rich plasma (PRP) is superior to platelets or plasma alone in stimulating fibroblast proliferation and migration, angiogenesis, and chemotaxis as relevant processes for wound healing. Transfusion 2019; 59:3492-3500. [DOI: 10.1111/trf.15535] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/16/2019] [Accepted: 08/01/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Ivo Bijl
- Department of Blood Cell Research Sanquin Research Amsterdam The Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres, Red Cross Hospital Beverwijk The Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centres, Red Cross Hospital Beverwijk The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic, Reconstructive and Hand Surgery Amsterdam Movement Sciences Amsterdam The Netherlands
| | - Dirk Korte
- Department of Blood Cell Research Sanquin Research Amsterdam The Netherlands
- Department of Product and Process Development Sanquin Blood Bank Amsterdam The Netherlands
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Romaldini A, Mastrogiacomo M, Cancedda R, Descalzi F. Platelet Lysate Activates Human Subcutaneous Adipose Tissue Cells by Promoting Cell Proliferation and Their Paracrine Activity Toward Epidermal Keratinocytes. Front Bioeng Biotechnol 2018; 6:203. [PMID: 30622945 PMCID: PMC6308153 DOI: 10.3389/fbioe.2018.00203] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/11/2018] [Indexed: 02/06/2023] Open
Abstract
Skin chronic wounds are non-healing ulcerative defects, which arise in association with a morbidity state, such as diabetes and vascular insufficiency or as the consequence of systemic factors including advanced age. Platelet Rich Plasma, a platelet-rich blood fraction, can significantly improve the healing of human skin chronic ulcers. Given that the subcutaneous adipose tissue is located beneath the skin and plays a role in the skin homeostasis, in this study, we investigated the in vitro response of human subcutaneous adipose tissue cells to platelet content in a model mimicking in vitro the in situ milieu of a deep skin injury. Considering that, at the wound site, plasma turn to serum, platelets are activated and inflammation occurs, human adipose-derived stromal cells (hASC) were cultured with Human Serum (HS) supplemented or not with Platelet Lysate (PL) and/or IL-1α. We observed that HS sustained hASC proliferation more efficiently than FBS and induced a spontaneous adipogenic differentiation in the cells. PL added to HS enhanced hASC proliferation, regardless the presence of IL-1α. In the presence of PL, hASC progressively lessened the adipogenic phenotype, possibly because the proliferation of less committed cells was induced. However, these cells resumed adipogenesis in permissive conditions. Accordingly, PL induced in quiescent cells activation of the proliferation-related pathways ERK, Akt, and STAT-3 and expression of Cyclin D1. Moreover, PL induced an early and transient increase of the pro-inflammatory response triggered by IL-1α, by inducing COX-2 expression and secretion of a large amount of PGE2, IL-6, and IL-8. Media conditioned by PL-stimulated hASC exerted a chemotactic activity on human keratinocytes and favored the healing of an in vitro scratch wound. In order to bridge the gap between in vitro results and possible in vivo events, the stimuli were also tested in ex vivo cultures of in toto human adipose tissue biopsies (hAT). PL induced cell proliferation in hAT and outgrowth of committed progenitor cells able to differentiate in permissive conditions. In conclusion, we report that the adipose tissue responds to the wound microenvironment by activating the proliferation of adipose tissue progenitor cells and promoting the release of factors favoring wound healing.
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Affiliation(s)
- Alessio Romaldini
- Department of Experimental Medicine (DIMES) and Department of Internal Medicine (DIMI), University of Genoa; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maddalena Mastrogiacomo
- Department of Experimental Medicine (DIMES) and Department of Internal Medicine (DIMI), University of Genoa; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ranieri Cancedda
- Department of Experimental Medicine (DIMES) and Department of Internal Medicine (DIMI), University of Genoa; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fiorella Descalzi
- Department of Experimental Medicine (DIMES) and Department of Internal Medicine (DIMI), University of Genoa; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Giusti I, Di Francesco M, D'Ascenzo S, Palumbo P, Rughetti A, Dell'Orso L, Varasano PA, Pressanti GL, Dolo V. Leukocyte depletion does not affect the in vitro healing ability of platelet rich plasma. Exp Ther Med 2018; 15:4029-4038. [PMID: 29556269 DOI: 10.3892/etm.2018.5887] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 01/19/2018] [Indexed: 01/15/2023] Open
Abstract
The clinical use of platelet-rich plasma (PRP) containing or deprived of leukocytes remains a subject of debate and a controversial issue. It is not yet clear whether leukocyte content has a positive or negative effect on tissue healing processes. Several studies, conducted mainly in the orthopedic field, support the use of leukocyte-poor (LP) PRP, whereas other studies have not identified any significant differences between the use of LP and leukocyte-rich PRP. In the present study, the role of leukocytes contained in PRP was assessed to verify their in vitro effect on fibroblasts and endothelial cells, which have a leading role in the biological processes associated with wound healing (including angiogenesis and matrix remodeling). The original sample of PRP was divided into two aliquots, one of which remained unaltered, while the other was deprived of leukocytes. The two aliquots were used in in vitro tests in order to verify the effects of leukocytes on proliferation, wound healing and tube formation, and in molecular analyses of growth factor and enzyme content. The present results highlighted a substantial overlap between the two formulations. This may be explained by similar levels of growth factors (vascular endothelial growth factor, thrombospondin-1, interferon-γ, platelet-derived growth factor-BB, -AA and -B, tumor growth factor-β1, fibroblast growth factor 7 and tumor necrosis factor-α) and enzymes (gelatinases and plasminogen activators) in the two formulations. These results support the hypothesis that the ability of the PRP to affect the in vitro biological response of endothelial cells and fibroblasts does not rely on the presence of leukocytes.
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Affiliation(s)
- Ilaria Giusti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Marianna Di Francesco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Sandra D'Ascenzo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Paola Palumbo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Anna Rughetti
- Immunotransfusion Medicine Unit, 'San Salvatore' Hospital, I-67100 L'Aquila, Italy
| | - Luigi Dell'Orso
- Immunotransfusion Medicine Unit, 'San Salvatore' Hospital, I-67100 L'Aquila, Italy
| | | | | | - Vincenza Dolo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
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Aielli F, Giusti R, Rughetti A, dell'Orso L, Ficorella C, Porzio G. Rapid resolution of refractory chemotherapy-induced oral mucositis with platelet gel-released supernatant in a pediatric cancer patient: a case report. J Pain Symptom Manage 2014; 48:e2-4. [PMID: 25131890 DOI: 10.1016/j.jpainsymman.2014.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 06/21/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Federica Aielli
- "L'Aquila per la Vita" Home Care Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Raffaele Giusti
- Medical Oncology Unit, Sant'Andrea Hospital-"Sapienza", University of Rome, Rome, Italy
| | - Anna Rughetti
- Division of Transfusion Medicine, Department of Health Sciences, "San Salvatore" Hospital, L'Aquila, Italy
| | - Luigi dell'Orso
- Division of Transfusion Medicine, Department of Health Sciences, "San Salvatore" Hospital, L'Aquila, Italy
| | - Corrado Ficorella
- Medical Oncology Department, University of L'Aquila, L'Aquila, Italy
| | - Giampiero Porzio
- "L'Aquila per la Vita" Home Care Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Platelet concentration in platelet-rich plasma affects tenocyte behavior in vitro. BIOMED RESEARCH INTERNATIONAL 2014; 2014:630870. [PMID: 25147809 PMCID: PMC4132404 DOI: 10.1155/2014/630870] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 07/03/2014] [Indexed: 01/08/2023]
Abstract
Since tendon injuries and tendinopathy are a growing problem, sometimes requiring surgery, new strategies that improve conservative therapies are needed. Platelet-rich plasma (PRP) seems to be a good candidate by virtue of its high content of growth factors, most of which are involved in tendon healing. This study aimed to evaluate if different concentrations of platelets in PRP have different effects on the biological features of normal human tenocytes that are usually required during tendon healing. The different platelet concentrations tested (up to 5 × 10(6) plt/µL) stimulated differently tenocytes behavior; intermediate concentrations (0.5 × 10(6), 1 × 10(6) plt/µL) strongly induced all tested processes (proliferation, migration, collagen, and MMPs production) if compared to untreated cells; on the contrary, the highest concentration had inhibitory effects on proliferation and strongly reduced migration abilities and overall collagen production but, at the same time, induced increasing MMP production, which could be counterproductive because excessive proteolysis could impair tendon mechanical stability. Thus, these in vitro data strongly suggest the need for a compromise between extremely high and low platelet concentrations to obtain an optimal global effect when inducing in vivo tendon healing.
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Topical application of platelet supernatant gel in the management of radiotherapy-induced mucositis: a case report. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:107-10. [PMID: 24333059 DOI: 10.2450/2013.0104-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/20/2013] [Indexed: 11/21/2022]
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