Plasma Gel Matrix as a Promising Carrier of Epigallocatechin Gallate for Regenerative Medicine

Plasma gel (PG) is a protein matrix prepared from platelet-poor plasma and can be utilized as a drug carrier for controlled release. We previously demonstrated its applicability as a carrier of polyphosphate. Epigallocatechin-3-gallate (EGCG) is the main flavonoid found in green tea and functions as a strong antioxidant. To explore the applicability of PG as an EGCG carrier, we examined the release of EGCG from the PG matrix using an in vitro system. Pooled platelet-poor plasma (PPP) was prepared from four healthy adult male donors, mixed with EGCG, and heated at 75 °C for 10 or 20 min to prepare the PG matrix. The PG-EGCG matrix was incubated in PBS at 37 °C, and the EGCG released into PBS was determined using spectrophotometry. The antioxidant capacity was determined based on the principle of the iodine decolorization reaction. EGCG precipitated and incorporated into the PG matrix during thermal preparation. Trypsin, used to simulate the in vivo degradation of PG, released EGCG from the PG matrix over time. The released EGCG maintained its antioxidant capacity during incubation. These results indicate that thermally prepared PG matrices can be utilized as a promising EGCG carrier in the fields of tissue engineering and regenerative medicine.

Plasma Gel Made of Platelet-Poor Plasma: In Vitro Verification as a Carrier of Polyphosphate

Plasma gel (PG) is a blood-derived biomaterial that can be prepared by heating or chemical cross-linking without the aid of intrinsic coagulation activity and has gradually been applied in the field of esthetic surgery. To explore the applicability of PG in regenerative therapy or tissue engineering, in this study, we focused on the advantages of the heating method and verified the retention capacity of the resulting PG for polyphosphate (polyP), a polyanion that contributes to hemostasis and bone regeneration. Pooled platelet-poor plasma (PPP) was prepared from four healthy male adult donors, mixed with synthetic polyP, and heated at 75 °C for 10 or 30 min to prepare PG in microtubes. The PG was incubated in PBS at 37 °C, and polyP levels in the extra-matrix PBS were determined by the fluorometric method every 24 h. The microstructure of PG was examined using scanning electron microscopy. In the small PG matrices, almost all of the added polyP (~100%) was released within the initial 24 h. In contrast, in the large PG matrices, approximately 50% of the polyP was released within the initial 24 h and thereafter gradually released over time. Owing to its simple chemical structure, linear polyP cannot be theoretically retained in the gel matrices used in this study. However, these findings suggest that thermally prepared PG matrices can be applied as carriers of polyP in tissue engineering and regenerative medicine.

Autologous platelet-rich plasma 'fluid' versus 'gel' form in combination with fractional CO2 laser in the treatment of atrophic acne scars: a split-face randomized clinical trial

BACKGROUND

The treatment of atrophic acne scars represents a therapeutic challenge. Recently, plasma gel has been introduced among treatment modalities.

OBJECTIVE

To compare the efficacy of platelet-rich-plasma 'fluid' versus 'gel' form combined with fractional CO₂ laser in the treatment of atrophic acne scars.

METHODS

Twenty-seven patients with atrophic acne scars were included. Treatment with fractional CO₂ laser plus plasma fluid/gel was randomly assigned to the right/left sides of the face. Clinical and Optical Coherence Tomography (OCT) assessments were scheduled at baseline, one month, and three months after the last session.

RESULTS

There was a significant improvement in clinical assessment scores at third-month follow-up on the plasma gel- and plasma fluid-treated sides compared to those at the first-month follow-up (p < .001). Scar depth decreased significantly at third-month follow-up when compared to baseline on both plasma gel- and plasma fluid-treated sides (p < .001). The numerical pain score was significantly lower on the plasma fluid-treated side compared to the plasma gel-treated side (p = .004).

CONCLUSION

The use of platelet-rich plasma in combination with fractional CO₂ laser, both in fluid and gel form, produced significant results in the treatment of atrophic acne scars. Patients reported an immediate more noticeable effect with plasma gel. However, the fluid injection was less painful.

A novel autologous dermal filler based on cultured fibroblasts and plasma gel for facial wrinkles: Long term results

Autologous cultured fibroblasts combined with plasma gel (Fibrogel^TM) can be used as an injectable autologous soft tissue filler. Herein, we report the assessment of the long-term clinical efficacy and safety of Fibrogel for facial wrinkles. Ten healthy adults were treated for facial wrinkles with Fibrogel, an innovative autologous filler. Patients underwent three treatment sessions at 1-month intervals for the correction of infraorbital, nasolabial, and marionette folds. In each session, 6-8 mL of Fibrogel filler containing 4 million fibroblasts/mL, was injected into the deep dermis or subdermal plane. Three evaluators independently assessed the efficacy at 3, 6 and 12 months after the last treatment, using the validated Global Esthetic Improvement Scale at two different times in a blinded manner. Infraorbital area and lower face were evaluated separately. All patients showed immediate improvement after the first injection at the infraorbital area and lower face. Follow-ups at 3, 6 and 12 months revealed that the improvement was persistent. Adverse reactions were mild and the treatment was well tolerated. Delivering autologous cultured fibroblasts embedded in an autologous plasma gel (Fibrogel) to the skin can provide immediate volume effect and long-term improvement. Therefore, Fibrogel can be considered as a promising novel autologous filler.

Treatment of atrophic acne scars: Topical or intralesional plasma gel?

BACKGROUND

Atrophic post-acne scarring is considered to be a therapeutic challenge.

OBJECTIVES

The aim was to compare the safety and efficacy of (A) FCL combined with intradermal injection of plasma gel, (B) FCL combined with topical application of plasma gel, and (C) FCL monotherapy in the treatment of atrophic post-acne scars.

METHODS

Thirty patients with facial atrophic post-acne scars were enrolled in this study and randomly assigned into one of three groups. All of them underwent four treatment sessions at 4-weeks intervals. They were assessed objectively by the quantitative global scarring grading system (GSGS). This system was applied at baseline, and after 1- and 6-month follow-up (FU). Subjective assessments were performed through the global esthetic improvement scale (GAIS) and level of patient satisfaction. The DLQI questionnaire was employed at the baseline and 6-month FU.

RESULTS

According to the quantitative GSGS scores, the reductions in group A (68.4%) and group B (63%) scores were comparable, and both were significantly higher than that in group C (41.2%) in all steps of evaluation. At 6-month FU, both groups A and B showed further significant improvement, while group C did not. Based on the GAIS and patients' satisfaction, there were no significant differences between all groups. The reductions in DLQI scores in groups A and B were comparable; however, both were significantly higher than group C (P < .001).

CONCLUSIONS

The combination of plasma gel and FCL resurfacing was noticeably outstanding in their efficacy and impact on the patients' quality of life.

Efficacy of platelet-poor plasma gel in combination with fractional CO2 laser in striae distensae: A clinical, histological, and immunohistochemical study

BACKGROUND

Platelet-poor plasma gel is a semi-solid plasma formulation that recently recommended as autologous bio-filler for treatment of atrophic dermal scars.

AIM

To compare the therapeutic efficacy and safety of intradermal injection of plasma gel in combination with fractional CO₂ laser versus fractional CO₂ laser alone in striae distensae (SD).

PATIENTS AND METHODS

This study included 36 SD patients treated by three sessions (one session/1.5 months) of fractional CO₂ laser on all SD lesions following intradermal injection of plasma gel on one side and saline (as placebo) on the other side.

RESULTS

Significant clinical improvements associated with remarkable narrowing of SD lesions and prominent enhancement of skin texture were observed on both treatment sides. Obviously, higher degrees of clinical improvements of SD lesions were reported following combined therapy with fractional CO₂ laser and plasma gel rather than fractional CO₂ laser monotherapy. However, post-inflammatory hyperpigmentation (PIH) was reported more frequently with fractional CO₂ laser monotherapy. Histopathological and immunohistochemical examinations revealed significant epidermal improvement, and homogenization, and orientation of dermal collagen bundles as a result of both therapeutic procedures.

CONCLUSION

Plasma gel in combination with fractional CO₂ laser could be considered a promising novel treatment modality for SD. Plasma gel not only improves the efficacy of fractional CO₂ laser but also decreases the frequency of PIH.

Platelet-poor plasma gel vs platelet-rich plasma for infraorbital rejuvenation: A clinical and dermoscopic comparative study

Infraorbital dark circles and tear trough deformity are considered common aesthetic problems. Numerous therapeutic modalities have been suggested with variable outcomes. The aim of this study was to compare the efficacy of platelet-poor plasma (PPP) gel vs platelet-rich plasma (PRP) in infraorbital rejuvenation. A total of 68 females presented with dark circles and/or tear trough deformity were recruited and treated by PPP gel injection in the right infraorbital region (Group A) and PRP injection in the left infraorbital region (Group B). They received three treatment sessions at 2-week interval, and followed up monthly for 3 months. They were evaluated clinically and dermoscopically before treatment and at the end of follow-up period. Both groups showed significant clinical improvements proved by significant reduction of degree of hyperpigmentation and tear trough rating scale. Obviously, more significant clinical and dermoscopic improvements were observed in Group A than Group B. Therefore, it could be concluded that both PPP gel and PRP were clinically effective procedures for aesthetic improvement of infraorbital region. Moreover, PPP gel seems to be significantly more effective than PRP as a therapeutic modality.

Autologous noncultured, nontrypsinized melanocyte-keratinocyte graft homogenized in plasma gel followed by narrow-band ultraviolet B therapy for stable vitiligo: A novel technique

There is a continuous need for modifications of epidermal cell grafting techniques treating stable vitiligo to make it easier, more economic, and with better outcome. To evaluate the efficacy and safety of noncultured, nontrypsinized epidermal cell graft homogenized with plasma gel, followed by narrow band-ultraviolet B (NB-UVB) in treatment of stable vitiligo, about 40 patients with stable vitiligo underwent harvesting of epidermal cells from the donor site by dermabrasion then the harvested cells were prepared, homogenized with autologous plasma gel, and applied to the abraded recipient, followed by 16 NB-UVB sessions after complete healing. Patches within the same anatomical site received only NB-UVB as controls. The percentage of improvement ranged from 23.33% to 100% with more than 75% uniform, homogenous repigmentation in 65% of patients. Donor site healed completely with normal skin. Noncultured, nontrypsinized epidermal cell grafting technique homogenized with plasma gel followed by NB-UVB sessions gave positive responses and was well tolerated in different body sites in stable resistant vitiligo.

Bio-Filler: An Effective Facial Rejuvenation Tool-Easy on Pocket

The Plasma Bio-Filler Facelift is an exciting aesthetic process being introduced in dermatology. The dermal filler gel is autologous and easy to obtain. It works well for fine rhytides reduction as well as to volumize, contour and rejuvenate the face, neck and hands. The consistency and autologous nature of plasma bio-filler are better accepted by patients than the high density hyaluronic acid fillers.

Assessment of the efficacy and safety of platelet poor plasma gel as autologous dermal filler for facial rejuvenation

BACKGROUND

The popularity of dermal fillers has grown rapidly in the last few years for facial rejuvenation. Plasma gel is an autologous gelatinous material that is prepared from the patient's own platelet poor plasma.

OBJECTIVE

To evaluate the clinical efficacy and safety of plasma gel injection as a dermal filler for facial rejuvenation.

PATIENTS AND METHODS

The current study was carried out on 52 females presented with facial aging divided into two groups: Group A included 34 females with facial wrinkles, and Group B included 18 females with tear trough deformity. After taking written informed consent, they received two sessions of plasma gel injections at 2-week interval and followed up monthly for 3 months. They were assessed clinically before treatment sessions and at the end of follow-up period.

RESULTS

Both studied groups showed immediate significant clinical improvement after plasma gel injection that maintained till the end of follow-up period. This finding was confirmed by significant reduction in the mean values of Wrinkle Severity Rating Scale (WSRS) in Group A and Tear Trough Rating Scale (TTRS) in group B, and significant improvement of skin homogeneity and texture in both groups. In general, the reported side effects were minimal and transient.

CONCLUSION

Autologous platelet poor plasma gel injection seems to be a cost-effective, safe, well-tolerated, and minimally invasive technique producing significant aesthetic correction of facial wrinkles and tear trough deformity.

Production of a composite hyaluronic acid/gelatin blood plasma gel for hydrogel-based adipose tissue engineering applications

Standard approaches to soft-tissue reconstruction include autologous adipose tissue transplantation, but most of the transferred adipose tissue is generally reabsorbed in a short time. To overcome this problem, long lasting implantable hydrogel materials that can support tissue regeneration must be produced. The purpose of this study was to evaluate the suitability of composite 3D natural origin scaffolds for reconstructive surgery applications through in vitro tests. The Young's modulus of the glutaraldehyde crosslinked hyaluronic acid/gelatin (HA/G) plasma gels, composed of human platelet-poor plasma, gelatin and human umbilical cord hyaluronic acid, was determined as 3.5 kPa, close to that of soft tissues. The composite HA/G plasma gels had higher porosity than plain plasma gels (72.5% vs. 63.86%). Human adipose tissue derived stem cells (AD-MSCs) were isolated from human lipoaspirates and characterized with flow cytometry, and osteogenic and adipogenic differentiation. Cell proliferation assay of AD-MSCs on the HA/G plasma gels revealed the nontoxic nature of these constructs. Adipogenic differentiation was distinctly better on HA/G plasma gels than on plain plasma gels. The results showed that the HA/G plasma gel with its suitable pore size, mechanical properties and excellent cell growth and adipogenesis supporting properties can serve as a useful scaffold for adipose tissue engineering applications.