Evaluation of adipose-derived stem cells (ASCS) exosome implantation and platelet-rich fibrin (PRF) on critical long bone defects in Sprague-Dawley rats

INTRODUCTION

This study aimed to assess the efficacy of adipose-derived mesenchymal stem cell exosomes (ASCs exosome) and platelet-rich fibrin (PRF) in treating critical long bone defects in Sprague-Dawley rats. Critical long bone defects, defined as exceeding 2 cm or 50% of the bone diameter, often pose a healing challenge. While autologous bone grafts have been considered, they have shown unreliable results and donor-site complications, necessitating alternative treatments.

METHODS

The research followed a quasi-experimental post-test only control group design involving 30 male Sprague-Dawley rats. The rats were divided into five groups and subjected to femur bone defect creation, internally fixed with a 1.4 mm K-wire, and treated with various combinations of hydroxyapatite (HA), bone graft (BG), ASCs exosome, and PRF. Histomorphometry and BMP-2 gene expression analysis were performed to evaluate bone healing.

RESULTS AND DISCUSSION

The results indicated that the group treated with HA + BG + ASCs exosome (group IV) exhibited the highest BMP-2 gene expression, while group III (HA + BG + ASCs exosome + PRF) had the highest chordin level. Overall, groups receiving ASCs exosome or PRF intervention showed elevated BMP-2 expression compared to the control group. The use of ASCs exosome and PRF showed comparable outcomes compared to bone graft administration in terms of histomorphometry analysis.

CONCLUSION

The administration of adipose tissue derived mesenchymal stem cells and PRF has a comparable outcome with the use of bone graft in terms of osseus area and expression of BMP-2 in critical bone defect.

Comparison of the effects of platelet-rich plasma and platelet-rich fibrin on the healing process of a rat's mucosal wound

Due to the problems associated with the use of PRP, a platelet concentrates without coagulation factors, called platelet-rich fibrin (PRF), has been developed that, in addition to tissue regeneration and wound healing, contains more white blood cells (WBCs), which are important in the wound healing process. In this study, the effect of these two platelet-rich plasmas on the thickness of the epithelium, the number of blood vessels and fibroblasts, and wound area were measured in two groups of PRP and PRF and at different periods. We divided the rats into three groups: the control group, the group receiving PRP, and the group receiving PRF. The results showed a significant difference in the number of fibroblasts, wound area, thickness of epithelium, and number of vessels in all three groups. Based on the results, the use of PRP and PRF in wounds can accelerate the formation of epithelium, create better and more blood vessels, create a platform for the migration and formation of fibroblast cells, and facilitate faster wound closure. Also, comparing PRP and PRF, it can be concluded that, finally, PRF acts better than PRP in epithelialization.

Platelet-rich fibrin in rhinoplasty: A precise and standardized approach

Rhinoplasty is a complex procedure. To achieve the expected aesthetic result, surgeons often use grafts both for structural and camouflage purposes. The perfect camouflage graft should be soft, malleable and precisely tailored to the patient's needs, with as few donor sites as possible. The use of diced cartilage has been widely described, but it cannot be used as a free graft in all cases. Platelet-rich fibrin is an interesting matrix for the creation of soft grafts with great precision and high reproducibility while promoting biocellular regeneration via growth factors. This article describes the use of platelet-rich fibrin in liquid and solid forms for the creation of standardized soft grafts with diced cartilage. We detail the procedure, and present the different grafts created by the author for dorsal camouflage and augmentation, tip management, and revision rhinoplasty.

New perspectives in regenerative medicine and surgery: the bioactive composite therapies (BACTs)

Regenerative medicine and surgery is a rapidly expanding branch of translational research in tissue engineering, cellular and molecular biology. To date, the methods to improve cell intake, survival, and isolation need to comply with a complex and still unclear regulatory frame, becoming everyday more restrictive and often limiting the effectiveness and outcome of the therapeutic choices. Thus, the authors developed a novel 360° regenerative strategy based on the synergic action of several new components called the bioactive composite therapies (BACTs) to improve grafted cells intake, and survival in total compliance with the legal and ethical limits of the current regulatory frame. The rationale at the origin of this new technology is based on the evidence that cells need supportive substrate to survive in vitro and this observation, applying the concept of translational medicine, is true also in vivo. Bioactive composite mixtures (BACMs) are tailor-made bioactive mixtures containing several bioactive components that support cells' survival and induce a regenerative response in vivo by stimulating the recipient site to act as an in situ real bioreactor. Many different tissues have been used in the past for the isolation of cells, molecules, and growth factors, but the adipose tissue and its stromal vascular fraction (SVF) remains the most valuable, abundant, safe, and reliable source of regenerative components and particularly of adipose-derived stems cells (ADSCs). The role of plastic surgeons as the historical experts in all the most advanced techniques for harvesting, manipulating, and grafting adipose tissue is fundamental in this constant process of expansion of regenerative procedures. In this article, we analyze the main causes of cell death and the strategies for preventing it, and we present all the technical steps for preparing the main components of BACMs and the different mixing modalities to obtain the most efficient regenerative action on different clinical and pathological conditions. The second section of this work is dedicated to the logical and sequential evolution from simple bioactive composite grafts (BACGs) that distinguished our initial approach to regenerative medicine, to BACTs where many other fundamental technical steps are analyzed and integrated for supporting and enhancing the most efficient regenerative activity. Level of Evidence: Not gradable.

Effect of Co-transplanting Stromal Vascular Fraction-Gelatin and Platelet-Rich Fibrin on the Long-Term Maintenance of Fat Volume

OBJECTIVE

In the present study, we aimed to investigate the survival of stromal vascular fraction-gelatin (SVF-gel) grafts and determine whether co-transplantation of SVF-gel and platelet-rich fibrin (PRF) improves long-term maintenance of fat volume (Wei et al. in Oncotarget 8:68542-68556, 2017) in a rabbit model.

METHODS

SVF-gel was transplanted into the ears of 12 rabbits with (experimental group) or without PRF (control group). Transplantation retention was evaluated based on weight, histology, and immunohistochemistry.

RESULTS

In the 2nd and 4th weeks, the volume of fat was larger in the experimental group than in the control group. In the 6th week, the absorption of fat was noticeable in both groups, and there was no significant difference in the fat survival rate between the two groups (experimental group: 1.051 ± 0.144 and control group: 0.789 ± 0.232, P > 0.05). HE staining results: At week 2, adipocytes were observed in the experimental group and tended to mature over time. These adipocytes also exhibited an ordered arrangement. Adipocytes with abnormal morphology appeared in the control group in the 4th week. At different weeks, there were more inflammatory cells and fibroblasts in the experimental group than in the control group, and they were arranged in an ordered fashion. Immunohistochemical results: More brown areas were observed in the experimental group than in the control group, and the morphology and distribution of adipocytes in the experimental group were better than those in the control group. The distribution of fibrocytes was also more regular in the experimental group than in the control group.

CONCLUSION

SVF-gel cannot maintain long-term filling in rabbit ears. The addition of PRF has no influence, although PRF can induce SVF-gel to transform into adipocytes, and the anti-inflammatory effect is noticeable in the early period following the procedure. Co-transplantation also helped to ensure orderly arrangement of fibrin. There were no "volume preservation differences in this experimental model" perhaps there are differences if other models/methodology are employed. No Level Assigned This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors - www.springer.com/00266 .

Treatment of mandibular grade III furcation involvement using platelet-rich fibrin and allogenic graft with 12-month follow-up - A case report

Introduction

Furcation involvement (FI) in multi-rooted teeth is challenging for proper oral hygiene, clinical treatment, and leads to poor prognosis. Traditional treatment modalities often result in sacrificing periodontal bone. Multiple regenerative approaches have been attempted to treat furcation defects, but complete regeneration of the periodontal apparatus in grade III furcation has not been reported. Platelet rich fibrin (PRF) shows great potential in enhancing tissue regeneration, angiogenesis, and prevention of infection. This case report introduces a treatment combining allogenic bone grafts with PRF to treat mandibular grade III furcation lesions with a one-year follow-up.

Case presentation

Two patients presented with grade III FIs of the mandibular first molars, with intrabony defects requiring guided tooth regeneration (GTR). PRF was collected from each patient to serve as biologics, by mixing with allogenic bone graft, and packed into the furcation and intrabony defects. The PRF membranes were also used for space maintenance. The twelve-month postoperative follow-up demonstrated quicker tissue healing, significant pocket reduction, clinical attachment gain, as well as radiographic bone fill in both cases.

Conclusion

Successful periodontal regeneration of grade III furcation defects can be achieved by using PRF in combination with bone allograft.

A mini-pig model for evaluating the efficacy of autologous platelet patches on induced acute full thickness wound healing

Background

Autologous platelet concentrates are currently widely used across different areas of regenerative medicine in order to enhance the wound healing process. Although several protocols for platelet concentrates are available, their application remains difficult due to different protocols leading to distinct products with vary potential biological uses. In this study, we attempted to make a platelet patch (PP) using mixtures of platelet rich plasma (PRP) injection and platelet rich fibrin (PRF) to promote wound repair and regeneration.

Results

Experiments were performed using a full-thickness wound model in mini-pigs. Autologous PRP, PRF and PP were prepared immediately before creating four full-thickness skin wounds in pigs. We quantified concentrations of platelets, thrombin and various growth factors to ensure that the desired effect can be produced. After surgery, hydrocolloid dressing, PRP injection, PRF and PP was applied to experimentally induced wounds. Application efficacy was evaluated by measurement of wound sizes and histological examination. The results indicated that all wounds showed a significant size reduction. Wound repair efficacy in response to PP treatment exhibited enhanced re-epithelialization compared to PRP and PRF (P < 0.05) and higher wound contraction than did PRF application (P < 0.05). Another aspect, experiment using DsRed transgenic pigs as blood donors demonstrated that leucocytes in PP were incorporated into the wound bed at the end of the study, suggesting that leucocytes activity is stimulated in response to PP application. Safety of the experimental processes was also confirmed by examination of organ biopsies.

Conclusions

We used a mini-pig model to evaluate the efficacy of lab-made PP on induced full-thickness wound healing. Results demonstrated that application of one piece of PP was enough to obtain comparable efficacy versus general utilization of PRP or PRF for wound care. We also demonstrated that leucocytes in PP were incorporated into the wound bed and no safety concerns have been found in the whole experiment. This study provides a novel and feasible method for veterinary or clinical wound care.

Combination of hydroxyapatite, platelet rich fibrin and amnion membrane as a novel therapeutic option in regenerative periapical endodontic surgery: Case series

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Our article was an attempt to focus on combined benefits of Bio-Gen mix^®, PRF and amnion membrane to provide a viable regenerative option in periapical surgery.

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To the best of our knowledge, there has been no evidence related to the application of a human placental membrane in periapical surgery. Our presented case reports provide an insight into this novel therapeutic option.

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The presented case reports confirm that the amnion membrane combined with bone graft and PRF have enhanced the healing outcomes and provided endodontists a sustainable tool while performing surgeries in the esthetic zone.

Introduction

Periapical surgery is the last resort in the arsenal of an endodontist to effectively deal with periapical lesions that result from necrosis of the pulp. Bone grafts, growth factors and membranes form an array of regenerative materials that influence the healing outcome of periapical surgery.

Presentation of case

The main purpose of the two cases reported here was to assess the potential benefits of a combination of bone graft, platelet-rich fibrin (PRF) and amnion membrane in terms of reduced post-operative discomfort, radiographic evidence of accelerated periapical bone healing and present a novel therapeutic option in the management of large periapical lesions. Two cases of radicular cysts were treated through a combined regenerative approachof Bio-Gen mix^®, PRF and amnion membrane. The patients were assessed for discomfort immediate post-operatively and after a week. The patients were recalled every month for the next 6 months for radiographic assessment of the periapical healing.

Discussion

Literature is replete with articles that have substantiated the role of demineralized bone matrix comprising a mixture of cancellous and cortical bone graft particles in enhancing regeneration. To the best of our knowledge, there has been no evidence related to the application of a human placental membrane in periapical surgery. Hence, the rationale of using a combined approach of Bio-Gen mix^®, PRF and amnion membrane was to combine the individual advantages of these materials to enhance clinical and radiographic healing outcomes. Our present case reports provide an insight into this novel therapeutic option.

Conclusion

The results of this case seriessubstantiatesthe credibility of using a combination ofamnion membrane with a bone graft and PRF to enhance radiographic healing outcome with decreased post-operative discomfort and present a viable regenerative treatment modality in periapical surgery.