Platelet-Released Growth Factors and Platelet-Rich Fibrin Induce Expression of Factors Involved in Extracellular Matrix Organization in Human Keratinocytes
Bayer Andreas,Wijaya Bernard,Möbus Lena,Rademacher Franziska,Rodewald Meno,Tohidnezhad Mersedeh,Pufe Thomas,Drücke Daniel,Gläser Regine,Harder Jürgen
International journal of molecular sciences
Platelet-released growth factor (PRGF) is a thrombocyte concentrate lysate which, like its clinically equivalent variations (e.g., Vivostat PRF (platelet-rich fibrin)), is known to support the healing of chronic and hard-to-heal wounds. However, studies on the effect of PRGF on keratinocytes remain scarce. This study aims to identify genes in keratinocytes that are significantly influenced by PRGF. Therefore, we performed a whole transcriptome and gene ontology (GO) enrichment analysis of PRGF-stimulated human primary keratinocytes. This revealed an increased expression of genes involved in extracellular matrix (ECM) organization. Real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) analysis confirmed the PRGF-mediated induction of selected ECM-related factors such as transforming growth factor beta-induced protein, fibronectin 1, matrix metalloproteinase-9, transglutaminase 2, fermitin family member 1, collagen type I alpha 1 and collagen type XXII alpha 1. PRGF-induced expression of the above factors was influenced by blockade of the epidermal growth factor receptor (EGFR), a receptor playing a crucial role in wound healing. A differential induction of the investigated factors was also detected in skin explants exposed to PRGF and in experimentally generated in vivo wounds treated with Vivostat PRF. Together, our study indicates that the induction of ECM-related factors may contribute to the beneficial wound-healing effects of PRGF-based formulations.
10.3390/ijms21124404
Safety and efficacy of ALRV5XR in women with androgenetic alopecia or telogen effluvium: A randomised, double-blinded, placebo-controlled clinical trial.
EClinicalMedicine
BACKGROUND:Scalp hair loss (alopecia) in women is a common ageing and senescing condition. It usually presents as androgenetic alopecia (AGA) or telogen effluvium (TE) and often has pronounced psychological consequences. ALRV5XR is a novel treatment aiming to regenerate a normal hair phenotype by targeting multiple molecular pathways linked to hair growth promotion and hair follicle stem cell activation. The primary objectives of this 24-week trial were to evaluate the safety and efficacy of ALRV5XR in terminal hair (TH) regrowth in women with AGA or TE. METHODS:This randomised, double-blind, placebo-controlled trial was performed in a USA community clinic. Healthy women 18-65 years of age with AGA or TE of Ludwig classification I-II and Fitzpatrick skin type I-VI were enrolled. They were allocated in a 1:1 ratio into ALRV5XR or placebo treatment groups using a random number table. Masked dermatologist assessments, phototrichograms and blood samples were obtained at baseline, 12 and 24 weeks. Subjects were given a masked treatment regimen of oral capsules, shampoo, conditioner and follicle serum for daily administration. Main outcomes were absolute and per cent changes in TH density and response rates. The trial was registered with clinicaltrials.gov (NCT04450602) and is completed. FINDINGS:46 subjects (23 ALRV5XR, 23 placebo) were enrolled between April 3 and October 20, 2018. Five subjects dropped out and two were non-compliant. Thirty-nine subjects completed the trial (18 ALRV5XR, 21 placebo). At 24 weeks, the absolute change in TH density improved by 30·1THs/cm (95% CI: 15·1-45·1; p=0·0002), and the relative density increased by 19·7% (95% CI: 8·0%-31·4%; p=0·0016). The odds ratio for being a responder (≥0 change) was 2·7. Efficacy increased 133% from week 12 to 24. Efficacy outcomes were similar in AGA and TE subjects. 66·7% of the ALRV5XR group responded by regrowing 40THs/cm or more hair. No adverse events were reported. INTERPRETATION:In women with AGA or TE, ALRV5XR treatment significantly increased hair regrowth without adverse events. ALRV5XR displayed a multi-fold improved efficacy and response rate when compared to published trials of standard therapy. Progressive acceleration of TH regrowth suggests regeneration of the structure and function of non-productive telogen follicles and prolonged treatment may restore a normal hair phenotype.
10.1016/j.eclinm.2021.100978
Telomere length and genetic variations affecting telomere length as biomarkers for facial regeneration with platelet-rich fibrin based on the low-speed centrifugation concept.
Nacopoulos Cleopatra,Gkouskou Kalliopi,Karypidis Dimitrios,Vlastos Ioannis,Vesala Anna-Maria,Choukroun Joseph,Miron Richard J,Prokopakis Emmanuel
Journal of cosmetic dermatology
BACKGROUND:Platelet-Rich Fibrin (PRF), a fibrin matrix produced by single blood centrifugation that contains leukocytes, platelets, and growth factors, is increasingly being utilized for facial regeneration purposes. However, our understanding of the involved pathophysiological mechanisms affecting regeneration is limited and current protocols require better optimization. Biomarkers that are related to skin aging such as telomere length (TL) have been proposed as a mean to analyze patients' stratification. OBJECTIVE:Our aim is to study whether the outcomes of a facial regeneration protocol performed with PRF are related to TL and genetic variations affecting TL. This can aid in the standardization of a surgical aesthetic protocol. PATIENTS AND METHODS:In all, 41 patients treated with PRF produced with the low-speed centrifugation concept were included in this observational study. The correlation between TL and genetic variations were assessed versus treatment outcomes, namely the number of sessions and aesthetic results utilizing the FACE-Q skin satisfaction questionnaire. RESULTS:In all, 39 of the 41 patients completed the treatment. TL correlated with the initial responses to FACE-Q (ρ = .33, P = .05). Genetic variations affecting TL was related to the change of FACE-Q (ρ = .35, P = .034) as well as to the number of treatment sessions (ρ = .38, P = .019). CONCLUSIONS:Telomere length (TL) was related to patient perceived facial skin appearance. In addition, genetic variations affecting TL were related to the final outcomes (number of sessions and improvements of FACE-Q results) and may be a useful biomarker for future regenerative procedures performed with PRF for facial regeneration.
10.1111/jocd.12666
Safety and efficacy of ALRV5XR in men with androgenetic alopecia: A randomised, double-blinded, placebo-controlled clinical trial.
EClinicalMedicine
BACKGROUND:Androgenetic alopecia (AGA) is the most common hair loss disorder seen in men. It can have an early onset but has also been associated with ageing and senescence. It often induces pronounced psychological impact. ALRV5XR, a new hair loss treatment herein evaluated, was designed to target multiple molecular pathways involved in hair growth and hair follicle stem cell biology. The main objectives of the study were the assessment of safety and efficacy profiles of ALRV5XR in men. METHODS:This 24-week, parallel randomised, placebo-controlled, double-blinded clinical trial was performed in a USA community clinic. Healthy men (age 22-65) with AGA and belonging to the Hamilton-Norwood (HN) classification I-VII and Fitzpatrick skin type (FST) I-VI, were randomly allocated in a 1:1 ratio into ALRV5XR or placebo treatment groups. Dermatologist assessment, phototrichograms, and blood samples were obtained in a blinded fashion at baseline, 12 and 24 weeks. Subjects were given a masked treatment consisting of oral capsules, shampoo, conditioner, and follicle serum, which was intended for daily use. Efficacy was assessed absolute and per cent changes in terminal hair (TH) density, and response rates. The trial was registered with clinicaltrials.gov (NCT04450589) and is completed. FINDINGS:Forty-six subjects were enroled in the study, 23 allocated to the ALRV5XR treatment and 23 to the placebo group. Enrolment occurred from April 11 to October 23, 2018. Thirty-six subjects completed the trial (17 ALRV5XR, 19 placebo) and 11 subjects in each group were evaluable for TH outcomes. At 24 weeks, the absolute change in TH density improved by 21·0 THs/cm (95% CI: 9·2-32·8; = 0·0014), and the relative density increased by 16·4% (95% CI: 7·4%-25·5%; = 0·0012). The odds ratio for being a responder (≥ 0 change) was 87·4. TH density increased linearly and was not affected by HN, FST, ethnicity, age, or body mass index. All subjects in the ALRV5XR group responded to treatment while 81·8% of the placebo group decreased TH density. ALRV5XR induced statistically significant changes in both decrease in vellus hair (VH) density as well as in concomitant increase of the TH/VH ratio when compared to placebo. ALRV5XR was well tolerated, and no adverse events were observed. INTERPRETATION:ALRV5XR treatment resulted in clinically significant TH regrowth in men with AGA. Furthermore, it appeared to reverse the characteristic hair miniaturisation seen in this condition. When compared to results of published trials of standard therapy, ALRV5XR showed a multi-fold increase both in efficacy and in response rates. In addition, the continuance of TH regrowth from 12 to 24 weeks suggests that the normal structure and function of non-productive telogen follicles is restored and that a normal hair phenotype may be attained by extended ALRV5XR treatment. FUNDING:Arbor Life Labs.
10.1016/j.eclinm.2021.101124
Platelet-released growth factors induce psoriasin in keratinocytes: Implications for the cutaneous barrier.
Bayer Andreas,Lammel Justus,Lippross Sebastian,Klüter Tim,Behrendt Peter,Tohidnezhad Mersedeh,Pufe Thomas,Cremer Jochen,Jahr Holger,Rademacher Franziska,Gläser Regine,Harder Jürgen
Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft
Millions of patients around the world suffer minor or major extremity amputation due to progressive wound healing complications of chronic or infected wounds, the therapy of which remains a challenge. One emerging therapeutic option for the treatment of these complicated wounds is the local application of an autologous thrombocytes concentrate lysate (e.g. platelet-released growth factors ((PRGF)) or Vivostat PRF) that contains a multitude of chemokines, cytokines and growth factors and is therefore supposed to stimulate the complex wound healing process. Although PRGF and Vivostat PRF are already used successfully to support healing of chronic, hard-to-heal and infected wounds the underlying molecular mechanisms are not well understood. Psoriasin, also termed S100A7, is a multifunctional antimicrobial protein expressed in keratinocytes and is involved in various processes such as wound-healing, angiogenesis, innate immunity and immune-modulation. In this study, we investigated the influence of PRGF on psoriasin expression in human primary keratinocytes in vitro and the influence of Vivostat PRF on psoriasin expression in experimentally generated skin wounds in vivo. PRGF treatment of primary keratinocytes caused a significant concentration- and time-dependent increase of psoriasin gene and protein expression in vitro that were partially mediated by the epidermal growth factor receptor (EGFR) and the interleukin-6 receptor (IL-6R). In accordance with these cell culture data, Vivostat PRF induced a significant psoriasin gene and protein expression when applied to artificially generated skin wounds in vivo. The observed psoriasin induction in keratinocytes may contribute to the wound healing-promoting effects of therapeutically used thrombocyte concentrate lysates.
10.1016/j.aanat.2017.04.002
The effect of platelet-rich fibrin on normal dermal fibroblast proliferation after mitomycin-c treatment: An in vitro study.
Dachlan Ishandono,Kurniawan Hendy Satrya,Wicaksana Aditya,Fauzi Aditya Rifqi,Makrufardi Firdian,Seswandhana Rosadi
Annals of medicine and surgery (2012)
Background:Disturbance in the wound healing can cause the wound turn into a chronic wound, which histologically shows fibroblast senescence with weak proliferation ability. Mitomycin-C could block cell proliferation that causes cell senescence which is similar to the chronic wound morphology. Platelet-Rich Fibrin (PRF) contains a large number of platelets, leukocytes, cytokines and growth factors. This study aims to determine whether PRF could improve the fibroblast proliferation after treatment with Mitomycin-C. Methods:Cultured normal human skin fibroblasts forth passage divided into five groups. The first group was treated with culture medium, and the second group with 10 μg/mL mitomycin-C for 2 h. The third, 4th and 5th group were treated with mitomycin-C for the same dose and period, then adding it with 100%, 50%, and 25% of PRF. The fibroblast proliferation was measured by MTT assay. Results:The fibroblast proliferation in the group with culture medium is 11.366,56 ± 4.073,32, meanwhile in the group with mitomycin-C treatment is 5.690,41 ± 2.834,22. The fibroblast proliferation in group with 100% PRF is 7.909,8 ± 3.392,19; group with 50% PRF 15.347,91 ± 8.413,02; and group with 25% PRF 13.449,56 ± 7.523,83. All of the PRF groups increased significantly compared to the group with Mitomycin-C treatment. Conclusions:Platelet-Rich Fibrin can improve normal dermal fibroblast proliferation after treatment with mitomycin-C in vitro.
10.1016/j.amsu.2021.01.093
Platelet-released growth factors induce the antimicrobial peptide human beta-defensin-2 in primary keratinocytes.
Bayer Andreas,Lammel Justus,Rademacher Franziska,Groß Justus,Siggelkow Markus,Lippross Sebastian,Klüter Tim,Varoga Deike,Tohidnezhad Mersedeh,Pufe Thomas,Cremer Jochen,Gläser Regine,Harder Jürgen
Experimental dermatology
Platelet-released growth factors (PRGF) and its related clinically used formulations [e.g. Vivostat platelet-rich fibrin (PRF(®) )] are thrombocyte concentrate lysates that support healing of chronic, hard-to-heal and infected wounds. Human beta-defensin-2 (hBD-2) is an antimicrobial peptide expressed in human keratinocytes exhibiting potent antimicrobial activity against wound-related bacteria. In this study, we analysed the influence of PRGF on hBD-2 expression in human primary keratinocytes and the influence of Vivostat PRF(®) on hBD-2 expression in experimentally generated skin wounds in vivo. Treatment of primary keratinocytes with PRGF caused a significant increase in hBD-2 gene and protein expressions in a concentration- and time-dependent manner. The use of blocking antibodies revealed that the PRGF-mediated hBD-2 induction was partially mediated by the epidermal growth factor receptor and the interleukin-6 receptor (IL-6R). Luciferase gene reporter assays indicated that the hBD-2 induction through PRGF required activation of the transcription factor activator protein 1 (AP-1), but not of NF-kappaB. In concordance with these cell culture data, Vivostat PRF(®) induced hBD-2 expression when applied to experimentally generated skin wounds. Together, our results indicate that the induction of hBD-2 by thrombocyte concentrate lysates can contribute to the observed beneficial effects in the treatment of chronic and infected wounds.
10.1111/exd.12966
Platelet-Rich Fibrin Lysate Can Ameliorate Dysfunction of Chronically UVA-Irradiated Human Dermal Fibroblasts.
Wirohadidjojo Yohanes Widodo,Budiyanto Arief,Soebono Hardyanto
Yonsei medical journal
To determine whether platelet-rich fibrin lysate (PRF-L) could restore the function of chronically ultraviolet-A (UVA)-irradiated human dermal fibroblasts (HDFs), we isolated and sub-cultured HDFs from six different human foreskins. HDFs were divided into two groups: those that received chronic UVA irradiation (total dosages of 10 J cm⁻²) and those that were not irradiated. We compared the proliferation rates, collagen deposition, and migration rates between the groups and between chronically UVA-irradiated HDFs in control and PRF-L-treated media. Our experiment showed that chronic UVA irradiation significantly decreased (p<0.05) the proliferation rates, migration rates, and collagen deposition of HDFs, compared to controls. Compared to control media, chronically UVA-irradiated HDFs in 50% PRF-L had significantly increased proliferation rates, migration rates, and collagen deposition (p<0.05), and the migration rates and collagen deposition of chronically UVA-irradiated HDFs in 50% PRF-L were equal to those of normal fibroblasts. Based on this experiment, we concluded that PRF-L is a good candidate material for treating UVA-induced photoaging of skin, although the best method for its clinical application remains to be determined.
10.3349/ymj.2016.57.5.1282
Injectable platelet rich fibrin facilitates hair follicle regeneration by promoting human dermal papilla cell proliferation, migration, and trichogenic inductivity.
Lu Kongye,Han Qiwen,Ma Zekun,Yan Qingqing,Pei Yunlong,Shi Pengzhi,Zhang Jin,Rong Kunjie,Ma Kun,Li Pingsong,Hou Tuanjie
Experimental cell research
Hair follicle regeneration has been successful in mice but failed in human being for years. Dermal papilla cells, a specialized mesenchymal stem cell derived from dermal papilla within hair follicles, is considered the key cells for hair follicle regeneration function as both regeneration initiator and regulator. Injectable platelet rich fibrin (i-PRF), a novel biomaterial rich in a variety of growth factors and three-dimensional scaffolds, has shown promising effects on tissue regeneration. In this study, we aimed to evaluate the application of i-PRF in human hair follicle regeneration by examining the biological effects of i-PRF on human dermal papilla cells (hDPCs). Biomaterial compatibility, cell viability, proliferation, migration, alkaline phosphatase activity and trichogenic inductivity were assessed after exposing hDPCs to different concentrations of i-PRF extracts. In addition, we investigated the ultrastructure of i-PRF with all cell components filtered. The results revealed that i-PRF possessing excellent biocompatibility and could significantly promote hDPCs proliferation, migration, and trichogenic inductivity. Furthermore, the concentration of i-PRF is able to remarkably influence hDPCs behavior in a dose-dependent pattern. Different concentrations exhibited differential effects on hDPCs behavior. In general, lower concentration promotes cell proliferation better than higher concentration, while higher concentration promotes cell function better reversely. Best concentration for hDPCs in vitro expending is 1% concentration. 20% concentration is optimal for hair follicle regeneration. In summary, our findings concluded that i-PRF facilitates hair follicle regeneration by promoting human dermal papilla cell proliferation, migration, and trichogenic inductivity.
10.1016/j.yexcr.2021.112888
Platelet-rich Fibrin in Nonhealing Leg Ulcers: A Simple and Effective Therapeutic Option.
Journal of cutaneous and aesthetic surgery
BACKGROUND:Nonhealing ulcers can occur due to a variety of causes and are associated with high morbidity, expensive, and prolonged treatment. We conducted this study to determine the efficacy of autologous platelet-rich fibrin (PRF) in nonhealing ulcers in various disorders, which is a very cost-effective and safe treatment option. MATERIALS AND METHODS:Eighteen patients with nonhealing leg ulcers were included. The ulcers were treated with PRF at weekly intervals. The response to treatment was recorded by calculating the area of ulcer at baseline and at every subsequent visit till the ulcers healed. RESULTS:The study included 18 patients of nonhealing leg ulcers due to leprosy ( = 6), neuropathic ulcer ( = 4), venous ulcer ( = 3), diabetic foot ulcer ( = 2), post-traumatic ulcer ( = 2), and post-full-thickness skin graft ulcer ( = 1). The mean size of the ulcers was 8.44 cm and mean duration was 5.55 months. The mean age of the patients was 40.5 years. The minimum and the maximum sittings required were three and nine, respectively (mean 5). No adverse events were noted. CONCLUSION:The treatment of nonhealing ulcer with PRF is an easy, safe, simple, and cost-effective method.
10.4103/JCAS.JCAS_130_19
Evaluation of the Effect of Platelet-Rich Fibrin Matrix in the Correction of Periorbital Wrinkles: An Experimental Clinical Trial.
Dermatology practical & conceptual
INTRODUCTION:Skin rejuvenation techniques have gained substantial popularity due to increased life expectancy over recent years. Platelet-rich fibrin matrix (PRFM) is the new generation of platelet aggregate products that have surfaced in recent years to treat skin aging. OBJECTIVES:We intend to use PRF to correct periorbital wrinkles in 15 volunteers and evaluate its effectiveness in this study. METHODS:To evaluate the efficacy of PRFM intervention, eight men and women over the age of thirty entered our study. Blood samples were taken and were immediately centrifuged at 700rpm for 5 minutes. PRFM was extracted from the plasma and injected at the sub-dermis site in periorbital areas. The initial severity of periorbital wrinkles was determined by Visioface 1000D, and obtained data were delivered to the statistical unit for statistical analysis. Scoring and evaluation were based on tissue volume and depth and were measured before and twelve weeks after injection. Adverse effects were also taken into consideration. RESULTS:The results demonstrated noticeable improvement in deep, fine, and small wrinkles, periocular hyperpigmentation, and overall skin freshness of the injection site. The subjects had swelling in the injection site for up to one day after the injection, which resolved without complications. CONCLUSIONS:PRFM was observed to have potential in skin rejuvenation, demonstrating promising outcomes in terms of safety and long-term effects in improving skin condition.
10.5826/dpc.1301a50
Nanofat-derived stem cells with platelet-rich fibrin improve facial contour remodeling and skin rejuvenation after autologous structural fat transplantation.
Wei Hua,Gu Shi-Xing,Liang Yi-Dan,Liang Zhi-Jie,Chen Hai,Zhu Mao-Guang,Xu Fang-Tian,He Ning,Wei Xiao-Juan,Li Hong-Mian
Oncotarget
Traditional autologous fat transplantation is a common surgical procedure for treating facial soft tissue depression and skin aging. However, the transplanted fat is easily absorbed, reducing the long-term efficacy of the procedure. Here, we examined the efficacy of nanofat-assisted autologous fat structural transplantation. Nanofat-derived stem cells (NFSCs) were isolated, mechanically emulsified, cultured, and characterized. Platelet-rich fibrin (PRF) enhanced proliferation and adipogenic differentiation of NFSCs . We then compared 62 test group patients with soft tissue depression or signs of aging who underwent combined nanofat, PRF, and autologous fat structural transplantation to control patients (77 cases) who underwent traditional autologous fat transplantation. Facial soft tissue depression symptoms and skin texture were improved to a greater extent after nanofat transplants than after traditional transplants, and the nanofat group had an overall satisfaction rate above 90%. These data suggest that NFSCs function similarly to mesenchymal stem cells and share many of the biological characteristics of traditional fat stem cell cultures. Transplants that combine newly-isolated nanofat, which has a rich stromal vascular fraction (SVF), with PRF and autologous structural fat granules may therefore be a safe, highly-effective, and long-lasting method for remodeling facial contours and rejuvenating the skin.
10.18632/oncotarget.19721
Comparison Between Injectable Platelet-rich Fibrin and Platelet-rich Plasma in Ameliorating UVA-induced Photoaging in Human Dermal Fibroblasts via the Activation of TGF-β/Smad Signaling Pathway.
Photochemistry and photobiology
Early-stage photoaging is characterized by skin laxity and wrinkling, which are mainly attributable to the ultraviolet (UV) irradiation-mediated imbalance between matrix metalloproteinase (MMP) production and collagen degradation. Injectable platelet-rich fibrin (i-PRF) is a novel blood concentrate with potential effects on photoaging. Over the past few decades, platelet-rich plasma (PRP) has been widely researched and used in different clinical fields as a first-generation platelet concentrate. The aim of this study was to compare the antiphotoaging effects of i-PRF in UVA-irradiated human dermal fibroblasts with those of PRP by examining cell proliferation, migration and apoptosis, ROS generation, MMP-1 and collagen I levels. The activation of the TGF-β/Smad signaling pathway by i-PRF and PRP was also investigated using western blotting. The results showed that i-PRF was more effective than PRP in promoting cell proliferation and migration. Moreover, i-PRF reduced ROS generation and cell apoptosis more effectively than PRP. With respect to the mechanism of collagen I upregulation, stronger stimulation of the TGF-β/Smad signaling pathway and greater suppression of MMP-1 expression were achieved by i-PRF than by PRP. Our results suggest that i-PRF can be a promising substitute for PRP in alleviating UVA-induced photoaging and should be explored further for its anti-photoaging properties.
10.1111/php.13628
Overexpressed perforin contributes to the melanocyte destruction via epigenetic regulation in patients with vitiligo.
International immunopharmacology
BACKGROUND:Perforin (PRF), a pivotal cytotoxic effector molecule of activated CD8 T cells, has a crucial role in the pathogenesis of vitiligo. However, the mechanisms leading to the abnormal perforin expression remain poorly understood in the CD8 T cells of vitiligo patients. OBJECTIVE:To investigate the contributions of DNA methylation to the abnormal expression of perforin in CD8 T cells of vitiligo patients. METHODS:Skin samples and CD8 T cells from peripheral blood were collected to detect the expression levels of perforin in vitiligo patients. The methylation status of the perforin promoter was investigated by bisulfite sequencing. The apoptosis of melanocytes co-cultured with CD8 T cells was evaluated to determinate the cytotoxic role of perforin. RESULTS:Increased CD8 and perforin cells were found in lesion of vitiligo patients. The expression levels of perforin were elevated in the CD8 T cells from peripheral blood of vitiligo patients and their culture supernatants. The perforin promoter was hypomethylated in vitiligo CD8 T cells. Treatment of normal CD8 T cells with the DNA methylation inhibitor 5-Azacytidine (5-Azac) reduced the perforin methylation level and caused perforin overexpression. The methylation levels of perforin were inversely correlated with its mRNA expression in CD8 T cells. The apoptosis rates of the melanocytes co-cultured with vitiligo- and 5-Azac-treated-normal CD8 T cells were significantly increased compared with normal-untreated CD8 T cells. And the apoptosis rates of melanocytes co-cultured with si-PRF-treated-vitiligo CD8 T cells were significantly decreased compared with vitiligo-untreated CD8 T cells. CONCLUSION:Hypomethylation of the perforin promoter contributes to its overexpression in CD8 T cells from vitiligo patients, which then mediates the melanocyte destruction in vitiligo.
10.1016/j.intimp.2022.109574
Injectable platelet-rich fibrin for treatment of female pattern hair loss.
Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology
This case series evaluated use of injectable platelet rich fibrin (termed i-PRF+) for the treatment of female pattern hair loss (FPHL). Eleven individuals underwent 3-monthly intradermal injections of i-PRF+ using a mesotherapy gun. The mean number of hair follicles containing hairs per unit area improved at 3- and 6-months follow-up ( < .001), and all participants had a negative hair pull test. Hair volume and thickness, and patient-reported outcome scores also improved at follow-up ( < .001). Adverse effects were minor and self-limited. A series of three i-PRF+ injection sessions were effective for the treatment of FPHL, as shown by improved hair analysis parameters and patient self-assessment scores.
10.1080/14764172.2024.2374858
Allogeneic Platelet-Rich Plasma: Is It Safe and Effective for Wound Repair?
Akbarzadeh Shiva,McKenzie Maxwell B,Rahman Md Mostafizur,Cleland Heather
European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes
BACKGROUND:Platelet-rich plasma (PRP) and its derivatives are an emerging biotechnology whereby concentrated platelets provide damaged tissue with growth factors, cytokines, and other mediators to improve healing outcomes. Although there is strong evidence in the benefits of autologous PRP for both acute and chronic wounds, allogeneic PRP has been studied far less in comparison. SUMMARY:In this mini-review, we discuss critical steps of allogenic PRP (and its derivatives) preparation. We performed a non-systematic review of the literature to identify animal and human subject studies testing allogenic PRP for wound treatment. We searched OVID Medline and PubMed for articles using the keywords "wound, ulcer, lesion, skin, and cutaneous" and "PRP, or platelet-rich plasma, or platelet-rich fibrin, or PRF, or platelet releasate" and "homologous, allogeneic or allogenic," which were limited to non-review articles and English language. Two studies in animal models and 8 studies in patients were reviewed. There were inconsistencies in preparation methods, treatment regimens, and some lacked a control group in their studies. Despite these variations, none of the studies identified any major side effects or adverse events. The treatment resulted in a reduced time to heal and/or reduced wound size in most cases. Key Messages: In situations where autologous PRP is not available or suitable, allogeneic PRP appears to provide a safe alternative. Its efficacy, however, requires larger-scale studies with appropriate controls. Standardization in PRP preparation and treatment regime are also needed to be able to interpret allogenic PRP efficacy.
10.1159/000514223
Platelet-Released Growth Factors Influence Wound Healing-Associated Genes in Human Keratinocytes and Ex Vivo Skin Explants.
International journal of molecular sciences
Platelet-released growth factors (PRGFs) or other thrombocyte concentrate products, e.g., Platelet-Rich Fibrin (PRF), have become efficient tools of regenerative medicine in many medical disciplines. In the context of wound healing, it has been demonstrated that treatment of chronic or complicated wounds with PRGF or PRF improves wound healing in the majority of treated patients. Nevertheless, the underlying cellular and molecular mechanism are still poorly understood. Therefore, we aimed to analyze if PRGF-treatment of human keratinocytes caused the induction of genes encoding paracrine factors associated with successful wound healing. The investigated genes were Semaphorin 7A (SEMA7A), Angiopoietin-like 4 (ANGPLT4), Fibroblast Growth Factor-2 (FGF-2), Interleukin-32 (IL-32), the CC-chemokine-ligand 20 (CCL20), the matrix-metalloproteinase-2 (MMP-2), the chemokine C-X-C motif chemokine ligand 10 (CXCL10) and the subunit B of the Platelet-Derived Growth Factor (PDGFB). We observed a significant gene induction of SEMA7A, ANGPLT4, FGF-2, IL-32, MMP-2 and PDGFB in human keratinocytes after PRGF treatment. The CCL20- and CXCL10 gene expressions were significantly inhibited by PRGF therapy. Signal transduction analyses revealed that the PRGF-mediated gene induction of SEMA7A, ANGPLT4, IL-32 and MMP-2 in human keratinocytes was transduced via the IL-6 receptor pathway. In contrast, EGF receptor signaling was not involved in the PRGF-mediated gene expression of analyzed genes in human keratinocytes. Additionally, treatment of ex vivo skin explants with PRGF confirmed a significant gene induction of SEMA7A, ANGPLT4, MMP-2 and PDGFB. Taken together, these results describe a new mechanism that could be responsible for the beneficial wound healing properties of PRGF or related thrombocytes concentrate products such as PRF.
10.3390/ijms23052827
Autologous Matrix of Platelet-Rich Fibrin in Wound Care Settings: A Systematic Review of Randomized Clinical Trials.
Journal of functional biomaterials
Platelet-rich fibrin (PRF) consists of a matrix that provides the necessary elements for wound healing, acting as a biodegradable scaffold for cell migration, proliferation, and differentiation, in addition to the delivery of growth factors and angiogenesis. This study aims to determine the effectiveness of the autologous PRF in the treatment of wounds of different etiologies. We carried out a systematic review of randomized clinical trials, guided by the recommendations of the Cochrane Collaboration using the following databases: Pubmed/MEDLINE, EMBASE, Web of Science, and CENTRAL. The search strategy resulted in the inclusion of ten studies that evaluated the use of PRF dressings for the healing of acute or chronic wounds of multiple etiologies. Among the 172 participants treated with PRF in wounds of varying etiologies and different segment times, 130 presented favorable events with the use of the intervention. Among the 10 studies included, only two of them did not demonstrate better results than the control group. The studies showed clinical heterogeneity, making it impossible to perform a meta-analysis. The findings do not provide enough evidence to support the routine use of PRF dressings as the first line of treatment for the healing of acute or chronic wounds of different etiologies. There was great variability in the application of the various protocols and the ways to prepare the PRF, resulting in clinical heterogeneity. Therefore, it makes it impossible to synthesize and to collect evidence from different types of studies in the meta-analysis, which affects the results and their proper discussion.
10.3390/jfb11020031
Injectable platelet-rich fibrin for facial rejuvenation: A prospective, single-center study.
Hassan Haidar,Quinlan Daniel J,Ghanem Ali
Journal of cosmetic dermatology
BACKGROUND:Autologous platelet-derived preparations have been used in many surgical fields to improve healing outcomes, with benefits reported in several aesthetic indications. AIMS:This single-center, prospective, uncontrolled study evaluated the efficacy of injectable platelet-rich fibrin (i-PRF) for facial skin rejuvenation using an objective skin analysis system and validated patient-reported outcome measures. PATIENTS/METHODS:PRF PROCESS system technology was used to prepare i-PRP. Eleven healthy female individuals were included in the study and over 3-months received monthly intradermal injections of i-PRF in 3 facial regions: malar areas (1 mL each side), nasolabial fold (0.5 mL each side), and upper lip skin above the vermilion border (1 mL). The efficacy of the procedures was assessed by objective skin analysis (VISIA ) and a subjective patient-reported outcome (FACE-Q) assessment at baseline and after 3 months. RESULTS:A significant improvement in skin surface spots (P = .01) and pores (P = .03) was seen at 3-months follow-up. Other variables, such as skin texture, wrinkles, ultraviolet spots, and porphyrins, showed a numerical improvement. FACE-Q scales that measure satisfaction with appearance all showed a significant improvement from baseline, including satisfaction with skin (P = .002), satisfaction with facial appearance (P = .025), satisfaction with cheeks (P = .001), satisfaction with lower face and jawline (P = .002), and satisfaction with lips (P = .04). No major adverse effects were reported. CONCLUSIONS:A series of three i-PRF injections resulted in significant rejuvenation of the face skin at 3-month follow-up, as shown by improved skin analysis parameters and patient self-assessment scores.
10.1111/jocd.13692
Leucocyte- and platelet-rich fibrin (L-PRF) as a regenerative medicine strategy for the treatment of refractory leg ulcers: a prospective cohort study.
Pinto Nelson R,Ubilla Matias,Zamora Yelka,Del Rio Verónica,Dohan Ehrenfest David M,Quirynen Marc
Platelets
Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients. Forty-four consecutive patients with VLUs (n = 28, 32 wounds: 17 ≤ 10 cm and 15 > 10 cm), DPUs (n = 9, 10 wounds), PUs (n = 5), or complex wounds (n = 2), all refractory to standard treatment for ≥3 months, received a weekly application of L-PRF membranes. L-PRF was prepared following the original L-PRF method developed more than 15 years ago (400g, 12 minutes) using the Intra-Spin L-PRF centrifuge/system and the XPression box kit (Intra-Lock, Boca Raton, FL, USA; the only CE/FDA cleared system for the preparation of L-PRF). Changes in wound area were recorded longitudinally via digital planimetry. Adverse events and pain levels were also registered. All wounds showed significant improvements after the L-PRF therapy. All VLUs ≤ 10 cm, all DFUs, as well as the two complex wounds showed full closure within a 3-month period. All wounds of patients with VLUs > 10 cm who continued therapy (10 wounds) could be closed, whereas in the five patients who discontinued therapy improvement of wound size was observed. Two out of the five PUs were closed, with improvement in the remaining three patients who again interrupted therapy (surface evolution from 7.35 ± 4.31 cm to 5.78 ± 3.81 cm). No adverse events were observed. A topical application of L-PRF on chronic ulcers, recalcitrant to standard wound care, promotes healing and wound closure in all patients following the treatment. This new therapy is simple, safe and inexpensive, and should be considered a relevant therapeutic option for all refractory skin ulcers.
10.1080/09537104.2017.1327654
Effectiveness of Injectable Platelet-Rich Fibrin Therapy in Alopecia and Facial Rejuvenation: A Systematic Review.
Cureus
Platelet-rich fibrin (PRF) has gained attention in regenerative medicine for its potential to enhance tissue repair and regeneration. Its application in dermatology, particularly for treating alopecia and facilitating facial rejuvenation, is of significant interest but requires systematic evaluation. This review aims to systematically assess the effectiveness of injectable PRF therapy in treating alopecia and facial rejuvenation procedures. We searched PubMed, Scopus, and Web of Science for studies published up to 2023 that involved injectable PRF for alopecia and facial rejuvenation. Eligible studies included prospective cohorts, original studies, case series, and retrospective studies that reported clinical outcomes. Key outcomes were improved hair growth for alopecia and skin texture, elasticity, and appearance for facial rejuvenation. Seven studies met the inclusion criteria, encompassing 130 patients. For alopecia, three studies reported a noticeable improvement in hair density and growth. For facial rejuvenation, four studies demonstrated moderate to significant improvements in skin texture and elasticity and a reduction in facial wrinkles and lines, confirmed by both subjective assessments and objective measurements such as VISIA® skin analysis. Injectable PRF therapy shows promise in treating androgenetic alopecia and enhancing facial esthetics, indicating its potential as an effective treatment option in regenerative dermatology. However, further research involving larger sample sizes, control groups, and longer follow-ups is required to validate these findings and establish standardized treatment protocols.
10.7759/cureus.62198
The distribution pattern and growth factor level in platelet-rich fibrin incorporated skin-derived mesenchymal stem cells: An study.
Ihsan Igo Syaiful,Karsari Deya,Ertanti Nora,Dinaryanti Aristika,Nugraha Alexander Patera,Purwati Purwati,Sudjarwo Sri Agus,Rantam Fedik Abdul
Veterinary world
Background and Aim:A skin wound in an animal must be cared for to prevent further health issues. Platelet-rich fibrin (PRF) and skin-derived mesenchymal stem cells (SMSCs) have been reported to have potential in increasing the rate of wound healing. This study aimed to analyze the distribution patterns and levels of platelet-derived growth factor (PDGF), insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), and transforming growth factor-β (TGF-β) in PRF incorporated with SMSCs. Materials and Methods:This study employed a true experiment () design with post-test only performed in the control group alone. PRF and SMSCs were extracted from the blood and skin of 16 rabbits. SMSCs were characterized using immunocytochemistry to examine clusters of differentiation for 45, 73, 90, and 105. PRF was incorporated into the SMSCs and then divided into four groups (N=32/n=8): Group A (PRF only), Group B (PRF+SMSCs, incubated for 1 day), Group C (PRF+SMSCs, incubated for 3 days), and Group D (PRF+SMSCs, incubated for 5 days). Scanning electron microscopy was used to examine the distribution pattern of SMSCs between groups. The supernatant serum (Group A) and supernatant medium culture (Group D) were collected for the measurement of PDGF, IGF, VEGF, and TGF-β using an enzyme-linked immunosorbent assay sandwich kit. An unpaired t-test was conducted to analyze the differences between Groups A and D (p<0.01). Results:Group D had the most morphologically visible SMSCs attached to the PRF, with elongated and pseudopodia cells. There was a significant difference between the levels of growth factor in Groups A and D (p=0.0001; p<0.01). Conclusion:SMSCs were able to adhere to and distribute evenly on the surface of PRF after 5 days of incubation. The PRF incorporated SMSCs contained high levels of PDGF, IGF, VEGF, and TGF- β, which may prove to have potential in enhancing wound healing.
10.14202/vetworld.2020.2097-2103
Platelet-Rich Plasma in Androgenetic Alopecia.
Sharma Aseem,Chouhan Kavish,Bhatia Satish,Dashore Shuken
Indian dermatology online journal
The goal of these recommendations is to provide a framework to practitioners for implementing useful, evidence-based recommendations for the preparation of platelet-rich plasma (PRP) and its use in androgenetic alopecia (AGA). The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these recommendations to its taskforce on PRP. A comprehensive literature search was done in the English language on the PRP across multiple databases. The grade of evidence and strength of recommendation were evaluated on the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) framework. A draft of clinical recommendations was developed on the best available evidence, which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, the final consensus statement was prepared. A total of 30 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], and case series) were critically evaluated, and the evidence thus gathered was used in the preparation of these recommendations. This expert group recommends use of manual double-spin method for the preparation of PRP for AGA. Minimum three to five sessions of PRP are recommended for AGA with a gap of 1 month between the two sessions. Patients with Grade II to V Norwood Hamilton classification of AGA are the ideal subset for PRP. A total of 5 to 7 mL of PRP and 0.05 to 0.1 mL/cm is the recommended dose of PRP for AGA. Activation of PRP is not required when it is used for AGA. About 1 to 1.5 million platelets/μL of platelets in PRP is the recommended platelet concentration in PRP for the treatment of AGA. I-PRF (injectable platelet-rich fibrin) has also been found to be useful in AGA, although further studies are required to establish its role. PRP can also have an adjunctive role in hair transplantation procedures.
10.4103/idoj.idoj_328_21
Histological aspects of full-thickness skin grafts augmented with platelet-rich fibrin in rat model.
Nica Oliviu,Popa Dragoş George,Grecu Alexandru Florian,Ciucă Eduard Mihai,Ciurea Marius Eugen
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
BACKGROUND AND OBJECTIVES:The restoration of the damaged tissue commences very early with a regulated sequence of biochemical events set into motion to repair the damage. While the understanding of this entire process is still incomplete, it has been established that platelets play a decisive role not only in hemostasis, but also in the wound healing process, through an abundance of growth factors and other signaling cytokines modulating the inflammatory response. To this end, we attempted to evaluate the effect of a platelet-rich biomaterial - platelet-rich fibrin (PRF) - in the augmentation of full-thickness skin grafts (FTSGs). MATERIALS AND METHODS:Skin defects were performed on the rats' dorsum and covered with FTSGs. The test group wound bed was treated with PRF before the suture of the graft. Skin graft specimens were obtained from the control and test group rats for histological and immunohistochemical examination on the 21st postsurgical day. Our study included 40 male Wistar rats. Average thickness of epidermal cell layers was recorded for each wound site. The average fibroblast count was compared between the control and test (PRF-augmented FTSG) groups. Blood vessel count and vascular density - the blood vessels were identified under low-power microscopy. The prominent vascular areas were then scanned in higher-power fields; individual vessels were marked and counted by hand. Vascular density was calculated. Mean vascular count for each graft was then calculated. RESULTS:The mean thickness of the epidermal layer was significantly higher and closer to the physiological epidermal thickness, in the test group than in the control group. The average fibroblast and fibrocyte count in the dermal layer in FTSGs augmented with PRF was higher than in the control group. We discovered a statistically insignificant increase in the blood vessel count and vascular density of the test group, compared to the control group. CONCLUSIONS:Our limited data supports the theory that the addition of PRF to FTSG recipient wound beds has the potential to improve graft take and regulate the proliferation of a thicker and more uniform epidermis, while decreasing healing time and dermal necrosis rates.
Precise Intradermal Injection of Nanofat-Derived Stromal Cells Combined with Platelet-Rich Fibrin Improves the Efficacy of Facial Skin Rejuvenation.
Liang Zhi-Jie,Lu Xiang,Li De-Quan,Liang Yi-Dan,Zhu Dan-Dan,Wu Fang-Xiao,Yi Xiao-Lin,He Ning,Huang Yan-Qing,Tang Chao,Li Hong-Mian
Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology
BACKGROUND/AIMS:The rejuvenation properties of nanofat grafting have been described in recent years. However, it is not clear whether the clinical efficacy of the procedure is attributable to stem cells or linked to other components of adipose tissue. In this study we isolated nanofat-derived stem cells (NFSCs) to observe their biological characteristics and evaluate the efficacy of precise intradermal injection of nanofat combined with platelet-rich fibrin (PRF) in patients undergoing facial rejuvenation treatment. METHODS:Third-passage NFSCs were isolated and cultured using a mechanical emulsification method and their surface CD markers were analyzed by flow cytometry. The adipogenic and osteogenic nature and chondrogenic differentiation capacity of NFSCs were determined using Oil Red O staining, alizarin red staining, and Alcian blue staining, respectively. Paracrine function of NFSCs was evaluated by enzyme-linked immunosorbent assay (ELISA) at 1, 3, 7, 14, and 28 days after establishing the culture. Then, the effects of PRF on NFSC proliferation were assessed in vitro. Finally, we compared the outcome in 103 patients with facial skin aging who underwent both nanofat and intradermal PRF injection (treatment group) and 128 patients who underwent hyaluronic acid (HA) injection treatment (control group). Outcomes in the two groups were compared by assessing pictures taken at the same angle before and after treatment, postoperative recovery, incidence of local absorption and cysts, and skin quality before treatment, and at 1, 12, 24 months after treatment using the VISIA Skin Image Analyzer and a SOFT5.5 skin test instrument. RESULTS:NFSCs expressed CD29, CD44, CD49d, CD73, CD90, and CD105, but did not express CD34, CD45, and CD106. NFSCs also differentiated into adipocytes, osteoblasts, and chondrocytes under appropriate induction conditions. NFSCs released large amounts of growth factors such as VEGF, bFGF, EGF, and others, and growth factor levels increased in a time-dependent manner. At the same time, PRF enhanced proliferation of NFSCs in vitro in a dose-dependent manner, and the growth curves under different concentrations of PRF all showed plateaus 6d after seeding. Facial skin texture was improved to a greater extent after combined injection of nanofat and PRF than after control injection of HA. The nanofat-PRF group had a higher satisfaction rate. Neither treatment caused any complications such as infection, anaphylaxis, or paresthesia during long-term follow-up. CONCLUSION:NFSCs demonstrate excellent multipotential differentiation and paracrine function, and PRF promotes proliferation of NFSCs during the early stage after seeding. Both nanofat-PRF and HA injection improve facial skin status without serious complications, but the former was associated with greater patient satisfaction, implying that nanofat-PRF injection is a safe, highly effective, and long-lasting method for skin rejuvenation.
10.1159/000489809
Healing of a Large Wound Defect Post Debridement, with PRF Therapy and High Dose Oral Vitamin C, in a Patient of Severe Irritant Contact Dermatitis Due to Slaked Lime: A Case Report.
Bansod Shashank
Journal of cutaneous and aesthetic surgery
Platelet-rich blood concentrates have been used to accelerate healing process in wounds and in bones since many decades worldwide. Platelet-rich fibrin (PRF) is a relatively new and established therapy, utilizing platelets and leucocytes trapped in fibrin matrix, for the treatment of non-healing ulcers and wounds. Many large series are available in this subject to prove its efficacy. Our patient, a known case of eczema, had applied slaked lime (calcium hydroxide) over an eczematous lesion on right leg and surrounding area, after which he developed deep wound with extensive erythema and blisters initially, which healed with necrosis due to patient's neglect, in about 2 weeks. On presentation to us, the lesion had undergone necrosis and hence decision to debride the lesion was taken. After debridement, a large defect was created, which we tried treating conservatively using PRF therapy primarily, followed by pressure dressing. High dose vitamin C was given orally. The patient required antibiotics intermittently. The patient responded well to this protocol and the wound defect was closed within a few weeks.
10.4103/JCAS.JCAS_86_20
Treatment with injectable platelet-rich fibrin in a rat model of melasma.
European journal of dermatology : EJD
The management of melasma is challenging. Platelet-rich plasma (PRP) therapy has been shown to be beneficial, however, the use of anticoagulants for PRP is dangerous. To evaluate the efficacy of recently developed blood-derived biomaterials (injectable platelet-rich fibrin [I-PRF]) in a rat model of melasma. Sprague Dawley (SD) rats were used to replicate an experimental animal model of melasma. SD rats exhibiting melasma were randomly divided into experimental and control groups. The experimental group was administered weekly intradermal injections of I-PRF, whereas the control group received an equivalent amount of saline. After four weeks, back skin was removed and evaluated based on (1) gross observation, (2) pathological examination and imaging analysis, and (3) biochemical detection. Data were analysed using SAS9.4 software. I-PRF, a safe blood product without anticoagulants, inhibited melanin production in the epidermis and reduced oxidative stress damage in the cortex, improving melasma. I-PRF is a safe and cost-effective blood-derived biomaterial which is useful for the treatment of melasma.
10.1684/ejd.2023.4586
Platelet-rich fibrin: A review of its role as a new treatment in androgenetic alopecia.
Journal of cosmetic dermatology
BACKGROUND:Androgenetic alopecia (AGA) is a major cause of hair loss resulting from a complex interplay between various genes and hormones with the result being follicular miniaturization and altered hair cycle dynamics. Platelet-rich plasma (PRP) has a well-established role as adjunctive therapy in AGA but there are many limitations of it. In an attempt to overcome the shortcomings of PRP, liquid platelet-rich fibrin (PRF) was developed. AIM:This article critically reviews the protocol for the preparation and clinical outcomes of PRF. PATIENTS/METHODS:The articles published so far in the English language regarding the preparation and clinical outcomes of PRF were reviewed. RESULTS:Among five studies analyzing various centrifugation speeds and centrifugation times, three of the studies favored low-speed centrifugation, whereas two studies did not support this methodology. A horizontal centrifuge may be preferred over a fixed-angle centrifuge for PRF. Five clinical studies on the use of PRF showed a significant effect on AGA. CONCLUSION:At present, there is no consensus regarding the preparation of PRF. Most studies used fixed-angle centrifugation favored low centrifuge speed and less centrifugation time. Larger studies are needed to determine the optimal centrifugation force and time. A horizontal centrifuge may be preferred over a fixed-angle centrifuge due to the higher yield of platelets, and lesser shear trauma to the cells. In addition, larger, well-designed studies are needed to confirm the benefits of PRF over PRP.
10.1111/jocd.16333
The Effect of Platelet-Rich Fibrin on Nasal Skin Thickness in Rhinoplasty.
Gode Sercan,Ozturk Arin,Kısmalı Erkan,Berber Veysel,Turhal Goksel
Facial plastic surgery : FPS
The study hypothesized the potential positive effects of platelet-rich fibrin (PRF) in postoperative rhinoplasty patients, such as better wound healing, less dead space, and less edema. The authors assessed PRF for nasal dorsum camouflage and studied its potential effects on nasal dorsal skin in rhinoplasty. Thirty-eight patients who underwent open approach primary rhinoplasty were categorized into two groups: nasal dorsal PRF group and control group. PRF membrane was used for nasal dorsum camouflage and laid over the bony dorsum and cartilage framework of the supratip area. Skin and subcutaneous soft tissue thickness were measured by linear superficial tissue ultrasound at the pre- and postoperative first week and the third month in both groups. Mean skin thickness over the supratip area was significantly higher in the control group in the first-week control. There were no significant differences in both first-week and third-month controls' nasal dorsum mean skin thickness measurements between the two groups. Regarding PRF complications, we encountered no complications in either group, including scarring, hematoma, infection, skin discoloration, and acne. The authors present the application of PRF membrane over the bony dorsum and cartilage framework of the supratip area. They observed its positive effect on postoperative edema, especially in the early postoperative period. Long-term investigations have to be performed to evaluate its potential effect on the rhinoplasty procedure. This was a level of evidence 3 study.
10.1055/s-0039-1693436
Acellular Fish Skin for Deep Dermal Traumatic Wounds Management; Introducing a Novel Dressing.
Archives of academic emergency medicine
The optimal therapy for deep wounds is based on the early debridement of necrotic tissue followed by wound coverage to avoid a systemic inflammatory response and optimize scar-free healing. The outcomes are affected by available resources and underlying patient factors, which cause challenges in wound care and suboptimal outcomes. Here we report a patient with deep dermal injury wounds, who was treated with platelet-rich fibrin (PRF) gel, plasma rich in growth factor (PRGF) gel, and acellular fish skin. Patient's outcomes regarding healing and scar quality were collected objectively and subjectively for one year after the injury. Wounds treated with acellular fish skin demonstrated accelerated wound healing, a significantly higher water-storage capacity, and better pain relief. Furthermore, improved functional and cosmetic outcomes, such as elasticity, skin thickness, and pigmentation, were demonstrated. It seems that, the PRGF gel and PRF in combination with acellular fish skin grafts resulted in the faster healing of wounds and better functional and aesthetic outcomes than split-thickness skin grafts treatment.
10.22037/aaem.v12i1.2103
Fluid platelet-rich fibrin stimulates greater dermal skin fibroblast cell migration, proliferation, and collagen synthesis when compared to platelet-rich plasma.
Journal of cosmetic dermatology
BACKGROUND:Regenerative therapies in the field of facial aesthetics have become a growing field of interest with many recent advancements made over the past decade to meet the growing worldwide demand. While first versions of platelet-derived concentrates were formulated with anticoagulants (PRP), recent modifications to centrifugation speeds and times have permitted the development of a liquid platelet-rich fibrin (fluid-PRF) without use of anticoagulants. OBJECTIVE:To compare this entirely natural platelet concentrate (fluid-PRF) to formally utilized PRP on skin cell behavior and regeneration. METHODS:Dermal skin fibroblast was cultivated with either fluid-PRF or PRP and investigated for their ability to promote/influence cell viability, migration, spreading, proliferation, and mRNA levels of known mediators of dermal biology including PDGF, TGF-beta, and fibronectin. RESULTS:All platelet concentrates were nontoxic to cells demonstrating high cell survival. Skin fibroblasts migrated over 350% more in fluid-PRF when compared to control and PRP (200% increase). Fluid-PRF also significantly induced greater cell proliferation at 5 days. While both PRP and fluid-PRF induced significantly elevated cell mRNA levels of PDGF, it was observed that TGF-beta, collagen 1, and fibronectin mRNA levels were all significantly highest in the fluid-PRF group. Lastly, fluid-PRF demonstrated a significantly greater ability to induce collagen matrix synthesis when compared to PRP. CONCLUSION:The findings from the present study demonstrate greater regenerative potential of fluid-PRF on human skin fibroblasts. Future clinical use of fluid-PRF in the field of facial aesthetics is necessary to further evaluate the potential advantages of anticoagulant removal from platelet concentrates.
10.1111/jocd.12955
Autolougous platelet concentrates in esthetic medicine.
Periodontology 2000
This narrative review summarizes current knowledge on the use of autologous platelet concentrates (APCs) in esthetic medicine, with the goal of providing clinicians with reliable information for clinical practice. APCs contain platelets that release various growth factors with potential applications in facial and dermatologic treatments. This review examines several facial esthetic applications of APCs, including acne scarring, skin rejuvenation, melasma, vitiligo, stretchmarks, peri-orbital rejuvenation, peri-oral rejuvenation, hair regeneration and the volumizing effects of APC gels. A systematic review of literature databases (PubMed/MEDLINE) was conducted up to October 2023 to identify randomized controlled trials (RCTs) in the English language on APCs for facial rejuvenation and dermatology. A total of 96 articles were selected including those on platelet rich plasma (PRP), plasma-rich in growth factors (PRGF), and platelet-rich fibrin (PRF). Clinical recommendations gained from the reviews are provided. In summary, the use of APCs in facial esthetics is a promising yet relatively recent treatment approach. Overall, the majority of studies have focused on the use of PRP with positive outcomes. Only few studies have compared PRP versus PRF with all demonstrating superior outcomes using PRF. The existing studies have limitations including small sample sizes and lack of standardized assessment criteria. Future research should utilize well-designed RCTs, incorporating appropriate controls, such as split-face comparisons, and standardized protocols for APC usage, including optimal number of sessions, interval between sessions, and objective improvement scores. Nevertheless, the most recent formulations of platelet concentrates offer clinicians an ability to improve various clinical parameters and esthetic concerns.
10.1111/prd.12582
Autologous blood products: Leucocyte and Platelets Rich Fibrin (L-PRF) and Platelets Rich Plasma (PRP) gel to promote cutaneous ulcer healing - a systematic review.
BMJ open
OBJECTIVE:To summarise evidence on the effectiveness of Platelet-Rich Plasma (PRP) gel and Leucocyte and Platelet Rich Fibrin (L-PRF) gel as agents promoting ulcer healing compared with the standard wound dressing techniques alone. DESIGN:Systematic review. ELIGIBILITY CRITERIA:Individual patient randomised controlled trials on skin ulcers of all types excluding traumatic lesions.Intervention group: treatment with topical application of L-PRF gel or PRP gel to the wound surface. CONTROL GROUP:treatment with standard skin ulcer care using normal saline, normgel or hydrogel dressings. INFORMATION SOURCES:Medline (Ovid), Excerpta Medica Database (EMBASE), Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science and manual search of studies from previous systematic reviews and meta-analyses. The papers published from 1946 to 2022 with no restriction on geography and language were included. The last date of the search was performed on 29 August 2022. DATA EXTRACTION AND SYNTHESIS:Independent reviewers identified eligible studies, extracted data, assessed risk of bias using V.2 of the Cochrane risk-of-bias tool for randomised trials tool and assessed certainty of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. MAIN OUTCOME MEASURES:Time to complete healing, proportion healed at a given time and rate of healing. RESULTS:Seven studies met the inclusion criteria, five using PRP gel and two using L-PRF gel. One study showed a better proportion of complete healing, three reported reduced meantime to complete healing and five showed improved rate of healing per unit of time in the intervention group. The risk of bias was high across all studies with one exception and the GRADE showed very low certainty of evidence. CONCLUSION:The findings show potential for better outcomes in the intervention; however, the evidence remains inconclusive highlighting a large research gap in ulcer treatment and warrant better-designed clinical trials. PROSPERO REGISTRATION NUMBER:CRD42022352418.
10.1136/bmjopen-2023-073209
Platelet-Rich Fibrin Accelerates Skin Wound Healing in Diabetic Mice.
Ding Yinjia,Cui Lei,Zhao Qiming,Zhang Weiqiang,Sun Huafeng,Zheng Lijun
Annals of plastic surgery
Diabetic foot ulcers (DFUs) are associated with an increased risk of secondary infection and amputation. Platelet-rich fibrin (PRF), a platelet and leukocyte concentrate containing several cytokines and growth factors, is known to promote wound healing. However, the effect of PRF on diabetic wound healing has not been adequately investigated. The aim of the study was to investigate the effect of PRF on skin wound healing in a diabetic mouse model. Platelet-rich fibrin was prepared from whole blood of 8 healthy volunteers. Two symmetrical skin wounds per mouse were created on the back of 16 diabetic nude mice. One of the 2 wounds in each mouse was treated with routine dressings (control), whereas the other wound was treated with PRF in addition to routine dressings (test), each for a period of 14 days. Skin wound healing rate was calculated.Use of PRF was associated with significantly improved skin wound healing in diabetic mice. On hematoxylin and eosin and CD31 staining, a significant increase in the number of capillaries and CD31-positive cells was observed, suggesting that PRF may have promoted blood vessel formation in the skin wound. In this study, PRF seemed to accelerate skin wound healing in diabetic mouse models, probably via increased blood vessel formation.
10.1097/SAP.0000000000001091
Platelet-rich fibrin accelerates skin wound healing in pressure injuries: a rat model.
Journal of wound care
OBJECTIVE:Platelet-rich fibrin (PRF) plays a role in promoting wound healing by releasing cytokines, chemokines and growth factors, and by inducing proliferation and activation of cells. A pressure injury (PI) is a treatable but serious and costly disease with adverse outcomes for the patient. However, traditional PI treatments are time-consuming, with limited effectiveness. Thus, we aimed to investigate the effects and mechanisms of PRF on skin wound healing in PIs in vivo in a rat model. METHOD:PRF was prepared from the blood of male Wistar rats. A rat model for PI ischaemia/reperfusion injury was established by placing a magnet onto the back skin, where a magnetic steel plate had been previously implanted. The rats were randomised into two groups: the control group was treated with sterile gauze dressings and the iPRF group received additional PRF. Skin wound healing rate was calculated and a CD31/Masson's trichrome stain performed. RESULTS:In this study, 16 rats were allocated to the two groups (n=8 in each group). PRF improved the skin wound healing rate of PIs in the rats; haematoxylin and eosin staining and CD31 staining showed that the number of capillaries increased significantly in the wound. However, Masson's trichrome staining showed no increase in fibrotic tissues after PRF treatment. CONCLUSION:In this in vivo rat model for PI, PRF accelerated skin wound healing by increasing angiogenesis in the wound.
10.12968/jowc.2022.31.9.800
Advances in spray products for skin regeneration.
Pleguezuelos-Beltrán Paula,Gálvez-Martín Patricia,Nieto-García Daniel,Marchal Juan Antonio,López-Ruiz Elena
Bioactive materials
To date, skin wounds are still an issue for healthcare professionals. Although numerous approaches have been developed over the years for skin regeneration, recent advances in regenerative medicine offer very promising strategies for the fabrication of artificial skin substitutes, including 3D bioprinting, electrospinning or spraying, among others. In particular, skin sprays are an innovative technique still under clinical evaluation that show great potential for the delivery of cells and hydrogels to treat acute and chronic wounds. Skin sprays present significant advantages compared to conventional treatments for wound healing, such as the facility of application, the possibility to treat large wound areas, or the homogeneous distribution of the sprayed material. In this article, we review the latest advances in this technology, giving a detailed description of investigational and currently commercially available acellular and cellular skin spray products, used for a variety of diseases and applying different experimental materials. Moreover, as skin sprays products are subjected to different classifications, we also explain the regulatory pathways for their commercialization and include the main clinical trials for different skin diseases and their treatment conditions. Finally, we argue and suggest possible future trends for the biotechnology of skin sprays for a better use in clinical dermatology.
10.1016/j.bioactmat.2022.02.023
The emerging role of biostimulators as an adjunct in facial rejuvenation: A systematic review.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
INTRODUCTION:Facial aging has long been an area of focus in esthetic surgery. It is the consequence of physiologic and environmental factors, with a trend toward non-surgical modalities. Although volume augmentation has long been a focus of non-surgical facial rejuvenation, there is emerging interest in the use of biostimulators to induce physiologic changes in the skin. This article aimed to provide an overview of this class of therapies. METHODS:A systematic review regarding the clinical use of biostimulatory agents including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) in facial rejuvenation was performed using PubMed databases. The protocol was developed following the preferred reporting for items for systematic reviews-protocols guidelines. Included studies matched predetermined criteria according to the employed intervention and outcomes. RESULTS:The systematic review was performed in September 2023, with the primary search yielding 464 articles. Abstract review resulted in 73 articles of potential relevance. Comprehensive review of the articles and manual reference checks were performed, independently, by 2 authors. This yielded a total of 45 articles that met the inclusion criteria. CONCLUSIONS:There is an increasing role for non-surgical modalities in facial rejuvenation. Biostimulatory agents may be used as an alternative, or act as an adjunct, to other non-surgical modalities. These agents induce physiologic changes that mitigate facial aging. There is limited, quantifiable data, which fully illustrate the effect in these products. Although these agents are known to illicit inflammatory changes, more controlled studies are needed to better elucidate the biostimulatory capacity of such non-surgical treatments.
10.1016/j.bjps.2024.02.069
Free Skin Grafting to Reconstruct Donor Sites after Radial Forearm Flap Harvesting: A Prospective Study with Platelet-Rich Fibrin (PRF).
Journal of clinical medicine
Reconstruction of the donor site after radial forearm flap harvesting is a common procedure in maxillofacial plastic surgery. It is normally carried out with split-thickness or full-thickness free skin grafts. Unfortunately, free skin graft transplantation faces wound healing impairments such as necrosis, (partial) graft loss, or tendon exposure. Several studies have investigated methods to reduce these impairments and demonstrated improvements if the wound bed is optimised, for example, through negative-pressure wound therapy or vacuum-assisted closure. However, these methods are device-dependent, expansive, and time-consuming. Therefore, the application of platelet-rich fibrin (PRF) to the wound bed could be a simple, cost-effective, and device-independent method to optimise wound-bed conditions instead. In this study, PRF membranes were applied between the wound bed and skin graft. Results of this study indicate improvements in the PRF versus non-PRF group (93.44% versus 86.96% graft survival, = 0.0292). PRF applied to the wound bed increases graft survival and reduces impairments. A possible explanation for this is the release of growth factors, which stimulate angiogenesis and fibroblast migration. Furthermore, the solid PRF membranes act as a mechanical barrier ("lubrication" layer) to protect the skin graft from tendon motion. The results of this study support the application of PRF in donor-site reconstruction with free skin grafts.
10.3390/jcm11123506
Effect of platelet-rich fibrin (PRF) membranes on the healing of infected skin wounds.
Archives of dermatological research
Tissue engineering focuses on wound healing and tissue regeneration. Platelet-rich fibrin (PRF) is a fibrin matrix containing cytokines, growth factors and cells that are gradually released into the wound over time. This study aimed to evaluate the effect of PRF membranes on wound repair and microbial control in infected wounds. Skin wounds were performed on the dorsum of rats using a 6 mm diameter metal punch. The defects were randomly assigned into four groups (n = 12/each) accordingly to the treatment: G1, noninfected wound filled only with clot; G2, noninfected wound with PRF; G3, infected wound (S. aureus) without PRF; G4, infected wound (S. aureus) with PRF. After 7 and 14 days, macroscopic and histological analyses of the wounds were performed. Furthermore, the quantification of β-defensin in PRF was measured by ELISA. At 14 days, the groups with PRF (G2 and G4) had wound sizes significantly smaller than the original defects (6 mm) (p < 0.05) and significantly smaller than those not treated with PRF, in both the infected and noninfected groups (p < 0.05). Furthermore, the groups with infected wounds (G3 and G4) demonstrated a significantly lower inflammation score in the PRF group than in the noninfected groups (p < 0.05). In vitro analysis of β-defensin was performed in all PRF membrane groups, and the median value was 1.444 pg/mL. PRF in the wounds of both control and infected rats played an important role in the modulation of tissue healing, most notably in infected sites.
10.1007/s00403-022-02401-8
Applications of the regenerative capacity of platelets in modern medicine.
Cytokine & growth factor reviews
Platelets produce platelet growth factors such as PDGF, IGF-1, EGF-, HGF, TGFβ, bFGF, and VEGF, which are crucial in regulating all stages of the wound healing process. The source of these substances is platelet-rich plasma (PRP). Over the past five decades, the interest and use of the regenerative properties of platelets have increased significantly in many different fields of medicine around the world. PRP and PRF plate preparations are used in: 1. Dentistry (they reduce bleeding, facilitate and accelerate soft tissue healing and bone regeneration - FGF 2, IGF-1, IGF-2, TGF-β1, and PDGF); 2. Sports medicine - IGF-1, IGF-2, TGF-β, VEGF, PDGF and bFGF, EGF); 3. dermatology and cosmetology (treatment of alopecia, hair reconstruction - FGF-7, HGF, acne scars, skin rejuvenation and regeneration, treatment of chronic and poorly healing wounds, burns, and acquired vitiligo); 4. Gynecology and reproductive medicine (treatment of infertility, erectile dysfunction - PDGF-β, TGF-β, IGF-1, in sexual dysfunction - PDGF, in vaginal atrophy); 5 Ophthalmology (in the healing of corneal epithelial wounds, in the treatment of dormant corneal ulcers, dry eye syndrome and the reconstruction of the corneal surface; 6. Neurology (regeneration of neurons, pain alleviation, and clinical symptoms - TGF-β 1, IGF-1, PDGF, VEGF) and FGF). Platelet-rich plasma therapy is a very interesting alternative and complement to traditional methods of treatment. However, the potential for using platelets is still not fully understood. The composition of platelet-rich plasma depends on many factors that may affect its use's efficacy and clinical benefits. Further research is necessary to standardize PRP delivery's preparation procedures and methods for a specific disease entity or clinical case.
10.1016/j.cytogfr.2021.11.003
L-PRP/L-PRF in esthetic plastic surgery, regenerative medicine of the skin and chronic wounds.
Cieslik-Bielecka Agata,Choukroun Joseph,Odin Guillaume,Dohan Ehrenfest David M
Current pharmaceutical biotechnology
The use of platelet concentrates for topical use is of particular interest for the promotion of skin wound healing. Fibrin-based surgical adjuvants are indeed widely used in plastic surgery since many years in order to improve scar healing and wound closure. However, the addition of platelets and their associated growth factors opened a new range of possibilities, particularly for the treatment of chronic skin ulcers and other applications of regenerative medicine on the covering tissues. In the 4 families of platelet concentrates available, 2 families were particularly used and tested in this clinical field: L-PRP (Leukocyte- and Platelet-rich Plasma) and L-PRF (Leukocyte- and Platelet-Rich Fibrin). These 2 families have in common the presence of significant concentrations of leukocytes, and these cells are important in the local cleaning and immune regulation of the wound healing process. The main difference between them is the fibrin architecture, and this parameter considerably influences the healing potential and the therapeutical protocol associated to each platelet concentrate technology. In this article, we describe the historical evolutions of these techniques from the fibrin glues to the current L-PRP and L-PRF, and discuss the important functions of the platelet growth factors, the leukocyte content and the fibrin architecture in order to optimize the numerous potential applications of these products in regenerative medicine of the skin. Many outstanding perspectives are appearing in this field and require further research.
Autologous platelet concentrates for facial rejuvenation.
Journal of applied oral science : revista FOB
BACKGROUND:Autologous platelet concentrates (APCs) are promising therapeutic agents in facial rejuvenation since they are a great source of cytokines, growth factors and other biologically active substances. Obtained from the patient's blood, they have the advantages of reducing immunological reactions, making the procedure safer, well tolerated, with minimal adverse effects and lower cost. Currently, they are used for facial rejuvenation both in combination with microneedling and in mesotherapy techniques, as well as to treat facial acne scars, melasma and wounds after laser ablative treatments. This review summarizes current knowledge on the use of APCs, ranging from basic concepts related to their composition and mechanisms of action to up-to-date information on their clinical efficacy. METHODOLOGY:MEDLINE (PubMed) was searched from inception through 2021 for English language publications on APCs for facial rejuvenation. RESULTS:A total of 100 files were found. Based on the available literature, APCs for skin rejuvenation are safe and well tolerated. The most studied product is the first-generation material, platelet-rich plasma (PRP). CONCLUSIONS:The results are in general favorable, but the quality of the studies is low. The second and third generation products, platelet-rich fibrin (PRF) and injectable platelet-rich fibrin (i-PRF), respectively, are easier to be obtained and, at least in vitro , seem to induce greater collagen production than PRP, especially under lower relative centrifugation forces, but to date only a few clinical trials evaluating these products exist. More high-quality trials with appropriate follow-up are necessary to provide adequate evidence that may help to improve the treatment regimens with APCs. Many aspects should be considered when designing clinical trials to evaluate APCs, such as the patients' characteristics that best predict a favorable response, the optimal number of sessions and the interval between them, the characteristics of the studies and the development of better instruments to evaluate skin aging.
10.1590/1678-7757-2022-0020
Extended platelet-rich fibrin.
Periodontology 2000
Platelet-rich fibrin (PRF) has been characterized as a regenerative biomaterial that is fully resorbed within a typical 2-3 week period. Very recently, however, a novel heating process was shown to extend the working properties of PRP/PRF from a standard 2-3 week period toward a duration of 4-6 months. Numerous clinicians have now utilized this extended-PRF (e-PRF) membrane as a substitute for collagen barrier membranes in various clinical applications, such as guided tissue/bone regeneration. This review article summarizes the scientific work to date on this novel technology, including its current and future applications in periodontology, implant dentistry, orthopedics and facial aesthetics. A systematic review was conducted investigating key terms including "Bio-Heat," "albumin gel," "albumin-PRF," "Alb-PRF," "extended-PRF," "e-PRF," "activated plasma albumin gel," and "APAG" by searching databases such as MEDLINE, EMBASE and PubMed. Findings from preclinical studies demonstrate that following a simple 10-min heating process, the transformation of the liquid plasma albumin layer into a gel-like injectable albumin gel extends the resorption properties to at least 4 months according to ISO standard 10 993 (subcutaneous animal model). Several clinical studies have now demonstrated the use of e-PRF membranes as a replacement for collagen membranes in GTR/GBR procedures, closing lateral windows in sinus grafting procedures, for extraction site management, and as a stable biological membrane during recession coverage procedures. Furthermore, Alb-PRF may also be injected as a regenerative biological filler that lasts extended periods with advantages in joint injections, osteoarthritis and in the field of facial aesthetics. This article highlights the marked improvement in the stability and degradation properties of the novel Alb-PRF/e-PRF technology with its widespread future potential use as a potential replacement for collagen membranes with indications including extraction site management, GBR procedures, lateral sinus window closure, recession coverage among others, and further highlights its use as a biological regenerative filler for joint injections and facial aesthetics. It is hoped that this review will pioneer future opportunities and research development in the field, leading to further progression toward more natural and less costly biomaterials for use in medicine and dentistry.
10.1111/prd.12537
The Benefits of Platelet-Rich Fibrin.
Karimi Kian,Rockwell Helena
Facial plastic surgery clinics of North America
Platelet-rich fibrin (PRF) is a next-generation autologous platelet therapy with immense potential in several medical fields. In cosmetic medicine, for example, PRF is useful in wound healing and skin rejuvenation as a primary and a supplemental technique owing to its fibrin matrix, cellular components, and prolonged release of growth factors. PRF is simple to obtain, inexpensive, and may be administered topically, injected, or in conjunction with other esthetic procedures. In this regard, PRF possesses diverse, and increasingly pertinent capacities in esthetic medicine and surgery.
10.1016/j.fsc.2019.03.005
Ten years of injectable platelet-rich fibrin.
Periodontology 2000
The use of platelet-rich fibrin (PRF) has seen widespread advantages over platelet-rich plasma (PRP) in many fields of medicine. However, until 2014, PRF remained clinically available only in its solid clotted form. Modifications to centrifugation protocols and tube technology have led to the development of a liquid injectable version of PRF (i-PRF). This narrative review takes a look back at the technological developments made throughout the past decade and further elaborates on their future clinical applications. Topics covered include improvements in isolation techniques and protocols, ways to further concentrate i-PRF, and the clinical impact and relevance of cooling i-PRF. Next, various uses of i-PRF are discussed, including its use in regenerative periodontology, implantology, endodontics, temporomandibular joint injections, and orthodontic tooth movement. Furthermore, various indications in medicine are also covered, including its use in sports injuries and osteoarthritis of various joints, treatment of diabetic ulcers/wound care, and facial esthetics and hair regrowth. Finally, future applications are discussed, mainly its use as a drug delivery vehicle for small biomolecules, such as growth factors, antibiotics, exosomes, and other medications that may benefit from the controlled and gradual release of biomolecules over time.
10.1111/prd.12538
Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF).
Masuki Hideo,Okudera Toshimitsu,Watanebe Taisuke,Suzuki Masashi,Nishiyama Kazuhiko,Okudera Hajime,Nakata Koh,Uematsu Kohya,Su Chen-Yao,Kawase Tomoyuki
International journal of implant dentistry
BACKGROUND:The development of platelet-rich fibrin (PRF) drastically simplified the preparation procedure of platelet-concentrated biomaterials, such as platelet-rich plasma (PRP), and facilitated their clinical application. PRF's clinical effectiveness has often been demonstrated in pre-clinical and clinical studies; however, it is still controversial whether growth factors are significantly concentrated in PRF preparations to facilitate wound healing and tissue regeneration. To address this matter, we performed a comparative study of growth factor contents in PRP and its derivatives, such as advanced PRF (A-PRF) and concentrated growth factors (CGF). METHODS:PRP and its derivatives were prepared from the same peripheral blood samples collected from healthy donors. A-PRF and CGF preparations were homogenized and centrifuged to produce extracts. Platelet and white blood cell counts in A-PRF and CGF preparations were determined by subtracting those counts in red blood cell fractions, supernatant acellular serum fractions, and A-PRF/CGF exudate fractions from those counts of whole blood samples. Concentrations of growth factors (TGF-β1, PDGF-BB, VEGF) and pro-inflammatory cytokines (IL-1β, IL-6) were determined using ELISA kits. RESULTS:Compared to PRP preparations, both A-PRF and CGF extracts contained compatible or higher levels of platelets and platelet-derived growth factors. In a cell proliferation assay, both A-PRF and CGF extracts significantly stimulated the proliferation of human periosteal cells without significant reduction at higher doses. CONCLUSIONS:These data clearly demonstrate that both A-PRF and CGF preparations contain significant amounts of growth factors capable of stimulating periosteal cell proliferation, suggesting that A-PRF and CGF preparations function not only as a scaffolding material but also as a reservoir to deliver certain growth factors at the site of application.
10.1186/s40729-016-0052-4
Fluid Platelet-Rich Fibrin (PRF) Versus Platelet-Rich Plasma (PRP) in the Treatment of Atrophic Acne Scars: A Comparative Study.
Archives of dermatological research
Platelet-rich fibrin (PRF), a second-generation platelet concentrate, was developed for the purpose of overcoming the limitations of Platelet-rich plasma (PRP). PRF can produce a higher cumulative release of growth factors than PRP. Also, this release is slow and prolonged, making it ideal for tissue regeneration and growth stimulation. This study was conducted to evaluate the efficacy of fluid PRF either alone or combined with needling versus PRP in the treatment of atrophic acne scars. A comparative study including 30 patients with atrophic acne scars who were divided into two equal groups. Group I included 15 patients in which the left side of the face was treated with intradermal injection of PRP while the right side was treated with combined needling with PRP. Group II included15 patients in which the left side of the face was treated with intradermal injection of fluid PRF while the right side was treated with combined needling with fluid PRF. All patients received four sessions with 3 weeks interval. The acne scars significantly improved in both sides of face in both groups. According to quartile grading scale and patient satisfaction; the therapeutic response was significantly higher in PRF group than PRP either alone or combined with needling. The combination with needling increases efficacy of PRF and PRP. Fluid PRF is highly effective, safe and simple procedure that can be used instead of PRP in the treatment of acne scars.
10.1007/s00403-022-02511-3
Injectable Platelet-Rich Fibrin (PRF): The newest biomaterial and its use in various dermatological conditions in our practice: A case series.
Shashank Bansod,Bhushan Madke
Journal of cosmetic dermatology
Injectable platelet-rich fibrin (I-PRF) is a second generation, fully autologous, blood-derived biomaterial having three-dimensional fibrin meshwork, like that of a PRF clot, while retaining the fluid nature, just like platelet-rich plasma (PRP). Along with platelets and its growth factors, injectable PRF predominantly has collagen type-1, lymphocytes along with its growth factors. Preparation of injectable PRF is simple and requires minimal instrumentation and materials, making it a cost-effective product. We have been trying using this biomaterial in the conditions where PRP and PRF clot are being used currently, like androgenetic alopecia, periorbital rejuvenation, temporary filler material and as an agent to promote wound healing with favorable results.
10.1111/jocd.13742