Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique.

Autor: Godoi TTF; Department of Orthopedics, The Federal University of São Paulo, São Paulo 04024-002, Brazil., Rodrigues BL; Brazilian Institute of Regenerative Medicine, Indaiatuba, São Paulo 13334-170, Brazil., Huber SC; Brazilian Institute of Regenerative Medicine, Indaiatuba, São Paulo 13334-170, Brazil., Santana MHA; Brazilian Association for Research in Regenerative Medicine, Indaiatuba, São Paulo 15015-040, Brazil., da Fonseca LF; Department of Orthopedics, The Federal University of São Paulo, São Paulo 04024-002, Brazil.; Brazilian Institute of Regenerative Medicine, Indaiatuba, São Paulo 13334-170, Brazil., Santos GS; Brazilian Institute of Regenerative Medicine, Indaiatuba, São Paulo 13334-170, Brazil., Azzini GOM; Brazilian Institute of Regenerative Medicine, Indaiatuba, São Paulo 13334-170, Brazil., Mosaner T; Prime Regen, São Paulo 01308-050, Brazil., Paulus-Romero C; American Academy and Board of Regenerative Medicine, Lakewood, CO 80401, USA., Lana JFSD; Brazilian Institute of Regenerative Medicine, Indaiatuba, São Paulo 13334-170, Brazil.
Jazyk: angličtina
Zdroj: Bioengineering (Basel, Switzerland) [Bioengineering (Basel)] 2022 Dec 19; Vol. 9 (12). Date of Electronic Publication: 2022 Dec 19.
DOI: 10.3390/bioengineering9120817
Abstrakt: Several musculoskeletal conditions are triggered by inflammatory processes that occur along with imbalances between anabolic and catabolic events. Platelet-rich plasma (PRP) is an autologous product derived from peripheral blood with inherent immunomodulatory and anabolic properties. The clinical efficacy of PRP has been evaluated in several musculoskeletal conditions, including osteoarthritis, tendinopathy, and osteonecrosis. When used in combination with hyaluronic acid (HA), a common treatment alternative, the regenerative properties of PRP are significantly enhanced and may provide additional benefits in terms of clinical outcomes. Recently, a new PRP-derived product has been reported in the literature and is being referred to as "plasma gel". Plasma gels are obtained by polymerizing plasmatic proteins, which form solid thermal aggregates cross-linked with fibrin networks. Plasma gels are considered to be a rich source of growth factors and provide chemotactic, migratory, and proliferative properties. Additionally, clot formation and the associated fibrinolytic reactions play an additional role in tissue repair. There are only a few scientific articles focusing on plasma gels. Historically, they have been utilized in the fields of aesthetics and dentistry. Given that the combination of three products (PRP, HA, and plasma gel) could enhance tissue repair and wound healing, in this technical note, we propose a novel regenerative approach, named "PRP-HA cellular gel matrix" (PRP-GM), in which leukocyte-rich PRP (LR-PRP) is mixed with a plasma gel (obtained by heating the plasma up) and HA in one syringe using a three-way stopcock. The final product contains a fibrin-albumin network entangled with HA's polymers, in which the cells and biomolecules derived from PRP are attached and released gradually as fibrinolytic reactions and hyaluronic acid degradation occur. The presence of leukocytes, especially monocytes and macrophages, promotes tissue regeneration, as type 2 macrophages (M2) possess an anti-inflammatory feature. In addition, HA promotes the viscosuplementation of the joint and induces an anti-inflammatory response, resulting in pain relief. This unique combination of biological molecules may contribute to the optimization of regenerative protocols suitable for the treatment of degenerative musculoskeletal diseases.
Databáze: MEDLINE
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