Rashid Iqbal
11-arid-2292
PhD Biochemistry
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Contents
Definition
 PRP Therapy
 Role of PRP in treatments
 Mechanism of action of PRP
 Preparation of PRP
 Applications of PRP
 Freeze dried PRP
 Hybrid biomaterials of PRP
 In-vitro PRP

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Physiologic effects of PRP
 Androgenic alopecia
 Recipient factors that influence PRP
 Advantages of PRP
 Disadvantages of PRP
 Summary
 References

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Platelet-Rich plasma (PRP)
Platelet-Rich plasma (PRP) is blood plasma that has
been enriched with platelets.
Platelets naturally make up only 10% of our blood‟s
cellular component. In PRP Platelet ratio is flipped to
90% platelets.
Used extensively in dermatology, orthopedics and
surgery
Alpha granules
PRP also has been referred to as;
 Platelet-enriched plasma
 Platelet-rich concentrate
 Autologous platelet gel
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What is PRP Therapy?
 PRP
is
◦ Non-surgical healing treatment
 PRP is injected into affected region
◦ Stimulate & enhance healing
 PRP is your own blood
◦ Mega doses of body‟s own healing
“ingredients”
 Stored in platelets
 Growth Factors
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ROLE OF PRP IN TREATMENTS
PRP is used in the treatment of;
 Chronic skin damage( EGF)
 Soft tissue ulcerations ( FGF)
 Periodontal (TGF)
 Maxillofacial surgery ( TGF-BMP)
 Cosmetic and plastic surgery ( Vempire
facelift)
 Hair loss treatment ( EGF , KGF)

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MECHANISM OF ACTION OF
PLATELET-RICH PLASMA
PRP functions as a tissue sealant and drug
delivery system with the platelets
initiating wound repair by releasing locally
acting growth factors via α granules
degranulation.
 Proteins contained in the α-granules are;
 PDGF, TGF-β, VEGF, EGF, FGF, Osteocalcin
(Oc) , Fibrinogen (Ff), Interleukin-1 (IL-1)
thrombospondin- 1 (TSP-1) etc.

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Cont….
These growth factors aid healing by;
1) Attracting un-differentiated cells
2) Triggering cell division
3) Promote new capillary growth
 PRP also play a role in host defense
mechanism at the wound site by
producing signaling proteins that attract
macrophages.

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Cont….
PRP also may contain a small number of
leukocytes, that synthesize interleukins as
part of a non-specific immune response.
 PRP have demonstrated antimicrobial
activity against Escherichia coli,
Staphylococcus aureus including
methicillin-resistant Staphylococcus aureus(
MRSA).

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PRP Preparation
1)
Collect whole blood from patient
1)
Acid-Citrate Dextrose
Soft Spin
 Separates RBCs from plasma 2400 rpm 10 min
2)
1)
1)
2)
“Platelet Poor Plasma”)
Remove RBCs from plasma
Hard Spin 3600 rpm 15 min
1)
Separates platelets from most of plasma volume
1)
Results in high concentration of platelets in given volume of plasma
2)
“Platelet Rich Plasma”
3)
Activated by thrombin or calcium
4)
PRP platelets ( 01 million/ul)
Efficient compact systems for PRP can be used at clinics and
hospital
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Applications OF PRP
 PRP
was first applied as a „„glue‟‟ in surgical
operations.
 Glue form was made by adding bovine
thrombin to PRP preparations to minimize
the rapid diffusion of growth factors at the
site of application.
 Now a days, to eliminate xenofactors, such
as bovine thrombin, Platelet-Rich Fibrin
(PRF) is developed and is called „„second
generation of PRP‟‟.
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Modes of Applications of PRP

•
Endogenous Application: PRP can be
applied in the form of injection in case of
intrinsic injuries (e.g.,bone injuries)
Exogenous Application: Fibrin sealant
derived from Platelet poor plasma (PPP)
mixed PRP can be exogenously applied to
tissues to promote wound healing and
tissue sealing
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Freeze-Dried PRP
 To
preserve and enhance the stability of PRP(
Wolkers et al.,2001)
 By adding trehalose, platelets could be preserved
for longer periods of time.
 Freeze-drying technology involves prehydration
and rehydration pocess.
 These biomaterials are now utilized in battlefield
clinics for the treatment of injured soldiers.
 Freeze-dried PRP preparations from a selected
allogeneic source, under strictly performed
quality control, can be a better alternative to
freshly prepared autologous PRP.
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Hybrid Biomaterials of PRP
 To
facilitate more rapid response to
emergency use in various surgical fields,
including periodontal and oral surgeries
 Recently developed hybrid biomaterials
by combining PRP and biodegradable
polyglactin mesh.
 Can be used even after a month
presevation.
 This material can be cut to an appropriate
size and adapted to the site of injury.
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In-Vitro PRP
PRP increased in-vitro proliferation of
tenocytes, osteoblasts, mesenchymal stem
cells
 Anitua 2005, Doucet 2005, Ogino 2006
PRP treatment of tendon stem cells invitro induces transformation into active
tenocytes
Thrombin and CaCl2 increased GF
release in dose dependent manner in invitro“Activation” of PRP
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Physiologic Effects of PRP
Wound Healing: PRP offered significant
benefits in terms of accelerated wound
healing and tissue repair.
 Stages in the wound healing process ;
1. Platelet aggregation
2. Clot formation
3. Matrix Deposition
4. Collagen Production
5. Epithelization
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Cont…


Bone Regeneration: Growth factors
released from platelets signal local
mesenchymal and epithelial cells to migrate,
divide, and increase synthesis of collagen and
matrix, thus providing a scaffold that
encourages migration of osteoblasts.
PRP is simultaneously osteogenic,
osteoconductive and osteoinductive. Greater
bone maturation and early-stage bone
regeneration.
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PRP in Androgenic Alopecia



Androgeneic alopecia is a common form
of hair loss in both men and women
By treatment through PRP, growth factors
released from platelets may act on stem cells
in the bulge area of the follicles, stimulating
the development of new follicles and
promoting Neovascularization
PRP hair treatment is a promising treatment
option for patients with thinning hair.
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Recipient Factors That Influence
PRP
Quality of PRP preparations
 Evaluate patient‟s suitability for PRP
therapy e.g., Bone Disease or Defects : If
the injury site does not contain sufficient
numbers of vitalized mesenchymal stem
cells (or osteoblastic progenitor cells), a
PRP preparation may not effectively
facilitate bone regeneration.

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Clinical Advantages of PRP
1.
2.
3.
4.
5.
Autologous PRP preparations in
regeneration and repair processes.
Bioactivity-supporting role.
Outstanding cost to benefit ratio.
Preparation on-site in a timely manner.
Extremely low risk for infection
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Clinical Disadvantages of PRP
1.
2.
3.
4.
Pain in the Injured Area
Infection (Allogenic PRP)
Allergic Reaction (Allogenic PRP)
Skin discoloration around PRP injection
area.
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Summary



Platelet-rich plasma (PRP) is defined as a
portion of the plasma fraction of autologous
blood having a platelet concentration above
baseline.
Similar to the natural healing process, with
the application of multiple growth factors.
As an autologous preparation, PRP is safer to
use than allogenic or homologous
preparations and is free from concerns over
transmissible diseases.
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References
1. Okuda K, Kawase T, Momose M, et al. Platelet-rich
plasma contain high levels of platelet-derived growth
factor and transforming growth factor-beta and
modulates the proliferation of periodontally related
cells in vitro. J Periodontol. 2003;74:849–57.
 2. Frechette JP, Martineau I, Gagnon G. Platelet-rich
plasmas: growth factor content and roles in wound
healing. J Dent Res. 2005;84:434–9.
 3. Weibrich G, Kleis WK, Hafner G. Growth factor
levels in the platelet-rich plasma produced by 2
different methods: curasantype PRP kit versus PCCS
PRP system. Int J Oral Maxillofac Implants.
2002;17:184–90.
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4. Alsousou J, Ali A, Willett K, Harrison P. The role of plateletrich plasma in tissue regeneration. Platelets. 2013;24:173–82.
5. Redler LH, Thompson SA, Hsu SH, Ahmad CS, Levine WN.
Platelet-rich plasma therapy: a systematic literature review
and evidence for clinical use. Physician Sports Med.
2011;39:42–51.
5. Naik B, Karunakar P, Jayadev M, Marshal VR. Role of platelet
rich fibrin in wound healing: a critical review. J Conserv Dent.
2013;16:284–93.
6. Burnouf T, Goubran HA, Chen TM, et al. Blood-derived
biomaterials and platelet growth factors in regenerative
medicine. Blood Rev. 2013;27:77–89.
7. Stuart JD, Morgan RF, Kenney JG. Single-donor fibrin glue
forhand burns. Ann Plast Surg. 1990;24:524–7.
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