دکتر مژگان پورمختار

Lead, mercury and cadmium are a serious threat to people. Since blood products are considered as hidden and potential sources of exposure to these heavy metals, systematic review of their concentration in blood donors helps make a decision about the necessity of such a blood donor screening. Therefore, the current protocol has been prepared with the aim of describing the method and steps of such a relevant systematic review.

English keywords "blood donor", Lead, Mercury, Cadmium, Pb, Hg, Cd will be searched online in PubMed, Scopus, Web of Science and ProQuest databases. After screening and selection of relevant articles by two referees, the necessary information will be extracted. If more than 5 primary studies are obtained, meta-analysis will be performed. The heterogeneity among studies will be evaluated by Cochran Q and I2 statistics. Fixed effects model or random effects model will be used to pool the means. Statistical analysis will be performed by meta package in R software.

This systematic review is ongoing and will be completed by March 19, 2024.

Conclusions :

This protocol has been prepared to describe the steps of conducting a systematic review of studies that have measured the blood concentration of lead, mercury and cadmium in blood donors with the aim of making a decision about the necessity of such a blood donor screening to obtain safer products and prevent the exposure of recipients.

Today, the issue of microbial resistance is considered as one of the most important challenges in the field of public health and the use of new biocompatible, safe and effective antimicrobial compounds is very important to solve this problem. Therefore, according to the antimicrobial properties of platelets, treatments based on platelet products can be used as complementary approaches along with antibiotics to treat microbial infections. In this review article, the properties and mechanism of the antimicrobial effect of platelets and platelet products along with some of the available evidence in this field have been briefly described.

The search process was done in Google scholar and PubMed databases using keywords “Platelets”, “Platelet-rich plasma” and “Anti-Infective Agents” without time restrictions. 107 relevant articles were selected and their findings regarding the properties and mechanism of the antimicrobial effect of platelets and platelet products were used.

Antimicrobial activities of platelet products are due to the presence of a large number of platelets and various types of bioactive molecules, high amounts of platelet microbicidal proteins, and using multiple mechanisms. On the other hand, biocompatibility, safety, high clinical efficacy and limited side effects are some of the advantages of using platelet products. However, standardization and optimization of their preparation protocols are also important challenges.

The use of platelet products together with antibiotics is a suitable option to treat various microbial infections.

The concepts of Skin health and beauty, which are as ancient as mankind and civilization, are considered as the main factors of human health and well-being. Therefore skin anti-aging strategies as well as skin rejuvenation methods that prevent, delay, repair and combat skin aging and eliminate its symptoms and maintain the structural and functional integrity of the skin, are of particular importance. Skin aging is a complex and unpreventable biological process that occurs as a result of both intrinsic and extrinsic factors such as physiological, behavioral, geographical, and environmental and lifestyle factors. This dynamic and multifactorial process results from the formation and accumulation of reactive oxygen species (ROS) and the induction of matrix metalloproteinases. Skin aging is characterized by a progressive deterioration of the skinchr('39')s functional properties, linked to alterations in dermal connective tissue due to the changes at the cell, gene and protein levels. Different physiological and pathological processes involved in skin aging, are accompanied by clinical manifestations such as cumulative structural and physiological changes in skin structure and appearance, pigmentation changes, reduced elasticity, and increased wrinkles in the skin. Considering the increasing trend of aging in the world, and the growing interest to maintain a youthful appearance, the demand for skin rejuvenation practices has greatly increased to improve the quality of life (QOL), self-esteem, and improved body image among aging population. The skin rejuvenation process uses a combination of different methods of bio-revitalization and techniques for repairing and strengthening different layers of the skin, along with changes in some other factors such as lifestyle, emotional and health status in order to relieve the aging signs. Platelet-rich plasma (PRP), derived from fresh whole blood, is a biological product which contains platelets concentrated above baseline level. Activated platelet cells can be considered as vehicles for growth factors (GFs) and cytokine delivery, which play a crucial role in up-regulation of collagen production and controlling oxidative damage. Besides, GFs reduce the signs of aging by modulating cell migration, proliferation, differentiation, angiogenesis and chemotaxis. They can also stimulate collagen synthesis, reverse the effects of collagenases, increase extracellular matrix accumulation, and promote endothelial and epithelial regeneration. This issue has caused PRP to be used in multiple clinical fields such as orthopedics, regenerative sport medicine, plastic surgery, dermatology and aesthetic medicine, gynecology, ophthalmology, and dentistry, with remarkable results. Skin rejuvenation, dermal augmentation, hair restoration, and acne scaring, are some of PRP dermatological indications. Topical application or direct injection of PRP compositions into the dermis can be considered as one of the simplest biological interventions in the field of reconstructive medicine and aesthetic treatments because of their capability to function as vehicles for growth factors and cytokine delivery. GFs and cytokines have the potential to address skin aging through stimulation of cell regeneration. Different GFs including platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF), present in PRP, stimulate human dermal fibroblasts. In fact Topical application of PRP or its direct injection into the skin, augment dermal elasticity by stimulating the removal of photodamaged extracellular matrix and induces the synthesis of new collagen and other matrix components by dermal fibroblasts via various molecular mechanisms. The ability of PRP to stimulate hyaluronic acid synthesis is another possible reason for skin rejuvenation. It should be noted that the topical application of Cosmeceutical formulations, containing biologically active ingredients, is preferable to invasive methods or systemic treatments. Because it is a safe, non-invasive, fast and simple procedure with the ability of topical delivery of active ingredient and direct impact on the desired location, fewer possible side effects and toxicities, and high user acceptability. Furthermore topically applied cosmeceutical preparations have advantages such as more solubility and spreadability, less drug degradation and enhanced bioavailability. Biocompatibility and biosafety, high clinical efficacy, fewer side effects, ease of use, non-invasiveness and greater acceptance and satisfaction of consumers, easier legal requirements, minimal manipulation, access to different methods of preparation, the possibility of adding different compounds to their formulation, reduced recovery time and downtime for patients, better aesthetic outcome, having antimicrobial activity and regeneration effect are some of PRP therapy benefits. However customizing PRP formulations for different clinical situations is an important challenge and should be carefully considered to achieve optimal efficacy, safety, tolerability, and stability. This article briefly discusses the concepts of skin health and beauty, skin aging and its clinical manifestations, classification of skin aging according to its causative factors, Skin rejuvenation strategies, mechanism actions of growth factors and platelet-rich plasma in skin rejuvenation, benefits of PRP therapies, Platelet preparation method, factors affecting the quality of PRP products, and formulation challenges. antibiotic resistance characteristics are determined and appropriate antibiotics are prescribed.