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platelet rich plasma

در نشریات گروه پزشکی
  • Jing Luan, Qi Wang, Wei Zheng, Yongjin He *
    Objective (s)

    Platelet-rich plasma (PRP) contains multiple growth hormones that may stimulate tissue repair. We aimed to assess PRP’s efficacy and explore possible mechanisms using the intervertebral disc degeneration (IDD) model. 

    Materials and Methods

    A total of 48 male Sprague-Dawley (SD) rats were randomly divided into three groups: sham, IDD+PBS, and IDD+PRP (n=16, respectively). IL-1β (10 ng/ml) was used to establish a humanized IDD model in human lumbar nucleus pulposus (NP) tissues from 36 patients with degenerative disc disease. These NP cells were randomly divided into three groups: sham, IDD+PBS, and IDD+PRP (n=12, respectively). RT-PCR and western blot were used to detect the expression of aggrecan, collagen II, IL-1β, IL-6, TNF-α, Bcl-2, cleaved-Caspase 3, Bax and Akt/mTOR/p70S6K signaling pathway. A related assay kit was used to detect MDA, SOD, and GSH.

    Results

    PRP affected the expression of aggrecan, collagen II, IL-1β, IL-6, TNF-α, MDA, SOD, GSH, Bcl-2, cleaved-Caspase 3, and Bax in IDD rats. Compared with the IDD+PBS group, the expression of p-mTOR, p-p70/S6K, and p-Akt was much lower in the rat IDD+PRP group (P<0.05). Similarly, with PRP treatment in the humanized IDD model, the expression of p-mTOR, p-p70/S6K, and p-Akt was also inhibited.

    Conclusion

    PRP may be a potential therapy for IDD via the mTOR signaling pathway in regulating and affecting extracellular matrix degradation, inflammatory factors, oxidative stress, and apoptosis.

    Keywords: Akt, Mtor, P70s6k-Signaling Pathway, Apoptosis, Extracellular Matrix- Degradation, Inflammatory Factors Intervertebral Disc Degeneration, Oxidative Stress, Platelet-Rich Plasma
  • Nader Pazyar*, Havva Hajati, Reza Yaghoobi, Nima Bakhtiari
    Background

    Melasma, characterized by irregular skin hyperpigmentation, presents a therapeutic challenge with limited universal solutions. Platelet-rich plasma (PRP) and Tranexamic Acid (TXA), coupled with microneedling, offer promising avenues for treatment. This clinical trial sought to compare the efficacy and adverse effects of microneedling with PRP versus TXA in managing melasma.

    Methods

    The study was a single-blind, randomized controlled trial from May 2022 to Apr 2023 and enrolled 23 female melasma patients. Using the coin toss method, patients were randomly assigned to receive microneedling with PRP on one side and microneedling with TXA on the other. Evaluation parameters included Melasma Area and Severity Index (MASI) scores, melasma improvement grading, patient satisfaction, and treatment-related side effects, monitored over three sessions at 3-week intervals.

    Results

    Both microneedling approaches demonstrated effectiveness, with the PRP group exhibiting significantly lower MASI scores at the 6th and 9th wk. However, no significant distinctions were observed in improvement grading or patient satisfaction between the PRP and TXA groups. Side effects were minimal, limited to transient burning and mild pain during the procedure.

    Conclusion

    Microneedling with PRP and TXA emerged as a safe and effective treatment for melasma. While the PRP group showed potential superiority in MASI scores, comprehensive considerations, including patient preferences and long-term outcomes, are crucial. Larger, multi-center studies with extended follow-up periods are warranted for a more nuanced understanding of these treatments in melasma management.

    Keywords: Melasma, Platelet-Rich Plasma, Tranexamic Acid, Microneedling, Clinical Trial
  • نیما باقری، مهدیه قیاثی*، خلیل پسته ای

    تاندونوپاتی روتاتور کاف شانه یکی از علل شایع در بیماران است که عملکرد روزانه وکیفیت زندگی فرد را تحت تاثیر قرار می دهد. مشکلات تاندنوپاتی از شایعترین مشکلات افراد مراجعه کننده به مراکز درمانی است که در بعضی افراد بهبود به دلیل موقعیت شغلی آنها از اهمیت بسزایی برخوردار است. پلاسمای غنی از پلاکت به علت داشتن عوامل رشد دخیل در ترمیم بافت ها در بیماران تاندنوپاتی مورد توجه قرار گرفته است. این مطالعه ی مروری اثر بالینی تزریق پلاسمای غنی از پلاکت را در تاندونوپاتی روتاتور کاف و همچنین مطالعات دیگر را هم که به صورت مقایسه ای با کورتیکواستروئید بوده، بررسی نموده است. یک جستجوی متون در پایگاه های مختلف علمی برای دستیابی به مقالات تا سال 2022 با بررسی اثرات بالینی تزریق PRP بر روی تاندونوپاتی انجام پذیرفت. این مطالعه از فروردین 1402 تا فروردین 1403 انجام شده است. پلاسمای غنی از پلاکت (PRP) یکی از فرآورده های مشتق شده از خون است که حاوی مقدار بیشتری از پلاکت فیزیولوژیکی است. این عوامل رشد به طور قابل توجهی به دنبال آسیب تاندون تنظیم می شوند و در مراحل مختلف فرآیند بهبود فعال هستند. PRP یک منبع اتولوگ فاکتورهای رشد است و برای درمان تاندونوپاتی و استئوآرتریت مفید است. تزریق PRP می تواند به عنوان یک روش مناسب و مطلوب در بیماران تاندنوپاتی و پارگی روتاتورکاف مخصوصا در بزرگسالان توصیه شود وجایگزین کورتون قرار گیرد. PRP یک روش درمانی کم تهاجمی است که در درمان بیماری های عضلانی و آسیب های تاندون ها استفاده می شود.

    کلید واژگان: پلاسمای غنی از پلاکت، درد شانه، تاندون، تاندنوپاتی
    Nima Bagheri, Mahdieh Ghiasi*, Khalil Pestehei

    Tendon ruptures may occur as a result of acute injuries or degenerative changes in the tendons caused by aging, excessive and long-term use of the shoulders, and sudden wear and tear. This tear may be partial or completely separate the tendon from its attachment to the bone. Rotator cuff tendinopathy of the shoulder is one of the common causes in patients that affect the daily performance and quality of life. Tendinopathy problems are one of the most common problems of people who refer to medical centers, and in some people, improvement is very important because of their job position. Platelet-rich plasma has received attention due to having growth factors involved in tissue repair in tendinopathy patients. This review study examined the clinical effect of platelet-rich plasma injection in rotator cuff tendinopathy, as well as other studies comparing it with corticosteroids. A literature search was conducted in various scientific databases to obtain articles up to 2022 examining the clinical effects of PRP injection on tendinopathy. Platelet-rich plasma (PRP) is one of the products derived from blood that contains a greater number of physiological platelets. PRP contains a large amount of growth factors such as TGF-β, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), which play an important role in cell proliferation, cell differentiation, chemotaxis and angiogenesis. These growth factors are significantly upregulated following tendon injury and are active at different stages of the healing process. Platelet-rich plasma is an autologous source of growth factors and has been shown to be beneficial in the treatment of tendinopathy and osteoarthritis. PRP injection can be recommended as a suitable and desirable method in tendinopathy and rotator cuff tear patients, especially in adults, and can be substituted for corticosteroids. PRP is a minimally invasive treatment method that is used to treat muscle diseases and tendon injuries. In this method, blood is taken from the person, and after that, the components of the blood are separated during a process, and the platelet-enriched plasma is re-injected into the muscles and tendons of the shoulder.

    Keywords: Platelet Rich Plasma, Shoulder Pain, Tendon, Tendinopathy
  • E. Carlos RODRIGUEZ-MERCHAN *, Hortensia De La Corte-Rodriguez

    The purpose of this in brief article was to determine the current role of intraarticular injections of hyaluronic acid (HA) and platelet-rich plasma (PRP) for the treatment of painful KOA. It has been reported that the average duration of effectiveness (pain relief) of one injection of extended-release HA is around one year. Kellgren-Lawrence grade (I-II versus III-IV), male gender, and older age are associated with a longer duration of effectiveness. Cartilage degeneration might be improved with a higher number of injections of HA. Intraarticular injections of HA alleviate pain, function, and diminish non-steroidal anti-inflammatory drugs (NSAIDs) consumption. In addition, several studies have indicated that the combination of HA and PRP is more effective than HA alone. Finally, other studies seemed to demonstrate that PRP was more effective than HA.        Level of evidence: III

    Keywords: Efficacy, Hyaluronic Acid, Intraarticular Injections, Knee Osteoarthritis, Platelet-Rich Plasma
  • Maliheh Khosromanesh, Sogol Alikarami, Ebrahim Espahbodi, Reza Atef Yekta, Koorosh Kamali, Hossein Majedi
    Background

    Sacroiliac joint (SIJ) pain poses a significant burden on patients and the healthcare system. Due to its potential for tissue regeneration, minimally invasive administration, and affordability, platelet-rich plasma (PRP) has recently gained attention in the management of SIJ pain. Although PRP is widely used for musculoskeletal conditions, there is limited evidence regarding its application in SIJ pain.

    Objectives

    This study aims to assess the impact of PRP injections in patients with chronic SIJ pain that is unresponsive to conservative treatments.

    Methods

    This study is a single-arm, open-label clinical trial. Patients aged between 30 and 80 years with chronic SIJ pain were included. Platelet-rich plasma was prepared from autologous blood and injected into the SIJ under ultrasound (US) guidance. Pain intensity was assessed using the Numeric Rating Scale (NRS), and functional disability was measured using the Modified Oswestry Disability Index (MODI) before the intervention, as well as one month and three months post-injection. Statistical analysis was performed using repeated measures ANOVA in SPSS version 23 to evaluate changes over time.

    Results

    A total of 16 patients were included in the study. At the one-month follow-up, the mean pain intensity dropped to 5.19 ± 2.66, followed by a slight increase to 5.75 ± 2.54 at the three-month follow-up. The mean MODI score was 67.00 ± 8.42 at baseline, improving to 46.75 ± 21.46 at one month, and slightly increasing to 50.50 ± 19.98 at three months. The overall changes in pain intensity and disability index over the three months were statistically significant (P < 0.001). No significant adverse events were reported.

    Conclusions

    Platelet-rich plasma injection resulted in significant pain reduction and functional improvement for chronic SIJ pain over three months, suggesting its potential as a minimally invasive therapeutic alternative for patients who are unresponsive to conventional therapies. While PRP appears to be a safe modality for SIJ pain management, further studies with larger sample sizes and extended follow-ups are needed to explore its effectiveness and safety.

    Keywords: Platelet-Rich Plasma, Sacroiliac Joint, Low Back Pain, Chronic Pain
  • Pooja Sharma *, Goutham B, Sunil Muddaiah, Sanju Somaiah, Balakrishna Shetty
    Aim

    Reducing orthodontic treatment duration is a significant concern for both patients and clinicians, as prolonged treatments can lead to complications like dental caries, root resorption, and decreased patient compliance. This study aims to compare the effectiveness of two minimally invasive techniques—Piezocision and platelet-rich plasma (PRP) injection in accelerating orthodontic tooth movement during space closure in patients with bimaxillary protrusion.

    Methods

    Sixteen patients diagnosed with Angle's Class I bimaxillary protrusion requiring extraction of first premolars were randomly assigned to two groups. Group A (n = 8) underwent Piezocision-assisted orthodontic treatment, while Group B (n = 8) received submucosal PRP injections. In both groups, one side of the maxillary arch served as the experimental side, and the contralateral side served as the control. Measurements of space closure were taken at the initiation of retraction (T0) and after 90 days (T1). Paired t-test, independent t-test, ANOVA and post hoc Tukey test were used for statistical analysis. P-value<0.05 was considered as significant.

    Results

    There were significant differences in mean difference of space closure between Piezocision experimental group and Piezocision controls(p=0.003);also, there were significant differences between PRP experimental group and PRP controls (p=0.000). In addition, this study did not show any significant differences in the mean difference of space closure between  Piezocision experimental and PRP experimental groups(p=0.252).

    Conclusion

    Piezocision and submucosal injection of PRP could increase the rate of space closure. There is no difference between Piezocision and PRP in rate of space closure.

    Keywords: Accelerated Orthodontics, Piezocision, Platelet-Rich Plasma, Space Closure, Bimaxillary Protrusion
  • مقدمه

    شکست مکرر لانه گزینی را می توان عمدتا با تعامل نامناسب بین جنین و آندومتر توضیح داد. تعادل پروفایل T-helper1/T-helper2 بر لانه گزینی موثر جنین تاثیر می گذارد. تعدیل ایمنی آندومتر از طریق تزریق داخل رحمی سلول های تک هسته ای فعال شده ی خون محیطی (PBMCs) یا پلاسمای غنی از پلاکت اتولوگ (PRP) یک گزینه درمانی بالقوه کارآمد است.

    هدف

    هدف اصلی این مطالعه بررسی حاملگی های بیوشیمیایی و بالینی ناشی از تجویز داخل رحمی PBMCs فعال شده و PRP در زنان RIF بود.

    مواد و روش ها

    این مطالعه کارآزمایی بالینی تصادفی شده دوسوکور در مرکز درمان ناباروری رویا جهاد دانشگاهی استان قم، از نوامبر 2022 تا آپریل 2024 انجام شد. 96 زن با حداقل 2 مورد RIF پس از لقاح آزمایشگاهی بطور تصادفی در گروه های کنترل، PBMC و PRP قرار گرفتند. به طور خلاصه، 3 میلی لیتر نمونه خون جمع آوری شد و PBMC ها با استفاده از محلول جداسازی Ficoll جدا شده و به مدت 72 ساعت کشت داده شدند. PRP با استفاده از سانتریفیوژ و از 10 میلی لیتر خون محیطی جدا شد. دو روز قبل از انتقال جنین، PBMC ها یا PRP به داخل حفره آندومتر منتقل شدند.

    نتایج

    به جز مدت زمان ناباروری که در گروه PBMC بیشتر از گروه کنترل بود، سایر خصوصیات پایه از نظر آماری تفاوتی نداشتند. همچنین میزان حاملگی بیوشیمیایی در گروه PRP (32/10) وPBMC  (32/12) در مقایسه با گروه شاهد (32/3) به طور قابل توجهی بالاتر بود (027/0 = p)، در حالی که میزان حاملگی بالینی فقط در گروهPBMC  (32/10) به طور معنی داری بالاتر از گروه کنترل (32/2) بود (038/0 = p).

    نتیجه گیری

    نه مداخلات PBMC و نه PRP برتری قابل توجهی نسبت به یکدیگر در مورد میزان بارداری بیوشیمیایی و بالینی نشان ندادند.

    کلید واژگان: سلول های تک هسته ای خون محیطی، پلاسمای غنی از پلاکت، شکست مکرر لانه گزینی، حاملگی
    Hoda Fazaeli, Azar Sheikholeslami, Zahra Ebrahimi, Naser Kalhor, Leila Naserpour*
    Background

    Recurrent implantation failure (RIF) can be explained mainly by improper crosstalk between the embryo and endometrium. The T-helper1/T-helper2 profile balance influences effective embryo implantation. Endometrial immunomodulation via intrauterine injection of activated peripheral blood mononuclear cells (PBMCs) or autologous platelet-rich plasma (PRP) is a potentially efficient treatment option.

    Objective

    This study aims to examine the biochemical and clinical pregnancies resulting from the intrauterine administering of activated PBMCs and PRP in RIF women.

    Materials and Methods

    This randomized clinical trial study was done in the Rooya Infertility Treatment Center, Qom, Iran from November 2022 to April 2024. 96 women with at least 2 RIFs were randomized into control, PBMC, and PRP groups. Briefly, 3 ml of blood sample was collected and PBMCs were isolated using Ficoll separation solution, and cultured for 72 hr. PRP was separated from 10 ml of peripheral blood through centrifugation. 2 days before embryo transfer PBMCs or PRP were transferred into the endometrial cavity.

    Results

    Except for the duration of infertility, which was higher in the PBMC group, all other baseline characteristics were not statistically different. Moreover, a significantly higher rate of biochemical pregnancy was observed in the PRP (10/32) and PBMC (12/32) groups compared to the control (3/32) (p = 0.027), while the rate of clinical pregnancy was only significantly higher in the PBMC group (10/32) than in the control group (2/32) (p = 0.038).

    Conclusion

    Neither PBMC nor PRP interventions exhibited a substantial advantage over one another regarding biochemical and clinical pregnancy rates.

    Keywords: Peripheral Blood Mononuclear Cells, Platelet-Rich Plasma, Recurrent Implantation Failure, Pregnancy
  • Mohsen Sheykhhasan*, Azar Sheikholeslami, Ali Kowsari, Naser Kalhor
    Background

    The antimicrobial characteristics of biological products are fundamental in medicine due to their ability to treat microbial infections. This research aimed to assess and compare the antimicrobial properties of various platelet concentrates, including platelet-rich plasma (PRP), plateletrich fibrin (PRF), plasma-rich in growth factor (PRGF), and conditioned medium (CM) derived from adipose-derived mesenchymal stem cells (ADSCs) obtained from rats.

    Methods

    This experimental study obtained blood-derived products from 50 healthy Wistar rats. After obtaining 5 mL blood sample from each rat via cardiac puncture, it was used to prepare PRGF (group 1), PRP (group 2), and PRF (group 3). For the preparation of PRGF, 0.9% mL of 3.8% sodium citrate was used for every 8.1 mL of the blood. The centrifugal speed was 2500 rpm for 8 min. For the preparation of PRP, the centrifugal speed was 1800 rpm for 10 min and then 3600 rpm for 10 min. PRF was obtained with a centrifugation method of 3000 rpm for 10 min immediately after blood collection, and no anticoagulant was used. Furthermore, 2–4 g abdominal adipose tissue from each rat was used to isolate and culture ADSCs. Then, the CM derived from ADSCs was obtained (group 4). Bacterial strains were grown in blood agar medium and were separately treated with these four groups for 24 h at 37 °C.

    Results

    In this study, PRP stopped the growth of the Staphylococcus epidermidis bacterium, with a clear zone of inhibition around the PRP. This blood-derived product also stopped the growth of Escherichia coli, while the PRF prevented the growth of three bacteria: Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa. PRGF and CM showed no antibacterial activity against these bacterial strains.

    Conclusion

    PRP and PRF can create antimicrobial conditions in vitro due to their secretion of growth factors like platelet factor 4, fibrinopeptide A, and fibrinopeptide B. They can equally be used as treatment options to ameliorate microbial infections,although preclinical and clinical trials are necessary to understand their characteristics and activities better.

    Keywords: Antibacterial Agents, Conditioned Medium, Growth Factors, Platelet-Rich Fibrin, Platelet-Rich Plasma
  • فاطمه محمدعلی، سید محمدصادق پزشکی، احترام السادات حسینی*
    سابقه و هدف

    جمع آوری و نگهداری پلاکت ها با چالش های متعددی همراه است، تا از یک سو از فعال شدن پلاکت ها جلوگیری شود و از سوی دیگر ظرفیت عملکردی آن ها در حین تزریق خون حفظ شود. امروزه یکی از مشکلات فرآورده پلاکتی، وجود تجمعات پلاکتی است. اعتقاد بر این است که ذرات معلق در فرآورده پلاکتی حاوی پلاکت هستند که در طول فرآیند آماده سازی و جداسازی تجمع می یابند. در این مطالعه، عوامل دخیل در ایجاد تجمعات پلاکتی مرور شده تا امکان بهینه سازی سیستم های تهیه و انتقال خون و فرآورده ها فراهم شود. هدف از این مطالعه بررسی متغیرهای مهم در تشکیل تجمعات پلاکتی بود.

    مواد و روش ها

    در این مقاله مروری، 47 مقاله در مورد تجمع پلاکتی موجود در فرآورده پلاکتی از پایگاه اطلاعاتی PubMed با کلمات کلیدی کنسانتره پلاکتی و تجمعات پلاکتی جمع آوری گردید.

    یافته ها

    در مطالعه های بررسی شده، میزان تجمع پلاکت ها در کنسانتره های پلاکتی تهیه شده به روش پلاسمای غنی از پلاکت بیشتر از روش بافی کوت و آفرزیس بود. فاکتورهای مختلفی هم چون دمای نگهداری، زمان و دمای استراحت پلاکتی، pH ، تحریک فیزیکی القایی، نوع کیسه پلاکتی، وجود باکتری و متغیرهای مرتبط با اهداکننده به عنوان عوامل دخیل در تشکیل تجمع پلاکتی در نظر گرفته شدند.

    نتیجه گیری

    شناخت متغیرهای مهم در تشکیل تجمعات پلاکتی جهت بهبود کیفیت فرآورده پلاکتی و افزایش اثربخشی تزریق این فرآورده امری ضروری است. استفاده از روش بافی کوت، استانداردسازی زمان و دما، جلوگیری از بروز آلودگی باکتریایی و در نظر داشتن متغیرهای مرتبط با اهداکننده از جمله راه کارهای پیشنهادی جهت کاستن از احتمال بروز تجمعات پلاکتی هستند.

    کلید واژگان: پلاکت های خون، بافی کوت خون، پلاسمای غنی از پلاکت، تجمع پلاکتی
    F. Mohammadali, S.M.S. Pezeshki, E. Hosseini*
    Background and Objectives

    The collection and storage of platelets is associated with several challenges, to prevent the activation of platelets on the one hand and maintain their functional capacity during blood transfusion on the other hand. Today, one of the problems of platelet concentrate is the existence of platelet aggregations. The suspended particles in the platelet concentrate are believed to contain platelets that accumulate during the preparation and separation. The purpose of this study was to review important variables in the formation of platelet aggregations.

    Materials and Methods

    In this review article, 47 articles about aggregates in platelet products were studied from the PubMed database with platelet concentrate and platelet aggregate keywords.

    Results

    In the reviewed studies, the accumulation of platelets in the platelet concentrates prepared by the Platelet-rich plasma (PRP) method was higher than in the buffy coat and apheresis methods. Various factors such as storage temperature, time and temperature of platelet rest, pH, induced physical stimulation, type of platelet bag, presence of bacteria, and variables related to the donor were considered as factors involved in the formation of platelet aggregation.

    Conclusions  :

    It is necessary to know the important variables in the formation of platelet aggregations to improve the platelet product's quality and increase the platelet transfusion's effectiveness. Using the Buffy coat method, standardizing time and temperature, preventing bacterial contamination, and considering the variables related to the donor are some of the proposed solutions to reduce the possibility of platelet aggregation.

    Keywords: Blood Platelets, Blood Buffy Coat, Platelet-Rich Plasma, Platelet Aggregation
  • سعیده پیشقدم، افسانه مافی*، عباس مقدم، سید علی حائری روحانی
    سابقه و هدف

    آلژینات، پلی ساکاریدی با منشاء طبیعی است که می تواند با یون های کلسیم کراسلینک برقرار کند و به حالت ژل دربیاید. پلاسمای غنی از پلاکت به عنوان منبع غنی از فاکتورهای رشد، افق های نوینی را برای استفاده در پزشکی بازساختی و رژنراسیون بافت های آسیب دیده گشوده است. هدف بررسی حاضر، سنتز هیدروژل آلژینات کلسیم بارگذاری شده با پلاسمای غنی از پلاکت و  بررسی موفولوژی آن با میکروسکوپ الکترونی روبشی گسیل میدانی (FESEM) بود.

    روش بررسی

    در این مطالعه 5 عدد موش صحرایی در محدوده وزنی 200 تا 300 گرم استفاده شد. جهت تهیه پلاسمای غنی از پلاکت، خونگیری از قلب تحت بیهوشی عمیق انجام گرفت. پس از دو بار سانتریفیوژ خون، پلاسمای غنی از پلاکت (PRP) به دست آمد. PRP و محلول کلرید کلسیم 6% هریک به طور جداگانه با استفاده از سوزن سرنگ انسولین، به صورت قطره قطره به صورت همزمان، در محلول آلژینات 1% (داخل همزن مکانیکی) ریخته شدند. پس از ژل شدن و خشکاندن انجمادی، توسط FESEM مرفولوژی آن بررسی شد. 

    یافته ها

    در بررسی میکروسکوپی، پلاکت های موجود در پلاسمای غنی از پلاکت که داخل هیدروژل آلژینات کلسیم به دام افتاده بودند به صورت تجمع پلاکتی قابل مشاهده بودند.

    نتیجه گیری

    نتایج مطالعه حاضر نشان دهنده قابلیت هیدروژل آلژینات کلسیم بارگذاری شده با پلاسمای غنی از پلاکت به عنوان بستری مناسب برای نگه داری و انتقال فاکتورهای رشد جهت ترمیم و بازسازی بافت های آسیب دیده است.

    کلید واژگان: پلاسمای غنی از پلاکت، هیدروژل، آلژینات کلسیم، میکروسکوپ الکترونی روبشی، پزشکی بازساختی
    Saeede Pishghadam, Afsaneh Mafi*, Abbas Moghadam, Ali Haeri Rohani
    Background

    Alginate is a natural polysaccharide that can cross-link with calcium ions and form a gel. Platelet-rich plasma, as a source of growth factors, has opened new horizons for use in regenerative medicine and regeneration of damaged tissues. The aim of this study was to synthesize calcium alginate hydrogel loaded with platelet-rich plasma and examine its morphology with a field emission scanning electron microscope (FESEM).  

    Materials and methods

    5 Wistar rats (200-300 g) were used in this study. The animals were anesthetized and their blood was collected via cardiac puncture and centrifuged twice to obtain platelet-rich plasma (PRP). PRP and 6% calcium chloride solution were poured into 1% alginate solution (within a mechanical stirrer) separately using an insulin syringe needle, drop by drop at the same time. After gelation and freeze-drying, its morphology was examined by field emission scanning electron microscope.

    Results

    In microscopic examination, the platelets of platelet-rich plasma trapped inside the calcium alginate hydrogel were visible as platelet aggregation.

    Conclusion

    The results of the present study showed the ability of calcium alginate hydrogel loaded with platelet-rich plasma as a suitable substrate for the storage and transfer of platelets rich in growth factors for the repair and regeneration of damaged tissues.

    Keywords: Platelet-Rich Plasma, Hydrogel, Calcium Alginate, Electron Microscope, Regenerative Medicine
  • Zahra Kiaipour, Mahdieh Shafiee, Ghasseem Ansari *

    Statement of the Problem: 

    Treatment of immature necrotic teeth is a problematic situation. Conventional root canal therapy is challenging and leaves a weak, fragile and undeveloped tooth for lifetime.

    Purpose

    This review was aimed to assess the outcome of available randomized clinical tr-ials (RCTs) on the efficacy of platelet concentrates (PC) in dentine-pulp complex regeneration.

    Materials and Method

    An electronic search was conducted on MEDLINE, EMBASE, Cochrane, and Google scholar databases. A further manual search was performed on the list of related articles in order to ensure inclusion of potentially missed articles in earlier electronic search. Those proved RCTs matched with the standard criteria were included following an initial assessment of abstracts and the text independently by the reviewers.

    Results

    From the total 602 harvested articles, only 13 met the criteria and were evaluated with 11 having parallel design and 2 split mouth. Only one study featured low risk of bias, while three had moderate risk and the rest were at high risk of bias. Six studies had used platelet rich plasma (PRP), 4 employed platelet rich fibrin (PRF), one utilized injectable platelet rich fibrin (I-PRF), and three used both PRF and PRP for their experimental groups while blood clot (BC) was used as the control group for all. The success rate was reported at 87.3% judged by the absence of pathologic signs and symptoms.

    Conclusion

    Dentin wall thickening, root lengthening and apex closure were higher in PC groups, however, these differences were not statistically significant in reported studies. It can be concluded that PCs promote the pulp tissue revitalization and continuation of root development. However, a consensus on its potency for true pulp regeneration is yet to be reached.

    Keywords: Dental Pulp, Regeneration, Platelet Concentrates, Platelet Rich Plasma, Platelet Rich Fibrin, Injectable Platelet Rich Fibrin
  • Abbas Ahmadi, Reza Atef Yekta, Alireza Khajeh Nasiri, Nader Ali Nazemian Yazdi, Mohsen Cheraghi, Mehdi Sanatkar, Ebrahim Espahbodi *
    Background

    Knee osteoarthritis (OA) is the most common reason for orthopedic secondary care referral. And it is one of the main causes of disability in adults worldwide. It is estimated to affect between 10 to 25% of patients over the age of 60. Intra-articular corticosteroid injection (IA CS) and physical therapy were the two choices in an attempt to provide symptomatic management or deferred surgery. There is a growing trend is intra-articular platelet-rich plasma (IA PRP) injection to reduce pain and improve function in OA patients. PRP is divided into two types: leukocyte-poor platelet-rich plasma (LP-PRP) and leukocyte-rich platelet-rich plasma (LR-PRP). It was shown that LR-PRP increases pro-inflammatory factors and also decreases anti-catabolic mediators, and LP-PRP has the opposite aspect.

    Methods

    In our research 40 patients were divided into two equal groups, IA corticosteroid and leukocyte-poor platelet-rich plasma (LP-PRP) 40 cc of blood from the basilic vein of the upper limb is used with two step centrifugation. The final samples were 4 millilitres product injected intra-articular. group two (corticosteroid (CS)) received an intra-articular injection of triamcinolone acetate (Kenalog) 40 mg/ml along with 4 ml of lidocaine 0.02% (Abureyhan Co.) for a total of 5 ml. The needle used is a 22-gauge pencil-point Quincke needle (Dr. Japan Co, Ltd), which is performed with the Sonosite Edge II ultrasound guide and in an anterior-lateral manner in the knee joint. Pain was assessed on a visual analogue scale (VAS range 0-10 points) before, one week, one month, two month and 3 months after the operation. The WOMAC questionnaire was also filled before injection and three months following injection and other variables were examined.

    Results

    There were no significant differences between the groups across all the baseline parameters including age, sex, body mass index and comorbidities including high blood pressure, diabetes and smoking. Both injection groups were effective in reducing patients' pain from one week to three months after injection. The level of pain in the first week after injection was significantly lower in the corticosteroid group than in the PRP group. In the first month and the third month after the injection, the pain reduction according to mean scores of VAS was the same in both groups.

    Conclusion

    In short, one injection of PRP can reduce the pain of patients with osteoarthritis of the knee as much as corticosteroids during a three-month treatment process. Considering the possible side effects of corticosteroids, this alternative treatment can be considered with further investigation.

    Keywords: Knee osteoarthritis, Platelet-rich plasma, Triamcinolone
  • Perwez Khan, Lubna Khan, Kumari Kanchan Kiran
    Purpose

    To assess the efficacy of autologous platelet‑rich plasma (PRP) injections in suprachoroidal space and subtenon space in cases of retinitis pigmentosa, which is a genetic disease, leading to gradual loss of vision. Till date, no treatment is available.

    Methods

    Seventy-eight eyes of 39 patients of retinitis pigmentosa having visual acuity ranging from reading of Early Treatment Diabetic Retinopathy Study (ETDRS) chart from 1 m onward to patients who were not able to read the ETDRS chart but whose visual acuity ranged from finger count close to face to <1 m were included in the study. The left and right eyes of each patient were randomized as the intervention eye and control eye. 0.2 mL of autologous PRP was injected in suprachoroidal space and 0.5 mL of PRP was injected in subtenon space of the intervention eye taking aseptic precautions. Injections were repeated at 15-day intervals up to 3 injections.

    Results

    Majority of patients were in the age group of 18–30 years(20 cases) followed by 31–45 years(13 cases) and more than 45 years(6 cases). Intervention eyes showed a statistically significant improvement in visual acuity and multifocal electroretinography (mfERG). Improvement was noted in amplitude density latency and in ring ratio of mfERG. There was a significant improvement in best-corrected visual acuity (BCVA). However, no improvement in mfERG or BCVA was observed in the control group.

    Conclusions

    Gene therapy may be the ultimate cure for retinitis pigmentosa, but it is unaffordable for many patients due to its high cost. PRP may be recognized as a modality to improve vision and stop further deterioration, especially in cases where functional vision is preserved. Negligible treatment costs and affordability will give power to economically disadvantaged patients.

    Keywords: Multifocal electroretinography, Platelet-rich plasma, Retinitis pigmentosa, Treatment
  • Fatima Zahra El Fatoiki, Hind Chagraoui *, Hayat Dahbi Skalli, Fouzia Hali, Soumiya Chiheb
    Background

     Chronic wounds, which are persistent disruptions in skin integrity, represent a significant global health challenge. Various types of ulcers, including venous, arterial, diabetic, pressure, and traumatic ulcers, contribute to personal, professional, and societal burdens. Autologous platelet-rich plasma (PRP) has emerged as a promising therapeutic option by leveraging the growth factors in platelets for tissue regeneration.

    Methods

     This prospective study, conducted from December 2021 to December 2023, enrolled 10 patients with chronic ulcers. The PRP gel was prepared through a systematic process that included blood collection, centrifugation, and activation.

    Results

     The study included 8 males and 2 females, with an average age of 48.8 years. Ulcer etiologies encompassed diabetic foot ulcers, arterial ulcers, and venous ulcers, among others. The initial average surface area of the ulcers was 18.7 cm2. Complete healing was observed in a case of Buerger's disease, while very good healing was achieved in one diabetic foot ulcer, one venous ulcer, and another case of Buerger's disease. Moderate healing was noted in five cases of arterial ulcers, and poor healing was observed in one case of prolidase deficiency. The average surface area post-treatment for all patients was reduced to 8.05 cm2, with no reported pain or adverse effects.

    Conclusions

     Platelet-rich plasma gel emerges as a promising alternative to traditional treatments, potentially lessening the overall impact on healthcare resources and enhancing the quality of life for individuals with chronic ulcers.

    Keywords: Platelet-Rich Plasma, Skin Ulcers, Buerger Disease, Diabetic Foot Ulcer, Prolidase Deficiency
  • مجتبی سروستانی، علیرضا رجب زاده، غلامرضا قوی پنجه*، طاهره مازوچی، مرتضی سلیمیان
    زمینه و هدف

    سندرم تخمدان پلی کیستیک (PCOS) یک اختلال اندوکرینی و ناباروری پیچیده است که با علائم مختلفی مانند مقاومت به انسولین، هایپرآندروژنیسم، عدم تخمک گذاری و وجود کیست در تخمدان مشخص می شود. این مطالعه با هدف تعیین تاثیر تزریق داخل تخمدانی پلاسمای غنی از پلاکت (PRP) بر مورفولوژی تخمدان و مقاومت به انسولین در موش صحرایی مدل PCOS انجام شد.

    روش ها

    در این مطالعه تجربی، 20 سر موش صحرایی نژاد ویستار به 4 گروه (5N=): کنترل، Sham، PCOS و گروه PCOS تیمار شده با PRP تقسیم شدند. برای القای PCOS از گاواژ مقدار 1 mg/kg لتروزول محلول در کربوکسی متیل سلولز 5/0 درصد استفاده شد. برای گروه تیمار شده با PRP، مقدار 35 میکرولیتر از PRP به طور مستقیم داخل هر دو تخمدان تزریق گردید. پس از دوره 14 روزه تریتمنت، سطح سرمی انسولین، گلوکز خون و شاخص مقاومت به انسولین (HOMA-IR) اندازه گیری شد. همچنین برش های بافتی از تخمدان زده شد و تغییرات هیستوپاتولوژیک و تعداد فولیکول ها بررسی گردید.

    یافته ها

    در مقایسه با گروه PCOS، تزریق داخل تخمدانی PRP سبب کاهش معنی داری در سطح سرمی انسولین (0/01<p) و گلوکز (0/01<p) شد. گروه های دریافت کننده PRP کاهش معنی داری در مقدار شاخص مقاومت با انسولین (HOMA-IR) را نشان دادند (0/0001<p. یافته های بافت شناسی نشان داد تیمار تک دوز با PRP سبب بهبود وضعیت پاتولوژیک تخمدان از جمله افزایش معنی دار تعداد فولیکول های سالم (در همه مراحل تکاملی) و جسم زرد (0/0001<p) و کاهش معنی دار تعداد فولکیول های کیستیک شد (0/0001<p).

    نتیجه گیری

    تزریق PRP می تواند سبب بهبود علائم PCOS از جمله مورفولوژی تخمدان و مقاومت به انسولین شود. با این حال مطالعات بیشتری برای بررسی مکانیسم های اثرگذاری PRP مورد نیاز است.

    کلید واژگان: سندرم تخمدان پلی کیستیک، پلاسمای غنی از پلاکت، مقاومت به انسولین، رت
    Mojtaba Sarvestani, Alireza Rajabzadeh, Gholamreza Ghavipanjeh*, Tahereh Mazoochi, Morteza Salimian
    Background and Aim

    Polycystic ovary syndrome (PCOS) is a multifaceted endocrine and infertility disorder characterized by symptoms such as insulin resistance, hyperandrogenism, anovulation, and ovarian cysts. This study aimed to examine the effect of intraovarian injection of platelet-rich plasma (PRP) on ovarian morphology and insulin resistance in a PCOS rat model.

    Methods

    In this experimental study, 20 Wistar rats were divided into four groups (N=5): control, sham, PCOS, and PCOS group treated with PRP. PCOS was induced using 1 mg/kg of letrozole dissolved in 0.5% carboxymethyl cellulose. The PRP group received 35 microliters of PRP injected directly into both ovaries. After 14 days of treatment, serum insulin levels, blood glucose, and the insulin resistance index (HOMA-IR) were measured. Ovarian tissue sections were also examined for histopathological changes and follicle count.

    Results

    Intraovarian injection of PRP led to a significant decrease in serum insulin levels (P<0.01) and glucose levels (P<0.01) compared to the PCOS group. The PRP-treated groups exhibited a significant reduction in the insulin resistance index (HOMA-IR) (P<0.0001). Histological analysis demonstrated that a single dose of PRP improved the ovarian pathological condition, resulting in a significant increase in healthy follicles at all developmental stages and corpus luteum (P<0.0001), along with a significant decrease in cystic follicles (P<0.0001).

    Conclusion

    Intraovarian PRP injection may ameliorate PCOS symptoms, including ovarian morphology and insulin resistance. However, further studies are necessary to elucidate the underlying mechanisms of PRP's effectiveness.

    Keywords: Polycystic Ovary Syndrome, Platelet-Rich Plasma, Insulin Resistance, Rat
  • مقدمه

    یافتن موثرترین راه برای بهبود میزان لانه گزینی در زنانی که تحت درمان با تکنولوژی کمک باروری هستند هنوز یک چالش است.

    هدف

    این مطالعه با هدف ارزیابی پیامدهای حاملگی درمان با پلاسمای غنی از پلاکت داخل رحمی (PRP) در زنان با سابقه حداقل دو شکست لانه گزینی انجام شد.

    مواد و روش ها

    در این مطالعه کوهورت گذشته نگر، داده های 852 زن کاندید انتقال جنین منجمد-ذوب شده از فروردین 1396 تا شهریور 1400 در پژوهشکده علوم تولید مثل یزد ایران استخراج شد. از این تعداد، 432 مورد درمان PRP داخل رحمی 48 ساعت قبل از انتقال دریافت کردند (گروه PRP) و نتایج بارداری با 420 نفر (گروه کنترل) که درمان را قبل از انتقال دریافت نکردند مقایسه شد.

    نتایج

    پیامدهای حاملگی شامل میزان حاملگی شیمیایی،کلینیکی، بارداری در حال پیشرفت و تولد زنده در گروه PRP از نظر آماری تفاوت معنی دار داشت (001/0 > p). اگرچه هنگامی که بر اساس تاریخچه تعداد موارد شکست لانه گزینی طبقه بندی انجام شد، این بهبود قابل توجه در هر چهار مورد تنها در زنان با سابقه ی حداقل دو شکست لانه گزینی دیده شد. در زنان با سابقه تنها یک شکست لانه گزینی، درمان با پی آر پی به طور قابل توجهی باعث بهبود حاملگی در حال پیشرفت و میزان تولد زنده شد (5/19%، 04/0 = p). همچنین، در زنانی که تخمک اهدایی دریافت کردند و شکست لانه گزینی مکرر داشتند، PRP باعث بهبود بارداری شد. اما از نظر آماری معنی دار نبود (15/0 = p).

    نتیجه گیری

    به نظر می رسد PRP در بهبود میزان بارداری در زنان با سابقه 2 یا بیشتر شکست لانه گزینی موثر بوده و همچنین افزایش نرخ تولد زنده را در بیمارانی که تنها یک بار لانه گزینی ناموفق داشتند نشان می دهد.

    کلید واژگان: پلاسمای غنی از پلاکت، شکست لانه گزینی جنین، فناوری کمک باروری، اهداکننده تخمک، میزان تولد زنده
    Neda Fattahi Meybodi, Maryam Eftekhar *, Behnaz Gandom
    Background

    Finding the most effective way to improve implantation rate in women who are receiving assisted reproductive technology treatment is still a challenge.

    Objective

    This study aimed to assess the pregnancy outcomes of intrauterine platelet-rich plasma (PRP) therapy in women with a history of at least 2 implantation failures.

    Materials and Methods

    In this retrospective cohort study, data of 852 women who were candidates for frozen-thawed embryo transfer was extracted from their medical records from April 2017 to September 2021 at Yazd Reproductive Sciences Institute, Yazd, Iran. Of these, 432 received intrauterine PRP treatment 48 hr before transfer (PRP group), and the results of the pregnancy outcomes compared with 420 of the control group who did not receive the treatment before transfer.

    Results

    Pregnancy outcomes, including chemical, clinical, ongoing pregnancy, and live birth rate were statistically significant in the PRP group (p < 0.001). However, when categorized according to the implantation history, this significant improvement in all 4 was only seen in women with at least 2 prior implantation failures. In women with a history of only one implantation failure, PRP therapy significantly improved the ongoing pregnancy and live birth rate (19.5%, p = 0.04). Also, in women who received donor eggs and had repeated implantation failure, PRP improved pregnancy outcomes clinically but not statistically (p = 0.15).

    Conclusion

    PRP seems to be effective in improving the pregnancy rate in women with a history of 2 or more implantation failures and also shows an increase in the live birth rate in women with only one implantation failure.

    Keywords: Platelet-rich plasma, Embryo implantation, Assisted reproductive technology, Ovum donor, Live birth rate
  • Maryam Eftekhar, Nosrat Neghab, Parisa Khani *
    Background
    Platelet-rich plasma (PRP) therapy has been shown to enhance tissue regeneration by expressing severalcytokines and growth factors (GFs). This study investigated the effect of intrauterine infusion of PRP as a noninvasiveautologous GF on pregnancy outcomes in women with repeated implantation failure.
    Materials and Methods
    This randomized clinical trial was conducted to compare the pregnancy rates between twogroups of women who were candidates for the frozen-thawed embryo transfer with a history of two or more implantationfailures. The PRP group (n=33) was treated with hormone replacement therapy+0.5 cc to 1 cc PRP infusedinto the uterine cavity two days before the embryo transfer. The control group (n=33) was only treated with hormonereplacement therapy. The endometrial preparation process was done similarly in both groups. The chemical, clinical,and ongoing pregnancy, and implantation rates were compared between the two groups.
    Results
    Our results showed that the chemical pregnancy rate was not statistically higher in the PRP group in comparisonwith the control group (36.4 vs. 24.2%). In addition, the clinical pregnancy, ongoing pregnancy, and implantationrates were higher in the PRP group than the control group; however, the difference between the two groups was notstatistically significant.
    Conclusion
    Administration of intrauterine PRP before embryo transfer in women with repeated implantation failure(RIF) does not affect assisted reproductive technology (ART) outcomes (registration number: IRCT2016090728950N3).
    Keywords: embryo Implantation, Platelet-rich plasma, Pregnancy Outcome
  • مریم رنجبر بوشهری، ناهید بابایی*، هادی اسمعیلی گورچین قلعه، غلامرضا خمیسی پور، غلامرضا فرنوش
    سابقه و هدف

    کولیت اولسراتیو یک بیماری التهابی روده است که عواملی از قبیل استعداد ژنتیکی، فاکتورهای محیطی و عملکرد نامتناسب سیستم ایمنی مخاطی در پاسخ به فلور میکروبی روده در این بیماری دخیل هستند. پلاسمای غنی از پلاکت یکی از مشتقات حاصل از خون است که خاصیت ضد التهابی و بازسازی کننده سلولی دارد. مطالعه حاضر جهت بررسی اثر ضد التهابی پلاسمای غنی از پلاکت بر تظاهرات بالینی و التهابی در مدل تجربی کولیت اولسراتیو صورت پذیرفت.

    مواد و روش ها

    در این مطالعه تجربی، از موش های نر نژاد BALB/c استفاده شد که به 4 گروه 10 تایی تقسیم شدند که شامل، گروه سالم (کنترل منفی)، گروه کولیت بدون درمان (کنترل مثبت)، گروه کولیت دریافت کننده PRP و گروه کولیت دریافت کننده سولفاسالازین، است. کولیت با تزریق درون رکتومی 100 میکرولیتر اسید استیک 4 درصد در تمام حیوانات به جز گروه کنترل منفی ایجاد شد. برنامه درمانی پس از القای کولیت و ظهور علایم آغاز گردید. موش ها 15 روز پس از آخرین تزریق آسان کشی شدند و میزان معیار فعالیت بیماری و فاکتورهای التهابی بررسی گردید.

    یافته ها

    نتایج نشان داد که معیار فعالیت بیماری، شدت التهاب و هم چنین مقادیر MPO، NO، بیان و تولید سایتوکاین های IL-1β، IL-6 و TNF-α، بیان ژن های التهابی COX2 و iNOS در گروه های درمانی به نسبت گروه کولیت بدون درمان کاهش معناداری یافته است.

    استنتاج

    نتایج نشان داد که پلاسمای غنی از پلاکت دارای اثرات ضد التهابی مطلوبی در بیماری کولیت اولسراتیو بوده و بعد از ارزیابی های تکمیلی می تواند به عنوان یک درمان کمکی به همراه داروهای مورد مصرف در درمان بیماران مبتلا به کولیت اولسراتیو مورد استفاده قرار گیرد.

    کلید واژگان: کولیت اولسراتیو، التهاب، پلاسمای غنی از پلاکت، سولفاسالازین
    Maryam Ranjbar Bushehri, Nahid Babaei*, Hadi Esmaeili Gouvarchin Ghaleh, Gholamreza Khamisipour, Gholamreza Farnoosh
    Background and purpose

    Ulcerative colitis is a kind of inflammatory bowel disease that involves factors such as genetic predisposition, environmental factors, and disproportionate function of the mucosal immune system in response to intestinal microbial flora. Platelet-rich plasma (PRP) is a blood derivative that has anti-inflammatory and cell-regenerating properties. This study aimed to investigate the effects of PRP on the clinical and inflammatory manifestations in an experimental model of ulcerative colitis.

    Materials and methods

    In this experiment, male BALB/c mice were segregated into four groups, each consisting of 10 mice: the healthy group (negative control), the colitis group without treatment (positive control), the colitis group receiving PRP, and colitis group receiving sulfasalazine. All animals, except for those in the negative control group, were subjected to colitis induction via intrarectal injection of 100 µl of 4% acetic acid. The treatment regimen commenced after the onset of UC symptoms. The mice were euthanasia after 15 days of the last injection, and the disease activity index, as well as the inflammatory factors, were assessed.

    Results

    According to the results, the treatment groups showed a significant decrease in disease activity index, the severity of inflammation, the level of MPO, NO, and IL-1β, IL-6, and TNF-α cytokines expression and production, as well as inflammatory genes COX2 and iNOS expression, compared to the positive control group.

    Conclusion

    The results showed that PRP has favorable anti-inflammatory effects in ulcerative colitis and after additional evaluations, it can be used as an adjunctive treatment along with the drugs used in the treatment of ulcerative colitis patients.

    Keywords: ulcerative colitis, inflammation, platelet-rich plasma, sulfasalazine
  • Masthan Basha Shaik*, Divya Vurundhur, Kiran Kumar Mallam, Mohammad Gulabi
    Background & Aims

    Platelet-rich plasma (PRP) has emerged as a treatment for osteoarthritis (OA) and rheumatoid arthritis (RA). The aim of the current study is to assess the effect of PRP injection and its influence on interleukin-6 (IL-6) in the synovial fluid of the knee joint in OA and RA patients.

    Materials & Methods

    Clinico-radiologically diagnosed case of OA and RA of 30 each was included during the study period of 2 years. 10 ml of patient blood collected and PRP was prepared by differential centrifugation method, and this freshly prepared PRP was injected to the affected knee joint slowly. IL-6 levels assessed in synovial fluid at pre-PRP injection and 1st, 3rd and 6th month post-PRP Injection. Pain was measured using Visual Analog Scale.

    Results

    The mean age of the cases was 58.5 years for OA and 47.2 years for RA. Females were predominantly compared to males. Majority were Kellegren Lawrence radiological grade 3 in 15 (50%) cases, following grade 2 in 8 (26.67%) cases, grade 4 in 6(20%) cases and grade 1 in 1(3.33%) case. Mean IL-6 in OA cases was 89.5±24.5 pg/ml at pre PRP, and 66.48±23.1 pg/ml at post PRP (p<0.001, paired t-test). Mean IL-6 in RA was 97.5±18.9 pg/ml at pre-PRP injection, and 89.6±17.9 at post PRP (p<0.001, paired t-test). In OA cases, paired t-test between the mean pain scores (VAS) at follow-up depicts that the mean difference and standard error of difference between 6-month follow-up and one-month follow-up was -1.23 ± 0.20 statistically significant differences (95%CI: -1.71 to -0.73). In RA cases, paired t-test between the mean pain scores (VAS) at followup depicts that the mean difference and standard error of difference between 6-month follow-up and one-month follow-up was -1.38 ± 0.19 statistically significant differences (95% CI: -1.69 to -0.75). There was a positive correlation between levels of IL-6 and pain score (r=0.309, p=0.004).

    Conclusion

    Study shows that anti-Inflammatory role of PRP, which was evidenced by the statistically significant difference in the IL-6 levels at follow-up. It may be beneficial to halt the progress in arthritic joints. This study successfully established an anti-inflammatory role of PRP in joint pathology by influencing the IL-6 levels.

    Keywords: Interleukin-6, Osteoarthritis, Platelet-Rich Plasma, Rheumatoid Arthritis
  • Ricardo Grillo, Sahand Samieirad*, Omid Alizadeh, Seyed Hossein Hosseini Zarch, Rozita Khodashahi, Navid Kazemian, Maria Da Graça Naclério-Homem

    Many people were affected by COVID-19 in its severe form. Some intercurrences are still emerging. We here report two cases of COVID-related osteonecrosis of the jaws (CRONJ). Two retrospective cases were admitted into Imam Reza Hospital, Mashhad, Iran with suspected CRONJ. One patient escaped from hospital while the other showed a positive result after our proposed treatment. A new aftermath to COVID-19 infections is emerging. Maxillofacial and orthopedic surgeons should be aware of this situation. CRONJ should be on the suspect list in patients with COVID-19. Measures that are useful in the treatment carried out, as well as some measures recommended in the literature, were discussed. Surgical treatment of CRONJ appears to be an effective alternative, especially in the more aggressive cases.

    Keywords: Osteonecrosis, Jaw, COVID-19, Platelet-Rich Fibrin, Platelet-Rich Plasma, Oral Pathology
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