Acceleration of Wound Healing Using Adipose-derived Stem Cell Therapy with Platelet Concentrates: Plateletrich Plasma (PRP) vs. Platelet-rich Fibrin (PRF)

혈소판 농축재제를 이용한 창상치유의 촉진

  • Hahn, Hyung-Min (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Jeon, Yeo-Reum (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Rha, Dong-Kyun (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Lew, Dae-Hyun (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
  • 한형민 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소) ;
  • 전여름 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소) ;
  • 나동균 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소) ;
  • 유대현 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소)
  • Received : 2011.03.19
  • Accepted : 2011.05.23
  • Published : 2011.07.10

Abstract

Purpose: Although platelet-rich plasma (PRP) potentiate the wound healing activity of adipose-derived stem cells (ADSCs), its effect cannot be sustained for a prolonged period of time due to short duration of action. This led us to design and produce platelet-rich fibrin (PRF), in an effort to develop a tool which lasts longer, and apply it on wound healing. Methods: Two symmetrical skin defects were made on the back of seven nude mice. ADSCs were applied to each wound, combined with either PRP or PRF. The wound area was measured over 14 days. By day 16, the wound was harvested and histologic analysis was performed including counting of the blood vessel. Results: The healing rate was more accelerated in PRP group in the first 5 days (p<0.05). However, PRF group surpassed PRP group after 6 days (p<0.05). The average number of blood vessels observed in the PRF group was $6.53{\pm}0.51$, compared with $5.68{\pm}0.71$ for the PRP group. Conclusion: PRF exerts a slow yet pervasive influence over the two-week course of the wound healing process. Thus, PRF is probably more beneficial for promoting the activity of ADSCs for a sustained period of time.

Keywords

References

  1. Blanton MW, Hadad I, Johnstone BH, Mund JA, Rogers PI, Eppley BL, March KL: Adipose stromal cells and plateletrich plasma therapies synergistically increase revascularization during wound healing. Plast Reconstr Surg 123: 56, 2009 https://doi.org/10.1097/PRS.0b013e318191be2d
  2. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G: Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 27: 63, 2009 https://doi.org/10.1080/08977190802636713
  3. Kim WS, Park BS, Park SH, Kim HK, Sung JH: Antiwrinkle effect of adipose-derived stem cell: activation of dermal fibroblast by secretory factors. J Dermatol Sci 53: 96, 2009 https://doi.org/10.1016/j.jdermsci.2008.08.007
  4. Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT: Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 91: 4, 2004
  5. Pallua N, Wolter T, Markowicz M: Platelet-rich plasma in burns. Burns 36: 4, 2010 https://doi.org/10.1016/j.burns.2009.05.002
  6. Cervelli V, Gentile P, Grimaldi M: Regenerative Surgery: Use of fat grafting combined with platelet-rich plasma for chronic lower-extremity ulcers. Aesthetic Plast Surg 33: 340, 2009 https://doi.org/10.1007/s00266-008-9302-z
  7. Bir SC, Esaki J, Marui A, Yamahara K, Tsubota H, Ikeda T, Sakata R: Angiogenic properties of sustained release platelet-rich plasma: characterization in-vitro and in the ischemic hind limb of the mouse. J Vasc Surg 50: 870, 2009 https://doi.org/10.1016/j.jvs.2009.06.016
  8. Kakudo N, Minakata T, Mitsui T, Kushida S, Notodihardjo FZ, Kusumoto K: Proliferation-promoting effect of platelet-rich plasma on human adipose-derived stem cells and human dermal fibroblasts. Plast Reconstr Surg 122: 1352, 2008 https://doi.org/10.1097/PRS.0b013e3181882046
  9. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B: Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101: e37, 2006 https://doi.org/10.1016/j.tripleo.2005.07.008
  10. Sunitha Raja V, Munirathnam Naidu E: Platelet-rich fibrin: evolution of a second generation platelet concentrate. Indian J Dent Res 19: 42, 2008 https://doi.org/10.4103/0970-9290.38931
  11. Lundquist R, Dziegiel MH, Agren MS: Bioactivity and stability of endogenous fibrogenic factors in platelet-rich fibrin. Wound Repair Regen 16: 356, 2008 https://doi.org/10.1111/j.1524-475X.2007.00344.x
  12. Moon MH, Kim SY, Kim YJ, Kim SJ, Lee JB, Bae YC, Sung SM, Jung JS: Human adipose tissue-derived mesenchymal stem cells improve postnatal neovascularization in a mouse model of hindlimb ischemia. Cell Physiol Biochem 17: 279, 2006 https://doi.org/10.1159/000094140
  13. O'Connell SM, Impeduglia T, Hessler K, Wang XJ, Carroll RJ, Dardik H: Autologous platelet-rich fibrin matrix as cell therapy in the healing of chronic lower-extremity ulcers. Wound Repair Regen 16: 749, 2008 https://doi.org/10.1111/j.1524-475X.2008.00426.x