Actualización en plasma rico en plaquetas

Autores/as

  • Silvia E. Castro Piedra Instituto Tecnológico de Costa Rica
  • Karla A. Arias Varela Centro de Excelencia de Investigación de Terapias de Avanzada

DOI:

https://doi.org/10.51481/amc.v61i4.1044

Palabras clave:

plasma rico en plaquetas, péptidos y proteínas de señalización intercelular, dermatología, regeneración, sistema músculo-esquelético

Resumen

El plasma rico en plaquetas es un producto derivado de la sangre, rico en péptidos y proteínas de señalización intercelular, así como citoquinas capaces de intervenir en cada una de las etapas de la regeneración de varios tejidos. Principalmente, se le han atribuido efectos antiinflamatorios en diferentes lesiones, así como otros efectos biológicos sobre las células y tejidos. A la fecha, no existe un protocolo estándar de producción o preparación, tampoco se ha descrito una dosis específica; la forma de aplicación es muy variable y depende de la condición por tratar. A pesar de ello, se han visto efectos positivos en campos como: odontología, ortopedia, dermatología, medicina reconstructiva, oftalmología, medicina deportiva, medicina vascular, entre otros. Su regulación es muy diversa a nivel internacional. Aunque hay expectativas con el tratamiento de plasma rico en plaquetas, no hay suficientes ensayos clínicos robustos que brinden un alto nivel de evidencia para validarlo como un tratamiento de rutina frente a determinada condición clínica. Además, no se pueden comparar fácilmente los resultados de diferentes investigaciones, por la variabilidad en el método de preparación y por la falta de homogeneidad en las lesiones tratadas, entre otros factores. Es por lo anterior que resulta necesario desarrollar más investigaciones serias que conlleven al establecimiento de un protocolo estandarizado, así como demostrar la efectividad de este nuevo tratamiento, de forma que se culmine con la implementación de nuevas terapias validadas y autorizadas para garantizar una mejoría real a los pacientes.

Citas

Lang S, Loibl M y Herrmann M. Platelet-Rich Plasma in Tissue Engineering: Hype and Hope. Eur Surg Res. 2018. 59: 265-275.

Chícharo D, Rubio M, Damiá E, Carrillo J, Cuervo B y Peláez P. Platelet Rich Plasma: New Insights for Cutaneous Wound Healing Management. J Funct Biomater. 2018. 9: 1-20.

Marx R. Platelet rich plasma (PRP): What is PRP and what is not PRP. Implant Dent. 2001. 10: 225-228.

Magalon J, Chateau A, Bertrand B, Louis M, Silvestre A, Giraudo L et al. DEPA classification: a proposal for standardizing PRP use and a retrospective application of available devices. BMJ Open Sport Exerc Med. 2016. 2: 1-5.

Badran K y Sand J. Platelet-Rich Plasma for Hair Loss Review of Methods and Results. Facial Plast Surg Clin North Am. 2018. 26: 469-485.

Escamilla M. Tesis doctoral: Eficacia y seguridad del plasma rico en plaquetas en pacientes con úlceras de etiología venosa. Universidad de Sevilla. 2016.

Etulain J, Mena H, Meiss R, Frechtel G, Gutt S, Negrotto S et al. An optimised protocol for platelet-rich plasma preparation to improve its angiogenic and regenerative properties. Sci Rep. 2018. 8: 1-15.

Xie J, Bian H, Qi S, Xu Y, Tang J, Li J et al. Effects of basic fibroblast growth factor on the expression of extracellular matrix and matrix metalloproteinase-1 in wound healing. Clin Exp Dermatol. 2008. 33: 176-182.

Hoseinpour F, Salavati S, Farsinejad A, Fatemi A y Mirzaee R. Platelet Rich in Growth Factors (PRGF): A Suitable Replacement for Fetal Bovine Serum (FBS) in Mesenchymal Stem Cell Culture. RMM. 2017. 5: 12-22.

El-Sharkawy H, Kantarci A, Deady J, Hasturk H, Liu H, Alshahat M et al. Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. J Periodontol. 2007. 78: 661-669.

Zhang J, Middleton K, Fu F, Im H y Wang J. HGF Mediates the Antiinflammatory Effects of PRP on Injured Tendons. PLoS ONE. 2013. 8: 1-12.

Etulain J, Mena H, Negrotto S y Schattner M. Stimulation of PAR-1 or PAR-4 promotes similar pattern of VEGF and endostatin release and pro-angiogenic responses mediated by human platelets. Platelets. 2015. 26: 799-804.

Dally J, Khan J, Voisey A, Charalambous C, John H, Woods H, et al. Hepatocyte Growth Factor Mediates Enhanced Wound Healing Responses and Resistance to Transforming Growth Factor-β1-Driven Myofibroblast Differentiation in Oral Mucosal Fibroblasts. Int J Mol Sci. 2017. 18: 1-15.

Eppley B, Wooden J y Higgins J. Platelet Quantification and Growth Factor Analysis from Platelet-Rich Plasma: Implications for Wound Healing. Plast Reconstr Surg. 2004. 114: 1502-1508.

Lacci K y Dardik A. Platelet-Rich-Plasma: Support for its use in wound healing. Yale J Biol Med. 2010. 83: 1-9.

Kowalska A, Rauova L y Poncz M. Role of the platelet chemokine platelet factor 4 (PF4) in hemostasis and thrombosis. Thromb Res. 2010. 125: 292296.

Van Del Doler J, Mooren, Vloon A, Stoelinga P y Jasen J. Platelet-Rich Plasma: Quantification of Growth Factor Levels and the Effect on Growth and Differentiation of Rat Bone Marrow Cells. Tissue Eng. 2006. 12: 3067-3073.

Ishikawa F, Miyazono K, Hellman U, Drexler H, Wernstedt C, Hagiwara K, et al. Identification of angiogenic activity and the cloning and expression of platelet-derived endothelial cell growth factor. Nature. 1989. 338: 557-562.

Santhosh K y Krishnan L. Endothelial cell growth factor (ECGF) enmeshed with fibrin matrix enhances proliferation of EC in vitro. Biomaterials. 2001. 22: 2769-2776.

Rodríguez J, Palomar M y Torres J. Plasma rico en plaquetas: fundamentos biológicos y aplicaciones en cirugía maxilofacial y estética facial. Rev Esp Cirug Oral y Maxilofac. 2012. 34:8-17.

Dhurat R y Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author’s Perspective. J Cutan Aesthet Surg. 2014. 7:189-197.

Chahla J, Cinque M, Piuzzi N, Mannava S, Geeslin A, Murray I, et al. A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature. J Bone Joint Surg Am. 2017. 99:1769-1779.

Ehrenfest D, Rasmusson L y Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and plateletrich fibrin (L-PRF). Trends Biotechnol. 2009. 27:158-167.

DeLong J, Russell R y Mazzocca A. Platelet-rich plasma: the PAW classification system. Arthroscopy. 2012. 28:998-1009.

Lana S, Cares S, Purita J, Tambeeli C, Silva G, Paulus C, et al. Leukocyte-rich PRP versus leukocyte-poor PRP - The role of monocyte/macrophage function in the healing cascade. J Clin Orthop Trauma. 2019. doi.org/10.1016/j. jcot.2019.05.008.

Anitua E, Prado R y Orive G. Closing regulatory gaps: New ground rules for platelet-rich plasma. Trends Biotech. 2015.33:492-495.

Villela D y Santos V. Evidence on the use of platelet-rich plasma for diabetic ulcer: A systematic review. Growth Factors. 2010.28:111-116.

Marck R, Gardien K, Stekelenburg C, Vehmeijer M, Baas D, Tuinebreijer W, et al. The application of platelet-rich plasma in the treatment of deep dermal burns: A randomized, double-blind, intra-patient controlled study. Wound Repair Regen. 2016. 24:712-720.

Nagaratna C, Asha G, Leelavthy B y Revathi T. Safety and efficacy of microneedling with autologous platelet rich plasma in chronic and stable alopecia areata. JPAD. 2018.28:59-63.

Giordano S, Romeo M, di Summa P, Salval A y Lankinen P. A Meta-analysis on Evidence of Platelet-rich Plasma for Androgenetic Alopecia. Int J Trichology. 2018. 10: 1-10.

Bubnov R, Yevseenko V e Seminiv I. Ultrasound guided injections of platelets rich plasma for muscle injury in professional athletes. Comparative study. Med Ultrason. 2013.15:101-105.

Han Y, Huang H, Pan J, Lin J, Zeng L, Liang G, et al. Comparison of plateletrich plasma vs hyaluronic acid injections in patients with knee osteoarthritis: A protocol for a systematic review and meta-analysis. Medicine (Baltimore). 2018. 97:1-4.

Lei X, Xu P y Cheng B. Problems and Solutions for Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Review. Aesthetic Plast Surg. 2018. 16: 1-13.

Kang R, Lee M, Seth R y Keller G. Platelet-Rich Plasma in Cosmetic Surgery. Int J Otorhinolaryngol Clinic. 2013. 5: 24-28.

Mideksa B, Martens A, Broeckx S, Meyer E, Chiers K, Duchateau L, et al. Regenerative Skin Wound Healing in Mammals: State-of-the-Art on Growth Factor and Stem Cell Based Treatments. Cell Physiol Biochem. 2015. 36:1-23.

Tavizon O y Romero A. Algunos aspectos clínico-patológicos de la úlcera de pierna. Dermatología Rev Mex. 2009. 52:80-91.

Lacci K y Dardik A. Platelet-Rich Plasma: Support for Its Use in Wound Healing. Yale J Biol Med. 2010. 83:1-9.

Comella K y Ikudayisi D. Injection of Stromal Vascular Fraction plus PlateletRich Plasma in a Non-Healing Decubitus Ulcer. J Med Cases. 2018. 9: 323327.

Ravi P, Vijayakumar C, Bosco C, Balagurunanthan K, Kalaiarasi R, Venkatesan K, et al. Efficacy of Homologous, Platelet-rich Plasma Dressing in Chronic Nonhealing Ulcers: An Observational Study. Cureus. 2018. 10:1-10.

Nettel F, Rodriguez N, Nigro J, Gonzalez M, Conde A, Muñoa A, Redigonda E, et al. Primer consenso latinoamericano de úlceras venosas. Rev Mex Angiol. 2013. 41: 95-126.

Wu L, Chen W, Huang A y Chan J. Platelet-derived growth factor-AA is a substantial factor in the ability of adipose-derived stem cells and endothelial progenitor cells to enhance wound healing. The FASEB J. 2018. 33:1-8.

Knighton D, Fiegel V, Austin L, Ciresi K y Butler E. Classification and Treatment of Chronic Nonhealing Wounds. Successful Treatment with Autologous Platelet-derived Wound Healing Factors. Ann Surg. 1986. 204: 322-330.

Kuffler D. Platelet Rich Plasma Promotes Axon Regeneration, Wound Healing and Pain Reduction: Fact or Fiction. Mol Neurobiol. 2015. 52:990-1014.

Etugov D, Mateeva V y Mateev G. Autologous platelet-rich plasma for treatment of venous leg ulcers: a prospective controlled study. J Biol Regul Homeost Agents. 2018. 32: 593-597.

Burgos N, Lobato I, Hernández I, Sebastián K, Rodríguez B, March A, et al. Autologous platelet-rich plasma in the treatment of venous leg ulcers in primary care: a randomised controlled, pilot study. J Wound Care. 2018. 27: S20-S24.

Cieslik A, Skowronski R, Jedrusik M y Pierchala M. The application of L-PRP in AIDS patients with crural chronic ulcers: A pilot study. Adv Med Sci. 2017. 63: 140-146.

De Oliveira M, Abbade L, Miot H, Ferreira R y Deffune E. Pilot Study of Homologous Platelet Gel in Venous Ulcers. Anais Brasileiros de Dermatologia. 2018. 92: 499-504.

Salazar A, Riera-del-Moral R, García M, Álvarez J, Concepción N y Riera-deCubas L. Uso del plasma rico en plaquetas para la cicatrización de úlceras crónicas de miembros inferiores. Actas Dermosifiliog. 2014. 105: 597-604.

Dionyssiou D, Demiri E, Foroglou P, Cheva A, Saratzis A, Aivazidis C et al. The effectiveness of intralesional injection of platelet-rich plasma in accelerating the healing of chronic ulcers: an experimental and clinical study. Int Wound J. 2013. 10: 397-406.

Sarvajnamurthy S, Suryanarayan S, Budamakuntala L y Suresh D. Autologous platelet rich plasma in chronic venous ulcers: study of 17 cases. J Cutan Aesthet Surg. 2013. 6: 97-99.

Moneib H, Youssef S, Aly D, Rizk M y Abdelhakeem Y. Autologous platelet-rich plasma versus conventional therapy for the treatment of chronic venous leg ulcers: A comparative study. J Cosmet Dermatol. 2018. 17:495-501.

Suthar M, Gupta S, Bukhari S y Ponemone V. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series. J Biomed Sci. 2017. 24:1-10.

Frykberg R, Driver V, Carman D, Lucero B, Borris C, Fylling C et al. Chronic Wounds Treated with a Physiologically Relevant Concentration of Platelet-rich Plasma Gel: A Prospective Case Series. Ostomy Wound Manage. 2010. 56: 36-44

El Taieb M, Ibrahim H, Nada E y Seif Al-Din M. Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation. Dermatol Ther. 2017. 30: 1 - 6.

Anitua E, Pino A, Jaén P y Navarro R. Platelet rich plasma for the management of hair loss: Better. J Cosmet Dermatol. 2018. 18: 1-4.

Moreno P. Histofisiología del folículo piloso y su importancia para la medicina regenerativa. Morfolia. 2017. 9:46-53.

“clinicaltrials.gov,” U.S. National Library of Medicine. 2018. [En linea]. Disponible en: https://clinicaltrials.gov/ct2/results?cond=Alopecia+Areata+ prp&term=&cntry=&state=&city=&dist=. [Accessed 10 11 2018].

Frautschi R, Hashem A, Halasa B, Cakmakoglu B y Zins J. Current Evidence for Clinical Efficacy of Platelet Rich Plasma in Aesthetic Surgery: A Systematic Review. Aesthet Surg J. 2017. 37: 353-362.

Gupta A y Carviel J. Meta-analysis of efficacy of platelet-rich plasma therapy for androgenetic alopecia. J Dermatolog Treat. 2017. 28:55-58.

Trink A, Sorbellini E, Bezzola P, Rodella L, Rezzani R, Ramot Y, et al. A randomized, double-blind, placebo and active-controlled, half-head study to evaluate the effects of platelet rich plasma on alopecia areata. Br J Dermatol. 2013. 169: 690-694.

Donovan J. Successful treatment of corticosteroid-resistant ophiasis-type alopecia areata (AA) with platelet-rich plasma (PRP). JAAD Case Rep. 2015. 1:305-307.

Singh S. Role of platelet-rich plasma in chronic alopecia areata: Our centre experience. Indian J Plast Surg. 2015. 48:57-59.

D’Ovidio R y Roberto M. Limited Effectiveness of Platelet-Rich-Plasma Treatment on Chronic Severe Alopecia Areata. Hair Ther Transplant. 2014. 4:1-2.

Cook C y Smith P. Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy in Treating Osteoarthritis of the Knee. Curr Rev Musculoskelet Med. 2018. 11: 583-592.

Ahmed H, Farrag S, Okasha A, Kadry A, Ata T, Monir A, et al. Clinical outcomes are associated with changes in ultrasonographic structural appearance after platelet-rich plasma treatment for knee osteoarthritis. Int J Rheum Dis. 2018. 21: 960-966.

Paknejad M, Shayesteh Y, Yaghobee A, Shariat S, Dehghan M y Motahari P. Evaluation of the effect of plasma rich in growth factors (PRGF) on bone regeneration. J Dent (Tehran). 2012: 9: 59-67.

Scully D, Naseem D y Matsakas A. Platelet biology in regenerative medicine of skeletal muscle. Acta Physiol (Oxf). 2018. 223:1-21.

Anitua E, Orive G, Pla R, Roman P, Serano V y Andía I. The effects of PRGF on bone regeneration and on titanium implant osseointegration in goats: A histologic and histomorphometric study. J Biomed Mater Res A. 2009. 91: 158-165.

Bernuzzi G, Patraglia F, Pedrini M, De Filippo M, Pogliacomi F, Verdano M et al. Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection. Blood Transfus. 2014. 12: s229-s234.

Hamid M, Ali M, Yusof A, George J y Lee L. Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. Am J Sports Med. 2014. 42: 2410-2418.

Zhang M, Park G, Zhou B y Luo D. Applications and efficacy of platelet-rich plasma in dermatology: A clinical review. J Cosmet Dermatol. 2018. 17: 660665.

Stellos K, Kopf S, Paul A, Marguart J, Gawaz M, Huard J, et al. Platelets in regeneration. Semin Thromb Hemost. 2010. 36: 175-184.

Sampson S, Gerhardt M y Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008. 1: 165-174.

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Publicado

2019-10-29 — Actualizado el 2019-10-29

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Cómo citar

Piedra, S. E. C., & Varela, K. A. A. (2019). Actualización en plasma rico en plaquetas. Acta Médica Costarricense , 61(4), 142-151. https://doi.org/10.51481/amc.v61i4.1044