Abstract
Platelets are anucleate derivatives of megakaryocytes that can release almost 4000 unique proteins stored in one of three types of granules: dense granules, alpha (α)-granules, or lysosomes. Platelet α-granules release several growth factors (GFs), cytokines, chemokines, and proteolytic enzymes that can promote healing and tissue regeneration by stimulating cell proliferation, differentiation, migration along with matrix remodeling, and angiogenesis. Treatment using autologous preparation of platelet-rich plasma (PRP) containing platelets whose concentration is three- to fivefold above baseline in the blood is widely popular in sports medicine and maxillofacial surgery, and more recently has gained traction in dermatology. PRP preparation is rapid, requiring minimal specialized equipment and training, and is relatively safe, easy, and affordable compared to other tissue regeneration therapies such as tissue engineering, gene therapy, or cell therapy. GFs secreted by platelets in PRP cause dermal matrix remodeling to enhance skin rejuvenation and healing of wounds and scars while keratinocyte and dermal papilla cell growth and proliferation are key features induced by GFs to promote wound healing and hair regeneration. Although achievements from use of PRP in clinical dermatology are invigorating, there is limited understanding about the basic science further complicated by lack of standardization in the clinical setting resulting in variable and inconsistent clinical response.
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References
Patel SR, Hartwig JH, Italiano JE. The biogenesis of platelets from megakaryocyte proplatelets. J Clin Invest. 2005;115:3348–54.
Weiss HJ. Platelet physiology and abnormalities of platelet function. N Engl J Med. 1975;293:580–8.
Łukasik Z, Makowski M, Makowska J. From blood coagulation to innate and adaptive immunity: the role of platelets in the physiology and pathology of autoimmune disorders. Rheumatol Int. 2018;38:959–74.
Pietrzak WS, Eppley BL. Platelet rich plasma: biology and new technology. J Craniofac Surg. 2005;16:1043–54.
Alves R, Grimalt R. A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Ski Appendage Disord. 2018;4:18–24.
Kalyam K, Kavoussi SC, Ehrlich M, Teng CC, Chadha N, Khodadadeh S, et al. Irreversible blindness following periocular autologous platelet-rich plasma skin rejuvenation treatment. Ophthalmic Plast Rec. 2017;33:S12–6.
Zhang M, Park G, Zhou B, Luo D. Applications and efficacy of platelet-rich plasma in dermatology: a clinical review. J Cosmet Dermatol. 2018;17:660–5.
Picard F, Hersant B, Bosc R, Meningaud J. Should we use platelet-rich plasma as an adjunct therapy to treat “acute wounds,” “burns,” and “laser therapies”: a review and a proposal of a quality criteria checklist for further studies. Wound Repair Regen. 2015;23:163–70.
Elghblawi E. Platelet-rich plasma, the ultimate secret for youthful skin elixir and hair growth triggering. J Cosmet Dermatol. 2018;17:423–30.
Sclafani AP, Azzi J. Platelet preparations for use in facial rejuvenation and wound healing: a critical review of current literature. Aesthet Plast Surg. 2015;39:495–505.
Hussain N, Johal H, Bhandari M. An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature. Sicot-J. 2017;3:57.
Giordano S, Romeo M, di Summa P, Salval A, Lankinen P. A meta-analysis on evidence of platelet-rich plasma for androgenetic alopecia. Int J Trichology. 2018;10(1):10.
Fitzpatrick J, Bulsara MK, McCrory P, Richardson MD, Zheng M. Analysis of platelet-rich plasma extraction. Orthop J Sports Med. 2017;5:2325967116675272.
Amable P, Carias R, Teixeira M, da Pacheco Í, do Amaral R, Granjeiro J, et al. Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther. 2013;4:67.
Mazzocca AD, McCarthy MR, Chowaniec DM, Cote MP, Romeo AA, Bradley JP, et al. Platelet-rich plasma differs according to preparation method and human variability. J Bone Jt Surg. 2012;94:308–16.
Castillo TN, Pouliot MA, Kim H, Dragoo JL. Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. Am J Sports Med. 2011;39:266–71.
Kushida S, Kakudo N, Morimoto N, Hara T, Ogawa T, Mitsui T, et al. Platelet and growth factor concentrations in activated platelet-rich plasma: a comparison of seven commercial separation systems. J Artif Organs. 2014;17:186–92.
do Amaral R, da Silva N, Haddad N, Lopes L, Ferreira F, Filho R, et al. Platelet-rich plasma obtained with different anticoagulants and their effect on platelet numbers and mesenchymal stromal cells cehavior in vitro. Stem Cells Int. 2016;2016:7414036.
Degen RM, Bernard JA, Oliver KS, Dines JS. Commercial separation systems designed for preparation of platelet-rich plasma yield differences in cellular composition. HSS J. 2017;13:75–80.
Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, Merli G, et al. Platelet-rich plasma: the choice of activation method affects the release of bioactive molecules. Biomed Res Int. 2016;2016:1–7.
Ruggeri ZM, Mendolicchio LG. Adhesion mechanisms in platelet function. Circ Res. 2007;100:1673–85.
Coppinger JA, Cagney G, Toomey S, Kislinger T, Belton O, McRedmond JP, et al. Characterization of the proteins released from activated platelets leads to localization of novel platelet proteins in human atherosclerotic lesions. Blood. 2004;103:2096–104.
Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. Bone Joint J. 2009;91:987–96.
Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma. Am J Sports Med. 2009;37:2259–72.
Pavlovic V, Ciric M, Jovanovic V, Stojanovic P. Platelet rich plasma: a short overview of certain bioactive components. Open Med-Warsaw. 2016;11:242–7.
Peterson JE, Zurakowski D, Italiano JE, Michel LV, Fox L, Klement GL, et al. Normal ranges of angiogenesis regulatory proteins in human platelets. Am J Hematol. 2010;85:487–93.
Sheu JR, Fong TH, Liu CM, Shen MY, Chen TL, Chang Y, et al. Expression of matrix metalloproteinase-9 in human platelets: regulation of platelet activation in in vitro and in vivo studies. Brit J Pharmacol. 2004;143:193–201.
Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114:1502–8.
Weibrich G, Kleis W, Hafner G, Hitzler WE. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Cranio Maxill Surg. 2002;30:97–102.
Martineau I, Lacoste E, Gagnon G. Effects of calcium and thrombin on growth factor release from platelet concentrates: kinetics and regulation of endothelial cell proliferation. Biomaterials. 2004;25:4489–502.
Lacoste E, Martineau I, Gagnon G. Platelet concentrates: effects of calcium and thrombin on endothelial cell proliferation and growth factor release. J Periodontol. 2003;74:1498–507.
Cho H, Song I, Park S-Y, Sung M, Ahn M-W, Song K. Individual variation in growth factor concentrations in platelet-rich plasma and its influence on human mesenchymal stem cells. Korean J Lab Med. 2011;31:212–8.
Evanson RJ, Guyton KM, Oliver DL, Hire JM, Topolski RL, Zumbrun SD, et al. Gender and age differences in growth factor concentrations from platelet-rich plasma in adults. Mil Med. 2014;179:799–805.
Andia I, Abate M. Platelet-rich plasma: underlying biology and clinical correlates. Regen Med. 2013;8:645–58.
Alser OH, Goutos I. The evidence behind the use of platelet-rich plasma (PRP) in scar management: a literature review. Scars Burn Heal. 2018;4:2059513118808773.
Ruiz A, Cuestas D, Garcıa P, Quintero J, Forero Y, Galvis I, et al. Early intervention in scar management and cutaneous burns with autologous platelet-rich plasma. J Cosmet Dermatol. 2018;17:1194–9.
Aal A, Ibrahim I, Sami N, Kareem I. Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars. J Cosmet Laser Ther. 2017;20:106–13.
Alam M, Hughart R, Champlain A, Geisler A, Paghdal K, Whiting D, et al. Effect of platelet-rich plasma injection for rejuvenation of photoaged facial skin: a randomized clinical trial. JAMA Dermatol. 2018;154:1447–52.
Sand J, Nabili V, Kochhar A, Rawnsley J, Keller G. Platelet-rich plasma for the aesthetic rurgeon. Facial Plast Surg. 2017;33:437–43.
Farage MA, Miller KW, Elsner P, Maibach HI. Characteristics of the aging skin. Adv Wound Care. 2013;2:5–10.
Quan T, Fisher GJ. Role of age-associated alterations of the dermal extracellular matrix microenvironment in human skin aging: a mini-review. Gerontology. 2015;61:427–34.
Abuaf O, Yildiz H, Baloglu H, Bilgili M, Simsek H, Dogan B. Histologic evidence of new collagen formulation using platelet rich plasma in skin rejuvenation: a prospective controlled clinical study. Ann Dermatol. 2016;28:718–24.
Kim D, Je Y, Kim C, Lee Y, Seo Y, Lee J, et al. Can platelet-rich plasma be used for skin rejuvenation? Evaluation of effects of platelet-rich plasma on human dermal fibroblast. Ann Dermatol. 2011;23:424–31.
Quan T, Qin Z, Xia W, Shao Y, Voorhees JJ, Fisher GJ. Matrix-degrading metalloproteinases in photoaging. J Invest Derm Symp Proc. 2009;14:20–4.
Yuksel E, Sahin G, Aydin F, Senturk N, Turanli A. Evaluation of effects of platelet-rich plasma on human facial skin. J Cosmet Laser Ther. 2014;16:206–8.
Gawdat HI, Tawdy AM, Hegazy RA, Zakaria MM, Allam RS. Autologous platelet-rich plasma versus readymade growth factors in skin rejuvenation: a split face study. J Cosmet Dermatol. 2017;16:258–64.
Papakonstantinou E, Roth M, Karakiulakis G. Hyaluronic acid: a key molecule in skin aging. Dermatoendocrinol. 2012;4:253–8.
Fabi S, Sundaram H. The potential of topical and injectable growth factors and cytokines for skin rejuvenation. Facial Plast Surg. 2014;30:157–71.
Aldag C, Teixeira D, Leventhal PS. Skin rejuvenation using cosmetic products containing growth factors, cytokines, and matrikines: a review of the literature. Clin Cosmet Investig Dermatol. 2016;9:411–9.
Chicharro-Alcántara D, Rubio-Zaragoza M, Damiá-Giménez E, Carrillo-Poveda JM, Cuervo-Serrato B, Peláez-Gorrea P, et al. Platelet rich plasma: new insights for cutaneous wound healing management. J Funct Biomaterials. 2018;9:10.
Fabbrocini G, Annunziata M, D’Arco V, Vita DV, Lodi G, Mauriello M, et al. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract. 2010;2010:893080.
Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016;15:434–43.
Oh I, Kim B, Kim M. Depressed facial scars successfully treated with autologous platelet-rich plasma and light-emitting diode phototherapy at 830 nm. Ann Dermatol. 2014;26:417–8.
ris C, Tziotzios C, Vale I. Cutaneous scarring: pathophysiology, molecular mechanisms, and scar reduction therapeutics part I. The molecular basis of scar formation. J Am Acad Dermatol. 2012;66:1–10.
Mancuso M, Santagostino E. Platelets: much more than bricks in a breached wall. Br J Haematol. 2017;178:209–19.
Asai J, Hirakawa S, Sakabe J, Kishida T, Wada M, Nakamura N, et al. Platelets regulate the migration of keratinocytes via podoplanin/CLEC-2 signaling during cutaneous wound healing in ice. Am J Pathol. 2016;186:101–8.
Grazul-Bilska A, Johnson M, Bilski J, Redmer D, Reynolds L, Abdullah A, et al. Wound healing: the role of growth factors. Drugs Today. 2003;39:787.
Murphy PS, Evans GR. Advances in wound healing: a review of current wound healing products. Plast Surg Int. 2012;2012:190436.
Hausauer AK, Jones DH. Evaluating the efficacy of different platelet-rich plasma regimens for management of androgenetic alopecia. Dermatol Surg. 2018;44:1191–200.
Lotti T, Goren A, Verner I, D’Alessio PA, Franca K. Platelet rich plasma in androgenetic alopecia: a systematic review. Dermatol Ther. 2019:e12837.
Bolanča Ž, Goren A, Getaldić-Švarc B, Vučić M, Šitum M. Platelet-rich plasma as a novel treatment for lichen planopillaris. Dermatol Ther. 2016;29:233–5.
Driskell RR, Clavel C, Rendl M, Watt FM. Hair follicle dermal papilla cells at a glance. J Cell Sci. 2011;124:1179–82.
Li Z, Choi H, Choi D, Sohn K, Im M, Seo Y, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012;38:1040–6.
Xiao S-E, Miao Y, Wang J, Jiang W, Fan Z-X, Liu X-M, et al. As a carrier–transporter for hair follicle reconstitution, platelet-rich plasma promotes proliferation and induction of mouse dermal papilla cells. Sci Rep. 2017;7:1125.
Gupta AK, Carviel J. A mechanistic model of platelet-rich plasma rreatment for androgenetic alopecia. Dermatol Surg. 2016;42:1335–9.
Kiso M, Hamazaki TS, Itoh M, Kikuchi S, Nakagawa H, Okochi H. Synergistic effect of PDGF and FGF2 for cell proliferation and hair inductive activity in murine vibrissal dermal papilla in vitro. J Dermatol Sci. 2015;79:110–8.
Jain R, De-Eknamkul W. Potential targets in the discovery of new hair growth promoters for androgenic alopecia. Expert Opin Ther Targets. 2014;18:787–806.
Yotsu RR, Hagiwara S, Okochi H, Tamaki T. Case series of patients with chronic foot ulcers treated with autologous platelet-rich plasma. J Dermatol. 2015;42:288–95.
Conde-Montero E, Horcajada-Reales C, Clavo P, Delgado-Sillero I, Suárez-Fernández R. Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma. Int Wound J. 2016;13:726–8.
Goldstein AT, King M, Runels C, Gloth M, Pfau R. Intradermal injection of autologous platelet-rich plasma for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol. 2017;76:158–60.
Hofny ER, Abdel-Motaleb AA, Ghazally A, Ahmed A, Hussein M. Platelet-rich plasma is a useful therapeutic option in melasma. J Dermatol Treat. 2018;29:1–6.
Gupta S, Revathi T, Sacchidanand S, Nataraj H. A study of the efficacy of platelet-rich plasma in the treatment of androgenetic alopecia in males. Indian J Dermatol Venereol Leprol. 2017;83:412.
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Shaik, J., Farah, R., Hordinsky, M. (2021). Biology of Platelet-Rich Plasma. In: Sadick, N.S. (eds) Platelet-Rich Plasma in Dermatologic Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-66230-1_1
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DOI: https://doi.org/10.1007/978-3-030-66230-1_1
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