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Platelet-Rich Plasma
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Lu Yin, Katerina Svigos, Kristen Lo Sicco, Jerry Shapiro
We have found that approximately 71% of androgenetic alopecia patients respond to PRP treatment [2]. One possible reason for the inter-individual differences in response to treatment may be the variation in growth factor concentrations after PRP preparation [10]. There may be an optimal window in which these growth factors maximize hair regrowth, as levels that are too low may not stimulate growth and high levels of certain cytokines may have negative, toxic effects [10, 44]. Only patients who are identified as responders will continue with four additional monthly PRP injections for a total of six treatments over 6 consecutive months. After these initial six treatments, maintenance therapy is initiated. Maintenance therapy consists of injections every 3 to 6 months. The frequency of maintenance injections is determined through clinical evaluation of each patient using trichometric measurements to assess response by quantifying hair density. Other important considerations are patients' own preferences and tolerance of the injection-associated pain when determining maintenance therapy frequency. Further research is necessary to establish optimal schedules for maintenance therapy as well as any prognostic factors contributing to differences in response to maintenance therapy.
Bevacizumab in the treatment of ocular disease
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Robert L Avery, Dante J Pieramici
Before the advent of laser photocoagulation, a majority of patients who developed PDR and macular edema would go on to experience moderate to severe vision loss.35,36 Panretinal photocoagulation (PRP), which is quite effective in halting and reversing the development of retinal and anterior segment neovascularization, appears to work in part by reducing the vitreoretinal levels of VEGF.5 However, there are drawbacks to this treatment. In particular, patients may experience a decrease in central, peripheral, and night vision.35 In addition, some patients do not respond completely, and advanced stages may be resistant to the most extensive of PRP treatments. When anterior segment or vitreous opacity, such as vitreous hemorrhage, is present, one must await clearing of the opacity, and this delay will allow the disease to progress.
Pityriasis rubra pilaris induced erythroderma
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Although PRP usually resolves within 1–3 years, treatment of the disease is generally difficult. It is often resistant to both topical and systemic therapies. Since spontaneous remission can occur in the disease course, evaluating the true merit of any therapeutic agent is difficult. Due to the relative rarity of the disease, no randomized controlled trials on PRP have been published in the literature.
Efficacy of autologous platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: a randomized open-label trial
Published in Journal of Dermatological Treatment, 2023
Mithinkumar Balasundaram, Rashmi Kumari, Sivaranjini Ramassamy
The overall incidence of adverse events was similar between treatment groups, 37% in Minoxidil arm and 53% in PRP arm (p = 0.21). Most of the adverse events were mild in Minoxidil arm. The common side effects were mild headache (n = 4) and scalp pruritus (n = 4). Three of the subjects experienced dryness of the scalp following minoxidil use. One of them experienced allergic contact dermatitis to the vehicle, presenting as erythema and a burning sensation over the hairline after one week of use. The episode resolved with topical steroid application in a week. He withdrew from the study, despite the advice to change the formulation. The pain was the most common side effect (n = 17) associated with PRP injection. This usually lasted for up to 4–5 h post-procedure. Five of them needed a painkiller for relief, while the remaining could tolerate it. Four patients refused further sessions after the second sitting, as they could not tolerate the pain post-injection. All of them presented for assessment at week 12.
Platelet-rich plasma outcomes do not correlate with patient satisfaction or perceived cost-effectiveness
Published in The Physician and Sportsmedicine, 2023
Edward S. Mojica, Charles C. Lin, Noah Kirschner, Paola F. Ortega, Eoghan T. Hurley, Kirk A. Campbell, Michael J. Alaia, Laith M. Jazrawi
PRP is an injection of the patient’s own whole-blood extract with concentrated amounts of platelets to damaged or vulnerable tissue in order to accelerate healing [12]. PRP’s therapeutic potential stems from the platelet’s ability to deliver supraphysiologic amounts of growth factors to tissue with poor healing potential [13–15]. This composite of endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), as well as autologous chemokines and cytokines, results in potent anti-inflammatory and analgesic effects. In doing so, it has been hypothesized to both aid cartilage repair and disrupt the inflammatory cascade that cyclically contributes to cartilage destruction [16]. Despite its theoretical and clinical utility, there is a high cost associated with the injections, with it typically ranked as one of the most expensive intra-articular injections for OA [17]. All of this considered, there exists little data on patient reception of the injectable and willingness to undergo this treatment, and subsequent treatments after their initial injection.
Chitosan-dipotassium orthophosphate lyophilizate: a novel in situ thermogel carrier system of allogeneic platelet lysate growth factors
Published in Drug Delivery, 2022
Toaa A. Abdelrahman, Amira Motawea, Marwa S. El-Dahhan, Galal M. Abdelghani
Albeit the above-mentioned advantages, the clinical application of PRP is challenged by the premature bolus release of bioactive GFs which have short circulation times. Studies have shown that this bolus delivery can reach a peak of ∼70% of the PRP bioactive molecules within 10 min of contact with the wound micro-environment (Anitua et al., 2012). Moreover, PRP has a short half-life due to the presence of proinflammatory cells that release special enzymes known as matrix metalloproteinases (MMPs). In turn, MMPs create a proteolytic microenvironment that actively breaks down GFs and cytokines in their proximity causing flush-out from the application site within 1 to 2 h (Marx, 2001). Commonly, PRP is applied to a wound in the form of a liquid, which makes its tissue residence time limited. Given these limitations, frequent dosing and higher doses may be required in order to render PRP treatment effective. This is impractical due to the need of multiple blood harvesting procedures, increasing bed-side time and patient discomfort (Oneto et al., 2021). In light of this, allogeneic hemoderivatives may offer a reasonable alternative especially given their comparable efficacy (He et al., 2020).