Obtenção, indicadores de qualidade e propriedades dos hormônios derivados de plaquetas humanas pela técnica de Lisado Plaquetário
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2016-07-18
Autores
Vanni, Isabele Silveira Rosa [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Muitas especialidades médicas têm utilizado o Plasma Rico em Plaquetas (PRP) em diferentes modalidades terapêuticas, como está ocorrendo com a Ortopedia e em Cirurgia Plástica. No entanto, a denominação utilizada para o PRP é muitas vezes equivocada. Diante do crescente número de especialidades médicas usando PRP ou Hormônios Derivados de Plaquetas (HDP) este trabalho foi delineado. Objetivo: compreende três etapas: 1) Levantamento bibliográfico em base de dados com a palavra-chave: platelet rich plasma com intuito de avaliar criticamente os artigos publicados na literatura em revistas com Fator de Impacto (FI)≥1; 2) Obter PRP, Concentrado de Plaquetas (CP) e HDP de indivíduos saudáveis, pela técnica de lisado plaquetário, após a utilização de agonista e congelamento / descongelamento (N=10) e 3) Avaliar o desempenho destes preparados como substituto do Soro Fetal Bovino na cultura de Células Tronco Mesenquimais humanas (CTMh). Casuística e Métodos: Os indicadores monitorados foram: idade, sexo, tipagem ABO/RhD, fenotipagem eritrocitária Rh, Kell e determinação de fatores de crescimento pelo sistema Multiplex-Milliplex®: PDGF- AA, RANTES/CCL5, PAI-1 (total), VEGF-A, FGF-1/FGF-ácido, FGF-2/FGF-básico, EGF, Angiopoietina-2, Fibrinogênio e Fator von Willebrand, estes dosados nas 3 preparações: PRP, CP e HDP. Todos os indicadores monitorados foram realizados análise estatística. Resultados: Foram analisados 50 artigos entre 2012-2016, destes, 29 com a palavra-chave platelet-rich plasma, 14 platelet lysate (PL) e 7 platelet growth factor (PGF). Os artigos publicados com a palavra-chave PL são de periódicos com maior FI e maior coerência com a metodologia, seguida do PGF e PRP. Contata-se que a maioria dos trabalhos com a terminologia PRP foi empregada de forma equivocada. Estes indicadores registram que não existe correlação entre a contagem plaquetária e a dosagem de hormônios. A idade dos indivíduos está inversamente relacionada com a concentração de fator, à exceção do FGF. Não há correlação da quantidade de fatores de crescimento e sexo. Indivíduos do grupo sanguíneo A, e fenótipo ee são melhores secretores de hormônios de crescimento. Quando se comparam os 3 métodos analisados, o CP e o HDP são estatisticamente superiores ao PRP quanto à dosagem de fatores de crescimento. A análise desempenho dos preparados, na concentração de 20% quando comparado com o Soro Fetal Bovino na mesma concentração, identifica que o melhor desempenho quantitativamente foi CP>PRP>HDP=CTLE. No entanto a análise histológica evidencia um grande número de células aderidas ao scaffold de fibrina, com desempenho nitidamente superior para o HDP. Conclusão: A maioria dos trabalhos publicados usa a terminologia PRP incorretamente. Levando-se em consideração a quantificação dos hormônios plaquetários dosados e o desempenho em cultura celular as melhores técnicas são CP e HDP, ficando o PRP em desvantagem.
Diversity medical specialties have been using Platelet Rich Plasma (PRP) therapy form as is happening with the Orthopedics and Plastic Surgery. However, the name used for the PRP is often used wrongly. This work was outlined considering the growing number of medical specialties using PRP or platelet-derived hormones (PDH). Objective: The work consisted of three steps: 1) Bibliographic search with the key word PRP in order to evaluate the articles published in journals with Impact Factor (IF) ≥1; 2) obtaining of PRP, platelet concentrate (PC) and PDH from healthy individuals using the platelet lysate technique after use agonist and freeze / thaw (N = 10); 3) evaluate the performance of these preparations as substitute for fetal bovine serum in culture of human mesenchymal stem cells. Methods: The indicators monitored were: age, sex, ABO / RhD, erythrocyte phenotyping Rh, Kell and determination of growth factors by Multiplex-Milliplex® system(PDGF-AA, RANTES / CCL5, PAI-1 (total), VEGF-A, FGF-1 / FGF-acid, FGF-2 / FGF-basic, EGF, Angiopoietin-2, fibrinogen and Factor von Wilebrand. The monitored indicators were performed statistical analysis. Results: These parameters were measured in three preparations: PRP, PC and PDH. It was analyzed 50 articles between 2012-2016, of these, 29 with the platelet-rich plasma password, 14 platelet lysate (PL) 7 and platelet growth factor (PGF). Articles published with the keyword PL are journals with higher IF and greater consistency with the methodology followed by PGF and last PRP. It was observed that most of the work with the PRP terminology was used wrongly. These indicators showed that there is no correlation between the platelet count and the dosage of hormones. The age of individuals is inversely related with the concentration of factors, excepting FGF. There is no correlation between the amount of growth factors and gender. Individuals belonging to blood group A and no phenotype E are better secreting of growth hormones. When comparing the three methods analyzed, PC and PDH are statistically higher than PRP on the dosage of growth factors. Compared with 20% of Fetal Bovine Serum, the performance was quantitatively better to PC> PRP> CTL=PDH on the viability of suspension cell. However, the histological analysis showed a large number of cells attached to the fibrin scaffold with higher performance to the PDH. Conclusion: The majority of published studies using PRP terminology are incorrectly. Considering the quantitation of platelet hormones and the performance in cell culture, the best techniques are PC and PDH.
Diversity medical specialties have been using Platelet Rich Plasma (PRP) therapy form as is happening with the Orthopedics and Plastic Surgery. However, the name used for the PRP is often used wrongly. This work was outlined considering the growing number of medical specialties using PRP or platelet-derived hormones (PDH). Objective: The work consisted of three steps: 1) Bibliographic search with the key word PRP in order to evaluate the articles published in journals with Impact Factor (IF) ≥1; 2) obtaining of PRP, platelet concentrate (PC) and PDH from healthy individuals using the platelet lysate technique after use agonist and freeze / thaw (N = 10); 3) evaluate the performance of these preparations as substitute for fetal bovine serum in culture of human mesenchymal stem cells. Methods: The indicators monitored were: age, sex, ABO / RhD, erythrocyte phenotyping Rh, Kell and determination of growth factors by Multiplex-Milliplex® system(PDGF-AA, RANTES / CCL5, PAI-1 (total), VEGF-A, FGF-1 / FGF-acid, FGF-2 / FGF-basic, EGF, Angiopoietin-2, fibrinogen and Factor von Wilebrand. The monitored indicators were performed statistical analysis. Results: These parameters were measured in three preparations: PRP, PC and PDH. It was analyzed 50 articles between 2012-2016, of these, 29 with the platelet-rich plasma password, 14 platelet lysate (PL) 7 and platelet growth factor (PGF). Articles published with the keyword PL are journals with higher IF and greater consistency with the methodology followed by PGF and last PRP. It was observed that most of the work with the PRP terminology was used wrongly. These indicators showed that there is no correlation between the platelet count and the dosage of hormones. The age of individuals is inversely related with the concentration of factors, excepting FGF. There is no correlation between the amount of growth factors and gender. Individuals belonging to blood group A and no phenotype E are better secreting of growth hormones. When comparing the three methods analyzed, PC and PDH are statistically higher than PRP on the dosage of growth factors. Compared with 20% of Fetal Bovine Serum, the performance was quantitatively better to PC> PRP> CTL=PDH on the viability of suspension cell. However, the histological analysis showed a large number of cells attached to the fibrin scaffold with higher performance to the PDH. Conclusion: The majority of published studies using PRP terminology are incorrectly. Considering the quantitation of platelet hormones and the performance in cell culture, the best techniques are PC and PDH.
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Palavras-chave
Plasma Rico em Plaquetas, Medicina Regenerativa, Plaquetas, Pesquisa bibliográfica, Revisão, Regenerative Medicine, Platelet-rich plasma, Platelet, Bibliographic Research, Revision