Advances in the Application of Autologous Platelet Concentrate in the Field of Gynecology

doi:10.12114/j.issn.1007-9572.2023.0213

Abstract

Abstract:

Autologous platelet concentrate (APC) is a platelet concentrate obtained by centrifugation of human or animal blood, mainly includes first-generation platelet concentrate platelet-rich plasma (PRP) and second-generation platelet concentrate platelet-rich fibrin (PRF), which is widely applied in varies fields such as dental implants, bone defect repairing and burn plastic surgery because of its role in wound healing and tissue repair. In recent years, autologous platelet concentrate has been applied to improve ovarian function, promote the repair of endometrial hyperplasia, treat cervical and vulvo-related lesions, and has achieved significant efficacy. However, there is a lack of effective integration of PRP and PRF research results in the field of gynecology. This paper systematically and comprehensively review the preparation, biological properties and applications in various gynecological diseases, in order to provide clinicians with new treatment ideas for gynecological diseases and reference for the further application of APC.

Key words: Gynecologic diseases, Platelet-rich plasma, Platelet-rich fibrin, Autologous platelet concentrates, Endometrial hyperplasia, Ovarian diseases, Review

摘要：

自体富血小板浓缩物是通过抽取人体或动物血液经过离心获得的血小板浓缩物，主要包括第一代血小板浓缩物富血小板血浆（PRP）及第二代血小板浓缩物富血小板纤维蛋白（PRF）。因其促进伤口愈合及组织修复的作用，被广泛运用于口腔种植、骨缺损修复、烧伤整形等领域。近年来，自体富血小板浓缩物开始运用于改善卵巢功能、促进子宫内膜增生修复、治疗宫颈及外阴相关病变，并取得了显著疗效，但目前缺乏对PRP、PRF在妇科领域研究成果的有效整合。本文系统、全面地梳理了自体富血小板浓缩物的制备、生物学特性以及在妇科多种疾病中的应用，以期能为临床医生提供妇科相关疾病新的治疗思路，并为自体富血小板浓缩物研究应用的深入开展提供借鉴。

关键词: 妇科疾病, 富血小板血浆, 富血小板纤维蛋白, 自体富血小板浓缩物, 子宫内膜增生, 卵巢疾病, 综述

WANG Xiaoxue,MAO Lele,WANG Zijun, et al. Advances in the Application of Autologous Platelet Concentrate in the Field of Gynecology[J]. Chinese General Practice, 2023, 26(35): 4472-4476. DOI: 10.12114/j.issn.1007-9572.2023.0213.
王小雪,毛乐乐,王子君等. 自体富血小板浓缩物在妇科领域中的应用研究进展[J]. 中国全科医学, 2023, 26(35): 4472-4476. DOI: 10.12114/j.issn.1007-9572.2023.0213.

References 45

[1]	NARAYANASWAMY R，PATRO B P，JEYARAMAN N，et al. Evolution and clinical advances of platelet-rich fibrin in musculoskeletal regeneration[J]. Bioengineering（Basel），2023，10（1）：58. DOI：10.3390/bioengineering10010058.
[2]	DOHAN D M，CHOUKROUN J，DISS A，et al. Platelet-rich fibrin（PRF）：a second-generation platelet concentrate. PartⅡ：platelet-related biologic features[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod，2006，101（3）：e45-50. DOI：10.1016/j.tripleo.2005.07.009.
[3]	NAZARI L，SALEHPOUR S，HOSSEINI M S，et al. The effects of autologous platelet-rich plasma in repeated implantation failure：a randomized controlled trial[J]. Hum Fertil（Camb），2020，23（3）：209-213. DOI：10.1080/14647273.2019.1569268.
[4]	KOBAYASHI E，FLÜCKIGER L，FUJIOKA-KOBAYASHI M，et al. Comparative release of growth factors from PRP，PRF，and advanced-PRF[J]. Clin Oral Investig，2016，20（9）：2353-2360. DOI：10.1007/s00784-016-1719-1.
[5]	PANDA S，MISHRA L，ARBILDO-VEGA H I，et al. Effectiveness of autologous platelet concentrates in management of young immature necrotic permanent teeth-a systematic review and meta-analysis[J]. Cells，2020，9（10）：2241. DOI：10.3390/cells9102241.
[6]	YU H Y，CHANG Y C. A bibliometric analysis of platelet-rich fibrin in dentistry[J]. Int J Environ Res Public Health，2022，19（19）：12545. DOI：10.3390/ijerph191912545.
[7]	LIU X Y，YIN M J，LI Y，et al. Genipin modified lyophilized platelet-rich fibrin scaffold for sustained release of growth factors to promote bone regeneration[J]. Front Physiol，2022，13：1007692. DOI：10.3389/fphys.2022.1007692.
[8]	EVANS A G，IVANIC M G，BOTROS M A，et al. Rejuvenating the periorbital area using platelet-rich plasma：a systematic review and meta-analysis[J]. Arch Dermatol Res，2021，313（9）：711-727. DOI：10.1007/s00403-020-02173-z.
[9]	GRAIET H，LOKCHINE A，FRANCOIS P，et al. Use of platelet-rich plasma in regenerative medicine：technical tools for correct quality control[J]. BMJ Open Sport Exerc Med，2018，4（1）：e000442. DOI：10.1136/bmjsem-2018-000442.
[10]	AMABLE P R，CARIAS R B，TEIXEIRA M V，et al. Platelet-rich plasma preparation for regenerative medicine：optimization and quantification of cytokines and growth factors[J]. Stem Cell Res Ther，2013，4（3）：67. DOI：10.1186/scrt218.
[11]	DHURAT R，SUKESH M. Principles and methods of preparation of platelet-rich plasma：a review and author's perspective[J]. J Cutan Aesthet Surg，2014，7（4）：189-197. DOI：10.4103/0974-2077.150734.
[12]	COPELLITI F，CATTANI C，DIMARTINO V，et al. Platelet derivatives and the immunomodulation of wound healing[J]. Int J Mol Sci，2022，23（15）：8370. DOI：10.3390/ijms23158370.
[13]	LOURENÇO E S，MOURÃO C F A B，LEITE P E C，et al. The in vitro release of cytokines and growth factors from fibrin membranes produced through horizontal centrifugation[J]. J Biomed Mater Res A，2018，106（5）：1373-1380. DOI：10.1002/jbm.a.36346.
[14]	VAN DER BIJL I，VLIG M，MIDDELKOOP E，et al. Allogeneic platelet-rich plasma（PRP）is superior to platelets or plasma alone in stimulating fibroblast proliferation and migration，angiogenesis，and chemotaxis as relevant processes for wound healing[J]. Transfusion，2019，59（11）：3492-3500. DOI：10.1111/trf.15535.
[15]	SHARARA F I，LELEA L L，RAHMAN S，et al. A narrative review of platelet-rich plasma（PRP）in reproductive medicine[J]. J Assist Reprod Genet，2021，38（5）：1003-1012. DOI：10.1007/s10815-021-02146-9.
[16]	SUGINAMI K，SATO Y，HORIE A，et al. Platelets are a possible regulator of human endometrial re-epithelialization during menstruation[J]. American Journal of Reproductive Immunology，2016：1-8. DOI：10.1111/aji.12609.
[17]	SUGINAMI K，SATO Y，HORIE A，et al. Platelet-derived microparticles and soluble factors differentially regulate human endometrial epithelial cell movement[J]. Am J Reprod Immunol，2017，77（4）：e12641. DOI：10.1111/aji.12641.
[18]	AGHAJANOVA L，HOUSHDARAN S，BALAYAN S，et al. In vitro evidence that platelet-rich plasma stimulates cellular processes involved in endometrial regeneration[J]. J Assist Reprod Genet，2018，35（5）：757-770. DOI：10.1007/s10815-018-1130-8.
[19]	JANG H Y，MYOUNG S M，CHOE J M，et al. Effects of autologous platelet-rich plasma on regeneration of damaged endometrium in female rats[J]. Yonsei Med J，2017，58（6）：1195-1203. DOI：10.3349/ymj.2017.58.6.1195.
[20]	ZHANG S W，LI P P，YUAN Z W，et al. Platelet-rich plasma improves therapeutic effects of menstrual blood-derived stromal cells in rat model of intrauterine adhesion[J]. Stem Cell Res Ther，2019，10（1）：61. DOI：10.1186/s13287-019-1155-7.
[21]	BAKACAK M，BOSTANCI M S，I·NANC F，et al. Protective effect of platelet rich plasma on experimental ischemia/reperfusion injury in rat ovary[J]. Gynecol Obstet Invest，2016，81（3）：225-231. DOI：10.1159/000440617.
[22]	STREIT-CIEC'KIEWICZ D，KOL-ODYN'SKA A，FUTYMA-GA，BKA K，et al. Platelet rich plasma in gynecology-discovering undiscovered-review[J]. Int J Environ Res Public Health，2022，19（9）：5284. DOI：10.3390/ijerph19095284.
[23]	EVERTS P A，VAN ERP A，DESIMONE A，et al. Platelet rich plasma in orthopedic surgical medicine[J]. Platelets，2021，32（2）：163-174. DOI：10.1080/09537104.2020.1869717.
[24]	TEHRANIAN A，ESFEHANI-MEHR B，PIRJANI R，et al. Application of autologous platelet-rich plasma（PRP）on wound healing after Caesarean section in high-risk patients[J]. Iran Red Crescent Med J，2016，18（7）：e34449. DOI：10.5812/ircmj.34449.
[25]	FANNING J，MURRAIN L，FLORA R，et al. PhaseⅠ/Ⅱ prospective trial of autologous platelet tissue graft in gynecologic surgery[J]. J Minim Invasive Gynecol，2007，14（5）：633-637. DOI：10.1016/j.jmig.2007.05.014.
[26]	MEDEL S，ALARAB M，KUFAISHI H，et al. Attachment of primary vaginal fibroblasts to absorbable and nonabsorbable implant materials coated with platelet-rich plasma：potential application in pelvic organ prolapse surgery[J]. Female Pelvic Med Reconstr Surg，2015，21（4）：190-197. DOI：10.1097/SPV.0000000000000178.
[27]	BEHNIA-WILLISON F，POUR N R，MOHAMADI B，et al. Use of platelet-rich plasma for vulvovaginal autoimmune conditions like lichen sclerosus[J]. Plast Reconstr Surg Glob Open，2016，4（11）：e1124. DOI：10.1097/GOX.0000000000001124.
[28]	HUA X L，ZENG Y，ZHANG R R，et al. Using platelet-rich plasma for the treatment of symptomatic cervical ectopy[J]. Int J Gynaecol Obstet，2012，119（1）：26-29. DOI：10.1016/j.ijgo.2012.05.029.
[29]	WHITE Y A R，WOODS D C，TAKAI Y，et al. Oocyte formation by mitotically active germ cells purified from ovaries of reproductive-age women[J]. Nat Med，2012，18（3）：413-421. DOI：10.1038/nm.2669.
[30]	CAKIROGLU Y，SALTIK A，YUCETURK A，et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency[J]. Aging（Albany NY），2020，12（11）：10211-10222. DOI：10.18632/aging.103403.
[31]	CAKIROGLU Y，YUCETURK A，KARAOSMANOGLU O，et al. Ovarian reserve parameters and IVF outcomes in 510 women with poor ovarian response（POR）treated with intraovarian injection of autologous platelet rich plasma （PRP）[J]. Aging（Albany NY），2022，14（6）：2513-2523. DOI：10.18632/aging.203972.
[32]	CHANG Y N，DUAN H，SHEN X，et al. Controversy in the management of oestrogen therapy before hysteroscopic adhesiolysis：a systematic review and meta-analysis[J]. Reprod Biomed Online，2020，41（4）：715-723. DOI：10.1016/j.rbmo.2020.06.012.
[33]	ZHANG Y L，SHI L B，LIN X N，et al. Unresponsive thin endometrium caused by Asherman syndrome treated with umbilical cord mesenchymal stem cells on collagen scaffolds：a pilot study[J]. Stem Cell Res Ther，2021，12（1）：420. DOI：10.1186/s13287-021-02499-z.
[34]	CHANG Y J，LI J J，CHEN Y Q，et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization[J]. Int J Clin Exp Med，2015，8（1）：1286-1290.
[35]	COLOMBO G V L，FANTON V，SOSA D，et al. Use of platelet rich plasma in human infertility[J]. J Biol Regul Homeost Agents，2017，31（2 Suppl. 2）：179-182.
[36]	CHANG Y J，LI J J，WEI L N，et al. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium[J]. Medicine（Baltimore），2019，98（3）：e14062. DOI：10.1097/MD.0000000000014062.
[37]	DOGRA Y，SINGH N，VANAMAIL P. Autologous platelet-rich plasma optimizes endometrial thickness and pregnancy outcomes in women with refractory thin endometrium of varied aetiology during fresh and frozen-thawed embryo transfer cycles[J]. JBRA Assist Reprod，2022，26（1）：13-21. DOI：10.5935/1518-0557.20210037.
[38]	NAZARI L，SALEHPOUR S，HOSEINI S，et al. Effects of autologous platelet-rich plasma on implantation and pregnancy in repeated implantation failure：a pilot study[J]. Int J Reprod Biomed，2016，14（10）：625-628.
[39]	CHOUKROUN J，DISS A，SIMONPIERI A，et al. Platelet-rich fibrin（PRF）：a second-generation platelet concentrate. Part Ⅴ：histologic evaluations of PRF effects on bone allograft maturation in sinus lift[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod，2006，101（3）：299-303. DOI：10.1016/j.tripleo.2005.07.012.
[40]	MICKO L，SALMA I，SKADINS I，et al. Can our blood help ensure antimicrobial and anti-inflammatory properties in oral and maxillofacial surgery?[J]. Int J Mol Sci，2023，24（2）：1073. DOI：10.3390/ijms24021073.
[41]	FARSHIDFAR N，AMIRI M A，JAFARPOUR D，et al. The feasibility of injectable PRF（I-PRF）for bone tissue engineering and its application in oral and maxillofacial reconstruction：from bench to chairside[J]. Biomater Adv，2022，134：112557. DOI：10.1016/j.msec.2021.112557.
[42]	GORLERO F，GLORIO M，LORENZI P，et al. New approach in vaginal prolapse repair：mini-invasive surgery associated with application of platelet-rich fibrin[J]. Int Urogynecol J，2012，23（6）：715-722. DOI：10.1007/s00192-012-1667-5.
[43]	SHIRVAN M K，ALAMDARI D H，GHOREIFI A. A novel method for iatrogenic vesicovaginal fistula treatment：autologous platelet rich plasma injection and platelet rich fibrin glue interposition[J]. J Urol，2013，189（6）：2125-2129. DOI：10.1016/j.juro.2012.12.064.
[44]	WANG Z J，YANG M K，MAO L L，et al. Efficacy and safety of autologous platelet-rich fibrin for the treatment of infertility with intrauterine adhesions[J]. J Obstet Gynaecol Res，2021，47（11）：3883-3894. DOI：10.1111/jog.14964.
[45]	杨慕坤，王子君，崔广霞，等. 富血小板纤维蛋白对宫腔粘连创面修复的影响研究[J]. 临床输血与检验，2022，24（3）：363-368.