Autologous PRP or "The Fairy Plate" in the magical land of regenerative autologous cellular medicine.
Antoine TURZI. CEO of RegenLab
INTRODUCTION
Like the salamander [1Human tissues have the ability to regenerate, thanks in part to the autocrine and paracrine properties of blood platelets.
Autologous platelets, extracted from a patient's own blood and prepared in the form of autologous platelet-rich plasma (PRP), have exceptional tissue-regenerating power, and their use in veterinary and human therapeutics ("One Health concept") has developed relatively recently but exponentially.
Dental implantology companies were the first to identify PRP as a healing gas pedal, thus facilitating the expansion of the dental implant trend in the USA by American stars, a little over 20 years ago: the "Gibbs" smile made its appearance, PRP having considerably reduced the "down time" (from over 24 months to 12 months) to finally have a dazzling smile!
This is how Biomet-3i-Implant Innovation was able to create the "PCCS" [2], an easy-to-use autologous PRP preparation system for maxillo-facial surgeons: a miniaturization of the machines used in transfusion centers, enabling PRP to be obtained at the patient's bedside from just 55 mL of autologous blood, collected in a hematology bag.
The first reference publication is Marx [3].
It is based on the improved PCCS process, Smart-PReP from Harvest technologies. It was at this time that the idea of platelet hyperconcentration was born, Haynesworth [4...seeing a correlation between platelet concentration and clinical efficacy.
In 2000, Robert Marx [5] defines PRP as a plasma solution containing 1 million platelets per microliter, i.e. 3-4 times the native value.
A few years later, Italian biologists demonstrated in the laboratory that a concentration of 2 times the native value gave the best cell proliferation score.
In fact, given that red blood cells and polynuclear white blood cells represent 45 % of whole blood volume, eliminating these cells results in a concentration factor of 1.6/1.8 times the native value, without the need for hyperconcentration.
This type of PRP is obtained, after a single centrifugation, with the new tubes containing a polymer enabling cell selection and automatic isolation of the PRP.
Then Dr. Ali Modarressi and Dr. Sarah Berndt [6, 7, 8, 9have published thatin vitro 20 % of PRP with a platelet concentration factor of 1.6 times the native value) is the ideal concentration for obtaining a 14-fold faster proliferation of adipose stem cells and an 8-10-fold higher proliferation of somatic cells (fibroblasts and endothelial cells) compared with standard culture conditions supplemented with fetal calf serum.
- In addition, this work demonstrated that cells grown in dPRP-supplemented media do not change their phenotype and their DNA structure remains unaffected over the long term!
- Today, the question is no longer how to produce GWP, but how to stabilize it. in situ and how to achieve greater therapeutic efficacy.
This gave rise 10 years ago to the Cellular Matrix PRP-HA concept, which combines PRP with a hyaluronic acid gel.
- Since then, a new Regenlab France plant has opened on the Saclay plateau in France, and a new version of this PRP, enriched by the association of cross-linked hyaluronic acid, has been born:
- RegenMatrix cross-linked PRP-HA is being studied in 16 French university hospitals for the treatment of grade 3-4 osteoarthritis of the knee.
- At the same time, a version of this innovation will be studied by the group led by Prof. JP Meningaud and Prof. B Hersant at Hôpital Mondor in Paris Est Créteil- APHP, for the correction of wrinkles with a single injection of this enriched PRP.
- Lastly, a new version of PRP tubes, including an anti-fibrinolytic, is being studied for the prevention of post-surgical infections, an effect expected to complement the acceleration of the scarring process demonstrated above.
CONCLUSION
As a preamble to this special "RegenLab" issue of "Look et Médecine" magazine, it has to be said that it took a fairy godmother to look after "Regenlab", enabling it to pursue its intense R&D activity on the therapeutic virtues of autologous platelets, culminating in the development of medical devices for the preparation of these different forms of PRP.
In May this year, the European Union and the European Investment Bank (EIB) presented RegenLab with the prestigious Innovation Champion Awards, in recognition of its outstanding clinical research into the development of autologous regenerative cell medicine.
This is revolutionary for our understanding of cell biology.
"A little science takes us away from God, a lot of science brings us closer", said Louis Pasteur.
REFERENCES
Axel Kahn, Fabrice " Le secret de la Salamandre " Ed. Groupe Robert Laffont, 2010. ISBN ; 284111421X,241 p.
Weibrich G, Kleis WK. Curasan PRP kit vs. PCCS PRP system. Collection efficiency and platelet counts of two different methods for the preparation of platelet-rich plasma. Clin Oral Implants Res 2002; 13(4): 437-43.
Robert E Platelet-rich plasma: evidence to support its use. J Oral Maxillofacial Surg. 2004 Apr; 62(4): 489-96. doi: 10.1016/j.joms.2003.12.003. PMID: 15085519
Haynesworth SE, Kadiyala S, Thomas T, Bruder Chemotactic and mitogenic stimulation of human mesenchymal stem cells by platelet rich plasma suggests a mechanism for bone repair. 48th Annual Meeting of the Orthopaedic Research Society. Dallas, 2002.
Monteleone K, Marx RE, Ghurani R. Healing Enhancement of Skin Graft Donor Sites with Platelet-Rich Plasma. Oral Abstract Session 6: Wound Repair/Cosmetic Surgery 2000; AAAOMS, 82nd Annual American Academy of Oral and Maxillofacial Surgery Meeting.
Berndt, et al. Angiogenesis Is Differentially Modulated by Platelet-Derived Products. Biomedicines 2021; 9 (3).
Berndt, , Turzi, A. & Modarressi, A. Production of Autologous Platelet-Rich Plasma for Boosting In Vitro Human Fibroblast Expansion. J Vis Exp. 10.3791/60816 (168), (2021).
Berndt, S., Turzi, A., Pittet-Cuenod, B. & Modarressi, A. Autologous Platelet-Rich Plasma (CuteCell PRP) Safely Boosts In Vitro Human Fibroblast Expansion. Tissue Eng Part A. 25 (21-22), 1550-63, (2019).
Atashi, , Jaconi, M. E., Pittet-Cuenod, B. & Modarressi, A. Autologous platelet-rich plasma: a biological supplement to enhance adipose-derived mesenchymal stem cell expansion. Tissue Eng Part C Methods. 21 (3), 253-262, (2015).
