Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Platelet-Rich Plasma Power Mix gel (ppm) - An Orthobiologic Optimization Protocol Rich in Growth Factors and Fibrin

Version 1 : Received: 6 June 2023 / Approved: 7 June 2023 / Online: 7 June 2023 (08:54:22 CEST)

A peer-reviewed article of this Preprint also exists.

Lana, J.F.; Purita, J.; Everts, P.A.; De Mendonça Neto, P.A.T.; de Moraes Ferreira Jorge, D.; Mosaner, T.; Huber, S.C.; Azzini, G.O.M.; da Fonseca, L.F.; Jeyaraman, M.; Dallo, I.; Santos, G.S. Platelet-Rich Plasma Power-Mix Gel (ppm)—An Orthobiologic Optimization Protocol Rich in Growth Factors and Fibrin. Gels 2023, 9, 553. Lana, J.F.; Purita, J.; Everts, P.A.; De Mendonça Neto, P.A.T.; de Moraes Ferreira Jorge, D.; Mosaner, T.; Huber, S.C.; Azzini, G.O.M.; da Fonseca, L.F.; Jeyaraman, M.; Dallo, I.; Santos, G.S. Platelet-Rich Plasma Power-Mix Gel (ppm)—An Orthobiologic Optimization Protocol Rich in Growth Factors and Fibrin. Gels 2023, 9, 553.

Abstract

Platelet and fibrin-rich orthobiologic products, such as autologous platelet concentrates, have been extensively studied and appreciated for their beneficial effects in multiple conditions. PRP and its derivatives, including PRF, have demonstrated encouraging outcomes in clinical and laboratory settings, particularly in the treatment of musculoskeletal disorders such as OA. Although PRP and PRF have distinct characteristics, they share similar properties. The relative abundance of platelets, peripheral blood cells and molecular components in these orthobiologic products stimulate numerous biological pathways. These include inflammatory modulation, augmented neovascularization, and delivery of pro-anabolic stimuli that regulate cell recruitment, proliferation, and differentiation. Furthermore, the fibrinolytic system, which is sometimes overlooked, plays a crucial role in musculoskeletal regenerative medicine by regulating proteolytic activity and promoting the recruitment of inflammatory cells and MSCs in areas of tissue regeneration, such as bone, cartilage, and muscle. PRP acts as a potent signaling agent; however, it diffuses easily, while the fibrin from PRF offers a durable scaffolding effect that promotes cell activity. The combination of fibrin with hyaluronic acid, another well-studied orthobiologic product, has been shown to improve its scaffolding properties, leading to more robust fibrin polymerization. This supports cell survival, attachment, migration, and proliferation. Therefore, the administration of the "power mix" containing HA and autologous PRP + PRF may prove to be a safe and cost-effective approach in regenerative medicine.

Keywords

platelet-rich plasma; platelet-rich fibrin; hyaluronic acid; orthobiologics; osteoarthritis; regenerative medicine

Subject

Biology and Life Sciences, Biology and Biotechnology

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