Combined Use of PRP and Stem Cells

The story begins with the knee of famous actress. In 2012, she embraced a novel treatment method labeled as "stem cell injection". She explained "I've tried every method worldwide for my knee. Recently, there's a procedure that involves drawing blood from one's own arteries, cultivating the cells, and reintroducing them into the knee. I've commenced the treatment. How effective is this joint injection? I am genuinely courageous!" Encouraging everyone to value their health.

Now, let's delve into the PRP technology that captures attention. In certain markets, PRP is often touted under various names like autologous blood, autologous serum stem cells, autologous cells, autologous living cells, autologous cytokines, etc. However, they all refer to one thing—Platelet-Rich Plasma (PRP), or even more advanced, Platelet-Rich Fibrin (PRF). While PRP is distinct from stem cells, it can complement stem cell applications.

In reality, PRP has been a staple in clinical practice for an extended period and is increasingly employed across diverse applications, not restricted to standalone PRP use but encompassing the combined application of PRP and stem cells.

Understanding "PRP" from Concept to Composition

To grasp the essence of "PRP," it's crucial to delve into its concept and composition.

What is PRP?

PRP, short for Platelet-rich plasma, is a plasma variant with a high concentration of platelets derived from one's own blood. It goes by various names, such as PRC (Platelet-rich concentrate), APG (Autogenous platelet gel, autologous platelet gel), and PRGF (Plasma rich in growth factor, plasma rich in growth factors). Yet, the most commonly used and endearing term is "PRP."

In essence, PRP is a blood product teeming with cell growth factors, obtained by concentrating, enriching, and separating an individual's own blood.

A Concise History of PRP

The roots of PRP technology extend far back:

• In 1984, the presence of multiple growth factors in human blood was first identified.
• By 1993, the concept of PRP emerged, recognizing its richness in platelets.
• In 1997, the Swiss state acknowledged its hemostatic function.
• From 2000 onward, PRP gradually found applications in surgery, burns, and dermatology treatments.
• In 2003, the Swiss Regen laboratory introduced a rapid PRP preparation kit.

PRP composition

The primary component of PRP is, undoubtedly, P—platelets. Platelets, categorized as cytoplasmic fragments of megakaryocytes and belonging to the white blood cell family, are formed in the bone marrow (as elucidated in a previous science exploration: members of the immune cell family: platelets). Platelets abound in numerous cell growth factors, including platelet-derived growth factor (PDGF), transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF), and insulin-like growth factor (IGF). Additionally, PRP contains fibrin and a small quantity of white blood cells.

PRP technology hinges on obtaining PRP, introducing a coagulant (referred to as an activator in the market, often 10% calcium chloride solution and thrombin), resulting in a gel. This gel is utilized to facilitate tissue repair and regeneration, serving the purpose of clinical treatment.

Exploring the Characteristics and Preparation Methods of PRP

PRP exhibits four distinctive characteristics:

1. Release of Biologically Active Factors: With a pH value of 6.5-6.7, the addition of suitable activators enhances wound and tissue healing, along with the release of cytokines promoting cell regeneration.
2. Natural Ratio of Secreted Active Factors: The concentration ratio of various growth factors closely mirrors the normal ratio found in the body, fostering interactions among each growth factor.
3. Ease of Activation and Inactivation: Upon activation, PRP exerts biological effects and can be processed into platelet gel. However, platelets are susceptible to damage, potentially rendering a substantial number of growth factors ineffective.
4. Concentration Effect of PRP: The platelet concentration in PRP is 3-17 times that of whole blood. Beyond the upper limit of cytokine concentration, the efficacy in promoting cell proliferation diminishes.

How is PRP prepared?

Presently, plasmapheresis and centrifugation stand as the primary methods for preparation. While the former boasts a high degree of automation, it comes with expensive equipment. As a result, centrifugation is the predominant method. Market-available specialized sleeves for rapid PRP preparation have significantly enhanced the enrichment factor and harvest rate.

Specific steps for PRP preparation, involving centrifugation, separate various blood components. Platelets, with their light specific gravity, predominantly remain in the upper plasma. The separation of this upper plasma results in platelet-rich plasma, where over 70% of the platelets in whole blood can be obtained.

When PRP meets Stem Cells

The body's self-repair mechanisms rely on the regulation of various growth factors, and PRP, containing diverse growth factors, plays a crucial role. Therefore, combining PRP with stem cells can establish and enhance the microenvironment for stem cell growth, elevating the survival rate of stem cells and naturally improving therapeutic outcomes.

Currently, the combination of PRP and stem cells is predominantly applied in the following ways:

1. Utilizing PRP Alongside Adipose Stem Cells for Knee Arthritis Treatment

PRP composite scaffold materials exhibit high osteoinductive activity, fostering bone tissue healing. Independently, PRP also possesses anti-inflammatory properties and promotes cartilage regeneration, aiding in the repair of minor cartilage defects. Combining the PRP composite scaffold with stem cells for treating knee arthritis and cartilage defects can create a more conducive microenvironment for stem cell growth (enhancing blood supply and reducing local inflammatory reactions). This combination promotes cartilage matrix synthesis and enhances the therapeutic effects on knee arthritis.

1. Incorporating PRP, Adipose Tissue, and Adipose Stem Cells in Medical Cosmetology

Primarily employed for facial and breast fillers, as well as facial rejuvenation. The key to the success of autologous fat particle transplantation lies in establishing a surrounding vascular network post-transplantation. Theoretically, factors promoting angiogenesis can enhance the survival of transplanted fat particles. PRP combined with adipose stem cells facilitates blood vessel growth, enhancing the blood supply around adipose tissue during fat filling and improving the survival rate of adipose tissue transplantation.

Conclusion

In general, PRP is widely considered to play a crucial role in expediting early-stage healing, alleviating pain and swelling, and minimizing complications, primarily due to its anti-inflammatory effects. This accelerated and enhanced healing period contributes to the reduction of surgical complications like pain and infection, even though the ultimate outcomes are similar.

An optimistic outlook is held for the application of PRP technology. PRP not only serves a vital function in hemostasis but also stands out as a rich source of growth factors, creating an optimal microenvironment for stem cells. Therefore, the combination of PRP and stem cells is seen as a good combination. Collaborating with fibroblasts, adipocytes, and adipose stem cells, PRP stimulates tissue to generate new collagen and extramatrix for cells, preventing their rapid clearance by the lymphatic and capillary systems post-injection. As such, there is heightened attention and anticipation for ongoing research and future applications in this field!