中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (12): 1920-1921.doi: 10.4103/1673-5374.172310

• 观点:神经损伤修复保护与再生 • 上一篇    下一篇

富血小板血浆:在修复神经损伤中的应用

  

  • 收稿日期:2015-09-28 出版日期:2015-12-30 发布日期:2015-12-30

Platelet-rich plasma: the role in neural repair

Margherita Giorgetti*, Gabriele Siciliano   

  1. Department of Hand Surgery and Reconstructive Microsurgery, University of Pisa, Pisa, Italy; Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
  • Received:2015-09-28 Online:2015-12-30 Published:2015-12-30
  • Contact: Margherita Giorgetti, M.D.,ma.giorgetti@ao-pisa.toscana.it.

摘要:

富血小板血浆促进组织再生的疗效已经在一些主要临床实践上被证实,如人类颌面,心脏和骨科手术。到目前为止,很少有研究提供关于其在周围神经损伤或中枢神经系统病理中局部使用富含血小板血浆的结果和对比模型。与使用富血小板血浆无生物活性剂比较后,Farrag等人证明了富血小板血浆在大鼠面神经再生模型中有更好的功能的结果。文章证明在病灶部位施加富血小板血浆,可以改进改坐骨神经再生的神经吻合效果,并显示出了纤维密度和电参数的增加现象。我们在严重腕综合症患者群体中得到的第一手数据表示,外科手术期间在受损神经部位应用富血小板血浆的效果已在动物模型中获得的结果。从这个角度来看,未来的临床试验研究设计应核实有关神经损伤再生医学临床水平上的富血小板血浆实际功效。

Abstract:

The efficacy of platelet rich plasma (PRP) to promote tissue regeneration has been largely confirmed in several clinical setting, such as in human maxillo-facial, heart and orthopaedic surgery. Up to date, few studies are available regarding the topical use of platelet rich plasma in models of peripheral nerve injury or central nervous system pathology and the results contrasting. Farrag et al. (2012) showed positive effects of PRP in a rat model of facial nerve regeneration with a better functional outcome with the use of PRP in comparison with no bioactive agents (platelet-poor plasma). Giannessi et al. (2014) evidenced improvement of the of sciatic nerve regeneration after neurorraphy when a PRP suturable membrane was applied in the lesion site, as showed by electrophysiological parameter showing increase of fiber density. Platelets contain the matrix proteins (fibronectin, vitronectin, and laminin). In a healing wound polypeptide growth factors identified in platelet granule, such as platelet-derived growth factor (PDGF) and transforming growth factor beta (TGFβ), through different signaling pathways, induce transcription, translation, cell division, and/or migration. Fibroblasts are drawn into the fibrin clot by PDGF and TGFβ. The fibroblasts begin to synthesize more fibronectin and also collagen, under the influence of platelet-derived serotonin and TGFβ. In addition, platelets induce cell proliferation and differentiation, stimulate neo angiogenesis and vascular restoring at the site of damage. The bioactive proteins control the nerve healing reducing the scar formation and supporting fiber nerve remyelination by release of large quantities of growth factors fragment, which could polymerize into platelet-rich gel with scaffolding effect.