Department of Laboratory Medicine, Medical University of Gdańsk, Poland.
Algocells, Regenexx, UK.
Neuromodulation. 2021 Dec;24(8):1451-1457. doi: 10.1111/ner.13105. Epub 2020 Feb 6.
Recent years have brought new developments in interventional chronic pain management, namely regenerative orthopedics utilizing platelet-rich plasma (PRP) as well as further evolution of pulsed radiofrequency neuromodulation (PRF). Both methods have been used separately. Here, we investigated whether PRF may potentiate the activation of platelets in PRP samples when both these techniques are combined together in in vitro conditions.
Studies were performed on concentrated PRP samples (PRPs) obtained from acid citrate dextrose-treated blood taken from 11 healthy volunteers. PRPs were divided into four groups: 1) nonactivated PRP; 2) thrombin-activated PRP as a positive control for maximal platelets activation; 3) PRF-treated PRP exposed for 20 min to PRF energy generated by neurotherm radio frequency generator at 500 kHz, with a voltage of 40 V and maximal temperature of 42°C; and 4) a combination of groups 2 and 3.
PRF-induced platelet activation measured by platelet factor 4 (PF4) and ATP release from PRPs was significantly higher compared to nonactivated PRPs, and similar to PF4 and ATP release from thrombin-activated PRPs. Thrombin activation did not potentiate PF4 release in PRF samples and even reduced ATP level. Additionally, PRF neither induced any platelet membrane damage measured by lactic dehydrogenase release from PRP nor modified any platelets viability or metabolism measured by MTT.
We confirmed that PRF may activate PRP without additional platelet activators. So, a combination of both methods PRF and PRP application may provide a more effective opportunity for tissue regeneration in dentistry, surgery, dermatology, or in orthopedics.
近年来，介入性慢性疼痛管理领域出现了新的发展，即利用富含血小板的血浆（PRP）的再生骨科以及脉冲射频神经调节（PRF）的进一步发展。这两种方法都是分开使用的。在这里，我们研究了当这两种技术在体外条件下结合使用时，PRF 是否会增强 PRP 样本中血小板的激活。
研究对象为从 11 名健康志愿者的柠檬酸葡萄糖酸盐处理血液中获得的浓缩 PRP 样本（PRP）。PRP 被分为四组：1）未激活的 PRP；2）凝血酶激活的 PRP 作为血小板最大激活的阳性对照；3）PRF 处理的 PRP，在 500 kHz 的神经热射频发生器产生的 PRF 能量下暴露 20 分钟，电压为 40 V，最高温度为 42°C；4）组 2 和 3 的组合。
与未激活的 PRP 相比，PRF 诱导的血小板因子 4（PF4）和 ATP 从 PRP 中的释放，其血小板激活明显更高，与凝血酶激活的 PRP 中的 PF4 和 ATP 释放相似。凝血酶激活并没有增强 PRF 样本中的 PF4 释放，甚至降低了 ATP 水平。此外，PRF 既没有诱导 PRP 中乳酸脱氢酶释放所测量的任何血小板膜损伤，也没有改变 MTT 测量的任何血小板活力或代谢。
我们证实 PRF 可以激活 PRP 而无需额外的血小板激活剂。因此，这两种方法 PRF 和 PRP 应用的结合可能为牙科、外科、皮肤科或骨科中的组织再生提供更有效的机会。
