Wang Shujun, Yang Jie, Zhao Guangchao, Liu Ran, Du Ying, Cai Zhimei, Luan Jianfeng, Shen Yanfei, Chen Baoan
Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
School of Medicine, Southeast University, Nanjing, China.
Wound Repair Regen. 2021 May;29(3):370-379. doi: 10.1111/wrr.12896. Epub 2021 Mar 22.
Human platelets play important roles in several physiologic and pathologic processes. Platelet concentrates are activated with thrombin or calcium, resulting in a viscous coagulum (platelet gel [PG]), composed of 95% platelets at least. PG is increasingly used for the treatment of a variety of soft and hard tissue defects, most notably in the management of chronic non-healing wounds. During wound healing, platelets not only play a critical role in primary hemostasis and thrombosis, but also release growth factors and cytokines to promote tissue regeneration, enhance collagen synthesis, and trigger an immune response. This review addresses a variety of aspects relevant to the functions of well-known platelet growth factors, animal and clinical studies of PG in the last decade, and different sources of platelets for PG. PG is used for non-healing chronic wounds, such as oral ulcerations related to epidermolysis bullosa and chronic graft-versus-host disease, for those, the traditional treatment effect is poor. PG maybe provide a new therapeutic direction for these diseases. Nevertheless, some uncertainty is present, the number of clinical studies is not enough. Hence, randomized controlled trials are still required to study the potential of the use of PG in the near future.
人类血小板在多种生理和病理过程中发挥着重要作用。血小板浓缩物用凝血酶或钙激活，形成一种粘性凝块（血小板凝胶[PG]），其至少由95%的血小板组成。PG越来越多地用于治疗各种软组织和硬组织缺损，最显著的是用于慢性难愈合伤口的处理。在伤口愈合过程中，血小板不仅在初级止血和血栓形成中起关键作用，还释放生长因子和细胞因子以促进组织再生、增强胶原蛋白合成并引发免疫反应。本文综述了与著名血小板生长因子功能相关的多个方面、过去十年PG的动物和临床研究以及PG的不同血小板来源。PG用于治疗难愈合的慢性伤口，如与大疱性表皮松解症相关的口腔溃疡和慢性移植物抗宿主病，对于这些疾病，传统治疗效果不佳。PG可能为这些疾病提供新的治疗方向。然而，目前存在一些不确定性，临床研究数量不足。因此，在不久的将来仍需要进行随机对照试验来研究使用PG的潜力。
