Everts Peter A, Lana José Fábio, Onishi Kentaro, Buford Don, Peng Jeffrey, Mahmood Ansar, Fonseca Lucas F, van Zundert Andre, Podesta Luga
Research & Education Division, Gulf Coast Biologics, Fort Myers, FL 33916, USA.
OrthoRegen Group, Max-Planck University, Indaiatuba, São Paulo 13334-170, Brazil.
Biomedicines. 2023 Jul 6;11(7):1922. doi: 10.3390/biomedicines11071922.
Angiogenesis is the formation of new blood vessel from existing vessels and is a critical first step in tissue repair following chronic disturbances in healing and degenerative tissues. Chronic pathoanatomic tissues are characterized by a high number of inflammatory cells; an overexpression of inflammatory mediators; such as tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1); the presence of mast cells, T cells, reactive oxygen species, and matrix metalloproteinases; and a decreased angiogenic capacity. Multiple studies have demonstrated that autologous orthobiological cellular preparations (e.g., platelet-rich plasma (PRP)) improve tissue repair and regenerate tissues. There are many PRP devices on the market. Unfortunately, they differ greatly in platelet numbers, cellular composition, and bioformulation. PRP is a platelet concentrate consisting of a high concentration of platelets, with or without certain leukocytes, platelet-derived growth factors (PGFs), cytokines, molecules, and signaling cells. Several PRP products have immunomodulatory capacities that can influence resident cells in a diseased microenvironment, inducing tissue repair or regeneration. Generally, PRP is a blood-derived product, regardless of its platelet number and bioformulation, and the literature indicates both positive and negative patient treatment outcomes. Strangely, the literature does not designate specific PRP preparation qualifications that can potentially contribute to tissue repair. Moreover, the literature scarcely addresses the impact of platelets and leukocytes in PRP on (neo)angiogenesis, other than a general one-size-fits-all statement that "PRP has angiogenic capabilities". Here, we review the cellular composition of all PRP constituents, including leukocytes, and describe the importance of platelet dosing and bioformulation strategies in orthobiological applications to initiate angiogenic pathways that re-establish microvasculature networks, facilitating the supply of oxygen and nutrients to impaired tissues.
血管生成是指从现有血管形成新的血管，是愈合和退行性组织发生慢性紊乱后组织修复的关键第一步。慢性病理解剖组织的特征是炎症细胞数量众多；炎症介质如肿瘤坏死因子-α（TNF-α）和白细胞介素-1（IL-1）过度表达；存在肥大细胞、T细胞、活性氧和基质金属蛋白酶；以及血管生成能力下降。多项研究表明，自体正统生物细胞制剂（如富血小板血浆（PRP））可改善组织修复并使组织再生。市场上有许多PRP装置。不幸的是，它们在血小板数量、细胞组成和生物制剂方面差异很大。PRP是一种血小板浓缩物，由高浓度的血小板组成，可含有或不含有某些白细胞、血小板衍生生长因子（PGF）、细胞因子、分子和信号细胞。几种PRP产品具有免疫调节能力，可影响患病微环境中的驻留细胞，诱导组织修复或再生。一般来说，PRP是一种血液衍生产品，无论其血小板数量和生物制剂如何，文献表明患者治疗结果有正有负。奇怪的是，文献并未指定可能有助于组织修复的特定PRP制备条件。此外，除了“PRP具有血管生成能力”这种一概而论的说法外，文献几乎没有涉及PRP中的血小板和白细胞对（新）血管生成的影响。在这里，我们回顾了包括白细胞在内的所有PRP成分的细胞组成，并描述了在正统生物应用中血小板剂量和生物制剂策略对于启动血管生成途径以重建微血管网络、促进向受损组织供应氧气和营养物质的重要性。
