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与富血小板血浆疗法相关的不良事件及未来有待解决的问题。

Adverse events related to platelet-rich plasma therapy and future issues to be resolved.

作者信息

Arita Anna, Tobita Morikuni

机构信息

Medical Technology Innovation Center, Juntendo University, A-Bld, 3F, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan.

出版信息

Regen Ther. 2024 Jul 20;26:496-501. doi: 10.1016/j.reth.2024.07.004. eCollection 2024 Jun.

Abstract

Platelet-rich plasma (PRP) is the portion of plasma with a platelet concentration above baseline that is recovered through centrifugation of autologous blood. PRP therapy is currently used for wound healing and pain relief in diverse medical fields. Although there have been recent reports of adverse events (AEs) possibly related to PRP treatment, the safety profile of PRP treatment remains unclear. Therefore, this review discusses the risks inherent in PRP therapy and the current issues by surveying reports on AEs associated with PRP treatment within different fields. PubMed was searched for research articles referring to AEs associated with PRP therapy from inception to January 2024. Literature survey revealed that PRP therapy may involve several AEs, including postoperative infections, blindness, inflammation, allergic reactions, and nodule development. The most commonly reported AE was postoperative infections. Since PRP therapy generally proceeds in the process of blood collection, manufacturing, and administration to patients, it is conjectured that PRP may have been contaminated with microorganisms at some point in this series of processes, leading to bacterial infection. Additionally, because PRP cannot be sterilized like pharmaceuticals, it is important to prevent microbial contamination during each PRP treatment process. However, the specific process that involves the risk of microbial contamination remains unclear. To take measures to prevent microbial contamination of PRP, it may be necessary to elucidate the risk factors for microbial contamination during PRP treatment. It may be important to elucidate the effectiveness and risks of PRP therapy as well as to establish a follow-up system after PRP treatment. Currently, most reports of AEs related to PRP therapy are case reports; therefore, the accumulation of high-quality evidence and detailed verification are necessary to determine the causal relationship between PRP therapy and each AE.

摘要

富含血小板血浆(PRP)是通过对自体血液进行离心而获得的血小板浓度高于基线水平的血浆部分。PRP疗法目前用于不同医学领域的伤口愈合和疼痛缓解。尽管最近有报道称可能存在与PRP治疗相关的不良事件(AE),但PRP治疗的安全性仍然不明确。因此,本综述通过调查不同领域中与PRP治疗相关的AE报告,讨论了PRP疗法固有的风险和当前存在的问题。在PubMed上搜索了从开始到2024年1月提及与PRP疗法相关的AE的研究文章。文献调查显示,PRP疗法可能涉及多种AE,包括术后感染、失明、炎症、过敏反应和结节形成。最常报告的AE是术后感染。由于PRP疗法通常在采血、制备和给患者给药的过程中进行,推测PRP可能在这一系列过程中的某个环节被微生物污染,导致细菌感染。此外,由于PRP不能像药品那样进行灭菌,在每次PRP治疗过程中预防微生物污染很重要。然而,涉及微生物污染风险的具体过程仍不清楚。为采取措施预防PRP的微生物污染,可能有必要阐明PRP治疗过程中微生物污染的风险因素。阐明PRP疗法的有效性和风险以及建立PRP治疗后的随访系统可能很重要。目前,大多数与PRP疗法相关的AE报告都是病例报告;因此,需要积累高质量证据并进行详细核查,以确定PRP疗法与每种AE之间的因果关系。

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