Jongkhajornpong Passara, Lekhanont Kaevalin, Rattanasiri Sasivimol, Pisitkun Prapaporn, Thakkinstian Ammarin
Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand.
Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ophthalmol Ther. 2025 Feb;14(2):363-377. doi: 10.1007/s40123-024-01082-y. Epub 2024 Dec 20.
The purpose of this study was to compare the growth factor concentrations in undiluted autologous platelet-rich plasma (APRP) and autologous serum (AS) eye drops.
This was a single-center, prospective trial conducted in a tertiary university hospital in Bangkok, Thailand. Ninety-six patients with moderate-to-severe dry eye disease, who were randomly assigned to receive either 100% APRP or 100% AS, were enrolled in the study. Primary outcome measures were the concentrations of epitheliotrophic factors, including epithelial growth factor (EGF), basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), β-nerve growth factor (β-NGF), platelet-derived growth factor (PDGF)-AA, PDGF-BB, transforming growth factor (TGF)-α, TGF-β1, and vascular endothelial growth factor (VEGF) in 100% APRP and 100% AS. Secondary outcome measures were the correlations between baseline patient characteristics and each growth factor concentration.
Undiluted APRP contained more EGF, bFGF, and β-NGF than undiluted AS (P < 0.001, P < 0.001, P = 0.018, respectively). Meanwhile, undiluted AS yielded higher concentrations of HGF, PDGF-AA, PDGF-BB, and VEGF compared with undiluted APRP (P < 0.001 all). There were no significant differences in TGF-α and TGF-β1 concentrations between the two groups. In the 100% APRP group, the platelet concentrations had positive correlations with the concentrations of EGF (P = 0.028) and VEGF (P = 0.020). In the 100% AS group, Sjögren's syndrome negatively correlated with the concentrations of PDGF-BB (P = 0.028) and VEGF (P = 0.023). Diabetes mellitus (DM) showed negative correlations with the concentrations of HGF (P = 0.001), TGF-α (P = 0.001), and VEGF (P = 0.002).
With our simple preparation protocols, 100% APRP contains higher concentrations of EGF, bFGF, and β-NGF, whereas 100% AS contains higher concentrations of HGF, PDGF-AA, PDGF-BB, and VEGF. This could allow ophthalmologists to tailor treatments to individual patients by targeting growth factor supply based on their underlying pathophysiology.
ClinicalTrials.gov identifier, NCT04683796.
本研究的目的是比较未稀释的自体富血小板血浆（APRP）和自体血清（AS）滴眼液中的生长因子浓度。
这是一项在泰国曼谷一家三级大学医院进行的单中心前瞻性试验。96例中重度干眼病患者被随机分配接受100% APRP或100% AS，纳入本研究。主要观察指标是100% APRP和100% AS中上皮营养因子的浓度，包括表皮生长因子（EGF）、碱性成纤维细胞生长因子（bFGF）、肝细胞生长因子（HGF）、β-神经生长因子（β-NGF）、血小板衍生生长因子（PDGF）-AA、PDGF-BB、转化生长因子（TGF）-α、TGF-β1和血管内皮生长因子（VEGF）。次要观察指标是基线患者特征与每种生长因子浓度之间的相关性。
未稀释的APRP比未稀释的AS含有更多的EGF、bFGF和β-NGF（分别为P < 0.001、P < 0.001、P = 分别为0.018）。同时，与未稀释的APRP相比，未稀释的AS产生的HGF、PDGF-AA、PDGF-BB和VEGF浓度更高（均为P < 0.001）。两组之间TGF-α和TGF-β1浓度无显著差异。在100% APRP组中，血小板浓度与EGF浓度（P = 0.028）和VEGF浓度（P = 0.020）呈正相关。在100% AS组中，干燥综合征与PDGF-BB浓度（P = 0.028）和VEGF浓度（P = 0.023）呈负相关。糖尿病（DM）与HGF浓度（P = 0.001）、TGF-α浓度（P = 0.001）和VEGF浓度（P = 0.002）呈负相关。
通过我们简单的制备方案，100% APRP含有较高浓度的EGF、bFGF和β-NGF，而100% AS含有较高浓度的HGF、PDGF-AA、PDGF-BB和VEGF。这可以使眼科医生根据患者潜在的病理生理学情况，通过针对生长因子供应来为个体患者量身定制治疗方案。
ClinicalTrials.gov标识符，NCT04683796。
