An introduction to application of platelet rich plasma (PRP) in skin rejuvenation
Introduction
Platelet-rich plasma (PRP), platelet-rich concentrate, autologous platelet gel or platelet releasate, all refer to one concept. which is an autologous concentration of human platelets contained in a small volume of plasma. It is known for a long time that fibrin clot and platelets have haemostatic and tissue repairing effect. In 1975, an article was published with the concept of platelet gel under the title of: ‘use of platelet-fibrinogen-thrombin mixture as a corneal adhesive. An exciting report was published in 1979 about the usage of gel foam in sutureless nerve anastomosis. After a few years an animal model showed that platelets and fibrin initiate a process consist of cell migration, collagen synthesis, fibroplasia and angiogensis which helps the lesion healing. The real application of platelet releasate in treating wounds, has begun in the mid-1980s after publication of Kingthon et al. in 1986.
In 1997 another important report was published about the maxillofacial surgery and platelet gels. The usages of platelet gel became more popular in late 1990s, after the publication (1998) of a paper about the effectiveness of the platelet-rich plasma (PRP) in bone regeneration in the field of dental care.
There are several growth factors in α-granules of platelets, secreted after the activation of platelets by aggregation initiators. These factors including platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF) regulate cell migration and attachment. Some studies indicate that platelets have anti-inflammatory and analgesic effects and secrete antimicrobial peptides, thus have antibiotic effects. More than 800 proteins are secreted in this matrix affect on various cell types: osteoblasts, chondrocytes, fibroblasts, endothelial cells, mesenchymal stem cells from different origins, myocytes and tendon cells which lead to a wide range of surgical and clinical procedures and treatments which help the platelet concentrated products.
Nowadays, there are publications about the use of PRP in chronic wound treatment, soft tissue injuries, periodontal and oral surgery, maxillofacial surgery, orthopedic and trauma surgery, spinal surgery, heart bypass surgery, burns, cosmetic and plastic surgery, gastrointestinal surgeries. We want to summarize the use of PRP in dermatology especially in skin rejuvenization.
Skin rejuvenation
In the past decade, PRP has attracted the attention of dermatologists specifically in the aesthetic field for skin rejuvenation.
Skin aging
Aging skins has obvious characteristics such as red-brown-mottled dyschromia, dryness and fine wrinkles. Moreover, cell replacement and wound healing decrease with age and some changes take place in skin texture such as sagging and wrinkling . Aged skin is known histologicaly, by a flattened dermo–epidermal junction, dermal atrophy and fewer fibroblasts. Among different degenerative processes cause skin aging, decreasing in fibroblasts collagen production the most important one. Interaction of fibroblasts with keratinocytes, adipocytes and mast cells is important in skin aging processes. In addition, they are loaded with several kinds of ECM (extra cellular matrix) proteins, glycoproteins, adhesive molecules and cytokines. They produce these molecules, strengthen the skin cell interactions and participate in fibroblast-keratinocyte-endothelium axis that preserves skin integrity and youth.
Several cytokines and growth factors work in the stimulation process of fibroblasts for collagen synthesis.
Nowadays, there is an increasing amount of harmful effects on the skin such as malignancies, immuno-suppression, hyper pigmentation, wrinkles, aging and etc., due to the increasing rate of UV radiation.
The prolonged human skin exposure to sun or UV irradiation lowers the resilient properties of the skin and so degenerates the three-dimensional structure of resilient fibers (elastotic degeneration), disorganizes collagen fibrils which lead to decreasing the skin flexibility. The UV radiation incorporates by special chromophore in the skin, such as melanin, deoxyribonucleic acid (DNA), ribonucleic acid, proteins, lipids, water, aromatic amino acids, trans-urocanic acid and etc. Which consequently create reactive oxygen species (ROS). ROS makes histochemical changes: the stratum spinosum thickening and dermoepidermal junction flattening.
On the other hand, the studies have shown the effect of growth factors and cytokines in preserving the skin texture such as fibroblast growth factor (FGF1) which is important in the regeneration and proliferation process of skin cells, accumulation of collagen type 1 alpha 1 protein in skin and inhibition of UV-induced skin damages.
Conventional anti-aging strategies, such as those involving lasers and topical treatments, typically aim to increase ECM synthesis through the activation of fibroblasts.
Platelet-rich plasma (PRP), platelet-rich concentrate, autologous platelet gel or platelet releasate, all refer to one concept. which is an autologous concentration of human platelets contained in a small volume of plasma. It is known for a long time that fibrin clot and platelets have haemostatic and tissue repairing effect. In 1975, an article was published with the concept of platelet gel under the title of: ‘use of platelet-fibrinogen-thrombin mixture as a corneal adhesive. An exciting report was published in 1979 about the usage of gel foam in sutureless nerve anastomosis. After a few years an animal model showed that platelets and fibrin initiate a process consist of cell migration, collagen synthesis, fibroplasia and angiogensis which helps the lesion healing. The real application of platelet releasate in treating wounds, has begun in the mid-1980s after publication of Kingthon et al. in 1986.
In 1997 another important report was published about the maxillofacial surgery and platelet gels. The usages of platelet gel became more popular in late 1990s, after the publication (1998) of a paper about the effectiveness of the platelet-rich plasma (PRP) in bone regeneration in the field of dental care.
There are several growth factors in α-granules of platelets, secreted after the activation of platelets by aggregation initiators. These factors including platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF) regulate cell migration and attachment. Some studies indicate that platelets have anti-inflammatory and analgesic effects and secrete antimicrobial peptides, thus have antibiotic effects. More than 800 proteins are secreted in this matrix affect on various cell types: osteoblasts, chondrocytes, fibroblasts, endothelial cells, mesenchymal stem cells from different origins, myocytes and tendon cells which lead to a wide range of surgical and clinical procedures and treatments which help the platelet concentrated products.
Nowadays, there are publications about the use of PRP in chronic wound treatment, soft tissue injuries, periodontal and oral surgery, maxillofacial surgery, orthopedic and trauma surgery, spinal surgery, heart bypass surgery, burns, cosmetic and plastic surgery, gastrointestinal surgeries. We want to summarize the use of PRP in dermatology especially in skin rejuvenization.
Skin rejuvenation
In the past decade, PRP has attracted the attention of dermatologists specifically in the aesthetic field for skin rejuvenation.
Skin aging
Aging skins has obvious characteristics such as red-brown-mottled dyschromia, dryness and fine wrinkles. Moreover, cell replacement and wound healing decrease with age and some changes take place in skin texture such as sagging and wrinkling . Aged skin is known histologicaly, by a flattened dermo–epidermal junction, dermal atrophy and fewer fibroblasts. Among different degenerative processes cause skin aging, decreasing in fibroblasts collagen production the most important one. Interaction of fibroblasts with keratinocytes, adipocytes and mast cells is important in skin aging processes. In addition, they are loaded with several kinds of ECM (extra cellular matrix) proteins, glycoproteins, adhesive molecules and cytokines. They produce these molecules, strengthen the skin cell interactions and participate in fibroblast-keratinocyte-endothelium axis that preserves skin integrity and youth.
Several cytokines and growth factors work in the stimulation process of fibroblasts for collagen synthesis.
Nowadays, there is an increasing amount of harmful effects on the skin such as malignancies, immuno-suppression, hyper pigmentation, wrinkles, aging and etc., due to the increasing rate of UV radiation.
The prolonged human skin exposure to sun or UV irradiation lowers the resilient properties of the skin and so degenerates the three-dimensional structure of resilient fibers (elastotic degeneration), disorganizes collagen fibrils which lead to decreasing the skin flexibility. The UV radiation incorporates by special chromophore in the skin, such as melanin, deoxyribonucleic acid (DNA), ribonucleic acid, proteins, lipids, water, aromatic amino acids, trans-urocanic acid and etc. Which consequently create reactive oxygen species (ROS). ROS makes histochemical changes: the stratum spinosum thickening and dermoepidermal junction flattening.
On the other hand, the studies have shown the effect of growth factors and cytokines in preserving the skin texture such as fibroblast growth factor (FGF1) which is important in the regeneration and proliferation process of skin cells, accumulation of collagen type 1 alpha 1 protein in skin and inhibition of UV-induced skin damages.
Conventional anti-aging strategies, such as those involving lasers and topical treatments, typically aim to increase ECM synthesis through the activation of fibroblasts.