[논문]혈소판 농축재제를 이용한 창상치유의 촉진

한형민; 전여름; 나동균; 유대현

혈소판 농축재제를 이용한 창상치유의 촉진
Acceleration of Wound Healing Using Adipose-derived Stem Cell Therapy with Platelet Concentrates: Plateletrich Plasma (PRP) vs. Platelet-rich Fibrin (PRF) 원문보기

大韓成形外科學會誌 = Journal of the Korean society of plastic and reconstructive surgeons, v.38 no.4, 2011년, pp.345 - 350

한형민 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소) , 전여름 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소) , 나동균 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소) , 유대현 (연세대학교 의과대학 성형외과학교실.인체조직복원연구소)

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Purpose: Although platelet-rich plasma (PRP) potentiate the wound healing activity of adipose-derived stem cells (ADSCs), its effect cannot be sustained for a prolonged period of time due to short duration of action. This led us to design and produce platelet-rich fibrin (PRF), in an effort to develop a tool which lasts longer, and apply it on wound healing. Methods: Two symmetrical skin defects were made on the back of seven nude mice. ADSCs were applied to each wound, combined with either PRP or PRF. The wound area was measured over 14 days. By day 16, the wound was harvested and histologic analysis was performed including counting of the blood vessel. Results: The healing rate was more accelerated in PRP group in the first 5 days (p<0.05). However, PRF group surpassed PRP group after 6 days (p<0.05). The average number of blood vessels observed in the PRF group was $6.53{\pm}0.51$, compared with $5.68{\pm}0.71$ for the PRP group. Conclusion: PRF exerts a slow yet pervasive influence over the two-week course of the wound healing process. Thus, PRF is probably more beneficial for promoting the activity of ADSCs for a sustained period of time.

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가설 설정

Our study showed that the effect of PRF on ADSCs in wound healing was superior to that of PRP, as we hypothesized. The group treated with a combination of PRF and ADSCs showed a significantly enhanced rate of wound healing than the PRP group.

제안 방법

The experimental group was comprised of the right side symmetrical wound of each mouse, treated with a combination of ADSCs and PRF. We injected 0.
4). The subjects were sedated with inhale anesthetic (Isoflurane), followed by cleansing of the normal skin with saline. Qualitative wound evaluation was recorded with metric ruler placed beside the experimental animal and digital photographs (EOS-400D digital SLR camera, macro-lens 50 mm, Canon Inc.
² This shortcoming can be overcome by the arrival of PRF with platelets incorporated within a three dimensional matrix, which in turn releases growth factors for a stable period of time.² This study sought to elucidate the long-lasting effects of PRF combined with ADSCs on wound healing and to create a protocol for concurrent chronic wound treatment.
Adipose-derived stem cells were injected in the same manner. To avoid spilling the PRP fluid over the wound when applied in injection, both wounds were dressed and sealed with adhesive and Tegaderm (3M Health Care, 3M, St. Paul, MN, USA) dressing first, and 0.3 mL of platelet-rich plasma and 0.1 mL of activator were applied to the wound bed by piercing the normal adjacent skin using 26-gauge needle and shooting beneath the Tegaderm dressing. The experimental animals were housed individually.
We injected 0.1 mL of ADSCs (cell count, 1 × 106) at a total of five sites, at 4 sites subcutaneously along the wound margin of 12, 3, 6, and 9 o’clock position and at the base of the wound intramuscularly using a 26-gauge needle with 1 mL of syringe.

대상 데이터

As animal experiments, nude mouse (7 week-old, 20~30 g) provided by Orient Bio, INC and raised in the AAALAC-approved experimental animal facility of our university. A total of seven nude mice were recruited for this experiment. Animals were anesthetized by inhaled anesthesia (Isoflurane) and peritoneal cavity anesthesia (Ketamine 30 mg/Kg and Xylazine 3 mg/Kg).

데이터처리

0 (SPSS Inc, Chicago, IL, USA), and technical data were presented as the mean ± standard deviation as well as percentages. For the comparison of discontinuous variables, a paired Student t-test was used, and the presence or absence of significance was assessed. P-value less than 0.
Statistical analysis of all data was performed by the personal computer program SPSS for Windows version 13.0 (SPSS Inc, Chicago, IL, USA), and technical data were presented as the mean ± standard deviation as well as percentages.

참고문헌 (13)

Blanton MW, Hadad I, Johnstone BH, Mund JA, Rogers PI, Eppley BL, March KL: Adipose stromal cells and plateletrich plasma therapies synergistically increase revascularization during wound healing. Plast Reconstr Surg 123: 56, 2009
Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G: Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 27: 63, 2009

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Kim WS, Park BS, Park SH, Kim HK, Sung JH: Antiwrinkle effect of adipose-derived stem cell: activation of dermal fibroblast by secretory factors. J Dermatol Sci 53: 96, 2009

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Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT: Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 91: 4, 2004
Pallua N, Wolter T, Markowicz M: Platelet-rich plasma in burns. Burns 36: 4, 2010

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Cervelli V, Gentile P, Grimaldi M: Regenerative Surgery: Use of fat grafting combined with platelet-rich plasma for chronic lower-extremity ulcers. Aesthetic Plast Surg 33: 340, 2009
Bir SC, Esaki J, Marui A, Yamahara K, Tsubota H, Ikeda T, Sakata R: Angiogenic properties of sustained release platelet-rich plasma: characterization in-vitro and in the ischemic hind limb of the mouse. J Vasc Surg 50: 870, 2009
Kakudo N, Minakata T, Mitsui T, Kushida S, Notodihardjo FZ, Kusumoto K: Proliferation-promoting effect of platelet-rich plasma on human adipose-derived stem cells and human dermal fibroblasts. Plast Reconstr Surg 122: 1352, 2008

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Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B: Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101: e37, 2006
Sunitha Raja V, Munirathnam Naidu E: Platelet-rich fibrin: evolution of a second generation platelet concentrate. Indian J Dent Res 19: 42, 2008

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Lundquist R, Dziegiel MH, Agren MS: Bioactivity and stability of endogenous fibrogenic factors in platelet-rich fibrin. Wound Repair Regen 16: 356, 2008

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Moon MH, Kim SY, Kim YJ, Kim SJ, Lee JB, Bae YC, Sung SM, Jung JS: Human adipose tissue-derived mesenchymal stem cells improve postnatal neovascularization in a mouse model of hindlimb ischemia. Cell Physiol Biochem 17: 279, 2006

상세보기
O'Connell SM, Impeduglia T, Hessler K, Wang XJ, Carroll RJ, Dardik H: Autologous platelet-rich fibrin matrix as cell therapy in the healing of chronic lower-extremity ulcers. Wound Repair Regen 16: 749, 2008

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혈소판 농축재제를 이용한 창상치유의 촉진
Acceleration of Wound Healing Using Adipose-derived Stem Cell Therapy with Platelet Concentrates: Plateletrich Plasma (PRP) vs. Platelet-rich Fibrin (PRF) 원문보기

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혈소판 농축재제를 이용한 창상치유의 촉진 Acceleration of Wound Healing Using Adipose-derived Stem Cell Therapy with Platelet Concentrates: Plateletrich Plasma (PRP) vs. Platelet-rich Fibrin (PRF) 원문보기

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혈소판 농축재제를 이용한 창상치유의 촉진
Acceleration of Wound Healing Using Adipose-derived Stem Cell Therapy with Platelet Concentrates: Plateletrich Plasma (PRP) vs. Platelet-rich Fibrin (PRF) 원문보기

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