Effect of Platelet-Rich Plasma on Peripheral Nerve Regeneration

 

 Buy Article Permissions and Reprints

ABSTRACT

Activated platelets release various growth factors, some of which are recognized to improve nerve regeneration. This study evaluated the effect of platelet-rich plasma (PRP) in end-to-end neurorrhaphy. A total of 45 Wistar rats were used, with the initial five used for PRP preparation. The right hind limbs were used as experimental, with the left as control. The animals were treated in five groups. Group A (n = 4): The right sciatic nerve was dissected only from the sciatic notch to the bifurcation. In all other groups, the nerve was sharply transected and repaired with: group B (n = 8): two sutures; group C (n = 8): six sutures; group D (n = 10): two sutures and PRP; and group E (n = 10): six sutures and PRP. Groups D and E were compared with groups B and C, respectively. Group E had a shorter latency time in electromyography (p < 0.01) and a thicker myelin layer in the histological evaluation (p < 0.003) in comparison with group C. These positive effects of PRP were not detected in the nerves were repaired with two sutures. In this animal model, the application of PRP to the repair site helped to improve remyelinization of the sciatic nerve in rats when the epineural repair was done with six sutures.

REFERENCES

• 1 Atabay K, Hong C, Heil B V et al.. The use of “sliding epineural sheath tube” for repair of peripheral nerve defects.  Plast Surg Forum. 1995;  18 121-123
  PubMedGoogle Scholar
• 2 Lolley R D, Bose W J, Bastian F et al.. Vein, silastic and polyglycolic acid fine mesh: a comparative study in peripheral nerve repair.  Ann Plast Surg. 1995;  35 266-271
  PubMedGoogle Scholar
• 3 Voinesco F, Glauser L, Kraftsik R et al.. Local administration of thyroid hormones in silicone chamber increases regeneration of rat transected sciatic nerve.  Exp Neurol. 1998;  150 69-81
  CrossrefPubMedGoogle Scholar
• 4 Wang K K, Nemeth I R, Seckel B R et al.. Hyaluronic acid enhances peripheral nerve regeneration in vivo.  Microsurgery. 1998;  18 270-275
  CrossrefPubMedGoogle Scholar
• 5 Gorgulu A, Imer M, Simsek O et al.. The effect of aprotinin on extraneural scarring in peripheral nerve surgery: an experimental study.  Acta Neurochir (Wien). 1998;  140 1303-1307
  CrossrefPubMedGoogle Scholar
• 6 Welch J A, Kraus K H, Wells M R et al.. Effect of combined administration of insulin-like growth factor and platelet-derived growth factor on the regeneration of transected and anastomosed sciatic nerve in rats.  Am J Vet Res. 1997;  58 1033-1037
  PubMedGoogle Scholar
• 7 Frostick S P, Yin Q, Kemp G J. Schwann cells, neurotrophic factors, and peripheral nerve regeneration.  Microsurgery. 1998;  18 397-405
  Google Scholar
• 8 Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats.  Acta Orthop Scand. 2004;  75 93-99
  CrossrefPubMedGoogle Scholar
• 9 Ozmen S, Ayhan S, Latifoglu O et al.. Stamp and paper method: a superior technique for the walking track analysis.  Plast Reconstr Surg. 2002;  109 1760-1761
  PubMedGoogle Scholar
• 10 Bain J R, Mackinnon S E, Hunter D A. Functional evaluation of complete sciatic peroneal and posterior tibial nerve lesions in the rat.  Plast Reconstr Surg. 1989;  83 129-138
  CrossrefPubMedGoogle Scholar
• 11 Ozgenel G Y. Effects of hyaluronic acid on peripheral nerve scarring and regeneration in rats.  Microsurgery. 2003;  23 575-581
  CrossrefPubMedGoogle Scholar
• 12 Eppley B L, Woodell J E, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing.  Plast Reconstr Surg. 2004;  114 1502-1508
  PubMedGoogle Scholar
• 13 Whitman D H, Berry R L, Green D M. Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery.  J Oral Maxillofac Surg. 1997;  55 1294-1299
  CrossrefPubMedGoogle Scholar
• 14 Marx R E, Carlson E R, Eichstaedt R M et al.. Platelet-rich plasma: growth factor enhancement for bone grafts.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;  85 638-646
  PubMedGoogle Scholar
• 15 Lowery G L, Kulkarni S, Pennisi A E. Use of autologous growth factors in lumbar spinal fusion.  Bone. 1999;  25(2, Suppl) 47S-50S
  CrossrefPubMedGoogle Scholar
• 16 Gehring S, Hoerauf H, Laqua H et al.. Preparation of autologous platelets for the ophthalmologic treatment of macular holes.  Transfusion. 1999;  39 144-148
  CrossrefPubMedGoogle Scholar
• 17 Man D, Plosker H, Winland-Brown J E. The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery.  Plast Reconstr Surg. 2001;  107 229-237
  CrossrefPubMedGoogle Scholar
• 18 Kanje M, Skottner A, Lundborg G et al.. Does insulin-like growth factor I (IGF-1) trigger the cell body reaction in the rat sciatic nerve?.  Brain Res. 1991;  563 285-287
  CrossrefPubMedGoogle Scholar
• 19 Kanje M, Skottner A, Sjoberg J et al.. Insulin-like growth factor I (IGF-I) stimulates regeneration of the rat sciatic nerve.  Brain Res. 1989;  486 396-398
  CrossrefPubMedGoogle Scholar
• 20 Near S L, Whalen L R, Miller J A et al.. Insulin-like growth factor II stimulates motor nerve regeneration.  Proc Natl Acad Sci U S A. 1992;  89 11716-11720
  PubMedGoogle Scholar
• 21 Sjoberg J, Kanje M. Insulin-like growth factor (IGF-1) as a stimulator of regeneration in the freeze-injured rat sciatic nerve.  Brain Res. 1989;  485 102-108
  CrossrefPubMedGoogle Scholar
• 22 Sondell M, Lundborg G, Kanje M. Vascular endothelial growth factor has neurotrophic activity and stimulates axonal outgrowth, enhancing cell survival and Schwann cell proliferation in the peripheral nervous system.  J Neurosci. 1999;  19 5731-5740
  PubMedGoogle Scholar
• 23 Ridley A J, Davis J B, Stroobant P et al.. Transforming growth factors-beta 1 and beta 2 are mitogens for rat Schwann cells.  J Cell Biol. 1989;  109 3419-3424
  CrossrefPubMedGoogle Scholar
• 24 Davis J B, Stroobant P. Platelet-derived growth factors and fibroblast growth factors are mitogens for rat Schwann cells.  J Cell Biol. 1990;  110 1353-1360
  CrossrefPubMedGoogle Scholar
• 25 Danielsen N, Pettmann B, Vahlsing H L et al.. Fibroblast growth factor effects on peripheral nerve regeneration in a silicone chamber model.  J Neurosci Res. 1988;  20 320-330
  CrossrefPubMedGoogle Scholar
• 26 Hansson H A. Insulin-like growth factors and nerve regeneration.  Ann N Y Acad Sci. 1993;  692 161-171
  CrossrefPubMedGoogle Scholar
• 27 Menovsky T, Beek J F. Carbon dioxide laser-assisted nerve repair: effect of solder and suture material on nerve regeneration in rat sciatic nerve.  Microsurgery. 2003;  23 109-116
  CrossrefPubMedGoogle Scholar
• 28 Ploncard P. Comparative study of circumferential nerve suture using the operating microscope. Electrophysiological and histological control.  Acta Neurochir (Wien). 1976;  34 175-183
  CrossrefPubMedGoogle Scholar
• 29 Jubran M, Widenfalk J. Repair of peripheral nerve transections with fibrin sealant containing neurotrophic factors.  Exp Neurol. 2003;  181 204-212
  CrossrefPubMedGoogle Scholar
• 30 Santos X, Rodrigo J, Hontanilla B et al.. Local administration of neurotrophic growth factor in subcutaneous silicon chambers enhances the regeneration of the sensory component of the rat sciatic nerve.  Microsurgery. 1999;  19 275-280
  CrossrefPubMedGoogle Scholar
• 31 Voinesco F, Glauser L, Kraftsik R et al.. Local administration of thyroid hormones in silicone chamber increases regeneration of rat transected sciatic nerve.  Exp Neurol. 1998;  150 69-81
  CrossrefPubMedGoogle Scholar
• 32 Wong C, Inman E, Spaethe R et al.. Fibrin-based biomaterials to deliver human growth factors.  Thromb Haemost. 2003;  89 573-582
  PubMedGoogle Scholar
• 33 Midha R, Munro C A, Dalton P D et al.. Growth factor enhancement of peripheral nerve regeneration through a novel synthetic hydrogel tube.  J Neurosurg. 2003;  99 555-565
  CrossrefPubMedGoogle Scholar
• 34 Weibrich G, Kleis W K, Hafner G et al.. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count.  J Craniomaxillofac Surg. 2002;  30 97-102
  CrossrefPubMedGoogle Scholar

Yakup SariguneyM.D. 

Department of Plastic, Reconstructive and Aesthetic Surgery

Gazi University Faculty of Medicine, Ankara, Turkey