مقالات پذیرفته شده در هشتمین کنگره بین المللی زیست پزشکی
Application of Autologous Blood Derivatives as an Effective Solution in Wound Healing
Application of Autologous Blood Derivatives as an Effective Solution in Wound Healing
Majid Zamani,1Saeid Kaviani,2,*Mehdi Yousefi,3Saeid Abroun,4Mohammad Hojjat-Farsangi,5Behzad Pourabbas,6
1. Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 2. Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 3. Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 4. Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 5. Bioclinicum, Department of Oncology-Pathology, Karolinska Institute, Bioclinicum, Stockholm, Sweden 6. Department of Polymer Engineering, Sahand University of Technology, Tabriz, Iran
Introduction: Wound healing is a complex and multi-step process, which disrupting any of its steps can cause the wound to become chronic and leave a scar in patients. Chronic wounds, in addition to causing psychological and social problems for the patient, impose heavy costs on the patient and the treatment system of the country. It seems necessary to use novel and more effective treatments in wound healing, especially autologous treatments with minimal side effects.
Methods: As a search strategy and study selection, we searched the PubMed and Medline databases through 2024 using related keywords (e.g., Blood derivatives, Platelet rich plasma, platelet lysate, Platelet-rich fibrin, Autologous conditioned serum, Conditioned plasma, Wound healing, Wound regeneration, and Regenerative medicine).
Results: Wound healing consists of different phases in which different cells, growth factors and cytokines play a role in each stage. Cells that play a role in wound healing by secreting different types of growth factors and cytokines reduce inflammation, increase cell proliferation and differentiation, and angiogenesis at the site of injury and promote wound healing. After causing an injury in the hemostasis phase, platelets come to the wound site and in addition to preventing bleeding, they also play a role in wound healing by releasing cytokines and growth factors. In the inflammatory phase, leukocytes are present at the wound site and prevent infection and remove cell derbies. Remaining inflammation in this phase causes a delay in wound healing. In the proliferation phase, cell proliferation, angiogenesis and re-epithelialization occur. The last phase is remodeling, in which the wound is completely repaired and the wound is completely healed by the production and deposition of collagen and the formation of the extracellular matrix. Various compounds such as hydrogels, scaffolds and nanoparticles are used to improve the wound healing process. Various types of blood derivatives are also used to promote wound healing. Blood derivatives used in wound healing include platelet-rich plasma, plasma-rich fibrin, platelet lysate, and autologous conditioned serum. Each of the mentioned products has advantages and disadvantages. Platelet-rich plasma has a large number of platelets and leukocytes. Platelets can improve wound healing by secreting growth factors, cytokines and various chemokines. Growth factors secreted from platelets such as transforming growth factor beta, platelet-derived growth factor, basic-fibroblast growth factor, vascular endothelial growth factor, and epidermal growth factor play an essential role in wound healing and can promote wound healing and improve its quality. Platelet-rich fibrin is in gel form, which makes it easier to separate and use in wound healing. Platelet lysate by destroying the cell membrane by freeze/thaw, adding platelet activating compounds and ultrasonication causes the release of platelet growth factors, cytokine, and chemokine. In platelet lysate, cell membranes and leukocytes are removed by filtering the sample, this prevents unwanted and negative reactions of cells and produces a pure product of proteins, growth factors and other plasma compounds. Autologous conditioned serum is one of the other blood derivatives that is produced by contacting blood with glass beads. This activates blood cells, especially monocytes, and increases the amount of growth factors and anti-inflammatory cytokines, especially Interleukin 1β receptor antagonist. Finally, the product is filtered with a 0.22 µm filter to produce a cell-free product like platelet lysate. Autologous conditioned serum, in addition to promoting wound healing by growth factors, inhibits inflammation with anti-inflammatory factors and helps to pass the inflammatory phase of wound healing. Blood products can be used in autologous form so that unwanted diseases and infections are not transferred to the recipient of the product.
Conclusion: Blood derivatives as an autologous therapy can promote wound healing. Each of the blood derivatives has unique characteristics and compositions and the type of wound and the patient's condition can determine the type of blood derivatives suitable for the patient.