Medical Application of Bioactive Preparations that Contain Growth Factors of Human Platelets
The use of biopreparations based on platelet-rich plasma (PRP) is one of the promising areas in regenerative medicine, which has been actively developing in the latest decade. In addition, when obtaining cell products for therapy and tissue engineering, bioactive substances that regulate cell proliferation and differentiation, which contain the main growth factors also produced by platelets, are used.Purpose. To assess the effectiveness of bioactive preparations that contain platelet growth factors in their usage for treatment of long-term non-healing wounds of the skin of the extremities in patients with diabetes mellitus and chronic ischemia in the lower limbs of non-diabetic genesis, as well as a bioactive additive in the production of biomedical cell products based on mesenchymal stem cells. Materials and methods. We studied the clinical effectiveness of PRP in the complex therapy of patients with chronic ischemia in the lower limbs of atherosclerotic genesis (n=16) and long-term non-healing wounds of the skin of the extremities in patients with diabetes (n=14). The efficiency of using the lysed platelet concentrate to obtain a biomedical cell product of mesenchymal cells was studied on 46 samples of cells obtained from the bone marrow of healthy donors (n=16), patients with multiple sclerosis (n=16), as well as from the adipose tissue of deceased donors (n=14). Results. The use of PRP in patients with chronic ischemia in the lower limbs of atherosclerotic genesis provided the increase of painless walking distance from 152 [100; 197] to 189 [151; 202] meters within 1 month of therapy with further positive dynamics within 6 months. In some patients, 6 months later, there was the regression of clinical symptoms with the change of the chronic arterial insufficiency stage from IIb to IIa. In patients with long-term non-healing ulcers of the skin of the extremities on the background of diabetes, complete wound healing occurred within 4-6 weeks after the initial use of PRP, followed by maintaining the integrity of the skin for 12 months. The addition of 5% lysed platelet concentrate to the culture medium provided the 1.6-2.4-fold reduction of the cultivation time of mesenchymal cells if compared with the use of 10% FBS. Conclusion. Bioactive drugs based on human platelets stimulate regenerative processes in damaged tissues, providing the increase of the effectiveness of complex therapy for chronic ischemia in the lower limbs of various origins; they are also highly effective and safe when used in the technological process of producing biomedical cell products.