WordNet

very productive; "rich seams of coal"
containing plenty of fat, or eggs, or sugar; "rich desserts"; "they kept gorging on rich foods"
having an abundant supply of desirable qualities or substances (especially natural resources); "blessed with a land rich in minerals"; "rich in ideas"; "rich with cultural interest"
high in mineral content; having a high proportion of fuel to air; "a rich vein of copper", "a rich gas mixture"
of great worth or quality; "a rich collection of antiques"
pleasantly full and mellow; "a rich tenor voice"
possessing material wealth; "her father is extremely rich"; "many fond hopes are pinned on rich uncles"
suggestive of or characterized by great expense; "a rich display"
(physical chemistry) a fourth state of matter distinct from solid or liquid or gas and present in stars and fusion reactors; a gas becomes a plasma when it is heated until the atoms lose all their electrons, leaving a highly electrified collection of nuclei and free electrons; "particles in space exist in the form of a plasma"
a green slightly translucent variety of chalcedony used as a gemstone
the colorless watery fluid of the blood and lymph that contains no cells, but in which the blood cells (erythrocytes, leukocytes, and thrombocytes) are suspended (同)plasm, blood_plasma
tiny bits of protoplasm found in vertebrate blood; essential for blood clotting (同)blood_platelet, thrombocyte

PrepTutorEJDIC

『金持ちの』,『富んだ』,豊かな / 《名詞的に》《the~;複数扱い》金持ちの人たち / (衣服・宝石・家具などが)高価でみごとな,ぜいたくな / (想像力などが)豊かな;(土地が)肥えた / (音・声が)豊かな,深みのある;(色が)濃い,あざやかな;(料理・酒の問が)濃くておいしい;(香りが)強い / 濃度が高い;(特に食物の)栄養価が高い,(油・卵・バターなどを多く含んで)濃厚な / 《話》非常におもしろい,こっけいな;《反晴的に》とんでもない,ばかげた
(また『blood plasma』)血漿,リンパ漿 / 原形質
『富』,財産,豊かさ

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/24 16:47:31」(JST)

wiki en

Platelet-rich plasma (Abbreviation: PRP) is blood plasma that has been enriched with platelets. As a concentrated source of autologous platelets, PRP contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue.

Components

The efficacy of certain growth factors in healing various injuries and the concentrations of these growth factors found within PRP are the theoretical basis for the use of PRP in tissue repair.^[1] The platelets collected in PRP are activated by the addition of thrombin and calcium chloride, which induces the release of these factors from alpha granules. The growth factors and other cytokines present in PRP include:^[1]^[2]

platelet-derived growth factor
transforming growth factor beta
fibroblast growth factor
insulin-like growth factor 1
insulin-like growth factor 2
vascular endothelial growth factor
epidermal growth factor
Interleukin 8
keratinocyte growth factor
connective tissue growth factor

Blood drawn from patient

Whole blood placed in Centrifuge prior to two stage centrifugation

Removal of PRP after double centrifugation

PRP is Injected into area of injury via ultrasound guidance

Preparation

There are, at present, two methods of PRP preparation approved by the U.S. Food and Drug Administration.^[3] Both processes involve the collection of the patient's whole blood (that is anticoagulated with citrate dextrose) before undergoing two stages of centrifugation (TruPRP) (Harvest) designed to separate the PRP aliquot from platelet-poor plasma and red blood cells.^[3] In humans, the typical baseline blood platelet count is approximately 200,000 per µL; therapeutic PRP concentrates the platelets by roughly five-fold.^[4] There is, however, broad variability in the production of PRP by various concentrating equipment and techniques.^[5]^[6]^[7]

Clinical applications

In humans, PRP has been investigated and used as a clinical tool for several types of medical treatments, including nerve injury,^[2] tendinitis,^[8]^[9] osteoarthritis,^[10] cardiac muscle injury,^[11] bone repair and regeneration,^[12] plastic surgery,^[13] and oral surgery.^[14] PRP has also received attention in the popular media as a result of its use in treating sports injuries in professional athletes.^[15]^[16]^[17]^[18]

Clinical validity

Results of basic science and preclinical trials have not yet been confirmed in large-scale controlled clinical trials. For example, clinical use of PRP for nerve injury and sports medicine has produced "promising" but "inconsistent" results in early trials.^[2]^[19] A 2009 systematic review of the scientific literature stated that there are few controlled clinical trials that have adequately evaluated the safety and efficacy of PRP treatments and concluded that PRP is "a promising, but not proven, treatment option for joint, tendon, ligament, and muscle injuries".^[19]

Proponents of PRP therapy argue that negative clinical results are associated with poor quality PRP produced by inadequate single spin devices. The fact that most gathering devices capture a percentage of a given thrombocyte count is a bias, since there is significant inter-individual variability in the platelet concentration of human plasma. More is not necessarily better in this case.^[4] The variability in platelet concentrating techniques may alter platelet degranulation characteristics that could affect clinical outcomes.^[2]

A 2010 Cochrane analysis found no evidence that PRP offered any benefit when used for sinus lifts during dental implant placement.^[14]

A 2014 Cochrane analysis found very weak (very low quality) evidence for a decrease in pain in those treated with platlet-rich therapies (PRT) from musculoskeletal injuries in the short term (up to three months). However, pooled data did not show a difference in function in the short, medium or long term. There was weak evidence that suggested that adverse events (harms) occurred at comparable, low rates in people treated with PRT and people not treated with PRT.^[20]

Implications for doping

Some concern exists as to whether PRP treatments violate anti-doping rules, such as those maintained by the World Anti-Doping Agency.^[1] It is not clear if local injections of PRP can have a systemic impact on circulating cytokine levels, in turn affecting doping tests; it is also not clear whether PRP treatments have systemic anabolic effects or affect performance.^[1] In January 2011, the World Anti-Doping Agency removed intramuscular injections of PRP from its prohibitions after determining that there is a "lack of any current evidence concerning the use of these methods for purposes of performance enhancement".^[21] In April 2014, Orioles first baseman Chris Davis, 28, underwent two PRP injections to speed the healing and recovery of an oblique injury. Left-hander Zach Britton had the procedure in his left shoulder in March 2012, according to the Baltimore Sun, and right-hander Dylan Bundy had the procedure last April before undergoing Tommy John surgery in June.

References

^ ^a ^b ^c ^d Borrione P, Gianfrancesco AD, Pereira MT, Pigozzi F (2010). "Platelet-rich plasma in muscle healing". Am J Phys Med Rehabil 89 (10): 854–61. doi:10.1097/PHM.0b013e3181f1c1c7. PMID 20855985.
^ ^a ^b ^c ^d Yu W, Wang J, Yin J (2011). "Platelet-Rich Plasma: A Promising Product for Treatment of Peripheral Nerve Regeneration After Nerve Injury". Int J Neurosci 121 (4): 176–180. doi:10.3109/00207454.2010.544432. PMID 21244302.
^ ^a ^b Arora NS, Ramanayake T, Ren YF, Romanos GE (2009). "Platelet-rich plasma: a literature review". Implant Dent 18 (4): 303–10. doi:10.1097/ID.0b013e31819e8ec6. PMID 19667818.
^ ^a ^b Marx RE (2004). "Platelet-rich plasma: evidence to support its use". Journal of Oral and Maxillofacial Surgery 62 (4): 489–96. doi:10.1016/j.joms.2003.12.003. PMID 15085519.
^ Dohan Ehrenfest DM, Rasmusson L, Albrektsson T (2009). "Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF)". Trends in Biotechnology 27 (3): 158–67. doi:10.1016/j.tibtech.2008.11.009. PMID 19187989.
^ Gonshor A (2002). "Technique for producing platelet-rich plasma and platelet concentrate: background and process". The International Journal of Periodontics & Restorative Dentistry 22 (6): 547–57. PMID 12516826.
^ Weibrich G, Kleis WK, Hafner G, Hitzler WE, Wagner W (2003). "Comparison of platelet, leukocyte, and growth factor levels in point-of-care platelet-enriched plasma, prepared using a modified Curasan kit, with preparations received from a local blood bank". Clinical Oral Implants Research 14 (3): 357–62. doi:10.1034/j.1600-0501.2003.00810.x. PMID 12755786.
^ Mishra A, Pavelko T (2006). "Treatment of chronic elbow tendinosis with buffered platelet-rich plasma". The American Journal of Sports Medicine 34 (11): 1774–8. doi:10.1177/0363546506288850. PMID 16735582.
^ Mishra A, Woodall J, Vieira A (2009). "Treatment of tendon and muscle using platelet-rich plasma". Clinics in Sports Medicine 28 (1): 113–25. doi:10.1016/j.csm.2008.08.007. PMID 19064169.
^ Andia I, Sanchez M, Maffulli N (2012). "joint pathology and platelet-rich plasma therapies". Expert Opinion in Biological Therapies 12 (1): 7–22. doi:10.1517/14712598.2012.632765. PMID 22171664.
^ Mishra A, Velotta J, Brinton TJ, et al. (2010). "RevaTen platelet-rich plasma improves cardiac function after myocardial injury". Cardiovasc Revasc Med 12 (3): 158–63. doi:10.1016/j.carrev.2010.08.005. PMID 21122486.
^ Griffin XL, Smith CM, Costa ML (2009). "The clinical use of platelet-rich plasma in the promotion of bone healing: a systematic review". Injury 40 (2): 158–62. doi:10.1016/j.injury.2008.06.025. PMID 19084836.
^ Por YC, Shi L, Samuel M, Song C, Yeow VK (2009). "Use of tissue sealants in face-lifts: a metaanalysis". Aesthetic Plastic Surgery 33 (3): 336–9. doi:10.1007/s00266-008-9280-1. PMID 19089492.
^ ^a ^b Esposito M (spring 2010). "Effectiveness of sinus lift procedures for dental implant rehabilitation: a Cochrane systematic review.". Eur J Oral Implantol. 3 (1): 7–26. doi:10.1002/14651858.CD008397. Cite uses deprecated parameters (help); Check date values in: |date= (help)
^ Alan Schwarz (2009-02-16). "A Promising Treatment for Athletes, in Blood". New York Times (New York).
^ Gretchen Reynolds (2011-01-26). "Phys Ed: Does Platelet-Rich Plasma Therapy Really Work?". New York Times.
^ Carina Storrs (2009-12-18). "Is Platelet-Rich Plasma an Effective Healing Therapy?". Scientific American.
^ Gina Kolata (2010-01-12). "Popular Blood Therapy May Not Work". New York Times.
^ ^a ^b Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA (2009). "Platelet-rich plasma: from basic science to clinical applications". Am J Sports Med 37 (11): 2259–72. doi:10.1177/0363546509349921. PMID 19875361.
^ Moraes VY (April 2014). "Platelet-rich therapies for musculoskeletal soft tissue injuries". Cochrane Database Syst Rev. 29 (4): CD010071. doi:10.1002/14651858.CD010071.pub3. Cite uses deprecated parameters (help)
^ "World Anti-Doping Agency announces changes to Prohibited List". Irish Medical Times. 2011-01-10.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 過負荷による（慢性）腱障害のマネージメントの概要 overview of the management of overuse chronic tendinopathy
2. 上顆炎（テニス肘およびゴルフ肘） epicondylitis tennis and golf elbow
3. 注入可能軟部組織充填剤：永久的に有効な充填剤 injectable soft tissue fillers permanent agents
4. 血液成分の調製 preparation of blood components
5. アキレス腱障害および腱断裂 achilles tendinopathy and tendon rupture

English Journal

Delayed animal aging through the recovery of stem cell senescence by platelet rich plasma.

Liu HY1, Huang CF2, Lin TC1, Tsai CY1, Tina Chen SY3, Liu A1, Chen WH1, Wei HJ1, Wang MF4, Williams DF5, Deng WP6.
Biomaterials.Biomaterials.2014 Dec;35(37):9767-76. doi: 10.1016/j.biomaterials.2014.08.034. Epub 2014 Sep 16.
Aging is related to loss of functional stem cell accompanying loss of tissue and organ regeneration potentials. Previously, we demonstrated that the life span of ovariectomy-senescence accelerated mice (OVX-SAMP8) was significantly prolonged and similar to that of the congenic senescence-resistant s
PMID 25239042

Synergistic anabolic actions of hyaluronic acid and platelet-rich plasma on cartilage regeneration in osteoarthritis therapy.

Chen WH1, Lo WC2, Hsu WC1, Wei HJ1, Liu HY1, Lee CH3, Tina Chen SY1, Shieh YH4, Williams DF5, Deng WP6.
Biomaterials.Biomaterials.2014 Dec;35(36):9599-607. doi: 10.1016/j.biomaterials.2014.07.058. Epub 2014 Aug 28.
Osteoarthritis (OA) is a common disease associated with tissue inflammation, physical disability and imbalanced homeostasis in cartilage. For advanced treatments, biological approaches are currently focused on tissue regeneration and anti-inflammation. This study was undertaken to evaluate the thera
PMID 25176059

Bone Marrow Aspirate Concentrate and Platelet-rich Plasma Enhanced Bone Healing in Distraction Osteogenesis of the Tibia.

Lee DH1, Ryu KJ, Kim JW, Kang KC, Choi YR.
Clinical orthopaedics and related research.Clin Orthop Relat Res.2014 Dec;472(12):3789-97. doi: 10.1007/s11999-014-3548-3.
BACKGROUND: During lower limb lengthening, poor bone regeneration is a devastating complication. Several local or systemic applications have been used to promote osteogenesis, and biologic stimulations are gaining attention, but their utility has not been proven in this setting.QUESTIONS/PURPOSES: I
PMID 24599650

Japanese Journal

CLINICAL INVESTIGATION : Effect of autologous platelet-rich plasma on persistent corneal epithelial defect after infectious keratitis

Kim Kyoung Min,Shin Yong-Tae,Kim Hong Kyun
Japanese journal of ophthalmology : the official English-language journal of the Japanese Ophthalmological Society 56(6), 544-550, 2012-11
NAID 40019483733