The Effects Of Age And Disease On The Active Components Of Platelet-rich Plasma And Its Optimized Preparation

ObjectivesIn recent years,platelet-rich plasma(PRP)has been widely used in clinical practice,but there are many problems related to PRP preparation and clinical application.This study was to investigate the effects of age,gender,diabetes,antiplatelet drugs on bioactive components in PRP and age on platelet ultrastructure,and to observe the feasibility of standardized PRP with platelet parameters as quality control indicators and its application to complex wounds in the elderly.MethodsForty-four volunteers were classified into four groups:group A(healthy people aged ?45 years);group B(aged>45 years old);group C(age>45 years with type 2 diabetes);group D(age>45 years with coronary heart disease and taking aspirin and clopidogrel).Determination of epidermal growth factor,fibroblast growth factor-2,insulin-like growth factor-1,platelet-derived growth factor-AA,platelet-derived growth factor AB/BB,vascular endothelial growth factor-A,and matrix metalloproteinase inhibitor-1,matrix metalloproteinase inhibitor-2,growth differentiation factor 11(GDF11)and Clusterin,antioxidant enzymes which have been confirmed to exist or may exist in PRP.Differences in the bioactive components of each group were compared using two-way analysis of variance.Fifteen healthy volunteers participated in this study.Three groups with five persons in each group were distinguished according to their age.i.e.,young(25-45 years,2 females and 3 males),middle aged(46?65 years,3 females and 2 males),and old aged(>65 years,2 females and 3 males).The volunteers' medical histories were thoroughly assessed before taking blood to make platelet transmission electron microscope specimen.The platelet parameters were used as quality control indicators to prepare standardized PRP to 21 elderly patients with complex wounds,and the therapeutic effects were observed.Results:PRP contains high concentrations of various growth factors and bioactive components such as GDF11.Statistical analysis showed that the concentration of the biologically active substance that partially promotes regeneration is lowered in older people compared with young people,diabetes or coronary heart disease,taking PRP antiplatelet drugs compared with older people of the same age.With ageing,platelet structure gradually changes,resulting in a decrease in the number of a-particles,and the morphology of platelets and membranes changes.PRP preparation method with platelet indices as quality-control indicators can prepare PRP with platelet concentration of 1000×109/L,which can promote complex wound healing in elderly patients.Discussion and conclusion:PRP stored at-80? for a long time contains a high concentration of active ingredient.GDF11 in PRP may be an important mechanism for its anti-aging of skin.Age,gender,diabetes,and coronary heart disease take antiplatelet drugs are important factors influencing the bioactive components in PRP.Age can affect the ultrastructure of platelets,and age affects its active ingredients and ultrastructure more than gender.Aging,diabetes,and antiplatelet drugs may reduce the quality of autologous PRP,thereby reducing its ability to regenerate.In the treatment of related diseases,consider the effects of age,diabetes and antiplatelet drugs,increase the frequency and amount of PRP if necessary,or use allogeneic PRP in young people.A standardized secondary centrifuged platelet-rich plasma preparation method with platelet parameters(Platelet concentration,Plateletcrit,Mean platelet volume and Platelet distribution width)as a quality control index can prepare PRP with a platelet concentration of about 1000×109/L,and can adjust platelets concentration in PRP as needed target concentration.The method is simple and practical,and can promote the healing of complex wounds in the elderly.