Introduction. Elevated concentration of proinflammatory cytokines followed by hyperinflammation is one of the hallmarks of severe and critical COVID-19. In the short term, this may result in ARDS and lung injury; subsequently, this may cause pulmonary fibrosis—a disease with poor prognosis—in the long run. Among the cytokines, interleukin-1β (IL-1β) is one of the most overexpressed in COVID-19. We speculate that administration of intravenous activated autologous platelet-rich plasma (aaPRP), which contains interleukin-1 receptor antagonist (IL-1RA), would lower IL-1β levels and benefit the severe and critical COVID-19 patients. Methods. After acquiring ethical clearance, we recruited 12 adult COVID-19 patients of both sexes from the Koja Regional Hospital (Jakarta, Indonesia) ICU. After selection, seven patients were included and divided into two groups, severe and critical. In addition to three doses of aaPRP, both groups received the same treatment of antiviral, steroid, and antibiotics. Quantification of plasma IL-1β levels was performed by beads multiplex assay a day before the first aaPRP administration and a day after the second and third aaPRP administration. PaO2/FiO2 ratio and lung injury scores were evaluated a day before and a day after each aaPRP administration. Results. Severe and critical patients’ initial plasma IL-1β concentration was 4.71 pg/mL and 3.095 pg/mL, respectively. After 2 treatments with aaPRP, severe patients’ plasma IL-1β concentration decreased 12.48 pg/mL, while critical patients’ plasma IL-1β concentration increased to 18.77 pg/mL. Furthermore, after 3 aaPRP treatments, significant amelioration of patients’ PaO2/FiO2 ratio from 71.33 mmHg at baseline to 144.97 mmHg was observed ( p < 0.05 ). However, no significant improvement in lung injury score was observed in severe and critical groups. All severe patients and one critical patient recovered. Conclusion. The use of aaPRP may prevent pulmonary fibrosis in severe COVID-19 patients through the reduction of patients’ plasma IL-1β concentration and the amelioration of PaO2/FiO2 ratio.

Introduction: Autologous platelet-rich plasma (PRP) has been a growing trend in the field of medicine due to its broad range of application and is considered safe from bloodborne diseases. Furthermore, various studies have tried to optimize the use of autologous PRP through various preparation protocols, including PRP activation. However, most of the studies available have not evaluated the safety for intravenous delivery of PRP, especially autologous activated PRP (aaPRP). Therefore, this study aimed to evaluate the safety of intravenous delivery of aaPRP.Methods: Blood was drawn from each patient and aaPRP was isolated through calcium activation and light irradiation. Each aaPRP was administered intravenously to all patients. Adverse events were documented and analyzed.Results: Six hundred eleven patients participated in this study with a total of 4244 aaPRP therapies. Quality control of autologous aaPRP showed no platelets present after both calcium activation and light irradiation. No adverse events such as allergic reaction, infection, and coagulation problems were observed on all patients over the course of the study.Conclusion: Our results showed that intravenous administration of autologous aaPRP is safe even in patients with various pathological conditions.

Migrain adalah penyakit yang dirasakan seumur hidup, sering berulang dan menghambat aktivitas penderitanya. Patogenesis migrain dispekulasikan berada pada sistem trigeminal dengan aktivitas neurotransmitter seperti CGRP, glutamat, serotonin dan nitrit oksida, vasodilatasi arteri serebri serta inflamasi neurogenic. Tata laksana migrain dengan konsumsi triptan didapatkan efek samping yang tak terduga antara penggunaan obat tersebut dengan kejadian iskemik serebrovaskular, jantung coroner dan hipertensi berat. Saat ini, telah ditemukan tata laksana terbaru dan sudah diakui untuk penyakit migrain. Pengobatan yang berhubungan dengan CGRP dan senyawa magnesium menawarkan manfaat yang cukup besar dibandingkan obat-obatan yang sudah ada.