Effect of platelet‐rich plasma on the outcome of mini‐punch grafting procedure in localized stable vitiligo: Clinical evaluation and relation to lesional basic fibroblast growth factor

Abstract

Surgical methods are favorably used for treatment of stable vitiligo, and platelet-rich plasma (PRP) can be added to augment the effect. The additive value of PRP, however, remains elusive. Basic fibroblast growth factor (bFGF) is released from activated platelets with a capacity for stimulating melanocyte proliferation and migration. The treatment outcomes for the mini-punch grafting (MPG)/phototherapy treatment with and without PRP were assessed and the relation between bFGF and the obtained results were evaluated. Thirty-four vitiliginous patches, two per each patient with stable vitiligo, were enrolled in this intrapatient-controlled study and treated with autologous MPG and subsequent exposure to phototherapy with and without enhancement via PRP procedure at the time of the procedure, and monthly for the subsequent 3 months. Re-pigmentation assessment via vitiligo scores as well as measurement of lesional bFGF were done. PRP assistance to MPG/phototherapy treatment resulted in earlier re-pigmentation at week 8. However, this enhancement effect vanished at the study end (week 20) as ideal re-pigmentation (>75% re-pigmentation) was encountered in 10 patches (58.8%) treated with MPG/phototherapy modality, and in 12 patches (70.6%) treated with PRP-assisted method without significant difference between them. Lesional bFGF increased after both treatments with a higher expression with PRP assistance but without clinical reflection on the final outcome. PRP can speed the re-pigmentation response for MPG/phototherapy procedure without any significant effect on the final outcome.

Growth Factors VEGF-A165 and FGF-2 as Multifunctional Biomolecules Governing Cell Adhesion and Proliferation

“…These results are in accordance with the study by Khan et al [47], where a simultaneous increase in both proliferation and differentiation of ADSCs were obtained when VEGF-A165 was combined with FGF-2. In general, our results are in line with all studies, in which FGF-2 is used for expansion of various cell types, such as mesenchymal stem cells including ADSCs [17], induced pluripotent stem cells [19] or chondrocytes [18], or for various regenerative therapies, in which the cell proliferation is needed, such as healing of cutaneous wounds [20,21], regeneration of damaged or diseased bone tissue [22,24], or treatment of vitiligo, requiring proliferation of melanocytes [26].…”

“…FGF-2 has been widely applied in clinical practice, particularly in cutaneous wound healing, such as second-degree burns and chronic ulcers [20,21], and in bone regenerative therapies, such as treatment of bone fractures, osteotomies, and osteonecrosis (for a review, see [22]), or treatment of periodontitis with intrabony defects ( [23]; for a review, see [24]). FGF-2 also proved its efficacy in the treatment of oral lichen planus [25] or vitiligo [26]. Animal studies also proved that FGF-2 is promising for regenerative therapy of spinal cord injury [27], of liver injury and liver diseases [28], or for treatment of alopecia [29].…”

Efficacy of autologous platelet‐rich plasma in the treatment of vitiligo: A 10‐patient prospective study

“…A high concentration of growth factors is released from platelets due to secretion of alpha granules 10 min after activation 3,6,7 (platelet‐derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor‐beta (TGF‐ β), basic fibroblast growth factor (b‐FGF), and insulin growth factor (IGF)) 8–11 …”

“…These multiple factors lead to the migration of melanocytes from peri‐lesional skin, thus allowing repigmentation 13–16 . Basic fibroblast growth factor (b‐FGF) enhances melanocyte migration, keratinocyte, and fibroblast proliferation 8 . The response for TGF‐β is better if vitiligo is stable 17 .…”

Research Progress on Targeted Antioxidant Therapy and Vitiligo

“…MSCs could thus be a promising method for the treatment of vitiligo [ 64 ]. Some studies have found that basic fibroblast growth factor promotes melanocyte migration and cytoskeletal rearrangements through PI3K/Akt and ERK signaling pathways, which might have certain clinical application value in melanocyte transplantation [ 65 , 66 ].…”