<p>Platelet-rich plasma plays an antibacterial, anti-inflammatory and cell proliferation-promoting role in an in vitro model for diabetic infected wounds</p>

Abstract

AimThis study was designed to examine the potential mechanism underlying these roles of platelet-rich plasma in treating diabetic foot ulcers (DFUs).MethodsStaphylococcus aureus and HaCaT were co-cultured under high glucose conditions to serve as an in vitro model for infected cells in DFUs. Platelet-rich gel (PRG) or extract liquid of platelet-rich gel (EPG) were used to interfere with the model to observe the growth of HaCaT cells and S. aureus, and the effect of miR-21 changes in HaCaT cells on PDCD4, NF-κB activity and related inflammatory factors.ResultsIncubation of HaCaT cells with S. aureus promoted the decline of cell proliferation. Under this condition, the level of PDCD4 and the activity of NF-κB were increased in HaCaT cells with concomitant increased of IL-6, TNF-α and decreased IL-10, TGF-β1 in cultured supernatant. Both of PRG and EPG exhibited specific anti-S. aureus activity where they protect HaCaT cells from bacterial damage and promote cell proliferation. Meanwhile, EPG was observed to increase intracellular miRNA-21 while reduce PDCD4 expression and inhibit NF-κB activity to suppress the inflammation in HaCaT cells.ConclusionThis in vitro model provides a valuable tool for study of wound healing in the treatment of DFUs. Our results suggest that miRNA-21 may regulate the expression of NF-κB through PDCD4 where it plays an anti-inflammatory role and promote proliferation in infected DFUs treated by PRP. These findings could provide novel therapeutic targets for refractory wounds.

Comparison of Allogeneic Platelet-rich Plasma With Autologous Platelet-rich Plasma for the Treatment of Diabetic Lower Extremity Ulcers

“…Novel biological therapies may regulate and reverse the possible mechanism of wound imbalance 31 , 32 . au-PRP-released growth factors and antibacterial peptides can increase antibacterial effects and promote diabetic wound repair, as well as relieve wound pain 23 , 24 , 33 – 35 . A systematic review and meta-analysis involving 431 participants with diabetic ulcers in eight randomized controlled trails indicated a significantly increased ratio of complete ulcer healing and reduced areas of ulcers under the treatment of au-PRP 36 .…”

“…In particular, au-PRP can enhance healing in the treatment of diabetic-associated foot ulcers 21 , 22 . Our previous clinical and basic studies suggest that au-PRP not only plays a role in stimulating soft tissue regeneration but also shows biological antibacterial properties in the treatment of diabetic foot ulcers with severe infection 23 , 24 . However, patients with DLEUs usually have severe complications and comorbidities.…”

<p>Limb Salvage and Prevention of Ulcer Recurrence in a Chronic Refractory Diabetic Foot Osteomyelitis</p>

“…26 Moreover, PRP also demonstrated antibacterial and anti-inflammatory roles in diabetic wounds. [27][28][29][30] In this case, the topical application of APG accelerated wound healing. Combined with the application of NPWT, bilayered acellular matrix grafting, and split-thickness skin grafting, APG shows obvious effectiveness in foot necrotizing fasciitis and gaseous gangrene.…”

Growth Factors Delivery System for Skin Regeneration: An Advanced Wound Dressing

“…The presence of these factors and of many others allow one to consider the PL not only a good substitute of FBS for in vitro cell cultures, but in particular a key player in the activation of in vivo regenerative processes. Platelet-derived products, such as PRP, PL, platelet gel, have been used to promote wound healing in the clinical practice for therapy of skin ulcers, osteoarticular regeneration, low back pain management and as antibacterial agent [36][37][38][39]. Considering the controversial literature data [40][41][42][43] on the effectiveness of the PRP, we figured that the inconsistency of the published results was most probably due to a poor quality of PRP produced by inadequate and uncontrolled procedures and to the extreme variability of the PRP product prepared from a single blood donation without considering the significant inter-individual variability in the platelet concentration of human plasma and the variability within the same individual, according to his health status.…”