改良型富血小板纤维蛋白的研究进展

Research progress of modified platelet-rich fibrin

本文通过论述近20年来,血小板浓缩物从第一代产品富血小板血浆(PRP)富含生长因子的血浆发展到第二代产品富血小板纤维蛋白(PRF),进展到现在的改良型富血小板纤维蛋白(A-PRF)等第三代产品以及血小板制品。介绍A-PRF的制备方法以及所具有的一系列生物学特征,比如A-PRF具有柔性纤维蛋白网的自体产物作为支架,在血管生成、成骨和这些生物材料在组织再生中的抗菌潜力中增加细胞迁移。在第三代血小板浓缩物中,整个生理纤维蛋白基质的方案更容易、更便宜、更快,从而形成三维网格,不像第一代那样刚性。A-PRF允许分子在较长时间内缓慢释放,并触发损伤部位的愈合和再生过程。A-PRF模仿伤口愈合的生理学和免疫学的潜力也是由于以下高浓度的生长因子释放:血管内皮生长因子,血小板衍生生长因子,转化生长因子-β,以及刺激组织愈合,血管形成和骨细胞增殖和分化的抗炎细胞因子。此外,中性粒细胞和单核/巨噬细胞的数量增加,释放重要的趋化分子,如趋化因子配体-5和eotaxin。最后探讨A-PRF在未来的临床应用的领域及效果预判,包括组织再生,骨缺损的修复和其他患者的溃疡/皮肤坏死甚至整形手术。最后对A-PRF研究存在的问题进行说明。

In this paper,we discuss the development of platelet concentrates from the first generation of platelet-rich plasma(PRP)rich in growth factors to the second generation of platelet-rich fibrin(PRF),to the third generation of modified platelet-rich fibrin(A-PRF)and platelet products in the past 20 years.The preparation method of A-PRF and A series of biological characteristics of A-PRF are described.For example,A-PRF has the autologous product of flexible fibrin mesh as A scaffold,which increases cell migration in angiogenesis,osteogenesis,and the antibacterial potential of these biomaterials in tissue regeneration.In the third generation of platelet concentrates,the scheme of the entire physiological fibrin matrix is easier,cheaper,and faster,resulting in a three-dimensional grid that is not as rigid as the first generation.A-prf allows the molecule to be released slowly over A longer period of time and triggers the healing and regeneration process at the damaged site.The potential of A-PRF to mimic the physiology and immunology of wound healing is also due to high concentrations of the following growth factors released:vascular endothelial growth factor,platelet-derived growth factor,transforming growth factor-beta,and anti-inflammatory cytokines that stimulate tissue healing,angiogenesis,and bone cell proliferation and differentiation.In addition,the number of neutrophils and mononuclear/macrophages increases,releasing important chemokine molecules such as chemokine ligand-5 and eotaxin.Finally,the future clinical applications of A-PRF,including tissue regeneration,bone defect repair and other patients with ulcer/skin necrosis and even plastic surgery,will be discussed.Finally,the problems existing in A-PRF research are explained.