Growth factors released from activated platelets initiate and modulate wound healing in both soft and hard tissues. A recent strategy to promote the wound-healing cascade is to prepare an autologous platelet concentrate suspended in plasma, also known as platelet-rich plasma, that contains growth factors and administer it to wound sites. The purpose of this study was to quantitate platelet number and growth factors released from a prepared platelet concentrate. Whole blood was drawn from 10 healthy patients undergoing cosmetic surgery and concentrated into platelet-rich plasma. Platelet counts on whole blood and platelet-rich plasma were determined using a Cell-Dyn 3200. Platelet-derived growth factor-BB, transforming growth factor-β1, vascular endothelial growth factor, endothelial growth factor, and insulin-like growth factor-1 were measured in the platelet-rich plasma using the enzyme-linked immunosorbent assay method. In addition, platelet activation during the concentration procedure was analyzed by measuring P selectin values in blood serum. An 8-fold increase in platelet concentration was found in the platelet-rich plasma compared with that of whole blood (baseline whole blood, 197 ± 42 × 103 platelets/μl; platelet concentrate, 1600 ± 330 × 103 platelets/μl). The concentration of growth factors also increased with increasing platelet number. However, growth factor concentration varied from patient to patient. On average for the whole blood as compared with platelet-rich plasma, the platelet-derived growth factor-BB concentration increased from 3.3 ± 0.9 ng/ml to 17 ± 8 ng/ml, transforming growth factor-β1 concentration increased from 35 ± 8 ng/ml to 120 ± 42 ng/ml, vascular endothelial growth factor concentration increased from 155 ± 110 pg/ml to 955 ± 1030 pg/ml, and endothelial growth factor concentration increased from 129 ± 61 pg/ml to 470 ± 320 pg/ml. No increase was found for insulin-like growth factor-1. In addition, no increase in platelet activation occurred during the concentration procedure as determined by the platelet surface receptor P selectin (45 ± 16 pg/ml to 52 ± 11 pg/ml, p = 0.65). In conclusion, a variety of potentially therapeutic growth factors were detected and released from the platelets in significant levels in platelet-rich plasma preparations. Sufficient concentrates and release of these growth factors through autologous platelet gels may be capable of expediting wound healing in a variety of as yet undetermined specific wound applications.
Indianapolis and Warsaw, Ind.
From the Division of Plastic Surgery, Indiana University School of Medicine, and Biomet.
Received for publication July 7, 2003; revised November 19, 2003.
Barry L. Eppley, M.D., D.M.D., Division of Plastic Surgery, Indiana University School of Medicine, 702 Barnhill Drive, Suite 3540, Indianapolis, Ind. 46202, email@example.com