Activated PRP versus PRGF (ie ENDORET®)
This is for a patient who asked what the difference is between PRP and PRGF.
The answer: it appears to be the same.
Platelet Rich Plasma as is typically used by most doctors and surgeon in the US.
The issue is the following:
1. PRP technically is just platelets and not activated with Calcium Chloride (see Ref 1 paper).
2. PRGF is activated PRP which means generally calcium choride was added as noted in below published protocol from Reference 1.
Activated PRP is what is used in the majority of PRP injection cases to my knowledge in the US.
Thus activated PRP is the same as PRGF.
It appears that the authors of the papers on PRGF or Endoret® had a significant vested interest. Either way activated PRP and PRGF do work to help patients with dry eye.
Be sure your surgeon is using activate PRP.
http://bti-biotechnologyinstitute.com/us/regenerative-medicine/applications-endoret/ophthalmology/
Reference 1:
Correspondence
Searching for the best blood-derived eye drops
Sir,
We have read with great interest the article by Than et al1 regarding the use of fingerprick autologous blood (FAB) as an alternative treatment for dry eye syndrome (DES). Sixteen patients diagnosed with DES were treated with FAB, 11 of whom had Sjögren syndrome, obtaining good results for the different clinical variables evaluated. The treatment dosage was four times daily for eight weeks.
We commend the authors’ search of a low-cost and readily accessible treatment for this type of syndrome. At the same time, we would like to offer some commentaries and additional perspectives to the study.1
First, our experience is that, in order to achieve optimal therapeutic effects, it would be recommended that the concentrations of platelets and growth factors would be greater than those obtained in whole blood. A good example of that is platelet-rich plasma (PRP),2 a therapy in which platelets are concentrated in a volume of plasma. Furthermore, we speculate that if platelet activation is not completed in FAB, the amount of platelet-derived growth factors would be lower than even autologous serum (AS).
Second, the authors should clarify whether there is platelet activation in the ocular surface, or whether it does not always occur, for example due to the clearance of FAB. The authors state that clots are observed in some patients, but this should be generalized so that the method is reproducible. Recent studies carried out on ocular surface cells show that the biological activity of non-activated PRP is lower than AS or other activated PRPs, such as plasma rich in growth factors (PRGF).3
Third, it is important to highlight that most of the patients (11/16) had been diagnosed with Sjögren syndrome, a long-term autoimmune disease in which the already exacerbated inflammatory component of DES is accentuated.4 An interesting approach for these cases might be to perform an inactivation protocol of immune components in the eye drops, preserving most of the biologically active molecules while reducing immunoglobulin content and complement activity.5
Last but not least, there are other issues to be considered, including the drawback of not using a standardized ready-to-use product, the large amount of fingerpricks delivered (448 fingerpricks in 8 weeks), and the variability of capillary blood.6
We strongly encourage the authors to further deepen research in the FAB mechanisms of action and product composition in order to optimize the treatment and improve the quality of life of DES patients, thus offering a fully characterized product.
References
- 1.Than J, Balal S, Wawrzynski J, Nesaratnam N, Saleh GM, Moore J et al. Fingerprick autologous blood: a novel treatment for dry eye syndrome. Eye (Lond) 2017; 31: 1655–1663.
- 2.Anitua E, de la Fuente M, Muruzabal F, Riestra A, Merayo-Lloves J, Orive G. Plasma rich in growth factors (PRGF) eye drops stimulates scarless regeneration compared to autologous serum in the ocular surface stromal fibroblasts. Exp Eye Res 2015; 135: 118–126.
- 3.Freire V, Andollo N, Etxebarria J, Hernaez-Moya R, Duran JA, Morales MC. Corneal wound healing promoted by 3 blood derivatives: an in vitro and in vivo comparative study. Cornea 2014; 33(6): 614–620.
- 4.Barabino S, Chen Y, Chauhan S, Dana R. Ocular surface immunity: homeostatic mechanisms and their disruption in dry eye disease. Prog Retin Eye Res 2012; 31(3): 271–285.
- 5.Sanchez-Avila RM, Merayo-Lloves J, Riestra AC, Anitua E, Muruzabal F, Orive G et al. The effect of immunologically safe plasma rich in growth factor eye drops in patients with Sjogren syndrome. J Ocul Pharmacol Ther 2017; 33(5): 391–399.
- 6.Bond MM, Richards-Kortum RR. Drop-to-drop variation in the cellular components of fingerprick blood: implications for point-of-care diagnostic development. Am J Clin Pathol 2015; 144(6): 885–894.
Author information
Affiliations
Foundation Eduardo Anitua, Vitoria, Spain
- E Anitua
- , R Prado
- , F Muruzabal
- & G Orive
Biotechnology Institute (BTI), Vitoria, Spain
- E Anitua
- , R Prado
- , F Muruzabal
- & G Orive
University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- E Anitua
- , R Prado
- , F Muruzabal
- & G Orive
Competing interests
The authors declare that EA is the Scientific Director of and GO, RP, and FM are scientists at BTI Biotechnology Institute, a biomedical company that investigates in the fields of oral implantology and PRGF-Endoret technology.
J Ocul Pharmacol Ther. 2017 Jun;33(5):391-399. doi: 10.1089/jop.2016.0166. Epub 2017 Apr 4.
The Effect of Immunologically Safe Plasma Rich in Growth Factor Eye Drops in Patients with Sjögren Syndrome.
Sanchez-Avila RM1, Merayo-Lloves J1, Riestra AC1, Anitua E2,3, Muruzabal F2,3, Orive G3,4,5, Fernández-Vega L1.
Author information
- 1
- 1 Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universdiad de Oviedo, Oviedo, Spain .
- 2
- 2 Fundación Eduardo Anitua, Vitoria, Spain .
- 3
- 3 Biotechnology Institute (BTI) , Vitoria, Spain .
- 4
- 4 NanoBioCel Group, Laboratory of Pharmaceutics, University of the Basque Country , School of Pharmacy, Vitoria, Spain .
- 5
- 5 Biomedical Research Networking Center in Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN), Vitoria, Spain .
Abstract
PURPOSE:
METHODS:
RESULTS:
CONCLUSIONS:
Cornea. 2015 Sep;34(9):1144-8. doi: 10.1097/ICO.0000000000000489.
Preservation of Biological Activity of Plasma and Platelet-Derived Eye Drops After Their Different Time and Temperature Conditions of Storage.
Abstract
PURPOSE:
METHODS:
RESULTS:
CONCLUSIONS:
PRGF Sample Preparation PRGF eye drops from each donor were obtained using the Endoret-Ophthalmology kit (BTI Biotechnology Institute, SL, Miñano, Álava, Spain).
Plasma rich in growth factors (PRGF) is an autologous platelet-rich plasma based on the use of the patient’s own blood, and the resulting therapeutic formulations derived from this technology contain a wide variety of growth factors, proteins, and biomaterials involved in tissue regeneration. The effectiveness, significant clinical advantages, and safety of this approach have been deeply demonstrated in several medical fields.2–5 In fact, PRGF provides a pool of biologically active proteins and growth factors, including plateletderived growth factor-AB (PDGF-AB), transforming growth factor-b1 (TGF-b1), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), thrombospondin-1 (TSP-1), and angiopoietin-1 (ANG-1) among others. These proteins are involved in a range of biological processes, including cell recruitment, growth, and differentiation.6,7
The authors declare the following competing financial interest(s): E.A. is the Scientific Director of and G.O. and F.M. are scientists at BTI Biotechnology Institute, a dental implant company that investigates in the fields of oral implantology and PRGF-Endoret technology
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