What is the Difference Between Platelet Rich Plasma and Platelet Poor Plasma? Is there any benefit of using Platelet Poor Plasma (PPP)?

What is the Difference Between Platelet Rich Plasma and Platelet Poor Plasma?
And

Is there any benefit of using Platelet Poor Plasma (PPP)? 

While I am still searching for a similar study to the one below on dry eye patients, it appears PPP is also beneficial to dry eye patients as it also contains growth factors, cytokines, and chemokines which help with wound healing. The concentration of growth factors are not as high as in PRP, but in the studies below, they noted a significant effect of PPP on periodontal (dental) ligament cell populations (ie, dental mucous membranes) (Ref 1) and bone grafts respectively (Ref 2).

I suspect the same effect would be true on ocular membrane cells. 

We have recently been giving PPP to our PRP drop patients so as not to throw out the remaining PPP. We have seen good effects of PRP drops in about 98% of patients. I do not believe PPP causes any harm and I suspect it helps when the initial PRP drops run out.

Thus, when you get PRP drops or injections under the care of your surgeon, talk to your surgeon about taking the Platelet Poor Plasma with you in sterile bottles to also use for dry eye symptoms. 

SLC

References:

1. 

Clinical Oral Investigations

pp 1–9| Cite as

Comparative effect of platelet-rich plasma, platelet-poor plasma, and fetal bovine serum on the proliferative response of periodontal ligament cell subpopulations

The proliferative effects reported here may be attributed to the growth factors present in both platelet-derived fractions [20, 45]. In previous studies, we have described that both PRP and PPP contain a similar protein profile that includes at least 40 different growth factors and active biomolecules [23]. Growth factors as PDGF isoforms (AA, AB, BB), EFG, and FGF-2 were identified using proteomic arrays and ELISA analyses. Those factors were present in both fractions. However, lower amounts of EGF and PDGFs were found on PPP fraction.

PRP and PPP harvesting protocols

PRP or PPP were obtained using a commercial kit (GPS®III, Platelet Concentration System, Warsaw, IN, USA) from three male healthy volunteers (age range 20–22 years) different from periodontal ligament donors, who signed a written informed consent following a protocol approved by the Ethical Committee at Pontificia Universidad Católica de Chile. Briefly, 30 mL of venous blood from each donor was collected into the GPS III system and centrifuged at 3200 RPM (2300 ± 40×g, the g force was calculated at the maximum RCF of the Drucker 230 V 50–60-Hz centrifuge, Biomet Biologicals, Warsaw, IN, USA) for 15 min, according to manufacturer’s instructions.

Subsequently, PPP was collected through the side port number 2 (yellow cap) of the GPS III device. Then, PRP was collected, using a syringe cross the port number 3 (red cap) of the GPS III device [25]. Both plasmatic fractions were placed in sterile plastic centrifuge tubes. To induce platelet activation, samples were incubated with 1% CaCl2 and thrombin from the same donor (10% of final volume) for 1 h at 37 °C. Later, both fractions were centrifuged for 10 min at 3200 RPM and supernatants were collected, filtered, aliquoted (500 μL) without pooling between donors and finally frozen at − 80 °C until their use [19].

2. 

Journal of Oral and Maxillofacial Surgery

Volume 76, Issue 10, October 2018, Pages 2097-2102

Dental implants

Influence of Platelet-Poor Plasma on Angiogenesis and Maintenance of Volume in Autogenous Bone Grafts

Author links open overlay panelJonas DantasBatistaPhD∗Pedro HenriqueJustino Oliveira LimirioPhD†Flaviana SoaresRochaPhD‡Camilla ChristianGomes MouraPhD§DarcenyZanetta-BarbosaPhD‖PaulaDechichiPhD¶

Purpose

The aim of this study was to evaluate the effect of different storage media on angiogenesisand maintaining autogenous bone graft volume in rabbits.

Material and Methods

Two grafts were removed bilaterally from the calvaria of 18 rabbits. One graft was removed and immediately fixed in the right mandibular angle (control group). The other graft was stored for 30 minutes in 1 of the following storage media (n = 6): saline solution (saline group), air exposure (dry group), or platelet-poor plasma (PPP group) and then retained by a screw in the right mandibular angle in the same animal. Four weeks later the animals were euthanized, and the grafted areas were harvested, fixed in 10% phosphate buffered formaldehyde solution, and embedded in paraffin. The 5-μm semi-serial sections were stained in hematoxylin and eosin and Mallory trichrome.

Results

Histologic analysis of all groups showed the bone graft was vascularized and well incorporated into the recipient site. The number of blood vessels decreased in the saline and dry groups compared with the control group (P < .03); in contrast, the number of blood vessels increased in the PPP group (P < .05). There were fewer osteoclasts in the saline group compared with the control group (P < .05). Furthermore, the saline group showed larger numbers of blood vessels than the dry group (P < .01). The PPP group showed larger bone graft volumes compared with the dry and saline groups (P < .01). In addition, the saline group showed larger bone graft volumes than the dry group (P < .01).

Conclusions

PPP improved angiogenesis, maintained the volume of the autogenous bone graft, and was a better storage medium during the trans-surgical period than the dry and saline media.

The present study showed that PPP used as storage medium in the trans-surgical period improved angiogenesis and maintenance of bone volume in autogenous bone grafts compared with saline and dry media. Thus, PPP could be an interesting alternative for graft storage in the trans-surgical period.

The present findings could be related to the vascular endothelial growth factor (VEGF) found in PPP.13 VEGF recruits hematopoietic stem cells to the ischemic site from bone marrow through circulation, produces capillary plexuses, and eventually forms mature vessels, leading to new vessels for vascular supply in ischemic limbs.14 Some studies have reported that VEGF stimulates endothelial cell proliferation and migration, which results in angiogenesis.14, 15