Which is Better: Platelet Rich Plasma (PRP) or Autologous Serum (AS). PRP vs AS

 

There is a paucity of studies comparing Preservative-Free Platelet Rich Plasma (PRP) or Preservative-Free Autologous Serum (AS) between eyes in patients with equal symptom scores. 

My clinical impression is that PRP is superior to AS in the vast majority of patients. We have had <0.1% of our patients say PRP did not help symptoms or made them feel worse (usually neuropathy patients). We have had about 3% of patients say AS did not help symptoms. I cannot recall anyone saying AS made their symptoms worse.

We have had about 15 patients who used PRP in one eye and AS in there other. Of the 15, 14 patients felt the PRP to be more effective, 1 did not notice a difference. I wonder if it has to do with autoantibodies circulating in the PRP versus AS or if it related to potential autoimmune disease, early neuropathy or diet?

More research is needed. The paper below shows PRP may be more effective than AS for ocular surface disease. 

SLC

. 2021 Nov 10;22(22):12176.

 doi: 10.3390/ijms222212176.

Proteomic Characterization of Plasma Rich in Growth Factors and Undiluted Autologous Serum

Eduardo Anitua 1 2, Francisco Muruzabal 1 2, Ander Pino 1 2, Roberto Prado 1 2, Mikel Azkargorta 3, Felix Elortza 3, Jesús Merayo-Lloves 4

Affiliations 

• PMID: 34830053
 
• PMCID: PMC8618701
 
• DOI: 10.3390/ijms222212176

Free PMC article

Abstract

Over the last three decades, there has been special interest in developing drugs that mimic the characteristics of natural tears for use it in the treatment of several ocular surface disorders. Interestingly, the composition of blood plasma is very similar to tears. Therefore, different blood-derived products like autologous serum (AS) and plasma rich in growth factors (PRGF) have been developed for the treatment of diverse ocular pathologies. However, scarce studies have been carried out to analyze the differences between both types of blood-derived products. In the present study, blood from three healthy donors was drawn and processed to obtain AS and PRGF eye drops. Then, human corneal stromal keratocytes (HK) were treated with PRGF or undiluted AS. Proteomic analysis was carried out to analyze and characterize the differential protein profiles between PRGF and AS, and the differentially expressed proteins in HK cells after PRGF and AS treatment. The results obtained in the present study show that undiluted AS induces the activation of different pathways related to an inflammatory, angiogenic, oxidative stress and scarring response in HK cells regarding PRGF. These results suggest that PRGF could be a better alternative than AS for the treatment of ocular surface disorders.

Keywords: AS; PRGF; PRP; autologous serum; cornea; keratocytes; ocular surface; plasma rich in growth factors; platelet-rich plasma; proteomic.