PRP Strattice

Incisional hernia continues to be a common complication of hernia repair in spite of the development of various synthetic and bio-synthetic repair materials. Poor long-term mechanical strength, leading to high recurrence rates, has limited the use of acellular dermal matrices (ADM) in ventral hernia repair (VHR). Biologically-derived meshes have been an area of increasing interest, but these materials bring the risk of more aggressive immune response and fibrosis in addition to the mechanical failures suffered by synthetic materials. Platelet rich plasma (PRP), a growth factor rich autologous blood product, has been shown to improve early neovascularization, tissue deposition, and to decrease rates of recurrence. Here, we demonstrate that platelet-rich plasma promotes release of growth factors SDF-1, TGFβ, and PDGF in a dose-dependent manner. Additionally, we show that platelet-rich plasma promotes angiogenesis both in vitro and in vivo, corresponding with increased expression of VEGF and COL1a. Finally, we show that the molecular and cellular activity initiated by platelet-rich plasma results in increased mechanical stiffness of the hernia repair mesh over time. Collectively, these data represent an important step in demonstrating the utility and the mechanism of platelet-derived plasma in biomaterial-aided wound healing and provide promising pre-clinical data that suggest such materials may improve surgical outcomes. The data below in two Excel sheets and three Prism files contain the raw data for our in vitro and in vivo experiments.

尽管各类合成与生物合成修补材料已取得长足发展，切口疝仍是疝修补术后常见的并发症。脱细胞真皮基质（acellular dermal matrices, ADM）因长期机械性能欠佳，导致复发率居高不下，这限制了其在腹疝修补（ventral hernia repair, VHR）中的应用。生物源性补片一直是研究热点，但这类材料除了会出现合成材料固有的机械失效问题外，还可能引发更强烈的免疫反应与纤维化。富血小板血浆（platelet rich plasma, PRP）是一种富含生长因子的自体血液制品，已有研究证实其可促进早期新生血管形成与组织沉积，并降低复发率。本研究证实，富血小板血浆可通过剂量依赖性方式促进生长因子SDF-1、TGFβ及PDGF的释放。此外，本研究还发现富血小板血浆可在体外与体内环境中促进血管生成，这与VEGF及COL1a的表达上调相一致。最终，本研究证实富血小板血浆介导的分子与细胞活性，可随时间推移提升疝修补补片的机械刚度。综上，本研究数据为阐明富血小板血浆在生物材料辅助创面愈合中的效用与作用机制提供了重要依据，并为其有望改善手术预后提供了极具前景的临床前数据。本研究的体外与体内实验原始数据，收录于下文的两份Excel表格与三份Prism文件中。