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A blog for all biological and medical ephemera, from the age of Abraham through the era of medical quackery and cure-all nostrums. Biomedical Ephemera by Arallyn is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Platelet-rich plasma (PRP) (also known as blood injection therapy)) is a medical treatment being used for a wide range of musculoskeletal problems. Blood injection therapy of this type has been used for knee osteoarthritis, degenerative cartilage, spinal fusion, bone fractures that don’t heal, and poor wound healing. Platelets are part of the blood that circulate around the body ready to help with blood clotting should you have a cut, broken bone, injury that bleeds internally, or any other type of injury. PRP treatment might also be used on the skin where delayed wound healing has created a site open to infection or for a pressure ulcer that is open and draining.
Since the early 1990s, it has been injected into non-healing tendon tears, fibrosed (scarred) tendons, and osteoarthritic knees.
The main purpose of platelet-rich plasma injection is to foster healing where it has not otherwise occurred or to speed up healing as in the case of an acute injury.
The procedure can be used non-surgically when treating tennis elbow, muscle injuries, joint osteoarthritis, or cartilage degeneration.
Treatment with platelet-rich plasma is broken down into two steps: preparing the platelet-rich plasma for injection and then injection into the affected area. For open incision or arthroscopic surgeries, such as labral and meniscal repairs or tendon or ligament repairs, the PRP is placed around the anchors and sutures holding the soft tissues together. Early attempts to use this procedure contained four times the normal amount of platelets but surgeons have found they can use far less than that to achieve the same result.
Immediately after the procedure, you will remain lying down and under observation for a few minutes up to a half an hour. Once you return home, you can use ice over the injected area, elevate the leg or arm, and limit your activities as much as needed to remain comfortable. The most surprising aspect of recovery after treatment with platelet-rich plasma is the speed of recovery. Similar findings have been observed in a small number of patients participating in a pilot study when platelet-rich plasma was used during surgery to repair ruptured Achilles tendons and rotator cuff tears. In some programs where platelet-rich plasma injections have been used for tendon problems, patients were allowed to do light activities after a second injection given 15 days after the first injection. You may see a physical therapist after this procedure to help you regain motion, strength, motor control, and function.
Niemann Pick Disease type C (NPC) is an autosomal recessive lipidosis that is characterized by lysosomal storage of cholesterol and glycosphingolipids.
In NPC cells, LDL-derived cholesterol accumulates in lysosomes and endosomes, LDL-cholesterol transport from endocytic compartments to other cellular compartments is delayed, and LDL does not elicit normal homeostatic responses.
We have extended our studies with NPC mouse model in order to study the central nervous system phenotype. This is caused due to a deficiency of available calcium (either because of a lack of vitamin D to process the calcium, or a primary deficiency of calcium), leading to a lack of joint mineralization.

Featuring illustrations, history, and totally useless trivia from the diverse realms of nature and medicine. Platelet-rich plasma refers to a sample of serum (blood) plasma that has as much as four times more than the normal amount of platelets. This treatment technique is fairly new in the sports medicine treatment of musculoskeletal problems, but gaining popularity quickly.
Besides containing clotting factors, the platelets release growth factors that help start the healing sequence. Patients with non-healing ulcers from poor circulation related to diabetes, paralysis, and immobility, and chronic neurologic disorders may be able to receive gel treatments to achieve healing. It’s even being tried on hernias, labral (shoulder cartilage) tears, meniscal tears of the knee, and ankle sprains. Anyone with a condition called thrombocytopenia (low platelet levels), anyone with a history of cancer, and women who are pregnant or breast-feeding will not qualify. Most non-surgical procedures can be done on an outpatient basis, usually in the office setting. The surgeon may use imaging such as fluoroscopy (real-time, 3-D X-rays) or dynamic musculoskeletal ultrasound to place the needle that delivers the PRP directly into the joint or other area of injury. Tiny clots form quickly, then the surgeon ties the sutures down reducing the tear, thus trapping the PRP clot in the repair site. You might have some discomfort in the area of the injection that can last a few days up to a week. Your doctor may suggest using Tylenol for pain relief but ibuprofen or other anti-inflammatories are not advised. For example, high-level athletes find they are able to return to full sports participation and competitive play in half the time expected for acute tendon injuries and with no bad side effects and no scar tissue or adhesions.
In normal mammalian cells, low-density lipoprotein (LDL) is bound and internalized by cell surface receptors and is hydrolyzed in the endocytic compartment.
The NPC1 gene has been cloned, but the biological function of the NPC1 protein has not been determined. Some of these infants will die from liver disease within 2 years; in others, the liver dysfunction will resolve. The NPC1 specific antisense oligonucleotide has been delivered to the cerebrospinal fluid of the mouse brain. This treatment enhances the body’s natural ability to heal itself and is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries. With a concentrated amount of platelets, larger quantities of these growth factors are released to stimulate a natural healing response. Connective tissues such as ligaments and tendons heal by filling in with scar tissue that doesn’t bear the brunt of large loads well. Because the growth factors released by the platelets can stimulate bone mineralization, platelet-rich plasma may help a break in a bone that isn’t healing. Some surgeons are using it more and more with any orthopedic surgery involving the soft tissues to augment (reinforce) bone or ligamentous graft materials already being used.

For example, studies show that after using the platelet-rich plasma (PRP) for tendon problems, new tendon cells (called tenocytes) start to develop in the area treated.
Thrombocytopenia can occur with drug treatment for blood clotting disorders, rheumatoid arthritis, or some forms of chemotherapy for cancer.
When used during surgery, platelet-rich plasma is inserted in the area where the healing needs to be enhanced before the wound is closed. You will not be asleep or anesthetized unless the plasma is applied during a surgical procedure.
That’s because the treatment is designed to set up an inflammatory response, so you don’t want to stop that process with medications.
Physical therapists are working with surgeons on a patient-by-patient basis to determine what might be best for each individual.
The cholesterol that is released is transported to the cell surface and endoplasmic reticulum.
The knockdown mice are currently being studied to determine whether NPC1 knockdown is widespread and whether there is resultant neurodegeneration and loss of learning and motor skills. Plasma is the clear portion of the blood in which all the other blood particles such as platelets, red blood cells, and white blood cells travel. The use of blood thinners such as Coumadin or Warfarin and the presence of infection in the wound site are also contraindications (reasons why platelet-rich plasma is not an option for you).
PRP is added to enhance ligament or tendon repairs such as anterior cruciate ligament (ACL) reconstruction, rotator cuff repairs, or Achilles tendon repair. Developing optimal tendon healing and muscle strength, will be a priority especially in high-level professional athletes who are eager to get back into the game. At present, no therapies exist that delay the onset of neurological or hepatic symptoms or reduce the severity of NPC disease. Other available treatments for chronic tendon problems do not necessarily improve the tendon’s ability to heal in the same way that PRP does. Our work is focused on the NPC1 gene, mutation of which is responsible for 95% of disease cases.
And injections of PRP don’t have the side effects that can occur with steroid injections or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs). The mechanism by which NPC1 protein dysfunction leads to liver disease and unknown. The NPC liver disease is propagated through the tumor necrosis factor (TNF) inflammatory pathway. Lighter particles (plasma without platelets or blood cells) make up the top layer in the test tube.

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