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| ADVANCES IN STEM CELL THERAPY Table. Common Growth Factors Found in Platelet-Rich Plasma 'JCSPCMBTU HSPXUI GBDUPS *OTVMJO MJLF HSPXUI GBDUPS FGF IGF *OUFSGFSPOT "MQIB (BNNB * " * ( *OUFSMFVLJO *- 1MBUFMFU EFSJWFE BOHJPHFOFTJT GBDUPS 1MBUFMFU EFSJWFE FQJEFSNBM HSPXUI GBDUPS 1MBUFMFU EFSJWFE HSPXUI GBDUPS BB CC BC 1MBUFMFU GBDUPS 1 TFMFDUJO 5SBOTGPSNJOH HSPXUI GBDUPS # # are capable of consistently concen- trating platelets to high-density therapeutic levels, including the >ÀÛiÃÌÊ/iVhnolo}iiÃÊ-m>ÀÌÊ*,i*ÓÊ centrifugation system (harvest- tech.com), which has been cleared LÞÊÌhiÊ °ÊÊ The Inflammatory Cascade *latelets contain a significant num- ber of growth factors, key signal proteins, chemokines, cytokines, and other proinflammatory bioac- tive factors that initiate and reg- ulate most basic aspects of the inflammatory cascade, resulting in natural wound healing (Table).ÎÇ UÊ liÛ>Ìi`Ê «l>ÌiliÌÊ VonVinÌÀ>- tions are known to stimu- late proliferation and differ- entiation, recruitment, and migration of mesenchymal and stromal repair cells to an injury site.38 UÊ iÀVÕl>Ìin}Ê«l>ÌiliÌÃ]ÊÜhinÊ>VÌi- vated, begin a degranulation process that secretes a variety of important growth factors and cytokines/chemokines.Î9 UÊActivated platelets also secrete stromal cell-derived factor 1 >l«h>Ê - -£>®]Ê ÜhiVhÊ ÃÕ«- ports primary adhesion and migration of mesenchymal stem/stromal cells.40 26 PDAF PDEGF PDGF 1' (.1 5(' # 5(' # Platelet’s Role in Wound Healing In many human stem/stromal cell protocols and some ÛiÌiÀin>ÀÞÊ ÃÌimÊ VillÊ «ÀoÌoVolÃ]Ê with and without stem/stromal cell additives, that have proven effective in acute and chronic full-thick- ness wound defects. Stimulation of the inflammatory cascade, coupled with the addition of AD-SC, remark- ably shortens the healing process by promoting tissue regeneration (see Figure 3).41 RESEARCH ÕlÌi«liÊ ÃÌÕ`iiÃ]Ê LoÌhÊ inÊ ÌhiÊ hÕm>nÊ >n`Ê ÛiÌiÀin>ÀÞÊ literature, have clearly demonstrated the ability of AD-SCs to actively participate in tissue homeostasis, regeneration, and open wound healing.{Ó-Èx AD-SCs also differentiate into and repair musculoskeletal con- nective tissue, including: UÊ i}>minÌ UÊ/in`on UÊ >ÀÌil>}i A B with AD-SC for placement into specific injury sites. /hiÀiÊ>ÀiÊ>lÃoÊm>nÞÊiÝ>m«liÃÊovÊÕÌiliâ>ÌionÊovÊ *,*Ê iÃÊ VomLini`Ê *,*]Ê C D Figure 3. Use of high-density platelet-rich plasma in equine open wound defect: (A) Pre-operative avulsion, 4-degree tissue loss, bone surface exposed, wound 8 days old; (B) postoperative wound at 48 hours with 1 sharp debridement and thrombin-activated HDPRP topical concentrate; (C) postoperative wound on day 8 with 2 debridements plus second activated HDPRP topical concentrate; (D) split-thickness skin graft taken from left chest, suture fixed, and meshed, with activated HDPRP under graft and plate- let-poor plasma as fibrin gel on surface. Today’s Veterinary Practice July/August 2011