Platelet-rich plasma : hype without substance?

[nomadreid]

TL;DR Summary

There are lots of studies concerning "platelet-rich plasma", but I am skeptical ....

I am skeptical about the scientific basis of "platelet-rich plasma" (PRP): the view expressed in https://www.painscience.com/articles/platelet-rich-plasma-does-it-work.php seems to sum up my objections, but as I am not in the medical field, I am not sure how valid such articles as https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683340/ are. (Many such articles are published, as is this one, in "open source" journals, which always rings alarm bells, but on the other hand some open source journals actually do have decent peer review.) Is there any good science behind PRP?

 

[trurle]

Summary: There are lots of studies concerning "platelet-rich plasma", but I am skeptical ...

I am skeptical about the scientific basis of "platelet-rich plasma" (PRP): the view expressed in https://www.painscience.com/articles/platelet-rich-plasma-does-it-work.php seems to sum up my objections, but as I am not in the medical field, I am not sure how valid such articles as https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683340/ are. (Many such articles are published, as is this one, in "open source" journals, which always rings alarm bells, but on the other hand some open source journals actually do have decent peer review.) Is there any good science behind PRP?

The story of PRP treatment controversy is actually very similar to glucosamine treatment controversy or placenta injection controversy. Seems in some cases (the dental surgery most likely) PRP treatment can be justified, but a lot of pressure do exist to try newly available treatment against just every malady, resulting in string of treatment failures. Please wait 20-30 years until medics will agree on the area of applicability (or its absence) of PRP treatment.

 

[nomadreid]

Thanks, trurle. So your "dental surgery most likely" seems to indicate that perhaps the justification given in the paper I cited: "The platelets contained in this concentrate of autologous plasma release their alpha granules after the coagulation process has been locally trigged in the wound site. These alpha granules contain a cocktail of growth factors which promote proliferation, chemotaxis and the differentiation of cells, which are essential to osteogenesis. Thus, besides its procoagulant effect, PRP is a source of growth factors involved in initiating and sustaining wound healing by accelerating bone repair, promoting fibroblast proliferation, and increasing tissue vascularity" might have some validity? That is, while I am waiting for a consensus and enough long-term studies, should I consider that the causal explanation could be a valid one? That is, there are lots of theories offering explanations that I know enough about to be able to either dismiss or to say "that might hold water", but my expertise in biology is close to nil, so that I cannot judge this one: are you saying that this explanation is out of the "silly" category and into the "could be" category?

 

[jim mcnamara]

No, it is merely a clinical observation based on smaller numbers. It is not a controlled trial. There are other clinical trials for this that do not indicate usefulness in other procedures. So, there is no medical justification for using it, unless you are a licensed dentist doing certain procedures. And then it is discretionary.

You are deriving too much science. Medicine/dentistry is both art and a science.
Learn about this here:
https://www.pharmaco-vigilance.eu/content/discrepancies-between-observational-studies-and-randomized-controlled-trial

 

[nomadreid]

Thanks, jim mcnamara, but the link you gave is broken ("page not found")

 

[jim mcnamara]

Interesting. I cannot get to it either. Hmm.

 

[Tom.G]

Append the letter 's' to the end of the link and it works.
https://www.pharmaco-vigilance.eu/c...onal-studies-and-randomized-controlled-trials

 

[nomadreid]

Thanks, Tom.G. I got it. Now I can say to jim mcnamara: thanks, a relevant article.