Presentacion PRP y Ozono Parte I Ingles

PRP and ozone in orthopedics and sports medicine, face rejuvenation and hair loss
Sara Maria Alfaro MD, physiatris, bioregulatory systems medicine, ozonetherapy

General Information
• Blood: is a specialized bodily fluid that delivers necessary substances to the body’s
cells – such as nutrients and oxygen – and transport waste product away from
those same cells.
• Blood consist of cells and extracellular components. These two tissue fractions are
represented by: formed elements and blood plasma.
Osmotic Balance, pH buffering action
Defense
Coagulation - Immunoglobulin
Osmotic Balance,
Na+, Ca+2, Mg+2, Cl-, HCO3- pH buffering action,
Regulation of Membrane -
Permeability
Glucose, amino acids and fatty acids, etc
(dissolved in the blood or bound to plasma proteins),
and removes waste products, such as carbon dioxide,
urea and lactic acid.
HISTORY OF USE OF PRP PRPGF
Platelet concentrated to accelerate the healing process

First describd in 1994 by Tayapongsak y cols. aplicaron por primera vez la innovadora idea del material adhesivo de fibrina
autólogo para favorecer la integración de injertos óseos en la reconstrucción de defectos mandibulares. En el estudio se muestra
como produjeron su adhesivo de fibrina en un laboratorio sanguineo, al separar una unidad de sangre entera en dos
componentes, uno de celulas rojas y otra fraccion de plasma para su empleo como crioprecipitado sobre las 2-3 semanas
siguientes. Ante las diferencias observadas dependiendo de la tecnica empleada para obtener este plasma
In 1999, Dr. Eduardo Anitua began to work in Spain with growth factors in
collaboration with the orthopedist, Dr. Miquel Sánchez, demonstrating the
regenerative nature of these factors on musculoskeletal tissues.
2002 , Dr. A. Alexandre (Treviso, Italy) presented a multicenter study on a sample of 6
665 patients treated with percutaneous discolysis with ozone giving a result of 81% of
abolition of pain and 12.5% of improvement.
Dr. Fernando Kirchner for the first time in 2012, applied Ozonated Growth Factors in
the vertebral disc while performing the traditional discolysis with ozone. His results
were more than good, 85% of resolution.
TYPES OF HUMAN
CELLS
1.Labile cells. multiply throughout life. bone
marrow, the lymphoid tissues, the skin, and the
linings of most ducts and hollow organs of the
body.
2.Stable cells, do not multiply continuously but

can do so when necessary. the liver, in many of
the glands , such as the pancreas and salivary
glands, in the lining of the kidney tubules, and in
the connective tissues. Normally these cells do
not divide unless some are destroyed by disease
or injury and must be replaced.
3.Permanent cells, incapable of multiplication

in the adult—only the permanent cells are
incapable of regeneration. These are the brain
cells and the cells of the skeletal and heart
muscles. When damaged are substituted with
fibrotic tissue.
Repair and regeneration
REGENERATION By
replacing damaged or
destroyed cells with healthy
new cells, identical to the
original cells.
REPAIR consists of the
formation of scar tissue.
Scar tissue is not identical
to any tissue in the body.
However, it does fill the
damaged tissue and allows
some functionality. the
processes of repair and
regeneration work to restore
an individual’s health after
injury
BASES FOR THE USE OF OZONATED PRP TO ENHANCE HEALING OF WOUNDS
The healing mechanism potentiation induced by supra-

physiological concentrations of autologous platelets in
damaged tissue or surgical site has been demonstrated
both in basic and clinical studies.
Due to the high concentration and release of these factors
the PRP can potentially increase recruitment and
proliferation of stem cells and endothelials.
The ozone promotes platelet aggregation and the release
of factors with mitogenic, angiogenic, cytoprotective and
chemotactic properties, especially when using heparin as
an anticoagulant; a significant increase of PDGF (platelet-
derived growth factor), TGF -β1 (Transforming Growth
Factor β1), eicosanoids and interleukin 8 (IL-8) is observed.
Studies on the biological effects of ozone: 10. Release of factors from ozonated human platelets G. Valacchi and
Velio BocciCA Institute of General Physiology, University of Siena, 53100 Siena Italy
Ozone (O3 ) can promote platelet aggregation particularly when heparin is used as an anticoagulant :
this observation is not surprising in the light of previous results showing the role of reactive oxygen
species (ROS) in platelet activation. In contrast, Ca2+ chelation with citrate markedly inhibits
aggregation. Thus, the selection of the most appropriate anticoagulant becomes crucial when blood
is intended to be used for autotransfusion (O3 -AHT) after being briefly exposed to a gas mixture
composed of about 97% oxygen and 3% ozone. It is known that platelets are a rich source of several
growth factors such as platelet-derive d growth factor (PDGF),transforming growth factor b 1 (TGF-b
1), eicosanoids and interleukins (IL).
O2 and O3 delivery to biological samples A predetermined volume of the O2 /O3 gas mixture at three
O3 concentrations (20, 40 and 80 m g/ml per ml of PRP) was collected with a silicone coated
disposable syringe and immediately introduced into a second syringe containing an equivalent
volume of PRP via a ‘y’ connector
We have now shown that two important healing factors, namely PDGF and TGFb 1, increase markedly
during incubation particularly in heparinized PRP samples exposed to a concentration of 40 and 80
mg/ml of O3 .
platelet aggregation corresponds to either 20±6%or as much as 68±14%for O3 concentrations of
either 40 or 80 m g/ml, respectively. The former O3 concentration still does allow an important
release of growth factors with no risk of blood coagulation and therefore may represent the optimal
O3 concentration.
Particularly PTG values decreased in approximate relation with the O3
concentration while TBARS values increased several folds (Fig.1).
Moreover we have observed that oxidation of PTG is far higher in
heparinized that Ca2+ chelated samples suggesting that physiological
Ca2+ levels favour ROS activity. Indeed intragroup analysis showed a
significant difference at a medium (40 m g/ml) and at a high (80 m
g/ml) O3 concentration.
Ozonated PRP and growth factor in the treatment of disc herniation and
discartrosis lumbar spine.
The purpose of this paper is to demonstrate the effectiveness and safety of ozone on the herniated disc and
the healing and restorative effect of ozonated growth factors on degenerated or damaged spinal disc
herniation,. We conducted a clinical study performing a monocentric, prospective, nonrandomized
intervention with ozone and ozonated Platelet Rich Plasma (PRPO3) . Sixty patients at an age range of 35 to 82
years who attended the consultation of Fiorela Clinical Institute (San Pedro Sula , Honduras) from July 2012 to
January 2013 were treated for severe lumbo-sciatica with an intensity of 7-8, according to the Visual Analogue
Scale (VAS). Patients diagnosed with lumbar disc herniation and degenerative disc syndrome, according to
recent magnetic resonance (not more than six months) were selected. In these 60 patients were performed
150 PRPO3 discolysis.
The Autologous Platelet Rich Plasma (PRP) was prepared in closed systems (PROTEAL ®) in the operating
room by a physician specialized in its preparation and acquisition. The blood was heparinized, PRP was
ozonolyzed to 40 and 80 mg / mL and was activated with 10% Calcium Chloride.
Schwartz, A.; Meléndez, Ch.; Martínez, M. (2013). Ozone and Ozonated Growth Factors in the Treatment of
Disc Herniation and Discartrosis Lumbar Spine. Revista Española de Ozonoterapia. Vol. 3, nº 1, pp. 21-33.
Platelet or Thrombocytes: which are derived from fragmentation of precursor
megakaryocytes. The average lifespan of a platelet is normally just 7 to 10 days. Platelet pay
a fundamental role in hemostasis and are a natural source of Growth Factors. They circulate in
the blood of mammals and are involved in hemostasis leading to the formation of blood clots.
The role of growth factors is not only stimulate cell proliferation by regulating cell cycle initiating
mitosis, but also to maintain cell survival, stimulate cell migration, cell differentiation or
even apoptosis.
The role of growth factors is regulated by different mechanisms that control gene activation as:
•Transcription and translation of growth factor gene;
•The modulation signal broadcast by the receiver;
•The control of the cellular response of molecules with opposite action to the initial response.
•The control extracellular availability of growth factor that is trapped in the extracellular matrix;
Types of Growth Factors and functions
Hematology analysis (platelet) of Buffy coat and PRP(Platelet-Rich Plasma)
in sPRP system
platelet concentrate count (X

103/μl)
Baseline platelet count Platelet concentrate count Increase above

Protocol sPRP
X 103/μl X 103/μl baseline
3200rpm, Buffy
2056 ± 186.1 1190 %
1700RCF, 172 ± 9.9 coat
5min PRP 1303 ± 111.9 760 %
○ assessed number of platelet by Electronic impedance method <Stromatolyser-FB [SYSMEX, JAPAN) kit> (n=10)
○ normal platelet number : 145 ~ 375 X 103/μl
○ Buffy coat : 20cc => 1cc concentration
○ PRP : 20cc => 2cc concentration
What is PRP?
PRP (Platelet – rich Plasma): is a natural concentrate of autologous blood growth factors
experiments in different fields of medicine in order to test its potential to enhance tissue
regeneration.
Application of PRP
PRP
Cosmetic Orthopedic
Medicine
GROWTH
FACTOR
REJUVENATION HEALING PROCESS

COSMETIC:
The preparation of PRP is one of the latest beauty and rejuvenation treatments that have emerged.
Indication : Skin rejuvenation,

Skin texture & tone (whitening), face lifting / reshaping
Acne scar & Pores
Wrinkle, Dark circle
To enhance the survival rate of fat transplantation
Alopecia
The application of platelet concentrate is also very useful in the following cases:
• Wound healing and bone tissue. Acceleration in the uptake of grafts

• Dentistry In cases of implants for regeneration, healing and assimilation.
• In people with deficits in the healing process as diabetics.
• Regeneration of skin ulcers or sores.

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PRP and ozone in orthopedics and sports medicine, face rejuvenation and hair loss

Sara Maria Alfaro MD, physiatris, bioregulatory systems medicine, ozonetherapy

Platelet concentrated to accelerate the healing process

2.Stable cells, do not multiply continuously but

3.Permanent cells, incapable of multiplication

The healing mechanism potentiation induced by supra-

platelet concentrate count (X

Baseline platelet count Platelet concentrate count Increase above

REJUVENATION HEALING PROCESS

Indication : Skin rejuvenation,

• Wound healing and bone tissue. Acceleration in the uptake of grafts

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