Plasma rich in growth factors (PRGF-Endoret) stimulates corneal wound healing and reduces haze formation after PRK surgery

Abstract

This study evaluated the efficacy of Plasma rich in growth factors (PRGF-Endoret) on the corneal wound healing process after Photorefractive keratectomy (PRK). To address this, blood from three healthy donors was collected, centrifuged and, the whole plasma column (WP) and the plasma fraction with the highest platelet concentration (F3) were collected. The effects of F3 and WP on the proliferation and migration of human corneal epithelial cells (HCE) were analyzed. PRK was performed on C57BL/6 mice. Animals were divided in three treatment groups: Control, F3, and WP. Corneal wound healing and haze formation were evaluated macroscopically. Eyes were collected at 1, 2, 3, and 7 days after surgery, and were processed for histological studies. Immunofluorescence was used to assess cellular proliferation, apoptosis and myofibroblast transformation in the mouse cornea. Results showed a significant increased on proliferation and wound healing after F3 and WP treatment when compared with control group. In vivo studies showed significant reduction on haze formation in mice treated with both PRGF-Endoret formulations (F3 and WP). Histological studies showed an increase of epithelial cell proliferation in corneas of control group, promoting an epithelial hyperplasia. The number of SMA-positive cells (corresponding to myofibroblast differentiation) was significantly lower in the PRGF-Endoret group than in the control group, correlating with the higher transparence results observed macroscopically in both PRGF-Endoret groups. According to this, it can be concluded that PRGF-Endoret accelerates corneal tissue regeneration after PRK, reducing haze formation.

Keywords: Corneal epithelial cells; ECM; EGF; ELISA; Enzyme-linked immunosorbent assay; Epithelial growth factor; Extracellular matrix; FBS; FGF; Fetal bovine serum; Fibroblast growth factor; HCE; NGF; Nerve growth factor; PBS; PDGF; PRGF-Endoret; PRK; PRP; Phosphate buffered saline; Photorefractive keratectomy; Plasma Rich in Growth Factors; Platelet-derived growth factor; SMA; Smooth muscle actin; TGF; TUNEL assay; Terminal deoxyribonucleotidyl transferase-mediated dUTP-fluorescein Nick-End labeling assay; Transforming growth factor-beta; cornea; myofibroblast; plasma rich in growth factors; platelet-rich plasma; wound healing.