Photoactivated PRP (PAPRP): Enhanced Effects through Light – The Future of Autologous Blood Therapy

Photoactivated PRP (PAPRP): Enhanced Effects through Light – The Future of Autologous Blood Therapy

Photoactivated PRP (PAPRP) - The revolution in regenerative medicine

Regenerative medicine has made tremendous progress in recent years, and one of the most promising developments is the photoactivation of Platelet-Rich Plasma (PRP). This innovative method, known as PAPRP, enhances the already impressive healing properties of PRP and opens up new possibilities in the treatment of various conditions. In this article you will learn all about photoactivated PRP - from the scientific principles to the clinical applications and advantages over conventional methods.

What is photoactivated PRP and how does it work?

Platelet-Rich Plasma (PRP) is a blood product that is obtained from the patient's own blood and contains a concentrated amount of blood platelets (thrombocytes). These platelets are rich in growth factors and bioactive proteins that play a crucial role in tissue healing and regeneration. PRP therapy has established itself in various medical fields, from orthopaedics to aesthetic medicine.

Photoactivated PRP (PAPRP) goes one step further. In this procedure, the PRP obtained is exposed to a special light before use - typically a polychromatic light for around 10 minutes. This irradiation with a specific wavelength of 645 nm, applied at a 60-degree angle from a distance of 3.5 cm, activates the blood platelets in a special way.

The photoactivation process differs fundamentally from conventional activation methods such as the addition of calcium chloride or thrombin. Instead of using chemical additives, photoactivation uses the properties of light to stimulate the platelets and enhance their regenerative properties. This leads to a controlled and sustained release of growth factors over a longer period of time.

The scientific basis of photoactivation is based on the principle of photobiomodulation - the ability of light to influence biological processes at the cellular level. When PRP is irradiated with light of certain wavelengths, complex biochemical reactions are triggered in the blood platelets, which increase their activity and effectiveness.

The biological mechanism behind PAPRP

To understand the revolutionary effect of photoactivated PRP, we must first consider the role of platelets in tissue healing. Platelets are not only responsible for blood clotting, but are also key players in the healing process. They contain alpha-granules filled with various growth factors and cytokines, including PDGF (Platelet-Derived Growth Factor), TGF-β (Transforming Growth Factor-beta), VEGF (Vascular Endothelial Growth Factor), EGF (Epidermal Growth Factor) and many others.

When PRP is photoactivated, something remarkable happens: the light irradiation leads to increased ATP secretion and subsequently to an increased release of calcium in the blood platelets. These biochemical changes trigger a cascade of events, including the formation of lamellipodia (flat protrusions of the cell membrane) and numerous pilopodia (finger-shaped protrusions) as well as the agglomeration of platelets - all indicators of successful activation.

The key advantage of photoactivation is the controlled and sustained release of growth factors. While conventional activation methods often lead to a rapid but short-lived release of growth factors, PAPRP enables a more consistent release over a period of up to 28 days. This extended duration of action is particularly important for chronic conditions where prolonged regenerative stimulation is required.

In addition, photoactivated PRP affects inflammation modulation in a unique way. It increases the expression of pro-inflammatory cytokine receptors such as IL-1 Ra and IL-2 Ra and promotes beta-endorphin photomodulation. These effects contribute to improved pain relief and inflammation control - two crucial factors for successful tissue healing.

Another fascinating aspect of PAPRP is its ability to increase the secretion of exosomes - tiny vesicles released by cells - from peripheral white blood cells, stem cells and platelets. These exosomes play an important role in cell communication and can stimulate regenerative processes in neighboring cells, thereby enhancing the healing effect of PAPRP.

Advantages of photoactivated PRP compared to standard PRP

Photoactivation offers numerous advantages over conventional PRP activation methods, making PAPRP a superior option for many medical applications.

1. Improved and more sustainable release of growth factors

One of the most significant advantages of PAPRP is the controlled and long-lasting release of growth factors. Scientific studies have shown that photoactivated PRP enables an activation-dependent, sustained release of growth factors over a period of up to 28 days. In contrast, conventional activation methods such as thrombin or calcium chloride lead to a rapid but short-lived release that subsides within a few hours or days.

This prolonged duration of action is particularly important in chronic conditions such as osteoarthritis, where continuous regenerative stimulation is required to achieve long-term improvements.

Growth factors

2. No dense fibrin matrix

Conventional activation methods such as thrombin lead to the formation of a dense fibrin matrix, which can hinder cell migration and thus healing. Bovine thrombin, for example, quickly forms a dense fibrin matrix, which initially releases a high concentration of growth factors, but can restrict the movement of cells in the tissue.

Photoactivated PRP, on the other hand, does not form such a dense matrix and allows for better cell migration and interaction in the treated tissue, which can contribute to more effective healing.

3. Reduced pain through beta-endorphin modulation

A notable benefit of PAPRP is its ability to modulate the production of beta-endorphins. These endogenous painkillers contribute to improved pain relief after treatment. Patients treated with photoactivated PRP often report less pain compared to conventional PRP treatments.

This light has been found to be an invaluable resource for achieving excellent results. It dramatically reduces inflammation, increases the production of natural painkillers and appears to enhance PRP or stem cells at work."

4. No need for chemical activators

Conventional PRP activation methods use chemical additives such as calcium chloride (CaCl) or bovine thrombin. These additives can have potential disadvantages, such as allergic reactions with bovine thrombin or limited usage time due to rapid compaction of the product.

Photoactivated PRP does not require the addition of external chemical agents, which minimizes the risk of adverse reactions and preserves the purity of the autologous product.

5. Regulatory advantages

An often overlooked but important benefit of PAPRP relates to regulatory issues. According to FDA guidelines, blood drawn from an individual and returned to the same individual as Platelet-Rich Plasma is not subject to HCT/P regulation under 21 CFR Part 1271 because it is a blood product.

However, the addition of a chemical activator such as CaCl or thrombin may be considered "more than minimal manipulation" under this law, which could lead to regulatory complications. Photoactivation, on the other hand, is NOT considered more than minimal manipulation, making PAPRP a more legally straightforward option.

Areas of application of PAPRP in medicine

The versatile regenerative properties of photoactivated PRP make it a valuable treatment option in various medical fields. From orthopaedics to aesthetic medicine, PAPRP shows impressive results in a variety of diseases and conditions.

- PAPRP in orthopaedics and sports medicine

One of the most well-studied applications of PA-PRP is for the treatment of knee osteoarthritis. Clinical studies have shown that photoactivated PRP can produce significant improvements in pain, stiffness, and functionality in patients with knee osteoarthritis.

A double-blind, randomized, controlled pilot study by Paterson et al. (2016) compared PA-PRP with hyaluronic acid (HA) in 37 individuals with knee osteoarthritis. The PA-PRP group showed significant improvements in the visual analog scale for pain, the KOOS pain score, and the knee quality of life (KQoL) in both physical and emotional terms. Functional improvements in hopping and squatting were also observed, while the HA group showed only limited improvements.

A larger prospective study of 232 patients, conducted by Mohiuddin et al. (2018), confirmed these results. After 12 months of treatment with PA-PRP, patients showed a significant reduction in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score from 31.21 to 11.82 on average, indicating significant improvements in pain, stiffness and physical function.

PAPRP in orthopaedics and sports medicine

- Treatment of tendon injuries

Tendon injuries, especially chronic tendinopathies, often respond well to PRP treatments. Photoactivated PRP offers particular advantages here due to its long-lasting release of growth factors, which are crucial for tendon regeneration.

In conditions such as Achilles tendinitis, tennis elbow (lateral epicondylitis) or golfer's elbow (medial epicondylitis), PAPRP can accelerate healing and reduce pain. The controlled modulation of inflammation by PAPRP is particularly beneficial in these conditions where a balance between pro- and anti-inflammatory processes is required for optimal healing.

Tendon injuries

- Use for muscle injuries

Muscle injuries are common in athletes and can cause long downtimes. PAPRP can promote muscle regeneration and shorten healing time. The growth factors in photoactivated PRP stimulate the proliferation and differentiation of muscle stem cells (satellite cells) and promote angiogenesis (formation of new blood vessels), which is crucial for muscle repair.

PRP for muscle injuries

- Regeneration of ligament damage

Ligaments have a limited healing capacity due to their limited blood supply. PAPRP can support the regeneration of ligament tissue by providing growth factors that stimulate collagen synthesis and improve tissue structure. For injuries such as ligament sprains or tears, PAPRP can be used as a complementary treatment to accelerate healing and restore functionality.

PRP for torn ligaments

PAPRP in aesthetic medicine and dermatology

- Regeneration of ligament damage

The versatile regenerative properties of photoactivated PRP make it a valuable treatment option in various medical fields. From orthopaedics to aesthetic medicine, PAPRP shows impressive results in a variety of diseases and conditions.

PAPRP in aesthetic medicine and dermatology

- Treatment of hair loss

PRP treatments have been shown to be effective in the treatment of androgenetic alopecia (hereditary hair loss). Photoactivated PRP could further enhance this effect. The growth factors in PAPRP stimulate the hair follicles, prolonging the growth phase of the hair cycle and promoting the formation of new blood vessels around the follicles.

The long-lasting release of growth factors by PAPRP is particularly beneficial in the treatment of hair loss, as continuous stimulation of the hair follicles is required for optimal results.

- Therapy for melasma and hyperpigmentation

A randomized double-blind study by Demir and Altun (2024) investigated the efficacy of photoactivated PRP compared to classic PRP in the treatment of melasma, a common hyperpigmentation disorder. Both treatments resulted in significant improvements, but patients treated with photoactivated PRP showed a higher tendency towards a 25-50% reduction in MASI (Melasma Area and Severity Index) scores.

The number of patients with a 25-50% reduction in MASI scores after treatment with photoactivated PRP was 1.7 times higher compared to the classic PRP group, suggesting a superior potential of PAPRP in the treatment of pigmentary disorders.

- Scar treatment and tightening

PAPRP can also be used in the treatment of acne scars, surgical scars and stretch marks. The regenerative properties of photoactivated PRP promote tissue repair and remodeling, resulting in improved scar structure and appearance.

Combining PAPRP with techniques such as microneedling can further enhance its effectiveness by delivering the growth factors deeper into the skin and further stimulating collagen production.

Other medical applications

1. Dentistry and oral surgery

In dentistry, PRP is used to promote bone regeneration after tooth extractions, for implants and for periodontal treatments. Photoactivated PRP could optimize these applications through its improved and more sustainable effect.

The growth factors in PAPRP promote osteogenesis (bone formation) and soft tissue healing, which can lead to better results in dental procedures.

PAPRP in aesthetic medicine and dermatology

- Wound healing for chronic wounds

Chronic wounds, such as diabetic foot ulcers or pressure ulcers, pose a significant medical challenge. PAPRP can promote wound healing through several mechanisms: stimulation of cell proliferation, promotion of angiogenesis, modulation of inflammation and provision of a matrix for cell migration.

The prolonged release of growth factors by photoactivated PRP is particularly beneficial in chronic wounds that require continuous regenerative stimulation.

- Potential in neuroregeneration

An emerging field of application for PAPRP is neuroregeneration. Preliminary research suggests that the growth factors contained in PRP can support the regeneration of nerve tissue. Photoactivation could enhance these neuroprotective and neuroregenerative effects, making PAPRP a potential treatment option for nerve injuries and neurodegenerative diseases.

Scientific evidence for the effectiveness of PAPRP

The growing number of scientific studies provides convincing evidence of the efficacy and safety of photoactivated PRP in various clinical applications.

Clinical studies on PAPRP for knee osteoarthritis

One of the most comprehensive studies on PA-PRP in knee osteoarthritis is the aforementioned double-blind, randomized, controlled pilot study by Paterson et al. (2016). This study compared PA-PRP with hyaluronic acid in 37 people with knee osteoarthritis and found significant improvements in the PA-PRP group in

  • Visual Analog Scale for Pain (p < 0.01, ETA = 0.686)
  • KOOS Pain (p < 0.05, ETA = 0.624)
  • KQoL Physical (p < 0.05, ETA = 0.706)
  • KQoL Emotional (p < 0.05, ETA = 0.715)

Functional improvements in jumping (p < 0.05, ETA = 0.799) and squatting (p < 0.01, ETA = 0.756) were also observed. The authors concluded that PA-PRP could be a safe and effective treatment option for knee osteoarthritis.

A larger prospective study by Mohiuddin et al. (2018) with 232 patients confirmed these results. After 12 months of treatment with PA-PRP, patients showed a significant reduction in WOMAC score from an average of 31.21 to 11.82, indicating significant improvements in pain, stiffness and physical function.

Research results in the field of dermatology

In the field of dermatology, the randomized double-blind study by Demir and Altun (2024) provides important insights into the efficacy of photoactivated PRP for melasma. The study compared photoactivated PRP with classic PRP in 38 female patients with melasma and found that both treatments led to significant improvements.

Interestingly, patients treated with photoactivated PRP showed a higher tendency towards a 25-50% reduction in MASI scores. The number of patients with such improvement was 1.7 times higher in the photoactivated PRP group than in the classic PRP group, although this difference was not statistically significant, possibly due to the limited sample size.

Comparative studies between activated and non-activated PRP

he systematic review and meta-analysis by Simental-Mendía et al. (2023) investigated the clinical efficacy of activated versus non-activated PRP in the treatment of knee osteoarthritis. The analysis included 14 clinical studies with a total of 1292 participants.

The results showed that exogenously activated PRP provided significant pain relief (SMD, -1.05 [95% CI -1,58 bis -0,52]; p = 0,0001) und funktionelle Verbesserung (SMD, -1,21 [95% CI -1,75 bis -0,67]; p < 0.0001). These improvements were not observed in studies with non-activated PRP.

This meta-analysis provides strong evidence that activation of PRP - including photoactivation - is critical for optimal clinical outcomes.

Laboratory studies on growth factor release

A study in the European Journal of Pharmaceutics and Biopharmaceutics (2020) investigated the sustained release of growth factors from photoactivated PRP. The researchers found that PRP was successfully activated by photoactivation and showed a sustained release of growth factors over a period of 28 days.

After photoactivation, ATP secretion and subsequently calcium release increased significantly. Photostimulation triggered lamellipodia expansion, numerous pilopodia formation and platelet agglomeration as activation indicators.

These laboratory results support the mechanism by which PAPRP achieves its clinical benefits and confirm the long-lasting effect of photoactivation.

The PAPRP treatment process: what patients can expect

For patients considering PAPRP treatment, it is important to understand how the process works and what they can expect.

PAPRP treatment

1. Preparation for the treatment

Before a PAPRP treatment, the patient should have a detailed consultation with the attending physician. The medical history, current medications and expectations will be discussed. The doctor will explain whether PAPRP is suitable for the patient's specific condition and what results can realistically be expected.

Certain medications, especially non-steroidal anti-inflammatory drugs (NSAIDs), should be discontinued 2-3 days prior to treatment as they can affect platelet function. Alcohol and nicotine should also be avoided 24-48 hours before treatment in order to achieve optimal results.

2. Blood sampling and PRP collection

On the day of treatment, a small amount of blood is first taken from the patient's vein using PRP tubes (typically 15-60 ml, depending on the type of treatment). This blood is then placed in a special PRP centrifuge, which separates the different blood components.

The platelets are concentrated through the centrifugation process, resulting in platelet-rich plasma. Depending on the application, the PRP can be processed differently to obtain different concentrations of platelets, white blood cells and other blood components.

3. The photoactivation process

Once the PRP has been obtained, the crucial step of photoactivation follows. The PRP is exposed to polychromatic light in a special device for around 10 minutes. This light has a specific wavelength of 645 nm and is applied at a 60-degree angle from a distance of 3.5 cm.

During this process, the platelets are activated without the need for chemical additives. The photoactivation triggers biochemical reactions in the platelets that lead to a controlled and sustained release of growth factors.

4. The injection or application

After photoactivation, the PAPRP is ready for use. There are different application methods depending on the treatment area:

  • Injection: for orthopaedic applications, such as the treatment of knee osteoarthritis or tendon injuries, the PAPRP is injected directly into the affected tissue. The doctor can use ultrasound to ensure the exact placement of the injection.
  • Topical application: For certain dermatologic treatments, PAPRP may be applied topically to the skin, often in combination with microneedling to improve penetration.
  • Infiltration: For scar treatments or hair loss, PAPRP can be infiltrated into the affected areas to promote local regeneration.

The application itself is usually quick and involves minimal discomfort. For injections, a local anaesthetic can be used to minimize pain.

5. Aftercare and expected results

After PAPRP treatment, patients can usually go home immediately. It is recommended to rest the treated area for 24-48 hours and to avoid excessive strain. Slight pain, swelling or redness at the injection site is normal and usually subsides within a few days.

The results of PAPRP treatment develop gradually over weeks and months as the regenerative processes take time. For orthopedic applications, patients often report a gradual improvement in pain and function over 4-6 weeks. For dermatologic treatments, improvements in skin texture and quality may become visible after 3-4 weeks.

The number of treatments required varies depending on the condition and individual response. For many treatments, 2-3 treatments 4-6 weeks apart are recommended, followed by maintenance treatments as needed.

Frequently asked questions about photoactivated PRP

The growing number of scientific studies provides convincing evidence of the efficacy and safety of photoactivated PRP in various clinical applications.

FAQ PAPRP

Is the PAPRP treatment painful?

The PAPRP treatment is usually associated with minimal pain. The blood collection is comparable to a routine blood test. A brief period of discomfort may occur during the injection, but this can be minimized by using a local anaesthetic. Mild pain or swelling may occur after the treatment, which usually subsides within a few days.

One advantage of PAPRP over conventional PRP is the improved beta-endorphin modulation, which can contribute to a reduced sensation of pain after treatment.

How many treatments are necessary?

The number of treatments required depends on the specific condition, its severity and the patient's individual response. For most orthopaedic applications, 2-3 treatments at 4-6 week intervals are recommended. For dermatologic applications, 3-4 treatments spaced 3-4 weeks apart may be optimal.

Chronic conditions such as advanced osteoarthritis may require regular maintenance treatments, typically every 6-12 months, to maintain results.

How long do the results last?

The duration of results varies depending on the application and individual factors. For orthopedic applications such as knee osteoarthritis, benefits can last 6-12 months or longer. Clinical studies of PAPRP for knee osteoarthritis have shown significant improvements lasting over 12 months.

For dermatologic applications, results can last 12-18 months, depending on factors such as age, lifestyle and skin care habits. The more sustained release of growth factors by PAPRP could lead to longer lasting results compared to conventional PRP.

Are there any side effects or risks?

PAPRP is a very safe treatment with minimal risks, as it is an autologous product (obtained from the patient's own blood). The most common side effects are slight pain, swelling or redness at the injection site, which usually subside within a few days.

Compared to conventional PRP activation methods, PAPRP offers the advantage that no chemical additives such as bovine thrombin are used, which could trigger allergic reactions.

Serious complications are extremely rare. As with any injection, there is a very small risk of infection, which is minimized by strict aseptic techniques.

Who is PAPRP suitable for and who is it not suitable for?

PAPRP may be suitable for a variety of patients suffering from conditions that could benefit from regenerative therapies, such as osteoarthritis, tendon injuries, skin problems or hair loss.

The treatment may not be suitable for:

  • Patients with certain blood disorders or low platelet counts
  • People with active infections or fever
  • Patients with cancer
  • Pregnant or breastfeeding women (due to lack of study data)
  • People taking certain anticoagulants that cannot be temporarily discontinued

A thorough consultation with a qualified physician is critical to determine if PAPRP is appropriate for a particular patient.

How does PAPRP differ from other regenerative therapies?

PAPRP differs from other regenerative therapies such as stem cell therapy, hyaluronic acid injections or corticosteroid injections in several ways:

  • Compared to stem cell therapy: while both approaches have regenerative properties, PAPRP is less invasive, less expensive and has fewer regulatory hurdles. PAPRP can also work synergistically with stem cell therapies by creating a favorable environment for stem cell survival and differentiation.
  • Compared to hyaluronic acid: Hyaluronic acid acts mainly as a joint lubricant and shock absorber, while PAPRP actively promotes regenerative processes. Studies have shown that PRP can provide better long-term results than hyaluronic acid in knee osteoarthritis, and photoactivation could further enhance these benefits.
  • Compared to corticosteroids: Corticosteroids provide rapid inflammation and pain relief, but can damage tissue with repeated use. PAPRP, on the other hand, promotes healing and regeneration and can provide more long-term benefits without damaging the tissue.

Conclusion: The future of regenerative medicine with PAPRP

Photoactivated PRP represents a significant advance in regenerative medicine. By harnessing the power of light to activate platelets, PAPRP offers numerous advantages over traditional PRP methods, including a more sustained release of growth factors, improved pain relief and no need for chemical additives.

Growing scientific evidence supports the efficacy and safety of PAPRP in various applications, from the treatment of knee osteoarthritis to dermatologic procedures. Clinical studies show significant improvements in pain, function and quality of life in patients treated with photoactivated PRP.

The future of PAPRP looks promising, with ongoing research investigating its potential in new areas of application such as neuroregeneration and the treatment of chronic wounds. Standardized protocols for photoactivation and personalized treatment approaches could further improve efficacy.

As a minimally invasive, low-risk autologous therapy with potentially significant benefits, PAPRP could play an increasingly important role in the future of regenerative medicine. For patients seeking alternative or complementary treatments for chronic conditions, photoactivated PRP offers a promising option that utilizes and enhances the body's natural healing processes.

FAQ PAPRP

Scientific studies and references

Paterson KL, Nicholls M, Bennell KL, Bates D. Intra-articular injection of photo-activated platelet-rich plasma in patients with knee osteoarthritis: a double-blind, randomized controlled pilot study. BMC Musculoskelet Disord. 2016;17:67. doi:10.1186/s12891-016-0920-3

Mohiuddin AKM, Lewis P, Choudhury KN, Sadiq BU. Clinical outcome of photoactivated platelet-rich plasma in the treatment of knee osteoarthritis. Regen Med Ther. 2018;4(1):2-4. doi:10.15761/ROM.1000162

Simental-Mendía M, Sánchez-García A, Vilchez-Cavazos F, Acosta-Olivo CA, Peña-Martínez VM, Simental-Mendía LE. Comparison of the clinical effectiveness of activated and non-activated platelet-rich plasma in the treatment of knee osteoarthritis: a systematic review and meta-analysis. Clin Rheumatol. 2023;42(3):681-690. doi:10.1007/s10067-022-06445-z

Demir FT, Altun E. Comparison of platelet-rich plasma efficacy with and without photoactivation in melasma: a randomized double-blind study. J Cosmet Dermatol. 2024. doi:10.1111/jocd.16540

Sustained release of growth factors from photoactivated PRP. European Journal of Pharmaceutics and Biopharmaceutics. 2020;148:67-76.

Photo-activated platelet-rich plasma based patient-specific bio-ink for cartilage tissue engineering. Biomedical Materials. 2020;15(6).

Cavallo C, Roffi A, Grigolo B, et al. Platelet-Rich Plasma: The Choice of Activation Method Affects the Release of Bioactive Molecules. Biomed Res Int. 2016;2016:6591717. doi:10.1155/2016/6591717

Zhao L, Hu M, Xiao Q, et al. Efficacy and safety of platelet-rich plasma in melasma: a systematic review and meta-analysis. Dermatol Ther (Heidelberg). 2021;11(5):1587-1597. doi:10.1007/s13555-021-00575-z

Legal information and disclaimer

Medical disclaimer: The information contained in this article is for educational purposes only and does not constitute medical advice. It is not intended as a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with questions about a medical condition or treatment option.

Consult a physician: Before beginning any PAPRP treatment, it is important to consult a qualified physician who can assess your individual situation and determine if this therapy is appropriate for you. Only a physician can evaluate the potential risks and benefits in relation to your specific health needs.

Individualized results: The results of PAPRP treatments can vary from person to person. Factors such as age, general health, severity of the condition and individual healing ability can affect the effectiveness of the treatment. The results described in this article do not necessarily represent the typical results that all patients can expect.

Current state of research: The information in this article is based on the current state of research at the time of publication. Regenerative medicine is a rapidly evolving field, and new findings may lead to changes in recommendations or practices. Always consult current, trustworthy sources for the latest information.

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