Abstract
Background
Combination treatments of botulinum toxin type-A and other rejuvenation agents or instruments are gradually becoming more popular. After observing a high incidence of therapy failure following simultaneous applications of botulinum toxin type-A and platelet-rich plasma mesotherapy, we aimed to investigate whether PRP has an inhibitory effect on botulinum toxin type-A.
Methods
Twenty-four New Zealand white rabbits were divided into 4 groups, and the anterior auricular muscle and overlying skin were used for injections. Groups I and II both received onabotulinumtoxinA intramuscular injections. In addition, autologous platelet-rich plasma mesotherapy was performed in Group I while Group II received saline mesotherapy. Group III was designed as the in vitro mixture group in which onabotulinumtoxinA and platelet-rich plasma were mixed and then administered intramuscularly. Group IV received saline within the mixture instead of platelet-rich plasma. The contralateral ears of all the rabbits served as control and were only treated with onabotulinumtoxinA. Visual evaluation of ear positions and electroneuromyographic studies were done prior to all procedures and at day 14. Anterior auricular muscles were harvested at day 14 and were evaluated with quantitative real-time PCR.
Results
Visual and electroneuromyographic studies revealed less onabotulinumtoxinA activity in Groups I and III. When platelet-rich plasma was administered through skin mesotherapy, onabotulinumtoxinA activity failure was more severe in comparison with direct contact. No significant difference in SNAP-25 mRNA expression through quantitative real-time PCR was observed between groups.
Conclusion
Although we could not explain the exact mechanism underlying this interaction, platelet-rich plasma applications result in less onabotulinumtoxinA muscle paralysis activity.
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References
American Society of Plastic Surgeons 2013 Plastic Surgery Statistics Report. http://www.plasticsurgery.org/Documents/news-resources/statistics/2013-statistics/cosmetic-procedures-national-trends-2013.pdf
Man D, Plosker H, Winland-Brown JE (2001) The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery. Plast Reconstr Surg 107(1):229–237
Naumann M, Carruthers A, Carruthers J et al (2010) Meta-analysis of neutralizing antibody conversion with BoNT-A (BOTOX®) across multiple indications. Mov Disord 25(13):2211–2218
Pfaffl MW, Horgan GW, Dempfle L (2002) Relative expression software tool (REST) for group wise comparison and statistical analysis of relative expression results in real-time PCR. Nucleic Acids Res 30:e36
Findikcioglu K, Findikcioglu F, Yavuzer R, Elmas C, Atabay K (2009) Effect of platelet-rich plasma and fibrin glue on healing of critical-size calvarial bone defects. J Craniofac Surg 20(1):34–40
Cho JM, Lee YH, Baek RM, Lee SW (2011) Effect of platelet-rich plasma on ultraviolet b-induced skin wrinkles in nude mice. J Plast Reconstr Aesthet Surg 64(2):e31–e39
Cervelli V, Palla L, Pascali M, De Angelis B, Curcio BC, Gentile P (2009) Autologous platelet-rich plasma mixed with purified fat graft in aesthetic plastic surgery. Aesthetic Plast Surg 33(5):716–721
Sariguney Y, Yavuzer R, Elmas C, Yenicesu I, Bolay H, Atabay K (2008) Effect of platelet-rich plasma on peripheral nerve regeneration. J Reconstr Microsurg 24(3):159–167
Kim DH, Je YJ, Kim CD, Lee YH, Seo YJ, Lee JH, Lee Y (2011) Can Platelet-rich Plasma Be Used for Skin Rejuvenation?. Evaluation of Effects of Platelet-rich Plasma on Human Dermal Fibroblast. Ann Dermatol 23(4):424–431
Bulam H, Ayhan S, Sezgin B, Özmen S, Çenetoğlu S (2013) Mesotherapy: is it a miracle or an air bubble on the tip of the needle? Turk Plast Surg 21(2):16–19
Rohrich RJ (2005) Mesotherapy: what is it? Does it work? Plast Reconstr Surg 115(5):1425
Taieb M, Gay C, Sebban S, Secnazi P (2012) Hyaluronic acid plus mannitol treatment for improved skin hydration and elasticity. J Cos-met Dermatol 11(2):87–92
Lacarrubba F, Tedeschi A, Nardone B, Micali G (2008) Mesotherapy for skin rejuvenation: assessment of the subepidermal low-echo genic band by ultrasound evaluation with cross-sectional B-mode scanning. Dermatol Ther 21(3):1–5
El-Domyati M, El-Ammawi TS, Moawad O et al (2012) Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation. Int J Dermatol 51(8):913–919
Amin SP, Phelps RG, Goldberg DJ (2006) Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation. Dermatol Surg 32(12):1467–1472
Herreros FO, Moraes AM, Velho PE (2011) Mesotherapy: a bibliographical review. An Bras Dermatol 86(1):96–101
Baker AH, Edwards DR, Murphy G (2002) Metalloproteinase inhibitors: biological actions and therapeutic opportunities. J Cell Sci 115(19):3719–3727
Miyoshi S, Shinoda S (1991) Alpha-macroglobulin-like plasma inactivator for Vibrio vulnificus metalloprotease. J Biochem 110(4):548–552
Saidi N, Samel M, Siigur J, Jensen PE (1999) Lebetase, an alpha (beta)-fibrin(ogen)olytic metalloproteinase of Viperalebetina snake venom, is inhibited by human alpha-macroglobulins. Biochim Biophys Acta 1434(1):94–102
Sjoberg J, Kanje M (1989) Insulin-like growth factor (IGF-1) as a stimulator of regeneration in the freeze-injured rat sciatic nerve. Brain Res 485:102–108
Sondell M, Lundborg G, Kanje M (1999) Vascular endothelial growth factor has neurotrophic activity and stimulates axonal outgrowth, enhancing cell survival and Schwann cell proliferation in the peripheral nervous system. J Neurosci 19:5731–5740
Jabor MA, Kaushik R, Shayani P, Ruiz-Razura A, Smith BK, Morimoto KW, Cohen BE (2003) Efficacy of reconstituted and stored botulinum toxin type A: an electrophysiologic and visual study in the auricular muscle of the rabbit. Plast Reconstr Surg 111(7):2419–2426
Elmas C, Ayhan S, Tuncer S, Erdogan D, Calguner E, Basterzï Y, Gozil R, Bahcelioglu M (2007) Effect of fresh and stored botulinum toxin a on muscle and nerve ultrastructure: an electron microscopic study. Ann Plast Surg 59(3):316–322
Gorgu M, Silistreli O, Karantinaci B, Ayhan M, Ozdemirkıran T, Celebisoy M (2006) Interaction of botulinum toxin type a with local anesthetic agents: an experimental study in rabbits. Aesth Plast Surg. 30:59–64
Capková K, Hixon MS, Pellett S, Barbieri JT, Johnson EA, Janda KD (2010) Benzylidenecyclopentenediones: first irreversible inhibitors against botulinum neurotoxin A’s zinc endopeptidase. Bioorg Med Chem Lett 20(1):206–208
Vartanian AJ, Dayan SH (2005) Complications of botulinumtoxin A use in facial rejuvenation Facial Plast. Surg Clin North Am 13(1):1–10
Acknowledgments
This study was approved by the Gazi University Ethical Committee for Experimental Research on Animals (Project no: G.U. ET-43-6865) and was financially supported by the Gazi University Research Fund (Project no: 01/2012-60).
Conflict of interest
The authors declare that they have no conflicts of interest to disclose within the blinded manuscript.
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All applicable institutional and/or national guidelines for the care and use of animals were followed.
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Bulam, H., Ayhan, S., Sezgin, B. et al. The Inhibitory Effect of Platelet-Rich Plasma on Botulinum Toxin Type-A: An Experimental Study in Rabbits. Aesth Plast Surg 39, 134–140 (2015). https://doi.org/10.1007/s00266-014-0418-z
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DOI: https://doi.org/10.1007/s00266-014-0418-z