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Int J Med Sci 2018; 15(3):238-247. doi:10.7150/ijms.22563

Research Paper

Platelet-Rich Plasma Injection in Burn Scar Areas Alleviates Neuropathic Scar Pain

Shu-Hung Huang^1,2,3,4,5, Sheng-Hua Wu^6,7,8, Su-Shin Lee^1,2,3,4, Yun-Nan Lin^1,2, Chee-Yin Chai⁹, Chung-Sheng Lai^1,2, Hui-Min David Wang^3,10✉

1. Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
2. Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
3. Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan
4. Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
5. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
6. Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
7. Department of Anesthesiology, Kaohsiung Muncipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
8. Department of Anesthesiology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
9. Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
10. Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung 402, Taiwan

Abstract

Objective: No effective treatments have yet been developed for burn-induced neuropathic pain. Platelet-rich plasma (PRP) has been reported to ameliorate various types of inflammation pain. However, the effect of PRP on burn-induced neuropathic pain is unclear.

Methods: Burn-induced neuropathic pain Sprague-Dawley rat model was confirmed using a mechanical response test 4 weeks after the burn injuries were sustained, following which PRP was injected in the scar area. The rats were divided into four groups (n = 6) as following: Group A, Sham; Group B, Sham + PRP; Group C, Burn; and Group D, Burn + PRP. Four weeks after the PRP injection, the animals were subjected to behavior tests and then sacrificed; specimens were collected for inflammation tests, Masson's trichrome stain and chromosome 10 (PTEN) in the injured skin; and PTEN, phosphorylated mammalian target of rapamycin (p-mTOR), p38, nuclear factor κB (NFκB), chemokine (CC motif) ligand 2 (CCL2), and CCL2 cognate receptor (CCR2) in spinal cord dorsal horns through immunohistochemistry and immunofluorescence staining.

Results: PRP significantly alleviated allodynia in burn-induced neuropathic pain 4 weeks after treatment, and PTEN expression in the skin and spinal cord were significantly increased in group D compared with the group C. p-PTEN, p-mTOR, and CCL2 expression in neuron cells; p-p38 and p-NFκB expression in microglia; and p-JNK and p-NFκB activation in spinal astrocytes decreased significantly in the group D compared with the group C.

Conclusions: PRP is effective in treating burn-induced neuropathic pain and may be used in clinical practice.

Keywords: PRP, Burn, Scar, Neuropathic Pain