From the Guidelines
The use of Platelet-Derived Growth Factor (PDGF) releasing nucleotides, specifically Polydeoxyribonucleotide (PDRN), induction is not recommended due to the poor quality of evidence and high risk of bias in the majority of studies. The standard protocol for PDRN induction typically includes injections of 5.625 mg PDRN in a 3 ml solution, administered 2-3 times weekly for 2-4 weeks, depending on the condition being treated. However, the evidence to support the use of PDGF is poor, with the majority of studies being assessed as being at high risk of bias 1.
Key Points to Consider
- The use of PDRN induction may involve administering PDRN through intradermal or subcutaneous injections for dermatological applications, or intramuscular or intra-articular administration for musculoskeletal conditions.
- PDRN works by binding to A2A adenosine receptors, stimulating VEGF production, enhancing fibroblast activity, and promoting angiogenesis, which can accelerate wound healing, reduce inflammation, and support tissue regeneration.
- However, the evidence from studies on PDGF, including PDRN, is inclusive, and the optimal frequency of applying the various products is unclear 1.
- Patients should be aware of the potential side effects, including temporary redness, swelling, or bruising at the injection site, and PDRN is contraindicated during pregnancy, in patients with autoimmune disorders, or those with hypersensitivity to the compound.
Clinical Decision Making
Given the poor quality of evidence and high risk of bias, the use of PDRN induction is not recommended as a routine treatment. Instead, clinicians should consider alternative treatments with stronger evidence bases and weigh the potential benefits and risks of PDRN induction on a case-by-case basis 1.
From the Research
Effect of Platelet-Derived Growth Factor (PDGF) Releasing Nucleotides
The effect of PDGF releasing nucleotides, specifically Polydeoxyribonucleotide (PDRN), induction has been studied in various research papers.
- PDRN has been shown to stimulate VEGF production during pathological conditions of low tissue perfusion, likely acting through the stimulation of A(2A) receptors 2.
- The use of PDRN has been found to be effective in experimental models of PAOD, hind limb ischemia, impaired wound healing, and burn injury 2.
- Platelet-rich plasma (PRP) has been found to have higher levels of PDGF-AB and PDGF-BB compared to whole blood, and the activation of PRP can further increase the levels of these growth factors 3.
- The growth factors released by activated PRP have been found to be significantly higher than those released by platelet-rich fibrin (PRF) 4.
- PDRN and polynucleotide (PN) have been found to improve tendon healing and reduce fatty infiltration in a diabetic rat model, with increased plasma levels of vascular endothelial growth factor and fibroblast growth factor 5.
- The mitogenic potential of PRP supernatants has been found to promote strong osteoblast and endothelial cell divisions, supporting the concept that PRPs may be beneficial in wound healing 6.
Key Findings
- PDRN induction has been found to stimulate VEGF production and improve tissue perfusion 2.
- PRP has been found to have higher levels of PDGF-AB and PDGF-BB compared to whole blood 3.
- The use of PDRN and PN has been found to improve tendon healing and reduce fatty infiltration in a diabetic rat model 5.
- The growth factors released by activated PRP have been found to be significantly higher than those released by PRF 4.
- PRP supernatants have been found to promote strong osteoblast and endothelial cell divisions, supporting the concept that PRPs may be beneficial in wound healing 6.