Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2024 | Month : April | Volume : 18 | Issue : 4 | Page : ZC05 - ZC08 Full Version

Vitronectin Levels in Leukocyte-platelet Rich Fibrin, Injectable-platelet Rich Fibrin, and Serum: A Cross-sectional Study


Published: April 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/69728.19251
Anirudh B Acharya, Aditi Lokhande, Swetha Acharya, Mihir Kulkarni, Srinath Thakur

1. Assistant Professor, Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates. 2. Consultant; Private Practitioner (Periodontics), Bengaluru, Karnataka, India. 3. Research Scholar, Department of Oral Pathology, JSS Dental College, Mysuru, Karnataka, India. 4. Associate Professor, Department of Periodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India. 5. Former Professor, Department of Periodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India.

Correspondence Address :
Dr. Anirudh B Acharya,
Assistant Professor, Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
E-mail: abacharya@gmail.com

Abstract

Introduction: Platelet-rich Fibrin (PRF) is an autologous platelet concentrate preparation containing several proteins that aid in healing. Vitronectin is one of these proteins that has not been quantified in all types of PRF. Various protocols have been suggested to alter the yield of different components of PRF to enhance wound healing. Hence, it is beneficial to know the vitronectin levels in PRF.

Aim: To detect, estimate, and compare the levels of vitronectin in two PRF protocols and serum.

Materials and Methods: The present cross-sectional study conducted in the Department of Periodontics at the SDM College of Dental Sciences and Hospital. Dharwad, Karnataka, India from January 2019 to June 2020 involved 12 systemically and periodontally healthy volunteers. Blood was obtained from each volunteer to collect and prepare serum, Leukocyte-PRF (L-PRF), and injectable-PRF (i-PRF), respectively. Three distinct samples-supernatant, exudate, and clot-were collected and categorised into seven groups (L-PRF supernatant, L-PRF exudate, L-PRF clot, i-PRF supernatant, i-PRF exudate, i-PRF clot, blood serum) that were assayed for levels of vitronectin. The data were statistically analysed using the independent t-test, one-way Analysis of Variance (ANOVA), and Newman-Keuls Post-hoc procedures.

Results: The mean age was 24.92±2.57 years. Vitronectin was detected and estimated in all the samples. Vitronectin levels ranged from 64.09±0.04 ng/mL to 64.20±0.21 ng/mL. One-way ANOVA applied to test between and within groups was significant (p=0.049). A statistically significant difference was observed only between L-PRF exudate and serum (p=0.05).

Conclusion: The comparable levels of vitronectin in L-PRF and i-PRF observed in present study suggest that vitronectin in these two PRF protocols may aid wound healing.

Keywords

Blood platelets, Blood protein, Enzyme-linked immunosorbent assay, Glycoprotein, Wound healing

Wound healing and tissue regeneration are intricate processes involving cellular and extracellular processes, and molecular signaling (1). Evidence regarding all aspects of these mechanisms is in continuing areas of research, but it is understood that platelets play a pivotal role. Platelet concentrates/platelet gels {thrombin-activated autologous Platelet-rich Plasma (PRP)} as topical applications (sometimes in combination with grafting biomaterials) have been employed in periodontal therapy (2). Platelets contribute to healing because they contain growth factors that influence the cell cycle, induction, differentiation, collagen production, vascularisation, and cell recruitment at the wound site (3), thereby being the rationale for using preparations containing platelets to boost wound healing, repair, and regeneration (4). These growth factors encompass a group of polypeptides with low molecular weights such as Platelet-derived Growth Factor (PDGF), Vascular Endothelial Growth Factor (VEGF), Epidermal Growth Factor (EGF), Transforming Growth Factor (TGF), and Insulin-like Growth Factor (IGF) that have properties contributing to cellular functions in wound healing and regenerative mechanisms [5,6]. Therefore, platelet concentrates like PRP and PRF are being routinely applied in periodontics and implant dentistry.

The use of PRP was first reported by Whitman DH et al., showing pronounced advantages because it could enhance osteoprogenitor cells in bone (7). However, PRP posed antigenic risks as it required the use of bovine thrombin. PRF, introduced by Choukroun J et al., is now a widely used platelet concentrate (8). It contains an autologous fibrin matrix and is more advantageous than PRP because it is strictly autologous, easy to prepare, and does not require biochemical handling of the blood (9). Various proteins and polypeptides present in PRF, and their concentrations are found to vary compared with serum or plasma. These substances have various physiological roles and can be hypothetically harvested differentially via variations in PRF preparation protocols. Vitronectin is a serum protein with multifunctional capabilities, primarily produced in the liver, and has been defined as an S-protein (a circulating 75 kDa glycoprotein) (10). It is homologous to adhesive proteins like fibrinogen, fibronectin, and von Willebrand factor, which are pro-coagulant, interacting with platelets and the vessel wall. Vitronectin is an important matrix-associated regulator of blood coagulation because it can bind heparin, plasminogen, Plasminogen Activator inhibitors (PA), and Thrombinantithrombin III (TAT) complexes (11). Vitronectin is derived from serum, readily binds proteoglycans in the extracellular matrix, and is found in tissues (12).

Considering the role of vitronectin in wound healing and regeneration, it is of interest to quantify this polypeptide in PRF. Also, an awareness of any particular PRF protocol that demonstrates an optimal concentration of vitronectin will be of clinical utility, clarifying its potential contribution to periodontal outcomes. Evidence exists regarding the measure of vitronectin in blood serum (12), but to the best of our knowledge, no investigations have reported the quantity of vitronectin in all PRF protocols. Therefore, the present study aimed to investigate PRF and blood serum with the objectives of detection, estimation, and comparison of vitronectin in L-PRF, i-PRF, and blood serum.

Material and Methods

The cross-sectional study was conducted in the Department of Periodontics at the SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India, from January 2019 to June 2020. The study protocol was in accordance with the Declaration of Helsinki of 1975 and its subsequent revisions in 2013. Ethical clearance was obtained from the Institutional Ethical Committee (IRB No. 2018/P/PERIO/68), and informed written consent was obtained from all participants before their enrollment in the study.

Inclusion and Exclusion criteia: Anamnesis, medical/dental/periodontal examinations, and blood collection were carried out on 12 volunteers (an equal number of males and females) with the inclusion criteria of being between 18-30 years of age and being systemically and periodontally healthy. Exclusion criteria included volunteers taking antibiotics, anti-inflammatory drugs, or other medications (such as anticoagulants, antiplatelets, antiresorptives) that could influence the study outcomes, those with active lesions or infections, pregnant or lactating women, and tobacco users.

Sample size: A convenient sample of 12 subjects was recruited for the study.

Study Procedure

The procedure for sample collection, extraction, and preparation of the different PRF protocols was followed based on earlier reports [8,13-15]. Blood samples were collected by drawing 15 mL of blood from the antecubital fossa of each participant, out of which L-PRF, i-PRF, and blood serum were prepared, each with 5 mL of blood. A 5 mL blood sample was collected in a dry glass-coated tube and kept motionless for 30 minutes to provide enough time for it to coagulate complete coagulation. The tube was then centrifuged at 3000 rpm for 15 minutes to obtain the blood serum. To prepare Choukroun J’s PRF [8,13-15], 5 mL of blood was taken in a glass-coated vacutainer and subjected to centrifugation (Choukroun PRF Duo Quattro® System-Full System, Nice, France) at 3000 rpm for 10 minutes to obtain L-PRF. The remaining 5 mL of blood was taken in another glass-coated vacutainer and centrifuged at 700 rpm for 3 minutes to obtain i-PRF.

After the processing of the PRF, distinct samples were collected, including a supernatant representing acellular plasma or Platelet-poor Plasma (PPP), an exudate derived from the PRF clot corresponding to the liquid confined within the fibrin mesh, and the PRF clot. To collect the exudate, the PRF clot was kept in a sterile metal cup for 10 minutes to allow for the slow release of serum from within (13). All collected samples were stored in Eppendorf’s collection tubes at -80°C. The collected supernatant, exudate, and clot, both from L-PRF and i-PRF, along with the serum, were divided into seven groups, namely, blood serum, i-PRF exudates, i-PRF clot, L-PRF supernatant, L-PRF exudates, and L-PRF clot, all of which were assayed for levels of vitronectin using a commercially available Enzyme-linked Immunosorbent Assay (ELISA) kit {detection range: 3-200 ng/mL; sensitivity: 1-10 ng/mL; Krishgen Biosystems (Kinesis Dx), Mumbai, India}. The samples were tested as per the manufacturer’s instructions at the concerned laboratory.

Statistical Analysis

The data were statistically analysed using statistical software (IBM-Statistical Packages for Social Sciences (SPSS) version 23.0, Armonk, NY, USA). The Kolmogorov-Smirnov test was applied for normality. Based on the normality of the distribution, appropriate parametric tests were used, including the independent t-test, one-way ANOVA, and Newman-Keuls Post-hoc procedures for comparisons. The probability value was set at p≤0.05.

Results

Total 12 volunteers were included in the study, with an equal number of males (n=6) and females (n=6) providing the required blood samples. The mean age was 24.92±2.57 years. A summary of vitronectin levels in the seven groups is presented in (Table/Fig 1), where the mean values ranged from 64.09±0.04 ng/mL to 64.20±0.21 ng/mL, revealing comparable levels of vitronectin amongst all groups. One-way ANOVA applied to test between, and within groups showed significance between the seven groups (p=0.049).

On pair-wise comparison of vitronectin by Newman-Kuels’ multiple post-hoc procedures of the seven groups, a statistically significant difference in-vitronectin concentration between L-PRF exudate and blood serum was observed (p=0.050) (Table/Fig 2). The level of vitronectin was quantitatively higher in the blood serum group when compared with the other groups, as shown in (Table/Fig 3).

Comparison of vitronectin levels between males and females by independent t-test was not statistically significant, implying that there is no variation in-vitronectin concentrations between males and females in the seven groups, as shown in (Table/Fig 4).

Discussion

The clinical use of platelet-rich concentrates is based on the premise that they have beneficial effects on wound healing and regenerative potential. In present investigation, the aim was to detect, quantify, and compare the levels of vitronectin in L-PRF, i-PRF, and blood serum of healthy volunteers. Vitronectin was detected, and its concentration was estimated in blood serum, i-PRF exudates, i-PRF clot, L-PRF supernatant, L-PRF exudates, and L-PRF clot obtained from all the samples. The influence of gender and age of these study subjects as a source of bias on vitronectin levels was minimised because of the equal number of males and females in each group and within the specified range of 18-30 years as a reflection of the prime age of health.

Vitronectin has been quantified in the serum of healthy controls (12),(16),(17),(18),(19). In present study’s samples, the levels of vitronectin in blood serum were higher than i-PRF supernatant, i-PRF exudates, i-PRF clot, L-PRF supernatant, L-PRF exudates, and L-PRF clot but comparable. Boyd NA and co-workers investigated (12) the serum concentration of vitronectin (mg/liter) in health and various disorders such as liver and renal diseases, systemic lupus erythematosus, rheumatoid arthritis, etc., using radial immunodiffusion assay, due to which a dependable comparison with the current study cannot be made. Serum vitronectin concentrations in healthy controls (198.70±46.47 μg/mL) were compared with coronary artery disease (347.74±231.10 μg/mL) in another study (16). The serum levels of vitronectin in the healthy controls aged 56.5±8.4 years of the aforementioned cited investigation were higher than the present study’s younger-aged participants. The report by Teschler H et al., has shown serum vitronectin as 58.4±11.1 ng/mL in healthy controls which is relatable to the serum vitronectin concentrations of present study (17). The aforesaid study compared healthy controls with hypersensitivity pneumonitis that had serum vitronectin levels 593.2±134.6 ng/mL. Other studies also showed variable serum vitronectin concentrations in health when compared to present study possibly due to different technical aspects (18),(19). It is to be noted that most of these previous studies compared serum vitronectin in health with a variety of diseases and no conclusion can be reached, in general, as to whether serum vitronectin concentration in health is higher, or lower than in disease. Also, there is a variation in healthy serum vitronectin concentrations among those reports. Therefore, attempting to compare present investigation’s vitronectin serum concentrations in health with the literature for a definitive estimate is difficult, but the understanding is that it is measurable in serum.

The reasons for evaluating vitronectin in L-PRF and i-PRF are because the L-PRF clot contains the majority of the platelets and leukocytes from the primary blood harvest, with a three-dimensional distribution and a strong fibrin architecture; this solid biomaterial is in an activated form and cannot be injected (20), and i-PRF can release increased concentrations of several growth factors and facilitate greater fibroblast migration and expression of PDGF, TGF-β, and collagen (21). Hence, it is relevant to have data regarding vitronectin in PRF to ascertain its availability in clinical procedures when using this platelet concentrate. The extensive study by Dohan Ehrenfest DM et al.,(20) estimating the amounts of TGF-β1, PDGF-AB, VEGF, TSP-1, fibronectin, and vitronectin in L-PRF, Plasma Rich In Growth Factors (PRGF), and Plasma Poor in Growth Factors (PPGF) at different time intervals has provided valuable data, concluding that vitronectin is the only protein to be released completely after four hours (in L-PRF, vitronectin ranged from 925±105 ng at 0-20 minutes to 10±4 ng at 5-7 days; vitronectin at 0-20 minutes in PRGF and PPGF was 245±76 ng and 426±156 ng, respectively). These measured values were obtained after subjecting the L-PRF to culture media before ELISA quantification. When compared with these estimates, the L-PRF vitronectin concentration was lower in the present investigation, which may be attributable to the difference in methodology. It has been observed that vitronectin in L-PRF clot exudate along with fibronectin may encourage fibrin adhesion and formation when combined with liquid PRGF (22). This should add stimulus to in-depth analyses of vitronectin in PRF research.

However, due to the paucity of data in the literature, present study cannot make a direct comparison of vitronectin quantification in L-PRF and i-PRF, but some of the other proteins in PRF of healthy individuals that have been investigated are taken into consideration for a quantitative perspective of PRF proteins. The concentrations of TGF-β1, PDGF-AB, PDGF-BB, VEGF, Bone Morphogenetic Protein-2 (BMP-2), and Fibroblast Growth Factor-2 (FGF-2) released by liquid fibrinogen were evaluated with ELISA by Serafini G et al., (23). Fibronectin was estimated in a PRGF preparation (24). Kobayashi E et al., compared growth factors PDGF-AA, PDGF-AB, PDGF-BB, TGF-β, VEGF, EGF, and IGF in PRP, PRF, and advanced-PRF (A-PRF) (13). The quantification of vitronectin was not done in any of these reports. The present study’s results indicate similar levels of vitronectin in L-PRF and i-PRF. This adds credence to present investigation’s data, which will contribute to the literature and help in future studies.

Limitation(s)

The small sample size, not having included other related proteins like fibronectin and thrombospondin, and the release kinetics of vitronectin from L-PRF and i-PRF not having been evaluated, are some of the limitations of present study.

Conclusion

In present investigation, vitronectin was detected and quantified in L-PRF and i-PRF. The vitronectin concentrations in L-PRF and i-PRF are comparable. This may be the first report that has measured vitronectin in i-PRF. The present study could also infer that the supernatant and the exudate from the clots, which are often discarded, might have clinical relevance for use in periodontal/oral surgical procedures. Further exploration of vitronectin is strongly advocated to enhance the understanding of its yield and behaviour concerning other components of PRF and different PRF protocols.

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DOI and Others

DOI: 10.7860/JCDR/2024/69728.19251

Date of Submission: Jan 20, 2024
Date of Peer Review: Feb 13, 2024
Date of Acceptance: Feb 26, 2024
Date of Publishing: Apr 01, 2024

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 22, 2024
• Manual Googling: Feb 10, 2024
• iThenticate Software: Feb 24, 2024 (5%)

ETYMOLOGY: Author Origin

EMENDATIONS: 6

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