title: The Inhibitory Effect of Platelet-Rich Plasma on Botulinum Toxin Type-A: An Experimental Study in Rabbits.
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.
  
  
  CONCLUSIONS
  Although we could not explain the exact mechanism underlying this interaction, platelet-rich plasma applications result in less onabotulinumtoxinA muscle paralysis activity.
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Bulam
authors.forename: Suhan
authors.initials: S
authors.lastname: Ayhan
authors.forename: Billur
authors.initials: B
authors.lastname: Sezgin
authors.forename: Murat
authors.initials: M
authors.lastname: Zinnuroglu
authors.forename: Ece
authors.initials: E
authors.lastname: Konac
authors.forename: Nuray
authors.initials: N
authors.lastname: Varol
authors.forename: Kemal
authors.initials: K
authors.lastname: Findikcioglu
authors.forename: Serhan
authors.initials: S
authors.lastname: Tuncer
authors.forename: Seyhan
authors.initials: S
authors.lastname: Cenetoglu
mesh_terms: D000818:Animals; D019274:Botulinum Toxins, Type A / Q000037:antagonists & inhibitors*; D008297:Male; D009465:Neuromuscular Agents / Q000037:antagonists & inhibitors*; D053657:Platelet-Rich Plasma; D011817:Rabbits
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A