Effects of Autologous Serum and Platelet-Rich Plasma on Human Corneal Endothelial Cell Regeneration: A Comparative Study

Objectives: To investigate the effects of autologous serum (AS) and platelet-rich plasma (PRP) on human corneal endothelial cell (HCEC) proliferation and apoptosis in comparison to Y-27632 as the commonly studied Rho-associated kinase (ROCK) inhibitor. Methods: The human corneal endothelial primary cell line was used for this study. As the treatment groups, HCECs were incubated with AS, PRP, and Y-27632, whereas the control group received no treatment. Cell proliferation (measured by 5-bromo-2'-deoxyuridine [BrdU] incorporation) and apoptosis (based on the caspase-3 level) were compared between the control, Y-27632, AS, and PRP groups. Results: In the Y-27632, AS, and PRP groups, the ratios of BrdU-incorporated cells were significantly higher (115 +/- 0.2%, 125 +/- 0.2%, 122 +/- 0.4% at 24 hr, and 138 +/- 2.4%, 160 +/- 0.2%, 142 +/- 0.2% at 48 hr, respectively) than in the control group (100 +/- 18.4% at 24 hr, 100 +/- 1.1% at 48 hr) (P < 0.05 for all). Furthermore, AS provided a higher HCEC proliferation ratio compared with the Y-27632 group at 24 and 48 hr (P < 0.05 for all). Caspase-3 was significantly lower in the AS group (60.3 +/- 3.3%) than in the control (100 +/- 2.3%), Y-27632 (101.9 +/- 5.2%), and PRP (101 +/- 6.8%) groups (P < 0.05 for all). Conclusions: The results of this study demonstrated for the first time that AS and PRP promoted HCEC proliferation and AS significantly decreased apoptosis in HCECs. A superior effect on HCEC proliferation was also observed with AS compared with Y-27632. Future autologous regenerative therapeutic options for corneal endothelial failure may involve the utilization of AS and PRP owing to their accessibility, simplicity in preparation, immunologic compatibility, and donor-free nature.