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Cited by 2Endometriosis Research and TreatmentPeriodontal Regeneration and TreatmentsEctopic Pregnancy Diagnosis and Management

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Comparative evaluation of ACRS and PRP on inflammation and lesion activity in a rat model of peritoneal endometriosis

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Karakaş, Erol, Ermiş, Mustafa, Erol, Hanifi, Akçakavak, Gökhan, Aslan, Nevzat Emre, Karataş, Özhan·2026·European Journal of Medical Research
DOI 10.1186/s40001-026-03969-xPMC PMC12879428

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Abstract

Purpose: This study aimed to comparatively evaluate the therapeutic effects of Autologous Cytokine-Rich Serum (ACRS) and Platelet-Rich Plasma (PRP) in a rat model of endometriosis, focusing on inflammation, angiogenesis, and myofibroblast activity. Methods: A total of 36 adult female Wistar Albino rats were randomly assigned to six groups: healthy control, ACRS-only, PRP-only, endometriosis (EM), EM + ACRS, and EM + PRP. Endometriosis, modeled as lesion formation on the peritoneal wall, was surgically induced in the relevant groups. ACRS and PRP were prepared from autologous blood and administered intraovarianly and intraperitoneally. Lesions were excised for histopathological and immunohistochemical analysis of TNF-α, IL-6 (inflammation), VEGFA (angiogenesis), and α-SMA (fibrosis). Results: Histopathological scores decreased in both EM + ACRS and EM + PRP groups compared to the EM group. ACRS showed stronger anti-inflammatory effects, with lower TNF-α and IL-6 expression. However, ACRS-treated tissues also exhibited elevated VEGFA and α-SMA expression, suggesting increased angiogenesis and stromal activity. Conclusions: Both ACRS and PRP showed therapeutic effects. ACRS more effectively suppressed inflammation but may promote lesion stabilization through enhanced angiogenesis and fibrotic remodeling. These findings highlight the complex biological activity of ACRS, which requires further investigation before clinical translation.

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Fig. 1 Microscopic evaluation of samples from different groups stained with Hematoxylin–Eosin (H&E). A–B–C Representative images of control groups (Group I, Group II, Group III) showing a score of 3 in the endometriosis grading system. D Image of Group IV showing a score of 0. E Image of Group V showing a score of 2. F Image of Group V showing a score of 2. (Asterisk; inflammatory cell infiltration)
Fig. 1 Microscopic evaluation of samples from different groups stained with Hematoxylin–Eosin (H&E). A–B–C Representative images of control groups (Group I, Group II, Group III) showing a score of 3 in the endometriosis grading system. D Image of Group IV showing a score of 0. E Image of Group V showing a score of 2. F Image of Group V showing a score of 2. (Asterisk; inflammatory cell infiltration)CC BY · PubMed Central
Fig. 2 Immunohistochemical expression of α-SMA, VEGFA, IL-6, and TNF-α across groups (DAB staining). (A; Group I, B; Group IV, C; Group V, D; Group VI)
Fig. 2 Immunohistochemical expression of α-SMA, VEGFA, IL-6, and TNF-α across groups (DAB staining). (A; Group I, B; Group IV, C; Group V, D; Group VI)CC BY · PubMed Central

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Citations

Cites

Research works printed but not linked: 26

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Metadata

Authors
Karakaş, E., Ermiş, M., Erol, H., Akçakavak, G., Aslan, N. E., & Karataş, Ö.
Affiliations
  • Erciyes University (TR)
  • Aksaray University (TR)
  • Yozgat Bozok Üniversitesi (TR)
  • Sivas Cumhuriyet Üniversitesi (TR)
Corresponding author
Karakaş, Erol
ORCID
Venue
European Journal of Medical Research
Publisher
Springer Science and Business Media LLC
Published
2026-02-05
Volume
31
Issue
1
Pages
228-228
ISSN
  • 0949-2321 (ISSN-L)
  • 2047-783X
DOI
10.1186/s40001-026-03969-x
PMC
PMC12879428
OpenAlex
W7127881621
Cited by
2
References
1
Citations by year
2026: 2
FWCI
10.69
Type
journal article
Language
en
Open access
Licence
Locations
  • European journal of medical research (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Ectopic Pregnancy Diagnosis and Management
Keywords
peritoneal endometriosis, platelet-rich plasma, inflammation, angiogenesis, fibrosis, TNF-α, interleukin-6, VEGF-A, alpha-smooth muscle actin, intraovarian injection, rat model
MeSH terms
Animals, Disease Models, Animal, Endometriosis, Female, Inflammation, Peritoneal Diseases, Tumor Necrosis Factor-alpha, Interleukin-6, Cytokines, Rats, Wistar, Vascular Endothelial Growth Factor A, Rats, Platelet-Rich Plasma

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