The Comparative Evaluation of the Therapeutic Effects of Autologous Cytokine-Rich Serum and Platelet-Rich Plasma in an Experimental Endometriosis Model

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, with a focus 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 was surgically induced in the relevant groups. ACRS and PRP were prepared from the animals' autologous blood and administered intraabdominally. After treatment, endometriotic implants were excised for histopathological scoring and immunohistochemical analysis targeting TNF-α, IL-6 (inflammation), VEGFA (angiogenesis), and α-SMA (myofibroblast activity). Results: Histopathological scores significantly decreased in both EM + ACRS and EM + PRP groups compared to the EM group. ACRS demonstrated superior anti-inflammatory effects, with greater reductions in TNF-α and IL-6 expression than PRP. However, ACRS-treated tissues showed higher VEGFA and α-SMA expression, suggesting enhanced angiogenic and fibrotic responses relative to PRP. Conclusions: Both ACRS and PRP exerted therapeutic effects in experimental endometriosis. ACRS was more effective in reducing inflammation but showed distinct effects on angiogenesis and fibrosis compared to PRP. These findings support the potential of ACRS as a novel therapeutic option, warranting further clinical investigation.