Comparative Evaluation of ACRS and PRP on Inflammation and Lesion Activity in a Rat Model of Peritoneal Endometriosis

Comparative Evaluation of ACRS and PRP on Inflammation and Lesion Activity in a Rat Model of Peritoneal Endometriosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparative Evaluation of ACRS and PRP on Inflammation and Lesion Activity in a Rat Model of Peritoneal Endometriosis Erol KARAKAŞ, Mustafa ERMIŞ, Hanifi EROL, Gökhan AKÇAKAVAK, Nevzat Emre Aslan, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7448487/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Feb, 2026 Read the published version in European Journal of Medical Research → Version 1 posted 11 You are reading this latest preprint version 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. Endometriosis Autologous Cytokine-Rich Serum (ACRS) Platelet-Rich Plasma (PRP) Inflammation Angiogenesis TNF-α IL-6 VEGFA α-SMA rat Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 05 Feb, 2026 Read the published version in European Journal of Medical Research → Version 1 posted Editorial decision: Revision requested 14 Nov, 2025 Reviews received at journal 29 Oct, 2025 Reviewers agreed at journal 26 Oct, 2025 Reviewers agreed at journal 24 Oct, 2025 Reviewers agreed at journal 18 Sep, 2025 Reviews received at journal 17 Sep, 2025 Reviewers agreed at journal 10 Sep, 2025 Reviewers invited by journal 04 Sep, 2025 Editor assigned by journal 31 Aug, 2025 Submission checks completed at journal 30 Aug, 2025 First submitted to journal 24 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7448487","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":512912559,"identity":"58713349-8179-4084-8e32-0115ef21cfee","order_by":0,"name":"Erol KARAKAŞ","email":"data:image/png;base64,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","orcid":"","institution":"University of Erciyes","correspondingAuthor":true,"prefix":"","firstName":"Erol","middleName":"","lastName":"KARAKAŞ","suffix":""},{"id":512912560,"identity":"08de72cd-74ba-4de4-9716-909d0ad9bbfd","order_by":1,"name":"Mustafa ERMIŞ","email":"","orcid":"","institution":"University of Erciyes","correspondingAuthor":false,"prefix":"","firstName":"Mustafa","middleName":"","lastName":"ERMIŞ","suffix":""},{"id":512912561,"identity":"0243c7a8-39fb-43a4-9843-7c432bf3e733","order_by":2,"name":"Hanifi EROL","email":"","orcid":"","institution":"University of Erciyes","correspondingAuthor":false,"prefix":"","firstName":"Hanifi","middleName":"","lastName":"EROL","suffix":""},{"id":512912562,"identity":"c5cf981c-497b-4aad-8f58-8d6c9485febd","order_by":3,"name":"Gökhan AKÇAKAVAK","email":"","orcid":"","institution":"University of Aksaray","correspondingAuthor":false,"prefix":"","firstName":"Gökhan","middleName":"","lastName":"AKÇAKAVAK","suffix":""},{"id":512912563,"identity":"4d88a268-873d-43c5-877c-afcbf690b30f","order_by":4,"name":"Nevzat Emre Aslan","email":"","orcid":"","institution":"University of Bozok","correspondingAuthor":false,"prefix":"","firstName":"Nevzat","middleName":"Emre","lastName":"Aslan","suffix":""},{"id":512912564,"identity":"9f4e8bf2-c0ac-4261-a5ba-d98794b769e8","order_by":5,"name":"Özhan Karataş","email":"","orcid":"","institution":"University of Sivas Cumhuriyet","correspondingAuthor":false,"prefix":"","firstName":"Özhan","middleName":"","lastName":"Karataş","suffix":""}],"badges":[],"createdAt":"2025-08-24 23:23:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7448487/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7448487/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s40001-026-03969-x","type":"published","date":"2026-02-05T15:57:55+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":102234073,"identity":"106c337e-55d3-462c-b719-4fc4a7fa6c09","added_by":"auto","created_at":"2026-02-09 16:05:38","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":934516,"visible":true,"origin":"","legend":"","description":"","filename":"RevisedManuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7448487/v1_covered_6953e792-e150-4e6d-91cf-1b47f9b7ae77.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparative Evaluation of ACRS and PRP on Inflammation and Lesion Activity in a Rat Model of Peritoneal Endometriosis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Endometriosis, Autologous Cytokine-Rich Serum (ACRS), Platelet-Rich Plasma (PRP), Inflammation, Angiogenesis, TNF-α, IL-6, VEGFA, α-SMA, rat","lastPublishedDoi":"10.21203/rs.3.rs-7448487/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7448487/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose: \u003c/strong\u003eThis 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.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e 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.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e 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.\u003c/p\u003e","manuscriptTitle":"Comparative Evaluation of ACRS and PRP on Inflammation and Lesion Activity in a Rat Model of Peritoneal Endometriosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-11 04:35:47","doi":"10.21203/rs.3.rs-7448487/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-14T21:58:06+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-29T07:46:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11060909546418060903287122732501815895","date":"2025-10-26T07:05:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"328956678473079730746257959306800472021","date":"2025-10-24T18:23:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"16889849514247695519732484187480995535","date":"2025-09-19T01:35:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-17T08:39:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"333396229579049193387340147496581224730","date":"2025-09-10T07:07:38+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-04T13:18:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-31T15:02:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-30T15:36:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Medical Research","date":"2025-08-24T23:12:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9afb7498-44dc-42e1-bd3a-6fffd9950675","owner":[],"postedDate":"September 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T16:01:54+00:00","versionOfRecord":{"articleIdentity":"rs-7448487","link":"https://doi.org/10.1186/s40001-026-03969-x","journal":{"identity":"european-journal-of-medical-research","isVorOnly":false,"title":"European Journal of Medical Research"},"publishedOn":"2026-02-05 15:57:55","publishedOnDateReadable":"February 5th, 2026"},"versionCreatedAt":"2025-09-11 04:35:47","video":"","vorDoi":"10.1186/s40001-026-03969-x","vorDoiUrl":"https://doi.org/10.1186/s40001-026-03969-x","workflowStages":[]},"version":"v1","identity":"rs-7448487","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7448487","identity":"rs-7448487","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}