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

**Authors:** Erol Karakaş, Mustafa Ermiş, Hanifi Erol, Gökhan Akçakavak, Nevzat Emre Aslan, Özhan Karataş

PMC · DOI: 10.1186/s40001-026-03969-x · European Journal of Medical Research · 2026-02-05

## TL;DR

This study compares two treatments, ACRS and PRP, for reducing inflammation and lesion activity in a rat model of endometriosis.

## Contribution

The novel contribution is a direct comparison of ACRS and PRP effects on inflammation, angiogenesis, and fibrosis in a rat endometriosis model.

## Key findings

- Both ACRS and PRP reduced histopathological scores compared to untreated endometriosis.
- ACRS showed stronger anti-inflammatory effects but increased angiogenesis and fibrosis markers.
- PRP had less pronounced effects on inflammation but did not elevate angiogenesis.

## Abstract

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.

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).

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.

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.

## Linked entities

- **Diseases:** endometriosis (MONDO:0005133)

## Full-text entities

- **Genes:** Il1rn (interleukin 1 receptor antagonist) [NCBI Gene 60582] {aka IL-1ra, Il1ra}, Egf (epidermal growth factor) [NCBI Gene 25313], Il1b (interleukin 1 beta) [NCBI Gene 24494] {aka IL-1F2}, Il4 (interleukin 4) [NCBI Gene 287287] {aka Il4e12}, Il10 (interleukin 10) [NCBI Gene 25325] {aka IL10X, If2a}, Tgfb1 (transforming growth factor, beta 1) [NCBI Gene 59086] {aka Tgfb}, Vegfa (vascular endothelial growth factor A) [NCBI Gene 83785] {aka VEGF-A, VEGF111, VEGF164, VPF, Vegf}, Tnf (tumor necrosis factor) [NCBI Gene 24835] {aka RATTNF, TNF-alpha, Tnfa}, Actg2 (actin gamma 2, smooth muscle) [NCBI Gene 25365] {aka ACTGE, SMGA}, Igf1 (insulin-like growth factor 1) [NCBI Gene 24482] {aka IGF}, Il6 (interleukin 6) [NCBI Gene 24498] {aka ILg6, Ifnb2}
- **Diseases:** inflammation (MESH:D007249), chronic pelvic pain (MESH:D011472), endometriotic lesions (MESH:D009059), pain (MESH:D010146), dislocation (MESH:D004204), dyschezia (MESH:D003248), weight loss (MESH:D015431), wound (MESH:D014947), ACRS (MESH:D000080424), infertility (MESH:D007246), peritoneal lesion (MESH:D010532), osteoporosis (MESH:D010024), neuropathic pain (MESH:D009437), dyspareunia (MESH:D004414), fibrosis (MESH:D005355), glandular (MESH:D009375), dysmenorrhea (MESH:D004412), musculoskeletal disorders (MESH:D009140), hyperplasia (MESH:D006965), infection (MESH:D007239), EM (MESH:D004715), osteoarthritis (MESH:D010003)
- **Chemicals:** water (MESH:D014867), paraffin (MESH:D010232), DAB (MESH:C000469), xylazine (MESH:D014991), hematoxylin (MESH:D006416), eosin (MESH:D004801), H&amp;E (MESH:D006371), reactive oxygen species (MESH:D017382), PDS (MESH:D010165), 3,3'-diaminobenzidine (MESH:D015100), ACD (MESH:C002113), PGA (MESH:D011454), ACRS (-), povidone-iodine (MESH:D011206), formalin (MESH:D005557)
- **Species:** Homo sapiens (human, species) [taxon 9606], Rattus norvegicus (brown rat, species) [taxon 10116]

## Full text

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## Figures

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Source: https://tomesphere.com/paper/PMC12879428