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Wakayama T, Saita Y, Kobayashi Y, Nishio H, Uchino S, Fukusato S, Ikeda H, Kaneko K. Quality comparison between two different types of platelet-rich plasma for knee osteoarthritis. Regen Med Res 2020; 8:3. [PMID: 33287956 PMCID: PMC7721479 DOI: 10.1051/rmr/200002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction: Knee osteoarthritis (KOA), the most common form of osteoarthritis (OA) is a considerable health concern worldwide. Platelet-rich plasma (PRP) is a common therapeutic option for KOA. Different types of PRPs have varying efficacies. However, a comparative analysis of the qualities of these PRPs is lacking. Methods: Two types of PRPs, including autologous protein solution (APS), and leukocyte-poor PRP (LP-PRP) along with whole blood (WB) and platelet-poor plasma (PPP) were characterized for platelet content, leukocyte content, and composition in 10 healthy volunteers (HV) (the controlled laboratory study) and 16 KOA patients (a retrospective observational study). Additionally, the levels of the platelet-derived growth factor (PDGF)-BB, and different cytokines were estimated in HV. Results: In HV, the concentrations of platelets and leukocytes, levels of different cytokines, including interleukin 1 receptor antagonist (IL-1Ra), soluble TNF receptor type II (sTNF-RII), and IL-1β, and the ratio of IL-1Ra/IL-1β were significantly higher in APS, whereas the PDGF-BB was higher in LP-PRP than APS. In KOA patients, a higher concentration of platelets was observed in LP-PRP, and a higher concentration of leukocytes was observed in APS than LP-PRP. Following the PAW classification system, LP-PRP was classified as P2-B type in HV (51.3 × 104/μl) and KOA (53.4 × 104/μl), whereas APS was classified as P3-A type in HV (110.1 × 104/μl) and P2-A type in KOA (29.0 × 104/μl). In a retrospective observational study, the KOA patients who underwent APS injection had a higher incidence of arthralgia, and this arthralgia lasted for a longer time than LP-PRP injection in the same individual. Discussion: The quality of the two PRPs differed distinctively depending on their preparation methods, which might affect their clinical efficacies and adverse events. Therefore, the characterization of these parameters should be prioritized while choosing PRP.
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Affiliation(s)
- Takanori Wakayama
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yoshitomo Saita
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yohei Kobayashi
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hirofumi Nishio
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Sayuri Uchino
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shin Fukusato
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hiroshi Ikeda
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan - Department of Physical Therapy, Juntendo University, Faculty of Health Science, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kazuo Kaneko
- Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Melbourne CS, Smith CA, Patel J, Platt B, Cook JL. Indications and associated outcomes for platelet-rich plasma injections performed in an academic orthopaedic-specific hospital: A patient satisfaction survey. CURRENT ORTHOPAEDIC PRACTICE 2020. [DOI: 10.1097/bco.0000000000000865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Giusti I, Di Francesco M, D'Ascenzo S, Palumbo P, Rughetti A, Dell'Orso L, Varasano PA, Pressanti GL, Dolo V. Leukocyte depletion does not affect the in vitro healing ability of platelet rich plasma. Exp Ther Med 2018; 15:4029-4038. [PMID: 29556269 DOI: 10.3892/etm.2018.5887] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 01/19/2018] [Indexed: 01/15/2023] Open
Abstract
The clinical use of platelet-rich plasma (PRP) containing or deprived of leukocytes remains a subject of debate and a controversial issue. It is not yet clear whether leukocyte content has a positive or negative effect on tissue healing processes. Several studies, conducted mainly in the orthopedic field, support the use of leukocyte-poor (LP) PRP, whereas other studies have not identified any significant differences between the use of LP and leukocyte-rich PRP. In the present study, the role of leukocytes contained in PRP was assessed to verify their in vitro effect on fibroblasts and endothelial cells, which have a leading role in the biological processes associated with wound healing (including angiogenesis and matrix remodeling). The original sample of PRP was divided into two aliquots, one of which remained unaltered, while the other was deprived of leukocytes. The two aliquots were used in in vitro tests in order to verify the effects of leukocytes on proliferation, wound healing and tube formation, and in molecular analyses of growth factor and enzyme content. The present results highlighted a substantial overlap between the two formulations. This may be explained by similar levels of growth factors (vascular endothelial growth factor, thrombospondin-1, interferon-γ, platelet-derived growth factor-BB, -AA and -B, tumor growth factor-β1, fibroblast growth factor 7 and tumor necrosis factor-α) and enzymes (gelatinases and plasminogen activators) in the two formulations. These results support the hypothesis that the ability of the PRP to affect the in vitro biological response of endothelial cells and fibroblasts does not rely on the presence of leukocytes.
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Affiliation(s)
- Ilaria Giusti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Marianna Di Francesco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Sandra D'Ascenzo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Paola Palumbo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Anna Rughetti
- Immunotransfusion Medicine Unit, 'San Salvatore' Hospital, I-67100 L'Aquila, Italy
| | - Luigi Dell'Orso
- Immunotransfusion Medicine Unit, 'San Salvatore' Hospital, I-67100 L'Aquila, Italy
| | | | | | - Vincenza Dolo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, I-67100 L'Aquila, Italy
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