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Jarosz A, Balcerzyk-Matić A, Iwanicka J, Iwanicki T, Nowak T, Szyluk K, Kalita M, Górczyńska-Kosiorz S, Kania W, Niemiec P. Association between Platelet-Derived Growth Factor Receptor Alpha Gene Polymorphisms and Platelet-Rich Plasma's Efficiency in Treating Lateral Elbow Tendinopathy-A Prospective Cohort Study. Int J Mol Sci 2024; 25:4266. [PMID: 38673853 PMCID: PMC11050239 DOI: 10.3390/ijms25084266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Individual differences in the response to platelet-rich plasma (PRP) therapy can be observed among patients. The genetic background may be the cause of this variability. The current study focused on the impact of genetic variants on the effectiveness of PRP. The aim of the present study was to analyze the impact of single nucleotide polymorphisms (SNP) of the platelet-derived growth factor receptor alpha (PDGFRA) gene on the effectiveness of treating lateral elbow tendinopathy (LET) with PRP. The treatment's efficacy was analyzed over time (2, 4, 8, 12, 24, 52 and 104 weeks after the PRP injection) on 107 patients using patient-reported outcome measures (PROM) and achievement of a minimal clinically important difference (MCID). Four SNPs of the PDGFRA gene (rs7668190, rs6554164, rs869978 and rs1316926) were genotyped using the TaqMan assay method. Patients with the AA genotypes of the rs7668190 and the rs1316926 polymorphisms, as well as carriers of the T allele of rs6554164 showed greater effectiveness of PRP therapy than carriers of other genotypes. Moreover, the studied SNPs influenced the platelets' parameters both in whole blood and in PRP. These results showed that PDGFRA gene polymorphisms affect the effectiveness of PRP treatment. Genotyping the rs6554164 and the rs1316926 SNPs may be considered for use in individualized patient selection for PRP therapy.
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Affiliation(s)
- Alicja Jarosz
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str., 40-752 Katowice, Poland; (A.J.); (A.B.-M.); (J.I.); (T.I.); (T.N.)
| | - Anna Balcerzyk-Matić
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str., 40-752 Katowice, Poland; (A.J.); (A.B.-M.); (J.I.); (T.I.); (T.N.)
| | - Joanna Iwanicka
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str., 40-752 Katowice, Poland; (A.J.); (A.B.-M.); (J.I.); (T.I.); (T.N.)
| | - Tomasz Iwanicki
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str., 40-752 Katowice, Poland; (A.J.); (A.B.-M.); (J.I.); (T.I.); (T.N.)
| | - Tomasz Nowak
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str., 40-752 Katowice, Poland; (A.J.); (A.B.-M.); (J.I.); (T.I.); (T.N.)
| | - Karol Szyluk
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Str., 41-940 Piekary Sląskie, Poland; (K.S.); (M.K.)
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 12 Str., 40-752 Katowice, Poland
| | - Marcin Kalita
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Str., 41-940 Piekary Sląskie, Poland; (K.S.); (M.K.)
| | - Sylwia Górczyńska-Kosiorz
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland;
| | - Wojciech Kania
- Department of Trauma and Orthopedic Surgery, Multidisciplinary Hospital in Jaworzno, Chełmońskiego 28 Str., 43-600 Jaworzno, Poland;
| | - Paweł Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str., 40-752 Katowice, Poland; (A.J.); (A.B.-M.); (J.I.); (T.I.); (T.N.)
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Liu M, Jiao X, Li R, Li J, Wang L, Wang L, Wang Y, Lv C, Huang D, Wei R, Wang L, Ji X, Guo X. Effects of acetazolamide combined with remote ischemic preconditioning on risk of acute mountain sickness: a randomized clinical trial. BMC Med 2024; 22:4. [PMID: 38166913 PMCID: PMC10762951 DOI: 10.1186/s12916-023-03209-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND We aimed to determine whether and how the combination of acetazolamide and remote ischemic preconditioning (RIPC) reduced the incidence and severity of acute mountain sickness (AMS). METHODS This is a prospective, randomized, open-label, blinded endpoint (PROBE) study involving 250 healthy volunteers. Participants were randomized (1:1:1:1:1) to following five groups: Ripc (RIPC twice daily, 6 days), Rapid-Ripc (RIPC four times daily, 3 days), Acetazolamide (twice daily, 2 days), Combined (Acetazolamide plus Rapid-Ripc), and Control group. After interventions, participants entered a normobaric hypoxic chamber (equivalent to 4000 m) and stayed for 6 h. The primary outcomes included the incidence and severity of AMS, and SpO2 after hypoxic exposure. Secondary outcomes included systolic and diastolic blood pressure, and heart rate after hypoxic exposure. The mechanisms of the combined regime were investigated through exploratory outcomes, including analysis of venous blood gas, complete blood count, human cytokine antibody array, ELISA validation for PDGF-AB, and detection of PDGF gene polymorphisms. RESULTS The combination of acetazolamide and RIPC exhibited powerful efficacy in preventing AMS, reducing the incidence of AMS from 26.0 to 6.0% (Combined vs Control: RR 0.23, 95% CI 0.07-0.70, P = 0.006), without significantly increasing the incidence of adverse reactions. Combined group also showed the lowest AMS score (0.92 ± 1.10). Mechanistically, acetazolamide induced a mild metabolic acidosis (pH 7.30 ~ 7.31; HCO3- 18.1 ~ 20.8 mmol/L) and improved SpO2 (89 ~ 91%) following hypoxic exposure. Additionally, thirty differentially expressed proteins (DEPs) related to immune-inflammatory process were identified after hypoxia, among which PDGF-AB was involved. Further validation of PDGF-AB in all individuals showed that both acetazolamide and RIPC downregulated PDGF-AB before hypoxic exposure, suggesting a possible protective mechanism. Furthermore, genetic analyses demonstrated that individuals carrying the PDGFA rs2070958 C allele, rs9690350 G allele, or rs1800814 G allele did not display a decrease in PDGF-AB levels after interventions, and were associated with a higher risk of AMS. CONCLUSIONS The combination of acetazolamide and RIPC exerts a powerful anti-hypoxic effect and represents an innovative and promising strategy for rapid ascent to high altitudes. Acetazolamide improves oxygen saturation. RIPC further aids acetazolamide, which synergistically regulates PDGF-AB, potentially involved in the pathogenesis of AMS. TRIAL REGISTRATION ClinicalTrials.gov NCT05023941.
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Affiliation(s)
- Moqi Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Xueqiao Jiao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Rui Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Jialu Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Lu Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Liyan Wang
- Department of Internal Medicine, Beijing Xiaotangshan Hospital, Beijing, 102211, China
| | - Yishu Wang
- Department of Internal Medicine, Beijing Xiaotangshan Hospital, Beijing, 102211, China
| | - Chunmei Lv
- Department of Internal Medicine, Beijing Xiaotangshan Hospital, Beijing, 102211, China
| | - Dan Huang
- Department of Internal Medicine, Beijing Xiaotangshan Hospital, Beijing, 102211, China
| | - Ran Wei
- Department of Internal Medicine, Beijing Xiaotangshan Hospital, Beijing, 102211, China
| | - Liming Wang
- Department of Internal Medicine, Beijing Xiaotangshan Hospital, Beijing, 102211, China
| | - Xunming Ji
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Xiuhai Guo
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China.
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Niemiec P, Jarosz A, Balcerzyk-Matić A, Iwanicka J, Nowak T, Iwanicki T, Gierek M, Kalita M, Garczorz W, Francuz T, Górczyńska-Kosiorz S, Kania W, Szyluk K. Genetic Variability in VEGFA Gene Influences the Effectiveness of Tennis Elbow Therapy with PRP: A Two-Year Prospective Cohort Study. Int J Mol Sci 2023; 24:17292. [PMID: 38139123 PMCID: PMC10743422 DOI: 10.3390/ijms242417292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Vascular endothelial growth factor (VEGF) is implicated in both the etiology of tendinopathy and its healing process. Polymorphic variants of the VEGFA gene exhibit varied expression, which can influence the phenotype and treatment effectiveness. The aim of the present study was to analyze the influence of VEGFA gene variants on the effectiveness of tennis elbow therapy using platelet-rich plasma (PRP), measured through common patient-reported outcome measures (PROMs). A cohort of 107 patients (132 elbows) with tennis elbow was prospectively analyzed, with a two-year follow-up (at weeks 2, 4, 8, 12, 24, 52, and 104 after PRP injection). PROMs values were compared between variants of five VEGFA gene polymorphisms (rs699947 A>C, rs2010963 C>G, rs1413711 C>T, rs3024998 C>T and rs3025021 C>T) at each follow-up point. Patients with genotypes GG (rs2010963) and CC (rs3024998) had better response to PRP therapy (significantly fewer symptoms and limitations in the upper limb compared to carriers of alleles C and T, respectively). Polymorphisms influenced also selected hematological parameters. VEGFA gene polymorphisms (rs2010963 and rs3024998) appear to be significant treatment modifiers for tendinopathy, and their genotyping may serve as an effective tool for personalized patient selection for PRP therapy.
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Affiliation(s)
- Paweł Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, the Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (P.N.); (A.B.-M.); (J.I.); (T.N.); (T.I.)
| | - Alicja Jarosz
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, the Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (P.N.); (A.B.-M.); (J.I.); (T.N.); (T.I.)
| | - Anna Balcerzyk-Matić
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, the Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (P.N.); (A.B.-M.); (J.I.); (T.N.); (T.I.)
| | - Joanna Iwanicka
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, the Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (P.N.); (A.B.-M.); (J.I.); (T.N.); (T.I.)
| | - Tomasz Nowak
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, the Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (P.N.); (A.B.-M.); (J.I.); (T.N.); (T.I.)
| | - Tomasz Iwanicki
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, the Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (P.N.); (A.B.-M.); (J.I.); (T.N.); (T.I.)
| | - Marcin Gierek
- Center for Burns Treatment, Jana Pawła II Str., 41-100 Siemianowice Śląskie, Poland;
| | - Marcin Kalita
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Str., 41-940 Piekary Śląskie, Poland; (M.K.); (K.S.)
| | - Wojciech Garczorz
- Department of Biochemistry, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (W.G.); (T.F.)
| | - Tomasz Francuz
- Department of Biochemistry, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland; (W.G.); (T.F.)
| | - Sylwia Górczyńska-Kosiorz
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland;
| | - Wojciech Kania
- Department of Trauma and Orthopedic Surgery, Multidisciplinary Hospital in Jaworzno, Chełmońskiego 28 Str., 43-600 Jaworzno, Poland;
| | - Karol Szyluk
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Str., 41-940 Piekary Śląskie, Poland; (M.K.); (K.S.)
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Str., 40-752 Katowice, Poland
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Giannetti A, Pantalone A, Antonucci I, Verna S, Di Gregorio P, Stuppia L, Calvisi V, Buda R, Salini V. The Role of Platelet-Rich Plasma on the Chondrogenic and Osteogenic Differentiation of Human Amniotic-Fluid-Derived Stem Cells. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15786. [PMID: 36497861 PMCID: PMC9738099 DOI: 10.3390/ijerph192315786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Amniotic fluid represents a new and promising source of engraftable stem cells. The purpose of this study was to investigate the in vitro effects of platelet-rich plasma (PRP) on amniotic-fluid-derived stem cells (AFSCs) on chondrogenic or osteogenic differentiation potential. Amniotic fluid samples were obtained from women undergoing amniocentesis for prenatal diagnosis at 16-18 weeks of pregnancy. Undifferentiated human AFSCs were cocultured with PRP for 14 days. The study includes two protocols investigating the effects of activated PRP using two different methods: via freeze-thaw cycles and via the addition of calcium gluconate. On the 14th day of culturing, the differentiation potential of the cocultured AFSCs was then compared with undifferentiated AFSCs. Staining with alcian blue solution (ABS) and alizarine red solution (ARS) was performed, and chondrogenic- and osteogenic-associated genes markers were investigated. ABS demonstrated enhanced glycosaminoglycan expression. Cocultured cells expressed chondrocyte-associated genes, determined by real-time polymerase chain reaction (RT-PCR), including type I collagen, type II collagen, COMP, and aggrecan. In regard to the osteogenic markers, osteopontin and bone sialoprotein, there were no changes. In particular, the activation of PRP using the freeze-thaw cycle protocol showed a higher expression of the chondrogenic markers. Our preliminary in vitro results showed that PRP has good potential in the chondrogenic differentiation of AFSCs.
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Affiliation(s)
- Alessio Giannetti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Andrea Pantalone
- Clinic of Orthopaedics and Traumatology, “SS. Annunziata” Hospital, 66100 Chieti, Italy
| | - Ivana Antonucci
- Center of Advanced Studies and Technology (CAST), “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Sandra Verna
- Immunohematology and Transfusional Medicine Service, “SS. Annunziata” Hospital, 66100 Chieti, Italy
| | - Patrizia Di Gregorio
- Immunohematology and Transfusional Medicine Service, “SS. Annunziata” Hospital, 66100 Chieti, Italy
| | - Liborio Stuppia
- Center of Advanced Studies and Technology (CAST), “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Vittorio Calvisi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Roberto Buda
- Clinic of Orthopaedics and Traumatology, “SS. Annunziata” Hospital, 66100 Chieti, Italy
- Department of Medicine and Aging Sciences, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Vincenzo Salini
- Department of Orthopaedics and Traumatology, San Raffaele Hospital, 20132 Milan, Italy
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Szyluk K, Jarosz A, Balcerzyk-Matić A, Iwanicka J, Iwanicki T, Nowak T, Gierek M, Negru M, Kalita M, Górczyńska-Kosiorz S, Kania W, Niemiec P. Polymorphic Variants of the PDGFRB Gene Influence Efficacy of PRP Therapy in Treating Tennis Elbow: A Prospective Cohort Study. J Clin Med 2022; 11:6362. [PMID: 36362590 PMCID: PMC9657684 DOI: 10.3390/jcm11216362] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Differences in response to PRP (platelet-rich plasma) therapy may be linked to the variability of growth factors and their receptor's genes. Considering that, we checked whether the platelet-derived growth factor receptor beta gene (PDGFRB) single nucleotide polymorphisms (SNPs) affect the effectiveness of PRP therapy in treating tennis elbow patients. METHODS The treatment efficacy was analyzed over time (2, 4, 8, 12, 24, 52, and 104 weeks after PRP injection) on 107 patients (132 elbows) using PROMs (patient-reported outcome measures), namely VAS (Visual Analog Scale), QDASH (quick version of Disabilities of the Arm, Shoulder, and Hand) and PRTEE (Patient-Rated Tennis Elbow Evaluation). Five polymorphisms of the PDGFRB gene (rs4324662, rs758588, rs3828610, rs3756311, and rs3756312) were genotyped. RESULTS The CC (rs3828610) and GG (rs3756311 and rs3756312) genotypes had a particularly strong impact on the effectiveness of the therapy, as measured by the values of PROMs, both in additive as well as dominant/recessive models. These homozygotes were also characterized by significantly higher values of MPV (mean platelet volume). CONCLUSIONS The PDGFRB gene SNPs affect the effectiveness of PRP therapy in treating tennis elbow patients and it may result from the differentiated metabolic activity of platelets in particular genotype variants.
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Affiliation(s)
- Karol Szyluk
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Str., 41-940 Piekary Śląskie, Poland
| | - Alicja Jarosz
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland
| | - Anna Balcerzyk-Matić
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland
| | - Joanna Iwanicka
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland
| | - Tomasz Iwanicki
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland
| | - Tomasz Nowak
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland
| | - Marcin Gierek
- Center for Burns Treatment, Jana Pawła II Str., 41-100 Siemianowice Śląskie, Poland
| | - Marius Negru
- Trauma and Orthopaedics Department, St. Bernard’s Hospital, Harbour Views Rd., Gibraltar GX11 1AA, UK
| | - Marcin Kalita
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Str., 41-940 Piekary Śląskie, Poland
| | - Sylwia Górczyńska-Kosiorz
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
| | - Wojciech Kania
- Department of Trauma and Orthopedic Surgery, Multidisciplinary Hospital in Jaworzno, Chełmońskiego 28 Str., 43-600 Jaworzno, Poland
| | - Paweł Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 Str., 40-752 Katowice, Poland
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