Combination of Preconditioned Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma Improves the Repair of Osteoarthritis in Rat

Ahmad, M. Rauf; Badar, Wafa; Khan, Muhammad Azmat Ullah; Mahmood, Azra; Latif, Noreen; Iqbal, Tariq; Assir, Muhammad Zaman Khan; Sleem, Mushtaq A

doi:10.2217/rme-2020-0040

Cited by 15 publications

(17 citation statements)

References 30 publications

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“…Moreover, in vitro studies alone cannot mirror the complexity of the joint environment response to PRP intra-articular injections, and in vivo studies are needed to confirm the suggested detrimental effects of leukocytes in PRP. 1 In a mouse model of posttraumatic knee OA, Jayaram et al 23 compared the intra-articular injection of LR-PRP and LP-PRP to assess the potential to alter disease progression. The authors observed controversial results, indicating better protection from cartilage volume loss at phase-contrast computed tomography analysis after LP-PRP, while LR-PRP demonstrated better protection from thermal hyperalgesia; in addition, the histologic evaluation did not show differences in terms of cartilage degeneration and synovitis.…”

Section: Discussionmentioning

confidence: 99%

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Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial

et al. 2022

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Background: Platelet-rich plasma (PRP) is gaining large interest in clinical practice as a minimally invasive injective treatment for knee osteoarthritis (OA). Different preparation methods are available, and the presence of leukocytes, deemed detrimental in some preclinical studies, is one of the most debated aspects regarding PRP efficacy. Purpose: To compare the safety and effectiveness of leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP) for the treatment of knee OA. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 192 patients with symptomatic knee OA (Kellgren-Lawrence grade 1-3) were randomly allocated to 3 weekly injections of LR-PRP or LP-PRP. LP-PRP was obtained with a filter for leukodepletion. LR-PRP and LP-PRP were divided into aliquots of 5 mL, with a mean platelet concentration of 1146.8 × 109/L and 1074.9 × 109/L and a mean leukocyte concentration of 7991.4 × 106/L and 0.1 × 106/L, respectively. Patients were evaluated at baseline and thereafter at 2, 6, and 12 months for the primary outcome, the International Knee Documentation Committee (IKDC) subjective score; and for secondary outcomes, the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, EuroQol–visual analog scale (EQ-VAS), and Tegner score. Results: No differences between groups were observed in terms of absolute values or improvement of the clinical scores across all follow-up intervals. The mean IKDC subjective score at baseline and 12 months improved from 45.6 to 60.7 in the LR-PRP group as compared with 46.8 to 62.9 in the LP-PRP group ( P = .626). No severe adverse events were described in either group, although 15 mild adverse events (knee pain or swelling) were reported: 12.2% for LR-PRP and 4.7% for LP-PRP ( P = .101). No statistically significant difference was also found between LR-PRP and LP-PRP in terms of failures (7.8% vs 3.5%, P = .331). Conclusion: This double-blind randomized trial showed that 3 intra-articular LR-PRP or LP-PRP injections produced similar clinical improvement in the 12 months of follow-up in patients with symptomatic knee OA. Both treatment groups reported a low number of adverse events, without intergroup differences. The presence of leukocytes did not significantly affect the clinical results of PRP injections. Registration: NCT02923700 (ClinicalTrials.gov identifier).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial

et al. 2022

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“…Furthermore, PRP has an anabolic effect on both MSCs and chondrocytes, assisting in proliferation, inhibiting deregulation, and supporting matrix development, which further maintains appropriate chondrocyte and stem cell development [ 32 ]. This combination leads to a reduction in TNF-α and IL-6 concentration, together with an increase in proteoglycans concentration in articular cartilage [ 33 ].…”

Section: Bioregenerative Therapies In Osteoarthritismentioning

confidence: 99%

“…Moreover, IA injection of ADSCs combined with arthroscopic debridement in patients with early knee OA has reported good results in terms of pain and function [ 79 ]. In addition, a combination of ADSCs with PRP in a rat model has shown that PRP potentiates the effect of ADSCs in damaged articular cartilage [ 33 ]. Recently, Okamoto-Okubo et al reported the best results with allogenic ADSCs over PRP in dogs with bilateral degenerative hip joint disease [ 80 ].…”

Section: Bioregenerative Therapies In Osteoarthritismentioning

confidence: 99%

Cell and Cell Free Therapies in Osteoarthritis

et al. 2021

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Osteoarthritis (OA) is the most common articular disease in adults and has a current prevalence of 12% in the population over 65 years old. This chronic disease causes damage to articular cartilage and synovial joints, causing pain and leading to a negative impact on patients’ function, decreasing quality of life. There are many limitations regarding OA conventional therapies—pharmacological therapy can cause gastrointestinal, renal, and cardiac adverse effects, and some of them could even be a threat to life. On the other hand, surgical options, such as microfracture, have been used for the last 20 years, but hyaline cartilage has a limited regeneration capacity. In recent years, the interest in new therapies, such as cell-based and cell-free therapies, has been considerably increasing. The purpose of this review is to describe and compare bioregenerative therapies’ efficacy for OA, with particular emphasis on the use of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP). In OA, these therapies might be an alternative and less invasive treatment than surgery, and a more effective option than conventional therapies.

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“…Ahmad et al in 2020 [50] published an experimental study on rats comparing the efficacy of PRP, ADMSCs, and their combination on a surgically induced osteoarthritic knee. They concluded that interleukin-6 expression is significantly reduced in the combined group, with a significantly higher proteoglycan content compared to the other groups.…”

Section: Osteoarthritismentioning

confidence: 99%

The Combined Use of Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells Promotes Healing. A Review of Experimental Models and Future Perspectives

et al. 2021

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Wound healing and tissue regeneration are a field of clinical medicine presenting high research interest, since various local and systematic factors can inhibit these processes and lead to an inferior result. New methods of healing enhancement constantly arise, which, however, require experimental validation before their establishment in everyday practice. Platelet-rich plasma (PRP) is a well-known autologous factor that promotes tissue healing in various surgical defects. PRP derives from the centrifugation of peripheral blood and has a high concentration of growth factors that promote healing. Recently, the use of adipose-derived mesenchymal stem cells (ADMSCs) has been thoroughly investigated as a form of wound healing enhancement. ADMSCs are autologous stem cells deriving from fat tissue, with a capability of differentiation in specific cells, depending on the micro-environment that they are exposed to. The aim of the present comprehensive review is to record the experimental studies that have been published and investigate the synergistic use of PRP and ADMSC in animal models. The technical aspects of experimentations, as well as the major results of each study, are discussed. In addition, the limited clinical studies including humans are also reported. Future perspectives are discussed, along with the limitations of current studies on the long-term follow up needed on efficacy and safety.

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Combination of Preconditioned Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma Improves the Repair of Osteoarthritis in Rat

Cited by 15 publications

References 30 publications

Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial

Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial

Cell and Cell Free Therapies in Osteoarthritis

The Combined Use of Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells Promotes Healing. A Review of Experimental Models and Future Perspectives

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