Harmful Effects of Leukocyte-Rich Platelet-Rich Plasma on Rabbit Tendon Stem Cells In Vitro

Zhang, Lei; Chen, Shuo; Chang, Peng; Bao, Nirong; Yang, Chao; Ti, Yufan; Zhou, Lei; Zhao, Jianning

doi:10.1177/0363546516644718

Cited by 64 publications

(59 citation statements)

References 48 publications

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“…This is important, because leukocyte-rich PRP is detrimental to the proliferation of some stem/progenitor cells, leading to impaired tissue healing, because leukocytes inhibit the release of growth factors, such as VEGF, EGF, TGFβ 1 , and PDGF, increasing catabolic cytokine concentrations and causing inflammation and apoptosis. 47 – 50 Therefore, differences in PRP composition due to different PRP-separation devices or physiological changes in the patient may account for some of the variability in the efficacy of PRP on pain reduction. 51 , 52 …”

Section: Introductionmentioning

confidence: 99%

Differing efficacies of autologous platelet-rich plasma in reducing pain following rotator-cuff injury in a single patient

Kuffler

2018

JPR

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Rotator-cuff tears (RCTs) are typically associated with chronic pain. The most common treatment for reducing pain is the injection of cortisone into the injury site. An alternative and increasingly used technique is the injection of autologous platelet-rich plasma (PRP). A limitation of cortisone is its pain relief is short-lived, while PRP has the limitation of providing pain relief to only about 50% of patients, making its efficacy questioned, although when it is effective, its efficacy is longer than cortisone. Little is known about what accounts for these limitations. This paper presents results from a patient with RCTs causing excruciating pain who received an injection of PRP into that shoulder resulting in complete pain elimination that was ongoing at 2 years and 2 months. When 7-month severe posttrauma pain associated with the RCT developed in the contralateral shoulder, PRP prepared the same way and injected by the same person who performed the first injection provided no pain relief. However, a subsequent single cortisone injection resulted in complete pain elimination, which was ongoing at >15 months. These observations indicate that PRP can have inconsistent effects in reducing pain, not only between patients but also within the same patient. Further, although the pain relief induced by cortisone is normally not long-lasting, when given following a PRP injection, it can induce complete pain relief lasting >15 months. This paper discusses possible reasons for the variability in PRP efficacy on pain relief and addresses the possibility that when administered together, PRP and cortisone may act in a complementary manner, leading to significantly greater and longer-lasting pain relief.

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Section: Introductionmentioning

confidence: 99%

Differing efficacies of autologous platelet-rich plasma in reducing pain following rotator-cuff injury in a single patient

Kuffler

2018

JPR

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“…It demonstrates enhanced COL1A1, COL3A1, decorin, fibronectin, aggrecan and connective tissue growth factor (CTGF) expression and reduced MMP-1 expression after exposure to LP-PRP. Similarly, the recent in vitro study by Zhang (Zhang et al 2016 ) showed that the exposure of rabbit tendon stem cells to LR-PRP decreased expression of VEGF, epidermal growth factor (EGF), Transforming Growth Factor Beta − 1 (TGF-β1) and platelet-derived growth factor (PDGF). Moreover, it reduced the production of collagen when compared to LP-PRP.…”

Section: Treatment Optionsmentioning

confidence: 85%

Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options

Abat¹,

Alfredson

Cucchiarini

et al. 2018

J EXP ORTOP

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The treatment of painful chronic tendinopathy is challenging. Multiple non-invasive and tendon-invasive methods are used. When traditional non-invasive treatments fail, the injections of platelet-rich plasma autologous blood or cortisone have become increasingly favored. However, there is little scientific evidence from human studies supporting injection treatment. As the last resort, intra- or peritendinous open or endoscopic surgery are employed even though these also show varying results. This ESSKA basic science committee current concepts review follows the first part on the biology, biomechanics and anatomy of tendinopathies, to provide a comprehensive overview of the latest treatment options for tendinopathy as reported in the literature.

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“…Moreover, the release of pro-inflammatory factors (cytokine and metalloproteinase) by the leukocytes may lead to deterioration of the extracellular matrix. Zhang et al [85] published the hypothesis that PRP containing high levels of leukocytes (L-PRP) increases the concentration of catabolic cytokine and induces inflammation and apoptosis of tendon cells. This study compared the effects of L-PRP and PRP on the morphology, proliferation, and differentiation of tendon cells.…”

Section: The Impact Of the Concentration Of Red And While Blood Cellsmentioning

confidence: 99%

The use of platelet-rich plasma to treat chronic tendinopathies: A technical analysis

Kaux¹,

Emonds-Alt²

2017

Platelets

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Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of "PRP." To optimize its use, it is important to look at the various stages of obtaining PRP. In this literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery.

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Harmful Effects of Leukocyte-Rich Platelet-Rich Plasma on Rabbit Tendon Stem Cells In Vitro

Abstract: This study revealed the direct effects of different compositions of PRP on TSCs and provided basic scientific data to help understand the cellular and molecular mechanisms of the efficacy of PRP treatment in clinical use.

Cited by 64 publications

References 48 publications

Differing efficacies of autologous platelet-rich plasma in reducing pain following rotator-cuff injury in a single patient

Differing efficacies of autologous platelet-rich plasma in reducing pain following rotator-cuff injury in a single patient

Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options

The use of platelet-rich plasma to treat chronic tendinopathies: A technical analysis

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