Is exclusion of leukocytes from platelet-rich plasma (PRP) a better choice for early intervertebral disc regeneration?

Abstract

BackgroundPlatelet-rich plasma (PRP) is becoming a promising strategy to treat early intervertebral disc degeneration (IDD) in clinics. Pure PRP without leukocytes (P-PRP) may decrease the catabolic and inflammatory changes in the early degenerated intervertebral discs. The aim of this study was to investigate the effects of P-PRP on nucleus pulposus-derived stem cells (NPSCs) isolated from early degenerated intervertebral discs in vitro.MethodsNPSCs isolated from early degenerated discs of rabbits were treated with P-PRP or leukocyte-platelet-rich PRP (L-PRP) in vitro, followed by measuring cell proliferation, stem cell marker expression, inflammatory gene expression, and anabolic and catabolic protein expression by immunostaining, quantitative real-time polymerase chain reaction, Western blot, and enzyme-linked immunosorbent assay.ResultsCell proliferation was induced by P-PRP in a dose-dependent manner with maximum proliferation at 10% P-PRP dose. P-PRP induced differentiation of NPSCs into active nucleus pulposus cells. P-PRP mainly increased the expression of anabolic genes and relative proteins, aggrecan (AGC), collagen types II (Col II), while L-PRP predominantly increased the expression of catabolic and inflammatory genes, matrix metalloproteinase-1 (MMP-1), MMP-13, interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor alpha (TNF-α), and protein production of IL-1β and TNF-α.ConclusionsLeukocytes in PRP activate inflammatory and catabolic effects on NPSCs from early degenerated intervertebral discs. Hence, P-PRP may be a more suitable therapeutic strategy for early IDD.

The blood cells count in leukocyte and leukocyte-poor platelet-concentrated plasma in patients with musculoskeletal disorders

“…2 A). Therefore, no significant difference was found between the platelet count in these biotechnological products, which coincides with the data of some studies on plateletrich plasma [36,40,43,47]. However, some studies have shown that the number of platelets in leukocyte-poor platelet concentrates is significantly lower than in leukocyte-containing ones [6,39].…”

Vertebral intraosseous plasma rich in growth factor (PRGF-Endoret) infiltrations as a novel strategy for the treatment of degenerative lesions of endplate in lumbar pathology: description of technique and case presentation

“…In order to obtain the best clinical results, we have used PRGF-Endoret, a leukocyte-free PRP (P-PRP) comprehensively characterized and classified [32] with a trajectory of more than 20 years [33]. Current evidence suggests that P-PRP may be the most appropriate therapeutic option [34], since the inclusion of leukocytes or erythrocytes in the PRP formulation would not provide any additional advantage, or could even be detrimental to the clinical outcome [35,36].…”

<p>Platelet-rich plasma in the management of chronic low back pain: a critical review</p>

“…Wang et al62 performed a study using rabbit NP-derived stem cells obtained from degenerated discs of rabbit and compared the effects of P-PRP and leukocyte-rich PRP (R-PRP). P-PRP stimulated AGN and COL2 at both mRNA and protein levels and inhibited TNF-α, IL-6, -8, MMP1, and MMP13 mRNA expressions, as well as IL-1β and TNF-α protein production.…”