Platelet-Rich Plasma Injections: Pharmacological and Clinical Considerations in Pain Management

Grossen, Audrey A.; Lee, Benjamin J.; Shi, Huaizhong; Shakir, Hakeem J; Cornett, Elyse M.; Kaye, Alan D.

doi:10.1007/s11916-022-01082-2

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…To date, however, an increasing number of systematic reviews and meta-analyses have reported that the positive effects of PRP application are not only limited to tissue regeneration but also provide symptomatic relief in the treatment of several orthopedic indications, such as rotator cuff tears [6][7][8][9], chronic lumber pain, long bone fracture [10,11], knee osteoarthritis [12], lateral epicondylitis [13], and tendon and ligament [14]. However, a non-negligible number of review articles has expressed skepticism through their meta-analyses of similar orthopedic indications and suggested further randomized clinical trials with qualified PRP preparations in similar clinical indications [15][16][17][18][19][20][21][22][23][24][25]. Such a controversial understanding is due to the quality of individual PRP preparations as well as the condition of individual recipients.…”

Section: Introductionmentioning

confidence: 99%

The levels of TGFβ1, VEGF, PDGF-BB, and PF4 in platelet-rich plasma of professional soccer players: a cross-sectional pilot study

et al. 2022

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Background Regenerative therapy using platelet-rich plasma (PRP), a rich source of growth factors, has become popular in orthopedic sports medicine. Elite athletes prefer PRP therapy for their injured muscles and tendons primarily to avoid the possible risks of surgical treatment. However, the clinical effectiveness of PRP therapy in elite athletes compared to that in non-athletes remains unknown. Therefore, to investigate the effectiveness of PRP therapy in professional athletes (pro-athletes), we focused on the quality of PRP preparations and compared the levels of bioactive molecules between pro-athletes and non-athletes. Methods PRP was prepared from healthy, non-smoking male professional soccer players (pro-athletes) (n = 22) and non-athletes (VEGF: n = 34, others: n = 38). The levels of TGFβ1, PDGF-BB, VEGF, and PF4 were determined using ELISA kits. Polyphosphate was probed with 4’,6-diamidino-2-phenylindole and monitored using a fluorometer. The body composition of the donors was determined using a bathroom weighing scale. Results The levels of TGFβ1 and VEGF were significantly lower in pro-athletes than in non-athletes, whereas PF4 levels were significantly higher in pro-athletes. No significant difference was found in PDGF-BB levels between these groups. Biomolecule levels were not correlated with polyphosphate levels. Conclusion TGFβ1, VEGF, and PDGF-BB levels in pro-athletes were not higher than those in non-athletes. These findings suggest that growth factor levels in PRP may not be a predominant determinant of the clinical effectiveness of PRP therapy in pro-athletes. Increased PF4 levels in pro-athletes suggest an immunological function of PRP that may positively influence tissue regeneration.

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Section: Introductionmentioning

confidence: 99%

The levels of TGFβ1, VEGF, PDGF-BB, and PF4 in platelet-rich plasma of professional soccer players: a cross-sectional pilot study

et al. 2022

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“…It contains higher levels of cytokines and growth factors that can promote angiogenesis, accelerate endothelial regeneration, stimulate tissue repair and healing processes, and increase collagen content in different types of tissues. [34][35][36][37][38] When platelets are activated in PRP, they can produce many growth factors, including platelet-derived growth factor, basic fibroblast growth factor, transforming growth factor-β, insulin-like growth factor, vascular endothelial growth factor, etc. They can promote the production of collagen II and chondrocytes, prevent apoptosis of mesenchymal stem cells and chondrocytes, and avert the catabolic effects of inflammatory cytokines like interleukin-1β and matrix metalloproteinase.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Efficacy of Platelet-Rich Plasma Injection Therapy versus Different Control Groups for Chronic Low Back Pain: A Network Meta-Analysis of Randomized Controlled Trials

Zhang,

Guan

et al. 2024

JPR

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Objective Low back pain is one of the main causes of disability in the world. Although regenerative medicine may represent breakthroughs in the management of low back pain, its use remains controversial. Therefore, we conducted a meta-analysis to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection therapy versus different control groups for chronic low back pain during 4 weeks, 3 months, and 6 months. Methods Different electronic databases were searched for randomized controlled trials up to August 2023. Mean changes from baseline in pain and Oswestry Disability Index (ODI) scores at 4 weeks, 3 months, and 6 months and standard deviations of outcome were recorded. Results Four articles with 154 cases were finally included in this meta-analysis. After 4 weeks, corticosteroid (CS) was the optimal treatment option for chronic low back pain in terms of improvement in pain and disability index (surface under the cumulative ranking curve [SUCRA]=71.3%, SUCRA=57.8%, respectively). After 3 months, radiofrequency (RF) emerged as the best therapy in pain (SUCRA=100%) and disability index (SUCRA=98.5%), followed by PRP (SUCRA=62.3%, SUCRA=64.3%, respectively), CS (SUCRA=24.6%, SUCRA=25.9%, respectively) and lidocaine (SUCRA=13.1%, SUCRA=11.3%, respectively). At 6 months, RF was most likely to be the best treatment in pain (SUCRA=94.9%) and disability index (SUCRA=77.3%), followed by PRP (SUCRA=71.2%, SUCRA=79.6%, respectively). However, compared with the last follow-up, there was a slight downward trend in improvement pain and disability index with RF, while PRP was still an upward trend. Conclusion This study demonstrated better short-term improvement of chronic low back pain with CS after 4 weeks. PRP and RF improvement effects matched, but follow-up of at least 6 months showed that PRP seemed to be more advantageous in improvement in disability indices. Considering the limitations of this study, these conclusions still need to be verified by more comparative RCTs and a longer follow-up period.

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“…When mice are experimentally rendered infertile by cyclophosphamide, treatment with conditioned medium and PRP was able to boost expression of ‘mothers against decapentaplegic’ homologs 1 and 2 (SMAD1, SMAD2), growth differentiation factor-9 (GDF9), and bone morphogenetic protein-15 (BMP15) [ 63 ]. Although synergy may be inferred with PRP and conditioned medium, PRP carries its own cytokines, including platelet derived growth factor (PDGF), GDF9, and TGF-β [ 64 , 65 ]. For human granulosa cells, TGF-β1 upregulates gap junction alpha-1 protein/connexin 43 (Cx43) to amplify intercellular communication specifically involving activin receptor-like kinase (ALK) 5-mediated SMAD-related proteins [ 66 ].…”

Section: Prp and Organ Damage Reversalmentioning

confidence: 99%

Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives

Sills

Wood

2023

Medicines

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Platelet-rich plasma (PRP) is an ‘orthobiologic’ with recognized roles in plastic surgery, musculoskeletal disorders, dentistry, dermatology, and more recently, ‘ovarian rejuvenation’. Intraovarian PRP involves a complex secretome discharged after platelet activation, comprising multiple cytokine mediators delivered surgically to older or inactive ovarian tissue. Loss of oocyte meiotic fidelity and impaired fertilization accompanying advanced maternal age are already managed by IVF, but only with eggs provided by younger donors. However, if the observed effect of rectifying embryo ploidy error can be proven beyond case reports and small series, activated PRP (or its condensed plasma cytokines) would deliver a welcome therapeutic disruption that is difficult to overstate. Because shortcomings in ovarian function are presently addressed mainly by pharmacological approaches (i.e., via recombinant gonadotropins, GnRH analogs, or luteal support), autologous PRP would represent an unusual departure from these interventions. Given the diversity of platelet cargo proteins, the target response of intraovarian PRP is probably not confined to oocytes or follicles. For example, PRP manipulates signal networks driving improved perfusion, HOX regulation, N-glycan post-translational modification, adjustment of voltage-gated ion channels, telomere stabilization, optimization of SIRT3, and ribosome and mitochondria recovery in older oocytes. While multichannel signals operating on various pathways are not unique to reproductive biology, in intraovarian PRP this feature has received little study and may help explain why its standardization has been difficult. Against this background, our report examines the research themes considered most likely to shape clinical practice.

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Platelet-Rich Plasma Injections: Pharmacological and Clinical Considerations in Pain Management

Cited by 5 publications

References 39 publications

The levels of TGFβ1, VEGF, PDGF-BB, and PF4 in platelet-rich plasma of professional soccer players: a cross-sectional pilot study

The levels of TGFβ1, VEGF, PDGF-BB, and PF4 in platelet-rich plasma of professional soccer players: a cross-sectional pilot study

The Clinical Efficacy of Platelet-Rich Plasma Injection Therapy versus Different Control Groups for Chronic Low Back Pain: A Network Meta-Analysis of Randomized Controlled Trials

Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives

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