Uso do soro autólogo condicionado e do plasma rico em plaquetas na terapia ortopédica de equinos

Abstract

ResumoAs lesões musculoesqueléticas que ocorrem durante a prática esportiva em equinos são debilitantes e demandam um longo período de tratamento e reabilitação, para muitas vezes obter-se após o tratamento apenas um tecido cicatricial, predispondo à recidiva. Em busca de terapias mais efetivas e da reparação tecidual de melhor qualidade, tem sido estudada a utilização de derivados sanguíneos, como plasma rico em plaquetas e soro autólogo condicionado. Apesar de ambos serem considerados hemoderivados, o soro autólogo condicionado e o plasma rico em plaquetas são produtos distintos com indicações totalmente diferentes para seu uso. Em lesões tendíneas e ligamentares o plasma rico em plaquetas apresenta resultado promissor em estudos clínicos e experimentais. Nas lesões osteoarticulares estes resultados são obtidos tanto com o soro autólogo condicionado como com o plasma rico em plaquetas. A presente revisão tem como objetivo apresentar estudos clínicos e experimentais (in vivo e in vitro) na espécie equina, que auxiliem na escolha do melhor hemoderivado a ser utilizado frente às diferentes lesões musculoesqueléticas. Palavras-chave: Plasma rico em plaquetas, soro autólogo condicionado, tendão, ligamento, articulação, músculo AbstractMusculoskeletal injuries that occur in horses during sports activities are often disabling and require a long period of treatment and rehabilitation, most resulting in scar tissue, predisposing to recurrence. In search of more effective therapies and tissue regeneration, studies have been carried out with blood derivatives -platelet rich plasma and autologous conditioned serum. In spite of both being bloodderived therapies, platelet rich plasma and autologous conditioned serum are distinct products, with equally distinct indications for their use. Platelet rich plasma shows promising results in ligament and tendon injuries in clinical and experimental trials. This occurs also in osteoarticular lesions with both hemoderivates, autologous conditioned serum and platelet rich plasma. This review aims to present clinical and experimental studies (in vivo and in vitro) in the equine species, as an aid for an appropriate therapeutic choice, when hemoderivates are considered for treatment of musculoskeletal lesions.

Does Double Centrifugation Lead to Premature Platelet Aggregation and Decreased TGF-β1 Concentrations in Equine Platelet-Rich Plasma?

“…For the double centrifugation protocol [4], three 15 mL tubes were used, containing 10.5 mL of blood each. After collection, the blood samples were incubated at room temperature for 25 min., and then were centrifugated at 300× g for 5 min., followed by another 25 min.…”

“…In the last decade, hemoderivative therapeutics has become a suitable alternative to treat musculoskeletal disorders in both human and veterinary medicine. Particularly, the platelet-rich plasma (PRP) has shown beneficial effects on several joint diseases, which help to relieve pain and improve the articular structures (reviews in [1,2,3,4]).…”

Protocols for preparation of platelet rich plasma (PRP) in Quarter Horses

“…Stimulates the differentiation and mitogenesis of mesenchymal cells and of lining cells, stimulates osteoblasts and the production of type I collagen, osteocalcin and alkaline phosphatase. Raines & Ross (1982), Frater et al (2018) Platelet degranulation usually starts within one hour of blood collection and the clinical effects of this degranulation are controversial (Prado Vendruscolo et al 2014). One way of assessing platelet degranulation is the measurement of P-selectin (Vestweber & Blanks 1999) but other substances present in the α-granules, such as VEGF, are likely candidates (Engels et al 2015).…”