Department of Clinical Sciences, Cornell University, Ithaca, NY 14853, USA.
Am J Sports Med. 2011 Oct;39(10):2135-40. doi: 10.1177/0363546511417792. Epub 2011 Aug 16.
BACKGROUND: Previous studies of bioactive molecules in platelet-rich plasma (PRP) have documented growth factor concentrations that promote tissue healing. However, the effects of leukocytes and inflammatory molecules in PRP have not been defined. HYPOTHESIS: The hypothesis for this study was that the concentration of growth factors and catabolic cytokines would be dependent on the cellular composition of PRP. STUDY DESIGN: Controlled laboratory study. METHODS: Platelet-rich plasma was made from 11 human volunteers using 2 commercial systems: Arthrex ACP (Autologous Conditioned Plasma) Double Syringe System (PRP-1), which concentrates platelets and minimizes leukocytes, and Biomet GPS III Mini Platelet Concentrate System (PRP-2), which concentrates both platelets and leukocytes. Transforming growth factor-β1 (TGF-β1), platelet-derived growth factor-AB (PDGF-AB), matrix metalloproteinase-9 (MMP-9), and interleukin-1β (IL-1β) were measured with enzyme-linked immunosorbent assay (ELISA). RESULTS: The PRP-1 system consisted of concentrated platelets (1.99×) and diminished leukocytes (0.13×) compared with blood, while PRP-2 contained concentrated platelets (4.69×) and leukocytes (4.26×) compared with blood. Growth factors were significantly increased in PRP-2 compared with PRP-1 (TGF-β1: PRP-2 = 89 ng/mL, PRP-1 = 20 ng/mL, P < .05; PDGF-AB: PRP-2 = 22 ng/mL, PRP-1 = 6.4 ng/mL, P < .05). The PRP-1 system did not have a higher concentration of PDGF-AB compared with whole blood. Catabolic cytokines were significantly increased in PRP-2 compared with PRP-1 (MMP-9: PRP-2 = 222 ng/mL, PRP-1 = 40 ng/mL, P < .05; IL-1β: PRP-2 = 3.67 pg/mL, PRP-1 = 0.31 pg/mL, P < .05). Significant, positive correlations were found between TGF-β1 and platelets (r(2) = .75, P < .001), PDGF-AB and platelets (r(2) = .60, P < .001), MMP-9 and neutrophils (r(2) = .37, P < .001), IL-1β and neutrophils (r(2) = .73, P < .001), and IL-1β and monocytes (r(2) = .75, P < .001). CONCLUSION: Growth factor and catabolic cytokine concentrations were influenced by the cellular composition of PRP. Platelets increased anabolic signaling and, in contrast, leukocytes increased catabolic signaling molecules. Platelet-rich plasma products should be analyzed for content of platelets and leukocytes as both can influence the biologic effects of PRP. CLINICAL RELEVANCE: Depending on the clinical application, preparations of PRP should be considered based on their ability to concentrate platelets and leukocytes with sensitivity to pathologic conditions that will benefit most from increased platelet or reduced leukocyte concentration.
背景:之前对富含血小板的血浆(PRP)中的生物活性分子的研究记录了促进组织愈合的生长因子浓度。然而,PRP 中的白细胞和炎症分子的影响尚未确定。
假设:本研究的假设是生长因子和分解代谢细胞因子的浓度将取决于 PRP 的细胞组成。
研究设计:对照实验室研究。
方法:使用 2 种商业系统从 11 名人类志愿者中制备富含血小板的血浆:Arthrex ACP(自体条件血浆)双注射器系统(PRP-1),浓缩血小板并最大程度减少白细胞,和 Biomet GPS III 微型血小板浓缩系统(PRP-2),浓缩血小板和白细胞。用酶联免疫吸附测定(ELISA)测量转化生长因子-β1(TGF-β1)、血小板衍生生长因子-AB(PDGF-AB)、基质金属蛋白酶-9(MMP-9)和白细胞介素-1β(IL-1β)。
结果:PRP-1 系统与血液相比,浓缩血小板(1.99×)和减少白细胞(0.13×),而 PRP-2 含有浓缩血小板(4.69×)和白细胞(4.26×)与血液相比。与 PRP-1 相比,PRP-2 中的生长因子显着增加(TGF-β1:PRP-2 = 89 ng/mL,PRP-1 = 20 ng/mL,P <.05;PDGF-AB:PRP-2 = 22 ng/mL,PRP-1 = 6.4 ng/mL,P <.05)。PRP-1 系统与全血相比,PDGF-AB 的浓度没有更高。与 PRP-1 相比,PRP-2 中的分解代谢细胞因子显着增加(MMP-9:PRP-2 = 222 ng/mL,PRP-1 = 40 ng/mL,P <.05;IL-1β:PRP-2 = 3.67 pg/mL,PRP-1 = 0.31 pg/mL,P <.05)。发现 TGF-β1 与血小板之间存在显着的正相关(r² =.75,P <.001),PDGF-AB 与血小板之间存在显着的正相关(r² =.60,P <.001),MMP-9 与中性粒细胞之间存在显着的正相关(r² =.37,P <.001),IL-1β 与中性粒细胞之间存在显着的正相关(r² =.73,P <.001),IL-1β 与单核细胞之间存在显着的正相关(r² =.75,P <.001)。
结论:生长因子和分解代谢细胞因子的浓度受 PRP 的细胞组成影响。血小板增加合成代谢信号,而白细胞增加分解代谢信号分子。富含血小板的血浆产品应根据其浓缩血小板和白细胞的能力进行分析,因为这两者都会影响 PRP 的生物学效应。
临床相关性:根据临床应用,应根据 PRP 浓缩血小板和白细胞的能力以及对最有利于增加血小板或减少白细胞浓度的病理状况的敏感性来考虑 PRP 的制备。
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