Effect of prolotherapy on cellular proliferation and collagen deposition in MC3T3-E1 and patellar tendon fibroblast populations.

Proliferative therapy, or prolotherapy, is a treatment for damaged connective tissues involving the injection of a solution (proliferant) which causes local cell death and triggers the body's wound healing cascade. Physicians vary in their use of this technique; it is employed for ligaments but has also been investigated for tissues such as cartilage. Physicians also vary in treatment regiments using different dosses of the proliferant. This study evaluates several proliferant dosages develop an optimal dosage that maximizes cell and collagen regeneration. This study also looks at cell and collagen regeneration in response to proliferant exposure outside of the healing cascade. MC3T3-E1 cells and patellar tendon fibroblasts were exposed to various amounts of the proliferant P2G and monitored over several weeks. The results showed an inverse relationship between proliferant concentration and cell viability and collagen production in MC3T3-E1 cells. Following exposure, cell populations experienced an initial decrease in cell number followed by increased proliferation. Trichrome staining over 4 weeks showed an increase in collagen production after proliferant exposure. However the cell numbers and amounts of collagen from the treated groups never surpassed those of the untreated groups, although collagen production was comparable in fibroblasts. The results of this basic study show that there is an effective proliferant dosage and point to a local response to the proliferant that increases cell proliferation and collagen production separate from the wound healing cascade. This local response may not be adequate for complete healing and assistance from the body's healing cascade may be required.