Dhillon Robinder S, Schwarz Edward M, Maloney Michael D
Arthritis Res Ther. 2012 Aug 8;14(4):219. doi: 10.1186/ar3914.
Chronic complex musculoskeletal injuries that are slow to heal pose challenges to physicians and researchers alike. Orthobiologics is a relatively newer science that involves application of naturally found materials from biological sources (for example, cell-based therapies), and offers exciting new possibilities to promote and accelerate bone and soft tissue healing. Platelet-rich plasma (PRP) is an orthobiologic that has recently gained popularity as an adjuvant treatment for musculoskeletal injuries. It is a volume of fractionated plasma from the patient's own blood that contains platelet concentrate. The platelets contain alpha granules that are rich in several growth factors, such as platelet-derived growth factor, transforming growth factor-β, insulin-like growth factor, vascular endothelial growth factor and epidermal growth factor, which play key roles in tissue repair mechanisms. PRP has found application in diverse surgical fields to enhance bone and soft-tissue healing by placing supra-physiological concentrations of autologous platelets at the site of tissue damage. The relative ease of preparation, applicability in the clinical setting, favorable safety profile and possible beneficial outcome make PRP a promising therapeutic approach for future regenerative treatments. However, there is a large knowledge gap in our understanding of PRPs mechanism of action, which has raised skepticism regarding its potential efficacy and use. Thus, the aim of this review is to describe the various factors proposed to contribute to the biological activity of PRP, and the published pre-clinical and clinical evidence to support it. Additionally, we describe the current techniques and technology for PRP preparation, and review the present shortcomings of this therapy that will need to be overcome if it is to gain broad acceptance.
慢性复杂性肌肉骨骼损伤愈合缓慢，给医生和研究人员都带来了挑战。骨科生物制剂是一门相对较新的科学，涉及应用从生物来源天然获取的材料（例如基于细胞的疗法），为促进和加速骨骼及软组织愈合提供了令人兴奋的新可能性。富血小板血浆（PRP）是一种骨科生物制剂，最近作为肌肉骨骼损伤的辅助治疗方法而受到欢迎。它是从患者自身血液中分离出来的一部分血浆，含有浓缩血小板。血小板含有富含多种生长因子的α颗粒，如血小板衍生生长因子、转化生长因子-β、胰岛素样生长因子、血管内皮生长因子和表皮生长因子，这些生长因子在组织修复机制中起关键作用。PRP已在不同的外科领域得到应用，通过在组织损伤部位放置超生理浓度的自体血小板来促进骨骼和软组织愈合。PRP制备相对容易、适用于临床、安全性良好且可能带来有益效果，使其成为未来再生治疗的一种有前景的治疗方法。然而，我们对PRP作用机制的理解存在很大的知识空白，这引发了对其潜在疗效和用途的怀疑。因此，本综述的目的是描述被认为有助于PRP生物活性的各种因素，以及支持这些因素的已发表的临床前和临床证据。此外，我们描述了目前PRP制备的技术和工艺，并综述了该疗法目前存在的、若要获得广泛认可需要克服的缺点。
