Department of Pathology, Microbiology and Immunology, University of California, Davis, CA 95616, USA.
Vet J. 2013 Oct;198(1):217-23. doi: 10.1016/j.tvjl.2013.07.020. Epub 2013 Aug 28.
Platelet-rich plasma (PRP) products may be useful for treatment of joint disease in horses, but may contain undesirable pro-inflammatory cytokines in addition to growth factors. This study investigated whether autologous PRP increases synovial fluid growth factor and cytokine concentrations when injected into normal equine metacarpophalangeal and metatarsophalangeal (fetlock) joints. Fetlock joints of seven healthy horses received one of four treatments: saline, resting PRP, CaCl2-activated PRP or thrombin-activated PRP. Synovial fluid was sampled prior to injection and at 6, 24, 48 and 96 h post-injection. Platelet-derived growth factor (PDGF-BB), transforming growth factor β1 (TGFβ1), interleukin (IL)-6 and tumor necrosis factor α (TNFα) concentrations in synovial fluid and PRP were measured by ELISA. Synovial fluid PDGF-BB, TGFβ1, IL-6, TNFα and IL-1 concentrations were also measured in vitro after incubation for 6h with resting PRP only. Growth factor concentrations, but not cytokine concentrations, were significantly higher in activated PRP than in resting PRP samples. After intra-articular injection with resting or thrombin-activated PRP, synovial TGFβ1 increased significantly compared to baseline levels. TNFα and IL-6 were significantly increased in synovial fluid after thrombin-activated PRP injection. In vitro, growth factor concentrations increased significantly in synovial fluid after mixing with PRP, indicating that exogenous activation of PRP for intra-articular injection may be unnecessary, whereas cytokine levels did not. In conclusion, thrombin-activated PRP induced an inflammatory cytokine response in joints, whereas resting or CaCl2-activated PRP did not. Synovial growth factor levels were low overall; the reported benefits of intra-articular PRP may not be attributable to changes in local PDGF or TGFβ1 concentrations.
富血小板血浆 (PRP) 产品可能对治疗马的关节疾病有用，但除了生长因子外，还可能含有不理想的促炎细胞因子。本研究旨在探讨自体 PRP 注射到正常马掌指和跖趾 (跗关节) 关节时是否会增加滑液中的生长因子和细胞因子浓度。7 匹健康马的跗关节接受了以下四种治疗之一：生理盐水、静止 PRP、CaCl2 激活的 PRP 或凝血酶激活的 PRP。在注射前和注射后 6、24、48 和 96 小时采集滑液样本。通过 ELISA 测量滑液和 PRP 中的血小板衍生生长因子 (PDGF-BB)、转化生长因子 β1 (TGFβ1)、白细胞介素 (IL)-6 和肿瘤坏死因子 α (TNFα) 浓度。仅在静止 PRP 孵育 6 小时后，还测量了滑液中的 PDGF-BB、TGFβ1、IL-6、TNFα 和 IL-1 浓度。与静止 PRP 样本相比，激活的 PRP 中的生长因子浓度显著更高，但细胞因子浓度没有差异。与基线水平相比，注射静止或凝血酶激活的 PRP 后，关节滑液中的 TGFβ1 显著增加。凝血酶激活的 PRP 注射后，滑液中的 TNFα 和 IL-6 显著增加。体外，与 PRP 混合后，滑液中的生长因子浓度显著增加，表明关节内注射 PRP 的外源激活可能不必要，而细胞因子水平没有增加。总之，凝血酶激活的 PRP 诱导关节产生炎症细胞因子反应，而静止或 CaCl2 激活的 PRP 则没有。总的来说，滑膜生长因子水平较低；关节内 PRP 的报道益处可能与局部 PDGF 或 TGFβ1 浓度的变化无关。
