Evanson J Richard, Guyton M Kelly, Oliver David L, Hire Justin M, Topolski Richard L, Zumbrun Steven D, McPherson James C, Bojescul John A
Department of Orthopaedics, Dwight D. Eisenhower Army Medical Center, 300 Hospital Road, Fort Gordon, GA 30905.
Department of Clinical Investigation, 38th Avenue, 7th Street, Building 38705, Fort Gordon, GA 30905.
Mil Med. 2014 Jul;179(7):799-805. doi: 10.7205/MILMED-D-13-00336.
The use of platelet-rich plasma (PRP) to facilitate healing of orthopedic-related injuries has gained popularity; however, the clinical benefits are not consistent. Differences may result from variations in growth factor (GF) levels in normal populations. The purpose of this study was to determine if GF levels present in activated PRP preparations differed by gender and age (≤ 25 versus >25 years) in a healthy population (N = 102). All GFs analyzed (epidermal growth factor [EGF], hepatocyte growth factor [HGF], insulin growth factor-1 [IGF-1], platelet-derived growth factor-AB [PDGF-AB], platelet-derived growth factor-BB [PDGF-BB], transforming growth factor beta-1 [TGFβ-1], and vascular endothelial growth factor) had higher levels for females and for those ≤ 25 years old. Of the GFs tested, four of seven were significantly higher (p < 0.05) for females (EGF, HGF, IGF-1, PDGF-BB), the most significant being IGF-1 (female, 85.0; male, 69.3 ng/mL; p < 0.01). Five of seven GFs achieved significance (p < 0.05) for people ≤ 25 years old (EGF, IGF-1, PDGP-AB, PDGF-BB, and TGFβ-1), with IGF and PDGF-AB achieving p < 0.001 (≤ 25 years, 85.1; >25 years, 56.8, and ≤ 25 years, 7.66; >25 years, 5.77 ng/mL, respectively). Finally, for both genders, most of the GFs were positively correlated with all GFs. This study demonstrated that both age and gender account for variations in specific GFs present in PRP, and this may partially explain some of the inconsistent results of PRP clinical trials.
使用富含血小板血浆（PRP）促进骨科相关损伤的愈合已受到广泛关注；然而，其临床益处并不一致。差异可能源于正常人群中生长因子（GF）水平的变化。本研究的目的是确定在健康人群（N = 102）中，活化PRP制剂中存在的GF水平是否因性别和年龄（≤25岁与>25岁）而异。所有分析的生长因子（表皮生长因子[EGF]、肝细胞生长因子[HGF]、胰岛素生长因子-1[IGF-1]、血小板衍生生长因子-AB[PDGF-AB]、血小板衍生生长因子-BB[PDGF-BB]、转化生长因子β-1[TGFβ-1]和血管内皮生长因子）在女性和≤25岁的人群中水平较高。在测试的生长因子中，七种中有四种在女性中显著更高（p < 0.05）（EGF、HGF、IGF-1、PDGF-BB），最显著的是IGF-1（女性，85.0；男性，69.3 ng/mL；p < 0.01）。七种生长因子中有五种在≤25岁的人群中具有显著性（p < 0.05）（EGF、IGF-1、PDGP-AB、PDGF-BB和TGFβ-1），IGF和PDGF-AB的p < 0.001（≤25岁，85.1；>25岁，56.8，以及≤25岁，7.66；>25岁，5.77 ng/mL）。最后，对于两性而言，大多数生长因子与所有生长因子呈正相关。本研究表明，年龄和性别均导致PRP中特定生长因子的变化，这可能部分解释了PRP临床试验中一些不一致的结果。
