Magalon J, Chateau A L, Bertrand B, Louis M L, Silvestre A, Giraudo L, Veran J, Sabatier F
Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, CIC BT 1409, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, Marseille, France.
Plastic Surgery Department , Hôpital de la Conception, AP-HM , Marseille , France.
BMJ Open Sport Exerc Med. 2016 Feb 4;2(1):e000060. doi: 10.1136/bmjsem-2015-000060. eCollection 2016.
BACKGROUND/AIM: Significant biological differences in platelet-rich plasma (PRP) preparations have been highlighted and could explain the large variability in the clinical benefit of PRP reported in the literature. The scientific community now recommends the use of classification for PRP injection; however, these classifications are focused on platelet and leucocyte concentrations. This presents the disadvantages of (1) not taking into account the final volume of the preparation; (2) omitting the presence of red blood cells in PRP and (3) not assessing the efficiency of production.
On the basis of standards classically used in the Cell Therapy field, we propose the DEPA (Dose of injected platelets, Efficiency of production, Purity of the PRP, Activation of the PRP) classification to extend the characterisation of the injected PRP preparation. We retrospectively applied this classification on 20 PRP preparations for which biological characteristics were available in the literature.
Dose of injected platelets varies from 0.21 to 5.43 billion, corresponding to a 25-fold increase. Only a Magellan device was able to obtain an A score for this parameter. Assessments of the efficiency of production reveal that no device is able to recover more than 90% of platelets from the blood. Purity of the preparation reveals that a majority of the preparations are contaminated by red blood cells as only three devices reach an A score for this parameter, corresponding to a percentage of platelets compared with red blood cells and leucocytes over 90%.
These findings should provide significant help to clinicians in selecting a system that meets their specific needs for a given indication.
背景/目的：富含血小板血浆（PRP）制剂存在显著的生物学差异，这可能解释了文献中报道的PRP临床疗效的巨大差异。科学界现在建议对PRP注射进行分类；然而，这些分类侧重于血小板和白细胞浓度。这存在以下缺点：（1）未考虑制剂的最终体积；（2）忽略PRP中红细胞的存在；（3）未评估生产效率。
基于细胞治疗领域经典使用的标准，我们提出了DEPA（注射血小板剂量、生产效率、PRP纯度、PRP激活）分类法，以扩展对注射用PRP制剂的表征。我们对20种PRP制剂进行了回顾性应用该分类法，这些制剂的生物学特性在文献中可用。
注射血小板剂量从0.21亿至54.3亿不等，相差25倍。只有麦哲伦设备能够在该参数上获得A评分。生产效率评估显示，没有设备能够从血液中回收超过90%的血小板。制剂纯度显示，大多数制剂被红细胞污染，因为只有三种设备在该参数上达到A评分，即血小板与红细胞和白细胞的百分比超过90%。
这些发现应为临床医生选择满足特定适应症特定需求的系统提供重要帮助。
