a Dipartimento di Scienze Biomediche , Chirurgiche e Odontoiatriche, Università degli Studi di Milano , Milan , Italy.
b Department of Nanomedicine , Houston Methodist Research Institute , Houston , TX , USA.
Platelets. 2018 Jun;29(4):326-337. doi: 10.1080/09537104.2017.1327652. Epub 2017 Jun 23.
In presence of large bone defects, delayed bone union, non-union, fractures, and implant surgery, bone reconstruction may be necessary. Different strategies have been employed to enhance bone healing among which the use of autologous platelet concentrates. Due to the high content of platelets and platelet-derived bioactive molecules (e.g., growth factors, antimicrobial peptides), they are promising candidates to increase bone healing. However, a high heterogeneity of both preclinical and clinical studies resulted in contrasting results. Aim of the present systematic review was to evaluate the efficacy of platelet concentrates in animal models of bone regeneration, considering the possible factors which might affect the outcome. An electronic search was performed on MEDLINE and SCOPUS databases. Animal studies with a minimum follow up of 2 weeks and a sample size of five subjects per group, using platelet concentrates for bone regeneration, were included. Articles underwent risk of bias assessment and further quality evaluation was done. Sixty studies performed on six animal species (rat, rabbit, dog, sheep, goat, and mini-pig) were included. The present part of the review considers only studies performed on rats and rabbits (35 articles). The majority of the studies were considered at medium risk of bias. Animal species, healthy models, platelet, growth factors and leukocytes concentration, and type of bone defect seemed to influence the efficacy of platelet concentrates in bone healing. However, final conclusions were not be drawn, since only few included studies evaluated leukocyte, growth factor content, or presence of other bioactive molecules in platelet concentrates. Further studies with a standardized protocol including characterization of the final products will provide useful information for clinical application of platelet concentrates in bone surgery.
在存在大的骨缺损、延迟骨愈合、骨不连、骨折和植入物手术的情况下，可能需要进行骨重建。已经采用了不同的策略来增强骨愈合，其中包括使用自体血小板浓缩物。由于血小板和血小板衍生的生物活性分子（例如生长因子、抗菌肽）含量高，它们是增加骨愈合的有前途的候选物。然而，临床前和临床研究的高度异质性导致了结果的差异。本系统评价的目的是评估血小板浓缩物在骨再生动物模型中的疗效，同时考虑可能影响结果的因素。在 MEDLINE 和 SCOPUS 数据库中进行了电子检索。纳入了至少随访 2 周且每组样本量为 5 个的使用血小板浓缩物进行骨再生的动物研究。文章进行了偏倚风险评估，并进一步进行了质量评估。纳入了 6 种动物（大鼠、兔、犬、绵羊、山羊和小型猪）的 60 项研究。本综述仅考虑了在大鼠和兔上进行的研究（35 篇）。大多数研究被认为具有中度偏倚风险。动物种类、健康模型、血小板、生长因子和白细胞浓度以及骨缺损类型似乎影响了血小板浓缩物在骨愈合中的疗效。然而，由于只有少数纳入的研究评估了白细胞、生长因子含量或血小板浓缩物中其他生物活性分子的存在，因此无法得出最终结论。具有标准化方案的进一步研究，包括对最终产品进行特征描述，将为血小板浓缩物在骨外科中的临床应用提供有用的信息。
