Department of Clinical Sciences, Orthopaedic Research Center, Translational Medicine Institute, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado.
Center for Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, Colorado.
J Orthop Res. 2020 Dec;38(12):2539-2550. doi: 10.1002/jor.24786. Epub 2020 Jul 17.
Platelet-rich plasma is autologous plasma that contains concentrated platelets compared to whole blood. It is relatively inexpensive to produce, can be easily isolated from whole blood, and can be administered while the patient is in the operating room. Further, because platelet-rich plasma is an autologous therapy, there is minimal risk for adverse reactions to the patient. Platelet-rich plasma has been used to promote bone regeneration due to its abundance of concentrated growth factors that are essential to wound healing. In this review, we summarize the methods for producing platelet-rich plasma and the history of its use in bone regeneration. We also summarize the growth factor profiles derived from platelet-rich plasma, with emphasis on those factors that play a direct role in promoting bone repair within the local fracture environment. In addition, we discuss the potential advantages of combining platelet-rich plasma with mesenchymal stem cells, a multipotent cell type often obtained from bone marrow or fat, to improve craniofacial and long bone regeneration. We detail what is currently known about how platelet-rich plasma influences mesenchymal stem cells in vitro, and then highlight the clinical outcomes of administering platelet-rich plasma and mesenchymal stem cells as a combination therapy to promote bone regeneration in vivo.
富含血小板的血浆是自体血浆，与全血相比，其中含有浓缩的血小板。与其他治疗方法相比，它的生产成本相对较低，可从全血中轻松分离，并且可以在患者处于手术室时进行给药。此外，由于富含血小板的血浆是一种自体疗法，因此对患者几乎没有不良反应的风险。由于富含浓缩生长因子，富含血小板的血浆可促进骨再生，这些生长因子对伤口愈合至关重要。在这篇综述中，我们总结了生产富含血小板的血浆的方法及其在骨再生中的应用历史。我们还总结了源自富含血小板的血浆的生长因子谱，重点介绍了那些在局部骨折环境中直接促进骨修复的因子。此外，我们讨论了将富含血小板的血浆与间充质干细胞（一种通常从骨髓或脂肪中获得的多能细胞类型）相结合的潜在优势，以改善颅面骨和长骨的再生。我们详细介绍了目前已知的富含血小板的血浆在体外对间充质干细胞的影响，然后重点介绍了联合治疗以促进体内骨再生时给予富含血小板的血浆和间充质干细胞的临床结果。
