Wakayama Takanori, Saita Yoshitomo, Kobayashi Yohei, Nishio Hirofumi, Uchino Sayuri, Fukusato Shin, Ikeda Hiroshi, Kaneko Kazuo
Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Department of Orthopaedics, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan - Department of Physical Therapy, Juntendo University, Faculty of Health Science, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Regen Med Res. 2020;8:3. doi: 10.1051/rmr/200002. Epub 2020 Dec 3.
Knee osteoarthritis (KOA), the most common form of osteoarthritis (OA) is a considerable health concern worldwide. Platelet-rich plasma (PRP) is a common therapeutic option for KOA. Different types of PRPs have varying efficacies. However, a comparative analysis of the qualities of these PRPs is lacking.
Two types of PRPs, including autologous protein solution (APS), and leukocyte-poor PRP (LP-PRP) along with whole blood (WB) and platelet-poor plasma (PPP) were characterized for platelet content, leukocyte content, and composition in 10 healthy volunteers (HV) (the controlled laboratory study) and 16 KOA patients (a retrospective observational study). Additionally, the levels of the platelet-derived growth factor (PDGF)-BB, and different cytokines were estimated in HV.
In HV, the concentrations of platelets and leukocytes, levels of different cytokines, including interleukin 1 receptor antagonist (IL-1Ra), soluble TNF receptor type II (sTNF-RII), and IL-1β, and the ratio of IL-1Ra/IL-1β were significantly higher in APS, whereas the PDGF-BB was higher in LP-PRP than APS. In KOA patients, a higher concentration of platelets was observed in LP-PRP, and a higher concentration of leukocytes was observed in APS than LP-PRP. Following the PAW classification system, LP-PRP was classified as P2-B type in HV (51.3 × 10/μl) and KOA (53.4 × 10/μl), whereas APS was classified as P3-A type in HV (110.1 × 10/μl) and P2-A type in KOA (29.0 × 10/μl). In a retrospective observational study, the KOA patients who underwent APS injection had a higher incidence of arthralgia, and this arthralgia lasted for a longer time than LP-PRP injection in the same individual.
The quality of the two PRPs differed distinctively depending on their preparation methods, which might affect their clinical efficacies and adverse events. Therefore, the characterization of these parameters should be prioritized while choosing PRP.
膝关节骨关节炎（KOA）是骨关节炎（OA）最常见的形式，是全球范围内备受关注的健康问题。富血小板血浆（PRP）是KOA常见的治疗选择。不同类型的PRP疗效各异。然而，缺乏对这些PRP质量的比较分析。
对两种类型的PRP，包括自体蛋白溶液（APS）和少白细胞PRP（LP-PRP），以及全血（WB）和少血小板血浆（PPP），在10名健康志愿者（HV）中进行血小板含量、白细胞含量和成分特征分析（对照实验室研究），并在16名KOA患者中进行回顾性观察研究。此外，还对HV中的血小板衍生生长因子（PDGF）-BB和不同细胞因子水平进行了评估。
在HV中，APS中的血小板和白细胞浓度、不同细胞因子水平，包括白细胞介素1受体拮抗剂（IL-1Ra）、可溶性肿瘤坏死因子受体II型（sTNF-RII）和IL-1β，以及IL-1Ra/IL-1β比值均显著高于其他组，而LP-PRP中的PDGF-BB高于APS。在KOA患者中，LP-PRP中血小板浓度较高，APS中白细胞浓度高于LP-PRP。按照PAW分类系统，LP-PRP在HV（51.3×10/μl）和KOA（53.4×10/μl）中被分类为P2-B型，而APS在HV（）中被分类为P3-A型，在KOA（29.0×10/μl）中被分类为P2-A型。在一项回顾性观察研究中，接受APS注射的KOA患者关节痛发生率较高，且与同一患者接受LP-PRP注射相比，这种关节痛持续时间更长。
两种PRP的质量因其制备方法不同而有显著差异，这可能会影响它们的临床疗效和不良事件。因此，在选择PRP时应优先对这些参数进行特征分析。
