Liu Xueli, Zhang Rong, Zhu Bin, Li Yujie, Liu Xinyue, Guo Sheng, Wang Chenglong, Wang Dingxuan, Li Sen
Department of Physical Education, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.
Department of Rehabilitation, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan 643000, P.R. China.
Exp Ther Med. 2021 Jun;21(6):639. doi: 10.3892/etm.2021.10071. Epub 2021 Apr 16.
Tendon-related disorders are common musculoskeletal system disorders in clinical practice, accounting for 30-50% of all sports-related injuries, and they are difficult to treat due to the hypovascular structure of the tendons. Platelet-rich plasma (PRP), including pure PRP and leukocyte- and platelet-rich plasma (L-PRP), has been attracting increasing attention, as it may stimulate tissue regeneration through the release of growth factors and cytokines. The aim of the present review was to provide a summary of the effects of L-PRP on tendon disorders and the underlying mechanisms through a comprehensive examination of the published literature, including , animal and clinical studies. It has been demonstrated that L-PRP results in comparatively greater pain relief and improved function in patients suffering from tendon disorders. Furthermore, L-PRP may exert its effects through a diverse range of mechanisms, such as neovascularization, cell proliferation and differentiation of tendon/progenitor stem cells into tenocytes, as well as extracellular matrix reorganization by transforming type III to type I collagen fibers. It has also been indicated that the effects of leukocytes in L-PRP depend on the biological state of the injured tissue and its surrounding microenvironment. L-PRP is beneficial and promotes tendon healing at the early stage, whereas it is likely detrimental to the repair of tendon at a later stage because of the risk of excessive catabolic and inflammatory responses. Overall, the application of L-PRP in tendon disorders appears to be a promising field that is worthy of further research.
肌腱相关疾病是临床实践中常见的肌肉骨骼系统疾病，占所有运动相关损伤的30%-50%，由于肌腱的血管结构较少，这些疾病难以治疗。富含血小板血浆（PRP），包括纯PRP和富含白细胞和血小板血浆（L-PRP），因其可能通过释放生长因子和细胞因子刺激组织再生而受到越来越多的关注。本综述的目的是通过全面审查已发表的文献，包括动物和临床研究，总结L-PRP对肌腱疾病的影响及其潜在机制。已经证明，L-PRP能使肌腱疾病患者的疼痛得到相对更大程度的缓解，并改善其功能。此外，L-PRP可能通过多种机制发挥作用，如新生血管形成、肌腱/祖干细胞向肌腱细胞的增殖和分化，以及通过将III型胶原纤维转化为I型胶原纤维进行细胞外基质重组。也有研究表明，L-PRP中白细胞的作用取决于受损组织及其周围微环境的生物学状态。L-PRP在早期阶段是有益的，并能促进肌腱愈合，而在后期可能对肌腱修复有害，因为存在过度分解代谢和炎症反应的风险。总体而言，L-PRP在肌腱疾病中的应用似乎是一个有前景的领域，值得进一步研究。
