Uchino Sayuri, Saita Yoshitomo, Wada Atsushi, Kobayashi Yohei, Wakayama Takanori, Nishio Hirofumi, Fukusato Shin, Momoi Yasumasa, Nakajima Ryosuke, Ikeda Hiroshi, Ishijima Muneaki
Department of Medicine for Orthopaedics and Motor Organ, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Department of Orthopaedics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Regen Ther. 2021 Jul 8;18:176-181. doi: 10.1016/j.reth.2021.06.004. eCollection 2021 Dec.
Platelet-rich plasma (PRP) therapy is used to treat pathological conditions such as degenerative inflammatory diseases including osteoarthritis (OA) by enhancing tissue repair and promoting anti-inflammatory effects. Although PRP therapy for patients with knee OA improved pain and functional scores, the association of clinical outcomes and quality of PRP including cell composition and concentration is unclear.
Therefore, this study analyzed blood cell counts, including the immature platelet fraction (IPF), in peripheral blood and PRP of 144 patients with knee OA who underwent PRP therapy. The mean leukocyte and platelet concentrations in whole blood and PRP were analyzed using an XN-1000 automated hematology analyzer. Visual analogue scale (VAS) scores and knee injury and osteoarthritis outcome scores (KOOS) before and 1 month after a single PRP injection were also determined.
Higher platelet and lower leukocyte concentration rates were observed in PRP compared with whole blood. The platelet concentration in whole blood was negatively correlated with VAS improvement. The percentage of IPF (IPF%) in whole blood was positively correlated with VAS improvement and KOOS (pain) improvement, whereas the IPF% in PRP tended to correlate with VAS improvement. Furthermore, multivariate logistic regression demonstrated the high IPF% in whole blood was significantly associated with VAS improvement. The low percentage of neutrophil (neutrophil%) in PRP was significantly associated with the VAS improvement and KOOS (ADL) improvement.
Therefore, PRP efficacy for OA might depend on the patient's biological status.
富血小板血浆（PRP）疗法用于治疗诸如骨关节炎（OA）等退行性炎症性疾病等病理状况，通过增强组织修复和促进抗炎作用来实现。尽管针对膝骨关节炎患者的PRP疗法改善了疼痛和功能评分，但PRP的临床结果与包括细胞组成和浓度在内的质量之间的关联尚不清楚。
因此，本研究分析了144例接受PRP治疗的膝骨关节炎患者外周血和PRP中的血细胞计数，包括未成熟血小板分数（IPF）。使用XN-1000全自动血液分析仪分析全血和PRP中的平均白细胞和血小板浓度。还测定了单次PRP注射前和注射后1个月的视觉模拟量表（VAS）评分以及膝关节损伤和骨关节炎疗效评分（KOOS）。
与全血相比，PRP中观察到更高的血小板浓度和更低的白细胞浓度率。全血中的血小板浓度与VAS改善呈负相关。全血中IPF的百分比（IPF%）与VAS改善和KOOS（疼痛）改善呈正相关，而PRP中的IPF%倾向于与VAS改善相关。此外，多因素逻辑回归表明全血中高IPF%与VAS改善显著相关。PRP中低百分比的中性粒细胞（中性粒细胞%）与VAS改善和KOOS（日常生活活动能力，ADL）改善显著相关。
因此，PRP对OA的疗效可能取决于患者的生物学状态。
