Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18 str, 40-752, Katowice, Poland.
District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 str, 41-940, Piekary Śląskie, Poland.
BMC Musculoskelet Disord. 2021 Aug 18;22(1):710. doi: 10.1186/s12891-021-04593-y.
There is variability in individual response to platelet-rich plasma (PRP) therapy in tennis elbow treatment. Genetic variation, especially within genes encoding growth factors may influence the observed inter-individual differences. The purpose of this study was to identify polymorphic variants of the platelet-derived growth factor beta polypeptide gene (PDGFB) that determine an improved individual response to PRP therapy in tennis elbow patients.
This prospective cohort study was designed in accordance with STROBE and MIBO guidelines. A cohort of 107 patients (132 elbows, 25 bilateral) was studied, including 65 females (77 elbows) and 42 males (55 elbows), aged 24-64 years (median 46.00 ± 5.50), with lateral elbow tendinopathy treated with autologous PRP injection. The effectiveness of PRP therapy was recorded in all subjects at 2, 4, 8, 12, 24 and 52 weeks after PRP injection using the Visual Analog Scale (VAS), quick version of Disabilities of the Arm, Shoulder and Hand score (QDASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE). In order to determine the PDGFB variants with the best response to PRP therapy, patient reported outcome measures were compared between individual genotypes within studied polymorphic variants (rs2285099, rs2285097, rs2247128, rs5757572, rs1800817 and rs7289325). The influence of single nucleotide polymorphisms on blood and PRP parameters, including the concentration of PDGF-AB and PDGF-BB proteins was also analyzed.
Our analysis identified genetic variants of the PDGFB gene that lead to a better response to PRP therapy. The TT (rs2285099) and CC (rs2285097) homozygotes had higher concentration of platelets in whole blood than carriers of other genotypes (p = 0.018) and showed significantly (p < 0.05) lower values of VAS (weeks 2-12), QDASH and PRTEE (weeks 2-24). The rs2285099 and rs2285097 variants formed strong haplotype block (r = 98, D'=100). The AA homozygotes (rs2247128) had significantly lower values of VAS (weeks 4-52), QDASH and PRTEE (weeks 8, 12).
PDGFB gene's polymorphisms increase the effectiveness of PRP therapy in tennis elbow treatment. Genotyping two polymorphisms of the PDGFB gene, namely rs2285099 (or rs2285097) and rs2247128 may be a helpful diagnostic tool while assessing patients for PRP therapy and modifying the therapy to improve its effectiveness.
富血小板血浆（PRP）治疗网球肘的个体反应存在差异。遗传变异，尤其是编码生长因子的基因中的遗传变异，可能会影响观察到的个体间差异。本研究的目的是确定血小板衍生生长因子β多肽基因（PDGFB）的多态性变异，这些变异决定了网球肘患者对 PRP 治疗的个体反应改善。
本前瞻性队列研究按照 STROBE 和 MIBO 指南进行设计。研究了 107 例患者（132 肘，25 例双侧），包括 65 名女性（77 肘）和 42 名男性（55 肘），年龄 24-64 岁（中位数 46.00±5.50），采用自体 PRP 注射治疗外侧肘肌腱病。所有患者在 PRP 注射后 2、4、8、12、24 和 52 周时使用视觉模拟量表（VAS）、手臂、肩部和手残疾快速版（QDASH）和患者网球肘评估（PRTEE）记录 PRP 治疗的效果。为了确定对 PRP 治疗反应最佳的 PDGFB 变体，在研究的多态性变体（rs2285099、rs2285097、rs2247128、rs5757572、rs1800817 和 rs7289325）内，比较了个体基因型之间的患者报告结局测量值。还分析了单核苷酸多态性对血液和 PRP 参数的影响，包括 PDGF-AB 和 PDGF-BB 蛋白的浓度。
我们的分析确定了 PDGFB 基因的遗传变异，这些变异导致对 PRP 治疗的反应更好。TT（rs2285099）和 CC（rs2285097）纯合子的全血血小板浓度高于其他基因型的携带者（p=0.018），并且在 2-12 周时 VAS（p<0.05）、QDASH 和 PRTEE 明显较低。rs2285099 和 rs2285097 变体形成了强单倍型块（r=98，D'=100）。AA 纯合子（rs2247128）的 VAS（4-52 周）、QDASH 和 PRTEE（8、12 周）值明显较低。
PDGFB 基因的多态性增加了 PRP 治疗网球肘的疗效。对 PDGFB 基因的两个多态性（rs2285099（或 rs2285097）和 rs2247128）进行基因分型可能是评估患者接受 PRP 治疗和修改治疗以提高其疗效的有用诊断工具。
