Department of Orthopaedics, Fu-Ya Medical Clinic, Taichung 40764, Taiwan.
Department of Medical Research, Mackay Children's Hospital, Taipei 10449, Taiwan.
Biomolecules. 2023 Mar 17;13(3):555. doi: 10.3390/biom13030555.
This study aimed to directly compare the contents and the clinical efficacy of the two autologous blood-derived products, platelet-rich plasma (PRP) and autologous conditioned serum (ACS) for osteoarthritis (OA) treatment. The contents of standard-prepared PRP and ACS prepared at 37 °C for 1 h, 3 h, 6 h, and 24 h from healthy volunteers were compared. The clinical efficacy of pain relief in patients with Stage III knee OA was evaluated by a patient-reported visual analog scale (VAS) pain rating. PDGF-BB levels in ACS 1 h were significantly higher than those in PRP, and the levels in ACS preparations remained stable. IGF-1 level of ACS 24 h showed a significant increase compared to those of other ACS preparations and PRP. ACS 3 h showed a turning of IL-1Ra level and revealed a time-dependent increase up to 24 h. ACS 6 h showed a turning increase in TNF-α levels. ACS 3 h was chosen for clinical comparison with PRP. The reduction in pain VAS in the ACS group was significantly more compared to those of the PRP group ( = 0.028). However, PRP showed significant earlier improvement ( < 0.001). Conclusion: ACS contained higher levels of PDGF-BB and IL-1Ra and provided better improvement in pain relief compared to PRP.
本研究旨在直接比较两种自体血液衍生产品，即富含血小板的血浆（PRP）和自体条件培养基（ACS）在骨关节炎（OA）治疗中的内容物和临床疗效。比较了从健康志愿者中制备的标准 PRP 和在 37°C 下制备的 ACS 在 1h、3h、6h 和 24h 的含量。通过患者报告的视觉模拟量表（VAS）疼痛评分评估了 III 期膝关节 OA 患者的疼痛缓解的临床疗效。ACS 1h 的 PDGF-BB 水平明显高于 PRP，并且 ACS 制剂的水平保持稳定。ACS 24h 的 IGF-1 水平与其他 ACS 制剂和 PRP 相比有显著增加。ACS 3h 的 IL-1Ra 水平呈转折性增加，并在 24h 内呈现时间依赖性增加。ACS 6h 的 TNF-α水平呈转折性增加。选择 ACS 3h 与 PRP 进行临床比较。ACS 组的疼痛 VAS 降低明显高于 PRP 组（=0.028）。然而，PRP 显示出明显更早的改善（<0.001）。结论：ACS 含有更高水平的 PDGF-BB 和 IL-1Ra，与 PRP 相比，ACS 在缓解疼痛方面有更好的改善。
