Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, PR China.
Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, PR China.
Biomed Pharmacother. 2024 Sep;178:117226. doi: 10.1016/j.biopha.2024.117226. Epub 2024 Jul 29.
Osteoarthritis (OA) is the most prevalent joint disease in the elderly population and its substantial morbidity and disability impose a heavy economic burden on patients and society. Knee osteoarthritis (KOA) is the most common subtype of OA, which is characterized by damage to progressive articular cartilage, synovitis, and subchondral bone sclerosis. Most current treatments for OA are palliative, primarily aim at symptom management, and do not prevent the progression of the disease or restore degraded cartilage. The activation of α-granules in platelets releases various growth factors that are involved in multiple stages of tissue repair, suggesting potential for disease modification. In recent years, platelet-based therapies, such as platelet-rich plasma, platelet-rich fibrin, and platelet lysates, have emerged as promising regenerative treatments for KOA, but their related effects and mechanisms are still unclear. Therefore, this review aims to summarize the biological characteristics and functions of platelets, classify the products of platelet-based therapy and related preparation methods. Moreover, we summarize the basic research of platelet-based regeneration strategies for KOA and discuss the cellular effects and molecular mechanisms. Further, we describe the general clinical application of platelet-based therapy in the treatment of KOA and the results of the meta-analysis of randomized controlled trials.
骨关节炎（OA）是老年人中最常见的关节疾病，其高发病率和高致残率给患者和社会带来了沉重的经济负担。膝骨关节炎（KOA）是 OA 最常见的亚型，其特征为进行性关节软骨损伤、滑膜炎和软骨下骨硬化。目前大多数 OA 的治疗方法都是姑息性的，主要旨在缓解症状，不能预防疾病进展或恢复已降解的软骨。血小板α颗粒的激活释放了多种参与组织修复多个阶段的生长因子，这表明其具有疾病修饰的潜力。近年来，基于血小板的治疗方法，如富含血小板的血浆、富含血小板的纤维蛋白和血小板裂解液，已成为治疗 KOA 的有前途的再生治疗方法，但它们的相关作用和机制尚不清楚。因此，本综述旨在总结血小板的生物学特性和功能，对基于血小板的治疗产品及其相关制备方法进行分类。此外，我们总结了基于血小板的 KOA 再生策略的基础研究，并讨论了其细胞作用和分子机制。最后，我们描述了基于血小板的治疗在 KOA 治疗中的一般临床应用以及随机对照试验的荟萃分析结果。
