富血小板血浆治疗慢性血友病性滑膜炎:临床与研究。

Treatment of Chronic Haemophilic Synovitis with PRP: Clinical and Studies.

机构信息

Department of Medicine, Argentine Catholic University, Buenos Aires C1032ABS, Argentina.

Haemophilia Foundation, Buenos Aires 3485, Argentina.

出版信息

Int J Mol Sci. 2024 Aug 23;25(17):9140. doi: 10.3390/ijms25179140.

Abstract

Intra-articular blood, iron and hemosiderin, hydroxyl radical cytokines, and neo-angiogenesis cause synovial inflammation, which leads to cartilage and joint damage. Platelet-rich plasma (PRP) inhibits most of the mediators that produce and maintain synovitis. We compile here our work showing the clinical effectiveness of intra-articular PRP injections and their potential role in stopping articular cartilage damage due to bleeding and its possible repair. A total of 116 joints, including knees (63%), elbows (19.8%), and ankles (17.2%), were treated with intra-articular injections of PRP. Moreover, we also show here the number of extracellular DNA traps (ETs) and the PRP effect in the synovial fluid of patients at the time of treatment and six months after. Clinically, it is demonstrated that PRP is effective in reducing bleeding episodes ( < 0.001) and pain ( < 0.0001) and improving the hemophilia joint health score (HJHS) ( < 0.001) at one year of follow-up. Furthermore, our results demonstrate that PRP inhibits ET formation and reconstitutes the immune system's cellular components in the synovial fluid of patients after treatment. We conclude that PRP can be considered an effective, safe, and easy treatment for hemophilic synovitis.

摘要

关节内血液、铁和血铁黄素、羟自由基细胞因子和新生血管形成会导致滑膜炎,从而导致软骨和关节损伤。富含血小板的血浆 (PRP) 可抑制产生和维持滑膜炎的大多数介质。我们在这里汇编了我们的工作,展示了关节内 PRP 注射的临床效果及其在因出血导致关节软骨损伤及其可能修复中的潜在作用。共有 116 个关节(包括膝关节 63%、肘关节 19.8%和踝关节 17.2%)接受了 PRP 关节内注射治疗。此外,我们还在此展示了治疗时和治疗后六个月患者关节滑液中外周 DNA 陷阱 (ET) 的数量和 PRP 的作用。临床研究表明,PRP 可有效减少出血发作(<0.001)和疼痛(<0.0001),并提高血友病关节健康评分(HJHS)(<0.001)在一年的随访中。此外,我们的研究结果表明,PRP 可抑制 ET 的形成,并在治疗后恢复患者关节滑液中免疫系统的细胞成分。我们得出结论,PRP 可被视为治疗血友病性滑膜炎的一种有效、安全且简单的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2e4/11395128/0e2064ed0b12/ijms-25-09140-g001.jpg

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