富血小板血浆在风湿性疾病中的应用。

Use of platelet-rich plasma in rheumatic diseases.

作者信息

Yessirkepov Marlen, Fedorchenko Yuliya, Zimba Olena, Mukanova Ulzhan

机构信息

Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.

Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76018, Ukraine.

出版信息

Rheumatol Int. 2024 Dec 31;45(1):13. doi: 10.1007/s00296-024-05776-1.

Abstract

Platelet-rich plasma (PRP) has gained increasing recognition as a promising therapeutic agent in managing rheumatic diseases. Conventional treatments, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs), primarily act on reducing inflammation but fail to address the underlying mechanisms of connective tissue degradation. PRP, an autologous preparation enriched with growth factors and bioactive molecules, is pivotal in modulating inflammation and fostering tissue regeneration. This review overviews the therapeutic potential of PRP across a spectrum of rheumatic diseases, such as osteoarthritis (OA), rheumatoid arthritis (RA), systemic sclerosis (SSc), and osteonecrosis. The regenerative capacity of PRP, driven by vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and transforming growth factor-beta (TGF-β), promotes tissue repair, reduces cartilage damage and improves joint function. Emerging evidence supports the efficacy of PRP in early-stage OA, demonstrating superior outcomes over traditional therapies like hyaluronic acid and glucocorticoids in terms of pain relief and functional improvement. Despite its benefits, PRP therapy is characterized by variability in treatment responses, with challenges in standardizing preparation protocols and treatment regimens. This review highlights the need for robust clinical trials to establish uniform treatment protocols, optimize patient selection, and evaluate the long-term clinical outcomes of PRP therapy in rheumatic diseases.

摘要

富血小板血浆(PRP)作为一种治疗风湿性疾病的有前景的治疗剂,已获得越来越多的认可。传统治疗方法,包括非甾体抗炎药(NSAIDs)、皮质类固醇和改善病情抗风湿药(DMARDs),主要作用于减轻炎症,但未能解决结缔组织降解的潜在机制。PRP是一种富含生长因子和生物活性分子的自体制剂,在调节炎症和促进组织再生方面起着关键作用。本文综述了PRP在一系列风湿性疾病中的治疗潜力,如骨关节炎(OA)、类风湿关节炎(RA)、系统性硬化症(SSc)和骨坏死。由血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)和转化生长因子-β(TGF-β)驱动的PRP的再生能力促进组织修复,减少软骨损伤并改善关节功能。新出现的证据支持PRP在早期OA中的疗效,在疼痛缓解和功能改善方面,其效果优于透明质酸和糖皮质激素等传统疗法。尽管PRP疗法有诸多益处,但其治疗反应存在变异性,在标准化制备方案和治疗方案方面存在挑战。本文综述强调需要进行强有力的临床试验,以建立统一的治疗方案,优化患者选择,并评估PRP疗法在风湿性疾病中的长期临床结果。

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