Hoewel platelet rich plasma (PRP) reeds tientallen jaren bestaat als behandeling voor diverse aandoeningen, wordt slechts enkele jaren dit bloedprodukt gebruikt in orthopedische toepassingen met wisselende resultaten (zie elders deze weblog voor meer berichten en onderzoek van Tilburgse bodem, mn bij tennisellebogen). Naast de behandeling de tenniselleboog en andere degeneratieve peesafwijkingen komen nu ook bewijzen in de literatuur dat laaggradige arthrose van de knie kan profiteren van behandeling met PRP. In de laatste editie van de Journal of Orthopaedic Research verscheen een drietal publicaties die op basaal nivo de waarde van PRP in kraakbeen- en peesregeneratie aantoonden.
Een studie meldde "that human PRP may enhance the migration and simulate the chondrogenic differentiation of human subchondral progenitor cells". Dit zijn de cellen die ook worden gezien na zogenaamde microfracturing procedures, welke worden gebruikt als behandeling van kraakbeendefecten. (Full abstract)
Een andere publicatie liet zien dat PRP "can induce human tenocyte proliferation and collagen synthesis which could be implemented for future tendon regeneration in reconstructive surgeries." (Full Abstract)
Een derde manuscript beschreef "synergy of tendon stem cells and platelet rich plasma in tendon healing". (Full abstract)Op de website http://bloodcure.com kunnen verdere updates omtrent de huidige stand van de wetenschap worden gevonden. Over deze trilogie meldde de eigenaar van de website, Allan Mishra, een van de early users van PRP in de orthopedie:
"Taken together this elite research data fully supports further clinical investigations into the use of PRP for tendon and cartilage disorders. Human clinical trials are expensive and difficult to execute in any field even more so in autologous biologic treatments such as PRP. This is partially true because there is dramatic variability in PRP preparations. This has led to confusing results. We need to focus on specific formulations for specific indications and then conduct well powered human trials. This will not be a simple task. Worldwide collaboration will be needed. The basic science data, however, are quite clear, PRP has impressive potential."
| |
| In cartilage repair, platelet-rich plasma (PRP) is used in one-step approaches utilizing microfracture and matrix-induced chondrogenesis procedures, bone marrow-derived cell transplantation, or intra-articular injection. The aim of our study was to evaluate the effect of human PRP on the migration and chondrogenic differentiation of human subchondral progenitors. Human progenitors were derived from subchondral cortico-spongious bone (CSP), were analyzed for their migration capacity upon PRP treatment in 96-well chemotaxis assays and cultured in high-density pellet cultures under serum-free conditions in the presence of 5% PRP. Chemotaxis assays showed that 0.1-100% PRP significantly (p?<?0.05) stimulate the migration of CSP compared to untreated controls. Histological staining of proteoglycan and immuno-staining of type II collagen indicated that progenitors stimulated with PRP show significantly increased cartilage matrix formation compared to untreated progenitors. Real-time gene expression analysis of typical chondrocyte marker genes as well as osteogenic and adipogenic markers like osteocalcin and fatty acid binding protein showed that PRP induces the chondrogenic differentiation sequence of human progenitors in high-density pellet cultures, while osteogenic or adipogenic differentiation was not evident. These results suggest that human PRP may enhance the migration and stimulate the chondrogenic differentiation of human subchondral progenitor cells known from microfracture. © 2011 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:845-852, 2012. | | | |
| Proliferation and differentiation of human tenocytes in response to platelet rich plasma: An in vitro and in vivo study. | | Wang Xiao; Qiu Yiwei; Triffitt James; Carr Andrew; Xia Zhidao; Sabokbar Afsie | | Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford OX3 7LD, UK. goodthing1209@gmail.com. | | Pub Date: 06/2012 | Source/Vol: Journal of orthopaedic research : official publication of the Orthopaedic Research Society / 30(6):982-90. | | | |
| Platelet rich plasma (PRP) is the autologous plasma fraction with a platelet-rich cellular component which is enriched with a number of growth factors. Due to its availability and low cost, PRP has become an increasingly popular clinical tool as an alternative source of growth factors for various applications, for example, tendon regeneration but with limited success in clinical trials. The main objective of the current study was to determine whether activated PRP [i.e., platelet rich plasma-clot release (PRCR)] could be used to induce the proliferation and collagen synthesis in human tenocyte in vitro. The advantage of using PRCR is that the platelet-derived bioactive factors are more concentrated and could initiate a more rapid and accelerated healing response than PRP. Our results demonstrated that 10% PRCR treatment accelerated the extent of cell proliferation and collagen production by human tenocytes in vitro. The expression of specific tenocyte markers were similar to conventional fetal bovine serum (FBS)-treated tenocytes implanted in mice within 14 days of implantation in diffusion chambers. Moreover, relatively more collagen fibrils were evident in PRCR-treated tenocytes in vivo as compared to 10% FBS-treated cells. Overall, our feasibility study has indicated that PRCR can induce human tenocyte proliferation and collagen synthesis which could be implemented for future tendon regeneration in reconstructive surgeries. © 2011 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:982-990, 2012. | |
| Synergy of tendon stem cells and platelet-rich plasma in tendon healing. | | Chen Lei; Dong Shi-Wu; Liu Jun-Peng; Tao Xu; Tang Kang-Lai; Xu Jian-Zhong | | Department of Orthopaedics Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China. | | Pub Date: 06/2012 | Source/Vol: Journal of orthopaedic research : official publication of the Orthopaedic Research Society / 30(6):991-7. | | | |
| Injured rat Achilles tendons were treated with botulism toxin to create a mechanically unloaded condition (unloaded) or left untreated (loaded), and then treated with phosphate-buffered saline (PBS), platelet-rich plasma (PRP), tendon stem cells (TSCs), or a combination (TSCs?+?PRP). mRNA and protein expression of collagen I, collagen III, tenascin C, and Smad 8 were determined by real time PCR and immunostaining, respectively. Loaded tendons treated with PBS, PRP, or TSCs for 3 or 14 days had higher collagen I mRNA expression than unloaded tendons. Loaded tendons treated with PBS for 3 or 14 days or with PRP for 3 days had higher collagen I protein levels than unloaded tendons. Loaded tendons treated for 3 days with PBS, for 14 days with PRP or TSCs or TSCs?+?PRP for 3 or 14 days had higher collagen III protein levels than unloaded tendons. Collagen I mRNA levels were higher in TSCs?+?PRP-treated loaded tendons compared to PBS-treated loaded tendons on day 3 of treatment. Based on changes in the expression of tendon-healing genes, our data suggest that the combination of TSCs and PRP has synergistic effects on tendon healing under both loaded and unloaded conditions, and loaded conditions improve tendon healing. © 2011 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:991-997, 2012. | |
Geen opmerkingen:
Een reactie posten