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Karadbhajne P, Dzoagbe HY, More A. Platelet-Rich Plasma (PRP) for Endometrial Treatment Efficacy and Safety in Assisted Reproductive Technology: A Comprehensive Review. Cureus 2024; 16:e59728. [PMID: 38841044 PMCID: PMC11151180 DOI: 10.7759/cureus.59728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 05/05/2024] [Indexed: 06/07/2024] Open
Abstract
Platelet-rich plasma (PRP) is among the new ground-breaking methods called for endometrial disorders detected in assisted reproductive technology (ART). This research work takes account of both a systematic literature review and an exploration of the molecular connections. The report aims to present the capabilities and benefits of the PRP in ART and the nonconformance and dangers involved in its use in ART. However, all these stages of ART need conducive endometrium, live micro embryo, and coordinated interaction between the blastocyst and the uterus. Despite all ART has achieved, implantation failure still exists as a problem having one quarter being attributed to the absence of the endometrial receptivity level. The review points to a corresponding increase in the role of autologous PRP in promoting cell proliferation, neo-angiogenesis, and anti-inflammatory effects to facilitate effective endometrial receptivity. The outcome of prior trials with the PRP approach proved to be positive for women with adenomyosis, thin endometrial lining, recurring implantation failure, chronic endometritis, and Asherman's syndrome. Challenges still exist in the proper placement of PRP for all women with infertility problems as well as how it works for individuals with blood disorders and infections. This study will look into the safest number of doses, the time of acting, and the possible future health hazards that both mother and child may face.
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Affiliation(s)
- Priti Karadbhajne
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hellen Y Dzoagbe
- Pharmacy, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Nursing, Public Health Nurses' School, Accra, GHA
| | - Akash More
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Partan RU, Putra KM, Hafizzanovian H, Darma S, Reagan M, Muthia P, Radiandina AS, Rahmawati E. Clinical Outcome of Multiple Platelet-Rich Plasma Injection and Correlation with PDGF-BB in the Treatment of Knee Osteoarthritis. J Pers Med 2024; 14:183. [PMID: 38392616 PMCID: PMC10890090 DOI: 10.3390/jpm14020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: Current treatments for knee osteoarthritis (KOA), such as intra-articular corticosteroids or hyaluronic acid (HA) injections, are controversial due to their ineffectiveness in preventing disease progression. Platelet-rich plasma (PRP) has become a promising and possible treatment for KOA. It is thought to enhance articular cartilage regeneration and reduce OA-related impairment. PRP contains growth factors such as PDGF-BB, which stimulates growth and inhibits joint damage. Based on numerous studies, after a certain amount of time, it was found that multiple PRP treatments reduced pain more than a single injection. This study evaluates the efficacy of multiple PRP (m-PRP) injections compared to multiple HA (m-HA) injections for KOA treatment, focusing on their correlation with PDGF-BB levels. (2) Methods: In this single-center, open-label, randomized, comparative clinical trial, 30 KOA patients received m-PRP and m-HA injections. VAS and WOMAC were used to evaluate clinical outcomes and PDGF-BB concentrations. (3) Results: The study analysis revealed a statistically significant reduction in pain indices. In both the m-PRP and m-HA groups after 12 weeks, m-PRP showed superior results. PDGF-BB concentrations also increased, with a strong negative correlation and statistical significance using Spearman's rho. (4) Conclusions: Multiple PRP injections are safe and associated with elevated PDGF-BB, reduced VAS and WOMAC scores, providing the potential for articular cartilage regeneration and inhibiting knee osteoarthritis progression.
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Affiliation(s)
- Radiyati Umi Partan
- Division of Rheumatology, Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
| | - Khoirun Mukhsinin Putra
- Division of Rheumatology, Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
| | - Hafizzanovian Hafizzanovian
- Division of Rheumatology, Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
| | - Surya Darma
- Division of Rheumatology, Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
| | - Muhammad Reagan
- Division of Rheumatology, Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
| | - Putri Muthia
- Division of Rheumatology, Department of Internal Medicine, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
| | - Afifah Salshabila Radiandina
- Stem Cell & Regenerative Therapies-From Bench to Market MSc, Faculty of Life Science & Medicine, King's College London, London WC2R 2LS, UK
| | - Eny Rahmawati
- Department of Clinical Pathology, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia
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Jha R, Bernstock JD, Chalif JI, Hoffman SE, Gupta S, Guo H, Lu Y. Updates on Pathophysiology of Discogenic Back Pain. J Clin Med 2023; 12:6907. [PMID: 37959372 PMCID: PMC10647359 DOI: 10.3390/jcm12216907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Discogenic back pain, a subset of chronic back pain, is caused by intervertebral disc (IVD) degeneration, and imparts a notable socioeconomic health burden on the population. However, degeneration by itself does not necessarily imply discogenic pain. In this review, we highlight the existing literature on the pathophysiology of discogenic back pain, focusing on the biomechanical and biochemical steps that lead to pain in the setting of IVD degeneration. Though the pathophysiology is incompletely characterized, the current evidence favors a framework where degeneration leads to IVD inflammation, and subsequent immune milieu recruitment. Chronic inflammation serves as a basis of penetrating neovascularization and neoinnervation into the IVD. Hence, nociceptive sensitization emerges, which manifests as discogenic back pain. Recent studies also highlight the complimentary roles of low virulence infections and central nervous system (CNS) metabolic state alteration. Targeted therapies that seek to disrupt inflammation, angiogenesis, and neurogenic pathways are being investigated. Regenerative therapy in the form of gene therapy and cell-based therapy are also being explored.
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Affiliation(s)
- Rohan Jha
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Joshua D. Bernstock
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Joshua I. Chalif
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Samantha E. Hoffman
- Harvard Medical School, Boston, MA 02115, USA
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Saksham Gupta
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Hong Guo
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Yi Lu
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
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Peng BY, Singh AK, Tsai CY, Chan CH, Deng YH, Wu CM, Chou YR, Tsao W, Wu CY, Deng WP. Platelet-derived biomaterial with hyaluronic acid alleviates temporal-mandibular joint osteoarthritis: clinical trial from dish to human. J Biomed Sci 2023; 30:77. [PMID: 37691117 PMCID: PMC10494357 DOI: 10.1186/s12929-023-00962-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Bioactive materials have now raised considerable attention for the treatment of osteoarthritis (OA), such as knee OA, rheumatoid OA, and temporomandibular joint (TMJ) OA. TMJ-OA is a common disease associated with an imbalance of cartilage regeneration, tissue inflammation, and disability in mouth movement. Recently, biological materials or molecules have been developed for TMJ-OA therapy; however, ideal treatment is still lacking. In this study, we used the combination of a human platelet rich plasma with hyaluronic acid (hPRP/HA) for TMJ-OA therapy to perform a clinical trial in dish to humans. METHOD Herein, hPRP was prepared, and the hPRP/HA combined concentration was optimized by MTT assay. For the clinical trial in dish, pro-inflammatory-induced in-vitro and in-vivo mimic 3D TMJ-OA models were created, and proliferation, gene expression, alcian blue staining, and IHC were used to evaluate chondrocyte regeneration. For the animal studies, complete Freund's adjuvant (CFA) was used to induce the TMJ-OA rat model, and condyle and disc regeneration were investigated through MRI. For the clinical trial in humans, 12 patients with TMJ-OA who had disc displacement and pain were enrolled. The disc displacement and pain at baseline and six months were measured by MRI, and clinical assessment, respectively. RESULTS Combined hPRP/HA treatment ameliorated the proinflammatory-induced TMJ-OA model and promoted chondrocyte proliferation by activating SOX9, collagen type I/II, and aggrecan. TMJ-OA pathology-related inflammatory factors were efficiently downregulated with hPRP/HA treatment. Moreover, condylar cartilage was regenerated by hPRP/HA treatment in a proinflammatory-induced 3D neocartilage TMJ-OA-like model. During the animal studies, hPRP/HA treatment strongly repaired the condyle and disc in a CFA-induced TMJ-OA rat model. Furthermore, we performed a clinical trial in humans, and the MRI data demonstrated that after 6 months of treatment, hPRP/HA regenerated the condylar cartilage, reduced disc displacement, alleviated pain, and increased the maximum mouth opening (MMO). Overall, clinical trials in dish to human results revealed that hPRP/HA promoted cartilage regeneration, inhibited inflammation, reduced pain, and increased joint function in TMJ-OA. CONCLUSION Conclusively, this study highlighted the therapeutic potential of the hPRP and HA combination for TMJ-OA therapy, with detailed evidence from bench to bedside. Trial registration Taipei Medical University Hospital (TMU-JIRB No. N201711041). Registered 24 November 2017. https://tmujcrc.tmu.edu.tw/inquiry_general.php .
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Affiliation(s)
- Bou-Yue Peng
- Department of Dentistry, Taipei Medical University Hospital, Taipei, 110301, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Abhinay Kumar Singh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Ching-Yu Tsai
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Chun-Hao Chan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Yue-Hua Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Chi-Ming Wu
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Yen-Ru Chou
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, 110301, Taipei, Taiwan
| | - Wen Tsao
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan
| | - Chia-Yu Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan.
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei, 110301, Taiwan.
| | - Win-Ping Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan.
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, 110301, Taiwan.
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, Taipei, 242062, Taiwan.
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Chen X, Wang Z, Deng R, Yan H, Liu X, Kang R. Intervertebral disc degeneration and inflammatory microenvironment: expression, pathology, and therapeutic strategies. Inflamm Res 2023; 72:1811-1828. [PMID: 37665342 DOI: 10.1007/s00011-023-01784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Intervertebral disc degeneration (IDD) is a leading cause of low back pain (LBP), posing a significant socioeconomic burden. Recent studies highlight the crucial role of inflammatory microenvironment in IDD progression. METHOD A keyword-based search was performed using the PubMed database for published articles. RESULTS AND CONCLUSIONS Dysregulated expression of inflammatory cytokines disrupts intervertebral disc (IVD) homeostasis, causing atrophy, fibrosis, and phenotypic changes in nucleus pulposus cells. Modulating the inflammatory microenvironment and restoring cytokine balance hold promise for IVD repair and regeneration. This comprehensive review systematically examines the expression regulation, pathological effects, therapeutic strategies, and future challenges associated with the inflammatory microenvironment and relevant cytokines in IDD. Key inflammatory cytokines, including interleukins (IL), tumor necrosis factor-alpha (TNF-α), and chemokines, exhibit significant pathological effects in IDD. Furthermore, major therapeutic modalities such as chemical antagonists, biologics, plant extracts, and gene transcription therapies are introduced to control and ameliorate the inflammatory microenvironment. These approaches provide valuable insights for identifying potential targets in future anti-inflammatory treatments for IDD.
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Affiliation(s)
- Xin Chen
- The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China
| | - Zihan Wang
- The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China
| | - Rongrong Deng
- The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China
| | - Hongjie Yan
- The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China
| | - Xin Liu
- The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China.
| | - Ran Kang
- The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China.
- Department of Orthopedics, Nanjing Lishui Hospital of Traditional Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China.
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6
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Simental-Mendía M, Lozano-Sepúlveda SA, Garza-Tapia M, Lara-Arias J, Acosta-Olivo CA, Vilchez-Cavazos F, Peña-Martínez VM. The Effects of the Combination of Rhein and Platelet-Rich Plasma on Human Articular Chondrocytes. Life (Basel) 2023; 13:1723. [PMID: 37629580 PMCID: PMC10455863 DOI: 10.3390/life13081723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/24/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The presence of side effects and low bioavailability of rhein has limited its use in the treatment of osteoarthritis. We aimed to evaluate the in vitro response of human articular chondrocytes to the presence of the combination of platelet-rich plasma (PRP) and rhein. METHODS Solutions of rhein were prepared to assess solubility and select a working concentration. A stimulus with interleukin-1β (IL-β, 10 ng/mL) was induced for 24 h on human chondrocytes. Five treatment groups were established: control, IL-β control, PRP, rhein, and PRP + rhein. Cell viability, cell migration, nitric oxide (NO) production, tumor necrosis factor-α (TNF-α), and gene expression analyses were carried out. RESULTS A concentration of 50 mg/L was selected after a dose-response curve assay. Both NO and tumor TNF-α production significantly decreased after PRP and PRP + rhein treatments at 24 and 48 h. The wound healing assay revealed a significant stimulation of migration after 72 h with the PRP and PRP + rhein treatments. Expression of IL-1β, IL-6, MMP-13, and ADAMTS-5 was significantly downregulated, particularly after treatment with the combination of PRP + rhein. CONCLUSIONS Much of the determinations denoted a better performance of the combination of PRP and rhein in decreasing the levels of the different targets evaluated; however, this was not great enough to detect a significant difference in comparison with the PRP treatment alone.
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Affiliation(s)
- Mario Simental-Mendía
- Orthopedic Trauma Service, “Dr. José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico; (M.S.-M.); (J.L.-A.); (C.A.A.-O.); (F.V.-C.)
| | - Sonia Amelia Lozano-Sepúlveda
- Department of Biochemistry and Molecular Medicine, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico;
| | - Marsela Garza-Tapia
- Department of Analytical Chemistry, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico;
| | - Jorge Lara-Arias
- Orthopedic Trauma Service, “Dr. José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico; (M.S.-M.); (J.L.-A.); (C.A.A.-O.); (F.V.-C.)
| | - Carlos Alberto Acosta-Olivo
- Orthopedic Trauma Service, “Dr. José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico; (M.S.-M.); (J.L.-A.); (C.A.A.-O.); (F.V.-C.)
| | - Félix Vilchez-Cavazos
- Orthopedic Trauma Service, “Dr. José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico; (M.S.-M.); (J.L.-A.); (C.A.A.-O.); (F.V.-C.)
| | - Víctor Manuel Peña-Martínez
- Orthopedic Trauma Service, “Dr. José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey 66455, Mexico; (M.S.-M.); (J.L.-A.); (C.A.A.-O.); (F.V.-C.)
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7
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Simental-Mendía M, Ortega-Mata D, Acosta-Olivo CA. Platelet-Rich Plasma for Knee Osteoarthritis: What Does the Evidence Say? Drugs Aging 2023:10.1007/s40266-023-01040-6. [PMID: 37347411 DOI: 10.1007/s40266-023-01040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 06/23/2023]
Abstract
The utilization of platelet-rich-plasma as a therapeutic intervention for knee osteoarthritis has gained immense attention since 2008. The increase in the number of scientific publications dedicated to this area can be attributed to the majority of favorable results reported in clinical trials and basic science studies. However, despite the growing evidence, the use of platelet-rich plasma in clinical practice still poses controversial aspects. The potential mechanisms of action described for platelet-rich-plasma so far indicate that it could serve as a disease-modifying drug, acting to counteract important aspects of knee osteoarthritis pathophysiology (cartilage breakdown, inflammation, and bone remodeling). Nevertheless, its efficacy in slowing down the progression of knee osteoarthritis remains unproven. While inconsistencies have been noted, the majority of controlled clinical trials and meta-analyses advocate for the utilization of platelet-rich-plasma in treating knee osteoarthritis, as it has demonstrated greater efficacy than hyaluronic acid and placebo, with a follow-up of at least 1 year. Despite advancements made in certain areas, significant diversity persists regarding the formulations used, therapeutic regimen, extended follow-up periods, patient selection, and assessment of clinically relevant outcomes. Consequently, the leading clinical practice guidelines do not recommend its use. In light of the emerging evidence, this narrative review aims to provide an objective evaluation of the recent available scientific literature (last 5 years) focused on randomized clinical trials and meta-analyses to present a current overview of the topic.
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Affiliation(s)
- Mario Simental-Mendía
- Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", School of Medicine, Universidad Autónoma de Nuevo León, Ave. Francisco I. Madero and Ave. Dr. José Eleuterio González, 64460, Monterrey, Nuevo León, Mexico
| | - Daniela Ortega-Mata
- Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", School of Medicine, Universidad Autónoma de Nuevo León, Ave. Francisco I. Madero and Ave. Dr. José Eleuterio González, 64460, Monterrey, Nuevo León, Mexico
| | - Carlos A Acosta-Olivo
- Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", School of Medicine, Universidad Autónoma de Nuevo León, Ave. Francisco I. Madero and Ave. Dr. José Eleuterio González, 64460, Monterrey, Nuevo León, Mexico.
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8
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Leisi S, Farahpour MR. Effectiveness of topical administration of platelet-rich plasma on the healing of methicillin-resistant Staphylococcus aureus-infected full-thickness wound model. J Plast Reconstr Aesthet Surg 2023; 77:416-429. [PMID: 36640596 DOI: 10.1016/j.bjps.2022.11.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
This study aimed to investigate the wound-healing activity of animal platelet-rich plasma (PRP) in wounds infected with methicillin-resistant Staphylococcus aureus (MRSA) in rats. After wound induction, the rats were divided into three groups: noninfected animals treated with PRP (PRP group), MRSA-infected animals treated with mupirocin (standard control group), and MRSA-infected animals treated with PRP (MRSA+PRP group). Scratch assays, MTT test, and live/dead cells were also investigated. Total bacterial count, parameters of wound area, histopathological assessment, and expressions of IL-1β, TNF-α, iNOS, PDGF, FGF-2, and TGF-β mRNA levels and immunofluorescent staining of CD31 and collagen type 1 were assessed. The results showed that culture with PRP increased migration. PRP only showed cytotoxicity in a concentration of 100%. Topical application of PRP (50 µL) reduced the wound area and total bacterial count compared with the control group (P<0.05). The mRNA levels of IL-1β, TNF-α, and iNOS expression on days 7 and 14 (P<0.05) decreased in the treated groups compared with control rats. The mRNA levels of PDGF and TGF-β expression (P<0.05) increased in the treatment groups compared with control rats on days 3 and 7 (P<0.05). FGF-2 expression was significantly higher in the treated groups compared with the control group on days 7 and 14 (P<0.05). Moreover, positive expressions of macrophage colony-stimulating factor (M-CSF), CD31, collagen type 1 and cytokeratin proteins keratinocyte proliferation, and re-epithelization were significantly (P<0.05) increased in both PRP and MRSA+PRP-treated groups compared with the control groups on days 7 and 14. Topical administration of PRP accelerated the wound healing in MRSA-infected wound by decreasing the inflammation and improving the proliferative phase.
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Affiliation(s)
- Samaneh Leisi
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia Branch, Islamic Azad University, Urmia, Iran
| | - Mohammad Reza Farahpour
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia Branch, Islamic Azad University, Urmia, Iran.
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9
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Hermilasari RD, Rizal DM, Wirohadidjojo YW. Potential Mechanism of Platelet-rich Plasma Treatment on Testicular Problems Related to Diabetes Mellitus. Prague Med Rep 2023; 124:344-358. [PMID: 38069642 DOI: 10.14712/23362936.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Diabetes mellitus is a condition of continuously increased blood glucose levels that causes hyperglycemia. This condition can result in disorders of various organs including testicular problems. The use of platelet-rich plasma (PRP) which is contained in several growth factors shows its potential in overcoming testicular problems. This literature review study was conducted to identify the potential of PRP in overcoming various testicular problems due to diabetic conditions.
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Affiliation(s)
- Rista Dwi Hermilasari
- Department of Public Health, Faculty of Public Health, University of Jember, Jember, Indonesia
| | - Dicky Moch Rizal
- Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Yohanes Widodo Wirohadidjojo
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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10
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Thu AC. The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2022; 39:206-215. [PMID: 35673831 PMCID: PMC9273137 DOI: 10.12701/jyms.2022.00290] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/17/2022] [Indexed: 01/16/2023]
Abstract
Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.
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Affiliation(s)
- Aung Chan Thu
- Department of Physical Medicine and Rehabilitation, University of Medicine, Mandalay, Myanmar
- Corresponding author: Aung Chan Thu, MD, PhD Department of Physical Medicine and Rehabilitation, University of Medicine, 30th Street, Between 73rd & 74th Streets, Mandalay, Myanmar Tel: +95-9977277511 • E-mail:
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11
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Human Adipose-Derived Stem Cells Delay Muscular Atrophy after Peripheral Nerve Injury in Rats. Cell Biochem Biophys 2022; 80:555-562. [PMID: 35802247 DOI: 10.1007/s12013-022-01082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/21/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Given that denervation atrophy often occurs in muscle after peripheral nerve injury, the effects of injections of human adipose-derived stem cells (hADSCs) and platelet-rich plasma (PRP) into muscle after peripheral nerve injury were examined. METHODS hADSCs were isolated from human subcutaneous fat tissue, and PRP was prepared from rat whole blood before injection into a rat sciatic nerve injury model. Muscle atrophy was evaluated by quantitating the gross musculature and muscle fiber area and walking footprint analysis. RESULTS At 4 weeks post-surgery, there were significant differences in the sciatic functional index between experimental (injected with hADSCs, PRP, or combined hADSCs + PRP) and non-operated groups (p < 0.0001), but no significant differences were observed between the different treatment groups (p > 0.05). Post hoc Bonferroni tests also showed significant differences in the wet muscle weight ratios of hADSC, PRP, and combined groups compared to PBS group. The gastrocnemius muscle fiber area was larger in hADSC group and the combined group compared to PBS group at 4 weeks post-surgery. CONCLUSION The injection of hADSCs delays muscular atrophy after sciatic nerve injury in rats; thus, hADSCs are a promising alternative for regenerating atrophied muscle.
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Di Francesco M, Fragassi A, Pannuzzo M, Ferreira M, Brahmachari S, Decuzzi P. Management of osteoarthritis: From drug molecules to nano/micromedicines. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2022; 14:e1780. [PMID: 35253405 PMCID: PMC9285805 DOI: 10.1002/wnan.1780] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/29/2021] [Accepted: 01/21/2022] [Indexed: 12/12/2022]
Abstract
With the change in lifestyle and aging of the population, osteoarthritis (OA) is emerging as a major medical burden globally. OA is a chronic inflammatory and degenerative disease initially manifesting with joint pain and eventually leading to permanent disability. To date, there are no drugs available for the definitive treatment of osteoarthritis and most therapies have been palliative in nature by alleviating symptoms rather than curing the disease. This coupled with the vague understanding of the early symptoms and methods of diagnosis so that the disease continues as a global problem and calls for concerted research efforts. A cascade of events regulates the onset and progression of osteoarthritis starting with the production of proinflammatory cytokines, including interleukin (IL)‐1β, IL‐6, tumor necrosis factor (TNF)‐α; catabolic enzymes, such as matrix metalloproteinases (MMPs)‐1, ‐3, and ‐13, culminating into cartilage breakdown, loss of lubrication, pain, and inability to load the joint. Although intra‐articular injections of small and macromolecules are often prescribed to alleviate symptoms, low residence times within the synovial cavity severely impair their efficacy. This review will briefly describe the factors dictating the onset and progression of the disease, present the current clinically approved methods for its treatment and diagnosis, and finally elaborate on the main challenges and opportunities for the application of nano/micromedicines in the treatment of osteoarthritis. Thus, future treatment regimens will benefit from simultaneous consideration of the mechanobiological, the inflammatory, and tissue degradation aspects of the disease. This article is categorized under:Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement
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Affiliation(s)
- Martina Di Francesco
- Laboratory of Nanotechnology for Precision Medicine, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Agnese Fragassi
- Laboratory of Nanotechnology for Precision Medicine, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Chemistry and Industrial Chemistry, University of Genova, Genoa, Italy
| | - Martina Pannuzzo
- Laboratory of Nanotechnology for Precision Medicine, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Miguel Ferreira
- Laboratory of Nanotechnology for Precision Medicine, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Sayanti Brahmachari
- Laboratory of Nanotechnology for Precision Medicine, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Paolo Decuzzi
- Laboratory of Nanotechnology for Precision Medicine, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
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Pan X, Yuan S, Xun X, Fan Z, Xue X, Zhang C, Wang J, Deng J. Long-Term Recruitment of Endogenous M2 Macrophages by Platelet Lysate-Rich Plasma Macroporous Hydrogel Scaffold for Articular Cartilage Defect Repair. Adv Healthc Mater 2022; 11:e2101661. [PMID: 34969180 DOI: 10.1002/adhm.202101661] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/21/2021] [Indexed: 01/08/2023]
Abstract
After cartilage damage, a large number of monocytes/macrophages infiltrate into adjacent synovium and the resident macrophages in synovial tissue transform to activated macrophages (M1), which secrete pro-inflammatory cytokines to induce sustained inflammation and chondrocyte apoptotic. However, current clinical therapies for cartilage repair can rarely achieve long-term anti-inflammatory regulation and satisfactory outcomes. Herein, a platelet lysate-rich plasma macroporous hydrogel (PLPMH) scaffold with around 100 µm pore size and 1.25 MPa Young's modulus is developed to sustainedly recruit and polarize endogenous anti-inflammatory macrophages (M2) for improving cartilage defect repair. PLPMH scaffold can steadily release sphingosine1-phosphate and proteins via gradual degradation, thus inducing M2 macrophages migration or resting (M0) macrophages migration and then polarization to M2 phenotype, and improving the secretion of anti-inflammatory cytokines. Furthermore, PLPMH scaffold exhibits negligible inflammatory responses in vivo and promotes endogenous M2 macrophage infiltration in large numbers and long-time duration to provide a local anti-inflammatory microenvironment, which even lasts for 42 d. In a rabbit model of cartilage defect, PLPMH scaffold increases the ratio of M2 macrophages and improves cartilage tissue regeneration. These studies support that PLPMH scaffold may have a great potential in articular cartilage tissue engineering by providing an anti-inflammatory and pro-regenerative microenvironment.
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Affiliation(s)
- Xiaoyun Pan
- Department of Orthopaedics The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou Zhejiang 325000 China
- Key Laboratory of Orthopaedics of Zhejiang Province Wenzhou Medical University Wenzhou Zhejiang 325000 China
| | - Shanshan Yuan
- Wenzhou Institute University of Chinese Academy Sciences Wenzhou Zhejiang 325000 China
| | - Xiaojie Xun
- Wenzhou Institute University of Chinese Academy Sciences Wenzhou Zhejiang 325000 China
| | | | - Xinghe Xue
- Department of Orthopaedics The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou Zhejiang 325000 China
- Key Laboratory of Orthopaedics of Zhejiang Province Wenzhou Medical University Wenzhou Zhejiang 325000 China
| | - Changhuan Zhang
- Wenzhou Institute University of Chinese Academy Sciences Wenzhou Zhejiang 325000 China
| | - Jilong Wang
- Wenzhou Institute University of Chinese Academy Sciences Wenzhou Zhejiang 325000 China
| | - Junjie Deng
- Department of Orthopaedics The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou Zhejiang 325000 China
- Key Laboratory of Orthopaedics of Zhejiang Province Wenzhou Medical University Wenzhou Zhejiang 325000 China
- Wenzhou Institute University of Chinese Academy Sciences Wenzhou Zhejiang 325000 China
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Altaie A, Baboolal TG, Wall O, Pandit H, Jones E, McGonagle D. Device-Based Enrichment of Knee Joint Synovial Cells to Drive MSC Chondrogenesis Without Prior Culture Expansion In Vitro: A Step Closer to 1-Stage Orthopaedic Procedures. Am J Sports Med 2022; 50:152-161. [PMID: 34779670 PMCID: PMC8739599 DOI: 10.1177/03635465211055164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/27/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Synovial fluid (SF) mesenchymal stem cells (MSCs) are derived from the synovial membrane and have cartilage repair potential. Their current use in clinical practice is largely exploratory. As their numbers tend to be small, therapeutic procedures using MSCs typically require culture expansion. Previous reports indicate that the stem cell-mobilizing device (STEM device) intraoperatively increases SF-MSCs. PURPOSE This study evaluated the chondrogenic potential of non-culture expanded synovium-mobilized MSCs and SF-microfragments obtained after enrichment using the STEM device and ascertained if device-mediated synovial membrane manipulation facilitated ongoing MSC release. STUDY DESIGN Controlled laboratory study. METHODS Two samples of aspiration fluid were collected intraoperatively before and after STEM device utilization from patients (n = 16) undergoing diagnostic or therapeutic knee arthroscopy. Human knee synovium (n = 5) was collected during total knee replacement, and a suspended culture was performed to assess the effect of the STEM device on ongoing MSC release. Colony forming unit-fibroblastic assays were used to determine the number of MSCs. Additionally, cytometric characterization of stromal and immune cells and chondrogenesis differentiation assay were performed without culture expansion. Filtered platelet concentrates were prepared using the HemaTrate system. RESULTS After STEM device use, a significant increase was evident in SF-MSCs (P = .03) and synovial fluid-resident synovial tissue microfragments (P = .03). In vitro-suspended synovium released significantly more MSCs following STEM device use than nonstimulated synovium (P = .01). The STEM device-released total cellular fraction produced greater in vitro chondrogenesis with significantly more glycosaminoglycans (GAGs; P < .0001) when compared with non-STEM device synovial fluid material. Nonexpanded SF-MSCs and SF-microfragments combined with autologous filtered platelet concentrate produced significantly more GAGs than the complete chondrogenic media (P < .0001). The STEM device-mobilized cells contained more M2 macrophage cells and fewer M1 cells. CONCLUSION Non-culture expanded SF-MSCs and SF-microfragments had the potential to undergo chondrogenesis without culture expansion, which can be augmented using the STEM device with increased MSC release from manipulated synovium for several days. Although preliminary, these findings offer proof of concept toward manipulation of the knee joint environment to facilitate endogenous repair responses. CLINICAL RELEVANCE Although numbers were small, this study highlights 3 factors relevant to 1-stage joint repair using the STEM device: increased SF-MSCs and SF-microfragments and prolonged synovial release of MSCs. Joint repair strategies involving endogenous MSCs for cartilage repair without the need for culture expansion in a 1-stage procedure may be possible.
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Affiliation(s)
- Ala Altaie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Thomas G. Baboolal
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Owen Wall
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds, UK
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds, UK
| | - Elena Jones
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds, UK
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Satin AM, Norelli JB, Sgaglione NA, Grande DA. Effect of Combined Leukocyte-Poor Platelet-Rich Plasma and Hyaluronic Acid on Bone Marrow-Derived Mesenchymal Stem Cell and Chondrocyte Metabolism. Cartilage 2021; 13:267S-276S. [PMID: 31282189 PMCID: PMC8804819 DOI: 10.1177/1947603519858739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Given the potential applications of combined biologics, the authors sought to evaluate the in vitro effect of combined platelet-rich plasma (PRP) and hyaluronic acid (HA) on cellular metabolism. DESIGN Bone marrow-derived mesenchymal stem cells (BMSCs) and chondrocytes were obtained from the femurs of Sprague-Dawley rats. An inflammatory model was created by adding 10 ng/mL interleukin-1-beta to culture media. Non-crosslinked high-molecular-weight HA, activated-PRP (aPRP), and unactivated-PRP (uPRP) were tested. Cellular proliferation and gene expression were measured at 1 week. Genes of interest included aggrecan, matrix metalloproteinase (MMP)-9, and MMP-13. RESULTS Combined uPRP-HA was associated with a significant increase in chondrocyte and BMSC proliferation at numerous preparations. There was a trend of increased chondrocyte aggrecan expression with combined PRP-HA. The greatest and only significant decrease in BMSC MMP-9 expression was observed with combined PRP-HA. While a significant reduction of BMSC MMP-13 expression was seen with PRP and HA-alone, a greater reduction was observed with PRP-HA. MMP-9 chondrocyte expression was significantly reduced in cells treated with PRP-HA. PRP-alone and HA-alone at identical concentrations did not result in a significant reduction. The greatest reduction of MMP-13 chondrocyte expression was observed in chondrocytes plus combined PRP-HA. CONCLUSIONS We demonstrated a statistically significant increase in BMSC and chondrocyte proliferation and decreased expression of catabolic enzymes with combined PRP-HA. These results demonstrate the additive in vitro effect of combined PRP-HA to stimulate cellular growth, restore components of the articular extracellular matrix, and reduce inflammation.
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Affiliation(s)
- Alexander M. Satin
- Department of Orthopaedic Surgery,
Long Island Jewish Medical Center, Northwell Health, New Hyde Park, NY,
USA
| | - Jolanta B. Norelli
- Donald and Barbara Zucker School
of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Orthopaedic Research Laboratory,
Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Nicholas A. Sgaglione
- Department of Orthopaedic Surgery,
Long Island Jewish Medical Center, Northwell Health, New Hyde Park, NY,
USA
- Donald and Barbara Zucker School
of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Daniel A. Grande
- Department of Orthopaedic Surgery,
Long Island Jewish Medical Center, Northwell Health, New Hyde Park, NY,
USA
- Donald and Barbara Zucker School
of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Orthopaedic Research Laboratory,
Feinstein Institute for Medical Research, Manhasset, NY, USA
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Lo WC, Chang CC, Chan CH, Singh AK, Deng YH, Lin CY, Tsao W, Chien ST, Lin CH, Deng WP. Platelet-Derived Biomaterials Exert Chondroprotective and Chondroregenerative Effects on Diabetes Mellitus-Induced Intervertebral Disc Degeneration. Life (Basel) 2021; 11:1054. [PMID: 34685425 PMCID: PMC8540580 DOI: 10.3390/life11101054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/24/2021] [Accepted: 10/03/2021] [Indexed: 11/16/2022] Open
Abstract
Complications of diabetes mellitus (DM) range from acute to chronic conditions, leading to multiorgan disorders such as nephropathy, retinopathy, and neuropathy. However, little is known about the influence of DM on intervertebral disc degeneration (IVDD). Moreover, traditional surgical outcomes in DM patients have been found poor, and to date, no definitive alternative treatment exists for DM-induced IVDD. Recently, among various novel approaches in regenerative medicine, the concentrated platelet-derived biomaterials (PDB), which is comprised of transforming growth factor-β1 (TGF-β1), platelet-derived growth factor (PDGF), etc., have been reported as safe, biocompatible, and efficacious alternatives for various disorders. Therefore, we initially investigated the correlations between DM and IVDD, through establishing in vitro and in vivo DM models, and further evaluated the therapeutic effects of PDB in this comorbid pathology. In vitro model was established by culturing immortalized human nucleus pulposus cells (ihNPs) in high-glucose medium, whereas in vivo DM model was developed by administering streptozotocin, nicotinamide and high-fat diet to the mice. Our results revealed that DM deteriorates both ihNPs and IVD tissues, by elevating reactive oxygen species (ROS)-induced oxidative stress, inhibiting chondrogenic markers and disc height. Contrarily, PDB ameliorated IVDD by restoring cellular growth, chondrogenic markers and disc height, possibly through suppressing ROS levels. These data imply that PDB may serve as a potential chondroprotective and chondroregenerative candidate for DM-induced IVDD.
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Affiliation(s)
- Wen-Cheng Lo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan;
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Chun-Hao Chan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-H.C.); (A.K.S.); (Y.-H.D.)
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
| | - Abhinay Kumar Singh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-H.C.); (A.K.S.); (Y.-H.D.)
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
| | - Yue-Hua Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-H.C.); (A.K.S.); (Y.-H.D.)
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
| | - Chia-Ying Lin
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Wen Tsao
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Shaw-Ting Chien
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
| | - Chang-Hsien Lin
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan;
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Win-Ping Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-H.C.); (A.K.S.); (Y.-H.D.)
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei 110301, Taiwan; (C.-Y.L.); (W.T.); (S.-T.C.)
- Graduate Institute of Basic Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
- Department of Life Science, Tunghai University, Taichung 407224, Taiwan
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Lo WC, Chiou CS, Tsai FC, Chan CH, Mao S, Deng YH, Wu CY, Peng BY, Deng WP. Platelet-Derived Biomaterials Inhibit Nicotine-Induced Intervertebral Disc Degeneration Through Regulating IGF-1/AKT/IRS-1 Signaling Axis. Cell Transplant 2021; 30:9636897211045319. [PMID: 34586895 PMCID: PMC8485278 DOI: 10.1177/09636897211045319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Apart from aging process, adult intervertebral disc (IVD) undergoes various degenerative processes. However, the nicotine has not been well identified as a contributing etiology. According to a few studies, nicotine ingestion through smoking, air or clothing may significantly accumulate in active as well as passive smokers. Since nicotine has been demonstrated to adversely impact various physiological processes, such as sympathetic nervous system, leading to impaired vasculature and cellular apoptosis, we aimed to investigate whether nicotine could induce IVD degeneration. In particular, we evaluated dose-dependent impact of nicotine in vitro to simulate its chronic accumulation, which was later treated by platelet-derived biomaterials (PDB). Further, during in vivo studies, mice were subcutaneously administered with nicotine to examine IVD-associated pathologic changes. The results revealed that nicotine could significantly reduce chondrocytes and chondrogenic indicators (Sox, Col II and aggrecan). Mice with nicotine treatment also exhibited malformed IVD structure with decreased Col II as well as proteoglycans, which was significantly increased after PDB administration for 4 weeks. Mechanistically, PDB significantly restored the levels of IGF-1 signaling proteins, particularly pIGF-1 R, pAKT, and IRS-1, modulating ECM synthesis by chondrocytes. Conclusively, the PDB impart reparative and tissue regenerative processes by inhibiting nicotine-initiated IVD degeneration, through regulating IGF-1/AKT/IRS-1 signaling axis.
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Affiliation(s)
- Wen-Cheng Lo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Neurosurgery, Taipei Medical University Hospital, Taipei
| | - Chi-Sheng Chiou
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei
| | - Feng-Chou Tsai
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301.,Division of Plastic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City
| | - Chun-Hao Chan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei
| | - Samantha Mao
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei
| | - Yue-Hua Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei
| | - Chia-Yu Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei
| | - Win-Ping Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei.,Graduate Institute of Basic Medicine, Fu Jen Catholic University, New Taipei City.,Department of Life Science, Tunghai University, Taichung
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Lo WC, Dubey NK, Tsai FC, Lu JH, Peng BY, Chiang PC, Singh AK, Wu CY, Cheng HC, Deng WP. Amelioration of Nicotine-Induced Osteoarthritis by Platelet-Derived Biomaterials Through Modulating IGF-1/AKT/IRS-1 Signaling Axis. Cell Transplant 2021; 29:963689720947348. [PMID: 32757664 PMCID: PMC7563024 DOI: 10.1177/0963689720947348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Besides inhalation, a few studies have indicated that the uptake of nicotine
through air or clothing may be a significant pathway of its exposure among
passive smokers. Nicotine is well known to exert various physiological impacts,
including stimulating sympathetic nervous system, causing vascular disturbances,
and inducing cell death. Therefore, we aimed to establish whether exposure of
nicotine could induce articular cartilage degeneration in a mouse model of
osteoarthritis (OA). We specifically assessed dose-dependent effect of nicotine
in vitro to mimic its accumulation. Further, during the
in vivo studies, mice subcutaneously administered with
nicotine was examined for OA-associated pathologic changes. We found that
nicotine significantly suppressed chondrocytes and chondrogenic markers (Sox,
Col II, and aggrecan). Nicotine-treated mice also showed altered knee joint
ultrastructure with reduced Col II and proteoglycans. After corroborating
nicotine-induced OA characteristics, we treated this pathologic condition
through employing platelet-derived biomaterial (PDB)-based regenerative therapy.
The PDB significantly suppressed OA-like pathophysiological characteristics by 4
weeks. The mechanistic insight underlying this therapy demonstrated that PDB
significantly restored levels of insulin-like growth factor 1 (IGF-1) signaling
pathway proteins, especially pIGF-1 R, pAKT, and IRS-1, regulating extracellular
matrix synthesis by chondrocytes. Taken together, the PDB exerts regenerative
and reparative activities in nicotine-mediated initiation and progression of OA,
through modulating IGF-1/AKT/IRS-1 signaling axis.
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Affiliation(s)
- Wen-Cheng Lo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Navneet Kumar Dubey
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Feng-Chou Tsai
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Plastic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jui-Hua Lu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pao-Chang Chiang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Dental Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Abhinay Kumar Singh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Yu Wu
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Win-Ping Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Basic Medicine, Fu Jen Catholic University, Taipei, Taiwan.,Department of Life Science, Tunghai University, Taichung, Taiwan
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Effects of Extracellular Vesicles from Blood-Derived Products on Osteoarthritic Chondrocytes within an Inflammation Model. Int J Mol Sci 2021; 22:ijms22137224. [PMID: 34281278 PMCID: PMC8267849 DOI: 10.3390/ijms22137224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is hallmarked by a progressive degradation of articular cartilage. One major driver of OA is inflammation, in which cytokines such as IL-6, TNF-α and IL-1β are secreted by activated chondrocytes, as well as synovial cells—including macrophages. Intra-articular injection of blood products—such as citrate-anticoagulated plasma (CPRP), hyperacute serum (hypACT), and extracellular vesicles (EVs) isolated from blood products—is gaining increasing importance in regenerative medicine for the treatment of OA. A co-culture system of primary OA chondrocytes and activated M1 macrophages was developed to model an OA joint in order to observe the effects of EVs in modulating the inflammatory environment. Primary OA chondrocytes were obtained from patients undergoing total knee replacement. Primary monocytes obtained from voluntary healthy donors and the monocytic cell line THP-1 were differentiated and activated into proinflammatory M1 macrophages. EVs were isolated by ultracentrifugation and characterized by nanoparticle tracking analysis and Western blot. Gene expression analysis of chondrocytes by RT-qPCR revealed increased type II collagen expression, while cytokine profiling via ELISA showed lower TNF-α and IL-1β levels associated with EV treatment. In conclusion, the inflammation model provides an accessible tool to investigate the effects of blood products and EVs in the inflammatory context of OA.
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Li X, Dai B, Guo J, Zheng L, Guo Q, Peng J, Xu J, Qin L. Nanoparticle-Cartilage Interaction: Pathology-Based Intra-articular Drug Delivery for Osteoarthritis Therapy. NANO-MICRO LETTERS 2021; 13:149. [PMID: 34160733 PMCID: PMC8222488 DOI: 10.1007/s40820-021-00670-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 05/03/2023]
Abstract
Osteoarthritis is the most prevalent chronic and debilitating joint disease, resulting in huge medical and socioeconomic burdens. Intra-articular administration of agents is clinically used for pain management. However, the effectiveness is inapparent caused by the rapid clearance of agents. To overcome this issue, nanoparticles as delivery systems hold considerable promise for local control of the pharmacokinetics of therapeutic agents. Given the therapeutic programs are inseparable from pathological progress of osteoarthritis, an ideal delivery system should allow the release of therapeutic agents upon specific features of disorders. In this review, we firstly introduce the pathological features of osteoarthritis and the design concept for accurate localization within cartilage for sustained drug release. Then, we review the interactions of nanoparticles with cartilage microenvironment and the rational design. Furthermore, we highlight advances in the therapeutic schemes according to the pathology signals. Finally, armed with an updated understanding of the pathological mechanisms, we place an emphasis on the development of "smart" bioresponsive and multiple modality nanoparticles on the near horizon to interact with the pathological signals. We anticipate that the exploration of nanoparticles by balancing the efficacy, safety, and complexity will lay down a solid foundation tangible for clinical translation.
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Affiliation(s)
- Xu Li
- Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Joint Laboratory of Chinese Academic of Science and Hong Kong for Biomaterials, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Innovative Orthopedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
| | - Bingyang Dai
- Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Joint Laboratory of Chinese Academic of Science and Hong Kong for Biomaterials, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Innovative Orthopedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
| | - Jiaxin Guo
- Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Joint Laboratory of Chinese Academic of Science and Hong Kong for Biomaterials, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Innovative Orthopedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
| | - Lizhen Zheng
- Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Joint Laboratory of Chinese Academic of Science and Hong Kong for Biomaterials, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
- Innovative Orthopedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China
| | - Quanyi Guo
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, Institute of Orthopedics, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jiang Peng
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, Institute of Orthopedics, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jiankun Xu
- Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China.
- Joint Laboratory of Chinese Academic of Science and Hong Kong for Biomaterials, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China.
- Innovative Orthopedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China.
| | - Ling Qin
- Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China.
- Joint Laboratory of Chinese Academic of Science and Hong Kong for Biomaterials, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China.
- Innovative Orthopedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong, SAR, People's Republic of China.
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Dos Santos RG, Santos GS, Alkass N, Chiesa TL, Azzini GO, da Fonseca LF, Dos Santos AF, Rodrigues BL, Mosaner T, Lana JF. The regenerative mechanisms of platelet-rich plasma: A review. Cytokine 2021; 144:155560. [PMID: 34004552 DOI: 10.1016/j.cyto.2021.155560] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/17/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022]
Abstract
Orthobiologics continue to gain popularity in many areas of medical science, especially in the field of regenerative medicine. Platelet-rich plasma derivatives are orthobiologic tools of particular interest. These biologic products can be obtained via centrifugation of a patient's whole blood and the components can then be subsequently isolated, concentrated and ultimately administered into injured tissues, particularly in areas where standard healing is disrupted. The elevated concentration of platelets above the basal value enables accelerated growth of various tissues with minimal side effects. The application of autologous orthobiologics is a relatively new biotechnology undergoing expansion which continues to reveal optimistic results in the stimulation and enhanced healing of various sorts of tissue injuries. The local release of growth factors and cytokines contained in platelet alpha granules accelerates and ameliorates tissue repair processes, mimicking and supporting standard wound healing. This effect is greatly enhanced upon combination with the fibrinolytic system, which are essential for complete regeneration. Fibrinolytic reactions can dictate proper cellular recruitment of certain cell populations such as mesenchymal stem cells and other immunomodulatory agents. Additionally, these reactions also control proteolytic activity in areas of wound healing and regenerative processes of mesodermal tissues including bone, cartilage, and muscle, which makes it particularly valuable for musculoskeletal health, for instance. Although many investigations have demonstrated significant results with platelet-rich plasma derivatives, further studies are still warranted.
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Affiliation(s)
- Rafael Gonzalez Dos Santos
- IOC - Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue - 2nd Floor, Room #29, Zip Code 13334-170, Indaiatuba, SP, Brazil.
| | - Gabriel Silva Santos
- IOC - Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue - 2nd Floor, Room #29, Zip Code 13334-170, Indaiatuba, SP, Brazil.
| | - Natasha Alkass
- Queensland University of Technology, 2 George St, Zip Code 4000, Brisbane, Queensland, Australia.
| | - Tania Liana Chiesa
- QML Pathology, 11 Riverview Place, Murarrie, Zip Code 4172, Brisbane, Queensland, Australia.
| | - Gabriel Ohana Azzini
- IOC - Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue - 2nd Floor, Room #29, Zip Code 13334-170, Indaiatuba, SP, Brazil.
| | - Lucas Furtado da Fonseca
- Universidade Federal De São Paulo - Escola Paulista de Medicina, 715 Napoleão de Barros St, Vila Clementino, Zip Code 04024-002, São Paulo, SP, Brazil.
| | - Antonio Fernando Dos Santos
- FARMERP- Faculdade de Medicina de São José do Rio Preto, 5416 Brigadeiro Faria Lima Avenue, Vila Sao Pedro, Zip Code 15090-000, São José do Rio Preto, SP, Brazil.
| | - Bruno Lima Rodrigues
- IOC - Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue - 2nd Floor, Room #29, Zip Code 13334-170, Indaiatuba, SP, Brazil.
| | - Tomas Mosaner
- IOC - Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue - 2nd Floor, Room #29, Zip code 13334-170, Indaiatuba, SP, Brazil.
| | - José Fábio Lana
- IOC - Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue - 2nd Floor, Room #29, Zip Code 13334-170, Indaiatuba, SP, Brazil.
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22
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Slimi F, Zribi W, Trigui M, Amri R, Gouiaa N, Abid C, Rebai MA, Boudawara T, Jebahi S, Keskes H. The effectiveness of platelet-rich plasma gel on full-thickness cartilage defect repair in a rabbit model. Bone Joint Res 2021; 10:192-202. [PMID: 33730862 PMCID: PMC7998069 DOI: 10.1302/2046-3758.103.bjr-2020-0087.r2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AIMS The present study investigates the effectiveness of platelet-rich plasma (PRP) gel without adjunct to induce cartilage regeneration in large osteochondral defects in a rabbit model. METHODS A bilateral osteochondral defect was created in the femoral trochlear groove of 14 New Zealand white rabbits. The right knees were filled with PRP gel and the contralateral knees remained untreated and served as control sides. Some animals were killed at week 3 and others at week 12 postoperatively. The joints were harvested and assessed by Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) MRI scoring system, and examined using the International Cartilage Repair Society (ICRS) macroscopic and ICRS histological scoring systems. Additionally, the collagen type II content was evaluated by the immunohistochemical staining. RESULTS After 12 weeks post-surgery, the defects of the PRP group were repaired by hyaline cartilage-like tissue. However, incomplete cartilage regeneration was observed in the PRP group for three weeks. The control groups showed fibrocartilaginous or fibrous tissue, respectively, at each timepoint. CONCLUSION Our study proved that the use of PRP gel without any adjuncts could successfully produce a good healing response and resurface the osteochondral defect with a better quality of cartilage in a rabbit model. Cite this article: Bone Joint Res 2021;10(3):192-202.
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Affiliation(s)
- Fathia Slimi
- Experimental Surgery of the Musculoskeletal System Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - Wassim Zribi
- Experimental Surgery of the Musculoskeletal System Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - Moez Trigui
- Experimental Surgery of the Musculoskeletal System Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - Raja Amri
- Experimental Surgery of the Musculoskeletal System Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - Nawrez Gouiaa
- Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Cyrine Abid
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Biotech Center of Sfax, Sfax, Tunisia
| | - Mohammed Ali Rebai
- Experimental Surgery of the Musculoskeletal System Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - Tahia Boudawara
- Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Samira Jebahi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Biotech Center of Sfax, Sfax, Tunisia
- Energy and Matter Research Laboratory, National Center for Nuclear Science and Technology (CNSTN), Sidi Thabet, Tunisia
| | - Hassib Keskes
- Experimental Surgery of the Musculoskeletal System Laboratory, Faculty of Medicine, Sfax, Tunisia
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23
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Makarczyk MJ, Gao Q, He Y, Li Z, Gold MS, Hochberg MC, Bunnell BA, Tuan RS, Goodman SB, Lin H. Current Models for Development of Disease-Modifying Osteoarthritis Drugs. Tissue Eng Part C Methods 2021; 27:124-138. [PMID: 33403944 PMCID: PMC8098772 DOI: 10.1089/ten.tec.2020.0309] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis (OA) is a painful and disabling disease that affects millions of people worldwide. Symptom-alleviating treatments exist, although none with long-term efficacy. Furthermore, there are currently no disease-modifying OA drugs (DMOADs) with demonstrated efficacy in OA patients, which is, in part, attributed to a lack of full understanding of the pathogenesis of OA. The inability to translate findings from basic research to clinical applications also highlights the deficiencies in the available OA models at simulating the clinically relevant pathologies and responses to treatments in humans. In this review, the current status in the development of DMOADs will be first presented, with special attention to those in Phase II-IV clinical trials. Next, current in vitro, ex vivo, and in vivo OA models are summarized and the respective advantages and disadvantages of each are highlighted. Of note, the development and application of microphysiological or tissue-on-a-chip systems for modeling OA in humans are presented and the issues that need to be addressed in the future are discussed. Microphysiological systems should be given serious consideration for their inclusion in the DMOAD development pipeline, both for their ability to predict drug safety and efficacy in human clinical trials at present, as well as for their potential to serve as a test platform for personalized medicine. Impact statement At present, no disease-modifying osteoarthritis (OA) drugs (DMOADs) have been approved for widespread clinical use by regulatory bodies. The failure of developing effective DMOADs is likely owing to multiple factors, not the least of which are the intrinsic differences between the intact human knee joint and the preclinical models. This work summarizes the current OA models for the development of DMOADs, discusses the advantages/disadvantages of each, and then proposes future model development to aid in the discovery of effective and personalized DMOADs. The review also highlights the microphysiological systems, which are emerging as a new platform for drug development.
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Affiliation(s)
- Meagan J. Makarczyk
- Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Qi Gao
- Department of Orthopaedic Surgery, Stanford University, California, USA
| | - Yuchen He
- Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Zhong Li
- Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael S. Gold
- Department of Neurobiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mark C. Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USA
| | - Bruce A. Bunnell
- Department of Microbiology, Immunology, and Genetics, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Rocky S. Tuan
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Stuart B. Goodman
- Department of Orthopaedic Surgery, Stanford University, California, USA
- Department of Bioengineering, Stanford University, California, USA
| | - Hang Lin
- Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- McGowan Institute for Regenerative Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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24
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Raeissadat SA, Gharooee Ahangar A, Rayegani SM, Minator Sajjadi M, Ebrahimpour A, Yavari P. Platelet-Rich Plasma-Derived Growth Factor vs Hyaluronic Acid Injection in the Individuals with Knee Osteoarthritis: A One Year Randomized Clinical Trial. J Pain Res 2020; 13:1699-1711. [PMID: 32753945 PMCID: PMC7354951 DOI: 10.2147/jpr.s210715] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/27/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE In this study, we aimed at performing a comparison between intra-articular injections of PRP-derived growth factor (PGRF) and hyaluronic acid regarding their effect on pain and patient's function in knee osteoarthritis, as well as their safety profiles. METHODS During our single-masked randomized clinical trial, the candidates with symptomatic knee osteoarthritis received two intra-articular injections of PRGF with 3 weeks apart or received three weekly injections of HA. The mean improvements from before treatment until the second, sixth, and twelfth months post-intervention in scores obtained by visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne index were our primary outcomes. RESULTS A total of 102 candidates were finally included in the study. Patients' mean age was 57.08±7.3 years old in the PRGF group compared to the mean age of 58.63±7.09 years old in HA patients. In the PRGF group, total WOMAC index decreased from 41.96±11.71 to 27.10±12.3 (P = 0.02), and from 39.71±10.4 to 32.41±11.8 in the HA group after 12 months (P > 0.05). Regarding the Lequesne index, pain, ADL, and global scores significantly decreased after 12 months in the PRGF group compared to the HA group (P<0.001). There was also a meaningful higher rate of satisfaction in the PRGF group compared to the HA group after 12 months of treatment (P<0.001). CONCLUSION Besides significantly higher satisfaction belonging to the PRGF group, there was a statistically significant improvement in VAS score and global, pain, and ADL score of Lequesne by passing 12 months from injection in PRGF compared to HA.
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Affiliation(s)
- Seyed Ahmad Raeissadat
- Physical Medicine and Rehabilitation Research Center, Clinical Research Development Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Seyed Mansoor Rayegani
- Physical Medicine and Rehabilitation Research Center, Clinical Research Development Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Adel Ebrahimpour
- Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pegah Yavari
- Physical Medicine and Rehabilitation Research Center, Clinical Research Development Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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25
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Medina-Porqueres I, Ortega-Castillo M, Muriel-Garcia A. Effectiveness of platelet-rich plasma in the management of hip osteoarthritis: a systematic review and meta-analysis. Clin Rheumatol 2020; 40:53-64. [PMID: 32607659 DOI: 10.1007/s10067-020-05241-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/02/2020] [Accepted: 06/12/2020] [Indexed: 01/16/2023]
Abstract
The effectiveness of platelet-rich plasma (PRP) injections for osteoarthritis (OA) is still controversial. Previous research supports the use of intra-articular PRP injections to promote a favorable environment for joint tissue healing and to delay the progression of OA. The purpose of this review is to investigate the effectiveness of PRP in the management of hip osteoarthritis (HOA). Five electronic databases were searched from inception to May 2019: Medline (via PubMed), SportDiscus via EBSCO, ProQuest Health & Medical Complete, CINAHL, and Cochrane. Risk of bias was assessed with the Cochrane risk of bias tool. The GRADE method was used to assess the level of evidence for the studies included in this review. Clinical trials evaluate PRP injections among adult patients diagnosed with HOA according to the American College of Rheumatology criteria. At least one outcome measure for pain or function must have been reported. A total of 4 trials (334 participants, 340 hips) were included, all marked as "moderate risk of bias". Pain and function were assessed throughout the studies with visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Harris Hip Score (HHS) tools. Intra-articular PRP injections were more effective at stages earlier than 3 months for both treatment groups with the exception of WOMAC score in one study. The superiority of PRP against comparative treatments was only reported in one study; longer-term evaluations from 4 to 12 months showed diverse results, with only one study reporting significantly better results for PRP. PRP may be beneficial and safe for patients with HOA at mid-term follow-up. However, its superiority over other procedures such as hyaluronic acid remains unclear. Further researches with high-quality designs and larger samples become imperative.
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Affiliation(s)
- Ivan Medina-Porqueres
- Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain. .,Medical Services, Malaga Football Club, Malaga, Spain.
| | - Miguel Ortega-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain.,Department of Nursing and Physical Therapy, Faculty of Health Sciences, University of Alcala, Alcala, Spain
| | - Alfonso Muriel-Garcia
- Department of Nursing and Physical Therapy, Faculty of Health Sciences, University of Alcala, Alcala, Spain.,Ramon and Cajal Hospital IRYCIS, CIBERESP, Madrid, Spain
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26
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Kesiktas FN, Dernek B, Sen EI, Albayrak HN, Aydin T, Yildiz M. Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study. Clin Rheumatol 2020; 39:3057-3064. [PMID: 32358661 PMCID: PMC7497346 DOI: 10.1007/s10067-020-05121-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 01/11/2023]
Abstract
Introduction/objectives Intra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane® (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA. Method Fifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up. Results Mean age was 55.8 ± 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p < 0.05). There were no statistically significant differences between the groups in terms of first week pain relief (p > 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group’s rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group. Conclusion As a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group.Key Points • The short-term effects of intra-articular HA, peptide, and PRP injections were compared in knee osteoarthritis. • HA, peptide, and PRP injections may be useful in pain relief and functional improvement in knee osteoarthritis. |
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Affiliation(s)
- Fatma Nur Kesiktas
- Department of PMR, MD, Istanbul Physical Medicine and Rehabilitation Education Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Bahar Dernek
- Department of PMR, MD, Istanbul Physical Medicine and Rehabilitation Education Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ekin Ilke Sen
- Department of PMR, MD, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Havva Nur Albayrak
- Department of PMR, MD, Istanbul Physical Medicine and Rehabilitation Education Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tugba Aydin
- Department of PMR, MD, Istanbul Physical Medicine and Rehabilitation Education Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Merve Yildiz
- Department of PMR, MD, Istanbul Physical Medicine and Rehabilitation Education Research Hospital, University of Health Sciences, Istanbul, Turkey
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27
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Canisso IF, Segabinazzi LG, Fedorka CE. Persistent Breeding-Induced Endometritis in Mares - a Multifaceted Challenge: From Clinical Aspects to Immunopathogenesis and Pathobiology. Int J Mol Sci 2020; 21:E1432. [PMID: 32093296 PMCID: PMC7073041 DOI: 10.3390/ijms21041432] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/29/2020] [Accepted: 02/07/2020] [Indexed: 12/12/2022] Open
Abstract
Post-breeding endometritis (i.e., inflammation/infection of the endometrium), is a physiological reaction taking place in the endometrium of mares within 48 hours post-breeding, aimed to clear seminal plasma, excess sperm, microorganisms, and debris from the uterine lumen in preparation for the arrival of an embryo. Mares are classified as susceptible or resistant to persistent breeding-induced endometritis (PBIE) based on their ability to clear this inflammation/infection by 48 hours post-breeding. Mares susceptible to PBIE, or those with difficulty clearing infection/inflammation, have a deficient immune response and compromised physical mechanisms of defense against infection. Molecular pathways of the innate immune response known to be involved in PBIE are discussed herein. The role of the adaptive uterine immune response on PBIE remains to be elucidated in horses. Advances in the pathobiology of microbes involved in PBIE are also revised here. Traditional and non-traditional therapeutic modalities for endometritis are contrasted and described in the context of clinical and molecular aspects. In recent years, the lack of efficacy of traditional therapeutic modalities, alongside the ever-increasing incidence of antibiotic-resistant microorganisms, has enforced the development of non-traditional therapies. Novel biological products capable of modulating the endometrial inflammatory response are also discussed here as part of the non-traditional therapies for endometritis.
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Affiliation(s)
- Igor F. Canisso
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Champaign, IL 61802, USA;
| | - Lorenzo G.T.M. Segabinazzi
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Champaign, IL 61802, USA;
- Department of Animal Reproduction and Veterinary Radiology, Faculty of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu 18618-000, São Paulo, Brazil
| | - Carleigh E. Fedorka
- The Maxwell H. Gluck Equine Research Center, University of Kentucky, Lexington, KY 40503, USA;
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28
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Yousefi-Ahmadipour A, Ebrahimi-Barough S, Niknia S, Allahverdi A, Mirzahosseini-Pourranjbar A, Tashakori M, Khajouee Ravari S, Asadi F, Heidari Barchi Nezhad R, Lotfibakhshaiesh N, Mirzaei MR. Therapeutic effects of combination of platelet lysate and sulfasalazine administration in TNBS-induced colitis in rat. Biomed Pharmacother 2020; 125:109949. [PMID: 32058216 DOI: 10.1016/j.biopha.2020.109949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/18/2020] [Accepted: 01/23/2020] [Indexed: 01/10/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic and idiopathic disease with gastrointestinal dysfunction. Current therapeutic approaches in IBD have several limitations such as, harmful side effects and high price for biologic drugs. It sounds that finding of an effective, safe and inexpensive strategy to overcome IBD is critical. Platelet derivatives, as biological pool of wide range of growth factors and cytokines, are widely used in regenerative medicine for treatment of soft and hard tissue lesions. We sought to determine whether platelet lysate (PL) alone or in combination with sulfasalazine (reference drug) can be a valuable strategy for overcoming IBD. In the present study, we investigated and compared the daily and alternate-day administration of PL alone or combined with sulfasalazine for treating colitis in a rat model of IBD. Histological damage scores of TNBS-induced colitis were reduced by co-administration of every alternate day PL and sulfasalazine. Pro-inflammatory cytokines TNF-α, IL-1 and IL-6 were decreased and anti-inflammatory cytokines IL-10 and TGF-β were increased after treatment with PL compared to that in the TNBS group. Furthermore, combined treatment with PL and sulfasalazine decreased apoptosis and inhibited the NF-κB signaling pathway. In conclusion, the combined administration of PL with conventional IBD therapy is able to effectively ameliorate IBD through modulation of inflammatory status.
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Affiliation(s)
- Aliakbar Yousefi-Ahmadipour
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Laboratory Sciences, Faculty of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Somayeh Ebrahimi-Barough
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seddigheh Niknia
- Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Amir Allahverdi
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Mahnaz Tashakori
- Department of Laboratory Sciences, Faculty of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Shima Khajouee Ravari
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Fatemeh Asadi
- Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Rahim Heidari Barchi Nezhad
- Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Nasrin Lotfibakhshaiesh
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Reza Mirzaei
- Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Evans A, Ibrahim M, Pope R, Mwangi J, Botros M, Johnson SP, Al Kassis S. Treating hand and foot osteoarthritis using a patient's own blood: A systematic review and meta-analysis of platelet-rich plasma. J Orthop 2020; 18:226-236. [PMID: 32071509 DOI: 10.1016/j.jor.2020.01.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 01/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background This study summarizes all literature investigating platelet-rich plasma (PRP) in the treatment of osteoarthritis of the hands and feet. Materials & methods This is a PRISMA compliant systematic review of 7 databases and includes a meta-analysis of randomized controlled trial (RCT) data on pain and function. Results Nine articles were included in the review. Meta-analysis of 4 RCTs shows PRP significantly improves pain and function versus control. More results are significant at longer duration follow-up. Conclusions PRP improves pain and function of osteoarthritis. Heterogeneity and risk-of-bias limit current data, requiring more RCTs to determine any regenerative potential of PRP. Prospero Systematic Review Registration Number 136582.
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Affiliation(s)
- Adam Evans
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN, 37208, USA
| | - Maryo Ibrahim
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN, 37208, USA
| | - Rand Pope
- Vanderbilt University School of Medicine, 1161 21st Ave South, Nashville, TN, 37232, USA
| | - James Mwangi
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN, 37208, USA
| | - Mina Botros
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN, 37208, USA
| | - Shepard P Johnson
- Vanderbilt University Medical Center Department of Plastic Surgery, D-4207 Medical Center North, 1211 Medical Center Drive, Nashville, TN, 37212, USA
| | - Salam Al Kassis
- Vanderbilt University Medical Center Department of Plastic Surgery, D-4207 Medical Center North, 1211 Medical Center Drive, Nashville, TN, 37212, USA
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30
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Cuervo B, Rubio M, Chicharro D, Damiá E, Santana A, Carrillo JM, Romero AD, Vilar JM, Cerón JJ, Sopena JJ. Objective Comparison between Platelet Rich Plasma Alone and in Combination with Physical Therapy in Dogs with Osteoarthritis Caused by Hip Dysplasia. Animals (Basel) 2020; 10:ani10020175. [PMID: 31972961 PMCID: PMC7070503 DOI: 10.3390/ani10020175] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/19/2019] [Accepted: 01/15/2020] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Finding successful treatments against osteoarthritis without secondary effects and objectively assessing their effectiveness in dogs is always challenging. In this sense, the aim of this study was to objectively assess the efficacy of platelet rich plasma alone and in combination with physical therapy by using a force platform in dogs with hip osteoarthritis. Dogs receiving only the platelet rich plasma treatment showed a significant improvement in limb function, although the effect decreased after 180 days; in contrast, the combined therapy maintained the maximum level of efficacy throughout the study period. Our study proved that physical therapy does not increase the level of efficacy of platelet rich plasma therapy but objectively contributes to prolonging its effect for more than this time period. Abstract Osteoarthritis (OA) is one of the most significant joint diseases worldwide. There are different therapies for OA treatment, and a relatively new strategy is the use of plasma rich in growth factors (PRGF), a platelet rich plasma (PRP) derivative. The objective of this study was to objectively assess the efficacy and duration of the effect of an intraarticular injection of PRGF and a combination of PRGF + physical therapy. The objective assessment was provided using a force platform. The obtained parameters were peak vertical force (PVF) and vertical impulse (VI). A total of 24 dogs with lameness and pain associated to OA attributable to bilateral hip dysplasia were included in the study. Animals were divided into two study groups and evaluated at baseline and at 30, 90, and 180 days after intraarticular PRGF or PRGF + physical therapy. Significant differences were observed at every checkpoint with respect to basal time in both groups. However, after 180 days, the PRGF group showed a decrease in PVF and VI with respect to the values obtained at 90 days. However, the PRGF + physical therapy group maintained increased values of both PVF and VI values during the 180-day study period.
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Affiliation(s)
- Belén Cuervo
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Mónica Rubio
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Deborah Chicharro
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Elena Damiá
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Angelo Santana
- Department of Mathematics, Universidad de Las Palmas de Gran Canaria, Campus de Tafira, 35018 Las Palmas, Spain;
| | - José María Carrillo
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - Ayla Del Romero
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
| | - José Manuel Vilar
- Department of Animal Pathology, Instituto Universitario de Investigaciones Biomédicas y Universitarias, Universidad de Las Palmas de Gran Canaria, 35416 Trasmontaña S/N. Arucas, Spain
- Correspondence:
| | - José Joaquín Cerón
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, 30100 Murcia, Spain
| | - Joaquín Jesús Sopena
- Bioregenerative Medicine and Applied Surgery Research Group, Departamento de medicina y cirugía animal, Facultad de veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (B.C.); (M.R.); (D.C.); (E.D.); (J.M.C.); (A.D.R.); (J.J.S.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, 08006 Barcelona, Spain
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Garbin LC, Olver CS. Platelet-Rich Products and Their Application to Osteoarthritis. J Equine Vet Sci 2019; 86:102820. [PMID: 32067662 DOI: 10.1016/j.jevs.2019.102820] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 08/04/2019] [Accepted: 10/22/2019] [Indexed: 12/15/2022]
Abstract
Autologous platelet-rich plasma (PRP) is a biological preparation made from the patient's own plasma that contains a platelet concentration above the whole blood baseline. Owing to the release of growth factors and other cytokines after degranulation, platelets have a central role in inflammation and in different stages of the healing process. For this reason, PRP-derived products have been used to enhance healing of musculoskeletal injuries and modulate progression of inflammatory processes, including osteoarthritis (OA). Osteoarthritis is one of the main causes of musculoskeletal disabilities in horses, and currently, there is no effective treatment for this disease. Treatments that focus on the modulation of inflammation and disease progression offer new hope for OA. Platelet-rich plasma provides a more practical and accessible option of therapy compared to other forms of biological treatment (i.e., stem cell therapies) and is believed to induce the production of functional matrix. However, several factors related to PRP production, including methods of preparation and application, and intraindividual variability, lead to an inconsistent product, precluding reliable conclusions about its efficacy for clinical use. The aim of this study was to review the benefits related to the clinical use of PRP in OA as well as factors that influence its use, the limitations of this treatment, and future directions of PRP research and therapy.
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Affiliation(s)
- Livia Camargo Garbin
- Department of Clinical Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, University of West Indies, St. Augustine, Trinidad and Tobago, West Indies.
| | - Christine S Olver
- Veterinary Diagnostic Laboratory, Clinical Pathology Section, Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
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32
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Jain E, Chinzei N, Blanco A, Case N, Sandell LJ, Sell S, Rai MF, Zustiak SP. Platelet-Rich Plasma Released From Polyethylene Glycol Hydrogels Exerts Beneficial Effects on Human Chondrocytes. J Orthop Res 2019; 37:2401-2410. [PMID: 31254416 PMCID: PMC6778705 DOI: 10.1002/jor.24404] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 06/14/2019] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is a debilitating joint disease resulting from chronic joint inflammation and erosion of articular cartilage. A promising biological treatment for OA is intra-articular administration of platelet-rich plasma (PRP). However, immediate bolus release of growth factors limits beneficial therapeutic effects of PRP, thus necessitating the demand for sustained release platforms. In this study, we evaluated the therapeutic value of PRP released from a polyethylene glycol (PEG) hydrogel on articular chondrocytes/cartilage explants derived from OA patients. Lyophilized PRP (PRGF) was encapsulated in PEG hydrogels at 10% w/v and hydrogel swelling, storage modulus and degradation and PRGF release kinetics were determined. PRGF releasate from the hydrogels was collected on day 1, 4, and 11. Encapsulation of PRGF at 10% w/v in PEG hydrogels had minimal effect on hydrogel properties. PRGF was released with an initial burst followed by sustained release until complete hydrogel degradation. Effect of PRGF releasates and bolus PRGF (1% w/v PRGF) on patient-derived cartilage explants or chondrocytes was assessed by chondrocyte proliferation (pico-green assay), gene expression for COL1A1, COL2A1, MMP13, COX2, and NFKB1 (real-time polymerase chain reaction), and measurement of nitric oxide concentration (Griess' assay). Compared to bolus PRGF, PRGF releasates enhanced chondrocyte proliferation, suppressed the expression of genes like MMP13, NFKB1, COL1A1, and COL2A1 and reduced levels of nitric oxide. Taken together, these results indicate that release of PRGF from PEG hydrogels may improve the therapeutic efficacy of PRP and merits further investigation in an animal model of OA. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2401-2410, 2019.
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Affiliation(s)
- Era Jain
- Biomedical Engineering, Saint Louis University
- Department of Biomedical Engineering, Washington University
| | - Nobuaki Chinzei
- Department of Orthopedic Surgery, Musculoskeletal Research Center, Washington University
| | | | | | - Linda J Sandell
- Department of Biomedical Engineering, Washington University
- Department of Orthopedic Surgery, Musculoskeletal Research Center, Washington University
- Department of Cell Biology & Physiology, Washington University
| | - Scott Sell
- Biomedical Engineering, Saint Louis University
| | - Muhammad Farooq Rai
- Department of Orthopedic Surgery, Musculoskeletal Research Center, Washington University
- Department of Cell Biology & Physiology, Washington University
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33
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Chen YT, Yang CC, Lin KC, Chen KH, Sung PH, Shao PL, Li YC, Chiang JY, Yip HK. Preactivated and disaggregated shape-changed platelets protect kidney against from ischemia-reperfusion injury in rat through attenuating inflammation reaction. J Tissue Eng Regen Med 2019; 13:2155-2168. [PMID: 31502757 DOI: 10.1002/term.2960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/29/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
This study tested the hypothesis that preactivated and disaggregated shape-changed platelet (PreD-SCP) therapy significantly protected rat kidney from ischemia-reperfusion (IR) injury. Adult-male Sprague-Dawley rats (n = 24) were equally categorized into Groups 1 (sham-operated control [SC]), 2 (SC + PreD-SCP), 3 (IR only), and 4 (IR + PreD-SCP). By 72 hr after IR procedure, the circulatory levels of creatinine, blood urine nitrogen and inflammatory biomarkers (interleukin [IL]-6/tumor necrosis factor [TNF]-α), and ratio of urine protein to urine creatinine were significantly higher in Group 3 than in other groups and significantly higher in Group 4 than in Groups 1 and 2, but they showed no different between Groups 1 and 2 (all p < .001). The microscopic findings showed that the expressions of kidney injury score, cellular inflammation (MMP-9/CD14//F4/80), and fibrotic area were identical to the circulatory inflammation, whereas the integrity of podocyte components (ZO-1/synaptopodin/podocin) exhibited an opposite to circulatory inflammation among the four groups (all p < .0001). The protein expressions of inflammatory (TNF-α/IL-1ß/NF-κB/iNOS/TRAF6/MyD88/TLR-4), apoptotic/cell death (mitochondrial Bax/cleaved caspase-3/p-53), oxidized protein, mitogen-activated protein kinase family (p-38/p-JNK/p-c-JUN), and mitochondrial-damaged biomarkers displayed a similar pattern, whereas the antiapoptotic (Bcl-2/Bcl-XL) and integrity of mitochondrial biomarkers followed an opposite trend to circulatory inflammation among the four groups (all p < .001). PreD-SCP therapy effectively protected the kidney against IR injury.
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Affiliation(s)
- Yen-Ta Chen
- Division of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Chao Yang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kun-Chen Lin
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuan-Hung Chen
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Hsun Sung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Lin Shao
- Department of Nursing, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Chen Li
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - John Y Chiang
- Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Hon-Kan Yip
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Nursing, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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34
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Yip HK, Chen KH, Dubey NK, Sun CK, Deng YH, Su CW, Lo WC, Cheng HC, Deng WP. Cerebro- and renoprotective activities through platelet-derived biomaterials against cerebrorenal syndrome in rat model. Biomaterials 2019; 214:119227. [DOI: 10.1016/j.biomaterials.2019.119227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 12/18/2022]
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35
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Arbeitsgemeinschaften und assoziierte Gesellschaften (AKS). J Dtsch Dermatol Ges 2019. [DOI: 10.1111/ddg.13793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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36
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Liu J, Jiang T, Li C, Wu Y, He M, Zhao J, Zheng L, Zhang X. Bioconjugated Carbon Dots for Delivery of siTnfα to Enhance Chondrogenesis of Mesenchymal Stem Cells by Suppression of Inflammation. Stem Cells Transl Med 2019; 8:724-736. [PMID: 30919586 PMCID: PMC6591550 DOI: 10.1002/sctm.18-0289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/20/2019] [Indexed: 01/05/2023] Open
Abstract
Although a promising strategy, the mesenchymal stem cell (MSC)‐based therapy of cartilage defects is sometimes accompanied with chronic inflammation during the remodeling status, which may hinder cartilage regeneration. During this process, the inflammatory cytokine tumor necrosis factor α (TNFα) plays an important role and may be a potential target. In this study, we investigated the effect of Tnfα RNA interference by introducing a functional and highly safe carbon dot (CD)‐SMCC nanovector synthesized by bioconjugation of CDs with a protein crosslinker, sulfosuccinimidyl‐4‐(N‐maleimidomethyl) cyclohexane‐1‐carboxylate (sulfo‐SMCC), as the vehicle of the silenced TNFα (siTnfα) on chondrogenesis of MSCs. The results showed that CD‐SMCC displayed intense fluorescence with well‐dispersed and positively charged properties, which favored effective binding and delivering of siTnfα into the MSCs. CD‐SMCC‐siTnfα nanoformula also exhibited considerably high transfection efficiency and nearly no cytotoxicity, which is preferred over commercial polyethyleneimine. Interference of Tnfα by CD‐SMCC‐siTnfα markedly promoted the chondrogenesis of MSCs, as indicated by upregulating cartilage‐specific markers. Furthermore, in vivo exploration indicated that CD‐SMCC‐siTnfα transfected MSCs accelerated cartilage regeneration. In conclusion, this study demonstrated that in combination with the novel CD‐SMCC nanovector, targeting Tnfα may facilitate stem cell‐based therapy of cartilage defects. stem cells translational medicine2019;8:724&736
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Affiliation(s)
- Jianwei Liu
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration & Guangxi Collaborative Innovation Center for Biomedicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China.,Department of Spine Osteopathia, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Tongmeng Jiang
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration & Guangxi Collaborative Innovation Center for Biomedicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China.,Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Chun Li
- Department of Spine Osteopathia, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Yang Wu
- Department of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Maolin He
- Department of Spine Osteopathia, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Jinmin Zhao
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration & Guangxi Collaborative Innovation Center for Biomedicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China.,Department of Spine Osteopathia, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China.,Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China.,Department of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Li Zheng
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration & Guangxi Collaborative Innovation Center for Biomedicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People's Republic of China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, People's Republic of China
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Mehranfar S, Abdi Rad I, Mostafavi E, Akbarzadeh A. The use of stromal vascular fraction (SVF), platelet-rich plasma (PRP) and stem cells in the treatment of osteoarthritis: an overview of clinical trials. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:882-890. [DOI: 10.1080/21691401.2019.1576710] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Sahar Mehranfar
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Isa Abdi Rad
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Ebrahim Mostafavi
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Abolfazl Akbarzadeh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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38
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The Role of Platelet-Rich Plasma in Cartilage Pathology: An Updated Systematic Review of the Basic Science Evidence. Arthroscopy 2019; 35:961-976.e3. [PMID: 30733026 DOI: 10.1016/j.arthro.2018.10.125] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/06/2018] [Accepted: 10/29/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To review the basic science studies on platelet-rich plasma (PRP) for cartilage and determine whether there has been an improvement in methodology and outcome reporting that would allow for a more meaningful analysis regarding the mechanism of action and efficacy of PRP for cartilage pathology. METHODS The PubMed/MEDLINE and EMBASE databases were screened in May 2017 with publication dates of January 2011 through May 2017 using the following key words: "platelet-rich plasma OR PRP OR autologous conditioned plasma (ACP) OR ACP AND cartilage OR chondrocytes OR chondrogenesis OR osteoarthritis OR arthritis." Two authors independently performed the search, determined study inclusion, and extracted data. Data extracted included cytology/description of PRP, study design, and results. RESULTS Twenty-seven studies (11 in vitro, 13 in vivo, 3 in vitro and in vivo) met the inclusion criteria and were included in the study. All of the studies (100%) reported the method by which PRP was prepared. Two studies reported basic cytologic analysis of PRP, including platelet, white blood cell, and red blood cell counts (6.7%). Nine studies reported both platelet count and white blood cell count (30.0%). Twelve studies reported platelet count alone (40.0%). Nine studies (30.0%) made no mention at all as to the composition of the PRP used. PRP was shown to increase cell viability, cell proliferation, cell migration, and differentiation. Several studies demonstrated increased proteoglycan and type II collagen content. PRP decreased inflammation in 75.0% of the in vitro studies reporting data and resulted in improved histologic quality of the cartilage tissue in 75.0% of the in vivo studies reporting data. CONCLUSIONS Although the number of investigations on PRP for cartilage pathology has more than doubled since 2012, the quality of the literature remains limited by poor methodology and outcome reporting. A majority of basic science studies suggest that PRP has beneficial effects on cartilage pathology; however, the inability to compare across studies owing to a lack of standardization of study methodology, including characterizing the contents of PRP, remains a significant limitation. Future basic science and clinical studies must at a minimum report the contents of PRP to better understand the clinical role of PRP for cartilage pathology. CLINICAL RELEVANCE Establishing proof of concept for PRP to treat cartilage pathology is important so that high-quality clinical studies with appropriate indications can be performed.
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40
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Chiou CS, Wu CM, Dubey NK, Lo WC, Tsai FC, Tung TDX, Hung WC, Hsu WC, Chen WH, Deng WP. Mechanistic insight into hyaluronic acid and platelet-rich plasma-mediated anti-inflammatory and anti-apoptotic activities in osteoarthritic mice. Aging (Albany NY) 2018; 10:4152-4165. [PMID: 30582743 PMCID: PMC6326674 DOI: 10.18632/aging.101713] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 12/06/2018] [Indexed: 12/17/2022]
Abstract
Osteoarthritis (OA) poses a major clinical challenges owing to limited regenerative ability of diseased or traumatized chondrocytes in articular cartilage. Previous studies have determined the individual therapeutic efficacies of hyaluronic acid (HA) and platelet-rich plasma (PRP) on OA; however, the underlying mechanism is still lacking. Therefore, we investigated mechanistic approach of HA+PRP therapy on chondrocyte apoptosis in IL-1β+TNF-α (I+T) treated in vitro OA model, in addition to in vivo anterior cruciate ligament transection-OA mice model. MTT assay showed an enhanced chondrocyte proliferation and viability in HA+PRP-treated group, compared to I+T, I+T/HA, I+T/PRP, I+T/HA+PRP groups. Further, HA+PRP also significantly suppressed ROS, apoptotic cleaved caspase-3 and PARP, p53 and p21 and MMP-1; whereas, cell cycle modulatory proteins including p-ERK, cyclin B1, D1, and E2 were upregulated. The sub-G1 population and TUNEL assay confirmed the higher abundance of healthy chondrocytes in HA+PRP group. A significantly decreased ARS staining in HA+PRP group was also noted, indicating reduced cartilaginous matrix mineralization compared to other groups. Conclusively, compared to HA or PRP, the combined HA+PRP might be a promising therapy for articular cartilage regeneration in osteoarthritic pathology, possibly via augmented anti-inflammatory, anti-oxidative chondrocyte proliferation and inhibited MMP-1 activity and matrix calcification.
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Affiliation(s)
- Chi-Sheng Chiou
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chi-Ming Wu
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Navneet Kumar Dubey
- Ceramics and Biomaterials Research Group, Advanced Institute of Materials Science, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Wen-Cheng Lo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Feng-Chou Tsai
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tran Dang Xuan Tung
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Stem Cells Center, Van Hanh General Hospital, Ho Chi Minh City, Vietnam
| | - Wei-Ching Hung
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taiwan
| | - Wei-Che Hsu
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taiwan
| | - Wei-Hong Chen
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taiwan
| | - Win-Ping Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taiwan
- Graduate Institute of Basic Medicine, Fu Jen Catholic University, Taipei, Taiwan
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Cook CS, Smith PA. Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy in Treating Osteoarthritis of the Knee. Curr Rev Musculoskelet Med 2018; 11:583-592. [PMID: 30350299 PMCID: PMC6220006 DOI: 10.1007/s12178-018-9524-x] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to update the reader on the current applications of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA). This review will focus on PRP's effect on the osteoarthritic joint, how PRP compares to traditional treatments of KOA, and provide clinical feedback on the use of PRP in an orthopedic and sports medicine practice. RECENT FINDINGS Recent research into the applications of PRP for KOA has further indicated both the efficacy and safety of PRP treatment. Although research has shown a tendency toward better efficacy at earlier stages of osteoarthritis (OA), evidence exists to indicate positive effects at all stages of OA. In summary, since KOA is an extremely prevalent condition that can be a challenge to treat, it is imperative that safe and effective nonoperative treatment methods be available to individuals that are suffering from this condition.
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Affiliation(s)
| | - Patrick A Smith
- Columbia Orthopaedic Group, Columbia, MO, USA.
- Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Ave., Columbia, MO, 65212, USA.
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Zubair U, Salam O, Zubair Z. Role of Intra-articular Platelet Rich Plasma in the Management of Osteoarthritis: A Review. Cureus 2018; 10:e3359. [PMID: 30510869 PMCID: PMC6257624 DOI: 10.7759/cureus.3359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Intra-articular injections are a minimally invasive option developed for the management of patients with joint degenerative conditions. These injections can involve the use of steroid preparations, hyaluronic acid, and blood products. Platelet-rich plasma (PRP) is a cost-effective management modality developed for patients with joint degenerative conditions and has provided promising outcomes. It provides nourishment to the chondrocytes through a rich supply of growth factors and cytokines. This article demonstrates the beneficial effects of PRP therapy in patients with osteoarthritis.
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Affiliation(s)
- Ujala Zubair
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Osama Salam
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Zarafshan Zubair
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
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Two cycles of plasma rich in growth factors (PRGF-Endoret) intra-articular injections improve stiffness and activities of daily living but not pain compared to one cycle on patients with symptomatic knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2018; 26:2615-2621. [PMID: 28526995 DOI: 10.1007/s00167-017-4565-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 05/03/2017] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess the clinical efficacy and safety of a treatment based on one cycle versus two cycles of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) on patients with knee osteoarthritis (OA). METHODS Ninety patients with knee OA were included and evaluated. A total of 48 patients received one cycle (OC group) (3 injections on a weekly basis), while 42 patients received two cycles of PRGF-Endoret (TC group) spaced 6 months between them. Patients were evaluated with LEQUESNE and WOMAC scores before treatment and after 48 weeks. Safety assessment was also performed. RESULTS A significant reduction of all assessed outcome measures was shown for both groups at 48 weeks compared with baseline values (P < 0.001). Patients of TCs group showed a significantly higher reduction (P < 0.05) in WOMAC stiffness subscales. Regarding LEQUESNE INDEX, a significantly higher reduction was observed in the TC group in all subscales except in pain score. In the maximum walking distance subscale (MCD), the improvement rate was 31.8% higher for the TCs group compared with the OC group (P < 0.01). In addition, the TC group showed a significant improvement in LEQUESNE activities of daily living (ADV) and global subscales of 14.7 and 11.8% (P < 0.05) higher, respectively, than the OC group. CONCLUSIONS Treatment with two cycles of PRGF did not show a significantly higher pain reduction compared with one cycle treatment. However, two cycles of PRGF showed a significant improvement in WOMAC stiffness, LEQUESNE MCD, LEQUESNE ADV and LEQUESNE global subscales. Therefore, patients treated with two cycles present an improvement in quality of life. LEVEL OF EVIDENCE II.
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Fotouhi A, Maleki A, Dolati S, Aghebati-Maleki A, Aghebati-Maleki L. Platelet rich plasma, stromal vascular fraction and autologous conditioned serum in treatment of knee osteoarthritis. Biomed Pharmacother 2018; 104:652-660. [DOI: 10.1016/j.biopha.2018.05.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/30/2018] [Accepted: 05/07/2018] [Indexed: 12/16/2022] Open
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Smyth NA, Ross KA, Haleem AM, Hannon CP, Murawski CD, Do HT, Kennedy JG. Platelet-Rich Plasma and Hyaluronic Acid Are Not Synergistic When Used as Biological Adjuncts with Autologous Osteochondral Transplantation. Cartilage 2018; 9:321-328. [PMID: 29156980 PMCID: PMC6042028 DOI: 10.1177/1947603517690022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
UNLABELLED Introduction Autologous osteochondral transplantation (AOT) is a treatment for osteochondral lesions with known concerns, including histological degradation of the graft and poor cartilage integration. Platelet-rich plasma (PRP) and hyaluronic acid (HA) have been described has having the potential to improve results. The aim of this study was to evaluate the effect of PRP and HA on AOT in a rabbit model. Methods Thirty-six rabbits underwent bilateral knee AOT treated with either the biological adjunct (PRP, n = 12; HA, n = 12; PRP + HA, n = 12) or saline (control). PRP and HA were administered as an intra-articular injection. The rabbits were euthanized at 3, 6, or 12 weeks postoperatively. The graft sections were assessed using the modified International Cartilage Repair Society (ICRS) scoring system. The results from the PRP alone group is from previously published data. Results The mean modified ICRS histological score for the PRP-treated group was higher than its control ( P = 0.002). The mean modified ICRS histological score for the HA-treated group showed no difference compared with its control ( P = 0.142). The mean modified ICRS histological score for the PRP + HA-treated group was higher than its control ( P = 0.006). There was no difference between the mean modified ICRS scores of the PRP- and the PRP + HA-treated grafts ( P = 0.445). Conclusion PRP may decrease graft degradation and improve chondral integration in an animal model. In this model, the addition of HA was not synergistic for the parameters assessed. LEVEL OF EVIDENCE Basic science, Level V. CLINICAL RELEVANCE PRP can be used as an adjunct to AOT, which may decrease graft degeneration and improve clinical outcomes. HA may not influence AOT.
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Affiliation(s)
- Niall A. Smyth
- University of Miami Miller School of Medicine, Miami, FL, USA,Niall A. Smyth, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Miami, FL 33136, USA.
| | - Keir A. Ross
- University of Maryland School of Medicine, New York, NY, USA
| | - Amgad M. Haleem
- University of Oklahoma School of Medicine, New York, NY, USA
| | | | | | - Huong T. Do
- Hospital for Special Surgery, New York, NY, USA
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McGoldrick NP, Murphy EP, Kearns SR. Osteochondral lesions of the ankle: The current evidence supporting scaffold-based techniques and biological adjuncts. Foot Ankle Surg 2018; 24:86-91. [PMID: 29409225 DOI: 10.1016/j.fas.2017.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 12/20/2016] [Accepted: 01/12/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Talar osteochondral lesions are more common than has been previously recognized. Optimal treatment remains unclear and the subject of much debate in the literature. Although reparative techniques such as microfracture have produced initial good results and remain the gold standard in the management of these lesions, the literature is deficient in long-term data. Recently, techniques focused on enhancing the local biological environment have been developed which have demonstrated promising outcomes. METHODS We reviewed the available evidence concerning scaffold-based techniques and biological adjuncts in the management of talar osteochondral lesions published in the English language on PubMed. RESULTS An update is provided on the current evidence concerning the role of biological adjuncts in the management of osteochondral lesions of the talus. CONCLUSIONS There has been an explosion of interest among the orthopaedic community in the role of biologics in the management of complex talar osteochondral lesions. A number of exciting new techniques have been developed which show promise. Robust randomized control trials are required to identify the optimal surgical strategy.
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Affiliation(s)
- N P McGoldrick
- Department of Trauma & Orthopaedic Surgery, University College Hospital Galway, Galway, Ireland.
| | - E P Murphy
- Department of Trauma & Orthopaedic Surgery, University College Hospital Galway, Galway, Ireland.
| | - S R Kearns
- Department of Trauma & Orthopaedic Surgery, University College Hospital Galway, Galway, Ireland.
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Preactivated and Disaggregated Shape-Changed Platelets Protected Against Acute Respiratory Distress Syndrome Complicated by Sepsis Through Inflammation Suppression. Shock 2018; 46:575-586. [PMID: 27058048 DOI: 10.1097/shk.0000000000000617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study tested the hypothesis that preactivated and disaggregated shape-changed platelet (PreD-SCP) therapy attenuates lung injury from acute respiratory distress syndrome (ARDS) induced by 100% oxygen inhalation and complicated by sepsis through peritoneal administration of 1.5 mg/kg lipopolysaccharide (LPS). METHODS Adult male Sprague-Dawley rats, weighing 325 to 350 g, were randomized into group 1 (normal controls [NC]), group 2 (NC + PreD-SCP [3.0 × 10, intravenous administration]), group 3 (ARDS-LPS), and group 4 (ARDS-LPS + PreD-SCP), and sacrificed by 72 h after ARDS induction. RESULTS The lung injury score was significantly higher in group 3 than that in other groups, and significantly higher in group 4 than that in groups 1 and 2, whereas the numbers of alveolar sacs and oxygen saturation (%) showed a reversed pattern compared with that of lung injury score among the four groups (all P < 0.0001) without significant difference between groups 1 and 2. The expressions of proinflammatory cells (CD11+, CD14+, CD68+) and proteins (tumor necrosis factor [TNF]-α, nuclear factor [NF]-κB, interleukin [IL]-1ββ, matrix metalloproteinase [MMP]-9, inducible nitric oxide synthase, intercellular adhesion molecule-1) exhibited a pattern identical to the lung injury score. Circulating levels of white blood cell, IL-6, TNF-α, myeloperoxidase and CCL5, and pulmonary protein expressions of oxidative stress (NOX-1/NOX-2, oxidized protein), apoptotic (Bax, cleaved caspase 3/poly (ADP-ribose) polymerase), fibrotic (Smad3, transforming growth factor [TGF]-β), and DNA damage (γ-H2AX) biomarkers showed an identical pattern, whereas protein expressions of antifibrotic (Smad1/5, bone morphogenetic protein [BMP]-2) and anti-inflammatory (Bcl-2) biomarkers demonstrated an opposite pattern compared with the proinflammatory indices among the four groups (all P < 0.001). CONCLUSIONS PreD-SCP therapy effectively improved lung injury in ARDS complicated by sepsis.
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Grazina R, Andrade R, Bastos R, Costa D, Pereira R, Marinhas J, Maestro A, Espregueira-Mendes J. Clinical Management in Early OA. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1059:111-135. [PMID: 29736571 DOI: 10.1007/978-3-319-76735-2_5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Knee osteoarthritis affects an important percentage of the population throughout their life. Several factors seem to be related to the development of knee osteoarthritis including genetic predisposition, gender, age, meniscal deficiency, lower limb malalignments, joint instability, cartilage defects, and increasing sports participation. The latter has contributed to a higher prevalence of early onset of knee osteoarthritis at younger ages with this active population demanding more consistent and durable outcomes. The diagnosis is complex and the common signs and symptoms are often cloaked at these early stages. Classification systems have been developed and are based on the presence of knee pain and radiographic findings coupled with magnetic resonance or arthroscopic evidence of early joint degeneration. Nonsurgical treatment is often the first-line option and is mainly based on daily life adaptations, weight loss, and exercise, with pharmacological agents having only a symptomatic role. Surgical treatment shows positive results in relieving the joint symptomatology, increasing the knee function and delaying the development to further degenerative stages. Biologic therapies are an emerging field showing early promising results; however, further high-level research is required.
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Affiliation(s)
- Rita Grazina
- Orthopaedic Surgery at Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E, Vila Nova de Gaia, Portugal
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - Ricardo Bastos
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Fluminense Federal University, Niteroi/Rio de Janeiro, Brazil
| | - Daniela Costa
- SMIC Dragão - Serviço Médico de Imagem Computorizada, Porto, Portugal
| | - Rogério Pereira
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - José Marinhas
- Orthopaedic Surgery at Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E, Vila Nova de Gaia, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - António Maestro
- Real Sporting de Gijón SAD, Gijón, Spain.,FREMAP Mutua de Accidentes, Gijón, Spain
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. .,Dom Henrique Research Centre, Porto, Portugal. .,Orthopaedics Department of Minho University, Minho, Portugal. .,3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal. .,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
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Inflammaging in cervical and lumbar degenerated intervertebral discs: analysis of proinflammatory cytokine and TRP channel expression. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:564-577. [DOI: 10.1007/s00586-017-5360-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 10/15/2017] [Accepted: 10/19/2017] [Indexed: 12/29/2022]
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50
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Bennell KL, Hunter DJ, Paterson KL. Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis. Curr Rheumatol Rep 2017; 19:24. [PMID: 28386761 DOI: 10.1007/s11926-017-0652-x] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Knee and hip osteoarthritis (OA) are major public health problems worldwide causing pain, disability and impaired quality of life. This narrative paper discusses platelet-rich plasma (PRP) as a treatment for hip and knee OA, with a focus on evidence from randomised controlled trials (RCTs). RECENT FINDINGS Since the first RCT of PRP in 2012, there has been 15 RCTs in knee OA and three in hip OA, mostly comparing PRP to another intra-articular injection therapy, hyaluronic acid. All studies are of low to moderate methodological quality and use variable PRP protocols. In general, results showed that PRP is a safe treatment with potential to provide symptomatic benefit for OA at least in the short term (up to 12 months). Younger patients with less severe disease may be more responsive. There are no RCTs investigating the effects of PRP on OA structural changes. No definitive conclusions can be made about the effects of PRP in OA given methodological concerns and considerable heterogeneity between studies. Further high-quality research is needed to establish the clinical and cost-effectiveness of PRP, the patients most likely to benefit and the optimal PRP protocol.
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Affiliation(s)
- Kim L Bennell
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - David J Hunter
- Institute of Bone and Joint Research, Kolling Institute and Rheumatology Department, Royal North Shore Hospital, University of Sydney, Sydney, Australia
| | - Kade L Paterson
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
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