Leukocyte-rich PRP for knee osteoarthritis: Current concepts.
Leukocyte-rich PRP for knee osteoarthritis: Current concepts.
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DOI：
10.1016/j.jcot.2019.01.011
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发表时间：
2019-10-01
影响因子：
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通讯作者：
Santana, Maria Helena Andrade
中科院分区：
文献类型：
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作者：
Lana, Jose Fabio;Macedo, Alex;Santana, Maria Helena Andrade
膝骨关节炎是一种主要的疼痛和衰弱的骨科疾病，在全球范围内影响大量成年人。多年来，这种严重的病症得到了广泛的研究，尽管已经使用了许多替代方案，但富血小板血浆 (PRP) 仍然是研究人员和临床医生中最受欢迎的解决方案之一。虽然 PRP 的制备涉及不同的配方和技术，可以手动生产或通过使用商业试剂盒生产，但 PRP 混合物中白细胞的存在是引起人们关注的一个因素，因为它们具有众所周知的促炎活性。尽管担心这一点是合理的，但应该考虑到，为了发生愈合过程，炎症阶段是必要的。处于炎症阶段的白细胞会释放促炎分子和抗炎分子，当与活化的血小板结合时，它们的潜力会增加。此外，由于巨噬细胞具有从亚型 1 转换为亚型 2 的可塑性，因此从 PRP 再生潜力的角度来看，将血沉棕黄层成分包含在 PRP 混合物中（将其分类为富含白细胞的富血小板血浆或 L-PRP）可能会带来好处而不是有害。
Knee osteoarthritis is a major painful and debilitating orthopaedic disease affecting a large number of adult individuals on a global scale. Over the years, this severe condition has been widely studied and while many alternatives have been utilized, platelet-rich plasma (PRP) remains one of the most popular solutions among researchers and clinicians alike. While there are different formulations and techniques involved in the preparation of PRP, produced either manually or via the use of commercial kits, the presence of leukocytes in a PRP mixture is a factor that raises concern due to their well-known pro-inflammatory activity. Although it is reasonable to worry about this, it should be taken into consideration that in order for the healing process to occur, the inflammatory phase is necessary. Leukocytes present in the inflammatory phase release both pro and anti-inflammatory molecules and, when combined with activated platelets, their potential increases. Additionally, due to the macrophage's plasticity to switch from the subtype 1 to subtype 2, it is suggested that the inclusion of the components from the buffy coat layer in a PRP mixture, classifying it as leukocyte-rich platelet-rich plasma or L-PRP, may provide benefits instead of detriments, from a standpoint of the regenerative potential of PRP.