Biology of platelet-rich plasma and its clinical application in cartilage repair.
Biology of platelet-rich plasma and its clinical application in cartilage repair.
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DOI：
10.1186/ar4493
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发表时间：
2014-02-25
影响因子：
4.9
通讯作者：
Tuan RS
中科院分区：
文献类型：
--
作者：
Xie X;Zhang C;Tuan RS
富血小板血浆（PRP）是一种生长因子和炎症介质的自体浓缩鸡尾酒，并已被认为是潜在的有效软骨修复。此外，PRP中的纤维蛋白原可被活化以形成纤维蛋白基质来填充软骨损伤，满足生理伤口愈合的初始要求。本文综述了基于实验室研究、动物研究和临床试验的PRP的合成代谢、抗炎和支架效应。在体外，发现PRP刺激软骨细胞和成体间充质干细胞（MSC）的细胞增殖和软骨基质产生，增强滑膜细胞的基质分泌，减轻IL-1β诱导的炎症，并为MSC提供有利的底物。在临床前研究中，PRP已被用作凝胶来填充软骨缺损，结果各不相同，或在动物模型中减缓关节炎的进展，结果良好。目前临床试验的结果表明，PRP可能具有填充软骨缺损以增强软骨修复、减轻骨关节炎症状和改善关节功能的潜力，并且具有可接受的安全性。虽然目前的证据似乎有利于PRP而不是透明质酸治疗骨关节炎，但由于报告的研究具有高度异质性以及PRP制剂的组成可变，PRP治疗的疗效仍然不可预测。未来的研究对于阐明单个PRP组分在调节特定致病机制中的功能活性至关重要。
Platelet-rich plasma (PRP) is an autologous concentrated cocktail of growth factors and inflammatory mediators, and has been considered to be potentially effective for cartilage repair. In addition, the fibrinogen in PRP may be activated to form a fibrin matrix to fill cartilage lesions, fulfilling the initial requirements of physiological wound healing. The anabolic, anti-inflammatory and scaffolding effects of PRP based on laboratory investigations, animal studies, and clinical trials are reviewed here. In vitro, PRP is found to stimulate cell proliferation and cartilaginous matrix production by chondrocytes and adult mesenchymal stem cells (MSCs), enhance matrix secretion by synoviocytes, mitigate IL-1β-induced inflammation, and provide a favorable substrate for MSCs. In preclinical studies, PRP has been used either as a gel to fill cartilage defects with variable results, or to slow the progression of arthritis in animal models with positive outcomes. Findings from current clinical trials suggest that PRP may have the potential to fill cartilage defects to enhance cartilage repair, attenuate symptoms of osteoarthritis and improve joint function, with an acceptable safety profile. Although current evidence appears to favor PRP over hyaluronan for the treatment of osteoarthritis, the efficacy of PRP therapy remains unpredictable owing to the highly heterogeneous nature of reported studies and the variable composition of the PRP preparations. Future studies are critical to elucidate the functional activity of individual PRP components in modulating specific pathogenic mechanisms.
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影响因子：
4.8
作者：
Cerza, Fabio;Carni, Stefano;Ciuffreda, Michele
通讯作者：
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DOI：
10.1302/0301-620x.84b2.11167
发表时间：
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通讯作者：
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