Effect of platelet-rich plasma on rat Achilles tendon healing is related to microbiota.
Effect of platelet-rich plasma on rat Achilles tendon healing is related to microbiota.
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DOI：
10.1080/17453674.2017.1293447
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发表时间：
2017-08
影响因子：
3.7
通讯作者：
Aspenberg P
中科院分区：
文献类型：
--
作者：
Dietrich F;Hammerman M;Blomgran P;Tätting L;Bampi VF;Silva JB;Aspenberg P
10年前，在《骨科学报》的3篇论文中，我们描述了富血小板血浆（PRP）促进大鼠跟腱横断模型的肌腱愈合。后来，我们发现微创伤也有类似的效果，可能是通过炎症起作用。这引起了人们的怀疑，即PRP中生长因子的作用可能是由于对炎症的非特异性影响。在测试这一假设时，我们注意到这种影响似乎与微生物群有关。我们试图在肌腱断裂后6小时局部注射PRP，并在11天后进行力学测试，以重现我们的旧发现。这个失败了。在对PRP生产方案、白细胞浓度和身体活动进行了无果而终的改变后，我们最终对携带潜在致病菌的大鼠进行了试验。共使用242只大鼠。在连续4次无病原体大鼠实验中，均未发现PRP对愈合的影响。相比之下，携带金黄色葡萄球菌的明显健康大鼠在PRP治疗后显示愈合肌腱的强度增加。这些大鼠脾脏中细胞毒性t细胞水平较高。在干净的大鼠身上复制旧实验的失败是惊人的，这些大鼠和携带葡萄球菌的大鼠之间的反应差异表明PRP的作用依赖于免疫状态。PRP的功能可能比仅仅释放生长因子更为复杂。因此，从我们先前对PRP的研究结果推断人类的情况变得更加不确定。
In 3 papers in Acta Orthopaedica 10 years ago, we described that platelet-rich plasma (PRP) improves tendon healing in a rat Achilles transection model. Later, we found that microtrauma has similar effects, probably acting via inflammation. This raised the suspicion that the effect ascribed to growth factors within PRP could instead be due to unspecific influences on inflammation. While testing this hypothesis, we noted that the effect seemed to be related to the microbiota. We tried to reproduce our old findings with local injection of PRP 6 h after tendon transection, followed by mechanical testing after 11 days. This failed. After fruitless variations in PRP production protocols, leukocyte concentration, and physical activity, we finally tried rats carrying potentially pathogenic bacteria. In all, 242 rats were used. In 4 consecutive experiments on pathogen-free rats, no effect of PRP on healing was found. In contrast, apparently healthy rats carrying Staphylococcus aureus showed increased strength of the healing tendon after PRP treatment. These rats had higher levels of cytotoxic T-cells in their spleens. The failure to reproduce older experiments in clean rats was striking, and the difference in response between these and Staphylococcus-carrying rats suggests that the PRP effect is dependent on the immune status. PRP functions may be more complex than just the release of growth factors. Extrapolation from our previous findings with PRP to the situation in humans therefore becomes even more uncertain.