Platelet-Rich Plasma: A Milieu of Bioactive Factors
Platelet-Rich Plasma: A Milieu of Bioactive Factors
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DOI：
10.1016/j.arthro.2011.10.018
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发表时间：
2012-03-01
影响因子：
4.7
通讯作者：
Fortier, Lisa A.
中科院分区：
文献类型：
--
作者：
Boswell, Stacie G.;Cole, Brian J.;Fortier, Lisa A.
富血小板血浆（PRP）等血小板浓缩物在运动医学和骨科中越来越受欢迎，以促进加速的生理愈合和功能恢复。每个PRP产品根据患者因素和用于产生它的系统而变化。一些患者的血液可能无法制造PRP，大多数临床医生使用PRP时没有对血液或制剂进行细胞计数，以确认溶液确实是PRP。这种环境中的成分具有影响肌肉骨骼组织再生和愈合的生物活性功能。血小板被胶原蛋白或其他分子激活，并从α颗粒中释放生长因子。其他物质从致密体和溶酶体中释放出来。可溶性蛋白也存在于PRP的止血功能中，而其他蛋白则作为肌肉骨骼损伤的生物标志物。电解质和可溶性血浆激素是细胞信号传导和调节所必需的。白细胞和红细胞存在于PRP中，并在炎症、免疫和其他细胞信号通路中起作用。这篇文章支持了一种新兴的范式，即不仅仅是血小板在PRP的临床反应中起作用。根据PRP制剂的具体成分，理论上临床使用可以与正在治疗的病理相匹配，以提高临床疗效。
Platelet concentrates such as platelet-rich plasma (PRP) have gained popularity in sports medicine and orthopaedics to promote accelerated physiologic healing and return to function. Each PRP product varies depending on patient factors and the system used to generate it. Blood from some patients may fail to make PRP, and most clinicians use PRP without performing cell counts on either the blood or the preparation to confirm that the solution is truly PRP. Components in this milieu have bioactive functions that affect musculoskeletal tissue regeneration and healing. Platelets are activated by collagen or other molecules and release growth factors from alpha granules. Additional substances are released from dense bodies and lysosomes. Soluble proteins also present in PRP function in hemostasis, whereas others serve as biomarkers of musculoskeletal injury. Electrolytes and soluble plasma hormones are required for cellular signaling and regulation. Leukocytes and erythrocytes are present in PRP and function in inflammation, immunity, and additional cellular signaling pathways. This article supports the emerging paradigm that more than just platelets are playing a role in clinical responses to PRP. Depending on the specific constituents of a PRP preparation, the clinical use can theoretically be matched to the pathology being treated in an effort to improve clinical efficacy.