Efficacy of autologous leukocyte-reduced platelet-rich plasma therapy for patellar tendinopathy in a rat treadmill model.
Efficacy of autologous leukocyte-reduced platelet-rich plasma therapy for patellar tendinopathy in a rat treadmill model.
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DOI：
10.11138/mltj/2016.6.2.205
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发表时间：
2016-04
期刊：
影响因子：
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通讯作者：
Mamoru Yoshida;H. Funasaki;K. Marumo
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文献类型：
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作者：
Mamoru Yoshida;H. Funasaki;K. Marumo
背景：目前已有一种自体富含血小板血浆(PRP)疗法应用于肌腱病，然而，其疗效和PRP的最佳血小板浓度尚不确定。我们在一个动物模型中对它们进行了分析，这些动物模型是通过重复跑步练习准备的。方法用啮齿类动物跑步机制作大鼠膝腱腱病模型。肌腱病大鼠双侧膝腱脂肪垫间隙注射去白细胞PRP1.0×10~6/μL组(P10组)、血小板浓度5.0×10~5/μL PRP组(P5组)或胫骨附着点多次干针刺法(MN组)。每天记录夜间(12h)自发活动次数，以评价疼痛缓解效果。用苏木精-伊红染色或TdT介导的dUTP缺口末端标记法制备的组织切片进行光镜分析。结果P10组大鼠自发活动次数明显多于P5组、MN组和对照组，并恢复到正常水平。在组织学检查中，P10和P5组的髌腱微撕裂、板层或凋亡细胞数明显低于MN组和对照组，但P10和P5组之间的差异无统计学意义。结论注射去白细胞的自体PRP可有效缓解肌腱病大鼠模型的疼痛，部分恢复其膝部肌腱。血小板浓度为1.0×10~6/μ的雷公藤多甙完全缓解疼痛，且优于血小板浓度为5.0×10~5/μ的L，但对组织学恢复和细胞凋亡的抑制作用无明显差异。
BACKGROUND An autologous platelet-rich plasma (PRP) therapy has currently been applied for the tendinopathy; however, its efficacy and an optimal platelets concentration in PRP were uncertain. We analyzed them in an animal model prepared using a repetitive running exercise. METHODS We made the tendinopathy rat model of patellar tendon using a rodent treadmill machine. Rats with tendinopathy were injected with leukocyte-reduced PRP at the platelets concentration of 1.0×106/μL (P10 group), PRP at the platelets concentration of 5.0×105/μL (P5 group) or normal saline (control group) into the space between the patellar tendon and the fat pad bilaterally or were multiply dry-needled at the tibial insertion site (MN group) at once. To assess the pain-reliving effect, the spontaneous locomotor activities at night (12 h) were measured every day. Histological sections of the patellar tendon stained with hematoxylineosin or prepared by TdT-mediated dUTP nick end labeling were microscopically analyzed. RESULTS The numbers of spontaneous locomotor activities in the P10 group were significantly larger than those in the P5, MN or control groups and they recovered up to a healthy level. On histologic examinations, the numbers of microtears, laminations, or apoptotic cells in the patellar tendons in the P10 or P5 groups were significantly lower than those in the MN or control groups, although no significant differences were observed between the P10 and P5 groups. CONCLUSIONS The injections of an autologous leukocyte-reduced PRP were effective for pain relief and for partial restoration of the patellar tendon in the tendinopathy rat model. The injections of a PRP at the platelets concentration of 1.0×106/μL completely relieved the pain and were more effective than those at the platelets concentration of 5.0×105/μL whereas there was no difference for the effect of histological restoration or apoptosis inhibition between them.