Comparison of the Acute Inflammatory Response of Two Commercial Platelet-Rich Plasma Systems in Healthy Rabbit Tendons
Comparison of the Acute Inflammatory Response of Two Commercial Platelet-Rich Plasma Systems in Healthy Rabbit Tendons
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DOI：
10.1177/0363546512442334
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发表时间：
2012-06-01
影响因子：
4.8
通讯作者：
Arnoczky, Steven P.
中科院分区：
文献类型：
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作者：
Dragoo, Jason L.;Braun, Hillary J.;Arnoczky, Steven P.
工作背景：大量研究表明，富血小板血浆（PRP）制剂在包含某些血液成分方面存在差异，这可能会影响宿主的细胞反应。假设：本研究在动物模型中评价了肌腱内注射后Biomet GPS III富白细胞PRP（LR-PRP）与MTF Cascade贫白细胞PRP（LP-PRP）的炎症效应。研究设计：对照实验室研究方法：总共对17只睾丸成熟的新西兰白色兔子进行了测试。在所有病例中，均对健康髌腱进行了治疗。在对照组动物中，一侧髌腱注射2 mL自体全血，另一侧注射2 mL无菌生理盐水。7条肌腱全部注射全血，7条肌腱注射生理盐水。在实验动物中，一侧髌腱注射2 mL LR-PRP，另一侧注射2 mL LP-PRP。10个肌腱注射LR-PRP，10个肌腱注射LP-PRP。在注射后5或14天对动物实施安乐死。收获肌腱，使用苏木精和伊红染色，并对总白色血细胞（WBC）、单核细胞（PBMC）（巨噬细胞和淋巴细胞）、多形核细胞（PMNs）、血管分布、纤维结构和纤维化。在注射后5天，用LR-PRP治疗的肌腱具有显著更高的总体肌腱评分（6.3 +/- 1.79 vs 1.8 +/- 1.64，P = .012），以及纤维结构的平均评分（1.4 +/- 0.22 vs 0.50 +/- 0.50，P = 0.012），表示组成破坏，总WBC（1.1 +/- 0.89 vs 0.10 +/- 0.22，P = 0.014），单核细胞（巨噬细胞和淋巴细胞）（0.80 +/- 0.45 vs 0.10 +/- 0.22，P = 0.014），血管分布（1.7 +/- 0.27 vs 0.80 +/- 0.16，P = 0.008）和纤维化（1.0 +/- 0.35 vs 0.3 +/- 0.45，P = 0.037）。除此之外，单核细胞无显著差异（P = .590），PMN细胞（P = 1.00），总WBC（P = .811），血管分布（P = .650），或总肌腱评分（P = .596）。结论：与白细胞贫乏的Cascade PRP相比，白细胞丰富的GPS III PRP在注射后5天引起显著更大的急性炎症反应。在intratendinous injection.Clinical Relevance后14天，无论注射类型如何，炎症反应或细胞结构均无显著差异：富血小板血浆注射液经常使用商业系统制备，并用于慢性肌腱病的临床治疗。重要的是表征由不同注射制剂阐明的细胞反应，以进一步了解它们对组织愈合的影响并辅助临床决策。未来的研究是必要的，以将这些发现应用于临床环境。
Background: Numerous studies have shown platelet-rich plasma (PRP) preparations differ with respect to the inclusion of certain blood components, which may affect the host's cellular response.Hypothesis: This study evaluated the inflammatory effect of Biomet GPS III leukocyte-rich PRP (LR-PRP) versus MTF Cascade leukocyte-poor PRP (LP-PRP) after intratendinous injection in an animal model. The authors anticipated that LR-PRP would incite a greater acute inflammatory response than LP-PRP.Study Design: Controlled laboratory study.Methods: A total of 17 skeletally mature New Zealand White rabbits were tested. In all cases, healthy patellar tendons were treated. In the control animals, one patellar tendon was injected with 2 mL autologous whole blood, and the other was injected with 2 mL sterile saline. Seven total tendons were injected with whole blood, and 7 tendons were injected with saline. In the experimental animals, one patellar tendon was injected with 2 mL LR-PRP, and the other was injected with 2 mL LP-PRP. Ten tendons were injected with LR-PRP, and 10 tendons were injected with LP-PRP. Animals were euthanized at 5 or 14 days after injection. Tendons were harvested and stained using hematoxylin and eosin and scored semi-quantitatively for total white blood cells (WBCs), mononuclear cells (macrophages and lymphocytes), polymorphonuclear cells (PMNs), vascularity, fiber structure, and fibrosis.Results: At 5 days after injection, tendons treated with LR-PRP had significantly greater overall tendon scores (6.3 +/- 1.79 vs 1.8 +/- 1.64, P = .012), as well as mean scores for fiber structure (1.4 +/- 0.22 vs 0.50 +/- 0.50, P = .012), denoting disrupted composition, total WBCs (1.1 +/- 0.89 vs 0.10 +/- 0.22, P = .014), mononuclear cells (macrophages and lymphocytes) (0.80 +/- 0.45 vs 0.10 +/- 0.22, P = .014), vascularity (1.7 +/- 0.27 vs 0.80 +/- 0.16, P = .008), and fibrosis (1.0 +/- 0.35 vs 0.3 +/- 0.45, P = .037) compared with tendons treated with LP-PRP. Otherwise, there were no significant differences in mononuclear cells (P = .590), PMN cells (P = 1.00), total WBCs (P = .811), vascularity (P = .650), or total tendon score (P = .596) in any of the treatment groups at 14 days.Conclusion: Compared with leukocyte-poor Cascade PRP, leukocyte-rich GPS III PRP causes a significantly greater acute inflammatory response at 5 days after injection. There is no significant difference in the inflammatory response or cellularity regardless of the injection type at 14 days after intratendinous injection.Clinical Relevance: Platelet-rich plasma injections are frequently prepared using commercial systems and are administered for clinical treatment of chronic tendinopathy. It is important to characterize the cellular responses elucidated by different injection preparations to further understand their effect on tissue healing and aid clinical decision making. Future investigations are necessary to apply these findings to the clinical setting.