Precision Assessment of Platelet Rich Plasma for Joint Preservation

富含血小板血浆对关节保护的精确评估

• 批准号: 10731741
• 负责人: CONSTANCE R CHU
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10731741
• 关键词: Academy; Acceleration; Address; Affect; Age; American; Anti-Inflammatory Agents; Area; Arthralgia; Attention; Autologous; Basic Science; Biological; Blood; Blood Platelets; Cartilage; Cartilage Matrix; Clinical; Clinical Treatment; Cortisone; Data; Degenerative polyarthritis; Disease; Disease Progression; Early treatment; Elements; Evaluation; Frequencies; Gait; General Population; Growth Factor; Health; Hyaluronic Acid; Individual; Individual Differences; Inflammation Mediators; Injection of therapeutic agent; Injections; Insulin-Like Growth Factor I; Intra-Articular Injections; Joint repair; Joints; Knee; Knee Osteoarthritis; Knee Prosthesis; Knowledge; Magnetic Resonance Imaging; Maps; Measures; Mechanics; Mission; Operative Surgical Procedures; Orthopedics; Outcome; Outcome Assessment; Outcome Measure; Outcome Study; Pain; Pain Measurement; Patient Outcomes Assessments; Patient Selection; Patients; Plasma; Population; Process; Progressive Disease; Property; Proteins; Proteomics; Research; Review Literature; Source; Structure; Surgeon; Swelling; Testing; Time; Traction; Veterans; Weight-Bearing state; Woman; Work; articular cartilage; chemokine; clinical care; clinical effect; clinical outcome assessment; cytokine; disability; follow-up; functional improvement; gait examination; improved; joint destruction; joint function; knee pain; knee replacement arthroplasty; meetings; pain reduction; pain relief; palliative; personalized medicine; pharmacologic; precision medicine; premature; preservation; programs; prospective; repaired; response; symptom treatment; treatment effect

This project addresses a critical clinical need for the VA. Knee pain due to progressive joint degeneration and eventual osteoarthritis (OA) are leading causes of disability, particularly in Veterans who are affected by OA at greater frequency and younger ages than the general population. Knee osteoarthritis is a progressive disease for which current treatment is palliative until complete joint destruction occurs and prosthetic knee replacement is performed. Cortisone injections have been widely used for more than 60 years to treat pain and swelling, but have also shown detrimental effects to articular cartilage. This introduces high clinical need for an injection therapy to improve joint pain and function while preserving cartilage health, especially in those with early disease where there is substantial remaining articular cartilage. Recently, intra-articular autologous platelet rich plasma (PRP) injections have gained traction as a promising new treatment for knee OA that can not only provide symptomatic relief but also potentially contribute growth factors to stimulate endogenous joint repair processes. However, the mechanisms of action of PRP are unknown as are the clinical outcomes in Veterans. Our preliminary data also shows substantial variability between individuals in the biological composition of autologous PRP. In this era of personalized and precision medicine, we propose to examine the outcomes of PRP treatment, and whether individual differences in PRP composition correlate with objective metrics of changes to ambulatory function and cartilage matrix structure following PRP injection treatment for early knee OA in Veterans. Achieving the Aims of this proposal will determine whether intra-articular injection of autologous platelet enriched plasma to treat early knee OA in Veterans and additional women, given within the actual clinical setting, results in positive treatment effects. The information gained will also fill critical knowledge gaps by elucidating potential mechanisms of action for PRP injections in the treatment of symptomatic early knee OA and combining objective scientific assessment (gait analysis and MRI) with standard patient-reported outcomes (PRO). Finally, the new knowledge gained will improve clinical care by informing on factors important to optimal patient selection for this new treatment.

该项目解决了VA的一个关键临床需求：进行性膝关节疼痛

项目成果

Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference.

• DOI: 10.5435/jaaos-d-18-00305
• 发表时间: 2019-01-15
• 期刊: The Journal of the American Academy of Orthopaedic Surgeons
• 作者: Chu CR;Rodeo S;Bhutani N;Goodrich LR;Huard J;Irrgang J;LaPrade RF;Lattermann C;Lu Y;Mandelbaum B;Mao J;McIntyre L;Mishra A;Muschler GF;Piuzzi NS;Potter H;Spindler K;Tokish JM;Tuan R;Zaslav K;Maloney W
• 通讯作者: Maloney W

Proceedings of the signature series symposium "cellular therapies for orthopaedics and musculoskeletal disease proven and unproven therapies-promise, facts and fantasy," international society for cellular therapies, montreal, canada, may 2, 2018.

• DOI: 10.1016/j.jcyt.2018.09.001
• 发表时间: 2018-11
• 期刊: Cytotherapy
• 影响因子: 4.5
• 作者: Piuzzi NS;Dominici M;Long M;Pascual-Garrido C;Rodeo S;Huard J;Guicheux J;McFarland R;Goodrich LR;Maddens S;Robey PG;Bauer TW;Barrett J;Barry F;Karli D;Chu CR;Weiss DJ;Martin I;Jorgensen C;Muschler GF
• 通讯作者: Muschler GF