Background
Platelet-rich plasma (PRP) has been increasingly used in sports medicine applications. Platelets are thought to release growth factors important in wound healing, including transforming growth factor (TGF-β1), platelet-derived growth factor (PDGF-AB), and vascular endothelial growth factor (VEGF). However, little is known about the effect of platelet activator choice on growth factor release kinetics.
Hypothesis
The choice of platelet activator would affect the timing and level of growth factor release from PRP.
Study Design
Controlled laboratory study.
Methods
Platelet-rich plasma aliquots were activated with either thrombin or collagen. A control group of whole blood aliquots was clotted with thrombin. Supernatant containing the released growth factors was collected daily for 1 week. Levels of TGF-β1, PDGF-AB, and VEGF were measured using enzyme-linked immunosorbent assay (ELISA).
Results
The use of thrombin as an activator resulted in immediate release of TGF-β1 and PDGF-AB, while the collagen-activated PRP clots released similar amounts each day for 5 days. The use of collagen as an activator resulted in an 80% greater cumulative release of TGF-β1 from the PRP aliquots over 7 days (P < .001). Concentrating platelets to 3 times the systemic blood level resulted in a 3-fold higher release of TGF-β1, 2.5-fold greater release of PDGF, and 5-fold greater release of VEGF (all P < .0001) when compared with whole blood control clots, but no significant differences in the timing of release were noted.
Conclusion
These experiments demonstrated that the choice of platelet activator can significantly influence the release kinetics of cytokines from PRP, with thrombin resulting in an immediate release and collagen having a more sustained release pattern.
Clinical Relevance
The level and rate of growth factor release depends on the selected platelet activator, a factor that should be considered when selecting a PRP system for a given application.
The use of type I collagen to activate clotting of PRP may be a safe and effective alternative to bovine thrombin. The use of collagen results in less clot retraction and equal release of PDGF-AB and VEGF compared with currently available methods of clot activation.
The local application of BMC / bone aspirate in the treatment of bone deficiencies may be a promising alternative to autogenous bone grafting and help reduce donor site morbidity.
The functional properties of formed elements of whole blood were studied following irradiation doses of 500 to 20,000 rads. Irradiated lymphocytes retained only 1.5 per cent of their 3H thymidine uptake after a 5,000-rad exposure and none after 7,500 rads. Red blood cells stored for 21 days and then irradiated with 5,000 rads had the same survival as nonirradiated controls. In contrast, 5,000 rads reduced platelet yields. However, transfused irradiated platelets produced the expected increases in platelet counts and controlled hemostasis in thrombocytopenic patients. After 5,000 rads, granulocytes had normal bacterial killing capacity, chemotactic mobility, and normal superoxide production after high-dose stimulation. Nitroblue tetrazolium reduction and ingestion stimulated by complement opsonized oil droplets were not diminished by 5,000- and 10,000-rad irradiation. The functional qualities of cellular blood components other than lymphocytes are not compromised by 5,000 rads. This irradiation dose may be an effective means of controlling incidence of graft-vs-host disease in immunosuppressed patients.
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