Advantages of Pure Platelet-Rich Plasma Compared with Leukocyte- and Platelet-Rich Plasma in Treating Rabbit Knee Osteoarthritis

Abstract

BackgroundConcentrated leukocytes in leukocyte- and platelet-rich plasma (L-PRP) may deliver increased levels of pro-inflammatory cytokines to activate the NF-κB signaling pathway, to counter the beneficial effects of growth factors on osteoarthritic cartilage. However, to date no relevant studies have substantiated that in vivo.Material/MethodsAutologous L-PRP and pure platelet-rich plasma (P-PRP) were prepared, measured for componential composition, and injected intra-articularly after 4, 5, and 6 weeks post-anterior cruciate ligament transection. Caffeic acid phenethyl ester (CAPE) was injected intraperitoneally to inhibit NF-κB activation. All rabbits were sacrificed after 8 weeks postoperative. Enzyme-linked immunosorbent assays were performed to determine interleukin 1β (IL-1β) and prostaglandin E2 (PGE2) concentrations in the synovial fluid, Indian ink staining was performed for gross morphological assessment, and hematoxylin and eosin staining and toluidine blue staining were performed for histological assessment.ResultsCompared with L-PRP, P-PRP injections achieved better outcomes regarding the prevention of cartilage destruction, preservation of cartilaginous matrix, and reduction of IL-1β and PGE2 concentrations. CAPE injections reversed the increased IL-1β and PGE2 concentrations in the synovial fluid after L-PRP injections and improved the outcome of L-PRP injections to a level similar to P-PRP injections, while they had no influence on the therapeutic efficacy of P-PRP injections.ConclusionsConcentrated leukocytes in L-PRP may release increased levels of pro-inflammatory cytokines to activate the NF-κB signaling pathway, to counter the beneficial effects of growth factors on osteoarthritic cartilage, and finally, result in a inferior efficacy of L-PRP to P-PRP for the treatment of osteoarthritis.

The Differential Effects of Leukocyte-Containing and Pure Platelet-Rich Plasma on Nucleus Pulposus-Derived Mesenchymal Stem Cells: Implications for the Clinical Treatment of Intervertebral Disc Degeneration

“…Western blot results showed the higher expression of NF- κ B/P65 protein in the L-PRP group compared with P-PRP. These results are consistent with previous studies showing that the NF- κ B pathway is activated by the high concentration of leukocytes in L-PRP [28, 29, 40]. …”

“…Different preparations for PPR bring out various components, and leukocyte is one of the critical elements. Exclusion of leukocytes in PRP has been proven more beneficial for osteoarthritis [28] and bone defects [29]. In addition, PRP rich in leukocytes (L-PRP) can release high concentrations of inflammatory cytokines, which result in the activation of NF- κ B pathway [28, 29].…”

“…Exclusion of leukocytes in PRP has been proven more beneficial for osteoarthritis [28] and bone defects [29]. In addition, PRP rich in leukocytes (L-PRP) can release high concentrations of inflammatory cytokines, which result in the activation of NF- κ B pathway [28, 29]. However, the potential harmful effects of leukocytes in PRP on nucleus pulposus-derived mesenchymal stem cells (NPMSCs) have seldom been studied.…”

Is there a treatment protocol in which platelet-rich plasma is effective?

“…28,29 Apart from these there was no well-proven study in which activation of PRP was mentioned and whether it was activated or not. There were some preclinical 30 and clinical 31,32 studies, but there was no consensus on a protocol. In literature, it was reported that early immature activation and growth factors release during the preparation of PRP pose other problems.…”

Concentrations of growth factors in platelet-rich plasma and platelet-rich fibrin in a rabbit model

“…Information regarding the concentration of GFs in rabbit PRP or PRF is very limited mainly due to a lack of immunoreagents able to detect them. One of the exceptions is the publication by Yin et al (2016), in which the authors measured TGF-β levels. Their results were higher when compared with ours but they used a commercially available kit from a different producer.…”