Comparisons of Cytokines, Growth Factors and Clinical Efficacy between Platelet-Rich Plasma and Autologous Conditioned Serum for Knee Osteoarthritis Management

Abstract

This study aimed to directly compare the contents and the clinical efficacy of the two autologous blood-derived products, platelet-rich plasma (PRP) and autologous conditioned serum (ACS) for osteoarthritis (OA) treatment. The contents of standard-prepared PRP and ACS prepared at 37 °C for 1 h, 3 h, 6 h, and 24 h from healthy volunteers were compared. The clinical efficacy of pain relief in patients with Stage III knee OA was evaluated by a patient-reported visual analog scale (VAS) pain rating. PDGF-BB levels in ACS 1 h were significantly higher than those in PRP, and the levels in ACS preparations remained stable. IGF-1 level of ACS 24 h showed a significant increase compared to those of other ACS preparations and PRP. ACS 3 h showed a turning of IL-1Ra level and revealed a time-dependent increase up to 24 h. ACS 6 h showed a turning increase in TNF-α levels. ACS 3 h was chosen for clinical comparison with PRP. The reduction in pain VAS in the ACS group was significantly more compared to those of the PRP group (p = 0.028). However, PRP showed significant earlier improvement (p < 0.001). Conclusion: ACS contained higher levels of PDGF-BB and IL-1Ra and provided better improvement in pain relief compared to PRP.

How to Enhance the Effects of Platelet Rich Plasma on Tissue Regeneration: AMPLEX PLUS Technology, a New Strategy

“…However, not equaling those achieved by the addition of AMPLEX PLUS. Enrichment with leukocytes [L-PRP] also did not have the desired effects [73]. These attempts, however, did not result in substantial improvement in its efficacy, probably due to the missing supply of some growth factors not present or present in trace amounts in the matrices used.…”

Pathogenic Mechanisms and Therapeutic Approaches in Obesity-Related Knee Osteoarthritis

“…It is derived from the patient's own blood and is rich in cytokines and growth factors secreted by platelets upon stimulation with glass beads [142]. A crucial step in the preparation is the incubation time, varying anywhere between 1 and 24 h, however a recent study found that incubation for 3 h had the optimal ratio between anti-to pro-inflammatory cytokines, with higher IL-1Ra levels and lower TNFα levels [143]. In addition, levels of IL-1Ra and platelet-derived growth factor (PDGF) were significantly higher in ACS than in platelet-rich plasma (PRP), suggesting better clinical efficacy [143].…”

“…A crucial step in the preparation is the incubation time, varying anywhere between 1 and 24 h, however a recent study found that incubation for 3 h had the optimal ratio between anti-to pro-inflammatory cytokines, with higher IL-1Ra levels and lower TNFα levels [143]. In addition, levels of IL-1Ra and platelet-derived growth factor (PDGF) were significantly higher in ACS than in platelet-rich plasma (PRP), suggesting better clinical efficacy [143]. Other authors compared the efficacy of intra-articular administration of ACS, PRP, hyaluronic acid and GCs and found that both blood-derived products performed better in terms of pain relief and functional improvement without a statistically significant difference between them [144].…”