Effect of platelet-rich plasma on degeneration change of rotator cuff muscles: In vitro and in vivo evaluations

Abstract

Atrophy with fatty degeneration is often seen in rotator cuff muscles with torn tendons. PRP has been reported to enhance tissue repair processes after tendon ruptures. However, the effect of PRP on atrophy and fatty degeneration of the muscle is not yet known. The aim of this study is to examine the effect of PRP on degeneration change of rotator cuff muscles in vitro and in vivo. A murine myogenic cell line and a rat rotator cuff tear model were used in this study and PRP was administrated into subacromial space which is widely used in clinical practice. In in vitro study, administration of PRP to C2C12 cells stimulated cell proliferation while inhibited both myogenic and adipogenic differentiation. In in vivo study, administration of PRP suppressed Oil Red-O positive lipid droplet formation. The expression of adipogenic genes was also decreased by PRP administration. In conclusion, PRP promoted proliferation of myoblast cells, while inhibiting adipogenic differentiation of myoblast cells and suppressing fatty degeneration change in rat torn rotator cuff muscles. Further investigations are needed to determine the clinical applicability of the PRP. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1806-1815, 2017.

Platelet biology in regenerative medicine of skeletal muscle

“…Variable levels of differentiation have been reported for different cell types, for example increased differentiation for rat bone marrow cells, human skeletal muscle myoblasts, rat muscle satellite cells, rabbit bone marrow mesenchymal stem cells and C2C12 myoblasts or maintained effect with hMDPCs, myo‐endothelial cells and pericytes compared to control conditions . Conversely, some studies reported that platelets inhibited differentiation of C2C12 myoblasts . This discrepancy in the current literature may provide the basis for a thorough consideration of the technical aspects in platelet applications that may affect the final outcome in a study.…”

“…Studies now emerging are finding beneficial results with platelet releasate in muscle regeneration similar to PRP treatments . One crucial and recent study added platelet releasate to a primary culture of rat gastrocnemius muscle cells with the aim of investigating the impact of releasate on cell proliferation .…”

“…One recent study examined the role of releasate on both myogenesis and adipogenesis in rats as well as in a C2C12 in vitro cell line . C2C12 cells are a mouse myoblast cell line capable of differentiation.…”

Complete Rotator Cuff Tear: An Evidence-Based Conservative Management Approach

“…PRP has been known to stimulate both the response of mesenchymal stem cells (MSCs) to the local area through growth factors such as plateletderived growth factor (PDGF), fibroblast growth factor and vascular endothelial growth factor (VEGF) and stimulate tendon stem cells to differentiate into tenocytes when certain growth factors are released, which promotes healing of the rotator cuff [67,68]. Furthermore, PRP can also assist in the proliferation of muscle cells [69], promoting inflammation [70], and the use of adhesion molecules to repair the torn tendon [71]. The proliferation of muscle cells allows for an increased number of fibroblasts and myotubes, thereby decreasing the overall time of recovery and increasing the strength of the rotator cuff [69].…”

“…Furthermore, PRP can also assist in the proliferation of muscle cells [69], promoting inflammation [70], and the use of adhesion molecules to repair the torn tendon [71]. The proliferation of muscle cells allows for an increased number of fibroblasts and myotubes, thereby decreasing the overall time of recovery and increasing the strength of the rotator cuff [69]. Non-growth factors released from platelets such as serotonin, histamine, dopamine, calcium and adenosine aid in inflammation proliferation [70].…”