Relationship of cytokine levels and clinical effect on platelet‐rich plasma‐treated lateral epicondylitis

Lim, Wonbong; Park, Sang Ha; Kim, M S Bora; Kang, Sun Kyoung; Lee, Jung Woo; Moon, Young Lae

doi:10.1002/jor.23714

Cited by 49 publications

(40 citation statements)

References 34 publications

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“…We can only speculate about the source of TGF-β being responsible for changing the expression of IL11 and NOX4 in the gingival fibroblasts. Basal TGF-β levels in blood plasma are low at around 5 ng/mL and it is the coagulation process that liberates the growth factor from platelet granules and, presumably, also other cells [35]. It is probably the activation of platelets during the blood draining and centrifugation even with hydrophobic plastic tubes that releases TGF-β into the PPP fraction.…”

Section: Discussionmentioning

confidence: 99%

Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel: Bioassays for TGF-β Activity

et al. 2020

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Liquid platelet-rich fibrin (PRF) can be prepared by high centrifugation forces separating the blood into a platelet-poor plasma (PPP) layer and a cell-rich buffy coat layer, termed concentrated PRF (C-PRF). Heating the liquid PPP was recently introduced to prepare an albumin gel (Alb-gel) that is later mixed back with the concentrated liquid C-PRF to generate Alb-PRF. PRF is a rich source of TGF-β activity; however, the overall TGF-β activity in the PPP and the impact of heating the upper plasma layer remains unknown. Here, we investigated for the first time the in vitro TGF-β activity of all fractions of Alb-PRF. We report that exposure of oral fibroblasts with lysates of PPP and the buffy coat layer, but not with heated PPP, provoked a robust increase in the TGF-β target genes interleukin 11 and NADPH oxidase 4 by RT-PCR, and for IL11 by immunoassay. Consistent with the activation of TGF-β signaling, expression changes were blocked in the presence of the TGF-β receptor type I kinase inhibitor SB431542. Immunofluorescence and Western blot further confirmed that lysates of PPP and the buffy coat layer, but not heated PPP, induced the nuclear translocation of Smad2/3 and increased phosphorylation of Smad3. The immunoassay further revealed that PPP and particularly BC are rich in active TGF-β compared to heated PPP. These results strengthen the evidence that not only the cell-rich C-PRF but also PPP comprise a TGF-β activity that is, however, heat sensitive. It thus seems relevant to mix the heated PPP with the buffy coat C-PRF layer to regain TGF-β activity, as proposed during the preparation of Alb-PRF.

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Section: Discussionmentioning

confidence: 99%

Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel: Bioassays for TGF-β Activity

et al. 2020

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“…Recently introduced autologous treatments, such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSC), have been largely investigated in orthopaedic surgery and proposed as OA treatments. The rationale for the use of these biologic products is based on their capability of modulating the joint environment by releasing a series of growth factors and immune-modulatory molecules that could play a beneficial role in reducing the local inflammation and promoting cartilage and synovium anabolism [ 1 ]. From a pathogenetic standpoint, cartilage homeostasis and bone remodelling are regulated by a complex network of metabolic pathways and, among these, the Wnt/ β -catenin pathway is activated in OA and is emerging as a regulator of tissue repair and fibrosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Wnt Pathway in the Pathogenesis of OA and Its Potential Therapeutic Implications in the Field of Regenerative Medicine

Santis

Matteo

Chisari

et al. 2018

BioMed Research International

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Introduction Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation, subchondral damage, and bone remodelling, affecting most commonly weight-bearing joints, such as the knee and hip. The loss of cartilage leads to joint space narrowing, pain, and loss of function which could ultimately require total joint replacement. The Wnt/β catenin pathway is involved in the pathophysiology of OA and has been proposed as a therapeutic target. Endogenous and pharmacological inhibitors of this pathway were recently investigated within innovative therapies including the use of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Methods A review of the literature was performed on the PubMed database based on the following inclusion criteria: article written in English language in the last 20 years and dealing with (1) the role of Wnt-β catenin pathway in the pathogenesis of osteoarthritis and (2) pharmacologic or biologic strategies modulating the Wnt-β catenin pathway in the OA setting. Results Evidences support that Wnt signalling pathway is likely linked to OA progression and severity. Its inhibition through natural antagonists and new synthetic or biological drugs shares the potential to improve the clinical condition of the patients by affecting the pathological activity of Wnt/β-catenin signalling. Conclusions While further research is needed to better understand the mechanisms regulating the molecular interaction between OA regenerative therapies and Wnt, it seems that biologic therapies for OA exert modulation on Wnt/β catenin pathway that might be relevant in achieving the beneficial clinical effect of those therapeutic strategies.

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“…15 In the practice of sports medicine, PRP injections have been used in the treatment of lateral epicondylitis, showing reduced rates of conversion to surgical treatment from medical management, 16 as well as marked improvement in visual analog scale (VAS) pain scale and tendon appearance on magnetic resonance imaging (MRI). 17 Furthermore, PRP has been shown to provide relief from pain and inflammation associated with OA, making it a therapeutic treatment in the management of OA. 3,8 PRP can be obtained from the patient on the same day as the injection is given and is processed through minimal steps, making it both cost-effective and convenient for treatment in patients with OA.…”

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confidence: 99%

The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis

et al. 2018

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With average life expectancy and the rising prevalence of obesity, osteoarthritis (OA) is creating an increasingly large financial and physical burden on the U.S. population today. As the body ages and experiences trauma, articular cartilage surfaces in joints are gradually worn away, leading to OA. Traditionally, treatment options have included lifestyle modifications, pain management, and corticosteroid injections, with joint replacement reserved for those who have exhausted nonsurgical measures. More recently, hyaluronic acid, micronized dehydrated human amniotic/chorionic membrane tissue, and platelet-rich plasma (PRP) injections have started to gain traction. PRP has been shown to have both anti-inflammatory effects through growth factors such as transforming growth factor-β and insulin-like growth factor 1, and stimulatory effects on mesenchymal stem cells and fibroblasts. Multiple studies have indicated that PRP is superior to hyaluronic acid and corticosteroids in terms of improving patient-reported pain and functionality scores. Unfortunately, there are many variations in PRP preparation, and lack of standardization in factors, such as speed and duration of centrifugation, leads to wide ranges of platelet and leukocyte concentrations. This review examines the current literature addressing the use of PRP in symptomatic knee OA and addresses suggestions for future studies in this area.

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Relationship of cytokine levels and clinical effect on platelet‐rich plasma‐treated lateral epicondylitis

Cited by 49 publications

References 34 publications

Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel: Bioassays for TGF-β Activity

Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel: Bioassays for TGF-β Activity

The Role of Wnt Pathway in the Pathogenesis of OA and Its Potential Therapeutic Implications in the Field of Regenerative Medicine

The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis

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