The application of thermal oscillation method to augment the effectiveness of autologous platelet rich plasma in treating elderly patients with knee osteoarthritis

Chen, Carl P.C.; Hsu, Chih‐Chin; Huang, Shuchun; Lin, Mu-Yun; Chen, Jean-Lon; Lin, Shu

doi:10.1016/j.exger.2020.111120

“…Although frozen PLTs can be stored for a longer time, their functional activity decreases significantly after re‐warming, which affects the quality of preservation 27,29 . Preservation with oscillation at 22 ± 2°C better maintains the functional activity of PLTs 28 . In order to ensure the quality of PLTs and the effects of transfusion, PLT concentrate is usually used within 1 week after sub‐packaging 30,31 .…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there are two main methods for PLT preservation, one is cryopreservation, 27 and the other is preservation at 22 ± 2 C with oscillation. 28 Although frozen PLTs can be stored for a longer time, their functional activity decreases significantly after re-warming, which affects the quality of preservation. 27,29 Preservation with oscillation at 22 ± 2 C better maintains the functional activity of PLTs.…”

Section: Discussionmentioning

confidence: 99%

Improvement of platelet preservation by inhibition ofTRPC6

Tan

¹

,

Lü²,

Yi³

et al. 2023

Transfusion Medicine

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Background: The preservation of platelets (PLTs) by room temperature (RT) oscillation limits their shelf life to between 4 and 7 days because of the decrease in PLT function. TRPC6 is a non-selective mechanically sensitive cation channel that has been shown to mediate Ca 2+ signalling, implying a role in PLT activation during preservation by RT oscillation.Objectives: This study was designed to investigate whether inhibition of TRPC6 can improve the RT preservation of PLTs and the possible underlying mechanism.Methods: Human PLTs from whole blood were stored at 22 ± 2 C with oscillation in plasma or M-sol (mixture of solutions). BI-749327, a specific TRPC6 inhibitor, was administered throughout the preservation period. PLT distribution width (PDW), mean platelet volume (MPV), maximum platelet aggregation rate (MAR) and average aggregation rate (AAR) were measured. The MTT method was used to assess the relative viability of PLTs. Flow cytometry was used to measure the changes of Ca 2+ concentration in PLTs and phosphatidylserine (PS) exposure on the PLT surface, and western blotting was used to assess the expression changes of platelet TRPC6 and CD62P proteins.Results: Compared with the control group, inhibition of TRPC6 with BI-749327 significantly reduced the PDW, MPV and Ca 2+ concentration, the MAR and AAR were significantly increased, the expression of TRPC6 and CD62P protein was significantly down-regulated in PLTs, and the PS exposure was significantly reduced on the PLT surface. However, these effects were all reversed by activation of TRPC6. Conclusion:Inhibition of TRPC6 improves the quality of PLT preservation by inhibiting the Ca 2+ signal mediated by TRPC6.

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“…Autologous platelet-rich plasma (PRP) has been shown to be more effective than other injection options, such as hyaluronic acid (HA), in treating patients with early stages of knee OA [ 5 ]. However, the effect of PRP in treating patients with severe stages of knee OA remains controversial [ 6 ]. Numerous growth factors are stored in the platelet α -granules, such as transforming (TGF- β ) and platelet-derived growth factors (PDGF).…”

Section: Introductionmentioning

confidence: 99%

“…Studies related to the development of viscous PRP in treating degenerative knee joint disorders are limited [ 6 ]. There is one study that mentioned the application of high viscous paste form-like PRP in facial rejuvenation.…”

Section: Introductionmentioning

confidence: 99%

Thermal Oscillation Changes the Liquid-Form Autologous Platelet-Rich Plasma into Paste-Like Form

Chen

¹

,

Chen

²

,

Suputtitada

³

2022

BioMed Research International

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Objectives. The texture of the autologous platelet-rich plasma (PRP) that is used in treating degenerative joint diseases such as knee osteoarthritis (OA) is usually in liquid form. However, the turnover rate of protein metabolism in the knee synovial fluid (SF) is less than one hour. This study examined the feasibility of the thermal oscillation technique in converting the liquid-form PRP into an injectable viscous paste-like PRP that may delay the degradation of PRP and continuously release growth factors in the knee joint for a longer period of time. Methods. This study was conducted in the rehabilitation department of a tertiary hospital. A total of 10 elderly patients with an average age of greater than 65 years and diagnosed with moderate degree of knee OA were recruited. The RegenPRP (RegenLab, Le Mont-sur-Lausanne, Switzerland) test tube chamber was used for PRP generation. A total of 60 milliliters (mL) of blood was drawn from each patient. 10 mL of blood was injected into each PRP test tube chamber. As a result, a total of 6 test tube chambers were obtained and each chamber was centrifuged for 15 minutes. Approximately 5 mL of PRP supernatant (the liquid-form end product) was aspirated and sent for thermal oscillation treatment. Five temperatures were tested: 55, 65, 75, 85, and 95 degrees Celsius. Oscillation was set at 200 revolutions per minute (rpm) for 15 minutes. The enzyme-linked immunosorbent assay (ELISA) was applied in measuring the concentration of platelet-derived growth factor (PDGF) in picogram/milliliter (pg/mL). Repeated measures ANOVA followed by the Bonferroni post hoc test was used to compare the PDGF concentrations between each testing condition. Results. Under 75 degrees Celsius of heating, the resultant paste-like PRP end product had the highest concentration of PDGF in picograms per milliliter (pg/mL) as compared with other heating conditions ( p < 0.05 ). The viscosity of the paste-like PRP was measured to be 70,000 centipoise (cP), which is similar to the viscosity of a toothpaste. The paste-like PRP end product was able to release PDGF continuously for about 14 days, with the highest concentration achieved on the 8th day with an average of 35646 ± 2499 pg / mL . In nonthermally treated liquid-form PRP sample, the highest number of PRP was observed on the 4th day with an average value of 8444 ± 831 pg / mL . Under the heating conditions of 55 and 95 degrees Celsius, the highest concentration of PDGF was observed on the 5th day ( 13346 ± 764 pg / mL and 3440 ± 303 pg / mL , respectively). Under the heating conditions of 65 and 85 degrees Celsius, the highest concentration of PDGF was observed on the 7th day ( 15468 ± 744 pg / mL and 20432 ± 1118 pg / mL , respectively). Conclusion. Through thermal oscillation, liquid-form PRP can be converted to paste-like PRP end product with a viscosity similar to that of a toothpaste. The best heating condition was discovered to be 75 degrees Celsius. The paste-like PRP was able to release PDGF continuously for about 2 weeks, with the highest concentration obtained on the 8th day. The findings in this study suggested that paste-like PRP may be a viable option in treating degenerative knee joint diseases.

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“…There are many bursae surrounding the knee; suprapatellar bursitis is the likely cause of pain and swelling [ 5 ]. This can be diagnosed using musculoskeletal ultrasound or magnetic resonance imaging (MRI) [ 6 , 7 ]. Knee swelling with pain is positively correlated with the volume of synovial fluid (SF) in the suprapatellar bursa.…”

Section: Introductionmentioning

confidence: 99%

Intra-Articular Laser Therapy May Be a Feasible Option in Treating Knee Osteoarthritis in Elderly Patients

Chen

¹

,

Hsu

²

,

Chen³

et al. 2022

BioMed Research International

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Knee osteoarthritis (OA) is a common problem in elderly patients. They are often troubled with altered knee function, such as pain and weakness. However, not all these patients are able to receive autologous platelet-rich plasma (PRP) injections as they may be taking antiplatelet or anticoagulant medications. Their physical condition may not allow them to receive total knee replacement surgery as well. Long-term oral intake of nonsteroidal anti-inflammatory drugs may be detrimental to the gastrointestinal tract. As a result, it is crucial to discover new treatment options that can alleviate painful knee symptoms in elderly knee OA patients. In this study, 19 elderly patients diagnosed with moderate degree of knee OA as well as suprapatellar bursitis were recruited. They received low-level laser therapy (LLLT) to their affected knees. Under ultrasound guidance, flexible fiber optic wire was inserted intra-articularly into the knee joint. Red laser followed by infrared irradiation was performed once every 2 weeks for a total of 3 times. The Lequesne index for knee OA and the volume of suprapatellar synovial fluid (SF) were measured. SF proteomic analyses were also performed up to a period of 6 months. The results revealed that after 3 LLLT, the Lequesne index significantly decreased, signifying improvement in the knee joint functional status. The volume of suprapatellar SF and SF proteins associated with inflammation also decreased significantly in the SF. These findings lasted up to a period of at least 3 months. Therefore, LLLT may be considered as a feasible option in treating elderly patients with knee OA who are not suitable for surgical interventions or intra-articular PRP injections.

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The application of thermal oscillation method to augment the effectiveness of autologous platelet rich plasma in treating elderly patients with knee osteoarthritis

Cited by 6 publications

References 20 publications

Improvement of platelet preservation by inhibition ofTRPC6

Improvement of platelet preservation by inhibition ofTRPC6

Thermal Oscillation Changes the Liquid-Form Autologous Platelet-Rich Plasma into Paste-Like Form

Intra-Articular Laser Therapy May Be a Feasible Option in Treating Knee Osteoarthritis in Elderly Patients

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