The Concentration of Plasma Provides Additional Bioactive Proteins in Platelet and Autologous Protein Solutions

Muir, Sean M; Reisbig, Natalie; Baria, Michael R.; Kaeding, Christopher C.; Bertone, Alicia L.

doi:10.1177/0363546519849671

Cited by 21 publications

(14 citation statements)

References 54 publications

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“…37,59 In addition, IL-1 receptor antagonist protein, thought to be more abundant in LR-PRP, may be responsible for the beneficial effects of the healing process because it blocks IL-1, decreases the activity of matrix metalloproteinase, and reduces the risk of cartilage degradation. 9,51 These potential benefits of leukocytes in LR-PRP, including IL-1 receptor antagonist protein and monocytes, might compensate for the catabolic effect of leukocytes, and even showed similar clinical efficacy such as pain and functional improvement compared with LP-PRP.…”

Section: Discussionmentioning

confidence: 99%

Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis

Kim

Park

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Platelet-rich plasma (PRP) has gained attention as a therapeutic option for knee osteoarthritis; however, its efficacy varies widely. Leukocytes in PRP raise the concern of aggravating proinflammatory activity. To date, PRP has rarely been investigated with regard to leukocyte concentration. Purpose: To provide clinical evidence of the intra-articular injection of PRPs containing different leukocyte concentrations. Study Design: Systematic review; Level of evidence, 4. Methods: We systematically searched the MEDLINE, Embase, Cochrane Library, CINAHL, and Scopus databases. PRP was classified into leukocyte-poor (LP-PRP) and leukocyte-rich (LR-PRP). Clinical outcomes including Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain score, International Knee Documentation Committee (IKDC) subjective score, and adverse reactions were evaluated. The Methodological Index for Non-Randomized Studies criteria were used for quality assessment. Results: Included were 32 studies with an evidence level between 1 and 4. Both LP-PRP and LR-PRP showed improvements above the minimal clinically important difference (MCID) in VAS pain score. No significant intergroup difference was seen at 3, 6, or 12 months of follow-up. Regarding function, both LP-PRP and LR-PRP showed improvements above the MCID in the WOMAC and IKDC scores, with no significant difference between the groups. Adverse reactions for pain were significantly higher in LR-PRP than in LP-PRP (odds ratio, 1.64; 95% confidence interval, 1.29-2.10; P = .01). After intra-articular PRP injection, LR-PRP showed a significantly higher rate of swelling than LP-PRP (odds ratio, 1.56; 95% confidence interval, 1.22-1.99; P = .02). The mean Methodological Index for Non-Randomized Studies score of the included studies was 18.6 (range, 10-24). Conclusion: Intra-articular PRP injection resulted in improvements above the MCID in terms of pain and function in patients with knee osteoarthritis up to 12 months. The risk of local adverse reactions appeared to be increased after LR-PRP compared with LP-PRP injection. The findings of this review can support the potential use of intra-articular PRP injection for the treatment of knee osteoarthritis. In clinical application, clinicians need to consider selecting a specific type of PRP for knee osteoarthritis.

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Section: Discussionmentioning

confidence: 99%

Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis

Kim

Park

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…The use of APS has been validated for the treatment of equine osteoarthritis in a recent study by Bertone et al In this study, they found that APS contained a 5.8-fold increase in IL-1ra, a 3.6-fold increase in soluble tumor necrosis factor receptor 1 (sTNF-R), and a 3.4-fold increase in IL-10 compared with concentrations in blood (17). Similarly, Muir et al found that APS contained a 6,500-fold increase in transforming growth factor beta (TGF-β) and a 3.3-fold increase in IL-1ra compared to plasma (18). Another study found that when chondrocytes were treated with APS in vitro, media from cultured chondrocytes contained significantly increased concentrations of IL-1Ra and IL-10 (19).…”

Section: Introductionmentioning

confidence: 97%

Evaluation of Autologous Protein Solution Injection for Treatment of Superficial Digital Flexor Tendonitis in an Equine Model

et al. 2021

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Autologous protein solution (APS) has been used anecdotally for intralesional treatment of tendon and ligament injuries, however, its use in these injuries has never been studied in vivo. Our objective was to evaluate the effect of APS on tendon healing in an equine superficial digital flexor (SDF) tendonitis model. We hypothesized intralesional injection of APS would result in superior structural and biomechanical healing. SDF tendonitis was induced in both forelimbs of eight horses using collagenase injection. One forelimb was randomly assigned to receive an intralesional injection of APS, while the other was injected with saline. Ultrasonographic examinations were performed at weeks −1, 0, 2, 4, 8, and 12 following treatment. At 12 weeks, horses were euthanized and SDF samples harvested. Histologic evaluation, biomechanical testing, gene expression analysis, total glycosaminoglycan (GAG) and total DNA quantification were performed. Collagen type III (COL3A1) expression was significantly higher (p = 0.028) in saline treated tendon than in normal tendon. Otherwise, there were no significant differences in gene expression. There were no significant differences in histologic or ultrasonographic scores between groups. Mean total DNA content was significantly higher (p = 0.024) in saline treated tendons than normal tendons, whereas total DNA content was not significantly different between APS treated tendon and normal tendon. Elastic modulus was higher in APS treated than saline treated tendon, but the difference was not significant. Reduced expression of COL3A1 in APS treated tendon may indicate superior healing. Increased total DNA content in saline treated tendon may indicate ongoing healing processes, vs. APS treated tendons which may be in the later stages of healing. Limitations include a relatively short study period and inconsistency in size and severity of induced lesions. Intralesional injection of APS resulted in some improvements in healing characteristics.

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“…The L-PRP device in this study produces an output with a high concentration of platelets and WBC with a normal concentration of plasma proteins. 61,62 ACS devices produce an output of a serum that contains plasma proteins and the WBC secretome when incubated in a clot with glass beads. ACS devices contain very little/no platelets or WBC.…”

Section: Discussionmentioning

confidence: 99%

“…13 APS devices produce outputs with concentrated platelets, white blood cells and plasma proteins. 62 Each one of these products contain different concentrations of different cells, cytokines, and growth factors.…”

Section: Discussionmentioning

confidence: 99%

The Use of Autologous Protein Solution (Pro-Stride®) and Leukocyte-Rich Platelet-Rich Plasma (Restigen®) in Canine Medicine

King¹,

Cawood²,

Bookmiller³

2021

VMRR

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The use of autologous orthobiologics is an emerging area of interest in veterinary medicine. In this retrospective study, we reviewed the clinical results achieved using two orthobiologics devices to address orthopedic injuries and tissue repair. Leukocyte (White blood cell)-rich platelet-rich plasma (L-PRP) devices produce outputs containing high concentrations of growth factors from venous blood. The Autologous Protein Solution (APS) device produces an orthobiologic containing high concentrations of growth factors and antiinflammatory cytokines. L-PRP has commonly been used to address soft tissue injuries. APS has been injected into the joint to address osteoarthritis. In the last five years, our practice has treated 35 dogs (38 treatments) with L-PRP and 98 dogs (108 treatments) with APS. Our group has used L-PRP and APS to address orthopedic conditions including osteoarthritis, bursitis, tendinitis, tendon/ligament rupture/repair procedures, post-surgical femoral head osteotomy/tibial-plateau-leveling osteotomy tissue repair, lumbosacral stenosis, patellar luxation, joint laxity, and osteochondral dissecans. The results achieved with L-PRP and APS have been favorable (observed pain improvement and minimal adverse reactions), but sometimes have not achieved complete pain relief or tissue repair. The most common application for L-PRP was patellar luxation and the most common application for APS was injection post-ACL surgery. Canine OA has been successfully managed in several patients with repeat injections of APS over the course of several years. Future studies on specific conditions are ongoing and including efforts to further characterize these products in canine medicine.

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The Concentration of Plasma Provides Additional Bioactive Proteins in Platelet and Autologous Protein Solutions

Cited by 21 publications

References 54 publications

Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis

Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis

Evaluation of Autologous Protein Solution Injection for Treatment of Superficial Digital Flexor Tendonitis in an Equine Model

The Use of Autologous Protein Solution (Pro-Stride®) and Leukocyte-Rich Platelet-Rich Plasma (Restigen®) in Canine Medicine

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