The Influence of Platelet-Rich Plasma on Angiogenesis During the Early Phase of Tendon Healing

Lyras, Dimitrios N; Kazakos, Konstantinos; Verettas, D.; Polychronidis, Alekos; Tryfonidis, M.; Botaitis, Sotirios; Agrogiannis, George; Simopoulos, Constantinos; Kokka, Anna; Patsouris, Efstratios

doi:10.3113/fai.2009.1101

Cited by 134 publications

(102 citation statements)

References 30 publications

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“…The multimolecular preparations, obtained from autologous blood, provide clinical benefits by modulating the early healing response through secretion of an array of signaling cytokines that influence inflammation and angiogenesis concurrently and influence cell migration and proliferation [10,13,23,24]. Plateletrich plasma affects healing, both physiologically and pathologically, and is currently used not only in surgery [2,16], but also as an injectable to treat pathological conditions such as osteoarthritis (OA) and tendinopathies [5,6,14], in which the disordered vascularization and deleterious neoinnervation are associated with reduced healing capability and increased vulnerability to chronic injuries.…”

Section: Introductionmentioning

confidence: 99%

Platelet-rich Plasma Modulates the Secretion of Inflammatory/Angiogenic Proteins by Inflamed Tenocytes

Andı́a

Rubio‐Azpeitia

Maffulli

2015

Clinical Orthopaedics &Amp; Related Research

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Background Platelet-rich plasma therapies for tendinopathy appear to provide moderate pain reduction. However, the biological mechanisms behind the observed clinical effects remain poorly characterized. Questions/purposes The purpose of this study was to explore whether platelet-rich plasma modifies the inflammatory/angiogenic status of already inflamed tenocytes by examining (1) gene expression; (2) modulation of chemokine and interleukin secretion; and (3) differences between healthy and tendinopathic tenocytes. Methods Cells from both healthy and tendinopathic tendons were exposed to interleukin (IL)-1ß and after treated with platelet-rich plasma. Modifications in the expression of selected genes were assessed by real-time reverse transcription-polymerase chain reaction and changes in secretion of angiogenic/inflammatory molecules by enzyme-linked immunosorbent assay. Platelet-rich plasmainduced changes in tendinopathic cells were compared with normal after normalizing platelet-rich plasma data against IL-1ß status in each specific sample. Results In IL-1ß-exposed cells, platelet-rich plasma downregulates expression of IL-6/CXCL-6 (mean, 0.015; 95% confidence interval [CI], 0.005-0.025; p = 0.026), IL-6R (mean, 0.61; 95% CI, 0.27-0.95; p = 0.029), and IL-8/CXCL-8 (mean, 0.02; 95% CI, 0.007-0.023; p = 0.026). Secretion of IL-6/CXCL6, 0.35 (95% CI, 0.3-0.4; p = 0.002), IL-8/CXCL8, 0.55 (95% CI, 0.5-0.7; p = 0.01), and monocyte chemoattractant protein-1/CCL2, 0.40 (95% CI, 0.2-0.6; p = 0.001) was reduced by platelet-rich plasma, whereas vascular endothelial growth factor increased by twofold, (95% CI, 1.7-2.3; p \ 0.001). RANTES/CCL5 increased by10-fold (95% CI, 4-17) and hepatocyte growth factor by 21-fold (95% CI, 0.2-42) in tendinopathic and by 2.3-fold (95% CI, 2-3) and threefold (95% CI, 1-5) in normal cells (p = 0.005 for both). Conclusions Platelet-rich plasma induces an immunomodulatory and proangiogenic phenotype consistent with healing mechanisms with few differences between tendinopathic and normal cells. Clinical Relevance Platelet-rich plasma injections in pathological and nearby tissue might help to recover tendon homeostasis.

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Section: Introductionmentioning

confidence: 99%

Platelet-rich Plasma Modulates the Secretion of Inflammatory/Angiogenic Proteins by Inflamed Tenocytes

Andı́a

Rubio‐Azpeitia

Maffulli

2015

Clinical Orthopaedics &Amp; Related Research

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“…Rat models have shown that PRP increases tendon strength 24 when injected locally. In rabbit Achilles tendons, increased vascularity and better tissue organization have been found 11 . Moreover, one clinical study comparing PRP treated patients with historical controls has indicated that peroperative PRP treatment allows earlier return to sports 17 .…”

Section: Introductionmentioning

confidence: 99%

Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures

et al. 2010

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“…16 Experimental studies on PRP suggested a potential benefit of PRP in enhancing the healing process by activating neovascularization in areas with poor vascularity. 17 Another experimental model support that platelet-rich fibrin matrix (an alternative preparation of similar properties) enhances endothelial cell proliferation. This may provide an explanation of wound healing effect of PRP.…”

Section: Discussionmentioning

confidence: 99%

Effect of autologous platelet-rich plasma in the promotion of healing of chronic ulcers

2017

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Background: Chronic ulcers are a big health problem worldwide. Having a great impact at personal, social and professional levels. The use of autologous Platelet Rich Plasma (PRP) is a major advance in the treatment of these ulcers as an easy and cost-effective method. Platelets provide numerous growth factors enhancing tissue healing. The aim of this study was to evaluate the safety and efficacy of autologous platelet-rich plasma as a treatment of chronic non-healing ulcers.Methods: Autologous PRP was prepared from whole blood by centrifugation and activated by 10% calcium chloride. Twenty-Four (24) patients with non-healing ulcers of different etiologies, whom they met our inclusion criteria, were treated with PRP injected every two weeks locally into their wounds until healing. The ulcer dimensions were measured every week. The follow-up period was 12 weeks after healing.Results: The mean age of the study population 41±21 years. Complete healing was achieved in all patients. The mean rate of healing (average decrease in ulcer dimensions) was 0.48 cm/week. The rate of healing was greater at the week following injection. The mean time for healing was 6.11 weeks.Conclusions: Author witnessed the useful effects of PRP application on enhancing wound healing. The results from our case series showed that PRP is a safe and effective treatment for the promotion of healing chronic ulcers. Further research and controlled, randomized prospective clinical trials on larger patient population are important to validate our results.

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The Influence of Platelet-Rich Plasma on Angiogenesis During the Early Phase of Tendon Healing

Abstract: Although these results need replication and further biomechanical research, PRP may promote tendon healing acceleration.

Cited by 134 publications

References 30 publications

Platelet-rich Plasma Modulates the Secretion of Inflammatory/Angiogenic Proteins by Inflamed Tenocytes

Platelet-rich Plasma Modulates the Secretion of Inflammatory/Angiogenic Proteins by Inflamed Tenocytes

Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures

Effect of autologous platelet-rich plasma in the promotion of healing of chronic ulcers

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