Abstract
Multiple studies have demonstrated a role for platelet-rich plasma (PRP) in accelerating and facilitating response to injury. The cellular response to injury progresses through four general stages: hemostasis, inflammation, proliferation, and finally remodeling. Each phase is characterized by enhanced cellular or molecular activity, all of which involve platelets. Blood plasma and platelets are responsible for hemostasis, while leukocytes and activated platelets mediate inflammation, and growth factors derived from platelet α-granules influence tissue regeneration. Specifically, the leukocyte content of PRP is thought influence the inflammatory phase, while angiogenic and mitogenic growth factor concentrations are believed to aid tissue regeneration [1]. Both the precise composition and formulation of PRP affect the cellular environment in which it is placed and determine its overall effect on tissue repair.
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References
Rozman P, Bolta Z. Use of platelet growth factors in treating wounds and soft-tissue injuries. Acta Dermatoven APA. 2007;16(4):156–65.
Rehfeldt F, Engler AJ, Eckhardt A, Ahmed F, Discher DE. Cell responses to the mechanochemical microenvironment – implications for regenerative medicine and drug delivery. Adv Drug Deliv Rev. 2007;59(13):1329–39.
Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009;37(11):2259–72.
Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10(4):225–8.
Creaney L, Hamilton B. Growth factor delivery methods in the management of sports injuries: the state of play. Br J Sports Med. 2008;42(5):314–20.
Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42(2):162–70.
Sundman EA, Cole BJ, Fortier LA. Growth Factor and Catabolic Cytokine Concentrations Are Influenced by the Cellular Composition of Platelet-Rich Plasma. Am J Sports Med. 2011;39(10):2135–40.
de Jonge S, de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, et al. One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial. Am J Sports Med. [Research Support, Non-U.S. Gov’t]. 2011;39(8):1623–9.
Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. The American journal of sports medicine. [Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. 2010;38(2):255–62.
Zimmermann R, Jakubietz R, Jakubietz M, Strasser E, Schlegel A, Wiltfang J, et al. Different preparation methods to obtain platelet components as a source of growth factors for local application. Transfusion. 2001;41(10):1217–24.
Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114(6):1502–8.
Araki J, Jona M, Suga H, Eto H, Kato H, Aoi N, et al. Optimized preparation method of platelet-concentrated plasma (PCP) and non-coagulating platelet-derived factor concentrates (PFC): maximization of platelet concentration and removal of fibrinogen. Tissue Eng Part C Methods. 2012;18(3):176–85.
Haynesworth SE, Kadiyala S, Liang LN. Mitogenic stimulation of human mesenchymal stem cells by platelet release suggest a mechanism for enhancement of bone repair by platelet concentrates. 48th meeting of the Orthopedic Research Society. Boston; 2002.
Lui Y, Kalen A, Risto O. Fibroblast proliferation due to exposure to a platelet concentrate in vitro is pH dependent. Wound Repair Regen. 2002;10(336).
Mastrangelo AN, Vavken P, Fleming BC, Harrison SL, Murray MM. Reduced platelet concentration does not harm PRP effectiveness for ACL repair in a porcine in vivo model. J Orthop Res Off Publ Orthop Res Soc. [Research Support, N.I.H., Extramural]. 2011;29(7):1002–7.
Yamaguchi R, Terashima H, Yoneyama S, Tadano S, Ohkohchi N. Effects of platelet-rich plasma on intestinal anastomotic healing in rats: PRP concentration is a key factor. J Surg Res. 2010;2.
Freeman MR, Schneck FX, Gagnon ML, Corless C, Soker S, Niknejad K, et al. Peripheral blood T lymphocytes and lymphocytes infiltrating human cancers express vascular endothelial growth factor: a potential role for T cells in angiogenesis. Cancer Res. 1995;55(18):4140–5.
Nielsen HJ, Werther K, Mynster T, Brunner N. Soluble vascular endothelial growth factor in various blood transfusion components. Transfusion. 1999;39(10):1078–83.
McCarrel T, Fortier L. Temporal growth factor release from platelet-rich plasma, trehalose lyophilized platelets, and bone marrow aspirate and their effect on tendon and ligament gene expression. J Orthop Res. 2009;27(8):1033–42.
Faurschou M, Borregaard N. Neutrophil granules and secretory vesicles in inflammation. Microbes Infect. 2003;5(14):1317–27.
Khalafi RS, Bradford DW, Wilson MG. Topical application of autologous blood products during surgical closure following a coronary artery bypass graft. Eur J Cardiothorac Surg. 2008;34(2):360–4.
Everts PA, Devilee RJ, Brown Mahoney C, van Erp A, Oosterbos CJ, Stellenboom M, et al. Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome. A prospective randomized double- blind study. Eur Surg Res. 2008;40(2):203–10.
Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;34(11):1774–8.
Laurens N, Koolwijk P, de Maat MP. Fibrin structure and wound healing. J Thromb Haemost. 2006;4(5):932–9.
Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L- PRF). Trends Biotechnol. 2009;27(3):158–67.
Flick MJ, Du X, Degen JL. Fibrin(ogen)-alpha M beta 2 interactions regulate leukocyte function and innate immunity in vivo. Exp Biol Med (Maywood). 2004;229(11):1105–10.
de Maat MP, Verschuur M. Fibrinogen heterogeneity: inherited and noninherited. Curr Opin Hematol. 2005;12(5):377–83.
Clark RA. Fibrin and wound healing. Ann N Y Acad Sci. 2001;936:355–67.
van Hinsbergh VW, Collen A, Koolwijk P. Role of fibrin matrix in angiogenesis. Ann N Y Acad Sci. 2001;936:426–37.
Doessing S, Holm L, Heinemeier KM, Feldt-Rasmussen U, Schjerling P, Qvortrup K, et al. GH and IGF1 levels are positively associated with musculotendinous collagen expression: experiments in acromegalic and GH deficiency patients. Eur J Endocrinol. 2010;163(6):853–62.
Gustafsson T, Kraus WE. Exercise-induced angiogenesis-related growth and transcription factors in skeletal muscle, and their modification in muscle pathology. Front Biosci. [Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S. Review]. 2001;6:D75–89.
Sanchez M, Azofra J, Anitua E, Andia I, Padilla S, Santisteban J, et al. Plasma rich in growth factors to treat an articular cartilage avulsion: a case report. Med Sci Sports Exerc. 2003;35(10):1648–52.
Banfi G, Corsi MM, Volpi P. Could platelet rich plasma have effects on systemic circulating growth factors and cytokine release in orthopaedic applications? Br J Sports Med. [Editorial]. 2006;40(10):816.
Ljungqvist A, Schwellnus MP, Bachl N, Collins M, Cook J, Khan KM, et al. International Olympic Committee consensus statement: molecular basis of connective tissue and muscle injuries in sport. Clin Sports Med. [Consensus Development Conference]. 2008;27(1):231–9, x–xi.
WADA Laboratory Committee. Decision Limits for the Confirmatory Quantification of Threshold Substances; 2009 Sep 15. Document Number: TD2009DL. Version: 1.0.
Kniess A, Ziegler E, Kratzsch J, Thieme D, Muller RK. Potential parameters for the detection of hGH doping. Anal Bioanal Chem. [Clinical Trial Comparative Study Controlled Clinical Trial Evaluation Studies Research Support, Non-U.S. Gov’t]. 2003;376(5):696–700.
Anitua E, Andia I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, et al. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res. 2005;23(2):281–6.
Juul A, Scheike T, Pedersen AT, Main KM, Andersson AM, Pedersen LM, et al. Changes in serum concentrations of growth hormone, insulin, insulin-like growth factor and insulin-like growth factor-binding proteins 1 and 3 and urinary growth hormone excretion during the menstrual cycle. Hum Reprod. [Research Support, Non-U.S. Gov’t]. 1997;12(10):2123–8.
de Mos M, van der Windt AE, Jahr H, van Schie HT, Weinans H, Verhaar JA, et al. Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med. 2008;36(6):1171–8.
Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004;91(1):4–15.
Min JK, Lee YM, Kim JH, Kim YM, Kim SW, Lee SY, et al. Hepatocyte growth factor suppresses vascular endothelial growth factor-induced expression of endothelial ICAM-1 and VCAM-1 by inhibiting the nuclear factor-kappaB pathway. Circ Res. 2005;96(3):300–7.
He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):707–13.
Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(6):638–46.
Weibrich G, Kleis WK, Hafner G, Hitzler WE. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Craniomaxillofac Surg. 2002;30(2):97–102.
Castillo TN, Pouliot MA, Kim HJ, Dragoo JL. Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. Am J Sports Med. 2011;39(2):266–71.
Dragoo JL, Braun HJ, Durham JL, Ridley BA, Odegaard JI, Luong R, Arnoczky SP. Comparison of the acute inflammatory response of two commercial platelet-rich plasma systems in healthy rabbit tendons. Am J Sports Med. 2012 Jun;40(6):1274–81. doi: 10.1177/0363546512442334. Epub 2012 Apr 10. PMID: 22495144.
Felisaz N, Boumediene K, Ghayor C, Herrouin JF, Bogdanowicz P, Galerra P, et al. Stimulating effect of diacerein on TGF-beta1 and beta2 expression in articular chondrocytes cultured with and without interleukin-1. Osteoarthritis Cartilage. 1999;7(3):255–64.
Roman-Blas JA, Stokes DG, Jimenez SA. Modulation of TGF-beta signaling by proinflammatory cytokines in articular chondrocytes. Osteoarthritis Cartilage. 2007;15(12):1367–77.
Anitua E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants. 1999;14(4):529–35.
Weibrich G, Kleis WK, Hitzler WE, Hafner G. Comparison of the platelet concentrate collection system with the plasma-rich-in-growth-factors kit to produce platelet-rich plasma: a technical report. Int J Oral Maxillofac Implants. 2005;20(1):118–23.
Pietrzak WS, An YH, Kang QK, Demos HA, Ehrens KH. Platelet-rich and platelet- poor plasma: development of an animal model to evaluate hemostatic efficacy. J Craniofac Surg. 2007;18(3):559–67.
Mazzucco L, Balbo V, Cattana E, Guaschino R, Borzini P. Not every PRP-gel is born equal. Evaluation of growth factor availability for tissues through four PRP-gel preparations: Fibrinet, RegenPRP-Kit, Plateltex and one manual procedure. Vox Sang. 2009;97(2):110–8.
Anitua E, Sanchez M, Nurden AT, Zalduendo M, de la Fuente M, Orive G, et al. Autologous fibrin matrices: a potential source of biological mediators that modulate tendon cell activities. J Biomed Mat Res Part A. [Evaluation Studies Research Support, Non-U.S. Gov’t]. 2006;77(2):285–93.
Brass LF. Thrombin and platelet activation. Chest. 2003;124(3 Suppl):18S–25.
Roussy Y, Bertrand Duchesne MP, Gagnon G. Activation of human platelet-rich plasmas: effect on growth factors release, cell division and in vivo bone formation. Clin Oral Implants Res. [Research Support, Non-U.S. Gov’t]. 2007;18(5):639–48.
Harrison S, Vavken P, Kevy S, Jacobson M, Zurakowski D, Murray MM. Platelet activation by collagen provides sustained release of anabolic cytokines. Am J Sports Med. 2011;39(4):729–34.
Anitua E, Alkhraisat MH, Orive G. Perspectives and challenges in regenerative medicine using plasma rich in growth factors. J Control Release. 2011;8.
Cognasse F, Hamzeh-Cognasse H, Lafarge S, Acquart S, Chavarin P, Courbil R, et al. Donor platelets stored for at least 3 days can elicit activation marker expression by the recipient’s blood mononuclear cells: an in vitro study. Transfusion. 2009;49(1):91–8.
Hartley PS, Savill J, Brown SB. The death of human platelets during incubation in citrated plasma involves shedding of CD42b and aggregation of dead platelets. Thromb Haemost. 2006;95(1):100–6.
Landi EP, Roveri EG, Ozelo MC, Annichino-Bizzacchi JM, Origa AF, de Carvalho Reis AR, et al. Effects of high platelet concentration in collecting and freezing dry platelets concentrates. Transfus Apher Sci. 2004;30(3):205–12.
Johnson LN, Winter KM, Reid S, Hartkopf-Theis T, Marks DC. Cryopreservation of buffy-coat-derived platelet concentrates in dimethyl sulfoxide and platelet additive solution. Cryobiology. 2011;62(2):100–6.
Farndale RW, Siljander PR, Onley DJ, Sundaresan P, Knight CG, Barnes MJ. Collagen-platelet interactions: recognition and signalling. Biochem Soc Symp. 2003;(70):81–94.
Fufa D, Shealy B, Jacobson M, Kevy S, Murray MM. Activation of platelet-rich plasma using soluble type I collagen. J Oral Maxillofac Surg. [Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, Non-P.H.S.]. 2008;66(4):684–90.
Zhang J, Wang JH. Platelet-rich plasma releasate promotes differentiation of tendon stem cells into active tenocytes. Am J Sports Med. 2010;38(12):2477–86.
Fallouh L, Nakagawa K, Sasho T, Arai M, Kitahara S, Wada Y, et al. Effects of autologous platelet-rich plasma on cell viability and collagen synthesis in injured human anterior cruciate ligament. J Bone Joint Surg Am. 2010;92(18):2909–16.
Leitner GC, Gruber R, Neumuller J, Wagner A, Kloimstein P, Hocker P, et al. Platelet content and growth factor release in platelet-rich plasma: a comparison of four different systems. Vox Sang. [Comparative Study Evaluation Studies]. 2006;91(2):135–9.
Kevy SV, Jacobson MS. Comparison of methods for point of care preparation of autologous platelet gel. J Extra Corpor Technol. [Comparative Study In Vitro Research Support, Non-U.S. Gov’t]. 2004;36(1):28–35.
Woodell-May JE, Ridderman DN, Swift MJ, Higgins J. Producing accurate platelet counts for platelet rich plasma: validation of a hematology analyzer and preparation techniques for counting. J Craniofac Surg. 2005;16:749–56; discussion 57–9.
Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. [Review]. 2004;62(4):489–96.
DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classification system. Arthroscopy. 2012;28(7):998–1009.
Mishra A, Harmon K, Woodall J, Vieira A. Sports medicine applications of platelet rich plasma. Curr Pharm Biotechnol. 2012;13(7):1185–95.
Kochan A, Scarpone M, Mandle R. Platelet rich plasma preparation: a comparison of the harvest SmartPReP 2 APC+ with the arteriocyte magellan. AAOS.org. 2009. http://orthodoc.aaos.org/WilliamFBennettMD/Comparison%20of%20SmartPReP%202%20and%20Arteriocyte%20Magellan.pdf.
http://www.perfusion.com/perfusion/prpdevicesummary.asp. Accessed 9 Apr 2013.
Mandle. Analysis of EmCyte Corporation Concentrating Systems. An independent review of pre-clinical performance data. http://www.emcyte.com/articles/PerformanceData.pdf.
Sánchez M, Anitua E, Azofra J, Andía I, Padilla S, Mujika I. Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. 2007;35(2):245–51.
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Wasterlain, A.S., Braun, H.J., Dragoo, J.L. (2016). Contents and Formulations of Platelet Rich Plasma. In: Maffulli, N. (eds) Platelet Rich Plasma in Musculoskeletal Practice. Springer, London. https://doi.org/10.1007/978-1-4471-7271-0_1
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