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Exercise-Mobilized Platelet-Rich Plasma: Short-Term Exercise Increases Stem Cell and Platelet Concentrations in Platelet-Rich Plasma

      Purpose

      To evaluate the effects of vigorous short-term exercise on the platelet and other cellular components of 2 point-of-care blood-processing devices: a buffy coat–based platelet-rich plasma (PRP) product and a plasma-based PRP product.

      Methods

      Twenty healthy subjects (aged 21-45 years) participated in a 20-minute vigorous exercise regimen on an upright stationary bike at 70% to 85% of maximum target heart rate. Pre- and post-exercise blood was processed in either a plasma-based or automated buffy coat–based PRP system. Complete blood counts were used to compare the cellular components in whole blood and the PRP products.

      Results

      Exercise significantly increased the concentrations of platelets by over 20% in whole blood (P < .001) and in both PRP products (P = .002 and P = .018). Both devices performed consistently with pre- and post-exercise blood. Buffy coat–based PRP prepared after exercise was also significantly larger in volume and had a significantly higher concentration of mobilized hematopoietic stem cells (hematopoietic progenitor cells [HPCs], from 1.7/μL to 2.7/μL, P = .043). The concentrations of all white blood cell types were increased, which could be differentially collected in the devices studied.

      Conclusions

      Exercise can be used to consistently alter the composition of PRP. Twenty minutes of vigorous exercise can increase platelet concentrations in plasma-based and buffy coat–based PRP products and can increase HPC concentrations and volume in buffy coat–based PRP.

      Clinical Relevance

      This study shows a nonpharmacologic method to increase platelet and HPC harvests from peripheral blood. This is important because it highlights a method for altering biological therapies with limited comorbidity.
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      References

        • DeLong J.M.
        • Beitzel K.
        • Mazzocca A.D.
        • Shepard D.
        • Roller B.L.
        • Hanypsiak B.T.
        Update on platelet-rich plasma.
        Curr Orthop Pract. 2011; 22: 514-523
        • Gulliksson H.
        Platelets from platelet-rich-plasma versus buffy-coat-derived platelets: What is the difference?.
        Rev Bras Hematol Hemoter. 2012; 34: 76-77
        • Castillo T.N.
        • Pouliot M.A.
        • Kim H.J.
        • Dragoo J.L.
        Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems.
        Am J Sports Med. 2011; 39: 266-271
        • Sundman E.A.
        • Cole B.J.
        • Fortier L.A.
        Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma.
        Am J Sports Med. 2011; 39: 2135-2140
        • Magalon J.
        • Bausset O.
        • Serratrice N.
        • et al.
        Characterization and comparison of 5 platelet-rich plasma preparations in a single-donor model.
        Arthroscopy. 2014; 30: 629-638
        • Hasani-Ranjbar S.
        • Soleymani Far E.
        • Heshmat R.
        • Rajabi H.
        • Kosari H.
        Time course responses of serum GH, insulin, IGF-1, IGFBP1, and IGFBP3 concentrations after heavy resistance exercise in trained and untrained men.
        Endocrine. 2012; 41: 144-151
        • Stelzer I.
        • Kropfl J.M.
        • Fuchs R.
        • et al.
        Ultra-endurance exercise induces stress and inflammation and affects circulating hematopoietic progenitor cell function.
        Scand J Med Sci Sports. 2015; 25: e442-e450
        • Marycz K.
        • Mierzejewska K.
        • Smieszek A.
        • et al.
        Endurance exercise mobilizes developmentally early stem cells into peripheral blood and increases their number in bone marrow: Implications for tissue regeneration.
        Stem Cells Int. 2016; 2016: 5756901
        • Bonsignore M.R.
        • Morici G.
        • Riccioni R.
        • et al.
        Hemopoietic and angiogenetic progenitors in healthy athletes: Different responses to endurance and maximal exercise.
        J Appl Physiol (1985). 2010; 109: 60-67
        • Baker J.M.
        • De Lisio M.
        • Parise G.
        Endurance exercise training promotes medullary hematopoiesis.
        FASEB J. 2011; 25: 4348-4357
        • Rochefort G.Y.
        • Delorme B.
        • Lopez A.
        • et al.
        Multipotential mesenchymal stem cells are mobilized into peripheral blood by hypoxia.
        Stem Cells. 2006; 24: 2202-2208
        • Wang Y.
        • Johnsen H.E.
        • Mortensen S.
        • et al.
        Changes in circulating mesenchymal stem cells, stem cell homing factor, and vascular growth factors in patients with acute ST elevation myocardial infarction treated with primary percutaneous coronary intervention.
        Heart. 2006; 92: 768-774
        • Drukala J.
        • Paczkowska E.
        • Kucia M.
        • et al.
        Stem cells, including a population of very small embryonic-like stem cells, are mobilized into peripheral blood in patients after skin burn injury.
        Stem Cell Rev. 2012; 8: 184-194
        • Rehman J.
        • Li J.
        • Parvathaneni L.
        • et al.
        Exercise acutely increases circulating endothelial progenitor cells and monocyte-/macrophage-derived angiogenic cells.
        J Am Coll Cardiol. 2004; 43: 2314-2318
        • Van Craenenbroeck E.M.
        • Vrints C.J.
        • Haine S.E.
        • et al.
        A maximal exercise bout increases the number of circulating CD34+/KDR+ endothelial progenitor cells in healthy subjects. Relation with lipid profile.
        J Appl Physiol (1985). 2008; 104: 1006-1013
        • Fox S.
        • Haskell W.
        The exercise stress test: Needs for standardization.
        in: Eliakim M. Neufeld H.N. Cardiology: Current topics and progress. Academic Press, New York1970: 149-154
        • Pollard Y.
        • Watts M.J.
        • Grant D.
        • Chavda N.
        • Linch D.C.
        • Machin S.J.
        Use of the haemopoietic progenitor cell count of the Sysmex SE-9500 to refine apheresis timing of peripheral blood stem cells.
        Br J Haematol. 1999; 106: 538-544
        • Vogel W.
        • Kopp H.G.
        • Kanz L.
        • Einsele H.
        Correlations between hematopoietic progenitor cell counts as measured by Sysmex and CD34+ cell harvest yields following mobilization with different regimens.
        J Cancer Res Clin Oncol. 2002; 128: 380-384
        • Yu J.
        • Leisenring W.
        • Fritschle W.
        • et al.
        Enumeration of HPC in mobilized peripheral blood with the Sysmex SE9500 predicts final CD34+ cell yield in the apheresis collection.
        Bone Marrow Transplant. 2000; 25: 1157-1164
        • DeLong J.M.
        • Russell R.P.
        • Mazzocca A.D.
        Platelet-rich plasma: The PAW classification system.
        Arthroscopy. 2012; 28: 998-1009
        • Campbell K.A.
        • Saltzman B.M.
        • Mascarenhas R.
        • et al.
        Does intra-articular platelet-rich plasma injection provide clinically superior outcomes compared with other therapies in the treatment of knee osteoarthritis? A systematic review of overlapping meta-analyses.
        Arthroscopy. 2015; 31: 2213-2221
        • Fitzpatrick J.
        • Bulsara M.
        • Zheng M.H.
        The effectiveness of platelet-rich plasma in the treatment of tendinopathy: A meta-analysis of randomized controlled clinical trials.
        Am J Sports Med. 2017; 45: 226-233
        • Diegelmann R.F.
        • Evans M.C.
        Wound healing: An overview of acute, fibrotic and delayed healing.
        Front Biosci. 2004; 9: 283-289
        • Morici G.
        • Zangla D.
        • Santoro A.
        • et al.
        Supramaximal exercise mobilizes hematopoietic progenitors and reticulocytes in athletes.
        Am J Physiol Regul Integr Comp Physiol. 2005; 289: R1496-R1503
        • Kucia M.J.
        • Wysoczynski M.
        • Wu W.
        • Zuba-Surma E.K.
        • Ratajczak J.
        • Ratajczak M.Z.
        Evidence that very small embryonic-like stem cells are mobilized into peripheral blood.
        Stem Cells. 2008; 26: 2083-2092
        • Gomperts B.N.
        • Belperio J.A.
        • Rao P.N.
        • et al.
        Circulating progenitor epithelial cells traffic via CXCR4/CXCL12 in response to airway injury.
        J Immunol. 2006; 176: 1916-1927
        • Kuznetsov S.A.
        • Mankani M.H.
        • Gronthos S.
        • Satomura K.
        • Bianco P.
        • Robey P.G.
        Circulating skeletal stem cells.
        J Cell Biol. 2001; 153: 1133-1140
        • Hamilton B.
        • Tol J.L.
        • Knez W.
        • Chalabi H.
        Exercise and the platelet activator calcium chloride both influence the growth factor content of platelet-rich plasma (PRP): Overlooked biochemical factors that could influence PRP treatment.
        Br J Sports Med. 2015; 49: 957-960
        • Chang E.
        • Paterno J.
        • Duscher D.
        • et al.
        Exercise induces stromal cell-derived factor-1alpha-mediated release of endothelial progenitor cells with increased vasculogenic function.
        Plast Reconstr Surg. 2015; 135: 340e-350e
        • Natale V.M.
        • Brenner I.K.
        • Moldoveanu A.I.
        • Vasiliou P.
        • Shek P.
        • Shephard R.J.
        Effects of three different types of exercise on blood leukocyte count during and following exercise.
        Sao Paulo Med J. 2003; 121: 9-14
        • Emmons R.
        • Niemiro G.M.
        • Owolabi O.
        • De Lisio M.
        Acute exercise mobilizes hematopoietic stem and progenitor cells and alters the mesenchymal stromal cell secretome.
        J Appl Physiol (1985). 2016; 120: 624-632
        • Mobius-Winkler S.
        • Hilberg T.
        • Menzel K.
        • et al.
        Time-dependent mobilization of circulating progenitor cells during strenuous exercise in healthy individuals.
        J Appl Physiol (1985). 2009; 107: 1943-1950
        • Peerschke E.I.
        • Moung C.
        • Pessin M.S.
        • Maslak P.
        Evaluation of new automated hematopoietic progenitor cell analysis in the clinical management of peripheral blood stem cell collections.
        Transfusion. 2015; 55: 2001-2009