Purpose
To investigate the composition and concentration of growth factors and cytokines in
platelet-rich plasma (PRP) with knee osteoarthritis and to explore the association
of the concentration of growth factors and cytokines with the platelet count of PRPs.
Methods
Patients who visited outpatient clinic with symptomatic knee osteoarthritis (Kellgren-Lawrence
grades 1 to 3) and had no blood dyscrasia were enrolled from October 2014 to March
2015. PRPs were obtained using a commercial system. Concentrations of growth factors
and cytokines were measured with an enzyme-linked immunosorbent assay. Anabolic factors
(platelet-derived growth factor [PDGF]-AA, -BB, and -AB, transforming growth factor-β,
vascular endothelial growth factor [VEGF], epidermal growth factor [EGF], basic fibroblast
growth factor [bFGF], and insulin-like growth factor 1), catabolic factors (interleukin
[IL]-1β and matrix metalloproteinase 13), and catabolic blockers (IL-1 receptor antagonist)
were included. The degree of variation was determined by coefficient of variation
(CoV).
Results
105 patients were included. Growth factors and cytokines showed wide variation. bFGF
showed the highest variation (CoV 78.45), and transforming growth factor-β1 showed
the lowest variation (CoV 5.30). Platelet count in PRP showed a positive correlation
with PDGF-BB and -AB, and VEGF (r = 0.270, P = .005; r = 0.231, P = .018; and r = 0.200, P = .041, respectively) and was negatively correlated with IL-1β (r = –0.220, P = .025).
Conclusion
Growth factors and cytokines in PRPs obtained from patients with knee osteoarthritis
show a wide variation; the highest variation was shown in bFGF. Platelet counts associated
positively with PDGF-AB and -BB and VEGF and negatively with IL-1β.
Clinical Relevance
This information leads to the concept that variation and association of specific factors
needs to be taken into consideration for future investigations of PRPs in clinical
application in patients with knee osteoarthritis.
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Article info
Publication history
Accepted:
April 7,
2019
Received:
June 17,
2018
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
See commentary on page 2885
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Platelet-Rich Plasma or Profit-Rich Placebo: Variability of Composition, Concentration, Preparation, and Many Other Yet-Unknown Factors Determine EffectivenessArthroscopyVol. 35Issue 10
- PreviewPlatelet-rich plasma (PRP) frequently is used in orthopaedics, and its application is supported by clinical studies for a variety of conditions. For knee osteoarthritis, it is more effective than hyaluronic acid, providing significant better pain relief and functional improvement. However, different compositions of PRP, absolute platelet counts, and many other physiological and demographic variables will influence the effectiveness. Variability of the composition of the ingredients of PRP surely has a substantial influence on outcome.
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