scholarly journals Platelet Rich Plasma for Treatment of Rheumatoid Arthritis: Case Series and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Humeira Badsha ◽  
Ghita Harifi ◽  
William D. Murrell
Keyword(s):  
Rheumatoid Arthritis ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Treatment Options ◽  
Case Series ◽  
Synovial Cell ◽  
Joint Inflammation ◽  
Inadequate Response ◽  
Muscle Injuries ◽  
Cell Proliferation And Differentiation

Platelet-rich plasma (PRP) is an autologous blood product with platelets above circulating levels and releases several growth factors after activation. PRP may help to decrease joint inflammation by modulating synovial cell proliferation and differentiation and inhibition of catabolic pathways in various articular conditions. Though PRP has shown good efficacy in osteoarthritis and other musculoskeletal conditions such as synovitis, epicondylitis, skeletal muscle injuries, and tendinopathy, there is limited experience for the use of PRP in patients with rheumatoid arthritis. Precise mechanisms of action of PRP are not known. We present clinical experience for treatment with PRP (2–4 ml) in four patients with rheumatoid arthritis who had inadequate response and persistent pain and inflammation with intra-articular steroids. Irrespective of past and ongoing treatments and duration of disease, all patients showed improvement in the visual analog scale and disease activity score of 28 joints at 4 and 8 weeks after injection. There was an improvement in joint inflammation on ultrasound imaging in some patients. These effects were sustained for up to 1 year. No adverse effects were reported in any patient. PRP may be a safe and useful therapy in patients with rheumatoid arthritis who fail to respond to one or more established treatment options.

Evaluating the efficacy of intra-articular injections of platelet rich plasma (PRP) in rheumatoid arthritis patients and its impact on inflammatory cytokines, disease activity and quality of life.

2020 ◽  
Vol 16 ◽  
Author(s):  
Dalia S. Saif ◽  
Nagwa N. Hegazy ◽  
Enas S. Zahran
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Cytokines ◽  
Platelet Rich Plasma ◽  
Joint Inflammation ◽  
Monthly Interval ◽  
Post Injection ◽  
Tnf Α

Background: Among rheumatoid arthritis patients (RA), general disease activity is well regulated by diseasemodifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B , TNF α, local joint inflammation, disease activity and quality of life (QL). Methods: Open labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, 6 months post injection. Results: Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. Conclusions: PRP is a safe, effective and useful therapy in treating RA patients who had insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.

Foot and Ankle Injections in Athletes

2021 ◽  
pp. 194173812110036
Author(s):  
Jonathan K. Ochoa ◽  
Christopher E. Gross ◽  
Robert B. Anderson ◽  
Andrew R. Hsu
Keyword(s):  
English Language ◽  
Platelet Rich Plasma ◽  
Empirical Studies ◽  
Autologous Blood ◽  
Case Series ◽  
Placental Tissue ◽  
Ankle Injuries ◽  
Extensive Literature ◽  
Foot And Ankle ◽  
Level Of Evidence

Context: Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety. Evidence Acquisition: An extensive literature review was performed through MEDLINE, Google Scholar, and EBSCOhost from database inception to 2021. Keywords searched were injections, athletes, sports, foot and ankle, corticosteroids, platelet-rich plasma, and placental tissue. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. Study Design: Clinical review. Level of Evidence: Level 4. Results: Corticosteroids, platelet-rich plasma/autologous blood, anesthetic, and placental tissue injections are commonly used in the treatment of foot and ankle injuries. Primary indications for injections in athletes include plantar fasciitis, Achilles tendinosis, isolated syndesmotic injury, and ankle impingement with varying clinical results. Conclusions: Despite promising results from limited case series and comparative studies, the data for safety and efficacy of injections for foot and ankle injuries in athletes remain inconclusive.

scholarly journals Fibroblast Like Synovial Cell Subsets in Rheumatoid Arthritis

2021 ◽  
Author(s):  
Søren Lomholt ◽  
Morten A. Nielsen ◽  
Maithri P. Aspari ◽  
Peter B. Jørgensen ◽  
Adam P. Croft ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cartilage Damage ◽  
Joint Destruction ◽  
Human Leukocyte ◽  
Synovial Cell ◽  
Joint Inflammation ◽  
Nuclear Factor Κb ◽  
Sequencing Studies ◽  
Sublining Layer ◽  
Lymphoid Structures

Fibroblasts like synoviocytes (FLS) play several significant roles in rheumatoid arthritis (RA) pathophysiology. This chapter will describe known roles of FLS in disease initiation, joint inflammation, disease persistence and joint destruction. It will describe the newly characterized subsets of FLS based on single cell RNA sequencing studies, and their association to specific aspects of the disease. Finally, we will discuss the future of targeting FLS in the treatment of RA. The FLS in the synovial lining layer are identified by surface complement decay-accelerating factor (CD55) along with lubricin and metallopeptidase expression. Pathological activation of this lining layer subset result in bone and cartilage damage in mice. FLS of the sublining layer are often characterized by THY1 expression, but recent studies have highlighted a heterogeneity where several distinct subsets are identified by additional markers. Sublining FLS expressing human leukocyte antigen-DRA (HLA-DRA) produce C-X-C motif chemokine 12 (CXCL12) and receptor activator of nuclear factor-κB ligand (RANKL) and seems to constitute a pro-inflammatory subset that is associated with inflammation and tertiary lymphoid structures. Another subset of FLS characterized by CD34 expression may discriminate a common progenitor fibroblast subset. Taken together, studies isolating and characterizing gene expression in synovial FLS report both associations of unknown importance and markers that may impose protective or destructive features. This supports evidence of FLS as active players in RA pathology capable of cellular recruitment, local cellular crosstalk and promotion of joint destruction. These discoveries may serve as an atlas for synovial activation in RA and have identified several potential fibroblast markers for the development of targeted treatment.

scholarly journals Application of platelet-rich plasma for canine osteoarthritis treatment - a clinical series

2021 ◽  
Vol 24 (4) ◽  
pp. 601-607
Author(s):  
K. B Aminkov ◽  
N. H. Mehandzhiyski ◽  
B. Y. Aminkov ◽  
N. Z. Zlateva-Panayotova
Keyword(s):  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Case Series ◽  
Brief Pain Inventory ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Knee Joints ◽  
Radiographic Findings ◽  
Clinical Series ◽  
Osteoarthritis Treatment

Osteoarthritis, also known as degenerative joint disease (DJD), is defined as a progressive and permanent long-term deterioration of the cartilage surrounding the joints. There is no known cause for primary DJD. However, there are a wide variety of causes for secondary DJD, such as trauma, abnormal wear of joints and cartilage, or a congenital defect present at birth such as an improperly formed hip. One of the most popular methods used to biologically enhance healing in the fields of orthopaedic surgery and medicine includes the use of autologous blood products, namely, platelet rich plasma (PRP). Reports suggest that PRP, presumably containing high levels of platelet growth factors, may promote the recovery of the affected cartilage. This case series presents clinical and radiographic findings of three dogs with osteoarthritis of the elbow and knee joints. Pain score were assessed by CBPI (Canine Brief Pain Inventory). Treatment with three-fold intra-articular application of PRP, obtained by double centrifugation method, resulted in significant improvement in the function of the affected joint. Therefore, it could be concluded that PRP was clinically effective in the treatment of osteoarthritis in these three cases.

scholarly journals Effectiveness of intra-articular therapies in osteoarthritis: a literature review

2017 ◽  
Vol 9 (8) ◽  
pp. 183-196 ◽  
Author(s):  
Peter Wehling ◽  
Christopher Evans ◽  
Jana Wehling ◽  
William Maixner
Keyword(s):  
Literature Review ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Treatment Options ◽  
Evidence Base ◽  
European Medicines Agency ◽  
Blood Products ◽  
Autologous Conditioned Serum ◽  
Health And Social Care ◽  
Care Systems

Osteoarthritis is a painful, chronic disease with widespread burden on patients, communities, health and social care systems. Conservative therapies, such as nonpharmacological interventions, systemic drug treatment and intra-articular therapies are used before resorting to surgery; nonetheless, disease control often remains inadequate. Recent advances in osteoarthritis management have aimed to provide greater variety of treatment options. Here, we summarize a targeted literature review evaluating efficacy and safety of intra-articular therapies for osteoarthritis. Injections of intra-articular therapies directly into the joint avoid conventional barriers to joint entry, increase bioavailability and lower systemic toxicity. Intra-articular corticosteroids and hyaluronic acid are established United States Food and Drug Administration (US FDA)/European Medicines Agency (EMA)-approved treatments; however, concerns exist regarding effect duration, safety, effectiveness across populations and heterogeneity. Newer therapies, such as autologous blood products and mesenchymal stem cells, are in development. Benefits of autologous blood products (e.g. platelet-rich plasma, autologous conditioned serum) include an expected improved safety profile and direct targeting of osteoarthritis-related pathophysiology. Autologous conditioned serum is cell-free and manufactured by a standardized process, whereas platelet-rich plasma composition and characteristics can vary. Currently, only limited efficacy comparisons between these biological treatments can be drawn; long-term clinical and safety studies are needed to increase the efficacy evidence base and earn consideration in treatment frameworks.

scholarly journals Platelet rich plasma application in chronic low back pain – clinical and anatomical rationale and review of the literature

2019 ◽  
pp. 27-41
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Case Series ◽  
Intervertebral Discs ◽  
Biologically Active ◽  
Common Symptom ◽  
Low Back

Low back pain (LBP) is an extremely common symptom in populations of all ages with significant economic and social burden worldwide. As such it should be among the priorities for trying to find more efficient methods for prevention and treatment. Currently the exact cause for the complaints can be found in most of the cases following thorough clinical examination, adequate diagnostic tests and modern image diagnosis. Most often the complaints are cause by degenerative processes affecting certain structures in the lumbosacral area – the intervertebral discs, the tendons/entheses along the iliac crest, the sacroiliac and lumbar facet joints. Platelet rich plasma (PRP) is a widely used therapeutic method aimed at recovering (both anatomical and functional) degenerative or traumatic damaged collagen tissues by injecting/applying autologous blood concentrate, rich in growth factors and other biologically active molecules. PRP demonstrates huge potential in stimulating cell proliferation and metabolic activity in vitro. Trials with animals show/prove the full recovery of the structural changes and the matrix integrity of the damaged tissue. In recent years some prospective clinical studies and published case series report that PRP could be a safe and efficient therapy for patients with chronic low back pain that do not yield to traditional/standard treatment options. Data though limited/scarce for the time being includes/covers the most common cause for this complaint, namely pathology of the intervertebral discs, facet and sacroiliac joints, as well as paraspinal soft tissues. The possibility for precise intralesional application of this regeneration autologous product in the damaged tissue gives it a huge advantage over the common algorithms currently used in the clinical practice to treat patients with such complaints. Future bigger studies including image methods to evaluate the structural recovery of the degenerative changed tissue responsible/blamed for the pain and functional deficit would bring light to the place PRP therapy should take in the treatment of low back pain.

Biological Basis of Treatments of Acute Muscle Injuries: A Short Review

2020 ◽  
Vol 24 (03) ◽  
pp. 256-261
Author(s):  
Ian Beggs
Keyword(s):  
Physical Therapy ◽  
Local Anesthetics ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Professional Sports ◽  
Early Mobilization ◽  
Short Review ◽  
Muscle Injuries ◽  
Inflammatory Drugs ◽  
Biological Context

AbstractMuscle strains occur frequently in recreational and professional sports. This article considers various treatment options in a biological context and reviews evidence of their efficacy. Treatments reviewed include the PRICE principle (Protection, Rest, Ice, Compression, Elevation), early mobilization, physical therapy, hematoma aspiration, platelet-rich plasma injections, use of nonsteroidal anti-inflammatory drugs, corticosteroids, and local anesthetics, cellular therapies, and surgery.

scholarly journals Effective Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease by B-Cell Targeted Therapy with Rituximab

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Wolfgang Hartung ◽  
Judith Maier ◽  
Michael Pfeifer ◽  
Martin Fleck
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
B Cell ◽  
Treatment Options ◽  
Joint Inflammation ◽  
Dmard Therapy ◽  
Sustained Improvement ◽  
Minute Walk

Rheumatoid arthritis- (RA-) associated interstitial lung disease (RA-ILD) is the extra-articular complication with most adverse impact on the quality of life and survival in RA patients. However, treatment options are limited and controlled studies are lacking. Here, we present the case of a 66-year-old patient suffering from severe RA-ILD, which has been successfully treated with Rituximab (RTX). After failure of conventional DMARD therapy, our patient showed sustained improvement of clinical pulmonary parameters as well as joint inflammation following B-cell depletion with RTX. The six-minute-walk test improved from 380 meters to 536 meters and the forced vital capacity from 2.49 liters to 3.49. The disease activity score could be reduced from 7.7 to 2.8. Therefore, RTX might be considered as an alternative treatment for RA-ILD in patients not responding to conventional DMARD therapy.

scholarly journals A Case Series on Natural Conceptions Resulting in Ongoing Pregnancies in Menopausal and Prematurely Menopausal Women Following Platelet-Rich Plasma Treatment

2019 ◽  
Vol 28 (9-10) ◽  
pp. 1333-1340 ◽  
Author(s):  
Konstantinos Pantos ◽  
Mara Simopoulou ◽  
Agni Pantou ◽  
Anna Rapani ◽  
Petroula Tsioulou ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Case Series ◽  
Oocyte Donation ◽  
Menopausal Woman ◽  
Vitro Fertilization ◽  
Menopausal Women ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Since the introduction of autologous platelet-rich plasma (PRP) in medical practice, various studies have documented that implementing PRP can enhance healing and the anti-aging process, employing angiogenesis regeneration due to the multiple growth factors and cytokines involved. Numerous reports have shown promising results with the use of PRP in ovarian treatment, regarding ovarian regeneration and reactivation of folliculogenesis. This case series reports on two women with premature ovarian failure (POF) aged 40 and 27 years, respectively, and one menopausal woman aged 46 years. All patients presented with lack of menstrual cycle for over a year. The women reported previous failed in vitro fertilization (IVF) attempts, and, after rejecting the option of oocyte donation, they opted for the approach of autologous ovarian PRP treatment. Following PRP treatment, the three patients were invited to conceive naturally. The primary outcome was the restoration of menstruation following autologous ovarian PRP treatment, as well as an improvement in hormonal profile, a decrease in follicle-stimulating hormone (FSH) levels, and a concurrent increase in anti-Müllerian hormone (AMH) levels. Further to that, our patients achieved pregnancy through natural conception within 2–6 months following PRP treatment, resulting in currently ongoing complication-free clinical pregnancies – a first report in the literature for menopausal and POF patients. Implementation of PRP should be further investigated through randomized controlled trials (RCTs), as it may hold the key to successful treatment for a certain cohort of patients exploring reproductive treatment options following menopause.

Evaluation of anti-arthritic effect of Torilis leptophylla and its comparison with indomethacin

2020 ◽  
Vol 14 (1) ◽  
pp. 25-29
Author(s):  
Javaria Fatima ◽  
Bushra Shaheen ◽  
Saba Batool ◽  
Tooba Malik ◽  
Sheikh Maria Qammar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Options ◽  
Joint Inflammation ◽  
Positive Control ◽  
Control Group ◽  
P Value ◽  
Standard Drug ◽  
Inflammatory Parameters ◽  
Group I ◽  
Anti Inflammatory

Background: Rheumatoid arthritis is an autoimmune debilitating disease involving multiple joints and organs. Many treatment options are available but all are associated with frequent side effects. Phytochemical screening of Torilis leptophylla has shown the presence of anti-inflammatory compounds like flavonoids, phenols and anthraquinones. This study was designed to evaluate its effect on joints inflammation (rheumatoid arthritis). Indomethacin is one of the oldest and most commonly used drugs for arthritis. It was used as a standard drug to compare with indomethacin. Methods: This experimental study was carried out in Pharmacology Department, University of Health Sciences, Lahore. Thirty six male albino Wistar rats were randomly divided into six groups (group I-control, group II-positive control, group III-10 mg indomethacin, group IV,V,VI--100mg, 200mg, 300mg Torilis leptophylla extract (TLE) administered (orally) respectively). Arthritis was induced by sub plantar injection of 0.1 ml Freund’s complete adjuvant (FCA) to all groups except the control group. Body weight (weekly) and ankle joint diameter (every 4th day) were measured. At day 29 blood was collected and all animals were killed by overdose of ether. Acid phosphatase and alkaline phosphatase levels were determined by chemistry analyzer (RX MONZA, RANDOX, Republic of Ireland). Statistical analysis was performed using SPSS 20. One way ANOVA and Post hoc -Tukey tests were applied. A p-value of ≤0.05 was considered statistically significant. Results: Treatment with indomethacin caused significant (p≤0.001) reduction in all the inflammatory parameters. Torilis leptophylla extract also significantly (p≤0.05) reduced all the inflammatory parameters. Anti-inflammatory effect was comparable to indomethacin. Conclusion: Torilis leptophylla has significant anti-arthritic activity as it modified the parameters of joint inflammation and destruction.

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