scholarly journals The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis

2021 ◽  
Vol 22 (11) ◽  
pp. 5492
Author(s):  
Dawid Szwedowski ◽  
Joanna Szczepanek ◽  
Łukasz Paczesny ◽  
Jan Zabrzyński ◽  
Maciej Gagat ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Operative Treatment ◽  
Animal Studies ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Treatment Protocols ◽  
Metabolic Functions ◽  
Inflammatory Drugs ◽  
Positive Effect

Knee osteoarthritis (KOA) represents a clinical challenge due to poor potential for spontaneous healing of cartilage lesions. Several treatment options are available for KOA, including oral nonsteroidal anti-inflammatory drugs, physical therapy, braces, activity modification, and finally operative treatment. Intra-articular (IA) injections are usually used when the non-operative treatment is not effective, and when the surgery is not yet indicated. More and more studies suggesting that IA injections are as or even more efficient and safe than NSAIDs. Recently, research to improve intra-articular homeostasis has focused on biologic adjuncts, such as platelet-rich plasma (PRP). The catabolic and inflammatory intra-articular processes that exists in knee osteoarthritis (KOA) may be influenced by the administration of PRP and its derivatives. PRP can induce a regenerative response and lead to the improvement of metabolic functions of damaged structures. However, the positive effect on chondrogenesis and proliferation of mesenchymal stem cells (MSC) is still highly controversial. Recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, significant progress has been made in understanding the mechanism of PRP action. In this review, we will discuss mechanisms related to inflammation and chondrogenesis in cartilage repair and regenerative processes after PRP administration in in vitro and animal studies. Furthermore, we review clinical trials of PRP efficiency in changing the OA biomarkers in knee joint.

scholarly journals Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

2020 ◽  
Author(s):  
Peter Everts ◽  
Kentaro Onishi ◽  
Prathap Jayaram ◽  
José Fábio Lana ◽  
and Kenneth Mautner
Keyword(s):  
Tissue Repair ◽  
Animal Studies ◽  
Platelet Rich Plasma ◽  
Unmet Need ◽  
Treatment Protocols ◽  
Rehabilitation Protocols ◽  
Recent Developments ◽  
Treatment Plans ◽  
New Research

Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

scholarly journals Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

2020 ◽  
Vol 21 (20) ◽  
pp. 7794
Author(s):  
Peter Everts ◽  
Kentaro Onishi ◽  
Prathap Jayaram ◽  
José Fábio Lana ◽  
Kenneth Mautner
Keyword(s):  
Tissue Repair ◽  
Animal Studies ◽  
Platelet Rich Plasma ◽  
Unmet Need ◽  
Treatment Protocols ◽  
Rehabilitation Protocols ◽  
Recent Developments ◽  
Treatment Plans ◽  
New Research

Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

scholarly journals Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines

2021 ◽  
Vol 14 (3) ◽  
pp. 205
Author(s):  
Dragan Primorac ◽  
Vilim Molnar ◽  
Vid Matišić ◽  
Damir Hudetz ◽  
Željko Jeleč ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Symptom Relief ◽  
Topical Administration ◽  
Symptomatic Therapy ◽  
Therapy Options ◽  
Professional Societies ◽  
Inflammatory Drugs ◽  
The Right

Osteoarthritis is the most common musculoskeletal progressive disease, with the knee as the most commonly affected joint in the human body. While several new medications are still under research, many symptomatic therapy options, such as analgesics (opioid and non-opioid), nonsteroid anti-inflammatory drugs, symptomatic slow-acting drugs in osteoarthritis, and preparations for topical administration, are being used, with a diverse clinical response and inconsistent conclusions across various professional societies guidelines. The concept of pharmacogenomic-guided therapy, which lies on principles of the right medication for the right patient in the right dose at the right time, can significantly increase the patient’s response to symptom relief therapy in knee osteoarthritis. Corticosteroid intra-articular injections and hyaluronic acid injections provoke numerous discussions and disagreements among different guidelines, even though they are currently used in daily clinical practice. Biological options, such as platelet-rich plasma and mesenchymal stem cell injections, have shown good results in the treatment of osteoarthritis symptoms, greatly increasing the patient’s quality of life, especially when combined with other therapeutic options. Non-inclusion of the latter therapies in the guidelines, and their inconsistent stance on numerous therapy options, requires larger and well-designed studies to examine the true effects of these therapies and update the existing guidelines.

scholarly journals Oxidative Stress as a Possible Target in the Treatment of Toxoplasmosis: Perspectives and Ambiguities

2021 ◽  
Vol 22 (11) ◽  
pp. 5705
Author(s):  
Karolina Szewczyk-Golec ◽  
Marta Pawłowska ◽  
Roland Wesołowski ◽  
Marcin Wróblewski ◽  
Celestyna Mila-Kierzenkowska
Keyword(s):  
Oxidative Stress ◽  
Animal Studies ◽  
Treatment Options ◽  
Natural Antioxidants ◽  
Redox Status ◽  
Host Cells ◽  
Common Disease ◽  
Parasite Viability

Toxoplasma gondii is an apicomplexan parasite causing toxoplasmosis, a common disease, which is most typically asymptomatic. However, toxoplasmosis can be severe and even fatal in immunocompromised patients and fetuses. Available treatment options are limited, so there is a strong impetus to develop novel therapeutics. This review focuses on the role of oxidative stress in the pathophysiology and treatment of T. gondii infection. Chemical compounds that modify redox status can reduce the parasite viability and thus be potential anti-Toxoplasma drugs. On the other hand, oxidative stress caused by the activation of the inflammatory response may have some deleterious consequences in host cells. In this respect, the potential use of natural antioxidants is worth considering, including melatonin and some vitamins, as possible novel anti-Toxoplasma therapeutics. Results of in vitro and animal studies are promising. However, supplementation with some antioxidants was found to promote the increase in parasitemia, and the disease was then characterized by a milder course. Undoubtedly, research in this area may have a significant impact on the future prospects of toxoplasmosis therapy.

scholarly journals In vitro responses to platelet-rich-plasma are associated with variable clinical outcomes in patients with knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Habib Zahir ◽  
Bijan Dehghani ◽  
Xiaoning Yuan ◽  
Yurii Chinenov ◽  
Christine Kim ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Inflammatory Responses ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Limited Information ◽  
Knee Oa ◽  
Patient Reported ◽  
Treatment Comparisons

AbstractAutologous blood-derived products such as platelet-rich plasma (PRP) are widely used to treat musculoskeletal conditions, including knee osteoarthritis (OA). However, the clinical outcomes after PRP administration are often variable, and there is limited information about the specific characteristics of PRP that impact bioactivity and clinical responses. In this study, we aimed to develop an integrative workflow to evaluate responses to PRP in vitro, and to assess if the in vitro responses to PRP are associated with the PRP composition and clinical outcomes in patients with knee OA. To do this, we used a coculture system of macrophages and fibroblasts paired with transcriptomic analyses to comprehensively characterize the modulation of inflammatory responses by PRP in vitro. Relying on patient-reported outcomes and achievement of minimal clinically important differences in OA patients receiving PRP injections, we identified responders and non-responders to the treatment. Comparisons of PRP from these patient groups allowed us to identify differences in the composition and in vitro activity of PRP. We believe that our integrative workflow may enable the development of targeted approaches that rely on PRP and other orthobiologics to treat musculoskeletal pathologies.

Non-operative treatment options for knee osteoarthritis: current concepts

2018 ◽  
Vol 3 (5) ◽  
pp. 274-281
Author(s):  
David A Parker ◽  
Corey Scholes ◽  
Thomas Neri
Keyword(s):  
Knee Osteoarthritis ◽  
Operative Treatment ◽  
Treatment Plan ◽  
Treatment Options ◽  
Primary Care Providers ◽  
Care Plan ◽  
Care Providers ◽  
Coordinated Care ◽  
Management Options ◽  
Functional Benefit

Knee osteoarthritis in younger patients can be a challenging condition to manage. The patient and clinician have a range of non-operative management options available, although the guidance to effectively apply these options is lacking. The following review summarises a range of non-operative treatment options as an accessible reference for primary care providers to establish a coordinated care plan in consultation with the patient as part of a shared decision making process. Options are summarised in non-pharmacological and pharmacological treatments. These options are based on the latest guidelines based on authoritative recommendations, as well as recent articles with a good level of evidence that have not yet been incorporated into these official contents. The coordination of treatment using a range of modalities remains poorly explained in the literature and the current review proposes a conceptual model for coordinated care to be provided. In this model, the patient is central to the interaction between the coordinator and specialist providers, and the treatment plan is tailored to provide the optimal pain relief and functional benefit specific to the patient.

Cellular transplantation and platelet-rich plasma injections for discogenic pain: a contemporary review

2021 ◽  
Author(s):  
Brian Fiani ◽  
Alden Dahan ◽  
Mohamed H El-Farra ◽  
Michael W Kortz ◽  
Juliana M Runnels ◽  
...  
Keyword(s):  
Animal Studies ◽  
Chronic Back Pain ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Intervertebral Discs ◽  
Disc Disease ◽  
Discogenic Pain ◽  
Cellular Transplantation ◽  
New Treatment ◽  
Growth Factor Therapy

Degenerative disc disease (DDD) is the leading cause of chronic back pain. It is a pathologic condition associated with aging and is believed to result from catabolic excess in the intervertebral discs’ (IVD) extracellular matrix. Two new treatment options are intradiscal cellular transplantation and growth factor therapy. Recent investigations on the use of these therapies are discussed and compared with emerging evidence supporting novel cellular injections. At present, human and animal studies provide a compelling rationale for the use of cellular injections in the treatment of discogenic pain. Since DDD results from the IVD extracellular matrix’s unmitigated catabolism, cellular injections are used to induce regeneration and homeostasis in the IVD. Here, we review intervertebral disc anatomy, DDD pathophysiology and clinical considerations, as well as the current and emerging literature investigating outcomes associated with cellular transplantation and platelet-rich plasma for discogenic pain. Further high-quality trials are certainly warranted.

scholarly journals Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Genes ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 854
Author(s):  
Dragan Primorac ◽  
Vilim Molnar ◽  
Eduard Rod ◽  
Željko Jeleč ◽  
Fabijan Čukelj ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Stromal Vascular Fraction ◽  
Disease Stage ◽  
Knee Oa ◽  
Marrow Mesenchymal Stem Cells ◽  
The Moment ◽  
And Function ◽  
Orthopedic Patients

Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.

scholarly journals Practical Islamic and Research Ethics: The Use of Animal Model in Orthopaedic Research

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Nurul Hafiza Mohd Jan ◽  
Ahmad Hafiz Zulkifly ◽  
Mohd Zulfadzli Ibrahim
Keyword(s):  
Animal Models ◽  
Animal Studies ◽  
Treatment Options ◽  
Practical Application ◽  
Ethical Guidelines ◽  
Islamic Ethics ◽  
Mortality And Morbidity ◽  
Orthopaedic Research ◽  
Animal Use

Introduction: The growing of mortality and morbidity that are related to orthopaedic cases have contributed to the development and innovation of technology which actively seeks for the best treatment options. In order to achieve the goal, animal models have been used as a bridge from in vitro to the clinical study to provide insights both as a precursor and beneficial to human-based research. Many animal models have been developed to investigate bone regeneration, pathological changes and reparation. Besides, animal models are used more commonly in orthopaedic innovation and development. Through the practical application of the 5Rs (reduction, refinement, replacement, reproducibility and responsibility) principles that correlate with the Islamic ethics in this research, this study aimed to provide an ultimate ethical standard on animal use in orthopaedic research. Besides the texts of the Qur’an and the prophetic narrations (hadith), both Muslim jurists (fuqaha) and ethicists’ relevant opinion on these matters would be unveiled. As from the Islamic viewpoints, the usage of animal is permittable for scientific research purposed within the permissible limits described by the  Shari’ah  and guided by ethical values derived from the Divine Revelations (al-wahy al-Ilahyi). By practising the guidelines, it is hoped that these ethical guidelines will help to educate the Muslim scholars and researchers to substantive improvements in terms of quality and the ethical standards of animal studies in orthopaedic research.

scholarly journals Synthesis and Photothermal Effects of Intracellular Aggregating Nanodrugs Targeting Nasopharyngeal Carcinoma

2021 ◽  
Vol 9 ◽  
Author(s):  
Ying Zhong ◽  
Naveen Kumar Bejjanki ◽  
Xiangwan Miao ◽  
Huanhuan Weng ◽  
Quanming Li ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cancer Cells ◽  
Laser Irradiation ◽  
Animal Studies ◽  
Near Infrared ◽  
Folate Receptor ◽  
Treatment Options ◽  
Iron Oxide Nanoparticle ◽  
Local Concentration

Chemotherapy for the treatment of nasopharyngeal carcinoma (NPC) is usually associated with many side effects; therefore, its treatment options have not yet been completely resolved. Improving distribution to the targeted tumor region and enhancing the cellular uptake of drugs can efficiently alleviate the above adverse medical effects. Near-infrared (NIR) laser light-mediated photothermal therapy (PTT) and photodynamic therapy (PDT) are promising strategies for cancer treatment. In the present study, we developed an efficient multifunctional nanocluster with enhanced targeting and aggregation efficiency for PTT and PDT that is composed of a biocompatible folic acid (FA), indocyanine green (ICG) and 2-cyanobenzothiazole (CBT)-functionalized peptide labeled with an aldehyde sodium alginate-modified magnetic iron oxide nanoparticle (ASA-MNP)-based nanocarrier. FA can bind to folate receptors on cancer cell membranes to enhance nanocluster uptake. CBT-modified peptide can react with glutathione (GSH), which is typically present at higher levels in cancer cells, to form intracellular aggregates and increase the local concentration of the nanodrug. In in vitro studies, these nanodrugs displayed the desired uptake capacity by NPC cells and the ability to suppress the growth of cancer cells under laser irradiation. Animal studies validated that these nanodrugs are safe and nontoxic, efficiently accumulate in NPC tumor sites following injection via the caudal vein, and shows superior inhibition of tumor growth in a tumor-bearing mouse model upon near-infrared laser irradiation. The results indicate the potential application of the multifunctional nanoparticles (NPs), which can be used as a new method for the treatment of folate receptor-positive NPC.

Sign in / Sign up

Export Citation Format

Share Document