Abstract
IntroductionPlatelet-rich plasma (PRP) is a fraction of plasma in which several growth factors are concentrated at high levels. The active soluble releasate isolated following platelet activation of PRP (PRP-releasate) has been demonstrated to stimulate the metabolism of IVD cells in vitro. The in vivo effect of PRP-releasate on degenerated IVD remains unknown. The purpose of this study was to determine the reparative effects of autologous PRP-releasate on degenerated intervertebral discs (IVDs).MethodsTo induce disc degeneration, New Zealand white rabbits (n = 12) received anular puncture in two noncontiguous discs. Autologous PRP and PPP (platelet-poor plasma) were isolated from fresh blood using two centrifugation techniques. Four weeks after the initial puncture, releasate isolated from clotted PPP or PRP (PPP- or PRP-releasate), or phosphate-buffered saline (PBS; control) was injected into the punctured discs. Disc height, magnetic resonance imaging (MRI) T2-mapping and histology were assessed.ResultsAnular puncture produced a consistent disc narrowing within four weeks. PRP-releasate induced a statistically significant restoration of disc height (PRP vs. PPP and PBS, P<0.05). In T2-quantification, the mean T2-values of the nucleus pulposus (NP) and anulus fibrosus (AF) of the discs were not significantly different among the three treatment groups. Histologically, the number of chondrocyte-like cells was significantly higher in the discs injected with PRP-releasate compared to that with PBS.ConclusionsThe administration of active PRP-releasate induced a reparative effect on rabbit degenerated IVDs. The results of this study suggest that the use of autologous PRP-releasate is safe and can lead to a clinical application for IVD degeneration.
Highlights
Platelet-rich plasma (PRP) is a fraction of plasma in which several growth factors are concentrated at high levels
The results of this study suggest that the use of autologous PRP-releasate is safe and can lead to a clinical application for intervertebral disc (IVD) degeneration
Radiographic assessment In all phosphate-buffered saline (PBS), platelet-poor plasma (PPP), and PRP groups, radiographs 4 weeks after the initial anular puncture showed a significant narrowing of disc height compared with that of the non-punctured L3/4 disc (Figure 2, see arrow)
Summary
Platelet-rich plasma (PRP) is a fraction of plasma in which several growth factors are concentrated at high levels. Many growth factors, such as transforming growth factor-b (TGF-b), insulin-like growth factor-1 (IGF-1), basic fibroblast growth factor, plateletderived growth factor (PDGF), epidermal growth factor (EGF), and bone morphogenetic protein (BMP)-2 and BMP-7 (otherwise known as osteogenic protein-1, or OP-1), have been shown to positively modulate the extracellular matrix of IVD cells (see review in [15]) In both in vitro and animal studies, autologous platelet-rich plasma (PRP), which contains concentrated levels of growth factors and other cytokines, has been shown to provide a ‘local environment for tissue regeneration’ [16]. The effective role of PRP on tissue repair or regeneration (or both) in a range of tissue types, including bone, cartilage, tendon, and muscle, has been reported (see review in [16])
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