Abstract
BackgroundPlatelet-rich plasma (PRP) is widely used to treat tendon injuries. Its therapeutic effect varies depending on the different cell components, and white blood cells (WBCs) may play an important role in this phenomenon. The purpose of this study was to evaluate how PRP with different concentrations of WBCs affect normal rabbit tendon and assess whether non-steroidal anti-inflammatory drugs (NSAIDs) can suppress the catabolic effects of WBCs.MethodsSixteen adult New Zealand White rabbits were used. Blood samples were collected from each rabbit, and PRP was extracted following two different protocols to obtain leukocyte-poor PRP (LP-PRP) and leukocyte-rich PRP (LR-PRP). LP-PRP or LR-PRP was injected into the patellar tendon of each rabbit, while normal saline (NS) was injected as control. In LR-PRP + NSAID group, Parecoxib was administered after LR-PRP injection. For each group, 2 rabbits were euthanatized at day 5 and 14. The patellar tendons were collected and stained with hematoxylin and eosin. A semi-quantitative approach was used to assess the inflammatory response and tendon destruction based on the evaluation of the WBCs, vascularization, fiber structure, and fibrosis.ResultsThe LR-PRP group exhibited a higher total tendon score than the LP-PRP group at day 5 after PRP injection, but there was no significant difference between the two groups at day 14. For the NSAID group, the tendon score was lower than that of the LR-PRP group both at day 5 and 14.ConclusionLR-PRP can promote a higher inflammatory response than LP-PRP in the normal rabbit patellar tendon, and this effect can be suppressed by NSAIDs.
Highlights
Platelet-rich plasma (PRP) is widely used to treat tendon injuries
Analysis of autologous blood product Compared to whole blood (WB), leukocyte-poor PRP (LP-PRP) (2.06-fold) and Leukocyte-rich PRP (LR-PRP) (2.96-fold) had a higher platelet concentration; LR-PRP had a higher concentration of platelets and white blood cells (WBCs) compared to LP-PRP
The most important finding of the study was that leukocyte-rich PRP (LRPRP), which contained a higher concentration of WBCs compared to LP-PRP, induced a higher inflammation reaction in normal rabbit tendon and this effect could be alleviated by administration of non-steroidal anti-inflammatory drugs (NSAIDs) both in acute (5 days) and chronic (14 days) phase
Summary
Platelet-rich plasma (PRP) is widely used to treat tendon injuries. Its therapeutic effect varies depending on the different cell components, and white blood cells (WBCs) may play an important role in this phenomenon. The purpose of this study was to evaluate how PRP with different concentrations of WBCs affect normal rabbit tendon and assess whether non-steroidal anti-inflammatory drugs (NSAIDs) can suppress the catabolic effects of WBCs. Platelet-rich plasma (PRP) is characterized by a high concentration of platelets, and is prepared by centrifuging autologous whole blood samples collected with anticoagulants. PRP is rich in autologous growth factors, including the transforming growth factor (TGF-β1), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF). These growth factors have the potential to stimulate the. A non-steroidal anti-inflammatory drug (NSAID), which is often used for postoperative pain management, selectively inhibits the activity of cyclooxygenase-2 (COX-2), and could be useful to control inflammation in the PRP-based treatment of tendon injuries [15, 16]
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