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Platelet-rich plasma: a milieu of bioactive factors.

Abstract

Platelet concentrates such as platelet-rich plasma (PRP) have gained popularity in sports medicine and orthopaedics to promote accelerated physiologic healing and return to function. Each PRP product varies depending on patient factors and the system used to generate it. Blood from some patients may fail to make PRP, and most clinicians use PRP without performing cell counts on either the blood or the preparation to confirm that the solution is truly PRP. Components in this milieu have bioactive functions that affect musculoskeletal tissue regeneration and healing. Platelets are activated by collagen or other molecules and release growth factors from alpha granules. Additional substances are released from dense bodies and lysosomes. Soluble proteins also present in PRP function in hemostasis, whereas others serve as biomarkers of musculoskeletal injury. Electrolytes and soluble plasma hormones are required for cellular signaling and regulation. Leukocytes and erythrocytes are present in PRP and function in inflammation, immunity, and additional cellular signaling pathways. This article supports the emerging paradigm that more than just platelets are playing a role in clinical responses to PRP. Depending on the specific constituents of a PRP preparation, the clinical use can theoretically be matched to the pathology being treated in an effort to improve clinical efficacy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.

    , , ,

    Source

    MeSH

    Blood Platelets
    Erythrocytes
    Humans
    Leukocytes
    Orthopedic Procedures
    Platelet-Rich Plasma
    Wound Healing

    Pub Type(s)

    Journal Article
    Video-Audio Media

    Language

    eng

    PubMed ID

    22284405

    Citation

    TY - JOUR T1 - Platelet-rich plasma: a milieu of bioactive factors. AU - Boswell,Stacie G, AU - Cole,Brian J, AU - Sundman,Emily A, AU - Karas,Vasili, AU - Fortier,Lisa A, Y1 - 2012/01/28/ PY - 2011/6/13/received PY - 2011/9/21/revised PY - 2011/10/19/accepted PY - 2012/1/28/aheadofprint PY - 2012/1/31/entrez PY - 2012/1/31/pubmed PY - 2012/7/31/medline SP - 429 EP - 39 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 28 IS - 3 N2 - Platelet concentrates such as platelet-rich plasma (PRP) have gained popularity in sports medicine and orthopaedics to promote accelerated physiologic healing and return to function. Each PRP product varies depending on patient factors and the system used to generate it. Blood from some patients may fail to make PRP, and most clinicians use PRP without performing cell counts on either the blood or the preparation to confirm that the solution is truly PRP. Components in this milieu have bioactive functions that affect musculoskeletal tissue regeneration and healing. Platelets are activated by collagen or other molecules and release growth factors from alpha granules. Additional substances are released from dense bodies and lysosomes. Soluble proteins also present in PRP function in hemostasis, whereas others serve as biomarkers of musculoskeletal injury. Electrolytes and soluble plasma hormones are required for cellular signaling and regulation. Leukocytes and erythrocytes are present in PRP and function in inflammation, immunity, and additional cellular signaling pathways. This article supports the emerging paradigm that more than just platelets are playing a role in clinical responses to PRP. Depending on the specific constituents of a PRP preparation, the clinical use can theoretically be matched to the pathology being treated in an effort to improve clinical efficacy. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/22284405/abstract/Platelet_Rich_Plasma:_A_Milieu_of_Bioactive_Factors_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S0749-8063(11)01219-9 ER -