Published online Jun 18, 2022. doi: 10.5312/wjo.v13.i6.587
Peer-review started: January 18, 2022
First decision: March 24, 2022
Revised: April 4, 2022
Accepted: May 7, 2022
Article in press: May 7, 2022
Published online: June 18, 2022
Processing time: 149 Days and 7.4 Hours
Autologous platelet-rich plasma (PRP) therapy is a method used to treat a variety of diseases related to soft tissue degeneration. The main idea behind this is to improve local healing and stimulate regeneration by administering large amounts of platelet-derived growth factors and cytokines. There are many commercial kits available to assist in obtaining PRP in an outpatient setting.
Due to the wide variety of PRP preparation systems, there are justified doubts about the quality of the obtained samples. Differences in the content of biologically active compounds between some PRP systems have already been demonstrated. However, only a small number of available systems and a limited number of cytokines and growth factors have been investigated.
To compare PRP obtained using four different commercial preparation systems in terms of the content of biologically active components, correlations between those components and their repeatability in each method.
After obtaining informed consent from participants, whole blood was collected from 12 young healthy male volunteers, and 4 different PRP samples were prepared from each of them in a single-donor model. PRP samples were prepared using different commercial kits: Arthrex Autologous Conditioned Plasma (ACP) Double Syringe System (Arthrex Inc., United States), the Mini GPS III Platelet Concentration System (Biomet Inc., United States), the Xerthra PRP kit (Biovico Sp. z o.o., Poland) and Dr. PRP (Rmedica, Republic of Korea). The content of cellular components in each sample was assessed using an automatic laboratory analyzer Mindray BC-5150 (Shenzhen Mindray Bio-Medical Electronics Co., PRC). To quantify the content of seven selected growth factors (Epidermal growth factor (EGF), Fibroblast Growth Factor- basic, Hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), Transforming Growth Factor-β1, Platelet-Derived Growth Factor-AA, Platelet-Derived Growth Factor-BB and thirteen inflammatory cytokines [(Interferon-α2, Interleukin-10, Interleukin-12p70, Interleukin-17A, Interleukin-18 (IL-18), Interleukin-23 (IL-23), Interleukin-33, Interleukin-6, Interleukin-8, Interferon-γ, Monocyte Chemoattractant Protein-1 (MCP-1), Tumor Necrosis Factor α (TNF-α)], bead-based multiplex immunoassays LEGENDplexTM (BioLegend, United States) that use fluorescence-encoded beads and flow cytometer measurements were performed.
Differences between PRPs obtained with various preparation systems were found in terms of cellular composition, repeatability, platelet capture efficiency, concentrations of growth factors and inflammatory cytokines. The highest ability to concentrate platelets (PLT) above the baseline was obtained with Mini GPS III (5.05 x) and the lowest with Arthrex ACP (1.47 x). Those two systems had the best repeatability of platelet concentrations assessed as the coefficient of variation of 13.25% and 12.18%, respectively. The highest concentrations of Epidermal growth factor, hepatocyte growth factor, vascular endothelial growth factor, platelet-derived growth factor-AA, platelet-derived growth factor-BB, IL-18, Interleukin-1β, Interleukin-8, MCP-1 and TNF-α were found in PRP with the highest PLT, white blood cells and red blood cells concentrations (obtained with Mini GPS III), and positive significant (P < 0.05) correlations between cell components and these paracrine factors (except TNF-α) were revealed.
The study provided new data on the differences between PRP obtained with the various commercial systems. The range of analyzed cytokines far exceeded the ranges investigated in earlier publications. The presented findings should help researchers and clinicians choose the system that best meets their expectations.
Further research should be focused on the comparison of PRPs obtained using different techniques in the context of their biological effect on soft tissues in vitro and their clinical efficacy in various diseases.