Platelet-rich plasma vs bone marrow aspirate concentrate: An overview of mechanisms of action and orthobiologic synergistic effects

Figure 1 Cell and platelet interactions in platelet-rich plasma-bone marrow aspirate concentrate milieu. Monocytes contained in bone marrow aspirate concentrate are further stimulated in the presence of platelet-rich plasma. Macrophage (MΦ) 1 is characterized by inflammatory cytokine secretion (interferon-γ) and nitric oxide production, resulting in an effective pathogen killing mechanism. The MΦ1 phenotype also produces vascular endothelial growth factor and fibroblast growth factor. The MΦ2 phenotype consists of anti-inflammatory cells with a high phagocytosis capacity. MΦ2 produces extracellular matrix components, angiogenic and chemotactic factors, and interleukin-10. In addition to pathogen defense, MΦ2 can alleviate the inflammatory response and promote tissue repair. Orange: Monocyte; Dark purple: Neutrophil; Light blue: Macrophage; Dark blue: Mesenchymal stem cells; Light purple: Activated platelets; Green: Growth factors; Dark yellow: Fibrin fibers.