• anterior cruciate ligament
• muscle injury
• platelet-rich plasma

Chronic inflammatory pain is associated with increased expression of interleukin (IL)-1, an inflammatory cytokine, and activity on its receptor (IL-1R). In response, the body produces IL-1R antagonist (IL-1Ra) to reduce this signaling. Autologous conditioned serum (ACS) is the only biologic therapy for spinal pathologies that enhances the action of endogenous IL-1Ra reserves to improve symptoms. This systematic review investigates the effectiveness of ACS in treating pain and disability caused by spinal pathologies.

To evaluate the use of ACS as a conservative management option for spinal pathology.

A systematic review of PubMed/Medline was performed to identify studies investigating administration of ACS for treatment of any spinal pathology.

Six articles were included, comprising 684 patients treated with epidural (n = 133) or transforaminal (n = 551) ACS injections. Patients had an average age of 54.0 years with slight female predominance (53.2%). The lumbar spine was most commonly treated, with 567 patients (82.9%) receiving injections for lumbar radiculopathy (n = 67), degenerative disc disease (DDD) (n = 372), or spinal stenosis (n = 128); cervical injections were performed in 109 patients (15.9%). Mean (SD) follow-up was 21.7 (4.8) weeks from first ACS injection. All studies investigating mechanical lumbar and lumbar or cervical radicular pain reported significant pain reduction at final follow-up compared to baseline. ACS achieved comparable or superior results to lumbar epidural steroid injections. Adverse events were reported in 21 patients (3.1%), with no serious adverse events.

ACS injection is a safe and effective intervention for pain reduction in many spinal pathologies, including cervical and lumbar radiculopathies.

• Spine
• Autologous conditioned serum
• Orthokine
• Regenokine
• Epidural steroid injection
• Interleukin-1
• Interleukin-1 receptor antagonist

• Autologous conditioned serum
• Dextrose prolotherapy
• Intraarticular medication
• Regenerative solution
• Temporomandibular joint

• Humans
• Glucose/therapeutic use
• Injections, Intra-Articular
• Pain/drug therapy
• Pilot Projects
• Prolotherapy
• Range of Motion, Articular
• Temporomandibular Joint
• Treatment Outcome

• Knee osteoarthritis
• autologous conditioned serum
• blood cell secretome
• function
• intra-articular injection
• pain
• quality of life
• triamcinolone acetonide

• Humans
• Osteoarthritis, Knee/drug therapy
• Double-Blind Method
• Quality of Life
• Activities of Daily Living
• Treatment Outcome
• Triamcinolone/therapeutic use
• Pain/drug therapy
• Glucocorticoids/therapeutic use
• Injections, Intra-Articular
• Triamcinolone Acetonide/therapeutic use

• Orthokine
• autologous conditioned serum
• degenerative disc disease
• interleukin-1 inhibitor
• low back pain
• lumbar spine

• PUSH
• Pressure Ulcer Scale for Healing
• autologous conditioned serum
• chronic
• diabetes
• hard-to-heal
• pressure ulcer
• randomised controlled trial
• ulcer
• wound
• wound care
• wound dressing
• wound healing

• TGF-β
• fibrosis
• platelet-rich plasma
• skeletal muscle
• suramin

• dynamic mobilization exercises
• ozone
• platelet-rich plasma
• shoeing
• therapeutic ultrasound

The purpose of this study was to investigate the effect of exogenous hydrogen sulfide (H₂S) treatment on skeletal muscle contusion. We established a skeletal muscle contusion model (S group) and an H₂S treated of skeletal muscle contusion model (H₂S group). Gastrocnemius muscles (GMs) were collected at day 1, day 5, day 10, and day 15 after injury, and comprehensive morphological and genetic analyses was conducted. H₂S treatment reduced M1 macrophage (CD68), profibrotic cytokines (TGF-β), pro-inflammatory cytokines (TNF-α, IFN-γ, IL-1β, and IL-6), chemokines (CCL2, CCR2, CCL3, CCL5, CXCL12, and CXCR4), matrix metalloproteinases (MMP-1, MMP-2, MMP-9, and MMP-14) and oxidative stress factor (gp91phox) expression levels, improved M2 macrophage (CD206) level. Thus, exogenous H₂S treatment reduced inflammation and oxidative stress, attenuated skeletal muscle fibrosis, and partly improved skeletal muscle injury.

• contusion
• fibrosis
• hydrogen sulfide
• inflammation
• skeletal muscle

Herein, the structural effect of autologous platelet-rich plasma (PRP) on posttraumatic skeletal muscle regeneration in rats with chronic hyperglycemia (CH) was tested. 130 white laboratory male rats divided into four groups (I—control; II—rats with CH; III—rats with CH and PRP treatment; and IV—rats for CH confirmation) were used for the experiment. CH was simulated by streptozotocin and nicotinic acid administration. Triceps surae muscle injury was reproduced by transverse linear incision. Autologous PRP was used in order to correct the possible negative CH effect on skeletal muscle recovery. On the 28th day after the injury, the regenerating muscle fiber and blood vessel number in the CH+PRP group were higher than those in the CH rats. However, the connective tissue area in the CH group was larger than that in the CH+PRP animals. The amount of agranulocytes in the regenerating muscle of the CH rats was lower compared to that of the CH+PRP group. The histological analysis of skeletal muscle recovery in CH+PRP animals revealed more intensive neoangiogenesis compared to that in the CH group. Herewith, the massive connective tissue development and inflammation signs were observed within the skeletal muscle of CH rats. Obtained results suggest that streptozotocin-induced CH has a negative effect on posttraumatic skeletal muscle regeneration, contributing to massive connective tissue development. The autologous PRP injection promotes muscle recovery process in rats with CH, shifting it away from fibrosis toward the complete muscular organ repair.

• ACS
• BCS
• PRP
• autologous conditioned serum
• blood clot secretome
• clinical study
• osteoarthritis
• platelet-rich plasma

Osteoarthritis is one of the most common chronic health conditions associated with pain and disability. Advanced therapies based on mesenchymal stem cells have become valuable options for the treatment of these pathologies. Conditioned serum (CS, “Orthokine”) has been used intra-articularly for osteoarthritic patients. In this work, we hypothesized that the rich content on anti-inflammatory proteins and growth factors of CS may exert a beneficial effect on the biological activity of human adipose-derived mesenchymal stem cells (hAdMSCs). In vitro studies were designed using hAdMSCs cocultured with CS at different concentrations (2.5, 5, and 10%). Chondrogenic differentiation assays and immunomodulatory experiments using in vitro-stimulated lymphocytes were performed. Our results demonstrated that CS significantly enhanced the differentiation of hAdMSCs toward chondrocytes. Moreover, hAdMSCs pre-sensitized with CS reduced the lymphocyte proliferation as well as their differentiation toward activated lymphocytes. These results suggest that in vivo coadministration of CS and hAdMSCs may have a beneficial effect on the therapeutic potential of hAdMSCs. Moreover, these results indicate that intra-articular administration of CS might influence the biological behavior of resident stem cells increasing their chondrogenic differentiation and inherent immunomodulatory activity. To our knowledge, this is the first in vitro study reporting this combination.

• Orthokine
• autologous conditioned serum
• chondrogenic
• immunomodulation
• mesenchymal stem cells
• osteoarthritis

• Muscle injury
• PRP
• Platelet-rich plasma
• Return to play
• Sports medicine

• Growth factors
• muscle healing, muscle strain
• platelet-rich plasma
• recovery

• Female
• Humans
• Male
• Muscle, Skeletal/abnormalities
• Platelet-Rich Plasma/cytology
• Platelet-Rich Plasma/metabolism
• Retrospective Studies

Skeletal muscle fibrosis caused by an increase in collagen deposition often occurs after distraction osteogenesis. Although studies are available reporting the effects of platelet-rich plasma (PRP) on tissue healing following injury, current findings remain controversial. This study focused on determining whether PRP reduces skeletal muscle fibrosis caused by distraction osteogenesis.

Tibial osteotomies were performed on 8-week-old wild type mice, and tibiae were distracted at a rate of 0.42 mm/day for 2 weeks, starting 1 week after osteotomy. Immediately after distraction was completed (3 weeks after osteotomy), PRP or phosphate buffered saline (as a sham) was injected into the gastrocnemius (GC) muscle. The GC muscles were harvested and analyzed.

The amount and area of collagenous tissue increased in both the PRP and control groups following distraction osteogenesis, but the changes were not significantly different between both groups at all time points (p = 0.89, 0.45, 0.33 and 0.52 at 4, 6, 8 and 10 weeks).

From this study, our results suggest that PRP did not significantly reduce skeletal muscle fibrosis due to distraction osteogenesis.

• Distraction osteogenesis
• Fibrosis
• Platelet-rich plasma
• Skeletal muscle

• PRP
• apoptosis
• skeletal muscle
• sport injury

• biology
• imaging
• muscle
• muscle injuries aetiology
• muscle injuries classification
• muscle injury treatment.

• Akt/mechanistic target of rapamycin pathway
• inflammatory factors
• muscle contusion
• muscle regeneration
• oxidative stress factors

• PRP
• cell migration
• mechanism
• platelet-rich plasma
• skeletal muscle

• fibrosis
• inflammation
• macrophages
• oxidative stress
• pro-fibrotic factors
• skeletal muscle

• inflammatory cytokines
• macrophages
• regeneration
• regulatory factors
• satellite cells
• skeletal muscle

• Cell cycle
• PRP
• proliferation
• skeletal muscle cells

• Flt-1
• VEGF
• leukocytes
• muscle contusion
• platelet-rich plasma

• Exercise-induced muscle damage
• Ferritin
• Plasma iron
• Platelet rich plasma

• Chemokines
• Contusion
• Cytokines
• Gene
• Macrophages
• Satellite cells
• Skeletal muscle

• Adult
• Aged
• Aged, 80 and over
• Blood Transfusion, Autologous
• Combined Modality Therapy
• Female
• Humans
• Injections, Intra-Articular
• Male
• Middle Aged
• Osteoarthritis, Knee/blood
• Osteoarthritis, Knee/physiopathology
• Osteoarthritis, Knee/therapy
• Pain Measurement
• Physical Therapy Modalities
• Prospective Studies
• Serum
• Time Factors

The need for therapeutic options for muscle injuries, which are increasingly frequent among sports practitioners, was the motivation for this experimental study, which had the aim of evaluating the histological effects of platelet-rich plasma (PRP) on repairs to muscle tissues of rats.

PRP was obtained by means of double centrifugation of blood from five animals. In 30 rats, an injury was produced in the middle third of the belly of the gastrocnemius muscle of each hind limb. These injuries did not receive any treatment in six rats (12 legs). In 24 rats, 0.9% physiological serum was injected into the injury in the left leg and PRP into the injury in the right leg. Samples from the treated and untreated tissue were evaluated histologically 7 and 21 days after the procedures.

The quantity of collagen in the injuries treated with PRP was significantly lower than that in the other injuries, in the evaluation made 7 days after the procedure, but it became equal to the other groups in the evaluation done on the 21st day. There was a significant increase (p < 0.001) in the quantity of collagen from the 7th to the 21st day in the injuries treated with PRP, but this was not seen in the injuries treated using other methods. The inflammatory process was shown to be more intense in the injuries treated with PRP than in the injuries of the other treatment groups, in the evaluation done 7 days after the procedure. However, the morphological aspects of these injuries were seen to be similar to those of the untreated injuries, 21 days after the procedure.

PRP promoted complete tissue restitution between the 7th and 21st days in experimental muscle injuries.

• Muscles/injuries
• Platelet-rich plasma
• Rats

Autologous blood-derived biologicals, including autologous conditioned serum (ACS), are frequently used to treat tendinopathies in horses despite limited evidence for their efficacy. The purpose of this study was to describe the effect of a single intralesional injection of ACS in naturally occurring tendinopathies of the equine superficial digital flexor tendon (SDFT) on clinical, ultrasonographic, and histological parameters.

Fifteen horses with 17 naturally occurring tendinopathies of forelimb SDFTs were examined clinically and ultrasonographically (day 0). Injured tendons were randomly assigned to the ACS-treated group (n = 10) receiving a single intralesional ACS injection or included as controls (n = 7) which were either untreated or injected with saline on day 1. All horses participated in a gradually increasing exercise programme and were re-examined nine times at regular intervals until day 190. Needle biopsies were taken from the SDFTs on days 0, 36 and 190 and examined histologically and for the expression of collagen types I and III by immunohistochemistry.

In ACS-treated limbs lameness decreased significantly until day 10 after treatment. Swelling (scores) of the SDFT region decreased within the ACS group between 50 and 78 days after treatment. Ultrasonographically, the percentage of the lesion in the tendon was significantly lower and the echogenicity of the lesion (total echo score) was significantly higher 78 and 106 days after intralesional ACS injection compared to controls. Histology revealed that, compared to controls, tenocyte nuclei were more spindle-shaped 36 days after ACS injection. Immunohistochemistry showed that collagen type I expression significantly increased between days 36 and 190 after ACS injection.

Single intralesional ACS injection of equine SDFTs with clinical signs of acute tendinopathy contributes to an early significant reduction of lameness and leads to temporary improvement of ultrasonographic parameters of repair tissue. Intralesional ACS treatment might decrease proliferation of tenocytes 5 weeks after treatment and increase their differentiation as demonstrated by elevated collagen type I expression in the remodelling phase. Potential enhancement of these effects by repeated injections should be tested in future controlled clinical investigations.

• prp
• biologics
• muscle injury
• muscle regeneration
• sports medicine

• R03 AR060871 NIAMS NIH HHS

• muscle injuries
• platelet-rich plasma
• sports
• tissue regeneration

• Athletic Injuries/therapy
• Humans
• Muscle, Skeletal/injuries
• Platelet-Rich Plasma

• Animals
• Interleukin-1beta/metabolism
• Male
• Models, Animal
• Muscle, Skeletal/drug effects
• Muscle, Skeletal/injuries
• Muscle, Skeletal/physiology
• Platelet-Rich Plasma
• Rats
• Rats, Wistar
• Regeneration/drug effects
• Transforming Growth Factor beta1/metabolism
• Wound Healing/drug effects