Basic Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2022; 13(6): 587-602
Published online Jun 18, 2022. doi: 10.5312/wjo.v13.i6.587
Content of blood cell components, inflammatory cytokines and growth factors in autologous platelet-rich plasma obtained by various methods
Maciej Dejnek, Jarosław Witkowski, Helena Moreira, Sylwia Płaczkowska, Piotr Morasiewicz, Paweł Reichert, Aleksandra Królikowska
Maciej Dejnek, Jarosław Witkowski, Paweł Reichert, Department of Trauma Surgery, Wroclaw Medical University, Wroclaw 50-556, Poland
Helena Moreira, Department of Medical Science Foundation, Wroclaw Medical University, Wroclaw 50-556, Poland
Sylwia Płaczkowska, Teaching and Research Diagnostic Laboratory, Department of Laboratory Diagnostics, Wroclaw Medical University, Wroclaw 50-556, Poland
Piotr Morasiewicz, Institute of Medical Sciences, Department of Orthopaedic and Trauma Surgery, University of Opole, Opole 45-052, Poland
Aleksandra Królikowska, Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Wroclaw Medical University, Wroclaw 50-355, Poland
Author contributions: Dejnek M, Reichert P, and Królikowska A designed and coordinated the study; Dejnek M, Witkowski J, Moreira H, and Płaczkowska S performed the experiments, acquired and analyzed data; Dejnek M, Reichert P, Królikowska A, and Morasiewicz P interpreted the data; Dejnek M wrote the manuscript; all authors approved the final version of the article.
Supported by the Wroclaw Medical University as a Regional Center of Excellence in the field of medical sciences and health sciences implemented under the funds of the Ministry of Science and Higher Education (Republic of Poland) in the program "Regional Initiative of Excellence" in the years 2019-2022, No. RID.Z501.20.008.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Ethics Committee of Wroclaw Medical University (KB - 163/2020, 30.03.2020).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest. The founders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
Data sharing statement: The datasets used during the current study are available from the corresponding author on reasonable request.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maciej Dejnek, MD, Research Scientist, Surgeon, Department of Trauma Surgery, Wroclaw Medical University, ul. Borowska 213, Wroclaw 50-556, Poland. maciej.dejnek@student.umed.wroc.pl
Received: January 18, 2022
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
Abstract
BACKGROUND

The evaluation of the efficacy of platelet-rich plasma (PRP) in clinical practice yields conflicting results and raises numerous controversies. This may be due to different concentrations of biologically active components in PRP obtained with the use of different methods of gravity separation.

AIM

To compare the content, repeatability and correlations between biologically active components in PRP obtained with four different commercial systems.

METHODS

From a whole blood sample of each of 12 healthy male volunteers, 4 PRP samples were prepared using 4 different commercial kits [Arthrex Autologous Conditioned Plasma (ACP), Mini GPS III, Xerthra, Dr. PRP] in accordance with the instructions provided by the manufacturers. A comparative analysis of blood cell components - 13 selected inflammatory cytokines and 7 growth factors - in the obtained PRP samples was performed using the Kruskal-Wallis test by ranks. The repeatability of results in each method was evaluated by the estimation of the coefficient of variation. The Spearman correlation was used to estimate the relationship between blood cell content and cytokines.

RESULTS

Significantly higher concentrations of platelets (PLT), white blood cells (WBC) and red blood cells (RBC) were found in PRP obtained with the use of Mini GPS III than in PRP obtained using other systems. Significant differences in the content of growth factors and cytokines in PRP were found. A positive correlation of the amount of PLT, RBC and WBC with the concentration of most of the growth factors was found but in only three inflammatory cytokines. The obtained correlations between blood cell components and cytokines differed between the systems in terms of statistical significance, which may be due to insufficient sample size. The repeatability of the obtained PLT concentration also varied between protocols with the lowest in Xerthra and the highest in Arthrex ACP.

CONCLUSION

Significant differences in the content of biologically active components and their repeatability were found in PRP obtained by various methods, providing new data for further research.

Keywords: Platelet-rich plasma; Cytokines; Chemokines; Growth factors

Core Tip: The presented study showed important differences between blood cell components and levels of selected growth factors and inflammatory cytokines in platelet-rich plasma obtained with four different commercial preparation systems in a single-donor model. The range of cytokines analyzed far exceeded the ranges investigated in earlier publications. This was also the first study to pay attention to the repeatability of the quality of the obtained platelet-rich plasma (PRP). New positive correlations were found between platelet content in PRP and several cytokines (Hepatocyte growth factor, Interleukin-1β, Monocyte chemoattractant protein-1, Interleukin-8, Interleukin-18). The demonstrated positive correlation between red blood cell content in PRP and cytokines has never been described before.