Platelet Rich Plasma or Autologous Platelet Therapy
Intra-articular or intralesional injection of autologous platelets has been reported to enhance the regenerative process in osteoarthritic joints (Textor, 2011) and tendon injury (Bosch 2010). Growth factors are stimulators, especially on osteoarthritis and cartilage repair because of their ability to recruit chondrogenic cells, stimulate proliferation and enhance synthesis of cartilage matrix (Kon et al. 2010; Spakova et al. 2012).
Growth factors stored in the platelets such as platelet-derived growth factor (PDGF), transforming growth factor 1 (TGF- 1), insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), basic fibroplastic growth factor (bFGF) and epidermal growth factor (EGF), have been shown to take part in the regulation and synthesis of the articular cartilage (Cole et al. 2010; Kon et al. 2011a ; Filardo et al. 2012). Platelets are also a source of cytokines, chemokines and other proteins that take part in the stimulating of chemotaxis, cell proliferation and maturation, modulation of inflammatory molecules and the attraction of leukocytes (Kon et al. 2011a). Other substances stored in the platelets such as metalloproteinases, antibacterial and fungicidal proteins, coagulation factors, calcium ions, serotonin and dopamine can also have an effect on the inflammation and tissue regeneration (Cole et al. 2010; Kon et al. 2011a; Filardo et al. 2012). Intra-articular administration of a platelet-rich concentrate has also been considered to have potential to slow down the progression of osteoarthritis by stimulating the cartilage anabolism (Stief et al. 2011).
Following the injection into the damaged tissue, the platelets of PRP begin active secretion of growth factors within 10 minutes with more than 95% of the total amount released within the first hour (Kon et al. 2011a). Although the secretion of growth factors occurs mainly in the first hour of the injection, the platelets remain viable for seven days and continue to release growth factors. Thus a single injection into the damaged tissue might be sufficient at least in most cases (Kon et al, 2011a; Leong et al 2012).
In horses PRP therapy is mostly used in the treatment of tendon and ligament injuries, in some cases in combination with stem cells. As PRP is intended to support and enhance tissue healing as an anabolic agent, in horses it is recommended to be used after an acute traumatic injury to musculoskeletal tissues (Textor 2011).
In dogs PRP therapy is relatively new, although the specific mechanism of action of the platelet-rich products remains speculative, platelet-rich products have shown to promote the repair and remodeling of injured tissues, and to prevent cartilage degradation and atrophy of the periarticular structures (Anitua et al 2013). The autologous nature of platelet-rich products, the ease of implementation and the relatively low costs are some of the qualities making this an attractive approach (Civinini et al 2011).
PRP is derived from the anticoagulated autologous blood by centrifugation that eliminates most of the red blood cells and concentrates platelets based on the specific gravities of each cell type (Foster et al. 2009; Kon et al. 2011b; Kisiday et al. 2012). The achieved platelet concentration varies, but is generally at least 4-5 or even over 10 times higher than that of the whole blood (Kon et al. 2011b; Kisiday et al. 2012).
The three main commercial methods of producing PRP are selective blood filtration, single-spinning methods and double-spinning procedures of which the two latter are the most common ones in the clinical use (Filardo et al. 2012). To ensure you use the right system for your practice, Nupsala supplies four of the leading PRP systems on the market. From the simple to use V-PET which uses blood filtration to the Harvest SmartPrep and CRT System, both of which boost the highest platelet concentration on the market.
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