Effect of two different preparations of platelet-rich plasma on synoviocytes

Elisa Assirelli, Giuseppe Filardo, Erminia Mariani, Elizaveta Kon, Alice Roffi, Franca Vaccaro, Maurilio Marcacci, Andrea Facchini, Lia Pulsatelli, Elisa Assirelli, Giuseppe Filardo, Erminia Mariani, Elizaveta Kon, Alice Roffi, Franca Vaccaro, Maurilio Marcacci, Andrea Facchini, Lia Pulsatelli

Abstract

Purpose: To analyse the modifications induced by two different platelet-rich plasma (PRP) preparations on osteoarthritis (OA) synoviocytes, by documenting changes in gene expression of factors involved in joint physiopathology.

Methods: OA synoviocytes were cultured for 7 days in medium with different concentrations of either P-PRP (a pure platelet concentrate without leucocytes but with a limited number of platelets), L-PRP (a higher platelet concentrate containing leucocytes) or platelet-poor plasma (PPP). Gene expression of interleukin (IL)-1beta, IL-6, IL-8/CXCL8, tumour necrosis factor alpha, IL-10, IL-4, IL-13, metalloproteinase-13, tissue inhibitor of metalloproteinase (TIMP)-1, (TIMP)-3, (TIMP)-4, vascular endothelial growth factor, transforming growth factor beta1, fibroblast growth factor (FGF)-2, hepatocyte growth factor (HGF), hyaluronic acid (HA) synthases (HAS)-1, (HAS)-2, and (HAS)-3 was analysed by RT-PCR. HA production was determined in culture supernatants by ELISA.

Results: IL-1β, IL-8 and FGF-2 were significantly induced by L-PRP compared to both P-PRP and PPP; HGF was down-modulated by L-PRP versus both P-PRP and PPP, and an inverse dose-response influence was shown for all preparations. Expression level of TIMP-4 was lower in the presence of L-PRP compared with P-PRP. HA production and HAS gene expression did not seem to be modulated by PRP.

Conclusions: L-PRP is able to sustain the up-regulation of proinflammatory factors, (IL-1beta, IL-8 and FGF-2), together with a down-modulation of HGF and TIMP-4 expression, two factors that have been recognized as anti-catabolic mediators in cartilage, thus supporting the need to further optimize the PRP preparations to be applied in clinical practice.

Figures

Fig. 1
Fig. 1
Gene expression analysis of interleukin (IL)-1beta, IL-8/CXCL8, IL-6, IL-10, tumour necrosis factor (TNF) alpha. Synovial fibroblasts were treated for 7 days with 5, 10, 20 % of L-PRP, P-PRP or PPP obtained from each subject (n = 7). Gene expression relative quantification was performed, and data are expressed as number of molecules *100,000 GAPDH. Boxes indicate the 25 and 75 % percentiles, whiskers indicate the minimum to maximum values, and bars indicate the median; p value significances are shown in tables beside each figure, as determined by General Linear Model statistical analysis and Kendall Tau correlation; ns not significant
Fig. 2
Fig. 2
Gene expression analysis of hepatocyte growth factor (HGF), fibroblast growth factor (FGF)-2, transforming growth factor (TGF) beta, vascular endothelial growth factor (VEGF). Synovial fibroblasts were treated for 7 days with 5, 10, 20 % of L-PRP, P-PRP or PPP obtained from each subject (n = 7). Gene expression relative quantification was performed, and data are expressed as number of molecules *100,000 GAPDH. Boxes indicate the 25 and 75 % percentiles, whiskers indicate the minimum to maximum values, and bars indicate the median; p value significances are shown in tables beside each figure, as determined by General Linear Model statistical analysis and Kendall Tau correlation; ns not significant
Fig. 3
Fig. 3
Gene expression analysis of cartilage matrix-degrading enzyme metalloproteinase-13 (MMP-13) and tissue inhibitor of metalloproteinase inhibitors (TIMP-1,-3,-4). Synovial fibroblasts were treated for 7 days with 5, 10, 20 % of L-PRP, P-PRP or PPP obtained from each subject (n = 7). Gene expression relative quantification was performed, and data are expressed as number of molecules *100,000 GAPDH. Boxes indicate the 25 and 75 % percentiles, whiskers indicate the minimum to maximum values, and bars indicate the median; p value significances are shown in tables beside each figure, as determined by General Linear Model statistical analysis; ns not significant
Fig. 4
Fig. 4
Hyaluronic acid modulation by PRP. Synovial fibroblasts were treated for 7 days with 5, 10, 20 % of L-PRP, P-PRP or PPP obtained from each subject (n = 7). Hyaluronic acid synthases 1-2-3 gene expression relative quantification was performed, and data are expressed as number of molecules *100,000 GAPDH. Hyaluronic acid protein production was normalized per number of cells. Boxes indicate the 25 and 75 % percentiles, whiskers indicate the minimum to maximum values, and bars indicate the median; p value significances are shown in tables beside each figure, as determined by General Linear Model statistical analysis and Kendall Tau correlation; ns not significant

References

    1. Ahmad Z, Howard D, Brooks RA, Wardale J, Henson FM, Getgood A, Rushton N. The role of platelet rich plasma in musculoskeletal science. JRSM Short Rep. 2012;3:40. doi: 10.1258/shorts.2011.011148.
    1. Anitua E, Sanchez M, Nurden AT, Zalduendo MM, de la Fuente M, Azofra J, Andia I. Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford) 2007;46:1769–1772. doi: 10.1093/rheumatology/kem234.
    1. Anitua E, Orive G, Aguirre JJ, Andia I. Clinical outcome of immediately loaded dental implants bioactivated with plasma rich in growth factors: a 5-year retrospective study. J Periodontol. 2008;79:1168–1176. doi: 10.1902/jop.2008.070580.
    1. Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, Andia I. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42:162–170. doi: 10.1111/j.1365-2184.2009.00583.x.
    1. Ashraf S, Walsh DA. Angiogenesis in osteoarthritis. Curr Opin Rheumatol. 2008;20:573–580. doi: 10.1097/BOR.0b013e3283103d12.
    1. Bendinelli P, Matteucci E, Dogliotti G, Corsi MM, Banfi G, Maroni P, Desiderio MA. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: mechanisms of NF-kappa B inhibition via HGF. J Cell Physiol. 2010;225:757–766. doi: 10.1002/jcp.22274.
    1. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!) Osteoarthr Cartil. 2013;21:16–21. doi: 10.1016/j.joca.2012.11.012.
    1. Bondeson J, Wainwright SD, Lauder S, Amos N, Hughes CE. The role of synovial macrophages and macrophage-produced cytokines in driving aggrecan ases, matrix metalloproteinases, and other destructive and inflammatory responses in osteoarthritis. Arthritis Res Ther. 2006;8:R187. doi: 10.1186/ar2099.
    1. Braun HJ, Kim HJ, Chu CR, Dragoo JL. The effect of platelet-rich plasma formulations and blood products on human synoviocytes: implications for intra-articular injury and therapy. Am J Sports Med. 2014;42:1204–1210. doi: 10.1177/0363546514525593.
    1. Browning SR, Weiser AM, Woolf N, Golish SR, SanGiovanni TP, Scuderi GJ, Carballo C, Hanna LS. Platelet-rich plasma increases matrix metalloproteinases in cultures of human synovial fibroblasts. J Bone Joint Surg Am. 2012;94:e1721–e1727. doi: 10.2106/JBJS.K.01501.
    1. Cheon H, Yu SJ, Yoo DH, Chae IJ, Song GG, Sohn J. Increased expression of pro-inflammatory cytokines and metalloproteinase-1 by TGF-beta1 in synovial fibroblasts from rheumatoid arthritis and normal individuals. Clin Exp Immunol. 2002;127:547–552. doi: 10.1046/j.1365-2249.2002.01785.x.
    1. Cheon H, Sun YK, Yu SJ, Lee YH, Ji JD, Song GG, Lee JH, Kim MK, Sohn J. Platelet-derived growth factor-AA increases IL-1beta and IL-8 expression and activates NF-kappaB in rheumatoid fibroblast-like synoviocytes. Scand J Immunol. 2004;60:455–462. doi: 10.1111/j.0300-9475.2004.01505.x.
    1. Cole BJ, Seroyer ST, Filardo G, Bajaj S, Fortier LA. Platelet-rich plasma: where are we now and where are we going? Sports Health. 2010;2:203–210. doi: 10.1177/1941738110366385.
    1. David-Raoudi M, Deschrevel B, Leclercq S, Galera P, Boumediene K, Pujol JP. Chondroitin sulfate increases hyaluronan production by human synoviocytes through differential regulation of hyaluronan synthases: role of p38 and Akt. Arthritis Rheum. 2009;60:760–770. doi: 10.1002/art.24302.
    1. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF) Trends Biotechnol. 2009;27:158–167. doi: 10.1016/j.tibtech.2008.11.009.
    1. Campo GM, Avenoso A, D’Ascola A, et al. Hyaluronan differently modulates TLR-and the inflammatory response in mouse chondrocytes. Biofactors. 2012;38(1):69–76. doi: 10.1002/biof.202.
    1. Engebretsen L, Steffen K, Alsousou J, Anitua E, Bachl N, Devilee R, Everts P, Hamilton B, Huard J, Jenoure P, Kelberine F, Kon E, Maffulli N, Matheson G, Mei-Dan O, Menetrey J, Philippon M, Randelli P, Schamasch P, Schwellnus M, Vernec A, Verrall G. IOC consensus paper on the use of platelet-rich plasma in sports medicine. Br J Sports Med. 2010;44:1072–1081. doi: 10.1136/bjsm.2010.079822.
    1. Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19:528–535. doi: 10.1007/s00167-010-1238-6.
    1. Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012;13:229. doi: 10.1186/1471-2474-13-229.
    1. Filardo G, Kon E. PRP: more words than facts. Knee Surg Sports Traumatol Arthrosc. 2012;20:1655–1656. doi: 10.1007/s00167-012-2136-x.
    1. Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di MA, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc. 2012;20:2082–2091. doi: 10.1007/s00167-011-1837-x.
    1. Filardo G, Kon E, Roffi A, Di Matteo B, Merli ML, Marcacci M (2013) Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2743-1
    1. Flugge LA, Miller-Deist LA, Petillo PA. Towards a molecular understanding of arthritis. Chem Biol. 1999;6:R157–R166. doi: 10.1016/S1074-5521(99)80043-X.
    1. Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009;37:2259–2272. doi: 10.1177/0363546509349921.
    1. Gobbi A, Karnatzikos G, Mahajan V, Malchira S. Platelet-rich plasma treatment in symptomatic patients with knee osteoarthritis: preliminary results in a group of active patients. Sports Health. 2012;4:162–172. doi: 10.1177/1941738111431801.
    1. Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol. 2011;23:471–478. doi: 10.1097/BOR.0b013e328349c2b1.
    1. Hall MP, Band PA, Meislin RJ, Jazrawi LM, Cardone DA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009;17:602–608.
    1. Haseeb A, Haqqi TM. Immunopathogenesis of osteoarthritis. Clin Immunol. 2013;146:185–196. doi: 10.1016/j.clim.2012.12.011.
    1. Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR, Moskowitz RW, Schnitzer TJ. Guidelines for the medical management of osteoarthritis: part II. Osteoarthritis of the knee. American college of rheumatology. Arthritis Rheum. 1995;38:1541–1546. doi: 10.1002/art.1780381104.
    1. Itano N, Sawai T, Yoshida M, Lenas P, Yamada Y, Imagawa M, Shinomura T, Hamaguchi M, Yoshida Y, Ohnuki Y, Miyauchi S, Spicer AP, McDonald JA, Kimata K. Three isoforms of mammalian hyaluronan synthases have distinct enzymatic properties. J Biol Chem. 1999;274:25085–25092. doi: 10.1074/jbc.274.35.25085.
    1. Kantarci A, Van Dyke TE. Lipoxins in chronic inflammation. Crit Rev Oral Biol Med. 2003;14:4–12. doi: 10.1177/154411130301400102.
    1. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494–502. doi: 10.1136/ard.16.4.494.
    1. Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van Dijk N, Della Villa S. Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2012;20:436–449. doi: 10.1007/s00167-011-1713-8.
    1. Kon E, Filardo G, Matteo BD, Marcacci M. PRP for the treatment of cartilage pathology. Open Orthop J. 2013;7:120–128. doi: 10.2174/1874325001307010120.
    1. Li X, Ellman MB, Kroin JS, Chen D, Yan D, Mikecz K, Ranjan KC, Xiao G, Stein GS, Kim SG, Cole B, van Wijnen AJ, Im HJ. Species-specific biological effects of FGF-2 in articular cartilage: implication for distinct roles within the FGF receptor family. J Cell Biochem. 2012;113:2532–2542. doi: 10.1002/jcb.24129.
    1. Lin YM, Huang YL, Fong YC, Tsai CH, Chou MC, Tang CH. Hepatocyte growth factor increases vascular endothelial growth factor-A production in human synovial fibroblasts through c-Met receptor pathway. PLoS One. 2012;7:e50924. doi: 10.1371/journal.pone.0050924.
    1. Liu-Bryan R. Synovium and the innate inflammatory network in osteoarthritis progression. Curr Rheumatol Rep. 2013;15:323. doi: 10.1007/s11926-013-0323-5.
    1. Mapp PI, Walsh DA. Mechanisms and targets of angiogenesis and nerve growth in osteoarthritis. Nat Rev Rheumatol. 2012;8:390–398. doi: 10.1038/nrrheum.2012.80.
    1. Mariani E, Cattini L, Neri S, Malavolta M, Mocchegiani E, Ravaglia G, Facchini A. Simultaneous evaluation of circulating chemokine and cytokine profiles in elderly subjects by multiplex technology: relationship with zinc status. Biogerontology. 2006;7:449–459. doi: 10.1007/s10522-006-9060-8.
    1. Maruotti N, Cantatore FP, Crivellato E, Vacca A, Ribatti D. Angiogenesis in rheumatoid arthritis. Histol Histopathol. 2006;21:557–566.
    1. Mazzocca AD, McCarthy MB, Chowaniec DM, Dugdale EM, Hansen D, Cote MP, Bradley JP, Romeo AA, Arciero RA, Beitzel K. The positive effects of different platelet-rich plasma methods on human muscle, bone, and tendon cells. Am J Sports Med. 2012;40:1742–1749. doi: 10.1177/0363546512452713.
    1. McCarrel TM, Minas T, Fortier LA. Optimization of leukocyte concentration in platelet-rich plasma for the treatment of tendinopathy. J Bone Joint Surg Am. 2012;94:e143–e148. doi: 10.2106/JBJS.L.00019.
    1. Moojen DJ, Everts PA, Schure RM, et al. Antimicrobial activity of platelet-leukocyte gel against staphylococcus aureus. J Orthop Res. 2008;26:404–410. doi: 10.1002/jor.20519.
    1. Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, Jordan JM. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59:1207–1213. doi: 10.1002/art.24021.
    1. Nurden AT. Platelets, inflammation and tissue regeneration. Thromb Haemost. 2011;105(Suppl 1):S13–S33. doi: 10.1160/THS10-11-0720.
    1. Park SI, Lee HR, Kim S, Ahn MW, Do SH. Time-sequential modulation in expression of growth factors from platelet-rich plasma (PRP) on the chondrocyte cultures. Mol Cell Biochem. 2012;361:9–17. doi: 10.1007/s11010-011-1081-1.
    1. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356–364. doi: 10.1177/0363546512471299.
    1. Perut F, Filardo G, Mariani E, Cenacchi A, Pratelli L, Devescovi V, Kon E, Marcacci M, Facchini A, Baldini N, Granchi D. Preparation method and growth factor content of platelet concentrate influence the osteogenic differentiation of bone marrow stromal cells. Cytotherapy. 2013;15:830–839. doi: 10.1016/j.jcyt.2013.01.220.
    1. Poole AR. Osteoarthritis as a whole joint disease. HSS J. 2012;8:4–6. doi: 10.1007/s11420-011-9248-6.
    1. Rosengren S, Corr M, Boyle DL. Platelet-derived growth factor and transforming growth factor beta synergistically potentiate inflammatory mediator synthesis by fibroblast-like synoviocytes. Arthritis Res Ther. 2010;12:R65. doi: 10.1186/ar2981.
    1. Sanchez M, Fiz N, Azofra J, Usabiaga J, Aduriz RE, Garcia GA, Albillos J, Garate R, Aguirre JJ, Padilla S, Orive G, Anitua E. A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy. 2012;28:1070–1078. doi: 10.1016/j.arthro.2012.05.011.
    1. Scanzello CR, Goldring SR. The role of synovitis in osteoarthritis pathogenesis. Bone. 2012;51:249–257. doi: 10.1016/j.bone.2012.02.012.
    1. Sellam J, Berenbaum F. The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis. Nat Rev Rheumatol. 2010;6:625–635. doi: 10.1038/nrrheum.2010.159.
    1. Smyth NA, Murawski CD, Fortier LA, Cole BJ, Kennedy JG. Platelet-rich plasma in the pathologic processes of cartilage: review of basic science evidence. Arthroscopy. 2013;29:1399–1409. doi: 10.1016/j.arthro.2013.03.004.
    1. Spakova T, Rosocha J, Lacko M, Harvanova D, Gharaibeh A. Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Am J Phys Med Rehabil. 2012;91:411–417. doi: 10.1097/PHM.0b013e3182aab72.
    1. Sun HB. Mechanical loading, cartilage degradation, and arthritis. Ann NY Acad Sci. 2010;1211:37–50. doi: 10.1111/j.1749-6632.2010.05808.x.
    1. Tsay RC, Vo J, Burke A, Eisig SB, Lu HH, Landesberg R. Differential growth factor retention by platelet-rich plasma composites. J Oral Maxillofac Surg. 2005;63:521–528. doi: 10.1016/j.joms.2004.09.012.
    1. Tschon M, Fini M, Giardino R, Filardo G, Dallari D, Torricelli P, Martini L, Giavaresi G, Kon E, Maltarello MC, Nicolini A, Carpi A. Lights and shadows concerning platelet products for musculoskeletal regeneration. Front Biosci (Elite Ed) 2011;3:96–107. doi: 10.2741/e224.
    1. Vincent TL. Fibroblast growth factor 2: good or bad guy in the joint? Arthritis Res Ther. 2011;13:127. doi: 10.1186/ar3447.
    1. Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cusco X, Garcia-Balletbo M. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Arch Orthop Trauma Surg. 2011;131:311–317. doi: 10.1007/s00402-010-1167-3.

Source: PubMed

Подписаться