Comparison of the efficacy of autologous Lp-PRP and Lr-PRP for treating intervertebral disc degeneration: in vitro and in vivo study.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2024-11-06 DOI:10.1186/s13018-024-05196-8

Bangke Zhang, BinBin Dong, Liang Wang, Yijin Wang, Zhongya Gao, Yang Li, Haibin Wang, Xuhua Lu

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Abstract

Background: Intervertebral disc degeneration (IDD) was the most common cause of low back pain. Platelet rich plasma (PRP) has the potential to repair IDD, however, there is still no conclusion on whether Leukocyte-poor platelet rich plasma (Lp-PRP) or Leukocyte-rich platelet rich plasma (Lr-PRP) is better for the treatment of IDD.

Methods: First, we conducted an in vitro study to compare the effects of autologous Lp-PRP and Lr-PRP on human degenerated nucleus pulposus (NP) cells. Then we verified the in vivo effects of autologous Lp-PRP and Lr-PRP in treating disc degeneration through a rabbit IDD model.

Results: The in vitro study showed both autologous Lp-PRP and Lr-PRP can promote the cell proliferation, the synthesis of COL II and Aggrecan of human degenerated NP cells, while Lp-PRP are better than Lr-PRP (P<0.05). In addition, only Lp-PRP can inhibit the apoptosis of human degenerated NP cells (P<0.05), whereas Lr-PRP activates the catabolism on the contrary (P<0.05). Further, the in vivo study through the rabbit IDD model verified that autologous Lp-PRP has better effects than autologous Lr-PRP in repairing IDD according to X-ray, MRI, histological, and immunohistochemical assessment (P<0.05, respectively). And the caspase-3 IHC results also showed that only autologous Lp-PRP treatment could inhibit apoptosis of NP cells in the rabbit IDD model (P<0.05).

Conclusion: Combining in vivo and in vitro studies, the present study confirmed that autologous Lp-PRP has a better effect than autologous Lr-PRP in repairing IDD, which may be due to the inflammatory factors (TNFα, IL-1β, etc.) in Lr-PRP antagonizing part of the repair effects and promoting the catabolism additionally. Therefore, our findings suggest that Lp-PRP may provide better results than Lr-PRP for treating IDD. Further randomized clinical trials will provide evidence to guide practice.

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比较自体 Lp-PRP 和 Lr-PRP 治疗椎间盘退行性变的疗效：体外和体内研究。

背景：椎间盘退变（IDD）是导致腰背痛的最常见原因。富血小板血浆（PRP）具有修复 IDD 的潜力，然而，白细胞贫乏型富血小板血浆（Lp-PRP）还是白细胞丰富型富血小板血浆（Lr-PRP）更适合治疗 IDD，目前还没有定论：首先，我们进行了一项体外研究，比较了自体Lp-PRP和Lr-PRP对人类退化髓核细胞的影响。然后，我们通过兔子IDD模型验证了自体Lp-PRP和Lr-PRP治疗椎间盘退变的体内效果：体外研究表明，自体Lp-PRP和Lr-PRP都能促进人退行性髓核细胞的增殖、COLⅡ和Aggrecan的合成，而Lp-PRP的效果优于Lr-PRP（PConclusion：结合体内和体外研究，本研究证实自体Lp-PRP比自体Lr-PRP修复IDD的效果更好，这可能是由于Lr-PRP中的炎症因子（TNFα、IL-1β等）拮抗了部分修复作用，另外促进了分解作用。因此，我们的研究结果表明，Lp-PRP治疗IDD可能比Lr-PRP效果更好。进一步的随机临床试验将为指导实践提供证据。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.