Assessment of Therapeutic Effects of Platelet-Rich Plasma in Knee Osteoarthritis: Possible Role of Inflammatory Cytokines
- 1 Departments of Medical Biochemistry, Faculty of Medicine, South Valley University, Egypt
- 2 College of Pharmacy, Al Ain University, United Arab Emirates
- 3 Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Jordan
- 4 Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt
- 5 Department of Orthopaedic Surgery, Faculty of Medicine, South Valley University, Egypt
- 6 Department of Diagnostic Radiology, Faculty of Medicine, South Valley University, Egypt
- 7 Department of Pharmacology, Faculty of Medicine, Assiut University, Egypt
Abstract
Osteoarthritis (OA) is a multifactorial disease that commonly affects the knee. Tumor Necrosis Factor-α (TNF-α) regulates inflammation during OA. Macrophage Migration Inhibitory Factor (MIF) may be involved in the pathophysiology of arthritis. Platelet-Rich Plasma (PRP) may reduce pain associated with OA. The present study assessed the possible therapeutic effects of PRP in patients with OA of the knee with varying severities. A prospective study was performed in 90 patients diagnosed with mild (30 cases), moderate (30 cases) and severe (30 cases) knee OA. Three Intra-Articular (IA) injections of PRP were administrated, 2 weeks a part, were received. Pain score and MRI Osteoarthritis Knee Score (MOAKS) were assessed. Serial synovial fluid cytokine assays to measure Tumor Necrosis Factor-α (TNF-α) and macrophage Migration Inhibitory Factor (MIF) were performed using commercially available ELISA kits. The assays were performed pre-injection (S1), 2 weeks after the first IA injection (S2) and 2 weeks after the second IA injection (S3) for all patients. The mean values of pain score and synovial TNF-α and MIF levels were significantly higher (S1, pre-injection) among severe OA than among those with either mild or moderate cases, p˂0.05 for all. Pain score and synovial TNF-α and MIF levels at S3 were significantly lower in those with mild, moderate and severe OA than the corresponding S1 values, (p˂0.05 for all). There was significant improvement in synovitis in both mild and moderate cases, (p˂0.05 for both). The IA injection of PRP reduces synovial fluid TNF-α and MIF levels significantly and exhibit significant therapeutic effects on synovitis by reducing inflammatory cytokine levels and bone marrow lesions primarily for mild knee OA and to a lesser extent for moderate cases.
DOI: https://doi.org/10.3844/ajbbsp.2021.267.280
Copyright: © 2021 Mohammed H. Hassan, Sawsan Abuhamdah, Tahia H. Saleem, Elsayed Said, Nehal Ashraf Zaki, Ghada M. Abdelrazek, Safaa Y. Salim and Hamdy Tammam. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Keywords
- Platelet Rich Plasma
- Knee Osteoarthritis
- MRI Osteoarthritis Knee Score
- Pain Score
- Synovial Fluid
- Tumor Necrosis Factor-α
- Macrophage Migration Inhibitory Factor