Research Article Open Access

Assessment of Therapeutic Effects of Platelet-Rich Plasma in Knee Osteoarthritis: Possible Role of Inflammatory Cytokines

Mohammed H. Hassan1, Sawsan Abuhamdah2,3, Tahia H. Saleem4, Elsayed Said5, Nehal Ashraf Zaki1, Ghada M. Abdelrazek6, Safaa Y. Salim7 and Hamdy Tammam5
  • 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.

American Journal of Biochemistry and Biotechnology
Volume 17 No. 2, 2021, 267-280

DOI: https://doi.org/10.3844/ajbbsp.2021.267.280

Submitted On: 25 April 2021 Published On: 15 June 2021

How to Cite: H. Hassan, M., Abuhamdah, S., H. Saleem, T., Said, E., Zaki, N. A., M. Abdelrazek, G., Y. Salim, S. & Tammam, H. (2021). Assessment of Therapeutic Effects of Platelet-Rich Plasma in Knee Osteoarthritis: Possible Role of Inflammatory Cytokines. American Journal of Biochemistry and Biotechnology, 17(2), 267-280. https://doi.org/10.3844/ajbbsp.2021.267.280

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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