富血小板血浆干预膝关节骨性关节炎模型兔关节软骨和滑膜的改变

Platelet-rich plasma interferes with changes in articular cartilage and synovium of rabbits with knee osteoarthritis

背景:研究显示富血小板血浆具有很强的促进软骨细胞修复和增生作用。目的:探讨富血小板血浆在骨性关节炎中对软骨细胞修复及滑膜炎症抑制的疗效。方法:新西兰大白兔40只,于兔耳中央动脉取血后采用Hokugo等的方法制备富血小板血浆,同时检测外周血及富血小板血浆的血小板、血小板衍生生长因子、转化生长因子β和血管内皮生长因子水平。采用前交叉韧带切断法来制作动物模型后随机将兔分为实验组和对照组,实验组双侧膝关节每周注射1次0.3 mL富血小板血浆;对照组每周注射1次0.3m L无菌生理盐水,共注射10周。注射后第2,4,6,8,10周对兔进行大体观察及膝关节组织学观察;检测关节软骨Ⅱ型胶原蛋白及基质金属蛋白酶13水平,并进行软骨组织Mankin评分。实验方案经重庆医科大学动物实验伦理委员会批准。结果与结论:①富血小板血浆中血小板、血小板衍生生长因子、转化生长因子β和血管内皮生长因子水平分别是正常血中的5.5,4.8,7.7和6.2倍(均P<0.05);②注射后第6周实验组Mankin评分小于对照组(P<0.05);③实验组第4,6,8,10周时Ⅱ型胶原蛋白水平明显高于对照组(P<0.05);实验组第2,4,6,8,10周时基质金属蛋白酶13水平明显小于对照组(P<0.05);④结果表明,关节腔内注射富血小板血浆能通过缓解关节滑膜炎症及延缓甚至阻断软骨细胞的损伤来抑制骨性关节炎的进展。

BACKGROUND:Studies have shown that platelet-rich plasma has a strong role in promoting chondrocyte repair and proliferation.OBJECTIVE:To investigate the efficacy of platelet-rich plasma in chondrocyte repair and synovial inflammation inhibition in osteoarthritis.METHODS:The blood samples were extracted from the central artery of the ear in 40 New Zealand white rabbits and platelet-rich plasma was prepared by the method of Hokugo.The platelet,platelet-derived growth factor,transforming growth factor-β,vascular endothelial growth factor in the peripheral blood and platelet-rich plasma were detected simultaneously.Animal models were made by resection of anterior cruciate ligament and divided into experimental group and control group.In the experimental group,0.3 mL of platelet-rich plasma was injected once a week for 10 weeks;in the control group,0.3 mL of sterile saline was injected once a week for 10 weeks.Gross observation and histological observation of knee joints were performed;articular cartilage type II collagen and matrix metalloproteinase 13 levels were measured;and Mankin score of the cartilage tissue was performed at 2,4,6,8,and 10 weeks after injection.The study protocol was approved by the Animal Experiment Ethics Committee of Chongqing Medical University.RESULTS AND CONCLUSION:(1)The concentrations of platelet,platelet-derived growth factor,transforming growth factor-β,vascular endothelial growth factor in platelet-rich plasma were 5.5,4.8,7.7,and 6.2 times those of the peripheral blood,respectively.And there were significant differences between the platelet-rich plasma and peripheral blood(P<0.05).(2)From the 6 th week,the Mankin score of the experimental group was significantly lower than that of the control group(P<0.05).(3)The expression of type II collagen protein in the experimental group was significantly higher than that in the control group at the 4 th,6 th,8 th and 10 th weeks after injection(P<0.05).The expression of matrix metalloproteinase-13 was significantly lower than that in the control group at the 2 nd,4 th,6 th,8 th and 10 th week(P<0.05).All these findings indicate that intra-articular injection of platelet-rich plasma can inhibit the development of osteoarthritis by alleviating synovial inflammation and delaying or blocking the damage of chondrocytes.