Background: Clinical studies claim that platelet-rich plasma (PRP) shortens recovery times because of its high concentration of growth factors that may enhance the tissue repair process. Most of these studies obtained PRP using different separation systems, and few analyzed the content of the PRP used as treatment.
Purpose: This study characterized the composition of single-donor PRP produced by 3 commercially available PRP separation systems.
Study Design: Controlled laboratory study.
Methods: Five healthy humans donated 100 mL of blood, which was processed to produce PRP using 3 PRP concentration systems (MTF Cascade, Arteriocyte Magellan, Biomet GPS III). Platelet, white blood cell (WBC), red blood cell, and fibrinogen concentrations were analyzed by automated systems in a clinical laboratory, whereas ELISA determined the concentrations of platelet-derived growth factor αβ and ββ (PDGF-αβ, PDGF-ββ), transforming growth factor β1 (TGF-β1), and vascular endothelial growth factor (VEGF).
Results: There was no significant difference in mean PRP platelet, red blood cell, active TGF-β1, or fibrinogen concentrations among PRP separation systems. There was a significant difference in platelet capture efficiency. The highest platelet capture efficiency was obtained with Cascade, which was comparable with Magellan but significantly higher than GPS III. There was a significant difference among all systems in the concentrations of WBC, PDGF-αβ, PDGF-ββ, and VEGF. The Cascade system concentrated leukocyte-poor PRP, compared with leukocyte-rich PRP from the GPS III and Magellan systems.
Conclusion: The GPS III and Magellan concentrate leukocyte-rich PRP, which results in increased concentrations of WBCs, PDGF-αβ, PDGF-ββ, and VEGF as compared with the leukocyte-poor PRP from Cascade. Overall, there was no significant difference among systems in the platelet concentration, red blood cell, active TGF-β1, or fibrinogen levels.
Clinical Relevance: Products from commercially available PRP separation systems produce differing concentrations of growth factors and WBCs. Further research is necessary to determine the clinical relevance of these findings.
AhamedJBurgNYoshinagaKJanczakCARifkinDBCollerBS. In vitro and in vivo evidence for shear-induced activation of latent transforming growth factor-beta1. Blood. 2008;112(9):3650-3660.
2.
AnituaEAndiaISanchezM. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res. 2005;23(2):281-286.
3.
BergUGustafssonTSundbergCJ. Local changes in the insulin-like growth factor system in human skeletal muscle assessed by microdialysis and arterio-venous differences technique. Growth Horm IGF Res. 2006;16(4):217-223.
4.
BerghoffWJPietrzakWSRhodesRD. Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics. 2006;29(7):590-598.
5.
BlobeGCSchiemannWPLodishHF. Role of transforming growth factor beta in human disease. N Engl J Med. 2000;342(18):1350-1358.
6.
CreaneyLHamiltonB. Growth factor delivery methods in the management of sports injuries: the state of play. Br J Sports Med. 2008;42(5):314-320.
7.
De CarliAVolpiPPelosiniI. New therapeutic approaches for management of sport-induced muscle strains. Adv Ther. 2009;26(12):1072-1083.
8.
de MosMvan der WindtAEJahrH. Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med. 2008;36(6):1171-1178.
9.
de VosRJWeirAvan SchieHT. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA. 13;303(2):144-149.
10.
Dohan EhrenfestDMRasmussonLAlbrektssonT. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leukocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009;27(3):158-167.
EppleyBLWoodellJEHigginsJ. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114(6):1502-1508.
13.
EvertsPABrown MahoneyCHoffmannJJ. Platelet-rich plasma preparation using three devices: implications for platelet activation and platelet growth factor release. Growth Factors. 2006;24(3):165-171.
14.
GandhiADoumasCO’ConnorJPParsonsJRLinSS. The effects of local platelet rich plasma delivery on diabetic fracture healing. Bone. 2006;38(4):540-546.
15.
GragedaE. Platelet-rich plasma and bone graft materials: a review and a standardized research protocol. Implant Dent. 2004;13(4):301-309.
16.
HallMPBandPAMeislinRJJazrawiLMCardoneDA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009;17(10):602-608.
17.
HammondJWHintonRYCurlLAMurielJMLoveringRM. Use of autologous platelet-rich plasma to treat muscle strain injuries. Am J Sports Med. 2009;37(6):1135-1142.
18.
HeldinCHErikssonUOstmanA. New members of the platelet-derived growth factor family of mitogens. Arch Biochem Biophys. 2002;398(2):284-290.
19.
KevySVJacobsonMS. Comparison of methods for point of care preparation of autologous platelet gel. J Extra Corpor Technol. 2004;36(1):28-35.
20.
ManDPloskerHWinland-BrownJE. The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery. Plast Reconstr Surg. 2001;107(1):229-237.
21.
MarlovitsSMousaviMGablerCErdosJVecseiV. A new simplified technique for producing platelet-rich plasma: a short technical note. Eur Spine J. 2004;13(suppl 1):S102-S106.
22.
MarxRE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489-496.
23.
MatrasH. [Effect of various fibrin preparations on reimplantations in the rat skin]. Osterr Z Stomatol. 1970;67(9):338-359.
24.
MenetreyJKasemkijwattanaCDayCS. Growth factors improve muscle healing in vivo. J Bone Joint Surg Br. 2000;82(1):131-137.
25.
MoojenDJEvertsPASchureRM. Antimicrobial activity of platelet-leukocyte gel against Staphylococcus aureus. J Orthop Res. 2008;26(3):404-410.
26.
RadiceFYanezRGutierrezVRosalesJPinedoMCodaS. Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy. 2010;26(1):50-57.
27.
SanchezMAnituaEAzofraJAndiaIPadillaSMujikaI. Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. 2007;35(2):245-251.
28.
SanchezMAnituaECugatR. Nonunions treated with autologous preparation rich in growth factors. J Orthop Trauma. 2009;23(1):52-59.
29.
SilvaASampaioR. Anatomic ACL reconstruction: does the platelet-rich plasma accelerate tendon healing?Knee Surg Sports Traumatol Arthrosc. 2009;17(6):676-682.
30.
SlaterMPatavaJKinghamKMasonRS. Involvement of platelets in stimulating osteogenic activity. J Orthop Res. 1995;13(5):655-663.
31.
TamimiFMMontalvoSTresguerresIBlanco JerezL. A comparative study of 2 methods for obtaining platelet-rich plasma. J Oral Maxillofac Surg. 2007;65(6):1084-1093.
32.
WeibrichGKleisWKHafnerGHitzlerWE. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Craniomaxillofac Surg. 2002;30(2):97-102.
33.
WernerSGroseR. Regulation of wound healing by growth factors and cytokines. Physiol Rev. 2003;83(3):835-870.
34.
WertherKChristensenIJNielsenHJ. Determination of vascular endothelial growth factor (VEGF) in circulating blood: significance of VEGF in various leukocytes and platelets. Scand J Clin Lab Invest. 2002;62(5):343-350.
35.
WhitmanDHBerryRLGreenDM. Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. J Oral Maxillofac Surg. 1997;55(11):1294-1299.
36.
ZimmermannRJakubietzRJakubietzM. Different preparation methods to obtain platelet components as a source of growth factors for local application. Transfusion. 2001;41(10):1217-1224.
