2015 ISAKOS Biennial Congress Paper #0

Do More Platelets in the Peripheral Blood Mean More Growth Factors in Platelet-Rich Plasma?

Pawel Reichert, Prof, Wroclaw POLAND
Maciej Dejnek, MD, Wrocław POLAND
Helena Moreira, PhD, Wroclaw POLAND
Sylwia Płaczkowska, PhD, Wroclaw POLAND
Aleksandra Krolikowska, PhD, Prof., Wroclaw POLAND
Department of Trauma Surgery, Clinical Department of Trauma Surgery, Wroclaw Medical University, Wroclaw, POLAND

FDA Status Cleared

Summary: The content of platelets and WBC in whole blood strongly correlates with their content in PRP, and thus with a higher content of some of the growth factors: TGF-ß1 (free active), EGF, FGF-basic, VEGF, HGF, PDGF-AA, PDGF-BB. Complete whole blood count analysis before PRP treatment may be helpful in making decision about its used.

Abstract:

Title
Do more platelets in the peripheral blood mean more growth factors in platelet-rich plasma?

Background

The justification behind platelet-rich plasma (PRP) injections in sports injuries is related to the high content of growth factors released locally from platelets a-granules. These molecules, involved in natural healing processes, are expected to accelerate tissue regeneration and recovery of athletes. The wide range of platelet counts in healthy blood, a variety of preparation protocols, and administration techniques may be among the causes of inconsistent results in PRP treatment. The study aimed to assess the relationship between the content of cellular components in the whole blood and PRP samples and their correlation with the content of growth factors.

Material And Methods

A blood sample was taken from 43 subjects aged 24 to 60, and PRP was prepared using the Mini GPS III Platelet Concentration System (Biomet Inc., USA). Complete blood count was evaluated in both whole blood and PRP samples. Multiplex bead immunoassays and flow cytometer measurements were used for seven growth factors assessment in PRP: Transforming growth factor-ß1 (TGF-ß1, free active), Epidermal growth factor (EGF), Fibroblast growth factor-basic (FGF-basic), Vascular endothelial growth factor (VEGF), Hepatocyte growth factor (HGF), Platelet-derived growth factor-AA (PDGF-AA), and Platelet-derived growth factor-BB (PDGF-BB). Statistical analysis was performed, searching for correlations between the cellular components of whole blood/PRP and the content of selected growth factors.

Results

The complete blood count analysis shows a wide range of the content of platelets (PLT 133 – 419 109/L), white blood cells (WBC 4,06 – 9,82 109/L), and red blood cells (RBC 3,93 – 5,82 1012/L). In PRP, the PLT concentration increased 4.5 times (from 249,67 ±56,51 to 1119,81 ±443,07), the WBC concentration increased 4.75 times (from 6,57 ±1,37 to 31,24 ±10,09), the RBC concentration decreased 4 times (from 4.89 ±0.43 to 1.15 ±0.80). There was a significant high correlation between all cellular components in whole blood and in PRP, except RBC. Significant positive Spearman correlations were found between the concentration of PLT in whole blood and the concentration of PDGF-BB in PRP (r = 0.41; p = 0.008 ) and also between concentration of WBC and VEGF (r = 0.35; p < 0.05), HGF (r = 0.36; p < 0.05) in PRP. Significant positive correlation were also found between the concentration of PLT in PRP and the concentration of EGF (r = 0.59; p = 0.001), PDGF-AA (r = 0.52; p = 0.001), PDGF-BB (r = 0.49; p = 0.001), WBC in PRP and VEGF (r = 0.39, p < 0.05). Significant negative correlations were found between the concentration of RBC in PRP and the concentration of TGF-ß (r = -0.43; p < 0.05), FGF-basic (r = -0.42; p < 0.05).

Conclusions

The content of platelets and WBC in whole blood strongly correlates with their content in PRP, and thus with a higher content of some of the growth factors. Complete whole blood count analysis before PRP treatment may be helpful in making decision about its used.