Oxidative Medicine and Cellular Longevity

Review Article

Effect of Platelet-Rich Plasma on Intervertebral Disc Degeneration In Vivo and In Vitro: A Critical Review

Table 1

In vitro effects of PRP on IVD cells.

(a)


Year	Study	System used to obtain PRP	Type of cells	Dose

2006	Akeda et al. [18]	SYMPHONY	Porcine IVD NP cell AF cell	10% PRP, 10% PPP
2006	Chen et al. [19]	Centrifuged	hNP	PRP (defined as TGF-β1 equivalent)
2009	Chen et al. [20]	Centrifuged	Porcine IVD organ induced with chymopapain	10% porcine PRP
2013	Mietsch et al. [32]	Centrifugation and double filtration	hNP MSC	10% PRP MSC
2014	Kim et al. [28]	GPS III System	hNP	5%, 10% PRP
2014	Liu et al. [29]	Not declared	ihNP	PRP (defined as TGF-β1 1 ng/ml equivalent)
2014	Pirvu et al. [21]	INTERCEPT Blood System	Bovine AF cells	25%–50% human PRP 25%–50% human platelet lysate
2016	Yang et al. [22]	Centrifuged	Rabbit NP cells	10%, 5%, 2.5%, and 1% volume fractions of PRP
2016	Cho et al. [30]	Centrifuged	Porcine AF cells with TNF-α	PRP of 1, 5, 10 × 10⁷ platelets/ml
2018	Wang et al. [24]	Two-step centrifugation	Rabbit NP-derived stem cells	5%–20% rabbit P-PRP or L-PRP
2018	Jia et al. [25]	Two-step centrifugation	NPMSCs	10% P-PRP or 10% L-PRP
2018	Hondke et al. [33]	Not declared	hAF	PRP 5%

(b)


Time of analysis	Activator	Results

72 h	Thrombin+CaCl₂	Cell proliferation↑, PG and col synthesis↑, PG accumulation↑
7, 9 days	Thrombin	NP cell proliferation and aggregation↑; optimum at 1 ng TGF-β1 concentration in PRP. Tissue construct ↑ COL II, AGN, SOX-9 mRNA ↑, GAG accumulation ↑phosphorylation of Smad2/3 ↑, apoptosis ↓
4 weeks	Thrombin	NP regeneration ↑mRNA involved in chondrogenesis and matrix accumulation↑
7 days, 4 weeks	Acetic acid	Cell proliferation↑ chondrogenic differentiation↓
48 h	CaCl₂	IL-1β and TNF-α led matrix synthesis gene expression↓; PRP degradation expression of COX-2 and MMP-3↓
7 days, 4 weeks	None	The expression of chondrogenic markers↑, inflammatory mediators ,matrix degrading enzymes in ihNPc↓
2, 4 days	Sonication	50% PL-DNA and GAG ↑. Matrix synthesis↑ of defect AF after PRP injection
1, 2, 3, 4, 5, 6, and 7 days	10% CaCl₂ 100 U thrombin	mRNA of COL II, AGN, and SOX-9↑; protein of COL X level TGF-b1/Smad2/3 ↑ COLII and AGN↑ by 2.5% PRP
24 h	1N HCL	COL II and AGN mRNA ↑,MMP1 mRNA, protein ↓
14 days	None	P-PRP: AGN, COL II↑, IL-1β, TNF-α, IL-6, IL-8, MMP-1, MMP-13 mRNA, IL-1β, TNF-α production ↓
7 days	10% CaCl₂	P-PRP: AGN, COL II↑ L-PRP: IL-1β, TNF-α MMP1, MMP-13 mRNA ↑ NF-κB/p65 protein↑
0, 7, 14, 21 days	Freezing and thawing	Stimulated migration and cell viability in early COL II mRNA ↑, COL1 and 3 mRNA ↓

Abbreviations: ACT: activation; NP: nucleus pulposus; AF: annulus fibrosus; AGN: aggrecan; COL II: type II collagen; COX-2: cyclooxygenase-2; GAG: glycosaminoglycan; IVD: intervertebral disc; MMP: metalloproteinase; MSC: mesenchymal stem cell; Sox-9:SRY-related high mobility group box gene-9; PG: proteoglycan; PRP: platelet-rich plasma; P-PRP: leukocyte-poor PRP; R-PRP: leukocyte-rich PRP; TNF: tumor necrosis factor.