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Increased leukocyte levels in some platelet-rich plasma preparations a cause for concern
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MONTREAL — Although platelet-rich plasma is useful in the repair of some musculoskeletal injuries, one researcher speaking at the International Cartilage Repair Society World Congress 2012, here, noted it is critical to understand that the material is more than just platelets and its ability to aid in healing is not based only on platelet concentration.
Lisa A. Fortier, PhD, noted in her presentation that platelet-rich plasma (PRP) consists of leukocytes and other plasma components beyond simply platelets, and the ideal combination and concentrations of these materials is still unknown.
“We don't even have a definition for platelet-rich plasma,” she said. “Everybody has a different definition.”
 Lisa A. Fortier, PhD |
PRP was initially used to deliver platelets and the growth factors they carried to an injury site, which led to the idea that larger amounts were better for the patient, which spurred manufacturers to create systems that would deliver greater platelet concentrations, Fortier, of Ithaca,, N.Y., said. This concept, however, led to increased leukocytes in certain preparations, a concept that Fortier found troubling because studies have suggested that leukocytes lead to the loss of normal tendon matrix and an increase in inflammatory molecules.
“This paradigm that we are really trying to change is that if some is good, more must be better,” she said. “What you need to remember is that it is not just the platelets you’re delivering. It is made from blood, so everything contained from blood is also going to be in platelet-rich plasma.”
More information is still needed, Fortier said, as there are few level 1 studies regarding the efficacy of PRP for treating various musculoskeletal pathologies. She noted that in her research she found PRP decreases inflammatory pain markers in patients with osteoarthritis. There is, however, no clinical data suggesting cartilage extracellular matrix protein production is increased with PRP use, Fortier added.
Reference:
- Fortier LA, McCarrell T, Cole BJ, et al. Platelet rich plasma: Overview of current knowledge: Hope, hype and reality. Paper #15.1.1. Presented at the International Cartilage Repair Society World Congress 2012. May 12-15. Montreal.
