Can we Engineer a better PRP to promote Orthopedic Healing?
POSTED ON 6/18/2012 IN Research BY Christopher Centeno
I've blogged before on our efforts to engineer a better PRP for our patients. One big concern has been that most bedside machines producing mass produced PRP produce a very blood contaminated PRP. PRP stands for Platelet Rich Plasma-a concentrate of your blood platelets used to help heal orthopedic injuries. Most of what's used by physicians comes from these bedside machines-which tends to be red in color because it contains your red blood cells. Why is this an issue? We've noticed for years that too many red blood cells can produce a very big inflammatory response in the patient as well as inhibit stem cell growth. In addition, we've also had concerns that these bedside PRP machines can't concentrate platelets enough, which also leads to poor performance. We use what we call "SCP", short for "Stem Cell Plasma"-our own mix of PRP without all of the blood (its amber in color). In engineering our version of PRP, we used our advanced lab facilities to find out which type of PRP (there are lots of ways to mix it), produced the best stimulation of stem cells in culture. The reasoning was simple, the goal of all PRP is to supply healing growth factors which work by stimulating local stem and other cells to work harder and heal your injury. So the idea that you would test PRP performance against human mesenchymal stem cells in culture made sense-the more the PRP helped stem cells grow-the more likely it was to perform well in real patients. Our first test with a bloody machine made PRP a few months ago showed that the machine made PRP wasn't very good at stimulating stem cells to grow. This was PRP produced by the second most common machine in use. So this time we tried the most common bedside PRP machine in use (which shall remain nameless). How did it go? Even worse for the bloody PRP. In this test (see above), without activating the blood contaminated machine made PRP-it produced no stem cell growth, compared to solid stem cell growth for our SCP. The graph above shows the SCP producing colonies of stem cells (CFUs), but nothing for the machine made PRP. The three patients shown are in their 20s, 40s, and 50s. The blue bars are SCP and if the PRP had shown any stem cell growth it would have been a red bar. Even with activation (giving the platelets a chemical kick), the bloody PRP (red bars) did little to stimulate stem cell growth compared to our lab made SCP (blue bars-see below). This experiment was repeated twice with the same result, to be sure that what we were seeing were actual differences. The upshot? It's likely that hundreds of thousands of patients a year are getting PRP shots with bloodly PRP-which is likely underperforming in how well it promotes healing. The two most common bedside PRP machines produce this blood contaminated PRP, which doesn't maximally prompt stem cells to grow. Using these tests, the two most common machines fare poorly against our PRP, which is engineered to get your stem cells to sing!
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