Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis
Abstract Background Osteoarthritis (OA) affects the entire joint, causing structural changes in articular cartilage, subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles that afflicts millions of people globally, leading to persistent pain and diminished quality of life...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Advances in Rheumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42358-024-00364-0 |
| _version_ | 1797233176006885376 |
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| author | Homero Garcia-Motta Cristiano Carvalho Evelyn Maria Guilherme Marcos Paulo Braz de Oliveira Karina Nogueira Zambone Pinto Rossi |
| author_facet | Homero Garcia-Motta Cristiano Carvalho Evelyn Maria Guilherme Marcos Paulo Braz de Oliveira Karina Nogueira Zambone Pinto Rossi |
| author_sort | Homero Garcia-Motta |
| collection | DOAJ |
| description | Abstract Background Osteoarthritis (OA) affects the entire joint, causing structural changes in articular cartilage, subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles that afflicts millions of people globally, leading to persistent pain and diminished quality of life. The intra-articular use of platelet-rich plasma (PRP) is gaining recognition as a secure therapeutic approach due to its potential regenerative capabilities. However, there is controversial clinical data regarding efficacy of PRP for OA treatment. In this context, gathering scientific evidence on the effects of PRP in treating OA in animal models could provide valuable insights into understanding its impact on aspects like cartilage health, synovial tissue integrity, and the inflammatory process in affected joints. Thus, the objective of this study was to assess the effects of PRP injections on inflammation and histopathological aspects of cartilage and synovium in animal models of OA through a comprehensive systematic review with meta-analysis. Methods A electronic search was conducted on Medline, Embase, Web of Science, The Cochrane Library, LILACS, and SciELO databases for relevant articles published until June 2022. A random-effects meta-analysis was employed to synthesize evidence on the histological characteristics of cartilage and synovium, as well as the inflammatory process. The GRADE approach was utilized to categorize the quality of evidence, and methodological quality was assessed using SYRCLE’s RoB tool. Results Twenty-one studies were included in the review, with twelve of them incorporated into the meta-analysis. PRP treatment demonstrated superior outcomes compared to the control group in terms of cartilage histology (very low quality; p = 0.0002), synovium histology (very low quality; p < 0.0001), and reductions in proinflammatory markers, including IL-1 (low quality; p = 0.002), IL-6 (very low quality; p < 0.00001), and TNF-α (very low; p < 0.00001). However, PRP treatment did not yield a significant impact on PDGF-A levels (very low quality; p = 0.81). Conclusion PRP appears capable of reducing proinflammatory markers (IL-1, IL-6, TNF-α) and mitigating cartilage and synovium damage in animals with OA. However, the levels of evidence of these findings are low to very low. Therefore, more rigorous studies with larger samples are needed to improve the quality of evidence. PROSPERO registration CRD42022250314 |
| first_indexed | 2024-04-24T16:12:00Z |
| format | Article |
| id | doaj.art-4c0aa374dc54470a9a9568b08d5cf63a |
| institution | Directory Open Access Journal |
| issn | 2523-3106 |
| language | English |
| last_indexed | 2024-04-24T16:12:00Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Advances in Rheumatology |
| spelling | doaj.art-4c0aa374dc54470a9a9568b08d5cf63a2024-03-31T11:38:47ZengBMCAdvances in Rheumatology2523-31062024-03-0164111610.1186/s42358-024-00364-0Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysisHomero Garcia-Motta0Cristiano Carvalho1Evelyn Maria Guilherme2Marcos Paulo Braz de Oliveira3Karina Nogueira Zambone Pinto Rossi4Morphology and Pathology Department, Federal University of São CarlosDepartment of Biosciences, Federal University of São Paulo, Campus Baixada SantistaPhysical Therapy Department, Federal University of São CarlosPhysical Therapy Department, Federal University of São CarlosMorphology and Pathology Department, Federal University of São CarlosAbstract Background Osteoarthritis (OA) affects the entire joint, causing structural changes in articular cartilage, subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles that afflicts millions of people globally, leading to persistent pain and diminished quality of life. The intra-articular use of platelet-rich plasma (PRP) is gaining recognition as a secure therapeutic approach due to its potential regenerative capabilities. However, there is controversial clinical data regarding efficacy of PRP for OA treatment. In this context, gathering scientific evidence on the effects of PRP in treating OA in animal models could provide valuable insights into understanding its impact on aspects like cartilage health, synovial tissue integrity, and the inflammatory process in affected joints. Thus, the objective of this study was to assess the effects of PRP injections on inflammation and histopathological aspects of cartilage and synovium in animal models of OA through a comprehensive systematic review with meta-analysis. Methods A electronic search was conducted on Medline, Embase, Web of Science, The Cochrane Library, LILACS, and SciELO databases for relevant articles published until June 2022. A random-effects meta-analysis was employed to synthesize evidence on the histological characteristics of cartilage and synovium, as well as the inflammatory process. The GRADE approach was utilized to categorize the quality of evidence, and methodological quality was assessed using SYRCLE’s RoB tool. Results Twenty-one studies were included in the review, with twelve of them incorporated into the meta-analysis. PRP treatment demonstrated superior outcomes compared to the control group in terms of cartilage histology (very low quality; p = 0.0002), synovium histology (very low quality; p < 0.0001), and reductions in proinflammatory markers, including IL-1 (low quality; p = 0.002), IL-6 (very low quality; p < 0.00001), and TNF-α (very low; p < 0.00001). However, PRP treatment did not yield a significant impact on PDGF-A levels (very low quality; p = 0.81). Conclusion PRP appears capable of reducing proinflammatory markers (IL-1, IL-6, TNF-α) and mitigating cartilage and synovium damage in animals with OA. However, the levels of evidence of these findings are low to very low. Therefore, more rigorous studies with larger samples are needed to improve the quality of evidence. PROSPERO registration CRD42022250314https://doi.org/10.1186/s42358-024-00364-0CartilagePlatelet-rich plasmaSynovitisInterleukinsTumor necrosis factor alpha |
| spellingShingle | Homero Garcia-Motta Cristiano Carvalho Evelyn Maria Guilherme Marcos Paulo Braz de Oliveira Karina Nogueira Zambone Pinto Rossi Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis Advances in Rheumatology Cartilage Platelet-rich plasma Synovitis Interleukins Tumor necrosis factor alpha |
| title | Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis |
| title_full | Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis |
| title_fullStr | Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis |
| title_full_unstemmed | Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis |
| title_short | Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis |
| title_sort | effects of intra articular injection of platelet rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis a systematic review with meta analysis |
| topic | Cartilage Platelet-rich plasma Synovitis Interleukins Tumor necrosis factor alpha |
| url | https://doi.org/10.1186/s42358-024-00364-0 |
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