Comparación de los efectos de la plasma rico en plaquetas y la fibrina rico en plaquetas sobre la lesión tendinosa inducida experimentalmente en conejos tratados con metilprednisolona
Resumen
El objetivo de este estudio es comparar los efectos de PRP y PRF en lesiones tendinosas tratadas con metilprednisolona. En este contexto, se evaluaron los efectos histopatológicos e inmunohistoquímicos de PRP y PRF en la curación de tendones. El estudio incluyó 30 conejos de Nueva Zelanda (15 hembras y 15 machos) con diferentes pesos (1,5-3 kg) y edades (1-3 años). Los grupos experimentales se designaron como el grupo de control con esteroides (Grupo B, n = 10), el grupo esteroides + PRP (Grupo C, n = 10) y el grupo esteroides + PRF (Grupo D, n = 10). Además, los tejidos de control de un estudio simultáneo sirvieron como grupo de control vacío (Grupo A). El día 14 del posoperatorio, se extirpó una sección que abarcaba el sitio de la tenotomía del área a través de una incisión. Se observó que la curación fue mejor en los grupos C y D en comparación con los grupos A y B. En el grupo A, la infiltración de células inflamatorias, que consistía principalmente en macrófagos y leucocitos polimorfonucleares, junto con una pequeña cantidad de linfocitos y células gigantes de cuerpo extraño, fue mayor que en todos los demás grupos. El grupo B mostró una menor infiltración de células inflamatorias en comparación con el grupo A. Además, se observaron hiperemia, hemorragia, necrosis, formación de nuevos vasos y fibroblastos de diferentes formas y orientaciones en los grupos A y B. En contraste, la infiltración celular fue significativamente menor en los grupos C y D, mientras que la vascularización, la actividad de los fibroblastos y la densidad de colágeno fueron mayores. Se observó que las fibras de colágeno formaban haces más regulares en los grupos C y D en comparación con los grupos de control. Los hallazgos sugieren que la combinación de PRP o PRF con metilprednisolona sistémica puede mejorar efectivamente la curación del tendón al modular las respuestas inflamatorias, reducir las adherencias y apoyar la formación de una matriz extracelular bien organizada.
Descargas
Citas
Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, Dohan AJJ, Mouhyi J, Dohan DM. Platelet-Rich Fibrin (PRF): A Second-Generation Platelet Concentrate. Part IV: Clinical Effects on Tissue Healing. Oral Surg.Oral Med. Oral Pathol. Oral Radiol. Endod. [Internet]. 2006; 101(3):e56–e60. doi: https://doi.org/dtqptc DOI: https://doi.org/10.1016/j.tripleo.2005.07.011
De Carli A, Lanzetti RM, Ciompi A, Lupariello D, Vadalà A, Argento G, Ferretti A, Vulpiani MC, Vetrano M. Can Platelet-Rich Plasma Have a Role in Achilles Tendon Surgical Repair? Knee Surg. Sports Traumatol. Arthrosc. [Internet]. 2016; 24(7):2231–2237. doi: https://doi.org/f8txx9 DOI: https://doi.org/10.1007/s00167-015-3580-1
Marx RE. Platelet-Rich Plasma (PRP): What Is PRP and What Is Not PRP?. Implant Dent. [Internet]. 2001; 10(4):225–228. doi: https://doi.org/c6x6mq DOI: https://doi.org/10.1097/00008505-200110000-00002
Berglund ME, Hart DA, Reno C, Wiig M. Growth Factor and Protease Expression during Different Phases of Healing after Rabbit Deep Flexor Tendon Repair. J. Orthop. Res. Off. Publ. Orthop. Res. Soc. [Internet]. 2011; 29(6):886–892. doi: https://doi.org/dtgg8q DOI: https://doi.org/10.1002/jor.21330
Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, Gogly B. Platelet-Rich Fibrin (PRF): A Second-Generation Platelet Concentrate. Part I: Technological Concepts and Evolution. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. [Internet]. 2006; 101(3):e3744.doi: https://doi.org/cg8ngt DOI: https://doi.org/10.1016/j.tripleo.2005.07.008
Virchenko O, Grenegård M, Aspenberg P. Independent and Additive Stimulation of Tendon Repair by Thrombin and Platelets. Acta Orthop. [Internet]. 2006; 77(6):960–966. doi: https://doi.org/c4krrn DOI: https://doi.org/10.1080/17453670610013295
Aspenberg P, Virchenko O. Platelet Concentrate Injection Improves Achilles Tendon Repair in Rats. Acta Orthop. Scand. [Internet]. 2004; 75(1):93–99. doi: https://doi.org/fnhsj6 DOI: https://doi.org/10.1080/00016470410001708190
Kearney RS, Costa ML. Current Concepts in the Rehabilitation of an Acute Rupture of the Tendo Achillis. J. Bone Joint Surg. Br. [Internet]. 2012; 94(1):28–31. doi: https://doi.org/fxpvs7 DOI: https://doi.org/10.1302/0301-620X.94B1.28008
Parafioriti A, Armiraglio E, Del Bianco S, Tibalt E, Oliva F, Berardi AC. Single Injection of Platelet-Rich Plasma in a Rat Achilles Tendon Tear Model. Muscles Ligaments Tendons J. [Internet]. 2011; 1(2):41–47. PMID: 23738245. Avaliable in: https://goo.su/ghzwWF
Takamura M, Yasuda T, Nakano A, Shima H, Neo M. The Effect of Platelet-Rich Plasma on Achilles Tendon Healing in a Rabbit Model. Acta Orthop. Traumatol. Turc. [Internet]. 2017; 51(1):65. doi: https://doi.org/n49d DOI: https://doi.org/10.1016/j.aott.2016.12.001
Coombes BK, Bisset L, Vicenzino B. Efficacy and Safety of Corticosteroid Injections and Other Injections for Management of Tendinopathy: A Systematic Review of Randomised Controlled Trials. Lancet Lond. Engl. [Internet]. 2010; 376(9754):1751–1767. doi: https://doi.org/chs9bs DOI: https://doi.org/10.1016/S0140-6736(10)61160-9
Dean BJF, Lostis E, Oakley T, Rombach I, Morrey ME, Carr AJ. The Risks and Benefits of Glucocorticoid Treatment for Tendinopathy: A Systematic Review of the Effects of Local Glucocorticoid on Tendon. Semin. Arthritis Rheum. [Internet]. 2014; 43(4):570–576. doi: https://doi.org/f2pvh3 DOI: https://doi.org/10.1016/j.semarthrit.2013.08.006
Van Der Linden PD, Sturkenboom MCJM, Herings RMC, Leufkens HMG, Rowlands S, Stricker BHCh. Increased Risk of Achilles Tendon Rupture With Quinolone Antibacterial Use, Especially in Elderly Patients Taking Oral Corticosteroids. Arch. Intern. Med. [Internet]. 2003; 163(15):1801. doi: https://doi.org/cfz85b DOI: https://doi.org/10.1001/archinte.163.15.1801
Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, Gogly B. Platelet-Rich Fibrin (PRF): A Second-Generation Platelet Concentrate. Part II: Platelet-Related Biologic Features. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. [Internet]. 2006; 101(3):e45–e50. doi: https://doi.org/fbsqc9 DOI: https://doi.org/10.1016/j.tripleo.2005.07.009
Kleinert HE, Schepel S, Gill T. Flexor tendon injuries. Surg. Clin. North. Am. [Internet]. 1981; 61(2):267–286. doi: https://doi.org/n49f DOI: https://doi.org/10.1016/S0039-6109(16)42381-9
Wong C-C, Huang Y-M, Chen C-H, Lin F-H, Yeh Y-Y, Bai M-Y. Cytokine and Growth Factor Delivery from Implanted Platelet-Rich Fibrin Enhances Rabbit Achilles Tendon Healing. Int. J. Mol. Sci. [Internet]. 2020; 21(9):3221. doi: https://doi.org/n49g DOI: https://doi.org/10.3390/ijms21093221
Bosch G, Moleman M, Barneveld A, van Weeren PR, van Schie HTM. The Effect of Platelet-Rich Plasma on the Neovascularization of Surgically Created Equine Superficial Digital Flexor Tendon Lesions. Scand. J. Med. Sci. Sports. [Internet]. 2011; 21(4):554–561. doi: https://doi.org/b95wcp DOI: https://doi.org/10.1111/j.1600-0838.2009.01070.x
Sen B, Güler S, Çeçen B, Kumtepe E, Bagriyanik A, Özkal S, Ali Özcan M, Özsan H, Sanli N, Tatari MH. The Effect of Autologous Platelet Rich Plasma in the Treatment of Achilles Tendon Ruptures: An Experimental Study on Rabbits. Balk. Med. J. [Internet]. 2016; 33(1):94–101. doi: https://doi.org/n49h DOI: https://doi.org/10.5152/balkanmedj.2015.15549
Dietrich F, L. Duré G, P. Klein C, F. Bampi V, V. Padoin A, D. Silva V, Braga-Silva J. Platelet-Rich Fibrin Promotes an Accelerated Healing of Achilles Tendon When Compared to Platelet-Rich Plasma in Rat. World J. Plast. Surg. [Internet]. 2015; 4(2):101–109. PMID: 26284178. Avaliable in: https://goo.su/5cKIERO
Liu X, Zhu B, Li Y, Liu X, Guo S, Wang C, Li S, Wang D. The Role of Vascular Endothelial Growth Factor in Tendon Healing. Front. Physiol. [Internet]. 2021; 12:766080. doi: https://doi.org/n49j DOI: https://doi.org/10.3389/fphys.2021.766080
Nakamura K, Kitaoka K, Tomita K. Effect of Eccentric Exercise on the Healing Process of Injured Patellar Tendon in Rats. J. Orthop. Sci. [Internet]. 2008; 13(4):371–378. doi: https://doi.org/bcxqpt DOI: https://doi.org/10.1007/s00776-008-1242-6
Chen CH, Cao Y, Wu YF, Bais AJ, Gao JS, Tang JB. Tendon Healing in Vivo: Gene Expression and Production of Multiple Growth Factors in Early Tendon Healing Period. J. Hand Surg. [Internet]. 2008; 33(10):1834–1842. doi: https://doi.org/d63tpf DOI: https://doi.org/10.1016/j.jhsa.2008.07.003
Sahin H, Tholema N, Petersen W, Raschke MJ, Stange R. Impaired Biomechanical Properties Correlate with Neoangiogenesis as Well as VEGF and MMP-3 Expression during Rat Patellar Tendon Healing. J. Orthop. Res. [Internet]. 2012; 30(12):1952–1957. doi: https://doi.org/f4czxx DOI: https://doi.org/10.1002/jor.22147
Stange R, Sahin H, Wieskötter B, Persigehl T, Ring J, Bremer C, Raschke MJ, Vieth V. In Vivo Monitoring of Angiogenesis during Tendon Repair: A Novel MRI-Based Technique in a Rat Patellar Tendon Model. Knee Surg. Sports Traumatol. Arthrosc. 2015; 23(8):2433–2439. doi: https://doi.org/f7kf9r DOI: https://doi.org/10.1007/s00167-014-2897-5
Hou Y, Mao Z, Wei X, Lin L, Chen L, Wang H, Fu X, Zhang J, Yu C. The Roles of TGF-Beta1 Gene Transfer on Collagen Formation during Achilles Tendon Healing. Biochem. Biophys. Res. Commun. [Internet]. 2009; 383(2):235–239. doi: https://doi.org/bjft8z DOI: https://doi.org/10.1016/j.bbrc.2009.03.159
Lyras DN, Kazakos K, Georgiadis G, Mazis G, Middleton R, Richards S, O’Connor D, Agrogiannis G. Does a Single Application of PRP Alter the Expression of IGF-I in the Early Phase of Tendon Healing? J. Foot Ankle Surg. [Internet]. 2011; 50(3);276–282. doi: https://doi.org/fbb9q3 DOI: https://doi.org/10.1053/j.jfas.2011.02.010
He P, Ruan D, Huang Z, Wang C, Xu Y, Cai H, Liu H, Fei Y, Heng BC, Chen W, Shen W. Comparison of Tendon Development Versus Tendon Healing and Regeneration. Front. Cell. Dev. Biol. [Internet]. 2022; 10:821667. doi: https://doi.org/n49k DOI: https://doi.org/10.3389/fcell.2022.821667
Tang JB, Wu YF, Cao Y, Chen CH, Zhou YL, Avanessian B, Shimada M, Wang XT, Liu PY. Basic FGF or VEGF Gene Therapy Corrects Insufficiency in the Intrinsic Healing Capacity of Tendons. Sci. Rep. [Internet]. 2016; 6:20643. doi: https://doi.org/f79mp3 DOI: https://doi.org/10.1038/srep20643
Lin J, Wang MX, Wei A, Zhu W, Murrell GA. The Cell Specific Temporal Expression of Nitric Oxide Synthase Isoforms during Achilles Tendon Healing. Inflamm. Res. [Internet]. 2001; 50(10):515–522. doi: https://doi.org/d9ww7d DOI: https://doi.org/10.1007/PL00000228
Bokhari AR, Murrell GAC. The Role of Nitric Oxide in Tendon Healing. J. Shoulder Elbow Surg. [Internet]. 2012; 21(2):238–244. doi: https://doi.org/fxtvh7 DOI: https://doi.org/10.1016/j.jse.2011.11.001
Murrell GAC. Using Nitric Oxide to Treat Tendinopathy. Br. J. Sports Med. [Internet]. 2007; 41(4):227. doi: https://doi.org/cphxpw DOI: https://doi.org/10.1136/bjsm.2006.034447
Doherty GP, Koike Y, Uhthoff HK, Lecompte M, Trudel G. Comparative Anatomy of Rabbit and Human Achilles Tendons with Magnetic Resonance and Ultrasound Imaging. Comp. Med. [Internet]. 2006; 56(1):68–74. PMID: 16521862. Avaliable in: https://goo.su/ReDgjU
Barbato KBG, Raposo C, Dias H, Paiva R, Costa J da, Rodriguez L, Almeida G de, Rocha-Barbosa O, Oliveira LP de, Carvalho J. Benefits of the Combined Use of NSAID and Early Exercise on Tendon Healing in a Murine Model. Open J. Anim. Sci. [Internet]. 2018; 8(4):357–369. doi: https://doi.org/n49m DOI: https://doi.org/10.4236/ojas.2018.84027
Blomgran P, Hammerman M, Aspenberg P. Systemic Corticosteroids Improve Tendon Healing When given after the Early Inflammatory Phase. Sci Rep. [Internet]. 2017; 7(1):12468. doi: https://doi.org/gb239w DOI: https://doi.org/10.1038/s41598-017-12657-0
Docheva D, Müller SA, Majewski M, Evans CH. Biologics for Tendon Repair. Adv. Drug Deliv. Rev. [Internet]. 2015; 84:222–239. doi: https://doi.org/f7dvqb DOI: https://doi.org/10.1016/j.addr.2014.11.015
Speed CA. Fortnightly Review: Corticosteroid Injections in Tendon Lesions. BMJ [Internet]. 2001; 323(7309):382–386. doi: https://doi.org/bkvfbx DOI: https://doi.org/10.1136/bmj.323.7309.382
Oxlund H. The Influence of a Local Injection of Cortisol onthe Mechanical Properties of Tendons and Ligaments and the Indirect Effect on Skin. Acta Orthop. Scand. [Internet]. 1980; 51(2):231–238. doi: https://doi.org/cg8bp8 DOI: https://doi.org/10.3109/17453678008990791
Beitzel K, McCarthy MB, Cote MP, Apostolakos J, Russell RP, Bradley J, ElAttrache NS, Romeo AA, Arciero RA, Mazzocca AD. The Effect of Ketorolac Tromethamine, Methylprednisolone, and Platelet-Rich Plasma on Human Chondrocyte and Tenocyte Viability. Arthrosc J. Arthrosc. Relat. Surg. [Internet]. 2013; 29(7):1164–1174. doi: https://doi.org/f2f34f DOI: https://doi.org/10.1016/j.arthro.2013.04.006
Tatari H, Kosay C, Baran O, Ozcan O, Ozer E. Deleterious Effects of Local Corticosteroid Injections on the Achilles Tendon of Rats. Arch. Orthop. Trauma Surg. [Internet]. 2001; 121(6):333–337. doi: https://doi.org/chgs4d DOI: https://doi.org/10.1007/s004020000236
Zargar Baboldashti N, Poulsen RC, Franklin SL, ThompsonMS, Hulley PA. Platelet-Rich Plasma Protects Tenocytes from Adverse Side Effects of Dexamethasone and Ciprofloxacin. Am. J. Sports Med. [Internet]. 2011; 39(9):1929–1935. doi: https://doi.org/fjx2nb DOI: https://doi.org/10.1177/0363546511407283
Zhang J, Keenan C, Wang JH-C. The Effects of Dexamethasone on Human Patellar Tendon Stem Cells: Implications for Dexamethasone Treatment of Tendon Injury. J. Orthop. Res. [Internet]. 2013; 31(1):105–110. doi: https://doi.org/n49n DOI: https://doi.org/10.1002/jor.22193
