What is the role of PRP in Stem Cell Therapy?

PRP stands for Platelet Rich Plasma, which isa main component of a PRP stem cell injection. The term is used very loosely to include anything that has growth factors and cytokines derived from blood (Platelets). When cells talk to each other, they make proteins and peptides that are the messages that pass from one cell to another and determine how the cell will respond. These are called cytokines and include growth factors. PRP stem cell injections for the knee, hip and spine use these cytokines to control the actions of surrounding cells. Platelets store granules of these cytokines that can be harvested and used.

The process of obtaining cytokines begins with a sample of blood being collected and centrifuged. The red blood cells collect at the bottom, while the plasma containing platelets can be taken from the top. This plasma with platelets can be used as is or can be centrifuged a second time to concentrate the platelets at the bottom of the tube.

We then have Platelet Rich Plasma (PRP) at the bottom and Platelet Poor Plasma (PPP) at the top. Collecting the PRP from the bottom, it can be used as is or it can be activated by adding Calcium Gluconate. This causes a clot to form, which excretes the cytokines from the platelets. The clot will slowly shrink as the cytokines are excreted. The platelets are now destroyed, and because the clotting factors have been used up, the plasma is now serum. The end product is cytokines in serum, which is used for stem cell therapy. This is obviously not PRP, as there are no platelets and no plasma.

When the plasma containing platelets are injected into the body, the platelets will be activated by contact with any tissue except endothelial cells (the cells that line arteries and stop platelets clotting). When this happens, the cytokines will be released slowly over 5 or more days. This clot is known as Platelet Rich Plasma Gel (PRPG).

The normal role of platelets in the body is to adhere to any gap in blood vessels, where they form a clot to block the hole and release cytokines to heal the damage. It is this healing power that can be utilised by doctors to heal tendon, joint and other soft tissue injuries.

Macquarie Stem Cells wanted to see if this function of platelets could be used to test if people will be responders or non-responders to stem cell therapy. We have tested this on a large number of patients using various combinations and the test has had some usefulness.

Using Platelet Rich Plasma therapy for osteoarthritis has not improved the results when given at the same time as stem cells, but there may be some utility when given two weeks before stem cells, as well as in the healing time after stem cell therapy.

Using the cytokines contained in platelets is like having a burst of stem cell activity. The results can last for one week in some patients whilst in others the results can be much longer, lasting up to a year or more. There will be a group of patients who only need plasma/platelets and others who will need stromal cells (stem cells) to get a lasting and complete effect.

A recently conducted case series has had significant findings relating to PRP stem cell injections. This study focused on knee osteoarthritis, which previously could only be treated with pain medication, anti-inflammatory drugs, or invasive joint replacement surgery.

Four different patients suffering from knee osteoarthritis were investigated to establish the effectiveness of an exercise rehabilitation program combined with Platelet Rich Plasma injections containing autologous StroMed and PRP. Over a 12 month period, each patient received regular PRP stem cell injections, participated in physical function tests, and recorded their symptoms in a questionnaire. At the conclusion of the study, all patients experienced improved outcomes, indicating that injecting a combination of stromal cells and PRP can be beneficial for osteoarthritis.

If youre interested in learning more about the role of Platelet Rich Plasma therapy for osteoarthritis, including PRP injections for the knee, hip or spine, contact Macquarie Stem Cells to arrange a consultation.

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