TY - JOUR
T1 - Platelet-Rich Plasma Activates Proinflammatory Signaling Pathways and Induces Oxidative Stress in Tendon Fibroblasts
AU - Hudgens, Joshua L.
AU - Sugg, Kristoffer B.
AU - Grekin, Jeremy A.
AU - Gumucio, Jonathan P.
AU - Bedi, Asheesh
AU - Mendias, Christopher L.
N1 - Funding Information:
This work was supported by National Institutes of Health grants R01-AR063649, F31-AR065931, and F32-AR067086.
Publisher Copyright:
© American Orthopaedic Society for Sports Medicine.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: Tendon injuries are one of the most common musculoskeletal conditions in active patients. Platelet-rich plasma (PRP) has shown some promise in the treatment of tendon disorders, but little is known as to the mechanisms by which PRP can improve tendon regeneration. PRP contains numerous different growth factors and cytokines that activate various cellular signaling cascades, but it has been difficult to determine precisely which signaling pathways and cellular responses are activated after PRP treatment. Additionally, macrophages play an important role in modulating tendon regeneration, but the influence of PRP on determining whether macrophages assume a proinflammatory or anti-inflammatory phenotype remains unknown. Purpose: To use genome-wide expression profiling, bioinformatics, and protein analysis to determine the cellular pathways activated in fibroblasts treated with PRP. The effect of PRP on macrophage polarization was also evaluated. Study Design: Controlled laboratory study. Methods: Tendon fibroblasts or macrophages from rats were cultured and treated with either platelet-poor plasma (PPP) or PRP. RNA or protein was isolated from cells and analyzed using microarrays, quantitative polymerase chain reaction, immunoblotting, or bioinformatics techniques. Results: Pathway analysis determined that the most highly induced signaling pathways in PRP-treated tendon fibroblasts were TNFα and NFκB pathways. PRP also downregulated the expression of extracellular matrix genes and induced the expression of autophagy-related genes and reactive oxygen species (ROS) genes and protein markers in tendon fibroblasts. PRP failed to have a major effect on markers of macrophage polarization. Conclusion: PRP induces an inflammatory response in tendon fibroblasts, which leads to the formation of ROS and the activation of oxidative stress pathways. PRP does not appear to significantly modulate macrophage polarization. Clinical Relevance: PRP might act by inducing a transient inflammatory event, which could then trigger a tissue regeneration response.
AB - Background: Tendon injuries are one of the most common musculoskeletal conditions in active patients. Platelet-rich plasma (PRP) has shown some promise in the treatment of tendon disorders, but little is known as to the mechanisms by which PRP can improve tendon regeneration. PRP contains numerous different growth factors and cytokines that activate various cellular signaling cascades, but it has been difficult to determine precisely which signaling pathways and cellular responses are activated after PRP treatment. Additionally, macrophages play an important role in modulating tendon regeneration, but the influence of PRP on determining whether macrophages assume a proinflammatory or anti-inflammatory phenotype remains unknown. Purpose: To use genome-wide expression profiling, bioinformatics, and protein analysis to determine the cellular pathways activated in fibroblasts treated with PRP. The effect of PRP on macrophage polarization was also evaluated. Study Design: Controlled laboratory study. Methods: Tendon fibroblasts or macrophages from rats were cultured and treated with either platelet-poor plasma (PPP) or PRP. RNA or protein was isolated from cells and analyzed using microarrays, quantitative polymerase chain reaction, immunoblotting, or bioinformatics techniques. Results: Pathway analysis determined that the most highly induced signaling pathways in PRP-treated tendon fibroblasts were TNFα and NFκB pathways. PRP also downregulated the expression of extracellular matrix genes and induced the expression of autophagy-related genes and reactive oxygen species (ROS) genes and protein markers in tendon fibroblasts. PRP failed to have a major effect on markers of macrophage polarization. Conclusion: PRP induces an inflammatory response in tendon fibroblasts, which leads to the formation of ROS and the activation of oxidative stress pathways. PRP does not appear to significantly modulate macrophage polarization. Clinical Relevance: PRP might act by inducing a transient inflammatory event, which could then trigger a tissue regeneration response.
KW - autophagy
KW - inflammation
KW - oxidative stress
KW - platelet-rich plasma
KW - tendinopathy
KW - tendon
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U2 - 10.1177/0363546516637176
DO - 10.1177/0363546516637176
M3 - Article
C2 - 27400714
AN - SCOPUS:84982855410
VL - 44
SP - 1931
EP - 1940
JO - The Journal of sports medicine
JF - The Journal of sports medicine
SN - 0363-5465
IS - 8
ER -