title: The Properties of 3 Different Plasma Formulations and Their Effects on Tendinopathic Cells.
abstract: Tendinopathies are attributed to failure of the healing process and inadequate tissue remodeling. Plasma injections can trigger regenerative responses by modifying the molecular microenvironment.
  
  
  
  To examine the differences in the mitotic, chemotactic, anabolic, and inflammatory effects between leukocyte- and platelet-rich plasma (L-PRP), platelet-rich plasma (PRP), and platelet-poor plasma (PPP).
  
  
  
  Controlled laboratory study.
  
  
  
  Tendinopathic cells were cultured in 3-dimensional (3D) hydrogels formed using PPP, PRP, and L-PRP. Cell migration was evaluated using a μ-Slide chemotaxis chamber with video microscopy. Proliferation was assessed using XTT assays. Expression of genes associated with matrix turnover, including type 1 collagen (COL1A1), COL3A1, aggrecan, decorin, fibronectin, matrix metalloproteinase 1 (MMP-1), MMP-3, A Disintegrin-Like And Metalloprotease With Thrombospondin Type 1 Motif proteins 4 (ADAMTS-4), and ADAMTS-5, was assessed using real-time reverse-transcription polymerase chain reaction. Secreted inflammatory proteins, including interleukin (IL)-1β, IL-6, IL-8, monocyte chemotactic protein 1 (MCP-1), and regulated on activation, normal T cell expressed and secreted (RANTES), as well as vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF), were quantified using enzyme-linked immunosorbent assay.
  
  
  
  Tendinopathic cells migrate at a higher velocity along L-PRP and PRP than along PPP gradients. PRP and L-PRP promote hypercellularity. PPP and PRP showed more pronounced anabolic properties, as demonstrated by enhanced COL1A1 and COL3A1 and reduced MMP-1 expression. Decorin, fibronectin, and aggrecan were downregulated in L-PRP compared with PPP and PRP. L-PRP and PRP were shown to be more proinflammatory than PPP in terms of IL-6 secretion, but cells in PPP showed MCP-1(high) phenotype. CTGF secretion was significantly reduced in L-PRP compared with PPP and PRP.
  
  
  
  The main advantages of L-PRP and PRP use, compared with PPP, include their stronger chemotactic and proliferative properties. While PPP and PRP stimulate matrix anabolism, L-PRP is more proinflammatory. Emphasis should be placed on the temporal needs and biological characteristics of injured tendons, and plasma formulations need to be tailored accordingly.
  
  
  
  Versatile systems allowing the preparation of different plasma formulations, such as PPP, PRP, or L-PRP, can help refine clinical applications by taking advantage of their different biological properties.
authors.affiliation: BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Rubio-Azpeitia
authors.affiliation: Arthroscopic Surgery Unit Research, Hospital Vithas San José, Vitoria-Gasteiz, Spain.
authors.forename: Ane M
authors.initials: AM
authors.lastname: Bilbao
authors.affiliation: Arthroscopic Surgery Unit Research, Hospital Vithas San José, Vitoria-Gasteiz, Spain.
authors.forename: Pello
authors.initials: P
authors.lastname: Sánchez
authors.affiliation: Arthroscopic Surgery Unit Research, Hospital Vithas San José, Vitoria-Gasteiz, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Delgado
authors.affiliation: BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain iandia2010@hotmail.com.
authors.forename: Isabel
authors.initials: I
authors.lastname: Andia
mesh_terms: D000328:Adult; D024042:Collagen Type I / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D007962:Leukocytes / Q000378:metabolism; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism; D053657:Platelet-Rich Plasma / Q000737:chemistry*; D052256:Tendinopathy / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D013710:Tendons / Q000187:drug effects / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D014945:Wound Healing
chemical_list: D024042:Collagen Type I; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D042461:Vascular Endothelial Growth Factor A; D020781:Matrix Metalloproteinase 1
keywords: PPP; PRP; anabolism; chemotaxis; inflammation; leukocyte-rich PRP; tendinopathy; tissue healing