Precision Assessment of Platelet Rich Plasma for Joint Preservation

富含血小板血浆对关节保护的精确评估

• 批准号: 10731741
• 负责人: CONSTANCE R CHU
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10731741
• 关键词: Academy; Acceleration; Address; Affect; Age; American; Anti-Inflammatory Agents; Area; Arthralgia; Attention; Autologous; Basic Science; Biological; Blood; Blood Platelets; Cartilage; Cartilage Matrix; Clinical; Clinical Treatment; Cortisone; Data; Degenerative polyarthritis; Disease; Disease Progression; Early treatment; Elements; Evaluation; Frequencies; Gait; General Population; Growth Factor; Health; Hyaluronic Acid; Individual; Individual Differences; Inflammation Mediators; Injection of therapeutic agent; Injections; Insulin-Like Growth Factor I; Intra-Articular Injections; Joint repair; Joints; Knee; Knee Osteoarthritis; Knee Prosthesis; Knowledge; Magnetic Resonance Imaging; Maps; Measures; Mechanics; Mission; Operative Surgical Procedures; Orthopedics; Outcome; Outcome Assessment; Outcome Measure; Outcome Study; Pain; Pain Measurement; Patient Outcomes Assessments; Patient Selection; Patients; Plasma; Population; Process; Progressive Disease; Property; Proteins; Proteomics; Research; Review Literature; Source; Structure; Surgeon; Swelling; Testing; Time; Traction; Veterans; Weight-Bearing state; Woman; Work; articular cartilage; chemokine; clinical care; clinical effect; clinical outcome assessment; cytokine; disability; follow-up; functional improvement; gait examination; improved; joint destruction; joint function; knee pain; knee replacement arthroplasty; meetings; pain reduction; pain relief; palliative; personalized medicine; pharmacologic; precision medicine; premature; preservation; programs; prospective; repaired; response; symptom treatment; treatment effect

This project addresses a critical clinical need for the VA. Knee pain due to progressive joint degeneration and eventual osteoarthritis (OA) are leading causes of disability, particularly in Veterans who are affected by OA at greater frequency and younger ages than the general population. Knee osteoarthritis is a progressive disease for which current treatment is palliative until complete joint destruction occurs and prosthetic knee replacement is performed. Cortisone injections have been widely used for more than 60 years to treat pain and swelling, but have also shown detrimental effects to articular cartilage. This introduces high clinical need for an injection therapy to improve joint pain and function while preserving cartilage health, especially in those with early disease where there is substantial remaining articular cartilage. Recently, intra-articular autologous platelet rich plasma (PRP) injections have gained traction as a promising new treatment for knee OA that can not only provide symptomatic relief but also potentially contribute growth factors to stimulate endogenous joint repair processes. However, the mechanisms of action of PRP are unknown as are the clinical outcomes in Veterans. Our preliminary data also shows substantial variability between individuals in the biological composition of autologous PRP. In this era of personalized and precision medicine, we propose to examine the outcomes of PRP treatment, and whether individual differences in PRP composition correlate with objective metrics of changes to ambulatory function and cartilage matrix structure following PRP injection treatment for early knee OA in Veterans. Achieving the Aims of this proposal will determine whether intra-articular injection of autologous platelet enriched plasma to treat early knee OA in Veterans and additional women, given within the actual clinical setting, results in positive treatment effects. The information gained will also fill critical knowledge gaps by elucidating potential mechanisms of action for PRP injections in the treatment of symptomatic early knee OA and combining objective scientific assessment (gait analysis and MRI) with standard patient-reported outcomes (PRO). Finally, the new knowledge gained will improve clinical care by informing on factors important to optimal patient selection for this new treatment.

该项目解决了VA的关键临床需求。膝盖疼痛由于进步 关节变性和最终的骨关节炎（OA）是残疾的主要原因， 特别是在较高频率和较年轻的OA影响的退伍军人中 比普通人群。膝关节骨关节炎是一种进行性疾病 当前的治疗是姑息性的，直到发生完全的关节破坏和假肢膝盖 进行更换。可可注射已广泛使用超过60 多年治疗疼痛和肿胀，但也显示出对关节的有害影响 软骨。这引入了注射疗法以改善关节疼痛的高临床需求 在保存软骨健康的同时起作用，尤其是在早期疾病的人中 那里存在大量的关节软骨。最近，关节内 自体血小板富血浆（PRP）注射已成为有希望的 膝盖OA的新疗法不仅可以提供症状缓解，还可以 潜在地促进生长因子刺激内源性关节修复过程。 但是，PRP的作用机制尚不清楚 退伍军人。我们的初步数据还显示了个人之间的实质性差异 自体PRP的生物组成。在这个个性化和精确的时代 医学，我们建议检查PRP治疗的结果，以及是否是否 PRP组成的个体差异与变化的客观指标相关 PRP注射治疗后的卧床功能和软骨基质结构 退伍军人的早期膝盖OA。实现该提议的目标将决定是否 自体血小板富含血浆的关节内注射以治疗早期的膝盖OA 在实际临床环境中给出的退伍军人和其他女性会导致阳性 治疗效果。获得的信息还将填补关键知识差距 阐明PRP注射的潜在作用机理 有症状的早期膝关节OA并结合客观科学评估（步态分析 和MRI）具有标准的患者报告结果（PRO）。最后，新知识 通过告知对最佳患者重要的因素，获得的临床护理将改善临床护理 选择这种新疗法。

项目成果

Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference.

• DOI: 10.5435/jaaos-d-18-00305
• 发表时间: 2019-01-15
• 期刊: The Journal of the American Academy of Orthopaedic Surgeons
• 作者: Chu CR;Rodeo S;Bhutani N;Goodrich LR;Huard J;Irrgang J;LaPrade RF;Lattermann C;Lu Y;Mandelbaum B;Mao J;McIntyre L;Mishra A;Muschler GF;Piuzzi NS;Potter H;Spindler K;Tokish JM;Tuan R;Zaslav K;Maloney W
• 通讯作者: Maloney W

Proceedings of the signature series symposium "cellular therapies for orthopaedics and musculoskeletal disease proven and unproven therapies-promise, facts and fantasy," international society for cellular therapies, montreal, canada, may 2, 2018.

• DOI: 10.1016/j.jcyt.2018.09.001
• 发表时间: 2018-11
• 期刊: Cytotherapy
• 影响因子: 4.5
• 作者: Piuzzi NS;Dominici M;Long M;Pascual-Garrido C;Rodeo S;Huard J;Guicheux J;McFarland R;Goodrich LR;Maddens S;Robey PG;Bauer TW;Barrett J;Barry F;Karli D;Chu CR;Weiss DJ;Martin I;Jorgensen C;Muschler GF
• 通讯作者: Muschler GF