A electronic search was conducted on Medline, Embase, Web of Science, The Cochrane Library, LILACS, and SciELO databases for relevant articles published until June 2022. A random-effects meta-analysis was employed to synthesize evidence on the histological characteristics of cartilage and synovium, as well as the inflammatory process. The GRADE approach was utilized to categorize the quality of evidence, and methodological quality was assessed using SYRCLE\'s RoB tool.
Twenty-one studies were included in the review, with twelve of them incorporated into the meta-analysis. PRP treatment demonstrated superior outcomes compared to the control group in terms of cartilage histology (very low quality; p = 0.0002), synovium histology (very low quality; p < 0.0001), and reductions in proinflammatory markers, including IL-1 (low quality; p = 0.002), IL-6 (very low quality; p < 0.00001), and TNF-α (very low; p < 0.00001). However, PRP treatment did not yield a significant impact on PDGF-A levels (very low quality; p = 0.81).
PRP appears capable of reducing proinflammatory markers (IL-1, IL-6, TNF-α) and mitigating cartilage and synovium damage in animals with OA. However, the levels of evidence of these findings are low to very low. Therefore, more rigorous studies with larger samples are needed to improve the quality of evidence.
CRD42022250314.
方法:在Medline上进行了电子搜索,Embase,WebofScience,科克伦图书馆,LILACS,以及截至2022年6月发布的相关文章的SciELO数据库。采用随机效应荟萃分析来综合软骨和滑膜组织学特征的证据,以及炎症过程。等级方法被用来对证据的质量进行分类,使用SYRCLE的RoB工具评估方法学质量。
结果:21项研究被纳入综述,其中12个纳入荟萃分析。在软骨组织学方面,PRP治疗显示出优于对照组的结果(质量非常低;p=0.0002),滑膜组织学(质量很低;p<0.0001),和减少促炎标志物,包括IL-1(低质量;p=0.002),IL-6(质量很低;p<0.00001),和TNF-α(非常低;p<0.00001)。然而,PRP处理对PDGF-A水平没有产生显著影响(非常低的质量;p=0.81)。
结论:PRP似乎能够减少促炎标志物(IL-1,IL-6,TNF-α)并减轻OA动物的软骨和滑膜损伤。然而,这些发现的证据水平低至非常低。因此,需要对更大样本进行更严格的研究,以提高证据质量.
■CRD42022250314。