Abstract：
Osteoarthritis (OA) affects the entire joint, causing structural changes in articular cartilage, subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles that afflicts millions of people globally, leading to persistent pain and diminished quality of life. The intra-articular use of platelet-rich plasma (PRP) is gaining recognition as a secure therapeutic approach due to its potential regenerative capabilities. However, there is controversial clinical data regarding efficacy of PRP for OA treatment. In this context, gathering scientific evidence on the effects of PRP in treating OA in animal models could provide valuable insights into understanding its impact on aspects like cartilage health, synovial tissue integrity, and the inflammatory process in affected joints. Thus, the objective of this study was to assess the effects of PRP injections on inflammation and histopathological aspects of cartilage and synovium in animal models of OA through a comprehensive systematic review with meta-analysis.
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.
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.
摘要：
背景：骨关节炎（OA）影响整个关节，引起关节软骨的结构变化，软骨下骨,韧带,胶囊,滑膜,以及折磨着全球数百万人的关节周围肌肉，导致持续性疼痛和生活质量下降。富血小板血浆（PRP）的关节内使用由于其潜在的再生能力而成为一种安全的治疗方法。然而,关于PRP治疗OA的疗效,临床数据存在争议.在这种情况下，收集有关PRP在动物模型中治疗OA的作用的科学证据可以提供有价值的见解，以了解其对软骨健康等方面的影响，滑膜组织完整性，和受影响关节的炎症过程。因此，本研究的目的是通过一项全面的系统评价和荟萃分析,评估注射PRP对OA动物模型中软骨和滑膜的炎症和组织病理学方面的影响.
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。
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。
