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Diz Osteoartritinde Plateletten Zengin Plazma Tedavisinin Hematolojik Parametrelere Etkisi

Year 2019, Volume: 5 Issue: 1, 74 - 79, 01.01.2019

Abstract

Amaç: Diz osteoartriti OA tedavisinde, plateletten zengin plazma PRP enjeksiyonu güncel tedavi seçeneklerinden biridir. Nötrofil lenfosit oranı NLR ve ortalama trombosit hacminin MPV birçok hastalıkta sistemik inflamasyonun göstergesi olabileceği düşünülmektedir. Çalışmadaki amacımız; diz osteoartritinde intraartiküler PRP enjeksiyonunun, NLR ve MPV aracılığıyla, sistemik inflamasyona olan etkisini değerlendirmektir.Gereç ve Yöntemler: Çalışmaya Kellgren-Lawrence evreleme sistemine göre en az evre 2 diz OA tanısı almış ve PRP enjeksiyonu yapılmış, 45-70 yaş arasındaki hastalar alındı. Hastaların verileri araştırmacılar tarafından otomasyon sisteminden retrospektif olarak taranarak enjeksiyon sonrası üçüncü günde hemogram analizi olan hastalar çalışmaya dahil edildi. Tedavi öncesi ve sonrası NLR ve MPV değerleri cinsiyet ve OA şiddetine göre analiz edildi.Bulgular: Çalışmaya 80’i kadın, 13’ü erkek olmak üzere 93 hasta dahil edildi. Hastaların ortalama yaşı 55,9±5,6’ydı. Tedavi öncesi ve sonrası hastaların ortalama NLR ve MPV değerlerinde anlamlı değişiklik saptanmadı p>0,05 . Tedavi öncesinde ortalama NLR değerleri evre IV OA’sı bulunan hastalarda evre II’ye göre anlamlı olarak yüksekti düzeltilmiş p:0.030 . OA şiddetinin diğer parametreler üzerine anlamlı etkisi saptanmadı.Sonuç: Çalışmada diz OA şiddeti yüksek olan hastalarda, inflamasyonun bir göstergesi olan NLR değerinin de yüksek olduğu saptanmıştır. Ancak PRP enjeksiyon öncesi ve sonrası NLR ve MPV değerlerinde anlamlı farklılık gözlenmemiştir. Bu konuda geniş hasta grupları ile yapılan ileri çalışmalara ihtiyaç vardır

References

  • Hunter DJ, Lo GH. The management of osteoarthritis: An overview and call to appropriate conservative treatment. Rheum Dis Clin N Am 2008; 34:689-712.
  • Kacar C, Gilgil E, Urhan S, Arikan V, Dündar U, Oksüz MC, Sünbüloglu G, Yildirim C, Tekeoglu I, Bütün B, Apaydin A, Tuncer T. The prevelance of symptomatic knee and distal interphalangeal joint osteoarthritis in the urban population of Antalya, Turkey. Rheumatol Int 2005; 25:201-4.
  • Wehling P, Evans C, Wehling J, Maixner W. Effectiveness of intra-articular therapies in osteoarthritis: A literature review. Ther Adv Musculoskelet Dis 2017; 9:183-96.
  • Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, Bridgett L, Williams S, Guillemin F, Hill CL, Laslett LL, Jones G, Cicuttini F, Osborne R, Vos T, Buchbinder R, Woolf A, March L. The global burden of hip and knee osteoarthritis: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014; 73:1323-30.
  • Tuncer T, Çay HF, Kaçar C, Altan L, Atik OS, Turan AA, et al. Diz osteoartrit tedavisinde kanıta dayalı öneriler: Türkiye Romatizma Araştırma ve Savaş Derneği Uzlaşı Raporu. Turk J Rheumatol 2012; 27:1-17.
  • Woodell-May J, Matuska A, Oyster M, Welch Z, O’Shaughnessey K, Hoeppner J. Autologous protein solution inhibits MMP-13 production by IL-1beta and TNFalpha-stimulated human articular chondrocytes. J Orthop Res 2011; 29:1320-6.
  • Yang Z, Zhang Z, Lin F, Ren Y, Liu D, Zhong R, Liang Y. Comparisons of neutrophil-, monocyte-, eosinophil-, and basophil- lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS 2017; 125:863- 71.
  • Schmoeller D, Picarelli MM, Paz Munhoz T, Poli de Figueiredo CE, Staub HL. Mean Platelet Volume and immature platelet fraction in autoimmune disorders. Front Med (Lausanne) 2017; 4:146.
  • Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R, Sonpavde G, Knox JJ, Tran B, Tannock IF, Amir E. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natl Cancer Inst 2014; 106(6):dju124.
  • Pyo JS, Sohn JH, Kang G. Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: A systematic review and meta-analysis. Platelets 2016; 27(8):722-8. Epub 2016 May 9.
  • Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, Meghani M, Akhtar M, Costantino T. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Rev Cardiovasc Ther 2013; 11: 55-9.
  • Sansanayudh N, Numthavaj P, Muntham D, Yamwong S, McEvoy M, Attia J, Sritara P, Thakkinstian A. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost 2015; 114:1299-309.
  • Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011; 17:47-58.
  • Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29:1039-49.
  • Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16:494-502.
  • Ulaşlı AM. Kas iskelet sistemi yaralanmalarında plateletten zengin plazma tedavisi. Kocatepe Tıp Dergisi 2012; 13:51-9.
  • Milants C, Bruyère O, Kaux JF. Responders to platelet- rich plasma in osteoarthritis: A technical analysis. Biomed Res Int 2017; 2017:7538604.
  • Andia I, Maffulli N. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol 2013; 9:721-30.
  • Haywood L, McWilliams DF, Pearson CI, Gill SE, Ganesan A, Wilson D, Walsh DA. Inflammation and angiogenesis in osteoarthritis. Arthritis Rheum 2003; 48(8):2173-7.
  • Fernández-Puente P, Mateos J, Fernández-Costa C, Oreiro N, Fernández-López C, Ruiz-Romero C, Blanco FJ. Identification of a panel of novel serum osteoarthritis biomarkers. J Proteome Res 2011; 10:5095-101.
  • Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol 2011; 23:471-8.
  • Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J 2012; 32:150-63.
  • Lindemann S, Tolley ND, Dixon DA, McIntyre TM, Prescott SM, Zimmerman GA, Weyrich AS. Activated platelets mediate inflammatory signaling by regulated interleukin 1beta synthesis. J Cell Biol 2001; 154:485-90.
  • Yılmaz B, Kesikburun S. Plateletten zengin plazma uygulamaları. Türk Fiz Tıp Rehab Derg 2013; 59:338-44.
  • Bendinelli P, Matteucci E, Dogliotti G, Corsi MM, Banfi G, Maroni P, Desiderio MA. Molecular basis of anti- inflammatory action of platelet-rich plasma on human chondrocytes: Mechanisms of NF-κB inhibition via HGF. J Cell Physiol 2010; 225:757-66.
  • Perkins ND. NF-kappaB: tumor promoter or suppressor? Trends Cell Biol 2004; 14:64-9.
  • Zahorec R. Ratio of neutrophil to lymphocyte counts- rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102:5-14.
  • Bath PM, Butterworth RJ. Platelet size: Measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996; 7:157-61.
  • Taşoğlu Ö, Bölük H, Şahin Onat Ş, Taşoğlu İ, Özgirgin N. Is blood neutrophil-lymphocyte ratio an independent predictor of knee osteoarthritis severity? Clin Rheumatol 2016; 35: 1579-83.
  • Taşoğlu Ö, Şahin A, Karataş G, Koyuncu E, Taşoğlu İ, Tecimel O, Özgirgin N. Blood mean platelet volume and platelet lymphocyte ratio as new predictors of hip osteoarthritis severity. Medicine (Baltimore) 2017; 96: e6073.
  • Hira S, Tamam C. Osteoartrit hastalarında hematolojik parametrelerin tanısal değeri. Cukurova Med J 2017; 42: 120-5.
  • Balbaloglu O, Korkmaz M, Yolcu S, Karaaslan F, Beceren NG. Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis. Platelets 2014; 25:81-5.
  • Atar E, Aşkın A. Diz osteoartrit hastalarında nötrofil/ lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin değerlendirilmesi. Cukurova Med J 2017; 42:329-36.

Effects of Platelet Rich Plasma Treatment on Hematological Parameters in Knee Osteoarthritis

Year 2019, Volume: 5 Issue: 1, 74 - 79, 01.01.2019

Abstract

Objective: In the treatment of knee osteoarthritis OA , platelet rich plasma PRP injection is one of the current treatment options. Neutrophil lymphocyte ratio NLR and mean platelet volume MPV are thought to be indicative of systemic inflammation in many diseases. Our purpose in this study was to evaluate the effects of intraarticular PRP injection on systemic inflammation via NLR and MPV in knee osteoarthritis. Material and Methods: Patients between 45-70 years of age with at least stage II knee OA according to the Kellgren-Lawrence grading system, and who had PRP injections were included in the study. Patients' data were retrospectively screened by the researchers from the automation system and patients with hemogram analysis on the third post-injection day were included in the study. NLR and MPV values before and after treatment were analyzed according to gender and OA severity.Results: The study included 93 patients, 80 female and 13 male. The mean age of the patients was 55.9 ± 5.6 years. Mean NLR and MPV values of the patients before and after treatment were not significantly changed p> 0.05 . Mean NLR values before treatment were significantly higher in patients with stage IV OA than in stage II adjusted p: 0.030 . No significant effect of OA severity on other parameters was determined. Conclusion: In this study, it was determined that the patients with high knee OA severity had higher NLR values which was an indicator of inflammation. However, there were no significant differences in NLR and MPV before and after PRP injection. There is a need for further studies with large patient groups in this regard

References

  • Hunter DJ, Lo GH. The management of osteoarthritis: An overview and call to appropriate conservative treatment. Rheum Dis Clin N Am 2008; 34:689-712.
  • Kacar C, Gilgil E, Urhan S, Arikan V, Dündar U, Oksüz MC, Sünbüloglu G, Yildirim C, Tekeoglu I, Bütün B, Apaydin A, Tuncer T. The prevelance of symptomatic knee and distal interphalangeal joint osteoarthritis in the urban population of Antalya, Turkey. Rheumatol Int 2005; 25:201-4.
  • Wehling P, Evans C, Wehling J, Maixner W. Effectiveness of intra-articular therapies in osteoarthritis: A literature review. Ther Adv Musculoskelet Dis 2017; 9:183-96.
  • Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, Bridgett L, Williams S, Guillemin F, Hill CL, Laslett LL, Jones G, Cicuttini F, Osborne R, Vos T, Buchbinder R, Woolf A, March L. The global burden of hip and knee osteoarthritis: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014; 73:1323-30.
  • Tuncer T, Çay HF, Kaçar C, Altan L, Atik OS, Turan AA, et al. Diz osteoartrit tedavisinde kanıta dayalı öneriler: Türkiye Romatizma Araştırma ve Savaş Derneği Uzlaşı Raporu. Turk J Rheumatol 2012; 27:1-17.
  • Woodell-May J, Matuska A, Oyster M, Welch Z, O’Shaughnessey K, Hoeppner J. Autologous protein solution inhibits MMP-13 production by IL-1beta and TNFalpha-stimulated human articular chondrocytes. J Orthop Res 2011; 29:1320-6.
  • Yang Z, Zhang Z, Lin F, Ren Y, Liu D, Zhong R, Liang Y. Comparisons of neutrophil-, monocyte-, eosinophil-, and basophil- lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS 2017; 125:863- 71.
  • Schmoeller D, Picarelli MM, Paz Munhoz T, Poli de Figueiredo CE, Staub HL. Mean Platelet Volume and immature platelet fraction in autoimmune disorders. Front Med (Lausanne) 2017; 4:146.
  • Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R, Sonpavde G, Knox JJ, Tran B, Tannock IF, Amir E. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natl Cancer Inst 2014; 106(6):dju124.
  • Pyo JS, Sohn JH, Kang G. Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: A systematic review and meta-analysis. Platelets 2016; 27(8):722-8. Epub 2016 May 9.
  • Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, Meghani M, Akhtar M, Costantino T. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Rev Cardiovasc Ther 2013; 11: 55-9.
  • Sansanayudh N, Numthavaj P, Muntham D, Yamwong S, McEvoy M, Attia J, Sritara P, Thakkinstian A. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost 2015; 114:1299-309.
  • Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011; 17:47-58.
  • Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29:1039-49.
  • Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16:494-502.
  • Ulaşlı AM. Kas iskelet sistemi yaralanmalarında plateletten zengin plazma tedavisi. Kocatepe Tıp Dergisi 2012; 13:51-9.
  • Milants C, Bruyère O, Kaux JF. Responders to platelet- rich plasma in osteoarthritis: A technical analysis. Biomed Res Int 2017; 2017:7538604.
  • Andia I, Maffulli N. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol 2013; 9:721-30.
  • Haywood L, McWilliams DF, Pearson CI, Gill SE, Ganesan A, Wilson D, Walsh DA. Inflammation and angiogenesis in osteoarthritis. Arthritis Rheum 2003; 48(8):2173-7.
  • Fernández-Puente P, Mateos J, Fernández-Costa C, Oreiro N, Fernández-López C, Ruiz-Romero C, Blanco FJ. Identification of a panel of novel serum osteoarthritis biomarkers. J Proteome Res 2011; 10:5095-101.
  • Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol 2011; 23:471-8.
  • Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J 2012; 32:150-63.
  • Lindemann S, Tolley ND, Dixon DA, McIntyre TM, Prescott SM, Zimmerman GA, Weyrich AS. Activated platelets mediate inflammatory signaling by regulated interleukin 1beta synthesis. J Cell Biol 2001; 154:485-90.
  • Yılmaz B, Kesikburun S. Plateletten zengin plazma uygulamaları. Türk Fiz Tıp Rehab Derg 2013; 59:338-44.
  • Bendinelli P, Matteucci E, Dogliotti G, Corsi MM, Banfi G, Maroni P, Desiderio MA. Molecular basis of anti- inflammatory action of platelet-rich plasma on human chondrocytes: Mechanisms of NF-κB inhibition via HGF. J Cell Physiol 2010; 225:757-66.
  • Perkins ND. NF-kappaB: tumor promoter or suppressor? Trends Cell Biol 2004; 14:64-9.
  • Zahorec R. Ratio of neutrophil to lymphocyte counts- rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102:5-14.
  • Bath PM, Butterworth RJ. Platelet size: Measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996; 7:157-61.
  • Taşoğlu Ö, Bölük H, Şahin Onat Ş, Taşoğlu İ, Özgirgin N. Is blood neutrophil-lymphocyte ratio an independent predictor of knee osteoarthritis severity? Clin Rheumatol 2016; 35: 1579-83.
  • Taşoğlu Ö, Şahin A, Karataş G, Koyuncu E, Taşoğlu İ, Tecimel O, Özgirgin N. Blood mean platelet volume and platelet lymphocyte ratio as new predictors of hip osteoarthritis severity. Medicine (Baltimore) 2017; 96: e6073.
  • Hira S, Tamam C. Osteoartrit hastalarında hematolojik parametrelerin tanısal değeri. Cukurova Med J 2017; 42: 120-5.
  • Balbaloglu O, Korkmaz M, Yolcu S, Karaaslan F, Beceren NG. Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis. Platelets 2014; 25:81-5.
  • Atar E, Aşkın A. Diz osteoartrit hastalarında nötrofil/ lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin değerlendirilmesi. Cukurova Med J 2017; 42:329-36.
There are 33 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Meral Bilgilisoy Filiz This is me

Alper Uçkun This is me

Publication Date January 1, 2019
Published in Issue Year 2019 Volume: 5 Issue: 1

Cite

Vancouver Bilgilisoy Filiz M, Uçkun A. Diz Osteoartritinde Plateletten Zengin Plazma Tedavisinin Hematolojik Parametrelere Etkisi. Akd Med J. 2019;5(1):74-9.