Before her work with rescue and transitioning horses, Dr. Stacie Boswell trained as an equine surgeon and contributed to the peer-reviewed scientific literature. This 2012 review, written while she worked in the laboratory of Dr. Lisa Fortier at Cornell University, examines platelet-rich plasma (PRP) — a treatment used in both human and equine orthopedics — and argues that its clinical effects come from far more than platelets alone.
Platelet-Rich Plasma: A Milieu of Bioactive Factors
Boswell SG, Cole BJ, Sundman EA, Karas V, Fortier LA. Arthroscopy. 2012 Mar;28(3):429-439.
Abstract
Platelet concentrates such as platelet-rich plasma (PRP) have gained popularity in sports medicine and orthopaedics to promote accelerated physiologic healing and return to function. Each PRP product varies depending on patient factors and the system used to generate it. Blood from some patients may fail to make PRP, and most clinicians use PRP without performing cell counts on either the blood or the preparation to confirm that the solution is truly PRP. Components in this milieu have bioactive functions that affect musculoskeletal tissue regeneration and healing. Platelets are activated by collagen or other molecules and release growth factors from alpha granules. Additional substances are released from dense bodies and lysosomes. Soluble proteins also present in PRP function in hemostasis, whereas others serve as biomarkers of musculoskeletal injury. Electrolytes and soluble plasma hormones are required for cellular signaling and regulation. Leukocytes and erythrocytes are present in PRP and function in inflammation, immunity, and additional cellular signaling pathways. This article supports the emerging paradigm that more than just platelets are playing a role in clinical responses to PRP. Depending on the specific constituents of a PRP preparation, the clinical use can theoretically be matched to the pathology being treated in an effort to improve clinical efficacy.
Read the full article at the publisher: doi.org/10.1016/j.arthro.2011.10.018. Citation on PubMed (PMID: 22284405).