Effect of intra-articular injection of platelet-rich plasma on interleukin-17 expression in synovial fluid and venous plasma of knee osteoarthritis patients_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Haisen ¹ ,  BAI Yuming ¹ , LIU Chang ¹ , JIN Shengli ¹ , SU Ke ¹ , LIU Ying ² , LÜ Zhichang ³

1. No.2 Department of Orthopaedics, Central Hospital of Cangzhou, Cangzhou Hebei, 061001, P.R.China;
2. Operation Room, People’s Hospital of Cangzhou, Cangzhou Hebei, 061001, P.R.China;
3. Derpatment of Orthopaedics, People’s Hospital of Xianxian county, Xianxian Hebei, 062250, P.R.China;

Corresponding author：

BAI Yuming, Email: 315097190@qq.com

Keywords：

Platelet-rich plasma; interleukin-17; osteoarthritis; knee

DOI：

10.7507/1002-1892.201704013

Video：

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Objective To investigate the interleukin-17 (IL-17) levels changes in both synovial fluid and venous plasma of patients with primary knee osteoarthritis (OA) after intra-articular injection of platelet-rich plasma (PRP). Methods Between January 2015 and January 2016, 30 patients with primary knee OA were treated by intra-articular injection of PRP once a week for 3 weeks (trial group). Thirty healthy individuals were recruited into the study as control. There was no significant difference in gender, age, and body mass index between 2 groups (P>0.05). Visual analogue scale (VAS) score and Knee Society Score (KSS) were used to evaluate pain level and function of the knee for patients with OA. The IL-17 levels in both venous plasma and synovial fluid were measured before injection and at 1, 3, 6, and 12 months after injection in trial group and the IL-17 levels in venous plasma were measured in control group. The levels were determined using ELISA method. Results There was no knee joint swelling, fever, local infection, or other uncomfortable symptoms for all patients in process of PRP injection. All patients were followed up 13.5 months on average (range, 12-15 months). In trial group, the VAS scores at different time points after injection were significantly lower than that before injection (P<0.05). And the KSS scores at different time points after injection were significantly higher than that before injection (P<0.05). There was no significant difference in VAS and KSS scores between different time points after injection (P>0.05). The IL-17 levels in venous plasma before and after injection in trial group were significantly higher than that in control group (P<0.05). The IL-17 levels in venous plasma at each time point after injection were significantly lower than that before injection (P<0.05). There was no significant difference in IL-17 levels in both venous plasma and synovial fluid between different time points after injection (P>0.05). Conclusion Intra-articular injection of PRP can significantly release the pain symptoms, improve joint function, and reduce IL-17 levels in both synovial fluid and venous plasma of the patients with knee OA, but IL-17 levels can not reduce to normal level.

Citation： ZHANG Haisen, BAI Yuming, LIU Chang, JIN Shengli, SU Ke, LIU Ying, LÜ Zhichang. Effect of intra-articular injection of platelet-rich plasma on interleukin-17 expression in synovial fluid and venous plasma of knee osteoarthritis patients. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 918-921. doi: 10.7507/1002-1892.201704013 Copy

1.	Cooper BG, Stewart RC, Burstein D, et al. A tissue-penetrating double network restores the mechanical properties of degenerated articular cartilage. Angew Chem Int Ed Engl, 2016, 55(13): 4226-4230.
2.	Honsawek S, Deepaisarnsakul B, Tanavalee A, et al. Association of the IL-6 -174G/C gene polymorphism with knee osteoarthritis in a Thai population. Genet Mol Res, 2011, 10(3): 1674-1680.
3.	Hulin-Curtis SL, Bidwell JL, Perry MJ. Evaluation of IL18 and IL18R1 polymorphisms: genetic susceptibility to knee osteoarthritis. Int J Immunogenet, 2012, 39(2): 106-109.
4.	张海森, 白玉明, 靳胜利, 等. 白细胞介素-17 基因多态性与骨关节炎易感性之间的相关性研究. 中华骨科杂志, 2016, 36(22): 1450-1455.
5.	张海森, 白玉明, 刘畅, 等. 血清及滑液白介素-17 水平与膝骨关节炎退变及膝痛程度的相关性研究. 中国医药导报, 2016, 13(33): 84-87.
6.	Kan J, Mishima S, Kashiwakura J, et al. Interleukin-17A expression in human synovial mast cells in rheumatoid arthritis and osteoarthritis. Allergol Int, 2016, 65 Suppl: S11-S16.
7.	Sadeghi-Ataabadi M, Mostafavi-Pour Z, Vojdani Z, et al. Fabrication and characterization of platelet-rich plasma scaffolds for tissue engineering applications. Mater Sci Eng C Mater Biol Appl, 2017, 71: 372-380.
8.	Duymus TM, Mutlu S, Dernek B, et al. Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc, 2017, 25(2): 485-492.
9.	Shen L, Yuan T, Chen S, et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res, 2017, 12(1): 16.
10.	Montañezheredia E, Irízar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritic knee pain: A randomized clinical trial in the context of the spanish national health care system. Int J Mol Sci, 2016, 17(7): 1064.
11.	Repetto I, Biti B, Cerruti P, et al. Conservative Treatment of Ankle Osteoarthritis: Can Platelet-Rich Plasma Effectively Postpone Surgery? J Foot Ankle Surg, 2017, 56(2): 362-365.
12.	van Oudenaarde K, Jobke B, Oostveen AC, et al. Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis-the CHECK study. Rheumatology (Oxford), 2017, 56(1): 113-120.
13.	Altman RD. Criteria for the classification of osteoarthritis of the knee and hip. Scand J Rheumatol Suppl, 1987, 65: 31-39.
14.	Silva AL, Demange MK, Gobbi RG, et al. Translation and Validation of the Knee Society Score-KSS for Brazilian Portuguese. Acta Ortop Bras, 2012, 20(1): 25-30.
15.	Karabis A, Nikolakopoulos S, Pandhi S, et al. High correlation of VAS pain scores after 2 and 6 weeks of treatment with VAS pain scores at 12 weeks in randomised controlled trials in rheumatoid arthritis and osteoarthritis: meta-analysis and implications. Arthritis Res Ther, 2016, 18(1): 1-7.
16.	Bondeson J, Wainwright SD, Lauder S, et al. The role of synovial macrophages and macrophage-produced cytokines in driving aggrecanases, matrix metalloproteinases, and other destructive and inflammatory responses in osteoarthritis. Arthritis Res Ther, 2006, 8(6): R187.
17.	Wu X, Kondragunta V, Kornman KS, et al. IL-1 receptor antagonist gene as a predictive biomarker of progression of knee osteoarthritis in a population cohort. Osteoarthritis Cartilage, 2013, 21(7): 930-938.
18.	Chen L, Li DQ, Zhong J, et al. IL-17RA aptamer-mediated repression of IL-6 inhibits synovium inflammation in a murine model of osteoarthritis. Osteoarthritis Cartilage, 2011, 19(6): 711-718.
19.	Wang K, Xu JH, Cai JY, et al. Serum levels of interleukin-17 and adiponectin are associated with infrapatellar fat pad volume and signal intensity alteration in patients with knee osteoarthritis. Arthritis Res Ther, 2016, 18(1): 193.
20.	Deligne C, Casulli S, Pigenet A, et al. Differential expression of interleukin-17 and interleukin-22 in inflamed and non-inflamed synovium from osteoarthritis patients. Osteoarthritis Cartilage, 2015, 23(11): 1843-1852.
21.	Wang K, Xu J, Cai J, et al. Serum levels of resistin and interleukin-17 are associated with increased cartilage defects and bone marrow lesions in patients with knee osteoarthritis. Mod Rheumatol, 2017, 27(2): 339-344.
22.	翟文亮, 周亮, 刘晖, 等. 富血小板血浆与透明质酸钠治疗膝关节骨关节炎的临床观察. 中华关节外科杂志(电子版), 2017, 11 (1): 90-93.
23.	刘步云, 孙育良, 何本祥, 等. 关节腔注射富血小板血浆与玻璃酸钠治疗膝关节骨关节炎的疗效比较. 实用骨科杂志, 2017, 23 (1): 71-73.
24.	冯晓林, 牟奎, 王建春, 等. 富血小板血浆用于膝关节骨关节炎的临床研究. 中华实验外科杂志, 2016, 33 (12): 2792-2793.
25.	丁权威, 吕帅洁, 沈兴潮, 等. 富血小板血浆联合透明质酸钠关节内注射治疗膝骨关节炎的前瞻性随机对照研究. 上海医药, 2017, 38(5): 25-28, 40.

1. Cooper BG, Stewart RC, Burstein D, et al. A tissue-penetrating double network restores the mechanical properties of degenerated articular cartilage. Angew Chem Int Ed Engl, 2016, 55(13): 4226-4230.
2. Honsawek S, Deepaisarnsakul B, Tanavalee A, et al. Association of the IL-6 -174G/C gene polymorphism with knee osteoarthritis in a Thai population. Genet Mol Res, 2011, 10(3): 1674-1680.
3. Hulin-Curtis SL, Bidwell JL, Perry MJ. Evaluation of IL18 and IL18R1 polymorphisms: genetic susceptibility to knee osteoarthritis. Int J Immunogenet, 2012, 39(2): 106-109.
4. 张海森, 白玉明, 靳胜利, 等. 白细胞介素-17 基因多态性与骨关节炎易感性之间的相关性研究. 中华骨科杂志, 2016, 36(22): 1450-1455.
5. 张海森, 白玉明, 刘畅, 等. 血清及滑液白介素-17 水平与膝骨关节炎退变及膝痛程度的相关性研究. 中国医药导报, 2016, 13(33): 84-87.
6. Kan J, Mishima S, Kashiwakura J, et al. Interleukin-17A expression in human synovial mast cells in rheumatoid arthritis and osteoarthritis. Allergol Int, 2016, 65 Suppl: S11-S16.
7. Sadeghi-Ataabadi M, Mostafavi-Pour Z, Vojdani Z, et al. Fabrication and characterization of platelet-rich plasma scaffolds for tissue engineering applications. Mater Sci Eng C Mater Biol Appl, 2017, 71: 372-380.
8. Duymus TM, Mutlu S, Dernek B, et al. Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc, 2017, 25(2): 485-492.
9. Shen L, Yuan T, Chen S, et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res, 2017, 12(1): 16.
10. Montañezheredia E, Irízar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritic knee pain: A randomized clinical trial in the context of the spanish national health care system. Int J Mol Sci, 2016, 17(7): 1064.
11. Repetto I, Biti B, Cerruti P, et al. Conservative Treatment of Ankle Osteoarthritis: Can Platelet-Rich Plasma Effectively Postpone Surgery? J Foot Ankle Surg, 2017, 56(2): 362-365.
12. van Oudenaarde K, Jobke B, Oostveen AC, et al. Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis-the CHECK study. Rheumatology (Oxford), 2017, 56(1): 113-120.
13. Altman RD. Criteria for the classification of osteoarthritis of the knee and hip. Scand J Rheumatol Suppl, 1987, 65: 31-39.
14. Silva AL, Demange MK, Gobbi RG, et al. Translation and Validation of the Knee Society Score-KSS for Brazilian Portuguese. Acta Ortop Bras, 2012, 20(1): 25-30.
15. Karabis A, Nikolakopoulos S, Pandhi S, et al. High correlation of VAS pain scores after 2 and 6 weeks of treatment with VAS pain scores at 12 weeks in randomised controlled trials in rheumatoid arthritis and osteoarthritis: meta-analysis and implications. Arthritis Res Ther, 2016, 18(1): 1-7.
16. Bondeson J, Wainwright SD, Lauder S, et al. The role of synovial macrophages and macrophage-produced cytokines in driving aggrecanases, matrix metalloproteinases, and other destructive and inflammatory responses in osteoarthritis. Arthritis Res Ther, 2006, 8(6): R187.
17. Wu X, Kondragunta V, Kornman KS, et al. IL-1 receptor antagonist gene as a predictive biomarker of progression of knee osteoarthritis in a population cohort. Osteoarthritis Cartilage, 2013, 21(7): 930-938.
18. Chen L, Li DQ, Zhong J, et al. IL-17RA aptamer-mediated repression of IL-6 inhibits synovium inflammation in a murine model of osteoarthritis. Osteoarthritis Cartilage, 2011, 19(6): 711-718.
19. Wang K, Xu JH, Cai JY, et al. Serum levels of interleukin-17 and adiponectin are associated with infrapatellar fat pad volume and signal intensity alteration in patients with knee osteoarthritis. Arthritis Res Ther, 2016, 18(1): 193.
20. Deligne C, Casulli S, Pigenet A, et al. Differential expression of interleukin-17 and interleukin-22 in inflamed and non-inflamed synovium from osteoarthritis patients. Osteoarthritis Cartilage, 2015, 23(11): 1843-1852.
21. Wang K, Xu J, Cai J, et al. Serum levels of resistin and interleukin-17 are associated with increased cartilage defects and bone marrow lesions in patients with knee osteoarthritis. Mod Rheumatol, 2017, 27(2): 339-344.
22. 翟文亮, 周亮, 刘晖, 等. 富血小板血浆与透明质酸钠治疗膝关节骨关节炎的临床观察. 中华关节外科杂志(电子版), 2017, 11 (1): 90-93.
23. 刘步云, 孙育良, 何本祥, 等. 关节腔注射富血小板血浆与玻璃酸钠治疗膝关节骨关节炎的疗效比较. 实用骨科杂志, 2017, 23 (1): 71-73.
24. 冯晓林, 牟奎, 王建春, 等. 富血小板血浆用于膝关节骨关节炎的临床研究. 中华实验外科杂志, 2016, 33 (12): 2792-2793.
25. 丁权威, 吕帅洁, 沈兴潮, 等. 富血小板血浆联合透明质酸钠关节内注射治疗膝骨关节炎的前瞻性随机对照研究. 上海医药, 2017, 38(5): 25-28, 40.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of intra-articular injection of platelet-rich plasma on interleukin-17 expression in synovial fluid and venous plasma of knee osteoarthritis patients

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