Study On The Therapy Effect Of Pure Platelet-rich Plasma Treating Hemorrhagic Arthritis

[Objective]:Hemorrhagic arthritis(HA)is a common synovium and cartilage injury associated with bleeding,which is more common in patients with coagulation disorder such as hemophilia.Attributed to the contribution of various cytokines and growth factors,Pure Platelet-Rich Plasma(P-PRP)has been demonstrated to have both anti-inflammatory and regenerative effects.The aim of this study was to investigate whether the P-PRP was effective for HA and whether the therapeutic effect differs from mild to severe HA.[Methods]:Autologous blood was drawn from New Zealand rabbits and injected into their left and right knees(hind legs)every week to establish the HA models.The injection was lasted for 8 weeks to establish the mild HA models and 16 weeks to establish the severe HA models.Autologous pure PRP(P-PRP)was injected into the left knees of the HA models,and the same volume of sterile 0.9%saline was injected into the corresponding right knees.Knee diameter measurement,MRI examination and H&E and toluidine blue staining were respectively performed to evaluate the histological difference of synovium and cartilage between the P-PRP treated groups and untreated groups.Normal knees were set as control group for comparison.[Results]:The treated groups achieved lower morphology change of knee joint through gross observation and less synovitis and bone marrow edema through MRI compared with untreated groups.Significant difference of cell number existed between mild treated and untreated groups(mean difference,307.40±14.23;95%CI,241.54-343.26;p<0.001),and between the severe treated and untreated groups(mean difference,699.20±82.80;95%CI,508.26-890.14;p<0.001)in H&E staining and cell counting.Toluidine blue staining of cartilage were also consistent with MRI results.In addition,the mild treated group had the least inflammation.The difference of diameter between mild treated and untreated groups was significantly larger than that between severe treated and untreated groups.(mean difference,1.17±0.32mm;p<0.01).H&E staining and cell counting of synovium showed the cell morphology and quantity of mild treated group were closest to normal(mean difference,71.00±9.62;95%CI,48.81-93.19;p<0.001).Toluidine blue staining of cartilage demonstrated the obvious cartilage matrix loss in the severe groups.[Conclusion]:P-PRP inhibits the progression of HA in aspects of the formation of synovitis and cartilage matrix loss,especially in the mild HA.This in vivo animal study provides the theoretical basis and possibility for the clinical application of P-PRP treating hemorrhagic diseases.