Table 1.
Summary of PRP’s molecular mechanisms of action.
| Authors | Year | Main Findings |
|---|---|---|
| Sundman et al. [27] | 2014 | PRP treatment decreases catabolism and matrix metalloproteinase-13 and increases hyaluronan synthase-2 expression in synoviocytes and cartilage synthetic activity. |
| Sakata et al. [28] | 2015 | PRP stimulates cell proliferation and superficial zone protein secretion by articular cartilage and synovium of the human knee joint. |
| Khatab et al. [29] | 2018 | Multiple PRP releasate injections reduce pain and synovial thickness, possibly through modulation of macrophage subtypes. |
| De Santis et al. [30] | 2018 | PRP therapy for OA exerts modulation on the Wnt/β catenin pathway that might be relevant in achieving its beneficial clinical effect. |
| Liu et al. [31] | 2019 | The therapeutic effects of exosomes derived from PRP on OA were similar or better compared with those of activated PRP in vitro or in vivo. |
| Jayaram et al. [4] | 2020 | The effects of PRP therapy on OA progression and disease-induced hyperalgesia might be leukocyte-dependent. |
| Yang et al. [32] | 2021 | PRP attenuates interleukin-1β, inducing chondrocyte apoptosis and inflammation at least partially through inhibiting hypoxia-inducible factor 2α. |
| Sun et al. [33] | 2021 | Micro-RNA (miR)-337 and miR-375 are involved in PRP-delayed OA progression by affecting inflammation and apoptosis. |
| Sheean et al. [34] | 2021 | Platelet α granules promote the release of various growth factors, including vascular endothelial growth factor and tissue growth factor β, and inflammation is modulated through inhibition of the nuclear factor-κB pathway. |
| Uchiyama et al. [35] | 2021 | The autologous protein solution leukocyte-rich PRP kit has a higher concentration of M1 and M2 macrophage-related factors. |
| Szwedowski et al. [36] | 2021 | Growth factors released in the OA knee joint after PRP injection: tumor necrosis factor, insulin-like growth factor, transforming growth factor, vascular endothelial growth factor, a disintegrin and metalloproteinase with thrombospondin motifs, interleukin, matrix metalloproteinase, epidermal growth factor, hepatocyte growth factor, fibroblast growth factor, keratinocyte growth factor, and platelet factor 4. |
PRP = platelet-rich plasma; OA = osteoarthritis.