Effects of Antiplatelet and Nonsteroidal Anti-inflammatory Medications on Platelet-Rich Plasma: A Systematic Review

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2020 May 20

PMID 32426401

Citations 8

Authors

Christopher Frey

Peter Chia Yeh

Prathap Jayaram

Affiliations

Soon will be listed here.

Abstract

Background: Platelet-rich plasma (PRP) has wide applications in orthopaedic care. Its beneficial effects are attributed to the growth factor profile from the platelet secretome. In theory, these effects would be diminished by medications that inhibit platelet activation and/or the subsequent release of growth factors.

Purpose: To determine whether commonly used antiplatelets, nonsteroidal anti-inflammatory drugs (NSAIDs), or anticoagulant medications affect platelet growth factor release in PRP.

Study Design: Systematic review; Level of evidence, 2.

Method: A systematic review of the literature related to antiplatelet, anti-inflammatory, and anticoagulant drugs was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We used the Downs and Black objective quality scoring system. The literature search consisted of PubMed and Cochrane Library databases. Search terms consisted of 1 item selected from "platelet-rich plasma," "platelet-derived growth factor," and "platelet-rich plasma AND growth factor" combined with 1 item from "antiplatelet," "aspirin," "anticoagulant," and "NSAID." Only studies published within the past 25 years were included.

Results: A total of 15 studies met the inclusion criteria: 7 studies detected no significant decrease in growth factors or mitogenesis, whereas 6 detected a decrease with antiplatelet agents, 1 detected mixed results with an antiplatelet agent, and 1 had mixed results with an antiplatelet agent/vasodilator. In terms of PRP activation, all 3 studies assessing collagen, the 2 studies analyzing adenosine diphosphate alone, and the 1 study investigating arachidonic acid found a decrease in growth factor concentration.

Conclusion: Antiplatelet medications may decrease the growth factor release profile in a cyclooxygenase 1- and cyclooxygenase 2-dependent manner. Eight of 15 studies found a decrease in growth factors or mitogenesis. However, more studies are needed to comprehensively understand antiplatelet effects on the PRP secretome.

Citing Articles

Aspirin Does Not Inhibit Platelet-Rich Plasma Releasate Efficacy in a Murine Model of Rotator Cuff Tendinopathy.

Magruder M, Caughey S, Carballo C, Eliasberg C, Liu Y, Havasy J HSS J. 2024; :15563316241243371.

PMID: 39564414 PMC: 11572607. DOI: 10.1177/15563316241243371.

Harmony in Healing: Investigating Platelet-Rich Plasma Activation during Acetylsalicylic Acid Treatment.

Maj M, Tomczyk R, Bajek A Int J Mol Sci. 2024; 25(20).

PMID: 39456821 PMC: 11508067. DOI: 10.3390/ijms252011037.

Effect of aspirin on platelet-rich plasma of diabetes mellitus with lower extremity atherosclerosis.

Zhang J, Shang S, Liu W, Cheng Y, Hu F, Cao Z Future Sci OA. 2024; 10(1):2413827.

PMID: 39440536 PMC: 11508953. DOI: 10.1080/20565623.2024.2413827.

Applications of Platelet Concentrates (PCs) in Regenerative Onco-Urology: A Systematic Review of Literature.

Gottardo A, Tulone G, Pavan N, Fulfaro F, Gristina V, Bazan Russo T Int J Mol Sci. 2024; 25(19.

PMID: 39409012 PMC: 11477022. DOI: 10.3390/ijms251910683.

Evidence-Based Clinical Practice Guidelines on Regenerative Medicine Treatment for Chronic Pain: A Consensus Report from a Multispecialty Working Group.

DSouza R, Her Y, Hussain N, Karri J, Schatman M, Calodney A J Pain Res. 2024; 17:2951-3001.

PMID: 39282657 PMC: 11402349. DOI: 10.2147/JPR.S480559.

References

Foster C, Prosser D, Agans J, Zhai Y, Smith M, Lachowicz J . Molecular identification and characterization of the platelet ADP receptor targeted by thienopyridine antithrombotic drugs. J Clin Invest. 2001; 107(12):1591-8. PMC: 200194. DOI: 10.1172/JCI12242. View

Jayaram P, Yeh P, Patel S, Cela R, Shybut T, Grol M . Effects of Aspirin on Growth Factor Release From Freshly Isolated Leukocyte-Rich Platelet-Rich Plasma in Healthy Men: A Prospective Fixed-Sequence Controlled Laboratory Study. Am J Sports Med. 2019; 47(5):1223-1229. DOI: 10.1177/0363546519827294. View

Ludwig H, Birdwhistell K, Brainard B, Franklin S . Use of a Cyclooxygenase-2 Inhibitor Does Not Inhibit Platelet Activation or Growth Factor Release From Platelet-Rich Plasma. Am J Sports Med. 2017; 45(14):3351-3357. DOI: 10.1177/0363546517730578. View

Downs S, Black N . The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998; 52(6):377-84. PMC: 1756728. DOI: 10.1136/jech.52.6.377. View

Smyth E . Thromboxane and the thromboxane receptor in cardiovascular disease. Clin Lipidol. 2010; 5(2):209-219. PMC: 2882156. DOI: 10.2217/clp.10.11. View

Anitua E, Troya M, Zalduendo M, Orive G . The effect of different drugs on the preparation and biological outcomes of plasma rich in growth factors. Ann Anat. 2014; 196(6):423-9. DOI: 10.1016/j.aanat.2014.06.002. View

Marwali M, Hu C, Mohandas B, Dandapat A, Deonikar P, Chen J . Modulation of ADP-induced platelet activation by aspirin and pravastatin: role of lectin-like oxidized low-density lipoprotein receptor-1, nitric oxide, oxidative stress, and inside-out integrin signaling. J Pharmacol Exp Ther. 2007; 322(3):1324-32. DOI: 10.1124/jpet.107.122853. View

Roberts D, McNicol A, Bose R . Mechanism of collagen activation in human platelets. J Biol Chem. 2004; 279(19):19421-30. DOI: 10.1074/jbc.M308864200. View

Warner T, Nylander S, Whatling C . Anti-platelet therapy: cyclo-oxygenase inhibition and the use of aspirin with particular regard to dual anti-platelet therapy. Br J Clin Pharmacol. 2011; 72(4):619-33. PMC: 3195738. DOI: 10.1111/j.1365-2125.2011.03943.x. View

10.

Takehara K, Igarashi A, Ishibashi Y . Dipyridamole specifically decreases platelet-derived growth factor release from platelets. Thromb Res Suppl. 1990; 12:73-9. DOI: 10.1016/0049-3848(90)90442-f. View

11.

Wilson A, Brittenden J, Bachoo P, Ford I, Nixon G . Randomized controlled trial of aspirin and clopidogrel versus aspirin and placebo on markers of smooth muscle proliferation before and after peripheral angioplasty. J Vasc Surg. 2009; 50(4):861-9. DOI: 10.1016/j.jvs.2009.06.017. View

12.

Mlynarek R, Kuhn A, Bedi A . Platelet-Rich Plasma (PRP) in Orthopedic Sports Medicine. Am J Orthop (Belle Mead NJ). 2016; 45(5):290-326. View

13.

Toyoda T, Isobe K, Tsujino T, Koyata Y, Ohyagi F, Watanabe T . Direct activation of platelets by addition of CaCl leads coagulation of platelet-rich plasma. Int J Implant Dent. 2018; 4(1):23. PMC: 6068057. DOI: 10.1186/s40729-018-0134-6. View

14.

Yazawa M, Ogata H, Nakajima T, Watanabe N . Influence of antiplatelet substances on platelet-rich plasma. J Oral Maxillofac Surg. 2004; 62(6):714-8. DOI: 10.1016/j.joms.2004.01.008. View

15.

Tian J, Lei X, Xuan L, Tang J, Cheng B . The effects of aging, diabetes mellitus, and antiplatelet drugs on growth factors and anti-aging proteins in platelet-rich plasma. Platelets. 2018; 30(6):773-792. DOI: 10.1080/09537104.2018.1514110. View

16.

Kehrel B, Wierwille S, Clemetson K, Anders O, Steiner M, Knight C . Glycoprotein VI is a major collagen receptor for platelet activation: it recognizes the platelet-activating quaternary structure of collagen, whereas CD36, glycoprotein IIb/IIIa, and von Willebrand factor do not. Blood. 1998; 91(2):491-9. View

17.

Stegner D, Nieswandt B . Platelet receptor signaling in thrombus formation. J Mol Med (Berl). 2010; 89(2):109-21. DOI: 10.1007/s00109-010-0691-5. View

18.

Cho M, Liu J, Pestina T, Steward S, Thomas D, Coffman T . The roles of alpha IIb beta 3-mediated outside-in signal transduction, thromboxane A2, and adenosine diphosphate in collagen-induced platelet aggregation. Blood. 2002; 101(7):2646-51. DOI: 10.1182/blood-2002-05-1363. View

19.

Leo M, Kumar A, Kirit R, Konathan R, Sivamani R . Systematic review of the use of platelet-rich plasma in aesthetic dermatology. J Cosmet Dermatol. 2015; 14(4):315-23. DOI: 10.1111/jocd.12167. View

20.

Lanas A, Haggerty P, Hirschowitz B . Ingestion of aspirin prevents platelet-induced human fibroblast growth. Implications for peptic ulcer healing. Scand J Gastroenterol. 1994; 29(1):17-22. DOI: 10.3109/00365529409090431. View