Orthop J Sports Med. 2017 Feb 24;5(2):2325967117690846. doi: 10.1177/2325967117690846. eCollection 2017.

Adult Cells Combined With Platelet-Rich Plasma for Tendon Healing: Cell Source Options.

Rubio-Azpeitia E¹, Sánchez P², Delgado D², Andia I¹.

Abstract

BACKGROUND:

The combination of cells with platelet-rich plasma (PRP) may fulfill tendon deficits and help overcome the limited ability of tendons to heal.

PURPOSE:

To examine the suitability of 3 human cell types in combination with PRP and the potential impact of the tenocyte-conditioned media (CM) to enhance tendon healing.

STUDY DESIGN:

Controlled laboratory study.

METHODS:

Tenocytes, bone marrow-derived mesenchymal stem cells, and skin fibroblasts were cultured in 3-dimensional PRP hydrogels supplemented or not with CM, and cell proliferation and migration were examined. The effect of tendon-derived CM on matrix-forming phenotype and secretion of inflammatory proteins was determined through their administration to mesenchymal stem cells, tendon, and skin fibroblasts by reverse transcription quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, respectively.

RESULTS:

Differences were found in the matrix-forming phenotype between each of the cell types. The ratio of collagen I:collagen III was greater in bone marrow-derived mesenchymal stem cells than in skin fibroblasts and tenocytes. The bone marrow-derived mesenchymal stem cells expressed increased levels of cartilage-related genes than tenocytes or skin fibroblasts. The presence of the tenocyte-CM stimulated basic healing mechanisms including proliferation and chemotaxis in all cell types. In addition, the tenocyte-CM modified the matrix-forming phenotype of every cell type when cultured in PRP hydrogels. Each cell type secreted interleukin-6, interleukin-8, and monocyte chemotactic protein-1 in PRP hydrogels, but mesenchymal stem cells secreted less interleukin-8 and monocyte chemotactic protein-1 than tenocytes or skin fibroblasts.

CONCLUSION:

The tenocyte-CM combined with PRP stimulated tenogenesis in mesenchymal stem cells and in skin fibroblasts and reduced the secretion of inflammatory proteins.

CLINICAL RELEVANCE:

Modifying the target tissue with PRP prior to cell implantation may optimize the effect of cell therapies. Skin fibroblasts and bone marrow-derived mesenchymal stem cells combined with PRP could be used to regenerate tendons.