Effects of platelet-rich plasma and triamcinolone acetonide on interleukin-1ß-stimulated human rotator cuff-derived cells

Abstract

Objectives: Triamcinolone acetonide (TA) is widely used for the treatment of rotator cuff injury because of its anti-inflammatory properties. However, TA can also produce deleterious effects such as tendon degeneration or rupture. These harmful effects could be prevented by the addition of platelet-rich plasma (PRP), however, the anti-inflammatory and anti-degenerative effects of the combined use of TA and PRP have not yet been made clear. The objective of this study was to determine how the combination of TA and PRP might influence the inflammation and degeneration of the rotator cuff by examining rotator cuff-derived cells induced by interleukin (IL)-1ß.

Methods: Rotator cuff-derived cells were seeded under inflammatory stimulation conditions (with serum-free medium with 1 ng/ml IL-1ß for three hours), and then cultured in different media: serum-free (control group), serum-free + TA (0.1mg/ml) (TA group), serum-free + 10% PRP (PRP group), and serum-free + TA (0.1mg/ml) + 10% PRP (TA+PRP group). Cell morphology, cell viability, and expression of inflammatory and degenerative mediators were assessed.

Results: Exposure to TA significantly decreased cell viability and changed the cell morphology; these effects were prevented by the simultaneous administration of PRP. Compared with the control group, expression levels of inflammatory genes and reactive oxygen species production were reduced in the TA, PRP, and TA+PRP groups. PRP significantly decreased the expression levels of degenerative marker genes.

Conclusions: The combination of TA plus PRP exerts anti-inflammatory and anti-degenerative effects on rotator cuff-derived cells stimulated by IL-1ß. This combination has the potential to relieve the symptoms of rotator cuff injury.Cite this article: T. Muto, T. Kokubu, Y. Mifune, A. Inui, R. Sakata, Y. Harada, F. Takase, M. Kurosaka. Effects of platelet-rich plasma and triamcinolone acetonide on interleukin-1ß-stimulated human rotator cuff-derived cells. Bone Joint Res 2016;5:602-609. DOI: 10.1302/2046-3758.512.2000582.

Keywords: Anti-degeneration; Anti-inflammation; Platelet-rich plasma; Rotator cuff-derived cell; Triamcinolone acetonide.

Fig. 1

Histological images showing cell morphology at day I (top) and day 3 (bottom), size bar 300 um (TA, triamcinolone acetonide; PRP, platelet-rich plasma)

Graphs showing cell viability after treatment in a serum free medium (a) or interleukin (IL)-1ß (b) (* p < 0.05)

Graphs showing cell viability after treatment of triamcinolone acetonide (TA) and/or platelet-rich plasma (PRP) at days one (a) and three (b) (* p < 0.05)

Graphs showing real-time PCR expression of serum free medium cultivation group and interleukin-1ß cultivation group (a; Cyclooxygenase-2 (COX-2), b; membrane-associated PGE synthase (mPGES), c; tumour necrosis factor (TNF)-α) (* p < 0.01)

Graphs showing real-time polymerase chain reaction expression of inflammatory marker genes (a; matrix metalloproteinase-3 (MMP-3) and b; thrombospondin motifs-4 (ADAMTS-4)) (* p < 0.05)

Reactive oxygen species analysis; (a) immunofluorescence staining and (b) quantitative analysis (* p < 0.05) (TA triamcinolone acetonide; PRP, platelet-rich plasma)