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. 2021 Dec 10;4(2):e335-e341.
doi: 10.1016/j.asmr.2021.10.004. eCollection 2022 Apr.

Double-Spin Leukocyte-Rich Platelet-Rich Plasma Is Predominantly Lymphocyte Rich With Notable Concentrations of Other White Blood Cell Subtypes

Anuj Marathe  1 , Shiv J Patel  1 , Bo Song  1 , Joseph M Sliepka  1 , Theodore S Shybut  2   3 , Brendan H Lee  4 , Prathap Jayaram  1   5
Affiliations

Double-Spin Leukocyte-Rich Platelet-Rich Plasma Is Predominantly Lymphocyte Rich With Notable Concentrations of Other White Blood Cell Subtypes

Anuj Marathe et al. Arthrosc Sports Med Rehabil. .

Abstract

Purpose: To comprehensively characterize a double-spin leukocyte-rich platelet-rich plasma (LR-PRP) formulation and to compare it with whole blood (WB) by quantitatively assessing platelet and WB cell subtype concentrations in each.

Methods: Prospective human ex vivo analysis with 12 healthy adult men with ages ranging from 25 to 31 was performed in a controlled laboratory setting. The main outcome measure was the leukocyte profile of human LR-PRP.

Results: In LR-PRP, lymphocytes were the predominant WB cell type (11.94 ± 2.97 × 103 cells/μL) followed by neutrophils (3.72 ± 1.28 × 103 cells/μL). The mean cumulative percentage of granulocytes was 23% ± 8% and agranulocytes was 77% ± 18%. There was a significant difference observed between granulocyte and agranulocyte percentage within both WB (P = .004, [95% CI: (7%,31%)]) and LR-PRP (P < .0001, [95% CI: (42%,66%)]) groups. In addition, there was a significant difference observed between the WB and LR-PRP granulocyte percentages (P < .0001, [95% CI: (29%,43%)]) and between the WB and LR-PRP agranulocyte percentages (P < .0001, [95% CI: (30%,42%)]).

Conclusions: Our study found that LR-PRP is predominantly lymphocyte rich with notable concentrations of other WB cell subtypes, including neutrophils, monocytes, eosinophils, basophils, and large unstained cells. While these subtypes are not routinely reported, they may play a role in modulating the local inflammatory environment. We also found significant differences in WB cell subtype concentrations between WB and LR-PRP.

Clinical relevance: PRP has been routinely used in many clinical practices without clear indications for its use and lacks standardization in its formulation. This study provides a comprehensive characterization of a broadly used PRP, LR-PRP, and further characterizes subtypes of WBC cells present in LR-PRP that have not been previously reported. Comprehensively reporting these subtypes in clinical trials of PRP is crucial to understanding how these cells participate in PRP's therapeutic potential. This type of data can help standardize future PRP formulations and improve patient outcomes.

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Figures

Fig 1
Fig 1
Platelet concentration reported in 103/μL in whole blood (WB) and leukocyte-rich platelet rich plasma (LR-PRP). Concentrations were obtained using a scatter cytogram and the platelet-integrated analysis method. Participants in each group: n = 12.
Fig 2
Fig 2
Pie chart representations of white blood cell components in whole blood and leukocyte-rich platelet rich plasma (LR-PRP). LUCs, large unsustained cells.
Fig 3
Fig 3
Stacked comparison of mean percentage of granulocytes and agranulocytes in whole blood and leukocyte-rich platelet rich plasma (LR-PRP).
See this image and copyright information in PMC

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