Establish evidence for how platelet-rich plasma relieves joint pain

• Project/Area Number: 17K15788
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Pain science
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: MIYATAKE Kazumasa 東京医科歯科大学, 大学院医歯学総合研究科, 助教 (00777435)
• Project Period (FY): 2017-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
• Keywords: 疼痛の非薬物治療 / 自己多血小板血漿 / 変形性関節症 / 動物モデル / 滑膜炎 / 軟骨変性 / 生理活性

Outline of Final Research Achievements

Several clinical trials in osteoarthritis (OA) have concluded that platelet rich plasma (PRP) injections have a beneficial effect on OA symptoms because of its availability and safety. Despite the increasing use of PRP, the mechanism of PRP to relieve joint pain remains still unknown. In this study, we investigated the effects on synovitis and joint pain in rat arthritis model.The proportion of weight of the PRP injected side significantly increased, which represent relief of joint pain. Histologically, infiltration of inflammatory cells into the synovial tissue and infrapatellar fat pad was significantly inhibited on PRP injected sides. In rat arthritis model, we proved that PRP injections reduced knee pain by regulating synovial inflammation.

Academic Significance and Societal Importance of the Research Achievements

PRP注射が、組織損傷の低減だけでなく疼痛改善効果を有していることは確認されているが、その作用機序は未だ不明であった。本研究はその作用機序の解析を目的としており、これまでの他の研究と全く関連を有しない。多くの膝関節の痛みに悩む患者に効果的な保存治療を行うことができず最終的に人工膝関節全置換術を選択せざるを得ない状況は、2003年に年間4万件であった手術件数が10年間で2倍になっている現状を生み出している。本研究の結果は、現在保険適応にない自己PRPの関節内投与による膝OAの疼痛抑制治療の認可につながる可能性があり、新たな膝OAの保存治療の確立に貢献できる可能性を有している。

Research Products

• [Journal Article] Time course analyses of structural changes in the infrapatellar fat pad and synovial membrane during inflammation-induced persistent pain development in rat knee joint. (2019)
  • Author(s): Inomata K, Tsuji K, Onuma H, Hoshino T, Udo M, Akiyama M, Nakagawa Y, Katagiri H, Miyatake K, Sekiya I, Muneta T, Koga H.
  • Journal Title: BMC Musculoskelet Disord. Volume: 20 Issue: 1 Pages: 8-8
  • DOI: 10.1186/s12891-018-2391-1
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Persistent synovial inflammation plays important roles in persistent pain development in the rat knee before cartilage degradation reaches the subchondral bone. (2018)
  • Author(s): Hoshino T, Tsuji K, Onuma H, Udo M, Ueki H, Akiyama M, Abula K, Katagiri H, Miyatake K, Watanabe T, Sekiya I, Koga H, Muneta T.
  • Journal Title: BMC Musculoskelet Disord. Volume: 19 Issue: 1 Pages: 291-291
  • DOI: 10.1186/s12891-018-2221-5
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Direct anterior versus anterolateral approach in one-stage supine total hip arthroplasty. Focused on nerve injury: A prospective, randomized, controlled trial (2018)
  • Author(s): Takada Ryohei、Jinno Tetsuya、Miyatake Kazumasa、Hirao Masanobu、Kimura Akimasa、Koga Daisuke、Yagishita Kazuyoshi、Okawa Atsushi
  • Journal Title: Journal of Orthopaedic Science Volume: 23 Issue: 5 Pages: 783-787
  • DOI: 10.1016/j.jos.2018.05.005
  • Peer Reviewed
• [Journal Article] Longitudinal morphological change of acetabular subchondral bone cyst after total hip arthroplasty in developmental dysplasia of the hip (2018)
  • Author(s): Takada Ryohei、Jinno Tetsuya、Miyatake Kazumasa、Yamauchi Yuki、Koga Daisuke、Yagishita Kazuyoshi、Okawa Atsushi
  • Journal Title: European Journal of Orthopaedic Surgery & Traumatology Volume: 28 Issue: 4 Pages: 621-625
  • DOI: 10.1007/s00590-017-2115-5
  • Peer Reviewed
• [Presentation] Pure platelet-rich plasma is most effective for the treatment of arthritis. (2019)
  • Author(s): Naoko Araya, Kazumasa Miyatake, Kunikazu Tuji, Takashi Hoshino, Hiroak Onuma, Saisei An, Ichiro Sekiya, Hideyuki Koga.
  • Organizer: Orthopaedic Research Society
  • Int'l Joint Research
• [Presentation] The enhancement of mesenchymal stem cells and chondrocytes proliferation by exosomes derived from human synovial mesenchymal stem cells . (2019)
  • Author(s): Kazumasa Kawata, Hiroki Katagiri, Kunikazu Tsuji, Kazumasa Miyatake, Yusuke Nakagawa, Ichiro Sekiya, Hideyuki Koga.
  • Organizer: Orthopaedic Research Society
  • Int'l Joint Research
• [Presentation] Intra-articular Injection of Synovial Mesenchymal Stem Cells in the Anterior Cruciate Ligament Transection Model in Rats :Evaluation of Cell-number Difference on Prevention of Cartilage Damage and Lower Limb Pain . (2018)
  • Author(s): Hiroko Ueki, Hiroki Katagiri, Kunikazu Tsuji, Kazumasa Miyatake, Takashi Hoshino, Hiroaki Onuma, Masaki Amemiya, Ichiro Sekiya, Hideyuki Koga, Takeshi Muneta.
  • Organizer: Orthopaedic Research Society 2018 Annual Meeting
  • Int'l Joint Research
• [Presentation] Acute inflammatory response is prerequisit to initiate proper healing process during meniscal regeneration in mice. (2018)
  • Author(s): Miyoko Ojima, Kanehiro Hiyama, Kazumasa Miyatake, Hiroki Katagiri, Takeshi Muneta, Ichiro Sekiya, Hideyuki Koga, Kunikazu Tsuji.
  • Organizer: OARSI 2018 World Congress on Osteoarthritis
  • Int'l Joint Research