anextThe exosomes of Ann Bio Plasma** can promote rotator cuff healing
Rotator cuff tear (RCT) is a common orthopaedic condition that often causes pain, weakness, and functional limitations in patients. In recent years, arthroscopic rotator cuff repair has become a widespread and effective surgical method in clinical practice. However, previous studies have shown that remodeled bone-tendon interfaces (BTIs) after surgery tend to form disorganized scar tissue due to insufficient blood** and lack of functional cells. This scar tissue exhibits low compliance and weak mechanical stress, which is strongly associated with postoperative retear rates (27%-94%), as well as the occurrence of other clinical complications. Currently, a large amount of research is focused on methods based on stem cell**, growth factor**, and functional tissue engineering techniques involving biomaterials to meet the regenerative needs of BTI. However, concerns about safety present significant challenges to the clinical translation of these methods.
Exosomes are bilayer nanoscale vesicles (about 20 150 nm), which exhibit stability and low immunogenicity, and serve as carriers of various biological information, facilitating cell-to-cell communication and cross-species information transfer. Currently, emerging cell-free products based on mesenchymal stem cell-derived exos** have made significant progress in the development of tissue engineering. However, in vitro expansion of stem cells presents challenges, resulting in low yields and high costs of exos, hindering clinical translation. Platelet-enriched plasma (PRP) is a highly concentrated platelet product known for its safety, standardized preparation, and relatively affordable cost. PRP has demonstrated a strong ability to promote tissue regeneration and repair in several areas, including the musculoskeletal system, nerve regeneration, and wound healing. However, PRP has shown some limitations in clinical application. Its reproducibility is compromised due to individual differences between donors and the effects of storage conditions. In addition, the lack of uniform PRP quality control standards led to significant heterogeneity in the concentrations obtained.
Recently, the research team of the Medical College of the Chinese People's Liberation Army published a research review entitled "In-situ gelation of fibrin gel encapsulating platelet-rich plasma-derived exosomes promotes rotator cuff healing" in the Nature sub-journal Communications Biology. The team developed the gel sustained-release system (FG-PPRP-EXOS) by evaluating fibrin gel (FG) to encapsulate PRP**'s EXOS (PRP-EXOS) in the context of a randomized controlled trial for the first time. The effect of PRP-EXOS on enhanced rotator cuff regeneration was evaluated by a variety of imaging examinations, including conventional ultrasound, SWE ultrasound, and micro-CT, combined with histological staining, and the results showed that this combination method significantly improved the healing process after rotator cuff injury.
In this study, the team first investigated the effect of PRP-EXOS on tendon stem progenitor cells (TSPCS) and subsequently determined that 50 g mL of PRP EXOS was the optimal concentration of the drug to effectively induce significant phenotypic changes in TSPCS in vitro. As expected, PRP-exos affect the differentiation of TSPCS into tendon and cartilage lineages. Real-time quantitative PCR (qRT-PCR) showed that the expression levels of genes such as col1a1, scx, col2a1 and sox9 were significantly increased on days 5 and 7. It was verified that FG-wrapped PRP-EXOs can enhance the biomechanical properties of the rotator cuff, promote the remodeling of BTI, and contribute to the recovery of target muscles in vivo. A multimodal assessment of the ** effect showed that the use of FG-PPRP-EXOS had a positive outcome on rotator cuff remodeling.
Effect of PRP-exos on the biological properties of TSPCS.
In summary, the team demonstrated the ability of PRP-EXOS to modulate positive rotator cuff remodeling after injury, the in situ gelation of FG-PPRP-EXOS during surgery is feasible, and the use of multimodal evaluation techniques provides a reliable basis for evaluating the efficacy of RCT repair, and these findings provide a solid foundation for further research on PRP-EXOS in vivo**RCT.
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