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Journal of orthopaedic research : official publication of the Orthopaedic Research Society2020; 38(6); 1365-1374; doi: 10.1002/jor.24584

Platelet-rich plasma lysate displays antibiofilm properties and restores antimicrobial activity against synovial fluid biofilms in vitro.

Abstract: Infectious arthritis is difficult to treat in both human and veterinary clinical practice. Recent literature reports Staphylococcus aureus as well as other gram-positive and gram-negative isolates forming free-floating biofilms in both human and equine synovial fluid that are tolerant to traditional antimicrobial therapy. Using an in vitro equine model, we investigated the ability of platelet-rich plasma (PRP) formulations to combat synovial fluid biofilm aggregates. Synovial fluid was infected, and biofilm aggregates allowed to form over a 2-hour period. PRP was collected and processed into different formulations by platelet concentration, leukocyte presence, and activation or lysis. Infected synovial fluid was treated with different PRP formulations with or without aminoglycoside cotreatment. Bacterial load (colony-forming unit/mL) was determined by serial dilutions and plate counting at 8 hours posttreatment. All PRP formulations displayed antimicrobial properties; however, formulations containing higher concentrations of platelets without leukocytes had increased antimicrobial activity. Lysis of PRP and pooling of the PRP lysate (PRP-L) from multiple horses as compared to individual horses further increased antimicrobial activity. This activity was lost with the removal of the plasma component or inhibition of the proteolytic activity within the plasma. Fractionation of pooled PRP-L identified the bioactive components to be cationic and low-molecular weight (<10 kDa). Overall, PRP-L exhibited synergism with amikacin against aminoglycoside tolerant biofilm aggregates with greater activity against gram-positive bacteria. In conclusion, the use of PRP-L has the potential to augment current antimicrobial treatment regimens which could lead to a decrease in morbidity and mortality associated with infectious arthritis.
© 2020 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
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Publication Date: 2020-01-14 PubMed ID: 31922274PubMed Central: PMC8018705DOI: 10.1002/jor.24584Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research demonstrates the antibiofilm properties of platelet-rich plasma lysate (PRP-L) when used against biofilms in synovial fluid, the liquid in joints. The study reveals that PRP-L exhibits increased effectiveness against infectious arthritis when used in the presence of a certain antibiotic, particularly on certain bacteria species.

Research Methods

  • An in vitro model replicating an equine (horse) joint environment was established, testing the behavior of synovial fluid biofilms, the stubborn layers of bacteria found in infectious arthritis.
  • Synovial fluid was deliberately infected, causing biofilm aggregates to form over a two-hour period.
  • Platelet-rich plasma (PRP) was collected and processed under varying conditions such as platelet concentration, the presence of white blood cells (leukocytes) and the use of an activation or lysis process.
  • Different PRP sets were then applied to the infected synovial fluid. Additionally, a common antibiotic class, aminoglycoside, was tested with PRP-L.
  • The bacterial load was then assessed eight hours after treatment using colony-forming unit measurements via dilutions and plate counting methods.

Key Findings

  • All PRP formulations used in the study exhibited some level of antibacterial properties.
  • The PRP lacking leukocytes and having higher platelet concentrates were found to have superior antimicrobial activity.
  • The process of platelet lysis, or breakdown, and the pooling of PRP lysate (PRP-L) from different sources resulted in further enhancement of antimicrobial traits.
  • The plasma component and the proteolytic activity within the plasma were identified as crucial to antimicrobial activity since their removal resulted in the loss of such antimicrobial properties.
  • The bioactive, or functioning, components of pooled PRP-L were identified to be cationic, holding a positive charge, and of a low molecular weight.
  • The PRP-L displayed enhanced effectiveness when used in conjunction with amikacin, a type of aminoglycoside antibiotic, revealing a synergistic relationship, particularly against gram-positive bacteria.

Conclusion

The use of PRP-L, either alone or in combination with antibiotics, might be valuable in treating types of infectious arthritis, and could lead to reduced morbidity and mortality rates among affected populations.

Cite This Article

APA
Gilbertie JM, Schaer TP, Schubert AG, Jacob ME, Menegatti S, Ashton Lavoie R, Schnabel LV. (2020). Platelet-rich plasma lysate displays antibiofilm properties and restores antimicrobial activity against synovial fluid biofilms in vitro. J Orthop Res, 38(6), 1365-1374. https://doi.org/10.1002/jor.24584

Publication

Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
NlmUniqueID: 8404726
Country: United States
Language: English
Volume: 38
Issue: 6
Pages: 1365-1374

Researcher Affiliations

Gilbertie, Jessica M
  • Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
  • Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.
  • Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania.
Schaer, Thomas P
  • Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania.
Schubert, Alicia G
  • Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
Jacob, Megan E
  • Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.
  • Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
Menegatti, Stefano
  • Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.
  • Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina.
Ashton Lavoie, R
  • Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina.
Schnabel, Lauren V
  • Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
  • Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.

MeSH Terms

  • Aminoglycosides / pharmacology
  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Arthritis, Infectious / drug therapy
  • Biofilms / drug effects
  • Female
  • Horses
  • Male
  • Molecular Weight
  • Platelet-Rich Plasma
  • Synovial Fluid / microbiology

Grant Funding

  • R01 AR072513 / NIAMS NIH HHS
  • S10 OD021633 / NIH HHS
  • S10 RR027128 / NCRR NIH HHS

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Citations

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