تقدير مستويات السايتوكينات (الحركيات الخلوية) المولدة للالتهاب والمضادة للالتهاب لدى مرضى فصال العظام في الركبة قبل وبعد الحقن بالبلازما الغنية بالصفيحات الدموية == Estimation Of Pro - Inflammatory And Anti - Inflammatory Cytokines In Patients With Knee Osteoarthrosis Before And After Injection With Platelets - Rich Plasma (Prp)
Author name:
حسنين خضير عبد العباس
Supervisor name:
عبد العظيم ياسين عبود البراك | سامر محمد رضا عنون | زيد وجيه رؤوف الشهواني
General topic:
Medicine
Specific topic:
Microbiology
Degree:
Doctorate
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
19T1136 - p.pdf
Abstract:
التهاب العظام والمفاصل Osteoarthrosis)) او فصال العظام او ما يعرف بالاسم الشائع السوفان هو مرض يحدث في غضروف المفصل الذي يعمل على عدم احتكاك عظام المفصل ,مما يؤدي الى تقليل هذه الحماية ضد الاحتكاك فتصبح حركة المفصل بها خشونة ومصحوبة بالالام عند استخدام ا | Osteoarthrosis (OA) are defined as a progressive architecture destruction of the joints compared to slow healing of these joints which leads to reduce protection against degeneration and the movement of the joint is associated with by the roughness and accompanied by pain when using the joint. Often this disease affect the knee joint, it may affect any other joint in the body, especially those that carry weights such as leg hinges the pelvis, elbow and spine. The aim of this study is to evaluate the efficacy of platelets - rich plasma injection in osteoarthritis knee and the estimation of the biological and immunological markers associated with the treatment. This study involved 50 patients suffering from inflammation of the knee joint under supervision of speiclist of orthopedic ,most of these patients attended Al - Shaheed Firooz hospital in wasit Governorate and specialty private clinics of orthopedic and Rheumatology in the district during the period from April 2015 until October 2015.The age of patients was about 35 - 65 years; 31 females and 19 males with 25 healthy matching group. All patients were injected into the knee joint by a specialist physician with two injections during two months with platelets - rich plasma (PRP)after its preparation from the same patient's blood in sterile conditions. This was done after the signing of the patient or one of his relatives on the written consent to conduct the injection process after explaining and clarifying the principle of injection and the purpose. The level of pain of patients group was measured by Visual Analogue Scale (VAS). The enzyme linked immunnosorbant assay ELISA method to determine the level of some of cytokines in serum of patients group (interleukin - 1beta, tumor necrosis factor - alpha,IL - 10,IL - 8 and Transforming growth factor - B1) in addition to measuring the concentration of C - Reactive protein (CRP).The rate of Erythrocyte Sedimentation Rate (ESR) was also estimated. All were done to all patients groups before and after injections with PRP in addition to healthy group. Statistical analysis showed no significant differences between males and females (54.5±1.2 males, 53.2±2.1 females). The study showed significant decrease in the mean of the Visual Analogue Scale (VAS) of patients before and after two months of injections with (PRP) 8.46 ± 0.104, 5.98 ± 0.129, , respectively, with highly significant differences (P=000.0) , also the study showed that there was no significant differences in VAS between age groups (30?s, 40?s, 50?s , 60?s) before and after injections with PRP (7.5,8.0 ,8.38 ,9.05), (5.0,5.55,5.69,6.7) respectively. The study also showed a difference in the mean for inflammatory marker C. Reactive protein concentration before and after injections with PRP 7.156± 0.328 µg/ml, 5.384± 0.196 respectively, in comparison with healthy group with highly significant differences (P=0.000).The study also showed a difference in the mean of ESR before and after injections with PRP (35.66± 0.879 mm/1hr, 23.7±0.856) respectively, with in comparison with healthy group highly significant differences (P=0.000).The mean of Interleukin 1 - Beta(IL - 1?) was decline after injections with PRP from 13.220±0.295, pg/ml to 9.622 ± 0.273 pg/ml in comparison with healthy group with highly significant differences (P=0.000). Also a decline in the mean of Tumor necrosis factor - alpha (TNF - ?) after injections with PRP from 62.384±0.927 pg/ml to 55.36 ± 1.121 pg/ml in comparison with healthy group with highly significant differences (P=0.000). The study also demonstrates a decrease in the mean of Interleukin - 8 (IL - 8) before and after injections with PRP (41.092±0.808 pg/ml, 35.93 ± 0.813pg/ml) respectively in comparison with healthy group with highly significant differences (P=0.000). An increase in the mean of Interleukin - 10(IL - 10) after injections with PRP from 5.108±0.291 pg/ml to 6.734±0.330pg/ml, in comparison with healthy group with highly significant differences (P=0.000). The final parameter in this study was demonstrated an increase in the mean of Transforming growth factor - ?1 (TGF - ?1) before and after injections with PRP (111.544±6.960, 149.212±7.540pg/ml) respectively in comparison with healthy group with highly significant differences (P=0.000). Association was obtained between VAS score and C. RP as well as ESR after treatment. PRP treatment also has an impact on increasing the level of anti - inflammatory IL - 10 and TGF - ?1 on one side and the decreasing level of pro - inflammatory IL - 1?, TNF - ?,IL - 8 (catabolic marker) on the other side these results suggest the inhibition of catabolic process demonstrated by reducing of VAS scores and the efficacy of effectiveness plasma rich platelets (PRP) treatment of osteoarthrosis.
