BECAS
ONETO Paula
artículos
Título:
Inhibition of Fenton reaction is a novel mechanism to explain the therapeutic effect of intra‐articular injection of PRP in patients with chronic haemophilic synovitis
Autor/es:
CAVIGLIA, HORACIO; DAFFUNCHIO, CARLA; GALATRO, GUSTAVO; CAMBIAGGI, GUILLERMO; ONETO, PAULA; DOUGLAS PRICE, ANA LAURA; LANDRO, MARÍA EULALIA; ETULAIN, JULIA
Revista:
HAEMOPHILIA THE OFFICIAL JOURNAL OF THE WORLD FEDERATION OF HEMOPHILIA
Editorial:
Wiley
Referencias:
Año: 2020
ISSN:
1351-8216
Resumen:
Introduction and Aim: Haemarthroses cause major morbidity in haemophilia resulting in chronic haemophilic synovitis (CHS) and arthropathy. Oxidation of haemoglobin-coupled iron released in synovium after haemolysis induces chondrocytes deathand cartilage damage, allowing postulate using iron-chelating drugs as potentialtherapeutic tool for haemophilic joint damage. Considering that albumin, the mostabundant plasma protein, is a physiologic iron chelator, we aim to demonstrate thatimpediment of haemoglobin oxidation is exerted by plasma as a mechanism involvedin the therapeutic effect of intra-articular injection of platelet-rich plasma in CHS.Methods: Oxidation of haemoglobin (Hb) to methaemoglobin (MeHb) through Fentonreaction was induced in vitro by addition of potassium ferricyanide in the presenceor absence of peripheral blood-derived platelets-rich or platelets-poor plasma (PRP/PPP) or albumin. The relevance of in vitro findings was analysed in synovial fluid (SF)samples from one patient with CHS obtained before and after 6 months of PRP intraarticular injection.Results: MeHb formation was completely impaired either by of PPP, PRP or albuminindicating that PRP exerts an anti-oxidative effect, probably due by plasma albumin.Analysis of SF samples revealed the presence of MeHb levels and haemosiderinladen macrophages in SF obtained before PRP treatment. Reduction of synovialMeHb, normalization of cellular composition and improvement of health joint haemophilic score, pain and bleeding episodes were registered after 6 months of PRPintra-articular injection.Conclusion: Inhibition of Fenton reaction and the consequent normalization of jointcellular composition is a noncanonical mechanism underlying the therapeutic effectof PRP intra-articular injection in CHS.
