Interleukin-6, Creatine Kinase, and Antioxidant Enzyme Activities following Platelet-Rich Plasma Treatment on Muscle Injury: A Pilot Study

  • Lingling Lai 1 Sport Medicine Department, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, 2 Sport Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • Ashril Yusof Sport Centre, University of Malaya, Kuala Lumpur, Malaysia.
  • Hamid M. S. A 1 Sport Medicine Department, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, 2 Sport Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • Selina Khoo Sport Centre, University of Malaya, Kuala Lumpur, Malaysia
  • A.M Nahar 1-Sport Medicine Department, University of Malaya Medical Centre, Kuala Lumpur, Malaysia 2- Sport Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,

Abstract

The aim of this study was to investigate the effect of autologous platelet-rich plasma (PRP) treatment alongside rehabilitation compared with rehabilitation alone on inflammatory cytokine (interleukin-6, IL-6), creatine kinase muscle type (CKM), and antioxidant enzymes (superoxide dismutase, SOD; catalase, CAT) following hamstring injury. This study was a randomised control trial. Participants diagnosed with grade-2 acute hamstring injury (n=16) were divided into 2 groups of PRP treatment with rehabilitation program (PRP-T) and rehabilitation program (CON). Blood samples were collected at baseline, and 2 fortnightly for the various biochemical assessments. Participants were certified to have recovered upon fulfilling return to play (RTP) criteria. Level of IL-6 and the activities of CKM, SOD, and CAT were measured. PRP-T group benefited from earlier time to RTP with significantly lower IL-6 level and CAT activity compared to CON group. There was no significant difference in CKM and SOD activities between the groups, though a trend of lower values in all variables was observed at week 4 compared to week 0. PRP treatment potentially improves muscle healing process by altering both the inflammatory and oxidative responses, hence hastens time to RTP.

KEY WORDS:  Autologous, blood injection, rehabilitation, sports injury, hamstring injury

Downloads

Download data is not yet available.

References

1. Jarvinen, T.A., et al., Muscle injuries: biology and treatment. Am J Sports Med, 2005. 33(5): p. 745-764.
2. Mishra, A., Woodall, J.Jr. and Vieira A., Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med, 2009. 28(1): p. 113-125.
3. Pedersen, B.K. and Hoffman-Goetz, L., Exercise and the immune system: regulation, integration, and adaptation. Physiol Rev, 2000. 80(3): p. 1055-1081.
4. Tidball, J.G., Inflammatory cell response to acute muscle injury. Med Sci Sports Exer, 1995. 27(7): p. 1022-1032.
5. Ostrowski, K., et al., A trauma-like elevation of plasma cytokines in humans in response to treadmill running. J Physiol, 1998. 513(3): p. 889-894.
6. Steensberg, A., et al., Production of interleukin-6 in contracting human skeletal muscles can account for the exercise-induced increase in plasma interleukin-6. J Physiol, 2000. 529(1): p. 237-242.
7. Powers, S.K. and Lennon, S.L., Analysis of cellular responses to free radicals: focus on exercise and skeletal muscle. P Nutr Soc, 1999. 58(4): p. 1025-1033.
8. Meydani, M., et al., Antioxidant response to exercise-induced oxidative stress and protection by vitamin E. Ann NY Acad Sci, 1992. 669: p. 363-364.
9. Halliwell, B., and Gutteridge, J.M.C., Iron toxicity and oxygen radicals: Free Radicals in Biology and Medicine. 2nd ed. Oxford: Clarendon Press; 1989. p. 86-123.
10. Hamilton, B., Hamstring muscle strain injuries: what can we learn from history? Brit J Sports Med, 2012. 46(13): p. 900-903.
11. Sherry, M.A. and Best, T.M., A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther, 2004. 34(3): p. 116-125.
12. Reynolds, J.F., et al., Non-steroidal anti-inflammatory drugs fail to enhance healing of acute hamstring injuries treated with physiotherapy. S Afri Med J, 1995. 85(6): p. 517-522.
13. Banfi, G., Corsi, M.M. and Volpi, P., Could platelet rich plasma have effects on systemic circulating growth factors and cytokine release in orthopaedic applications? Brit J Sports Med, 2006. 40(10): p. 816.
14. Wright-Carpenter, T., et al., Treatment of muscle injuries by local administration of autologous conditioned serum: a pilot study on sportsmen with muscle strains. Int J Sports Med, 2004. 25(8): p. 588-593.
15. Wright-Carpenter, T., et al., Treatment of muscle injuries by local administration of autologous conditioned serum: animal experiments using a muscle contusion model. Int J Sports Med, 2004. 25(8): p. 582-587.
16. Dimauro, I., et al., Platelet-Rich Plasma and Skeletal Muscle Healing: A Molecular Analysis of the Early Phases of the Regeneration Process in an Experimental Animal Model. PLoS One, 2014. 9(7): p. e102993.
17. Hamid, M.S.A., Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. Am J Sports Med, 2014. 42(10): p. 2410-2418.
18. Bernuzzi et al., Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection. Blood Transfus, 2014. 12(Suppl 1): p. s229-234.
19. Peetrons, P., Ultrasound of muscles. Eur Radiol, 2002. 12(1): p. 35-43.
20. DeLong, J.M., Russell, R.P. and Mazzocca, A.D., Platelet-rich plasma: the PAW classification system. Arthroscopy, 2012. 28(7): p. 998-1009.
21. Warren, P., et al., Clinical predictors of time to return to competition and of recurrence following hamstring strain in elite Australian footballers. Brit J Sports Med, 2010. 44(6): p. 415-419.
22. Cameron, D.M. and Bohannon, R.W., Relationship between active knee extension and active straight leg raise test measurements. J Orthop Sports Phys Ther, 1993. 17(5): p. 257-260.
23. Aebi, H., Catalase in vitro. Methods Enzymol, 1984. 105: p. 121-126.
24. Dupont, W.D. and Plummer, W.D.Jr., Power and sample size calculations. A review and computer program. Control Clin Trials, 1990. 11(2): p. 116-128.
25. Gallucci, S., Myoblasts produce IL-6 in response to inflammatory stimuli. Int Immunol, 1998. 10(3): p. 267-273.
26. Horn, F., Henze, C. and Heidrich, K., Interleukin-6 signal transduction and lymphocyte function. Immunobiology, 2000. 202(2): p. 151-167.
27. El-Sharkawy, H., et al., Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. J Periodontol, 2007. 78(4): p. 661-669.
28. Tohidnezhad, M., et al., Platelet-released growth factors can accelerate tenocyte proliferation and activate the anti-oxidant response element. Histochem Cell Biol, 2011. 135(5): p. 453-460.
29. Ishii, T., et al., Transcription factor Nrf2 coordinately regulates a group of oxidative stress-inducible genes in macrophages. J Biol Chem, 2000. 275(21): p. 16023-16029.
30. Philippou, A., et al., Systemic cytokine response following exercise-induced muscle damage in humans. Clin Chem Lab Med, 2009. 47(6): p. 777-782.
31. Serrao, F.V., et al., Functional changes of human quadriceps muscle injured by eccentric exercise. Braz J Med Biol Res, 2003. 36(6): p. 781-786.
32. Li, G., Feng, X. and Wang, S., Effects of Cu/Zn superoxide dismutase on strain injury-induced oxidative damage to skeletal muscle in rats. Physiol Res, 2005. 54(2): p. 193-199.
33. Gregersen, S., et al., Inflammatory and oxidative stress responses to high-carbohydrate and high-fat meals in healthy humans. J Nutr Met, 2012. 2012: p. 238056.
34. Rettig, A.C., Meyer, S. and Bhadra, A.K., Platelet-rich plasma in addition to rehabilitation for acute hamstring injuries in NFL players clinical effects and time to return to play. Orthop J Sports Med, 2013. 1(1): p. 2325967113494354.
Published
2016-06-16
How to Cite
Lai, L., Yusof, A., M. S. A, H., Khoo, S., & Nahar, A. (2016). Interleukin-6, Creatine Kinase, and Antioxidant Enzyme Activities following Platelet-Rich Plasma Treatment on Muscle Injury: A Pilot Study. International Journal of Applied Exercise Physiology, 5(2), 44-54. Retrieved from http://www.ijaep.com/index.php/IJAE/article/view/52
Section
Applied Exercise Physiology