Vitamin D and Platelet Rich Plasma Make Stem Cells into Bones

Biotechnol Lett. 2010 Jan 3, Feng et al.

There are several procedures in medicine that have been used for a while without detailed understanding of how exactly they work. An example of this is platelet rich plasma. It has been used for decades in accelerating healing of bones, although its mechanisms of action were never really understood. Platelet rich plasma is obtained by taking blood from a patient, spinning it on a centrifuge to clear out the red cells and white cells, and collecting the portion that has plasma and a high concentration of platelets.

What was known about platelet rich plasma is that platelets contain many growth factors such as fibroblast growth factor that increasing wound healing, bone morphogenic proteins which increase bone regeneration, and vascular endothelial growth factor which causes new blood vessels to be formed, a process called angiogenesis that is critical in proper bone healing.

In a recent paper a potential mechanism of platelet rich plasma's bone healing activity was described. The group of Feng et al from the Department of Orthopaedics of the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, China reported that platelet rich plasma increases the differentiation of mesenchymal stem cells into bone cells. While it has been known for years that mesenchymal stem cells are capable of becoming bone, this is the first time it was shown that something as simple to use such as platelet rich plasma can be used stimulate this process.

Mesenchymal stem cells were originally discovered as stem cells that become bone, fat, and cartilage, however newer studies have demonstrated a wider differentiation ability, with reports claiming generation of neurons, hepatocytes, islets, and pulmonary alveolar tissue. The clinical relevance of mesenchymal stem cells comes from the fact that Osiris has a mesenchymal stem cell based product on the market called OsteoCel, for non-healing bone fractures. Additionally, numerous clinical trials are underway with mesenchymal stem cells for conditions ranging from heart failure, to stroke, to chronic obstructive pulmonary disease.

In the research report that was published in the peer reviewed journal Biotechnology Letters, the scientists demonstrated that vitamin D actually helped to increase the effects of platelet rich plasma on the differentiation process. The investigators reported that several nutritional considerations may be critical when contemplating manipulation of stem cells using growth factors. They cited work from an Italian group showing that in addition to vitamin D, vitamin a and C are cofactors for the differentiation of stem cells into therapeutically active cells.

A key question is whether the platelet rich plasma may be used in combination with stem cells for accelerating formation of other tissues.