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Exercise and the platelet activator calcium chloride both influence the growth factor content of platelet-rich plasma (PRP): overlooked biochemical factors that could influence PRP treatment
  1. Bruce Hamilton1,
  2. Johannes L Tol2,
  3. Wade Knez3,
  4. Hakim Chalabi4
  1. 1High Performance Sport New Zealand, Millenium Institute of Sport and Health, Auckland, New Zealand
  2. 2Department of Sports Medicine, Aspetar; Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  3. 3Department of Research and Education, Aspetar; Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  4. 4CMO Office, Qatar Orthopaedic and Sports Medicine Hospital, Qatar
  1. Correspondence to Dr Bruce Hamilton, Sports Medicine, High Performance Sport NZ, AUT/Millenium Institute of Sport and Health, Mairangi Bay, Auckland 0632 New Zealand; bruce.hamilton{at}, bruce.hamilton1510{at}


Background There is strong evidence that exercise affects platelet haemostasis factors, but this potential effect on growth factor concentrations in platelet-rich plasma (PRP) has never been studied. In addition, there is a paucity of studies focusing on the effects of activating agents used in conjunction with PRP. The first aim of this study was to evaluate the effect of exercise on platelet and platelet-derived growth factors (PDGF)-AB, hepatocyte growth factor (HGF), insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) concentrations in PRP. The second aim was to study the effect of the activating agent calcium chloride (CaCl2) on growth factor concentration in relation to different exercise states.

Methods Controlled laboratory study. Ten healthy participants performed 1 h of submaximal exercise with blood being withdrawn immediately pre, post and 18 h following. PRP was prepared in each condition in both an activated CaCl2 and non-activated form. Concentrations of PDGF-AB, HGF, IGF-1 and VEGF were evaluated using standard ELISA systems.

Results Exercise had no significant effect on platelet concentration, but significantly suppressed both VEGF and PDGF-AB concentrations. Exercise state had no significant effect on IGF-1 or HGF concentration. Activation with CaCl2 resulted in a significant increase in PDGF-AB and IGF-1 concentrations, unchanged VEGF and significantly reduced HGF concentrations.

Conclusions Exercise significantly impacts on PDGFs in PRP with significantly reduced concentrations of VEGF and PDFG-AB. Furthermore, the activation of PRP with CaCl2 results in a differentiated GF release from platelets. These relevant factors can potentially influence outcome in daily clinical practice and are recommended to be accounted for in future study design.

  • Sporting injuries
  • Molecular biochemistry
  • Exercise physiology

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