Journal CME April 2025, Optimizing orthobiologic therapies with exercise, diet, and supplements-PM R - 2025 - Montagnino - Optimizing orthobiologic therapies with exercise diet and supplements

PM R - 2025 - Montagnino - Optimizing orthobiologic therapies with exercise diet and supplements

Pdf Summary

The article explores the interactions between lifestyle factors—exercise, diet, and supplements—and the effectiveness of orthobiologic treatments like platelet-rich plasma (PRP) and cell-based injections such as mesenchymal stromal cells (MSCs). PRP injections utilize concentrated platelets from the patient to enhance healing in musculoskeletal injuries, while MSC-based therapies aim to regenerate tissue by providing multipotent cells.<br /><br />Key Factors Influencing PRP Efficacy:<br />1. Exercise is shown to increase platelet count and function, with high-intensity exercise particularly effective in enhancing platelet adhesion and growth factor release.<br />2. Diet can impact platelet behavior; low-inflammatory diets like the Mediterranean diet are associated with better platelet function. In contrast, diets high in saturated fats, sugars, and certain supplements like omega-3 fatty acids or vitamin E might inhibit platelet activity.<br />3. Supplements such as Carica papaya leaf extract may boost platelet count, but others, including magnesium and fish oil, can reduce platelet aggregation and activation.<br /><br />For MSC-based therapies, factors affecting success include:<br />1. Exercise may help delay MSC senescence and increase their differentiation potential, especially beneficial in older populations.<br />2. Supplements like curcumin, glucosamine, and vitamins C and D have shown potential for improving MSC proliferation and differentiation.<br />3. Diets rich in anti-inflammatory foods and certain polyphenols may support MSC function, while calorie restriction could improve MSC availability and function.<br />4. Adjustments in oxygen levels—hypoxic or hyperbaric—might also enhance MSC viability and function.<br /><br />The article emphasizes the need for further research to determine the optimal lifestyle modifications to enhance these therapies' efficacy. It highlights the potential of tailored approaches incorporating physical activity, dietary patterns, and supplementation to optimize patient outcomes in regenerative medicine.

Keywords

orthobiologic treatments

platelet-rich plasma

mesenchymal stromal cells

exercise

diet

supplements

musculoskeletal injuries

regenerative medicine

anti-inflammatory foods

cell-based injections