Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling).
Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bio formulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.
PRP Terminology and Classification
The development of PRP products to stimulate tissue repair and regeneration has been an important research field in biomaterial and pharmaceutical sciences for decades. The tissue healing cascade incorporates many players, including platelets with their growth factor and cytokine granules, leukocytes, fibrin matrix, and many other cytokines, which work synergistically. During this cascade, a complex coagulation process occurs, consisting of platelet activation and subsequent release of the contents of dense and α-platelet granules, polymerization of fibrinogen (released by platelets or free in the plasma) into a fibrin mesh, and platelet plug development.
Post time: Oct-13-2022