Platelet-rich plasma in the pathologic processes of tendinopathy: a review of basic science studies

Abstract

Tendinopathy is a medical condition that includes a spectrum of inflammatory and degenerative tendon changes caused by traumatic or overuse injuries. The pathological mechanism of tendinopathy has not been well defined, and no ideal treatment is currently available. Platelet-rich plasma (PRP) is an autologous whole blood derivative containing a variety of cytokines and other protein components. Various basic studies have found that PRP has the therapeutic potential to promote cell proliferation and differentiation, regulate angiogenesis, increase extracellular matrix synthesis, and modulate inflammation in degenerative tendons. Therefore, PRP has been widely used as a promising therapeutic agent for tendinopathy. However, controversies exist over the optimal treatment regimen and efficacy of PRP for tendinopathy. This review focuses on the specific molecular and cellular mechanisms by which PRP manipulates tendon healing to better understand how PRP affects tendinopathy and explore the reason for the differences in clinical trial outcomes. This article has also pointed out the future direction of basic research and clinical application of PRP in the treatment of tendinopathy, which will play a guiding role in the design of PRP treatment protocols for tendinopathy.

Association between Platelet-Derived Growth Factor Receptor Alpha Gene Polymorphisms and Platelet-Rich Plasma’s Efficiency in Treating Lateral Elbow Tendinopathy—A Prospective Cohort Study

“…Nevertheless, the course of angiogenesis also has a major role during LET treatment. Proper angiogenesis is necessary during wound healing and regeneration; however, pathological neovascularization is one of the main characteristics of tendinopathy [26]. Research has shown that the PDGFRα homodimer promotes angiogenesis after binding with PDGF-AA and PDGF-CC [22].…”

“…Therefore, it seems that the same processes that are involved in the treatment of tendinopathy also contribute to its development. The therapeutic effects of PRP in treating tendinopathy include stimulating cell proliferation, the synthesis of collagen, the regulation of angiogenesis, and modulation of inflammation [26]. The growth factors contained in PRP, including PDGFs, are responsible for the PRP's properties.…”

Liquid platelet-rich fibrin produced via horizontal centrifugation decreases the inflammatory response and promotes chondrocyte regeneration in vitro

“…Wang Z (Wang et al, 2021) and Lee JS (Lee et al, 2022) et al have demonstrated that PRP is capable of promoting chondrogenic differentiation of stem cells, which is consistent with our own results. As the final therapeutic conclusion of HA and PRP for the treatment of OA is still undefined throughout so many basic research and preclinical studies (Zhang et al, 2022;Lu et al, 2023), this is a meaningful research direction not only in basic research, but also for future clinical research.…”

Clinical evaluation of platelet-rich plasma therapy for osteonecrosis of the femoral head: A systematic review and meta-analysis

“…PRP contains various types of growth factors, inhibitors of inflammatory factors, and a rich fibrin network. Many of the ingredients synergistically participate in cell proliferation, growth, and differentiation, thereby regulating tissue repair, healing, and regeneration [11][12][13]. The number of primary studies in this area has increased substantially over the years [14][15][16][17].…”