Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Abstract

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 bioformulation, 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.

Platelet Lysate Nebulization Protocol for the Treatment of COVID-19 and Its Sequels: Proof of Concept and Scientific Rationale

“…However, the interaction of viruses with platelets alters both their structure and functionality (9), becoming more hyperreactive (10). As a consequence, the response of the immune cells is exaggerated and dysregulated (11), aggravating processes such as inflammation. The stabilizing function of the alveolocapillary barrier carried out by platelets (12) is also altered due to thrombocytopenia and platelet alteration (13).…”

“…It is also being applied in different pathologies in other branches of medicine such as ophthalmology, dermatology, nervous system lesions, and recently in gynecology as a treatment for ovarian and uterine pathology, for example. In all these pathologies, its efficacy and the ideal composition and dose of PRP are still being studied in multiple clinical studies [11].…”

“…Platelet-rich plasma, a biological therapy approved by regulatory agencies, is based on the concentration of the platelets present in blood [11]. Platelets are small anucleate cells derived from megakaryocytes whose biosynthesis takes place in both bone marrow and lungs [12,13].…”

Targeting Cartilage Degradation in Osteoarthritis

“…Platelet-rich plasma (PRP) therapy for OA involves intra-articular injection with a preparation of autologous plasma containing high platelet levels. Once in the joint, platelets are activated by abundant cartilage ECM proteins, leading to release of their cytoplasmic components, including several anabolic growth factors such as TGF-β1, platelet-derived growth factor (PDGF), insulin-like growth factor (IGF), and FGF2, which promote aggrecan and collagen synthesis, while reducing expression and activity of catabolic metalloproteases [ 58 ].…”

Systematic Review: Adipose-Derived Mesenchymal Stem Cells, Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

“…PRP is a high-concentration platelet-oriented plasma obtained from animal or human whole blood via centrifugation [7], which is typically 3-to 7-fold of the mean platelet concentration in whole blood. Containing α-granules, platelets secrete several growth factors (GFs) after being activated, such as transforming growth factor-β (TGF-β), plateletderived growth factor (PDGF), vascular endothelial growth factor (VEGF), and so forth [8,9].…”