Biological Mechanisms and Clinical Challenges of Platelet-Rich Plasma in Chronic Musculoskeletal Pain and Wound Care
Summary: This review examines platelet-rich plasma (PRP)’s mechanisms—growth factor release (PDGF, TGF-β, VEGF) for immunomodulation and tissue repair—in chronic musculoskeletal pain and wound healing, including DFUs. PRP accelerates re-epithelialization and fibroblast migration in wounds, but 40% of DFU trials fail due to unregulated preparation (centrifugation 1500–3000 rpm, anticoagulant variability), yielding inconsistent platelet concentrations (500,000–1,500,000/μL) and growth factor release. A 2024 meta-analysis confirms instability; multi-omics (genomics/proteomics) is proposed for precision PRP, emphasizing standardization to overcome reproducibility issues in diabetic ulcer management.
Key Highlights:
- Mechanisms: PRP releases EGF/VEGF for angiogenesis; supports fibroblast migration in DFUs.
- Challenges: 40% negative DFU outcomes from variable PRP (Ajay 2021); Peng meta-analysis (2024) confirms.
- Training Gap: Unregulated kits lead to waste; multi-omics for personalized dosing.
- Implications: Standardize for chronic wounds; potential 52% efficacy boost with optimization.
- Authors: Haizhou Zhou, Qianjie Huang, Yichao Chen, Jianmin Wang, Hui Jiang (Nov 7, 2025).
Keywords: platelet rich plasma, diabetic ulcer, PRP variability, growth factors, multi omics