Influence of Platelet-Rich and Platelet-Poor Plasma on Endogenous Mechanisms of Skeletal Muscle Repair/Regeneration

Abstract

The morpho-functional recovery of injured skeletal muscle still represents an unmet need. None of the therapeutic options so far adopted have proved to be resolutive. A current scientific challenge remains the identification of effective strategies improving the endogenous skeletal muscle regenerative program. Indeed, skeletal muscle tissue possesses an intrinsic remarkable regenerative capacity in response to injury, mainly thanks to the activity of a population of resident muscle progenitors called satellite cells, largely influenced by the dynamic interplay established with different molecular and cellular components of the surrounding niche/microenvironment. Other myogenic non-satellite cells, residing within muscle or recruited via circulation may contribute to post-natal muscle regeneration. Unfortunately, in the case of extended damage the tissue repair may become aberrant, giving rise to a maladaptive fibrotic scar or adipose tissue infiltration, mainly due to dysregulated activity of different muscle interstitial cells. In this context, plasma preparations, including Platelet-Rich Plasma (PRP) and more recently Platelet-Poor Plasma (PPP), have shown advantages and promising therapeutic perspectives. This review focuses on the contribution of these blood-derived products on repair/regeneration of damaged skeletal muscle, paying particular attention to the potential cellular targets and molecular mechanisms through which these products may exert their beneficial effects.

Platelet-Rich Plasma Modulates Gap Junction Functionality and Connexin 43 and 26 Expression During TGF-β1–Induced Fibroblast to Myofibroblast Transition: Clues for Counteracting Fibrosis

“…In recent years, great attention has been paid to the identification of new therapeutic agents and treatments that may promote the repair/regeneration of damaged skeletal muscle. In such a context, several in vitro and in vivo studies provided evidence supporting the advantage of the use of PRP for muscle regenerative purpose [30,66]. In this line, we have recently demonstrated the capability of PRP to either stimulate proliferation and differentiation of myogenic progenitors, including satellite cells [58], or prevent the TGF-β1 induced differentiation of fibroblasts towards myofibroblasts [48,57].…”

“…In this regard, Platelet-Rich Plasma (PRP)-defined as a plasma fraction with a concentration of platelets above baseline levels and representing a source of numerous biologically active molecules-may offer promising perspectives [30]. Indeed, many in vitro and in vivo studies have demonstrated the anti-fibrotic potential of this blood product in different tissues [31][32][33][34][35][36][37][38], including skeletal muscle [30,[39][40][41][42][43][44][45][46], and have indicated the fibroblast-myofibroblast transition as the cell process target of its action [31][32][33]36,38,44,47,48]. Furthermore, the positive contribution of PRP to skeletal muscle regeneration has been demonstrated either in vivo or in vitro, thanks to its capability to promote the myogenic program [30].…”

Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial

“…There is a growing consensus for the positive effects of PRP as an adjuvant therapy to aid the healing of surgical wounds and injuries. In fact, the growth factors present in PRP are involved in every stage of wound healing [71][72][73] , and several reviews [74][75][76][77][78] , systematic reviews [79][80][81] , and clinical studies [82][83][84] have reported their involvement in enhanced soft-tissue healing outcomes. Our results did not show statistically significant differences in the SWAS scores between the groups because they both obtained the best possible score.…”

Platelet Rich Plasma for Treatment of Rheumatoid Arthritis: Case Series and Review of Literature

“…Pain relief with PRP is reported in patients with skeletal muscle injuries and strains [35][36][37]. ere is also evidence for reduction of inflammation and size of fibrotic scars with PRP in skeletal muscle injury [38].…”