Platelet-Rich Fibrin Scaffolds for Cartilage and Tendon Regenerative Medicine: From Bench to Bedside

Abstract

Nowadays, research in Tissue Engineering and Regenerative Medicine is focusing on the identification of instructive scaffolds to address the requirements of both clinicians and patients to achieve prompt and adequate healing in case of injury. Among biomaterials, hemocomponents, and in particular Platelet-rich Fibrin matrices, have aroused widespread interest, acting as delivery platforms for growth factors, cytokines and immune/stem-like cells for immunomodulation; their autologous origin and ready availability are also noteworthy aspects, as safety- and cost-related factors and practical aspects make it possible to shorten surgical interventions. In fact, several authors have focused on the use of Platelet-rich Fibrin in cartilage and tendon tissue engineering, reporting an increasing number of in vitro, pre-clinical and clinical studies. This narrative review attempts to compare the relevant advances in the field, with particular reference being made to the regenerative role of platelet-derived growth factors, as well as the main pre-clinical and clinical research on Platelet-rich Fibrin in chondrogenesis and tenogenesis, thereby providing a basis for critical revision of the topic.

Therapeutic Potential of Dental Pulp Stem Cells and Leukocyte- and Platelet-Rich Fibrin for Osteoarthritis

“…In addition, Wong et al treated chondrocytes with different concentrations of PRF CM and showed a proliferative effect on chondrocytes and induced chondrogenic differentiation of chondrocytes [37]. Moreover, Barbon et al revealed that pre-clinical studies strongly indicate a significant enhancement of cartilage regeneration after PRF treatment [34]. There are several reasons for the discrepancy in outcomes between our study and studies proving beneficial effects of PRP or PRF in OA.…”

“…Moreover, the leukocyte fraction in L-PRF has been reported to be accountable for the overproduction of several growth factors, including VEGF and inflammatory cytokines [59,61], which have been described to negatively impact chondrogenesis in vitro [31,[62][63][64][65][66][67]. In contrast, many other growth factors present in L-PRF ex and L-PRF CM are reported to have beneficial influences on MSC chondrogenesis [31,34,68,69]. To date, our data strongly indicate that the supplementation of L-PRF ex and L-PRF CM does not alter MSC chondrogenesis in vitro.…”

Regenerative Potential of Platelet-Rich Fibrin Releasate Combined with Adipose Tissue–Derived Stem Cells in a Rat Sciatic Nerve Injury Model

“…PRFr can be used in a variety of clinical applications, based on the premise that higher GF content should promote better healing. Interestingly, beside the enrichment in platelets and leukocytes, the entrapment of stem-like cells with high regenerative potential within the fibrin network has recently been acknowledged 35 , providing an even more solid basis for the use of PRF in regenerative medicine 17 . Literature records concerning the nerve regeneration with stem cell and platelet-rich fibrin therapies are currently limited.…”

Spinal Reflex Recovery after Dorsal Rhizotomy and Repair with Platelet-Rich Plasma (PRP) Gel Combined with Bioengineered Human Embryonic Stem Cells (hESCs)

“…PRF consists of a leukocyte-platelet-rich dense fibrin matrix with cytokines, platelets, and blood stem cells combined altogether [ 32 ]. This biomaterial can act as a proper scaffold for cells, and it is capable of releasing higher quantities of growth factors compared to PRP [ 33 , 34 ], properties that permit the crescent use of both PRF and PRP in surgical procedures [ 33 , 35 ].…”