The role of allogeneic platelet-rich plasma in patients with diabetic foot ulcer: Current perspectives and future challenges

Abstract

The frequency of chronic cutaneous wounds are sharply increasing in aging populations. Patients with age-related diseases, such as diabetes, tumors, renal failure and stroke are prone to soft tissue and skin injury, compounded by slowed healing in aging. Imbalance of wound inflammation, loss of growth factor secretion, and impairment of tissue repair abilities are all possible reasons for failed healing. Therefore, it is vital to explore novel approaches to accelerate wound healing. Platelet-rich plasma (PRP) as a cell therapy has been widely applied for tissue repair and regeneration. PRP promotes wound healing by releasing antimicrobial peptides, growth factors and micro-RNAs. Medical evidence indicates that autologous platelet-rich plasma (au-PRP) can promote wound healing effectively, safely and rapidly. However, its clinical application is usually restricted to patients with chronic cutaneous wounds, generally because of other severe complications and poor clinical comorbidities. Allogeneic platelet-rich plasma (al-PRP), with abundant sources, has demonstrated its superiority in the field of chronic wound treatment. Al-PRP could overcome the limitations of au-PRP and has promising prospects in clinical applications. The aim of this review is to summarize the current status and future challenges of al-PRP in chronic cutaneous wound management. We also summarized clinical cases to further describe the application of al-PRP for chronic wounds in clinical practice.

Allogeneic platelet gel therapy for refractory abdominal wound healing: A preliminary study

“…The benefit of allogeneic PRP is that it can be collected from voluntary blood donors, and be ready to use at any time without having to collect any samples from the patient. 17,29 Moreover, it has been demonstrated that the potential immunogenicity of allogeneic PRP is not a significant risk. 30 There is a non-systematic review that discusses allogeneic PRP for wound treatment, 17 including 3 case series and 5 randomized controlled trials.…”

Expanding applications of allogeneic platelets, platelet lysates, and platelet extracellular vesicles in cell therapy, regenerative medicine, and targeted drug delivery

“…Platelet derivatives, including PRP and “platelet gels” used for regenerative medicine, are still typically obtained from autologous patient-specific blood fractions [ 81 , 82 ]. However, there is now an increasing focus on considering allogeneic (donor-derived whole blood or apheresis) PCs prepared by blood establishments and hospital blood banks as starting materials to make platelet-derived biomaterials [ 17 – 19 , 24 – 27 , 83 – 86 ]. Preparation procedures of PCs from allogeneic blood donors by blood establishments (a term equivalent to blood centers) using whole-blood donations or plateletpheresis procedures were described in previous publications [ 9 , 10 , 87 – 89 ] and are summarized below.…”

“…Several reasons contribute to the growing interest in platelet biomaterials made from allogeneic donations rather than autologous sources. First, certain patients may face challenges in donating 50–100 mL of their own blood due to various health conditions, lack of venous access, the presence of comorbidities such as thrombocytopenia (a low platelet count), platelet dysfunctions, diabetes, peripheral arterial and neuropathic disease [ 17 – 19 ], or the use of antithrombotic medications, which can impact the blood-clotting process and platelet functions [ 20 ]. Secondly, the variability in autologous platelet derivatives, affecting growth factor content and immune cell and inflammatory cytokine profile, further complicates their use [ 21 ].…”

“…Considering these challenges, exploring the benefits and addressing the challenges associated with allogeneic sources to prepare platelet biomaterials as “off-the-shelf” products becomes an appealing approach for further investigation [ 24 ]. The successful use of allogeneic PRP has been previously documented in the treatment of chronic skin wounds, diabetic foot ulcers [ 17 , 18 , 25 – 27 ], and osteoarthritis [ 28 ]. Similarly, allogeneic serum has shown therapeutic value for dry eye syndrome and other ocular surface pathologies [ 26 , 29 – 31 ] especially in situations where autologous materials was unsuitable or inconvenient.…”

Protective Actions in Apical Periodontitis: The Regenerative Bioactivities Led by Mesenchymal Stem Cells

“…These findings also inspire research on biomaterials and tissue engineering since promoting dECM exposure can be a novel target. Platelet-rich plasma is a widely used biologic that is rich in TGF-β, IGF1, platelet-derived growth factor (PDGF), and other growth factors [ 108 , 121 ]. In one study, the combination of a tricalcium phosphate (TCP) material and platelet-rich plasma showed a promising therapeutic effect in the treatment of AP lesions [ 108 ].…”