Platelet-rich plasma, a source of autologous growth factors and biomimetic scaffold for peripheral nerve regeneration

Abstract

In mammals, axons of injured peripheral nerves (PNI) can and do regenerate, but often the functional recovery is incomplete or suboptimal. In recent years, in vivo tissue engineering approaches through molecular intervention and scaffolding are offering promising outcomes. Evidence is accumulating in both preclinical and clinical settings indicating that Platelet-rich plasma (PRP) and fibrin scaffolds obtained from this technology hold an important adjuvant therapeutic potential. Areas covered: This review addresses current molecular and cellular data in intrinsic nerve repair processes and describes different strategies to harness and enhance these processes by using biochemical and biomechanical cues. It focuses on autologous fibrin, plasma and platelet-derived growth factors as filler or scaffolds that can synergize with the gold standard therapy and other nerve guidance conduits. Expert opinion: PRP is applied as a filler of nerve conduits or vein-muscle grafts across nerve gaps post trauma by infiltrating the nerve stumps perineurally and intraneurally in neuropathies, or as scaffolds to bridge or wrap nerve stumps, with significant neurological recovery and pain reduction. The application of PRP at the injured nerve site might be considered as an 'off the shelf' alternative.

Keywords: Injured peripheral nerves; Platelet-rich plasma; growth factors; regeneration; scaffold.