Repair and regeneration: Connecting the dots among coagulation, immune system, the sensory nervous system and fibrogenesis

Abstract

Two conditions have challenged the survival of living beings with a closed circulatory system, namely trauma and infection. These conditions account for the primary life-threatening emergencies, namely, bleeding and microbial invasion. Through natural selection and conservation, evolution has shaped the biological defence system of vertebrates to cope with bleeding and microbial invasion by systems consisting of several interlinked modules such as coagulation, the innate immune system, and fibrogenesis. In humans, pivotal players in the biological defence system modules are platelets, leukocytes and fibrinogen, located within a connective tissue, namely, the blood, which acts as an incessantly dynamic and renewing kind of container in mammals. Drawing on the regenerative potential of platelets, plasma biomolecules and fibrin matrix, several systems of producing autologous platelets-and plasma derived products (APPDPs) have been developed and aimed at enhancing the natural in vivo tissue regenerative capacity of damaged tissues. However, in spite of skill and care in the elaboration and application of these blood products by medical staff, consistency in the surgical application of platelet rich plasma remains illusive due to a nonuniform approach in both the composition of these products and the modalities of their application. As a consequence, there is both light and shadow in the outcomes of this treatment.