Potential links between tendon pathology and platelet rich plasma biology

Abstract

Tendons are prone to chronic lesions, especially in the presence of risk factors such as overuse, trauma and metabolic disorders. Current therapies cannot meet the clinical demand for tendon conditions, and biological interventions such as Platelet Rich Plasma (PRP) can provide a critical opportunity to benefit patients with tendinopathy. Assuming that tendon pathology is consequence of a failed healing response to tissue micro-damage, the signalling cytokines in PRP can modify tissue microenvironment, and enhance healing mechanisms. PRP hypothesis is based on biological hallmarks of tendinopathy, including inflammation, stem cell exhaustion and aberrant differentiation, tenocyte dysfunction with disorganization of extracellular matrix (ECM), altered intercellular communication and subsequent transition from health to disease. PRP can act against by modulating inflammation and angiogenesis, stimulating proliferation of tenocytes and tendon progenitor cells, and tissue anabolism. Progress in translational PRP research would help to establish a comprehensive description of the relationship between PRP essential components, main pathological components of tendinopathy and healing mechanisms.