Biological Mechanisms and Clinical Challenges of Platelet-Rich Plasma in Chronic Musculoskeletal Pain: From Standardized Preparation to Multi-Omics-Guided Precision Therapy

Abstract

Background: Chronic musculoskeletal pain (CMP) affects over 1 billion people globally. Platelet-rich plasma (PRP) therapy has emerged as a promising regenerative approach. Methods: This review synthesizes current literature on PRP’s biological mechanisms, preparation techniques, clinical efficacy, and ethical challenges, with a focus on multi-omics integration for personalized therapy. Results: PRP promotes tissue repair through growth factor release and immunomodulation, but clinical translation is hampered by preparation variability, lack of predictive biomarkers, and ethical concerns. Multi-omics approaches (genomics, proteomics, metabolomics) offer potential for efficacy prediction and treatment personalization. Conclusion: Standardization of PRP preparation and rigorous long-term trials are urgently needed. Multi-omics-guided strategies may enhance precision in PRP therapy for CMP.