Platelet-Rich Fibrins as Local Drug-Delivery Carriers

The present review article explores the emerging evidence on the use of autologous platelet concentrates (APCs) as sustained release vehicles for a variety of drugs, including antibiotics, antifungals, antidiabetic drugs, exosomes, and vitamins for localized delivery approaches. The incorporation of such bioactive agents into APCs could enhance their therapeutic efficacy, support antimicrobial effects, wound healing and regeneration, and potentially reduce the need for systemic therapy. Although platelet-rich plasma (PRP) has also been studied as a carrier of bioactive agents, the rapid degranulation of platelets and lack of a cohesive fibrin network in PRP lead to a short-lived burst-type release profile. On the other hand, platelet-rich fibrin (PRF) has a three-dimensional scaffold of fibrin in which the growth factors and drug agents are retained, characteristics which make PRF-based APCs advantageous over PRP in the field of drug-delivery systems. However, a major challenge remains to be the absence of standardized drug-loaded APCs preparation protocols, with variations in centrifugation parameters, tube composition, and biomolecules' loading techniques, thereby influencing the APCs' structural integrity and release kinetics. The present review further highlights key findings on optimal loading strategies and the interactions between incorporated agents and the carrying APCs. It further highlights the level of current evidence for each of these drug-loaded APCs under investigation, their strength of recommendation, and possible knowledge gaps. Future work should focus on further developing and standardizing preparation protocols, advancing controlled release technologies, and validating efficacy through large scale clinical trials. Overall, bioactive drug-loaded APCs could represent a promising platform for targeted antimicrobial, antifungal, and regenerative therapies, bridging infection management with precision-guided tissue healing.