PRP and SCI therapy: Mechanisms, translation and challenges

Spinal cord injury (SCI) can cause sensory and motor dysfunction in patients, and even lead to permanent paralysis and sensory loss. It can also induce refractory neuropathic pain, which seriously affects patients 'quality of life. Currently, there are few selective and effective methods to promote SCI functional recovery. Platelet-rich plasma (PRP) is a high-concentration platelet concentrate extracted from autologous blood by centrifugation. It contains multiple growth factors and has the potential to promote tissue regeneration. PRP and its derived exosomes have the ability to promote nerve regeneration, regulate the pathological microenvironment of SCI, and contribute to functional recovery. Its functional mechanisms in treating SCI include promoting axon regeneration and myelination, anti-inflammation, promoting angiogenesis, blood-spinal cord barrier (BSCB) protection and pain regulation, which is also a potential treatment method for treating SCI. Recently, PRP has been carried out in a small amount in the clinical treatment of SCI. However, due to the lack of high-quality clinical evidence for PRP, the efficacy of PRP in clinical applications is still controversial. Therefore, this article discusses the functional role of PRP in the treatment of SCI as well as the therapeutic potential, value, and current challenges of PRP in the clinical application of SCI.