Skip to main content

Biology of Platelet-Rich Plasma

  • Chapter
  • First Online:
Platelet-Rich Plasma in Dermatologic Practice

Abstract

Platelets are anucleate derivatives of megakaryocytes that can release almost 4000 unique proteins stored in one of three types of granules: dense granules, alpha (α)-granules, or lysosomes. Platelet α-granules release several growth factors (GFs), cytokines, chemokines, and proteolytic enzymes that can promote healing and tissue regeneration by stimulating cell proliferation, differentiation, migration along with matrix remodeling, and angiogenesis. Treatment using autologous preparation of platelet-rich plasma (PRP) containing platelets whose concentration is three- to fivefold above baseline in the blood is widely popular in sports medicine and maxillofacial surgery, and more recently has gained traction in dermatology. PRP preparation is rapid, requiring minimal specialized equipment and training, and is relatively safe, easy, and affordable compared to other tissue regeneration therapies such as tissue engineering, gene therapy, or cell therapy. GFs secreted by platelets in PRP cause dermal matrix remodeling to enhance skin rejuvenation and healing of wounds and scars while keratinocyte and dermal papilla cell growth and proliferation are key features induced by GFs to promote wound healing and hair regeneration. Although achievements from use of PRP in clinical dermatology are invigorating, there is limited understanding about the basic science further complicated by lack of standardization in the clinical setting resulting in variable and inconsistent clinical response.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Patel SR, Hartwig JH, Italiano JE. The biogenesis of platelets from megakaryocyte proplatelets. J Clin Invest. 2005;115:3348–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Weiss HJ. Platelet physiology and abnormalities of platelet function. N Engl J Med. 1975;293:580–8.

    Article  CAS  PubMed  Google Scholar 

  3. Łukasik Z, Makowski M, Makowska J. From blood coagulation to innate and adaptive immunity: the role of platelets in the physiology and pathology of autoimmune disorders. Rheumatol Int. 2018;38:959–74.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Pietrzak WS, Eppley BL. Platelet rich plasma: biology and new technology. J Craniofac Surg. 2005;16:1043–54.

    Article  PubMed  Google Scholar 

  5. Alves R, Grimalt R. A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Ski Appendage Disord. 2018;4:18–24.

    Article  Google Scholar 

  6. Kalyam K, Kavoussi SC, Ehrlich M, Teng CC, Chadha N, Khodadadeh S, et al. Irreversible blindness following periocular autologous platelet-rich plasma skin rejuvenation treatment. Ophthalmic Plast Rec. 2017;33:S12–6.

    Article  Google Scholar 

  7. Zhang M, Park G, Zhou B, Luo D. Applications and efficacy of platelet-rich plasma in dermatology: a clinical review. J Cosmet Dermatol. 2018;17:660–5.

    Article  PubMed  Google Scholar 

  8. Picard F, Hersant B, Bosc R, Meningaud J. Should we use platelet-rich plasma as an adjunct therapy to treat “acute wounds,” “burns,” and “laser therapies”: a review and a proposal of a quality criteria checklist for further studies. Wound Repair Regen. 2015;23:163–70.

    Article  PubMed  Google Scholar 

  9. Elghblawi E. Platelet-rich plasma, the ultimate secret for youthful skin elixir and hair growth triggering. J Cosmet Dermatol. 2018;17:423–30.

    Article  PubMed  Google Scholar 

  10. Sclafani AP, Azzi J. Platelet preparations for use in facial rejuvenation and wound healing: a critical review of current literature. Aesthet Plast Surg. 2015;39:495–505.

    Article  Google Scholar 

  11. Hussain N, Johal H, Bhandari M. An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature. Sicot-J. 2017;3:57.

    Google Scholar 

  12. Giordano S, Romeo M, di Summa P, Salval A, Lankinen P. A meta-analysis on evidence of platelet-rich plasma for androgenetic alopecia. Int J Trichology. 2018;10(1):10.

    Article  Google Scholar 

  13. Fitzpatrick J, Bulsara MK, McCrory P, Richardson MD, Zheng M. Analysis of platelet-rich plasma extraction. Orthop J Sports Med. 2017;5:2325967116675272.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Amable P, Carias R, Teixeira M, da Pacheco Í, do Amaral R, Granjeiro J, et al. Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther. 2013;4:67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Mazzocca AD, McCarthy MR, Chowaniec DM, Cote MP, Romeo AA, Bradley JP, et al. Platelet-rich plasma differs according to preparation method and human variability. J Bone Jt Surg. 2012;94:308–16.

    Article  Google Scholar 

  16. Castillo TN, Pouliot MA, Kim H, Dragoo JL. Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. Am J Sports Med. 2011;39:266–71.

    Article  PubMed  Google Scholar 

  17. Kushida S, Kakudo N, Morimoto N, Hara T, Ogawa T, Mitsui T, et al. Platelet and growth factor concentrations in activated platelet-rich plasma: a comparison of seven commercial separation systems. J Artif Organs. 2014;17:186–92.

    Article  CAS  PubMed  Google Scholar 

  18. do Amaral R, da Silva N, Haddad N, Lopes L, Ferreira F, Filho R, et al. Platelet-rich plasma obtained with different anticoagulants and their effect on platelet numbers and mesenchymal stromal cells cehavior in vitro. Stem Cells Int. 2016;2016:7414036.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Degen RM, Bernard JA, Oliver KS, Dines JS. Commercial separation systems designed for preparation of platelet-rich plasma yield differences in cellular composition. HSS J. 2017;13:75–80.

    Article  PubMed  Google Scholar 

  20. Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, Merli G, et al. Platelet-rich plasma: the choice of activation method affects the release of bioactive molecules. Biomed Res Int. 2016;2016:1–7.

    Article  CAS  Google Scholar 

  21. Ruggeri ZM, Mendolicchio LG. Adhesion mechanisms in platelet function. Circ Res. 2007;100:1673–85.

    Article  CAS  PubMed  Google Scholar 

  22. Coppinger JA, Cagney G, Toomey S, Kislinger T, Belton O, McRedmond JP, et al. Characterization of the proteins released from activated platelets leads to localization of novel platelet proteins in human atherosclerotic lesions. Blood. 2004;103:2096–104.

    Article  CAS  PubMed  Google Scholar 

  23. Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. Bone Joint J. 2009;91:987–96.

    CAS  Google Scholar 

  24. Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma. Am J Sports Med. 2009;37:2259–72.

    Article  PubMed  Google Scholar 

  25. Pavlovic V, Ciric M, Jovanovic V, Stojanovic P. Platelet rich plasma: a short overview of certain bioactive components. Open Med-Warsaw. 2016;11:242–7.

    Article  CAS  Google Scholar 

  26. Peterson JE, Zurakowski D, Italiano JE, Michel LV, Fox L, Klement GL, et al. Normal ranges of angiogenesis regulatory proteins in human platelets. Am J Hematol. 2010;85:487–93.

    Article  CAS  PubMed  Google Scholar 

  27. Sheu JR, Fong TH, Liu CM, Shen MY, Chen TL, Chang Y, et al. Expression of matrix metalloproteinase-9 in human platelets: regulation of platelet activation in in vitro and in vivo studies. Brit J Pharmacol. 2004;143:193–201.

    Article  CAS  Google Scholar 

  28. Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114:1502–8.

    Article  PubMed  Google Scholar 

  29. Weibrich G, Kleis W, Hafner G, Hitzler WE. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Cranio Maxill Surg. 2002;30:97–102.

    Article  Google Scholar 

  30. Martineau I, Lacoste E, Gagnon G. Effects of calcium and thrombin on growth factor release from platelet concentrates: kinetics and regulation of endothelial cell proliferation. Biomaterials. 2004;25:4489–502.

    Article  CAS  PubMed  Google Scholar 

  31. Lacoste E, Martineau I, Gagnon G. Platelet concentrates: effects of calcium and thrombin on endothelial cell proliferation and growth factor release. J Periodontol. 2003;74:1498–507.

    Article  CAS  PubMed  Google Scholar 

  32. Cho H, Song I, Park S-Y, Sung M, Ahn M-W, Song K. Individual variation in growth factor concentrations in platelet-rich plasma and its influence on human mesenchymal stem cells. Korean J Lab Med. 2011;31:212–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Evanson RJ, Guyton KM, Oliver DL, Hire JM, Topolski RL, Zumbrun SD, et al. Gender and age differences in growth factor concentrations from platelet-rich plasma in adults. Mil Med. 2014;179:799–805.

    Article  PubMed  Google Scholar 

  34. Andia I, Abate M. Platelet-rich plasma: underlying biology and clinical correlates. Regen Med. 2013;8:645–58.

    Article  CAS  PubMed  Google Scholar 

  35. Alser OH, Goutos I. The evidence behind the use of platelet-rich plasma (PRP) in scar management: a literature review. Scars Burn Heal. 2018;4:2059513118808773.

    PubMed  PubMed Central  Google Scholar 

  36. Ruiz A, Cuestas D, Garcıa P, Quintero J, Forero Y, Galvis I, et al. Early intervention in scar management and cutaneous burns with autologous platelet-rich plasma. J Cosmet Dermatol. 2018;17:1194–9.

    Article  PubMed  Google Scholar 

  37. Aal A, Ibrahim I, Sami N, Kareem I. Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars. J Cosmet Laser Ther. 2017;20:106–13.

    PubMed  Google Scholar 

  38. Alam M, Hughart R, Champlain A, Geisler A, Paghdal K, Whiting D, et al. Effect of platelet-rich plasma injection for rejuvenation of photoaged facial skin: a randomized clinical trial. JAMA Dermatol. 2018;154:1447–52.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Sand J, Nabili V, Kochhar A, Rawnsley J, Keller G. Platelet-rich plasma for the aesthetic rurgeon. Facial Plast Surg. 2017;33:437–43.

    Article  CAS  PubMed  Google Scholar 

  40. Farage MA, Miller KW, Elsner P, Maibach HI. Characteristics of the aging skin. Adv Wound Care. 2013;2:5–10.

    Article  Google Scholar 

  41. Quan T, Fisher GJ. Role of age-associated alterations of the dermal extracellular matrix microenvironment in human skin aging: a mini-review. Gerontology. 2015;61:427–34.

    Article  CAS  PubMed  Google Scholar 

  42. Abuaf O, Yildiz H, Baloglu H, Bilgili M, Simsek H, Dogan B. Histologic evidence of new collagen formulation using platelet rich plasma in skin rejuvenation: a prospective controlled clinical study. Ann Dermatol. 2016;28:718–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Kim D, Je Y, Kim C, Lee Y, Seo Y, Lee J, et al. Can platelet-rich plasma be used for skin rejuvenation? Evaluation of effects of platelet-rich plasma on human dermal fibroblast. Ann Dermatol. 2011;23:424–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Quan T, Qin Z, Xia W, Shao Y, Voorhees JJ, Fisher GJ. Matrix-degrading metalloproteinases in photoaging. J Invest Derm Symp Proc. 2009;14:20–4.

    Article  CAS  Google Scholar 

  45. Yuksel E, Sahin G, Aydin F, Senturk N, Turanli A. Evaluation of effects of platelet-rich plasma on human facial skin. J Cosmet Laser Ther. 2014;16:206–8.

    Article  PubMed  Google Scholar 

  46. Gawdat HI, Tawdy AM, Hegazy RA, Zakaria MM, Allam RS. Autologous platelet-rich plasma versus readymade growth factors in skin rejuvenation: a split face study. J Cosmet Dermatol. 2017;16:258–64.

    Article  PubMed  Google Scholar 

  47. Papakonstantinou E, Roth M, Karakiulakis G. Hyaluronic acid: a key molecule in skin aging. Dermatoendocrinol. 2012;4:253–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Fabi S, Sundaram H. The potential of topical and injectable growth factors and cytokines for skin rejuvenation. Facial Plast Surg. 2014;30:157–71.

    Article  CAS  PubMed  Google Scholar 

  49. Aldag C, Teixeira D, Leventhal PS. Skin rejuvenation using cosmetic products containing growth factors, cytokines, and matrikines: a review of the literature. Clin Cosmet Investig Dermatol. 2016;9:411–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Chicharro-Alcántara D, Rubio-Zaragoza M, Damiá-Giménez E, Carrillo-Poveda JM, Cuervo-Serrato B, Peláez-Gorrea P, et al. Platelet rich plasma: new insights for cutaneous wound healing management. J Funct Biomaterials. 2018;9:10.

    Article  CAS  Google Scholar 

  51. Fabbrocini G, Annunziata M, D’Arco V, Vita DV, Lodi G, Mauriello M, et al. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract. 2010;2010:893080.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016;15:434–43.

    Article  PubMed  Google Scholar 

  53. Oh I, Kim B, Kim M. Depressed facial scars successfully treated with autologous platelet-rich plasma and light-emitting diode phototherapy at 830 nm. Ann Dermatol. 2014;26:417–8.

    Article  PubMed  PubMed Central  Google Scholar 

  54. ris C, Tziotzios C, Vale I. Cutaneous scarring: pathophysiology, molecular mechanisms, and scar reduction therapeutics part I. The molecular basis of scar formation. J Am Acad Dermatol. 2012;66:1–10.

    Article  CAS  Google Scholar 

  55. Mancuso M, Santagostino E. Platelets: much more than bricks in a breached wall. Br J Haematol. 2017;178:209–19.

    Article  PubMed  Google Scholar 

  56. Asai J, Hirakawa S, Sakabe J, Kishida T, Wada M, Nakamura N, et al. Platelets regulate the migration of keratinocytes via podoplanin/CLEC-2 signaling during cutaneous wound healing in ice. Am J Pathol. 2016;186:101–8.

    Article  CAS  PubMed  Google Scholar 

  57. Grazul-Bilska A, Johnson M, Bilski J, Redmer D, Reynolds L, Abdullah A, et al. Wound healing: the role of growth factors. Drugs Today. 2003;39:787.

    Article  CAS  Google Scholar 

  58. Murphy PS, Evans GR. Advances in wound healing: a review of current wound healing products. Plast Surg Int. 2012;2012:190436.

    PubMed  PubMed Central  Google Scholar 

  59. Hausauer AK, Jones DH. Evaluating the efficacy of different platelet-rich plasma regimens for management of androgenetic alopecia. Dermatol Surg. 2018;44:1191–200.

    Article  CAS  PubMed  Google Scholar 

  60. Lotti T, Goren A, Verner I, D’Alessio PA, Franca K. Platelet rich plasma in androgenetic alopecia: a systematic review. Dermatol Ther. 2019:e12837.

    Google Scholar 

  61. Bolanča Ž, Goren A, Getaldić-Švarc B, Vučić M, Šitum M. Platelet-rich plasma as a novel treatment for lichen planopillaris. Dermatol Ther. 2016;29:233–5.

    Article  PubMed  Google Scholar 

  62. Driskell RR, Clavel C, Rendl M, Watt FM. Hair follicle dermal papilla cells at a glance. J Cell Sci. 2011;124:1179–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Li Z, Choi H, Choi D, Sohn K, Im M, Seo Y, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012;38:1040–6.

    Article  CAS  PubMed  Google Scholar 

  64. Xiao S-E, Miao Y, Wang J, Jiang W, Fan Z-X, Liu X-M, et al. As a carrier–transporter for hair follicle reconstitution, platelet-rich plasma promotes proliferation and induction of mouse dermal papilla cells. Sci Rep. 2017;7:1125.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  65. Gupta AK, Carviel J. A mechanistic model of platelet-rich plasma rreatment for androgenetic alopecia. Dermatol Surg. 2016;42:1335–9.

    Article  CAS  PubMed  Google Scholar 

  66. Kiso M, Hamazaki TS, Itoh M, Kikuchi S, Nakagawa H, Okochi H. Synergistic effect of PDGF and FGF2 for cell proliferation and hair inductive activity in murine vibrissal dermal papilla in vitro. J Dermatol Sci. 2015;79:110–8.

    Article  CAS  PubMed  Google Scholar 

  67. Jain R, De-Eknamkul W. Potential targets in the discovery of new hair growth promoters for androgenic alopecia. Expert Opin Ther Targets. 2014;18:787–806.

    Article  CAS  PubMed  Google Scholar 

  68. Yotsu RR, Hagiwara S, Okochi H, Tamaki T. Case series of patients with chronic foot ulcers treated with autologous platelet-rich plasma. J Dermatol. 2015;42:288–95.

    Article  PubMed  Google Scholar 

  69. Conde-Montero E, Horcajada-Reales C, Clavo P, Delgado-Sillero I, Suárez-Fernández R. Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma. Int Wound J. 2016;13:726–8.

    Article  PubMed  Google Scholar 

  70. Goldstein AT, King M, Runels C, Gloth M, Pfau R. Intradermal injection of autologous platelet-rich plasma for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol. 2017;76:158–60.

    Article  PubMed  Google Scholar 

  71. Hofny ER, Abdel-Motaleb AA, Ghazally A, Ahmed A, Hussein M. Platelet-rich plasma is a useful therapeutic option in melasma. J Dermatol Treat. 2018;29:1–6.

    Google Scholar 

  72. Gupta S, Revathi T, Sacchidanand S, Nataraj H. A study of the efficacy of platelet-rich plasma in the treatment of androgenetic alopecia in males. Indian J Dermatol Venereol Leprol. 2017;83:412.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maria Hordinsky .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Shaik, J., Farah, R., Hordinsky, M. (2021). Biology of Platelet-Rich Plasma. In: Sadick, N.S. (eds) Platelet-Rich Plasma in Dermatologic Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-66230-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-66230-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-66229-5

  • Online ISBN: 978-3-030-66230-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics