Biogenesis, Isolation, and Mechanistic Applications of Platelet-Rich Plasma and Prp-Derived Exosomes in Diabetic and Chronic Wound Healing: A Comprehensive Narrative Review Publisher



M Saberian MOSTAFA ; M Davoudi MARYAM ; A Ghafourian AMIRREZA ; H Moradi HEMEN ; F Taslim Bakhsh FATEMEH ; R Afrisham REZA
Source: Regenerative Engineering and Translational Medicine Published:2025

Abstract

Background: Platelet-rich plasma (PRP) and PRP-derived exosomes (PRP-Exos) are emerging therapies to accelerate wound healing and reduce complications such as infection, chronic ulcers, and excessive scarring. Methods: In this narrative review, we systematically searched PubMed, Scopus, Web of Science, and Google Scholar for studies up to September 2024 using keywords related to “Platelet-Rich Plasma,” “PRP-Derived Exosomes,” and “Wound Healing.” We included preclinical and clinical articles evaluating mechanisms, isolation/characterization techniques, and therapeutic outcomes. Results: PRP enhances tissue repair by releasing growth factors (e.g., PDGF, VEGF, TGF-β) that stimulate angiogenesis, inflammation resolution, and keratinocyte proliferation. PRP-Exos, carrying stable bioactive cargo, further promote re-epithelialization and collagen synthesis via pathways such as Hippo/YAP and JAK2/STAT3. Incorporation into hydrogels improves growth factor release kinetics and retention, leading to faster wound closure in diabetic and chronic wound models. However, variability in PRP preparation and exosome isolation limits reproducibility. Conclusion: Standardizing PRP and PRP-Exos protocols is essential to harness their full potential in wound management. Future research should focus on optimized combination therapies and robust manufacturing methods to ensure consistent clinical efficacy. Lay summary: Platelet-rich plasma (PRP) and its exosomes (PRP-Exos) promote wound healing by delivering growth factors, enhancing angiogenesis, and modulating inflammation. PRP-Exos offer improved stability but are influenced by preparation variability. This review outlines their production, mechanisms, and therapeutic clinical applications, emphasizing the need for standardized protocols to ensure consistent, reliable outcomes. © 2025 Elsevier B.V., All rights reserved.