Platelet-rich plasma (PRP), has recently been identified as a biological material that could be applied to tissue regeneration.

In recent years there have been many studies on growth factors. Platelets, of which prp is rich, release substances that allow the healing of tissue and affect the behavior of the other cells modulating the inflammation and the neoformation of blood vessels (neoangiogenesis). Platelets in fact have a fundamental role to mediate the healing of damage tissue thanks to their ability to release growth factors.

Recent reports suggested that certain growth factors, such as vascular VEGF, fibroblast growth factor (FGF)-2, FGF-4, FGF-6, FGF-7, FGF-9, FGF-17, transforming growth factor (TGF)-beta1, TGF-beta2, HGF, keratinocyte growth factor, platelet-derived growth factor AA, and IGF-1, regulate the maintenance of ASC stemness [37]. These factors affect a plethora of responses such as angiogenesis, cellular migration, apoptosis, proliferation, and differentiation [56–59]. In particular, the proliferation of ASCs is regulated by paracrine factors such as FGF-2, FGF-4, interleukin (IL)-6, and stromal-derived factor 1, whereas FGF-2, endothelial growth factor, TGF-beta, and other factors are involved in differentiation.

Exposure of PRP to calcium chloride or calcium gluconate induces platelet degranulation.

Several studies describe the potential benefits of using PRP in tissue regeneration; in particular, PRP therapy has been proposed in wound healing. Moreover, because PRP is able to stimulate proliferation of undifferentiated stem cells as well as cell differentiation, it might be used in conjunction with stem cell transplantation to promote tissue regeneration.

ASCs hold great potential for use in stem cell therapy. After being transplanted, however, ASCs face a complex and hostile environment in which local hypoxia, oxidative stress, and inflammation may lead to cell loss or death on a large scale. Insufficient retention and survival of transplanted ASCs can dramatically reduce their therapeutic effects. In this regard, PRP is an attractive cell-maintained biomaterial, and the activated PRP scaffold can enhance the stemness properties of ASCs, although further analysis and investigation are needed to establish novel cell therapies.

The evidence compiled to date suggests that this combination treatment represents a promising approach in various fields of medicine.