The potential of platelet-rich plasma and PRP-derived biologics for neurological disorders: mechanisms and translational research.

Platelet-rich plasma (PRP), an autologous blood derivative rich in multiple growth factors and cytokines, has shown broad application prospects in the field of tissue repair and regeneration. In recent years, the therapeutic potential of PRP in neurological disorders has gained increasing attention. This article systematically reviews the classification systems, preparation methods, and the molecular mechanisms and application progress of PRP in neural repair. In preclinical studies, PRP has been shown to release insulin-like growth factor-1 (IGF-1), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-β (TGF-β), which may synergistically activate PI3K/Akt and MAPK/ERK signaling pathways, suggesting potential tissue repair, axonal regenerative, angiogenic, and immunomodulatory effects. The three-dimensional fibrin scaffold formed upon platelet activation not only provides physical support for cell migration and axonal growth but also enables the sustained local release of growth factors. In central nervous system disorders, intrathecal PRP has shown potential in animal models to alleviate neuroinflammation after spinal cord injury(SCI), and intranasal administration can improve cognitive function and neurogenesis in Alzheimer's disease(AD) models. In peripheral nervous system disorders, local injection or PRP filling within nerve conduits significantly promotes regeneration and functional recovery after injuries to the sciatic nerve, facial nerve, and others. Furthermore, the therapeutic efficacy of PRP is influenced by factors such as preparation method, cellular composition (leukocyte content), administration route, and activation method. Although preclinical evidence is substantial, the clinical application of PRP in neurological disorders still faces challenges including a lack of standardization, unclear mechanisms, and the need to verify long-term safety. This review aims to provide a theoretical basis and practical reference for further research and clinical translation of PRP in the field of neural repair.