Leukocyte- and Platelet Rich Fibrin, an autologous biomaterial to improve regeneration of large gap peripheral nerve injuries

Abstract

Introduction: Current treatment options for peripheral nerve injuries (PNI) are insufficient to completely restore lost functions. We focus on a new therapeutic approach to augment peripheral nerve regeneration after injury. We hypothesise that Leukocyte- and Platelet-Rich Fibrin (L PRF) promotes functional recovery after nerve injuries by stimulating and supporting axon regeneration. Materials and methods: We characterized the morphology of L-PRF and performed a secretome analysis to analyse the GFs released by L PRF. We assessed the effect of L-PRF on neurite outgrowth and survival. A pilot experiment was performed in vivo to test the neuroregenerative capabilities of L-PRF. Results: L-PRF consists of two definable areas: the fibrin matrix, and the cell-rich area. A plethora of GFs are present in L-PRF and slowly released over time from the fibrin clot. L-PRF has a positive effect on neurite growth and survival of DRG neurons in culture. The in vivo pilot experiment showed that decellularized blood vessels are suitable to implant L-PRF in PNI. 2 weeks after PNI there is an increased cell infiltration. Conclusion: L-PRF is an autologous biomaterial that consists out of a fibrin matrix that can support regenerating axons. Furthermore, L-PRF slowly releases many growth factors that positively affect neuronal cell survival, and neurite growth. The pilot study showed that L-PRF supports axon regeneration, and aids cell infiltration. L-PRF can be used as an alternative therapy in PNI but more characterization is needed.