Molecular Intervention with Plasma-Rich Growth Factors to Enhance Muscle Perfusion and Tissue Remodeling in Ischemic Diseases

This chapter reviews the therapeutic potential of platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF) as biological delivery systems to treat ischemic diseases of skeletal muscle and heart. It describes how platelet-derived products provide a sustained local source of multiple pro-angiogenic, pro-survival, anti-fibrotic, and pro-myogenic factors (including VEGF, PDGF, HGF, IGF-1, and SDF-1), together with a fibrin scaffold that supports cell survival and tissue remodeling. Experimental studies in hind-limb ischemia models show that PRP/PRGF enhances angiogenesis, accelerates reperfusion, reduces fibrosis and apoptosis, and improves muscle fiber caliber and regeneration. Similar benefits are reported in multiple myocardial infarction models, including improved ventricular function, reduced adverse remodeling, and increased vascularization. The chapter further discusses how combining PRP/PRGF with stem cells or biomaterials can improve cell retention and regenerative efficacy. Overall, PRP/PRGF is presented as a safe, autologous, and clinically promising strategy to promote coordinated angiogenesis and myogenesis in ischemic tissues.