Infiltration of plasma rich in growth factors enhances in vivo angiogenesis and improves reperfusion and tissue remodeling after severe hind limb ischemia

This study evaluates the regenerative effects of plasma rich in growth factors (PRGF) on vascular and skeletal muscle repair after severe hind limb ischemia. Using in vitro assays, the authors show that PRGF induces dose-dependent proliferation and protects against apoptosis in human endothelial cells and skeletal myoblasts. In vivo, PRGF markedly enhances angiogenesis in a Matrigel plug assay, increasing both capillary and arteriole formation compared with controls. In a mouse model of iliac artery ligation, intramuscular PRGF infiltration significantly improves limb reperfusion by 28 days, as measured by microPET imaging, and is associated with reduced muscle atrophy and increased muscle mass and caliber. PRGF treatment also attenuates post-ischemic fibrosis and promotes myocyte recovery, as demonstrated by decreased collagen deposition and increased desmin-positive fibers in treated muscles. The authors conclude that PRGF acts as a local, sustained delivery system of multiple growth factors that promotes functional angiogenesis, enhances tissue reperfusion, limits fibrosis, and supports coordinated myogenesis during skeletal muscle regeneration after ischemic injury.