Letter to the Editor: Optimizing platelet-rich plasma therapy for diabetic foot ulcers: From bench to bedside

Abstract

Huang et al recently published a study in the World Journal of Diabetes, which reported that platelet-rich plasma (PRP) combined with endovascular angioplasty enhances angiogenesis and promotes healing in diabetic foot ulcers (DFUs). While this study provides valuable translational evidence, several mechanistic and clinical considerations warrant further discussion. Cell type-specific, concentration-dependent responses suggest that a uniform PRP formulation may not optimally address the heterogeneous wound microenvironment. In addition, PRP’s effects on diabetes-related endothelial dysfunction, treatment scalability, and variability in PRP composition were not fully explored. Addressing these issues may help refine PRP-based therapeutic strategies and improve their clinical applicability in DFU management.

Keywords: Diabetic foot ulcer; Platelet-rich plasma; Wound healing; Angiogenesis; Endovascular procedures

Core Tip: This commentary builds upon a recent study to propose key refinements for platelet-rich plasma (PRP) therapy in diabetic foot ulcers. We argue against a uniform PRP concentration, advocating instead for cell-type-specific formulations. Furthermore, we highlight the need to address diabetic endothelial dysfunction beyond angiogenesis, and to establish standardized, clinically-relevant protocols based on PRP bioactivity and precise patient stratification. These steps are crucial to transition PRP from a promising treatment to a reliably optimized and personalized therapeutic strategy.