Three decades of PRPs: keeping the flame alive for blood as a source of repair and regeneration

INTRODUCTION: Blood has always been a source for regenerative strategies, and platelet‑rich plasma (PRP) is one example. The global development of PRP has witnessed an exponential surge, resulting in a myriad of PRP versions and different modalities of application. The quick translation of this biologic into clinical application is due to its favorable safety profile and promising, although heterogeneous efficacy data, drawing on its versatile network of multidomain proteins with immunomodulatory, anti-inflammatory, trophic, antifibrotic and analgesic effects. Nevertheless, the field of PRP faces several challenges regarding their clinical and therapeutic efficacy which stem from the many preparation methods yielding PRPs with different biological compositions, the varied modalities of application, patient age and underlying conditions, among other factors. AREA COVERED: This review seeks to contextualize and clarify the emergence, expansion and therapeutic possibilities, as well as the limits of PRP within a historical context. EXPERT OPINION: PRP has transitioned from a simple platelet concentrate into a complex, biomimetic fibrin matrix that delivers critical growth factors to naturally accelerate tissue repair. However, its clinical predictability remains challenged by both autologous patient variability and methodological differences. Overcoming these hurdles will require a standardized biological classification and guidelines to reliably target specific pathologies.