Sensory improvement of leprosy peripheral neuropathy in patients treated with perineural injection of platelet-rich plasma

Abstract

Leprosy (Hansen's disease) is a chronic granulomatous infection caused by Mycobacterium leprae with peripheral neuropathy as cutaneous and neurological manifestations. Peripheral nerve regeneration may be stimulated by vascular endothelial growth factor and other growth factors (GFs) that have important roles in extracellular matrix regeneration. All of those GFs can be found in platelet-rich plasma (PRP) preparation. The effect of PRP injection in leprosy peripheral neuropathy has never been reported. A double-blind, randomized, control clinical trial was conducted among 60 patients with leprosy peripheral neuropathy. They were randomized to receive either a 1-ml injection of PRP as treatment or a 1-ml injection of platelet-poor plasma (PPP) as control. Skin sensibilities were measured by two-point discrimination test (TPDT) and visual analog scale (VAS), which were taken before and two weeks after treatment. Perineural injection of PRP was shown to be significantly more effective than PPP (P < 0.05) either in VAS or TPDT measurements. In both groups, the patients had a tingling sensation at the time of injection that disappeared shortly after. This study shows that perineural PRP injection could promote improvement of peripheral neuropathy sensibility in patients with leprosy. More research is needed to better determine the effects of PRP in nerve regeneration.