PLATELTEX®: A NEW GENERATION OF PLATELET-RICH PLASMA (PRP) WITH RAPID GELATION TIME
Plateltex® is a new generation platelet gel preparation ( glue-like) and platelet rich plasma (PRP). It is commercially available as Plateltex® ACT ( Activation kit; Plateltex® S.R.O). It ushers in a new era of wound healing and care, especially because of the rapid gelation, and slower more controlled release of growth factors.
CLINICAL INDICATIONS FOR USE OF PLATELTEX® ACT: A NEW GENERATION OF PRP
- Maxilla-facial surgery: mandibular reconstruction, dental implants, oro-nasal fistulae
- Ear nose and throat surgery: nasal fractures
- Plastic reconstructive surgery and aesthetics: musculo cutaneous reconstruction, mammoplasty
- Orthopaedics: pseudoarthrosis, osteosynthesis, titanium implants
- Neurosurgery: cranial floor and dural surgery
- Other: Chronic ulceration and need in wound healing and care: General medicine, Geriatrics, Diabetes, Vascular surgery, Cardio thoracic surgery, General surgery and Radiotherapy.
- Chronic upper and lower extremity chronic ulceration and poor wound healing: chronic venous ulceration and diabetic neuropathic ulceration
HOW DOES PLATELTEX® WORK AS A BIOLOGICAL STIMULANT FOR WOUND HEALING AND CARE?
Platelets play an important role in primary and secondary wound healing. Bioactive substances such as growth factors are released when the platelets are activated. Known platelet derived GF that influence wound healing include PDGF, TGF, VEGF and EGF. This is well documented. This is what is found in platelet-rich plasma (PRP). Platelet gel, looks like gelatine. A glue-like gel can be produced when thrombin, calcium, and batroxobin is mixed with PRP. The fibrinogen is cleaved to form fibrin that polymerizes to produce a glue-like gel ( see illustration). Platelets are trapped and retained in the gel in activated and inactivated form. When activated, bioactive molecules are released from the platelet granules then diffuse into the surrounding environment to facilitate the tissue regeneration/wound healing process.
VALUABLE SCIENTIFIC DATA AND INFORMATION REGARDING PLATELTEX® ACT: ADVANTAGES OF PLATELTEX® ACT GENERATED PRP FOR CLINICAL APPLICATION
- CE marked and authorised for human use
- Extremely low side effect profile because the patient’s autologous plasma is used
- Platelet yield in PRP is excellent.
- Growth factor yield in platelet gel preparation is excellent
- Gel preparation occurs in 8-10 minutes and the quality of the gel is excellent and lends itself to the application of wounds. The speed of preparation is welcomed by surgeons in theatre. Operation time can be cut down and this leads to costs savings
- The product has been tested in-vitro and in the clinic
- The platelet concentrate is embedded in the semisolid (gel) network of polymerized fibrin.
- Plateltex® has the leading edge as platelet-rich plasma ( PRP) for topical therapy. It is highly competitive compared to other existing commercial products: PRGF, PRP-LANDESBER, CURASAN, PCCS, HARVEST, VIVOSTAT, REGEN AND FIBRINET.
- The yield of PDGF-AB, TGF-B VEGF, FGF are good and highly efficient in the PRP
- Plateltex® provides excellent platelet recovery, collection efficiency and PDGF-AB availability
- Gelation of the PRP is induced by batroxobin ( a patented system)
- Batroxobin, the enzyme used to induce gelation, acts differently from thrombin, which is used by most other PRP generation systems. In this case the platelets treated with batroxobin do not become activated; become passively entrapped in the fibrin network, and GF release occurs slowly. This important observation will tailor the slow release of GF over a prolonged period allowing a better anabolic and biological effect for wound healing. This might well be preferable to quick thrombin-induced growth factor release
- Plateltex® (Bratislava, Slovakia) is a valuable new addition for cellular therapy with human autologous platelets and growth factors relevant to chronic wound care and healing. This has special application in soft and bony tissue repair via the topical approach
- Compared to other products, PLATELTEX® uses calcium gluconate and batroxobin which is a unique combination. This combination provides formation of a stable and easy-to-handle gel in a mean time of 8 min because the batroxobin and calcium gluconate act synergistically. Batroxobin has been used in clinical practice for 30-years.Batroxobin only removes fibropeptide A, whereas thrombin catalyses the release of both fibrinopeptide A and B
- Thrombin is inhibited by heparin, while batroxobin is not
- According to Muzzacco et al 2008: suggest that these differences explain the delayed batroxobin-induced clot retraction. This group have also strongly suggested that the kind of fibrin polymerization, the life span and the availability of the platelet-released cytokines can be modulated
- Plateltex® as well, is effective as other small blood volume-processing systems in producing high quality and enriched PRP by rapid gelation , that is of special interest to the practising clinician.
- According to Muzzacco et al from Italy, the characteristics of the batroxobin-activated PRP gel are therapeutically valuable in selected clinical settings requiring long-term availability of platelet-derived trophic factors. This may well be the case scenario with the treatment of chronic slow healing wounds, varicose ulcers and diabetic foot ulceration.
PLATELTEX® ACT: IN VITRO CELL BIOLOGY QUANTIFICATION STUDIES 2008
Epidermal ( keratinocytes) and mesodermal cell lines ( adipose derived fibroblasts and dermal fibroblasts) including monolayers, have been tested in tissue culture with batroxobin-induced gelation ( PLATELTEX®). Quantification data show enhanced and sustained cell proliferation and monolayer formation in these enriched cell culture mediums. See figures 1-3 , below.
Figure 1: Plateltex provides rapid gelation in 8-10 minutes, that is very convenient for surgeons in theatre.
Figure 2: In vitro studies. Plateltex provides for rapid gelation.
Figure 3: Plateltex is non toxic to proliferating fibroblasts in culture. It is therefore unlikely that cell proliferation, and migration will be affected in vivo.
BOLANDCELL REFERENCES: KEY ARTICLES RELEVANT TO THE CLINICAL APPLICATION OF PLATELTEX® AND PLATELET RICH PLASMA (PRP)
- Mazzucco L et al. Platelet-rich plasma and platelet gel preparation using Plateltex®. Vox Sanguinis 2008: 1-7 ( New product launch and review from Prof Borzini’s Unit in Alessandria, Italy). Keywords for publication are: batroxobin, platelet gel, platelet-rich plasma.
- Borzini P, et al. Transfusion 2005, 35:1759-1767.
- Du Toit DF et al. Int J Shoulder Surg ( Platelet-rich plasma)2007: 1:64-73.
- Mazzucco L, et al. Transfusion 2004, 44: 1013-1018
- Borzini P, et al. Transfus Med 2006, 16:303-304
- Borzini P, et al. Science Series 2007, 2: 272-281
- Du Toit DF et al. Shoulder surgeon and autologous cellular regeneration-from bench to bed: Part 1: The link between the human fibroblast, connective tissue disorders and shoulder. ( Platelet-rich plasma)Int J Shoulder Surgery2007:1; 87-95.
- Marx RE et al. Quintessence Books, Chicago, 2005 1-154 (text book and excellent overview by the pioneer in the United States).
- Eppley BL et al. Plast Reconstr Surg 2006: 118, 147e-59e
- Pietrzak WS et al. J Craniofasc Surg 2007,18: 559-67
- Pietrzak WS et al. J Craniofasc Surg 2005,16:1043-54
- Du Toit DF et al. Specialist Forum. ( Platelet –rich plasma)September 2007.36-42.( Volume 7)
- Du Toit DF et al. Specialist Forum. ( Platelet –rich plasma)October 2007.15-22. ( Volume 7)
- Du Toit DF. New research developments and advances in the application of autologous cellular regeneration ( ACR) and platelet-rich plasma (PRP) in South Africa. The Specialist Forum. November 2007: vol 7: 30-31.
CELL BIOLOGY GALLERY REGARDING PLATELTEX AND PLATELET-RICH PLASMA