What sets the dermaV celluVance™ PRP Kits apart from other PRP kits?
The celluVance™ PRP kits are the first of its kind to be manufactured in South Africa in a Good
Manufacturing Practice (GMP) accredited laboratory and Medicines Control Council (MCC) licensed manufacturing facility. The
manufacturing process complies with the strictest international standards to ensure sterility and safety. After 4 years of extensive research the celluVance™ PRP kit was designed to achieve optimal results while ensuring a practical easy-to-use extraction and activation process for physicians.
The celluVance™ range can be classified as a leukocyte containing PRP (L-PRP) kit with clotting factors and a platelet concentration between two to five times the base line platelet count. These type of devices are advantageous due to the fact that leukocytes possess anti-infectious actions and immune regulation properties.
Why are activators used and not just blood tubes. The answer is that we are trying to mimic this illustration cascade ex vivo.
EC – Endothelial cells
vWF – von Willebrand Factor
c – Collagen
Xa – Activated Factor X
5-HT – Serotonin
TXA – Thromboxane A
ADP – Adenosine diphosphate
AP - adhesion proteins
GPIa - glycoprotein Ia
GPIb: glycoprotein Ib
GP IIb/IIIa - glycoprotein IIb/IIIa;
GF - growth factors
HF - haemostasis factors
Activated platelets express and release growth factors and cytokines that mediate the different phases of the wound healing cascade. GF such as TGF-β are stored in granules in a latent form in the platelet and requires platelet activation resulting in degranulation to release it in its active form. During wound healing, platelet receptors bind to exposed collagen, vWF, ADP or TXA which results in release of stored Ca , activating several Ca dependent proteases which aid in platelet activation. Platelet activation leads to a conformational change in the platelet which ids in aggregation by forming bridges with plasma fibrin. During platelet activation, thromboplastin is synthesised from the megakaryocyte derived mRNA. Thromboplastin aids in the activation of the extrinsic coagulation cascade which ultimately leads to the cleavage of prothrombin into thrombin in a Ca dependent manner. Citrate anticoagulant is used to collect the whole blood for PRP preparation as it prevents blood coagulation.
Chelating Ca , forming calcium citrate complexes that prevents activation of the Ca dependent proteases. Aim to mimic the wound healing cascade during PRP preparation to ensure a product that would contain active GF.
Some of these devices and protocols go a step further and ensure that the coagulation cascade further amplifies the platelet activation and guarantee the formation of a fibrin clot or gel by combining the PRP- Ca preparation with a exogenous thrombin, autologous thrombin, organic solvents and or a negatively charged surface such as glass.
Using thrombin from an exogenous source leads to a PRP preparation that cannot be classified as autologous. Furthermore, it may induce immunological reactions in the patient.
To prepare autologous thrombin:
Additional whole blood is collected from a patient.
The PRP or PPP fraction obtained combined with Ca in a glass container. Glass is used as it initiates the intrinsic blood coagulation pathway by activating Factor XII.
A fibrin clot is formed. The newly formed clot is compressed and the supernatant collected which is combined with the previously obtained PRP fraction in a 1:4 ratio, volume per volume. Most GF are stored in a latent form in the platelet granules which are released after activation and degranulation of the platelets Administration of non-activated PRP may lead to
GF that are in contact with the tissue but unable to provide the necessary growth signals.
“Complete PRP is both a fresh clot and the supernatant. This knowledge is germane to those who have advanced the concept of developing PRP from clotted blood or to companies that have promoted "serum separator tubes." Serum is not plasma and contains almost no platelets. It is impossible to develop PRP from clotted whole blood. Because the two functional roles of platelets in nature are initiation of healing and hemostasis, platelets become part of the physical blood clot and, therefore, the serum is devoid of platelets.”
Xian LJ, et al. Cytotherapy. 2015;17:293-300
“At the time of the application, the PRP is combined with a certain volume of a sterile saline solution containing calcium chloride (a citrate inhibitor that allows the plasma to coagulate) and thrombin (an activator that allows polymerization of the fibrin
into an insoluble gel, which causes the platelets to degranulate and release the indicated mediators and cytokines)”
Marx RE. Implant Dentistry. 2001;10(4):225-228