Mazzucco L, Balbo V, Cattana E, Borzini P
Blood Transfusion Centre and Biotechnology Laboratory, Ospedale SS Antonio e Biagio, Alessandria, Italy.
Vox Sang. 2008 Apr;94(3):202-208. doi: 10.1111/j.1423-0410.2007.01027.x. Epub 2008 Jan 7.
The platelet gel is made by embedding concentrate platelets within a semisolid (gel) network of polymerized fibrin. It is believed that this blood component will be used more and more in the treatment of several clinical conditions and as an adjunctive material in tissue engineering. Several systems are available to produce platelet-rich plasma (PRP) for topical therapy. Recently, a new system became commercially available, Plateltex. Here we report the technical performance of this system in comparison with the performance of other commercially available systems: PRGF, PRP-Landesber, Curasan, PCCS, Harvest, Vivostat, Regen and Fibrinet.
Both the PRP and the gel were prepared according to the manufacturer's directions. The blood samples of 20 donors were used. The yield, the efficiency, and the amount of platelet-derived growth factor AB (PDGF-AB), transforming growth factor beta, vascular endothelial growth factor and fibroblast growth factor were measured in the resulting PRP. The feature of the batroxobin-induced gelation was evaluated.
The yield, the collection efficiency and the growth factor content of Plateltex were comparable to those of most of the other available systems. The gelation time was not dependent on the fibrinogen concentration; however, it was strongly influenced by the contact surface area of the container where the clotting reaction took place (P < 0.0001).
Plateltex provided platelet recovery, collection efficiency and PDGF-AB availability close to those provided by other systems marketed with the same intended use. Batroxobin, the enzyme provided to induce gelation, acts differently from thrombin, which is used by most other systems. Platelets treated with thrombin become activated; they release their growth factors quickly. Furthermore, thrombin-platelet interaction is a physiological mechanism that hastens the clot-retraction rate. On the contrary, platelets treated with batroxobin do not become activated; they are passively entrapped within the fibrin network, and their growth factor release occurs slowly. In these conditions, the clot retraction takes longer to occur. According to these differences between thrombin and batroxobin, it is expected that batroxobin-induced PRP activation will tailor slow release of the platelet content, thus, providing longer in loco availability of trophic factors. In selected clinical conditions, this durable anabolic factor availability might be preferable to quick thrombin-induced growth factor release.
血小板凝胶是通过将浓缩血小板包埋在聚合纤维蛋白的半固体（凝胶）网络中制成的。人们认为这种血液成分在多种临床病症的治疗中以及作为组织工程中的辅助材料将得到越来越广泛的应用。有多种系统可用于制备用于局部治疗的富血小板血浆（PRP）。最近，一种新系统Plateltex已上市。在此我们报告该系统与其他市售系统（PRGF、PRP-Landesber、Curasan、PCCS、Harvest、Vivostat、Regen和Fibrinet）相比的技术性能。
PRP和凝胶均按照制造商的说明制备。使用了20名捐赠者的血样。对所得PRP中的产量、效率以及血小板衍生生长因子AB（PDGF-AB）、转化生长因子β、血管内皮生长因子和成纤维细胞生长因子的含量进行了测量。对巴曲酶诱导的凝胶化特性进行了评估。
Plateltex的产量、采集效率和生长因子含量与大多数其他可用系统相当。凝胶化时间不依赖于纤维蛋白原浓度；然而，它受到发生凝血反应的容器接触表面积的强烈影响（P < 0.0001）。
Plateltex提供的血小板回收率、采集效率和PDGF-AB可用性与其他具有相同预期用途的市售系统相近。用于诱导凝胶化的巴曲酶的作用方式与大多数其他系统使用的凝血酶不同。用凝血酶处理的血小板会被激活；它们会迅速释放其生长因子。此外，凝血酶-血小板相互作用是一种加速凝块回缩速率的生理机制。相反，用巴曲酶处理的血小板不会被激活；它们被被动地包埋在纤维蛋白网络中，其生长因子释放缓慢。在这些情况下，凝块回缩需要更长时间才会发生。根据凝血酶和巴曲酶之间的这些差异，预计巴曲酶诱导的PRP激活将使血小板内容物缓慢释放，从而在局部提供更长时间的营养因子可用性。在某些临床情况下，这种持久的合成代谢因子可用性可能比凝血酶快速诱导的生长因子释放更可取。
