Patent Grant
8734373
Various embodiments of the invention relate to assemblies, devices, kits and methods for preparing a platelet-rich plasma (PRP).
PRP is a product of blood plasma that is rich in platelets. PRP may be used in a variety of therapeutic or cosmetic applications including enhancing wound healing in dental implants and sinus elevations, heart surgery, orthopedic surgery and dermatology (chronic wound healing) [Barry L. et al, Plastic Reconstructive Surgery 114(6): pp. 1502-1508, 2004; Barry L. et al, Plastic Reconstructive Surgery 118(6): 147e-15, 2006; and Kajikawa Y. et al, J. Cell Physiol., 215(3): pp. 837-45, 2008; and Jacques Otto (published online: http://www.theottoclinic.ie/skin_rejuvenation.htm). PRP may also be utilized as a culture medium for cell expansion in the laboratory.
WO2005/065269 discloses several compositions comprising PRP and fibroblast cells for the treatment of skin, in particular, repeated administration of PRP in a dermatologically acceptable carrier to skin to e.g. reduce appearance of wrinkles.
Various exemplary embodiments of the invention are directed towards, an assemblies, devices, kits and methods to obtain PRP in a state ready for use in therapeutic or cosmetic applications or procedures. Optionally, whole blood is withdrawn from a subject, inserted into a test tube for centrifugation-based separation of the PRP fraction.
One aspect of some embodiments of the invention relates to an elongated filter device that has a filter at one end, the filter having an effective pore size such to permit passage of platelets and not permit passage of white blood cells (WBCs) larger than a defined size. The other end of the elongated filter device has an opening. Said one end fits tightly within the walls of the test tube. For obtaining PRP said one end of the elongated filter device is forced into the test tube and thereby applying pressure on the fluid content within the test tube. Fluid with the platelets then filters into the hollow tube, while the WBCs (or at least those with a size larger than said effective pore size) are filtered out. Thus, a substantially WBC-selective PRP is obtained within the hollow tube and can then be withdrawn through said other end and used within the framework of medical or cosmetic procedures. There are different types of WBCs which, among others, differ from one another in their size. It is possible, according to the invention, for the filter to have a defined effective pore size to permit passage into the elongated filter device of WBCs of certain categories smaller than its effective pore size, while filtering out other WBCs.
In accordance with one aspect of the invention, there is provided an assembly for preparing PRP comprising a test tube and an elongated filter device. The test tube is adapted for receiving whole blood and for obtaining therein, by procedures including centrifugation, a PRP fraction. Such test tubes may be, although not necessarily, of a kind known in the art.
The elongated filter device has first and second ends and a lumen that extends therein. Fitted at the first end is a filter that has an effective pore size so as to provide passage for a platelet therethrough, while not permitting passage of WBCs larger than a defined size, into the lumen. The second end of said elongated filter device is open. The first end of the elongated filter device is adapted to tightly fit into the test tube, such that when forced into the test tube, it can exert pressure on the PRP fraction to cause said fraction to filter into the lumen, through the filter, while retaining WBCs of a size larger than said defined size in the test tube.
Through such procedure, a WBC-selective PRP is obtained in the lumen, which can be withdrawn by use of a syringe which is inserted through the other end and used, e.g. even as such, for injection within the framework of a medical or cosmetic procedure. In one embodiment, the WBC-selective PRP can be allowed to clot and thereafter collected and used for a medical or a cosmetic procedure.
According to another aspect of the invention, there is provided a kit for preparing a WBC-selective PRP that comprises said assembly. Optionally, the kit includes packaging material and/or instructions for use and/or a blood withdrawal tool (e.g. needle and/or syringe). In some exemplary embodiments of the invention, kits are provided as single unit packs (i.e. sufficient components to process a single sample). In other exemplary embodiments of the invention, kits are provided as multiple unit packs (i.e. sufficient components to process multiple samples; e.g. 10; 25, 50, 100, 500 or 1000 samples or intermediate or greater numbers of samples).
By a further aspect of the invention, there is provided a method of preparing a WBC-selective PRP that comprises centrifuging a test tube containing whole blood obtained from a subject, thereby obtaining a platelet poor plasma (PPP) fraction, a platelet rich plasma (PRP) fraction and optionally a platelet pellet. The PPP fraction is then removed from the collection tube. Optionally, the platelet pellet may be suspended in the PRP. An elongated filter device is provided that has a first end fitted with a filter and a second end with an opening and a lumen therein extending between the two ends. Said filter has an effective pore size such to permit passage of platelets and not permit passage of white blood cells into the lumen, the elongated filter device being adapted for tight fitting into said test tube. Said elongated filter device forced into said test tube to, thereby exert pressure on the PRP fraction causing said fraction to pass through the filter into said lumen while the WBCs or at least a substantial portion of them that has a size larger than said effective pore size, remain in the test tube to thereby obtain a WBC-selective PRP within said lumen.
According to one embodiment of the invention, said assembly comprises a grip that can be fitted over a second end of the elongated filter device that permits the user to grip it and thereby force it into the test tube. In use, for the purpose of forcing said elongated filter device into the test tube, the test tube and the elongated filter device are axially aligned and the elongated filter device is axially forced into the test tube. Typically, but not exclusively, the grip has a leading edge formed and positioned in manner so as to limit the axial movement of said elongated filter device into the test tube.
In accordance with an embodiment of the invention, the filter has pores with a cut-off size less than 5, 7, 8, 10, 12, 14, 17, 20 or 23 μm. In accordance with an embodiment of the invention, prior to use, the platelets in the WBC-selective PRP are activated. This may be achieved, according to one embodiment, by mixing the WBC-selective PRP with an activating agent, such as thrombin and CaCl2.
In another aspect, the present invention provides a second assembly for preparing platelet-rich plasma (PRP), comprising a test tube for receiving a blood sample or a platelet-comprising blood fraction and a sliding filter member disposed within the test tube. In one embodiment, the sliding filter member comprises a body, the outer walls of the body are cylindrical shaped and adapted for fluid-tight contact with the inner walls of the test tube and is slidable in an axial direction along the test tube. The body has an axial openings there-through fitted with a filter with an effective pore size such to permit passage of platelets and not permit passage of white blood cells (WBC) larger than a defined size. The filter slider member has a specific density such that during centrifugation it is forced down into said sample or fraction to separate between a platelet-comprising upper fraction from the rest of the blood or blood fraction.
In some embodiments, the specific density of the filter slider member is between about 1.03-1.08.
According to another aspect of the invention, there is provided a kit for preparing a WBC-selective PRP that comprises said device.
In another aspect, the present invention provides a method of preparing platelet rich blood fraction having a reduced white blood cell content that makes use of said second assembly. By this method blood or a platelet-comprising blood fraction is introduced into the test tube such that it is below the filter slider member. The test tube is then centrifuged to thereby obtain a blood fraction rich with platelets and having a reduced white blood cell content above the filter member.
By one embodiment the test tube has two openings at opposite ends, each fitted with a stopper and the filter slider member is a priori inside the test tube (one of the stoppers will be referred to as “bottom stopper”; the other as “top stopper”). Blood or a platelet-comprising blood fraction is introduced through the bottom stopper and following centrifugation said member migrates towards the bottom stopper separating between a PRP fraction and RBC fraction. The PRP, typically following a suspension of the platelet pellet that may form on top of said member, is withdrawn through a top stopper.
By another embodiment a test tube with a single opening is used. Blood or a platelet-comprising blood fraction is introduced through the opening and then a filter slider member is inserted, the test tube is then typically sealed and the process proceeds in a similar manner to that of the first embodiment.
In some exemplary embodiments of the invention, there is provided an assembly. The assembly includes: (a) a test tube for receiving a blood sample or a platelet-includes fraction thereof and for obtaining therein, by a procedure that includes centrifugation, a platelet rich plasma (PRP) fraction; (b) an elongated filter device having a first and second end and a lumen extending there between, and having a filter fitted at the first end, the filter having a effective pore size such to permit passage of platelets and not permit passage of white blood cells (WBC) larger than a defined size into the lumen, the second end having an opening; the first end of the elongated filter device being adapted for tight fitting into the test tube such that when forced into the test tube to exert pressure on the PRP fraction, the PRP fraction with the platelets filters into the lumen and white blood cells of a size large than the defined size remain in the test tube to thereby obtain a WBC-selective PRP within the lumen.
Optionally, the tight fitting is achieved by an elastomeric ring element fitted on the external wall of the first end of the elongated filter device.
Optionally, the elongated filter device has frustoconical shape with a broad first end tapering towards the second end.
Optionally, the assembly includes a grip element for fitting around external walls of the elongated filter device.
Optionally, the grip is adapted to engage with the elongated filter device and the test tube to thereby limit the forced movement of the first end of the elongated filter device into the tube.
Optionally, the assembly includes a grip fitted over the second end and having leading edge with internal diameter identical to external diameter of the elongated filter device in a mid-portion thereof between the two ends.
Optionally, the assembly has a portion at the leading end that can engage with rim of the tube to thereby limit the forced movement of the first end of the elongated filter device into the tube.
Optionally, the opening at the second end permits a syringe access for withdrawal of the WBC-selective PRP from the lumen.
Optionally, the filter includes pores having a cutoff size of no more than approximately 5 μm, 7 μm, 8 μm 10 μm 12 μm 14 μm, 17 μm, 20 μm, or 23 μm.
Optionally, the PRP is autologous PRP.
In some exemplary embodiments of the invention, there is provided a kit for preparing platelet rich plasma (PRP) having a reduced white blood cell content (WBC-selective PRP), including an assembly according as described above.
Optionally, the kit is for use in treating a subject with the WBC-selective PRP.
Optionally, the treatment is at least one selected from the group consisting of wound healing, PRP injection to the skin, cosmetic treatment, skin regeneration treatment and anti-aging treatment.
Optionally, the PRP is autologous PRP.
In some exemplary embodiments of the invention, there is provided a method of preparing platelet rich plasma (PRP) having a reduced white blood cell content (WBC-selective PRP). The method includes: (a) centrifuging a test tube containing whole blood obtained from a subject, thereby obtaining a platelet poor plasma (PPP) fraction, a platelet rich plasma (PRP) fraction and optionally a platelet pellet; (b) removing the PPP fraction from the test tube; (c) optionally, suspending the platelet pellet in the PRP; (d) providing an elongated filter device having a first end fitted with a filter and a second end with an opening and a lumen therein extending between the two ends, the filter having a effective pore size such to permit passage of platelets and not permit passage of white blood cells into the lumen, the elongated filter device being adapted for tight fitting into the test tube; and (e) forcing the elongated filter device into the test tube, thereby exerting pressure on the PRP fraction to force the fraction with the platelets to pass through the filter into the lumen while the white blood cells (WBC) remain in test tube to thereby obtain a WBC-selective PRP within the lumen.
Optionally, the method includes
(f) activating the platelets the WBC-selective PRP.
Optionally, the activation includes mixing the WBC-selective PRP with an activating agent.
Optionally, step (a) further includes suspending the platelet rich plasma (PRP) phase and/or the platelet pellet.
In some exemplary embodiments of the invention, there is provided a method as described above, wherein step (a) further includes:
(a) removing the platelet poor plasma (PPP) from the test tube; and
(b) suspending the platelet rich plasma (PRP) phase and/or the platelet pellet.
In some exemplary embodiments of the invention, there is provided a method of preparing platelet rich plasma (PRP) having a reduced white blood cell content, includes:
(a) centrifuging a rigid collection tube containing whole blood obtained from a subject, thereby obtaining a platelet poor plasma (PPP) phase, a platelet rich plasma (PRP) phase and optionally a platelet pellet; and
(b) obtaining a WBC-selective PRP by the use of an assembly as described herein.
Optionally, the method further includes removing the platelet poor plasma (PPP) from the collection tube.
Optionally, the method further includes:
(a) removing the platelet poor plasma (PPP) from the collection tube; and
(b) suspending the remaining platelet content of the collection tube.
Optionally, the method further includes activation of the obtained platelet rich plasma (PRP).
Optionally, the method further includes activating by mixing the obtained platelet rich plasma (PRP) with an activating agent selected from the group consisting of Thrombin and CaCl2.
Optionally, the PRP is autologous PRP.
In some exemplary embodiments of the invention, there is provided an assembly for preparing platelet-rich plasma (PRP), including: a test tube for receiving a blood sample or a platelet-includes blood fraction; and a sliding filter member includes a body, the outer walls of the body are cylindrical shaped and adapted for fluid-tight contact with the inner walls of the test tube and slidable in an axial direction along the test tube; the body has an axial openings therethrough fitted with a filter with an effective pore size such to permit passage of platelets and not permit passage of white blood cells (WBC) larger than a defined size, the filter slider member having a specific density such so that during centrifugation it is forced down into the sample or fraction to separate between a platelet-includes upper fraction from the rest of the blood or blood fraction.
Optionally, the specific density of the slider filter member is between about 1.03-1.08.
Optionally, the test tube has openings at its two ends fitted with stoppers.
Optionally, the filter includes pores having a cutoff size of no more than approximately 5 μm, 7 μm 10 μm 12 μm 14 μm, 17 μm, 20 μm, or 23 μm.
In some exemplary embodiments of the invention, there is provided a kit for preparing platelet rich plasma (PRP) having a reduced white blood cell content (WBC-selective PRP), including an assembly as described herein.
In some exemplary embodiments of the invention, there is provided a method of preparing platelet rich plasma (PRP) having a reduced white blood cell content (WBC-selective PRP). The method includes: (a) centrifuging a test tube having a slider filter with an effective pore size such to permit passage of platelets and not permit passage of white blood cells (WBC) larger than a defined size, the test tube containing whole blood obtained from a subject, thereby obtaining a platelet poor plasma (PPP) fraction, a platelet rich plasma (PRP) fraction and optionally a platelet pellet; and (b) optionally, suspending the platelet pellet in the PRP; thereby obtaining a WBC-selective PRP.
Optionally, the method includes
(c) activating the platelets the WBC-selective PRP.
In some exemplary embodiments of the invention, there is provided a method of preparing platelet rich blood fraction having a reduced white blood cell content, which includes introducing blood or a platelet-including blood fraction into an assembly as described herein and centrifuging the assembly; thereby obtaining a blood fraction rich with platelets and having a reduced white blood cell content above the filter member.
Optionally, the method further includes:
(a) removing the platelet poor plasma (PPP) from the test tube; and
(b) suspending the remaining platelet content of the test tube.
Optionally, the method further includes activation of the obtained platelet rich plasma (PRP).
In some exemplary embodiments of the invention, there is provided a filtration device which includes: a sleeve with a filter in its base, the filter having a pore size which permits passage of platelets but does not permit passage of at least a selected fraction of white blood cells (WBC) and adapted to: (i) circumferentially contact an inner wall of a test tube; and (ii) slidingly descend into the test tube in response to an applied pressure.
In some exemplary embodiments of the invention, there is provided a kit for preparing platelet rich plasma (PRP) which includes: a device as described above and the test tube.
In some exemplary embodiments of the invention, there is provided a method of preparing platelet rich plasma (PRP) which includes: (a) pre-treating a blood sample to produce a platelet poor plasma (PPP) fraction, a platelet rich plasma (PRP) fraction and, optionally, a platelet pellet; (b) removing the PPP fraction; (c) optionally, suspending the platelet pellet in the PRP; (d) in a test tube, causing a filter having a pore size which permits passage of platelets but does not permit passage of at least a selected fraction of white blood cells (WBC) circumferentially contact an inner wall of a test tube and slidingly descend into the test tube so that a WBC depleted PRP fraction accumulates above the filter.
In some exemplary embodiments of the invention, there is provided an assembly which includes: (a) a collection tube adapted to receive blood or a blood fraction including platelets; and (b) a sliding filter member adapted for fluid-tight contact with inner walls of the test tube and slidable axially into the test tube and fitted with a filter having a pore size which permits passage of platelets but does not permit passage of at least a selected fraction of white blood cells (WBC); wherein the filter member is characterized by a specific gravity selected so that during centrifugation at a defined g-force it descends into the blood or fraction to produce platelet-rich plasma (PRP) above the filter.
In some exemplary embodiments of the invention, there is provided a method which includes: (a) providing whole blood in a test tube; (b) inserting into the tube above the whole blood a sliding filter member fitted with a filter having a pore size which permits passage of platelets but does not permit passage of at least a selected fraction of white blood cells (WBC) and adapted for fluid-tight contact with inner walls of the test tube; (c) centrifuging the test tube to produce a platelet poor plasma (PPP) fraction distally above the filter, a platelet pellet in proximity to an upper surface of the filter and a platelet rich plasma (PRP) fraction between the PPP and the pellet thereby obtaining PRP having a reduced white blood cell content (WBC-selective PRP).
Optionally, the method includes re-suspending the pellet in the PRP.
The invention will now be further illustrated by description of some specific embodiments with reference to the annexed drawings. As will be appreciated, the illustrated embodiments are exemplary only of the wider scope of the invention, as described herein, and are not intended to be limiting.
In order to understand the invention and to see how it may be carried out in practice, embodiments will now be described, by way of non-limiting example only, with reference to the accompanying drawings, in which:
The term “PRP” or “platelet rich plasma” as used herein should be understood to mean a blood product which comprises platelets concentrate in a small volume of plasma. The term “PRS” is used herein to denote a platelet rich serum.
The term “WBC-selective PRP” as used herein should be understood to encompass PRP having reduced number of white blood cells or a selective population of WBCs. The term “WBC-selective PRP” typically refers to a PRP that comprises WBCs at a concentration which is less than 50%, at times less than 40%, 30%, 20%, 10%, 5%, 4%, 3%, 2% or even less than 1% than that in the blood. The term “WBC-selective PRP” may also refer to PRP devoid of a certain population of WBCs, typically such that are filtered-out by a filter with a certain pore size.
As used herein the term “about X” or “approximately X” or “substantially X” usually refers to a range 25% less than to 25% more than of X (X±25%), at times X±20%, X±15% and preferably X±10%.
The PRP or PRS obtained in accordance with the invention may be used for treating aging skin and wrinkled-skin cells, accelerating healing of bone cells, treating surgery wounds, diabetic wounds, ulcer wounds, and pressure wounds and is used as autologous biological cells formation and/or biological glue.
In particular, some exemplary embodiments of the invention enable the preparation of PRP in a practitioner's treatment settings. The preparation of a WBC-selective PRP according to the invention is relatively rapid, e.g. about 30, 40, 50 or 60 minutes.
Reference is being made to
In some embodiments, test tubes are made of glass or MPA (modified poly Amide) or modified PET (Poly Ethylene Terephtalate). In some embodiments, the test tube has a layered structure such that the interior wall of the test tube comprises polypropylene. Test tubes can further be provided with a special stopper. By way of non-limiting example the stopper is made of butyl rubber or its halo derivative formulations at hardness between 40-60 Shore A. The hardness assures stable vacuum for at least the shelf life of the test tube which can be between 18-24 months.
The test tubes used can be of various sizes which depend of the required quantity of whole blood to be drawn from the treated subject. The test tubes have typically a size suitable for blood samples in the range of 4 ml to 100 ml.
The test tubes, by some embodiments, can contain an anticoagulant 26 such as, but not limited to buffer citrate, modified ACD (citric/citrate dextrose), heparinate salts, EDTA salts, iodo acetate salts, oxalate salts, fluoride salts as water solutions or lyophilized material or wet or dry spray on inner wall and so forth.
While test tube may optionally include an anti-coagulant 26, in some procedures an anti-coagulant may a priori not be included. For example, if the blood sample is withdrawn and maintained in cold conditions, an anti-coagulant may not be needed. In addition, in some procedures, the anti-coagulant may be mixed with the whole blood which was withdrawn from a subject, prior to inserting the whole blood into the tube.
In some embodiments, test tubes contain a barrier-forming substance 28 to assist in the centrifugation-based separation of blood into its components. Such barrier-forming substance may be of the kind known per se, for example gel polymers. Gel polymers may, for example, be based on polyacrylic, polyolefin or polyester with a specific gravity in the range of about 1.03 to 1.08 (e.g. 105). Following centrifugation, blood components, particularly red blood cells, will remain beneath the gel barrier and other, including platelets, will remain above it.
In some embodiments, the test tubes or the kit will contain an activator such as, but not limited to thrombin, silicate based formulations or CaCl2. In cases where chemically induced activation is not desired, activation can be affected by mechanical means known in the art, including the use of test tubes having specialized clot nucleation sites. Examples are polystyrene and/or glass beads and microbeads that can serve as blood clot accelerator (BCA)
The assembly also comprises an elongated hollow tube 40 shown in
Additionally, the size of a macrophage is about 21 μm. Monocytes are characterized by a size distribution of about 14-17 μm. The chosen filter with the defined effective pore size can thus enable collection, for example, of PRP together with monocytes, and lymphocytes, and exclude others. Different effective pore size can allow other combinations. For example, for those applications where granulocytes and macrophages are desired, the effective pore size will be about 25 μm.
Filter 42 is mounted on an insert 50, fitted snuggly within said first end and having a flexible skirt 52. Therefore, once end 42 is axially inserted into the test tube, the flexible skirt 52 provides a tight seal with the internal walls of the test tube. In other words, skirt 52 circumferentially contacts an inner wall of a test tube into which it is inserted. The flexible skirt 52 can be made of rubber or a ring shaped elastomer.
The second end 44 has an opening such as opening 58. Included in this embodiment is a grip member 54 fitted tightly about second end 44. The grip member 54 is formed with a central depression 56 and opening 58 that leads into lumen 41. The lumen 41 is formed, by this embodiment, within this depression. The pressure in the hollow tube's interior is thus equated with the external pressure. Furthermore, opening 58 permits the insertion of a syringe to withdraw the filtered product, i.e. the WBC-selective PRP.
Through agitation/mixing, it can then mix with the anti-coagulant 26, optionally included within the test tube. Alternatively, as already noted above, the blood sample may be mixed with an anti-coagulant, prior to insertion into tube 20.
The test tube is then subjected to centrifugation. Centrifugation is used to separate the red blood cells (RBC) from the plasma and the platelets.
Centrifugation may, for example, be at about 1,000-1,500 g and for a time period of 5-10 minutes. Centrifugation results in platelet enrichment 2-5 times compared to their native concentration in whole blood.
An example of such fractionated blood is shown in
The platelets are concentrated at the bottom end of the plasma fraction, typically forming a pellet 74. By removal of part of the plasma to yield more enriched plasma 72′ which is shown in
At this stage, the stopper 22 is removed, and hollow tube 40 is then inserted by axially aligning the two and axially forcing the latter into the former, in the direction of arrow 80 shown in
In some embodiments of the invention, leading edge 55 of the grip member 54 is so configured and positioned so as to provide a limit for the axial movement of elongated filter device 40 into test tube; namely this axial movement will proceed until said edge comes into contact with the lips 25 of the test tube 20. In other words leading edge 55 of grip member 54 limits sliding descent of elongated filter device 40 into the test tube in response to an applied pressure. By use of a suitable needle, the WBC-selective PRP 82 can then be withdrawn into a syringe and subsequently used within the framework of a medical or a cosmetic procedure.
The kit in accordance with the invention typically includes, at the minimum, a test tube, such as test tube 20, and an elongated filter device, such as elongated filter device 40. Additionally, a kit may also include a variety of reagents such as clotting activators, and anticoagulants, a syringe for withdrawal of blood from the patient, as well as a syringe with a needle adapted for withdrawal of the WBC-selective PRP from the elongated filter device and subsequent inoculation of a subject.
In accordance with some embodiments provided in the kit, the PRP may be activated by reagents such as thrombin and calcium dichloride which may be inoculated into the lumen of said hollow tube, prior to withdrawal of the WBC-selective PRP or may be retained within the syringe and mixed with the WBC-selective PRP following its withdrawal into the syringe.
Reference is first being made to
Typically, the test tube's interior maintains a vacuum. The test tubes, by some embodiments, can contain an anticoagulant 235, such as those noted above.
The assembly 200 comprises a slider filter member 100, which is shown in more details in
The slider filter is slidable in an axial direction along the test tube. The body 110 has an axial opening 120 there-through fitted with a filter 130. The filter 130 has an effective pore size such to permit passage of platelets and not permit passage of white blood cells (WBC) larger than a defined size. Regarding pore size determine criteria—see above.
Another embodiment of a slider filter member 100′ is shown in
In some embodiments, the specific density of the filter slider member 100 ranges between about 1.03 to 1.08. The density allows centrifugal separation of blood fractions in accordance with their respective densities in conjunction with filtration of WBCs, in a manner to be explained further below.
In use, needle 302 is inserted into a vein, and upon connecting the test tube to adapter 306, as can be seen in
The test tube is then subjected to centrifugation. During the centrifugation procedure the filter slider member 100 is forced down into the blood sample thereby eventually separating between a PRP fraction 426 and an RBC-comprising fraction 425, as shown in
In some embodiments, the RBC fraction may be removed with a syringe via a needled inserted through pierceable portion of bottom stopper 230, followed by a second, more rigorous centrifugation step, for example 1,000-1,500 g and for a time period of 5-15 minutes. The second centrifugation will usually yield a more pronounced platelet pellet 427 on top of the slider filter 100.
Additionally, the PRP or autologous PRP prepared in accordance with some exemplary embodiments of the invention can also be injected as a mesotherapy technique. The later typically comprises multiple superficial injections into the skin. The PRP can further optionally be used like synthetic dermal filler applied into wrinkles, lines and for use in lip-, cheek-, and chin augmentation. The duration of such rejuvenation process is approximately 300 days, but the clinical effect can last longer because of new collagen and elastin formation.
It is expected that during the life of this patent many gel types and/or filter media will be developed and the scope of the invention is intended to include all such new technologies a priori.
As used herein the term “about” refers to ±10%.
Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.
Specifically, a variety of numerical indicators have been utilized. It should be understood that these numerical indicators could vary even further based upon a variety of engineering principles, materials, intended use and designs incorporated into the invention. Additionally, components and/or actions ascribed to exemplary embodiments of the invention and depicted as a single unit may be divided into subunits. Conversely, components and/or actions ascribed to exemplary embodiments of the invention and depicted as sub-units/individual actions may be combined into a single unit/action with the described/depicted function.
Alternatively, or additionally, features used to describe a method can be used to characterize an apparatus, assembly or kit and features used to describe an apparatus, assembly or kit can be used to characterize a method.
It should be further understood that the individual features described hereinabove can be combined in all possible combinations and sub-combinations to produce additional embodiments of the invention. The textual description, figures and examples presented here are illustrative in nature and are not intended to limit the scope of the invention which is defined solely by the following claims. Specifically, the invention has been described in the context of filter sleeves which slidingly descend into tubes but might also be embodied by filter sleeves which remain stationary while tubes containing a sample are raised with respect to them.
All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention.
The terms “include”, and “have” and their conjugates as used herein mean “including but not necessarily limited to”.
Additional objects, advantages, and novel features of various embodiments of the invention will become apparent to one ordinarily skilled in the art upon examination of the following examples, which are not intended to be limiting. Additionally, each of the various embodiments and aspects of the invention as delineated hereinabove and as claimed in the claims section below finds experimental support in the following examples.
Reference is now made to the following examples, which together with the above descriptions; illustrate the invention in a non limiting fashion.
Using an assembly for preparing platelet-rich plasma (PRP) of the kind shown in
(1) Blood is drawn according to the volume dictated by the test tube, for example 20 ml of venous blood divided into 2 test tubes of 10 ml each. The test tubes include a barrier-forming gel. The test tube holds a vacuum and is closed by a closure/stopper, e.g. made of rubber.
(2) The whole blood is mixed gently in the test tube to create good contact with the anticoagulant.
(3) The test tube with the mixture is centrifuged for 5-15 minutes at about 700-1100 g or 1000-1500 g By way of non-limiting example the mixture can be centrifuged for a period of 7, 8, 10, 12, 15 minutes. Centrifugation can be performed, for example, at 700 g, 800 g, 1000 g, 1200 g or 1350 g. A gel barrier is formed separating between a fraction that includes the red-blood cell and plasma. The platelets and the WBCs have specific gravity lower than the gel, and therefore are located above the gel.
(4) PPP (Platelet Poor Plasma) is removed by a decantation method. The decantation is optionally done using a transfer pipette or a blunt needle attached to syringe. Typically, more than half of the plasma is PPP; therefore removal of more than half of the upper phase in the test tube is required.
(5) The remaining plasma above the gel barrier is vibrated to suspend the platelet pellet. This is done by vortex or another agitator type.
(6) An elongated filter device of the kind specified herein, is pushed gently in an axial direction into the test tube so that the filter at its first, leading edge passes gently through the PRP phase until the lower end of the filter is in close proximity to the upper face of the gel. Consequently a WBC-selective PRP accumulates within the lumen of said member. Depending on the effective pore size, some fraction of the WBCs, typically mononuclear cells may also enter said lumen.
(7) The elongated filter device has an opening at its second end and through this opening the WBC-selective PRP is withdrawn by a syringe with an attached needle which may be either pre-washed or un-washed with activator such as Thrombin, CaCl2 solution, or silicate solution/suspension.
Results obtained by the above procedure are shown in the Table 1 below (8 minutes centrifugation at 1350 g).
An assembly of the kind shown in
Results obtained by the above procedure are shown in Tables 2 and 3.
An assembly with a pre-inserted slider filter of the kind shown in
1) Blood is drawn into the assembly from the bottom cap of the tube. Blood is drawn according to the volume dictated by the test tube, for example 20 ml of venous blood divided into 2 test tubes of 10 ml each. The test tube holds a vacuum and is closed by a top cap and bottom cap e.g. made of rubber.
2) The whole blood is mixed gently in the test tube to create good contact with the anticoagulant.
3) The test tube with the mixture is centrifuged for 5-15 minutes at about 400-800 g. By way of non-limiting example the mixture can be centrifuged for a period of 7, 8, 10, 12, 15 minutes. Centrifugation can be performed, for example, at 700 g or 800 g. A pre-inserted slider filter separates between a fraction that includes the red-blood cell and plasma. The platelets have specific gravity lower than the slider filter, and therefore are located above the slider filter. WBCs fractions are located in accordance to their respective density and the effective pore size of the slider filter. Optionally, the RBCs fraction below the slider filter can be removed by decantation via the bottom cap. Additional centrifugation can be used to form a platelet pellet on top of the slider filter at about 1,000-1,500 g for 5-15 minutes. Other centrifugation forces may also be used as mentioned above in Example 1.
4) PPP (Platelet Poor Plasma) is removed by a decantation method. The decantation is optionally done using a transfer pipette or a blunt needle attached to syringe. Typically, more than half of the plasma is PPP; therefore removal of more than half of the upper phase in the test tube is required.
5) The remaining WBC-selective PRP above the slider filter is vibrated to suspend the platelet pellet. This is done by vortex or another agitator type.
6) WBC-selective PRP is withdrawn by a syringe with an attached needle which may be either pre-washed or un-washed with activator such as Thrombin, CaCl2 solution, or silicate solution/suspension.
Blood sample analysis was conducted in the Sheba Medical Center at Tel Hashomer, Israel. Using an assembly for preparing platelet-rich plasma (PRP) of the kind shown in
Results obtained by the above procedure are shown in the Table 4. Content analysis of processed samples was preformed both immediately (t=0) following WBC-selective PRP collection and after 4 hours (t=4). It should be noted that content of the processed samples, can be obtained at t=0, t=1, t=2, t=3, t=4, t=5 or more (t, hours), at the discretion of the physician or technician employed to perform the procedure according to various embodiments of the invention.
The blood sample analysis demonstrated the WBC-selectivity of PRP preparation achievable by the assemblies, kits and of various exemplary embodiments of the invention i.e. the ability of the methods, kits and assemblies to obtain a substantially or entirely WBC-selective PRP. In particular, an assembly for preparation of PRP according to exemplary embodiments of the invention can be used to reduce the WBC content in the prepared PRP by at least a fold, 2 fold or more.
Results presented in Table 4 indicate that exemplary embodiments of the invention can be used to obtain PRP comprising WBC in the range of 0.001 to 250, 0.01 to 250, 0.02 to 250, 0.1 to 250, 1 to 250, 1.1 to 250, 1.3 to 250, 2 to 250, 2.3 to 250, 3 to 250, 3.9 to 250 or 4.2 to 250 (K/μL).
Alternatively or additionally, Results presented in Table 4 indicate that exemplary embodiments of the invention can be used to obtain PRP comprising WBC in the range of 0.001 to 100, 0.01 to 100, 0.02 to 100, 0.1 to 100, 1 to 100, 1.1 to 100, 1.3 to 100, 2 to 100, 2.3 to 100, 3 to 100, 3.9 to 100 or 4.2 to 100 (K/μL). Yet another exemplary embodiment of present invention can be used to obtain PRP comprising WBC in the range of 0.001 to 25, 0.01 to 25, 0.02 to 25, 0.1 to 25, 1 to 25, 1.1 to 25, 1.3 to 25, 2 to 25, 2.3 to 25, 3 to 25, 3.9 to 25 or 4.2 to 25 (K/μL).
Alternatively or additionally, Results presented in Table 4 indicate that exemplary embodiments of the invention can be used to obtain PRP comprising WBC in the range of 0.001 to 5, 0.01 to 5, 0.02 to 5, 0.1 to 5, 1 to 5, 1.1 to 5, 1.3 to 5, 2 to 5, 2.3 to 5, 3 to 5, 3.9 to 5 or 4.2 to 5 (K/μL). Another exemplary embodiment of the invention can be used to obtain PRP comprising WBC in the range of 5 to 10, 5 to 25, 10 to 50 or 25 to 250 (K/μL). In some embodiments, the assembly for PRP can be used to deplete white blood cell content from PRP.
It should be noted that the methods, kits and assemblies of exemplary embodiments of the invention can also be used to obtain preparations of PRP having increased platelet derived growth factor content in comparison to preparations of PRP not being subjected to WBC filtration. These platelet derived growth factor can be selected for the group consisting PDGF, EGF and VEGF. In some embodiments, the methods, kits and assemblies for preparing PRP of the described exemplary embodiments can be used to obtain preparations of PRP comprising VEGF in the range of 135 to 500, 150 to 500, 190 to 500, 220 to 500, 280 to 500, 370 to 500, 135 to 370, 150 to 370, 190 to 370, 220 to 370 or 280 to 370 pg/ml. In other embodiments, the methods, kits and assemblies for preparing PRP of the described exemplary embodiments can be used to obtain preparations of PRP comprising EGF in the range of 140 to 500, 215 to 500, 310 to 500 or 215 to 310 pg/ml. In other embodiments, the methods, kits and assemblies for preparing PRP of the described exemplary embodiments can be used to obtain preparations of PRP comprising PDGF (such as PDGF—BB) as in the range of 980 to 3000, 980 to 2700, 1300 to 2700 or 1700 to 2700 pg/ml.
The selection of WBC content within the prepared PRP can be controlled, for example, by using an elongated filter device comprising pores having a varying size, cutoff size or mean pore sizes. In this respect, the pore sizes can be selected from 5 μm, 7 μm, 8 μm, 10 μm, 12 μm, 14 μm, 17 μm, 20 μm, or 23 μm. Optionally, centrifugation prior to filtration contributes to a reduction in clogging of filter pores. In summary, results presented in table 4, confirm that Exemplary embodiments of the invention are suitable for preparation of PRP in a practitioner's treatment settings.
Blood sample analysis was conducted in the Rosenblatt Clinical Laboratories, Tel Aviv, Israel. Using an assembly for preparing platelet-rich plasma (PRP) of the kind shown in
Results obtained are shown in the following Table 5.
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