Apag Activated plasma albumin gel
APAG is designed to facilitate the heat induced aggregation of human serum albumin (HSA), particularly using the faction PPP (plasma poor in platelet). As results of temperature and time controlled heat induction, the protein aggregates became elongated oligomers with fibrillar-like features. The early stage aggregation of HSA follows a downhill pathway that does not require the formation of an organized nucleus.
When HSA is denatured, secondary and tertiary structures are altered but the peptide bonds of the primary structure between the amino acids are left intact. Since all structural levels of the protein determine its function, the protein can no longer perform its function once it has been denatured. The purpose of APAG is the obtainment of a bio compatible polymeric material useful as a filler material in aesthetic intervention.
The presence of inorganic salts like NaCl or CaCl2 can retard the denaturation / aggregation process (Stirpe et al., 2011). Recommended volume of PRP is 2 mL without CaCl2, with polymerization time of 8/15 min in APAG.
During heat stress the formation of intermolecular anti-parallel β-sheet structures was observed in various proteins (Wang, 2005). The underlying formation of hydrogen bonds between the molecules occurred independent from the initially existing secondary structure of the native molecule (Dong et al., 1995). During aggregation some amino acid chains and molecular regions of the protein might become accessible to the formation of new intermolecular interactions. Hydrophobic regions or free thiol-groups might be exposed at the proteins surface enabling association through non-covalent or disulfide bonds.
Although albumin is the most abundant plasma protein, it is considered to be non-adhesive to platelets, as it lacks any known amino acid sequences for binding platelet receptors. However, recent studies have suggested that platelets adhere to unfolding albumin by mechanisms linked to its conformational state (Sivaraman et al., 2009).
CGF and A.P.A.G. (solid form)
CGF conduces to the regeneration of the skin, and its solid form (APAG/activated plasma albumin gel) is used as a bio-dermal-filler to smooth out wrinkles.
The thrombocyte is the key player in this therapy.
Wound closure takes place within a short period, due to adhesion and aggregation of the thrombocytes, At the beginning of every wound healing, vascular permeability is increased, causing fluid to exude from the vessels and form oedema, thus easing the proliferative processes.
In this phase, the growth factors of the alpha-granules of the thrombocytes are released and attracted to the tissue (chemotaxis).
It is primarily the fibroblasts that contribute to the healing process (collagen). Growth factors such as TGF-ß, PDGF, FGF stimulate the fibroblasts to divide and migrate. In the wounded area, new cells and blood vessels are built to compensate the defect. The CGF-Therapy uses this wound healing process.
A.P.A.G. Method
The gel is applied over the entire wound, which will then be covered with an autologous membrane. The autologous membrane is always obtained from the same blood sample and same separation process: the blood collected is placed in a sterile vacuum tube different from the previous.
With red test tubes, we can obtain a separation in the solid phase, from which a membrane is formed; robust, elastic and suturable of about 1.5 x 2.5 cm.
The membrane stimulates the growth of the epithelium on the wound.
With no compressive bandage, the membrane accompanies and helps to overcome the inflammatory process.
It is derived from a sample of peripheral blood from the same patient; Skin ulcers and wounds that do not heal can have a significant impact on quality of life. Denaturalized Albumin with Platelets, Cells CD34+ - autologous healing agents that stimulate the natural auto-healing induced starting from the wound bed with slow "Biphasic" release - prolonged by growth factors.
^ Gel- Plasma rich in platelets (PPP Denaturalized Albumin A.P.A.G. + PRP + CD34+) for the treatment of chronic wounds and other.
^ It can be used for the treatment of exudative wounds, ulcers of the upper-lower extremities, pressure sores and diabetic ulcers.
^ It is a “Scaffold” of natural fibrin (derived from plasma) which acts as a scaffold for the adhesion of new cells.
^ The results are visible in a few days and not weeks.
^ Promotes the healing process of wounds from post-surgical trauma.
^ It helps to manage mechanically or surgically debrided wound (helps to heal).
= Ulcers in Diabetics
= Vascular ulcers
= Decubitus ulcers
= Post Traumatic ulcers
Denaturalized Albumin with Platelets , Cells CD34+ - autologous healing agents that stimulate the natural auto-healing induced starting from the wound bed with slow "Biphasic" release - prolonged by growth factors.
1st Phase
The denaturation of albumin by heating leads to the construction of a web structure, scaffold.
2nd Phase
During cooling, the platelets homogenize the above-mentioned structures.
Advantages
A.P.A.G. is the latest dermal filler, ideal for real natural augmentations and satisfies all requirements to modern injections. The only filler, which is a 100% endogenic and hence well tolerated by the body. Blood is closely monitored by the body's system - no other substance can offer this benefit.
Therapeutical
- Outstanding patients' acceptance,
- Can be used for all facial areas,
- Viscosity of A.P.A.G. can be adjusted (greater flexibility for a more precise treatment)
Economical
- Reasonable/inexpensive, even in larger quantities
- No purchase quantity to fulfill /idle capital
- No stock
- No expiry date to consider
Comparison with Chemical substances hyaluronic Acid
- Exogenous, with unintended body reactions
- Requires a great faith in the origin/source and purity of the products
- Antibody response against non-HA additives/impurities in the product
- Causes fibrotic tissue/usage of blunt cannula impossible
- Eventuality of granuloma formations months to years after the injection
- Undesirable retention of water in the tissues/puffy face
- Uneven skin texture due to irregular degradation of HA inside the skin
- Allergies and hypersensitivities
Comparison with Chemical substances Botox
Botox does not count as filler. It reduces wrinkles by blocking signals from the nerves to the muscles (muscle can't contract anymore) BUT: fewer wrinkles do not necessarily mean a more youthful appearance - it is the facial volume loss, the reduction of fat tissue and muscles which are the vital factors for a younger looking face. Plasma-Gel helps to volumize and integrates into the Patient's tissue to forms a natural facial shape.
Comparison with autologous fat
- A much higher and complex framework
- Liposuction has to be done in the first place
- Time-consuming to prepare fat tissue before transferring
- Not worthwhile with small interventions
- Application tends to be costly
- Caution has to be taken in patients with metabolic syndrome
When HSA is denatured, secondary and tertiary structures are altered but the peptide bonds of the primary structure between the amino acids are left intact. Since all structural levels of the protein determine its function, the protein can no longer perform its function once it has been denatured. The purpose of APAG is the obtainment of a bio compatible polymeric material useful as a filler material in aesthetic intervention.
The presence of inorganic salts like NaCl or CaCl2 can retard the denaturation / aggregation process (Stirpe et al., 2011). Recommended volume of PRP is 2 mL without CaCl2, with polymerization time of 8/15 min in APAG.
During heat stress the formation of intermolecular anti-parallel β-sheet structures was observed in various proteins (Wang, 2005). The underlying formation of hydrogen bonds between the molecules occurred independent from the initially existing secondary structure of the native molecule (Dong et al., 1995). During aggregation some amino acid chains and molecular regions of the protein might become accessible to the formation of new intermolecular interactions. Hydrophobic regions or free thiol-groups might be exposed at the proteins surface enabling association through non-covalent or disulfide bonds.
Although albumin is the most abundant plasma protein, it is considered to be non-adhesive to platelets, as it lacks any known amino acid sequences for binding platelet receptors. However, recent studies have suggested that platelets adhere to unfolding albumin by mechanisms linked to its conformational state (Sivaraman et al., 2009).
CGF and A.P.A.G. (solid form)
CGF conduces to the regeneration of the skin, and its solid form (APAG/activated plasma albumin gel) is used as a bio-dermal-filler to smooth out wrinkles.
The thrombocyte is the key player in this therapy.
Wound closure takes place within a short period, due to adhesion and aggregation of the thrombocytes, At the beginning of every wound healing, vascular permeability is increased, causing fluid to exude from the vessels and form oedema, thus easing the proliferative processes.
In this phase, the growth factors of the alpha-granules of the thrombocytes are released and attracted to the tissue (chemotaxis).
It is primarily the fibroblasts that contribute to the healing process (collagen). Growth factors such as TGF-ß, PDGF, FGF stimulate the fibroblasts to divide and migrate. In the wounded area, new cells and blood vessels are built to compensate the defect. The CGF-Therapy uses this wound healing process.
A.P.A.G. Method
The gel is applied over the entire wound, which will then be covered with an autologous membrane. The autologous membrane is always obtained from the same blood sample and same separation process: the blood collected is placed in a sterile vacuum tube different from the previous.
With red test tubes, we can obtain a separation in the solid phase, from which a membrane is formed; robust, elastic and suturable of about 1.5 x 2.5 cm.
The membrane stimulates the growth of the epithelium on the wound.
With no compressive bandage, the membrane accompanies and helps to overcome the inflammatory process.
It is derived from a sample of peripheral blood from the same patient; Skin ulcers and wounds that do not heal can have a significant impact on quality of life. Denaturalized Albumin with Platelets, Cells CD34+ - autologous healing agents that stimulate the natural auto-healing induced starting from the wound bed with slow "Biphasic" release - prolonged by growth factors.
^ Gel- Plasma rich in platelets (PPP Denaturalized Albumin A.P.A.G. + PRP + CD34+) for the treatment of chronic wounds and other.
^ It can be used for the treatment of exudative wounds, ulcers of the upper-lower extremities, pressure sores and diabetic ulcers.
^ It is a “Scaffold” of natural fibrin (derived from plasma) which acts as a scaffold for the adhesion of new cells.
^ The results are visible in a few days and not weeks.
^ Promotes the healing process of wounds from post-surgical trauma.
^ It helps to manage mechanically or surgically debrided wound (helps to heal).
= Ulcers in Diabetics
= Vascular ulcers
= Decubitus ulcers
= Post Traumatic ulcers
Denaturalized Albumin with Platelets , Cells CD34+ - autologous healing agents that stimulate the natural auto-healing induced starting from the wound bed with slow "Biphasic" release - prolonged by growth factors.
1st Phase
The denaturation of albumin by heating leads to the construction of a web structure, scaffold.
2nd Phase
During cooling, the platelets homogenize the above-mentioned structures.
Advantages
A.P.A.G. is the latest dermal filler, ideal for real natural augmentations and satisfies all requirements to modern injections. The only filler, which is a 100% endogenic and hence well tolerated by the body. Blood is closely monitored by the body's system - no other substance can offer this benefit.
Therapeutical
- Outstanding patients' acceptance,
- Can be used for all facial areas,
- Viscosity of A.P.A.G. can be adjusted (greater flexibility for a more precise treatment)
Economical
- Reasonable/inexpensive, even in larger quantities
- No purchase quantity to fulfill /idle capital
- No stock
- No expiry date to consider
Comparison with Chemical substances hyaluronic Acid
- Exogenous, with unintended body reactions
- Requires a great faith in the origin/source and purity of the products
- Antibody response against non-HA additives/impurities in the product
- Causes fibrotic tissue/usage of blunt cannula impossible
- Eventuality of granuloma formations months to years after the injection
- Undesirable retention of water in the tissues/puffy face
- Uneven skin texture due to irregular degradation of HA inside the skin
- Allergies and hypersensitivities
Comparison with Chemical substances Botox
Botox does not count as filler. It reduces wrinkles by blocking signals from the nerves to the muscles (muscle can't contract anymore) BUT: fewer wrinkles do not necessarily mean a more youthful appearance - it is the facial volume loss, the reduction of fat tissue and muscles which are the vital factors for a younger looking face. Plasma-Gel helps to volumize and integrates into the Patient's tissue to forms a natural facial shape.
Comparison with autologous fat
- A much higher and complex framework
- Liposuction has to be done in the first place
- Time-consuming to prepare fat tissue before transferring
- Not worthwhile with small interventions
- Application tends to be costly
- Caution has to be taken in patients with metabolic syndrome