How do leukocytes (WBC) effect PRF?
Leukocyte-Rich PRF (LR-PRF)
Advantages:
Disadvantages:
Why LP-PRF Is Preferred in Aesthetics
LR-PRF in Aesthetics
Juventix PRF
Juventix PRF is considered leukocyte-poor (low WBC) compared to whole blood. According to independent hematology data, the WBC count in Juventix PRP/PRF is 0.75 × 10⁶/mL after processing, compared to 3.4 × 10⁶/mL in whole blood—a substantial reduction1. This places Juventix PRF in the leukocyte-poor category, as it contains significantly fewer white blood cells than baseline blood and well below the threshold typically used to define leukocyte-rich preparations 1,6.
This low WBC content is intentional, as Juventix kits are designed to minimize red and white blood cell contamination while maximizing platelets, which is often preferred in aesthetic and regenerative applications to reduce inflammation and improve tolerability 6.
Table of the most prominent aesthetic PRF systems and whether they are typically classified as leukocyte-poor PRF (Lp-PRF) or leukocyte-rich PRF (Lr-PRF)
(Use tablet or computer to see table)
PRF system
Leukocyte Poor or Rich
Juventix
Poor
EZ PRF
Rich
Bio-PRF
Rich
Selphyl-PRF
Poor
Integrity-PRF
Rich
Atlas PRF
Rich
ProGen/Eclpise PRF
Poor
Care PRF
Rich
Regen PRF
Poor
Notes:
- Comparable or Superior Outcomes in Some Cases: Several studies suggest Lp-PRF can yield outcomes comparable to or better than Lr-PRF in specific clinical contexts, such as knee osteoarthritis and some soft tissue injuries 1,3,8.
- Better Tolerability: Patients may experience less swelling, pain, and adverse reactions after Lp-PRF treatment 6,7.
- Lower Growth Factor Release: Lp-PRF generally contains lower levels of certain growth factors and cytokines compared to Lr-PRF, which may limit its regenerative potential in some cases 4,5.
- Potentially Less Effective for Early Healing: Some studies show that Lp-PRF may be less effective than Lr-PRF at stimulating early cell proliferation and matrix formation, especially in tendon and ligament repair 4,5.
- Not Ideal for All Indications: May not provide the same level of immune support or antimicrobial effect as Lr-PRF, which could be a disadvantage in contaminated wounds or high-infection-risk settings 3,5.
- Immune and Antimicrobial Support: High leukocyte content enhances immune response and may help fight infection, making it valuable in wound healing and surgical applications 3.
- Growth Factor Release: Lr-PRF typically contains higher levels of growth factors such as TGF-β1 and PDGF-AB, which can stimulate cell proliferation and tissue regeneration 4,5.
- Angiogenesis and Matrix Deposition: Promotes angiogenesis (new blood vessel formation) and collagen production, supporting robust early tissue healing 2,4,5.
- Enhanced Early Healing: Studies show Lr-PRF can better stimulate tenocyte (tendon cell) proliferation and gene expression relevant to tissue repair, especially in the early stages of healing 4,5.
- Increased Inflammation: The higher leukocyte content can lead to increased local inflammation and a more intense post-injection pain response 3,6,7.
- Potential for Catabolic Effects: Excess leukocytes may release pro-inflammatory cytokines (e.g., TNF-α, IL-1β), which could contribute to tissue catabolism and possibly hinder healing in some contexts 3,7,8.
- Not Always Superior: In some clinical scenarios, Lr-PRF does not show clear superiority over Lp-PRF or even saline, especially regarding pain and function in certain musculoskeletal conditions 6,8.
- Lower Inflammation: LP-PRF contains fewer white blood cells, resulting in a reduced inflammatory response. This is important in aesthetic procedures, where excessive inflammation can lead to increased swelling, pain, or post-procedure downtime 1,2.
- Better Tolerability: The anti-inflammatory profile of LP-PRF makes it more suitable for sensitive facial areas and for patients seeking minimal side effects and quicker recovery 1.
- Comparable or Superior Outcomes: Clinical studies and reviews indicate that LP-PRF can yield outcomes that are comparable or even superior to LR-PRF in aesthetic contexts, such as facial rejuvenation and hair restoration 1,2.
- Patient Satisfaction: Reduced risk of inflammation and adverse reactions leads to higher patient satisfaction in cosmetic treatments 1,2.
- Role of Leukocytes: LR-PRF contains more white blood cells, which can enhance immune response and tissue remodeling. However, in aesthetics, this can also mean a higher risk of post-procedure inflammation and discomfort 2,6.
- Best for Wounds/Infection: LR-PRF may be more useful in settings where infection risk is higher or robust tissue healing is needed, but is less favored for purely cosmetic procedures 2,6.
- Some systems may allow protocol adjustments (centrifuge speed/time) to alter leukocyte content, but the above reflects typical or manufacturer-recommended use.
- Leukocyte-rich PRF (LR-PRF) is favored for enhanced regenerative and immune-modulating effects, while leukocyte-poor PRF (LP-PRF) is often chosen for aesthetics to reduce inflammation and improve tolerability.
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