Ingcamango eyaziwa namhlanje njenge-PRP yaqala ukuvela kwintsimi ye-hematology kwi-1970s.I-Hematologists yaqulunqa igama elithi PRP kumashumi eminyaka eyadlulayo kwiinzame zokuchaza iplasma efunyenwe kwizibalo zeplatelet ngaphezulu kwexabiso le-basal kwigazi leperipheral.Ngaphezulu kweminyaka elishumi kamva, i-PRP yayisetyenziselwa utyando lwe-maxillofacial njengendlela ye-platelet-rich fibrin (PRF).Umxholo we-fibrin kule mveliso ye-PRP inexabiso elikhulu kwi-adhesive kunye ne-homeostatic properties, ngelixa i-PRP inezixhobo eziqhubekayo zokulwa nokuvuvukala kwaye ivuselela ukwanda kweeseli.Ekugqibeleni, malunga ne-1990s, i-PRP yaduma, kwaye ekugqibeleni, iteknoloji yadluliselwa kwezinye iindawo zonyango.Ukusukela ngoko, le biology intle ifundwe ngokubanzi kwaye isetyenziswa ukunyanga ukonzakala okwahlukeneyo kwe-musculoskeletal kwiimbaleki eziqeqeshiweyo, inegalelo ngakumbi kwingqalelo yayo yeendaba.Ukongezelela ekusebenzeni kakuhle kwi-orthopedics kunye neyeza lezemidlalo, i-PRP isetyenziselwa i-ophthalmology, i-gynecology, i-urology kunye ne-cardiology, i-pediatrics kunye nokuhlinzwa kweplastiki.Kwiminyaka yakutshanje, i-PRP iye yadunyiswa ngabadermatologists ngokukwazi ukunyanga izilonda zesikhumba, ukuhlaziywa kwesilonda, ukuvuselelwa kwezicubu, ukuvuselelwa kwesikhumba kunye nokulahlekelwa kweenwele.
Ukuqwalasela ukuba i-PRP iyaziwa ngokulawula ngokuthe ngqo ukuphilisa kunye neenkqubo zokuvuvukala, i-cascade yokuphulukisa kufuneka ifakwe njengesalathisi.Inkqubo yokuphulukisa ihlukaniswe ngamanqanaba amane alandelayo: i-hemostasis;ukudumba;ukwanda kweselula kunye ne-matrix, kwaye ekugqibeleni ukulungiswa kwenxeba.
1. Ukuphilisa izicubu
I-cascade ye-tissue-healing cascade ivuliwe, inkqubo ekhokelela ekudityanisweni kweplatelet, ukubunjwa kwe-clot, kunye nokuphuhliswa kwe-matrix ye-extracellular yesikhashana (ECM. IiPlatelets emva koko zibambelela kwi-collagen eveziweyo kunye neeprotheni ze-ECM, ezibangela ubukho be-α-granules kwi-Release of Iimolekyuli zeBioactive.Iiplatelets zineendidi zeemolekyuli zebhayoloji, ezibandakanya ukukhula, ichemokines, kunye neecytokines, kunye nabalamli abanokudumba okufana neprostaglandin, iprostatic cyclin, histamine, thromboxane, serotonin, kunye nebradykinin.
Inqanaba lokugqibela lenkqubo yokuchacha lixhomekeke ekulungisweni kwenxeba.Ukulungiswa kwezicubu kulawulwa ngokuqinileyo ukuseka ibhalansi phakathi kwe-anabolic kunye neempendulo ze-catabolic.Ngethuba le nqanaba, i-platelet-derived growth factor (PDGF), i-factor factor growth factor (TGF-β) kunye ne-fibronectin ivuselela ukwanda kunye nokufuduka kwe-fibroblasts, kunye nokuhlanganiswa kwamacandelo e-ECM.Nangona kunjalo, ixesha lokuvuthwa kwenxeba lixhomekeke ubukhulu becala kubunzima benxeba, iimpawu zomntu ngamnye, kunye namandla athile okuphilisa kwezicubu ezonzakeleyo, kunye nezinto ezithile ze-pathophysiological kunye ne-metabolic inokuchaphazela inkqubo yokuphilisa, njenge-ischemia yezicubu, i-hypoxia, ukusuleleka. , Ukukhula kokungalingani, kunye nezifo ezinxulumene ne-metabolic syndrome.
I-pro-inflammatory microenvironment ephazamisa inkqubo yokuphilisa.Ukwenza nzima imicimbi, kukho umsebenzi ophezulu weprotease othintela isenzo sendalo sokukhula kwemeko (GF).Ukongeza ekubeni neempawu ze-mitogenic, i-angiogenic, kunye ne-chemotactic, i-PRP ikwangumthombo ocebileyo wezinto ezininzi zokukhula, i-biomolecules enokuthi ithintele imiphumo ephazamisayo kwizicubu ezivuthayo ngokulawula ukuvuvukala okugqithisileyo kunye nokuseka i-anabolic stimuli.Ukunikezelwa kwezi zakhiwo, Abaphandi banokufumana amandla amakhulu ekuphatheni iintlobo ezahlukeneyo zokulimala.
2. Cytokine
I-Cytokines kwi-PRP idlala indima ebalulekileyo ekulawuleni iinkqubo zokulungiswa kwezicubu kunye nokulawula umonakalo ovuthayo.I-cytokines ezichasayo ziyi-spectrum ebanzi yeemolekyuli ze-biochemical ezidibanisa iimpendulo ze-cytokine ezine-pro-inflammatory, ikakhulu ezibangelwa yi-macrophages esebenzayo.Ii-cytokines ezichasayo zisebenzisana ne-cytokine inhibitors ezithile kunye ne-soluble cytokine receptors ukulungelelanisa ukuvuvukala.I-Interleukin (IL) -i-1 i-receptor antagonists, i-IL-4, i-IL-10, i-IL-11 kunye ne-IL-13 ihlelwe njenge-cytokines eziphambili ezichasayo.Ngokuxhomekeke kuhlobo lwesilonda, ezinye ii-cytokines, ezifana ne-interferon, i-leukemia inhibitory factor, i-TGF-β kunye ne-IL-6, inokubonisa imiphumo ye-pro-okanye anti-inflammatory.I-TNF-α, i-IL1 kunye ne-IL-18 ine-receptors ethile ye-cytokine enokuthi inqanda imiphumo ye-pro-inflammatory yezinye iiprotheni [37].I-IL-10 yenye yezona cytokines ezinamandla kakhulu ezichasayo, ziyakwazi ukuhla-ukulawula i-cytokines ye-pro-inflammatory ezifana ne-IL-1, i-IL-6 kunye ne-TNF-α, kwaye i-up-regulate anti-inflammatory cytokines.Ezi ndlela zokulawula ezichaseneyo zidlala indima ebalulekileyo kwimveliso kunye nomsebenzi we-cytokines e-pro-inflammatory.Ukongeza, ii-cytokines ezithile zinokubangela iimpendulo ezithile zokubonisa ezivuselela i-fibroblasts, ezibaluleke kakhulu ekulungisweni kwezicubu.I-cytokines evuthayo i-TGFβ1, i-IL-1β, i-IL-6, i-IL-13, kunye ne-IL-33 ivuselela i-fibroblasts ukuba ihluke kwi-myofibroblasts kunye nokuphucula i-ECM [38].Ngaloo ndlela, i-fibroblasts ikhupha i-cytokines TGF-β, i-IL-1β, i-IL-33, i-CXC, kunye ne-CC chemokines, ekhuthaza iimpendulo ze-pro-inflammatory ngokusebenza kunye nokugaya iiseli ze-immune ezifana ne-macrophages.Ezi iiseli ezivuthayo zineendima ezininzi kwindawo yesilonda, ngokuyinhloko ngokukhuthaza ukukhutshwa kwenxeba - kunye ne-biosynthesis ye-chemokines, i-metabolites kunye nezinto ezikhulayo, eziyimfuneko ekuhlaziyweni kwezicubu ezintsha.Ngaloo ndlela, ii-cytokines ezikhoyo kwi-PRP zidlala indima ebalulekileyo ekukhuthazeni iimpendulo ze-immune zohlobo lweseli, ukuqhuba isisombululo sesigaba sokuvuvukala.Enyanisweni, abanye abaphandi baye babiza le nkqubo ngokuthi "ukuvutha okuvuselelayo," ebonisa ukuba isigaba sokuvuvukala, nangona isigulane siphazamiseka, linyathelo elibalulekileyo eliyimfuneko ukuze inkqubo yokulungiswa kwezicubu ifikelele kwisigqibo esiyimpumelelo, ngenxa yeendlela ze-epigenetic apho izibonakaliso ezivuthayo zikhuthaza iselula. iplastiki.
3. IFibrin
Iiplatelets zithwala izinto ezininzi ezinxulumene nenkqubo ye-fibrinolytic enokunyusa okanye ithobe impendulo ye-fibrinolytic.Ubudlelwane bexeshana kunye negalelo elihambelanayo lamacandelo e-hematological kunye nokusebenza kweplatelet ekuthotyweni kwehlwili kuhlala kungumba ofanele ukuxoxwa ngokubanzi kuluntu.Uncwadi lubonisa izifundo ezininzi ezijolise kuphela kwiiplatelet, ezaziwa ngokukwazi ukuphembelela inkqubo yokuphilisa.Ngaphandle kwezifundo ezininzi ezibalaseleyo, amanye amacandelo e-hematological, afana ne-coagulation factor kunye ne-fibrinolytic system, afunyenwe ukuba enze igalelo elibalulekileyo ekulungiseni amanxeba okusebenzayo.Ngokwenkcazo, i-fibrinolysis yinkqubo yebhayoloji eyinkimbinkimbi exhomekeke ekusebenziseni i-enzymes ethile ukuququzelela ukuthotywa kwe-fibrin.Impendulo ye-fibrinolytic iphakanyiswe ngabanye ababhali ukuba iimveliso zokutshatyalaliswa kwe-fibrin (fdp) ngokwenene zinokuba yi-agent ye-molecular enoxanduva lokuvuselela ukulungiswa kwezicubu, ukulandelelana kweziganeko ezibalulekileyo zebhayoloji ngaphambi kokufakwa kwe-fibrin kunye nokususwa kwi-angiogenesis, efunekayo ukuphulukiswa kwesilonda.Ukubunjwa kwehlwili emva kokulimala kusebenza njengoluhlu olukhuselayo olukhusela izicubu ekulahlekeni kwegazi, ukuhlaselwa ngama-microbial agents, kunye nokubonelela nge-matrix yesikhashana apho iiseli zinokufuduka ngexesha lokulungiswa.Ihlwili kungenxa yokuqhekeka kwe-fibrinogen yi-serine proteases kunye neeplatelet aggregate kwi-cross-linked fibrin fibrous network.Le mpendulo iqalisa i-polymerization ye-fibrin monomers, isiganeko esiphambili ekubunjweni kwehlwili legazi.Amahlwili anokuthi asebenze njengeendawo zokugcina iicytokines kunye nezinto ezikhulayo, ezithi zikhutshwe xa kuthotywa iiplatelet ezisebenzayo.Inkqubo ye-fibrinolytic ilawulwa ngokuqinileyo yi-plasmin kwaye idlala indima ephambili ekukhuthazeni ukufuduka kweeseli, ukukhula kwe-bioavailability ye-bioavailability, kunye nokulawulwa kwezinye iinkqubo zeprotease ezibandakanyekayo ekudumbeni kwezicubu kunye nokuvuselelwa.Amacandelo aphambili kwi-fibrinolysis, njenge-urokinase plasminogen activator receptor (uPAR) kunye ne-plasminogen activator inhibitor-1 (PAI-1) ziyaziwa ukuba zibonakaliswe kwiiseli ze-mesenchymal stem (MSCs), uhlobo lweeseli ezikhethekileyo eziyimfuneko ekuphulukiseni isilonda esiphumeleleyo.
4. Ukufuduka kweeSeli
Ukusebenza kwe-plasminogen ngokusebenzisa umbutho we-UPA-uPAR yinkqubo ekhuthaza ukufuduka kweeseli ezivuthayo njengoko kuphucula i-extracellular proteolysis.Ekubeni i-uPAR ayinayo i-transmembrane kunye ne-intracellular domains, iprotheni idinga i-co-receptors efana ne-interins kunye ne-vitreins ukulawula ukufuduka kweeseli.Ngaphaya koko, ukubophelela kwe-UPA-uPAR kukhokelele ekwandeni kobudlelwane be-UPAR ye-vitreous connexins kunye nee-interins, ukukhuthaza ukunamathela kweeseli.I-Plasminogen activator inhibitor-1 (PAI-1) yona ikhupha iiseli, itshabalalisa i-upar-vitrein kunye ne-integrin- xa ibophelela kwi-UPA ye-uPA-upar-integrin eyinkimbinkimbi kwi-cell surface Ukusebenzisana kwee-voxels zeglasi.
Kwimeko yeyeza lokuvuselela, iiseli ze-mesenchymal stem zihlanganiswa ukusuka kumathambo wethambo kwimeko yomonakalo onzima womzimba kwaye ngaloo ndlela inokufumaneka kwi-circulation yezigulane ezineefracture ezininzi.Nangona kunjalo, kwiimeko ezithile, ezifana nokungaphumeleli kwesigxina sokugqibela, ukungaphumeleli kwesibindi sokugqibela, okanye ngexesha lokuqala lokulahlwa emva kokutshintshwa kwentliziyo, ezi seli zingenakubonwa egazini [66].Okubangel 'umdla kukuba, la mathambo omntu avela kwi-mesenchymal (stromal) ye-progenitor cells ayinakubonwa egazini labantu abasempilweni [67].Indima ye-UPAR kumongo wethambo i-mesenchymal stem cell mobilization nayo yacetywa ngaphambili, efana nokwenzekayo ekuhlanganiseni i-hematopoietic stem cell (HSC).Varabaneni et al.Iziphumo zibonise ukuba ukusetyenziswa kwe-granulocyte colony-stimulating factor in uPAR-deficient mice kubangele ukungaphumeleli kwe-MSCs, kwakhona ukuqinisa indima yenkxaso yenkqubo ye-fibrinolytic ekufudukeni kweeseli.Uphononongo olongezelelweyo luye lwabonisa ukuba i-glycosylphosphatidylinositol-anchored uPA receptors ilawula ukunamathela, ukufuduka, ukwanda, kunye nokwahlula ngokusebenzisa iindlela ezithile zokubonisa i-intracellular, ngolu hlobo lulandelayo: i-pro-survival phosphatidylinositol 4,5-bisphosphate 3-kinase pathways1/Akt2 , kunye ne-adhesion kinase (FAK).
Ii-MSCs zibonise ukubaluleka ngakumbi kumxholo wokuphiliswa kwenxeba.Ngokomzekelo, iigundane ezingenayo i-plasminogen zibonise ukulibaziseka okukhulu kwiziganeko zokuphulukisa amanxeba, ezibonisa ukuba i-plasmin ibandakanyeka kakhulu kule nkqubo.Ebantwini, ukulahlekelwa yiplasmin nako kunokukhokelela kwiingxaki zokuphiliswa kwenxeba.Ukuphazamiseka kokuhamba kwegazi kunokuthintela kakhulu ukuvuselelwa kwezicubu, ezichaza ukuba kutheni ezi nkqubo zokuhlaziya zinzima kakhulu kwizigulane zesifo sikashukela.
5. IiMonocytes kunye neeNkqubo zokuHlaziya
Ngokutsho kweencwadi, kukho ingxoxo eninzi malunga nendima ye-monocytes ekuphulukiseni isilonda.I-Macrophages ikakhulu ithathwe kwi-monocytes yegazi kwaye idlala indima ebalulekileyo kunyango lokuvuselela [81].Ekubeni i-neutrophils ikhupha i-IL-4, i-IL-1, i-IL-6 kunye ne-TNF-α, ezi seli zivame ukungena kwindawo yesilonda malunga neeyure ze-24-48 emva kokulimala.IiPlatelets zikhulula i-thrombin kunye ne-platelet factor 4 (PF4), ii-chemokines ezimbini ezikhuthaza ukuqeshwa kwee-monocytes kunye nokwahlukana kwazo kwii-macrophages kunye neeseli ze-dendritic.Uphawu olumangalisayo lwe-macrophages yiplastiki yazo, oko kukuthi, ukukwazi kwabo ukutshintsha i-phenotypes kunye nokwahlukana kwezinye iindidi zeeseli ezifana neeseli ze-endothelial, ezithi emva koko zibonise imisebenzi eyahlukeneyo ekuphenduleni i-biochemical stimuli kwi-microenvironment yenxeba.Iiseli ezivuthayo zivakalisa i-phenotypes ezimbini ezinkulu, i-M1 okanye i-M2, kuxhomekeke kwisignali ye-molecular yendawo engumthombo we-stimulus.I-M1 macrophages ibangelwa yi-microbial agents kwaye ngaloo ndlela ineempembelelo ezingaphezulu zokuvuvukala.Ngokwahlukileyo, i-M2 macrophages iveliswa ngokuqhelekileyo ngohlobo lwe-2 impendulo kwaye ineempawu ezichasayo, ezibonakaliswa ngokunyuka kwe-IL-4, IL-5, IL-9, kunye ne-IL-13.Ikwabandakanyeka ekulungiseni izicubu ngokuveliswa kwezinto zokukhula.Utshintsho olusuka kwi-M1 ukuya kwi-M2 isoforms luqhutyelwa kakhulu ngamanqanaba okugqibela okuphulukisa isilonda, apho i-M1 macrophages ibangela i-neutrophil apoptosis kwaye iqalise ukucocwa kwezi seli).I-Phagocytosis yi-neutrophils ivuselela uchungechunge lweziganeko apho ukuveliswa kwe-cytokine kuvaliwe, i-macrophages ye-polarizing kunye nokukhulula i-TGF-β1.Lo mbandela wokukhula ngumlawuli ophambili wokuhlukana kwe-myofibroblast kunye nokunciphisa amanxeba, okuvumela isisombululo sokuvuvukala kunye nokuqaliswa kwesigaba sokwandisa kwi-cascade yokuphulukisa [57].Enye iprotheni enxulumene kakhulu ebandakanyeka kwiinkqubo zeselula yi-serine (SG).Le granulan ye-hematopoietic cell-secreted ifunyenwe iyimfuneko yokugcina iiprotheni ezifihliweyo kwiiseli ezithile zokuzivikela, ezifana neeseli ze-mast, i-neutrophils, kunye ne-cytotoxic T lymphocytes.Ngelixa iiseli ezininzi ezingezizo i-hematopoietic nazo zenza i-serotonin, zonke iiseli ezivuthayo zivelisa isixa esikhulu sale proteni kwaye zigcinwe kwiigranules ukuze ziqhubeke nokusebenzisana nabanye abalamli abavuthayo, kubandakanya i-proteases, i-cytokines, i-chemokines, kunye nemeko yokukhula.Amatyathanga e-glycosaminoglycan (GAG) ahlawuliswa kakubi (GAG) kwi-SG abonakala ebaluleke kakhulu kwi-homeostasis yegranule eyimfihlo, njengoko inokubophelela kwaye iququzelele ukugcinwa kwamalungu egranule ahlawuliswe kakhulu kwiseli-, iprotein-, kunye ne-GAG yetsheyini engqalileyo.Ngokumalunga nokubandakanyeka kwabo kwi-PRP, u-Woulfe kunye noogxa baye babonisa ngaphambili ukuba ukusilela kwe-SG kuhambelana kakhulu ne-morphology yeplatelet etshintshiweyo;iziphene kwi-platelet factor 4, i-beta-thromglobulin, kunye nokugcinwa kwePDGF kwiiplatelet;ukuhlanganiswa kweplatelet engalunganga kunye ne-secretion in vitro kunye ne-thrombosis kwi-vivo form defects.Ngoko ke abaphandi bagqiba ukuba le proteoglycan ibonakala iyinkosi yokulawula i-thrombosis.
Iimveliso ezityebileyo zePlatelet zinokufunyanwa ngokuqokelela kunye nokubeka igazi lomntu wonke kwi-centrifuging, ukwahlula umxube kwiingqimba ezahlukeneyo eziqukethe i-plasma, iiplatelet, i-leukocytes, kunye ne-leukocytes.Xa ugxininiso lweplatelet luphezulu kunexabiso le-basal, ukukhula kwamathambo kunye nezicubu ezithambileyo kunokukhawuleziswa kunye neziphumo ebezingalindelekanga ezincinci.Ukusetyenziswa kwemveliso ye-autologous ye-PRP yi-biotechnology entsha eqhubeka ibonisa iziphumo ezithembisayo ekuvuseleleni nasekuphuculeni ukuphiliswa kokulimala kwezicubu ezahlukeneyo.Ukusebenza kwale ndlela yonyango engenye inokuthi ibhekiselele ekuhanjisweni kwezihloko zoluhlu olubanzi lwezinto ezikhulayo kunye neeprotheni, ukulinganisa kunye nokuxhasa ukuphulukiswa kwenxeba lomzimba kunye neenkqubo zokulungisa izicubu.Ngaphezu koko, inkqubo ye-fibrinolytic ngokucacileyo inempembelelo ebalulekileyo ekulungisweni kwezicubu jikelele.Ukongeza kwikhono layo lokuguqula ukuqeshwa kweeseli ezivuthayo kunye neeseli ze-mesenchymal stem, imodareyitha umsebenzi we-proteolytic kwiindawo zokuphulukisa amanxeba kwaye ngexesha lokuhlaziywa kwezicubu ze-mesodermal ezibandakanya ithambo, i-cartilage kunye ne-muscle, kwaye ngoko ke ingundoqo kwicandelo leyeza le-musculoskeletal.
Ukukhawuleza ukuphilisa kuyinjongo efunwa kakhulu ngabasebenzi abaninzi kwiingcali zonyango, kwaye i-PRP imele isixhobo esihle se-biological esiqhubeka nokubonelela ngophuhliso oluthembisayo kwi-tandem yokuvuselela kunye nokulungelelaniswa kakuhle kweziganeko zokuvuselela.Nangona kunjalo, njengoko esi sixhobo sonyango sihlala sintsonkothile, ngakumbi kuba sikhupha inkitha yezinto ezisebenzayo kunye neendlela ezahlukeneyo zokusebenzisana kunye neziphumo zokubonisa, uphando olongezelelweyo luyafuneka.
(Imixholo yeli nqaku ishicilelwe, kwaye asiboneleli nasiphi na isiqinisekiso esicacileyo okanye esichaziweyo sokuchaneka, ukuthembeka okanye ukugqibelela kokuqulathwe kweli nqaku, kwaye abanaxanduva ngezimvo zeli nqaku, nceda uqonde.)
Ixesha lokuposa: Jul-19-2022