Usoro ọgwụgwọ Platelet Rich Plasma (PRP) na-akwalite ọgwụgwọ anụ ahụ.

Taa, echiche a maara dị ka PRP pụtara na mbụ na ngalaba hematology na 1970s.Ndị na-ahụ maka ọbara ọbara kere okwu ahụ PRP ọtụtụ iri afọ gara aga iji kọwaa plasma enwetara site na ọnụ ọgụgụ platelet dị elu karịa uru bụ isi nke ọbara dị n'akụkụ.Ihe karịrị afọ iri ka e mesịrị, a na-eji PRP mee ihe na ịwa ahụ maxillofacial dị ka ụdị platelet ọgaranya fibrin (PRF).Ọdịnaya nke fibrin dị na ntinye PRP a nwere uru dị mkpa n'ihi nrapagide ya na njirimara steeti, ebe PRP kwadoro ihe mgbochi mkpali ma na-akpali mgbasawanye cell.N'ikpeazụ, gburugburu 1990s, PRP malitere ịghọ ewu ewu.N'ikpeazụ, e bufere teknụzụ a na ngalaba ahụike ndị ọzọ.Kemgbe ahụ, a na-amụ ụdị ihe ọmụmụ ihe dị mma nke ọma ma tinye ya n'ọrụ na ọgwụgwọ nke mmerụ ahụ dị iche iche nke anụ ahụ nke ndị ọkachamara na-eme egwuregwu, bụ nke kwalitere nlebara anya ya zuru oke na mgbasa ozi.Na mgbakwunye na ịdị irè na orthopedics na ọgwụ egwuregwu, a na-ejikwa PRP na ophthalmology, gynecology, urology and cardiology, pediatrics and plastic surgery.N'ime afọ ndị na-adịbeghị anya, ndị ọkachamara n'ihe gbasara anụ ahụ na-etokwa PRP maka ike ya n'ịgwọ ọnya anụ ahụ, nrụzi afụ, imegharị anụ ahụ, mmeghari akpụkpọ ahụ na ọbụna ntutu isi.

N'iburu n'uche na PRP nwere ike ịchịkwa usoro ọgwụgwọ na mkpali ozugbo, ọ dị mkpa ịmebata cascade na-agwọ ọrịa dịka ntụaka.A na-ekewa usoro ọgwụgwọ ahụ n'ime usoro anọ ndị a: hemostasis;Mbufụt;Mmụba cell na matriks, na n'ikpeazụ imezi mmerụ ahụ.

Ọgwụgwọ anụ ahụ

A na-eme ka mmeghachi omume cascade na-agwọ anụ ahụ na-arụ ọrụ, nke na-eduga na nchịkọta platelet Nhazi nke clots na mmepe nke matrix extracellular nwa oge (ECM).Mgbe ahụ, platelet na-arapara n'ahụ collagen ekpughere na protein ECM, na-akpalite ntọhapụ nke ụmụ irighiri ihe ndị dị na a-granules.Platelet nwere ihe dị iche iche nke bioactive molecules, gụnyere ihe ndị na-eto eto, ihe ndị na-ahụ maka chemotherapy na cytokines, yana ndị mgbasa ozi proinflammatory, dị ka prostaglandin, prostate cyclin, histamine, thromboxane, serotonin na bradykinin.

Oge ikpeazụ nke usoro ọgwụgwọ na-adabere na ngbanwe nke ọnya ahụ.A na-ahazi nhazigharị anụ ahụ nke ọma iji guzobe nguzozi n'etiti mmeghachi omume anabolic na catabolic.N'oge a, ihe na-eto eto nke na-enweta platelet (PDGF) na ihe na-agbanwe agbanwe (TGF-β) Fibronectin na fibronectin na-akpali mgbasawanye na mbugharị nke fibroblasts, yana njikọ nke ECM components.Otú ọ dị, oge nke ọnya maturation na-adabere n'ụzọ dị ukwuu n'ịdị njọ nke ọnya ahụ, njirimara onye ọ bụla na ikike ọgwụgwọ kpọmkwem nke anụ ahụ merụrụ ahụ.Ụfọdụ pathophysiological na metabolic ihe nwere ike imetụta usoro ọgwụgwọ, dị ka anụ ahụ ischemia, hypoxia, ọrịa, uto na-akpata ahaghị nhata, na ọbụna ọrịa ndị metụtara metabolic syndrome.

Ihe microenvironment proinflammatory na-egbochi usoro ọgwụgwọ.Ihe gbagwojuru anya bụ na ọrụ protease dị elu na-egbochi ihe okike nke uto (GF).Na mgbakwunye na njirimara mitotic, angiogenic na chemotactic, PRP bụkwa isi iyi nke ọtụtụ ihe na-eto eto.Ihe biomolecules ndị a nwere ike mebie mmetụta ndị na-emerụ ahụ na anụ ahụ na-akpasu iwe site n'ịchịkwa mmụba na-abawanye na ịmepụta ihe mkpali anabolic.N'ịtụle àgwà ndị a, ndị na-eme nchọpụta nwere ike ịhụ ikike dị ukwuu n'ịgwọ mmerụ dị mgbagwoju anya dị iche iche.

Ọtụtụ ọrịa, karịsịa nke ọdịdị anụ ahụ, na-adabere na ngwaahịa ndị dị ndụ nke na-achịkwa usoro mkpali, dị ka PRP maka ọgwụgwọ ọrịa ogbu na nkwonkwo.N'okwu a, ahụike nke cartilage articular dabere na nguzozi ziri ezi nke mmeghachi omume anabolic na catabolic.N'iburu ụkpụrụ a n'uche, iji ụfọdụ ihe ndị na-ahụ maka ihe ndị dị ndụ nwere ike ime nke ọma n'inweta nguzozi dị mma.PRP n'ihi na ọ na-ahapụ platelet α- A na-eji ihe ndị na-eto eto dị na granules eme ihe iji chịkwaa ikike nke mgbanwe anụ ahụ, nke na-ebelatakwa mgbu.N'ezie, otu n'ime isi ihe mgbaru ọsọ nke ọgwụgwọ PRP bụ ịkwụsị isi ihe na-egbuke egbuke na microenvironment catabolic ma kwalite mgbanwe na ọgwụ ndị na-egbu egbu.Ndị ode akwụkwọ ndị ọzọ egosila na mbụ na thrombin na-arụ ọrụ PRP na-abawanye ntọhapụ nke ọtụtụ mkpụrụ ndụ ihe ndụ.Ihe ndị a na-agụnye ihe ndị na-eto eto hepatocyte (HGF) na tumor necrosis factor (TNF-α), Mgbanwe ihe na-eto eto beta1 (TGF- β 1) , vascular endothelial growth factor (VEGF) na epidermis Growth factor (EGF).Ọmụmụ ihe ndị ọzọ egosila na PRP na-akwalite mmụba nke ụdị collagen ii collagen na aggrecan mRNA ọkwa, na-ebelata mgbochi nke pro-inflammatory cytokine interleukin - (IL) 1 na ha.A na-atụkwa aro na n'ihi HGF na TNF-α [28] PRP nwere ike inye aka guzobe mmetụta mgbochi mkpali.Nkwadebe nke mkpụrụ ndụ abụọ a na-ebelata kappaB (NF-κВ) ọrụ mgbochi na nkwupụta;Nke abuo, site na okwu TGF-β 1 na-egbochikwa monocyte chemotaxis, si otú a na-egbochi mmetụta TNF-α na transactivation nke chemokines.HGF yiri ka ọ na-arụ ọrụ dị mkpa na mmetụta mgbochi mkpali nke PRP kpatara.Cytokine a na-egbu egbu na-egbu egbu na-ebibi ụzọ akara NF-κ B na okwu cytokine proinflammatory na-egbochi nzaghachi mkpali.Na mgbakwunye, PRP nwekwara ike ibelata ọkwa dị elu nke nitric oxide (NO).Dịka ọmụmaatụ, na cartilage articular, mmụba nke NO ịta ahụhụ egosila na ọ na-egbochi njikọ nke collagen ma na-ebute chondrocyte apoptosis, ebe ọ na-abawanye njikọ nke matrix metalloproteinases (MMPs), si otú ahụ na-akwalite mgbanwe nke catabolism.N'ihe gbasara mmebi cell, a na-ewerekwa PRP ka ọ nwere ike ịchịkwa autophagy nke ụdị sel ụfọdụ.Mgbe ha ruru steeti ịka nká ikpeazụ, ụfọdụ otu cell na-atụfu ikike nke steeti kwụ ọtọ na mmeghari onwe ha.Otú ọ dị, nchọpụta ndị na-adịbeghị anya egosiwo na ọgwụgwọ PRP nwere ike gbanwee ọnọdụ ndị a na-emerụ ahụ nke ọma.Moussa na ndị ọrụ ibe gosipụtara na PRP nwere ike ịmepụta nchebe nke chondrocytes site n'ịbawanye autophagy na ihe nrịbama mgbochi, na-ebelata apoptosis nke cartilage osteoarthritis mmadụ.Garcia Pratt et al.A na-akọ na autophagy na-ekpebi mgbanwe n'etiti izu ike na ịka nká nke mkpụrụ ndụ stem muscle.Ndị nchọpụta ahụ kwenyere na, na vivo, nhazi nke autophagy jikọtara ọnụ na-ezere nchịkọta nke mmebi intracellular ma gbochie ịka nká na arụ ọrụ nke sel satịlaịtị.Ọbụlagodi na mkpụrụ ndụ sel mmadụ merela agadi, dịka n'oge na-adịbeghị anya, Parrish na Rodes nyekwara onyinye dị ukwuu, na-ekpughekwu ikike mgbochi mkpali nke PRP.N'oge a, a na-elekwasị anya na mmekọrịta dị n'etiti platelet na neutrophils.N'ime nyocha ha, ndị nchọpụta kọwara na platelet arụ ọrụ nke arachidonic acid wepụtara bụ ndị neutrophils na-etinye uche na ya wee ghọọ leukotrienes na prostaglandins, bụ ndị a ma ama na ụmụ irighiri ihe.Otú ọ dị, mmekọrịta neutrophil platelet na-enye ohere ka a gbanwee leukotriene n'ime lipoproteins, bụ nke egosipụtara na ọ bụ protein na-egbochi mkpali nke nwere ike igbochi ọrụ nke neutrophils ma gbochie dialysis, ma kwalite ihe nketa ruo na njedebe ikpeazụ nke ọgwụgwọ cascade.

Ihe microenvironment proinflammatory na-egbochi usoro ọgwụgwọ.Ihe gbagwojuru anya bụ na ọrụ protease dị elu na-egbochi ihe okike nke uto (GF).Na mgbakwunye na njirimara mitotic, angiogenic na chemotactic, PRP bụkwa isi iyi nke ọtụtụ ihe na-eto eto.Ihe biomolecules ndị a nwere ike mebie mmetụta ndị na-emerụ ahụ na anụ ahụ na-akpasu iwe site n'ịchịkwa mmụba na-abawanye na ịmepụta mkpali anabolic.

Ihe kpatara cell

Cytokines na PRP na-arụ ọrụ dị mkpa n'ịgbanwe usoro nhazi nke anụ ahụ na ịchịkwa mmebi mkpali.Cytokines mgbochi mkpali bụ ụdị dị iche iche nke biochemical nke na-emezi nzaghachi nke cytokines proinflammatory, nke kachasị site na macrophages na-arụ ọrụ.Cytokines mgbochi mkpali na-emekọrịta ihe na ndị na-egbochi cytokine kpọmkwem yana ndị na-anabata cytokine soluble iji mezie mbufụt.Interleukin (IL) - 1 ndị na-anabata ndị na-anabata ya, IL-4, IL-10, IL-11 na IL-13 bụ ndị a na-ekewa dị ka isi ọgwụ mgbochi mkpali, cytokines.Dị ka ụdị ọnya dị iche iche si dị, ụfọdụ cytokines, dị ka interferon, leukemia inhibitory factor, TGF-β na IL-6, nke nwere ike igosi proinflammatory ma ọ bụ mgbochi mkpali mmetụta.TNF-a, IL-1 na IL-18 nwere ụfọdụ ndị na-anabata cytokine, nke nwere ike igbochi mmetụta proinflammatory nke protein ndị ọzọ [37].IL-10 bụ otu n'ime cytokines na-egbochi mkpali kachasị dị irè, nke nwere ike belata cytokines proinflammatory dị ka IL-1, IL-6 na TNF-α, na-achịkwa ihe mgbochi mkpali.Usoro mgbochi nchịkwa ndị a na-ekere òkè dị mkpa na mmepụta na ọrụ nke cytokines proinflammatory.Tụkwasị na nke ahụ, ụfọdụ cytokines nwere ike ịkpalite nzaghachi mgbaàmà kpọmkwem iji kpalie fibroblasts, nke dị oké mkpa maka ịrụzi anụ ahụ.Cytokine na-egbuke egbuke TGF β 1, IL-1 β, IL-6, IL-13 na IL-33 na-akpali fibroblasts ka ọ dị iche na myofibroblasts ma melite ECM [38].N'aka nke ya, fibroblasts na-ezobe cytokine TGF-β, IL-1 β, IL-33, CXC na CC chemokines na-akwalite nzaghachi mkpali site n'ịkwalite na iweghachite sel ndị na-alụso ọrịa ọgụ dị ka macrophages.Mkpụrụ ndụ ndị a na-akpasu iwe na-arụ ọtụtụ ọrụ na ọnya, tumadi site n'ịkwalite mkpochapụ ọnya - yana biosynthesis nke chemokines, metabolites na ihe ndị na-eto eto, bụ nke dị oké mkpa maka mwughachi anụ ahụ ọhụrụ.Ya mere, cytokines na PRP na-ekere òkè dị mkpa n'ịkwalite ụdị sel nke na-emeziwanye mmeghachi omume mgbochi na ịkwalite nlọghachi nke ogbo mkpali.N'ezie, ụfọdụ ndị nchọpụta họpụtara usoro a dị ka "mbufụt nke na-eme ka ọ dịghachi ndụ", na-egosi na ọkwa na-egbuke egbuke, n'agbanyeghị nchegbu nke onye ọrịa, bụ ihe dị mkpa na nke dị oke mkpa maka njedebe na-aga nke ọma nke usoro nhazi anụ ahụ, na-eburu n'uche usoro epigenetic nke na-egosi ọkụ ọkụ. kwalite cell plasticity.

Ọrụ cytokines na mbufụt akpụkpọ anụ nwa ebu n'afọ dị oke mkpa na nyocha nke ọgwụ na-emegharị ahụ.Ọdịiche dị n'etiti usoro ọgwụgwọ nwa ebu n'afọ na nke okenye bụ na anụ ahụ nwa ebu n'afọ mebiri emebi na-alaghachikwa n'ọnọdụ mbụ ha dị ka afọ nwa ebu n'afọ na ụdị anụ ahụ dị mkpa.N'ime ụmụ mmadụ, akpụkpọ anụ nwa ebu n'afọ nwere ike ịmaliteghachi kpamkpam n'ime izu iri abụọ na anọ, ebe ndị okenye, ọgwụgwọ ọnya nwere ike iduga n'ọkpụkpụ.Dị ka anyị maara, ma e jiri ya tụnyere anụ ahụ dị mma, ihe ndị na-arụ ọrụ nke anụ ahụ dị n'ahụ na-ebelata nke ukwuu, ọrụ ha dịkwa oke.A na-elebara anya nke ọma na cytokine IL-10, nke achọpụtara na ọ na-egosipụta nke ọma n'ime mmiri ọmụmụ na akpụkpọ nwa ebu n'afọ, ma gosipụta na ọ na-ekere òkè n'ịrụzi akpụkpọ ahụ nwa ebu n'afọ n'efu, nke mmetụta pleiotropic nke cytokine na-akwalite.ZgheibC et al.Mgbanwe nke akpụkpọ anụ nwa n'ime transgenic knockout (KO) IL-10 ụmụ oke na ụmụ oke njikwa.Ụmụ oke IL-10KO gosipụtara ihe ịrịba ama nke mbufụt na ọkpụkpụ na-emepụta gburugburu grafts, ebe ndị na-ahụ maka nchịkwa na-egosi na ọ dịghị mgbanwe dị ịrịba ama na ihe ndị na-emepụta ihe na-enweghị ihe ọ bụla na-agwọ ọrịa.

Mkpa ọ dị ịchịkwa nguzozi dị nro n'etiti okwu nke cytokines na-egbochi mkpali na pro-inflammatory bụ na nke ikpeazụ, mgbe a na-emepụta ihe karịrị ya, na-ezipụ ihe mgbaàmà nke mmebi cell site na ibelata okwu nke ụfọdụ mkpụrụ ndụ ihe nketa.Dịka ọmụmaatụ, na ọgwụ musculoskeletal, IL-1 β Down na-achịkwa SOX9, nke na-ahụ maka mmepe cartilage.SOX9 na-emepụta ihe odide ederede dị mkpa maka mmepe cartilage, na-achịkwa ụdị II collagen alpha 1 (Col2A1), ma na-ahụ maka itinye koodu ụdị II collagen genes.IL-1 β N'ikpeazụ, okwu Col2A1 na aggrecan belatara.Otú ọ dị, ọgwụgwọ na ngwaahịa bara ụba platelet egosiwo na ọ na-egbochi IL-1 β Ọ ka bụ ihe jikọrọ ọgwụ na-emegharị ahụ iji nọgide na-enwe nkwupụta nke mkpụrụ ndụ ihe nketa collagen ma belata apoptosis nke chondrocytes nke cytokines proinflammatory kpatara.

Mkpali anabolic: Na mgbakwunye na ịhazi ọnọdụ mkpali nke anụ ahụ mebiri emebi, cytokines na PRP na-ekerekwa òkè na mmeghachi omume anabolic site n'ịrụ ọrụ ha nke mitosis, mmasị kemịkalụ na mmụba.Nke a bụ ọmụmụ in vitro nke Cavallo et al.Iji mụọ mmetụta PRP dị iche iche na chondrocytes mmadụ.Ndị nchọpụta ahụ chọpụtara na ngwaahịa PRP nwere obere platelet na leukocyte na-akpali ọrụ chondrocyte nkịtị, nke na-enyere aka ịkwalite ụfọdụ usoro cellular nke nzaghachi anabolic.Dịka ọmụmaatụ, a na-ahụ okwu nke ụdị ii collagen na aggregating glycans.N'ụzọ dị iche, ọnụ ọgụgụ dị elu nke platelet na leukocytes yiri ka ọ na-akpali ụzọ mgbaàmà ekwentị ndị ọzọ metụtara cytokines dị iche iche.Ndị na-ede akwụkwọ na-atụ aro na nke a nwere ike ịbụ n'ihi ọnụnọ nke ọnụ ọgụgụ dị ukwuu nke mkpụrụ ndụ ọbara ọcha na ụdị PRP a.Mkpụrụ ndụ ndị a na-egosi na ọ bụ ya kpatara mmụba nke ụfọdụ ihe na-eto eto, dị ka VEGF, FGF-b, na interleukins IL-1b na IL-6, nke nwere ike na-akpali TIMP-1 na IL-10.N'ikwu ya n'ụzọ ọzọ, ma e jiri ya tụnyere usoro PRP "ọjọọ", ngwakọta PRP bara ụba na platelet na mkpụrụ ndụ ọbara ọcha yiri ka ọ na-akwalite mmekpa ahụ nke chondrocytes.

Ọmụmụ ihe mere Schnabel et al.e mere iji nyochaa ọrụ nke autologous biomaterials na anụ ahụ akwara ịnyịnya.Ndị na-ede akwụkwọ chịkọtara ọbara na akwara akwara site na ịnyịnya isii na-eto eto (2-4 afọ), ma lekwasị anya na ọmụmụ nke usoro okwu mkpụrụ ndụ ihe nketa, DNA na collagen ọdịnaya nke eriri akwara nke flexor digitorum superficialis nke ịnyịnya zụlitere na ọkara nwere PRP. ma ọ bụ ngwaahịa ọbara ndị ọzọ.A na-emepụta ihe ndị na-agbapụta akwara na ọbara, plasma, PRP, plasma deficient plasma (PPP) ma ọ bụ ụmị ọkpụkpụ (BMA), na amino acid agbakwunyere na 100%, 50% ma ọ bụ 10% DMEM na-enweghị ọbara.Na-agba ọsọ biochemical analysis na ọdabara mgbe…, ndị nchọpụta kwuru na TGF- β Ntụkwasị nke PPGF-BB na PDGF-1 na PRP ọkara bụ karịsịa elu karịa nke ndị ọzọ niile ngwaahịa ọbara nwalere.Tụkwasị na nke ahụ, anụ ahụ akwara nke a na-emepụta na 100% PRP ọkara gosipụtara mmụba nke mkpụrụ ndụ ihe nketa nke protein matrix COL1A1, COL3A1 na COMP, ma emeghị ka enzymes catabolic MMPs3 na 13. Ma ọ dịkarịa ala n'ihe gbasara nhazi akwara, nke a na vivo ọmụmụ na-akwado iji ya mee ihe. autolo – ngwaahịa ọbara gouty, ma ọ bụ PRP, maka ọgwụgwọ nke nnukwu anụ mammalian tendinitis.

Chen et al.A tụlekwara mmetụta nrụzigharị nke PRP.N'ime usoro ọmụmụ ha gara aga, ndị nchọpụta gosipụtara na, na mgbakwunye na ịkwalite mmepụta nke cartilage, PRP kwalitekwara mmụba nke njikọ ECM ma gbochie mmeghachi omume mkpali nke cartilage articular na nucleus pulposus.PRP nwere ike rụọ ọrụ TGF site na phosphorylation nke Smad2/3- β Signal ụzọ na-arụ ọrụ dị mkpa na uto cell na ọdịiche.Tụkwasị na nke ahụ, a na-ekwenyekwa na eriri fibrin na-emepụta mgbe arụ ọrụ PRP gasịrị na-enye usoro siri ike nke akụkụ atọ, na-eme ka mkpụrụ ndụ nwee ike ịkwado, nke nwere ike iduga n'ịrụ anụ ọhụrụ.

Ndị nchọpụta ndị ọzọ enyela aka dị ukwuu n'ịgwọ ọnya anụ ahụ na-adịghị ala ala na ngalaba nke dermatology.Nke a bụkwa ihe kwesịrị ịrịba ama.Dịka ọmụmaatụ, nchọpụta Hessler na Shyam mere na 2019 na-egosi na PRP bara uru dị ka ọgwụgwọ ọzọ nwere ike ime ma dị irè, ebe ọnya na-adịghị ala ala na-eguzogide ọgwụ ka na-ebute nlekọta ahụike dị ukwuu.Karịsịa, ọnya ụkwụ nke ọrịa shuga bụ nnukwu nsogbu ahụike a ma ama, nke na-eme ka ọ dị mfe ebipụ ụkwụ.Nnyocha nke Ahmed et al.na 2017 gosiri na autologous PRP gel nwere ike kpalie ọnya na-agwọ ọrịa na ndị ọrịa na-adịghị ala ala ọrịa ọnya afọ ọnya site na-ahapụ mkpa uto ihe, si otú budata mma na-agwọ ọrịa.N'otu aka ahụ, Gonchar na ndị ọrụ ibe tụlere ma kwurịta ikike nrụpụta nke PRP na uto ihe ọṅụṅụ mmanya na-emeziwanye ọgwụgwọ ọnya ụkwụ nke ọrịa shuga.Ndị nchọpụta ahụ tụrụ aro na iji ngwakọta ihe na-eto eto nwere ike ịbụ ihe ngwọta nwere ike ime, nke nwere ike imeziwanye uru nke iji PRP na otu ihe na-eto eto.Ya mere, e jiri ya tụnyere iji otu ihe na-eto eto, nchikota nke PRP na usoro ọgwụgwọ ndị ọzọ nwere ike ịkwalite ọgwụgwọ ọnya na-adịghị ala ala.

Fibrin

Platelet na-ebu ọtụtụ ihe metụtara sistemu fibrinolytic, nke nwere ike ịhazigharị ma ọ bụ wedata mmeghachi omume fibrinolytic.Mmekọrịta oge na ntinye aka nke akụkụ hematological na arụ ọrụ platelet na mbelata mkpụkọ ka bụ nsogbu kwesịrị mkparịta ụka buru ibu na obodo.Akwụkwọ a na-ewebata ọtụtụ ọmụmụ na-elekwasị anya naanị na platelet, bụ ndị a ma ama maka ikike ha nwere imetụta usoro ọgwụgwọ.N'agbanyeghị ọnụ ọgụgụ buru ibu nke ọmụmụ pụtara ìhè, a chọpụtakwara na akụkụ hematological ndị ọzọ, dị ka coagulation factor na fibrinolytic system, na-enye aka nke ukwuu n'ịrụzi ọnya dị irè.Site na nkọwa, fibrinolysis bụ usoro ihe omimi dị mgbagwoju anya nke dabere na ịgbalite ụfọdụ enzymes iji kwalite mmebi nke fibrin.Ndị ode akwụkwọ ndị ọzọ atụpụtala mmeghachi omume fibrinolysis na ngwaahịa fibrin deradaration (fdp) nwere ike bụrụ ihe na-akpata molekụla maka ịkpali mmezi anụ ahụ.Usoro nke ihe omume dị mkpa dị mkpa na mbụ sitere na ntinye fibrin na mwepụ nke angiogenesis, nke dị mkpa maka ọgwụgwọ ọnya.Nhazi nke clots mgbe mmerụ ahụ gasịrị na-eje ozi dị ka mkpuchi nchebe iji chebe anụ ahụ pụọ na mfu ọbara na mbuso agha nke microbial, ma na-enyekwa matrix nwa oge nke mkpụrụ ndụ nwere ike ịkwaga n'oge usoro nrụzi.Mkpụkọ ahụ bụ n'ihi na fibrinogen bụ nke serine protease na-ekejisị ya, a na-achịkọtakwa platelet n'ime eriri eriri fibrin jikọtara ya.Mmeghachi omume a kpalitere polymerization nke fibrin monomer, nke bụ isi ihe na-eme ka e nwee mkpụkọ ọbara.A pụkwara iji clot mee ihe dị ka ebe nchekwa nke cytokines na ihe ndị na-eto eto, bụ ndị a na-ewepụta n'oge mmebi nke platelet na-arụ ọrụ.A na-achịkwa usoro fibrinolytic nke ọma site na plasmin, ma na-arụ ọrụ dị mkpa n'ịkwalite mbugharị cell, bioavailability nke ihe ndị na-eto eto na nhazi nke usoro protease ndị ọzọ na-etinye aka na nsị anụ ahụ na ịmaliteghachi.Akụkụ bụ isi nke fibrinolysis, dị ka urokinase plasminogen activator receptor (uPAR) na plasminogen activator inhibitor-1 (PAI-1), ka amara na egosipụtara na mkpụrụ ndụ mesenchymal stem (MSC), nke bụ ụdị sel pụrụ iche dị mkpa maka ọgwụgwọ ọnya na-aga nke ọma. .

Mbugharị cell

Ịkwalite plasminogen site na njikọ uPA uPAR bụ usoro na-akwalite mbugharị nke mkpụrụ ndụ mkpali n'ihi na ọ na-eme ka proteolysis extracellular.N'ihi enweghị ngalaba transmembrane na intracellular, uPAR chọrọ ndị na-anabata ya dị ka integrin na vitllin iji chịkwaa mbugharị cell.Ọ gara n'ihu gosi na njide nke uPA uPAR butere mmụba na mmekọrita nke uPAR maka vitrectonectin na integrin, nke kwalitere nrapanye cell.Plasminogen activator inhibitor-1 (PAI-1) na-eme ka mkpụrụ ndụ kewapụ.Mgbe ọ na-ejikọta na uPA nke uPA upar integrin complexes n'elu cell, ọ na-emebi mmekọrịta dị n'etiti upar vitellin na integrin vitellin.

N'ihe gbasara ọgwụ na-emegharị ahụ, a na-achịkọta mkpụrụ ndụ ọkpụkpụ mesenchymal site na ụmị ọkpụkpụ n'ihe banyere mmebi akụkụ ahụ siri ike, ya mere enwere ike ịhụ ha na mgbasa nke ndị ọrịa nwere ọtụtụ mgbaji.Otú ọ dị, n'ọnọdụ ndị a kapịrị ọnụ, dị ka ọdịda akụrụ ọgwụgwụ nke njedebe, nkwụsị imeju nke njedebe, ma ọ bụ n'oge a jụrụ ajụ mgbe a gbanwere obi, mkpụrụ ndụ ndị a nwere ike ghara ịchọta n'ime ọbara [66].N'ụzọ na-akpali mmasị, ụmị ọkpụkpụ mmadụ ndị a nwetara mesenchymal (stromal) progenitor sel enweghị ike ịhụ n'ime ọbara nke ndị nwere ahụike [67].Atụpụtala ọrụ uPAR n'ịchịkọta ụmị ọkpụkpụ mesenchymal stem cell (BMSCs) na mbụ, nke yiri ihe omume uPAR na mkpokọta mkpụrụ ndụ hematopoietic stem cell (HSCs).Varabaneni et al.Nsonaazụ gosiri na iji ihe na-akpali akpali nke granulocyte colony na ụmụ oke uPAR kpatara ọdịda MSC, nke mere ka ọrụ nkwado nke usoro fibrinolysis sikwuo ike na ịkwaga cell.Nnyocha ndị ọzọ gosikwara na glycosyl phosphatidylinositol anchored uPA receptors na-achịkwa adhesion, migration, proliferation and differentiation site n'ime ka ụfọdụ ụzọ mgbaàmà intracellular, dị ka ndị a: survivable phosphatidylinositol 4,5-diphosphate 3-kinase / Akt na ERK1/2 na-aga n'ihu ụzọ na-egosi ụzọ. (FAK).

N'ihe gbasara ọgwụgwọ ọnya MSC, ihe kpatara fibrinolytic egosila na ọ dị mkpa karịa.Dịka ọmụmaatụ, ụmụ oke plasminogen na-enweghị ike gosipụtara nnukwu igbu oge na ihe omume ịgwọ ọnya, na-egosi na plasmin dị mkpa na usoro a.N'ime mmadụ, mfu nke plasmin nwekwara ike ibute nsogbu nke ọgwụgwọ ọnya.Nkwụsị nke ọbara na-erugharị nwere ike igbochi mmegharị anụ ahụ nke ukwuu, nke na-akọwakwa ihe kpatara usoro mmeghari ndị a ji esi ike karịa ndị ọrịa nwere ọrịa shuga.

A na-ewebata mkpụrụ ndụ ụmị ọkpụkpụ mesenchymal n'ebe ọnya ahụ iji mee ka ọgwụgwọ ọnya dị ngwa ngwa.N'okpuru ọnọdụ kwụsiri ike, mkpụrụ ndụ ndị a gosipụtara uPAuPAR na PAI-1.Abụọ ikpeazụ protein bụ hypoxia inducible ihe α (HIF-1 α) Ezubere iche dị nnọọ adaba n'ihi na HIF-1 na MSCs α The ebighị nke FGF-2 na HGF kwalite ụkpụrụ elu nke FGF-2 na HGF;HIF-2 α N'aka nke ya, VEGF-A [77] na-achịkwa, nke ọnụ na-enye aka n'ịgwọ ọnya,.Na mgbakwunye, HGF yiri ka ọ na-eme ka mbanye nke mkpụrụ ndụ ụmị ọkpụkpụ mesenchymal n'ime ebe ọnya n'ụzọ dị nro.Ekwesiri iburu n'uche na egosila ọnọdụ ischemic na hypoxic na-egbochi nke ọma na nrụzi ọnya.Ọ bụ ezie na BMSC na-ebikarị n'anụ ahụ ndị na-enye ọkwa oxygen dị ala, ndụ nke BMSC ndị a na-atụgharị na vivo na-adị oke n'ihi na mkpụrụ ndụ ndị a na-atụgharị na-anwụkarị n'okpuru ọnọdụ ọjọọ a hụrụ na anụ ahụ mebiri emebi.Ọdịmma nke adhesion na nlanarị nke ụmị ọkpụkpụ mesenchymal stem cell n'okpuru hypoxia dabere na ihe fibrinolytic nke mkpụrụ ndụ ndị a zoro ezo.PAI-1 nwere njikọ dị elu maka vitellin, ya mere ọ nwere ike ịsọ mpi maka njikọ nke uPAR na integrin na vitellin, si otú ahụ na-egbochi njikọ cell na ịkwaga.

Monocyte na usoro mmeghari ohuru

Dị ka akwụkwọ akụkọ si kwuo, e nwere ọtụtụ mkparịta ụka gbasara ọrụ monocytes na-agwọ ọnya.Macrophages na-esite na monocytes ọbara ma na-ekere òkè dị mkpa na ọgwụ na-emegharị ahụ [81].N'ihi na neutrophils na-ezobe IL-4, IL-1, IL-6 na TNF-α, mkpụrụ ndụ ndị a na-abanyekarị na ọnya ahụ banyere 24-48 awa mgbe mmerụ ahụ gasịrị.Platelet na-ahapụ thrombin na platelet factor 4 (PF4), nke nwere ike ịkwalite mbanye nke monocytes wee kewaa n'ime macrophages na sel dendritic.Akụkụ dị ịrịba ama nke macrophages bụ plasticity ha, ya bụ, ha nwere ike ịtụgharị phenotypes na ọdịiche dị n'ime ụdị sel ndị ọzọ, dị ka sel endothelial, wee gosipụta ọrụ dị iche iche na ihe mkpali biochemical dị iche iche na microenvironment ọnya.Mkpụrụ ndụ mkpali na-egosipụta phenotypes abụọ bụ isi, M1 ma ọ bụ M2, dabere na akara molekụla mpaghara dị ka isi iyi nke mkpali.A na-ebute macrophages M1 site na ndị na-ahụ maka microbial, n'ihi ya, ha nwere mmetụta ndị ọzọ na-eme ka ahụ dị mma.N'ụzọ dị iche, M2 macrophages na-emekarị site n'ụdị mmeghachi omume 2 ma nwee ihe mgbochi mkpali, nke a na-eji na-abawanye na IL-4, IL-5, IL-9, na IL-13.Ọ na-etinyekwa aka na nrụzi anụ ahụ site na mmepụta ihe na-eto eto.Mgbanwe site na M1 gaa na M2 subtype na-ebute nke ukwuu site na njedebe ikpeazụ nke ọgwụgwọ ọnya.M1 macrophages na-akpalite neutrophil apoptosis ma malite mkpochapụ nke mkpụrụ ndụ ndị a).Phagocytosis nke neutrophils na-eme ka usoro ihe omume dị iche iche, nke a na-agbanyụ mmepụta nke cytokines, macrophages polarizing na ịtọhapụ TGF- 1. Ihe na-eto eto a bụ isi ihe na-achịkwa myofibroblast dị iche iche na nhụjuanya ọnya, nke na-enye ohere mkpebi nke mbufụt na mmalite nke usoro mgbasawanye na cascade na-agwọ ọrịa [57].Protein ọzọ nwere njikọ chiri anya na usoro sel bụ serine (SG).Achọpụtara na hemopoietic cell secretory granule proteoglycan dị mkpa iji chekwaa protein ndị zoro ezo na sel ndị na-alụso ọrịa ọgụ, dị ka mkpụrụ ndụ mast, neutrophils na cytotoxic T lymphocytes.Ọ bụ ezie na ọtụtụ mkpụrụ ndụ ndị na-abụghị hematopoietic na-emepụta plasminogen, mkpụrụ ndụ niile na-emepụta ihe na-emepụta nnukwu protein a ma chekwaa ya na granules maka mmekọrịta ọzọ na ndị mgbasa ozi ndị ọzọ na-egbuke egbuke, gụnyere proteases, cytokines, chemokines na ihe ndị na-eto eto.Agbụ glycosaminoglycan (GAG) nke ebubo na-adịghị mma na SG dị ka ọ dị oke mkpa maka nkwụsi ike nke granules nzuzo, ebe ha nwere ike ijikọ ma kwado nchekwa nke akụrụngwa granular ebubo na cell, protein na GAG kpọmkwem n'ụzọ.Banyere ikere òkè ha na nyocha PRP, Woulfe na ndị ọrụ ibe egosila na ụkọ SG nwere njikọ chiri anya na mgbanwe mgbanwe morphological platelet;Platelet factor 4 β- Mmejọ nke nchekwa PDGF na thromboglobulin na platelet;Mkpokọta platelet na-adịghị mma na nzuzo in vitro na ntụpọ thrombosis na vivo.Ya mere, ndị nchọpụta kwubiri na proteoglycan a yiri ka ọ bụ isi nchịkwa nke thrombosis.

Ngwaahịa bara ụba nke platelet nwere ike nweta ọbara nkeonwe site na nchịkọta na centrifugation, wee kewaa ngwakọta ahụ n'ụdị dị iche iche nwere plasma, platelet, sel ọbara ọcha na sel ọbara ọcha.Mgbe ntinye platelet dị elu karịa uru bụ isi, ọ nwere ike mee ka ọganihu nke ọkpụkpụ na anụ ahụ dị nro dịkwuo elu, na-enwe mmetụta kachasị nta.Ngwa nke ngwaahịa PRP autologous bụ nkà na ụzụ ọhụrụ dị ọhụrụ, bụ nke gosipụtara na-enwe nchekwube na-akpali akpali na ịkwalite ọgwụgwọ nke mmerụ anụ ahụ dị iche iche.Enwere ike ikwu na ịdị irè nke usoro ọgwụgwọ ọzọ a na-ebute site na nnyefe mpaghara nke ọtụtụ ihe na-eto eto na protein iji mee ka ọ dị mma ma kwado usoro ọgwụgwọ ọnya physiological na nhazi anụ ahụ.Na mgbakwunye, usoro fibrinolytic doro anya nwere mmetụta dị mkpa na nrụzi anụ ahụ dum.Na mgbakwunye na-agbanwe mbanye cell mbanye nke mkpali mkpụrụ ndụ na ụmị ọkpụkpụ mesenchymal stem cell, ọ nwekwara ike mezie proteolytic ọrụ nke ọnya na-agwọ ọrịa na usoro mmeghari nke mesodermal anụ ahụ, gụnyere ọkpụkpụ, cartilage na muscle, n'ihi ya, ọ bụ isi akụrụngwa nke. ọgwụ musculoskeletal.

Ọgwụgwọ ngwa ngwa bụ ebumnuche nke ọtụtụ ndị ọkachamara na ngalaba ahụike na-achụso.PRP na-anọchite anya ngwa ọrụ ndu dị mma, nke na-aga n'ihu na-enye mmepe na-ekwe nkwa n'ịkwalite na ịhazi ihe omume mmeghari ohuru.Otú ọ dị, n'ihi na ngwá ọrụ ọgwụgwọ a ka dị nnọọ mgbagwoju anya, karịsịa n'ihi na ọ na-ewepụta ọtụtụ ihe ndị na-emepụta ihe na-emepụta ihe na usoro mmekọrịta ha dị iche iche na mmetụta ntụgharị mgbaàmà, a chọrọ nyocha ọzọ.

(A na-ebipụtaghachi ọdịnaya nke isiokwu a, ma anyị anaghị enye nkwa ọ bụla ma ọ bụ nkwenye doro anya maka izi ezi, ntụkwasị obi ma ọ bụ izu oke nke ọdịnaya dị n'ime edemede a, ọ bụghịkwa maka echiche nke isiokwu a, biko ghọta.)