Echiche a maara taa dị ka PRP mbụ pụtara na ngalaba hematology na 1970s.Ndị ọkà mmụta ọbara na-emepụta okwu ahụ bụ PRP ọtụtụ iri afọ gara aga na mgbalị iji kọwaa plasma enwetara site na ọnụ ọgụgụ platelet karịa ụkpụrụ basal na ọbara.Ihe karịrị afọ iri ka e mesịrị, a na-eji PRP mee ihe na ịwa ahụ maxillofacial dị ka ụdị nke fibrin-rich platelet (PRF).Ọdịnaya fibrin dị na ihe nrụpụta PRP a bara ezigbo uru maka nrapado ya na akụrụngwa homeostatic, ebe PRP nwere ihe mgbochi mkpali na-adịgide adịgide ma na-akpali mmụba cell.N'ikpeazụ, n'ihe dị ka 1990s, PRP ghọrọ ewu ewu, na n'ikpeazụ, a na-ebufe nkà na ụzụ na mpaghara ahụike ndị ọzọ.Kemgbe ahụ, a mụọla usoro ihe ọmụmụ ihe a dị mma ma tinye ya n'ọrụ iji gwọọ mmerụ ahụ dị iche iche nke anụ ahụ na ndị ọkachamara na-eme egwuregwu, na-enye aka n'ihu na mgbasa ozi mgbasa ozi ya.Na mgbakwunye na ịdị irè na orthopedics na nkà mmụta egwuregwu, PRP na-eji na ophthalmology, gynecology, urology and cardiology, pediatrics and plastic surgery.N'ime afọ ndị na-adịbeghị anya, ndị ọkachamara n'ọrịa anụ ahụ na-etokwa PRP maka ike ya ịgwọ ọnya anụ ahụ, ngbanwe nhụsianya, mmeghari anụ ahụ, mmeghari akpụkpọ ahụ na ọbụna ntutu isi.
N'iburu n'uche na a maara PRP ka ọ na-emegharị ọgwụgwọ na usoro mkpali ozugbo, a ghaghị iwebata cascade na-agwọ ọrịa dị ka ntụaka.A na-ekewa usoro ọgwụgwọ ahụ n'ime usoro anọ ndị a: hemostasis;mbufụt;cellular na matrix proliferating, na n'ikpeazụ ọnya imezigharị.
1. Agwọ anụ ahụ
A na-arụ ọrụ cascade nke anụ ahụ na-agwọ ọrịa, usoro nke na-eduga na nchịkọta platelet, ịmepụta clot, na mmepe nke matrix extracellular nwa oge (ECM. Platelets wee na-agbasosi ike na protein collagen na ECM, na-ebute ọnụnọ nke α-granules na Ntọhapụ nke Molecules bioactive. Platelet nwere ụdị mkpụrụ ndụ ihe dị iche iche, gụnyere ihe ndị na-eto eto, chemokines, na cytokines, yana ndị mgbasa ozi na-akwalite mkpali dị ka prostaglandins, prostatic cyclin, histamine, thromboxane, serotonin, na bradykinin.
Oge ikpeazụ nke usoro ọgwụgwọ na-adabere na ngbanwe nke ọnya ahụ.A na-ahazi nhazi nke anụ ahụ nke ọma iji guzobe nguzozi n'etiti nzaghachi anabolic na catabolic.N'ime oge a, ihe na-eto eto na-enweta platelet (PDGF), ihe na-eme ka ọganihu na-eto eto (TGF-β) na fibronectin na-akpali mmụba 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 ịgwọ ọrịa kpọmkwem nke anụ ahụ merụrụ ahụ, na ụfọdụ pathophysiological na metabolic ihe nwere ike imetụta usoro ọgwụgwọ, dị ka anụ ahụ ischemia, hypoxia, ọrịa. , Ihe na-akpata uto, na ọbụna ọrịa ndị metụtara metabolic syndrome.
Ihe microenvironment pro-inflammatory nke na-egbochi usoro ọgwụgwọ.Iji mee ka okwu dị mgbagwoju anya, enwekwara ọrụ protease dị elu nke na-egbochi ihe okike nke uto (GF).Na mgbakwunye na inwe mitogenic, angiogenic, na chemotactic Njirimara, PRP bụkwa ebe bara ụba nke ọtụtụ ihe na-eto eto, biomolecules nke nwere ike igbochi mmetụta ọjọọ na anụ ahụ na-agba ọkụ site na ịchịkwa mbufụt na-arịwanye elu na ịmepụta ihe mkpali anabolic.Nyere ihe onwunwe ndị a, ndị na-eme nchọpụta nwere ike ịhụ ikike dị ukwuu n'ịgwọ ọtụtụ mmerụ ahụ dị mgbagwoju anya.
2. Cytokine
Cytokines na PRP na-arụ ọrụ dị mkpa n'ịhazi usoro nrụzi anụ ahụ na ịhazi mmebi mkpali.Cytokines mgbochi mkpali bụ ụdị dị iche iche nke mkpụrụ ndụ biochemical nke na-emezi nzaghachi cytokine pro-inflammatory, bụ nke macrophages na-arụ ọrụ na-ebute.Cytokines mgbochi mkpali na-emekọ ihe na ndị na-egbochi cytokine kpọmkwem yana ndị na-anabata cytokine soluble iji gbanwee mbufụt.Interleukin (IL) -1 ndị na-anabata ndị na-anabata ya, IL-4, IL-10, IL-11 na IL-13 bụ nkewa dị ka cytokines bụ isi mgbochi mkpali.Dabere n'ụdị ọnya, ụfọdụ cytokines, dị ka interferon, leukemia inhibitory factor, TGF-β na IL-6, nwere ike igosi pro- ma ọ bụ mgbochi mkpali mmetụta.TNF-a, IL1 na IL-18 nwere ụfọdụ ndị na-anabata cytokine nke nwere ike igbochi mmetụta pro-inflammatory nke protein ndị ọzọ [37].IL-10 bụ otu n'ime cytokines na-egbochi mkpali kachasị ike, ọ nwere ike belata-achịkwa cytokines pro-inflammatory dị ka IL-1, IL-6 na TNF-α, na-achịkwa cytokines mgbochi mkpali.Usoro ndị a na-emegide usoro iwu na-arụ ọrụ dị egwu na mmepụta na ọrụ nke cytokines pro-inflammatory.Tụkwasị na nke ahụ, ụfọdụ cytokines nwere ike ịkpalite nzaghachi mgbaàmà kpọmkwem nke na-akpali fibroblasts, nke dị oke mkpa maka ịrụzi anụ ahụ.Cytokines na-egbuke egbuke TGFβ1, IL-1β, 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 cytokines TGF-β, IL-1β, IL-33, CXC, na CC chemokines, nke na-akwalite nzaghachi pro-inflammatory site n'ịkwalite na iwere sel ndị na-adịghị ike dị ka macrophages.Mkpụrụ ndụ ndị a na-akpasu iwe nwere ọtụtụ ọrụ na saịtị ọnya, nke bụ isi site n'ịkwalite mkpochapụ ọnya - yana biosynthesis nke chemokines, metabolites na ihe ndị na-eto eto, bụ ndị dị mkpa maka ịmegharị anụ ahụ ọhụrụ.Ya mere, cytokines dị na PRP na-arụ ọrụ dị mkpa n'ịkwalite mmeghachi omume mgbochi nke ụdị cell, na-ebute mkpebi nke oge mkpali.N'ezie, ụfọdụ ndị na-eme nchọpụta akpọwo usoro a "mbufụt nke na-emegharịghachi," na-atụ aro na akụkụ ahụ ọkụ ọkụ, n'agbanyeghị obi mgbawa nke onye ọrịa, bụ nzọụkwụ dị oke mkpa maka usoro nrụzi anụ ahụ iji nweta nkwubi okwu na-aga nke ọma, nyere usoro epigenetic nke ihe mgbaàmà na-akwalite cellular. plasticity.
3. Fibrin
Platelet na-ebu ọtụtụ ihe metụtara sistemu fibrinolytic nke nwere ike imezi ma ọ bụ mebie nzaghachi fibrinolytic.Mmekọrịta nwa oge na ntinye aka nke akụkụ hematological na ọrụ platelet na mbelata mkpụkọ ka bụ okwu kwesịrị nnukwu mkparịta ụka n'ime obodo.Akwụkwọ ndị ahụ na-enye ọtụtụ ọmụmụ ihe na-elekwasị anya naanị na platelet, bụ ndị a maara maka ikike ha nwere imetụta usoro ọgwụgwọ ahụ.N'agbanyeghị ọtụtụ nchọpụta pụtara ìhè, a chọpụtakwara ihe ndị ọzọ na-ahụ maka hematological, dị ka ihe na-akpata coagulation na usoro fibrinolytic, na-enye aka dị mkpa maka nrụzi ọnya dị irè.Site na nkọwapụta, fibrinolysis bụ usoro ndu dị mgbagwoju anya nke na-adabere na ịgbalite ụfọdụ enzymes iji kwado mmebi nke fibrin.Ndị na-ede akwụkwọ ndị ọzọ atụwo nzaghachi fibrinolytic na ngwaahịa mmebi fibrin (fdp) nwere ike ịbụ ndị na-ahụ maka ihe na-akpali akpali maka ịrụzi anụ ahụ, usoro nke ihe omume dị mkpa dị ndụ tupu ntinye fibrin na mwepụ na angiogenesis, nke dị mkpa maka ọgwụgwọ ọnya.Nhazi nke clot mgbe mmerụ ahụ gasịrị na-arụ ọrụ dịka mkpuchi nchebe nke na-echebe anụ ahụ pụọ na mfu ọbara, mbuso agha nke microbial agents, ma na-enyekwa matrix nwa oge nke mkpụrụ ndụ nwere ike ịkwaga n'oge mmezi.Mgbochi ahụ bụ n'ihi nbipu nke fibrinogen site na serine proteases na nchịkọta platelet na netwọk fibrin fibrous jikọtara ya.Mmeghachi omume a na-ebute polymerization nke fibrin monomers, bụ isi ihe na-eme n'ime mkpụkọ ọbara.Mkpuchi nwekwara ike na-arụ ọrụ dị ka reservoirs maka cytokines na uto ihe, nke a na-wepụtara na mmebi nke platelet arụ ọrụ.A na-ahazi usoro fibrinolytic nke ọma site na plasmin ma na-arụ ọrụ dị mkpa n'ịkwalite mbugharị cell, ihe na-akpata bioavailability na-eto eto, na nhazi nke usoro protease ndị ọzọ na-etinye aka na nsị anụ ahụ na ịmaliteghachi.Ihe ndị dị mkpa dị na fibrinolysis, dị ka urokinase plasminogen activator receptor (uPAR) na plasminogen activator inhibitor-1 (PAI-1) mara na a ga-egosipụta na mkpụrụ ndụ mesenchymal stem (MSCs), ụdị sel pụrụ iche dị mkpa maka ọgwụgwọ ọnya na-aga nke ọma.
4. Cell Migration
Ịkwalite plasminogen site na njikọ uPA-uPAR bụ usoro na-akwalite mmegharị cell mkpali ka ọ na-eme ka proteolysis extracellular.Ebe ọ bụ na uPAR enweghị ngalaba transmembrane na intracellular, protein ahụ chọrọ ndị na-anabata ya dị ka integrins na vitrein iji mezie mbugharị cell.Ọzọkwa, njide uPA-uPAR butere mmụba mmekọrịta nke uPAR maka connexins vitreous na integrins, na-akwalite nnabata cell.Plasminogen activator inhibitor-1 (PAI-1) n'aka nke ya na-ewepụ mkpụrụ ndụ, na-ebibi upar-vitrein na integrin- mgbe ọ na-ejikọta na uPA nke uPA-upar-integrin mgbagwoju na cell elu Mmekọrịta nke iko voxels.
N'ihe gbasara ọgwụ na-emegharị ahụ, a na-achịkọta mkpụrụ ndụ mesenchymal site na ụmị ọkpụkpụ n'ọnọdụ nke mmebi akụkụ ahụ siri ike na ya mere enwere ike ịhụ na mgbasa nke ndị ọrịa nwere ọtụtụ mgbaji.Otú ọ dị, n'ọnọdụ ụfọdụ, dị ka ọdịda akụrụ ọgwụgwụ nke njedebe, nkwụsị imeju nke njedebe, ma ọ bụ n'oge mmalite nke ịjụ na-esote ntugharị obi, mkpụrụ ndụ ndị a nwere ike ghara ịchọta n'ime ọbara [66].N'ụzọ na-akpali mmasị, a pụghị ịhụ mkpụrụ ndụ progenitor mesenchymal (stromal) ọkpụkpụ ọkpụkpụ ndị a n'ime ọbara nke ndị nwere ahụike [67].Atụpụtakwara na mbụ ọrụ maka uPAR na ụmị ọkpụkpụ mesenchymal stem cell mkpokọta, yiri ihe na-eme na mkpokọta hematopoietic stem cell (HSC).Varabaneni et al.Nsonaazụ gosiri na iji ihe na-akpali akpali nke granulocyte colony na ụmụ oke enweghị uPAR kpatara ọdịda nke MSC, na-ewusi ọrụ nkwado nke sistemu fibrinolytic na mbugharị cell.Nnyocha ndị ọzọ egosiwokwa na glycosylphosylphosphatidylinositol-anchored uPA receptors na-achịkwa adhesion, migration, proliferation, na dị iche iche site n'ime ka ụfọdụ ụzọ mgbaàmà intracellular, dị ka ndị a: pro-survival phosphatidylinositol 4,5-bisphosphate 3-kinase / Akt na ụzọ ERK1. , na adhesion kinase (FAK).
Ndị MSC egosipụtala mkpa ọzọ n'ihe gbasara ọgwụgwọ ọnya.Dịka ọmụmaatụ, ụmụ oke na-enweghị plasminogen gosipụtara nnukwu igbu oge na ihe omume ọgwụgwọ ọnya, na-atụ aro na plasmin na-etinye aka na usoro a.N'ime mmadụ, mfu nke plasmin nwekwara ike ibute nsogbu nke ọgwụgwọ ọnya.Mmebi nke usoro ọbara nwere ike igbochi mmeghari anụ ahụ nke ukwuu, nke na-akọwa ihe kpatara usoro mmeghari ndị a ji bụrụ ihe ịma aka na ndị ọrịa na-arịa ọrịa shuga.
5. Monocytes na usoro mmeghari
Dị ka akwụkwọ ndị ahụ si kwuo, e nwere ọtụtụ mkparịta ụka banyere ọrụ monocytes na-agwọ ọnya.Macrophages bụ nke sitere na monocytes ọbara ma na-arụ ọrụ dị mkpa na ọgwụ na-emegharị ahụ [81].Ebe ọ bụ na neutrophils na-ezobe IL-4, IL-1, IL-6 na TNF-[alpha], mkpụrụ ndụ ndị a na-abanye n'ime ebe ọnya ahụ dịka awa 24-48 mgbe mmerụ ahụ gasịrị.Platelets na-ahapụ thrombin na platelet factor 4 (PF4), chemokines abụọ na-akwalite mbanye nke monocytes na ọdịiche ha na macrophages na sel dendritic.Akụkụ dị ịrịba ama nke macrophages bụ plasticity ha, ya bụ, ikike ha ịgbanwe phenotypes na transdifferentiate n'ime ụdị sel ndị ọzọ dị ka sel endothelial, nke mechara gosipụta ọrụ dị iche iche na nzaghachi dị iche iche biochemical stimuli na microenvironment ọnya.Mkpụrụ ndụ mkpali na-egosipụta nnukwu phenotypes abụọ, M1 ma ọ bụ M2, dabere na akara molekụla mpaghara bụ isi mmalite nke mkpali ahụ.A na-ebute macrophages M1 site na ndị na-ahụ maka microbial ma si otú ahụ nwee mmetụta pro-inflammatory karịa.N'ụzọ dị iche, M2 macrophages na-emekarị site n'ụdị nzaghachi 2 ma nwee ihe ndị na-egbochi mkpali, nke a na-ejikarị 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.Ntughari site na M1 gaa na M2 isoforms na-ebutekarị site na usoro ọgwụgwọ ọnya na-esote, ebe M1 macrophages na-ebute neutrophil apoptosis ma na-ebute mkpochapụ nke mkpụrụ ndụ ndị a).Phagocytosis site na neutrophils na-eme ka usoro ihe omume na-agbanyụ mmepụta cytokine, na-eme ka macrophages na-emepụta ma na-ahapụ TGF-β1.Ihe na-eto eto a bụ isi ihe na-achịkwa myofibroblast dị iche iche na ọnya ọnya, na-enye ohere nkwụsị nke mbufụt na mmalite nke proliferative na-amụba na cascade na-agwọ ọrịa [57].Protein ọzọ nwere njikọ chiri anya na usoro sel bụ serine (SG).Achọpụtala granulan a na-ezobe hematopoietic dị ka ọ dị mkpa maka nchekwa nke 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-emepụtakwa serotonin, mkpụrụ ndụ niile na-egbuke egbuke 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 na-eto eto.Agbụ glycosaminoglycan (GAG) na-adịghị mma na SG dị ka ọ dị oke mkpa maka granule homeostasis nzuzo, n'ihi na ha nwere ike ijikọ ma kwado nchekwa nke akụrụngwa granule ebubo nke ukwuu n'ụdị cell-, protein na GAG kpọmkwem.Banyere itinye aka ha na PRP, Woulfe na ndị ọrụ ibe egosila na erughi SG nwere njikọ siri ike na mgbanwe mgbanwe platelet;ntụpọ na platelet factor 4, beta-thromglobulin, na PDGF nchekwa na platelet;nchịkọta platelet na-adịghị mma na nzuzo in vitro na thrombosis na vivo ụdị ntụpọ.Ya mere, ndị nchọpụta kwubiri na proteoglycan a yiri ka ọ bụ onye na-achịkwa thrombosis.
Enwere ike nweta ngwaahịa ndị nwere platelet site n'ịchịkọta na ịgbanye ọbara dum nke mmadụ, kewaa ngwakọta ahụ n'ụdị dị iche iche nwere plasma, platelet, leukocytes, na leukocytes.Mgbe mkpokọta platelet dị elu karịa ụkpụrụ basal, ọkpụkpụ na uto anụ ahụ dị nro nwere ike ime ngwa ngwa site na obere mmetụta.Ngwa nke ngwaahịa PRP autologous bụ ihe ọhụrụ biotechnology nke na-aga n'ihu na-egosi nsonaazụ na-ekwe nkwa na mkpali na nkwalite ọgwụgwọ nke mmerụ anụ ahụ dị iche iche.Enwere ike ịsị na ịdị irè nke usoro ọgwụgwọ ọzọ a na-ebute site na nnyefe elu nke ọtụtụ ihe na-eto eto na protein, na-eṅomi ma na-akwado ọgwụgwọ ọnya physiological na usoro nhazi anụ ahụ.Ọzọkwa, usoro fibrinolytic nwere mmetụta dị mkpa na nrụzi anụ ahụ dum.Na mgbakwunye na ikike ya ịgbanwe mbanye cellular nke sel mkpali na mesenchymal stem cell, ọ na-agbanwe ọrụ proteolytic na mpaghara ọgwụgwọ ọnya yana n'oge mmeghari nke anụ ahụ mesodermal gụnyere ọkpụkpụ, cartilage na akwara, ya mere ọ bụ isi ihe na akụrụngwa ọgwụ musculoskeletal.
Ịme ngwa ngwa ịgwọ ọrịa bụ ihe mgbaru ọsọ nke ọtụtụ ndị ọkachamara na-ahụ maka ahụike na-achọsi ike, na PRP na-anọchite anya ngwá ọrụ dị ndụ dị mma nke na-aga n'ihu na-enye ọganihu na-ekwe nkwa na mkpali na nhazi nke ọma nke ihe omume mmeghari.Otú ọ dị, dị ka ngwá ọrụ ọgwụgwọ a ka dị mgbagwoju anya, karịsịa ebe ọ bụ na ọ na-ewepụta ọtụtụ ihe ndị na-emepụta ihe na-emepụta ihe na usoro mmekọrịta ha dị iche iche na mmetụta mgbaàmà, a chọrọ ọmụmụ ihe 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.)
Oge nzipu: Jul-19-2022