Nghọta Ọhụrụ nke ọgwụgwọ Platelet Rich Plasma (PRP) - Nkebi II

PRP nke oge a: "PRP ụlọ ọgwụ"

N'ime afọ 10 gara aga, atụmatụ ọgwụgwọ nke PRP enweela nnukwu mgbanwe.Site na nyocha nnwale na ụlọ ọgwụ, anyị nwere nghọta ka mma ugbu a banyere platelet na physiology cell ndị ọzọ.Tụkwasị na nke ahụ, ọtụtụ nyocha nhazi usoro dị elu, meta-analyses na randomized tests egosila ịdị irè nke PRP biotechnology n'ọtụtụ ebe ahụike, gụnyere dermatology, ịwa ahụ obi, ịwa ahụ plastik, ịwa ahụ ọkpụkpụ, nchịkwa mgbu, ọrịa ọkpụkpụ azụ, na ọgwụ egwuregwu. .

Njirimara PRP dị ugbu a bụ mkpokọta platelet ya zuru oke, nke na-agbanwe site na nkọwa mbụ nke PRP (gụnyere ntinye platelet dị elu karịa uru ntọala) ruo ihe karịrị 1 × 10 6/µ L ma ọ bụ ihe dị ka ugboro 5 kacha nta na platelet. ndabere.Na nyocha sara mbara nke Fadadu et al.33 PRP usoro na protocol ka enyochara.Ọnụ ọgụgụ platelet nke nkwadebe PRP ikpeazụ nke ụfọdụ n'ime usoro ndị a mepụtara dị ala karịa nke ọbara dum.Ha kọrọ na ihe platelet nke PRP mụbara dị ka 0.52 na otu ngwa ihe atụ (Selphyl®).N'ụzọ dị iche, ntụgharị ugboro abụọ EmCyte Genesis PurePRPII ® Ọnụnọ platelet nke ngwaọrụ ahụ mepụtara bụ nke kachasị elu (1.6 × 10 6 /µL).

N'ụzọ doro anya, in vitro na usoro anụmanụ abụghị ebe nyocha dị mma maka mgbanwe na-aga nke ọma na omume ụlọ ọgwụ.N'otu aka ahụ, ọmụmụ ihe atụnyere ngwaọrụ anaghị akwado mkpebi ahụ, n'ihi na ha na-egosi na ntinye platelet n'etiti ngwaọrụ PRP dị nnọọ iche.Ọ dabara nke ọma, site na teknụzụ na nyocha nke proteomics, anyị nwere ike ịbawanye nghọta anyị maka ọrụ cell na PRP nke na-emetụta nsonaazụ ọgwụgwọ.Tupu enwee nkwenye na nhazi na usoro PRP ahaziri ahazi, PRP kwesịrị ịgbaso usoro PRP ụlọ ọgwụ iji kwalite usoro nrụzi anụ ahụ dị ukwuu na nsonaazụ ụlọ ọgwụ na-aga n'ihu.

Usoro PRP Clinical

Ka ọ dị ugbu a, a na-akọwapụta PRP nke ụlọ ọgwụ dị irè dị ka ihe mgbagwoju anya nke autologous multicellular components na obere plasma nke enwetara site na akụkụ nke ọbara mpụta mgbe centrifugation gasịrị.Mgbe centrifugation gasịrị, PRP na ihe ndị mejupụtara sel ndị na-abụghị platelet nwere ike nwetaghachi site na ngwaọrụ ịta ahụhụ dịka njupụta cell dị iche iche (nke njupụta platelet bụ nke kachasị ala).

Jiri PurePRP-SP ® Cell density separation akụrụngwa (EmCyte Corporation, Fort Myers, FL, USA) mee ihe maka ọbara dum mgbe usoro centrifugation abụọ gasịrị.Mgbe usoro centrifugation nke mbụ gasịrị, e kewapụrụ akụkụ ọbara niile ka ọ bụrụ ọkwa abụọ bụ isi, nkwusioru plasma platelet na oyi akwa ọbara uhie.Na A, centrifugation nzọụkwụ nke abụọ emechaala.Enwere ike iwepụta ụda PRP n'ezie maka ngwa onye ọrịa.Mmụba dị na B na-egosi na a haziri ahazi multi-component erythrocyte sedimentation aja aja oyi akwa (nke a na-anọchi anya ahịrị na-acha anụnụ anụnụ) na ala nke akụrụngwa, nke nwere nnukwu mkpokọta platelet, monocytes na lymphocytes, dabere na gradient njupụta.N'ihe atụ a, dị ka usoro nkwadebe C-PRP na neutrophils dara ogbenye, a ga-ewepụta pasent kacha nta nke neutrophils (<0.3%) na erythrocytes (<0.1%).

Platelet granule

Na ngwa ngwa PRP nke mbụ, α- Granules bụ ihe a na-akpọkarị platelet n'ime ime ụlọ, n'ihi na ha nwere ihe nchịkọta coagulation, ọnụ ọgụgụ buru ibu nke PDGF na angiogenic regulators, ma ha nwere obere ọrụ thrombogenic.Ihe ndị ọzọ na-agụnye chemokine na cytokine ndị a na-amachaghị nke ọma, dị ka platelet factor 4 (PF4), protein protein pre-platelet, P-selectin (onye na-arụ ọrụ nke integrin) na chemokine RANTES (nke a na-achịkwa site na ịgbalite, na-egosipụta sel T nkịtị na ma eleghị anya. nzuzo).Ọrụ n'ozuzu nke ihe mejupụtara granule platelet ndị a bụ iweta na ịgbalite mkpụrụ ndụ ndị ọzọ na-alụso ọrịa ọgụ ma ọ bụ kpalite mbufụt cell endothelial.

A na-eji akụrụngwa granular dị oke dị ka ADP, serotonin, polyphosphate, histamine na adrenaline eme ihe n'ezoghị ọnụ dị ka ndị na-achịkwa ịgbalite platelet na thrombosis.Nke kachasị mkpa, ọtụtụ n'ime ihe ndị a nwere ọrụ nke imezi mkpụrụ ndụ na-alụso ọrịa ọgụ.A na-amata Platelet ADP site na P2Y12ADP nnabata na mkpụrụ ndụ dendritic (DC), si otú a na-abawanye antigen endocytosis.DC (antigen na-eweta cell) dị ezigbo mkpa maka ịmalite nzaghachi mgbochi sel T yana ịchịkwa nzaghachi nchebe nchebe, nke na-ejikọta usoro ahụ ji alụso ọrịa ọgụ na usoro ahụ ji alụso ọrịa ọgụ.Na mgbakwunye, platelet adenosine triphosphate (ATP) na-eziga akara site na T cell receptor P2X7, na-eduga n'ịbawanye ọdịiche nke CD4 T cell cell n'ime sel proinflammatory T 17 (Th17).Ngwakọta granul dense platelet ndị ọzọ (dị ka glutamate na serotonin) na-ebute Mbugharị cell T ma na-abawanye ọdịiche monocyte na DC, n'otu n'otu.Na PRP, immunomodulators ndị a sitere na oke irighiri ihe na-aba ụba nke ukwuu ma nwee nnukwu ọrụ mgbochi.

Ọnụọgụ nke mmekọrịta chiri anya na nke na-apụtachaghị ìhè n'etiti platelet na sel ndị ọzọ (nnabata) dị ukwuu.Ya mere, ntinye nke PRP na mpaghara anụ ahụ nke anụ ahụ nwere ike ịkpata mmetụta dị iche iche.

Ntinye uche nke platelet

C-PRP kwesịrị ịnwe usoro ọgwụgwọ nke platelet gbanyere mkpọrọgwụ iji mepụta mmetụta ọgwụgwọ bara uru.Platelet dị na C-PRP kwesịrị ịkpali mmụba cell, njikọ nke ihe mesenchymal na neurotrophic, na-akwalite mbugharị nke mkpụrụ ndụ chemotactic ma kpalie ọrụ immunoregulatory, dị ka egosiri na ọnụ ọgụgụ ahụ.

platelet arụ ọrụ, ntọhapụ nke PGF na ụmụ irighiri ihe na-emekọrịta ihe na-emekọrịta mmekọrịta dị iche iche nke cell: chemotaxis, adhesion cell, mbugharị, na sel dị iche iche, ma na-ahazi ọrụ nchịkwa nchịkwa.Mkparịta ụka cell-cell platelet ndị a na-enye aka na angiogenesis na ọrụ mkpali, na n'ikpeazụ na-akpali usoro nrụzi anụ ahụ.Mkpebi: BMA: ụmị ọkpụkpụ aspirate, EPC: endothelial progenitor cell, EC: endothelial cell, 5-HT: 5-hydroxytryptamine, RANTES: arụ ọrụ ụkpụrụ nke nkịtị T cell okwu na putative secretion, JAM: junction adhesion molecule ụdị, CD40L: 40 ligand, SDF-1 α: Stromal cell-enwetara ihe-1 α, CXCL: chemokine (CXC motif) ligand, PF4: ihe na-akpata platelet 4. Na-enweta site na Everts et al.

Marx bụ onye mbụ gosipụtara na ọgwụgwọ ọkpụkpụ na anụ ahụ dị nro na-eme ka ọ dịkwuo mma, yana ọnụ ọgụgụ platelet kacha nta bụ 1 × 10 6 / µL. E gosipụtara nsonaazụ ndị a na nyocha nke njikọ lumbar site na intervertebral foramen, mgbe dose platelet dị ukwuu karịa. 1.3 × Na 106 platelet/µ L, ọmụmụ a gosipụtara njikọ karịa.Na mgbakwunye, Giusti et al.ekpughere 1.5 × Usoro nrụzi anụ ahụ na dose nke 109 chọrọ platelet/mL iji kpalite angiogenesis na-arụ ọrụ site na ọrụ sel endothelial.N'ime ọmụmụ ihe ikpeazụ, mkpokọta dị elu belatara ikike angiogenesis nke platelet n'ime na gburugburu follicles.Na mgbakwunye, data mbụ gosiri na dose nke PRP ga-emetụtakwa nsonaazụ ọgwụgwọ.Ya mere, iji mee ka mmeghachi omume angiogenesis pụta ìhè ma kpalie mmụba cell na mbugharị cell, C-PRP kwesịrị ịnwe ma ọ dịkarịa ala 7.5 na 5-mL PRP ọgwụgwọ karama × 10 9 nwere ike ịnapụta platelet.

Na mgbakwunye na ịdabere na dose, mmetụta PRP na ọrụ cell yiri ka ọ dabere na oge.Sophie et al.Nsonaazụ ndị a na-egosi na ikpughe oge dị mkpirikpi na lysates platelet mmadụ nwere ike ịkpalite mmụba cell ọkpụkpụ na chemotaxis.N'ụzọ megidere nke ahụ, ikpughe ogologo oge na PRP ga-eduga na ọkwa dị ala nke alkaline phosphatase na nhazi ịnweta.

Mkpụrụ ndụ ọbara uhie

Mkpụrụ ndụ ọbara uhie na-ahụ maka ibuga oxygen na anụ ahụ na ibufe carbon dioxide site na anụ ahụ gaa na ngụgụ.Ha enweghị oghere ma mejupụtara mkpụrụ ndụ heme na-ejikọta na protein.Ihe ndị mejupụtara ígwè na heme dị na mkpụrụ ndụ ọbara uhie na-akwalite nchikota oxygen na carbon dioxide.N'ozuzu, okirikiri ndụ nke mkpụrụ ndụ ọbara uhie dị ihe dị ka ụbọchị 120.A na-ewepụ ha na mgbasa site na macrophages site na usoro a na-akpọ RBC ịka nká.Enwere ike mebie mkpụrụ ndụ ọbara uhie na ihe nlele PRP n'okpuru ọnọdụ shear (dịka ọmụmaatụ, ịwa ahụ ọbara ọbara dum, usoro mgbasa ozi na-alụso ọrịa ọgụ, nrụgide oxidative ma ọ bụ atụmatụ ntinye uche PRP ezughị ezu).Ya mere, akpụkpọ anụ RBC cell na-emebi ma na-ahapụ haemoglobin na-egbu egbu (Hb), nke a tụrụ site na haemoglobin free plasma (PFH), heme na ígwè.PFH na ngwaahịa mmebi ya (heme na ígwè) jikọtara ọnụ na-eduga na mmerụ ahụ na mmetụta cytotoxic na anụ ahụ, na-eduga na nrụgide oxidative, ọnwụ nke nitric oxide, ịgbalite ụzọ mkpali na immunosuppression.Mmetụta ndị a ga-emecha mee ka microcirculation dysfunction, vasoconstriction mpaghara na mmerụ ahụ vaskụla, yana mmebi anụ ahụ dị njọ.

Ihe kachasị mkpa bụ na mgbe a na-ebuga RBC nwere C-PRP na anụ ahụ, ọ ga-eme ka mmeghachi omume mpaghara a na-akpọ eryptosis, nke ga-eme ka ntọhapụ nke cytokine dị irè na macrophage migration inhibitor.Cytokine a na-egbochi mbugharị nke monocytes na macrophages.Ọ na-egosipụta akara ngosi pro-inflammatory siri ike na anụ ahụ gbara ya gburugburu, na-egbochi mbugharị sel stem na mmụba fibroblast, ma na-eduga n'ịrụ ọrụ sel dị ukwuu na mpaghara.Ya mere, ọ dị mkpa igbochi mmetọ RBC na nkwadebe PRP.Na mgbakwunye, ọ dịbeghị mgbe ekpebiela ọrụ mkpụrụ ndụ ọbara uhie na nrụgharị anụ ahụ.Usoro C-PRP zuru oke na usoro nkwadebe ga-ebelata ma ọ bụ ọbụna wepụ ọnụnọ nke mkpụrụ ndụ ọbara uhie, si otú a na-ezere nsonaazụ ọjọọ nke hemolysis na polycythemia.

Leukocytes na C-PRP

Ọnụnọ nke mkpụrụ ndụ ọbara ọcha na nkwadebe PRP dabere na akụrụngwa ọgwụgwọ na atụmatụ nkwadebe.Na ngwá ọrụ PRP dabeere na plasma, a na-ekpochapụ mkpụrụ ndụ ọbara ọcha kpamkpam;Agbanyeghị, mkpụrụ ndụ ọbara ọcha gbadoro anya na nkwadebe PRP nke oyi akwa erythrocyte sedimentation aja aja.N'ihi usoro nchebe ya na nke ndị ọbịa, mkpụrụ ndụ ọbara ọcha na-emetụta ihe dị n'ime bayoloji nke ọnọdụ anụ ahụ siri ike na nke na-adịghị ala ala.A ga-atụlekwu atụmatụ ndị a n'okpuru.Ya mere, ọnụnọ nke leukocytes kpọmkwem na C-PRP nwere ike ime ka mmetụta cellular na anụ ahụ dị ịrịba ama.Kpọmkwem, dị iche iche PRP erythrocyte sedimentation agba aja aja-acha odo odo usoro na-eji dị iche iche nkwadebe atụmatụ, si otú na-emepụta dị iche iche nke neutrophils, lymphocytes na monocytes na PRP.Enweghị ike ịlele eosinophils na basophils na nkwadebe PRP n'ihi na akpụkpọ ahụ ha na-esighi ike na-eguzogide ike nhazi centrifugal.

Neutrophils

Neutrophils bụ leukocytes dị mkpa n'ọtụtụ ụzọ ọgwụgwọ.Ụzọ ndị a na-ejikọta ya na protein antimicrobial dị na platelet iji mepụta nnukwu ihe mgbochi megide nje ndị na-efe efe.A na-ekpebi ịdị adị nke neutrophils dabere na ebumnuche ọgwụgwọ nke C-PRP.Enwere ike ịchọrọ mmụba nke mbufụt anụ ahụ na nlekọta ọnya na-adịghị ala ala PRP biotherapy ma ọ bụ na ngwa ndị ezubere maka uto ọkpụkpụ ma ọ bụ ọgwụgwọ.N'ụzọ dị mkpa, achọtawo ọrụ neutrophil ọzọ n'ọtụtụ ụdị, na-emesi ọrụ ha ike na angiogenesis na nrụzi anụ ahụ.Otú ọ dị, neutrophils nwekwara ike ịkpata mmetụta ọjọọ, n'ihi ya, ha adịghị mma maka ụfọdụ ngwa.Zhou na Wang gosipụtara na iji PRP bara ụba na neutrophils nwere ike ime ka mmụba nke ụdị III collagen na ụdị collagen I, si otú ahụ na-eme ka fibrosis dịkwuo njọ ma na-ebelata ike akwara.Àgwà ndị ọzọ na-emerụ ahụ nke neutrophils na-edozi bụ ntọhapụ nke cytokines na-egbuke egbuke na matrix metalloproteinases (MMPs), nke nwere ike ịkwalite mbufụt na catabolism mgbe etinyere ya na anụ ahụ.

Leukomonocyte

Na C-PRP, mononuclear T na B lymphocytes na-etinye uche karịa mkpụrụ ndụ ọbara ọcha ọ bụla.Ha nwere njikọ chiri anya na mgbochi cytotoxic na-emekọrịta ihe na cell.Lymphocytes nwere ike ịkpalite mmeghachi omume sel iji lụso ọrịa ọgụ na ime mgbanwe maka ndị mwakpo.Na mgbakwunye, T-lymphocyte ewepụtara cytokines (interferon-γ [IFN-γ] na interleukin-4 (IL-4) na-akwalite polarization nke macrophages Verassar et al. ụdị òké site n'ịchịkwa ọdịiche nke monocytes na macrophages.

Monocyte – multipotent mmezi cell

Dịka ngwaọrụ nkwadebe PRP ejiri mee ihe, monocytes nwere ike ịpụta ma ọ bụ ghara ịdị na karama ọgwụgwọ PRP.N'ụzọ dị mwute, arụmọrụ ha na ikike mmeghari na-adịkarịghị atụle n'akwụkwọ.Ya mere, a na-akwụ obere nlebara anya na monocytes na usoro nkwadebe ma ọ bụ usoro ikpeazụ.Otu Monocyte dị iche iche, sitere na sel ndị nna na ụmị ọkpụkpụ, na-ebuga ya na anụ ahụ dị n'akụkụ site na ụzọ hematopoietic stem cell dị ka mkpali microenvironment si dị.N'oge homeostasis na mbufụt, monocytes na-ekesa na-ahapụ ọbara ọbara ma na-eweghachi ya na anụ ahụ merụrụ ahụ ma ọ bụ mebie.Ha nwere ike na-eme dị ka macrophages (M Φ) Effector cell ma ọ bụ progenitor sel.Monocytes, macrophages na mkpụrụ ndụ dendritic na-anọchi anya usoro phagocytic mononuclear (MPS) .. Ihe a na-ahụkarị nke MPS bụ plasticity nke usoro okwu mkpụrụ ndụ ya na nkwụsị ọrụ n'etiti ụdị sel ndị a.N'ime anụ ahụ mebiri emebi, macrophages bi, ihe ndị na-eto eto na-eme ihe na mpaghara, cytokines pro-inflammatory, mkpụrụ ndụ apoptotic ma ọ bụ necrotic na ngwaahịa microbial na-amalite monocytes ka ha kewaa n'ime otu cell MPS.Were ya na mgbe C-PRP nwere monocytes dị elu na-agbanye n'ime microenvironment mpaghara nke ọrịa ahụ, monocytes nwere ike ịdị iche na M Φ Iji mee ka mgbanwe dị ukwuu na cell.

Site na monocyte ruo M % Na usoro mgbanwe, kpọmkwem M Φ Phenotype.N'ime afọ iri gara aga, e mepụtara ihe nlereanya, nke na-ejikọta M Φ A na-akọwa usoro mgbagwoju anya nke ịgbalite dị ka polarization nke steeti abụọ dị iche iche: M Φ Phenotype 1 (M Φ 1, Classic activation) na M Φ Phenotype 2 (M Φ). 2, ọzọ ịgbalite).M Φ 1 bụ ihe nzuzo cytokine na-egbuke egbuke (IFN-γ) na nitric oxide na-emepụta usoro igbu egbu pathogen dị irè.M Φ The phenotype na-emepụtakwa vascular endothelial growth factor (VEGF) na fibroblast growth factor (FGF).M Φ Ihe mejupụtara phenotype bụ mkpụrụ ndụ mgbochi mkpali nwere nnukwu phagocytosis.M Φ 2 Mepụta akụrụngwa matrix extracellular, angiogenesis na chemokines, yana interleukin 10 (IL-10).Na mgbakwunye na nchebe pathogen, M Φ Ọ nwekwara ike ibelata mbufụt ma kwalite nrụzi anụ ahụ.Ọ bụ ihe kwesịrị ịrịba ama na M Φ 2 kewara n'ime M in vitro Φ 2a, M Φ 2b na M Φ 2. Ọ dabere na mkpali.Na vivo ntụgharị asụsụ nke ụdị ndị a siri ike n'ihi na anụ ahụ nwere ike ịnwe otu M % agwakọtara.N'ụzọ na-akpali mmasị, dabere na mgbaàmà gburugburu ebe obibi na ọkwa IL-4, proinflammatory M Φ 1 nwere ike gbanwee iji kwalite nrụzi M Φ 2. Site na data ndị a, ọ bụ ihe ezi uche dị na ya iche na e nwere nnukwu nchịkọta monocytes na M Φ C-PRP nkwadebe. nwere ike inye aka n'ịrụzi anụ ahụ ka mma n'ihi na ha nwere nrụzi anụ ahụ na-egbochi mkpali yana ike ngbanwe mgbaàmà cell.

Nkọwa mgbagwoju anya nke ntakiri mkpụrụ ndụ ọcha na PRP

Ọnụnọ nke mkpụrụ ndụ ọbara ọcha na karama ọgwụgwọ PRP dabere na ngwaọrụ nkwadebe PRP ma nwee ike inwe nnukwu ọdịiche.Enwere ọtụtụ esemokwu gbasara ịdị adị nke leukocytes na ntinye aka ha na ngwaahịa sub-PRP dị iche iche (dịka PRGF, P-PRP, LP-PRP, LR-PRP, P-PRF na L-PRF) Na nyocha na nso nso a, isii randomized. Nnwale ndị a na-achịkwa (ọkwa ọkwa 1) na nchọpụta atọ na-atụ anya atụnyere (ọkwa 2) metụtara ndị ọrịa 1055, na-egosi na LR-PRP na LP-PRP nwere nchekwa yiri nke ahụ.Onye edemede ahụ kwubiri na mmeghachi omume ọjọọ nke PRP nwere ike ọ gaghị ejikọta ya na ntinye nke mkpụrụ ndụ ọbara ọcha.N'ọmụmụ ihe ọzọ, LR-PRP agbanweghị interleukin mkpali (IL-1) na OA ikpere β, IL-6, IL-8 na IL-17).Nsonaazụ ndị a na-akwado echiche na ọrụ nke leukocytes na ọrụ ndu nke PRP na vivo nwere ike sitere na mkparịta ụka n'etiti platelet na leukocytes.Mmekọrịta a nwere ike ịkwalite biosynthesis nke ihe ndị ọzọ (dị ka lipoxygen), nke nwere ike ịkwụsị ma ọ bụ kwalite nlọghachi nke mbufụt.Mgbe mwepụta mbụ nke ụmụ irighiri ihe na-akpasu iwe (arachidonic acid, leukotriene na prostaglandin), a na-ahapụ lipoxygen A4 site na platelet arụ ọrụ iji gbochie ịgbalite neutrophil.Ọ bụ na gburugburu ebe a ka M Φ Phenotype si M Φ 1 Gbanwee na M Φ 2. Tụkwasị na nke ahụ, a na-enwewanye ihe àmà na-egosi na mkpụrụ ndụ mononuclear na-ekesa nwere ike ịdị iche n'ime ụdị sel dị iche iche na-abụghị phagocytic n'ihi ike ha.

Ụdị PRP ga-emetụta omenala MSC.E jiri ya tụnyere ihe nlele PRP ma ọ bụ PPP dị ọcha, LR-PRP nwere ike ibute mmụba dị elu nke ụmị ọkpụkpụ nke enwetara MSC (BMMSCs), na mwepụta ngwa ngwa yana ọrụ PGF ka mma.Njirimara ndị a niile na-enyere aka ịgbakwunye monocytes n'ime karama ọgwụgwọ PRP na ịmata ikike immunomodulatory ha na ikike dị iche iche.

Usoro mgbochi mgbochi na mgbanwe nke PRP

Ọrụ physiological kachasị ama nke platelet bụ ịchịkwa ọbara ọgbụgba.Ha na-agbakọta na ebe mmebi anụ ahụ na arịa ọbara mebiri emebi.Ihe omume ndị a na-ebute site na nkwupụta nke integrins na selectins nke na-akpalite adhesion na nchịkọta platelet.Endothelium mebiri emebi na-eme ka usoro a dịkwuo njọ, na collagen ekpughere na protein ndị ọzọ nke subendothelial matrix na-akwalite ọrụ miri emi nke platelet.N'okwu ndị a, egosipụtara ọrụ dị mkpa nke mmekọrịta dị n'etiti von Willebrand factor (vWF) na glycoprotein (GP), karịsịa GP-Ib.Mgbe platelet rụchara ọrụ, platelet α-, Dense, lysosome na T-granules na-ahazi exocytosis wee hapụ ọdịnaya ha na gburugburu extracellular.

Platelet adhesion molekul

Iji ghọta nke ọma ọrụ PRP na anụ ahụ na-egbuke egbuke na platelet na nzaghachi mgbochi, anyị kwesịrị ịghọta otú ndị na-anabata ihe dị iche iche nke platelet (integrins) na njikọ molecules adhesion (JAM) na cell mmekọrịta nwere ike ịmalite usoro dị egwu na ihe mgbochi ebumpụta ụwa na ime mgbanwe.

Integrins bụ mkpụrụ ndụ nrapado n'elu sel nke a na-ahụ n'ụdị sel dị iche iche ma gosipụta ya n'ọtụtụ na platelet.Integrins gụnyere a5b1, a6b1, a2b1 LFA-2, (GPIa/IIa) na aIIbb3 (GPIIb/IIIa).Na-emekarị, ha na-adị na static na ala mmekọrịta ala.Mgbe emechara ya, ha na-atụgharị gaa na ọnọdụ njikọ njikọ njikọ njikọ dị elu.Integrin nwere ọrụ dị iche iche na platelet ma na-ekere òkè na mmekọrịta nke platelet na ọtụtụ ụdị sel ọbara ọcha, sel endothelial na matrix extracellular.Na mgbakwunye, GP-Ib-V-IX complex na-egosipụta na akpụkpọ ahụ platelet ma bụrụ onye na-anabata ya maka ijikọ na von vWF.Mmekọrịta a na-eme ka kọntaktị mbụ dị n'etiti platelet na akụkụ subendothelial ekpughere.Platelet integrin na GP complex nwere njikọ na usoro mkpali dị iche iche ma na-arụ ọrụ dị mkpa na nhazi nke platelet-leukocytes.Kpọmkwem, integrin aIIbb3 dị mkpa iji guzobe mgbagwoju kwụsiri ike site na ijikọta fibrinogen na macrophage 1 antigen (Mac-1) receptor na neutrophils.

Platelets, neutrophils na vaskụla endothelial sel na-egosipụta kpọmkwem mkpụrụ ndụ adhesion cell, nke a na-akpọ selectin.N'okpuru ọnọdụ mkpali, platelet na-egosipụta P-selectin na neutrophil L-selectin.Mgbe arụ ọrụ platelet gasịrị, P-seletin nwere ike jikọta na ligand PSGL-1 nke dị na neutrophils na monocytes.Na mgbakwunye, njikọ PSGL-1 na-amalite mmeghachi omume cascade nke intracellular, nke na-eme ka neutrophils site na neutrophil integrin Mac-1 na antigen 1 (LFA-1) metụtara ọrụ lymphocyte.Mac-1 arụ ọrụ na-ejikọta GPIb ma ọ bụ GPIIb/IIIa na platelet site na fibrinogen, si otú a na-eme ka mmekọrịta dị n'etiti neutrophils na platelet guzosie ike.Na mgbakwunye, LFA-1 na-arụ ọrụ nwere ike ijikọ na platelet intercellular adhesion molecule 2 iji mee ka mgbagwoju anya neutrophil-platelet guzosie ike iji kwalite nrapagide ogologo oge na sel.

Platelet na leukocytes na-arụ ọrụ dị mkpa na nzaghachi mgbochi ebumpụta ụwa na ngbanwe

Ahụ nwere ike ịmata ahụ ndị mba ọzọ na anụ ahụ merụrụ ahụ na nnukwu ọrịa ma ọ bụ nke na-adịghị ala ala iji bido ọnya ọgwụgwọ cascade mmeghachi omume na ụzọ mkpali.Usoro mgbochi ebumpụta ụwa na nke na-agbanwe agbanwe na-echebe onye ọbịa ahụ pụọ ​​na ọrịa, mkpụrụ ndụ ọbara ọcha na-arụkwa ọrụ dị mkpa n'ịgbakọta n'etiti sistemụ abụọ ahụ.Kpọmkwem, monocytes, macrophages, neutrophils na mkpụrụ ndụ egbu egbu eke na-arụ ọrụ dị mkpa na sistemu ebumpụta ụwa, ebe lymphocytes na mpaghara ha na-ekere òkè yiri nke ahụ na usoro ahụ ji alụso ọrịa ọgụ.

Platelet na leukocyte na-emekọrịta ihe n'ime mmekọrịta sel na-alụso ọrịa ọgụ.Platelet na-emekọrịta ihe na neutrophils na monocytes, na n'ikpeazụ na M Φ Interact, gbanwee ma na-abawanye ọrụ mmetụta ha.Mmekọrịta platelet-leukocyte ndị a na-eduga na mbufụt site na usoro dị iche iche, gụnyere NETosis.Mkpebi: MPO: myeloperoxidase, ROS: ụdị oxygen na-emeghachi omume, TF: ihe anụ ahụ, NET: neutrophil extracellular trap, NF-κ B: Nuclear factor kappa B, M Φ: Macrophages.

Usoro ahụ ji alụso ọrịa ọgụ

Ọrụ nke usoro ahụ ji alụso ọrịa ọgụ bụ ịchọpụtaghị microorganisms na-emebi emebi ma ọ bụ iberibe anụ ahụ ma kpalie mkpochapụ ha.Mgbe ụfọdụ ihe arụrụ arụ nke a na-akpọ ndị na-anabata ihe nrịba ama n'elu (PRRs) na-ejikọta ya na ụkpụrụ molekụla metụtara pathogen na ụkpụrụ molekụla metụtara mmebi, usoro ahụ ji alụso ọrịa ọgụ ga-arụ ọrụ.Enwere ọtụtụ ụdị PRR, gụnyere Toll-like receptor (TLR) na RIG-1 dị ka nnata (RLR).Ndị nnabata a nwere ike rụọ ọrụ kappa B (NF-κ B) bụ isi ihe na-eme ka ọ bụrụ ihe na-eme ka ọ rụọ ọrụ, ọ na-achịkwa ọtụtụ akụkụ nke mmeghachi omume mgbochi na-agbanwe agbanwe.N'ụzọ na-akpali mmasị, platelet na-egosipụtakwa ụdị dị iche iche nke ụmụ irighiri ihe na-anabata immunoregulatory n'elu ha na cytoplasm, dị ka P-selectin, protein transmembrane CD40 ligand (CD40L), cytokines (dị ka IL-1 β, TGF- β) na platelet-kpọmkwem TLR. Ya mere, platelet nwere ike imekọrịta ihe na sel dị iche iche na-alụso ọrịa ọgụ.

Platelet-ọcha cell mmekọrịta na mgbochi ebumpụta ụwa

Mgbe platelet na-abanye ma ọ bụ wakporo ọbara ma ọ bụ anụ ahụ, platelet bụ otu n'ime sel ndị na-achọpụta mmerụ ahụ endothelial na microbial pathogens.Mkpokọta Platelet na ịkwalite ntọhapụ nke platelet agonists ADP, thrombin na vWF, na-eme ka platelet rụọ ọrụ na nkwupụta nke ndị na-anabata platelet chemokine C, CC, CXC na CX3C, si otú a na-ebute platelet na saịtị ma ọ bụ mmerụ ahụ.

A na-ekpebi usoro ahụ ji alụso ọrịa ọgụ site na mkpụrụ ndụ ihe nketa iji chọpụta ndị mwakpo, dị ka nje, nje bacteria, nje nje na nsị, ma ọ bụ ọnyá na ọnya anụ ahụ.Ọ bụ usoro na-abụghị nke a kapịrị ọnụ, n'ihi na a ga-achọpụta pathogen ọ bụla dị ka onye mba ọzọ ma ọ bụ na-abụghị nke onwe ya ma dị ngwa ngwa.Usoro ahụ ji alụso ọrịa ọgụ na-adabere na nhazi nke protein na phagocytes, bụ ndị na-amata njirimara ndị echekwara nke ọma na ngwa ngwa na-eme ka mmeghachi omume na-alụso ọrịa ọgụ na-enyere aka kpochapụ ndị na-awakpo, ọ bụrụgodị na onye ọbịa ahụ ekpughere ya kpọmkwem na mbụ.

Neutrophils, monocytes na sel dendritic bụ sel ndị na-alụso ọrịa ọgụ na-adịkarị n'ime ọbara.Mbanye ha dị mkpa maka nzaghachi mgbochi mbụ zuru oke.Mgbe a na-eji PRP eme ihe na nkà mmụta ọgwụ na-emegharị ahụ, mmekọrịta nke platelet-white cell na-achịkwa mbufụt, ọgwụgwọ ọnya na nrụzi anụ ahụ.TLR-4 na platelet na-akpali mmekọrịta platelet-neutrophil, nke na-achịkwa ihe a na-akpọ leukocyte oxidative burst site na ịhazi ntọhapụ nke ụdị oxygen reactive (ROS) na myeloperoxidase (MPO) sitere na neutrophils.Na mgbakwunye, mmekọrịta dị n'etiti platelet-neutrophil na neutrophil degenranulation na-eduga n'ịmepụta ọnyà neutrophil-extracellular (NET).NET bụ nke neutrophil nucleus na ihe ndị ọzọ dị na neutrophil intracellular, nke nwere ike ijide nje bacteria ma gbuo ha site na NETosis.Nhazi nke NET bụ usoro igbu egbu nke neutrophils.

Mgbe arụ ọrụ platelet gasịrị, monocytes nwere ike ịkwaga na anụ ahụ na-arịa ọrịa na nke mebiri emebi, ebe ha na-arụ ọrụ adhesion ma na-ezobe ụmụ irighiri ihe na-egbuke egbuke nke nwere ike gbanwee chemotaxis na proteolytic Njirimara.Tụkwasị na nke ahụ, platelet nwere ike ime ka monocyte NF-κ B rụọ ọrụ iji mezie ọrụ mmetụta nke monocytes, nke bụ isi ihe mgbasa ozi nke nzaghachi mkpali na ịgbalite na ọdịiche nke mkpụrụ ndụ na-alụso ọrịa ọgụ.Platelet na-akwalitekwa mgbawa oxidative endogenous nke monocytes iji kwalite mbibi nke nje phagocytic.A na-edozi ntọhapụ nke MPO site na mmekọrịta kpọmkwem n'etiti platelet-monocyte CD40L-MAC-1.N'ụzọ na-akpali mmasị, mgbe P-selectin na-arụ ọrụ platelet n'okpuru ọnọdụ anụ ahụ na-adịghị ala ala na nke na-adịghị ala ala, chemokines platelet PF4, RANTES, IL-1 β na CXCL-12 nwere ike igbochi apoptosis nke monocytes, ma kwalite ọdịiche ha na macrophages.

Usoro ahụ ji alụso ọrịa ọgụ na-agbanwe agbanwe

Mgbe usoro ahụ ji alụso ọrịa ọgụ na-abụghị nke achọpụtara microbial ma ọ bụ mmebi anụ ahụ, usoro ahụ ji alụso ọrịa ọgụ a kapịrị ọnụ ga-eweghara.Usoro ngbanwe gụnyere antigen na-ejikọta B lymphocytes (sel B) na T-lymphocytes (Treg) nke na-ahazi mkpochapụ nke nje.Enwere ike kewaa mkpụrụ ndụ T ka ọ bụrụ mkpụrụ ndụ T inyeaka (sel Th) na sel cytotoxic T (sel Tc, nke a makwaara dị ka mkpụrụ ndụ T egbu egbu).A na-ekewakwa mkpụrụ ndụ Th1, Th2 na Th17, nke nwere ọrụ dị mkpa na mbufụt.Selụ th nwere ike izoputa cytokines proinflammatory (dịka IFN-γ, TNF-β) na ọtụtụ interleukins (dịka, IL-17) Ha na-arụ ọrụ nke ọma n'igbochi nje virus intracellular na nje nje. sel Tc bụ mkpụrụ ndụ mmetụta, nke nwere ike iwepụ microorganisms intracellular na extracellular ezubere iche na sel.

N'ụzọ na-akpali mmasị, mkpụrụ ndụ Th2 na-emepụta IL-4 ma na-emetụta M Φ Polarization, M Φ Nduzi Ntugharị M Φ 2 Phenotype, ebe IFN-γ M Φ Mgbanwe na M Φ 1 Phenotype na-egbuke egbuke, nke dabere na dose na oge nke cytokines.Mgbe IL-4 na-arụ ọrụ, M Φ 2 na-eme ka mkpụrụ ndụ Treg dị iche na sel Th2, wee mepụta IL-4 ọzọ (njikwa nzaghachi ziri ezi).Mkpụrụ ndụ Th na-atụgharị M % A na-eduzi phenotype na phenotype na-emegharịghachi na nzaghachi nye ndị na-ahụ maka ihe ndị dị ndụ sitere na anụ ahụ.Usoro a dabere na ihe akaebe na-egosi na mkpụrụ ndụ Th na-ekere òkè dị ukwuu n'ịchịkwa mbufụt na nrụzi anụ ahụ.

Platelet-ọcha cell mmekọrịta na mgbochi imeghari

Usoro ahụ ji alụso ọrịa ọgụ na-eme mgbanwe na-eji antigen-kpọmkwem ndị na-anabata ya ma na-echeta nje ndị ahụ na-ebu ụzọ zute, ma na-ebibi ha mgbe emesịa zute onye ọbịa ahụ.Otú ọ dị, nzaghachi ndị a na-emegharị ahụ na-emegharị ahụ ji nwayọọ nwayọọ malite.Konia et al.Ọ na-egosi na akụkụ platelet na-enye aka n'ichepụta ihe ize ndụ na nrụzi anụ ahụ, yana mmekọrịta dị n'etiti platelet na leukocytes na-akwalite nkwalite mmeghachi omume mgbochi.

N'oge mmeghachi omume mgbochi na-agbanwe agbanwe, platelet na-akwalite nzaghachi monocyte na macrophage site na DC na NK cell maturation, na-eduga kpọmkwem T cell na B cell nzaghachi.Ya mere, ihe ndị mejupụtara platelet granule na-emetụta kpọmkwem mgbochi mgbochi site n'igosipụta CD40L, molecule nke dị mkpa maka ịhazi mmeghachi omume mgbochi.Platelets site na CD40L ọ bụghị naanị na-ekere òkè na ngosipụta antigen, kamakwa ọ na-emetụta mmeghachi omume cell T.Liu et al.Achọpụtara na platelet na-achịkwa nzaghachi cell CD4 T n'ụzọ dị mgbagwoju anya.Usoro a dị iche iche nke CD4 T cell subsets pụtara na platelet na-akwalite mkpụrụ ndụ CD4 T iji meghachi omume na mkpali mkpali, si otú a na-emepụta nzaghachi pro-inflammatory na mgbochi mkpali siri ike.

Platelets na-ahazikwa mmeghachi omume ngbanwe nke mkpụrụ ndụ B na nje nje nje.A maara nke ọma na CD40L na sel CD4 T na-arụ ọrụ ga-eme ka CD40 nke mkpụrụ ndụ B, na-enye mgbaàmà nke abụọ achọrọ maka ịgbalite lymphocyte B nke na-adabere na T-cell, ntụgharị allotype na-esote, na B cell iche na mmụba.N'ozuzu, nsonaazụ ya na-egosi n'ụzọ doro anya ọrụ dị iche iche nke platelet na mgbochi mgbanwe, na-egosi na platelet na-ejikọta mmekọrịta dị n'etiti mkpụrụ ndụ T na sel B site na CD40-CD40L, si otú a na-eme ka nzaghachi cell B na-adabere na T-cell.Na mgbakwunye, platelet bara ụba na ndị na-anabata ihe n'elu sel, nke nwere ike ịkwalite ịgbalite platelet ma wepụta ọnụ ọgụgụ dị ukwuu nke mkpali na mkpụrụ ndụ ndụ na-echekwa n'ime mkpụrụ ndụ platelet dị iche iche, si otú a na-emetụta mmeghachi omume mgbochi ebumpụta ụwa na nke na-agbanwe agbanwe.

Mgbasawanye ọrụ nke serotonin sitere na platelet na PRP

Serotonin (5-hydroxytryptamine, 5-HT) nwere ọrụ doro anya na usoro nhụjuanya nke etiti (CNS), gụnyere ntachi obi mgbu.A na-eme atụmatụ na ihe ka ọtụtụ n'ime mmadụ 5-HT na-emepụta na tract gastrointestinal na mgbe ahụ site na mgbasa ọbara, bụ ebe a na-etinye ya na platelet site na onye na-ebugharị serotonin reuptake na-echekwa ya n'ime ihe ndị dị arọ na nnukwu uche (65 mmol / L).5-HT bụ neurotransmitter ama ama nke na-enyere aka ịhazi usoro neuropsychological dị iche iche na CNS (etiti 5-HT).Otú ọ dị, ọtụtụ n'ime 5-HT dị na mpụga CNS (mgbe 5-HT), ọ na-etinyekwa aka n'ịhazi usoro na ọrụ ndụ ndụ nke ọtụtụ akụkụ ahụ, gụnyere ọrịa obi, ngụgụ, eriri afọ, urogenital na platelet.5-HT nwere metabolism na-adabere na ya na ụdị sel dị iche iche, gụnyere adipocytes, mkpụrụ ndụ epithelial na sel ọbara ọcha.Peripheral 5-HT bụkwa onye na-ahụ maka mgbochi ọrịa siri ike, nke nwere ike ịkpali ma ọ bụ gbochie mbufụt ma na-emetụta mkpụrụ ndụ na-alụso ọrịa ọgụ dị iche iche site na onye na-anabata ya 5-HT (5HTR).

Paracrine na usoro autocrine nke HT

Ọrụ nke 5-HT na-arụ ọrụ site na mmekọrịta ya na 5HTRs, nke bụ ezinụlọ karịrị nke nwere ndị otu asaa (5-HT 1-7) yana opekata mpe 14 ụdị nnabata dị iche iche, gụnyere onye 5-HT 7 nke achọpụtara nso nso a, akụkụ ya na arụ ọrụ na njikwa mgbu.N'ime usoro nke mbibi platelet, platelet na-arụ ọrụ na-ezobe ọnụ ọgụgụ dị ukwuu nke platelet sitere na 5-HT, nke nwere ike ịkwalite mkpụkọ vaskụla ma kpalite ịgbalite platelet na lymphocytes n'akụkụ site na ngosipụta nke 5-HTR na sel endothelial, sel anụ ahụ dị nro. sel ndị na-alụso ọrịa ọgụ.Pacala et al.A mụrụ mmetụta mitotic nke 5-HT na sel endothelial vaskụla, na ikike nke ịkwalite uto nke arịa ọbara mebiri emebi site na-akpali akpali angiogenesis kpebiri.Otu esi ahazi usoro ndị a abụghị nke doro anya, mana ọ nwere ike ịgụnye ụzọ mgbaàmà ụzọ abụọ dị iche iche na microcircuit anụ ahụ iji dozie ọrụ nke mkpụrụ ndụ endothelial vaskụla na mkpụrụ ndụ anụ ahụ dị nro, fibroblasts na sel ndị na-adịghị ahụkebe site na ndị na-anabata 5-HT kpọmkwem na sel ndị a. .Ọrụ autocrine nke platelet 5-HT ka akọwara platelet ịgbalite [REF].Ntọhapụ nke 5-HT na-akwalite nkwalite platelet na iwere ndị na-ekesa platelet, na-eduga na ịgbalite mmeghachi omume cascade nke mgbaàmà na ndị na-eme elu na-akwado mmeghachi omume platelet.

Mmetụta immunomodulatory 5-HT

Ihe akaebe na-aga n'ihu na-egosi na serotonin nwere ike ịrụ ọrụ na 5HTR dị iche iche dị ka modulator na-alụso ọrịa ọgụ.Dịka 5HTR siri kwuo n'ụdị leukocytes dị iche iche na-etinye aka na mmeghachi omume mkpali, 5-HT sitere na platelet na-arụ ọrụ dị ka onye na-achịkwa ihe mgbochi na ma usoro mgbochi na-agbanwe agbanwe.5-HT nwere ike ịkwalite mmụba Treg ma mezie ọrụ nke mkpụrụ ndụ B, mkpụrụ ndụ na-egbu egbu na neutrophils site n'iweta DC na monocytes na saịtị mkpali.Nnyocha e mere n'oge na-adịbeghị anya egosiwo na 5-HT sitere na platelet nwere ike ịhazi ọrụ nke mkpụrụ ndụ na-alụso ọrịa ọgụ n'okpuru ọnọdụ ụfọdụ.Ya mere, n'iji C-PRP, nchịkọta platelet dị elu karịa 1 × 10 6/µ L nwere ike inye aka bufee ntinye nke 5-HT sitere na nnukwu platelet na anụ ahụ.N'ime microenvironment nke ihe ndị na-egbuke egbuke ji mara, PRP nwere ike imekọrịta ihe na ọtụtụ mkpụrụ ndụ na-alụso ọrịa ọgụ na-arụ ọrụ dị mkpa na pathologies ndị a, nke nwere ike imetụta nsonaazụ ụlọ ọgwụ.

Ọgụgụ na-egosipụta nzaghachi 5-HT multifaceted mgbe agbalitechara platelet PRP mkpali.Mgbe arụ ọrụ platelet gasịrị, platelet na-ahapụ granules ha, gụnyere 5-HT na nnukwu granules, nke nwere mmetụta dị iche iche dị iche iche na sel ndị na-alụso ọrịa ọgụ, sel endothelial na sel anụ ahụ dị nro.Mkpebi: SMC: mkpụrụ ndụ anụ ahụ dị nro, EC: sel endothelial, Treg: T lymphocytes nkịtị, M Φ: Macrophages, DC: mkpụrụ ndụ dendritic, IL: interleukin, IFN-γ: Interferonna Hull et al.

Mmetụta analgesic nke PRP

platelets na-arụ ọrụ ga-ahapụ ọtụtụ ndị mgbasa ozi pro-inflammatory na mgbochi mkpali, nke nwere ike ọ bụghị nanị na-akpata mgbu, kamakwa belata mbufụt na mgbu.Ozugbo etinyere ya, ihe na-ahụkarị platelet dynamics nke PRP na-agbanwe microenvironment tupu arụzi anụ ahụ na ịmaliteghachi site n'ụzọ dịgasị iche iche dị mgbagwoju anya metụtara anabolism na catabolism, mmụba cell, ọdịiche na nhazi cell cell.Njirimara ndị a nke PRP na-eduga na ntinye nke PRP na ọnọdụ ahụike dị iche iche na-ejikọta ya na mgbu na-adịghị ala ala (dị ka mmerụ egwuregwu, ọrịa ọkpụkpụ, ọrịa ọkpụkpụ na mgbagwoju anya ọnya na-adịghị ala ala), ọ bụ ezie na a chọpụtabeghị kpọmkwem usoro ahụ.

Na 2008, Evertz et al.Ọ bụ nke mbụ a na-achịkwa nke a na-achịkwa iji kọọ mmetụta analgesic nke nkwadebe PRP, nke a kwadebere site na oyi akwa aja aja nke autologous erythrocyte sedimentation ọnụego ma rụọ ọrụ na autologous thrombin mgbe ịwa ahụ ubu.Ha kwuru na mbelata dị ukwuu n'ọ̀tụ̀tụ̀ ọ̀tụ̀tụ̀ analogue a na-ahụ anya, ojiji nke ọgwụ analgesics dabeere na opioid, na nrụzigharị gachara nke ọma karị.Ọ bụ ihe kwesịrị ịrịba ama na ha na-egosipụta mmetụta analgesic nke platelet na-arụ ọrụ ma na-akọwapụta usoro platelet na-ahapụ 5-HT.Na nkenke, platelet na-ehi ụra na PRP a kwadebere ọhụrụ.Mgbe agbalitechara platelet ozugbo ma ọ bụ na-apụtaghị ìhè (ihe na-akpata anụ ahụ), platelet na-agbanwe ọdịdị ma mepụta ụgha nke ọma iji kwalite nchịkọta platelet.Mgbe ahụ, ha na-ahapụ intracellular α- na oke ahụ.PGF, cytokines na lysosomes platelet ndị ọzọ ga-awakpo anụ ahụ e ji PRP rụọ ọrụ.Kpọmkwem, mgbe oke oke na-ahapụ ọdịnaya ha, ha ga-ahapụ nnukwu 5-HT nke na-achịkwa mgbu.Na C-PRP, mkpokọta platelet dị okpukpu 5 ruo 7 karịa nke dị n'ọbara dị n'akụkụ.Ya mere, ntọhapụ nke 5-HT sitere na platelet bụ ihe gbasara mbara igwe.N'ụzọ na-akpali mmasị, Sprott et al.Akụkọ ahụ kwuru na a na-ebelata ihe mgbu nke ukwuu mgbe acupuncture na moxibustion gasịrị, ntinye nke platelet ewepụtara 5-HT belatara nke ukwuu, mgbe ahụ, ọkwa plasma nke 5-HT mụbara.

Na mpụta, platelet, mkpụrụ ndụ mast na sel endothelial ga-ahapụ 5-HT endogenous n'oge mmerụ anụ ahụ ma ọ bụ trauma ịwa ahụ.N'ụzọ na-akpali mmasị, a chọtara ụdị 5-HT dị iche iche nke neurons na mpaghara mpaghara, nke kwadoro na 5-HT nwere ike igbochi nnyefe nociceptive na mpaghara mpaghara.Ọmụmụ ihe ndị a na-egosi na 5-HT nwere ike imetụta nnyefe nociceptive nke anụ ahụ dị n'akụkụ site na 5-HT1, 5-HT2, 5-HT3, 5-HT4 na 5-HT7.

Usoro 5-HT na-anọchite anya usoro dị ike nke nwere ike ibelata na ịbawanye ogo mgbu mgbe mkpali na-emerụ ahụ gasịrị.A kọwapụtara ụkpụrụ nke etiti na mpaghara nke akara nociceptive na mgbanwe na usoro 5-HT na ndị ọrịa nwere mgbu na-adịghị ala ala.N'ime afọ ndị na-adịbeghị anya, ọnụ ọgụgụ dị ukwuu nke ọmụmụ elekwasịwo anya na ọrụ 5-HT na ndị na-anabata ya na nhazi na ịhazi ozi ndị na-emerụ ahụ, na-ebute ọgwụ ndị dị ka ndị na-emechi ihe nchịkwa nke serotonin (SSRI).Ọgwụ a na-egbochi iweghachi nke serotonin n'ime neurons presynaptic mgbe ahapụchara serotonin.Ọ na-emetụta ogologo oge na ike nke nkwurịta okwu serotonin ma bụrụ ọgwụgwọ ọzọ maka mgbu na-adịghị ala ala.Achọkwuru nyocha ụlọ ọgwụ iji ghọta nke ọma usoro mkpụrụ ndụ nke PRP-enwetara 5-HT iwu mgbu na ọrịa na-adịghị ala ala na nke na-emebi emebi.

Enwere ike nweta data ndị ọzọ iji dozie mmetụta analgesic nke PRP nwere ike nweta mgbe nyochachara ụdị anụmanụ analgesic.Nkwubi okwu ngụkọ atụnyere na ụdị ndị a bụ ihe ịma aka n'ihi na ọmụmụ ihe ndị a nwere ọtụtụ mgbanwe.Ka o sina dị, ụfọdụ ọmụmụ ụlọ ọgwụ ekwupụtawo mmetụta nociceptive na analgesic nke PRP.Ọtụtụ nnyocha egosiwo na ndị ọrịa na-anata ọgwụgwọ maka tendinosis ma ọ bụ rotator cuff anya mmiri nwere obere ihe mgbu.N'ụzọ dị iche, ọtụtụ nchọpụta ndị ọzọ egosila na PRP nwere ike ibelata ma ọ bụ ọbụna wepụ ihe mgbu nke ndị ọrịa na-arịa ọrịa ọkpụkpụ azụ, OA, plantar fasciitis na ọrịa ụkwụ na nkwonkwo ụkwụ ndị ọzọ.Achọpụtala mkpokọta platelet ikpeazụ na ihe mejupụtara mkpụrụ ndụ ndụ dị ka njirimara PRP bụ isi, nke na-enyere aka ịhụ mmetụta analgesic na-agbanwe agbanwe mgbe etinyere PRP.Ngbanwe ndị ọzọ gụnyere usoro nnyefe PRP, teknụzụ ngwa, ụkpụrụ ịgbalite platelet, ọkwa ọrụ ndụ nke PGF na cytokines ewepụtara, ụdị anụ ahụ nke ngwa PRP na ụdị mmerụ ahụ.

Ọ bụ ihe kwesịrị ịrịba ama na Kuffler doziri ikike nke PRP iji belata ihe mgbu na ndị ọrịa nwere obere mgbu na-adịghị ala ala na-adịghị ala ala, nke abụọ na nhụjuanya na-adịghị emegharị ahụ.Ebumnuche nke ọmụmụ a bụ iji nyochaa ma enwere ike ibelata mgbu neuropathic ma ọ bụ belata n'ihi PRP na-akwalite mmeghari axonal na lekwasịrị anya azụghachi akwara.N'ụzọ dị ịtụnanya, n'etiti ndị ọrịa na-anata ọgwụgwọ, a ka na-ewepụ ma ọ bụ na-ebelata ihe mgbu neuropathic ma ọ dịkarịa ala afọ isii mgbe ịwachara ahụ.Tụkwasị na nke ahụ, ndị ọrịa niile malitere iwepụ ihe mgbu n'ime izu atọ mgbe ngwa PRP gasịrị.

N'oge na-adịbeghị anya, a hụwo mmetụta PRP analgesic yiri nke ahụ n'ọhịa nke ọnya na-ahụ maka ọnya na nlekọta anụ ahụ.N'ụzọ na-akpali mmasị, ndị na-ede akwụkwọ kọrọ akụkụ physiological nke ọnya ọnya metụtara mmerụ ahụ na anụ ahụ hypoxia.Ha tụlekwara mkpa ọ dị angiogenesis n'ịkwalite ikuku oxygen na nnyefe nri.Ọmụmụ ihe ha gosiri na e jiri ya tụnyere ndị na-ahụ maka njikwa, ndị ọrịa na-anata ọgwụgwọ PRP nwere obere ihe mgbu na ụbara angiogenesis.N'ikpeazụ, Johal na ndị ọrụ ibe ya mere nyocha nhazi usoro na meta-analysis wee kwubie na PRP nwere ike ibelata ihe mgbu mgbe ị na-eji PRP na-egosi orthopedic, karịsịa na ndị ọrịa na-enweta ọgwụgwọ epicondylitis mpụga na ikpere OA.N'ụzọ dị mwute, ọmụmụ ihe a akọwapụtaghị mmetụta nke mkpụrụ ndụ ọbara ọcha, mkpokọta platelet ma ọ bụ iji ndị na-arụ ọrụ platelet exogenous, n'ihi na mgbanwe ndị a ga-emetụta ọrụ PRP n'ozuzu ya.Ọnụ ọgụgụ platelet PRP kacha mma maka oke mgbu mgbu amabeghị.N'ụdị oke nke tendinosis, mkpokọta platelet dị 1.0 × 10 6 / μ Na L, enwere ike ịbelata mgbu ahụ kpamkpam, ebe ihe mgbu nke PRP kpatara na ọkara nke mkpokọta platelet na-ebelata nke ukwuu.Ya mere, anyị na-agba ume ka ọmụmụ ihe ndị ọzọ na-agwọ ọrịa nyochaa mmetụta analgesic nke dị iche iche PRP nkwadebe.

PRP na mmetụta angiogenesis

Nkwadebe C-PRP na ọgwụ nrụgharị ziri ezi na-enye ohere ịnye biomolecules nke ewepụtara site na nnukwu mkpokọta platelet na-arụ ọrụ na saịtị anụ ahụ ezubere iche.Ya mere, a malitela mmeghachi omume dị iche iche nke cascade, nke na-enye aka na nhazi usoro mgbochi na saịtị, usoro mkpali na angiogenesis iji kwalite ọgwụgwọ na nrụzi anụ ahụ.

Angiogenesis bụ usoro nzọụkwụ dị iche iche na-agbanwe agbanwe gụnyere germination na microvessels anụ ahụ sitere na arịa ọbara ndị dịbu adị.Angiogenesis na-aga n'ihu n'ihi usoro dị iche iche nke usoro ndu, gụnyere mbugharị cell endothelial, mmụba, ọdịiche na nkewa.Usoro cellular ndị a bụ ihe achọrọ maka ịmepụta arịa ọbara ọhụrụ.Ha dị mkpa maka uto nke arịa ọbara ndị dịbu adị iji weghachi ọbara na-erugharị ma kwado ọrụ metabolic dị elu nke nrụzi anụ ahụ na ịmaliteghachi anụ ahụ.Ọkpụkpụ ọbara ọhụrụ a na-enye ohere ịnye oxygen na nri nri, na mwepụ nke ngwaahịa sitere na anụ ahụ a na-agwọ.

A na-ahazi ọrụ angiogenesis site na ihe na-akpali akpali nke angiogenic VEGF na ihe mgbochi angiogenic (dịka, angiostatin na thrombospondin-1 [TSP-1]).N'ime microenvironment na-arịa ọrịa na nke mebiri emebi (gụnyere obere ikuku oxygen, obere pH na ọkwa lactic acid dị elu), ihe ndị na-eme ihe na-eme ka mpaghara mpaghara ga-eweghachi ọrụ angiogenesis.

Ọtụtụ mgbasa ozi soluble platelet, dị ka FGF bụ isi na TGF-β na VEGF nwere ike kpalie mkpụrụ ndụ endothelial imepụta arịa ọbara ọhụrụ.Landsdown na Fortier kọrọ nsonaazụ dị iche iche metụtara nhazi PRP, gụnyere isi mmalite intraplatelet nke ọtụtụ ndị na-achịkwa angiogenic.Tụkwasị na nke ahụ, ha kwubiri na mmụba nke angiogenesis na-enye aka na ọgwụgwọ nke ọrịa MSK na mpaghara ndị na-adịghị mma na-adịghị mma, dị ka anya mmiri meniscus, mmerụ ahụ akwara na mpaghara ndị ọzọ na-adịghị mma.

Na-akwalite na mgbochi angiogenic platelet Njirimara

N'ime iri afọ ole na ole gara aga, nchọpụta ndị e bipụtara egosila na platelet na-ekere òkè dị mkpa na hemostasis bụ isi, nhazi nke clot, ihe na-eto eto na ntọhapụ cytokine, na ụkpụrụ angiogenesis dịka akụkụ nke usoro nhazi anụ ahụ.N'ụzọ doro anya, PRP α- The granules nwere ngwa agha nke ihe uto pro-angiogenic, protein anti-angiogenic na cytokines (dị ka PF4, plasminogen activator inhibitor-1 na TSP-1), ma lekwasịrị anya ntọhapụ nke ihe ụfọdụ na-arụ ọrụ. .Ọrụ na angiogenesis.Ya mere, ọrụ PRP n'ịchịkwa ụkpụrụ angiogenesis nwere ike ịkọwa site n'ịkwalite ndị na-anabata ihe ntanetị kpọmkwem, TGF- β Initiate pro-angiogenic na mgbochi angiogenic mmeghachi omume.Ekwuputala ikike nke platelet iji megharịa ụzọ angiogenesis na angiogenesis pathological na tumor angiogenesis.

Ihe na-eto eto angiogenic nke sitere na Platelet na ihe na-eto eto nke na-egbochi angiogenic, nke sitere na α- Na ụmụ irighiri ihe na nrapado.Nke kachasị mkpa, a na-anabatakarị na mmetụta zuru oke nke platelet na angiogenesis bụ pro-angiogenic na-akpali akpali.A na-atụ anya na ọgwụgwọ PRP ga-achịkwa ntinye nke angiogenesis, nke ga-enye aka na mmetụta ọgwụgwọ nke ọtụtụ ọrịa, dị ka ọgwụgwọ ọnya na nrụzi anụ ahụ.Nlekọta nke PRP, karịsịa nchịkwa nke PGF dị elu na cytokines platelet ndị ọzọ, nwere ike ịkpata angiogenesis, angiogenesis na arteriogenesis, n'ihi na 1a na-enweta stromal cell na-ejikọta na CXCR4 onye na-anabata ya na sel progenitor endothelial.Bill et al.A na-atụ aro na PRP na-abawanye neovascularization ischemic, nke nwere ike ịbụ n'ihi mkpali nke angiogenesis, angiogenesis na arteriogenesis.N'ime ụdị in vitro ha, mmụba cell endothelial na nhazi nke capillary sitere na ọnụ ọgụgụ dị ukwuu nke PDG dị iche iche, nke VEGF bụ isi ihe na-akpali akpali.Ihe ọzọ dị mkpa ma dị mkpa maka iweghachi ụzọ angiogenesis bụ mmekọrịta dị n'etiti ọtụtụ PGF.Richardson et al.E gosipụtara na ọrụ synergistic nke angiogenic factor platelet-derived growth factor-bb (PDGF-BB) na VEGF mere ka ọ bụrụ ngwa ngwa nke netwọk vaskụla tozuru okè ma e jiri ya tụnyere ọrụ nke onye na-eto eto.Ejikọtara mmetụta nke ihe ndị a n'oge na-adịbeghị anya n'ọmụmụ ihe gbasara nkwalite mgbasa ozi cerebral na ụmụ oke nwere hypoperfusion ogologo oge.

Nke kachasị mkpa, nyocha in vitro tụlere mmetụta ịba ụba nke mkpụrụ ndụ endothelial vein nke mmadụ na mkpokọta platelet dị iche iche na nhọrọ nke ngwaọrụ nkwadebe PRP na atụmatụ dose platelet, nsonaazụ ya gosiri na ọgwụ kachasị mma bụ 1.5 × 10 6 platelet / μ. 50. Iji kwalite angiogenesis.Ọnụnọ nke platelet dị elu nwere ike igbochi usoro angiogenesis, ya mere mmetụta ya adịghị mma.

Cell ịka nká, ịka nká na PRP

Enwere ike ịkpalite senescence cell site na mkpali dị iche iche.Nke a bụ usoro nke mkpụrụ ndụ na-akwụsị ikewa ma na-enwe mgbanwe phenotypic pụrụ iche iji gbochie uto na-enweghị njedebe nke mkpụrụ ndụ mebiri emebi, nke na-arụ ọrụ dị mkpa na mgbochi ọrịa cancer.N'ime usoro ịka nká nke physiological, ịka nká nke mkpụrụ ndụ ga-akwalite ịka nká cell, na ike ịmaliteghachi nke MSC ga-ebelata.

Mmetụta nke ịka nká na cell ịka nká

Na vivo, ọtụtụ ụdị cell ga-aka nká ma na-agbakọta n'ime anụ ahụ dị iche iche n'oge ịka nká, n'ime nke a nwere ọnụ ọgụgụ buru ibu nke mkpụrụ ndụ ịka nká.Mkpokọta mkpụrụ ndụ ịka nká yiri ka ọ na-abawanye site na mmụba nke afọ, mmebi usoro ahụ ji alụso ọrịa ọgụ, mmebi anụ ahụ ma ọ bụ ihe ndị metụtara nchekasị.Achọpụtala usoro ịka nká cellular dị ka ihe na-akpata ọrịa ndị metụtara afọ, dị ka ọrịa ogbu na nkwonkwo, ọkpụkpụ ọkpụkpụ na nkwụsị nke intervertebral disc degeneration.Ụdị ihe mkpali dị iche iche ga-eme ka ịka nká cell dịkwuo njọ.Na nzaghachi, phenotype secretory metụtara senescence (SASP) ga-ezobe nnukwu mkpụrụ ndụ protein na cytokines.Ụdị phenotype a pụrụ iche metụtara mkpụrụ ndụ ịka nká, nke ha na-ezobe ọkwa dị elu nke cytokines na-egbuke egbuke (dị ka IL-1, IL-6, IL-8), ihe ndị na-eto eto (dị ka TGF- β, HGF, VEGF, PDGF), MMP, na cathepsin.E jiri ya tụnyere ndị na-eto eto, SAPS egosila na ọ na-abawanye na afọ, n'ihi na a na-ebibi usoro nke na-eguzosi ike n'ihe, na-akpata ịka nká cell na ibelata ikike ịmaliteghachi.Kpọmkwem, na nkwonkwo ọrịa na skeletal muscle ọrịa.N'akụkụ a, a na-ewere ịka nká nke na-alụso ọrịa ọgụ dị ka mgbanwe dị ịrịba ama na ụdịdị nzuzo nzuzo nke mkpụrụ ndụ na-alụso ọrịa ọgụ, na-egosi na ntinye nke TNF-a, IL-6 na / ma ọ bụ Il-1b na-abawanye, na-eduga na mbufụt na-adịghị ala ala.Okwesiri iburu n'uche na dysfunction cell cell na-ejikọta ya na usoro ndị na-abụghị nke cell, dị ka sel ịka nká, karịsịa mmepụta nke pro-inflammatory na ihe na-emeghachi omume site na SASP.

N'ụzọ megidere nke ahụ, SASP nwekwara ike kpalite plasticity cell na reprogramming nke sel ndị dị n'akụkụ.Na mgbakwunye, SASP nwere ike ịhazi nkwurịta okwu na ndị mgbasa ozi dị iche iche na-alụso ọrịa ọgụ ma mee ka mkpụrụ ndụ na-alụso ọrịa ọgụ na-akwalite mkpochapụ nke sel ịka nká.Ịghọta ọrụ na ọrụ nke mkpụrụ ndụ ịka nká ga-enye aka na ọgwụgwọ na imegharị anụ ahụ nke akwara MSK na ọnya na-adịghị ala ala.

Ọ bụ ihe kwesịrị ịrịba ama na Ritcka et al.Emere nyocha buru ibu, na ọrụ SASP bụ isi na uru bara uru n'ịkwalite plasticity cell na nrụgharị anụ ahụ ka achọpụtara, ewebatakwa echiche nke nnyefe ọgwụgwọ na-agafe agafe nke mkpụrụ ndụ ịka nká.Ha ji nlezianya kwuo na ịka nká na-abụkarị usoro bara uru ma na-emeghachi omume.

Cell ịka nká na ikike nke PRP

Ka ọnụ ọgụgụ nke mkpụrụ ndụ stem na-ebelata, ịka nká ga-emetụta arụmọrụ nke mkpụrụ ndụ stem.N'otu aka ahụ, n'ime mmadụ, njirimara sel stem (dịka nkụ, mmụba na ọdịiche) na-ebelatakwa ka afọ.Wang na Nirmala kọrọ na ịka nká ga-ebelata njirimara mkpụrụ ndụ akwara akwara na ọnụ ọgụgụ ndị na-anabata ihe na-eto eto.Nnyocha anụmanụ gosiri na ntinye nke PDGF na ịnyịnya na-eto eto dị elu.Ha kwubiri na mmụba nke ọnụ ọgụgụ ndị na-anabata GF na ọnụ ọgụgụ nke GF na-eto eto nwere ike ịnweta nzaghachi cellular ka mma na ọgwụgwọ PRP karịa ndị okenye na ndị na-eto eto.Nchọpụta ndị a na-ekpughe ihe kpatara ọgwụgwọ PRP nwere ike isi ghara ịdị irè ma ọ bụ ọbụna na-adịghị arụ ọrụ na ndị ọrịa agadi nwere obere sel stem na "adịghị mma".E gosipụtara na usoro ịka nká nke cartilage ịka nká na-atụgharị na oge ezumike nke chondrocytes na-abawanye mgbe ịgbanye PRP.Jia et al.A na-eji ya amụ fibroblast dermal fibroblasts in vitro photoaging, yana na enweghị ọgwụgwọ PRP, iji dokwuo anya usoro nke PGF counteraction na ihe nlereanya a.Otu PRP gosipụtara mmetụta kpọmkwem na matrix extracellular, mmụba ụdị m collagen na mbelata njikọ nke metalloproteinases, na-egosi na PRP nwere ike igbochi ịka nká cell, yana ọrịa MSK na-emebi emebi.

N'ọmụmụ ihe ọzọ, a na-eji PRP chịkọta mkpụrụ ndụ ụmị ọkpụkpụ ochie site na ụmụ oke ndị merela agadi.E kpebisiri ike na PRP nwere ike nwetaghachi ọrụ dị iche iche nke sel sel site na ịka nká, dị ka mmụba cell na nhazi colony, ma wughachi akara ndị metụtara ịka nká cell.

N'oge na-adịbeghị anya, Oberlohr na ndị ọrụ ibe ya nyochachara ọrụ nke ịka nká cell na-eme ka ahụ ike na-esiwanye ike, ma nyochaa PRP na platelet-poor plasma (PPP) dịka nhọrọ ọgwụgwọ ndu maka nrụzi ọkpụkpụ ọkpụkpụ.Ha chere na ọgwụgwọ PRP ma ọ bụ PPP maka nrụzi akwara skeletal ga-adabere na ihe ndị dị ndụ ahaziri maka akara mkpụrụ ndụ SASP kpọmkwem na ihe ndị ọzọ na-eduga na mmepe fibrosis.

Ọ bụ ihe ezi uche dị na ya ikwere na tupu ntinye nke PRP, ịka nká cell ezubere iche nwere ike imeziwanye njirimara mmeghari nke ịdị irè ọgwụgwọ ndu site na ibelata ihe SASP mpaghara.A na-atụ aro na nhọrọ ọzọ iji meziwanye nsonaazụ PRP na ọgwụgwọ PPP maka ịmaliteghachi anụ ahụ skeletal bụ ịhọrọ iji wepụ mkpụrụ ndụ ịka nká na ndị na-eme agadi.Obi abụọ adịghị ya na nchọpụta nyocha na nso nso a banyere mmetụta PRP na ịka nká cell na ịka nká na-adọrọ mmasị, ma ha ka nọ na mmalite mbụ.Ya mere, ọ bụghị ezi uche na-atụ aro ọ bụla n'oge a.

(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.)