Pfungwa inozivikanwa nhasi sePRP yakatanga kuonekwa mumunda wehematology muma1970.Hematologists vakagadzira izwi rekuti PRP makumi emakore apfuura mukuyedza kutsanangura plasma yakawanikwa kubva kune maplatelet kuverenga pamusoro peiyo basal kukosha muropa remukati.Anopfuura makore gumi gare gare, PRP yakashandiswa mukuvhiya maxillofacial sechimiro cheplatelet-rich fibrin (PRF).Iyo fibrin yemukati mune ino PRP inotorwa ndeyekukosha kukuru kune yayo adhesive uye homeostatic properties, nepo PRP ine inopfuurira anti-inflammatory properties uye inokurudzira kupararira kwesero.Pakupedzisira, kumativi e1990s, PRP yakave yakakurumbira, uye pakupedzisira, teknolojia yakaendeswa kune dzimwe nzvimbo dzokurapa.Kubva ipapo, iyi biology yakanaka yakadzidzwa zvakanyanya uye yakashandiswa kurapa kwakasiyana-siyana musculoskeletal kukuvara kwevatambi vehunyanzvi, zvichienderera mberi nekupa kutarisisa kwayo kwenhau.Mukuwedzera pakubudirira mune zvemapfupa uye mishonga yemitambo, PRP inoshandiswa mune ophthalmology, gynecology, urology uye cardiology, pediatrics uye kuvhiyiwa kwepurasitiki.Mumakore achangopfuura, PRP yakarumbidzwawo nedermatologists nokuda kwekugona kwayo kurapa maronda eganda, kudzokorora kwevanga, kuvandudzwa kwetishu, kuvandudzwa kweganda uye kunyange kurasikirwa kwebvudzi.
Tichifunga nezve chokwadi chekuti PRP inozivikanwa kuti ishandise zvakananga kuporesa uye maitiro ekuzvimba, iyo yekurapa cascade inofanirwa kuunzwa sereferensi.Kupora kunokamurwa kuita matanho mana anotevera: hemostasis;kuzvimba;cellular uye matrix kuwanda, uye pakupedzisira kugadzirisa maronda.
1. Tissue Healing
A tissue-healing cascade inoshandiswa, nzira inotungamirira ku platelet aggregation, clot kuumbwa, uye kukura kwechinguva chiduku che extracellular matrix (ECM. Platelets inobva yaomerera kune yakafumurwa collagen uye ECM mapuroteni, zvichikonzera kuvapo kwe α-granules muKusunungurwa kwe Ma<em>Bioactive Molecules.Ma<em>platelets ane ma<em>bioactive molecules akasiyana siyana, anosanganisira kukura kwezvinhu, chemokines, uye ma<em>cytokines, pamwe chete neanopa-inflammatory mediators akaita se prostaglandin, prostatic cyclin, histamine, thromboxane, serotonin, uye bradykinin.
Nhanho yekupedzisira yekupora kunoenderana nekugadziriswa kweronda.Kugadziriswa kwetissue kunodzorwa zvakasimba kuti pave nekuenzanisa pakati pevanabolic uye catabolic mhinduro.Munguva iyi, platelet-derived growth factor (PDGF), kushandura kukura kwechikonzero (TGF-β) uye fibronectin inokurudzira kuwedzera uye kutama kwe fibroblasts, pamwe chete nekugadzirwa kwezvikamu zveECM.Nekudaro, nguva yekukura kwemaronda inotsamira pakuoma kweronda, hunhu hwemunhu, uye chaiyo kuporesa kugona kwenyama yakakuvara, uye zvimwe pathophysiological uye metabolic zvinhu zvinogona kukanganisa maitiro ekuporesa, senge tishu ischemia, hypoxia, hutachiona. , Kukura kwezvinhu kusaenzana, uye kunyange metabolic syndrome-inoenderana nezvirwere.
A pro-inflammatory microenvironment iyo inokanganisa maitiro ekuporesa.Kuomesa zvinhu, kune zvakare yakakwira protease chiitiko chinodzivirira chiitiko chechisikigo chekukura factor (GF).Pamusoro pekuve nemitogenic, angiogenic, uye chemotactic zvivakwa, PRP zvakare inopfuma sosi yezvakawanda zvinokura zvinhu, biomolecules inogona kurwisa zvinokonzeresa zvinokonzeresa mumatishu akaputika nekudzora kuwedzeredza kuzvimba uye kumisikidza anabolic stimuli.Zvichipa zvinhu izvi, Vatsvakurudzi vanogona kuwana mikana yakakura mukurapa kwakasiyana-siyana kwekukuvara kwakaoma.
2. Cytokine
MaCytokines muPRP anoita mabasa akakosha mukugadzirisa matishu ekugadzirisa maitiro uye kugadzirisa kukuvara kwekuzvimba.Anti-inflammatory cytokines ihupamhi hwakasiyana-siyana hwebiochemical molecules inopindira pro-inflammatory cytokine mhinduro, inonyanya kukonzerwa nemacrophages akagadzirwa.Anti-inflammatory cytokines inopindirana neiyo cytokine inhibitors uye soluble cytokine receptors kugadzirisa kuzvimba.Interleukin (IL) -1 receptor antagonists, IL-4, IL-10, IL-11 uye IL-13 inorondedzerwa seyo ma-cytokines makuru anopesana nekuputika.Zvichienderana nerudzi rwevanga, mamwe ma cytokines, akadai se interferon, leukemia inhibitory factor, TGF-β uye IL-6, inogona kuratidza pro- kana anti-inflammatory effects.TNF-α, IL1 uye IL-18 vane mamwe ma-cytokine receptors anogona kudzivisa pro-inflammatory migumisiro yemamwe mapuroteni [37].IL-10 ndeimwe yeakanyanya simba anopesana nekuputika cytokines, inogona pasi-kugadzirisa pro-inflammatory cytokines yakadai seIL-1, IL-6 uye TNF-α, uye up-regulate anti-inflammatory cytokines.Aya ma-counter-regulatory maitiro anoita mabasa akakosha mukugadzira uye basa repro-inflammatory cytokines.Pamusoro pezvo, mamwe ma cytokines anogona kukonzeresa mhinduro dzakanangana dzinokurudzira fibroblasts, iyo yakakosha pakugadzirisa matishu.Iyo inoputika cytokines TGFβ1, IL-1β, IL-6, IL-13, uye IL-33 inokurudzira fibroblasts kuti iparadzanise mumyofibroblasts uye inovandudza ECM [38].Uyezve, fibroblasts inobudisa cytokines TGF-β, IL-1β, IL-33, CXC, uye CC chemokines, iyo inokurudzira mhinduro dzepro-inflammatory nekuita uye kutora masero ekudzivirira zvirwere zvakadai semacrophages.Aya masero ekuputika ane mabasa akawanda panzvimbo yeronda, kunyanya nekusimudzira kuchenesa maronda - pamwe chete ne biosynthesis ye chemokines, metabolites uye kukura kwezvinhu, izvo zvinokosha pakugadzirisa mutsara mutsva.Nokudaro, ma cytokines aripo muPRP anoita basa rinokosha mukukurudzira masero emhando-mediated immune response, kutyaira kugadziriswa kwechikamu chekuputika.Kutaura zvazviri, vamwe vatsvakurudzi vakatumidza nzira iyi "regenerative kuzvimba," zvichiratidza kuti chikamu chekuzvimba, pasinei nekushungurudzika kwemurwere, inhanho inokosha inodiwa kuti nzira yekugadzirisa matishu isvike pakuguma kwakabudirira, zvichipiwa epigenetic nzira iyo zviratidzo zvinopisa zvinokurudzira masero. plasticity.
3. Fibrin
Maplatelet anotakura zvinhu zvakati wandei zvine chekuita nefibrinolytic system inogona kukwidza kana kudzikisira mhinduro yefibrinolytic.Hukama hwenguva pfupi uye mupiro wehukama wezvikamu zvehematological uye kushanda kweplatelet mukuora kwegwaro rinoramba riri nyaya yakakodzera kukurukurwa kwakadzama munharaunda.Zvinyorwa zvinopa zvidzidzo zvakawanda zvinongotarisa pamaplatelet, ayo anozivikanwa nekugona kwavo kukanganisa maitiro ekuporesa.Zvisinei nezvidzidzo zvakawanda zvakatanhamara, zvimwe zvikamu zvehematological, senge coagulation factor uye fibrinolytic system, zvakawanikwawo zvichipa zvakakosha kugadzirisa maronda.Netsanangudzo, fibrinolysis inzira yakaoma yebhayoloji inotsamira pakushandiswa kwemamwe ma enzymes kufambisa kuparara kwefibrin.Mhinduro yefibrinolytic yakataurwa nevamwe vanyori kuti zvigadzirwa zvefibrin degradation (fdp) zvinogona kunge zviri mamolecular agents ane basa rekukurudzira kugadziriswa kwetishu, kutevedzana kwezviitiko zvakakosha zvebhaibheri kusati kwaiswa fibrin uye kubviswa kubva kuangiogenesis, izvo zvinodiwa pakupora maronda.Kuumbwa kwevhavha mushure mekukuvara kunoshanda sechidziviriro chekudzivirira chinodzivirira mutsara kubva pakurasikirwa kweropa, kupindira nehutachiona hwehutachiona, uye inopawo matrix yenguva pfupi iyo masero anogona kutama panguva yekugadzirisa.Iro clot inokonzerwa nekutsemuka kwefibrinogen ne serine proteases uye maplatelet aggregate mu cross-linked fibrin fibrous network.Kuita uku kunotanga polymerization yefibrin monomers, chiitiko chikuru mukuumbwa kweropa.Mavharomu anogonawo kuita semadziva ema cytokines uye kukura zvinhu, izvo zvinoburitswa pa degranulation yemaplatelet akaitwa.Iyo fibrinolytic system inodzorwa zvakasimba neplasmin uye inoita basa rakakosha mukusimudzira kutama kwesero, kukura factor bioavailability, uye kudzora mamwe maprotease masisitimu anosanganisirwa mukuzvimba kwetishu uye kuberekwa patsva.Zvikamu zvakakosha mufibrinolysis, senge urokinase plasminogen activator receptor (uPAR) uye plasminogen activator inhibitor-1 (PAI-1) inozivikanwa kuti inoratidzwa mu mesenchymal stem masero (MSCs), rudzi rwesero yakakosha inodiwa kuti ibudirire maronda apore.
4. Cell Migration
Kuita kweplasminogen kuburikidza neUPA-uPAR kushamwaridzana inzira inokurudzira kuputika kwesero kutama sezvo ichiwedzera extracellular proteolysis.Sezvo uPAR ichishaya transmembrane uye intracellular domains, puroteni inoda ma-co-receptors akadai se integrins uye vitreins kudzora kufamba kwesero.Kupfuurirazve, kusungirirwa kweUPA-uPAR kwakakonzera kuwedzera kushamwaridzana kwePAR ye vitreous connexins uye integrins, kukurudzira kunamatira kwesero.Plasminogen activator inhibitor-1 (PAI-1) inobvisa masero, ichiparadza upar-vitrein uye integrin- apo inosunga kuUPA yeUPA-upar-integrin complex pane cell surface Kudyidzana kwemagirazi mavhokseli.
Muchirevo chemishonga yekudzorera, mesenchymal stem masero anounganidzwa kubva mumapfupa emapfupa mumamiriro ezvinhu ehutano hwakanyanya hwehutano uye nokudaro hunogona kuwanikwa mukutenderera kwevarwere vane kuputsika kwakawanda.Zvisinei, mune mamwe mamiriro ezvinhu, akadai sekuguma-danho renal kukundikana, kupera kwechiropa kusakundikana, kana panguva yekutanga kurambwa kunotevera kuchinjwa kwemwoyo, masero aya anogona kusaonekwa muropa [66].Sezvineiwo, aya mapfupa emunhu anotorwa mesenchymal (stromal) progenitor masero haagone kuonekwa muropa revanhu vane hutano [67].Basa rePAR mumwongo mesenchymal stem cell mobilization rakambotaurwa zvakare, zvakafanana nezvinoitika muhematopoietic stem cell (HSC) yekuunganidza.Varabaneni et al.Zvigumisiro zvakaratidza kuti kushandiswa kwegranulocyte colony-stimulating factor muPAR-inoshaya mbeva yakakonzera kukundikana kweMSCs, zvakare kusimbisa basa rinotsigira refibrinolytic system mukutama kwesero.Zvimwe zvidzidzo zvakaratidzawo kuti glycosylphosphatidylinositol-anchored uPA receptors inodzora kunamatira, kutama, kupararira, uye kusiyanisa nekuita dzimwe nzira dzechiratidzo chemukati, sezvinotevera: pro-survival phosphatidylinositol 4,5-bisphosphate 3-kinase nzira1/Akt 2 nzira uye ERK2. , uye adhesion kinase (FAK).
MSCs dzakaratidza kumwe kukosha mumamiriro ekupora maronda.Semuenzaniso, plasminogen-inoshaya mbeva yakaratidza kunonoka kwakanyanya muzviitiko zvekuporesa maronda, zvichiratidza kuti plasmin inobatanidzwa zvakanyanya mukuita uku.Muvanhu, kurasikirwa kweplasmin kunogonawo kukonzera matambudziko ekupora maronda.Kuvhiringidza kwekuyerera kweropa kunogona kurambidza zvakanyanya kuvandudzwa kwetishu, izvo zvinotsanangura kuti nei nzira idzi dzekudzorera dzichinyanya kuoma kune varwere vane chirwere cheshuga.
5. Monocytes uye Regeneration Systems
Maererano nemabhuku, kune hurukuro yakawanda pamusoro pebasa re monocytes mukuporesa maronda.Macrophages inonyanya kutorwa kubva muropa monocytes uye inoita basa rakakosha mukurapa regenerative [81].Sezvo neutrophils secrete IL-4, IL-1, IL-6 uye TNF-α, masero aya anowanzopinda panzvimbo yeronda anenge maawa 24-48 mushure mekukuvara.Platelets inoburitsa thrombin uye platelet factor 4 (PF4), maviri chemokines anokurudzira kutorwa kwemamonocytes uye kusiyanisa kwavo kuita macrophages uye dendritic masero.Chinhu chinokatyamadza chemacrophage ipurasitiki yavo, kureva, kugona kwavo kushandura phenotypes uye transdifferentiate mune mamwe marudzi esero senge endothelial masero, ayo anozoratidza mabasa akasiyana mukupindura kwakasiyana biochemical stimuli mune ronda microenvironment.Masero anoputika anoratidza maviri makuru phenotypes, M1 kana M2, zvichienderana nechiratidzo chemo molecule iyo ndiyo inobva pakukurudzira.M1 macrophages anokonzerwa ne microbial agents uye saka ane mamwe maitiro e-pro-inflammatory effects.Kusiyana neizvi, M2 macrophages anowanzo kugadzirwa nemhando yechipiri mhinduro uye ane anti-kuzvimba zvivakwa, izvo zvinowanzo zivikanwa nekuwedzera muIL-4, IL-5, IL-9, uye IL-13.Inobatanidzwawo mukugadzirisa matishu kuburikidza nekugadzirwa kwezvinhu zvinokura.Shanduko kubva kuM1 kuenda kuM2 isoforms inonyanya kufambiswa nematanho ekupedzisira ekupora maronda, uko M1 macrophages inokonzeresa neutrophil apoptosis uye inotanga kubviswa kwemasero aya).Phagocytosis neutrophils inomutsa mutsara wezviitiko umo kugadzirwa kwe cytokine kunodzimwa, polarizing macrophages uye kusunungura TGF-β1.Ichi chinhu chekukura ndicho chigadziriso chikuru chekusiyanisa kwemyofibroblast uye kuputika kweronda, zvichibvumira kugadziriswa kwekuputika uye kutanga kwechikamu chekuwedzera muhutano hwekuporesa [57].Imwe mapuroteni ane hukama zvakanyanya anobatanidzwa mumaserura maitiro ndeye serine (SG).Iyi hematopoietic cell-yakavanzika granulan yakawanikwa ichidikanwa kuchengetedza mapuroteni akavanzika mumasero ekudzivirira emuviri, senge mast cells, neutrophils, uye cytotoxic T lymphocytes.Nepo masero mazhinji asiri-hematopoietic anogadzirawo serotonin, maseru ese anopisa anoburitsa akawanda eprotein iyi uye anoichengeta mumagranules kuti awedzere kudyidzana nevamwe varevereri vanopisa, kusanganisira maproteases, cytokines, chemokines, uye kukura factor.Cheni dze glycosaminoglycan (GAG) dzakachajiswa zvisina kunaka muSG dzinoita sedzakakosha pakuvanzika granule homeostasis, sezvo dzichigona kusunga nekufambisa kuchengetwa kwezvikamu zvegranule zvakachajiswa musero-, protein-, uye GAG cheni-chaiyo nzira.Nezvekubatanidzwa kwavo muPRP, Woulfe nevamwe vaaishanda navo vakamboratidza kuti kushayikwa kweSG kunobatanidza zvakasimba nekuchinja kweplatelet morphology;kukanganisa muplatelet factor 4, beta-thromglobulin, uye PDGF kuchengetedza mumaplatelet;kukanganiswa kweplatelet aggregation uye secretion in vitro uye thrombosis in vivo maitiro akaremara.Saka vatsvakurudzi vakagumisa kuti iyi proteoglycan inoratidzika seyo inyanzvi yekugadzirisa thrombosis.
Zvigadzirwa zveplatelet-rich zvinogona kuwanikwa nekuunganidza uye kuisa mukati meropa remunhu wese, kupatsanura musanganiswa muzvikamu zvakasiyana zvine plasma, maplatelet, leukocytes, uye leukocytes.Kana kuwanda kweplatelet kwakakwira kupfuura basal values, kukura kwebhonzo uye nyoro kunogona kukwidziridzwa nekushomeka kwemhedzisiro.Iko kushandiswa kweautologous PRP zvigadzirwa ichangoburwa biotechnology inoramba ichiratidza zvinovimbisa mhedzisiro mukukurudzira uye nekuwedzera kuporeswa kweakasiyana matishu kukuvara.Kushanda kweiyi imwe nzira yekurapa inogona kuve yakakonzerwa nekuburitswa kwepamusoro kweakasiyana ekukura zvinhu uye mapuroteni, kutevedzera uye kutsigira physiological kuporesa ronda uye kugadzirisa matishu maitiro.Uyezve, iyo fibrinolytic system zvakajeka ine kukosha kwakakosha pakugadziriswa kwematishu.Pamusoro pekugona kwayo kushandura masero ekutsvagisa maseru ekuzvimba uye mesenchymal stem maseru, inogadzirisa basa reproteolytic munzvimbo dzekuporesa maronda uye panguva yekuvandudzwa kwemesodermal tishu zvinosanganisira bhonzo, cartilage uye tsandanyama, uye saka yakakosha musculoskeletal mushonga chikamu.
Kukurumidzira kuporeswa ivavariro inotsvakwa zvakanyanya nenyanzvi dzakawanda munharaunda yekurapa, uye PRP inomiririra yakanaka biological chishandiso chinoenderera mberi nekupa chinovimbisa budiriro mukukurudzira uye yakanyatso kurongeka tandem yezviitiko zvekuvandudza.Nekudaro, sezvo chishandiso ichi chekurapa chinoramba chakaoma, kunyanya sezvo ichiburitsa zviuru zvebioactive zvinhu uye maitiro avo akasiyana ekudyidzana uye kusaina mhedzisiro, zvimwe zvidzidzo zvinodikanwa.
(Zviri muchinyorwa ichi zvakadhindwa patsva, uye isu hatipe chero vimbiso yechokwadi, kuvimbika kana kuzara kwezviri muchinyorwa chino, uye hatina mhosva yemafungiro echinyorwa ichi, ndapota nzwisisa.)
Nguva yekutumira: Jul-19-2022