PRP yemazuva ano: "Clinical PRP"
Mumakore gumi apfuura, chirongwa chekurapa chePRP chakachinja zvikuru.Kuburikidza nekuyedza uye kutsvagisa kwekiriniki, isu tave nekunzwisisa kuri nani kweplatelet uye mamwe maseru physiology.Mukuwedzera, maitiro akawanda epamusoro-soro akarongeka, kuongororwa kwemeta uye miedzo yakarongeka yakaratidza kushanda kwePRP biotechnology mune zvakawanda zvekurapa, kusanganisira dermatology, kuvhiyiwa kwemwoyo, kuvhiyiwa kwepurasitiki, kuvhiyiwa kwemapfupa, kugadzirisa marwadzo, zvirwere zvemusana, uye mishonga yemitambo. .
Ikozvino hunhu hwePRP ndeye mhedziso yeplatelet concentration, iyo inoshanduka kubva kune yekutanga tsananguro yePRP (kusanganisira platelet concentration yakakwira kupfuura kukosha kwekutanga) kusvika kune inopfuura 1 × 10 6/µ L kana kanenge 5 nguva shoma yeplatelet concentration mumaplatelet kubva. baseline.Mukuongorora kwakadzama naFadadu et al.33 PRP masisitimu uye mapuroteni akaongororwa.Nhamba yeplatelet yegadziriro yekupedzisira yePRP inogadzirwa nemamwe emagetsi aya yakaderera pane yeropa rose.Vakataura kuti platelet factor yePRP yakawedzera yakaderera se 0.52 ine imwechete spin kit (Selphyl ®).Kusiyana neizvi, kaviri-kutenderera EmCyte Genesis PurePRPII ® Mushonga weplatelet inogadzirwa nemudziyo ndiyo yakakwirira (1.6 × 10 6 /µL) .
Zviripachena, in vitro uye nzira dzemhuka haisi iyo yakanaka yekutsvagisa nharaunda yekubudirira shanduko kuita yekiriniki maitiro.Saizvozvo, chidzidzo chekuenzanisa chemudziyo hachitsigire sarudzo, nekuti inoratidza kuti iyo platelet yekumisikidza pakati pePRP zvishandiso zvakasiyana kwazvo.Neraki, kuburikidza neproteomics yakavakirwa tekinoroji uye kuongororwa, tinogona kuwedzera kunzwisisa kwedu kwesero rinoshanda muPRP rinokanganisa mhedzisiro yekurapa.Usati wasvika kubvumirana pamusoro pezvirongwa zvePRP zvakagadziriswa uye zvigadziro, PRP inofanira kutevera kliniki PRP maumbirwo ekukurudzira maitiro makuru ekugadzirisa matishu uye migumisiro yekliniki inofambira mberi.
Clinical PRP formula
Parizvino, kiriniki inoshanda yePRP (C-PRP) yakave yakaonekwa seyakaoma kuumbwa kwe autologous multicellular components mudiki volume plasma yakawanikwa kubva kune chikamu cheropa remukati mushure me centrifugation.Mushure mekuita centrifugation, PRP uye iyo isiri-platelet cell components inogona kudzorerwa kubva kumudziyo wekugadzirisa maererano nemhando dzakasiyana dzemasero (iyo iyo platelet density ndiyo yakaderera).
Shandisa PurePRP-SP ® Cell density separation equipment (EmCyte Corporation, Fort Myers, FL, USA) yakashandiswa kweropa rose mushure memaitiro maviri ecentrifugation.Mushure mekutanga centrifugation process, chikamu cheropa rose chakakamurwa kuita zvidimbu zviviri, platelet (lean) plasma suspension uye red blood cell layer.MuA, danho rechipiri recentrifugation rakapedzwa.Iyo chaiyo PRP vhoriyamu inogona kutorwa kune murwere application.Kukwidziridzwa muB kunoratidza kuti kune yakarongeka yakawanda-chikamu erythrocyte sedimentation brown layer (inomiririrwa neblue line) pazasi pemidziyo, iyo ine yakanyanya kuwanda kweplatelet, monocytes uye lymphocytes, zvichibva pane density gradient.Mumuenzaniso uyu, maererano neC-PRP yegadziriro yeprotocol ine neutrophils isina kunaka, iyo shoma muzana yeutrophils (<0.3%) uye erythrocytes (<0.1%) ichabviswa.
Platelet granule
Mukutanga kwekiriniki yePRP application, α- Granules ndiyo inonyanya kutaurwa yeplatelet yemukati chimiro, nekuti ine coagulation zvinhu, nhamba huru yePDGF uye angiogenic regulators, asi ine zvishoma thrombogenic basa.Zvimwe zvinhu zvinosanganisira zvishoma zvinonyatsozivikanwa chemokine uye cytokine zvikamu, senge platelet factor 4 (PF4), pre-platelet basic protein, P-selectin (an activator ye integrin) uye chemokine RANTES (inodzorwa ne activation, inoratidzira akajairwa T masero uye zvichida. secreting).Basa rose reaya chaiwo maplatelet granule zvikamu ndere kuunganidza uye kumisa mamwe maseru edziviriro kana kukonzera endothelial cell kuzvimba.
Dense granular components seADP, serotonin, polyphosphate, histamine uye adrenaline zvinonyanya kushandiswa sezvinodzora zveplatelet activation uye thrombosis.Chinonyanya kukosha, zvizhinji zvezvinhu izvi zvine basa rekugadzirisa masero ekudzivirira.Platelet ADP inozivikanwa neP2Y12ADP receptor pane dendritic masero (DC), nokudaro kuwedzera antigen endocytosis.DC (antigen presenting cell) yakakosha pakutanga T cell immune reaction uye kudzora inodzivirira immune system, iyo inobatanidza iyo innate immune system uye adaptive immune system.Mukuwedzera, platelet adenosine triphosphate (ATP) inotumira zviratidzo kuburikidza neT cell receptor P2X7, zvichiita kuti kuwedzerwa kusiyanisa kweCD4 T mubatsiri masero muproinflammatory T mubatsiri 17 (Th17) masero.Mamwe maplatelet dense granule components (senge glutamate uye serotonin) anokurudzira T cell kutama uye kuwedzera monocyte kusiyana kuDC, zvichiteerana.MuPRP, aya ma immunomodulators anotorwa kubva kune dense masisitimu akafumiswa zvakanyanya uye ane akasimba ekudzivirira ekudzivirira.
Nhamba yezvakananga uye zvisina kunanga zvinogona kupindirana pakati peplatelet nemamwe (receptor) masero yakakura.Nokudaro, kushandiswa kwePRP munharaunda yepathological tissue environment kunogona kukonzera zvakasiyana-siyana zvinokonzera kukanganisa.
Platelet concentration
C-PRP inofanira kunge iine kliniki doses ye concentrated platelet kuti ibudise migumisiro inobatsira yekurapa.Platelets muC-PRP inofanira kukurudzira kuwedzera kwesero, kuumbwa kwe mesenchymal uye neurotrophic factor, kukurudzira kutama kwemasero echemotactic uye kukurudzira immunoregulatory basa, sezvinoratidzwa mumufananidzo.
Activated maplatelet, kusunungurwa kwePGF uye adhesion molecules inopindirana zvakasiyana-siyana zvekubatana kwesero: chemotaxis, cell adhesion, migration, uye kupatsanurwa kwesero, uye kugadzirisa mabasa ekudzivirira zvirwere.Uku kupindirana kweplatelet cell-cell kunobatsira kune angiogenesis uye kuzvimba chiitiko, uye pakupedzisira kunomutsa maitiro ekugadzirisa matishu.Mhedziso: BMA: bone marrow aspirate, EPC: endothelial progenitor masero, EC: endothelial masero, 5-HT: 5-hydroxytryptamine, RANTES: activated regulation of normal T cell expression uye putative secretion, JAM: junction adhesion molecule type, CD40L: cluster 40 ligand, SDF-1 α: Stromal cell-derived factor-1 α, CXCL: chemokine (CXC motif) ligand, PF4: platelet factor 4. Yakatorwa kubva kuEverts et al.
Marx ndiye munhu wekutanga kuratidza kuti mapfupa uye zvinyoro zvinyoro kuporesa zvakasimudzirwa, uye huwandu hushoma hweplatelet hwaive 1 × 10 6 /µL. Izvi zvakawanikwa zvakasimbiswa muongororo ye lumbar fusion kuburikidza ne intervertebral foramen, apo muyero weplatelet waive wakakura kupfuura. 1.3 × Pa106 maplatelet/µ L, chidzidzo ichi chakaratidza kuwedzera kusanganiswa.Mukuwedzera, Giusti et al.Yakazarurwa 1.5 × Mushonga wekugadzirisa matishu pachiyero che109 inoda maplatelet / mL kuti iite angiogenesis inoshanda kuburikidza ne endothelial cell chiitiko.Muchidzidzo chekupedzisira, kuwanda kwepamusoro kwakaderedza mikana yeangiogenesis yemaplatelet mukati nekutenderedza follicles.Mukuwedzera, data yapfuura yakaratidza kuti muyero wePRP waizokanganisawo migumisiro yekurapa.Nokudaro, kuitira kuti zvive zvakanyanya kukonzera angiogenesis reaction uye kukurudzira kuwedzera kwesero uye kutama kwemasero, C-PRP inofanira kunge iine 7.5 mu5-mL PRP bhodhoro rekurapa × 10 9 inogona kuendesa maplatelet.
Pamusoro pekutsamira kwedosi, mhedzisiro yePRP pane sero basa inoita seinonyanya kutsamira nguva.Sophie et al.Mhedzisiro iyi inoratidza kuti kuratidzwa kwenguva pfupi kumaplatelet lysates evanhu kunogona kukurudzira kuwedzera kwebhonzo uye kemotaxis.Pane zvinopesana, kuratidzwa kwenguva refu kuPRP kunotungamirira kumazinga akaderera e alkaline phosphatase uye mineral formation.
Sero dzvuku reropa
Masero matsvuku eropa ndiwo ane basa rekutakura okisijeni kuenda kumatishu uye kuendesa kabhoni dhaikisaidhi kubva kumatishu kuenda kumapapu.Izvo hazvina nucleus uye inoumbwa nemamorekuru eheme anosunga kumapuroteni.Iron uye heme zvikamu mumasero matsvuku eropa zvinokurudzira kusanganiswa kweokisijeni necarbon dioxide.Kazhinji, hupenyu hwemasero matsvuku eropa hunenge mazuva zana nemakumi maviri.Vanobviswa kubva mukutenderera nema macrophages kuburikidza nenzira inonzi RBC kuchembera.Masero matsvuku eropa muPRP samples anogona kukuvadzwa pasi pemamiriro ekuveura (somuenzaniso, kuvhiyiwa kweropa rose, immune-mediated process, oxidative stress kana kusakwana PRP concentration).Naizvozvo, RBC cell membrane inoora uye inoburitsa chepfu hemoglobin (Hb), inoyerwa neplasma isina hemoglobin (PFH), heme nesimbi.].PFH uye zvigadzirwa zvayo zvekusvibisa (heme nesimbi) zvakabatana zvinotungamira kune zvinokuvadza uye cytotoxic mhedzisiro pamatishu, zvichitungamira kune oxidative kusagadzikana, kurasikirwa kwenitric oxide, activation yezviputi nzira uye immunosuppression.Izvi zvinozopedzisira zvaita kuti microcirculation dysfunction, yemunharaunda vasoconstriction uye kukuvara kwevascular, pamwe nekukuvara kwakanyanya kwetishu.
Chinhu chinonyanya kukosha ndechekuti kana RBC ine C-PRP ichiendeswa kune matishu, ichaita kuti nzvimbo yemunharaunda inonzi eryptosis, iyo ichaita kuti kusunungurwa kwe cytokine inoshanda uye macrophage migration inhibitor.Iyi cytokine inodzivisa kutama kwe monocytes uye macrophages.Iyo inoshandisa yakasimba pro-kuzvimba masaini kune yakatenderedza matishu, inhibits stem cell kutama uye fibroblast kuwanda, uye inotungamira kune yakakosha sero kusashanda zvakanaka.Naizvozvo, zvakakosha kudzikamisa kusvibiswa kweRBC mukugadzirira kwePRP.Mukuwedzera, basa remasero matsvuku eropa mukuvandudzwa kwetishu harina kumbozivikanwa.Yakakwana C-PRP centrifugation uye nzira yekugadzirira inowanzoderedza kana kutobvisa kuvapo kwemasero matsvuku eropa, nokudaro kudzivisa migumisiro yakaipa yehemolysis uye polycythemia.
Leukocytes muC-PRP
Kuvapo kwemasero machena eropa mukugadzirira kwePRP kunoenderana nemichina yekurapa uye chirongwa chekugadzirira.Mune plasma-based PRP michina, masero machena eropa anobviswa zvachose;Zvisinei, masero machena eropa ainyanya kuiswa muPRP kugadzirira erythrocyte sedimentation brown layer.Nekuda kwemaitiro ayo ekudzivirira uye ekudzivirira ekudzivirira, masero machena eropa anokanganisa zvakanyanya mukati biology yeacute uye isingaperi tishu mamiriro.Aya maficha achakurukurwa zvakanyanya pazasi.Naizvozvo, kuvapo kweakananga leukocyte muC-PRP kunogona kukonzera akakosha maseru uye tishu mhedzisiro.Kunyanya zvakanyanya, akasiyana PRP erythrocyte sedimentation brown-yellow layer masisitimu anoshandisa zvirongwa zvakasiyana zvekugadzirira, nokudaro achigadzira chikamu chakasiyana cheneutrophils, lymphocytes uye monocytes muPRP.Eosinophils uye basophils hazvigone kuyerwa muPRP gadziriro nekuti maseru avo membranes haana kusimba kuti amire centrifugal kugadzirisa masimba.
Neutrophils
Neutrophils inokosha leukocytes munzira dzakawanda dzekuporesa.Idzi nzira dzinosangana nemapuroteni eantimicrobial aripo mumaplatelet kuita dense chipingamupinyi kurwisa utachiona hunopinda.Kuvapo kweneutrophils kunotsanangurwa maererano nechinangwa chekurapa cheC-PRP.Kuwedzera kwemazinga ekuzvimba kwematishu kunogona kudikanwa mukuchengeta maronda asingaperi PRP biotherapy kana mumashandisirwo akanangana nekukura kwemapfupa kana kuporesa.Zvinonyanya kukosha, mamwe mabasa eutrophil akawanikwa mune akati wandei mamodheru, achisimbisa basa ravo mu angiogenesis uye kugadzirisa matishu.Nekudaro, neutrophils inogonawo kukonzera zvinokuvadza, saka haina kukodzera kune mamwe maapplication.Zhou naWang vakaratidza kuti kushandiswa kwePRP yakapfuma mune neutrophils kunogona kukonzera kuwedzera kwehuwandu hwemhando III collagen kunyora I collagen, nokudaro kuwedzera fibrosis uye kuderedza tendon simba.Mamwe maitiro anokuvadza anoyananiswa neutrophils ndiko kuburitswa kweanopisa cytokines uye matrix metalloproteinases (MMPs), iyo inogona kukurudzira kuzvimba uye catabolism kana ichiiswa kune tishu.
Leukomonocyte
MuC-PRP, mononuclear T uye B lymphocytes yakanyanyisa kudarika mamwe masero machena eropa.Izvo zvine hukama zvakanyanya nesero-mediated cytotoxic adaptive immunity.Lymphocyte inogona kukonzeresa kuita kwesero kurwisa hutachiona uye kujairana nevanopinda.Mukuwedzera, T-lymphocyte inotorwa ma cytokines (interferon- γ [IFN- γ] Uye interleukin-4 (IL-4) inowedzera polarization ye macrophages. Verassar et al. iyo mbeva modhi nekudzora kusiyanisa kwe monocytes uye macrophages.
Monocyte - multipotent kugadzirisa sero
Zvinoenderana neiyo PRP yekugadzirira mudziyo inoshandiswa, monocytes inogona kubuda kana kusavapo muPRP bhodhoro rekurapa.Nehurombo, kuita kwavo uye kugona kwekuzvarwa patsva hakuwanzo kukurukurwa mumabhuku.Nokudaro, kutarisisa kuduku kunobhadharwa kune monocytes mune nzira yekugadzirira kana yekupedzisira fomu.Monocyte boka rine heterogeneous, rinobva kumasero ekutanga ari mumwongo, uye kutakurwa kuenda kune peripheral tishu kuburikidza nehematopoietic stem cell pathway zvinoenderana ne microenvironment stimulation.Munguva yehomeostasis uye kuzvimba, mamonocyte anotenderera anosiya rwizi rweropa uye anonyorerwa kune akakuvara kana kuderedzwa tishu.Vanogona kuita se macrophages (M Φ) Effector masero kana progenitor masero.Monocytes, macrophages uye dendritic masero anomiririra mononuclear phagocytic system (MPS) .Muzvinyama zvakasvibiswa, macrophages anogara, anogara achiita kukura kwezvinhu, pro-inflammatory cytokines, apoptotic kana necrotic masero uye microbial zvigadzirwa zvinotanga monocytes kuti zviparadzanise muMPS masero emapoka.Ngatitii kana C-PRP ine monocytes yakakura inoiswa mukati memunharaunda microenvironment yechirwere, monocytes inogona kusiyanisa muM Φ Kukonzera kuchinja kukuru kwesero.
Kubva ku monocyte kusvika kuM Φ Muchiito chekushandura, chaiyo M Φ Phenotype.Mumakore gumi apfuura, muenzaniso wakagadzirwa, unobatanidza M Φ Iyo yakaoma nzira yekugadzirisa inotsanangurwa sepolarization yezvikamu zviviri zvinopesana: M Φ Phenotype 1 (M Φ 1, Classic activation) uye M Φ Phenotype 2 (M Φ 2, imwe nzira activation).M Φ 1 inoratidzirwa nekuputika kwe cytokine secretion (IFN- γ) Uye nitric oxide kuti ibudise nzira inoshanda yekuuraya pathogen.M Φ Iyo phenotype inogadzirawo vascular endothelial growth factor (VEGF) uye fibroblast growth factor (FGF).M Φ Iyo phenotype inoumbwa ne-anti-inflammatory cells ane high phagocytosis.M Φ 2 Gadzira extracellular matrix components, angiogenesis uye chemokines, uye interleukin 10 (IL-10).Mukuwedzera kune kudzivirirwa kwepathogen, M Φ Inogonawo kuderedza kuzvimba uye kukurudzira kugadziriswa kwetishu.Zvinokosha kuziva kuti M Φ 2 yakakamurwa kuva M in vitro Φ 2a, M Φ 2b uye M Φ 2. Zvinoenderana nekukurudzira.In vivo kududzira kweaya madiki kwakaoma nekuti nyama yacho inogona kunge iine yakasanganiswa M Φ Mapoka.Zvinofadza, zvichibva pane zviratidzo zvezvakatipoteredza zvemunharaunda uye mazinga e-IL-4, proinflammatory M Φ 1 inogona kuchinjwa kuti ikurudzire kugadzirisa M Φ 2. Kubva pane idzi data, zvinonzwisisika kufunga kuti kune huwandu hwakawanda hwemonocytes uye M Φ C-PRP kugadzirira. inogona kubatsira pakugadzirisa matishu zviri nani nekuti vane anti-kuzvimba matishu kugadzirisa uye sero chiratidzo chekufambisa masimba.
Yakavhiringidzika tsananguro yewhite blood cell fraction muPRP
Kuvapo kwemasero machena eropa mumabhodhoro ekurapa ePRP kunoenderana nePRP yekugadzirira mudziyo uye inogona kunge ine misiyano yakakura.Kune makakatanwa mazhinji pamusoro pekuvapo kwemaleukocytes uye mupiro wavo kune akasiyana-siyana ePRP zvigadzirwa (sePRGF, P-PRP, LP-PRP, LR-PRP, P-PRF uye L-PRF) Muongororo ichangoburwa, nhanhatu randomized. miedzo inodzorwa (yemwero yeuchapupu 1) uye zvitatu zvinotarisirwa zvidzidzo zvekuenzanisa (yero yeuchapupu 2) yaisanganisira varwere ve1055, zvichiratidza kuti LR-PRP uye LP-PRP yaive nekuchengetedzwa kwakafanana.Munyori akagumisa kuti kukanganisa kwakashata kwePRP kungave kusina kuwirirana zvakananga nekubatanidzwa kwemasero machena eropa.Mune imwe dzidzo, LR-PRP haina kushandura kuputika kweinterleukin (IL-1) muOA mabvi β, IL-6, IL-8 uye IL-17).Izvi zvinoguma zvinotsigira maonero ekuti basa re leukocytes mubasa rehupenyu rePRP mu vivo rinogona kubva kune crosstalk pakati peplatelet uye leukocytes.Kudyidzana uku kunogona kukurudzira biosynthesis yezvimwe zvinhu (zvakadai se lipoxygen), iyo inogona kukanganisa kana kukurudzira kudzoreredzwa kwekuzvimba.Mushure mekutanga kusunungurwa kwemamolekemu anopisa (arachidonic acid, leukotriene uye prostaglandin), lipoxygen A4 inosunungurwa kubva kumagetsi akashandiswa kudzivirira neutrophil activation.Icho chiri munharaunda iyi iyo M Φ Phenotype kubva kuM Φ 1 Shandura kuM Φ 2. Mukuwedzera, kune humwe uchapupu hunowedzera hwokuti kutenderera masero emononuclear anogona kusiyanisa mumhando dzakasiyana-siyana dzisiri-phagocytic masero nekuda kwehuwandu hwavo.
Mhando yePRP ichabata MSC tsika.Kuenzaniswa nePRP yakachena kana PPP samples, LR-PRP inogona kukurudzira zvakanyanya kuwanda kwemwongo wemapfupa anobva maMSCs (BMMSCs), nekukurumidza kuburitswa uye zvirinani PGF biological chiitiko.Ese aya maitiro anobatsira kuwedzera monocytes muPRP bhodhoro rekurapa uye nekuziva kugona kwavo immunomodulatory uye kugona kusiyanisa.
Congenital uye inogadzirisa immune regulation yePRP
Basa rinonyanya kuzivikanwa rehutano hwemaplatelet nderekudzora kubuda ropa.Vanounganidza panzvimbo yekukuvara kwetishu uye tsinga dzeropa dzakakuvadzwa.Zviitiko izvi zvinokonzerwa nekutaura kwe integrins uye selectins iyo inokurudzira platelet adhesion uye aggregation.Iyo yakakanganisika endothelium inowedzera kuwedzera kuita uku, uye iyo yakafumurwa collagen uye mamwe subendothelial matrix mapuroteni anosimudzira yakadzika activation yemaplatelet.Muzviitiko izvi, basa rinokosha rekubatana pakati pe von Willebrand factor (vWF) uye glycoprotein (GP), kunyanya GP-Ib, yakaratidza.Mushure mekuita kweplatelet activation, platelet α-, Dense, lysosome uye T-granules inogadzirisa exocytosis uye inoburitsa zviri mukati mekunze kwenzvimbo.
Platelet adhesion molecule
Kuti tinzwisise zviri nani basa rePRP mumasumbu anoputika uye maplatelet mumhinduro yekudzivirira zvirwere, tinofanira kunzwisisa kuti zvakasiyana sei platelet surface receptors (integrins) uye junction adhesion molecules (JAM) uye kupindirana kwesero kunogona kutanga maitiro akaoma mune innate uye adaptive immunity.
Integrins maseru epamusoro adhesion mamorekuru anowanikwa mumhando dzakasiyana siyana uye anoratidzwa muhuwandu hukuru pamaplatelet.Integrins inosanganisira a5b1, a6b1, a2b1 LFA-2, (GPIa/IIa) uye aIIbb3 (GPIIb/IIIa).Kazhinji, ivo varipo mune static uye yakaderera affinity state.Mushure mekuita, vanochinja kune iyo yakakwirira ligand inosunga hukama.Integrins ane mabasa akasiyana pamaplatelet uye anotora chikamu mukudyidzana kwemaplatelet ane akati wandei marudzi emasero machena eropa, endothelial masero uye extracellular matrix.Pamusoro pezvo, GP-Ib-V-IX yakaoma inoratidzwa pane platelet membrane uye ndiyo huru receptor yekusunga ne von vWF.Kudyidzana uku kunopindirana kwekutanga kusangana pakati pemaplatelet uye akafumura subendothelial zvimiro.Platelet integrin uye GP yakaoma inoenderana neyakasiyana-siyana yekuzvimba maitiro uye inoita basa rakakosha mukuumbwa kweplatelet-leukocyte yakaoma.Kunyanya, integrin aIIbb3 inofanirwa kuumba yakagadzikana yakaoma nekubatanidza fibrinogen ne macrophage 1 antigen (Mac-1) receptor pane neutrophils.
Platelets, neutrophils uye vascular endothelial masero anoratidza chaiwo cell adhesion mamorekuru, anonzi selectin.Mumamiriro ezvinhu ekuputika, maplatelet anoratidza P-selectin uye neutrophil L-selectin.Mushure mekushandiswa kweplatelet, P-selectin inogona kusunga kune ligand PSGL-1 iripo pane neutrophils uye monocytes.Mukuwedzera, PSGL-1 inosunga inotanga intracellular signal cascade reaction, iyo inoshandisa neutrophils kuburikidza neutrophil integrin Mac-1 uye lymphocyte function-related antigen 1 (LFA-1).Activated Mac-1 inosunga kuGPIb kana GPIIb/IIIa pamaplatelet kuburikidza nefibrinogen, nokudaro kudzikamisa kudyidzana pakati pemaneutrophils nemaplatelet.Mukuwedzera, yakashandiswa LFA-1 inogona kusanganiswa neplatelet intercellular adhesion molecule 2 kuti iwedzere kudzikamisa neutrophil-platelet complex kukurudzira kunamatira kwenguva refu nemasero.
Maplatelet uye leukocyte anoita basa rakakosha mukusaziva uye kuchinjika mhinduro dzekudzivirira
Muviri unogona kuziva mitumbi yekunze uye matishu akakuvara muzvirwere zvakanyanya kana zvisingaperi kuti utange kuporesa maronda cascade reaction uye nzira yekuzvimba.Iwo ekuzvarwa uye anochinjika masisitimu edziviriro anodzivirira mugadziri kubva kuhutachiona, uye masero machena eropa anoita basa rakakosha mukupindirana pakati peaviri masisitimu.Kunyanya, monocytes, macrophages, neutrophils uye masero emuurayi echisikigo anoita basa rakakosha mune innate system, nepo lymphocytes uye ma subsets avo anoita basa rakafanana mukugadzirisa immune system.
Platelet uye leukocyte kupindirana mune innate immune cell kusangana.Platelet inopindirana neutrophils uye monocytes, uye pakupedzisira neM Φ Bata, gadzirisa uye uwedzere maitiro avo ekuita.Uku kudyidzana kweplatelet-leukocyte kunotungamira mukuzvimba kuburikidza nenzira dzakasiyana, kusanganisira NETosis.Mhedziso: MPO: myeloperoxidase, ROS: reactive oxygen species, TF: tissue factor, NET: neutrophil extracellular trap, NF- κ B: Nuclear factor kappa B, M Φ: Macrophages.
Innate immune system
Basa reiyo innate immune system ndere kusanyatsoona tupukanana tusingaoneki kana zvimedu zvematishu uye kukurudzira kuchena kwavo.Kana zvimwe zvimiro zvemamorekuru zvinodaidzwa kunzi surface expression pattern recognition receptors (PRRs) zvasangana nepathogen-inoenderana nemamolecular maitiro uye kukuvara-ane chekuita nemamolecular mapatani, iyo innate immune system ichaitwa.Kune akawanda marudzi ePRR, anosanganisira Toll-like receptor (TLR) uye RIG-1 senge receptor (RLR).Aya ma-receptors anogona kuita iyo main transcription factor kappa B (NF- κ B) Inogadzirisawo akawanda maficha emukati uye anogadzirisa immune immune.Sezvineiwo, maplatelet anoratidzawo akasiyana immunoregulatory receptor molecules pamusoro pavo uye cytoplasm, akadai P-selectin, transmembrane protein CD40 ligand (CD40L), cytokines (akadai IL-1 β, TGF- β) Uye platelet-specific TLR. Naizvozvo, maplatelet anogona kudyidzana nemasero ezvirwere zvakasiyana-siyana.
Platelet-white cell kupindirana mune innate immunity
Kana maplatelet achipinda kana kupinda muropa kuyerera kana matishu, maplatelet ndeimwe yemasero anoona endothelial kukuvara uye hutachiona hwehutachiona kutanga.Platelet aggregation uye kukurudzira kusunungurwa kweplatelet agonists ADP, thrombin uye vWF, zvichiita kuti platelet activation uye kutaura kweplatelet chemokine receptors C, CC, CXC uye CX3C, zvichiita kuti maplatelet munzvimbo ine utachiona kana kukuvara.
Dzidziso yomuzvarirwo inofanotemerwa kuti ione vapambi, semavhairasi, mabhakitiriya, tupukanana uye chepfu, kana maronda enyama nemaronda.Iyo isiri-chaiyo system, nekuti chero pathogen ichaonekwa seyekunze kana isiri yega uye nekukurumidza inowanikwa.Iyo innate immune system inotsamira pane seti yemapuroteni uye phagocytes, ayo anoona akanyatso kuchengetedzwa maitiro ehutachiona uye nekukurumidza kumisa maitiro ekudzivirira ekudzivirira kubatsira kubvisa vapambi, kunyangwe kana muenzi asati amboonekwa kune chaiwo hutachiona.
Neutrophils, monocytes uye dendritic masero ndiwo anonyanya kuzivikanwa masero emumuviri emuropa muropa.Kutora kwavo kwakakosha kuti pave nemhinduro yakakwana yekutanga immune system.Apo PRP inoshandiswa mumishonga yekuvandudza, platelet-white cell interaction inogadzirisa kuzvimba, kuporesa maronda uye kugadzirisa matishu.TLR-4 pamaplatelet inokurudzira kuwirirana kweplatelet-neutrophil, iyo inodzora iyo inonzi leukocyte oxidative kuputika nekugadzirisa kusunungurwa kweiyo reactive oxygen marudzi (ROS) uye myeloperoxidase (MPO) kubva kune neutrophils.Mukuwedzera, kuwirirana pakati peplatelet-neutrophil uye neutrophil degranulation inotungamirira pakuumbwa kweneutrophil-extracellular traps (NETs).NETs inoumbwa neutrophil nucleus uye zvimwe neutrophil intracellular zvirimo, izvo zvinogona kubata mabhakitiriya nekuauraya kuburikidza neNETosis.Kuumbwa kweNETs chinhu chakakosha chekuuraya cheneutrophils.
Mushure mekuita kweplatelet activation, monocytes inogona kutamira kune inorwara uye inodzika matishu, kwaanoita mabasa ekubatanidza uye kuburitsa mamorekuru ekuzvimba anogona kushandura chemotaxis uye proteolytic zvinhu.Mukuwedzera, maplatelet anogona kukonzera monocyte NF- κ B kushandiswa kwekugadzirisa kushanda kwekuita kwemonocytes, iyo ndiyo murevereri mukuru wekupindura kwekuputika uye kushandiswa uye kusiyanisa kwemasero emuviri.Platelets inowedzera kukurudzira endogenous oxidative burst ye monocytes kukurudzira kuparadzwa kwe phagocytic pathogens.Kuburitswa kweMPO kunopindirana nekudyidzana kwakananga pakati peplatelet-monocyte CD40L-MAC-1.Zvinofadza kuti, apo P-selectin inoshandisa maplatelet pasi pemamiriro ezvinhu akaoma uye asingagumi, machemokines anokonzerwa neplatelet PF4, RANTES, IL-1 β Uye CXCL-12 inogona kudzivirira kungoerekana apoptosis ye monocytes, asi kukurudzira kusiyanisa kwavo mu macrophages.
Adaptive immune system
Mushure meiyo isiri-chaiyo innate immune system yaziva hutachiona kana kukuvara kwetishu, chaiyo inogadzirisa immune system inotora.Maitiro ekugadzirisa anosanganisira antigen-binding B lymphocytes (B masero) uye anowanzo T lymphocytes (Treg) anoronga kubviswa kwezvirwere.Masero eT anogona kukamurwa kuita mubatsiri T masero (Th masero) uye cytotoxic T masero (Tc masero, anozivikanwawo seT anouraya masero).Masero eTh anowedzera kukamurwa kuita Th1, Th2 uye Th17 masero, ane mabasa akakosha mukuzvimba.Masero anogona kubudisa proinflammatory cytokines (eg IFN- γ, TNF- β) Uye akawanda interleukins (eg, IL-17) Anonyanya kushanda mukudzivirira intracellular virus uye hutachiona hwehutachiona. Masero eTc ndiwo masero anoita masero, anogona kubvisa zvakanangwa intracellular uye extracellular microorganisms uye masero.
Zvinofadza kuti masero eT2 anogadzira IL-4 uye anokanganisa M Φ Polarization, M Φ Kutungamirirwa patsva M Φ 2 Phenotype, nepo IFN- γ M Φ Shandura kukuputika M Φ 1 Phenotype, iyo inobva pachiyero uye nguva ye cytokines.Mushure mokunge IL-4 inoshandiswa, M Φ 2 inokonzera masero eTreg kuti aparadzanise mumasero eT2, uye obva abudisa mamwe IL-4 (positive feedback loop).Th masero anoshandura M Φ Iyo phenotype inotungamirirwa kune regenerative phenotype mukupindura kune biological agents of tissue origin.Iyi nzira yakavakirwa pauchapupu hwekuti masero eT anoita basa rakakosha mukudzora kuzvimba uye kugadzirisa matishu.
Platelet-white cell kupindirana mune adaptive immunity
Iyo inogadzirisa immune system inoshandisa antigen-specific receptors uye inorangarira hutachiona hwakambosangana nahwo, uye hunoaparadza kana hwazosangana nemugamuchiri.Nekudaro, aya anochinjika ekudzivirira ekudzivirira akakura zvishoma nezvishoma.Konias et al.Zvinoratidza kuti chikamu cheplatelet chinobatsira pakuona njodzi uye kugadziriswa kwetishu, uye kuti kuwirirana pakati peplatelet uye leukocytes kunokurudzira kushandiswa kwekugadzirisa kwekudzivirira kwekudzivirira muviri.
Munguva yekuchinja kwekudzivirira kwemuviri, maplatelet anokurudzira monocyte uye macrophage mhinduro kuburikidza neDC uye NK cell maturation, zvichiita kuti zvive zvakananga T cell uye B cell mhinduro.Naizvozvo, maplatelet granule zvikamu zvinokanganisa zvakananga kuchinjika kusadzivirirwa nekutaura CD40L, molekuru yakakosha pakugadzirisa inogadzirisa immune immune.Maplatelet kuburikidza neCD40L haangoite basa mukuratidzwa kweantigen, asiwo anokanganisa T cell reaction.Liu et al.Zvakaonekwa kuti maplatelet anoronga CD4 T cell mhinduro nenzira yakaoma.Uyu mutemo wakasiyana weCD4 T cell subsets unoreva kuti maplatelet anokurudzira masero eCD4 T kuti apindure kune zvinokonzerwa nekuputika, nokudaro achibudisa mhinduro yakasimba ye-pro-inflammatory uye anti-inflammatory.
Platelets zvakare inogadzirisa B cell-mediated adaptive mhinduro kune microbial pathogens.Zvinonyatsozivikanwa kuti CD40L pamasero eCD4 T akaiswa achaita kuti CD40 yeB masero, ichipa chiratidzo chechipiri chinodiwa kuti T-cell-inotsamira B lymphocyte activation, inotevera allotype kutendeuka, uye B cell kusiyanisa uye kuwanda.Kazhinji, zvigumisiro zvinonyatsoratidza mabasa akasiyana-siyana emaplatelet mukugadzirisa zvirwere, zvichiratidza kuti maplatelet anobatanidza kuwirirana pakati peT masero neB masero kuburikidza neCD40-CD40L, nokudaro kuwedzera T-cell-dependent B cell response.Pamusoro pezvo, maplatelet akapfuma musero repamusoro receptors, izvo zvinogona kusimudzira platelet activation uye kuburitsa huwandu hukuru hwekuzvimba uye biological inoshanda mamorekuru akachengetwa muzvikamu zvakasiyana zveplatelet, zvichikanganisa maitiro emudumbu uye anogadzirisa immune.
Basa rakawedzerwa replatelet-derived serotonin muPRP
Serotonin (5-hydroxytryptamine, 5-HT) ine basa rakajeka rinokosha mukati mehutano hwehutano (CNS), kusanganisira kushivirira marwadzo.Inofungidzirwa kuti yakawanda yevanhu 5-HT inogadzirwa mumakumbo emimba uyezve kuburikidza nekutenderera kweropa, iyo inotorwa nemaplatelet kuburikidza ne serotonin reuptake transporter uye inochengetwa muzvikamu zvakasvibirira pakakwirira (65 mmol / L).5-HT inonyanya kuzivikanwa neurotransmitter uye hormone inobatsira kugadzirisa zvakasiyana-siyana neuropsychological process muCNS (central 5-HT).Zvisinei, yakawanda ye5-HT iripo kunze kweCNS (peripheral 5-HT), uye inobatanidzwa mukugadzirisa maitiro ekugadzirisa uye masero ehupenyu hwemaitiro akawanda emagetsi, kusanganisira moyo, mapapu, gastrointestinal, urogenital uye platelet functional systems.5-HT ine-concentration-dependent metabolism pamhando dzakasiyana-siyana dzemasero, kusanganisira adipocytes, epithelial cells uye masero machena eropa.Peripheral 5-HT zvakare ine simba immune modulator, iyo inogona kukurudzira kana kuvharidzira kuzvimba uye kukanganisa maseru ekudzivirira akasiyana-siyana kuburikidza neayo chaiwo 5-HT receptor (5HTR).
Paracrine uye autocrine nzira yeHT
Chiitiko che5-HT chinopindirana nekudyidzana kwayo ne5HTRs, iyo imhuri yepamusoro ine nhengo nomwe (5-HT 1 - 7) uye ingangoita gumi nemana akasiyana receptor subtypes, kusanganisira iyo ichangobva kuwanikwa nhengo 5-HT 7, iyo peripheral uye. kushanda mukugadzirisa marwadzo.Mukugadzirisa kweplatelet degranulation, maplatelet akashandiswa anobudisa nhamba yakawanda yeplatelet-yakatorwa 5-HT, iyo inogona kukurudzira kuputika kwevascular uye kukurudzira kushandiswa kwemaplatelet ari pedyo uye lymphocytes kuburikidza nekutaura kwe5-HTR pamasero endothelial, masero anotsvedza masero uye immune masero.Pacala et al.Iyo mitotic effect ye5-HT pamasero e-vascular endothelial yakadzidzwa, uye kukwanisa kwekusimudzira kukura kwemitsipa yeropa yakakuvadzwa nekusimudzira angiogenesis yakatemwa.Kuti maitiro aya anodzorwa sei haana kunyatso kujeka, asi anogona kusanganisira kusiyanisa nzira mbiri dzechiratidzo mutishu microcircuit kudzora mashandiro evascular endothelial masero uye yakatsetseka mhasuru masero, fibroblasts uye immune masero kuburikidza neakananga 5-HT receptors pamasero aya. .Iyo autocrine basa replatelet 5-HT mushure mekushandiswa kweplatelet yakatsanangurwa [REF].Kuburitswa kwe5-HT kunowedzera kushandiswa kwemaplatelet uye kutorwa kwemaplatelet anotenderera, zvichitungamira ku activation yechiratidzo che cascade reactions uye kumusoro kwepamusoro zvinotsigira platelet reactivity.
Immunomodulatory 5-HT maitiro
Humbowo hwakawanda hunoratidza kuti serotonin inogona kuita basa mu5HTR yakasiyana seye immune modulator.Maererano ne5HTR inoratidzwa mumhando dzakasiyana-siyana dzeleukocyte dzinobatanidzwa mukuita kwekuvhiringidza, platelet-yakatorwa 5-HT inoita semutongi wezvirwere mune zvose zviri zviviri uye zvinogadzirisa zvirwere zvemuviri.5-HT inogona kukurudzira kupararira kweTreg uye kugadzirisa mabasa emasero eB, masero emuurayi echisikigo uye neutrophils nekutsvaga DC uye monocytes kunzvimbo yekuputika.Zvidzidzo zvenguva pfupi zvakaratidza kuti platelet-yakatorwa 5-HT inogona kugadzirisa kushanda kwemasero ekudzivirira pasi pemamiriro ezvinhu chaiwo.Nokudaro, kushandisa C-PRP, iyo platelet concentration yakakura kudarika 1 × 10 6 / µ L inogona kubatsira zvakanyanya kutakura kusanganiswa kwe5-HT yakabva kune maplatelet makuru kusvika kumucheka.Mune microenvironment inoratidzwa nezvikamu zvinopisa, PRP inogona kuwirirana nemasero akawanda ekudzivirira muviri anoita basa rinokosha mumatambudziko aya, izvo zvinogona kukanganisa migumisiro yekliniki.
Mufananidzo unoratidza huwandu hwakawanda hwe5-HT mhinduro mushure mekushandiswa kwekuputika kwePRP maplatelet.Mushure mekushandiswa kweplatelet, maplatelet anosunungura magranules avo, kusanganisira 5-HT mumagranules ane dense, ane maitiro akasiyana-siyana akasiyana-siyana emasero ekudzivirira zvirwere, endothelial masero uye masero akatsetseka.Mhedziso: SMC: masero anotsvedza mhasuru, EC: endothelial masero, Treg: yakajairika T lymphocytes, M Φ: Macrophages, DC: dendritic masero, IL: interleukin, IFN- γ: Interferon γ。 Yakagadziriswa uye yakagadziridzwa kubva kuEverts et al.uye Hull et al.
Analgesic mhedzisiro yePRP
Activated maplatelet anosunungura akawanda e-pro-inflammatory uye anti-inflammatory mediators, izvo zvisingagoni kukonzera marwadzo chete, asiwo kuderedza kuzvimba uye kurwadziwa.Kana yangoshandiswa, iyo inowanzoitwa platelet dynamics yePRP inoshandura microenvironment isati yagadziriswa uye kuberekwa patsva kuburikidza nenzira dzakasiyana-siyana dzakaoma dzine chokuita neanabolism uye catabolism, kuwedzera kwesero, kusiyanisa uye stem cell regulation.Aya maitiro ePRP anotungamirira kukushandiswa kwePRP muhutano hwakasiyana-siyana hwehutachiona hunowanzobatanidzwa nekurwadziwa kusingaperi (zvakadai sekukuvara kwemitambo, chirwere chemapfupa, chirwere chepelinha uye yakaoma chironda chisingaperi), kunyange zvazvo nzira chaiyo isati yanyatsogadziriswa.
Muna 2008, Evertz et al.Ndiyo yekutanga kurongeka kunodzorwa kuyedza kurondedzera analgesic mhedzisiro yePRP kugadzirira, iyo inogadzirirwa kubva kune brown layer ye autologous erythrocyte sedimentation rate uye inogadziriswa ne autologous thrombin mushure mekuvhiyiwa kwepafudzi.Vakacherechedza kuderedzwa kwakakosha kwekuona analogue scale scores, kushandiswa kweopioid based analgesics, uye kubudirira kwakanyanya mushure mekugadzirisa.Zvinokosha kuziva kuti vanoratidza analgesic mhedzisiro yemaplatelet akabatidzwa uye vanofungidzira nezve mabatiro eplatelet anoburitsa 5-HT.Muchidimbu, maplatelet akarara muPRP ichangogadzirwa.Mushure mekushandiswa kweplatelet zvakananga kana zvisina kunanga (tishu chinhu), maplatelet anochinja chimiro uye anoburitsa manyepo akakwana kukurudzira kuunganidzwa kweplatelet.Zvadaro, vanosunungura intracellular α- Uye dense particles.Iyo matishu inobatwa neyakagadziriswa PRP ichapindwa nePGF, cytokines uye mamwe maplatelet lysosomes.Kunyanya zvakanyanya, kana dense zvimedu zvinoburitsa zviri mukati, ivo vanoburitsa yakawanda ye5-HT inodzora marwadzo.MuC-PRP, kuiswa kweplatelet ndeye 5 kusvika ku7 nguva yakakwirira kupfuura iyo iri muropa reropa.Nokudaro, kusunungurwa kwe5-HT kubva kumaplatelet ndeyekuongorora nyeredzi.Sezvineiwo, Sprott et al.Mushumo wacho wakacherechedza kuti kurwadziwa kwakanyanyisa kusunungurwa mushure mekugadzirisa muviri uye moxibustion, kuiswa kweplatelet yakabva ku5-HT yakaderedzwa zvakanyanya, uye ipapo chiyero cheplasma che5-HT chakawedzerwa.
Munharaunda, maplatelet, mast masero uye endothelial masero achasunungura endogenous 5-HT panguva yekukuvara kwetishu kana kuvhiyiwa.Zvinofadza kuti zvakasiyana-siyana zve5-HT zvinogamuchira neurons zvakaonekwa munzvimbo yeperipheral, iyo yakasimbisa kuti 5-HT inogona kupindira nekutapurirwa kwenociceptive munharaunda yeperipheral.Izvi zvidzidzo zvinoratidza kuti 5-HT inogona kukanganisa kutumirwa kwenociceptive yezvipembenene zvemukati kuburikidza ne5-HT1, 5-HT2, 5-HT3, 5-HT4 uye 5-HT7 receptors.
Iyo 5-HT system inomiririra hurongwa hwakasimba hunogona kuderedza uye kuwedzera huwandu hwemarwadzo mushure mekukurudzira kunokuvadza.Iyo yepakati uye yeperipheral regulation ye nociceptive zviratidzo uye shanduko mu5-HT system zvakataurwa kune varwere vane kurwadziwa kusingaperi.Mumakore achangopfuura, nhamba huru yezvidzidzo yakatarisa pamusoro pebasa re5-HT uye maitiro ayo anogamuchirwa mukugadzirisa nekugadzirisa mashoko anokuvadza, zvichiita kuti mishonga yakadai sekusarudza serotonin reuptake inhibitors (SSRI).Ichi chinodhaka chinodzivisa kudzokororwa kwe serotonin mu presynaptic neurons mushure mekusunungurwa kwe serotonin.Inobata nguva uye kusimba kweserotonin kutaurirana uye ndiyo imwe nzira yekurapa yekurwadziwa kusingaperi.Kuwedzera tsvakurudzo yekiriniki inodiwa kuti unzwisise zvakajeka maitiro e-molecular yePRP-yakatorwa 5-HT marwadzo ekugadzirisa mune zvirwere zvisingaperi uye zvinopera.
Imwe data yekugadzirisa iyo inogona analgesic mhedzisiro yePRP inogona kuwanikwa mushure meiyo analgesic mhuka yemuenzaniso bvunzo.Kuenzanisa kwehuwandu hwemhedziso mumamodeli aya inonetsa nekuti zvidzidzo izvi zvine zvakawanda zvakasiyana.Zvakadaro, zvimwe zvidzidzo zvekiriniki zvakataura nezve nociceptive uye analgesic mhedzisiro yePRP.Tsvakurudzo dzinoverengeka dzakaratidza kuti varwere vanowana kurapwa kwe tendinosis kana rotator cuff misodzi vane zororo shoma.Kusiyana neizvi, zvimwe zvidzidzo zvakawanda zvakaratidza kuti PRP inogona kuderedza kana kubvisa marwadzo evarwere vane tendon degeneration, OA, plantar fasciitis nezvimwe zvirwere zvetsoka nemakumbo.Mhedzisiro yekupedzisira yeplatelet uye biological cell composition yakaonekwa seyakakosha PRP maitiro, ayo anobatsira kutarisa inopindirana analgesic effect mushure mekushandiswa kwePRP.Zvimwe zvakasiyana-siyana zvinosanganisira nzira yekuendesa PRP, teknolojia yekushandisa, platelet activation protocol, biological activity level yePGF uye cytokines yakasunungurwa, rudzi rwemhando yePRP application uye rudzi rwekukuvara.
Zvinokosha kuziva kuti Kuffler akagadzirisa zvingaita zvePRP mukuderedza marwadzo kune varwere vane unyoro kusvika kunorwadza kusingaperi neuropathic, yechipiri kune yakakuvadzwa isina-regenerative nerve.Chinangwa chechidzidzo ichi ndechekuongorora kana kurwadziwa kweuropathic kunogona kuderedzwa kana kuderedzwa nekuda kwePRP inokurudzira axonal regeneration uye chinangwa chekudzorera nerve reinnervation.Zvinoshamisa kuti pakati pevarwere vanowana kurapwa, kurwadziwa kweuropathic kuchiri kubviswa kana kuderedzwa makore matanhatu mushure mekuvhiyiwa.Mukuwedzera, varwere vose vakatanga kubvisa marwadzo mukati memavhiki matatu mushure mekushandiswa kwePRP.
Munguva pfupi yapfuura, yakafanana analgesic PRP migumisiro yakaonekwa mumunda we postoperative ronda uye kutarisira ganda.Sezvineiwo, vanyori vakashuma maitiro emuviri ekurwadziwa kweronda anoenderana nekukuvara kwevascular uye ganda tishu hypoxia.Vakakurukurawo kukosha kweangiogenesis mukugadzirisa oxygenation uye kutakura kwekudya.Kudzidza kwavo kwakaratidza kuti kana zvichienzaniswa neboka rinodzora, varwere vanowana kurapwa kwePRP vaiva nemarwadzo mashoma uye zvakanyanya kuwedzera angiogenesis.Pakupedzisira, Johal nevamwe vake vakaita ongororo yakarongeka uye meta-analysis uye vakagumisa kuti PRP inogona kuderedza marwadzo mushure mekushandisa PRP muzviratidzo zvemapfupa, kunyanya kune varwere vanogamuchira kunze epicondylitis uye mabvi OA kurapwa.Nehurombo, chidzidzo ichi hachina kutsanangura mhedzisiro yemasero machena eropa, kuiswa kweplatelet kana kushandiswa kwekunze kweplatelet activators, nekuti izvi zvinosiyana zvingakanganisa kushanda kwese kwePRP.Iyo yakakwana yePRP platelet yekumisikidza yekurerutsa marwadzo haina kujeka.Mumuenzaniso wemakonzo we tendinosis, mutsara weplatelet waiva 1.0 × 10 6 / μ PaL, marwadzo anogona kusunungurwa zvachose, asi kurwadziwa kunokonzerwa nePRP nehafu yeplatelet kuderedzwa.Nokudaro, tinokurudzira zvidzidzo zvechipatara zvakawanda kuti tiongorore migumisiro yeanalgesic yezvakasiyana zvePRP gadziriro.
PRP uye angiogenesis effect
Kugadzirira kweC-PRP mumushonga chaiwo wekuvandudza inobvumira kuburitswa kwemabiomolecules anoburitswa nehuwandu hwemaplatelet akaiswa panzvimbo dzakanangwa dzematishu.Naizvozvo, kwakasiyana-siyana kwekuita kwecascade kwakatangwa, izvo zvinobatsira kune-saiti immune regulation, kuzvimba maitiro uye angiogenesis kukurudzira kuporeswa uye kugadzirisa matishu.
Angiogenesis isimba rekuita-matanho akawanda anosanganisira kumera uye matishu microvessels kubva mutsinga dzeropa dzagara dziripo.Angiogenesis yakafambira mberi nekuda kwemaitiro akasiyana-siyana ehupenyu, kusanganisira endothelial cell migration, kupararira, kusiyanisa uye kupatsanura.Aya ma cellular maitiro ndiwo anodiwa pakugadzirwa kwetsinga itsva dzeropa.Izvo zvakakosha pakukura kwemitsipa yeropa yakagara iripo kuti idzorere kuyerera kweropa uye kutsigira yakakwira metabolic chiitiko chekugadzirisa matishu uye kuvandudzwa kwetishu.Iyi tsinga mitsva yeropa inobvumira kuendeswa kweokisijeni uye chikafu, uye kubviswa kwe-zvigadzirwa kubva mumatishu anorapwa.
Angiogenesis chiitiko chinodzorwa nekukurudzira angiogenic factor VEGF uye anti-angiogenic zvinhu (semuenzaniso, angiostatin uye thrombospondin-1 [TSP-1]).Muchirwere uye yakaora microenvironment (kusanganisira yakaderera okisijeni tension, yakaderera pH uye yakakwirira lactic asidhi nhanho), omunharaunda angiogenic zvinhu achadzorera angiogenesis basa.
Mazhinji maplatelet soluble media, akadai seyakakosha FGF uye TGF- β Uye VEGF inogona kukurudzira endothelial masero kuburitsa mitsva yeropa.Landsdown naFortier vakashuma mhedzisiro dzakasiyana dzine chekuita nePRP kuumbwa, kusanganisira iyo intraplatelet masosi eakawanda angiogenic regulators.Mukuwedzera, vakagumisa kuti kuwedzera kweangiogenesis kunobatsira kuporesa kwechirwere cheMSK munzvimbo dzine vascularization yakaipa, yakadai se meniscus tear, tendon kukuvara uye dzimwe nzvimbo dzine urombo vascularization.
Kukurudzira uye anti-angiogenic platelet properties
Mumakumi mashoma emakore apfuura, zvidzidzo zvakaburitswa zvakaratidza kuti maplatelet anoita basa rakakosha mukutanga hemostasis, clot formation, kukura factor uye cytokine kuburitswa, uye angiogenesis regulation sechikamu chekugadzirisa tishu.Zvinoshamisa kuti, PRP α- Iwo magranules ane arsenal yepro-angiogenic kukura zvinhu, anti-angiogenic mapuroteni uye cytokines (akadai sePF4, plasminogen activator inhibitor-1 uye TSP-1), uye inotarisa kusunungurwa kwezvimwe zvinhu zvinoita basa. .Basa mu angiogenesis.Nokudaro, basa rePRP mukudzora angiogenesis regulation rinogona kutsanangurwa nekushandiswa kweiyo chaiyo cell surface receptors, TGF- β Tanga pro-angiogenic uye anti-angiogenic reactions.Kugona kweplatelet kudzidzira angiogenesis nzira yakasimbiswa mune pathological angiogenesis uye tumor angiogenesis.
Platelet-yakatorwa angiogenic kukura chinhu uye anti-angiogenic kukura chinhu, inotorwa kubva α- Uye dense uye anonamira mamorekuru.Chinonyanya kukosha, zvinowanzogamuchirwa kuti mhedzisiro yeplatelet pane angiogenesis ndeye pro-angiogenic uye inokurudzira.Zvinotarisirwa kuti PRP therapy ichadzora induction ye angiogenesis, iyo ichaita kuti pave nemigumisiro yekurapa kwezvirwere zvakawanda, zvakadai sekuporesa maronda uye kugadziriswa kwetishu.Kutungamirirwa kwePRP, kunyanya kutungamirirwa kwepamusoro pePGF uye mamwe maplatelet cytokines, anogona kukonzera angiogenesis, angiogenesis uye arteriogenesis, nokuti stromal cell-derived factor 1a inosunga kuCXCR4 receptor pane endothelial progenitor masero.Bill et al.Zvinokurudzirwa kuti PRP inowedzera ischemic neovascularization, iyo inogona kunge yakakonzerwa nekukurudzira angiogenesis, angiogenesis uye arteriogenesis.Mune yavo in vitro modhi, endothelial cell kuwanda uye kuumbwa kwecapillary kwakakonzerwa nenhamba huru yePDG dzakasiyana, iyo VEGF yaive iyo huru angiogenic stimulator.Chimwe chakakosha uye chakakosha chekudzorera iyo angiogenesis nzira ndeye synergy pakati pePGF dzakawanda.Richardson et al.Zvakaratidzwa kuti synergistic basa reangiogenic factor platelet-derived growth factor-bb (PDGF-BB) uye VEGF yakatungamirira kukurumidza kuumbwa kwekukura kwevascular network kana ichienzaniswa nebasa rekukura kwemunhu.Iko kusanganiswa kwezvinhu izvi kwakasimbiswa munguva pfupi yapfuura mune chidzidzo pamusoro pekusimudzirwa kwecerebral collateral circulation mumakonzo ane hypoperfusion kwenguva refu.
Chinonyanya kukosha, chidzidzo che in vitro chakayera kuwedzera kwemaitiro emunhu umbilical vein endothelial masero uye ma platelet akasiyana-siyana pakusarudzwa kwePRP kugadzirira mudziyo uye platelet dose zano, uye zvakabuda zvakaratidza kuti yakakwana platelet dose yaiva 1.5 × 10 6 maplatelet/ μ. 50. Kukurudzira angiogenesis.Kunyanya kuwandisa kweplatelet kunogona kutadzisa iyo angiogenesis maitiro, saka mhedzisiro yacho haina kunaka.
Sero kuchembera, kuchembera uye PRP
Cell senescence inogona kukonzerwa nekukurudzira kwakasiyana siyana.Iyi inzira iyo masero anomira kupatsanurwa uye kuita yakasarudzika phenotypic shanduko kudzivirira kusingadzivirirwe kukura kweakakuvadzwa maseru, ayo anoita basa rakakosha mukudzivirira kenza.Mukuita kwekuchembera kwemuviri, kuchembera kwesero kunosimudzirawo kuchembera kwesero, uye kugona kuzvarwa patsva kweMSCs kuchaderedzwa.
Migumisiro yekukwegura uye kukwegura kwesero
Mu vivo, marudzi akawanda emasero achakwegura uye aunganidze mumatishu akasiyana-siyana panguva yekukwegura, pakati payo pane nhamba huru yemasero ekukwegura.Kuunganidzwa kwemasero ekuchembera kunoratidzika kuwedzera nekuwedzera kwezera, kukuvara kwemuviri wemuviri, kukuvadzwa kwematishu kana zvinhu zvine chekuita nekushushikana.Iyo nzira yekukwegura kwemasero yakaonekwa sechirwere chechirwere chezvirwere zvine chokuita nezera, zvakadai se osteoarthritis, osteoporosis uye intervertebral disc degeneration.Zvimwe zvakasiyana-siyana zvinokurudzira zvichawedzera kukwegura kwesero.Mukupindura, iyo senescence-inoenderana secretory phenotype (SASP) ichavhara yakakwira kuwanda kweprotein masero uye cytokines.Iyi phenotype inokosha inobatanidza nemasero ekukwegura, umo vanobudisa mazinga akakwirira e-inflammatory cytokines (yakadai seIL-1, IL-6, IL-8), kukura kwezvinhu (zvakadai seTGF- β, HGF, VEGF, PDGF), MMP, uye cathepsin.Kuenzaniswa nevechidiki, SAPS yakaratidza kuwedzera nezera, nekuti iyo yakatsiga-yemamiriro maitiro inoparadzwa, zvichikonzera kuchembera kwesero uye kuderedzwa kugona kuberekwa patsva.Kunyanya, muzvirwere zvekubatana uye skeletal muscle zvirwere.Panyaya iyi, kuchembera kwekudzivirira kunoonekwa sekuchinja kukuru muhutano hwekudzivirira kwemasero ekudzivirira muviri, zvichiratidza kuti kusungirirwa kweTNF-a, IL-6 uye / kana Il-1b kunowedzera, zvichiita kuti kuderedzwa kusingaperi kusingaperi.Zvakakosha kucherechedza kuti stem cell dysfunction ine chekuitawo neasiri-cellular autonomous maitiro, senge masero ekuchembera, kunyanya kugadzirwa kwepro-inflammatory uye anti-regenerative zvinhu kuburikidza neSASP.
Pane zvinopesana, SASP inogonawo kukurudzira cell plasticity uye reprogramming yemaseru ari padyo.Pamusoro pezvo, SASP inogona kuronga kutaurirana nevamiriri vezvirwere zvakasiyana-siyana uye kumisa maseru edziviriro kusimudzira kucheneswa kwemasero ekuchembera.Kunzwisisa basa uye basa remasero ekuchembera kuchaita kuti kuporesa uye kugadziriswa kwetishu zveMSK tsandanyama uye maronda asingaperi.
Zvinokosha kuziva kuti Ritcka et al.Chidzidzo chakakura chakaitwa, uye basa guru uye rinobatsira reSASP mukusimudzira masero epurasitiki uye kuvandudzwa kwetishu rakawanikwa, uye pfungwa yekurapa kwenguva pfupi kuendeswa kwemasero ekukwegura yakaunzwa.Vakataura nokungwarira kuti kukwegura kunonyanya kubatsira uye kuita kuti munhu atangezve kuberekwa.
Kuchembera kwesero uye kugona kwePRP
Sezvo huwandu hwema stem cell huchiderera, kuchembera kuchakanganisa kuita kwe stem cell.Saizvozvo, muvanhu, stem cell maitiro (akadai sekuoma, kuwanda uye kusiyanisa) anodererawo nezera.Wang naNirmala vakashuma kuti kuchembera kwaizoderedza maitiro etendon cell stem masero uye nhamba yekukura factor receptors.Chidzidzo chemhuka chakaratidza kuti kuwanda kwePDGF mumabhiza madiki kwaive kwakakwira.Vakagumisa kuti kuwedzera kwenhamba yeGF receptors uye nhamba yeGF muvanhu vechidiki inogona kuva nekupindura kweserura kune PRP kurapwa kupfuura vanhu vakuru muvanhu vaduku.Izvi zvakawanikwa zvinoratidza kuti nei kurapwa kwePRP kungave kushoma kana kusashanda muvarwere vakura vane mashoma stem maseru uye "husina kunaka".Zvave zvichiratidzwa kuti kukwegura kwekuchembera kukwegura kunoshandurwa uye nguva yekuzorora yechondrocytes inowedzera mushure mejojo yePRP.Jia et al.Inoshandiswa kudzidza mbeva dermal fibroblasts in vitro photoaging, ine uye isina PRP kurapwa, kujekesa maitiro ePGF kupokana mune iyi modhi.Boka rePRP rakaratidza mhedzisiro yakananga pane extracellular matrix, yakawedzera mhando I collagen uye yakaderedza synthesis yemetalloproteinases, zvichiratidza kuti PRP inogona kurwisa kuchembera kwesero, uye zvakare mukuderera kwechirwere cheMSK.
Mune chimwe chidzidzo, PRP yakashandiswa kuunganidza masero emapfupa emapfupa kubva kumakonzo akwegura.Izvo zvakatemerwa kuti PRP inogona kudzoreredza akasiyana e stem cell mabasa kubva mukuchembera, sekuwanda kwesero uye kuumbwa kwekoloni, uye kuvakazve mamaki ane chekuita nekuchembera kwesero.
Munguva ichangopfuura, Oberlohr nevamwe vake vakadzidza zvakanyanya basa rekuchembera kwesero mukuderedza kuvandudzwa kwemhasuru, uye vakaongorora PRP uye platelet-varombo plasma (PPP) sezvipenyu zvekurapa maitiro ekugadzirisa skeletal muscle.Ivo vakafungidzira kuti PRP kana PPP kurapwa kwe skeletal tsandanyama kugadziriswa kwaizobva pane biological zvinhu zvakagadzirirwa SASP chaiwo maseru mamaki uye zvimwe zvinhu zvinotungamira mukukura kwefibrosis.
Zvinonzwisisika kutenda kuti kusati kwashandiswa kwePRP, kuchembera kwesero kunotarirwa kunogona kuvandudza maitiro ekuberekwazve kwehutano hwehutano hwehupenyu nekuderedza nzvimbo dzeSASP.Izvo zvave zvataurwa kuti imwe sarudzo yekuvandudza mhedzisiro yePRP uye PPP kurapwa kwe skeletal muscle regeneration ndeyekusarudza kubvisa masero achembera ane kuchembera scavengers.Hapana mubvunzo kuti tsvakurudzo ichangobva kuitika pamusoro pemigumisiro yePRP pakukwegura kwesero uye kuchembera inonakidza, asi ichiri muchikamu chekutanga.Naizvozvo, hazvina musoro kuita chero mazano panguva ino.
(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: Mar-01-2023