Kajeno, mohopolo o tsejoang e le PRP o hlahile pele lefapheng la hematology ka bo-1970.Lingaka tsa Hematologists li thehile lentsoe PRP lilemong tse mashome tse fetileng ho hlalosa plasma e fumanoang ho tsoa ho palo ea platelet e phahameng ho feta boleng ba motheo ba mali a peripheral.Lilemo tse fetang leshome hamorao, PRP e ile ea sebelisoa ho buuoa ka maxillofacial e le mofuta oa platelet rich fibrin (PRF).Likahare tsa fibrin ho sehlahisoa sena sa PRP se na le bohlokoa ba bohlokoa ka lebaka la ho khomarela le litšoaneleho tse tsitsitseng, ha PRP e na le thepa e tsitsitseng e khahlanong le ho ruruha 'me e susumetsa ho ata ha lisele.Qetellong, lilemong tsa bo-1990, PRP e ile ea qala ho tsebahala.Qetellong, theknoloji ena e ile ea fetisetsoa likarolong tse ling tsa bongaka.Ho tloha ka nako eo, mofuta ona oa biology e ntle e 'nile ea ithutoa haholo' me ea sebelisoa ho phekola likotsi tse sa tšoaneng tsa mesifa le masapo a baatlelete ba litsebi, tse ileng tsa tsoela pele ho khothalletsa tlhokomelo ea eona e atileng mecheng ea litaba.Ntle le ho atleha ho meriana ea masapo le meriana ea lipapali, PRP e boetse e sebelisoa ho ophthalmology, gynecology, urology le cardiology, bana le ho buuoa ka polasetiki.Lilemong tsa morao tjena, PRP e boetse e rorisoa ke dermatologists ka bokhoni ba eona ba ho phekola liso tsa letlalo, ho lokisoa ha leqeba, ho tsosolosoa ha lisele, ho tsosolosa letlalo esita le ho lahleheloa ke moriri.
Ha re nahana ka taba ea hore PRP e ka laola ka ho toba mekhoa ea pholiso le ea ho ruruha, hoa hlokahala ho kenyelletsa pholiso ea pholiso e le mokhoa oa ho bua.Mokhoa oa ho folisa o arotsoe ka mekhahlelo e mene e latelang: hemostasis;Ho ruruha;Ho ata ha lisele le matrix, 'me qetellong ho lokisoa ha maqeba.
Pholiso ea Lisele
The tissue folisa cascade reaction is activated, e lebisang ho platelet aggregation Ho thehoa ha li-clots le nts'etsopele ea nakoana ea extracellular matrix (ECM).Ebe, liplatelete li khomarela collagen e pepesitsoeng le protheine ea ECM, e leng se etsang hore ho lokolloe limolek'hule tsa bioactive tse teng ka li-granules.Liplatelete li na le mefuta e sa tšoaneng ea limolek'hule tsa bioactive, ho kenyelletsa le lintlha tsa khōlo, mabaka a chemotherapy le li-cytokine, hammoho le li-proinflammatory mediators, tse kang prostaglandin, prostate cyclin, histamine, thromboxane, serotonin le bradykinin.
Mohato oa ho qetela oa ho fola o itšetlehile ka ho nchafatsoa ha leqeba.Ho lokisoa ha lisele ho laoloa ka thata ho theha tekano lipakeng tsa anabolic le liketso tsa catabolic.Nakong ena, sekhahla sa kholo ea platelet-derived growth factor (PDGF) le phetoho ea kgolo (TGF- β) Fibronectin le fibronectin li susumetsa ho ata le ho falla ha fibroblasts, hammoho le ho qaptjoa ha likarolo tsa ECM.Leha ho le joalo, nako ea ho hōla ha leqeba e itšetlehile haholo ka ho teba ha leqeba, litšobotsi tsa motho ka mong le bokhoni bo khethehileng ba ho folisa ba leqeba le lemetseng.Lintho tse ling tsa pathophysiological le metabolism li ka ama mokhoa oa ho fola, joalo ka tishu ischemia, hypoxia, tšoaetso, ho se leka-lekane ha kholo, esita le mafu a amanang le metabolic syndrome.
The proinflammatory microenvironment e sitisa mokhoa oa ho folisa.Ntho e rarahaneng le ho feta ke hore ts'ebetso e phahameng ea protease e thibela ketso ea tlhaho ea kholo ea kholo (GF).Ntle le thepa ea eona ea mitotic, angiogenic le chemotactic, PRP e boetse ke mohloli o ruileng oa lintlha tse ngata tsa kholo.Li-biomolecule tsena li ka 'na tsa loantša liphello tse kotsi liphatseng tsa lefutso ka ho laola ho ruruha ho eketsehileng le ho theha tšusumetso ea anabolic.Ha ho nahanoa ka litšobotsi tsena, bafuputsi ba ka fumana monyetla o moholo oa ho phekola likotsi tse fapaneng tse rarahaneng.
Mafu a mangata, haholo-holo a tlhaho ea musculoskeletal, a itšetlehile haholo ka lihlahisoa tsa likokoana-hloko tse laolang mokhoa oa ho ruruha, tse kang PRP bakeng sa phekolo ea osteoarthritis.Tabeng ena, bophelo bo botle ba lefufuru la articular bo itšetlehile ka tekanyo e nepahetseng ea anabolic le liketso tsa catabolic.Ho nahanoa ka molao-motheo ona, tšebeliso ea lintho tse ling tse molemo tsa likokoana-hloko e ka ipaka e atlehile ho finyella ho leka-lekana ho nepahetseng.PRP hobane e ntša liplatelete α- Lintho tsa ho hōla tse nang le li-granules li sebelisoa haholo ho laola bokhoni ba phetoho ea lisele, e leng ho fokotsang bohloko.Ha e le hantle, e 'ngoe ea lipakane tse ka sehloohong tsa phekolo ea PRP ke ho emisa microenvironment e ka sehloohong ea ho ruruha le ea catabolic le ho khothalletsa phetoho ho lithethefatsi tse khahlanong le ho ruruha.Bangoli ba bang ba kile ba bontša hore thrombin activated PRP e eketsa ho lokolloa ha limolek'hule tse 'maloa tsa likokoana-hloko.Lintlha tsena li kenyelletsa hepatocyte growth factor (HGF) le tumor necrosis factor (TNF- α) , Transforming growth factor beta1 (TGF- β 1), vascular endothelial growth factor (VEGF) le epidermis Growth factor (EGF).Liphuputso tse ling li bontšitse hore PRP e khothalletsa keketseho ea mofuta oa ii collagen le maemo a aggrecan mRNA, ha e ntse e fokotsa ho thibela pro-inflammatory cytokine interleukin - (IL) 1 ho tsona.Hape ho ile ha boleloa hore ka lebaka la HGF le TNF- α [28] PRP e ka thusa ho theha phello e khahlanong le ho ruruha.Litokisetso tsena ka bobeli tsa limolek'hule li fokotsa tšebetso ea nyutlelie kappaB (NF- κВ) Anti activation and expression;Taba ea bobeli, ka polelo ea TGF- β 1 e boetse e thibela monocyte chemotaxis, ka hona e hanyetsa TNF- α Phello ea phetiso ea chemokine.HGF e bonahala e bapala karolo ea bohlokoa ho phello e khahlanong le ho ruruha e bakoang ke PRP.Cytokine ena e matla e khahlanong le ho ruruha e senya tsela ea ho bontša NF- κ B le polelo ea proinflammatory cytokine e thibela karabelo ea ho ruruha.Ho phaella moo, PRP e ka boela ea fokotsa boemo bo phahameng ba nitric oxide (NO).Mohlala, ka har'a lefufuru la articular, ho eketseha ha mohopolo oa NO ho ipakile ho thibela collagen synthesis le ho etsa hore chondrocyte apoptosis, ha e ntse e eketsa motsoako oa matrix metalloproteinases (MMPs), ka tsela eo e khothaletsa phetoho ea catabolism.Mabapi le ho senyeha ha lisele, PRP e boetse e nkoa e ka khona ho laola autophagy ea mefuta e itseng ea lisele.Ha li fihla boemong ba ho tsofala ba ho qetela, lihlopha tse ling tsa lisele li lahleheloa ke monyetla oa ho ema le ho inchafatsa.Leha ho le joalo, liphuputso tsa morao-rao li bontšitse hore phekolo ea PRP e ka fetola maemo ana a kotsi.Moussa le basebetsi-'moho le eena ba ile ba paka hore PRP e ka etsa hore ho be le tšireletso ea li-chondrocyte ka ho eketsa li-autophagy le li-anti-inflammatory markers, ha li ntse li fokotsa apoptosis ea lefuba la masapo a motho.Garcia Pratt le al.Ho tlalehoa hore autophagy e etsa qeto ea phetoho pakeng tsa ho phomola le ho tsofala ha lisele tsa mesifa ea mesifa.Bafuputsi ba lumela hore, ka vivo, ho tloaeleha ha autophagy e kopantsoeng ho qoba ho bokella tšenyo ea intracellular le ho thibela botsofali le ho fokotseha ha tšebetso ea lisele tsa sathelaete.Esita le liseleng tsa batho tse tsofalang, tse kang morao tjena, Parrish le Rodes le tsona li entse tlatsetso e kholo, li senola ka ho eketsehileng matla a khahlanong le ho ruruha a PRP.Lekhetlong lena, ho tsepamisitsoe maikutlo ho tšebelisano lipakeng tsa liplatelete le li-neutrophils.Phuputsong ea bona, bafuputsi ba ile ba hlalosa hore liplatelete tse sebelisoang tse hlahisitsoeng ke arachidonic acid li ile tsa kenngoa ke li-neutrophils 'me tsa fetoloa leukotrienes le prostaglandins, tse tsejoang ke limolek'hule tsa ho ruruha.Leha ho le joalo, tšebelisano ea platelet neutrophil e lumella leukotriene hore e fetohe lipoprotein, e 'nileng ea pakoa e le protheine e sebetsang e khahlanong le ho ruruha e ka fokotsang ts'ebetso ea li-neutrophils le ho thibela dialysis, le ho khothalletsa lefa ho fihlela mohato oa ho qetela oa pholiso ea pholiso.
The proinflammatory microenvironment e sitisa mokhoa oa ho folisa.Ntho e rarahaneng le ho feta ke hore ts'ebetso e phahameng ea protease e thibela ketso ea tlhaho ea kholo ea kholo (GF).Ntle le thepa ea eona ea mitotic, angiogenic le chemotactic, PRP e boetse ke mohloli o ruileng oa lintlha tse ngata tsa kholo.Li-biomolecule tsena li ka 'na tsa loantša liphello tse kotsi liphatseng tsa lefutso ka ho laola ho ruruha ho eketsehileng le ho theha anabolic stimulation.
Ntho ea Seleng
Li-cytokine ho PRP li phetha karolo ea bohlokoa ho laola mokhoa oa ho lokisa lisele le ho laola tšenyo ea ho ruruha.Li-cytokine tse khahlanong le ho ruruha ke mefuta e mengata ea limolek'hule tsa biochemical tse sebetsanang le karabelo ea li-cytokine tsa proinflammatory, haholo-holo tse susumetsoang ke macrophages a sebetsang.Li-cytokine tse khahlanong le ho ruruha li sebelisana le li-cytokine inhibitors tse khethehileng le li-receptor tsa cytokine tse qhibilihang ho laola ho ruruha.Interleukin (IL) - 1 receptor antagonists, IL-4, IL-10, IL-11 le IL-13 li khetholloa e le lithethefatsi tse ka sehloohong tse khahlanong le ho ruruha, li-cytokines.Ho ea ka mefuta e fapaneng ea maqeba, li-cytokine tse ling, tse kang interferon, leukemia inhibitory factor, TGF- β Le IL-6, e ka bontšang liphello tsa proinflammatory kapa anti-inflammatory.TNF-α, IL-1 le IL-18 li na le li-receptor tse itseng tsa cytokine, tse ka thibelang phello ea ho ruruha ea liprotheine tse ling [37].IL-10 ke e 'ngoe ea li-cytokine tse sebetsang ka ho fetisisa tse thibelang ho ruruha, tse ka fokotsang ho laola li-cytokine tsa proinflammatory tse kang IL-1, IL-6 le TNF- α， Le holimo ho laola lintho tse khahlanong le ho ruruha.Mekhoa ena e khahlanong le taolo e bapala karolo ea bohlokoa tlhahisong le tšebetsong ea li-cytokine tsa proinflammatory.Ntle le moo, li-cytokine tse ling li ka 'na tsa etsa hore ho be le karabelo e itseng ea matšoao ho susumetsa li-fibroblasts, tse bohlokoa bakeng sa tokiso ea lisele.Ho ruruha ha cytokine TGF β 1, IL-1 β, IL-6, IL-13 le IL-33 li susumetsa li-fibroblasts hore li khetholle ho myofibroblasts le ho ntlafatsa ECM [38].Ka lehlakoreng le leng, li-fibroblasts li hlahisa cytokine TGF- β, IL-1 β, IL-33, CXC le CC chemokines li khothalletsa ho arabela ka ho ruruha ka ho kenya le ho bokella lisele tsa 'mele tsa ho itšireletsa mafung tse kang macrophages.Lisele tsena tse ruruhileng li bapala likarolo tse ngata leqebeng, haholo-holo ka ho khothalletsa ho tlosoa ha maqeba - le biosynthesis ea chemokines, metabolites le lintlha tsa kholo, e leng tsa bohlokoa bakeng sa tsosoloso ea lisele tse ncha.Ka hona, li-cytokine ho PRP li phetha karolo ea bohlokoa ho susumetsang karabelo ea 'mele ea ho itšireletsa mafung le ho khothalletsa ho fokotseha ha sethala sa ho ruruha.Ha e le hantle, bafuputsi ba bang ba khethile mokhoa ona e le "ho ruruha ho tsosolosang", ho bontšang hore mohato oa ho ruruha, ho sa tsotellehe matšoenyeho a mokuli, ke mohato o hlokahalang le oa bohlokoa bakeng sa ho qetela ka katleho ea ts'ebetso ea ho lokisa lisele, ho nahanela mokhoa oa epigenetic oo ho ruruha ho bontšang matšoao. khothalletsa cell plasticity.
Karolo ea li-cytokine ho ruruha ha letlalo la lesea ke ea bohlokoa haholo ho lipatlisiso tsa meriana e tsosolosang.Phapang pakeng tsa mekhoa ea ho folisa lesea le batho ba baholo ke hore ka linako tse ling lisele tse senyehileng tsa lesea li khutlela boemong ba tsona ba pele ho ea ka lilemo tsa lesea le mefuta ea lisele tse amehang.Ho batho, letlalo la lesea le ka tsosolosoa ka ho feletseng nakong ea libeke tse 24, athe ho batho ba baholo, ho fola ha maqeba ho ka lebisa ho thehoeng ha lebali.Joalo ka ha re se re tsebile, ha re bapisoa le lisele tse phetseng hantle, thepa ea mochini ea maqeba e fokotsehile haholo, 'me mesebetsi ea bona ea fokola.Ho lebisoa tlhokomelo e khethehileng ho cytokine IL-10, e fumanoang e hlahisoa haholo ke amniotic fluid le letlalo la fetal, 'me ho ipakile hore e na le karolo ea ho lokisa letlalo la lesea ntle le leqeba, e khothalletsoang ke phello ea pleiotropic ea cytokine.ZgheibC et al.Ho fetisetsoa ha letlalo la lesea ho transgenic knockout (KO) IL-10 litoeba le litoeba tsa taolo li ile tsa ithutoa.Litoeba tsa IL-10KO li bontšitse matšoao a ho ruruha le ho thehoa ha maqeba ho pota-potile li-grafts, ha li-grafts tsa sehlopha sa taolo li ne li sa bontše liphetoho tse kholo linthong tsa biomechanical le ho folisa lebali.
Bohlokoa ba ho laola ho leka-lekana ho tsitsitseng pakeng tsa polelo ea li-cytokine tse thibelang ho ruruha le tse thibelang ho ruruha ke hore ea morao-rao, ha e hlahisoa ho feta tekano, qetellong e romela matšoao a ho senyeha ha lisele ka ho fokotsa ponahalo ea liphatsa tse itseng tsa lefutso.Ka mohlala, meriana ea musculoskeletal, IL-1 β Down e laola SOX9, e ikarabellang bakeng sa nts'etsopele ea lefufuru.SOX9 e hlahisa lintlha tsa bohlokoa tsa ho ngoloa bakeng sa nts'etsopele ea lefufuru, e laola mofuta oa II collagen alpha 1 (Col2A1), 'me e ikarabella bakeng sa ho kenya liphatsa tsa lefutso tsa mofuta oa II collagen.IL-1 β Qetellong, polelo ea Col2A1 le aggrecan e fokotsehile.Leha ho le joalo, phekolo e nang le lihlahisoa tse nang le platelet e ngata e bontšitsoe ho thibela IL-1 β E ntse e le molekane ea ka khonehang oa meriana e tsosolosang ho boloka polelo ea liphatsa tsa lefutso tsa collagen le ho fokotsa apoptosis ea li-chondrocyte tse bakoang ke li-cytokine tsa proinflammatory.
Ho tsosoa ha li-anabolic: Ntle le ho laola boemo ba ho ruruha ha lisele tse senyehileng, li-cytokine tsa PRP li boetse li kenya letsoho karabelong ea anabolic ka ho phetha karolo ea tsona ea mitosis, ho khahloa ke lik'hemik'hale le ho ata.Ena ke thuto ea in vitro e etelletsoeng pele ke Cavallo et al.Ho ithuta liphello tsa li-PRP tse fapaneng ho li-chondrocyte tsa batho.Bafuputsi ba hlokometse hore lihlahisoa tsa PRP tse nang le li-platelet tse batlang li le tlaase le li-leukocyte li susumetsa mosebetsi o tloaelehileng oa chondrocyte, e leng se loketseng ho khothalletsa mekhoa e meng ea cellular ea karabelo ea anabolic.Mohlala, polelo ea mofuta oa II collagen le aggregating glycans e ile ea bonoa.Ka lehlakoreng le leng, likhahla tse phahameng tsa liplatelete le li-leukocyte li bonahala li susumetsa litsela tse ling tsa liselefouno tse amanang le li-cytokine tse sa tšoaneng.Bangoli ba fana ka maikutlo a hore sena se ka 'na sa bakoa ke ho ba teng ha palo e kholo ea lisele tse tšoeu tsa mali ka mokhoa ona o khethehileng oa PRP.Lisele tsena li bonahala li ikarabella bakeng sa pontšo e eketsehileng ea lintlha tse itseng tsa kholo, tse kang VEGF, FGF-b, le interleukins IL-1b le IL-6, tse ka 'nang tsa susumetsa TIMP-1 le IL-10.Ka mantsoe a mang, ha ho bapisoa le mokhoa o "mpe" oa PRP, motsoako oa PRP o ruileng ka li-platelet le lisele tse tšoeu tsa mali ho bonahala li khothalletsa ho hlasela ha li-chondrocyte.
Thuto e entsoeng ke Schnabel et al.e ne e etselitsoe ho lekola karolo ea li-autologous biomaterials meleng ea tendon ea pere.Bangoli ba ile ba bokella lisampole tsa mali le li-tendon ho lipere tse tšeletseng tse kholo (lilemo tse 2-4), 'me li tsepamisitse maikutlo thutong ea gene expression pattern, DNA le collagen content ea tendon explants ea flexor digitorum superficialis ea lipere tse hlahisitsoeng bohareng ba PRP. kapa lihlahisoa tse ling tsa mali.Li-explants tsa tendon li ne li hlahisoa ka mali, plasma, PRP, platelet deficient plasma (PPP) kapa masapo a masapo a masapo (BMA), 'me li-amino acid li kenyelelitsoe ho 100%, 50% kapa 10% ea serum ea mahala ea DMEM.Ha ho etsoa tlhahlobo e sebetsang ea lik'hemik'hale ka mor'a ..., bafuputsi ba hlokometse hore TGF- β The concentration of PDGF-BB le PDGF-1 in PRP medium e ne e phahame haholo ho feta ea lihlahisoa tse ling tsa mali tse lekiloeng.Ho phaella moo, lisele tsa tendon tse hlahisitsoeng ka 100% PRP medium li bontšitse ho eketseha ha liphatsa tsa lefutso tsa liprotheine tsa matrix COL1A1, COL3A1 le COMP, empa ha lia ka tsa eketsa li-enzyme tsa catabolic MMPs3 le 13. Bonyane mabapi le sebopeho sa tendon, thuto ena ea vivo e tšehetsa tšebeliso ea autolo - sehlahisoa sa mali sa gouty, kapa PRP, bakeng sa phekolo ea tendonitis e kholo ea mammalian.
Chen et al.Phello ea ho tsosolosa ea PRP e ile ea tšohloa hape.Letotong la liphuputso tsa bona tse fetileng, bafuputsi ba ile ba paka hore, ntle le ho ntlafatsa sebopeho sa lefufuru, PRP e ile ea boela ea khothalletsa ho eketseha ha ECM synthesis le ho thibela ho ruruha ha lefufuru la articular le nucleus pulposus.PRP e ka etsa hore TGF e sebetse ka phosphorylation ea Smad2 / 3- β Tsela ea pontšo e phetha karolo ea bohlokoa ho holisa lisele le ho arohana.Ho phaella moo, ho boetse ho lumeloa hore li-clots tsa fibrin tse entsoeng ka mor'a ts'ebetso ea PRP li fana ka mohaho o tiileng oa likarolo tse tharo, tse nolofalletsang lisele ho khomarela, tse ka lebisang ho hahoa ha lisele tse ncha.
Bafuputsi ba bang ba entse tlatsetso e khōlō ho phekoleng liso tse sa foleng tsa letlalo lefapheng la letlalo.Sena le sona sea hlokomeleha.Mohlala, lipatlisiso tse entsoeng ke Hessler le Shyam ka selemo sa 2019 li bonts'a hore PRP e bohlokoa joalo ka kalafo e 'ngoe e ka khonehang le e sebetsang, athe seso se sa foleng se hananang le lithethefatsi se ntse se tlisa moroalo o moholo oa moruo ho tsa bophelo bo botle.Haholo-holo, lefu la tsoekere leoto la lefu la tsoekere ke bothata bo tsebahalang haholo ba bophelo bo botle, bo etsang hore ho be bonolo ho pongoa matsoho.Phuputso e hatisitsoeng ke Ahmed et al.ka 2017 e bontšitse hore autologous PRP gel e ka susumetsa pholiso ea maqeba ho bakuli ba nang le lefu la tsoekere le sa foleng leoto ka ho lokolla lintlha tse hlokahalang tsa ho hōla, kahoo ba ntlafatsa haholo tekanyo ea pholiso.Ka mokhoa o ts'oanang, Gonchar le basebetsi-'moho ba ile ba hlahloba le ho buisana ka bokhoni ba ho tsosolosa PRP le li-cocktails tsa kholo ho ntlafatsa phekolo ea liso tsa maoto a lefu la tsoekere.Bafuputsi ba ile ba etsa tlhahiso ea hore tšebeliso ea metsoako ea kgolo e ka 'na ea e-ba tharollo e ka khonehang, e ka ntlafatsang melemo ea ho sebelisa PRP le ntlha e le' ngoe ea kgolo.Ka hona, ha ho bapisoa le tšebeliso ea ntho e le 'ngoe ea ho hōla, motsoako oa PRP le mekhoa e meng ea phekolo e ka khothalletsa haholo pholiso ea liso tse sa foleng.
Fibrin
Liplatelete li na le lintlha tse 'maloa tse amanang le sistimi ea fibrinolytic, e ka nyolohang e laola kapa ea theosa e laola karabelo ea fibrinolytic.Kamano ea nako le monehelo o lekanyelitsoeng oa likarolo tsa hematological le mosebetsi oa platelet ho senyeha ha lesela e ntse e le bothata bo lokelang ho buisanoa ka bongata sechabeng.Lingoliloeng li hlahisa lithuto tse ngata tse shebaneng feela le liplatelete, tse tummeng ka bokhoni ba tsona ba ho ama mokhoa oa pholiso.Ho sa tsotellehe palo e kholo ea lithuto tse hlaheletseng, likarolo tse ling tsa hematological, tse kang coagulation factor le fibrinolytic systems, le tsona li fumanoe li tlatsetsa haholo ho lokisoeng ha maqeba ka katleho.Ka tlhaloso, fibrinolysis ke ts'ebetso e rarahaneng ea likokoana-hloko e itšetlehileng ka ts'ebetso ea li-enzyme tse itseng ho khothalletsa ho senyeha ha fibrin.Karabelo ea Fibrinolysis e hlahisitsoe ke bangoli ba bang hore lihlahisoa tsa degradation tsa fibrin (fdp) e kanna ea ba limolek'hule tse ikarabellang bakeng sa ho hlohlelletsa tokiso ea lisele.Tatelano ea liketsahalo tsa bohlokoa tsa likokoana-hloko pele e tsoa ho fibrin deposition le ho tlosoa ha angiogenesis, e hlokahalang bakeng sa pholiso ea maqeba.Ho thehoa ha li-clots ka mor'a kotsi ho sebetsa e le lera le sireletsang ho sireletsa lisele tsa mali ho lahleheloa ke mali le ho hlaseloa ke likokoana-hloko, hape li fana ka matrix ea nakoana eo lisele li ka fallang ka eona nakong ea ts'ebetso ea ho lokisa.Leqeba le bakoa ke hore fibrinogen e petsoha ke serine protease, 'me liplatelete li bokelloa ka har'a letlooeng la fiber ea fiber.Karabelo ena e ile ea etsa hore ho be le polymerization ea fibrin monomer, e leng ketsahalo e ka sehloohong ea ho thehoa ha leqeba la mali.Leqeba le ka boela la sebelisoa e le letamo la li-cytokine le lintlha tsa kholo, tse lokolloang nakong ea degranulation ea liplatelete tse kentsoeng.Sistimi ea fibrinolytic e laoloa ka thata ke plasmin, 'me e phetha karolo ea bohlokoa ho khothaletse ho falla ha lisele, bioavailability ea lintlha tsa kholo le taolo ea litsamaiso tse ling tsa protease tse amehang ho ruruheng ha lisele le ho nchafatsa.Likarolo tsa bohlokoa tsa fibrinolysis, joalo ka urokinase plasminogen activator receptor (uPAR) le plasminogen activator inhibitor-1 (PAI-1), li tsejoa li hlahisoa ka lisele tsa mesenchymal stem (MSCs), e leng mefuta e khethehileng ea lisele tse hlokahalang bakeng sa ho folisa leqeba ka katleho. .
Ho falla ha Lisele
Ts'ebetso ea plasminogen ka mokhatlo oa uPA uPAR ke ts'ebetso e khothalletsang ho falla ha lisele tsa ho ruruha hobane e matlafatsa proteolysis ea extracellular.Ka lebaka la khaello ea libaka tsa transmembrane le intracellular, uPAR e hloka li-co receptors tse kang integrin le vitellin ho laola ho falla ha lisele.E ile ea boela ea bontša hore ho tlama ha UPA uPAR ho entse hore ho be le keketseho ea kamano ea UPAR bakeng sa vitrectonectin le integrin, e khothalletsang ho khomarela lisele.Plasminogen activator inhibitor-1 (PAI-1) le eona e etsa hore lisele li itokolle.Ha e tlama ho uPA ea uPA upar integrin complex holim'a sele, e senya tšebelisano lipakeng tsa upar vitellin le integrin vitellin.
Sebakeng sa meriana ea ho tsosolosa, lisele tsa 'mele tsa mesenchymal stem li bokelloa ho tloha mokong oa masapo tabeng ea tšenyo e khōlō ea litho, kahoo li ka fumanoa ho potoloha ha bakuli ba nang le fractures tse ngata.Leha ho le joalo, maemong a itseng, a kang ho hloleha ha renal ea ho qetela, ho hlōleha ha sebete sa ho qetela, kapa nakong ea ho lahloa ka mor'a ho fetisoa ha pelo, lisele tsena li ka 'na tsa se ke tsa fumanoa maling [66].Hoa thahasellisa hore lisele tsena tsa masapo a motho tse tsoang mesenchymal (stromal) li ne li ke ke tsa fumanoa maling a batho ba phelang hantle [67].Karolo ea UPAR ho bokelleng ha masapo a mesenchymal stem cell (BMSCs) e 'nile ea hlahisoa pejana, e ts'oanang le ketsahalo ea uPAR ho bokelleng li-hematopoietic stem cell (HSCs).Varabaneni et al.Liphetho li bonts'itse hore ts'ebeliso ea "granulocyte colony-stimulating factor" ho litoeba tse haelloang ke UPAR e bakile ho hloleha ha MSC, e ileng ea boela ea matlafatsa karolo ea ts'ehetso ea sistimi ea fibrinolysis ho phallo ea lisele.Liphuputso tse ling li boetse li bontšitse hore glycosyl phosphatidylinositol anchored uPA receptors e laola ho khomarela, ho falla, ho ata le ho arohana ka ho kenya litsela tse ling tsa matšoao a intracellular, ka tsela e latelang: phosphatidylinositol 4,5-diphosphate 3-kinase / Akt2 le adhesion pathways, le ERK1. (FAK).
Boemong ba pholiso ea maqeba a MSC, ntlha ea fibrinolytic e pakile bohlokoa ba eona bo eketsehileng.Ka mohlala, litoeba tse haelloang ke plasminogen li bontšitse ho lieha ho matla ha liketsahalo tsa ho folisa maqeba, ho bontša hore plasmin e ne e le ea bohlokoa ts'ebetsong ena.Ho batho, tahlehelo ea plasmin le eona e ka baka mathata a ho folisa maqeba.Ho sitisa ho phalla ha mali ho ka thibela haholo ho tsosolosoa ha lisele, e leng se hlalosang hore na ke hobane'ng ha mekhoa ena ea tsosoloso e le thata ho bakuli ba nang le lefu la tsoekere.
Lisele tsa 'mele oa masapo a mesenchymal li ile tsa kenngoa sebakeng sa leqeba ho potlakisa ho fola ha maqeba.Tlas'a maemo a tsitsitseng, lisele tsena li hlahisa uPAuPAR le PAI-1.Liprotheine tse peli tsa ho qetela ke hypoxia inducible factor α (HIF-1 α) Targeting e bonolo haholo hobane HIF-1 ho MSCs α The activation of FGF-2 le HGF khothalletsa up regulation of FGF-2 le HGF;HIF-2 α Ka lehlakoreng le leng, VEGF-A [77] e laoloa, e leng hammoho e tlatsetsang ho folisa maqeba,.Ho feta moo, HGF e bonahala e ntlafatsa ho hira lisele tsa 'mele tsa mesenchymal stem libakeng tsa maqeba ka mokhoa oa synergistic.Hoa lokela ho hlokomeloa hore maemo a ischemic le hypoxic a bontšitsoe hore a kena-kenana haholo le ho lokisoa ha maqeba.Leha li-BMSC li tloaetse ho phela ka har'a lisele tse fanang ka maemo a tlase a oksijene, ho phela ha li-BMSC tse fetisitsoeng ka har'a vivo ho fokotseha hobane lisele tse fetisitsoeng hangata li shoa tlasa maemo a mabe a bonoang liseleng tse senyehileng.Qetello ea ho khomarela le ho phela ha 'moko oa mesenchymal stem lisele tse tlas'a hypoxia e itšetlehile ka lintlha tsa fibrinolytic tse hlahisoang ke lisele tsena.PAI-1 e na le kamano e phahameng bakeng sa vitellin, kahoo e ka hlōlisana bakeng sa ho tlama ha uPAR le integrin ho vitellin, kahoo e thibela ho khomarela le ho falla.
Monocyte le Sistimi ea Tsosoloso
Ho ea ka lingoliloeng, ho na le lipuisano tse ngata mabapi le karolo ea monocyte pholisong ea maqeba.Macrophages haholo-holo e tsoa ho li-monocyte tsa mali 'me e phetha karolo ea bohlokoa meriana e tsosolosang [81].Hobane li-neutrophils li hlahisa IL-4, IL-1, IL-6 le TNF- α, Hangata lisele tsena li phunyeletsa leqeba lihora tse ka bang 24-48 ka mor'a kotsi.Liplatelete li lokolla thrombin le platelet factor 4 (PF4), e ka khothalletsang ho hiroa ha monocyte le ho arola ka macrophages le lisele tsa dendritic.Tšobotsi ea bohlokoa ea macrophages ke polasetiki ea bona, ke hore, ba ka fetola li-phenotypes 'me ba arola mefuta e meng ea lisele, tse kang lisele tsa endothelial, ebe li bontša mesebetsi e fapaneng ho mefuta e sa tšoaneng ea lik'hemik'hale tsa likokoana-hloko sebakeng sa microenvironment ea leqeba.Lisele tsa ho ruruha li hlahisa li-phenotype tse peli tse kholo, M1 kapa M2, ho itšetlehile ka pontšo ea limolek'hule tsa sebaka seo e le mohloli oa ts'usumetso.Li-macrophages tsa M1 li susumetsoa ke likokoana-hloko, kahoo li na le liphello tse ngata tsa ho ruruha.Ka lehlakoreng le leng, li-macrophages tsa M2 hangata li hlahisoa ke mekhoa ea mofuta oa 2 'me li na le thepa e khahlanong le ho ruruha, e tsejoang ka ho eketseha ha IL-4, IL-5, IL-9, le IL-13.E boetse e ameha ho lokisoeng ha lisele ka ho hlahisa lintlha tsa kgolo.Phetoho ho tloha ho M1 ho ea ho M2 subtype e tsamaisoa haholo ke mohato oa morao oa ho folisa maqeba.Li-macrophages tsa M1 li etsa hore ho be le neutrophil apoptosis le ho qala ho tlosoa ha lisele tsena).Phagocytosis ea neutrophils e etsa hore ho be le letoto la liketsahalo, moo tlhahiso ea li-cytokine e tingoang, polarizing macrophages le ho lokolla TGF-β 1. Ntho ena ea kgolo ke molaoli oa bohlokoa oa phapang ea myofibroblast le ho fokotseha ha leqeba, e leng se lumellang ho rarolla ho ruruha le ho ruruha. ho qaleha ha mohato oa ho ata nakong ea pholiso ea pholiso [57].Protheine e 'ngoe e amanang haholo e amehang lits'ebetsong tsa cellular ke serine (SG).Hemopoietic cell secretory granule proteoglycan e fumanoe e hlokahala ho boloka liprotheine tsa lekunutu liseleng tse ikhethileng tsa 'mele, joalo ka lisele tsa mast, neutrophils le cytotoxic T lymphocyte.Le hoja lisele tse ngata tseo e seng tsa hematopoietic li boetse li etsa plasminogen, lisele tsohle tsa ho ruruha li hlahisa palo e kholo ea protheine ena 'me li e boloka ka li-granules bakeng sa tšebelisano e eketsehileng le bahlaseli ba bang ba ho ruruha, ho akarelletsa le proteases, cytokines, chemokines le lintlha tsa kholo.Liketane tsa glycosaminoglycan (GAG) tse qosoang hampe ho SG li bonahala li le bohlokoa ho tiiseng ha li-granules tsa sephiri, kaha li khona ho tlama le ho thusa ho boloka likaroloana tsa granular tse qosoang ka mokhoa o ikhethileng oa sele, protheine le ketane ea GAG.Mabapi le ho kenya letsoho ha bona lipatlisisong tsa PRP, Woulfe le basebetsi-'moho ba kile ba bontša hore khaello ea SG e amana haufi-ufi le liphetoho tsa morphological platelet;Platelet factor 4 β- Litšitiso tsa polokelo ea PDGF ka thromboglobulin le liplatelete;Pokello e mpe ea platelet le secretion in vitro le thrombosis defect in vivo.Ka hona, bafuputsi ba fihletse qeto ea hore proteoglycan ena e bonahala e le eona e laolang thrombosis.
Lihlahisoa tse ruileng tsa Platelet li ka fumana mali a motho ka ho bokella le ho centrifugation, 'me li arola motsoako ka likarolo tse fapaneng tse nang le plasma, liplatelete, lisele tse tšoeu tsa mali le lisele tse tšoeu tsa mali.Ha khatello ea platelet e phahame ho feta boleng ba motheo, e ka potlakisa kholo ea masapo le lisele tse bonolo, ka litla-morao tse fokolang.Tšebeliso ea lihlahisoa tsa PRP tsa autologous ke theknoloji e ncha e batlang e le ncha, e 'nileng ea bontša liphello tse ntle ka ho susumetsa le ho ntlafatsa pholiso ea likotsi tse fapaneng tsa lisele.Ho sebetsa ha mokhoa ona o mong oa phekolo ho ka 'na ha bakoa ke ho fana ka sebaka sa libaka tsa mefuta e mengata ea ho hōla le liprotheine ho etsisa le ho tšehetsa mokhoa oa ho folisa leqeba la' mele le mokhoa oa ho lokisa lisele.Ntle le moo, ho hlakile hore sistimi ea fibrinolytic e na le tšusumetso ea bohlokoa ho lokisoeng ha lisele.Ntle le ho fetola khiro ea lisele tsa lisele tse ruruhileng le lisele tsa 'mele tsa mesenchymal stem, e ka laola ts'ebetso ea proteolytic ea libaka tsa pholiso ea maqeba le ts'ebetso ea nchafatso ea lisele tsa mesodermal, ho kenyeletsoa lesapo, lefufuru le mesifa, ka hona ke karolo ea bohlokoa ea moriana oa mesifa le masapo.
Pholiso e potlakileng ke sepheo se phehelloang haholo ke litsebi tse ngata lefapheng la bongaka.PRP e emela sesebelisoa se setle sa baeloji, se ntseng se tsoela pele ho fana ka nts'etsopele e ts'episang ho hlasimolla le ho hokahanya sekhahla sa liketsahalo tse nchafatsang.Leha ho le joalo, hobane sesebelisoa sena sa phekolo se ntse se rarahane haholo, haholo-holo hobane se lokolla lintlha tse ngata tsa bioactive le mekhoa ea tsona e sa tšoaneng ea ho sebelisana le liphello tsa ho fetisetsa lipontšo, lipatlisiso tse ling lia hlokahala.
(Likahare tsa sengoloa sena li hatisitsoe hape, 'me ha re fane ka tiisetso efe kapa efe e hlakileng kapa e boletsoeng bakeng sa ho nepahala, ho ts'epahala kapa botlalo ba litaba tse teng sengolong sena,' me ha re ikarabelle bakeng sa maikutlo a sengoloa sena, ka kopo utloisisa.)
Nako ea poso: Dec-16-2022