Khopolo e tsejoang kajeno e le PRP e qalile ho hlaha lefapheng la hematology ka bo-1970.Li-Hematologists li ile tsa qapa lentsoe PRP lilemong tse mashome tse fetileng ho leka ho hlalosa plasma e fumanoeng ho tsoa lipalong tsa liplatelete ka holimo ho boleng ba basal maling 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 tsoa ho PRP ena ke tsa bohlokoa haholo bakeng sa thepa ea eona ea ho khomarela le ea homeostatic, ha PRP e na le mekhoa e tsitsitseng e khahlanong le ho ruruha 'me e susumetsa ho ata ha lisele.Qetellong, ho pota 1990s, PRP e ile ea tsebahala, 'me qetellong, theknoloji e ile ea fetisetsoa likarolong tse ling tsa bongaka.Ho tloha ka nako eo, biology ena e ntle e 'nile ea ithutoa haholo' me ea sebelisoa ho phekola likotsi tse sa tšoaneng tsa mesifa le masapo ho baatlelete ba litsebi, e leng se tlatsetsang tlhokomelong ea eona ea mecha ea litaba.Ntle le ho atleha ho meriana ea masapo le meriana ea lipapali, PRP e sebelisoa ho ophthalmology, gynecology, urology le cardiology, bana le ho buuoa ka polasetiki.Lilemong tsa morao tjena, PRP e boetse e rorisoa ke litsebi tsa dermatologists bakeng sa bokhoni ba eona ba ho phekola liso tsa letlalo, ho tsosolosa leqeba, ho tsosolosoa ha lisele, ho tsosolosa letlalo esita le ho lahleheloa ke moriri.
Ha re nahana ka taba ea hore PRP e tsejoa ka ho laola ka ho toba mekhoa ea pholiso le ea ho ruruha, pholiso ea pholiso e tlameha ho hlahisoa e le boitsebiso.Mokhoa oa ho folisa o arotsoe ka mekhahlelo e mene e latelang: hemostasis;ho ruruha;ho ata ha cellular le matrix, 'me qetellong ho lokisoa ha maqeba.
1. Pheliso ea Lisele
Pholiso ea li-tissue ea pholiso e sebetsa, e leng mokhoa o lebisang ho bokellaneng ha platelet, ho thehoa ha lesela, le nts'etsopele ea matrix ea nakoana ea extracellular (ECM. Platelets ebe e khomarela liprotheine tsa collagen le ECM tse pepeneneng, e leng se etsang hore ho be le α-granules ho Release of Li-Platelet li na le mefuta e fapaneng ea limolek'hule tsa bioactive, ho kenyelletsa le lintlha tsa kholo, li-chemokine, le li-cytokine, hammoho le li-mediator tse thibelang ho ruruha tse kang prostaglandin, prostatic 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 botsitso pakeng tsa likarabo tsa anabolic le catabolic.Nakong ena, sekhahla sa khōlo e entsoeng ka platelet (PDGF), phetoho ea kgolo (TGF-β) le fibronectin e 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 matla a khethehileng a pholiso ea lisele tse lemetseng, 'me lintlha tse itseng tsa pathophysiological le metabolism li ka ama mokhoa oa ho fola, joalo ka li-tissue ischemia, hypoxia, tšoaetso. , Ho se leka-lekane ha Growth factor, esita le mafu a amanang le metabolic syndrome.
Microenvironment ea pro-inflammatory e sitisang mokhoa oa ho folisa.Ho thatafatsa litaba, ho boetse ho na le ts'ebetso e phahameng ea protease e thibelang ketso ea tlhaho ea kholo ea kholo (GF).Ntle le ho ba le thepa ea mitogenic, angiogenic, le chemotactic, PRP e boetse ke mohloli o ruileng oa lintlha tse ngata tsa kholo, li-biomolecules tse ka thibelang liphello tse senyang liseleng tse ruruhileng ka ho laola ho ruruha ho feteletseng le ho theha tšusumetso ea anabolic.Ho fanoe ka thepa ena, Bafuputsi ba ka 'na ba fumana bokhoni bo boholo ba ho phekola mefuta e sa tšoaneng ea likotsi tse rarahaneng.
2. Cytokine
Li-cytokine ho PRP li phetha karolo ea bohlokoa ho laola mekhoa ea 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 likarabo tsa cytokine tsa pro-inflammatory, haholo-holo tse bakoang ke li-macrophages tse entsoeng.Li-cytokine tse khahlanong le ho ruruha li sebelisana le li-cytokine inhibitors tse khethehileng le li-receptor tsa cytokine tse qhibilihang ho fetola ho ruruha.Interleukin (IL) -1 receptor antagonists, IL-4, IL-10, IL-11 le IL-13 li khetholloa e le li-cytokine tse ka sehloohong tse khahlanong le ho ruruha.Ho itšetlehile ka mofuta oa leqeba, li-cytokine tse ling, tse kang interferon, leukemia inhibitory factor, TGF-β le IL-6, li ka bontša liphello tse ntle kapa tse khahlanong le ho ruruha.TNF-α, IL1 le IL-18 li na le li-receptor tse itseng tsa cytokine tse ka thibelang liphello tsa pro-inflammatory tsa liprotheine tse ling [37].IL-10 ke e 'ngoe ea li-cytokine tse matla ka ho fetisisa tse khahlanong le ho ruruha, e ka theola-ho laola li-cytokine tse thibelang ho ruruha tse kang IL-1, IL-6 le TNF-α, le ho laola li-cytokine tse khahlanong le ho ruruha.Mekhoa ena e khahlanong le taolo e bapala karolo ea bohlokoa tlhahisong le ts'ebetsong ea li-cytokine tsa pro-inflammatory.Ho feta moo, li-cytokine tse ling li ka 'na tsa etsa hore ho be le likarabo tse tobileng tse susumetsang li-fibroblasts, tse bohlokoa bakeng sa tokiso ea lisele.Li-cytokine tsa ho ruruha TGFβ1, IL-1β, IL-6, IL-13, le IL-33 li susumetsa li-fibroblasts hore li arohane le myofibroblasts le ho ntlafatsa ECM [38].Ka lehlakoreng le leng, li-fibroblasts li hlahisa li-cytokines TGF-β, IL-1β, IL-33, CXC, le CC chemokines, tse khothalletsang likarabo tse thibelang ho ruruha ka ho kenya le ho bokella lisele tsa 'mele tsa ho itšireletsa mafung tse kang macrophages.Lisele tsena tsa ho ruruha li na le mesebetsi e mengata sebakeng sa maqeba, haholo-holo ka ho khothalletsa ho tlosoa ha maqeba - hammoho le biosynthesis ea chemokines, metabolites le lintlha tsa ho hōla, tse bohlokoa bakeng sa ho tsosolosoa ha lisele tse ncha.Ka hona, li-cytokine tse teng ho PRP li phetha karolo ea bohlokoa ho susumetsang likarabo tsa 'mele tsa ho itšireletsa mafung tsa mofuta oa lisele, ho khanna qeto ea mohato oa ho ruruha.Ha e le hantle, bafuputsi ba bang ba rehile mokhoa ona "ho ruruha ho tsosolosang," ho fana ka maikutlo a hore mohato oa ho ruruha, ho sa tsotellehe ho tsieleha ha mokuli, ke mohato oa bohlokoa o hlokahalang bakeng sa ts'ebetso ea ho lokisa lisele ho fihlela sephetho se atlehileng, ho fanoe ka mekhoa ea epigenetic eo lipontšo tsa ho ruruha li khothalletsang lisele tsa cellular. polasetiki.
3. Fibrin
Liplatelete li na le lintlha tse 'maloa tse amanang le tsamaiso ea fibrinolytic e ka' nang ea laola kapa ea theola karabelo ea fibrinolytic.Kamano ea nakoana le tlatsetso e lekanyelitsoeng ea likarolo tsa hematological le tšebetso ea liplatelete ho senyeha ha lesela e ntse e le taba e loketsoeng ke lipuisano tse pharalletseng sechabeng.Lingoliloeng li fana ka lithuto tse ngata tse lebisang tlhokomelo feela ho li-platelet, tse tsejoang ka bokhoni ba tsona ba ho susumetsa mokhoa oa ho folisa.Ho sa tsotellehe liphuputso tse ngata tse hlaheletseng, likarolo tse ling tsa hematological, tse kang coagulation factor le fibrinolytic system, le tsona li fumanoe li kenya letsoho tabeng ea ho lokisa maqeba ka katleho.Ka tlhaloso, fibrinolysis ke ts'ebetso e rarahaneng ea baeloji e itšetlehileng ka ts'ebetso ea li-enzyme tse itseng ho thusa ho senyeha ha fibrin.Karabo ea fibrinolytic e 'nile ea hlahisoa ke bangoli ba bang hore lihlahisoa tsa fibrin degradation (fdp) ha e le hantle e ka' na ea e-ba limolek'hule tse ikarabellang bakeng sa ho tsosa tokiso ea lisele, tatellano ea liketsahalo tsa bohlokoa tsa likokoana-hloko pele fibrin e kenngoa le ho tlosoa ho angiogenesis, e hlokahalang bakeng sa pholiso ea maqeba.Ho thehoa ha lesela ka mor'a kotsi ho sebetsa e le lera le sireletsang le sireletsang lisele ho lahleheloa ke mali, ho hlaseloa ke likokoana-hloko, hape ho fana ka matrix a nakoana ao lisele li ka fallang nakong ea ho lokisoa.Leqeba le bakoa ke ho petsoha ha fibrinogen ke li-serine protease le li-platelet aggregate ho marang-rang a marang-rang a fibrin fibrous.Karabelo ena e qala polymerization ea fibrin monomers, ketsahalo e ka sehloohong ho thehoeng ha leqeba la mali.Li-clots li ka boela tsa sebetsa e le matamo a li-cytokine le lintlha tsa kholo, tse lokolloang ha liplatelete tse sebetsang li senyeha.Sistimi ea fibrinolytic e laoloa ka thata ke plasmin mme e bapala karolo ea bohlokoa ho khothaletse ho falla ha lisele, kholo ea bioavailability ea kholo, le taolo ea litsamaiso tse ling tsa protease tse amehang ho ruruheng le ho nchafatsa lisele.Likarolo tsa bohlokoa tsa fibrinolysis, tse kang urokinase plasminogen activator receptor (uPAR) le plasminogen activator inhibitor-1 (PAI-1) li tsejoa hore li hlahisoa ka lisele tsa mesenchymal stem (MSCs), mofuta o khethehileng oa sele o hlokahalang bakeng sa ho folisa maqeba ka katleho.
4. Ho falla ha Lisele
Ts'ebetso ea plasminogen ka mokhatlo oa uPA-uPAR ke ts'ebetso e khothalletsang ho falla ha lisele tse nang le ts'oaetso ha e ntse e ntlafatsa proteolysis ea extracellular.Kaha uPAR e haelloa ke libaka tsa transmembrane le intracellular, protheine e hloka li-co-receptors tse kang li-interins le vitreins ho laola phallo ea lisele.Ho feta moo, tlamahano ea UPA-uPAR e entse hore ho be le kamano e eketsehileng ea uPAR bakeng sa li-vitreous connexins le li-interins, e khothalletsang ho khomarela lisele.Plasminogen activator inhibitor-1 (PAI-1) le eona e tlosa lisele, e senya upar-vitrein le integrin- ha e tlama ho UPA ea uPA-upar-integrin complex holim'a cell surface Tšebelisano ea li-voxels tsa khalase.
Sebakeng sa meriana ea ho tsosolosa, lisele tsa mesenchymal stem li bokelloa ho tloha mokong oa masapo ho ea ka tšenyo e khōlō ea litho tsa 'mele' me kahoo li ka fumanoa ho potoloha ha bakuli ba nang le fractures tse ngata.Leha ho le joalo, maemong a mang, a kang ho hloleha ha renal ea ho qetela, ho hlōleha ha sebete sa ho qetela, kapa nakong ea ho qaleha ha ho hana 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 pele tsa masapo tse entsoeng ka masapo a mesenchymal (stromal) li ke ke tsa fumanoa maling a batho ba phelang hantle [67].Karolo ea UPAR molemong oa ho bokella lisele tsa 'mele oa mesenchymal stem cell le eona e kile ea sisinngoa pele, e ts'oanang le se etsahalang ho bokellaneng ha hematopoietic stem cell (HSC).Varabaneni et al.Liphetho li bonts'itse hore ts'ebeliso ea "granulocyte colony-stimulating factor" ho litoeba tse haelloang ke uPAR li bakile ho hloleha ha li-MSC, hape tsa tiisa karolo ea ts'ehetso ea sistimi ea fibrinolytic ho phallo ea lisele.Liphuputso tse ling li boetse li bontšitse hore li-receptor tsa glycosylphosphatidylinositol-anchored uPA li laola ho khomarela, ho falla, ho ata, le ho arohana ka ho kenya tšebetsong litsela tse ling tsa matšoao a intracellular, ka tsela e latelang: pro-survival phosphatidylinositol 4,5-bisphosphate 3-kinase / Akt2 le ERK2. , le adhesion kinase (FAK).
Li-MSC li bontšitse bohlokoa bo bong maemong a pholiso ea maqeba.Ka mohlala, litoeba tse haelloang ke plasminogen li bontšitse tieho e matla liketsahalong tsa pholiso ea maqeba, e leng se bontšang hore plasmin e ameha haholo ts'ebetsong ena.Ho batho, tahlehelo ea plasmin le eona e ka baka mathata a ho folisa maqeba.Ho senyeha ha phallo ea mali ho ka thibela haholo ho tsosolosoa ha lisele, e leng se hlalosang hore na ke hobane'ng ha mekhoa ena ea ho tsosolosa e le phephetso ho bakuli ba lefu la tsoekere.
5. Li-Monocyte le Mekhoa 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 monocyte ea mali 'me e phetha karolo ea bohlokoa meriana e tsosolosang [81].Kaha li-neutrophils li hlahisa IL-4, IL-1, IL-6 le TNF-α, lisele tsena hangata li kenella sebakeng sa maqeba hoo e ka bang lihora tse 24-48 ka mor'a kotsi.Liplatelete li lokolla thrombin le platelet factor 4 (PF4), lik'hemik'hale tse peli tse khothalletsang ho hiroa ha li-monocyte le ho aroloa ha tsona ka macrophages le lisele tsa dendritic.Tšobotsi e tsotehang ea li-macrophages ke polasetiki ea tsona, ke hore, bokhoni ba tsona ba ho fetola phenotypes le ho fetola mefuta e meng ea lisele tse kang lisele tsa endothelial, tseo ka mor'a moo li bonts'ang mesebetsi e fapaneng ho latela tšusumetso e fapaneng ea lik'hemik'hale tsa biochemical tikolohong ea leqeba.Lisele tsa ho ruruha li hlahisa li-phenotype tse peli tse kholo, M1 kapa M2, ho itšetlehile ka pontšo ea limolek'hule ea sebaka seo e leng mohloli oa tšusumetso.Li-macrophages tsa M1 li hlahisoa ke li-microbial agents 'me kahoo li na le liphello tse ngata tsa ho ruruha.Ka lehlakoreng le leng, M2 macrophages hangata e hlahisoa ke karabo ea mofuta oa 2 mme e na le thepa e khahlanong le ho ruruha, eo ka tloaelo e khetholloang 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 isoforms e tsamaisoa haholo ke mehato ea morao-rao ea ho folisa maqeba, moo M1 macrophages e hlahisang neutrophil apoptosis le ho qala ho tlosoa ha lisele tsena).Phagocytosis ka li-neutrophils e kenya tšebetsong letoto la liketsahalo tseo ho tsona tlhahiso ea cytokine e timang, polarizing macrophages le ho lokolla TGF-β1.Ntho ena ea khōlo ke molaoli oa bohlokoa oa phapang ea myofibroblast le ho fokotseha ha leqeba, ho lumella qeto ea ho ruruha le ho qaleha ha karolo ea ho ata ha pholiso ea pholiso [57].Protheine e 'ngoe e amanang haholo e amehang lits'ebetsong tsa cellular ke serine (SG).Granulan ena e sirelelitsoeng ka lisele tsa mali e fumanoe e hlokahala bakeng sa polokelo ea liprotheine tse patiloeng liseleng tse khethehileng tsa 'mele tsa ho itšireletsa mafung, tse kang mast cell, neutrophils, le cytotoxic T lymphocyte.Le hoja lisele tse ngata tseo e seng tsa hematopoietic li boetse li etsa serotonin, lisele tsohle tsa ho ruruha li hlahisa palo e kholo ea protheine ena ebe e e boloka ka li-granules bakeng sa ho sebelisana ho eketsehileng le bahlaseli ba bang ba ho ruruha, ho akarelletsa le proteases, cytokines, chemokines le kholo ea kholo.Liketane tsa glycosaminoglycan (GAG) tse qosoang hampe ho SG li bonahala li le bohlokoa bakeng sa secretory granule homeostasis, kaha li khona ho tlama le ho nolofatsa ho bolokoa ha likaroloana tsa granule tse qosoang haholo ka sele-, protein-, le ka mokhoa o khethehileng oa ketane ea GAG.Mabapi le ho kenya letsoho ha bona ho PRP, Woulfe le basebetsi-'moho ba kile ba bontša hore khaello ea SG e amahanngoa ka matla le morphology ea platelet e fetotsoeng;bofokoli ho platelet factor 4, beta-thromglobulin, le polokelo ea PDGF ka liplatelete;ho fokola ha platelet aggregation le secretion in vitro le thrombosis in vivo form defects.Ka hona, bafuputsi ba fihletse qeto ea hore proteoglycan ena e bonahala e le taolo e kholo ea thrombosis.
Lihlahisoa tse nang le li-platelet tse ngata li ka fumanoa ka ho bokella le ho kenya mali 'ohle a motho ka hare, ho arola motsoako ka likarolo tse fapaneng tse nang le plasma, platelets, leukocyte le leukocyte.Ha khatello ea platelet e phahame ho feta boleng ba basal, kholo ea masapo le lisele tse bonolo li ka potlakisoa ka litla-morao tse fokolang.Tšebeliso ea lihlahisoa tsa autologous PRP ke biotechnology e batlang e le ncha e tsoelang pele ho bontša liphello tse tšepisang khothatsong le ho ntlafatsa pholiso ea likotsi tse fapaneng tsa lisele.Ho sebetsa ha mokhoa ona o mong oa phekolo ho ka bakoa ke ho fana ka lihlooho tsa mefuta e mengata ea kholo le liprotheine, ho etsisa le ho tšehetsa mokhoa oa ho folisa maqeba a 'mele le mekhoa ea ho lokisa lisele.Ho feta moo, tsamaiso ea fibrinolytic ka ho hlaka e na le tšusumetso ea bohlokoa ho lokisoeng ha lisele ka kakaretso.Ntle le bokhoni ba eona ba ho fetola khiro ea lisele tsa lisele tsa ho ruruha le lisele tsa mesenchymal stem, e fetola ts'ebetso ea proteolytic libakeng tsa pholiso ea maqeba le nakong ea nchafatso ea lisele tsa mesodermal tse kenyeletsang lesapo, lefufuru le mesifa, ka hona ke senotlolo sa motsoako oa meriana ea mesifa le mesifa.
Ho potlakisa pholiso ke sepheo se batloang haholo ke litsebi tse ngata lefapheng la bongaka, 'me PRP e emela sesebelisoa se setle sa likokoana-hloko se ntseng se tsoela pele ho fana ka tsoelo-pele e ts'episang ts'ebetsong le ts'ebetsong e hlophisitsoeng hantle ea liketsahalo tsa tsosoloso.Leha ho le joalo, kaha sesebelisoa sena sa phekolo se lula se rarahane, haholo-holo kaha se lokolla lintho tse ngata tse phelang le mekhoa ea tsona e fapaneng ea ho sebelisana le liphello tsa matšoao, ho hlokahala lithuto tse ling.
(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: Jul-19-2022