PRP ea sejoale-joale: "Clinical PRP"
Lilemong tse 10 tse fetileng, leano la kalafo la PRP le bile le liphetoho tse kholo.Ka lipatlisiso tsa liteko le tsa bongaka, joale re na le kutloisiso e betere ea platelet le physiology e 'ngoe ea lisele.Ho phaella moo, litlhahlobo tse 'maloa tsa boleng bo phahameng ba tsamaiso, litlhahlobo tsa meta le liteko tse laoloang ka nako e telele li bontšitse katleho ea PRP biotechnology likarolong tse ngata tsa bongaka, ho akarelletsa le dermatology, opereishene ea pelo, ho buuoa ka polasetiki, ho buuoa ka masapo, ho laola bohloko, maloetse a mokokotlo le meriana ea lipapali. .
Tšobotsi ea hajoale ea PRP ke khatello ea eona e felletseng ea liplatelete, e fetohang ho tloha tlhalosong ea pele ea PRP (ho kenyeletsoa khatello ea platelet e phahameng ho feta boleng ba motheo) ho feta 1 × 10 6/µ L kapa ka makhetlo a ka bang 5 palo e tlase ea liplatelete ho tloha motheo.Tlhahlobisong e pharaletseng ea Fadadu et al.Litsamaiso tsa 33 tsa PRP le li-protocol li ile tsa hlahlojoa.Palo ea liplatelete tsa tokisetso ea ho qetela ea PRP e hlahisoang ke tse ling tsa litsamaiso tsena e tlase ho feta ea mali kaofela.Ba tlalehile hore palo ea platelet ea PRP e eketsehile ka tlaase ho 0.52 ka sekoti se le seng sa spin (Selphyl ®).Ka lehlakoreng le leng, ho potoloha habeli EmCyte Genesis PurePRPII ® Motsoako oa platelet o hlahisoang ke sesebelisoa ke o phahameng ka ho fetisisa (1.6 × 10 6 /µL) .
Ho hlakile hore mekhoa ea in vitro le ea liphoofolo ha se sebaka se loketseng sa ho etsa lipatlisiso bakeng sa phetoho e atlehileng ea boikoetliso ba bongaka.Ka mokhoa o ts'oanang, thuto ea papiso ea lisebelisoa ha e tšehetse qeto, hobane e bontša hore mahloriso a platelet pakeng tsa lisebelisoa tsa PRP a fapane haholo.Ka lehlohonolo, ka theknoloji e thehiloeng ho proteomics le tlhahlobo, re ka eketsa kutloisiso ea rona ea mesebetsi ea sele ho PRP e amang liphello tsa phekolo.Pele ho fihlela tumellano mabapi le litokisetso le litlhahlobo tse tloaelehileng tsa PRP, PRP e lokela ho latela mekhoa ea kliniki ea PRP ho khothalletsa mekhoa e mengata ea ho lokisa lisele le liphello tse tsoelang pele tsa kliniki.
Kliniki PRP foromo
Hona joale, PRP ea kliniki e sebetsang hantle (C-PRP) e 'nile ea khetholloa e le motsoako o rarahaneng oa likarolo tse ngata tsa autologous ka plasma e nyenyane e fumanoang ho tsoa karolong ea mali ea peripheral ka mor'a centrifugation.Ka mor'a hore ho be le centrifugation, PRP le likarolo tsa eona tse se nang li-platelet li ka fumanoa ho tloha mochine oa mahloriso ho ea ka li-cell density tse fapaneng (tseo platelet density e tlaase ka ho fetisisa).
Sebelisa lisebelisoa tsa ho arohana ha lisele tsa PurePRP-SP ® (EmCyte Corporation, Fort Myers, FL, USA) bakeng sa mali a feletseng ka mor'a mekhoa e 'meli ea centrifugation.Ka mor'a ts'ebetso ea pele ea centrifugation, karolo eohle ea mali e ile ea aroloa ka likarolo tse peli tsa motheo, platelet (lean) plasma suspension le lera le khubelu la lisele tsa mali.Ka A, mohato oa bobeli oa centrifugation o phethiloe.Molumo oa sebele oa PRP o ka ntšoa bakeng sa kopo ea mokuli.Ho holisa ka B e bontša hore ho na le hlophisitsoe ka likarolo tse ngata tsa erythrocyte sedimentation sootho lera (e emetsoeng ke mola o moputsoa) botlaaseng ba thepa, e nang le concentrations phahameng ea liplatelete, monocyte le lymphocyte, e thehiloeng segokanyipalo gradient.Mohlala ona, ho ea ka protocol ea ho itokisa ea C-PRP e nang le li-neutrophils tse futsanehileng, karolo ea bonyane ea li-neutrophils (<0.3%) le erythrocyte (<0.1%) e tla ntšoa.
Granule ea platelet
Ts'ebetsong ea pele ea PRP ea kliniki, α- Granules ke sebopeho sa ka hare sa platelet se atisang ho boleloa, hobane se na le lintlha tsa coagulation, palo e kholo ea PDGF le li-angiogenic regulators, empa li na le ts'ebetso e nyenyane ea thrombogenic.Lintlha tse ling li kenyelletsa likaroloana tse sa tsejoeng haholo tsa chemokine le cytokine, joalo ka platelet factor 4 (PF4), protheine ea mantlha ea pre-platelet, P-selectin (activator ea integrin) le chemokine RANTES (e laoloang ke ts'ebetso, e hlalosang lisele tse tloaelehileng tsa T mme ho ka etsahala hore ebe e sebetsa. ho pata).Mosebetsi o akaretsang oa likaroloana tsena tse khethehileng tsa granule ea platelet ke ho bokella le ho kenya tšebetsong lisele tse ling tsa 'mele tsa ho itšireletsa mafung kapa ho baka ho ruruha ha lisele tsa endothelial.
Likarolo tse teteaneng tsa granular joalo ka ADP, serotonin, polyphosphate, histamine le adrenaline li sebelisoa ka mokhoa o hlakileng e le taolo ea ts'ebetso ea liplatelete le thrombosis.Habohlokoa le ho feta, tse ngata tsa likarolo tsena li na le mosebetsi oa ho fetola lisele tsa 'mele.Platelet ADP e amoheloa ke P2Y12ADP receptor ka lisele tsa dendritic (DC), kahoo e eketsa endocytosis ea antigen.DC (antigen presenting cell) e bohlokoa haholo bakeng sa ho qala karabelo ea 'mele ea ho itšireletsa mafung ea T cell le ho laola karabelo ea 'mele ea ho itšireletsa mafung, e hokahanyang sesole sa tlhaho le sesole sa 'mele se feto-fetohang.Ho phaella moo, platelet adenosine triphosphate (ATP) e romela lipontšo ka T cell receptor P2X7, e lebisang ho phapano e eketsehileng ea lisele tse thusang tsa CD4 T ho lisele tsa proinflammatory T helper 17 (Th17).Likarolo tse ling tsa platelet dense granule (tse kang glutamate le serotonin) li etsa hore lisele tsa T li falle le ho eketsa phapang ea monocyte ho DC, ka ho latellana.Ho PRP, li-immunomodulators tsena tse tsoang likarolong tse teteaneng li matlafatsoa haholo 'me li na le mesebetsi e mengata ea ho itšireletsa mafung.
Palo ea litšebelisano tse ka bang teng ka kotloloho le tse sa tobang lipakeng tsa liplatelete le lisele tse ling (tse amohelang li-receptor) li ngata.Ka hona, ts'ebeliso ea PRP sebakeng sa tikoloho ea lisele tsa pathological e ka baka litlamorao tse fapaneng tsa ho ruruha.
Khatello ea liplatelete
C-PRP e lokela ho ba le litekanyetso tsa kliniki tsa liplatelete tse tsepamisitsoeng ho hlahisa liphello tse molemo tsa phekolo.Liplatelete tsa C-PRP li lokela ho susumetsa ho ata ha lisele, ho qaptjoa ha mesenchymal le neurotrophic factor, ho khothalletsa ho falla ha lisele tsa chemotactic le ho susumetsa ts'ebetso ea immunoregulatory, joalokaha ho bontšitsoe setšoantšong.
Li-platelet tse sebetsang, ho lokolloa ha PGF le limolek'hule tsa ho khomarela li kopanya mefuta e fapaneng ea litšebelisano tsa lisele: chemotaxis, ho khomarela lisele, ho falla le ho arohana ha lisele, le ho laola mesebetsi ea tsamaiso ea 'mele ea ho itšireletsa mafung.Litšebelisano tsena tsa lisele tsa platelet li kenya letsoho ho angiogenesis le ts'ebetso ea ho ruruha, 'me qetellong li hlohlelletsa tšebetso ea tokiso ea lisele.Likhutšoane: BMA: aspirate ea moko oa masapo, EPC: lisele tsa endothelial progenitor, EC: lisele tsa endothelial, 5-HT: 5-hydroxytryptamine, RANTES: taolo e sebetsang ea polelo e tloaelehileng ea T cell le secretion putative, JAM: junction adhesion molecule mofuta, CD40L: cluster 40 ligand, SDF-1 α: Stromal cell-derived factor-1 α, CXCL: chemokine (CXC motif) ligand, PF4: platelet factor 4. E nkiloe ho Everts et al.
Marx e bile motho oa pele oa ho paka hore pholiso ea masapo le lisele tse bonolo li ile tsa ntlafatsoa, 'me palo e fokolang ea platelet e ne e le 1 × 10 6 /µL. Liphetho tsena li tiisitsoe phuputsong ea lumbar fusion ka intervertebral foramen, ha tekanyo ea platelet e ne e le kholo ho feta. 1.3 × Ho li-platelet tse 106/µ L, thuto ena e bontšitse ho kopana ho hoholo.Ho phaella moo, Giusti et al.E senotsoe 1.5 × Mokhoa oa ho lokisa lisele ka tekanyo ea 109 o hloka li-platelet / mL ho etsa hore angiogenesis e sebetse ka ts'ebetso ea lisele tsa endothelial.Phuputsong ea morao-rao, ho tsepamisa maikutlo ho phahameng ho fokolitse bokhoni ba angiogenesis ba liplatelete ka har'a le ho potoloha follicles.Ho phaella moo, boitsebiso ba pejana bo bontšitse hore tekanyo ea PRP e tla boela e ama liphello tsa phekolo.Ka hona, e le ho etsa hore ho be le maikutlo a angiogenesis haholo le ho susumetsa ho ata ha lisele le ho falla ha lisele, C-PRP e lokela ho ba le bonyane 7.5 ka botlolo ea phekolo ea 5-mL PRP × 10 9 e ka fana ka liplatelete.
Ntle le ho itšetleha ka tekanyo, phello ea PRP mosebetsing oa lisele e bonahala e itšetlehile haholo ka nako.Sophie et al.Liphetho tsena li fana ka maikutlo a hore ho pepeseha ha nako e khutšoane ho li-platelet lysate tsa motho ho ka tsosa ho ata ha lisele tsa masapo le chemotaxis.Ho fapana le hoo, ho pepeseha ha nako e telele ho PRP ho tla lebisa maemong a tlaase a alkaline phosphatase le ho thehoa ha diminerale.
Sele e khubelu ea mali
Lisele tse khubelu tsa mali li na le boikarabelo ba ho tsamaisa oksijene liseleng le ho fetisetsa carbon dioxide ho tloha liseleng ho ea matšoafong.Ha li na khubu 'me li entsoe ka limolek'hule tsa heme tse tlamahanyang liprotheine.Likarolo tsa tšepe le tsa heme liseleng tse khubelu tsa mali li khothalletsa ho kopana ha oksijene le carbon dioxide.Ka kakaretso, potoloho ea bophelo ea lisele tse khubelu tsa mali e ka ba matsatsi a 120.Li tlosoa ho potoloha ke macrophages ka mokhoa o bitsoang botsofali ba RBC.Lisele tse khubelu tsa mali ka lisampole tsa PRP li ka 'na tsa senyeha tlas'a maemo a ho kuta (mohlala, ho buuoa ka mali ka ho feletseng, mokhoa oa ho itšireletsa mafung, khatello ea oxidative kapa morero o sa lekaneng oa mahloriso oa PRP).Ka hona, lera la lisele tsa RBC lea bola le ho ntša hemoglobin e chefo (Hb), e lekantsoeng ka plasma ea mahala hemoglobin (PFH), heme le tšepe.].PFH le lihlahisoa tsa eona tsa ho senyeha (heme le tšepe) li kopane li lebisa liphellong tse kotsi le tsa cytotoxic ho lisele, tse lebisang khatellong ea oxidative, tahlehelo ea nitric oxide, ts'ebetso ea litsela tsa ho ruruha le ho itšireletsa mafung.Liphello tsena li tla qetella li lebisa ho se sebetseng ha microcirculation, vasoconstriction ea sebakeng seo le kotsi ea methapo, hammoho le tšenyo e tebileng ea lisele.
Ntho ea bohlokoa ka ho fetisisa ke hore ha RBC e nang le C-PRP e isoa liseleng, e tla baka karabelo ea sebakeng seo e bitsoang eryptosis, e tla etsa hore ho lokolloe cytokine e sebetsang hantle le macrophage migration inhibitor.Cytokine ena e thibela ho falla ha monocyte le macrophages.E fana ka matšoao a matla a pro-inflammatory ho lisele tse potolohileng, e thibela ho falla ha lisele tsa stem le ho ata ha fibroblast, 'me e lebisa ho se sebetseng ha lisele tsa lehae.Ka hona, ke habohlokoa ho fokotsa tšilafalo ea RBC litokisetsong tsa PRP.Ho phaella moo, karolo ea lisele tse khubelu tsa mali tsosolosong ea lisele ha e e-s'o ka e tsejoa.Mokhoa o lekaneng oa centrifugation ea C-PRP le mokhoa oa ho itokisa hangata o tla fokotsa kapa o felise boteng ba lisele tse khubelu tsa mali, kahoo ho qoba liphello tse mpe tsa hemolysis le polycythemia.
Leukocyte ho C-PRP
Ho ba teng ha lisele tse tšoeu tsa mali litokisetsong tsa PRP ho itšetlehile ka thepa ea phekolo le morero oa ho lokisetsa.Lisebelisoa tsa PRP tse thehiloeng ho plasma, lisele tse tšoeu tsa mali li felisoa ka ho feletseng;Leha ho le joalo, lisele tse tšoeu tsa mali li ne li tsepamisitsoe haholo tokisetsong ea PRP ea erythrocyte sedimentation brown layer.Ka lebaka la mekhoa ea eona ea ho itšireletsa mafung le ea ho itšireletsa, lisele tse tšoeu tsa mali li ama haholo biology ea ka hare ea maemo a mabe le a sa foleng.Lintlha tsena li tla tšohloa ka tlase.Ka hona, ho ba teng ha li-leukocyte tse khethehileng ho C-PRP ho ka baka liphello tse kholo tsa lisele le lisele.Ka ho khetheha, mefuta e fapaneng ea PRP erythrocyte sedimentation sootho-yellow layer layer e sebelisa mekhoa e fapaneng ea ho itokisa, kahoo e hlahisa karolo e fapaneng ea li-neutrophils, lymphocyte le monocyte ho PRP.Li-eosinophils le li-basophil li ke ke tsa lekanyetsoa litokisetsong tsa PRP hobane lisele tsa bona tsa lisele li fokola haholo hore li ka mamella matla a ho sebetsana le centrifugal.
Li-neutrophils
Li-neutrophils ke li-leukocyte tsa bohlokoa litseleng tse ngata tsa pholiso.Litsela tsena li kopana le liprotheine tse thibelang likokoana-hloko tse teng ka har'a liplatelete ho etsa mokoallo o teteaneng khahlanong le likokoana-hloko tse hlaselang.Ho ba teng ha li-neutrophils ho khethoa ho ea ka sepheo sa phekolo ea C-PRP.Maemo a eketsehileng a ho ruruha ha lisele a ka 'na a hlokoa tlhokomelong e sa foleng ea PRP biotherapy kapa lits'ebetsong tse reretsoeng ho hōla ha masapo kapa ho folisa.Habohlokoa, mesebetsi e eketsehileng ea neutrophil e fumanoe mefuteng e 'maloa, e totobatsang karolo ea bona ho angiogenesis le tokiso ea lisele.Leha ho le joalo, li-neutrophils le tsona li ka baka litlamorao tse kotsi, ka hona ha li loketse lits'ebetso tse ling.Zhou le Wang ba ile ba paka hore tšebeliso ea PRP e ruileng ka li-neutrophils e ka lebisa keketseho ea karolelano ea mofuta oa III oa collagen ho mofuta oa I collagen, kahoo e mpefatsa fibrosis le ho fokotsa matla a tendon.Litšobotsi tse ling tse kotsi tse kenngoeng ke li-neutrophils ke ho lokolloa ha li-cytokine tsa ho ruruha le matrix metalloproteinases (MMPs), tse ka khothalletsang ho ruruha le catabolism ha li sebelisoa ho lisele.
Leukomonocyte
Ho C-PRP, li-lymphocyte tsa T le B tsa mononuclear li tsepame ho feta lisele tse ling tse tšoeu tsa mali.Li amana haufi-ufi le sele-mediated cytotoxic adaptive immune immune.Li-lymphocyte li ka etsa hore lisele li fetohe ho loantša tšoaetso le ho ikamahanya le bahlaseli.Ho phaella moo, T-lymphocyte derived cytokines (interferon- γ [IFN- γ] And interleukin-4 (IL-4) e ntlafatsa polarization ea macrophages. Verassar et al. Ho pakoa hore li-lymphocyte tse tloaelehileng tsa T li ka khothalletsa pholiso ea linama ka tsela e sa tobang. mohlala oa mouse ka ho laola phapang ea monocyte le macrophages.
Monocyte - lisele tsa ho lokisa tse ngata
Ho ea ka sesebelisoa sa ho itokisa sa PRP se sebelisitsoeng, li-monocyte li ka 'na tsa hlahella kapa li se teng ka botlolong ea phekolo ea PRP.Ka bomalimabe, ts'ebetso ea bona le bokhoni ba ho nchafatsa ha ho buuoe ka seoelo libukeng.Ka hona, tlhokomelo e fokolang e lefshoa ho li-monocyte ka mokhoa oa ho itokisa kapa mokhoa oa ho qetela.Sehlopha sa monocyte se na le mefuta e fapaneng, se tsoang liseleng tsa progenitor mokong oa masapo, 'me se isoa liseleng tsa peripheral ka tsela ea hematopoietic stem cell pathway ho latela microenvironment stimulation.Nakong ea homeostasis le ho ruruha, li-monocyte tse potolohang li tloha maling 'me li kenngoa liseleng tse lemetseng kapa tse senyehileng.Li ka sebetsa e le li-macrophages (M Φ) Lisele tsa Effector kapa lisele tsa progenitor.Li-monocyte, macrophages le lisele tsa dendritic li emela tsamaiso ea mononuclear phagocytic (MPS) .Liseleng tse senyehileng, li-macrophages tse lulang sebakeng sa heno, li-cytokine tsa pro-inflammatory, lisele tsa apoptotic kapa necrotic le lihlahisoa tsa likokoana-hloko li qala li-monocyte ho arohana ka lihlopha tsa lisele tsa MPS.Ha re re ha C-PRP e nang le monocyte e nang le lihlahisoa tse ngata e kenngoa sebakeng sa microenvironment ea lefu lena, li-monocyte li ka 'na tsa arohana ho M Φ Ho baka liphetoho tse kholo tsa lisele.
Ho tloha monocyte ho ea ho M Φ Ts'ebetsong ea phetoho, e tobileng M Φ Phenotype.Lilemong tse leshome tse fetileng, ho entsoe mohlala, o kopanyang M Φ Mokhoa o rarahaneng oa ts'ebetso o hlalosoa e le polarization ea linaha tse peli tse fapaneng: M Φ Phenotype 1 (M Φ 1, Classic activation) le M Φ Phenotype 2 (M Φ 2, ts'ebetso e 'ngoe).M Φ 1 e khetholloa ke ho ruruha ha cytokine secretion (IFN- γ) Le nitric oxide ho hlahisa mokhoa o sebetsang oa ho bolaea likokoana-hloko.M Φ Phenotype e boetse e hlahisa vascular endothelial growth factor (VEGF) le fibroblast growth factor (FGF).M Φ Phenotype e entsoe ka lisele tse khahlanong le ho ruruha tse nang le phagocytosis e phahameng.M Φ 2 Hlahisa likaroloana tsa extracellular matrix, angiogenesis le chemokines, le interleukin 10 (IL-10).Ntle le tšireletso ea pathogen, M Φ E ka boela ea fokotsa ho ruruha le ho khothalletsa ho lokisoa ha lisele.Hoa hlokomeleha hore M Φ 2 e arotsoe ka M in vitro Φ 2a, M Φ 2b le M Φ 2. E itšetlehile ka tšusumetso.Phetolelo ea li-subtypes tsena e thata hobane lisele li ka ba le lihlopha tsa M Φ tse tsoakiloeng.Hoa thahasellisa hore, ho itšetlehile ka matšoao a sebaka sa tikoloho le maemo a IL-4, proinflammatory M Φ 1 e ka fetoloa ho khothalletsa ho lokisoa M Φ 2. Ho tsoa ho lintlha tsena, hoa utloahala ho nahana hore ho na le likhahla tse phahameng tsa monocyte le M Φ C-PRP litokisetso. li ka kenya letsoho ho lokisoeng ha lisele tse ntle hobane li na le tokiso ea lisele tse thibelang ho ruruha le matla a ho fetisa matšoao a lisele.
Tlhaloso e ferekanyang ea karoloana ea lisele tse tšoeu tsa mali ho PRP
Ho ba teng ha lisele tse tšoeu tsa mali ka libotlolong tsa phekolo ea PRP ho itšetlehile ka sesebelisoa sa ho lokisetsa PRP 'me se ka ba le phapang e khōlō.Ho na le likhohlano tse ngata mabapi le boteng ba leukocyte le tlatsetso ea bona ho lihlahisoa tse fapaneng tsa PRP (tse kang PRGF, P-PRP, LP-PRP, LR-PRP, P-PRF le L-PRF) Tlhahlobo ea morao tjena, tse tšeletseng tse sa tloaelehang. liteko tse laoloang (boemo ba bopaki ba 1) le lithuto tse tharo tse lebeletsoeng tse bapisoang (boemo ba bopaki ba 2) li kenyelelitse bakuli ba 1055, tse bontšang hore LR-PRP le LP-PRP li ne li e-na le tšireletso e tšoanang.Mongoli o ile a etsa qeto ea hore karabelo e mpe ea PRP e ka 'na ea se ke ea amana ka ho toba le mahloriso a lisele tse tšoeu tsa mali.Phuputsong e 'ngoe, LR-PRP ha ea ka ea fetola interleukin ea ho ruruha (IL-1) ho OA lengole β, IL-6, IL-8 le IL-17).Liphetho tsena li tšehetsa pono ea hore karolo ea leukocyte mosebetsing oa likokoana-hloko oa PRP ka vivo e ka 'na ea tsoa ho crosstalk pakeng tsa liplatelete le leukocyte.Tšebelisano ena e ka khothalletsa biosynthesis ea lintlha tse ling (tse kang lipoxygen), tse ka fokotsang kapa tsa khothalletsa ho fokotseha ha ho ruruha.Ka mor'a ho lokolloa ha pele ha limolek'hule tsa ho ruruha (arachidonic acid, leukotriene le prostaglandin), lipoxygen A4 e lokolloa liplatelete tse sebetsang ho thibela ts'ebetso ea neutrophil.Ke tikolohong ena moo M Φ Phenotype ho tloha M Φ 1 Fetolela ho M Φ 2. Ho phaella moo, ho na le bopaki bo ntseng bo eketseha ba hore lisele tsa mononuclear tse potolohang li ka arola ka mefuta e sa tšoaneng ea lisele tse se nang phagocytic ka lebaka la bongata ba tsona.
Mofuta oa PRP o tla ama setso sa MSC.Ha ho bapisoa le lisampole tse hloekileng tsa PRP kapa PPP, LR-PRP e ka etsa hore ho be le keketseho e phahameng haholo ea masapo a tsoang ho li-MSC (BMMSCs), ka ho lokolloa ka potlako le ts'ebetso e ntle ea PGF ea likokoana-hloko.Litšobotsi tsena kaofela li thusa ho kenyelletsa monocyte ka botlolong ea kalafo ea PRP le ho lemoha bokhoni ba bona ba ho itšireletsa mafung le bokhoni ba ho khetholla.
Congenital le adaptive immune regulation ea PRP
Mosebetsi o tsebahalang haholo oa 'mele oa li-platelet ke ho laola mali.Li ipokellela sebakeng sa tšenyo ea lisele le methapo ea mali e senyehileng.Liketsahalo tsena li bakoa ke polelo ea li-integrin le li-selectins tse susumetsang ho khomarela le ho kopana ha platelet.Endothelium e senyehileng e mpefatsa ts'ebetso ena le ho feta, 'me collagen e pepesitsoeng le liprotheine tse ling tsa subendothelial matrix li khothalletsa ts'ebetso e tebileng ea liplatelete.Maemong ana, karolo ea bohlokoa ea tšebelisano pakeng tsa von Willebrand factor (vWF) le glycoprotein (GP), haholo-holo GP-Ib, e pakiloe.Kamora ts'ebetso ea platelet, platelet α-, Dense, lysosome le T-granules li laola exocytosis mme li lokolle litaba tsa tsona tikolohong ea kantle ho sele.
Molek'hule ea ho khomarela liplatelete
E le hore re utloisise hamolemo karolo ea PRP ho li-tissue tsa ho ruruha le li-platelet ka karabelo ea 'mele ea ho itšireletsa mafung, re lokela ho utloisisa hore na li-receptors tse fapaneng tsa platelet surface (integrins) le limolek'hule tsa ho khomarela li-junction (JAM) le litšebelisano tsa lisele li ka qala mekhoa ea bohlokoa ea ho itšireletsa mafung le ho ikamahanya le maemo.
Li-integrin ke limolek'hule tse khomarelang holim'a lisele tse fumanoang mefuteng e fapaneng ea lisele 'me li hlahisoa ka bongata ho li-platelet.Li-integrins li kenyelletsa a5b1, a6b1, a2b1 LFA-2, (GPIa/IIa) le aIIbb3 (GPIIb/IIIa).Hangata, li teng maemong a tsitsitseng le a tlase.Ka mor'a ho kenya ts'ebetsong, ba fetohela boemong ba kamano e phahameng ea ligand e tlamang.Li-integrin li na le mesebetsi e fapaneng ho li-platelet mme li kenya letsoho tšebelisanong ea liplatelete tse nang le mefuta e mengata ea lisele tse tšoeu tsa mali, lisele tsa endothelial le matrix a extracellular.Ho phaella moo, GP-Ib-V-IX e rarahaneng e hlahisoa ka lera la platelet 'me ke eona e ka sehloohong e amohelang ho tlama le von vWF.Tšebelisano ena e etsa hore ho be le puisano ea pele pakeng tsa liplatelete le likarolo tse pepenene tsa subendothelial.Platelet integrin le GP complex li amana le mekhoa e sa tšoaneng ea ho ruruha 'me li phetha karolo ea bohlokoa ho thehoeng ha platelet-leukocyte complex.Ka ho khetheha, integrin aIIbb3 e hlokahala ho theha motsoako o tsitsitseng ka ho kopanya fibrinogen le macrophage 1 antigen (Mac-1) receptor ka neutrophils.
Liplatelete, li-neutrophils le lisele tsa vascular endothelial li hlahisa limolek'hule tse itseng tsa ho khomarela lisele, tse bitsoang selectin.Tlas'a maemo a ho ruruha, liplatelete li hlalosa P-selectin le neutrophil L-selectin.Ka mor'a ts'ebetso ea platelet, P-selectin e ka tlama ho ligand PSGL-1 e teng ho li-neutrophils le monocyte.Ho phaella moo, PSGL-1 e tlamang e qala karabelo ea intracellular signal cascade, e kenyang li-neutrophils ka neutrophil integrin Mac-1 le lymphocyte e amanang le ts'ebetso ea antigen 1 (LFA-1).Activated Mac-1 e tlama GPIb kapa GPIIb/IIIa ka liplatelete ka fibrinogen, kahoo e tsitsisa tšebelisano lipakeng tsa li-neutrophils le liplatelete.Ho phaella moo, LFA-1 e sebelisitsoeng e ka kopana le molek'hule ea platelet intercellular adhesion 2 ho tsoela pele ho tsitsisa neutrophil-platelet complex ho khothalletsa ho khomarela nako e telele le lisele.
Li-platelet le li-leukocyte li phetha karolo ea bohlokoa karabelong ea tlhaho le e feto-fetohang ea 'mele ea ho itšireletsa mafung
'Mele o ka lemoha' mele oa linaha tse ling le lisele tse lemetseng ho mafu a hlobaetsang kapa a sa foleng ho qala karabelo ea pholiso ea maqeba le tsela ea ho ruruha.Mekhoa ea tlhaho ea 'mele ea ho itšireletsa mafung le e ikamahanyang le maemo e sireletsa moeti tšoaetsong,' me lisele tse tšoeu tsa mali li phetha karolo ea bohlokoa ho kopana pakeng tsa litsamaiso tsena tse peli.Ka ho khetheha, li-monocyte, macrophages, neutrophils le lisele tse bolaeang tsa tlhaho li phetha karolo ea bohlokoa tsamaisong ea tlhaho, ha li-lymphocyte le lihlopha tsa tsona li bapala karolo e tšoanang tsamaisong ea 'mele ea ho itšireletsa mafung.
Litšebelisano tsa platelet le leukocyte litšebelisanong tsa lisele tsa tlhaho tsa 'mele.Platelet e sebelisana le li-neutrophils le monocyte, 'me qetellong ka M Φ Tšebelisano, fetola le ho eketsa mesebetsi ea bona ea phello.Litšebelisano tsena tsa platelet-leukocyte li lebisa ho ruruha ka mekhoa e fapaneng, ho kenyelletsa le NEtosis.Likgutsufatso: MPO: myeloperoxidase, ROS: mefuta ea oksijene e sebetsang, TF: factor factor, NET: trap neutrophil extracellular, NF- κ B: Nuclear factor kappa B, M Φ: Macrophages.
Mokhoa oa tlhaho oa ho itšireletsa mafung
Mosebetsi oa sesole sa 'mele ke ho tsebahatsa likokoana-hloko tse hlaselang kapa likotoana tsa lisele le ho etsa hore li hlake.Ha likarolo tse ling tsa limolek'hule tse bitsoang surface expression pattern recognition receptors (PRRs) li kopana le limolek'hule tse amanang le pathogen le mekhoa ea limolek'hule tse amanang le tšenyo, sesole sa tlhaho sa tlhaho se tla sebetsa.Ho na le mefuta e mengata ea li-PRR, ho kenyeletsoa Toll-like receptor (TLR) le RIG-1 joaloka receptor (RLR).Li-receptor tsena li ka kenya tšebetsong ntho e ka sehloohong ea transcription factor kappa B (NF- κ B) E boetse e laola likarolo tse ngata tsa karabelo ea tlhaho le e feto-fetohang ea 'mele ea ho itšireletsa mafung.Hoa thahasellisa hore liplatelete li boetse li hlahisa mefuta e fapaneng ea limolek'hule tsa immunoregulatory receptor holim'a tsona le cytoplasm, tse kang P-selectin, transmembrane protein CD40 ligand (CD40L), li-cytokines (tse kang IL-1 β, TGF- β) Le platelet-specific TLR. Kahoo, liplatelete li ka sebelisana le lisele tse sa tšoaneng tsa 'mele.
Tšebelisano-'moho ea lisele tse tšoeu tsa platelet ka ho itšireletsa mafung
Ha liplatelete li kena kapa li hlasela phallo ea mali kapa lisele, liplatelete ke e 'ngoe ea lisele tse lemohang kotsi ea endothelial le likokoana-hloko tsa likokoana-hloko pele.Platelet aggregation le ho khothalletsa ho lokolloa ha platelet agonists ADP, thrombin le vWF, e leng se hlahisang ts'ebetso ea platelet le polelo ea platelet chemokine receptors C, CC, CXC le CX3C, kahoo e baka liplatelete sebakeng se nang le tšoaetso kapa kotsi.
Tsamaiso ea tlhaho ea 'mele ea ho itšireletsa mafung e reriloe esale pele ka liphatsa tsa lefutso ho bona bahlaseli, ba kang livaerase, libaktheria, likokoana-hloko le chefo, kapa maqeba a linama le maqeba.Ke mokhoa o sa khetheheng, hobane kokoana-hloko leha e le efe e tla tsejoa e le ea kantle ho naha kapa e se nang boithati 'me e fumaneha kapele.Tsamaiso ea 'mele ea ho itšireletsa mafung e itšetlehile ka sehlopha sa liprotheine le li-phagocyte, tse hlokomelang litšobotsi tse bolokiloeng hantle tsa likokoana-hloko le ho potlakela ho kenya ts'ebetso ea ho itšireletsa mafung ho thusa ho felisa bahlaseli, le haeba moeti a e-s'o ka a pepesehela likokoana-hloko tse itseng pele.
Li-neutrophils, li-monocyte le lisele tsa dendritic ke lisele tse atileng haholo tsa ho itšireletsa mafung maling.Ho hiroa ha bona hoa hlokahala bakeng sa karabelo e lekaneng ea pele ea ho itšireletsa mafung.Ha PRP e sebelisoa meriana e tsosolosang, platelet-white cell interaction e laola ho ruruha, ho folisa maqeba le ho lokisoa ha lisele.TLR-4 ka li-platelet e susumetsa ho sebelisana ha platelet-neutrophil, e laolang seo ho thoeng ke ho phatloha ha leukocyte oxidative ka ho laola ho lokolloa ha mefuta e sebetsang ea oksijene (ROS) le myeloperoxidase (MPO) ho tloha ho neutrophils.Ho phaella moo, tšebelisano pakeng tsa platelet-neutrophil le neutrophil degranulation e lebisa ho thehoeng ha maraba a neutrophil-extracellular (NETs).Li-NET li entsoe ka nucleus ea neutrophil le tse ling tsa neutrophil intracellular content, tse ka tšoarang libaktheria le ho li bolaea ka NETosis.Ho thehoa ha NETs ke mokhoa oa bohlokoa oa ho bolaea oa li-neutrophils.
Kamora ts'ebetso ea liplatelete, li-monocyte li ka fallela liseleng tse kulang le tse senyehang, moo li etsang mesebetsi ea ho khomarela le ho ntša limolek'hule tsa ho ruruha tse ka fetolang chemotaxis le thepa ea proteolytic.Ho phaella moo, liplatelete li ka etsa hore monocyte NF- κ B e sebetse ho laola ts'ebetso ea phello ea monocyte, e leng mokena-lipakeng oa bohlokoa oa karabo ea ho ruruha le ts'ebetso le ho arohana ha lisele tsa 'mele.Liplatelete li tsoela pele ho khothaletsa ho phatloha ha oxidative ea endogenous ea monocyte ho khothaletsa ho timetsoa ha likokoana-hloko tsa phagocytic.Ho lokolloa ha MPO ho kopanngoa ke tšebelisano e tobileng pakeng tsa platelet-monocyte CD40L-MAC-1.Hoa thahasellisa hore ha P-selectin e etsa hore liplatelete li sebetse tlas'a maemo a matla le a sa foleng a ho ruruha, li-chemokines tse entsoeng ka platelet PF4, RANTES, IL-1 β Le CXCL-12 li ka thibela apoptosis e ikemetseng ea monocyte, empa li khothalletsa ho arohana ha tsona ka macrophages.
Tsamaiso ea 'mele ea ho itšireletsa mafung
Kamora hore sesole sa 'mele se sa ikemelang se lemohe tšenyo ea likokoana-hloko kapa lisele, sesole sa 'mele se ikamahanyang le maemo se tla nka sebaka.Mekhoa ea ho ikamahanya le maemo e kenyelletsa li-lymphocyte tsa B tsa antigen-binding (B lisele) le li-lymphocyte tse tloaelehileng tsa T (Treg) tse hokahanyang ho tlosoa ha likokoana-hloko.Lisele tsa T li ka aroloa hoo e batlang e le lisele tsa T tse thusang (Th cell) le lisele tsa T tsa cytotoxic (Tc cell, tse tsejoang hape e le T killer cell).Lisele tsa Th1 li arotsoe ka lisele tsa Th1, Th2 le Th17, tse nang le mesebetsi ea bohlokoa ho ruruha.Lisele li ka hlahisa li-cytokine tsa proinflammatory (mohlala, IFN- γ, TNF- β) Le li-interleukin tse 'maloa (mohlala, IL-17) Li sebetsa ka ho khetheha ho thibela kokoana-hloko ea intracellular le tšoaetso ea baktheria. Lisele tsa Tc ke lisele tse sebetsang, tse ka felisang likokoana-hloko le lisele tse lebisitsoeng ho intracellular le extracellular.
Hoa thahasellisa hore lisele tsa Th2 li hlahisa IL-4 'me li ama M Φ Polarization, M Φ Tataiso ea ho tsosolosoa M Φ 2 Phenotype, ha IFN- γ M Φ Fetola ho ruruha M Φ 1 Phenotype, e itšetlehileng ka tekanyo le nako ea li-cytokines.Ka mor'a hore IL-4 e sebelisoe, M Φ 2 e etsa hore lisele tsa Treg li arohane ka lisele tsa Th2, ebe li hlahisa IL-4 e eketsehileng (positive feedback loop).Lisele tsa Th li fetola M Φ Phenotype e lebisitsoe ho phenotype e tsosolosang ho arabela ho li-biological agents tsa tlhaho ea lisele.Mokhoa ona o itšetlehile ka bopaki ba hore lisele tsa Th li phetha karolo ea bohlokoa ho laola ho ruruha le ho lokisoa ha lisele.
Tšebelisano-'moho ea lisele tse tšoeu tsa Platelet ka ho itšireletsa mafung
Sistimi ea 'mele ea ho itšireletsa mafung e sebelisa li-receptor tse khethehileng tsa antigen 'me e hopola likokoana-hloko tse kileng tsa kopana le tsona,' me ea li senya ha e kopana le moamoheli.Leha ho le joalo, likarabo tsena tse ikamahanyang le 'mele oa ho itšireletsa mafung li ile tsa hōla butle-butle.Konias et al.E bontša hore karolo ea platelet e kenya letsoho tabeng ea ho lemoha kotsi le ho lokisoa ha lisele, le hore tšebelisano pakeng tsa liplatelete le leukocyte e khothalletsa ts'ebetso ea karabelo ea 'mele ea ho itšireletsa mafung.
Nakong ea karabelo ea 'mele ea ho itšireletsa mafung, liplatelete li khothalletsa likarabo tsa monocyte le macrophage ka DC le NK cell maturation, e lebisang ho likarabo tse itseng tsa T cell le B cell.Ka hona, likaroloana tsa granule tsa platelet li ama ka kotloloho boits'ireletso ba mmele ka ho hlahisa CD40L, molek'hule e bohlokoa bakeng sa ho laola karabelo ea 'mele ea ho itšireletsa mafung.Li-platelet ka CD40L ha li na karolo feela tlhahisong ea antigen, empa li boetse li ama karabelo ea lisele tsa T.Liu et al.Ho ile ha fumaneha hore liplatelete li laola karabelo ea lisele tsa CD4 T ka tsela e rarahaneng.Taolo ena e fapaneng ea li-subsets tsa lisele tsa CD4 T e bolela hore li-platelet li khothalletsa lisele tsa CD4 T ho arabela ts'ebetsong ea ho ruruha, kahoo li hlahisa likarabo tse matla tsa ho ruruha le ho thibela ho ruruha.
Li-platelet li boetse li laola karabelo e feto-fetohang ea lisele tsa B ho likokoana-hloko tsa likokoana-hloko.Hoa tsebahala hore CD40L ho lisele tsa CD4 T tse kentsoeng li tla hlahisa CD40 ea lisele tsa B, ho fana ka letšoao la bobeli le hlokahalang bakeng sa ts'ebetso ea B lymphocyte e itšetlehileng ka T-cell, phetoho e latelang ea allotype, le B cell phapang le ho ata.Ka kakaretso, liphetho li bontša ka ho hlaka mesebetsi e fapa-fapaneng ea li-platelet ka mokhoa oa ho itšireletsa mafung, ho bontša hore li-platelet li kopanya ho sebelisana pakeng tsa lisele tsa T le lisele tsa B ka CD40-CD40L, kahoo li matlafatsa karabelo ea lisele tsa B tse itšetlehileng ka T-cell.Ho phaella moo, li-platelet li na le li-receptors tse ngata tsa lisele, tse ka khothalletsang ts'ebetso ea liplatelete le ho lokolla palo e kholo ea limolek'hule tse sebetsang tsa ho ruruha le tsa likokoana-hloko tse bolokiloeng likarolong tse fapaneng tsa platelet, kahoo li ama karabelo ea tlhaho ea 'mele ea ho itšireletsa mafung.
Karolo e atolositsoeng ea serotonin e tsoang ho platelet ho PRP
Serotonin (5-hydroxytryptamine, 5-HT) e na le karolo e hlakileng ea bohlokoa tsamaisong ea methapo e bohareng (CNS), ho kenyelletsa le mamello ea bohloko.Ho hakanngoa hore boholo ba 5-HT ea motho e hlahisoa ka mpeng ea mala 'me joale ka ho potoloha ha mali, moo e kenngoa ke liplatelete ka serotonin reuptake transporter' me e bolokoe ka likaroloana tse teteaneng ka bongata bo phahameng (65 mmol / L).5-HT ke neurotransmitter e tsebahalang haholo le hormone e thusang ho laola mekhoa e sa tšoaneng ea neuropsychological CNS (bohareng ba 5-HT).Leha ho le joalo, boholo ba 5-HT bo teng ka ntle ho CNS (peripheral 5-HT), 'me e ameha ho laola mesebetsi ea likokoana-hloko le ea lisele tsa likokoana-hloko tsa mekhoa e mengata ea litho, ho akarelletsa le pelo, matšoafo, mala, urogenital le platelet functional systems.5-HT e na le metabolism e itšetlehileng ka mahloriso ka mefuta e sa tšoaneng ea lisele, ho akarelletsa le li-adipocyte, lisele tsa epithelial le lisele tse tšoeu tsa mali.Peripheral 5-HT e boetse e le mochine o matla oa ho itšireletsa mafung, o ka susumetsang kapa oa thibela ho ruruha le ho ama lisele tse sa tšoaneng tsa 'mele oa ho itšireletsa mafung ka 5-HT receptor (5HTR) e khethehileng.
Paracrine le autocrine mochine oa HT
Ketsahalo ea 5-HT e kopanngoa ke tšebelisano ea eona le 5HTRs, e leng lelapa le leholo le nang le litho tse supileng (5-HT 1 - 7) le bonyane li-subtypes tse fapaneng tsa 14, ho kenyelletsa le setho sa morao tjena se sibolotsoeng 5-HT 7, peripheral le sebetsa taolong ea bohloko.Nakong ea ho senyeha ha liplatelete, li-platelet tse sebetsang li boloka palo e kholo ea platelet-derived 5-HT, e ka khothalletsang ho fokotseha ha methapo le ho susumetsa ts'ebetso ea liplatelete tse haufi le li-lymphocyte ka polelo ea 5-HTR ka lisele tsa endothelial, lisele tsa mesifa e boreleli le lisele tsa 'mele.Pacala et al.Phello ea mitotic ea 5-HT liseleng tsa vascular endothelial e ile ea ithutoa, 'me monyetla oa ho khothalletsa ho hōla ha methapo ea mali e senyehileng ka ho susumetsa angiogenesis e ile ea khethoa.Tsela eo mekhoa ena e laoloang ka eona ha e hlake ka ho feletseng, empa e ka 'na ea kenyelletsa litsela tse peli tse fapaneng tsa matšoao ka har'a microcircuit ea lisele ho laola mesebetsi ea lisele tsa vascular endothelial le lisele tse boreleli tsa mesifa, li-fibroblasts le lisele tsa' mele tsa ho itšireletsa mafung ka li-receptor tse khethehileng tsa 5-HT liseleng tsena. .Mosebetsi oa autocrine oa platelet 5-HT kamora ts'ebetso ea platelet e hlalositsoe [REF].Ho lokolloa ha 5-HT ho ntlafatsa ts'ebetso ea liplatelete le ho hira liplatelete tse potolohang, e leng se lebisang ho ts'ebetsong ea li-signal cascade reactions le li-influencers tse tšehetsang platelet reactivity.
Phello ea immunomodulatory 5-HT
Bopaki bo ntseng bo eketseha bo bontša hore serotonin e ka bapala karolo ea 5HTR e fapaneng e le modulator ea 'mele ea ho itšireletsa mafung.Ho ea ka 5HTR e hlalositsoeng ka li-leukocyte tse fapa-fapaneng tse amehang karabelong ea ho ruruha, 5-HT e entsoeng ka platelet e sebetsa e le molaoli oa 'mele oa ho itšireletsa mafung ka bobeli le tsamaiso ea 'mele ea ho itšireletsa mafung.5-HT e ka susumetsa Treg ho ata le ho laola mesebetsi ea lisele tsa B, lisele tse bolaeang tsa tlhaho le li-neutrophils ka ho hira DC le monocyte sebakeng sa ho ruruha.Liphuputso tsa morao-rao li bontšitse hore 5-HT e entsoeng ka platelet e ka laola mosebetsi oa lisele tsa 'mele tlas'a maemo a itseng.Ka hona, ho sebelisa C-PRP, mahloriso a platelet a kholo ho feta 1 × 10 6 / µ L e ka thusa haholo ho tsamaisa mahloriso a 5-HT a tsoang ho liplatelete tse kholo ho ea ho lisele.Sebakeng sa microenvironment e khetholloang ke likarolo tsa ho ruruha, PRP e ka sebelisana le lisele tse 'maloa tsa' mele tsa 'mele tse phethang karolo ea bohlokoa ho li-pathologies tsena, tse ka amang liphello tsa kliniki.
Setšoantšo se bonts'ang karabelo ea 5-HT e nang le likarolo tse ngata ka mor'a ts'ebetso ea liplatelete tsa PRP tsa ho ruruha.Ka mor'a ts'ebetso ea li-platelet, li-platelet li lokolla li-granules tsa tsona, ho kenyelletsa le 5-HT ka li-granules tse teteaneng, tse nang le liphello tse fapaneng tse fapaneng ho lisele tse sa tšoaneng tsa 'mele, lisele tsa endothelial le lisele tse boreleli tsa mesifa.Likhutšoane: SMC: lisele tsa mesifa tse boreleli, EC: lisele tsa endothelial, Treg: T lymphocyte tse tloaelehileng, M Φ: Macrophages, DC: lisele tsa dendritic, IL: interleukin, IFN- γ: Interferon γ。 E fetotsoe le ho ikamahanya le maemo ho tloha Everts et al.le Hull et al.
Phello ea analgesic ea PRP
Li-platelet tse sebetsang li tla lokolla li-mediator tse ngata tse thibelang ho ruruha le tse khahlanong le ho ruruha, tse ke keng tsa baka bohloko feela, empa hape li fokotsa ho ruruha le bohloko.Hang ha e sebelisoa, matla a tloaelehileng a platelet a PRP a fetola microenvironment pele ho lokisoa le ho tsosolosoa ha lisele ka litsela tse sa tšoaneng tse rarahaneng tse amanang le anabolism le catabolism, ho ata ha lisele, ho khetholla le ho laola lisele tsa stem.Litšobotsi tsena tsa PRP li lebisa ho sebelisoa ha PRP maemong a sa tšoaneng a mafu a kliniki hangata a amahanngoa le bohloko bo sa foleng (joaloka kotsi ea lipapali, lefu la masapo, lefu la mokokotlo le leqeba le rarahaneng le sa foleng), le hoja mokhoa o tobileng o e-s'o ka o etsoa ka botlalo.
Ka 2008, Evertz et al.Ke teko ea pele e laoloang ka mokhoa o sa reroang ho tlaleha phello ea analgesic ea ho lokisetsa PRP, e lokiselitsoeng ho tloha lera le sootho la tekanyo ea autologous erythrocyte sedimentation le ho kenngoa ka autologous thrombin ka mor'a ho buuoa mahetleng.Ba hlokometse ho fokotseha ho hoholo ha lintlha tsa pono ea analogue scale, tšebeliso ea li-analgesics tse thehiloeng ho opioid, le ho atleha haholoanyane ka mor'a ho buuoa.Hoa hlokomeleha hore li bonahatsa phello ea analgesic ea liplatelete tse sebetsang 'me li hakanya ka mochine oa liplatelete tse lokollang 5-HT.Ka bokhutšoanyane, li-platelet li robetse ho PRP e sa tsoa lokisoa.Ka mor'a ts'ebetso ea li-platelet ka ho toba kapa ka tsela e sa tobang (lefu la lisele), li-platelet li fetola sebōpeho 'me li hlahisa leshano le lekaneng ho khothalletsa platelet aggregation.Ka mor'a moo, li lokolla likaroloana tsa intracellular α- Le tse teteaneng.Lithane tse tšoaroang ka PRP e kentsoeng li tla hlaseloa ke PGF, cytokines le li-lysosome tse ling tsa platelet.Haholo-holo, ha likaroloana tse teteaneng li lokolla litaba tsa tsona, li tla lokolla palo e kholo ea 5-HT e laolang bohloko.Ho C-PRP, mahloriso a platelet ke 5 ho makhetlo a 7 ho feta a mali a peripheral.Ka hona, ho lokolloa ha 5-HT ho tloha liplatelete ke tsa linaleli.Hoa thahasellisa hore Sprott et al.Tlaleho e hlokometse hore bohloko bo ne bo imolohile haholo ka mor'a ho hlaba ka linalete le moxibustion, khatello ea platelet e nkiloeng ho 5-HT e fokotsehile haholo, 'me joale boemo ba plasma ba 5-HT bo ile ba eketseha.
Sebakeng sa peripheral, liplatelete, lisele tsa mast le lisele tsa endothelial li tla lokolla 5-HT e sa feleng nakong ea kotsi ea lisele kapa ts'oaetso ea ho buuoa.Hoa thahasellisa hore mefuta e fapa-fapaneng ea li-receptor tsa 5-HT ea li-neuron e ile ea fumanoa sebakeng sa peripheral, e leng se ileng sa tiisa hore 5-HT e ka kena-kenana le phetisetso ea nociceptive sebakeng sa peripheral.Liphuputso tsena li bontša hore 5-HT e ka ama phetisetso ea li-nociceptive ea lisele tsa peripheral ka 5-HT1, 5-HT2, 5-HT3, 5-HT4 le 5-HT7 receptors.
Tsamaiso ea 5-HT e emela tsamaiso e matla e ka fokotsang le ho eketsa tekanyo ea bohloko ka mor'a ho tsosoa ho kotsi.Taolo e bohareng le ea peripheral ea matšoao a nociceptive le liphetoho tsamaisong ea 5-HT e tlalehiloe ho bakuli ba nang le bohloko bo sa foleng.Lilemong tsa morao tjena, palo e kholo ea liphuputso e tsepamisitse maikutlo ho karolo ea 5-HT le li-receptor tsa eona tse fapaneng ho sebetsa le ho laola boitsebiso bo kotsi, e leng se hlahisang lithethefatsi tse kang serotonin reuptake inhibitors (SSRI) e khethiloeng.Setlhare sena se thibela ho nkeloa hape ha serotonin ho li-neuron tsa presynaptic kamora ho lokolloa ha serotonin.E ama nako le matla a puisano ea serotonin 'me ke mokhoa o mong oa phekolo bakeng sa bohloko bo sa foleng.Ho hlokahala lipatlisiso tse ling tsa kliniki ho utloisisa ka ho hlaka mokhoa oa limolek'hule oa taolo ea bohloko ea 5-HT e tsoang ho PRP ho mafu a sa foleng le a senyehang.
Lintlha tse ling tsa ho rarolla phello e ka 'nang ea e-ba teng ea analgesic ea PRP e ka fumanoa ka mor'a tlhahlobo ea mohlala oa liphoofolo tsa analgesic.Liqeto tsa papiso ea lipalo mefuteng ena li thata hobane lithuto tsena li na le mefuta e mengata haholo.Leha ho le joalo, lithuto tse ling tsa kliniki li buile ka liphello tsa nociceptive le analgesic tsa PRP.Liphuputso tse 'maloa li bontšitse hore bakuli ba fumanang phekolo bakeng sa tendinosis kapa meokho ea rotator ha ba na bohloko bo fokolang.Ka lehlakoreng le leng, liphuputso tse ling tse 'maloa li bontšitse hore PRP e ka fokotsa kapa ea felisa bohloko ba bakuli ba nang le ho senyeha ha tendon, OA, plantar fasciitis le maloetse a mang a maoto le a maqaqailana.Motsoako oa ho qetela oa platelet le sebopeho sa lisele tsa likokoana-hloko li 'nile tsa khetholloa e le litšobotsi tsa bohlokoa tsa PRP, tse thusang ho boloka phello e tsitsitseng ea analgesic ka mor'a ho sebelisoa ha PRP.Liphetoho tse ling li kenyelletsa mokhoa oa ho fana ka PRP, theknoloji ea kopo, platelet activation protocol, boemo ba ts'ebetso ea likokoana-hloko ea PGF le li-cytokine tse lokollotsoeng, mofuta oa lisele tsa kopo ea PRP le mofuta oa kotsi.
Hoa hlokomeleha hore Kuffler e rarollotse bokhoni ba PRP ho fokotsa bohloko ho bakuli ba nang le bohloko bo bobebe ho isa ho bo matla bo sa foleng ba neuropathic, bo ka sehloohong ho methapo e senyehileng e sa tsosoloseng.Sepheo sa thuto ena ke ho batlisisa hore na bohloko ba neuropathic bo ka fokotsoa kapa bo fokotsehile ka lebaka la PRP e khothalletsang tsosoloso ea axonal le sepheo sa ho tsosolosa methapo ea kutlo.Hoa makatsa hore ebe har'a bakuli ba fumanang phekolo, bohloko ba neuropathic bo ntse bo tlosoa kapa bo fokotsehile bonyane lilemo tse tšeletseng ka mor'a ho buuoa.Ho phaella moo, bakuli bohle ba ile ba qala ho imolla bohloko nakong ea libeke tse tharo ka mor'a ho sebelisoa ha PRP.
Haufinyane tjena, liphello tse tšoanang tsa analgesic PRP li 'nile tsa hlokomeloa tšimong ea leqeba la ka mor'a ho buuoa le tlhokomelo ea letlalo.Hoa thahasellisa hore ebe bangoli ba tlalehile likarolo tsa 'mele tsa bohloko ba maqeba tse amanang le kotsi ea methapo le hypoxia ea letlalo.Ba boetse ba buisana ka bohlokoa ba angiogenesis ho ntlafatsa oksijene le phepelo ea limatlafatsi.Phuputso ea bona e bontšitse hore ha ho bapisoa le sehlopha sa taolo, bakuli ba fumanang phekolo ea PRP ba ne ba e-na le bohloko bo fokolang 'me ba eketsa angiogenesis haholo.Qetellong, Johal le basebetsi-'moho le eena ba ile ba etsa tlhahlobo e hlophisitsoeng le tlhahlobo ea meta 'me ba etsa qeto ea hore PRP e ka fokotsa bohloko ka mor'a ho sebelisa PRP ka matšoao a masapo, haholo-holo ho bakuli ba fumanang epicondylitis ea ka ntle le phekolo ea lengole la OA.Ka bomalimabe, thuto ena ha ea ka ea hlakisa liphello tsa lisele tse tšoeu tsa mali, khatello ea platelet kapa tšebeliso ea li-activator tse sa tloaelehang tsa platelet, hobane mefuta ena e ne e tla ama katleho ea kakaretso ea PRP.Phapang e nepahetseng ea PRP platelet bakeng sa phomolo e kholo ea bohloko ha e hlake.Mohlala oa rat ea tendinosis, mahloriso a platelet e ne e le 1.0 × 10 6 / μ Ho L, bohloko bo ka imoloha ka ho feletseng, ha bohloko bo bakoang ke PRP ka halofo ea platelet e fokotseha haholo.Ka hona, re khothaletsa lithuto tse ngata tsa kliniki ho batlisisa litlamorao tsa analgesic tsa litokisetso tse fapaneng tsa PRP.
PRP le phello ea angiogenesis
Litokisetso tsa C-PRP ka meriana e nepahetseng ea ho tsosolosa li lumella ho fana ka li-biomolecules tse lokolloang ke likarolo tse phahameng tsa liplatelete tse sebelisoang libakeng tse lebisitsoeng tsa lisele.Ka hona, mefuta e fapaneng ea liketso tsa cascade e qalile, e leng se kenyang letsoho taolong ea 'mele ea ho itšireletsa mafung, ts'ebetso ea ho ruruha le angiogenesis ho khothalletsa pholiso le tokiso ea lisele.
Angiogenesis ke ts'ebetso e matla ea mehato e mengata e kenyelletsang ho mela le li-microvessels tsa lisele tse tsoang methapong ea mali e neng e le teng pele.Angiogenesis e tsoetse pele ka lebaka la mekhoa e sa tšoaneng ea likokoana-hloko, ho kenyelletsa le ho falla ha lisele tsa endothelial, ho ata, ho arohana le ho arohana.Mekhoa ena ea lisele ke lintho tse hlokahalang bakeng sa ho thehoa ha methapo e mecha ea mali.Li bohlokoa bakeng sa kholo ea methapo ea mali e seng e ntse e le teng ho khutlisetsa phallo ea mali le ho ts'ehetsa ts'ebetso e phahameng ea metabolic ea tokiso ea lisele le nchafatso ea lisele.Methapo ena e mecha ea mali e lumella ho fana ka oksijene le limatlafatsi, le ho tlosoa ha lihlahisoa tse tsoang liseleng tse phekoloang.
Ts'ebetso ea angiogenesis e laoloa ke ntho e susumetsang ea angiogenic factor VEGF le anti-angiogenic factor (mohlala, angiostatin le thrombospondin-1 [TSP-1]).Sebakeng sa microenvironment e kulang le e senyehileng (ho kenyeletsoa tsitsipano e tlase ea oksijene, pH e tlase le boemo bo phahameng ba lactic acid), lintlha tsa lehae tsa angiogenic li tla khutlisetsa tšebetso ea angiogenesis.
Mecha e mengata e qhibilihang ea platelet, joalo ka FGF ea mantlha le TGF- β 'Me VEGF e ka susumetsa lisele tsa endothelial ho hlahisa methapo e mecha ea mali.Landsdown le Fortier li tlalehile liphetho tse fapaneng tse amanang le sebopeho sa PRP, ho kenyelletsa le mehloli ea intraplatelet ea balaoli ba bangata ba angiogenic.Ho phaella moo, ba ile ba etsa qeto ea hore ho eketseha ha angiogenesis ho tlatsetsa ho folisa lefu la MSK libakeng tse nang le vascularization e mpe, tse kang meniscus tear, kotsi ea tendon le libaka tse ling tse nang le vascularization e mpe.
Ho khothaletsa le ho thibela angiogenic platelet properties
Lilemong tse mashome a seng makae tse fetileng, liphuputso tse hatisitsoeng li pakile hore liplatelete li phetha karolo ea bohlokoa ho hemostasis e ka sehloohong, ho thehoa ha lesela, ntlha ea kholo le ho lokolloa ha cytokine, le taolo ea angiogenesis e le karolo ea mokhoa oa ho lokisa lisele.Ho makatsang ke hore, PRP α- Li-granules li na le pokello ea lintlha tsa kholo ea pro-angiogenic, liprotheine tse khahlanong le angiogenic le li-cytokine (tse kang PF4, plasminogen activator inhibitor-1 le TSP-1), 'me li lebisa tlhokomelo ho lokolloa ha lintlha tse itseng tse phethang karolo. .Karolo ea angiogenesis.Ka hona, karolo ea PRP ea ho laola taolo ea angiogenesis e ka hlalosoa ka ts'ebetsong ea li-receptor tse khethehileng tsa sele, TGF- β Qala liketso tsa pro-angiogenic le anti-angiogenic.Bokhoni ba liplatelete ba ho sebelisa tsela ea angiogenesis bo netefalitsoe ho pathological angiogenesis le tumor angiogenesis.
Platelet-derived angiogenic growth factor le anti-angiogenic growth factor, e nkiloeng ho α- Le limolek'hule tse teteaneng le tse khomarelang.Habohlokoa ka ho fetisisa, ho amoheloa ka kakaretso hore phello e akaretsang ea liplatelete ho angiogenesis ke pro-angiogenic le e susumetsang.Ho lebeletsoe hore phekolo ea PRP e tla laola ho kenngoa ha angiogenesis, e leng ho tla tlatsetsa phello ea phekolo ea maloetse a mangata, a kang ho folisa maqeba le ho lokisoa ha lisele.Tsamaiso ea PRP, haholo-holo tsamaiso ea khatello e phahameng ea PGF le li-cytokine tse ling tsa platelet, li ka etsa hore angiogenesis, angiogenesis le arteriogenesis, hobane stromal cell-derived factor 1a e tlama ho receptor ea CXCR4 liseleng tsa endothelial progenitor.Bill le ba bang.Ho boleloa hore PRP e eketsa ischemic neovascularization, e ka 'nang ea bakoa ke ho susumetsa angiogenesis, angiogenesis le arteriogenesis.Moetsong oa bona oa in vitro, ho ata ha lisele tsa endothelial le sebopeho sa capillary li ile tsa hlahisoa ke palo e kholo ea li-PDG tse fapaneng, tseo VEGF e neng e le eona ntho e ka sehloohong e susumetsang angiogenic.Ntho e 'ngoe ea bohlokoa le ea bohlokoa bakeng sa ho khutlisetsa tsela ea angiogenesis ke ho sebelisana pakeng tsa li-PGF tse ngata.Richardson le ba bang.Ho ile ha pakoa hore ts'ebetso ea synergistic ea angiogenic factor platelet-derived growth factor-bb (PDGF-BB) le VEGF e entse hore ho thehoe ka potlako marang-rang a holileng a methapo ea mali ha a bapisoa le mosebetsi oa motho ka mong oa kgolo.Phello e kopaneng ea lintlha tsena e sa tsoa netefatsoa phuputsong ea ntlafatso ea potoloho ea cerebral collateral circulation ho litoeba tse nang le hypoperfusion ea nako e telele.
Habohlokoa le ho feta, phuputso ea in vitro e ile ea lekanya phello ea ho ata ha lisele tsa endothelial tsa mothapo oa motho le likhakanyo tse fapaneng tsa platelet ha ho khethoa sesebelisoa sa ho lokisa PRP le leano la lethal dose la platelet, 'me liphetho li bonts'a hore tekanyo e nepahetseng ea platelet e ne e le 1.5 × 10 6 platelets/ μ. 50. Ho khothalletsa angiogenesis.Ho ba le platelet e ngata haholo ho ka sitisa tšebetso ea angiogenesis, kahoo phello e mpe.
Botsofali ba lisele, botsofali le PRP
Boleng ba lisele bo ka susumetsoa ke lintho tse fapaneng tse susumetsang.Ena ke ts'ebetso eo lisele li emisang ho arohana le ho etsa liphetoho tse ikhethang tsa phenotypic ho thibela kholo e sa lekanyetsoang ea lisele tse senyehileng, tse phethang karolo ea bohlokoa ho thibela mofetše.Ts'ebetsong ea botsofali ba fisioloji, botsofali ba ho ikatisa ha lisele le bona bo tla khothaletsa botsofali ba lisele, 'me matla a nchafatso a li-MSC a tla fokotseha.
Liphello tsa botsofali le botsofali ba lisele
Ka vivo, mefuta e mengata ea lisele e tla tsofala ebe e bokellana ka har'a lisele tse fapaneng nakong ea botsofali, moo ho nang le palo e kholo ea lisele tse tsofalang.Ho bokellana ha lisele tse tsofalang ho bonahala ho eketseha ka ho eketseha ha lilemo, ho senyeha ha tsamaiso ea 'mele ea ho itšireletsa mafung, ho senyeha ha lisele kapa mabaka a amanang le khatello ea kelello.Mokhoa oa ho tsofala ha lisele tsa cellular o 'nile oa tsejoa e le sesosa sa pathogenic sa mafu a amanang le lilemo, a kang lefu la masapo a masapo, lefu la masapo le ho senyeha ha intervertebral disc.Lintho tse fapaneng tse susumetsang li tla mpefatsa botsofali ba lisele.Ha e arabela, "senescence-related secretory phenotype" (SASP) e tla hlahisa likarolo tse phahameng tsa lisele tsa protheine le li-cytokine.Phenotype ena e khethehileng e amana le lisele tsa botsofali, tseo ho tsona li hlahisang li-cytokine tse phahameng tsa ho ruruha (tse kang IL-1, IL-6, IL-8), lintlha tsa kgolo (tse kang TGF- β, HGF, VEGF, PDGF), MMP, le cathepsin.Ha ho bapisoa le bacha, SAPS e bonahetse e eketseha ka lilemo, hobane ts'ebetso ea boemo bo tsitsitseng e senyeha, e bakang botsofali ba lisele le ho fokotsa matla a ho nchafatsa.Ka ho khetheha, mafung a manonyeletso le mafu a mesifa ea masapo.Tabeng ena, botsofali ba 'mele ba ho itšireletsa mafung bo nkoa e le phetoho e kholo ea li-secretion spectrum tsa lisele tsa' mele tsa ho itšireletsa mafung, tse bontšang hore khatello ea TNF-a, IL-6 le / kapa Il-1b e eketseha, e lebisang ho ho ruruha ho sa foleng ho tlaase.Ke habohlokoa ho hlokomela hore ho se sebetse ha lisele tsa stem ho boetse ho amana le mekhoa e ikemetseng e se nang lisele, joalo ka lisele tse tsofalang, haholo-holo tlhahiso ea lintho tse thibelang ho ruruha le tse thibelang ho tsosolosa ka SASP.
Ho fapana le hoo, SASP e ka boela ea susumetsa polasetiki ea lisele le ho hlophisa bocha lisele tse haufi.Ntle le moo, SASP e ka hlophisa puisano le bakena-lipakeng ba fapaneng ba 'mele le ho kenya tšebetsong lisele tsa' mele tsa 'mele ho khothaletsa ho hlakoloa ha lisele tsa botsofali.Ho utloisisa karolo le mosebetsi oa lisele tsa botsofali ho tla kenya letsoho pholisong le ho lokisoa ha lisele tsa mesifa ea MSK le maqeba a sa foleng.
Hoa hlokomeleha hore Ritcka et al.Ho ile ha etsoa boithuto bo pharaletseng, 'me karolo e ka sehloohong le e molemo ea SASP ea ho khothalletsa polasetiki ea lisele le tsosoloso ea lisele e ile ea fumanoa,' me khopolo ea phepelo ea nakoana ea phekolo ea lisele tsa botsofali e ile ea hlahisoa.Ba ile ba bolela ka hloko hore botsofali ke ntho e molemo ka ho fetisisa le e tsosolosang bophelo.
Botsofali ba lisele le bokhoni ba PRP
Ha palo ea lisele tsa stem e fokotseha, botsofali bo tla ama ts'ebetso ea lisele tsa stem.Ka ho tšoanang, ho batho, litšobotsi tsa lisele tsa stem (tse kang ho omella, ho ata le ho arohana) le tsona li fokotseha ka lilemo.Wang le Nirmala ba tlaleha hore botsofali bo tla fokotsa litšobotsi tsa lisele tsa stem cell le palo ea li-receptor factor factor.Phuputso ea liphoofolo e bontšitse hore khatello ea PDGF ho lipere tse nyenyane e ne e phahame.Ba fihletse qeto ea hore keketseho ea palo ea li-receptor tsa GF le palo ea GF ho batho ba bacha e ka ba le karabelo e ntle ea cellular ho kalafo ea PRP ho feta batho ba baholo ho batho ba bacha.Liphuputso tsena li senola hore na ke hobane'ng ha phekolo ea PRP e ka 'na ea se ke ea sebetsa hantle kapa e sa sebetse ho bakuli ba tsofetseng ba nang le lisele tse fokolang tsa stem le "boleng bo bobe".Ho 'nile ha pakoa hore mokhoa oa botsofali oa lefuba la botsofali o khutlisetsoa morao' me nako ea phomolo ea li-chondrocyte e eketseha ka mor'a ente ea PRP.Jia et al.E sebelisetsoa ho ithuta mouse dermal fibroblasts in vitro photoaging, ka phekolo ea PRP le ntle le eona, ho hlakisa mokhoa oa ho hanyetsa PGF mofuteng ona.Sehlopha sa PRP se bontšitse phello e tobileng holim'a matrix a extracellular, ho eketseha ha mofuta oa I collagen le ho fokotsa motsoako oa metalloproteinase, ho bontša hore PRP e ka thibela botsofali ba lisele, hape le ka lefu le fokolang la MSK.
Phuputsong e 'ngoe, PRP e ne e sebelisetsoa ho bokella lisele tse tsofetseng tsa moko oa masapo ho litoeba tse tsofetseng.Ho 'nile ha etsoa qeto ea hore PRP e ka tsosolosa mefuta e sa tšoaneng ea lisele tsa stem ho tloha botsofaling, tse kang ho ata ha lisele le ho thehoa ha kolone, le ho tsosolosa matšoao a amanang le botsofali ba lisele.
Haufinyane tjena, Oberlohr le basebetsi-'moho le eena ba ile ba ithuta ka ho pharaletseng karolo ea botsofali ba lisele ho fokolisa ho tsosolosoa ha mesifa, 'me ba hlahloba PRP le platelet-poor plasma (PPP) e le mekhoa ea phekolo ea likokoana-hloko bakeng sa ho lokisoa ha mesifa ea masapo.Ba ne ba nahana hore phekolo ea PRP kapa PPP bakeng sa ho lokisoa ha mesifa ea masapo e tla thehoa linthong tsa likokoana-hloko tse etselitsoeng li-cell marker tse khethehileng tsa SASP le lintlha tse ling tse lebisang ho nts'etsopele ea fibrosis.
Hoa utloahala ho lumela hore pele ho ts'ebeliso ea PRP, botsofali ba sele bo lebisitsoeng bo ka ntlafatsa litšobotsi tsa tsosoloso ea katleho ea phekolo ea likokoana-hloko ka ho fokotsa lintlha tsa SASP tsa sebaka seo.Ho 'nile ha etsoa tlhahiso ea hore khetho e' ngoe ea ho ntlafatsa liphello tsa phekolo ea PRP le PPP bakeng sa ho tsosolosoa ha mesifa ea masapo ke ho tlosa lisele tse tsofetseng ka mokhoa o ikhethileng ka li-scavengers tsa botsofali.Ha ho pelaelo hore liphello tsa lipatlisiso tsa morao-rao mabapi le phello ea PRP ka botsofali ba lisele le botsofali li hlolla, empa li ntse li le sethaleng sa pele.Ka hona, ha ho utloahale ho etsa litlhahiso leha e le life nakong ena.
(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: Mar-01-2023