Karolo ea liplatelete mokong oa masapo a aspiration concentrate
PRP le bone marrow aspiration concentrate (BMAC) li sebelisoa bakeng sa letoto la phekolo ea meriana sebakeng sa ofisi le ho buuoa ka lebaka la melemo ea bona ea ho tsosolosa ho MSK le mafu a mokokotlo, tsamaiso ea bohloko bo sa foleng le matšoao a lisele tse bonolo.PRP ha e laole feela ho falla ha lisele le ho ata ha lisele, empa hape e tlatsetsa ho angiogenesis le ho lokisoa ha ECM ho theha microenvironment e ntle le ho khothalletsa ho lokisoa le ho tsosolosoa ha lisele.
Mokhoa oa ho lokisa BMAC
Li-BMAC ke metsoako ea lisele tse fapaneng tse nang le li-BMMSC, e leng se etsang hore e be mohloli oa lisele tsa endogenous bakeng sa phekolo ea ho lokisa meriana e nchafatsang.Ba phetha karolo ka ho fokotsa apoptosis ea lisele, fibrosis le ho ruruha;'Me u kenye tšebetso ea cascade e lebisang ho ata ha lisele.Ho phaella moo, li-BMMSC li na le monyetla oa ho khetholla mefuta e sa tšoaneng ea lisele tsa lisele, ho akarelletsa le osteoblasts, adipocytes, myoblasts, lisele tsa epithelial le li-neuron.Li boetse li khothalletsa angiogenesis ka litsela tsa paracrine le autocrine.Ho bohlokoa hape hore BMMSC e kenye letsoho taolong ea 'mele ea ho itšireletsa mafung e ikemetseng ntle le lisele tse ikhethileng tsa' mele, tse nkang karolo mothating oa ho ruruha oa tokiso ea maqeba.Ho feta moo, li-BMMSC li tšehetsa ho thaothoa ha lisele libakeng tse ncha tsa phekolo ea angiogenesis ho potlakisa kaho ea phallo ea mali ea lehae.Jin le al.Ho ile ha pakoa hore ka lebaka la bosieo ba scaffolds tse lekaneng, lebelo la ho pholoha ha BMMSC le bokhoni ba eona ba ho lokisa le ho khetholla ho khothalletsa pholiso li ile tsa senyeha.Leha pokello ea linama, tokiso ea mohlala le mokhoa oa ts'ebetso oa PRP le BMAC li fapane, lithuto li bonts'a hore li ka tlatsana.Ebile, ho kopanya PRP le BMAC ho sehlahisoa sa baeloji ho ka ba le melemo e meng.
Ho kopanya PRP le BMAC
Ho ea ka lipatlisiso tse sa tsejoeng haholo, molao-motheo oa ho kopanya PRP le BMAC o itšetlehile ka libaka tse 'maloa.Ntlha ea pele, PRP e ka fana ka tikoloho e loketseng ea microenvironment moo BMSC e ka ntlafatsang ho ata ha lisele le ho arohana le ho eketsa angiogenesis.Taba ea bobeli, PRP e 'nile ea sebelisoa e le scaffold bakeng sa lisele tsena hammoho le BMAC.Ho fapana le hoo, motsoako oa PRP le BMAC e ka ba sesebelisoa se matla sa baeloji ho hohela baahi ba BMMSC.Motsoako oa PRP-BMAC o 'nile oa sebelisoa ho phekola tendinosis, maqeba, likotsi tsa mokokotlo oa mokokotlo, li-intervertebral discs tse senyehang le bokooa ba osteochondral bo nang le bokhoni bo boholo ba ho tsosolosoa.Ka bomalimabe, le hoja likaroloana tse fapaneng tsa lisele tsa masapo li kenyelletsa liplatelete, litlaleho tse fokolang li bua ka bongata ba liplatelete mokong o nkiloeng le ka mor'a phekolo ea BMAC, empa li ka ntšoa ka mekhoa e nepahetseng ea takatso.Hoa hlokahala lipatlisiso tse ling ho utloisisa hore na li-concentrate tse eketsehileng tsa platelet li hloka ho sebelisoa hammoho le BMAC.Hajoale, ha ho na lintlha tse mabapi le karo-karolelano e nepahetseng ea liplatelete ho MSC (kapa lisele tse ling tsa moko oa masapo), tse nang le phello e ntle mokhoeng oa phepo oa MSC ho lokisoeng ha lisele.Ka nepo, lisebelisoa tsa pokello ea moko oa masapo le theknoloji li ka ntlafatsoa ho ntša liplatelete tse lekaneng tsa moko oa masapo.
Ntho ea kholo ea PRP le phello ea phepo ea BMAC
PRP platelet growth factor ke protheine ea bohlokoa e amehang ts'ebetsong ea tokiso ea BMAC.Mefuta e fapa-fapaneng ea PGF le li-cytokine tse ling tse amehang ts'ebetsong ea phepo ea BMAC e ka qala ho lokisoa ha lisele ka ho fokotsa lisele tsa apoptosis, anabolism le liphello tse khahlanong le ho ruruha, le ho kenya tšebetsong ho ata ha lisele, phapang le angiogenesis ka litsela tsa paracrine le autocrine.
Ho hlakile hore karolo ea khōlo e entsoeng ka platelet le likarolo tse teteaneng tsa granule li ameha ts'ebetsong ea phepo e nepahetseng ea BMAC le ho tšehetsa tokiso ea lisele le tsosoloso e bakoang ke MSC.Likgutsufatso: MSC: mesenchymal stem cell, HSC: hematopoietic stem cell.
Ho totobetse hore ha ho phekoloa OA, PDGF e phetha karolo e itseng ea ho tsosolosoa ha lefufuru le tlhokomelo ea homeostasis ka ho ata ha MSC le ho thibela IL-1-induced chondrocyte apoptosis le ho ruruha.Ho phaella moo, tse tharo tsa TGF- β Li-subtypes li sebetsa ka matla ho susumetsa sebopeho sa lefufuru le ho thibela ho ruruha, 'me li bontša bokhoni ba ho khothalletsa pholiso ea lisele tse amanang le MSC ka ho sebelisana ha intermolecular.Phello ea phepo e nepahetseng ea MSC e amana le mosebetsi oa PGF le secretion ea li-cytokine tsa tokiso.Ha e le hantle, li-cytokine tsena kaofela li lokela ho ba teng ka botlolong ea phekolo ea BMAC 'me li isoa sebakeng sa kotsi ea lisele ho ntšetsa pele phekolo e ntle ka ho fetisisa e amanang le MSC.
Thutong e kopanetsoeng ea OA, Mui ñ os-L ó pez et al.E bonts'a hore MSC e tsoang ho lisele tsa synovial e fetotse ts'ebetso, e bakang tahlehelo ea bokhoni ba eona ba ho hlaphoheloa.Hoa thahasellisa hore ente e tobileng ea PRP ho subchondral bone ea osteoarthritis e ile ea fella ka ho fokotseha ha MSC ka synovial fluid, e bontšang ntlafatso ea kliniki.Phello ea phekolo e kenella ka ho fokotsa ts'ebetso ea ho ruruha ho synovial fluid ea bakuli ba OA.
Ho na le tlhahisoleseding e fokolang e fumanehang mabapi le boteng kapa mahloriso a PGF ho BMAC kapa karo-karolelano e loketseng e hlokehang ho tshehetsa tshebetso ya phepo ya BMMSC.Lingaka tse ling li kopanya mahloriso a phahameng a PRP le BMAC ho fumana li-graft tse sebetsang haholoanyane tsa biologically, tse lebeletsoeng ho ntlafatsa liphello tsa phekolo ea meriana e nchafatsang.Leha ho le joalo, ho na le lintlha tse fokolang tse fumanehang tsa polokeho le katleho, tse bontšang hore ho kopanya khatello e phahameng ea PRP le BMAC ke khetho e sebetsang haholoanyane ea phekolo.Ka hona, re lumela hore e kanna ea se be ho loketseng ho thetsa BMMSC ka ho e kenya tšebetsong ka bongata bo phahameng ba platelet mothating ona.
Tšebelisano ea liplatelete le lithethefatsi tsa antiplatelet le li-NSAID
PRP e na le likarolo tse ngata tsa sephiri 'me e entsoe ka mecha e mengata ea likokoana-hloko.Phello ea phekolo ea PRP e amahanngoa le bakena-lipakeng bana.Le hoja baemeli ba phekolo ea li-platelet ba tsejoa hantle, mokhoa o nepahetseng oa ho etsoa le kinetics ea lithethefatsi tsena tsa anabolic le catabolic ha li hlake ka ho feletseng.E 'ngoe ea likhaello tse ka sehloohong tsa ho finyella mekhoa ea phekolo ke ho hlōla ho se tšoane ha bakena-lipakeng bana ba likokoana-hloko e le ho lebisa tlhokomelo ea liphello tse laoloang hantle tse tlaase tse lulang li phetoa le tse molemo ho tsa bongaka.Ka lebaka lena, lithethefatsi (tse kang li-non-steroidal anti-inflammatory drugs (NSAIDs)) li ka ama ho lokolloa ha lihlopha tsa li-platelet secretory.Phuputsong ea morao-rao e bulehileng ea tatellano e tsitsitseng, ho noa letsatsi le leng le le leng 81 mg ea aspirin (ASA) ho fokolitse polelo ea baemeli ba bohlokoa, ba kang TGF- β 1. PDGF le VEGF.
Liphello tsena li bakoa ke thibelo e ke keng ea fetoloa ea cyclooxygenase-1 (COX-1) le inhibition e feto-fetohang ea cyclooxygenase-2 (COX-2), e leng li-enzyme tse peli tse hlokahalang bakeng sa ho fokotseha ha platelet.Tlhahlobo ea morao-rao e hlophisitsoeng e fumane hore lithethefatsi tsa antiplatelet li ka fokotsa sekhahla sa kholo ea kholo ka mokhoa o itšetlehileng ka COX-1 le COX-2, 'me lithuto tse 8 ho tse 15 li fumane hore lintlha tsa kholo li fokotsehile.
Lithethefatsi (mohlala, li-NSAID) li atisa ho sebelisoa ho kokobetsa bohloko le ho fokotsa ho ruruha ho bakoang ke lefu la MSK.Mokhoa oa li-NSAID ke ho thibela tšebetso ea liplatelete ka ho tlama ka mokhoa o ke keng oa fetoloa ka enzyme ea COX le ho laola tsela ea arachidonic acid.Ka hona, ts'ebetso ea liplatelete e tla fetoha nakong ea potoloho eohle ea bophelo ba liplatelete, ka hona ho thibela phetiso ea matšoao a PGF.Li-NSAID li thibela tlhahiso ea cytokine (mohlala, PDGF, FGF, VEGF, le IL-1 β, IL-6, le IL-8), ha e ntse e ntlafatsa TNF- α. Leha ho le joalo, ho na le boitsebiso bo fokolang mabapi le phello ea molek'hule ea li-NSAID ho PRP.Ha ho na tumellano mabapi le nako e ntle ea ho lokisetsa le ho tsamaisa PRP ho bakuli ba sebelisang li-NSAID.Mannava le basebetsi-'moho ba ile ba lekanya anabolic le catabolic biological factor in the leucocyte-rich PRP ea baithaopi ba phetseng hantle ba nkang naproxen.Ba fumane hore ka mor'a ho sebelisa naproxen bakeng sa beke e le 'ngoe, maemo a PDGF-AA le PDGF-AB (mitogen e sebetsang bakeng sa ho khothalletsa angiogenesis) a fokotsehile haholo.Ka mor'a beke e le 'ngoe, boemo ba ntlha ea kholo bo ile ba khutlela haufi le boemo ba motheo.Ka mor'a ho sebelisa naproxen bakeng sa beke e le 'ngoe, boemo ba LR-PRP ba proinflammatory le catabolic factor IL-6 le bona bo fokotsehile,' me bo khutlela boemong ba motheo ka mor'a nako ea ho qeta beke e le 'ngoe.Hona joale, ha ho na thuto ea kliniki ho paka hore bakuli ba nang le naproxen ka mor'a phekolo ea PRP ba na le liphello tse mpe;Leha ho le joalo, ho khothalletsoa ho nahana ka nako ea ho hlatsoa beke e le 'ngoe ho tsosolosa litekanyetso tsa PDGF-AA, PDGF-BB le IL-6 boemong ba motheo ho ntlafatsa mosebetsi oa bona oa likokoana-hloko.Ho hlokahala lipatlisiso tse eketsehileng ho utloisisa ka botlalo liphello tsa antiplatelet le NSAID ho sehlopha sa secretion sa PRP le lipakane tsa eona tse tlaase.
Kopanya ts'ebeliso ea plasma e nang le platelet e ngata le ho tsosolosa
Le hoja lipatlisiso tsa motheo tsa saense li bontša hore phekolo ea 'mele le mojaro oa mechine li na le karolo e hlakileng ea ho tsosolosa sebopeho sa tendon ka mor'a ho kenngoa ha PRP, ha ho na tumellano mabapi le moralo o motle oa ho tsosolosa lefu la MSK ka mor'a phekolo ea PRP.
Phekolo ea PRP e kenyelletsa ente ea liplatelete tse tsepamisitsoeng tikolohong ea lisele ho laola bohloko le ho khothaletsa tokiso ea lisele.Bopaki bo matla ka ho fetisisa ba kliniki bo teng ho OA ea lengole.Leha ho le joalo, tšebeliso ea PRP ha ho phekoloa tendinosis ea matšoao e phehisana khang, 'me liphello tse tlalehiloeng li fapane.Hangata lithuto tsa liphoofolo li bontša ntlafatso ea histological ea tendinosis ka mor'a ho kenella ha PRP.Liphuputso tsena li bontša hore mojaro oa mechine o ka tsosolosa li-tendon, 'me mojaro le ente ea PRP e sebetsa hammoho ho khothalletsa pholiso ea tendon.Phapang ea litokisetso tsa PRP, litokisetso tsa likokoana-hloko, litokisetso, merero ea ente le li-subtypes tsa kotsi ea tendon li ka lebisa ho se tšoane ha liphello tsa kliniki.Ho phaella moo, le hoja bopaki ba saense bo tšehetsa melemo ea merero ea tsosoloso, lipatlisiso tse seng kae tse hatisitsoeng tsa kliniki li leka ho laola le ho kopanya merero e tsitsitseng ea ho tsosolosa ka mor'a PRP.
Haufinyane tjena, Onishi et al.Karolo ea mojaro oa mechine le phello ea likokoana-hloko ea PRP ho lefu la tendon la Achilles e ile ea hlahlojoa.Ba ile ba hlahloba lithuto tsa kliniki tsa mohato oa I le oa II oa lefu la tendon la Achilles le tšoaroang ka PRP, ba lebisa tlhokomelo ho moralo oa tsosoloso ka mor'a ente ea PRP.Mananeo a hlokometsoeng a tsosoloso a bonahala a ntlafatsa ho latela boikoetliso le ho ntlafatsa liphello le bokhoni ba ho shebella tekanyo ea boikoetliso.Liteko tse 'maloa tse entsoeng hantle tsa Achilles tendon PRP li kopantsoe le phekolo ea post-PRP le moralo oa ho tsosolosa mojaro oa mechine e le karolo ea bohlokoa ea leano la tsosoloso.
Pono ea bokamoso le liqeto
Khatelo-pele ea theknoloji ea lisebelisoa tsa PRP le mekhoa ea ho itokisa e bontša liphello tse tšepisang tsa mokuli, le hoja tlhaloso ea mefuta e fapaneng ea likokoana-hloko tsa PRP le litšobotsi tse amehang tsa likokoana-hloko tsa sehlahisoa sa ho qetela li ntse li sa tsejoe hantle.Ho phaella moo, bokhoni bo feletseng ba lipontšo le likopo tsa PRP ha bo so tsejoe.Ho fihlela morao tjena, PRP e 'nile ea rekisoa e le sehlahisoa sa mali sa autologous, se ka fanang ka lingaka matla a ho sebelisa thekenoloji ea autologous platelet growth factor pathology le mafu a itseng.Qalong, mokhoa o le mong feela oa ts'ebeliso e atlehileng ea PRP e atisang ho qotsoa ke sampole e lokisitsoeng, eo mahloriso a eona a platelet a phahametseng boleng bohle ba mali.Kajeno, ka lehlohonolo, litsebi li na le kutloisiso e pharaletseng ea ts'ebetso ea PRP.
Tlhahlobisong ena, re lumela hore ho ntse ho e-na le khaello ea maemo le lihlopha ho theknoloji ea ho lokisetsa;Ka hona, ha ho na tumellano ho mahlahana a likokoana-hloko tsa PRP hona joale, le hoja lingoliloeng tse ngata li fihletse tumellano mabapi le khatello ea tekanyo ea platelet e sebetsang e hlokahalang ho ntšetsa pele (e ncha) angiogenesis.Mona, re tsebisitse ka bokhutšoanyane ts'ebetso ea li-PGF, empa ka mokhoa o pharalletseng re bonts'itse mokhoa o ikhethileng oa liplatelete le phello ea phello ea lisele tse tšoeu tsa mali le li-MSC, hammoho le tšebelisano e ileng ea latela ea lisele.Ka ho khetheha, ho ba teng ha lisele tse tšoeu tsa mali litokisetsong tsa PRP ho fana ka kutloisiso e tebileng ea liphello tse kotsi kapa tse molemo.Karolo e hlakileng ea liplatelete le tšebelisano ea tsona le boits'ireletso ba tlhaho le bo ikamahanyang le maemo ho buisanoe.Ho phaella moo, ho hlokahala lithuto tsa kliniki tse lekaneng le tse ngotsoeng hantle ho fumana matla a feletseng le phello ea phekolo ea PRP ka lipontšo tse sa tšoaneng.
(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