Uyu munsi, igitekerezo kizwi nka PRP cyagaragaye bwa mbere mu bijyanye na hematologiya mu myaka ya za 70.Abahanga mu kuvura indwara z’imiti bashizeho ijambo PRP mu myaka mirongo ishize kugirango basobanure plasma yakuwe mu mubare wa platel urenze agaciro k’ibanze k’amaraso ya peripheri.Nyuma yimyaka irenga icumi, PRP yakoreshejwe mukubaga maxillofacial nkuburyo bwa fibrine ikungahaye kuri fibrin (PRF).Ibiri muri fibrin muriyi nkomoko ya PRP bifite agaciro gakomeye bitewe no kwizirika hamwe nibiranga imiterere ihamye, mugihe PRP yagumanye imiti igabanya ubukana kandi igatera ikwirakwizwa ry'uturemangingo.Amaherezo, nko muri za 90, PRP yatangiye kumenyekana.Hanyuma, iryo koranabuhanga ryimuriwe mu zindi nzego z'ubuvuzi.Kuva icyo gihe, ubu bwoko bw’ibinyabuzima bwiza bwarigishijwe cyane kandi bukoreshwa mu kuvura ibikomere bitandukanye by’imitsi y’imikino yabakinnyi babigize umwuga, ibyo bikaba byaratumye abantu benshi bitabira itangazamakuru.Usibye kuba ingirakamaro mu magufa no mu buvuzi bwa siporo, PRP ikoreshwa no mu kuvura amaso, indwara z'abagore, urologiya na kardiologiya, ubuvuzi bw'abana ndetse no kubaga plastique.Mu myaka yashize, PRP yashimiwe kandi n’aba dermatologiste kubera ubushobozi ifite mu kuvura ibisebe by’uruhu, gusana inkovu, kuvugurura ingirabuzimafatizo, kuvugurura uruhu ndetse no guta umusatsi.
Urebye ko PRP ishobora gukoresha mu buryo butaziguye inzira yo gukiza no gutwika, ni ngombwa kumenyekanisha kasake ikiza nkaho ikoreshwa.Inzira yo gukira igabanijwemo ibyiciro bine bikurikira: hemostasis;Umuriro;Ikwirakwizwa rya selile na matrix, hanyuma amaherezo yo gukomeretsa.
Gukiza imyenda
Tissue ikiza cascade reaction irakorwa, biganisha ku guteranya platine Gukora uturemangingo no guteza imbere matrice idasanzwe yigihe gito (ECM).Hanyuma, platine yumira kuri kolagene yagaragaye hamwe na proteyine ya ECM, bigatuma irekurwa rya molekile ya bioaktike igaragara muri a-granules.Platelets irimo molekile zitandukanye za bioactive, zirimo ibintu bikura, ibintu bya chimiotherapie na cytokine, hamwe nabunzi ba proinflammatory, nka prostaglandine, prostate cyclin, histamine, tromboxane, serotonine na bradykinin.
Icyiciro cyanyuma cyibikorwa byo gukira biterwa no guhindura igikomere.Kuvugurura imyenda bigengwa cyane kugirango habeho uburinganire hagati ya anabolike na catabolika.Kuri iki cyiciro, gukura kwa platine (PDGF) no guhindura ibintu bikura (TGF- β) Fibronectine na fibronectine bitera ikwirakwizwa ryimuka rya fibroblast, hamwe no guhuza ibice bya ECM.Nyamara, igihe cyo gukura kw'igikomere biterwa ahanini n'uburemere bw'igikomere, ibiranga umuntu ku giti cye ndetse n'ubushobozi bwihariye bwo gukiza bw'imitsi yakomeretse.Bimwe mubintu bya pathophysiologique na metabolic birashobora kugira ingaruka kumikorere yo gukira, nka ischemia tissue, hypoxia, infection, ubusumbane bwimikurire, ndetse nindwara ziterwa na syndrome de metabolike.
Ibidukikije bya proinflammatory bibangamira inzira yo gukira.Igikomeye cyane nuko ibikorwa bya protease byinshi bibuza ibikorwa bisanzwe byikura (GF).Usibye imiterere ya mitoto, angiogenic na chemotactique, PRP nayo ni isoko ikungahaye kubintu byinshi bikura.Izi biomolecules zirashobora kurwanya ingaruka mbi mumyanya yumuriro mugucunga umuriro mwinshi no gushiraho anabolike.Urebye ibyo biranga, abashakashatsi barashobora kubona imbaraga zikomeye zo kuvura ibikomere bitandukanye.
Indwara nyinshi, cyane cyane iz'imitsi ya musculoskeletal, zishingiye cyane cyane ku binyabuzima bigenga uburyo bwo gutwika, nka PRP yo kuvura osteoarthritis.Muri iki gihe, ubuzima bwa karitsiye ya artique biterwa nuburinganire nyabwo bwimikorere ya anabolike na catabolika.Ukizirikana iri hame, ikoreshwa ryibintu byiza byibinyabuzima bishobora kwerekana ko bigenda neza kugirango ugere ku buringanire bwiza.PRP kuko irekura platine α- Ibintu bikura bikubiye muri granules bikoreshwa cyane muguhindura ubushobozi bwo guhindura tissue, nabyo bigabanya ububabare.Mubyukuri, imwe mu ntego nyamukuru zo kuvura PRP ni uguhagarika ibidukikije byangiza cyane na catabolike no guteza imbere imiti igabanya ubukana.Abandi banditsi berekanye mbere ko trombine ikora PRP yongera irekurwa rya molekile nyinshi yibinyabuzima.Muri ibyo bintu harimo gukura kwa hepatocyte (HGF) hamwe nikibyimba cya necrosis (TNF- α) 、 Guhindura ibintu bikura beta1 (TGF- β 1), imikurire yimitsi iva mu mitsi (VEGF) hamwe niterambere rya epidermis (EGF).Ubundi bushakashatsi bwerekanye ko PRP iteza imbere kwiyongera kwubwoko bwa ii collagen na aggrecan mRNA, mugihe bigabanya kubuza kwanduza cytokine interleukin - (IL) 1 kuri bo.Hasabwe kandi ko kubera HGF na TNF- α [28] PRP ishobora gufasha gushiraho ingaruka zo kurwanya inflammatory.Iyi myiteguro yombi ya molekile igabanya ibintu bya kirimbuzi kappaB (NF- κВ) Ibikorwa byo kurwanya ibikorwa no kwerekana;Icya kabiri, binyuze muri TGF- β 1 imvugo nayo irinda monocyte chemotaxis, bityo ikarwanya TNF- α Ingaruka kuri transactivation ya chemokine.HGF isa nkaho igira uruhare rukomeye mubikorwa byo kurwanya inflammatory biterwa na PRP.Iyi cytokine ikomeye yo kurwanya inflammatory yangiza inzira ya NF- κ B yerekana inzira hamwe na cytokine ya protinflammatory ibuza igisubizo.Mubyongeyeho, PRP irashobora kandi kugabanya urwego rwo hejuru rwa aside nitide (OYA).Kurugero, muri karitsiye ya articular, kwiyongera kwa NO kwibanda byagaragaye ko bibuza synthesis ya kolagen no gutera chondrocyte apoptose, mugihe byongera synthesis ya matrix metalloproteinase (MMPs), bityo bigateza imbere ihinduka rya catabolism.Kubijyanye no kwangirika kwakagari, PRP nayo ifatwa nkaho ishobora gukoresha autophagy yubwoko bwihariye.Iyo ugeze kumusaza wanyuma, amatsinda amwe atakaza ubushobozi bwimiterere ihagaze no kwiyubaka.Nyamara, ubushakashatsi buherutse gukorwa bwerekanye ko kuvura PRP bishobora guhindura ibi bihe bibi.Moussa na bagenzi be bagaragaje ko PRP ishobora kurinda chondrocytes mu kongera ibimenyetso bya autophagy na anti-inflammatory, mu gihe bigabanya apoptose ya karitsiye ya osteoarthritis.Garcia Pratt n'abandi.Biravugwa ko autophagy igena inzibacyuho hagati yo kuruhuka no gusaza byimitsi yingirangingo.Abashakashatsi bemeza ko, muri vivo, ubusanzwe bwa autofagy ihuriweho birinda kwirundanya kwangirika kw’imitsi kandi bikarinda gusaza no kugabanuka kwimikorere ya selile.Ndetse no gusaza ingirabuzimafatizo z'umuntu, nka vuba aha, Paruwasi na Rode nazo zatanze umusanzu ukomeye, bikomeza kwerekana ubushobozi bwo kurwanya inflammatory PRP.Iki gihe, icyibandwaho ni imikoranire hagati ya platine na neutrophile.Mu iperereza ryabo, abashakashatsi basobanuye ko platine ikora yasohowe na aside arachidonic yakiriwe na neutrophile hanyuma ihinduka leukotriène na prostaglandine, izwi na molekile ikongora.Nyamara, imikoranire ya platel neutrophil ituma leukotriene ihinduka lipoproteine, byagaragaye ko ari poroteyine nziza yo kurwanya inflammatory ishobora kugabanya imikorere ya neutrophile kandi ikarinda dialyse, kandi igateza umurage kugeza ku ntera yanyuma ya casade ikiza.
Ibidukikije bya proinflammatory bibangamira inzira yo gukira.Igikomeye cyane nuko ibikorwa bya protease byinshi bibuza ibikorwa bisanzwe byikura (GF).Usibye imiterere ya mitoto, angiogenic na chemotactique, PRP nayo ni isoko ikungahaye kubintu byinshi bikura.Izi biomolecules zirashobora kurwanya ingaruka mbi mumyanya yumuriro mugucunga umuriro mwinshi no gushiraho anabolike.
Akagari
Cytokine muri PRP igira uruhare runini mugukoresha inzira yo gusana ingirabuzimafatizo no kugenzura ibyangiritse.Anti inflammatory cytokine ni ubwoko butandukanye bwa molekile ya biohimiki ihuza igisubizo cya protinflammatory cytokine, ahanini iterwa na macrophage ikora.Anti inflammatory cytokine ikorana na inhibitor ya cytokine yihariye hamwe na reseptor ya cytokine ikora kugirango igabanye umuriro.Interleukin (IL) - 1 antagonist antagonist, IL-4, IL-10, IL-11 na IL-13 bashyizwe mu rwego rw’imiti nyamukuru irwanya inflammatory, cytokine.Ukurikije ubwoko butandukanye bwibikomere, cytokine zimwe na zimwe, nka interferon, leukemia inhibitory factor, TGF- β Na IL-6, zishobora kwerekana ingaruka za proinflammatory cyangwa anti-inflammatory.TNF- α 、 IL-1 na IL-18 bifite reseptor zimwe na zimwe za cytokine, zishobora kubuza ingaruka za porinflammatory izindi poroteyine [37].IL-10 ni imwe mu mikorere irwanya anti-inflammatory cytokine, ishobora kugabanya kugenzura cytokine ya protinflammatory nka IL-1, IL-6 na TNF- α ， Kandi ikagenga ibintu birwanya inflammatory.Ubu buryo bwo kurwanya amategeko bugira uruhare runini mu gukora no mu mikorere ya cytokine ya proinflammatory.Byongeye kandi, cytokine zimwe zishobora gukurura ibimenyetso byerekana ibisubizo byihariye kugirango bikangure fibroblast, ningirakamaro mugusana ingirangingo.Cytokine ikongora TGF β 1 、 IL-1 β 、 IL-6, IL-13 na IL-33 itera fibroblast gutandukanya myofibroblast no kunoza ECM [38].Na none, fibroblast isohora cytokine TGF- β 、 IL-1 β 、 IL-33, CXC na CC chemokine itera imbaraga zo gutwika mugukora no kwinjiza ingirabuzimafatizo nka macrophage.Utugingo ngengabuzima twinshi dufite uruhare runini mu gikomere, cyane cyane mu guteza imbere igikomere - hamwe na biosynthesis ya chemokine, metabolite hamwe nimpamvu zikura, zikaba ari ingenzi cyane mu kongera kubaka ingirangingo nshya.Kubwibyo, cytokine muri PRP igira uruhare runini mukubyutsa ubwoko bwimikorere yimikorere yumubiri no guteza imbere gusubira inyuma.Mubyukuri, abashakashatsi bamwe bavuze ko iki gikorwa ari "ugusubirana imbaraga", byerekana ko icyiciro cyo gutwika, nubwo umurwayi ahangayitse, ari intambwe ikenewe kandi ikomeye kugirango irangize neza inzira yo gusana ingirabuzimafatizo, hitawe ku buryo bwa epigenetike bwerekana ibimenyetso byerekana umuriro. guteza imbere plastike.
Uruhare rwa cytokine mugutwika uruhu rwuruhinja rufite akamaro kanini mubushakashatsi bwubuvuzi bushya.Itandukaniro riri hagati yuburyo bwo gukiza no gukura ni uko ibyangiritse byangiritse rimwe na rimwe bisubira uko byahoze ukurikije imyaka y'uruhinja n'ubwoko bw'inyama.Mu bantu, uruhu rw'uruhinja rushobora kubyara burundu mu byumweru 24, mugihe mubantu bakuru, gukira ibikomere bishobora gutera inkovu.Nkuko twabizi, ugereranije nuduce twiza, imiterere yubukorikori bwimitsi yinkovu iragabanuka cyane, kandi imikorere yayo ni mike.By'umwihariko hitabwa cyane kuri cytokine IL-10, ugaragara ko igaragara cyane mu mazi ya amniotic ndetse no ku ruhu rw’inda, kandi byagaragaye ko igira uruhare mu gusana inkovu ku buntu uruhu rw’uruhinja, byatewe n'ingaruka za pleiotropique ya cytokine.ZgheibC n'abandi.Kwiga uruhu rwuruhinja muri transgenic knockout (KO) IL-10 n'imbeba zo kugenzura byakozweho ubushakashatsi.Imbeba za IL-10KO zerekanaga ibimenyetso byerekana umuriro no gukomeretsa inkovu hirya no hino, mu gihe ibihangano byo mu itsinda ryabigenzuye byerekanaga ko nta mpinduka nini zigeze zigaragara mu miterere y’ibinyabuzima kandi nta gukiza inkovu.
Akamaro ko kugenzura uburinganire bworoshye hagati yimvugo ya anti-inflammatory na pro-inflammatory cytokine nuko iyanyuma, iyo itanzwe cyane, amaherezo ikohereza ibimenyetso byangirika kwingirabuzimafatizo igabanya imvugo ya genes zimwe na zimwe.Kurugero, mubuvuzi bwimitsi, IL-1 β Hasi agenga SOX9, ishinzwe iterambere rya karitsiye.SOX9 itanga ibintu byingenzi byandikirwa mugutezimbere karitsiye, igenga ubwoko bwa II kolagen alpha 1 (Col2A1), kandi ishinzwe gushushanya ubwoko bwa II bwa kolagen.IL-1 β Hanyuma, imvugo ya Col2A1 na aggrecan yagabanutse.Nyamara, kuvura hamwe nibicuruzwa bikungahaye kuri platine byagaragaye ko bibuza IL-1 still Biracyari umufasha w’ubuvuzi bushya kugira ngo ukomeze kwerekana imiterere ya gen code ya kolagen no kugabanya apoptose ya chondrocytes iterwa na cytokine ya proinflammatory.
Kubyutsa Anabolic: Usibye kugenzura imiterere yumubiri wangiritse, cytokine muri PRP inagira uruhare muri reaction ya anabolike ikina uruhare rwabo rwa mitito, gukurura imiti no gukwirakwiza.Ubu ni ubushakashatsi bwa vitro iyobowe na Cavallo n'abandi.Kwiga ingaruka za PRP zitandukanye kuri chondrocytes zabantu.Abashakashatsi bagaragaje ko ibicuruzwa bya PRP bifite platine nkeya hamwe na leukocyte yibanda ku bikorwa bisanzwe bya chondrocyte, ibyo bikaba bifasha mu guteza imbere uburyo bumwe na bumwe bw’imikorere ya anabolike.Kurugero, imvugo yubwoko ii collagen hamwe no guteranya glycans byagaragaye.Ibinyuranye, ubunini bwa platine na leukocytes bisa nkibitera izindi nzira zerekana ibimenyetso bya cytokine zitandukanye.Abanditsi bavuga ko ibyo bishobora guterwa no kuba hari umubare munini wamaraso yera muri ubu buryo bwa PRP.Utugingo ngengabuzima dusa nkaho dushinzwe kongera imvugo yibintu bimwe na bimwe bikura, nka VEGF, FGF-b, na interleukins IL-1b na IL-6, na byo bishobora gutera TIMP-1 na IL-10.Muyandi magambo, ugereranije na formulaire "mbi" PRP, imvange ya PRP ikungahaye kuri platine na selile yera bisa nkaho biteza imbere ugereranije na chondrocytes.
Ubushakashatsi bwakozwe na Schnabel n'abandi.yashizweho kugirango isuzume uruhare rwibinyabuzima byitwa autologique biologique muri tissue tendon tissue.Abanditsi bakusanyije icyitegererezo cy’amaraso n’amasoko aturutse ku mafarashi atandatu akuze (afite imyaka 2-4), kandi bibanda ku bushakashatsi bwakozwe ku miterere ya gene, ADN hamwe na kolagen biri mu bisobanuro bya tendon bisobanura flexor digitorum superficialis y’amafarasi yororerwa mu buryo burimo PRP cyangwa ibindi bicuruzwa byamaraso.Ubushakashatsi bwa Tendon bwarezwe mumaraso, plasma, PRP, plasma yabuze plasma (PPP) cyangwa aspirate yamagufa (BMA), na aside amine yongewemo 100%, 50% cyangwa 10% ya serumu yubusa DMEM.Mugukoresha isesengura ryibinyabuzima ryakoreshejwe nyuma ya…, abashakashatsi bavuze ko TGF- concent Ubwinshi bwa PDGF-BB na PDGF-1 muburyo bwa PRP bwari hejuru cyane ugereranije nibindi bicuruzwa byamaraso byapimwe.Byongeye kandi, udusimba twa tendon dufite imico 100% ya PRP yerekanaga ubwiyongere bwa gene ya proteine za matrix COL1A1, COL3A1 na COMP, ariko ntizongere imisemburo ya catabolike MMPs3 na 13. Nibura mubijyanye nimiterere ya tendon, ibi mubushakashatsi bwa vivo bishyigikira ikoreshwa rya autolo - ibicuruzwa byamaraso ya gouty, cyangwa PRP, kugirango bivure tendinite nini y’inyamabere.
Chen n'abandi.Ingaruka zo kongera kubaka PRP zaganiriweho.Mu bushakashatsi bwabo bwabanje, abashakashatsi bagaragaje ko, usibye kuzamura imitsi ya karitsiye, PRP yanateje imbere kwiyongera kwa synthesis ya ECM kandi inabuza kwanduza indwara ya karitsiye na nucleus pulposus.PRP irashobora gukora TGF ikoresheje fosifora ya Smad2 / 3- β Inzira y'ibimenyetso igira uruhare runini mu mikurire no gutandukanya.Byongeye kandi, byizerwa kandi ko uturemangingo twa fibrin twakozwe nyuma yo gukora PRP itanga imiterere ihamye yibice bitatu, ituma selile zifatika, zishobora gutuma hubakwa imyenda mishya.
Abandi bashakashatsi bagize uruhare runini mu kuvura ibisebe byuruhu bidakira mu bijyanye na dermatology.Ibi kandi biragaragara.Kurugero, ubushakashatsi bwakozwe na Hessler na Shyam muri 2019 bwerekana ko PRP ifite agaciro nkubuvuzi bushoboka kandi bunoze, mugihe ibisebe bidakira birwanya ibiyobyabwenge bikomeje kuzana umutwaro munini mubukungu mubuvuzi.By'umwihariko, ibisebe bya diyabete ni ikibazo kizwi cyane cy’ubuzima, bigatuma ingingo zoroha gucibwa.Ubushakashatsi bwashyizwe ahagaragara na Ahmed n'abandi.muri 2017 yerekanye ko gel autologique PRP ishobora gutera gukira ibikomere kubarwayi barwaye ibisebe bya diyabete idakira bakarekura ibintu bikenewe bikura, bityo bikazamura cyane umuvuduko wo gukira.Mu buryo nk'ubwo, Gonchar na bagenzi be basuzumye kandi baganira ku bushobozi bushya bwa PRP hamwe na cocktail yo gukura mu kunoza uburyo bwo kuvura ibisebe bya diyabete.Abashakashatsi basabye ko gukoresha imvange ziterwa no gukura bishobora kuba igisubizo gishoboka, gishobora kunoza ibyiza byo gukoresha PRP hamwe niterambere rimwe.Kubwibyo, ugereranije no gukoresha ikintu kimwe cyo gukura, guhuza PRP nizindi ngamba zo kuvura birashobora guteza imbere gukira ibisebe bidakira.
Fibrin
Amashanyarazi atwara ibintu byinshi bijyanye na sisitemu ya fibrinolytike, ishobora kugenga cyangwa kumanura igenga fibrinolytique.Umubano wigihe nintererano ugereranije nibice bya hematologiya nibikorwa bya platel mugutesha agaciro biracyari ikibazo gikwiye kuganirwaho cyane mubaturage.Ubuvanganzo butangiza ubushakashatsi bwinshi bwibanda gusa kuri platine, buzwiho ubushobozi bwo kugira ingaruka kumikorere.Nubwo hari umubare munini wubushakashatsi bwibanze, ibindi bice byamaraso, nkibintu bya coagulation na sisitemu ya fibrinolytike, nabyo byagaragaye ko bigira uruhare runini mugusana ibikomere neza.Mubisobanuro, fibrinolysis ninzira igoye yibinyabuzima biterwa nigikorwa cyimisemburo runaka kugirango iteze kwangirika kwa fibrin.Fibrinolysis reaction yatanzwe nabandi banditsi ko ibicuruzwa bitesha agaciro fibrin (fdp) mubyukuri bishobora kuba ibintu bya molekuline bishinzwe gusana ingirabuzimafatizo.Urukurikirane rwibintu byingenzi byibinyabuzima mbere ni kuva muri fibrin no gukuraho angiogenez, ikenewe mugukiza ibikomere.Ihinduka ryimitsi nyuma yimvune ikora nk'urwego rwo gukingira kurinda ingirabuzimafatizo gutakaza amaraso no gutera mikorobe, kandi ikanatanga matrisa y'agateganyo inyama zishobora kwimuka mugihe cyo gusana.Imyenda iterwa na fibrinogen ikozwe na proteine serine, kandi platine ikusanyirizwa hamwe ihuza fibrin fibre mesh.Iyi reaction yatumye polymerisation ya fibrin monomer, aricyo kintu nyamukuru cyo gutembera kw'amaraso.Umwenda urashobora kandi gukoreshwa nkikigega cya cytokine nibintu bikura, bisohoka mugihe cyo kwangirika kwa platine ikora.Sisitemu ya fibrinolytike igengwa cyane na plasmin, kandi igira uruhare runini mugutezimbere kwimuka kwingirabuzimafatizo, bioavailable yibintu bikura no kugenga izindi sisitemu za protease zigira uruhare mu gutwika no kuvuka.Ibice byingenzi bigize fibrinolysis, nka reseptor ya urokinase plasminogen (uPAR) hamwe na plasminogen activator inhibitor-1 (PAI-1), bizwi ko bigaragarira mu ngirabuzimafatizo ya Mesenchymal (MSCs), ni ubwoko bw’ingirabuzimafatizo zikenewe kugira ngo ibikomere bikire neza .
Kwimuka kwakagari
Gukora plasminogen binyuze mumashyirahamwe ya UPA uPAR ninzira iteza imbere kwimuka kwingirabuzimafatizo kuko byongera proteolysis idasanzwe.Bitewe no kubura transembrane na domacellular domaine, uPAR ikenera reseptor nka integrin na vitelline kugirango igenzure kwimuka kwakagari.Yagaragaje kandi ko guhuza uPA uPAR byatumye habaho kwiyongera kwa UPAR kuri vitrectonectine na integrin, byateje imbere ingirabuzimafatizo.Plasminogen activate inhibitor-1 (PAI-1) nayo ituma selile zitandukana.Iyo ihujwe na uPA ya uPA upar integrin complex hejuru ya selile, isenya imikoranire hagati ya vitellin upar na vitrine vitrine.
Mu rwego rwubuvuzi bushya, selile stem mesenchymal stem selile ikangurwa kuva mumagufwa mugihe habaye kwangirika kwingingo zikomeye, kuburyo zishobora kuboneka mukuzenguruka kwabarwayi bafite imvune nyinshi.Ariko rero, mu bihe byihariye, nko kunanirwa kw'impyiko zanyuma, kunanirwa kw'umwijima kurangiza, cyangwa mugihe cyo kwangwa nyuma yo guterwa umutima, utugingo ngengabuzima ntidushobora kuboneka mu maraso [66].Igishimishije ni uko utugingo ngengabuzima twa muntu twakomotse kuri mesenchymal (stromal) progenitor selile ntishobora kuboneka mumaraso yabantu bafite ubuzima bwiza [67].Uruhare rwa uPAR mugukangurira amagufa ya mesenchymal stem selile (BMSCs) rwasabwe mbere, ibyo bikaba bisa no kuba uPAR mugukangurira ingirabuzimafatizo ya hematopoietic (HSCs).Varabaneni n'abandi.Ibisubizo byerekanye ko ikoreshwa rya granulocyte colony-itera imbaraga mu mbeba zabuze uPAR zateye kunanirwa kwa MSC, byongeye gushimangira uruhare rwo gushyigikira sisitemu ya fibrinolysis mu kwimuka kwakagari.Ubundi bushakashatsi bwerekanye kandi ko glycosyl phosphatidylinositol yometse kuri reseptor ya UPA igenga guhuza, kwimuka, gukwirakwizwa no gutandukana ukoresheje inzira zimwe na zimwe zerekana ibimenyetso, nkuko bikurikira: kurokoka fosifatiidilinositol 4,5-diphosphate 3-kinase / Akt na ERK1 / 2 byerekana inzira, (FAK).
Mu rwego rwo gukira ibikomere bya MSC, fibrinolytique yerekanye akamaro kayo.Kurugero, imbeba zabuze plasminogene zerekanye gutinda cyane mubikorwa byo gukira ibikomere, byerekana ko plasmin yari ingenzi muriki gikorwa.Mu bantu, gutakaza plasmin birashobora kandi gutera ingorane zo gukira ibikomere.Guhagarika gutembera kw'amaraso birashobora kubuza cyane kuvugurura ingirabuzima fatizo, binasobanura impamvu izi nzira zo kuvugurura bigoye cyane ku barwayi ba diyabete.
Amagufa marrow mesenchymal stem selile yinjijwe ahakomeretse kugirango yihutishe gukira ibikomere.Mubihe bihamye, selile zagaragaje uPAuPAR na PAI-1.Poroteyine ebyiri zanyuma ni hypoxia ibintu bidashoboka α (HIF-1 α) Kwibanda biroroshye cyane kuko HIF-1 muri MSCs α Gukora kwa FGF-2 na HGF byateje imbere amabwiriza ya FGF-2 na HGF;HIF-2 α Na none, VEGF-A [77] iragenzurwa, ifatanya hamwe gukira ibikomere,.Byongeye kandi, HGF isa niyongera imbaraga mu kwinjiza amagufwa ya mesenchymal stem selile ahantu hakomeretse muburyo bumwe.Tugomba kumenya ko imiterere ya ischemic na hypoxic byagaragaye ko bibangamira cyane gusana ibikomere.Nubwo BMSCs ikunda kuba mu ngingo zitanga urugero rwa ogisijeni nkeya, kubaho kwa BMSCs zatewe muri vivo biba bike kuko ingirabuzimafatizo zatewe akenshi zipfa mu bihe bibi bigaragara mu ngingo zangiritse.Iherezo rya adhesion hamwe no kubaho kw'amagufwa ya mesenchymal stem selile munsi ya hypoxia biterwa nibintu bya fibrinolytike byasohowe na selile.PAI-1 ifitanye isano na vitelline, bityo irashobora guhatanira guhuza uPAR na integrin na vitelline, bityo bikabuza gufatira hamwe kwimuka.
Sisitemu ya Monocyte no Kuvugurura
Dukurikije ibitabo, hari ibiganiro byinshi ku ruhare rwa monocytes mu gukiza ibikomere.Makrophage ahanini ikomoka kuri monocytes yamaraso kandi igira uruhare runini mubuvuzi bushya [81].Kuberako neutrophile isohora IL-4, IL-1, IL-6 na TNF- α ， Utugingo ngengabuzima twinjira mu gikomere nyuma y'amasaha 24-48 nyuma yo gukomereka.Amashanyarazi arekura trombine na platine yibintu 4 (PF4), bishobora guteza imbere kwinjiza monocytes no gutandukanya macrophage na selile dendritic.Ikintu cyingenzi kiranga macrophage ni plastike yabo, ni ukuvuga ko ishobora guhindura fenotipa no gutandukanya ubundi bwoko bwimikorere, nka selile endoteliyale, hanyuma ikerekana imikorere itandukanye kubitera ibinyabuzima bitandukanye mubidukikije bikomeretsa mikorobe.Ingirabuzimafatizo zigaragaza ibintu bibiri by'ingenzi, M1 cyangwa M2, bitewe n'ibimenyetso bya molekile byaho nk'isoko yo gukangura.M1 macrophage iterwa na mikorobe, bityo igira ingaruka nyinshi za proinflammatory.Ibinyuranye, macrophage ya M2 ikorwa muburyo bwa 2 kandi ifite imiti igabanya ubukana, ubusanzwe irangwa no kwiyongera kwa IL-4, IL-5, IL-9, na IL-13.Ifite kandi uruhare mu gusana imyenda binyuze mu gutanga ibintu bikura.Guhinduka kuva M1 kugera kuri M2 subtype ahanini biterwa nicyiciro cyatinze cyo gukira ibikomere.M1 macrophage itera neutrophil apoptose kandi igatangira gukuraho utugingo ngengabuzima).Phagocytose ya neutrophile ikora urukurikirane rwibintu, aho umusaruro wa cytokine uzimya, guhuza macrophage no kurekura TGF- β 1。 Iki kintu cyo gukura nikintu cyingenzi kigenga itandukanyirizo rya myofibroblast no kwikuramo ibikomere, bituma hakemurwa umuriro kandi gutangiza icyiciro cyo gukwirakwira muri casade ikiza [57].Iyindi poroteyine ifitanye isano cyane na selile ni serine (SG).Iyi selile ya hemopoietic selile granule proteoglycan yasanze ari nkenerwa kubika poroteyine zi banga mu ngirabuzimafatizo zihariye z'umubiri, nka selile mast, neutrophile na lymphocytes T cytotoxic T.Nubwo ingirabuzimafatizo nyinshi zitari hematopoietic nazo zikorana plasminogene, selile zose zitera umuriro zitanga umubare munini wiyi poroteyine kandi ikabika muri granules kugirango irusheho gukorana n’abandi bahuza batera umuriro, harimo protease, cytokine, chemokine nimpamvu zikura.Iminyururu ya glycosaminoglycan (GAG) yuzuye nabi muri SG isa nkaho ari ingenzi cyane ku gutuza kwa granules ziva mu ibanga, kuko zishobora guhuza no koroshya ububiko bw’ibice bya granulaire byashizwe mu ngirabuzimafatizo, poroteyine, na GAG mu buryo bwihariye.Ku bijyanye n’uruhare rwabo mu bushakashatsi bwa PRP, Woulfe na bagenzi be bagaragaje mbere ko kubura SG bifitanye isano rya bugufi n’imihindagurikire y’imiterere ya platine;Ikintu cya platel 4 β- Inenge zububiko bwa PDGF muri tromboglobuline na platine;Gukusanya platelet mbi no gusohora muri vitro na trombose inenge muri vivo.Abashakashatsi rero banzuye ko iyi proteoglycan isa nkaho igenga trombose.
Ibicuruzwa bikungahaye kuri platel birashobora kubona amaraso yumuntu ku giti cye binyuze mu gukusanya no muri centrifugation, no kugabanya imvange mubice bitandukanye birimo plasma, platine, selile yera na selile yera.Iyo kwibumbira hamwe kwa platel birenze agaciro kibanze, birashobora kwihutisha imikurire yamagufa nuduce tworoshye, hamwe ningaruka nkeya.Gukoresha ibicuruzwa bya PRP autologique ni biotehnologiya nshya, ikomeje kwerekana ibisubizo byiza mugukangura no kuzamura gukira ibikomere bitandukanye.Ingaruka yubu buryo butandukanye bwo kuvura irashobora guterwa no gutanga kwaho ibintu byinshi byikura hamwe na poroteyine kugirango bigereranye kandi bishyigikire ibikomere bya physiologique hamwe no gusana ingirangingo.Byongeye kandi, sisitemu ya fibrinolytike biragaragara ko ifite uruhare runini mugusana ingirangingo zose.Usibye guhindura ingirabuzimafatizo zinjira mu ngirabuzimafatizo no mu magufa ya mesenchymal stem selile, irashobora kandi kugenga ibikorwa bya proteolyitike y’ahantu hakira ibikomere ndetse no kuvugurura imikorere yimitsi ya mesodermal, harimo amagufa, karitsiye n imitsi, bityo rero nikintu cyingenzi mubigize imiti ya musculoskeletal.
Kwakira byihuse nintego ikurikiranwa cyane nabanyamwuga benshi mubuvuzi.PRP yerekana igikoresho cyiza cyibinyabuzima, gikomeje gutanga iterambere ryiza mugukangura no guhuza caskade yibintu bishya.Nyamara, kubera ko iki gikoresho cyo kuvura kiracyari ingorabahizi, cyane cyane ko kirekura ibintu bitabarika bioaktike nuburyo butandukanye bwimikoranire hamwe ningaruka zo kwanduza ibimenyetso, ubushakashatsi burakenewe.
Ibiri muri iyi ngingo byongeye gusubirwamo, kandi ntidutanga ingwate iyo ari yo yose cyangwa yerekana ko ari ukuri, kwiringirwa cyangwa kuzuza ibikubiye muri iyi ngingo, kandi ntabwo dushinzwe ibitekerezo by'iyi ngingo, nyamuneka ubyumve.）
Igihe cyo kohereza: Ukuboza-16-2022