PRP igezweho: “Clinical PRP”
Mu myaka 10 ishize, gahunda yo kuvura PRP yagize impinduka nini.Binyuze mubushakashatsi bwubushakashatsi nubuvuzi, ubu twasobanukiwe neza na platine nizindi ngirabuzimafatizo.Byongeye kandi, isuzumabumenyi ryinshi ryo mu rwego rwo hejuru, isesengura rya meta hamwe n’ibigeragezo byateganijwe byagaragaje akamaro ka PRP biotechnologie mu buvuzi bwinshi, harimo dermatology, kubaga umutima, kubaga plastique, kubaga amagufwa, kuvura ububabare, indwara z’umugongo, n’ubuvuzi bwa siporo .
Ibiranga ubu PRP nubushuhe bwuzuye bwa platelet, ihinduka kuva mubisobanuro byambere bya PRP (harimo na platelet yibanze kurenza agaciro kibanze) ikagera kuri 1 × 10 6 / µ L cyangwa inshuro zigera kuri 5 byibuze byibuze byibuze byibanda kuri platine kuva shingiro.Mu isubiramo ryinshi na Fadadu n'abandi.Sisitemu ya PRP na protocole byasuzumwe.Umubare wa platel wateguwe PRP yanyuma yakozwe na sisitemu zimwe na zimwe ziri munsi yamaraso yose.Batangaje ko ibintu bya platel ya PRP byiyongereye kugeza kuri 0.52 hamwe nigikoresho kimwe cya spin (Selphyl ®).Ibinyuranye, kuzunguruka kabiri EmCyte Itangiriro PurePRPII concent Ihuriro rya platine ryakozwe nigikoresho nicyo kinini (1.6 × 10 6 / µL).
Biragaragara, muri vitro nuburyo bwinyamanswa ntabwo aribwo buryo bwiza bwubushakashatsi bwo guhindura imikorere yubuvuzi.Mu buryo nk'ubwo, ubushakashatsi bwo kugereranya ibikoresho ntabwo bushigikira icyemezo, kuko byerekana ko kwibanda kwa platine hagati yibikoresho bya PRP bitandukanye cyane.Kubwamahirwe, binyuze muri proteomics ikoranabuhanga nisesengura, turashobora kongera imyumvire yimikorere ya selile muri PRP igira ingaruka kubisubizo byubuvuzi.Mbere yo kumvikana ku myiteguro isanzwe ya PRP no kuyitegura, PRP igomba gukurikiza amavuriro ya PRP kugirango iteze imbere uburyo bukomeye bwo gusana ingirabuzimafatizo hamwe n’ibisubizo by’amavuriro bigenda bitera imbere.
Amavuriro ya PRP
Kugeza ubu, ivuriro ryiza rya PRP (C-PRP) ryaranzwe nkibintu bigoye bigize ibice bigize autologique multicellular bigize plasma ntoya yabonetse mu gice cyamaraso ya periferiya nyuma ya centrifugation.Nyuma ya centrifugation, PRP nibigize selile itari platel irashobora kugarurwa mubikoresho byakusanyirijwe hamwe bitewe nubucucike butandukanye (muri bwo ubwinshi bwa platel ni bwo buke).
Koresha PurePRP-SP equipment Ibikoresho byo gutandukanya ingirabuzimafatizo (EmCyte Corporation, Fort Myers, FL, USA) byakoreshejwe kumaraso yose nyuma yuburyo bubiri bwa centrifugation.Nyuma yuburyo bwa mbere bwa centrifugation, ibice byose byamaraso byatandukanijwe mubice bibiri byibanze, guhagarika platine (lean) plasma na selile yamaraso itukura.Muri A, intambwe ya kabiri ya centrifugation yararangiye.Umubare nyawo wa PRP urashobora gukururwa kugirango usabe abarwayi.Gukura muri B byerekana ko hateguwe ibice byinshi bigize erythrocyte sedimentation yubururu (bigereranywa numurongo wubururu) munsi yibikoresho, birimo ibice byinshi bya platine, monocytes na lymphocytes, bishingiye kuri gradient.Muri uru rugero, ukurikije protocole ya C-PRP hamwe na neutrophile ikennye, hazakurwa ijanisha ntarengwa rya neutrophile (<0.3%) na erythrocytes (<0.1%).
Amashanyarazi
Mubikorwa byambere byo kwa muganga PRP, α- Granules nuburyo bukunze kuvugwa muburyo bwa platine imbere, kuko burimo ibintu bya coagulation, umubare munini wa PDGF hamwe na angiogenic, ariko bifite imikorere mike ya trombogene.Ibindi bintu birimo chemokine itazwi cyane hamwe na cytokine, nka platelet factor 4 (PF4), proteine yibanze ya pre-platelet, P-selinine (ukora enterin) na chemokine RANTES (bigengwa na activation, byerekana selile zisanzwe T kandi birashoboka ibanga).Igikorwa rusange cyibice bigize granule yihariye ni ugushaka no gukora izindi selile z'umubiri cyangwa gutera endothelia selile.
Ibice byinshi bya granular nka ADP, serotonine, polyphosifate, histamine na adrenaline bikoreshwa cyane muburyo bwo kugenzura imikorere ya platine na trombose.Icy'ingenzi cyane, ibyinshi muribi bintu bifite umurimo wo guhindura ingirabuzimafatizo.Platelet ADP izwi na reseptor ya P2Y12ADP kuri selile dendritic (DC), bityo ikongera antigen endocytose.DC.Byongeye kandi, platine adenosine triphosphate (ATP) yohereza ibimenyetso binyuze muri reseptor ya T selile P2X7, bigatuma habaho itandukanyirizo ry’utugingo ngengabuzima twa CD4 T mu ngirabuzimafatizo za porinflammatory T 17 (Th17).Ibindi bikoresho bya platine yuzuye (nka glutamate na serotonine) bitera kwimuka kwa T kandi byongera itandukaniro rya monocyte kuri DC.Muri PRP, izo immunomodulator zikomoka ku bice byimbitse zirakungahaye cyane kandi zifite imikorere myinshi yubudahangarwa.
Umubare wimikorere itaziguye kandi itaziguye hagati ya platine nizindi selile (reseptor) ni nini.Kubwibyo, ikoreshwa rya PRP mubidukikije byindwara ya pathologiya irashobora gutera ingaruka zitandukanye.
Kwibanda kuri platel
C-PRP igomba kuba irimo amavuriro ya platine yibanze kugirango itange ingaruka nziza zo kuvura.Platelets muri C-PRP igomba gukangura ikwirakwizwa ry'uturemangingo, synthesis ya mesenchymal na neurotrophique, guteza imbere kwimuka kwa selile chimotactique no gukangurira ibikorwa byo gukingira indwara, nkuko bigaragara ku gishushanyo.
Amashanyarazi akora, kurekura PGF na molekules ya adhesion ihuza imikoranire itandukanye ya selile: chemotaxis, gufatira ingirabuzimafatizo, kwimuka, no gutandukanya selile, no kugenzura ibikorwa byo kugenzura ubudahangarwa bw'umubiri.Iyi mikorere ya platel selile-selile igira uruhare muri angiogenez no mubikorwa byo gutwika, kandi amaherezo igatera inzira yo gusana ingirangingo.Amagambo ahinnye: BMA: aspirate yamagufa, EPC: selile progenitor ya endoteliyale, EC: selile endothelia, 5-HT: 5-hydroxytryptamine, RANTES: kugenzura ibikorwa byimikorere ya selile isanzwe ya T hamwe no gusohora, JAM: ubwoko bwa molekile ihuza, CD40L: cluster 40 ligand, SDF-1 α factor Ikintu gikomoka kuri selile-1 α ， CXCL: chemokine (CXC motif) ligand, PF4: platelet factor 4. Yakuwe muri Everts nibindi.
Marx niwe muntu wa mbere wagaragaje ko gukiza amagufwa hamwe nuduce tworoheje byongerewe imbaraga, kandi umubare muto wa platelet wari 1 × 10 6 / µL。 Ibi bisubizo byemejwe mu bushakashatsi bwakozwe ku guhuza ibibyimba binyuze mu mikorere ya intervertebral, igihe ikinini cya platine cyari kinini kuruta 1.3 × Kuri platine 106 / µ L, ubu bushakashatsi bwerekanye byinshi.Byongeye kandi, Giusti n'abandi.Byerekanwe 1.5 mechanism Uburyo bwo gusana ingirangingo ku kigero cya 109 busaba platine / mL kugirango itere angiogenezi ikora binyuze mumikorere ya selile ya endoteliyale.Mu bushakashatsi bwa nyuma, kwibanda cyane byagabanije ubushobozi bwa angiogenezi ya platine no hafi yayo.Byongeye kandi, amakuru yambere yerekanaga ko igipimo cya PRP nacyo cyagira ingaruka kubisubizo byo kuvura.Kubwibyo, kugirango umuntu agaragaze cyane angiogenezeze kandi atume ikwirakwizwa ryimikorere ningirabuzimafatizo, C-PRP igomba kuba irimo byibuze 7.5 mumacupa ya 5-mL PRP icupa × 10 9 irashobora gutanga platine.
Usibye kwishingira dose, ingaruka za PRP kubikorwa bya selile bisa nkaho biterwa cyane nigihe.Sophie n'abandi.Ibisubizo byerekana ko guhura nigihe gito na lysates ya muntu bishobora gutera amagufwa kwiyongera hamwe na chemotaxis.Ibinyuranye, guhura nigihe kirekire na PRP bizatuma urwego rwo hasi rwa fosifata ya alkaline na minerval.
Utugingo ngengabuzima dutukura
Utugingo ngengabuzima dutukura dufite inshingano zo gutwara ogisijeni mu ngingo no kohereza dioxyde de carbone iva mu bihaha.Ntibifite nucleus kandi bigizwe na molekile ya heme ihuza poroteyine.Ibice bya fer na heme mu ngirangingo z'amaraso atukura biteza imbere guhuza ogisijeni na dioxyde de carbone.Mubisanzwe, ubuzima bwingirabuzimafatizo zamaraso zitukura ni iminsi 120.Bakuweho kuzenguruka na macrophage binyuze munzira yitwa RBC gusaza.Utugingo ngengabuzima dutukura mu byitegererezo bya PRP turashobora kwangirika mugihe cyogosha (urugero, kubaga amaraso yose, kubaga amaraso, uburyo bwo gukingira indwara, guhagarika umutima cyangwa gahunda ya PRP idahagije).Kubera iyo mpamvu, selile ya RBC ibora kandi ikarekura ubumara bwa hemoglobine (Hb), bupimwa na plasma yubusa hemoglobine (PFH), heme nicyuma.]PFH n'ibicuruzwa byayo bitesha agaciro (heme na fer) hamwe biganisha ku ngaruka mbi na cytotoxique ku ngingo, biganisha ku guhagarika umutima, gutakaza okiside ya nitric, gukora inzira zanduza no gukingira indwara.Izi ngaruka amaherezo zizatera imikorere mibi ya microcirculation, vasoconstriction yaho ndetse no gukomeretsa kwamaraso, ndetse no kwangirika kwingirangingo.
Icy'ingenzi ni uko iyo RBC irimo C-PRP igeze ku nyama, bizatera reaction yaho yitwa eryptose, izatera irekurwa ryiza rya cytokine na macrophage yimuka.Iyi cytokine ibuza kwimuka kwa monocytes na macrophage.Ikoresha ibimenyetso bikomeye byo gutwika ibice bikikije umubiri, ikabuza kwimuka kwingirangingo yimitsi no gukwirakwizwa kwa fibroblast, kandi biganisha ku mikorere idasanzwe ya selile.Kubwibyo, ni ngombwa kugabanya kwanduza RBC mu myiteguro ya PRP.Byongeye kandi, uruhare rw'uturemangingo tw'amaraso atukura mu kuvugurura ingirabuzimafatizo ntirwigeze rumenyekana.Centrifugation ihagije ya C-PRP hamwe nogutegura mubisanzwe bizagabanya cyangwa bikureho ingirabuzimafatizo zamaraso zitukura, bityo birinde ingaruka mbi za hemolysis na polycythemia.
Leukocytes muri C-PRP
Kuba hari selile yera mumyiteguro ya PRP biterwa nibikoresho byo kuvura na gahunda yo gutegura.Mu bikoresho bya PRP bishingiye kuri plasma, selile yera irandurwa burundu;Nyamara, selile yamaraso yibanze cyane mugutegura PRP yo gutegura erythrocyte sedimentation layer layer.Bitewe nubudahangarwa bwacyo hamwe nuburyo bwo kwirwanaho, selile yamaraso igira ingaruka cyane kubinyabuzima bwimbere bwimiterere yimitsi ikaze kandi idakira.Ibi bice bizaganirwaho hepfo aha.Kubwibyo, kuba leukocytes yihariye muri C-PRP irashobora gutera ingaruka zikomeye zingirabuzimafatizo.By'umwihariko, uburyo butandukanye bwa PRP erythrocyte sisitemu yubururu bwumuhondo-umuhondo ikoresha gahunda zitandukanye zo gutegura, bityo bikabyara umubare utandukanye wa neutrophile, lymphocytes na monocytes muri PRP.Eosinofile na basofile ntibishobora gupimwa mugutegura PRP kubera ko utugingo ngengabuzima twabo tworoshye cyane ku buryo tutashobora kwihanganira ingufu zitunganya centrifugal.
Neutrophile
Neutrophile ningirakamaro ya leukocytes munzira nyinshi zikiza.Izi nzira zihuza na poroteyine zirwanya mikorobe ziboneka muri platine kugirango zibe inzitizi ikomeye yo kurwanya virusi itera.Kubaho kwa neutrophile bigenwa ukurikije intego yo kuvura C-PRP.Kwiyongera kurwego rwo gutwika tissue birashobora gukenerwa mukuvura ibikomere bidakira PRP biotherapy cyangwa mubikorwa bigamije gukura kw'amagufwa cyangwa gukira.Icy'ingenzi, ibikorwa bya neutrophil byongeye kuboneka muburyo butandukanye, bishimangira uruhare rwabo muri angiogenez no gusana ingirangingo.Nyamara, neutrophile irashobora kandi gutera ingaruka mbi, ntabwo rero ikwiranye na progaramu zimwe.Zhou na Wang bagaragaje ko ikoreshwa rya PRP rikungahaye kuri neutrophile rishobora gutuma habaho kwiyongera kw'ikigereranyo cy'ubwoko bwa III kolagen n'ubwoko bwa I kolagen, bityo bikongera fibrosis kandi bikagabanya imbaraga za tendon.Ibindi bintu byangiza byunganirwa na neutrophile ni ukurekura cytokine ikongora hamwe na matrix metalloproteinase (MMPs), ishobora guteza uburibwe na catabolisme iyo ikoreshejwe ingirangingo.
Leukomonocyte
Muri C-PRP, lymphocytes monon nuclear T na B yibanda cyane kurenza izindi selile zera zera.Bifitanye isano ya hafi na selile-medrated cytotoxic adaptive immunité.Lymphocytes irashobora gukurura ingirabuzimafatizo zo kurwanya kwandura no kumenyera abateye.Byongeye kandi, T-lymphocyte ikomoka kuri cytokine (interferon- γ [IFN- γ] Na interleukin-4 (IL-4) byongera polarisiyasi ya macrophage. Verassar nibindi. Byaragaragaye ko lymphocytes T isanzwe ishobora guteza imbere mu buryo butaziguye gukira ingirabuzimafatizo mu icyitegererezo cyimbeba mugutandukanya monocytes na macrophage.
Monocyte - selile yo gusana
Ukurikije igikoresho cyo gutegura PRP cyakoreshejwe, monocytes irashobora gusohoka cyangwa kutabaho mumacupa yo kuvura PRP.Kubwamahirwe, imikorere yabo nubushobozi bushya ntibivugwaho gake mubitabo.Kubwibyo, hitabwa cyane kuri monocytes muburyo bwo gutegura cyangwa formulaire yanyuma.Itsinda rya Monocyte ntirishobora gutandukana, rikomoka ku ngirabuzimafatizo ya progenitor mu mitsi yo mu magufa, kandi ikajyanwa mu mitsi ya peripheri binyuze mu nzira ya hematopoietic stem selile inzira ikurikije ibidukikije.Mugihe cya homeostasis no gutwika, monocytes izenguruka iva mumaraso kandi yinjizwa mumitsi yakomeretse cyangwa yangiritse.Bashobora gukora nka macrophage (M Φ) Ingirabuzimafatizo cyangwa ingirabuzimafatizo.Monocytes, macrophage na selile dendritic byerekana sisitemu ya fagocytike ya monone nucléaire (MPS) .. Ikintu gisanzwe kiranga MPS ni plastike yimiterere yacyo ya gene hamwe no guhuza imikorere hagati yubwoko butandukanye.Mubice byangiritse, macrophage ituye, ibintu bikura bikura mukarere, cytokine itera inflammatory, selile apoptotic cyangwa nerotic selile nibicuruzwa bya mikorobe bitangiza monocytes kugirango itandukane mumatsinda ya selile MPS.Dufate ko mugihe C-PRP irimo monocytes itanga umusaruro mwinshi yatewe muri microen ibidukikije yindwara, monocytes irashobora gutandukana muri M Φ Gutera impinduka zikomeye za selile.
Kuva kuri monocyte kugeza M Φ Muburyo bwo guhinduka, M specific Phenotype.Mu myaka icumi ishize, hateguwe icyitegererezo, gihuza M mechanism Uburyo bugoye bwo gukora busobanurwa nka polarisiyasi y’ibihugu bibiri bitandukanye: M Φ Phenotype 1 (M Φ 1, Classic activation) na M Φ Phenotype 2 (M Φ 2, ubundi buryo bwo gukora).M Φ 1 irangwa no gusohora cytokine ikongora (IFN- γ) Na aside nitide kugirango itange uburyo bwiza bwo kwica indwara.M phen Fenotipi itanga kandi imikurire yimitsi iva mu mitsi (VEGF) hamwe niterambere rya fibroblast (FGF).M phen Fenotype igizwe na selile anti-inflammatory hamwe na fagocytose nyinshi.M Φ 2 Gukora matrix idasanzwe, angiogenez na chemokine, na interleukin 10 (IL-10).Usibye kwirinda indwara ya virusi, M Φ Irashobora kandi kugabanya gucana no guteza imbere gusana ingirangingo.Birashimishije ko M Φ 2 yagabanijwemo M muri vitro Φ 2a 、 M Φ 2b na M Φ 2. Biterwa no gukangura.Muri vivo ibisobanuro byiyi subtypes biragoye kuko tissue ishobora kuba irimo M mixed Amatsinda avanze.Igishimishije, ukurikije ibimenyetso by’ibidukikije byaho ndetse n’urwego rwa IL-4, proinflammatory M Φ 1 irashobora guhindurwa kugirango iteze imbere gusana M Φ 2。 Duhereye kuri aya makuru, birakwiriye gutekereza ko hari monocytes nyinshi hamwe n’imyiteguro ya M Φ C-PRP irashobora kugira uruhare mugusana neza tissue kuko zifite anti-inflammatory gusana hamwe nubushobozi bwa transduction ya selile.
Ibisobanuro bitiranya agace k'amaraso yera muri PRP
Kuba hari selile yera mumacupa yo kuvura PRP biterwa nigikoresho cyo gutegura PRP kandi gishobora kugira itandukaniro rikomeye.Hariho amakimbirane menshi yerekeye kubaho kwa leukocytes nintererano yabyo mubicuruzwa bitandukanye bya PRP (nka PRGF, P-PRP, LP-PRP, LR-PRP, P-PRF na L-PRF) Mu isuzuma riherutse, batandatu batoranijwe ibigeragezo byagenzuwe (urwego rwibimenyetso 1) hamwe nubushakashatsi butatu bwo kugereranya (urwego rwibimenyetso 2) bwarimo abarwayi 1055, byerekana ko LR-PRP na LP-PRP bafite umutekano nkuwo.Umwanditsi yanzuye avuga ko imyitwarire mibi ya PRP idashobora kuba ifitanye isano itaziguye no kwegeranya kwa selile yera.Mu bundi bushakashatsi, LR-PRP ntabwo yahinduye interleukin yaka umuriro (IL-1) mu ivi rya OA β 、 IL-6, IL-8 na IL-17).Ibisubizo bishyigikira igitekerezo cyuko uruhare rwa leukocytes mubikorwa byibinyabuzima bya PRP muri vivo rushobora guturuka kumuhanda uri hagati ya platine na leukocytes.Iyi mikoranire irashobora guteza imbere biosynthesis yizindi mpamvu (nka lipoxygene), ishobora guhagarika cyangwa guteza imbere gusubira inyuma.Nyuma yo kurekurwa kwambere kwa molekile yaka umuriro (acide arachidonic, leukotriene na prostaglandine), lipoxygene A4 irekurwa muri platine ikora kugirango birinde neutrophil.Ni muri ibi bidukikije niho M Φ Phenotype kuva M Φ 1 Hindura kuri M Φ 2。 Byongeye kandi, hari ibimenyetso byinshi byerekana ko kuzenguruka ingirabuzimafatizo zishobora gutandukanya ubwoko butandukanye bw'utugingo ngengabuzima tutari fagocyitike kubera ubwinshi bwazo.
Ubwoko bwa PRP buzagira ingaruka kumuco wa MSC.Ugereranije nicyitegererezo cya PRP cyangwa PPP, LR-PRP irashobora gutuma ikwirakwizwa ryinshi ryimitsi yamagufa ikomoka kuri MSCs (BMMSCs), hamwe no kurekura byihuse nibikorwa byiza bya PGF.Ibi byose biranga bifasha kongera monocytes mumacupa yo kuvura PRP no kumenya ubushobozi bwabo bwo gukingira no gutandukanya ubushobozi.
Ubudahangarwa bw'umubiri hamwe no guhuza n'imikorere ya PRP
Igikorwa kizwi cyane cya physiologique ya platine ni ukugenzura amaraso.Zirundanyiriza ahanditse tissue hamwe nimiyoboro yamaraso yangiritse.Ibi byabaye biterwa no kwerekana integin hamwe na selinine itera platine gufatana hamwe.Endotelium yangiritse irusheho kwiyongera kuriyi nzira, kandi kolagen yagaragaye hamwe nizindi poroteyine zo mu bwoko bwa subendothelial matrike ziteza imbere gukora cyane.Muri ibi bihe, byagaragaye ko uruhare runini rwimikoranire hagati ya von Willebrand (vWF) na glycoproteine (GP), cyane cyane GP-Ib, byagaragaye.Nyuma yo gukora platine, platelet α- 、 Ubucucike, lysosome na T-granules bigenga exocytose kandi ikarekura ibiyirimo mubidukikije bidasanzwe.
Platelet adhesion molekile
Kugirango twumve neza uruhare rwa PRP mumyanya yumubiri hamwe na platine mugukingira indwara, dukwiye kumva uburyo reseptor zitandukanye zakira (integin) hamwe na molekile ihuza adhesion (JAM) hamwe n’imikoranire ya selile bishobora gutangiza inzira zikomeye mubudahangarwa bw'umubiri kandi buhuza n'imiterere.
Integrins ni selile ya selile ya selile iboneka mubwoko butandukanye kandi ikagaragazwa cyane kuri platine.Integrines zirimo a5b1, a6b1, a2b1 LFA-2, (GPIa / IIa) na aIIbb3 (GPIIb / IIIa).Mubisanzwe, babaho muburyo buhamye kandi buke.Nyuma yo gukora, bahindura kuri reta ya ligand ndende ihuza isano.Integrins ifite imirimo itandukanye kuri platine kandi ikagira uruhare mubikorwa bya platine nubwoko butandukanye bwingirangingo zamaraso yera, selile endoteliyale na matrix idasanzwe.Mubyongeyeho, GP-Ib-V-IX igizwe na platelet membrane kandi niyo reseptor nyamukuru yo guhuza von vWF.Iyi mikoranire ihuza itumanaho ryambere hagati ya platine nuburyo bugaragara.Platelet integrin hamwe na GP bifitanye isano nuburyo butandukanye bwo gutwika kandi bigira uruhare runini mugushinga platelet-leucocyte.By'umwihariko, integrin aIIbb3 irakenewe kugirango habeho urwego ruhamye uhuza fibrinogen na macrophage 1 antigen (Mac-1) reseptor kuri neutrophile.
Platelets, neutrophile na selile endothelia selile zigaragaza molekile yihariye ya selile, bita selin.Mugihe cyo gutwika, platine yerekana P-selinine na neutrophil L-selin.Nyuma yo gukora platelet, P-selin irashobora guhuza ligand PSGL-1 ibaho kuri neutrophile na monocytes.Byongeye kandi, guhuza PSGL-1 bitangiza ibimenyetso byerekana ibimenyetso bya kasake, bikora neutrophile binyuze muri neutrophil integrin Mac-1 na lymphocyte imikorere ifitanye isano na antigen 1 (LFA-1).Gukora Mac-1 ihuza GPIb cyangwa GPIIb / IIIa kuri platine binyuze muri fibrinogen, bityo bigahindura imikoranire hagati ya neutrophile na platine.Byongeye kandi, LFA-1 ikora irashobora guhuza hamwe na platelet intercellular adhesion molekile 2 kugirango irusheho gushimangira urwego rwa neutrophil-platelet kugirango ruteze imbere igihe kirekire hamwe na selile.
Platelets na leukocytes bigira uruhare runini mubisubizo byubudahangarwa bw'umubiri
Umubiri urashobora kumenya imibiri yamahanga hamwe nudukomere twakomerekejwe nindwara zikaze cyangwa zidakira kugirango utangire gukira igikomere cascade reaction ninzira yumuriro.Sisitemu yubudahangarwa bw'umubiri kandi ihuza n'imihindagurikire irinda nyirubwite kwandura, kandi uturemangingo tw'amaraso yera tugira uruhare runini mu guhuzagurika hagati ya sisitemu zombi.By'umwihariko, monocytes, macrophage, neutrophile na selile selile zica bigira uruhare runini muri sisitemu yavukanye, mugihe lymphocytes hamwe na sisitemu yabyo bigira uruhare runini mumikorere yubudahangarwa bw'umubiri.
Imikoranire ya platel na leukocyte mubikorwa byimikorere ya selile.Platelet ikorana na neutrophile na monocytes, hanyuma amaherezo na M Φ Gukorana, guhindura no kongera imikorere yabakozi.Iyi mikoranire ya platel-leucocyte itera gucana binyuze muburyo butandukanye, harimo na NETose.Amagambo ahinnye: MPO: myeloperoxidase, ROS: ubwoko bwa ogisijeni ikora, TF: ibintu bya tissue, NET: umutego udasanzwe wa neutrophil, NF- κ B: Ikintu cya kirimbuzi kappa B, M Φ ： Macrophage.
Sisitemu yubudahangarwa
Uruhare rwimikorere yubudahangarwa bw'umubiri ni ukumenya bidasanzwe kumenya mikorobe zitera cyangwa ibice by'imitsi kandi bikabatera guhinduka.Iyo ibintu bimwe na bimwe bya molekulari byitwa imiterere yerekana imiterere yo kwakirwa (PRRs) bihujwe na molekuline ziterwa na patogene hamwe na molekuline yangiza, sisitemu yumubiri ivuka izakora.Hariho ubwoko bwinshi bwa PRRs, harimo Toll-imeze nka reseptor (TLR) na RIG-1 nka reseptor (RLR).Izi reseptors zirashobora gukora ibintu byingenzi byandikirwa kappa B (NF- κ B) Itegeka kandi ibintu byinshi byerekana ubudahangarwa bw'umubiri.Igishimishije, platine irerekana kandi molekile zitandukanye za reseptor ya immunoregulatory reseptor hejuru yazo na cytoplazme, nka P-selectin, transembrane protein CD40 ligand (CD40L), cytokine (nka IL-1 β 、 TGF- β） Na TLR yihariye ya TLR. . Kubwibyo, platine irashobora gukorana ningirabuzimafatizo zitandukanye.
Platelet-yera ingirabuzimafatizo mu budahangarwa bw'umubiri
Iyo platine yinjiye cyangwa yibasiye amaraso cyangwa tissue, platine ni imwe mu ngirabuzimafatizo zerekana imvune ya endoteliyale na mikorobe zitera mbere.Guteranya kwa platel no guteza imbere irekurwa rya platine agoniste ADP, trombine na vWF, bikaviramo gukora platelet no kwerekana imiti ya reseptor ya chemokine C, CC, CXC na CX3C, bityo bigatera platine ahantu yanduye cyangwa gukomeretsa.
Ubudahangarwa bw'umubiri buvukanye bwateganijwe mbere yo kumenya abateye, nka virusi, bagiteri, parasite n'uburozi, cyangwa ibikomere by'imitsi n'ibikomere.Nuburyo budasanzwe, kuberako indwara zose zizamenyekana nkabanyamahanga cyangwa abadafite ubwabo kandi vuba vuba.Ubudahangarwa bw'umubiri buvuka bushingiye kuri poroteyine na fagocytes, zimenya neza ibimenyetso biranga indwara ziterwa na virusi kandi zigahita zitangiza ubudahangarwa bw'umubiri kugira ngo zifashe kurandura abateye, kabone nubwo nyirubwite atigeze ahura na virusi yihariye mbere.
Neutrophile, monocytes na selile dendritic nizo selile zikunze kuvuka mumaraso.Kwiyandikisha kwabo birakenewe kugirango habeho igisubizo gihagije hakiri kare.Iyo PRP ikoreshwa mubuvuzi bushya, imikoranire ya selile-yera igenga gucana, gukira ibikomere no gusana ingirangingo.TLR-4 kuri platine itera imikoranire ya platel-neutrophil, igenga icyo bita okiside ya leukocyte iturika muguhindura irekurwa ryubwoko bwa ogisijeni (ROS) na myeloperoxidase (MPO) muri neutrophile.Byongeye kandi, imikoranire hagati ya platel-neutrophil na neutrophil degranulation itera gushiraho imitego ya neutrophil-idasanzwe (NET).NET igizwe na neutrophil nucleus nibindi bintu bya neutrophil biri mu nda, bishobora gufata bagiteri bikabica binyuze muri NETose.Ishirwaho rya NET nuburyo bwingenzi bwo kwica neutrophile.
Nyuma yo gukora platine, monocytes irashobora kwimukira mumyanya irwaye kandi yangirika, aho ikorera ibikorwa byo gufatira hamwe no gusohora molekile yumuriro ishobora guhindura chemotaxis hamwe na proteolyique.Byongeye kandi, platine irashobora gutera monocyte NF- κ B gukora kugirango igenzure imikorere ya monocytes, ikaba ari umuhuza wingenzi wibisubizo byumuriro no gukora no gutandukanya ingirabuzimafatizo.Platelets ikomeza guteza imbere okiside ya endogenous okiside ya monocytes kugirango itume irimbuka rya phagocytic.Isohora rya MPO ryunganirwa n’imikoranire itaziguye hagati ya platel-monocyte CD40L-MAC-1.Igishimishije, iyo P-selinine ikora platine mugihe cyimitsi ikaze kandi idakira, chemokine ikomoka kuri platine PF4, RANTES, IL-1 β Na CXCL-12 irashobora kwirinda apoptose ya monocytes, ariko igateza imbere itandukaniro ryayo muri macrophage.
Sisitemu yo kwirinda indwara
Nyuma yuko sisitemu yubudahangarwa idasanzwe yavutse imenye kwangirika kwa mikorobe cyangwa ingirangingo, sisitemu yihariye yo kurwanya imihindagurikire y'ikirere izafata.Sisitemu yo kurwanya imihindagurikire y'ikirere irimo lymphocytes B ya antigen-B (B selile) na lymphocytes T isanzwe (Treg) ihuza guhuza indwara ziterwa na virusi.T selile irashobora kugabanywa mubice bifasha T selile (Th selile) na cytotoxic T selile (Tc selile, izwi kandi nka T killer selile).Utugingo ngengabuzima twongeye kugabanywamo selile Th1, Th2 na Th17, zifite imirimo yingenzi mugutwika.Utugingo ngengabuzima turashobora gusohora cytokine ya proinflammatory (urugero: IFN- γ 、 TNF- β） Kandi interleukine nyinshi (urugero, IL-17). Zifite akamaro kanini mu gukumira virusi yo mu nda no kwandura bagiteri. Tc selile ningirabuzimafatizo, zishobora gukuraho mikorobe ngengabuzima na selile.
Igishimishije, Th2 selile itanga IL-4 kandi ikagira ingaruka kuri M Φ Polarisation, M ided Kuyobora kuvugurura M Φ 2 Fenotype, mugihe IFN- γ M Φ Guhindura umuriro M Φ 1 Fenotype, biterwa numubare nigihe cya cytokine.IL-4 imaze gukora, M Φ 2 itera selile Treg gutandukanya selile Th2, hanyuma ikabyara IL-4 (ibitekerezo byiza).Utugingo ngengabuzima duhindura M phen Fenotipi yerekejwe kuri fenotipi ivugurura ibisubizo byibinyabuzima bikomoka kumubiri.Ubu buryo bushingiye ku bimenyetso byerekana ko Th selile igira uruhare runini mu kugenzura ibicanwa no gusana ingirangingo.
Platelet-yera ingirabuzimafatizo mu budahangarwa bw'umubiri
Sisitemu yo kwirinda indwara ikoresha imiti igabanya ubukana bwa antigen kandi ikibuka mbere na virusi itera indwara, ikayisenya iyo ihuye na nyirayo.Nyamara, ibyo bisubizo birinda umubiri byateye imbere buhoro.Konias n'abandi.Irerekana ko ibice bigize platine bigira uruhare mubitekerezo byokugiraho ingaruka no gusana ingirangingo, kandi ko imikoranire hagati ya platine na leukocytes itera imbaraga zo gukingira indwara.
Mugihe cyo kurwanya imihindagurikire y'ikirere, platine itera monocyte na macrophage ibisubizo binyuze mumikurire ya DC na NK, biganisha kuri selile yihariye ya T na B.Kubwibyo rero, ibice bya platelet granule bigira ingaruka kuburyo butaziguye ubudahangarwa bwo kurwanya imihindagurikire y'ikirere mu kwerekana CD40L, molekile ikenewe mu kugenzura imiterere y’umubiri.Platelets ikoresheje CD40L ntabwo igira uruhare mugutanga antigen gusa, ahubwo inagira ingaruka kuri T selile.Liu n'abandi.Byagaragaye ko platine igenga CD4 T igisubizo muburyo bugoye.Iri tandukaniro ritandukanye rya CD4 T selile isobanura ko platine iteza selile CD4 T kugirango isubize ibitera umuriro, bityo bitange ibisubizo bikomeye byo gutwika no kurwanya inflammatory.
Amashanyarazi kandi agenga B selile yifashishije imiterere yo kurwanya imiterere ya mikorobe.Birazwi neza ko CD40L kuri selile ikora CD4 T izatera CD40 ya selile B, itanga ikimenyetso cya kabiri gisabwa kugirango T-selile-iterwa na lymphocyte ya B, nyuma ya allotype ihinduka, hamwe no gutandukanya B selile no gukwirakwizwa.Muri rusange, ibisubizo byerekana neza imikorere itandukanye ya platine mu budahangarwa bw'imihindagurikire y'ikirere, byerekana ko platine ihuza imikoranire hagati ya selile T na selile B binyuze muri CD40-CD40L, bityo bikazamura T-selile ishingiye kuri B selile.Byongeye kandi, platine ikungahaye cyane ku bikoresho byo mu bwoko bwa selile, bishobora guteza imbere gukora platine no kurekura umubare munini wa molekile ikora kandi ikabika ibinyabuzima bibitswe mu bice bitandukanye bya platine, bityo bikagira ingaruka ku gukingira indwara.
Uruhare rwagutse rwa platine ikomoka kuri serotonine muri PRP
Serotonine (5-hydroxytryptamine, 5-HT) ifite uruhare runini muri sisitemu yo hagati (CNS), harimo no kwihanganira ububabare.Bigereranijwe ko abantu benshi-5-HT ikorerwa mu nzira ya gastrointestinal hanyuma ikanyura mu maraso, aho yinjizwa na platine ikoresheje transport ya serotonine reuptake ikabikwa mu bice byimbitse cyane (65 mmol / L).5-HT ni neurotransmitter izwi cyane na hormone ifasha kugenzura imikorere itandukanye ya neuropsychologue muri CNS (hagati 5-HT).Nyamara, ibyinshi muri 5-HT bibaho hanze ya CNS (periferique 5-HT), kandi igira uruhare mugutunganya imikorere yibinyabuzima ya sisitemu na selile yibinyabuzima byinshi, harimo umutima, imitsi, ibihaha, gastrointestinal, urogenital na platine ikora.5-HT ifite metabolism iterwa no kwibanda ku bwoko butandukanye, harimo adipocytes, selile epithelia na selile yera.Periferique 5-HT nayo ni modulator ikomeye yubudahangarwa, ishobora gukangura cyangwa guhagarika umuriro kandi ikagira ingaruka ku ngirabuzimafatizo zitandukanye binyuze muri reseptor yihariye ya 5-HT (5HTR).
Uburyo bwa Paracrine na autocrine ya HT
Igikorwa cya 5-HT cyahujwe nubufatanye bwacyo na 5HTRs, kikaba ari umuryango udasanzwe hamwe nabanyamuryango barindwi (5-HT 1 - 7) nibura byibuze 14 byakira reseptor, harimo umunyamuryango uherutse kuvumburwa 5-HT 7, impande zose na imikorere mu gucunga ububabare.Muburyo bwo kwangirika kwa platine, platine ikora isohora umubare munini wa platine ikomoka kuri 5-HT, ishobora guteza imbere kugabanuka kwimitsi kandi igatera imbaraga zo gukora platine yegeranye na lymphocytes binyuze mumagambo ya 5-HTR kumasemburo ya endoteliyale, ingirabuzimafatizo zoroheje na ingirabuzimafatizo.Pacala n'abandi.Ingaruka ya mitotike ya 5-HT ku ngirabuzimafatizo ya endoteliyale yakozwe, kandi hamenyekanye ubushobozi bwo kuzamura imikurire y’amaraso yangiritse mu gutera angiogenez.Uburyo izi nzira zitunganijwe ntabwo bisobanutse neza, ariko birashobora kuba birimo inzira zinyuranye zerekana inzira ebyiri zerekana inzira ya microcircuit ya tissue kugirango igenzure imikorere yingirabuzimafatizo ya endoteliyale yimitsi ningirabuzimafatizo zoroheje, fibroblast na selile immunite binyuze mumyanya 5-HT yakira kuri selile. .Imikorere ya autocrine ya platelet 5-HT nyuma yo gukora platelet yasobanuwe [REF].Isohora rya 5-HT ryongera imbaraga za platine no kwinjiza platine izenguruka, biganisha kumikorere ya cascade yerekana ibimenyetso hamwe na effet zo hejuru zishyigikira reaction ya platine.
Immunomodulatory 5-HT ingaruka
Ibimenyetso byinshi kandi byinshi byerekana ko serotonine ishobora kugira uruhare muri 5HTR itandukanye nka modulator ikingira indwara.Dukurikije 5HTR yagaragajwe muri leukocytes zitandukanye zigira uruhare mu gutwika ibintu, 5-HT ikomoka kuri platine ikora nk'umuteguro w’ubudahangarwa haba mu mikorere y’umubiri ndetse no guhuza n'imiterere.5-HT irashobora gukurura ikwirakwizwa rya Treg kandi ikagenga imikorere ya selile B, selile yica naturel na neutrophile mukwinjiza DC na monocytes kurubuga.Ubushakashatsi buherutse gukorwa bwerekanye ko 5-HT ikomoka kuri platel ishobora kugenga imikorere yingirabuzimafatizo mu bihe byihariye.Kubwibyo, ukoresheje C-PRP, ubunini bwa platine burenze 1 × 10 6 / µ L burashobora gufasha cyane gutwara ubwikorezi bwa 5-HT bukomoka kuri platine nini kugeza kumubiri.Muri microen ibidukikije irangwa nibice bitera umuriro, PRP irashobora gukorana ningirangingo nyinshi z'umubiri zigira uruhare runini muri izi ndwara, zishobora kugira ingaruka kubisubizo byubuvuzi.
Igishushanyo cyerekana ibisubizo byinshi-5 HT nyuma yo gukora kwa platine ya PRP.Nyuma yo gukora kwa platine, platine irekura granules zayo, harimo 5-HT muri granules yuzuye, ifite ingaruka zitandukanye zitandukanye kumasemburo atandukanye yumubiri, selile endothelia selile na selile selile.Amagambo ahinnye: SMC: ingirabuzimafatizo zoroheje, EC: selile endoteliyale, Treg: Lymphocytes T isanzwe, M Φ ： Macrophage, DC: selile dendritic, IL: interleukin, IFN- γ ： Interferon γ。 Yahinduwe kandi ahuza na Everts nibindi.na Hull n'abandi.
Ingaruka zo gusesengura PRP
Amashanyarazi akoreshwa azarekura abunzi benshi batera inflammatory kandi barwanya inflammatory, ntibishobora gutera ububabare gusa, ahubwo binagabanya uburibwe nububabare.Bimaze gukoreshwa, imbaraga za platine zisanzwe za PRP zihindura ibidukikije mbere yo gusana ingirabuzimafatizo no kuvugurura binyuze munzira zitandukanye zigoye zijyanye na anabolism na catabolisme, ikwirakwizwa ry'utugari, gutandukanya no kugenzura ingirabuzimafatizo.Ibi biranga PRP biganisha ku ikoreshwa rya PRP mu bihe bitandukanye by’indwara z’indwara zisanzwe zifitanye isano n’ububabare budakira (nko gukomeretsa siporo, indwara z’amagufwa, indwara y’umugongo n’igikomere kidakira), nubwo uburyo nyabwo butaramenyekana neza.
Muri 2008, Evertz n'abandi.Nibigeragezo byambere byateganijwe kugenzurwa kugirango bigaragaze ingaruka zidasanzwe zo gutegura PRP, itegurwa uhereye kumurongo wijimye wikigero cya autologique erythrocyte igabanuka kandi igakorwa hamwe na trombine autologique nyuma yo kubagwa ibitugu.Bagaragaje igabanuka rikabije ry’amanota ya analogue yerekana, gukoresha imiti igabanya ubukana bwa opioid, ndetse no gusubiza mu buzima busanzwe nyuma yo kubagwa.Birashimishije kubona bagaragaza ingaruka zidasanzwe za platine ikora kandi bagatekereza kuburyo bwa platine irekura 5-HT.Muri make, platine irasinziriye muri PRP nshya.Nyuma yo gukora platine mu buryo butaziguye cyangwa butaziguye (tissue tissue), platine ihindura imiterere kandi itanga ibinyoma bihagije kugirango iteze hamwe.Noneho, barekura ingirabuzimafatizo α- N'ibice byuzuye.Tissue ivurwa hamwe na PRP ikora izaterwa na PGF, cytokine nizindi lysosomes.By'umwihariko, iyo ibice byuzuye birekuye ibiyirimo, bizarekura umubare munini wa 5-HT ugenga ububabare.Muri C-PRP, ubunini bwa platel burenze inshuro 5 kugeza kuri 7 kurenza ayo mumaraso ya periferi.Kubwibyo, kurekura 5-HT muri platine ni astronomie.Igishimishije, Sprott n'abandi.Raporo yagaragaje ko ububabare bworoheje cyane nyuma ya acupuncture na moxibustion, ubwinshi bwa platine yakomotse kuri 5-HT bwaragabanutse cyane, hanyuma urwego rwa plasma ya 5-HT rwiyongera.
Muri periferique, platine, selile ya mast na selile endothelia izarekura endogenous 5-HT mugihe cyo gukomeretsa ingirangingo cyangwa ihahamuka ryo kubaga.Igishimishije ni uko mu bice bya peripheri hagaragaye imiti itandukanye ya 5-HT yakira neuron, yemeje ko 5-HT ishobora kubangamira kwanduza nociceptive mu gace kegereye.Ubu bushakashatsi bwerekana ko 5-HT ishobora kugira ingaruka ku kwanduza nociceptive kwanduza ingirabuzimafatizo binyuze kuri 5-HT1, 5-HT2, 5-HT3, 5-HT4 na 5-HT7.
Sisitemu 5-HT yerekana sisitemu ikomeye ishobora kugabanya no kongera urugero rwububabare nyuma yo gukanguka kwangiza.Amabwiriza yo hagati na periferique yerekana ibimenyetso bya nociceptive hamwe nimpinduka muri sisitemu ya 5-HT byagaragaye kubarwayi bafite ububabare budakira.Mu myaka yashize, umubare munini w’ubushakashatsi wibanze ku ruhare rwa 5-HT hamwe n’iyakirwa ryarwo mu gutunganya no kugenzura amakuru yangiza, bikavamo ibiyobyabwenge nka serotonine yatoranijwe yangiza (SSRI).Uyu muti urabuza gufata serotonine muri neuron ya presynaptic nyuma yo kurekura serotonine.Ihindura igihe nuburemere bwitumanaho rya serotonine kandi nubundi buryo bwo kuvura ububabare budashira.Ubundi bushakashatsi bwamavuriro burakenewe kugirango twumve neza uburyo bwa molekuline ya PRP ikomoka kuri 5-HT igabanya ububabare mu ndwara zidakira kandi zangirika.
Andi makuru yo gukemura ingaruka zishobora guterwa na PRP arashobora kuboneka nyuma yikizamini cyikigereranyo cyinyamanswa.Kugereranya imyanzuro yibarurishamibare muri ubu buryo iragoye kuko ubu bushakashatsi burimo ibintu byinshi bihinduka.Nubwo bimeze bityo, ubushakashatsi bwamavuriro bwakemuye ingaruka za nociceptive na analgesic za PRP.Ubushakashatsi bwinshi bwerekanye ko abarwayi bahabwa imiti ya tendinose cyangwa rotator cuff amarira bafite ububabare buke.Ibinyuranye na byo, ubundi bushakashatsi bwinshi bwerekanye ko PRP ishobora kugabanya cyangwa no gukuraho ububabare bw’abarwayi bafite ikibazo cyo kwangirika kw'imitsi, OA, plantar fasciitis n'izindi ndwara z'amaguru n'amaguru.Ubwinshi bwa platelet yibanze hamwe nibinyabuzima bigize selile byagaragaye nkibintu byingenzi biranga PRP, bifasha kwitegereza ingaruka zidakira nyuma yo gukoresha PRP.Izindi mpinduka zirimo uburyo bwo gutanga PRP, tekinoroji yo gukoresha, protocole yo gukora platelet, urwego rwibikorwa bya biologiya ya PGF na cytokine yasohotse, ubwoko bwimyenda ya porogaramu ya PRP nubwoko bwimvune.
Twibuke ko Kuffler yakemuye ubushobozi bwa PRP mu kugabanya ububabare ku barwayi bafite ububabare bworoheje bukabije bukabije bwa neuropathique, ubwa kabiri bwangiza imyakura idasubirana.Intego yubu bushakashatsi nugukora iperereza niba ububabare bwa neuropathique bushobora kugabanuka cyangwa kugabanuka bitewe na PRP iteza imbere kuvugurura imitsi no kugarura imitsi.Igitangaje ni uko mu barwayi barimo kuvurwa, ububabare bwa neuropathique buracyakurwaho cyangwa bugabanywa byibuze nyuma yimyaka itandatu nyuma yo kubagwa.Byongeye kandi, abarwayi bose batangiye kugabanya ububabare mugihe cyibyumweru bitatu nyuma yo gusaba PRP.
Vuba aha, ingaruka zisa na PRP zidasanzwe zagaragaye mubijyanye no gukomeretsa nyuma yo kubagwa no kwita ku ruhu.Igishimishije, abanditsi batangaje ibyerekeranye na physiologique yububabare bwakomeretse bujyanye no gukomeretsa kwamaraso hamwe na hypoxia yuruhu.Baganiriye kandi ku kamaro ka angiogenezez mu guhuza ogisijeni no gutanga intungamubiri.Ubushakashatsi bwabo bwerekanye ko ugereranije nitsinda rishinzwe kugenzura, abarwayi bahabwa imiti ya PRP bafite ububabare buke kandi bakiyongera cyane angiogenez.Hanyuma, Johal na bagenzi be bakoze isuzuma rifatika hamwe nisesengura rya meta maze banzura bavuga ko PRP ishobora kugabanya ububabare nyuma yo gukoresha PRP mu bimenyetso by’amagufwa, cyane cyane ku barwayi bahabwa epicondylitis yo hanze ndetse no kuvura ivi OA.Kubwamahirwe, ubu bushakashatsi ntibwerekanye ingaruka zamaraso yera, kwibanda kuri platine cyangwa gukoresha moteri ikora ya exogenous, kuko izi mpinduka zagira ingaruka kumikorere rusange ya PRP.Ibyiza bya PRP platelet yibanze kububabare bukabije ntibisobanutse.Muburyo bwimbeba ya tendinose, platine yibanze kuri 1.0 × 10 6 / μ Kuri L, ububabare burashobora kugabanuka rwose, mugihe ububabare bwatewe na PRP hamwe na kimwe cya kabiri cyibice bya platine byagabanutse cyane.Kubwibyo, turashishikarizwa kwiga amavuriro menshi kugirango dukore iperereza ku ngaruka ziterwa no gutegura PRP zitandukanye.
Ingaruka ya PRP na angiogenez
Imyiteguro ya C-PRP mubuvuzi bwuzuye bushya butuma habaho gutanga biomolecules irekurwa nubunini bwinshi bwa platine ikorerwa ahabigenewe.Kubwibyo rero, hatangijwe uburyo butandukanye bwa caskade, bigira uruhare mukugenzura ubudahangarwa bw'umubiri, inzira yo gutwika hamwe na angiogenezi kugirango biteze gukira no gusana ingirangingo.
Angiogenezi ni inzira igenda itera intambwe nyinshi zirimo kumera hamwe na mikorobe ya tissue biva mu mitsi y'amaraso yariho mbere.Angiogenezi yateye imbere kubera uburyo butandukanye bwibinyabuzima, harimo kwimuka kwa selile endoteliyale, gukwirakwizwa, gutandukanya no kugabana.Izi ngirabuzimafatizo ni ngombwa kugira ngo habeho imiyoboro mishya y'amaraso.Nibyingenzi kugirango imikurire yimitsi ibanziriza iyambere kugirango igarure amaraso kandi ishyigikire ibikorwa byinshi bya metabolike yo gusana ingirabuzimafatizo no kuvugurura ingirangingo.Iyi miyoboro mishya yamaraso itanga itangwa rya ogisijeni nintungamubiri, no kuvanaho ibicuruzwa biva mu ngingo zavuwe.
Igikorwa cya Angiogenezi kigengwa no gukurura ibintu bya angiogenic VEGF nibintu birwanya antiogene (urugero, angiostatin na trombospondin-1 [TSP-1]).Muri microen ibidukikije irwaye kandi yangiritse (harimo ubushyuhe buke bwa ogisijeni, pH nkeya na aside irike ya lactique), ibintu bya angiogenic byaho bizagarura ibikorwa bya angiogenez.
Itangazamakuru ryinshi rya elegitoronike, nka FGF na TGF- β Na VEGF irashobora gukangura ingirabuzimafatizo kugirango itange imiyoboro mishya y'amaraso.Landsdown na Fortier batanze ibisubizo bitandukanye bijyanye na PRP, harimo intraplatelet isoko ya angiogenic igenzura.Byongeye kandi, banzuye bavuga ko kwiyongera kwa angiogenez bigira uruhare mu gukiza indwara ya MSK mu bice bifite imitsi idahwitse, nko kurira kwa menisque, gukomeretsa imitsi ndetse n’utundi turere dufite imitsi mibi.
Gutezimbere no kurwanya anti-angiogenic
Mu myaka mike ishize, ubushakashatsi bwashyizwe ahagaragara bwerekanye ko platine igira uruhare runini muri hemostasis yibanze, kwibumbira mu mitsi, ibintu bikura no kurekura cytokine, no kugenzura angiogenezi mu rwego rwo gusana ingirangingo.Iparadizo, PRP α- Ibinyamisogwe birimo arsenal yibintu bikura bikura, anti-angiogenic proteine na cytokine (nka PF4, plasminogen activator inhibitor-1 na TSP-1), kandi bigamije kurekura ibintu byihariye bigira uruhare .Uruhare muri angiogenez.Kubwibyo, uruhare rwa PRP mugucunga amabwiriza ya angiogenezeze rushobora gusobanurwa nogukora kwakirwa ryihariye ryimikorere ya selile, TGF- β Gutangiza pro-angiogenic na anti-angiogenic reaction.Ubushobozi bwa platine bwo gukoresha inzira ya angiogenezi byemejwe muri patologi angiogenez na tumor angiogenez.
Platelet ikomoka kuri angiogenic yo gukura no kurwanya anti-angiogenic gukura, ikomoka kuri α- Na molekile yuzuye kandi ifata.Icy'ingenzi cyane, biremewe muri rusange ko ingaruka rusange ya platine kuri angiogenezi ari pro-angiogenic kandi ikangura.Biteganijwe ko ubuvuzi bwa PRP buzagenzura kwinjiza angiogenez, bizagira uruhare mu kuvura indwara nyinshi, nko gukira ibikomere no gusana ingirangingo.Ubuyobozi bwa PRP, cyane cyane imiyoborere yibanze cyane PGF hamwe na cytokine ya platine, irashobora gutera angiogenez, angiogenez na arteriogenez, kubera ko ingirabuzimafatizo ikomoka kuri tromal 1a ihuza reseptor ya CXCR4 kuri selile ya progenitor.Bill n'abandi.Birasabwa ko PRP yongera ischemic neovascularization, ishobora guterwa no gukangura angiogenez, angiogenez na arteriogenez.Muri moderi yabo ya vitro, ikwirakwizwa rya selile ya endoteliyale hamwe no gukora capillary byatewe numubare munini wa PDGs zitandukanye, muri zo VEGF niyo nyamukuru itera angiogenic.Ikindi kintu cyingenzi kandi cyingenzi mugusubiza inzira ya angiogenez ni ubufatanye hagati ya PGF nyinshi.Richardson n'abandi.Byaragaragaye ko ibikorwa byo guhuza ibintu bya angiogenic factor platelet ikomoka kumikurire-bb (PDGF-BB) na VEGF byatumye habaho imiyoboro yihuse y'urusobe rw'imitsi ikuze ugereranije nibikorwa byikintu gikura.Ingaruka ziterwa nibi bintu ziherutse kwemezwa mu bushakashatsi bwakozwe ku kuzamura ubwonko bw’ubwonko bw’imbeba hamwe na hypoperfusion y'igihe kirekire.
Icy'ingenzi cyane, ubushakashatsi bwakozwe na vitro bwapimye ingaruka zo gukwirakwira kwingirangingo zumuntu zifata ingirabuzimafatizo hamwe nubushakashatsi butandukanye bwa platel ku guhitamo ibikoresho byo gutegura PRP hamwe ningamba zo gufata imiti, kandi ibisubizo byerekanaga ko ikinini cyiza cya platine cyari 1.5 × 10 6 platine / μ 50. Guteza imbere angiogenez.Kwibanda cyane kwa platel birashobora kubuza inzira ya angiogenez, ingaruka rero ni mbi.
Gusaza kwa selile, gusaza na PRP
Ingirabuzimafatizo zishobora guterwa no gukangura ibintu bitandukanye.Ubu ni inzira ingirabuzimafatizo zihagarika amacakubiri kandi zikagira impinduka zidasanzwe za fenotipiki kugirango hirindwe imikurire itagabanijwe ya selile yangiritse, igira uruhare runini mu gukumira kanseri.Muburyo bwo gusaza kwumubiri, gusaza kwigana ingirabuzimafatizo nabyo bizatera gusaza ingirabuzimafatizo, kandi ubushobozi bwo kuvugurura MSCs buzagabanuka.
Ingaruka zo gusaza no gusaza kwa selile
Muri vivo, ubwoko bwinshi bwimikorere izasaza kandi ikegeranya mubice bitandukanye mugihe cyo gusaza, muribwo harimo umubare munini wingirabuzimafatizo.Ikusanyirizo ry'utugingo ngengabuzima dusa nkaho kwiyongera hamwe no kwiyongera kwimyaka, kwangirika kwimikorere yumubiri, kwangirika kwimitsi cyangwa ibintu bifitanye isano na stress.Uburyo bwo gusaza kwa selile bwamenyekanye nkimpamvu zitera indwara ziterwa nimyaka, nka osteoarthritis, osteoporose na disque de détale.Ibitera imbaraga bizongera gusaza kwa selile.Igisubizo, senescence ifitanye isano na senotype yibanga (SASP) izasohora intungamubiri nyinshi za selile na cytokine.Iyi phenotype idasanzwe ifitanye isano ningirabuzimafatizo zishaje, aho zisohora cytokine nyinshi (nka IL-1, IL-6, IL-8), ibintu bikura (nka TGF- β 、 HGF, VEGF, PDGF), MMP, na cathepsin.Ugereranije n’urubyiruko, SAPS byagaragaye ko yiyongera uko imyaka igenda ishira, kubera ko inzira-ihamye-leta isenywa, bigatuma gusaza kwingirabuzimafatizo no kugabanya ubushobozi bushya.By'umwihariko, mu ndwara zifatanije n'indwara z'imitsi.Ni muri urwo rwego, gusaza kw’umubiri bifatwa nkimpinduka zikomeye mumyanya ndangagitsina ya selile yumubiri, byerekana ko kwibumbira hamwe kwa TNF-a, IL-6 na / cyangwa Il-1b byiyongera, biganisha ku gutwika indwara zo mu rwego rwo hasi.Birakwiye ko tumenya ko imikorere mibi yingirabuzimafatizo nayo ifitanye isano nuburyo bwigenga butari selile, nka selile zishaje, cyane cyane kubyara ibintu bitera imbaraga kandi birwanya imbaraga binyuze muri SASP.
Ibinyuranye na byo, SASP irashobora kandi gukangura plastike ya selile no kongera porogaramu ya selile zegeranye.Byongeye kandi, SASP irashobora gutunganya itumanaho hamwe nabunzi batandukanye bakingira umubiri kandi igakora selile yumubiri kugirango iteze imbere ingirabuzimafatizo zishaje.Gusobanukirwa uruhare n'imikorere ya selile zishaje bizagira uruhare mu gukira no guhindura imitsi ya MSK n'ibikomere bidakira.
Birashimishije ko Ritcka n'abandi.Hakozwe ubushakashatsi bwimbitse, kandi uruhare runini kandi rwingirakamaro rwa SASP mugutezimbere plastike ya selile no kuvugurura ingirabuzima fatizo, havumburwa igitekerezo cyo kuvura byigihe gito ingirabuzimafatizo zishaje.Biyubashye bavuze ko gusaza ahanini ari inzira nziza kandi igarura ubuzima.
Gusaza kwakagari hamwe nubushobozi bwa PRP
Mugihe umubare wingirabuzimafatizo zigabanuka, gusaza bizagira ingaruka kumikorere ya selile.Mu buryo nk'ubwo, mu bantu, ibiranga ingirabuzimafatizo (nko gukama, gukwirakwizwa no gutandukana) nabyo bigabanuka uko imyaka igenda ishira.Wang na Nirmala bavuze ko gusaza bizagabanya ibiranga ingirabuzimafatizo ngengabuzima ndetse n'umubare w'abakira ibintu.Ubushakashatsi bw’inyamaswa bwerekanye ko PDGF yibanze ku mafarashi akiri muto.Bashoje bavuga ko kwiyongera k'umubare w'abakira GF n'umubare wa GF ku rubyiruko bishobora kugira igisubizo cyiza cya selile ku buvuzi bwa PRP kurusha abantu bakuze mu rubyiruko.Ubu bushakashatsi bwerekana impamvu kuvura PRP bishobora kutagira ingaruka nziza cyangwa bikanagira ingaruka ku barwayi bageze mu zabukuru bafite ingirabuzimafatizo nke kandi “ubuziranenge”.Byaragaragaye ko gahunda yo gusaza ya karitsiye ishaje ihinduka kandi igihe cyo kuruhuka cya chondrocytes cyiyongera nyuma yo guterwa PRP.Jia n'abandi.Ikoreshwa mukwiga fibroblast yimbeba dermal mumafoto ya vitro, hamwe na PRP itavuwe, kugirango isobanure uburyo bwo kurwanya PGF murubu buryo.Itsinda rya PRP ryerekanye ingaruka zitaziguye kuri matrice idasanzwe, kongera ubwoko bwa I kolagen no kugabanya synthesis ya metalloproteinase, byerekana ko PRP ishobora kurwanya gusaza kwingirabuzimafatizo, ndetse no mu ndwara ya MSK yangirika.
Mu bundi bushakashatsi, PRP yakoreshejwe mu gukusanya amagufwa yo mu magufa ashaje kuva imbeba zashaje.Byemejwe ko PRP ishobora kugarura imikorere itandukanye yingirabuzimafatizo kuva gusaza, nko gukwirakwiza selile no gushinga ubukoloni, no kongera kubaka ibimenyetso bijyanye no gusaza kwakagari.
Vuba aha, Oberlohr na bagenzi be bize cyane ku ruhare rwo gusaza kw ingirabuzimafatizo mu kugabanya imitsi, kandi basuzuma PRP na plasma ikennye (PPP) nk'uburyo bwo kuvura ibinyabuzima byo gusana imitsi ya skeletale.Batekerezaga ko kuvura PRP cyangwa PPP mu gusana imitsi ya skeletale bizashingira ku bintu biologiya byakorewe ibimenyetso byihariye bya SASP nibindi bintu biganisha ku mikurire ya fibrosis.
Nibyiza kwizera ko mbere yo gushyira mu bikorwa PRP, gusaza kwingirabuzimafatizo bishobora guteza imbere imiterere mishya yo kuvura ibinyabuzima bigabanya ibintu bya SASP byaho.Hasabwe ko ubundi buryo bwo kunoza ibisubizo byo kuvura PRP na PPP kuvura imitsi ya skeletale ari uguhitamo gukuramo ingirabuzimafatizo zishaje hamwe no gusaza.Ntagushidikanya ko ubushakashatsi buherutse gukorwa ku ngaruka za PRP ku gusaza kwa selile no gusaza birashimishije, ariko biracyari mu ntangiriro.Kubwibyo, ntabwo bihuje n'ubwenge gutanga igitekerezo icyo aricyo cyose.
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: Werurwe-01-2023