Lub tswv yim paub niaj hnub no yog PRP thawj zaug tshwm sim hauv thaj chaw hematology hauv xyoo 1970s.Hematologists coined lub sij hawm PRP xyoo dhau los nyob rau hauv ib qho kev sim los piav txog cov ntshav tau los ntawm platelet suav saum toj no basal qhov tseem ceeb hauv cov ntshav peripheral.Ntau tshaj li kaum xyoo tom qab, PRP tau siv hauv kev phais maxillofacial ua ib daim ntawv ntawm platelet-nplua nuj fibrin (PRF).Cov ntsiab lus fibrin hauv PRP derivative no muaj txiaj ntsig zoo rau nws cov khoom nplaum thiab homeostatic, thaum PRP muaj cov khoom siv tiv thaiv kab mob thiab txhawb kev loj hlob ntawm tes.Thaum kawg, nyob ib ncig ntawm 1990s, PRP tau nrov, thiab thaum kawg, thev naus laus zis tau pauv mus rau lwm qhov chaw kho mob.Txij thaum ntawd los, qhov zoo biology no tau kawm ntau thiab siv los kho ntau yam kev raug mob musculoskeletal hauv cov neeg ncaws pob kws tshaj lij, ntxiv rau nws txoj kev mloog xov xwm thoob plaws.Ntxiv nrog rau kev ua haujlwm zoo hauv orthopedics thiab kis las tshuaj, PRP yog siv rau hauv ophthalmology, gynecology, urology thiab cardiology, pediatrics thiab phais yas.Nyob rau hauv xyoo tas los no, PRP kuj tau txais kev qhuas los ntawm cov kws kho mob dermatologist rau nws lub peev xwm los kho cov kab mob ntawm daim tawv nqaij, kho caws pliav, kho cov ntaub so ntswg, tawv nqaij rejuvenation thiab txawm plaub hau poob.
Xav txog qhov tseeb tias PRP paub ncaj qha los tswj kev kho mob thiab cov txheej txheem inflammatory, qhov kev kho mob yuav tsum tau qhia raws li kev siv.Cov txheej txheem kho tau muab faib ua plaub theem hauv qab no: hemostasis;mob;cellular thiab matrix proliferation, thiab thaum kawg mob remodeling.
1. Kev kho cov ntaub so ntswg
Cov ntaub so ntswg-kho zoo li cascade yog qhib, txheej txheem uas ua rau platelet sib sau ua ke, tsim cov hlab ntsha, thiab kev loj hlob ntawm ib ntus extracellular matrix (ECM. Platelets ces ua raws li cov collagen thiab ECM cov proteins, ua rau muaj cov α-granules hauv kev tso tawm. Platelets muaj ntau yam bioactive molecules, nrog rau cov yam ntxwv loj hlob, chemokines, thiab cytokines, nrog rau cov tshuaj tiv thaiv kab mob xws li prostaglandins, prostatic cyclin, histamine, thromboxane, serotonin, thiab bradykinin.
Cov theem kawg ntawm cov txheej txheem kho yog nyob ntawm qhov kho qhov txhab.Kev kho cov ntaub so ntswg nruj nruj kom tsim kom muaj qhov sib npaug ntawm cov lus teb anabolic thiab catabolic.Thaum lub sijhawm no, platelet-derived growth factor (PDGF), transforming growth factor (TGF-β) thiab fibronectin txhawb kev loj hlob thiab kev tsiv teb tsaws ntawm fibroblasts, nrog rau kev sib xyaw ntawm ECM cov khoom.Txawm li cas los xij, lub sij hawm ntawm lub qhov txhab loj hlob feem ntau yog nyob ntawm qhov mob ntawm qhov txhab, tus yam ntxwv ntawm tus kheej, thiab lub peev xwm kho tau ntawm cov ntaub so ntswg raug mob, thiab qee yam kab mob pathophysiological thiab metabolic tuaj yeem cuam tshuam rau cov txheej txheem kho, xws li cov ntaub so ntswg ischemia, hypoxia, kab mob. , Kev loj hlob ntawm qhov tsis txaus ntseeg, thiab txawm tias cov kab mob metabolic cuam tshuam nrog.
Ib qho pro-inflammatory microenvironment uas cuam tshuam nrog cov txheej txheem kho.Ua kom muaj teeb meem nyuaj, kuj tseem muaj kev ua haujlwm siab protease uas inhibits natural action of growth factor (GF).Ntxiv nrog rau muaj mitogenic, angiogenic, thiab chemotactic zog, PRP kuj yog ib qho chaw nplua nuj ntawm ntau yam kev loj hlob, biomolecules uas tuaj yeem cuam tshuam cov teebmeem hauv cov ntaub so ntswg los ntawm kev tswj cov mob hnyav thiab tsim cov tshuaj anabolic stimuli.Muab cov khoom no, Cov Kws Tshawb Fawb tuaj yeem pom muaj peev xwm kho tau ntau yam kev raug mob nyuaj.
2. Cytokine
Cytokines hauv PRP ua lub luag haujlwm tseem ceeb hauv kev tswj cov txheej txheem kho cov ntaub so ntswg thiab tswj kev puas tsuaj.Anti-inflammatory cytokines yog ib tug dav spectrum ntawm biochemical molecules uas kho cov pro-inflammatory cytokine teb, feem ntau induced los ntawm activated macrophages.Anti-inflammatory cytokines cuam tshuam nrog tshwj xeeb cytokine inhibitors thiab soluble cytokine receptors los kho qhov mob.Interleukin (IL)-1 receptor antagonists, IL-4, IL-10, IL-11 thiab IL-13 yog cais raws li lub ntsiab tiv thaiv cytokines.Nyob ntawm seb hom qhov txhab, qee qhov cytokines, xws li interferon, leukemia inhibitory factor, TGF-β thiab IL-6, tuaj yeem ua rau muaj kev cuam tshuam los yog tiv thaiv kev mob.TNF-α, IL1 thiab IL-18 muaj qee yam cytokine receptors uas tuaj yeem cuam tshuam cov teebmeem ntawm lwm cov proteins [37].IL-10 yog ib qho ntawm cov muaj zog tshaj plaws los tiv thaiv cytokines, nws tuaj yeem txo qis-tswj cov cytokines xws li IL-1, IL-6 thiab TNF-α, thiab nce- tswj kev tiv thaiv cytokines.Cov txheej txheem tiv thaiv kev tswj hwm no ua lub luag haujlwm tseem ceeb hauv kev tsim khoom thiab kev ua haujlwm ntawm pro-inflammatory cytokines.Tsis tas li ntawd, qee qhov cytokines tuaj yeem ua rau cov lus teb tshwj xeeb uas txhawb nqa fibroblasts, uas yog qhov tseem ceeb rau kev kho cov ntaub so ntswg.Cov inflammatory cytokines TGFβ1, IL-1β, IL-6, IL-13, thiab IL-33 txhawb nqa fibroblasts kom sib txawv rau hauv myofibroblasts thiab txhim kho ECM [38].Nyob rau hauv lem, fibroblasts secrete cytokines TGF-β, IL-1β, IL-33, CXC, thiab CC chemokines, uas txhawb nqa cov lus teb los ntawm activating thiab recruiting hlwb xws li macrophages.Cov kab mob inflammatory no muaj ntau lub luag haujlwm ntawm qhov chaw mob, feem ntau los ntawm kev txhawb nqa qhov txhab tshem tawm - nrog rau biosynthesis ntawm chemokines, metabolites thiab loj hlob yam tseem ceeb, uas yog qhov tseem ceeb rau kev kho cov ntaub so ntswg tshiab.Yog li, cytokines tam sim no nyob rau hauv PRP ua lub luag haujlwm tseem ceeb hauv stimulating cell type-mediated immune responses, drive the resolution of the inflammatory phase.Qhov tseeb, qee cov kws tshawb fawb tau hu cov txheej txheem no "rov tsim kho mob," qhia tias theem inflammatory, txawm tias tus neeg mob tsis xis nyob, yog ib qho tseem ceeb ntawm cov txheej txheem kho cov ntaub so ntswg kom ncav cuag qhov kev ua tiav, muab cov txheej txheem epigenetic los ntawm cov teeb meem inflammatory txhawb cellular. yas.
3. Fibrin
Platelets muaj ntau yam cuam tshuam nrog cov kab mob fibrinolytic uas tuaj yeem txhim kho lossis txo qis cov lus teb fibrinolytic.Kev sib raug zoo ntawm lub cev thiab kev txheeb ze ntawm cov khoom hematological thiab platelet muaj nuj nqi hauv cov hlab ntsha degradation tseem yog ib qho teeb meem tsim nyog ntawm kev sib tham dav hauv zej zog.Cov ntaub ntawv nthuav tawm ntau cov kev tshawb fawb tsom rau cov platelets, uas paub txog lawv lub peev xwm los cuam tshuam cov txheej txheem kho.Txawm hais tias muaj ntau yam kev tshawb fawb, lwm yam hematological Cheebtsam, xws li coagulation yam thiab fibrinolytic system, kuj tau pom tias yuav ua tau ib qho tseem ceeb pab rau kev kho mob zoo.Los ntawm kev txhais, fibrinolysis yog ib txoj kev lom zem uas tso siab rau kev ua kom muaj qee yam enzymes los pab txhawb kev degradation ntawm fibrin.Cov lus teb fibrinolytic tau pom zoo los ntawm lwm tus kws sau ntawv tias cov khoom lag luam fibrin degradation (fdp) tuaj yeem yog cov tshuaj molecular lub luag haujlwm rau kev kho cov ntaub so ntswg, ib ntu ntawm cov xwm txheej tseem ceeb ua ntej fibrin deposition thiab tshem tawm ntawm angiogenesis, uas yog tsim nyog rau kev kho mob.Kev tsim cov ntshav txhaws tom qab raug mob ua raws li cov txheej txheem tiv thaiv uas tiv thaiv cov ntaub so ntswg los ntawm cov ntshav poob, cuam tshuam los ntawm cov kab mob microbial, thiab tseem muab cov matrix ib ntus los ntawm cov hlwb tuaj yeem txav mus los thaum kho.Cov hlab ntsha yog vim qhov sib cais ntawm fibrinogen los ntawm serine proteases thiab platelets sib sau ua ke hauv kev sib txuas ntawm fibrin fibrous network.Cov tshuaj tiv thaiv no pib lub polymerization ntawm fibrin monomers, qhov tshwm sim tseem ceeb hauv cov ntshav txhaws.Clots kuj tuaj yeem ua raws li cov dej cia rau cytokines thiab cov yam ntxwv loj hlob, uas tau tso tawm thaum degranulation ntawm cov platelets qhib.Cov kab mob fibrinolytic yog nruj tswj hwm los ntawm plasmin thiab ua lub luag haujlwm tseem ceeb hauv kev txhawb nqa cell migration, kev loj hlob ntawm bioavailability, thiab kev tswj hwm ntawm lwm cov kab mob protease koom nrog hauv cov ntaub so ntswg o thiab rov tsim dua tshiab.Cov khoom tseem ceeb hauv fibrinolysis, xws li urokinase plasminogen activator receptor (uPAR) thiab plasminogen activator inhibitor-1 (PAI-1) paub tias tau hais tawm hauv mesenchymal qia hlwb (MSCs), ib hom xovtooj tshwj xeeb tsim nyog rau kev kho qhov txhab zoo.
4. Cell Migration
Kev ua kom cov plasminogen los ntawm lub koom haum uPA-uPAR yog txheej txheem uas txhawb nqa cov cell tsiv teb tsaws chaw vim nws txhim kho cov txheej txheem ntawm cov cellular proteolysis.Txij li thaum uPAR tsis muaj cov transmembrane thiab intracellular domains, cov protein yuav tsum tau co-receptors xws li integrins thiab vitreins los tswj cov cell tsiv teb tsaws.Ntxiv mus, uPA-uPAR khi ua rau muaj kev sib raug zoo ntawm uPAR rau vitreous connexins thiab integrins, txhawb nqa cell adhesion.Plasminogen activator inhibitor-1 (PAI-1) nyob rau hauv lem disengages hlwb, rhuav tshem upar-vitrein thiab integrin- thaum nws khi rau uPA ntawm lub uPA-upar-integrin complex ntawm lub cell nto kev sib cuam tshuam ntawm iav voxels.
Nyob rau hauv cov ntsiab lus ntawm cov tshuaj regenerative, mesenchymal qia hlwb raug mob los ntawm cov pob txha pob txha nyob rau hauv cov ntsiab lus ntawm kev puas tsuaj loj ntawm lub cev thiab yog li yuav pom nyob rau hauv cov kev ncig ntawm cov neeg mob uas muaj ntau yam pob txha.Txawm li cas los xij, hauv qee qhov xwm txheej, xws li lub raum tsis ua haujlwm kawg, lub siab tsis ua haujlwm kawg, lossis thaum lub sijhawm pib tsis lees txais tom qab hloov lub plawv, cov hlwb no yuav tsis pom hauv cov ntshav [66].Interestingly, cov tib neeg pob txha pob txha-derived mesenchymal (stromal) progenitor hlwb tsis tuaj yeem kuaj pom hauv cov ntshav ntawm cov neeg noj qab haus huv [67].Lub luag haujlwm rau uPAR hauv cov pob txha pob txha mesenchymal qia cell mobilization kuj tau hais tseg yav dhau los, zoo ib yam li qhov tshwm sim hauv hematopoietic stem cell (HSC) mobilization.Varabaneni et al.Cov txiaj ntsig tau pom tias kev siv cov granulocyte colony-stimulating factor hauv uPAR-tsis muaj nas ua rau tsis ua haujlwm ntawm MSCs, rov txhawb lub luag haujlwm txhawb nqa ntawm fibrinolytic system hauv cell migration.Cov kev tshawb fawb ntxiv kuj tau pom tias glycosylphosphatidylinositol-anchored uPA receptors tswj adhesion, migration, proliferation, thiab sib txawv los ntawm activating tej yam intracellular signaling pathways, raws li nram no: pro-survival phosphatidylinositol 4,5-bisphosphate ER/2ktwayAsphate thiab , thiab adhesion kinase (FAK).
MSCs tau pom qhov tseem ceeb ntxiv hauv cov ntsiab lus ntawm kev kho qhov txhab.Piv txwv li, cov nas uas tsis muaj plasminogen ua rau muaj kev cuam tshuam loj heev hauv cov xwm txheej kho mob, qhia tias plasmin cuam tshuam rau txoj haujlwm no.Hauv tib neeg, kev poob ntawm plasmin kuj tuaj yeem ua rau muaj teeb meem ntawm qhov txhab kho.Kev cuam tshuam ntawm cov ntshav ntws tuaj yeem cuam tshuam cov ntaub so ntswg rov tsim dua tshiab, uas piav qhia vim li cas cov txheej txheem rov ua dua tshiab no nyuaj rau cov neeg mob ntshav qab zib.
5. Monocytes thiab Regeneration Systems
Raws li cov ntaub ntawv, muaj ntau qhov kev sib tham txog lub luag haujlwm ntawm monocytes hauv kev kho qhov txhab.Macrophages feem ntau yog muab los ntawm cov ntshav monocytes thiab ua lub luag haujlwm tseem ceeb hauv cov tshuaj regenerative [81].Txij li thaum neutrophils secrete IL-4, IL-1, IL-6 thiab TNF-[alpha], cov hlwb no feem ntau nkag mus rau qhov chaw mob li ntawm 24-48 teev tom qab raug mob.Platelets tso tawm thrombin thiab platelet factor 4 (PF4), ob chemokines uas txhawb kev nrhiav neeg ntawm monocytes thiab lawv qhov sib txawv rau hauv macrophages thiab dendritic hlwb.Ib qho tshwj xeeb ntawm macrophages yog lawv cov yas, piv txwv li, lawv lub peev xwm hloov phenotypes thiab hloov pauv mus rau lwm hom cell xws li endothelial hlwb, uas tom qab tso tawm cov haujlwm sib txawv hauv kev teb rau kev sib txawv biochemical stimuli hauv qhov txhab microenvironment.Cov hlwb inflammatory qhia ob qhov loj phenotypes, M1 los yog M2, nyob ntawm seb lub zos molecular teeb liab uas yog lub hauv paus ntawm lub stimulus.M1 macrophages raug ntxias los ntawm cov kab mob microbial thiab yog li muaj kev cuam tshuam ntau dua.Hauv qhov sib piv, M2 macrophages feem ntau yog tsim los ntawm hom 2 cov lus teb thiab muaj cov tshuaj tiv thaiv kab mob, uas feem ntau tshwm sim los ntawm kev nce hauv IL-4, IL-5, IL-9, thiab IL-13.Nws kuj tseem koom nrog kev kho cov ntaub so ntswg los ntawm kev tsim cov khoom loj hlob.Kev hloov ntawm M1 mus rau M2 isoforms feem ntau yog tsav los ntawm cov theem tom qab ntawm qhov txhab kho, qhov twg M1 macrophages ua rau neutrophil apoptosis thiab pib tshem tawm cov hlwb).Phagocytosis los ntawm neutrophils activates ib tug saw ntawm cov txheej xwm nyob rau hauv uas cytokine ntau lawm yog muab tua, polarizing macrophages thiab tso TGF-β1.Qhov kev loj hlob zoo li no yog tus tswj hwm tseem ceeb ntawm kev sib txawv ntawm myofibroblast thiab qhov txhab contraction, tso cai rau kev daws teeb meem ntawm qhov mob thiab pib ntawm cov theem proliferative hauv kev kho mob cascade [57].Lwm cov protein muaj feem cuam tshuam rau hauv cov txheej txheem ntawm tes yog serine (SG).Qhov no hematopoietic cell-secreted granulan tau pom tias tsim nyog rau kev khaws cia ntawm cov proteins zais cia hauv cov kab mob tshwj xeeb, xws li mast cells, neutrophils, thiab cytotoxic T lymphocytes.Txawm hais tias muaj ntau lub hlwb uas tsis yog hematopoietic kuj tseem tsim cov serotonin, tag nrho cov hlwb inflammatory tsim cov protein ntau thiab khaws cia rau hauv granules rau kev sib txuas ntxiv nrog rau lwm cov inflammatory mediators, xws li proteases, cytokines, chemokines, thiab kev loj hlob.Tsis zoo them glycosaminoglycan (GAG) chains nyob rau hauv SG zoo nkaus li yog ib qho tseem ceeb rau secretory granule homeostasis, raws li lawv muaj peev xwm khi rau thiab pab txhawb kev khaws cia ntawm cov khoom siv granule hauv cell-, protein-, thiab GAG chain-specific yam.Hais txog lawv txoj kev koom tes hauv PRP, Woulfe thiab cov npoj yaig tau qhia yav dhau los tias SG tsis txaus yog cuam tshuam nrog kev hloov pauv platelet morphology;qhov tsis xws luag hauv platelet factor 4, beta-thromglobulin, thiab PDGF cia hauv platelets;platelet aggregation tsis zoo thiab tso tawm hauv vitro thiab thrombosis hauv vivo daim ntawv tsis raug.Cov kws tshawb fawb thiaj li xaus lus tias qhov no proteoglycan zoo li yog tus tswj hwm ntawm thrombosis.
Platelet-nplua nuj cov khoom tuaj yeem tau txais los ntawm kev sau thiab centrifuging ib tus neeg tag nrho cov ntshav, cais cov sib tov rau hauv cov txheej txheem sib txawv uas muaj cov ntshav, platelets, leukocytes, thiab leukocytes.Thaum platelet concentrations siab tshaj qhov tseem ceeb, cov pob txha thiab cov ntaub so ntswg loj hlob tuaj yeem nrawm nrog cov kev mob tshwm sim tsawg.Daim ntawv thov ntawm autologous PRP cov khoom lag luam yog ib qho tshiab biotechnology uas tseem qhia tau tias muaj txiaj ntsig zoo hauv kev txhawb nqa thiab txhim kho kev kho mob ntawm ntau yam kev raug mob.Qhov kev ua tau zoo ntawm qhov kev kho mob lwm txoj hauv kev no tuaj yeem raug ntaus nqi los ntawm kev xa khoom ntawm ntau yam kev loj hlob thiab cov proteins, ua qauv thiab txhawb nqa lub cev qhov txhab kho thiab kho cov txheej txheem.Tsis tas li ntawd, fibrinolytic system kom meej meej muaj feem cuam tshuam rau tag nrho cov ntaub so ntswg kho.Ntxiv nrog rau nws lub peev xwm los hloov cov cellular recruitment inflammatory cells thiab mesenchymal qia hlwb, nws modulates proteolytic kev ua si nyob rau hauv lub qhov txhab kho qhov txhab thiab thaum lub sij hawm rov tsim ntawm mesodermal ntaub so ntswg nrog rau cov pob txha, pob txha mos thiab cov leeg, thiab yog li ntawd tseem ceeb nyob rau hauv musculoskeletal tshuaj tivthaiv.
Kev kho kom nrawm nrawm yog lub hom phiaj xav tau los ntawm ntau tus kws tshaj lij hauv kev kho mob, thiab PRP sawv cev rau cov cuab yeej lom neeg muaj txiaj ntsig zoo uas txuas ntxiv muab kev cog lus tsim kho hauv kev txhawb nqa thiab kev sib koom tes zoo ntawm cov xwm txheej rov ua dua tshiab.Txawm li cas los xij, vim tias cov cuab yeej kho mob no tseem nyuaj, tshwj xeeb tshaj yog txij li nws tso tawm ntau yam ntawm cov khoom siv bioactive thiab lawv cov kev sib cuam tshuam ntau yam thiab cov teeb meem cuam tshuam, yuav tsum muaj kev tshawb fawb ntxiv.
(Cov ntsiab lus ntawm tsab xov xwm no tau luam tawm dua, thiab peb tsis muab ib qho kev qhia lossis kev lees paub rau qhov raug, kev ntseeg tau lossis ua tiav ntawm cov ntsiab lus muaj nyob rau hauv tsab xov xwm no, thiab tsis muaj lub luag haujlwm rau cov kev xav ntawm tsab xov xwm no, thov nkag siab.)
Post lub sij hawm: Lub Xya hli ntuj-19-2022