Kev nkag siab tshiab ntawm Platelet Rich Plasma (PRP) Kev Kho Mob - Ntu II

Niaj hnub nimno PRP: "Clinical PRP"

Hauv 10 xyoo dhau los, txoj kev kho mob ntawm PRP tau hloov pauv zoo.Los ntawm kev sim thiab kev tshawb fawb soj ntsuam, peb tam sim no muaj kev nkag siab zoo dua ntawm platelet thiab lwm yam cell physiology.Tsis tas li ntawd, ntau qhov kev ntsuam xyuas zoo tshaj plaws, kev tshuaj ntsuam xyuas meta thiab kev sim ntsuas randomized tau qhia txog kev ua haujlwm ntawm PRP biotechnology hauv ntau qhov kev kho mob, suav nrog kev kho mob dermatology, phais plawv, phais yas, phais orthopedic, kev tswj mob, kab mob txha caj qaum, thiab kev ua kis las. .

Cov yam ntxwv tam sim no ntawm PRP yog nws qhov tseeb platelet concentration, uas hloov los ntawm thawj lub ntsiab lus ntawm PRP (xws li platelet concentration siab tshaj tus nqi hauv paus) mus rau ntau tshaj 1 × 10 6 / µ L lossis li 5 npaug ntawm qhov tsawg kawg nkaus platelet concentration hauv platelets los ntawm hauv paus.Hauv kev tshuaj xyuas dav dav los ntawm Fadadu li al.33 PRP cov txheej txheem thiab cov txheej txheem raug soj ntsuam.Cov platelet suav ntawm qhov kawg PRP npaj ua los ntawm qee cov kab ke no qis dua li ntawm tag nrho cov ntshav.Lawv tau tshaj tawm tias platelet qhov tseem ceeb ntawm PRP nce qis li 0.52 nrog cov khoom siv ib zaug (Selphyl ®).Nyob rau hauv sib piv, ob-rotation EmCyte Chiv Keeb PurePRPII ® Cov platelet concentration uas ua los ntawm cov cuab yeej yog siab tshaj (1.6 × 10 6 /µL).

Obviously, hauv vitro thiab tsiaj txoj kev tsis yog qhov zoo tshaj plaws kev tshawb fawb ib puag ncig rau kev ua tiav kev hloov pauv mus rau kev kho mob.Ib yam li ntawd, kev tshawb nrhiav kev sib piv ntawm cov cuab yeej tsis txhawb nqa qhov kev txiav txim siab, vim tias lawv qhia tias platelet concentration ntawm PRP cov cuab yeej sib txawv heev.Hmoov zoo, los ntawm proteomics raws li thev naus laus zis thiab kev tshuaj xyuas, peb tuaj yeem ua rau peb nkag siab txog kev ua haujlwm ntawm tes hauv PRP uas cuam tshuam rau kev kho mob.Ua ntej ncav cuag kev pom zoo ntawm tus qauv PRP kev npaj thiab cov qauv tsim, PRP yuav tsum ua raws li kev kho mob PRP formulations los txhawb cov txheej txheem kho cov ntaub so ntswg thiab cov txiaj ntsig kho mob tau zoo.

Clinical PRP formula

Tam sim no, kev kho mob zoo PRP (C-PRP) tau pom tias yog ib qho kev sib xyaw ua ke ntawm autologous multicellular Cheebtsam hauv cov ntim me me uas tau txais los ntawm ib feem ntawm cov ntshav peripheral tom qab centrifugation.Tom qab centrifugation, PRP thiab nws cov tsis-platelet cell Cheebtsam tuaj yeem rov qab los ntawm cov khoom siv concentration raws li qhov sib txawv ntawm tes (ntawm qhov platelet ntom yog qhov qis tshaj).

Siv PurePRP-SP ® Cov khoom siv ntawm tes sib cais (EmCyte Corporation, Fort Myers, FL, USA) tau siv rau tag nrho cov ntshav tom qab ob txoj kev centrifugation.Tom qab thawj txheej txheem centrifugation, tag nrho cov ntshav tivthaiv tau muab cais ua ob txheej txheej, platelet (lean) plasma suspension thiab cov qe ntshav liab.Hauv A, cov kauj ruam thib ob centrifugation tau ua tiav.Qhov tseeb PRP ntim tuaj yeem muab rho tawm rau tus neeg mob daim ntawv thov.Kev nthuav dav hauv B qhia tau hais tias muaj cov txheej txheem ntau yam erythrocyte sedimentation xim av txheej (sawv cev los ntawm kab xiav) nyob rau hauv qab ntawm cov khoom siv, uas muaj ntau cov platelets, monocytes thiab lymphocytes, raws li qhov ceev gradient.Hauv qhov piv txwv no, raws li C-PRP npaj raws tu qauv nrog cov neutrophils tsis zoo, qhov tsawg kawg nkaus feem pua ​​​​ntawm neutrophils (<0.3%) thiab erythrocytes (<0.1%) yuav raug muab rho tawm.

Platelet granule

Nyob rau hauv daim ntawv thov PRP thaum ntxov, α- Granules yog cov feem ntau hais txog platelet sab hauv cov qauv, vim hais tias lawv muaj coagulation yam, ib tug loj tus naj npawb ntawm PDGF thiab angiogenic regulators, tab sis muaj tsawg thrombogenic muaj nuj nqi.Lwm yam tseem ceeb suav nrog cov tshuaj tsis tshua muaj neeg paub txog chemokine thiab cytokine Chemical Chemokine, xws li platelet factor 4 (PF4), pre-platelet basic protein, P-selectin (ib qho activator ntawm integrin) thiab chemokine RANTES ( tswj los ntawm kev ua kom muaj zog, qhia txog T hlwb ib txwm muaj. zais cia).Lub luag haujlwm tag nrho ntawm cov txheej txheem platelet granule tshwj xeeb yog txhawm rau nrhiav thiab qhib lwm lub cev tiv thaiv kab mob lossis ua rau cov kab mob endothelial.

Cov khoom hnyav hnyav xws li ADP, serotonin, polyphosphate, histamine thiab adrenaline yog siv ntau dua los ua cov tswj hwm ntawm platelet activation thiab thrombosis.Qhov tseem ceeb tshaj plaws, ntau ntawm cov ntsiab lus no muaj kev ua haujlwm ntawm kev hloov kho lub cev tiv thaiv kab mob.Platelet ADP tau lees paub los ntawm P2Y12ADP receptor ntawm dendritic cells (DC), yog li ua rau cov tshuaj tiv thaiv kab mob endocytosis.DC (antigen nthuav tawm cell) tseem ceeb heev rau kev pib T cell tiv thaiv kab mob thiab tswj kev tiv thaiv lub cev tiv thaiv kab mob, uas txuas lub cev tiv thaiv kab mob hauv lub cev thiab kev tiv thaiv kab mob.Tsis tas li ntawd, platelet adenosine triphosphate (ATP) xa cov teeb liab los ntawm T cell receptor P2X7, ua rau muaj kev sib txawv ntawm CD4 T pab hlwb rau hauv proinflammatory T helper 17 (Th17) hlwb.Lwm cov platelet ntom ntom granule Cheebtsam (xws li glutamate thiab serotonin) ua rau T cell tsiv teb tsaws thiab ua kom cov monocyte sib txawv rau DC, feem.Hauv PRP, cov immunomodators tau muab los ntawm cov nplais tuab yog cov tshuaj tiv thaiv kab tiv thaiv kab mob muaj zog.

Tus naj npawb ntawm kev sib cuam tshuam ncaj qha thiab tsis ncaj ntawm platelets thiab lwm yam (receptor) hlwb yog qhov dav.Yog li ntawd, daim ntawv thov ntawm PRP nyob rau hauv lub zos pathological ntaub so ntswg puag ncig yuav induce ntau yam inflammatory teebmeem.

Platelet concentration

C-PRP yuav tsum muaj cov tshuaj kho mob ntawm cov ntshav platelets kom tsim tau cov txiaj ntsig zoo.Platelets nyob rau hauv C-PRP yuav tsum txhawb nqa cell proliferation, synthesis ntawm mesenchymal thiab neurotrophic yam, txhawb kev tsiv teb tsaws ntawm chemotactic hlwb thiab txhawb kev tiv thaiv kab mob, raws li qhia hauv daim duab.

Activated platelets, tso tawm PGF thiab adhesion molecules kho ntau yam kev sib cuam tshuam ntawm tes: chemotaxis, cell adhesion, tsiv teb tsaws, thiab kev sib txawv ntawm tes, thiab tswj kev tiv thaiv kab mob.Cov platelet cell-cell kev sib cuam tshuam pab txhawb rau angiogenesis thiab inflammatory kev ua, thiab thaum kawg txhawb cov txheej txheem kho cov ntaub so ntswg.Cov ntawv luv: BMA: pob txha pob txha aspirate, EPC: endothelial progenitor hlwb, EC: endothelial hlwb, 5-HT: 5-hydroxytryptamine, RANTES: activated regulation ntawm ib txwm T cell qhia thiab putative secretion, JAM: junction adhesion molecule hom, CD40L: pawg 40 ligand, SDF-1 α: Stromal cell-derived factor-1 α, CXCL: chemokine (CXC motif) ligand, PF4: platelet factor 4. Adapted from Everts li al.

Marx yog thawj tus neeg ua pov thawj tias cov pob txha thiab cov nqaij mos kho tau zoo dua qub, thiab qhov tsawg kawg nkaus platelet suav yog 1 × 10 6 / µL. Cov txiaj ntsig no tau lees paub hauv kev tshawb fawb ntawm lumbar fusion los ntawm intervertebral foramen, thaum platelet koob ntau dua. 1.3 × Ntawm 106 platelets / µ L, qhov kev tshawb fawb no pom tau tias muaj kev sib txuam ntau dua.Tsis tas li ntawd, Giusti et al.Qhia tawm 1.5 × Cov txheej txheem kho cov ntaub so ntswg ntawm ib koob ntawm 109 yuav tsum tau platelets / mL los txhawb kev ua haujlwm angiogenesis los ntawm endothelial cell kev ua.Hauv txoj kev tshawb fawb tom kawg, cov concentration ntau dua txo cov peev xwm angiogenesis ntawm platelets hauv thiab ib ncig ntawm cov follicles.Tsis tas li ntawd, cov ntaub ntawv ua ntej tau pom tias koob tshuaj PRP tseem yuav cuam tshuam rau kev kho mob.Yog li ntawd, txhawm rau txhawm rau ua kom muaj cov tshuaj tiv thaiv angiogenesis thiab txhawb kev loj hlob ntawm tes thiab kev txav chaw ntawm tes, C-PRP yuav tsum muaj tsawg kawg yog 7.5 hauv 5-mL PRP kho lub raj mis × 10 9 tuaj yeem xa cov platelets.

Ntxiv nrog rau kev siv tshuaj, qhov cuam tshuam ntawm PRP ntawm kev ua haujlwm ntawm tes zoo li yog lub sijhawm nyob ntawm lub sijhawm.Sophie et al.Cov txiaj ntsig no qhia tau tias qhov luv luv rau tib neeg platelet lysates tuaj yeem ua rau cov pob txha cell proliferation thiab chemotaxis.Ntawm qhov tsis sib xws, kev raug mus ntev rau PRP yuav ua rau qis qis ntawm alkaline phosphatase thiab cov ntxhia tsim.

Ntshav liab

Cov qe ntshav liab yog lub luag haujlwm thauj cov pa oxygen mus rau cov ntaub so ntswg thiab xa cov pa roj carbon dioxide los ntawm cov ntaub so ntswg mus rau lub ntsws.Lawv tsis muaj nucleus thiab yog tsim los ntawm heme molecules uas khi rau cov proteins.Cov hlau thiab heme Cheebtsam hauv cov qe ntshav liab txhawb kev sib xyaw ntawm oxygen thiab carbon dioxide.Feem ntau, lub neej voj voog ntawm cov qe ntshav liab yog li 120 hnub.Lawv raug tshem tawm ntawm kev ncig los ntawm macrophages los ntawm cov txheej txheem hu ua RBC aging.Cov qe ntshav liab hauv cov qauv PRP tej zaum yuav raug puas tsuaj nyob rau hauv cov txheej txheem shear (piv txwv li, kev phais ntshav tag nrho, cov txheej txheem tiv thaiv kab mob, oxidative kev nyuaj siab lossis tsis txaus PRP concentration scheme).Yog li, RBC cell membrane decomposes thiab tso tawm cov tshuaj lom hemoglobin (Hb), ntsuas los ntawm plasma dawb hemoglobin (PFH), heme thiab hlau.].PFH thiab nws cov khoom degradation (heme thiab hlau) ua ke ua rau muaj kev phom sij thiab cytotoxic ntawm cov ntaub so ntswg, ua rau oxidative kev nyuaj siab, poob ntawm nitric oxide, ua kom cov kab mob inflammatory thiab tiv thaiv kab mob.Cov teebmeem no thaum kawg yuav ua rau microcirculation dysfunction, vasoconstriction hauv zos thiab vascular raug mob, nrog rau cov ntaub so ntswg loj.

Qhov tseem ceeb tshaj plaws yog tias thaum RBC uas muaj C-PRP raug xa mus rau cov ntaub so ntswg, nws yuav ua rau cov tshuaj tiv thaiv hauv zos hu ua eryptosis, uas yuav ua rau muaj kev tso tawm ntawm cytokine zoo thiab macrophage migration inhibitor.Qhov no cytokine inhibits kev tsiv teb tsaws ntawm monocytes thiab macrophages.Nws ua rau muaj zog pro-inflammatory signals rau cov ntaub so ntswg nyob ib puag ncig, inhibits qia cell migration thiab fibroblast proliferation, thiab ua rau muaj kev cuam tshuam loj hauv zos cell dysfunction.Yog li ntawd, nws yog ib qho tseem ceeb kom txwv tsis pub muaj kab mob RBC hauv PRP npaj.Tsis tas li ntawd, lub luag haujlwm ntawm cov qe ntshav liab hauv cov ntaub so ntswg rov tsim dua tshiab yeej tsis tau txiav txim siab.Tsim nyog C-PRP centrifugation thiab cov txheej txheem npaj feem ntau yuav txo lossis txawm tias tshem tawm cov qe ntshav liab, yog li zam qhov tshwm sim tsis zoo ntawm hemolysis thiab polycythemia.

Leukocytes hauv C-PRP

Lub xub ntiag ntawm cov qe ntshav dawb hauv PRP kev npaj yog nyob ntawm cov khoom siv kho mob thiab cov txheej txheem npaj.Hauv cov khoom siv plasma-raws li PRP, cov qe ntshav dawb raug tshem tawm tag nrho;Txawm li cas los xij, cov qe ntshav dawb tau ua kom muaj zog hauv PRP kev npaj ntawm erythrocyte sedimentation xim av txheej.Vim nws lub cev tiv thaiv kab mob thiab kev tiv thaiv tus tswv cuab, cov qe ntshav dawb cuam tshuam rau sab hauv biology ntawm cov mob hnyav thiab mob ntev.Cov yam ntxwv no yuav tau tham ntxiv hauv qab no.Yog li, muaj cov leukocytes tshwj xeeb hauv C-PRP tuaj yeem ua rau muaj kev cuam tshuam loj ntawm cov cellular thiab cov ntaub so ntswg.Tshwj xeeb tshaj yog, sib txawv PRP erythrocyte sedimentation xim av-daj txheej tshuab siv cov txheej txheem kev npaj sib txawv, yog li tsim qhov sib txawv ntawm neutrophils, lymphocytes thiab monocytes hauv PRP.Eosinophils thiab basophils tsis tuaj yeem ntsuas hauv PRP kev npaj vim tias lawv cov cell membranes tsis yooj yim dhau los tiv thaiv kev ua haujlwm centrifugal.

Neutrophils

Neutrophils yog cov leukocytes tseem ceeb hauv ntau txoj hauv kev kho.Cov txheej txheem no ua ke nrog cov tshuaj tua kab mob antimicrobial muaj nyob rau hauv platelets los ua ib qho kev thaiv kab mob tiv thaiv kab mob.Lub neej ntawm neutrophils yog txiav txim siab raws li kev kho mob lub hom phiaj ntawm C-PRP.Kev nce qib ntawm cov ntaub so ntswg o tuaj yeem yuav tsum tau nyob rau hauv kev kho mob mob ntev PRP biotherapy lossis hauv cov ntawv thov tsom rau pob txha loj hlob lossis kho.Qhov tseem ceeb, ntxiv cov haujlwm neutrophil tau pom nyob rau hauv ntau tus qauv, hais txog lawv lub luag haujlwm hauv angiogenesis thiab kho cov ntaub so ntswg.Txawm li cas los xij, neutrophils tuaj yeem ua rau muaj kev phom sij, yog li lawv tsis haum rau qee qhov kev siv.Zhou thiab Wang tau ua pov thawj tias kev siv PRP nplua nuj nyob rau hauv neutrophils tuaj yeem ua rau nce qhov sib piv ntawm hom III collagen rau hom I collagen, yog li exacerbating fibrosis thiab txo cov leeg lub zog.Lwm yam teeb meem kev sib haum xeeb los ntawm neutrophils yog tso tawm inflammatory cytokines thiab matrix metalloproteinases (MMPs), uas tuaj yeem txhawb o thiab catabolism thaum siv rau cov ntaub so ntswg.

Leukomonocyte

Hauv C-PRP, mononuclear T thiab B lymphocytes muaj ntau dua li lwm cov qe ntshav dawb.Lawv muaj feem cuam tshuam nrog cov cell-mediated cytotoxic adaptive tiv thaiv kab mob.Lymphocytes tuaj yeem ua rau cov tshuaj tiv thaiv cell tiv thaiv kab mob thiab hloov mus rau invaders.Tsis tas li ntawd, T-lymphocyte muab tau los ntawm cytokines (interferon- γ [IFN- γ] Thiab interleukin-4 (IL-4) txhim khu cov polarization ntawm macrophages. Verassar li al. tus qauv nas los ntawm kev tswj qhov sib txawv ntawm monocytes thiab macrophages.

Monocyte - multipotent kho cell

Raws li PRP npaj cov cuab yeej siv, monocytes yuav protrude los yog tsis muaj nyob rau hauv lub raj mis kho PRP.Hmoov tsis zoo, lawv qhov kev ua tau zoo thiab kev muaj peev xwm rov tsim dua tshiab tsis tshua tau tham hauv cov ntaub ntawv.Yog li ntawd, me ntsis kev saib xyuas yog them rau monocytes nyob rau hauv txoj kev npaj los yog cov qauv kawg.Monocyte pawg yog heterogeneous, pib los ntawm progenitor hlwb nyob rau hauv cov pob txha pob txha, thiab thauj mus rau peripheral cov ntaub so ntswg los ntawm hematopoietic qia cell txoj kev raws li microenvironment stimulation.Thaum lub sij hawm homeostasis thiab o, circulating monocytes tawm hauv cov hlab ntsha thiab raug recruited rau cov ntaub so ntswg raug mob los yog degraded.Lawv tuaj yeem ua raws li macrophages (M Φ) Effector cells lossis progenitor cells.Monocytes, macrophages thiab dendritic hlwb sawv cev rau mononuclear phagocytic system (MPS).Hauv cov ntaub so ntswg degenerated, cov neeg nyob hauv macrophages, hauv zos ua yeeb yam loj hlob, pro-inflammatory cytokines, apoptotic los yog necrotic hlwb thiab cov khoom microbial pib monocytes kom sib txawv rau MPS cell pawg.Piv txwv tias thaum C-PRP uas muaj cov tshuaj monocytes siab tau txhaj rau hauv cov cheeb tsam microenvironment ntawm tus kab mob, cov kab mob monocytes yuav sib txawv rau hauv M Φ Ua rau muaj kev hloov pauv loj ntawm tes.

Los ntawm monocyte rau M Φ Hauv cov txheej txheem ntawm kev hloov pauv, tshwj xeeb M Φ Phenotype.Nyob rau hauv kaum xyoo dhau los, ib tug qauv tau tsim, uas integrates M Φ lub complex mechanism ntawm kev ua kom tau piav raws li polarization ntawm ob lub xeev opposite: M Φ Phenotype 1 (M Φ 1, Classic activation) thiab M Φ Phenotype 2 (M Φ 2, lwm txoj kev qhib).M Φ 1 yog tus cwj pwm los ntawm inflammatory cytokine secretion (IFN- γ) Thiab nitric oxide los tsim cov kab mob tua kab mob zoo.M Φ Cov phenotype kuj ua rau vascular endothelial kev loj hlob zoo (VEGF) thiab fibroblast kev loj hlob (FGF).M Φ Cov phenotype yog tsim los ntawm cov tshuaj tiv thaiv kab mob uas muaj phagocytosis siab.M Φ 2 Tsim cov khoom siv hauv matrix, angiogenesis thiab chemokines, thiab interleukin 10 (IL-10).Ntxiv nrog rau kev tiv thaiv kab mob, M Φ Nws tuaj yeem txo qhov mob thiab txhawb kev kho cov ntaub so ntswg.Nws yog ib qho tseem ceeb uas M Φ 2 tau muab faib ua M hauv vitro Φ 2a, M Φ 2b thiab M Φ 2. Nws nyob ntawm qhov stimulus.Hauv vivo txhais lus ntawm cov subtypes no nyuaj vim tias cov ntaub so ntswg tuaj yeem muaj M Φ pawg sib xyaw.Interestingly, raws li nyob rau hauv lub zos ib puag ncig cov cim qhia thiab IL-4 theem, proinflammatory M Φ 1 yuav hloov dua siab tshiab los txhawb kev kho M Φ 2. Los ntawm cov ntaub ntawv no, nws yog tsim nyog xav tias muaj siab concentrations ntawm monocytes thiab M Φ C-PRP npaj. tuaj yeem pab kho cov ntaub so ntswg zoo dua vim tias lawv muaj kev kho cov ntaub so ntswg tiv thaiv kab mob thiab cov teeb liab hloov pauv ntawm tes.

Tsis meej pem txhais ntawm cov qe ntshav dawb feem hauv PRP

Lub xub ntiag ntawm cov qe ntshav dawb nyob rau hauv lub raj mis kho PRP nyob ntawm PRP cov cuab yeej npaj thiab tej zaum yuav muaj qhov sib txawv loj.Muaj ntau qhov kev tsis sib haum xeeb txog kev muaj leukocytes thiab lawv txoj kev koom tes rau cov khoom sib txawv sub-PRP (xws li PRGF, P-PRP, LP-PRP, LR-PRP, P-PRF thiab L-PRF) Hauv kev tshuaj xyuas tsis ntev los no, rau randomized. tswj kev sim (pov thawj theem 1) thiab peb txoj kev tshawb fawb sib piv (cov pov thawj theem 2) koom nrog 1055 tus neeg mob, qhia tias LR-PRP thiab LP-PRP muaj kev nyab xeeb zoo sib xws.Tus kws sau ntawv xaus lus tias qhov tsis zoo ntawm PRP yuav tsis cuam tshuam ncaj qha rau cov ntshav dawb.Hauv lwm txoj kev tshawb fawb, LR-PRP tsis tau hloov cov inflammatory interleukin (IL-1) hauv OA lub hauv caug β, IL-6, IL-8 thiab IL-17).Cov txiaj ntsig no txhawb kev pom tias lub luag haujlwm ntawm leukocytes hauv kev ua haujlwm lom neeg ntawm PRP hauv vivo tuaj yeem los ntawm crosstalk ntawm platelets thiab leukocytes.Qhov kev sib cuam tshuam no tuaj yeem txhawb nqa biosynthesis ntawm lwm yam (xws li lipoxygen), uas tuaj yeem cuam tshuam lossis txhawb kev rov ua haujlwm ntawm qhov mob.Tom qab thawj zaug tso tawm ntawm inflammatory molecules (arachidonic acid, leukotriene thiab prostaglandin), lipoxygen A4 yog tso tawm los ntawm activated platelets los tiv thaiv neutrophil activation.Nws yog nyob rau hauv ib puag ncig no uas M Φ Phenotype los ntawm M Φ 1 Hloov mus rau M Φ 2. Tsis tas li ntawd, muaj cov pov thawj nce ntxiv tias cov kab mob mononuclear tuaj yeem sib txawv rau ntau hom tsis-phagocytic cell vim lawv pluripotency.

Hom PRP yuav cuam tshuam rau MSC kab lis kev cai.Piv nrog cov qauv PRP lossis PPP ntshiab, LR-PRP tuaj yeem ua rau muaj kev loj hlob ntawm cov pob txha pob txha los ntawm MSCs (BMMSCs), nrog kev tso tawm sai dua thiab zoo dua PGF lom neeg ua haujlwm.Tag nrho cov yam ntxwv no yog qhov zoo rau kev ntxiv cov monocytes rau hauv lub raj mis kho PRP thiab lees paub lawv lub peev xwm immunomodulatory thiab muaj peev xwm sib txawv.

Congenital thiab adaptive tiv thaiv kab mob ntawm PRP

Lub nto moo tshaj plaws physiological muaj nuj nqi ntawm platelets yog tswj los ntshav.Lawv sib sau ua ke ntawm cov ntaub so ntswg puas tsuaj thiab cov hlab ntsha puas.Cov xwm txheej no yog tshwm sim los ntawm kev qhia ntawm integrins thiab selectins uas txhawb nqa platelet adhesion thiab aggregation.Cov kab mob endothelium puas ntxiv ua rau cov txheej txheem no, thiab cov collagen thiab lwm cov subendothelial matrix proteins txhawb kev sib sib zog nqus ua kom cov platelets.Hauv cov xwm txheej no, lub luag haujlwm tseem ceeb ntawm kev sib cuam tshuam ntawm von Willebrand factor (vWF) thiab glycoprotein (GP), tshwj xeeb tshaj yog GP-Ib, tau raug pov thawj.Tom qab platelet activation, platelet α-, ntom, lysosome thiab T-granules tswj exocytosis thiab tso lawv cov ntsiab lus mus rau hauv ib puag ncig extracellular.

Platelet adhesion molecule

Txhawm rau kom nkag siab zoo dua lub luag haujlwm ntawm PRP hauv cov ntaub so ntswg thiab cov platelets hauv lub cev tiv thaiv kab mob, peb yuav tsum nkag siab tias qhov sib txawv ntawm platelet nto receptors (integrins) thiab junction adhesion molecules (JAM) thiab kev sib cuam tshuam ntawm tes tuaj yeem pib cov txheej txheem tseem ceeb hauv lub cev thiab kev tiv thaiv kab mob.

Integrins yog cell nto adhesion molecules pom nyob rau hauv ntau hom cell thiab qhia nyob rau hauv ntau qhov ntau ntawm platelets.Integrins muaj xws li a5b1, a6b1, a2b1 LFA-2, (GPIa/IIa) thiab aIIbb3 (GPIIb/IIIa).Feem ntau, lawv muaj nyob rau hauv lub xeev zoo li qub thiab tsis tshua muaj affinity.Tom qab ua kom tiav, lawv hloov mus rau lub xeev siab ligand binding affinity.Integrins muaj cov haujlwm sib txawv ntawm cov platelets thiab koom nrog kev sib cuam tshuam ntawm platelets nrog ntau hom qe ntshav dawb, endothelial cells thiab extracellular matrix.Tsis tas li ntawd, GP-Ib-V-IX complex yog qhia ntawm platelet membrane thiab yog lub ntsiab receptor rau khi nrog von vWF.Qhov kev cuam tshuam no cuam tshuam qhov kev sib cuag thawj zaug ntawm platelets thiab nthuav tawm cov qauv subendothelial.Platelet integrin thiab GP complex muaj feem xyuam rau ntau yam txheej txheem inflammatory thiab ua lub luag haujlwm tseem ceeb hauv kev tsim cov platelet-leucocyte complex.Tshwj xeeb, integrin aIIbb3 yog qhov tsim nyog los tsim ib qho chaw ruaj khov los ntawm kev sib txuas ntawm fibrinogen nrog macrophage 1 antigen (Mac-1) receptor ntawm neutrophils.

Platelets, neutrophils thiab vascular endothelial hlwb qhia tshwj xeeb cell adhesion molecules, hu ua selectin.Nyob rau hauv cov mob inflammatory, platelets qhia P-selectin thiab neutrophil L-selectin.Tom qab platelet activation, P-selectin tuaj yeem khi rau ligand PSGL-1 uas muaj nyob rau ntawm neutrophils thiab monocytes.Tsis tas li ntawd, PSGL-1 binding pib intracellular teeb liab cascade cov tshuaj tiv thaiv, uas activates neutrophils los ntawm neutrophil integrin Mac-1 thiab lymphocyte muaj nuj nqi ntsig txog antigen 1 (LFA-1).Activated Mac-1 khi rau GPIb lossis GPIIb / IIIa ntawm platelets los ntawm fibrinogen, yog li stabilizing kev sib cuam tshuam ntawm neutrophils thiab platelets.Tsis tas li ntawd, activated LFA-1 tuaj yeem ua ke nrog platelet intercellular adhesion molecule 2 kom ruaj khov neutrophil-platelet complex los txhawb lub sij hawm ntev adhesion nrog cov hlwb.

Platelets thiab leukocytes ua lub luag haujlwm tseem ceeb hauv cov lus teb hauv lub cev thiab hloov kho lub cev

Lub cev tuaj yeem paub txog lub cev txawv teb chaws thiab cov ntaub so ntswg raug mob hauv cov kab mob hnyav los yog mob ntev los pib qhov txhab kho qhov txhab thiab cov kab mob inflammatory.Lub cev tsis muaj zog thiab yoog raws lub cev tiv thaiv tus tswv ntawm kev kis kab mob, thiab cov qe ntshav dawb ua lub luag haujlwm tseem ceeb hauv kev sib tshooj ntawm ob lub cev.Tshwj xeeb, monocytes, macrophages, neutrophils thiab cov cell killer ntuj ua lub luag haujlwm tseem ceeb hauv lub cev, thaum lymphocytes thiab lawv cov subsets ua lub luag haujlwm zoo sib xws hauv lub cev tiv thaiv kab mob.

Platelet thiab leukocyte kev sib cuam tshuam hauv kev tiv thaiv kab mob hauv lub cev.Platelet cuam tshuam nrog neutrophils thiab monocytes, thiab thaum kawg nrog M Φ Sib cuam tshuam, kho thiab ua kom lawv cov nyhuv effector.Cov kev sib cuam tshuam ntawm platelet-leucocyte no ua rau mob los ntawm kev sib txawv, suav nrog NETosis.Cov ntawv luv: MPO: myeloperoxidase, ROS: reactive oxygen hom, TF: cov ntaub so ntswg, NET: neutrophil extracellular trap, NF- κ B: Nuclear factor kappa B, M Φ: Macrophages.

Innate tiv thaiv kab mob

Lub luag haujlwm ntawm lub cev tiv thaiv kab mob hauv lub cev yog txhawm rau txheeb xyuas cov kab mob nkag mus lossis cov ntaub so ntswg thiab txhawb nqa lawv cov kev tshem tawm.Thaum qee cov qauv molecular hu ua deg expression pattern recognition recognition receptors (PRRs) ua ke nrog cov kab mob ntsig txog cov qauv molecular thiab kev puas tsuaj cuam tshuam txog cov qauv molecular, lub cev tiv thaiv kab mob hauv lub cev yuav qhib.Muaj ntau ntau hom PRRs, suav nrog Tus Xov Tooj Zoo Li receptor (TLR) thiab RIG-1 zoo li receptor (RLR).Cov receptors no tuaj yeem qhib lub ntsiab lus tseem ceeb kappa B (NF- κ B) Nws kuj tswj tau ntau yam ntawm innate thiab adaptive tiv thaiv kab mob.Interestingly, platelets kuj qhia ntau yam immunoregulatory receptor molecules ntawm lawv qhov chaw thiab cytoplasm, xws li P-selectin, transmembrane protein CD40 ligand (CD40L), cytokines (xws li IL-1 β, TGF- β) Thiab platelet-specific TLR. Yog li ntawd, platelets tuaj yeem cuam tshuam nrog ntau lub cev tiv thaiv kab mob.

Platelet-white cell sib cuam tshuam hauv kev tiv thaiv kab mob hauv lub cev

Thaum platelets nkag los yog nkag mus rau hauv cov ntshav los yog cov ntaub so ntswg, platelets yog ib qho ntawm cov hlwb uas kuaj pom cov kab mob endothelial thiab cov kab mob microbial ua ntej.Platelet aggregation thiab txhawb kev tso tawm ntawm platelet agonists ADP, thrombin thiab vWF, ua rau platelet activation thiab qhia cov platelet chemokine receptors C, CC, CXC thiab CX3C, yog li ua rau platelets nyob rau hauv cov kab mob los yog raug mob.

Innate lub cev tsis muaj zog yog qhov tsis pom zoo ua ntej, xws li cov kab mob, cov kab mob, lossis cov nqaij mos thiab cov kiav txhab.Nws yog ib qho uas tsis yog qhov tshwj xeeb, vim tias txhua tus kab mob yuav raug txheeb xyuas tias txawv teb chaws lossis tsis yog tus kheej thiab nyob sai.Lub cev tiv thaiv kab mob hauv lub cev tso siab rau cov txheej txheem ntawm cov protein thiab phagocytes, uas paub txog cov yam ntxwv zoo ntawm cov kab mob thiab ua kom lub cev tiv thaiv kab mob sai sai los pab tshem tawm cov neeg tawm tsam, txawm tias tus tswv tsev tsis tau raug cov kab mob tshwj xeeb ua ntej.

Neutrophils, monocytes thiab dendritic hlwb yog cov kab mob hauv lub cev tsis muaj zog tshaj plaws hauv cov ntshav.Lawv kev nrhiav neeg ua haujlwm yog qhov tsim nyog rau kev tiv thaiv kab mob thaum ntxov.Thaum PRP siv rau hauv cov tshuaj regenerative, platelet-dawb cell kev sib cuam tshuam tswj kev mob, qhov txhab kho thiab kho cov ntaub so ntswg.TLR-4 ntawm platelets txhawb nqa platelet-neutrophil kev sib cuam tshuam, uas tswj qhov hu ua leukocyte oxidative tawg los ntawm kev tswj kev tso tawm ntawm cov pa oxygen reactive (ROS) thiab myeloperoxidase (MPO) los ntawm neutrophils.Tsis tas li ntawd, kev sib cuam tshuam ntawm platelet-neutrophil thiab neutrophil degranulation ua rau kev tsim cov neutrophil-extracellular ntxiab (NETs).NETs yog tsim los ntawm neutrophil nucleus thiab lwm yam neutrophil intracellular cov ntsiab lus, uas tuaj yeem ntes cov kab mob thiab tua lawv los ntawm NETosis.Kev tsim ntawm NETs yog qhov tseem ceeb tua cov txheej txheem ntawm neutrophils.

Tom qab platelet activation, monocytes tuaj yeem txav mus rau cov kab mob thiab cov ntaub so ntswg degenerative, qhov chaw lawv ua haujlwm adhesion thiab secrete inflammatory molecules uas yuav hloov chemotaxis thiab proteolytic zog.Tsis tas li ntawd, platelets tuaj yeem ua rau monocyte NF-κ B ua kom tswj tau cov kev ua haujlwm ntawm monocytes, uas yog tus neeg nruab nrab ntawm cov lus teb inflammatory thiab ua kom muaj zog thiab sib txawv ntawm lub cev tiv thaiv kab mob.Platelets ntxiv txhawb cov endogenous oxidative tawg ntawm monocytes los txhawb kev puas tsuaj ntawm phagocytic pathogens.Kev tso tawm MPO yog kho los ntawm kev sib cuam tshuam ncaj qha ntawm platelet-monocyte CD40L-MAC-1.Interestingly, thaum P-selectin activates platelets nyob rau hauv mob thiab mob inflammatory cov ntaub so ntswg mob, platelet-derived chemokines PF4, RANTES, IL-1 β Thiab CXCL-12 tuaj yeem tiv thaiv spontaneous apoptosis ntawm monocytes, tab sis txhawb lawv qhov sib txawv rau hauv macrophages.

Adaptive tiv thaiv kab mob

Tom qab lub cev tsis muaj zog tiv thaiv kab mob hauv lub cev paub txog cov kab mob microbial lossis cov ntaub so ntswg puas tsuaj, lub cev tiv thaiv kab mob tshwj xeeb yuav coj mus.Cov kev hloov kho muaj xws li antigen-binding B lymphocytes (B hlwb) thiab cov pa T lymphocytes (Treg) uas tswj xyuas kev tshem tawm cov kab mob.T hlwb tuaj yeem muab faib ua pawg pab pawg T (Th cells) thiab cytotoxic T cells (Tc cells, tseem hu ua T killer cells).Th cells tau muab faib ntxiv rau hauv Th1, Th2 thiab Th17 hlwb, uas muaj cov haujlwm tseem ceeb hauv kev mob.Th cells tuaj yeem zais cov cytokines proinflammatory (piv txwv li IFN- γ, TNF- β) Thiab ob peb interleukins (xws li, IL-17). Tc hlwb yog cov hlwb effector, uas tuaj yeem tshem tawm cov kab mob hauv lub cev thiab cov kab mob extracellular thiab cov hlwb.

Interestingly, Th2 hlwb tsim IL-4 thiab cuam tshuam rau M Φ Polarization, M Φ Qhia kev tsim kho M Φ 2 Phenotype, thaum IFN- γ M Φ Hloov mus rau inflammatory M Φ 1 Phenotype, uas nyob ntawm cov koob tshuaj thiab lub sijhawm ntawm cytokines.Tom qab IL-4 tau qhib, M Φ 2 induces Treg hlwb kom sib txawv rau hauv Th2 hlwb, thiab tom qab ntawd tsim cov IL-4 ntxiv (zoo tswv yim voj).Th hlwb hloov M Φ Cov phenotype yog qhia rau cov phenotype regenerative nyob rau hauv teb rau cov kab mob lom ntawm cov ntaub so ntswg keeb kwm.Cov txheej txheem no yog ua raws li cov pov thawj uas Th cells ua lub luag haujlwm tseem ceeb hauv kev tswj kev mob thiab kho cov ntaub so ntswg.

Platelet-white cell sib cuam tshuam hauv kev tiv thaiv kab mob

Lub cev tiv thaiv kab mob yoog tau siv cov tshuaj tiv thaiv tshwj xeeb tshwj xeeb thiab nco qab cov kab mob yav dhau los, thiab rhuav tshem lawv thaum nws tom qab ntsib tus tswv tsev.Txawm li cas los xij, cov tshuaj tiv thaiv kab mob no tau tsim maj mam.Konias et al.Nws qhia tau hais tias cov tshuaj tiv thaiv platelet ua rau muaj kev pheej hmoo rau kev nkag siab thiab kho cov ntaub so ntswg, thiab kev sib cuam tshuam ntawm platelets thiab leukocytes txhawb kev ua kom lub cev tiv thaiv kab mob.

Thaum lub sij hawm hloov lub cev tiv thaiv kab mob, platelets txhawb monocyte thiab macrophage cov lus teb los ntawm DC thiab NK cell maturation, ua rau cov lus teb tshwj xeeb T cell thiab B cell.Yog li, cov khoom siv platelet granule ncaj qha cuam tshuam rau kev tiv thaiv kab mob los ntawm kev nthuav qhia CD40L, ib qho molecule uas yog ib qho tseem ceeb rau kev tswj hwm kev tiv thaiv kab mob.Platelets los ntawm CD40L tsis tsuas yog ua lub luag haujlwm hauv kev nthuav qhia antigen, tab sis kuj cuam tshuam rau T cell cov tshuaj tiv thaiv.Liu et al.Nws tau pom tias platelets tswj CD4 T cell teb hauv txoj kev nyuaj.Qhov kev cai sib txawv ntawm CD4 T cell subsets txhais tau hais tias platelets txhawb CD4 T hlwb los teb rau inflammatory stimuli, yog li tsim muaj zog pro-inflammatory thiab anti-inflammatory teb.

Platelets kuj tswj B cell-mediated adaptive teb rau microbial pathogens.Nws paub zoo tias CD40L ntawm CD4 T hlwb yuav ua rau CD40 ntawm B hlwb, muab lub teeb liab thib ob xav tau rau T-cell-dependent B lymphocyte activation, tom qab allotype hloov dua siab tshiab, thiab B cell sib txawv thiab kev loj hlob.Feem ntau, cov txiaj ntsig tau qhia meej meej txog ntau yam kev ua haujlwm ntawm platelets hauv kev tiv thaiv kab mob, qhia tias platelets txuas kev sib cuam tshuam ntawm T cell thiab B hlwb los ntawm CD40-CD40L, yog li txhim kho T-cell-dependent B cell teb.Tsis tas li ntawd, platelets yog nplua nuj nyob rau hauv cell deg receptors, uas yuav txhawb platelet activation thiab tso tawm ib tug loj tus naj npawb ntawm inflammatory thiab biological active molecules khaws cia nyob rau hauv txawv platelet hais, yog li cuam tshuam rau lub innate thiab adaptive tiv thaiv kab mob.

Lub luag haujlwm nthuav dav ntawm platelet-derived serotonin hauv PRP

Serotonin (5-hydroxytryptamine, 5-HT) muaj lub luag haujlwm tseem ceeb hauv lub hauv paus paj hlwb (CNS), suav nrog kev mob siab rau.Nws kwv yees tias feem ntau ntawm cov tib neeg 5-HT yog tsim nyob rau hauv lub plab hnyuv ib ntsuj av thiab tom qab ntawd los ntawm cov ntshav ncig, qhov twg nws yog absorbed los ntawm platelets los ntawm serotonin reuptake transporter thiab khaws cia nyob rau hauv cov khoom ntom ntom ntawm high concentration (65 mmol / L).5-HT yog ib tug paub zoo neurotransmitter thiab cov tshuaj hormones uas pab tswj ntau yam neuropsychological txheej txheem hauv CNS (central 5-HT).Txawm li cas los xij, feem ntau ntawm 5-HT muaj nyob sab nraud CNS (peripheral 5-HT), thiab nws tau koom nrog kev tswj hwm lub cev thiab cov cellular lom ua haujlwm ntawm ntau lub cev, suav nrog cov hlab plawv, lub ntsws, plab hnyuv, urogenital thiab platelet functional systems.5-HT muaj cov concentration-dependent metabolism ntawm ntau hom cell, nrog rau adipocytes, epithelial hlwb thiab cov qe ntshav dawb.Peripheral 5-HT kuj yog lub zog tiv thaiv kab mob, uas tuaj yeem txhawb lossis inhibit qhov mob thiab cuam tshuam rau ntau lub cev tiv thaiv kab mob los ntawm nws qhov tshwj xeeb 5-HT receptor (5HTR).

Paracrine thiab autocrine mechanism ntawm HT

Cov kev ua ntawm 5-HT yog kho los ntawm nws cov kev sib cuam tshuam nrog 5HTRs, uas yog ib tug superfamily nrog xya tus tswv cuab (5-HT 1 - 7) thiab tsawg kawg yog 14 txawv receptor subtypes, nrog rau cov tsis ntev los no nrhiav tswv cuab 5-HT 7, nws peripheral thiab ua haujlwm hauv kev tswj qhov mob.Nyob rau hauv tus txheej txheem ntawm platelet degranulation, activated platelets secrete ib tug loj tus naj npawb ntawm platelet-derived 5-HT, uas yuav txhawb vascular contraction thiab txhawb lub activation ntawm nyob ib sab platelets thiab lymphocytes los ntawm kev qhia ntawm 5-HTR ntawm endothelial hlwb, cov leeg nqaij du thiab. lub cev tiv thaiv kab mob.Pacala et al.Cov nyhuv mitotic ntawm 5-HT ntawm vascular endothelial hlwb tau kawm, thiab lub peev xwm ntawm kev txhawb kev loj hlob ntawm cov hlab ntsha puas tsuaj los ntawm stimulating angiogenesis.Yuav ua li cas cov txheej txheem no raug tswj tsis tau meej meej, tab sis nws yuav koom nrog kev sib txawv ntawm ob txoj kev teeb liab hauv cov ntaub so ntswg microcircuit los tswj cov haujlwm ntawm vascular endothelial hlwb thiab cov leeg nqaij du, fibroblasts thiab lub cev tiv thaiv kab mob los ntawm 5-HT receptors tshwj xeeb ntawm cov hlwb no. .Kev ua haujlwm autocrine ntawm platelet 5-HT tom qab platelet activation tau piav qhia [REF].Kev tso tawm ntawm 5-HT txhim kho kev ua kom cov platelets thiab kev nrhiav neeg ua haujlwm ntawm cov platelets, ua rau kev ua kom cov teeb liab cascade tshwm sim thiab cov dej ntws ntws los txhawb cov platelet reactivity.

Immunomodulatory 5-HT nyhuv

Ntau thiab ntau cov pov thawj qhia tias serotonin tuaj yeem ua lub luag haujlwm hauv 5HTR sib txawv raws li kev tiv thaiv kab mob.Raws li 5HTR qhia nyob rau hauv ntau yam leukocytes koom nrog inflammatory cov tshuaj tiv thaiv, platelet-derived 5-HT ua raws li kev tiv thaiv kab mob hauv ob qho tib si hauv lub cev thiab kev tiv thaiv kab mob.5-HT tuaj yeem txhawb nqa Treg proliferation thiab tswj cov haujlwm ntawm B hlwb, cov cell killer ntuj thiab neutrophils los ntawm kev nrhiav DC thiab monocytes rau qhov chaw mob.Cov kev tshawb fawb tsis ntev los no tau pom tias platelet-derived 5-HT tuaj yeem tswj hwm kev ua haujlwm ntawm lub cev tiv thaiv kab mob hauv qee yam mob.Yog li, siv C-PRP, platelet concentration ntau dua 1 × 10 6 / µ L tuaj yeem pab thauj cov concentration ntawm 5-HT tau los ntawm cov platelets loj rau cov ntaub so ntswg.Nyob rau hauv microenvironment yam ntxwv los ntawm inflammatory Cheebtsam, PRP tuaj yeem cuam tshuam nrog ntau lub cev tiv thaiv kab mob uas ua lub luag haujlwm tseem ceeb hauv cov kab mob no, uas yuav cuam tshuam rau kev kho mob.

Daim duab qhia txog cov lus teb multifaceted 5-HT tom qab ua kom muaj cov kab mob PRP platelets.Tom qab ua kom cov platelets, platelets tso lawv cov granules, nrog rau 5-HT nyob rau hauv ntom granules, uas muaj ntau yam sib txawv los ntawm ntau lub cev tiv thaiv kab mob, endothelial hlwb thiab cov leeg nqaij.Cov ntawv luv: SMC: cov leeg nqaij du, EC: endothelial hlwb, Treg: pa T lymphocytes, M Φ: Macrophages, DC: dendritic cells, IL: interleukin, IFN- γ: Interferon γ. Hloov kho thiab hloov kho los ntawm Everts li al.thiab Hull et al.

Cov nyhuv analgesic ntawm PRP

Activated platelets yuav tso tawm ntau cov pro-inflammatory thiab anti-inflammatory mediators, uas tsis tsuas yog ua rau mob, tab sis kuj txo o thiab mob.Ib zaug siv, cov platelet dynamics ntawm PRP hloov lub microenvironment ua ntej cov ntaub so ntswg kho thiab rov tsim dua tshiab los ntawm ntau txoj hauv kev uas cuam tshuam nrog anabolism thiab catabolism, cell proliferation, sib txawv thiab qia cell tswj.Cov yam ntxwv ntawm PRP no ua rau daim ntawv thov ntawm PRP nyob rau hauv ntau yam kev kho mob pathological feem ntau cuam tshuam nrog kev mob ntev (xws li kev raug mob kis las, kab mob orthopedic, kab mob txha caj qaum thiab qhov txhab mob ntev), txawm hais tias qhov tseeb mechanism tsis tau txiav txim siab tag nrho.

Nyob rau hauv 2008, Evertz et al.Nws yog thawj zaug randomized tswj kev sim los qhia txog cov nyhuv analgesic ntawm PRP npaj, uas yog npaj los ntawm cov xim av txheej ntawm autologous erythrocyte sedimentation tus nqi thiab qhib nrog autologous thrombin tom qab lub xub pwg phais.Lawv tau sau tseg qhov txo qis hauv cov qhab nia ntawm qhov pom kev sib piv, kev siv cov tshuaj opioid raws li kev kho mob, thiab kev ua haujlwm zoo dua tom qab ua haujlwm.Nws yog noteworthy tias lawv muaj kev cuam tshuam cov nyhuv analgesic ntawm activated platelets thiab speculate rau lub mechanism ntawm platelets tso 5-HT.Nyob rau hauv luv luv, platelets yog dormant nyob rau hauv freshly npaj PRP.Tom qab ua kom cov platelets ncaj qha lossis tsis ncaj (cov ntaub so ntswg), platelets hloov cov duab thiab tsim cov khoom cuav txaus los txhawb platelet aggregation.Tom qab ntawd, lawv tso tawm intracellular α- Thiab cov khoom ntom ntom.Cov ntaub so ntswg kho nrog qhib PRP yuav raug cuam tshuam los ntawm PGF, cytokines thiab lwm yam platelet lysosomes.Tshwj xeeb tshaj yog, thaum cov khoom ntom ntom tso tawm lawv cov ntsiab lus, lawv yuav tso tawm ntau ntawm 5-HT uas tswj qhov mob.Hauv C-PRP, platelet concentration yog 5 mus rau 7 npaug ntau dua li cov ntshav peripheral.Yog li ntawd, kev tso tawm ntawm 5-HT los ntawm platelets yog astronomical.Interestingly, Sprott et al.Daim ntawv tshaj tawm tau pom tias qhov mob tau txo qis tom qab acupuncture thiab moxibustion, qhov concentration ntawm platelet tau los ntawm 5-HT tau txo qis, thiab tom qab ntawd qib plasma ntawm 5-HT tau nce.

Nyob rau hauv lub peripheral, platelets, mast hlwb thiab endothelial hlwb yuav tso endogenous 5-HT thaum lub sij hawm cov ntaub so ntswg raug mob los yog phais raug mob.Interestingly, ntau yam ntawm 5-HT receptors ntawm neurons tau kuaj pom nyob rau hauv peripheral cheeb tsam, uas tau lees tias 5-HT tuaj yeem cuam tshuam nrog kev sib kis nociceptive hauv cheeb tsam peripheral.Cov kev tshawb fawb no qhia tau hais tias 5-HT tuaj yeem cuam tshuam qhov kev xa tawm ntawm cov ntaub so ntswg peripheral los ntawm 5-HT1, 5-HT2, 5-HT3, 5-HT4 thiab 5-HT7 receptors.

5-HT system sawv cev rau lub zog muaj zog uas tuaj yeem txo qis thiab nce qib ntawm qhov mob tom qab muaj teeb meem stimulation.Lub hauv paus thiab peripheral kev tswj ntawm nociceptive signals thiab kev hloov nyob rau hauv 5-HT system tau tshaj tawm nyob rau hauv cov neeg mob uas mob ntev.Nyob rau hauv xyoo tas los no, ntau cov kev tshawb fawb tau tsom mus rau lub luag haujlwm ntawm 5-HT thiab nws cov receptors hauv kev ua thiab tswj cov ntaub ntawv tsis zoo, ua rau cov tshuaj xws li xaiv serotonin reuptake inhibitors (SSRI).Cov tshuaj no inhibits reuptake ntawm serotonin rau hauv presynaptic neurons tom qab tso tawm ntawm serotonin.Nws cuam tshuam rau lub sijhawm thiab kev siv ntawm kev sib txuas lus serotonin thiab yog lwm txoj kev kho mob rau mob ntev.Kev tshawb fawb soj ntsuam ntxiv yog xav tau kom nkag siab meej txog cov txheej txheem molecular ntawm PRP-derived 5-HT kev cai mob hauv cov kab mob ntev thiab degenerative.

Lwm cov ntaub ntawv los daws qhov muaj peev xwm analgesic nyhuv ntawm PRP tuaj yeem tau txais tom qab kuaj mob analgesic tsiaj.Cov kev sib piv cov ntaub ntawv sau tseg hauv cov qauv no nyuaj vim tias cov kev tshawb fawb no muaj ntau qhov sib txawv.Txawm li cas los xij, qee qhov kev tshawb fawb soj ntsuam tau hais txog qhov nociceptive thiab analgesic teebmeem ntawm PRP.Ntau qhov kev tshawb fawb tau pom tias cov neeg mob tau txais kev kho mob tendinosis lossis rotator cuff kua muag muaj qhov mob me ntsis.Hauv qhov sib piv, ob peb lwm cov kev tshawb fawb tau pom tias PRP tuaj yeem txo lossis tshem tawm qhov mob ntawm cov neeg mob uas muaj cov leeg degeneration, OA, plantar fasciitis thiab lwm yam kab mob ko taw thiab pob taws.Qhov kawg platelet concentration thiab lom cell muaj pes tsawg leeg tau raug txheeb xyuas raws li cov yam ntxwv tseem ceeb ntawm PRP, uas pab saib xyuas cov nyhuv analgesic zoo ib yam tom qab siv PRP.Lwm qhov sib txawv muaj xws li PRP tus me nyuam txoj kev, daim ntawv thov thev naus laus zis, platelet activation raws tu qauv, theem kev lom zem ntawm PGF thiab cytokines tso tawm, cov ntaub so ntswg ntawm daim ntawv thov PRP thiab hom kev raug mob.

Nws yog ib qho tseem ceeb uas Kuffler tau daws qhov muaj peev xwm ntawm PRP hauv kev txo qhov mob hauv cov neeg mob uas mob me mus rau mob hnyav mob neuropathic, thib ob rau cov paj hlwb uas tsis yog rov ua dua tshiab.Lub hom phiaj ntawm txoj kev tshawb no yog los tshawb xyuas seb qhov mob neuropathic puas tuaj yeem txo qis lossis txo qis vim PRP txhawb nqa axonal regeneration thiab lub hom phiaj paj hlwb reinnervation.Kuj ceeb tias, ntawm cov neeg mob tau txais kev kho mob, qhov mob neuropathic tseem raug tshem tawm lossis txo qis tsawg kawg rau xyoo tom qab kev phais.Tsis tas li ntawd, txhua tus neeg mob pib txo qhov mob hauv peb lub lis piam tom qab thov PRP.

Tsis ntev los no, zoo li cov tshuaj tua kab mob PRP tau pom nyob rau hauv kev kho mob tom qab phais thiab kev tu tawv nqaij.Interestingly, cov kws sau ntawv tau tshaj tawm txog lub cev ntawm lub qhov txhab mob uas cuam tshuam nrog vascular raug mob thiab daim tawv nqaij hypoxia.Lawv kuj tau tham txog qhov tseem ceeb ntawm angiogenesis hauv kev ua kom cov pa oxygenation thiab cov khoom noj khoom haus zoo.Lawv txoj kev tshawb fawb pom tau tias piv nrog pab pawg tswj hwm, cov neeg mob tau txais kev kho mob PRP muaj qhov mob tsawg dua thiab ua rau muaj kev cuam tshuam loj heev.Thaum kawg, Johal thiab nws cov npoj yaig tau ua qhov kev tshuaj xyuas thiab kev tshuaj xyuas meta thiab xaus lus tias PRP tuaj yeem txo qhov mob tom qab siv PRP hauv orthopedic indications, tshwj xeeb tshaj yog rau cov neeg mob tau txais kev kho mob epicondylitis sab nraud thiab hauv caug OA.Hmoov tsis zoo, txoj kev tshawb no tsis tau qhia meej txog cov txiaj ntsig ntawm cov qe ntshav dawb, platelet concentration lossis siv cov exogenous platelet activators, vim tias cov kev hloov pauv no yuav cuam tshuam rau tag nrho cov txiaj ntsig ntawm PRP.Qhov zoo tshaj plaws PRP platelet concentration rau qhov mob siab tshaj plaws yog tsis meej.Hauv cov qauv nas ntawm tendinosis, platelet concentration yog 1.0 × 10 6 / μ Ntawm L, qhov mob tuaj yeem txo tau tag nrho, thaum qhov mob nyem los ntawm PRP nrog ib nrab ntawm platelet concentration yog txo qis.Yog li ntawd, peb txhawb kom cov kev tshawb fawb soj ntsuam ntau ntxiv los tshawb xyuas cov teebmeem analgesic ntawm kev npaj PRP sib txawv.

PRP thiab angiogenesis nyhuv

C-PRP npaj nyob rau hauv cov tshuaj regenerative meej tso cai xa cov biomolecules tso tawm los ntawm siab concentrations ntawm platelets qhib rau ntawm lub hom phiaj cov ntaub so ntswg.Yog li ntawd, ntau yam kev cuam tshuam cascade tau pib, uas ua rau muaj kev tiv thaiv ntawm qhov chaw tiv thaiv kab mob, txheej txheem inflammatory thiab angiogenesis los txhawb kev kho thiab kho cov ntaub so ntswg.

Angiogenesis yog cov txheej txheem ntau kauj ruam uas cuam tshuam nrog kev loj hlob thiab cov ntaub so ntswg microvessels los ntawm cov hlab ntsha uas twb muaj lawm.Angiogenesis tau nce zuj zus vim muaj ntau yam ntawm cov txheej txheem lom neeg, suav nrog kev txav chaw endothelial cell, kev loj hlob, kev sib txawv thiab kev faib tawm.Cov txheej txheem cellular no yog qhov yuav tsum tau ua ua ntej rau kev tsim cov hlab ntsha tshiab.Lawv yog ib qho tseem ceeb rau kev loj hlob ntawm cov hlab ntsha preexisting los kho cov ntshav khiav thiab txhawb cov metabolic siab ntawm cov ntaub so ntswg kho thiab cov ntaub so ntswg.Cov hlab ntsha tshiab no tso cai rau kev xa cov pa oxygen thiab cov as-ham, thiab tshem tawm cov khoom los ntawm cov ntaub so ntswg kho.

Kev ua haujlwm ntawm Angiogenesis yog tswj hwm los ntawm stimulating angiogenic factor VEGF thiab anti-angiogenic yam (xws li, angiostatin thiab thrombospondin-1 [TSP-1]).Nyob rau hauv cov kab mob thiab degraded microenvironment (xws li tsis tshua muaj oxygen nro, pH tsis tshua muaj thiab siab lactic acid theem), cov tshuaj angiogenic hauv zos yuav rov ua haujlwm angiogenesis.

Ntau cov platelet soluble media, xws li yooj yim FGF thiab TGF- β Thiab VEGF tuaj yeem tsim cov hlwb endothelial los tsim cov hlab ntsha tshiab.Landsdown thiab Fortier tau tshaj tawm ntau yam txiaj ntsig ntsig txog PRP muaj pes tsawg leeg, suav nrog cov khoom siv hauv lub cev ntawm ntau tus tswj hwm angiogenic.Tsis tas li ntawd, lawv tau txiav txim siab tias qhov nce ntawm angiogenesis pab kho cov kab mob MSK nyob rau hauv cov cheeb tsam uas muaj vascularization tsis zoo, xws li meniscus tear, tendon raug mob thiab lwm qhov chaw uas muaj vascularization tsis zoo.

Txhawb nqa thiab anti-angiogenic platelet zog

Hauv ob peb lub xyoo dhau los, cov kev tshawb fawb luam tawm tau ua pov thawj tias platelets ua lub luag haujlwm tseem ceeb hauv thawj hemostasis, kev tsim cov qog, kev loj hlob thiab kev tso tawm cytokine, thiab kev tswj hwm angiogenesis ua ib feem ntawm cov txheej txheem kho cov ntaub so ntswg.Paradoxically, PRP α- Cov granules muaj cov arsenal ntawm pro-angiogenic kev loj hlob yam, anti-angiogenic proteins thiab cytokines (xws li PF4, plasminogen activator inhibitor-1 thiab TSP-1), thiab lub hom phiaj tso tawm ntawm tej yam tseem ceeb uas ua lub luag haujlwm. .Lub luag haujlwm hauv angiogenesis.Yog li, lub luag haujlwm ntawm PRP hauv kev tswj hwm kev tswj hwm angiogenesis yuav raug txiav txim siab los ntawm kev ua kom lub cev ntawm cov receptors tshwj xeeb, TGF- β Pib ua cov tshuaj tiv thaiv angiogenic thiab tiv thaiv angiogenic.Lub peev xwm ntawm platelets rau kev tawm dag zog angiogenesis txoj hauv kev tau lees paub hauv pathological angiogenesis thiab qog angiogenesis.

Platelet-derived angiogenic loj hlob zoo tshaj plaws thiab anti-angiogenic kev loj hlob yam, muab tau los ntawm α- Thiab ntom thiab nplaum molecules.Qhov tseem ceeb tshaj plaws, nws feem ntau lees txais tias tag nrho cov txiaj ntsig ntawm platelets ntawm angiogenesis yog pro-angiogenic thiab stimulating.Nws cia siab tias PRP txoj kev kho yuav tswj tau qhov induction ntawm angiogenesis, uas yuav pab txhawb kev kho mob ntawm ntau yam kab mob, xws li qhov txhab kho thiab kho cov ntaub so ntswg.Kev tswj hwm ntawm PRP, tshwj xeeb tshaj yog kev tswj hwm ntawm siab concentration PGF thiab lwm yam platelet cytokines, tuaj yeem ua rau angiogenesis, angiogenesis thiab arteriogenesis, vim stromal cell-derived factor 1a khi rau CXCR4 receptor ntawm endothelial progenitor hlwb.Bill et al.Nws tau pom zoo tias PRP nce ischemic neovascularization, uas tej zaum yuav yog vim kev txhawb nqa ntawm angiogenesis, angiogenesis thiab arteriogenesis.Hauv lawv cov qauv hauv vitro, endothelial cell proliferation thiab capillary tsim tau raug ntxias los ntawm ntau tus PDGs sib txawv, ntawm uas VEGF yog lub ntsiab angiogenic stimulator.Lwm qhov tseem ceeb thiab qhov tseem ceeb rau kev kho cov kab mob angiogenesis yog kev sib koom ua ke ntawm ntau yam PGFs.Richardson et al.Nws tau raug pov thawj tias kev ua haujlwm sib koom ua ke ntawm angiogenic factor platelet-derived growth factor-bb (PDGF-BB) thiab VEGF coj mus rau kev tsim sai sai ntawm cov vascular network loj hlob piv nrog rau cov haujlwm ntawm tus neeg loj hlob zoo.Kev sib xyaw ua ke ntawm cov xwm txheej no tsis ntev los no tau lees paub hauv kev tshawb fawb txog kev txhim kho ntawm cerebral collateral ncig nyob rau hauv nas nrog rau lub sij hawm ntev hypoperfusion.

Qhov tseem ceeb tshaj plaws, kev tshawb fawb hauv vitro tau ntsuas qhov kev loj hlob ntawm tib neeg cov hlab ntsha ntawm cov hlab ntsha endothelial thiab ntau yam platelet concentrations ntawm kev xaiv PRP npaj cov cuab yeej thiab cov tshuaj platelet, thiab cov txiaj ntsig tau pom tias cov koob tshuaj platelet zoo yog 1.5 × 10 6 platelets / μ 50. Txhawb nqa angiogenesis.platelet concentration ntau dhau tuaj yeem cuam tshuam cov txheej txheem angiogenesis, yog li cov nyhuv tsis zoo.

Cell aging, laus thiab PRP

Cell senescence tuaj yeem raug ntxias los ntawm ntau yam stimuli.Qhov no yog ib txoj hauv kev uas cov hlwb tsis sib faib thiab hloov pauv phenotypic tshwj xeeb los tiv thaiv kev loj hlob tsis muaj kev txwv ntawm cov hlwb puas, uas ua lub luag haujlwm tseem ceeb hauv kev tiv thaiv kev mob qog noj ntshav.Nyob rau hauv tus txheej txheem ntawm physiological aging, cell replication aging kuj yuav txhawb cell aging, thiab lub regeneration muaj peev xwm ntawm MSCs yuav raug txo.

Cov teebmeem ntawm kev laus thiab kev laus ntawm tes

Nyob rau hauv vivo, ntau hom cell yuav muaj hnub nyoog thiab sib sau nyob rau hauv ntau yam ntaub so ntswg thaum laus, ntawm cov uas muaj ib tug loj tus naj npawb ntawm aging hlwb.Lub tsub zuj zuj ntawm cov laus cov hlwb zoo li nce nrog cov hnub nyoog nce, kev tiv thaiv kab mob, cov ntaub so ntswg puas los yog cov teeb meem ntsig txog kev ntxhov siab.Cov txheej txheem ntawm kev laus ntawm cellular tau raug txheeb xyuas raws li qhov tshwm sim ntawm cov kab mob uas muaj hnub nyoog, xws li osteoarthritis, osteoporosis thiab intervertebral disc degeneration.Ntau yam stimuli yuav ua rau cov cell aging.Hauv kev teb, cov senescence-related secretory phenotype (SASP) yuav zais cov protein ntau ntawm cov hlwb thiab cytokines.Qhov tshwj xeeb phenotype no muaj feem xyuam rau cov hlwb laus, uas lawv zais cov cytokines siab (xws li IL-1, IL-6, IL-8), kev loj hlob (xws li TGF- β, HGF, VEGF, PDGF), MMP, thiab cathepsin.Piv nrog rau cov tub ntxhais hluas, SAPS tau ua pov thawj tias muaj hnub nyoog nce ntxiv, vim tias cov txheej txheem tsis tu ncua ntawm lub xeev raug rhuav tshem, ua rau muaj kev laus ntawm tes thiab txo qis kev muaj peev xwm.Tshwj xeeb, nyob rau hauv cov kab mob sib koom ua ke thiab cov kab mob skeletal leeg.Hauv qhov no, kev tiv thaiv kev laus yog suav tias yog ib qho kev hloov pauv tseem ceeb hauv kev zais cia ntawm lub cev tiv thaiv kab mob, qhia tias qhov concentration ntawm TNF-a, IL-6 thiab / lossis Il-1b nce, ua rau qis qis qis.Nws yog ib nqi sau cia hais tias qia cell dysfunction kuj muaj feem xyuam rau cov uas tsis yog-cellular autonomous mechanisms, xws li kev laus hlwb, tshwj xeeb tshaj yog zus tau tej cov pro-inflammatory thiab anti-regenerative yam los ntawm SASP.

Ntawm qhov tsis sib xws, SASP tseem tuaj yeem txhawb nqa cell plasticity thiab reprogramming ntawm cov hlwb uas nyob ib sab.Tsis tas li ntawd, SASP tuaj yeem txhim kho kev sib txuas lus nrog ntau tus neeg kho lub cev tiv thaiv kab mob thiab ua kom lub cev tiv thaiv kab mob los txhawb kev tshem tawm ntawm cov laus.Kev nkag siab txog lub luag haujlwm thiab kev ua haujlwm ntawm cov hlwb laus yuav pab txhawb kev kho thiab kho cov ntaub so ntswg ntawm MSK cov leeg thiab cov qhov txhab mob.

Nws yog noteworthy tias Ritcka et al.Kev tshawb fawb dav tau ua tiav, thiab lub luag haujlwm tseem ceeb thiab muaj txiaj ntsig ntawm SASP hauv kev txhawb nqa cell plasticity thiab cov ntaub so ntswg rov tsim dua tshiab tau pom, thiab lub tswv yim ntawm kev kho mob ib ntus ntawm cov hlwb laus tau qhia.Lawv cautiously hais tias kev laus yog ib qho tseem ceeb thiab cov txheej txheem regenerative.

Cell aging thiab muaj peev xwm ntawm PRP

Raws li tus naj npawb ntawm qia hlwb txo qis, kev laus yuav cuam tshuam rau kev ua haujlwm ntawm qia hlwb.Ib yam li ntawd, hauv tib neeg, cov yam ntxwv ntawm qia cell (xws li dryness, proliferation thiab sib txawv) kuj txo nrog hnub nyoog.Wang thiab Nirmala tau tshaj tawm tias kev laus yuav txo tau cov yam ntxwv ntawm cov leeg ntawm tes qia hlwb thiab cov naj npawb ntawm kev loj hlob receptors.Ib txoj kev tshawb fawb tsiaj tau pom tias qhov concentration ntawm PDGF hauv cov nees hluas yog siab.Lawv tau txiav txim siab tias qhov nce ntawm tus naj npawb ntawm GF receptors thiab tus naj npawb ntawm GF hauv cov tub ntxhais hluas tuaj yeem muaj cov lus teb ntawm cellular zoo rau kev kho PRP dua li cov laus hauv cov neeg hluas.Cov kev tshawb pom no qhia tias vim li cas kev kho PRP yuav tsis zoo lossis txawm tias tsis muaj txiaj ntsig hauv cov neeg laus uas muaj cov qia hlwb tsawg thiab "tsis zoo".Nws tau raug pov thawj tias cov txheej txheem kev laus ntawm cov pob txha laus yog thim rov qab thiab lub sijhawm so ntawm chondrocytes tau nce ntxiv tom qab txhaj tshuaj PRP.Jia et al.Nws yog siv los kawm nas dermal fibroblasts hauv vitro photoaging, nrog thiab tsis muaj PRP kev kho mob, kom paub meej cov txheej txheem ntawm PGF counteraction hauv cov qauv no.PRP pab pawg tau pom tias muaj kev cuam tshuam ncaj qha rau ntawm cov cellular matrix, nce hom I collagen thiab txo cov synthesis ntawm metalloproteinases, qhia tias PRP tuaj yeem tiv thaiv kev laus ntawm tes, thiab tseem muaj cov kab mob MSK degenerative.

Hauv lwm txoj kev tshawb fawb, PRP tau siv los sau cov laus cov pob txha pob txha los ntawm cov nas muaj hnub nyoog.Nws tau raug txiav txim siab tias PRP tuaj yeem rov qab tau ntau yam ntawm cov qia cell ua haujlwm los ntawm kev laus, xws li kev loj hlob ntawm tes thiab kev tsim cov colony, thiab rov tsim kho cov cim ntsig txog kev laus ntawm tes.

Tsis ntev los no, Oberlohr thiab nws cov npoj yaig tau kawm txog lub luag haujlwm ntawm kev laus ntawm tes hauv kev ua kom cov leeg tsis muaj zog, thiab ntsuas PRP thiab platelet-plasma tsis zoo (PPP) raws li kev kho mob lom rau kev kho cov leeg pob txha.Lawv pom tias PRP lossis PPP kev kho mob rau cov leeg pob txha yuav ua raws li cov khoom siv roj ntsha hloov kho rau SASP cov cim ntawm tes thiab lwm yam uas ua rau kev txhim kho fibrosis.

Nws yog qhov tsim nyog ntseeg tias ua ntej siv PRP, lub hom phiaj kev laus ntawm tes tuaj yeem txhim kho cov yam ntxwv ntawm kev kho mob lom los ntawm kev txo qis hauv zos SASP yam.Nws tau raug pom zoo tias lwm qhov kev xaiv los txhim kho cov txiaj ntsig ntawm PRP thiab PPP kev kho mob rau cov pob txha pob txha rov tsim dua tshiab yog xaiv kom tshem tawm cov laus nrog cov laus scavengers.Tsis muaj qhov tsis ntseeg tias qhov kev tshawb fawb tsis ntev los no ntawm cov txiaj ntsig ntawm PRP ntawm cell aging thiab aging yog fascinating, tab sis lawv tseem nyob rau hauv thawj theem.Yog li ntawd, nws tsis tsim nyog los ua cov lus qhia nyob rau lub sijhawm no.

(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.)