Lub luag haujlwm ntawm platelets hauv pob txha pob txha aspiration concentrate
PRP thiab pob txha pob txha aspiration concentrate (BMAC) tau raug siv rau ntau qhov kev kho mob hauv chaw ua haujlwm ib puag ncig thiab phais vim tias lawv cov txiaj ntsig rov ua dua tshiab hauv MSK thiab cov kab mob txha caj qaum, kev kho mob ntev thiab cov ntaub so ntswg mos.PRP tsis tsuas yog tswj cov cell migration thiab cell proliferation, tab sis kuj pab txhawb rau angiogenesis thiab ECM remodeling los tsim ib tug haum microenvironment thiab txhawb cov ntaub so ntswg kho thiab rov tsim dua tshiab.
BMAC kho txheej txheem
BMACs yog heterogeneous cell compositions uas muaj BMMSCs, ua rau lawv ib tug endogenous cell qhov chaw rau regenerative tshuaj kho kho.Lawv ua lub luag haujlwm los ntawm kev txo cov cell apoptosis, fibrosis thiab o;Thiab qhib cov tshuaj tiv thaiv cascade ua rau kev loj hlob ntawm tes.Tsis tas li ntawd, BMMSCs muaj peev xwm sib txawv rau ntau hom kab mob ntawm tes, suav nrog osteoblasts, adipocytes, myoblasts, epithelial cells thiab neurons.Lawv kuj txhawb angiogenesis los ntawm paracrine thiab autocrine txoj hauv kev.Nws tseem yog ib qho tseem ceeb uas BMMSC yog ib qho kev txhawb nqa rau kev tswj hwm kev tiv thaiv kab mob ywj pheej ntawm lub cev tiv thaiv kab mob, uas koom nrog rau theem inflammatory ntawm kev kho qhov txhab.Tsis tas li ntawd, BMMSCs txhawb kev nrhiav cov hlwb mus rau qhov chaw kho mob angiogenesis tshiab txhawm rau txhawm rau txhawm rau txhim kho cov ntshav hauv zos.Jin et al.Nws tau ua pov thawj tias qhov tsis muaj qhov txaus txaus, qhov ciaj sia taus ntawm BMMSC thiab nws qhov kev kho thiab kev sib txawv muaj peev xwm los txhawb kev kho mob tau raug puas tsuaj.Txawm hais tias kev sau cov ntaub so ntswg, cov qauv kev npaj thiab cov txheej txheem ntawm kev ua ntawm PRP thiab BMAC sib txawv, cov kev tshawb fawb qhia tau tias lawv tuaj yeem sib ntxiv.Qhov tseeb, kev sib txuas ntawm PRP thiab BMAC rau hauv cov khoom siv roj ntsha tuaj yeem muaj qhov zoo ntxiv.
Ua ke PRP thiab BMAC
Raws li qee qhov kev tshawb fawb me me, lub hauv paus ntsiab lus ntawm kev sib txuas ntawm PRP thiab BMAC yog nyob ntawm ntau qhov chaw.Ua ntej, PRP tuaj yeem muab qhov tsim nyog microenvironment nyob rau hauv uas BMSC tuaj yeem txhim kho kev loj hlob ntawm tes thiab kev sib txawv thiab ua kom muaj cov kab mob angiogenesis.Qhov thib ob, PRP tau siv los ua ib qho scaffold rau cov hlwb no nrog BMAC.Ntawm qhov tsis sib xws, kev sib xyaw ua ke ntawm PRP thiab BMAC tuaj yeem dhau los ua cov cuab yeej lom neeg muaj zog los nyiam BMMSC cov pej xeem.PRP-BMAC compound tau siv los kho tendinosis, qhov txhab, kev raug mob ntawm tus txha caj qaum, degenerative intervertebral discs thiab osteochondral tsis xws luag nrog lub peev xwm rov tsim dua tshiab.Hmoov tsis zoo, txawm hais tias heterogeneous pob txha pob txha ntawm tes muaj xws li platelets, ob peb tsab ntawv ceeb toom hais txog qhov concentration ntawm platelets hauv cov pob txha rho tawm thiab tom qab BMAC kev kho mob, tab sis lawv tuaj yeem muab rho tawm los ntawm txoj kev xav kom tsim nyog.Kev tshawb fawb ntxiv yog xav tau kom nkag siab seb puas ntxiv platelet concentrates yuav tsum tau siv ua ke nrog BMAC.Tam sim no, tsis muaj cov ntaub ntawv hais txog qhov zoo ntawm cov platelets rau MSC (lossis lwm cov pob txha pob txha) cov hlwb, uas muaj kev cuam tshuam zoo rau kev noj haus ntawm MSC hauv kev kho cov ntaub so ntswg.Qhov zoo tshaj plaws, cov khoom siv pob txha pob txha thiab cov thev naus laus zis tuaj yeem ua kom zoo kom tshem tawm cov pob txha pob txha txaus platelets.
PRP txoj kev loj hlob zoo thiab BMAC noj zaub mov zoo
PRP platelet kev loj hlob zoo yog ib qho tseem ceeb ntawm cov protein koom nrog hauv kev kho cov txheej txheem ntawm BMAC.Kev sib txawv ntawm PGF thiab lwm yam cytokines koom nrog hauv cov txheej txheem kev noj haus ntawm BMAC tuaj yeem pib kho cov ntaub so ntswg los ntawm kev txo cov cell apoptosis, anabolism thiab tiv thaiv kab mob, thiab ua kom cov cell proliferation, sib txawv thiab angiogenesis los ntawm paracrine thiab autocrine pathways.
Platelig-doldated Kev Loj Hlob thiab tuab koom nrog cov txheej txheem kev noj haus ntawm BMAC thiab txhawb nqa cov ntaub so ntswg kho thiab tsim kev tsim los ntawm MSC.Cov ntawv luv: MSC: mesenchymal qia hlwb, HSC: hematopoietic qia hlwb.
Pom tseeb, hauv kev kho OA, PDGF ua lub luag haujlwm tshwj xeeb hauv kev tsim cov pob txha mos thiab kev saib xyuas homeostasis los ntawm MSC proliferation thiab inhibition of IL-1-induced chondrocyte apoptosis thiab o.Tsis tas li ntawd, peb TGF- β Cov subtypes yog nquag txhawb kev tsim cov pob txha mos thiab inhibiting o, thiab lawv qhia lub peev xwm los txhawb MSC-txog cov ntaub so ntswg kho los ntawm kev sib cuam tshuam ntawm intermolecular.Kev noj zaub mov zoo ntawm MSC muaj feem cuam tshuam nrog kev ua haujlwm ntawm PGF thiab kev tso tawm ntawm kev kho cytokines.Qhov zoo tshaj plaws, tag nrho cov cytokines no yuav tsum muaj nyob rau hauv BMAC kho lub raj mis thiab thauj mus rau qhov chaw raug mob los txhawb qhov zoo tshaj plaws MSC-txog cov ntaub so ntswg kho.
Hauv kev tshawb nrhiav OA sib koom, Mui ñ os-L ó pez et al.Nws qhia tau tias MSC muab tau los ntawm cov ntaub so ntswg synovial tau hloov ua haujlwm, ua rau poob ntawm nws lub peev xwm rov qab los.Qhov zoo siab, kev txhaj tshuaj ncaj qha ntawm PRP rau hauv cov pob txha subchondral ntawm osteoarthritis ua rau txo qis ntawm MSC hauv cov kua dej synovial, qhia txog kev txhim kho kev kho mob.Cov nyhuv kho yog kho los ntawm kev txo cov txheej txheem inflammatory hauv cov kua synovial ntawm OA cov neeg mob.
Muaj cov ntaub ntawv me me txog qhov muaj los yog qhov siab ntawm PGF hauv BMAC lossis qhov zoo tagnrho qhov yuav tsum tau los txhawb kev noj zaub mov zoo ntawm BMMSC.Qee cov kws kho mob ua ke ua ke siab PRP concentration nrog BMAC kom tau txais cov khoom siv roj ntsha ntau dua, uas yuav tsum ua kom zoo dua cov txiaj ntsig kev kho mob ntawm cov tshuaj regenerative.Txawm li cas los xij, muaj qee cov ntaub ntawv muaj kev nyab xeeb thiab kev ua tau zoo, qhia tias kev sib xyaw PRP siab nrog BMAC yog qhov kev xaiv kho mob zoo dua.Yog li, peb ntseeg tias nws yuav tsis tsim nyog los tswj BMMSC los ntawm kev ua kom lawv muaj platelet concentration nyob rau theem no.
Kev sib cuam tshuam ntawm platelets nrog cov tshuaj antiplatelet thiab NSAIDs
PRP muaj ib tug dav spectrum ntawm secretory Cheebtsam thiab yog tsim los ntawm ntau yam kab mob lom.Kev kho mob ntawm PRP yog ntaus nqi rau cov neeg kho mob.Txawm hais tias cov kws kho mob kho mob hauv cov platelets paub zoo, qhov kev tsim kho kom zoo thiab kinetics ntawm cov tshuaj anabolic thiab catabolic tsis meej kiag li.Ib qho ntawm cov kev txwv tseem ceeb ntawm kev ua tiav cov qauv tshuaj yog kom kov yeej cov kev sib raug zoo ntawm cov txiaj ntsig zoo hauv cov txiaj ntsig zoo hauv cov txiaj ntsig zoo uas ib txwm muaj txiaj ntsig thiab kho tau.Vim li no, cov tshuaj (xws li cov tshuaj uas tsis yog-steroidal anti-inflammatory tshuaj (NSAIDs)) tuaj yeem cuam tshuam rau kev tso tawm ntawm platelet secretory pawg.Hauv kev tshawb nrhiav qhib-daim ntawv teev tseg tsis ntev los no, kev noj tshuaj txhua hnub ntawm 81 mg ntawm cov tshuaj aspirin (ASA) txo qhov kev qhia ntawm cov kws kho mob tseem ceeb, xws li TGF- β 1. PDGF thiab VEGF.
Cov teebmeem no raug ntaus nqi los ntawm qhov tsis tuaj yeem thim rov qab inhibition ntawm cyclooxygenase-1 (COX-1) thiab qhov kho tau inhibition ntawm cyclooxygenase-2 (COX-2), uas yog ob lub enzymes xav tau rau kev txo qis platelet degranulation.Kev tshuaj xyuas tsis ntev los no tau pom tias cov tshuaj antiplatelet tuaj yeem txo qhov kev loj hlob ntawm kev tso tawm nkhaus hauv COX-1 thiab COX-2 nyob ntawm tus yam ntxwv, thiab 8 ntawm 15 qhov kev tshawb fawb pom tias qhov kev loj hlob tsawg zuj zus.
Cov tshuaj (xws li NSAIDs) feem ntau yog siv los txo qhov mob thiab txo qhov mob los ntawm tus kab mob MSK.Lub mechanism ntawm NSAIDs yog inhibit platelet activation los ntawm irreversibly khi nrog COX enzyme thiab tswj arachidonic acid txoj kev.Yog li ntawd, kev ua haujlwm ntawm platelets yuav hloov pauv thaum lub sijhawm tag nrho lub neej ntawm platelets, yog li tiv thaiv PGF teeb liab kis tau tus mob.NSAIDs inhibit cytokine ntau lawm (piv txwv li, PDGF, FGF, VEGF, thiab IL-1 β, IL-6, thiab IL-8), thaum txhim kho TNF- α. Txawm li cas los xij, muaj cov ntaub ntawv me me ntawm qhov cuam tshuam ntawm NSAIDs ntawm PRP.Tsis muaj kev pom zoo rau lub sijhawm zoo tshaj plaws rau kev npaj thiab kev tswj hwm ntawm PRP hauv cov neeg mob uas siv NSAIDs.Mannava thiab cov npoj yaig tau txheeb xyuas cov tshuaj anabolic thiab catabolic lom hauv cov leucocyte-nplua nuj PRP ntawm cov neeg ua haujlwm noj qab haus huv noj naproxen.Lawv pom tias tom qab siv naproxen rau ib lub lim tiam, theem ntawm PDGF-AA thiab PDGF-AB (zoo mitogen rau kev txhawb nqa angiogenesis) tau txo qis.Tom qab ib lub lim tiam, theem ntawm kev loj hlob zoo rov qab mus rau ze rau theem pib.Tom qab siv naproxen rau ib lub lim tiam, LR-PRP theem ntawm proinflammatory thiab catabolic yam tseem ceeb IL-6 kuj txo, thiab rov qab mus rau theem pib tom qab ib lub lim tiam tshem tawm.Tam sim no, tsis muaj kev tshawb fawb soj ntsuam los ua pov thawj tias cov neeg mob nrog naproxen tom qab kev kho mob PRP muaj txiaj ntsig tsis zoo;Txawm li cas los xij, nws raug nquahu kom xav txog lub sijhawm ntxuav ib lub lis piam los kho cov PDGF-AA, PDGF-BB thiab IL-6 qhov tseem ceeb rau qib hauv paus txhawm rau txhim kho lawv cov kev ua haujlwm lom neeg.Kev tshawb fawb ntxiv yog xav tau kom nkag siab txog qhov cuam tshuam ntawm antiplatelet thiab NSAID ntawm PRP secretion pawg thiab nws cov hom phiaj hauv qab.
Ua ke daim ntawv thov ntawm platelet-nplua nuj plasma nrog kev kho mob
Txawm hais tias kev tshawb fawb tseem ceeb qhia tau hais tias kev kho lub cev thiab cov khoom siv kho tshuab muaj lub luag haujlwm meej hauv kev rov qab los ntawm cov leeg nqaij tom qab kev txhaj tshuaj PRP, tsis muaj kev pom zoo rau txoj kev kho kom zoo tshaj plaws rau cov kab mob MSK tom qab kev kho PRP.
PRP kev kho mob suav nrog kev txhaj tshuaj ntawm cov platelets hauv cov ntaub so ntswg hauv ib puag ncig los tswj qhov mob thiab txhawb kev kho cov ntaub so ntswg.Cov pov thawj muaj zog tshaj plaws muaj nyob hauv lub hauv caug OA.Txawm li cas los xij, kev siv PRP hauv kev kho mob ntawm cov tsos mob tendinosis muaj teeb meem, thiab cov txiaj ntsig tau tshaj tawm txawv.Cov kev tshawb fawb tsiaj feem ntau qhia txog kev txhim kho histological ntawm tendinosis tom qab PRP infiltration.Cov kev tshawb fawb no qhia tau tias cov khoom siv thauj khoom tuaj yeem rov tsim cov leeg, thiab cov load thiab PRP txhaj tshuaj ua haujlwm ua ke los txhawb cov leeg kho.Qhov sib txawv ntawm kev npaj PRP, kev npaj tshuaj lom neeg, kev npaj, kev txhaj tshuaj thiab cov leeg nqaij pob txha raug mob tuaj yeem ua rau muaj qhov sib txawv ntawm kev kho mob.Tsis tas li ntawd, txawm hais tias cov pov thawj kev tshawb fawb txhawb nqa cov txiaj ntsig ntawm cov phiaj xwm kev kho mob, ob peb qhov kev tshawb fawb soj ntsuam tau sim los tswj thiab sib koom ua ke raws li kev npaj kho mob tom qab PRP.
Tsis ntev los no, Onishi et al.Lub luag haujlwm ntawm cov khoom siv thauj khoom thiab PRP lom cov nyhuv hauv Achilles tendon kab mob tau tshuaj xyuas.Lawv tau soj ntsuam theem I thiab theem II kev tshawb fawb soj ntsuam ntawm Achilles tendon kab mob kho nrog PRP, tsom mus rau txoj kev npaj kho mob tom qab txhaj tshuaj PRP.Cov kev saib xyuas kev kho mob zoo li txhim kho kev ua raws li kev tawm dag zog thiab txhim kho cov txiaj ntsig thiab muaj peev xwm los saib xyuas cov koob tshuaj.Ntau qhov tsim tau zoo Achilles tendon PRP kev sim ua ke nrog kev kho mob tom qab PRP nrog cov khoom siv kho mob rov ua dua tshiab raws li qhov tseem ceeb ntawm kev tsim kho tshiab.
Cov kev xav yav tom ntej thiab cov lus xaus
Cov kev kawm tau zoo ntawm PRP cov cuab yeej thiab cov txheej txheem kev npaj qhia tau hais tias cov neeg mob tau txais txiaj ntsig zoo, txawm hais tias lub ntsiab lus ntawm PRP cov tshuaj lom neeg sib txawv thiab cov yam ntxwv lom ntawm cov khoom kawg tseem tsis tau lees paub.Tsis tas li ntawd, tag nrho cov peev txheej ntawm PRP cov lus qhia thiab cov ntawv thov tsis tau txiav txim siab.Txog thaum tsis ntev los no, PRP tau ua lag luam muag raws li cov khoom lag luam autologous ntshav derivative, uas yuav muab cov kws kho mob muaj peev xwm siv autologous platelet kev loj hlob technology hauv kev qhia txog kab mob thiab kab mob.Thaum xub thawj, tib qho kev ntsuas rau kev ua tiav ntawm kev siv PRP uas feem ntau hais txog yog cov qauv npaj, uas nws cov platelet concentration siab dua tag nrho cov ntshav.Niaj hnub no, hmoov zoo, cov kws kho mob muaj kev nkag siab ntau dua ntawm kev ua haujlwm ntawm PRP.
Nyob rau hauv qhov kev tshuaj xyuas no, peb lees paub tias tseem tsis muaj cov qauv tsim thiab kev faib tawm hauv kev npaj tshuab;Yog li ntawd, tsis muaj kev pom zoo rau PRP cov tshuaj lom neeg nyob rau tam sim no, txawm hais tias ntau cov ntaub ntawv tau pom zoo rau cov tshuaj platelet concentration uas yuav tsum tau los txhawb (tshiab) angiogenesis.Ntawm no, peb tau piav qhia luv luv txog cov haujlwm ntawm PGFs, tab sis ntau qhov nthuav dav qhia txog cov txheej txheem platelet tshwj xeeb thiab cov txiaj ntsig ntawm cov qe ntshav dawb thiab MSCs, nrog rau kev sib cuam tshuam ntawm tes-cell tom ntej.Tshwj xeeb, muaj cov qe ntshav dawb nyob rau hauv cov kev npaj PRP muab kev nkag siab tob txog qhov teeb meem lossis muaj txiaj ntsig zoo.Lub luag haujlwm meej ntawm platelets thiab lawv cov kev cuam tshuam nrog lub cev thiab lub cev tiv thaiv kab mob tau raug tham.Tsis tas li ntawd, cov kev tshawb fawb soj ntsuam txaus thiab cov ntaub ntawv zoo yog xav tau los txiav txim siab tag nrho cov peev xwm thiab kev kho mob ntawm PRP hauv ntau qhov kev qhia.
(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: Mar-01-2023