A yau, manufar da aka fi sani da PRP ta fara bayyana a fagen ilimin jini a cikin 1970s.Masanan ilimin halittar jini sun kirkiro kalmar PRP shekarun da suka gabata don bayyana plasma da aka samu daga adadin platelet sama da ainihin ƙimar jini na gefe.Fiye da shekaru goma bayan haka, an yi amfani da PRP a cikin maxillofacial tiyata a matsayin nau'i na fibrin mai arziki a cikin platelet (PRF).Abubuwan da ke cikin fibrin a cikin wannan abin da aka samo na PRP yana da mahimmancin ƙima saboda mannewa da kuma daidaitawar halaye, yayin da PRP ya ci gaba da haɓaka kayan haɓakawa kuma yana ƙarfafa haɓakar ƙwayoyin cuta.A ƙarshe, a kusa da 1990s, PRP ta fara zama sananne.A ƙarshe, an canza wannan fasaha zuwa wasu wuraren kiwon lafiya.Tun daga wannan lokacin, irin wannan nau'in ilimin halitta mai kyau an yi nazari sosai tare da yin amfani da shi don magance raunuka daban-daban na ƙwayoyin tsoka na ƙwararrun 'yan wasa, wanda ya kara inganta hankalinsa a cikin kafofin watsa labaru.Bugu da ƙari, kasancewa mai tasiri a cikin magungunan kasusuwa da magungunan wasanni, ana kuma amfani da PRP a fannin ilimin ido, likitan mata, urology da cardiology, likitan yara da aikin filastik.A cikin 'yan shekarun nan, PRP kuma ta sami yabo daga masu ilimin fata saboda yuwuwarta na magance gyambon fata, gyara tabo, sake farfadowar nama, sabunta fata har ma da asarar gashi.
Idan akai la'akari da gaskiyar cewa PRP na iya yin amfani da hanyoyin warkarwa da ƙwayoyin cuta kai tsaye, ya zama dole don gabatar da cascade na warkarwa a matsayin tunani.An raba tsarin warkarwa zuwa matakai hudu masu zuwa: hemostasis;Kumburi;Yaɗuwar tantanin halitta da matrix, kuma a ƙarshe gyare-gyaren rauni.
Warkar da Nama
Ana kunna amsawar warakawar nama, wanda ke haifar da tarawar platelet Samuwar gudan jini da haɓaka matrix extracellular na wucin gadi (ECM).Sa'an nan, platelets suna manne wa fallasa collagen da furotin ECM, suna haifar da sakin kwayoyin halitta masu rai da ke cikin a-granules.Platelets sun ƙunshi nau'o'in kwayoyin halitta iri-iri, ciki har da abubuwan girma, abubuwan chemotherapy da cytokines, da masu shiga tsakani, irin su prostaglandin, prostate cyclin, histamine, thromboxane, serotonin da bradykinin.
Mataki na ƙarshe na aikin warkaswa ya dogara da sake fasalin rauni.An tsara gyaran gyare-gyaren nama sosai don tabbatar da daidaituwa tsakanin halayen anabolic da catabolic.A wannan mataki, nau'in haɓakar haɓakar platelet (PDGF) da canza yanayin girma (TGF-β) Fibronectin da fibronectin suna haɓaka haɓakawa da ƙaura na fibroblasts, da kuma haɗakar abubuwan ECM.Duk da haka, lokacin balagaggen rauni ya dogara da girman girman rauni, halaye na mutum da takamaiman ikon warkarwa na nama da ya ji rauni.Wasu abubuwan pathophysiological da na rayuwa na iya shafar tsarin warkaswa, irin su ischemia nama, hypoxia, kamuwa da cuta, rashin daidaituwar haɓakar haɓaka, har ma da cututtukan da ke da alaƙa da cututtukan rayuwa.
Microenvironment na proinflammatory yana tsoma baki tare da tsarin warkarwa.Mafi rikitarwa shine babban aikin protease yana hana aikin yanayin girma (GF).Bugu da ƙari ga mitotic, angiogenic da chemotactic Properties, PRP kuma mai arziki ne na yawancin abubuwan girma.Wadannan kwayoyin halittu na iya magance illa masu cutarwa a cikin kyallen takarda masu kumburi ta hanyar sarrafa ƙarar kumburi da kafa abubuwan motsa jiki na anabolic.Idan aka yi la'akari da waɗannan halaye, masu bincike na iya samun babbar dama wajen magance raunuka daban-daban.
Yawancin cututtuka, musamman ma na musculoskeletal yanayi, sun dogara sosai akan samfurori na halitta waɗanda ke tsara tsarin kumburi, irin su PRP don maganin osteoarthritis.A wannan yanayin, lafiyar guringuntsi ya dogara da daidaitaccen ma'auni na halayen anabolic da catabolic.Tare da wannan ka'ida a zuciya, amfani da wasu ingantattun ma'auni na halitta na iya tabbatar da nasara wajen cimma daidaito mai kyau.PRP saboda yana sakin platelets α- Abubuwan haɓaka da ke ƙunshe a cikin granules ana amfani dasu sosai don daidaita yuwuwar canjin nama, wanda kuma yana rage zafi.A gaskiya ma, daya daga cikin manyan manufofi na maganin PRP shine dakatar da ƙananan ƙwayoyin cuta da ƙwayoyin cuta na catabolic da kuma inganta canji zuwa magungunan ƙwayoyin cuta.Sauran marubutan sun nuna a baya cewa thrombin da aka kunna PRP yana ƙaruwa da sakin kwayoyin halitta da yawa.Wadannan abubuwan sun haɗa da haɓakar haɓakar haɓakar hanta (HGF) da ƙwayar necrosis factor (TNF-α), Canjin haɓakar haɓakar beta1 (TGF- β 1), Factor na haɓakar endothelial na jijiyoyin bugun jini (VEGF) da Factor Growth Factor (EGF).Sauran binciken sun nuna cewa PRP yana haɓaka haɓaka nau'in collagen ii collagen da aggrecan mRNA matakan, yayin da rage hana pro-inflammatory cytokine interleukin - (IL) 1 akan su.An kuma ba da shawarar cewa saboda HGF da TNF-α [28] PRP na iya taimakawa wajen kafa sakamako mai kumburi.Duk waɗannan shirye-shiryen ƙwayoyin cuta suna rage kappaB factor factor (NF-κВ) Anti kunnawa aiki da magana;Abu na biyu, ta hanyar TGF- β 1 magana kuma yana hana monocyte chemotaxis, ta haka yana magance tasirin TNF-α akan musayar chemokines.HGF yana da alama yana taka muhimmiyar rawa a cikin tasirin anti-mai kumburi da PRP ta haifar.Wannan cytokine mai ƙarfi mai ƙarfi yana lalata hanyar siginar NF-κ B da kuma maganganun cytokine na proinflammatory ya hana amsawar kumburi.Bugu da ƙari, PRP kuma na iya rage girman matakin nitric oxide (NO).Alal misali, a cikin guringuntsi na articular, an tabbatar da karuwar NO maida hankali don hana haɗin haɗin gwiwar collagen da kuma haifar da apoptosis na chondrocyte, yayin da yake ƙara haɓakar matrix metalloproteinases (MMPs), don haka inganta canji na catabolism.Dangane da lalata tantanin halitta, ana kuma la'akari da PRP don iya sarrafa autophagy na takamaiman nau'ikan tantanin halitta.Lokacin da aka kai ga yanayin tsufa na ƙarshe, wasu ƙungiyoyin tantanin halitta sun rasa yuwuwar yanayin a tsaye da sabunta kansu.Koyaya, binciken da aka yi kwanan nan ya nuna cewa maganin PRP na iya juyar da waɗannan yanayin cutarwa sosai.Moussa da abokan aiki sun tabbatar da cewa PRP na iya haifar da kariya ga chondrocytes ta hanyar haɓaka autophagy da alamomi masu kumburi, yayin da rage apoptosis na guringuntsi na osteoarthritis na mutum.Garcia Pratt et al.An ba da rahoton cewa autophagy yana ƙayyade canji tsakanin hutawa da kuma tsufa na ƙwayar ƙwayar tsoka.Masu binciken sun yi imanin cewa, a cikin vivo, daidaitawar haɗin kai na autophagy yana guje wa tarawar lalacewa ta ciki kuma yana hana tsufa da raguwar aikin tauraron dan adam.Ko da a cikin tsofaffin ƙwayoyin jikin ɗan adam, irin su kwanan nan, Parrish da Rodes kuma sun ba da gudummawa mai mahimmanci, suna ƙara bayyana yiwuwar maganin kumburi na PRP.A wannan lokacin, an mayar da hankali kan hulɗar tsakanin platelets da neutrophils.A cikin binciken da suka yi, masu binciken sun bayyana cewa platelets da aka saki ta hanyar arachidonic acid, neutrophils sun shiga cikin kwayoyin halitta kuma sun canza su zuwa leukotrienes da prostaglandins, wadanda aka sani da kwayoyin kumburi.Koyaya, hulɗar neutrophil platelet yana ba da damar canza leukotriene zuwa lipoproteins, waɗanda aka tabbatar sun zama furotin mai ƙarfi mai ƙarfi wanda zai iya iyakance kunna neutrophils kuma ya hana dialysis, da haɓaka gado zuwa mataki na ƙarshe na cascade waraka.
Microenvironment na proinflammatory yana tsoma baki tare da tsarin warkarwa.Mafi rikitarwa shine babban aikin protease yana hana aikin yanayin girma (GF).Bugu da ƙari ga mitotic, angiogenic da chemotactic Properties, PRP kuma mai arziki ne na yawancin abubuwan girma.Wadannan kwayoyin halitta na iya magance illa masu cutarwa a cikin kyallen takarda masu kumburi ta hanyar sarrafa ƙarar kumburi da kafa haɓakar anabolic.
Factor cell
Cytokines a cikin PRP suna taka muhimmiyar rawa wajen sarrafa tsarin gyaran nama da kuma daidaita lalacewar kumburi.Cytokines na anti-mai kumburi nau'ikan kwayoyin halitta ne masu yawa waɗanda ke daidaita martanin cytokines masu kumburi, galibi waɗanda aka kunna ta macrophages.Cytokines masu kumburi suna hulɗa tare da takamaiman masu hana cytokine da masu karɓar cytokine masu narkewa don daidaita kumburi.Interleukin (IL) - 1 antagonists masu karɓa, IL-4, IL-10, IL-11 da IL-13 an rarraba su azaman manyan magungunan ƙwayoyin cuta, cytokines.Dangane da nau'in raunuka daban-daban, wasu cytokines, irin su interferon, cutar sankarar bargo mai hanawa, TGF- β Da IL-6, wanda zai iya nuna proinflammatory ko anti-mai kumburi sakamako.TNF-a, IL-1 da IL-18 suna da wasu masu karɓar cytokine, wanda zai iya hana tasirin proinflammatory na sauran sunadaran [37].IL-10 yana daya daga cikin cytokines masu kumburi mafi inganci, wanda zai iya saukar da tsarin cytokines na proinflammatory irin su IL-1, IL-6 da TNF-α, Kuma sama da daidaita abubuwan anti-mai kumburi.Wadannan hanyoyin hana ka'idoji suna taka muhimmiyar rawa wajen samarwa da aiki na cytokines na proinflammatory.Bugu da ƙari, wasu cytokines na iya haifar da takamaiman amsawar sigina don tayar da fibroblasts, waɗanda ke da mahimmanci don gyaran nama.Cytokine mai kumburi TGF β 1, IL-1 β, IL-6, IL-13 da IL-33 suna motsa fibroblasts don bambanta cikin myofibroblasts da haɓaka ECM [38].Hakanan, fibroblasts suna ɓoye cytokine TGF-β, IL-1 β, IL-33, CXC da CC chemokines suna haɓaka amsawar kumburi ta hanyar kunnawa da ɗaukar ƙwayoyin rigakafi kamar macrophages.Wadannan sel masu kumburi suna taka rawa da yawa a cikin rauni, galibi ta hanyar haɓaka raunin rauni - da biosynthesis na chemokines, metabolites da abubuwan haɓaka, waɗanda ke da mahimmanci don sake gina sabbin kyallen takarda.Sabili da haka, cytokines a cikin PRP suna taka muhimmiyar rawa wajen haɓaka nau'in kwayar halitta ta hanyar amsawar rigakafi da kuma inganta haɓakar matakin kumburi.A gaskiya ma, wasu masu bincike sun ba da wannan tsari a matsayin "ƙumburi na farfadowa", yana nuna cewa matakin kumburi, duk da damuwa na mai haƙuri, mataki ne mai mahimmanci kuma mai mahimmanci don nasarar nasarar aikin gyaran nama, la'akari da tsarin epigenetic wanda kumburi ya nuna. inganta cell plasticity.
Matsayin cytokines a cikin kumburin fata na tayi yana da matukar mahimmanci ga binciken maganin farfadowa.Bambanci tsakanin hanyoyin warkar da tayin da manya shine lalacewar kyallen jikin tayi wani lokaci suna komawa zuwa asalinsu gwargwadon shekarun tayi da nau'ikan nama masu dacewa.A cikin mutane, fatar tayi na iya sake farfadowa gaba daya a cikin makonni 24, yayin da a cikin manya, warkar da raunuka na iya haifar da samuwar tabo.Kamar yadda muka sani, idan aka kwatanta da kyallen takarda masu lafiya, kayan aikin injiniya na kyallen takarda suna raguwa sosai, kuma ayyukansu suna da iyaka.An ba da kulawa ta musamman ga cytokine IL-10, wanda aka gano yana bayyana sosai a cikin ruwan amniotic da fatar tayi, kuma an tabbatar da cewa yana taka rawa wajen gyaran fatar tayi kyauta, wanda tasirin cytokine ya inganta.ZgheibC et al.An yi nazarin dashen fata na tayin zuwa ƙwanƙwasa transgenic (KO) IL-10 mice da mice masu sarrafawa.IL-10KO mice sun nuna alamun kumburi da kuma tabo a kusa da grafts, yayin da masu yin amfani da su a cikin ƙungiyar kulawa ba su nuna wani gagarumin canje-canje a cikin kayan aikin kwayoyin halitta ba kuma ba su warkar da tabo ba.
Muhimmancin daidaita ma'auni mai laushi tsakanin maganganun anti-inflammatory da pro-inflammatory cytokines shine cewa na karshen, lokacin da aka yi yawa, a ƙarshe yana aika sakonni na lalata kwayoyin halitta ta hanyar rage bayyanar wasu kwayoyin halitta.Misali, a cikin magungunan musculoskeletal, IL-1 β Down yana daidaita SOX9, wanda ke da alhakin haɓakar guringuntsi.SOX9 yana samar da mahimman abubuwan rubutu don haɓakar guringuntsi, yana daidaita nau'in II collagen alpha 1 (Col2A1), kuma yana da alhakin ɓoye nau'in ƙwayoyin collagen na II.IL-1 β A ƙarshe, an rage bayyanar Col2A1 da aggrecan.Duk da haka, an nuna jiyya tare da samfurori masu arziki na platelet don hana IL-1 β Har yanzu yana da alaƙa mai yiwuwa na maganin farfadowa don kula da maganganun kwayoyin halitta na collagen da kuma rage apoptosis na chondrocytes da aka haifar da cytokines na proinflammatory.
Ƙarfafawar Anabolic: Bugu da ƙari ga daidaita yanayin yanayin kumburi na nama mai lalacewa, cytokines a cikin PRP kuma suna shiga cikin aikin anabolic ta hanyar wasa da ayyukansu na mitosis, sha'awar sinadarai da haɓakawa.Wannan binciken in vitro ne wanda Cavallo et al.Don nazarin tasirin PRPs daban-daban akan chondrocytes na mutum.Masu binciken sun lura cewa samfuran PRP tare da ƙarancin platelet da ƙididdigar leukocyte suna haɓaka ayyukan chondrocyte na yau da kullun, wanda ke ba da gudummawa ga haɓaka wasu hanyoyin salon salula na amsawar anabolic.Misali, an lura da nau'in collagen na ii da aggregating glycans.Sabanin haka, babban taro na platelets da leukocytes suna da alama suna tada sauran hanyoyin siginar salula da suka shafi cytokines daban-daban.Mawallafa sun ba da shawarar cewa wannan na iya kasancewa saboda kasancewar adadin fararen jini mai yawa a cikin wannan tsari na PRP na musamman.Wadannan sel suna da alhakin ƙara bayyanar wasu abubuwan girma, irin su VEGF, FGF-b, da interleukins IL-1b da IL-6, wanda zai iya tayar da TIMP-1 da IL-10.A wasu kalmomi, idan aka kwatanta da ma'anar "mara kyau" PRP, cakuda PRP mai wadata a cikin platelets da fararen jini yana da alama yana inganta haɓakar dangi na chondrocytes.
Binciken da Schnabel et al.an ƙera shi don kimanta rawar da ke tattare da kwayoyin halitta masu sarrafa kansu a cikin kyallen jikin doki.Marubutan sun tattara samfuran jini da na jijiya daga dawakai matasa shida (2-4 shekaru), kuma sun mai da hankali kan nazarin tsarin maganganun kwayoyin halitta, DNA da abun ciki na collagen na jijiya na flexor digitorum superficialis na dawakai da aka haɓaka a cikin matsakaici mai ɗauke da PRP. ko wasu kayayyakin jini.An yi al'adar filaye na tendon a cikin jini, plasma, PRP, plasma deficient plasma (PPP) ko kasusuwan kasusuwa (BMA), kuma an ƙara amino acid zuwa 100%, 50% ko 10% DMEM kyauta.A cikin gudanar da bincike na biochemical da ya dace bayan…, masu binciken sun lura cewa TGF- β Adadin PPGF-BB da PDGF-1 a cikin matsakaicin PRP ya fi na sauran samfuran jini da aka gwada.Bugu da ƙari, ƙwayoyin tsoka da aka yi amfani da su a cikin 100% PRP matsakaici sun nuna yawan maganganun kwayoyin halitta na matrix proteins COL1A1, COL3A1 da COMP, amma ba su kara yawan enzymes na catabolic MMPs3 da 13. Akalla dangane da tsarin tendon, wannan a cikin vivo binciken yana goyan bayan amfani da autolo - samfurin jini na gouty, ko PRP, don maganin manyan cututtuka na mammalian.
Chen et al.An kara tattauna tasirin sake gina PRP.A cikin jerin binciken da suka gabata, masu binciken sun tabbatar da cewa, baya ga haɓaka haɓakar ƙwayar guringuntsi, PRP kuma ya inganta haɓakar haɓakar ECM kuma ya hana ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta.PRP na iya kunna TGF ta hanyar phosphorylation na Smad2 / 3- β siginar hanyar siginar yana taka muhimmiyar rawa a ci gaban cell da bambanta.Bugu da ƙari, an kuma yi imanin cewa ƙwayar fibrin da aka kafa bayan kunna PRP yana samar da ingantaccen tsari mai girma uku, yana ba da damar sel su manne, wanda zai iya haifar da gina sababbin kyallen takarda.
Sauran masu bincike sun ba da gudummawa sosai wajen magance cututtukan fata na yau da kullun a fannin ilimin fata.Wannan kuma abin lura ne.Misali, binciken da Hessler da Shyam suka gudanar a cikin 2019 ya nuna cewa PRP na da kima a matsayin mai yuwuwa kuma mai inganci madadin magani, yayin da cututtukan da ke jure wa miyagun ƙwayoyi har yanzu yana kawo babban nauyi na tattalin arziki ga kiwon lafiya.Musamman, ciwon ƙafar gyambon ƙafar ƙafafu, sanannen babbar matsala ce ta kiwon lafiya, wanda ke sa a yanke gaɓoɓi.Binciken da Ahmed et al.a cikin 2017 ya nuna cewa autologous PRP gel na iya tayar da raunin rauni a cikin marasa lafiya da ciwon ƙafar ƙafar ciwon sukari na yau da kullun ta hanyar sakin abubuwan haɓaka da suka dace, don haka inganta ƙimar waraka.Hakazalika, Gonchar da abokan aiki sun sake dubawa kuma sun tattauna yiwuwar farfadowa na PRP da ci gaban abubuwan hadaddiyar giyar don inganta maganin ciwon ƙafar ƙafar ciwon sukari.Masu binciken sun ba da shawarar cewa yin amfani da gaurayawan haɓakar haɓakar haɓaka zai iya zama mafita mai yuwuwa, wanda zai iya haɓaka fa'idodin amfani da PRP da haɓakar haɓaka guda ɗaya.Sabili da haka, idan aka kwatanta da yin amfani da nau'i mai girma guda ɗaya, haɗin PRP da sauran hanyoyin magani na iya inganta mahimmancin warkar da cututtuka na yau da kullum.
Fibrin
Platelets suna ɗauke da abubuwa da yawa masu alaƙa da tsarin fibrinolytic, wanda zai iya haɓakawa ko saukar da daidaita yanayin fibrinolytic.Dangantakar lokaci da gudunmawar dangi na abubuwan haɗin jini da aikin platelet a cikin lalatawar jini har yanzu matsala ce da ta cancanci tattaunawa mai yawa a cikin al'umma.Littattafan sun gabatar da karatu da yawa waɗanda kawai ke mayar da hankali kan platelet, waɗanda suka shahara saboda ikon su na shafar tsarin warkarwa.Duk da ɗimbin ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun jini, irin su abubuwan haɗin gwiwa da tsarin fibrinolytic, an kuma gano su don ba da gudummawa sosai ga ingantaccen gyaran rauni.Ta hanyar ma'anar, fibrinolysis shine tsarin ilimin halitta mai rikitarwa wanda ya dogara da kunna wasu enzymes don inganta lalata fibrin.Wasu mawallafa sun ba da shawarar amsawar Fibrinolysis cewa samfuran lalata fibrin (fdp) na iya zama ainihin ƙwayoyin ƙwayoyin cuta da ke da alhakin haɓaka gyaran nama.Jerin muhimman abubuwan da suka faru na nazarin halittu a baya daga fibrin jijiya da kuma cire angiogenesis, wanda ya zama dole don warkar da rauni.Samuwar ƙwanƙwasa bayan rauni yana aiki azaman kariya mai kariya don kare kyallen takarda daga asarar jini da mamaye ƙwayoyin ƙwayoyin cuta, kuma yana samar da matrix na wucin gadi ta hanyar da sel zasu iya yin ƙaura yayin aikin gyarawa.Ciwon ya faru ne saboda fibrinogen da ake toshe shi ta hanyar serine protease, kuma ana tattara platelets a cikin ragamar fibrin fiber mai alaƙa da giciye.Wannan halayen ya haifar da polymerization na fibrin monomer, wanda shine babban abin da ya faru na samuwar jini.Hakanan za'a iya amfani da gudan jini azaman tafki na cytokines da abubuwan haɓaka, waɗanda aka saki yayin lalatawar platelet ɗin da aka kunna.Tsarin fibrinolytic yana da ƙayyadaddun tsari ta hanyar plasmin, kuma yana taka muhimmiyar rawa wajen inganta ƙaura ta tantanin halitta, da bioavailability na abubuwan girma da kuma tsarin sauran tsarin protease da ke cikin kumburi na nama da farfadowa.Mahimman abubuwan da ke cikin fibrinolysis, irin su urokinase plasminogen activator receptor (uPAR) da plasminogen activator inhibitor-1 (PAI-1), an san su da za a bayyana su a cikin sel masu kara kuzari (MSCs), waɗanda nau'ikan tantanin halitta ne na musamman waɗanda ake buƙata don samun nasarar warkar da rauni. .
Hijirar Kwayoyin Halitta
Kunna plasminogen ta ƙungiyar uPA uPAR tsari ne da ke haɓaka ƙaura na ƙwayoyin kumburi saboda yana haɓaka proteolysis na waje.Saboda rashin transmembrane da yanki na cikin salula, uPAR yana buƙatar masu karɓar haɗin gwiwa kamar integrin da vitllin don daidaita ƙaura ta tantanin halitta.Ya kuma nuna cewa ɗaurin uPA uPAR ya haifar da haɓakar alaƙar uPAR don vitrectonectin da integrin, wanda ke haɓaka mannewar tantanin halitta.Plasminogen activator inhibitor-1 (PAI-1) bi da bi yana sa sel su rabu.Lokacin da ya ɗaure da uPA na uPA na hadaddun integrin na uPA akan saman tantanin halitta, yana lalata hulɗar da ke tsakanin upar vitellin da integrin vitellin.
A cikin yanayin maganin farfadowa, ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta ta haifar da lalacewa ta jiki mai tsanani.Koyaya, a cikin takamaiman lokuta, irin su gazawar renal na ƙarshen mataki, gazawar hanta na ƙarshe, ko yayin ƙin yarda bayan dashen zuciya, waɗannan ƙwayoyin cuta bazai iya gano su cikin jini [66].Abin sha'awa shine, waɗannan ƙwayoyin kasusuwa na ɗan adam waɗanda aka samu mesenchymal (stromal) sel masu tasowa ba za a iya gano su a cikin jinin mutane masu lafiya ba [67].An ba da shawarar rawar da uPAR ke takawa a cikin tattarawar ƙwayoyin jijiyoyi na ƙasusuwan kasusuwa (BMSCs) a baya, wanda yayi kama da abin da ya faru na uPAR a cikin ƙaddamar da ƙwayoyin hematopoietic stem cell (HSCs).Varabaneni et al.Sakamakon ya nuna cewa yin amfani da granulocyte colony-stimulating factor a cikin rashi na uPAR ya haifar da gazawar MSC, wanda ya sake ƙarfafa aikin goyon bayan tsarin fibrinolysis a cikin ƙaura ta cell.Har ila yau, ƙarin nazarin ya nuna cewa glycosyl phosphatidylinositol mai karɓa na uPA yana daidaita mannewa, ƙaura, haɓakawa da bambance-bambance ta hanyar kunna wasu hanyoyin siginar intracellular, kamar haka: phosphatidylinositol mai tsira 4,5-diphosphate 3-kinase / Akt da ERK1/2 da siginar sigina. (FAK).
A cikin mahallin warkar da rauni na MSC, fibrinolytic factor ya tabbatar da ƙarin mahimmancinsa.Alal misali, ƙananan ƙwayoyin plasminogen sun nuna jinkiri mai tsanani a cikin abubuwan da ke warkar da raunuka, yana nuna cewa plasmin yana da mahimmanci a cikin wannan tsari.A cikin mutane, asarar plasmin kuma na iya haifar da rikitarwa na warkar da rauni.Katsewar jini yana iya hana haɓakar nama sosai, wanda kuma ya bayyana dalilin da yasa waɗannan hanyoyin haɓakawa suka fi ƙalubale ga marasa lafiya da ciwon sukari.
An dauki kwayoyin jikin kasusuwa mesenchymal zuwa wurin rauni don hanzarta warkar da rauni.A ƙarƙashin ingantattun yanayi, waɗannan ƙwayoyin sun bayyana uPAuPAR da PAI-1.Sunadaran guda biyu na ƙarshe sune abubuwan da ba za su iya haifar da hypoxia ba α (HIF-1 α) Targeting yana da matukar dacewa saboda HIF-1 a cikin MSCs α Kunna FGF-2 da HGF sun haɓaka ƙa'idodin FGF-2 da HGF;HIF-2 α Bi da bi, VEGF-A [77] an inganta shi, wanda tare yana taimakawa wajen warkar da rauni.Bugu da kari, HGF da alama tana inganta daukar daukar ma'aikata boneyment sel metence sel cikin wuraren rauni a cikin yanayin synergistic.Dole ne a lura cewa an nuna yanayin ischemic da hypoxic don tsoma baki sosai tare da gyaran rauni.Kodayake BMSCs suna rayuwa a cikin kyallen takarda waɗanda ke samar da ƙananan matakan oxygen, rayuwar BMSC da aka dasa a cikin vivo ya zama iyakance saboda ƙwayoyin da aka dasa sau da yawa suna mutuwa a ƙarƙashin mummunan yanayi da aka gani a cikin kyallen takarda.Makomar mannewa da rayuwa na ƙwanƙolin kasusuwa mesenchymal stem cell a ƙarƙashin hypoxia ya dogara da abubuwan fibrinolytic da waɗannan ƙwayoyin suka ɓoye.PAI-1 yana da babban kusanci ga vitellin, don haka zai iya yin gasa don ɗaure uPAR da integrin zuwa vitllin, ta haka yana hana mannewar tantanin halitta da ƙaura.
Monocyte da Tsarin farfadowa
Bisa ga wallafe-wallafen, akwai tattaunawa da yawa game da rawar monocytes a cikin warkar da raunuka.Macrophages galibi sun fito ne daga monocytes na jini kuma suna taka muhimmiyar rawa a cikin maganin farfadowa [81].Saboda neutrophils suna ɓoye IL-4, IL-1, IL-6 da TNF-α, Wadannan ƙwayoyin suna shiga cikin rauni game da 24-48 hours bayan rauni.Platelets sun saki thrombin da kuma platelet factor 4 (PF4), wanda zai iya inganta daukar nauyin monocytes kuma ya bambanta cikin macrophages da dendritic sel.Wani muhimmin fasalin macrophages shine filastik su, wato, za su iya canza nau'in halitta kuma su bambanta zuwa wasu nau'in tantanin halitta, irin su sel endothelial, sa'an nan kuma suna nuna ayyuka daban-daban zuwa nau'i-nau'i daban-daban na kwayoyin halitta a cikin microenvironment na rauni.Kwayoyin kumburi suna bayyana manyan abubuwa biyu, M1 ko M2, dangane da siginar kwayoyin halitta na gida a matsayin tushen kuzari.M1 macrophages ana haifar da su ta hanyar ƙananan ƙwayoyin cuta, don haka suna da ƙarin tasiri mai tasiri.Sabanin haka, M2 macrophages yawanci ana samar da su ta nau'in halayen 2 kuma suna da kaddarorin anti-mai kumburi, yawanci ana nuna haɓakar IL-4, IL-5, IL-9, da IL-13.Har ila yau, yana shiga cikin gyaran nama ta hanyar samar da abubuwan girma.Juyin mulki daga M1 zuwa M2 subtype yana da tasiri sosai ta ƙarshen matakin warkar da rauni.M1 macrophages yana haifar da neutrophil apoptosis kuma ya fara kawar da waɗannan sel).phagocytosis na neutrophils yana kunna jerin abubuwan da suka faru, wanda aka kashe samar da cytokines, polarizing macrophages da sakewa TGF- 1. Wannan haɓakar haɓaka shine babban mai kula da bambancin myofibroblast da raunin rauni, wanda ya ba da damar ƙuduri na kumburi farkon lokacin yaduwa a cikin warakawar waraka [57].Wani sunadaran da ke da alaƙa da ke cikin tsarin salula shine serine (SG).An gano wannan ƙwayar hemopoietic cell secretory granule proteoglycan ya zama dole don adana sunadarai na sirri a cikin takamaiman ƙwayoyin rigakafi, kamar ƙwayoyin mast, neutrophils da cytotoxic T lymphocytes.Ko da yake yawancin ƙwayoyin da ba na hematopoietic ba suma suna haɗa plasminogen, duk ƙwayoyin kumburi suna samar da adadi mai yawa na wannan furotin kuma suna adana shi a cikin granules don ƙarin hulɗa tare da sauran masu shiga tsakani, ciki har da proteases, cytokines, chemokines da abubuwan girma.Sarƙoƙin glycosaminoglycan (GAG) maras kyau a cikin SG suna da alama suna da mahimmanci ga kwanciyar hankali na granules na sirri, saboda suna iya ɗaurewa da sauƙaƙe ma'ajiyar abubuwan da aka caje da gaske a cikin tantanin halitta, furotin, da takamaiman sarkar GAG.Game da shigar da su a cikin binciken PRP, Woulfe da abokan aiki sun nuna a baya cewa rashi na SG yana da alaƙa da sauye-sauyen morphological platelet;Matsakaicin Platelet 4 β- Rashin lahani na ajiyar PDGF a cikin thromboglobulin da platelets;Rashin haɓakar platelet da ɓarna a cikin vitro da lahani na thrombosis a cikin vivo.Saboda haka masu binciken sun kammala cewa wannan proteoglycan alama shine babban mai kula da thrombosis.
Abubuwan da ke da wadatar platelet za su iya samun cikakken jinin mutum ta hanyar tattarawa da tarawa, kuma su rarraba cakuda zuwa yadudduka daban-daban waɗanda ke ɗauke da plasma, platelets, farin jini da farin jini.Lokacin da ƙwayar platelet ya fi girma fiye da ƙimar asali, zai iya hanzarta ci gaban kashi da nama mai laushi, tare da ƙananan sakamako masu illa.Aiwatar da samfuran PRP mai sarrafa kansa wani sabon ilimin kimiyyar halittu ne, wanda ya ci gaba da nuna kyakkyawan sakamako a cikin ƙarfafawa da haɓaka warkar da raunuka daban-daban.Ana iya danganta tasirin wannan madadin hanyar magani ga isar da gida na nau'ikan abubuwan haɓaka da furotin don yin kwaikwaya da tallafawa aikin warkar da rauni na jiki da tsarin gyaran nama.Bugu da ƙari, tsarin fibrinolytic a fili yana da tasiri mai mahimmanci akan dukan gyaran nama.Bugu da ƙari, canza ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar kuma kuma tana iya tsara aikin proteolytic na wuraren warkar da raunuka da kuma sake farfadowa na kyallen takalma na mesodermal, ciki har da kashi, guringuntsi da tsoka, don haka yana da mahimmancin bangaren. maganin musculoskeletal.
Gaggauta waraka ita ce manufar da ƙwararru da yawa ke bi a fannin likitanci.PRP tana wakiltar ingantaccen kayan aikin ilimin halitta, wanda ke ci gaba da samar da ci gaba mai ban sha'awa a cikin haɓakawa da daidaita abubuwan da suka faru na sabuntawa.Duk da haka, saboda har yanzu wannan kayan aikin warkewa yana da matukar rikitarwa, musamman saboda yana fitar da abubuwan da ba su da yawa na bioactive da hanyoyin hulɗarsu daban-daban da tasirin sigina, ana buƙatar ƙarin bincike.
(Ana sake buga abubuwan da ke cikin wannan labarin, kuma ba mu bayar da garantin bayyananne ko bayyananniyar garanti don daidaito, amintacce ko cikar abubuwan da ke cikin wannan labarin ba, kuma ba mu da alhakin ra'ayoyin wannan labarin, da fatan za a fahimta.)
Lokacin aikawa: Dec-16-2022