Fikradda maanta loo yaqaan PRP ayaa markii ugu horreysay ka soo muuqatay goobta dhiigbaxa 1970-meeyadii.Dhakhaatiirta dhiigga waxay soo saareen ereyga PRP tobanaan sano ka hor iyagoo isku dayaya inay qeexaan balasmaha laga helay tirada platelet ee ka sarreeya qiyamka aasaasiga ah ee dhiigga durugsan.In ka badan toban sano ka dib, PRP waxaa loo isticmaalay qalliinka maxillofacial sida nooc ka mid ah fibrin-hodan ku ah platelet (PRF).Maadada fibrin ee ku jirta soosaarkan PRP ayaa qiimo weyn u leh alaabteeda xabagta iyo guriga, halka PRP ay leedahay sifooyin ka hortag ah oo joogto ah oo ay kiciso kororka unugyada.Ugu dambeyntii, qiyaastii 1990-meeyadii, PRP waxay noqotay mid caan ah, ugu dambeyntiina, tignoolajiyada waxaa loo wareejiyay goobo kale oo caafimaad.Tan iyo markaas, bayoolajigan togan ayaa si weyn loo darsay oo lagu dabaqay si loo daaweeyo dhaawacyo kala duwan oo murqaha ah ee ciyaartoyda xirfadleyda ah, taas oo sii kordhinaysa dareenka warbaahinta baahsan.Marka laga soo tago in ay wax ku ool u tahay lafaha iyo daawaynta isboortiga, PRP waxaa loo isticmaalaa daawaynta indhaha, haweenka, kaadi mareenka iyo wadnaha, dhakhtarka carruurta iyo qalliinka caagga ah.Sanadihii la soo dhaafay, PRP ayaa sidoo kale lagu ammaanay dhakhaatiirta maqaarka ee suurtogalka ah inay daaweeyaan boogaha maqaarka, dib u habeynta nabarrada, dib u soo kabashada unugyada, dib u soo kabashada maqaarka iyo xitaa timo lumis.
Iyadoo la tixgelinayo xaqiiqda ah in PRP loo yaqaano inay si toos ah u maareyso bogsashada iyo hababka bararka, bogsashada bogsashada waa in loo soo bandhigaa tixraac ahaan.Habka bogsashada waxaa loo qaybiyaa afar marxaladood oo soo socda: hemostasis;caabuq;kororka unugyada iyo matrixka, iyo ugu dambeyntii dib-u-qaabaynta dhaawaca.
1. Bogsiinta unugyada
Cascade bogsiinta nudaha ayaa la hawlgeliyay, habraaca keenaya isku-darka platelet, samaynta xinjirowga, iyo horumarinta matrix ka baxsan unugga ku meel gaadhka ah Molecules Bioactive: Platelets waxa ay ka kooban yihiin unugyo kala duwan oo noole noole ah, oo ay ku jiraan arrimaha koritaanka, chemokines, cytokines, iyo sidoo kale dhexdhexaadiyeyaasha ka hortagga bararka sida prostaglandins, prostatic cyclin, histamine, thromboxane, serotonin, iyo bradykinin.
Marxaladda ugu dambeysa ee habka bogsashada waxay ku xiran tahay dib u habeynta dhaawaca.Dib-u-habaynta unugyada si adag ayaa loo habeeyey si loo dhiso isku dheelitirnaanta u dhexeeya jawaabaha anabolic iyo catabolic.Inta lagu jiro marxaladan, factor koritaanka platelet-derived (PDGF), factor koritaanka beddelka (TGF-β) iyo fibronectin kicin faafinta iyo socdaalka ee fibroblasts, iyo sidoo kale synthesize ee qaybaha ECM.Si kastaba ha ahaatee, wakhtiga qaangaarka nabarku wuxuu inta badan ku xiran yahay darnaanta nabarka, sifooyinka shakhsi ahaaneed, iyo awoodda bogsashada gaarka ah ee nudaha dhaawacan, iyo arrimo pathophysiological iyo dheef-shiid kiimikaad qaarkood waxay saameyn karaan habka bogsashada, sida ischemia nudaha, hypoxia, caabuqa. , Isku dheelitir la'aanta qodobka koritaanka, iyo xitaa cudurrada la xidhiidha dheef-shiid kiimikaadka.
Deegaan yar-yar oo u ololeeya bararka oo farageliya habka bogsashada.Si loo adkeeyo arrimaha, waxaa sidoo kale jira firfircooni sare oo protease ah oo xannibaya ficilka dabiiciga ah ee factor koritaanka (GF).Marka lagu daro haysashada guryaha mitogenic, angiogenic, iyo kiimikaad, PRP sidoo kale waa il qani ah oo ka mid ah arrimo badan oo korriin ah, biomolecules kuwaas oo ka hortagi kara saamaynta tirtirka ah ee unugyada bararka iyada oo la xakameynayo bararka sii kordhaya iyo sameynta kicinta anabolic.Marka la eego guryahan, cilmi-baarayaashu waxay heli karaan awood weyn oo lagu daweynayo dhaawacyo adag oo kala duwan.
2. Cytokine
Cytokines ee PRP waxay door muhiim ah ka ciyaaraan maaraynta hababka dayactirka unugyada iyo nidaaminta dhaawaca bararka.Cytokines ka-hortagga caabuqa waa noocyo kala duwan oo unugyo kiimikaad ah oo dhexdhexaadiya jawaabaha cytokine-ka-bararka, oo inta badan ay keento macrophages firfircoon.Cytokines anti-bararka waxay la falgalaan xannibaadaha cytokine gaar ah iyo qaboojiyeyaasha cytokine ee milmay si ay u beddelaan bararka.Interleukin (IL) -1 antagonists reseptor, IL-4, IL-10, IL-11 iyo IL-13 ayaa loo kala saaraa sida cytokines-ka-hortagga ugu weyn.Iyadoo ku xiran nooca nabarka, qaar ka mid ah cytokines, sida interferon, leukemia inhibitory factor, TGF-β iyo IL-6, waxay soo bandhigi karaan saameyn ka hortag ah ama anti-bararka.TNF-a, IL1 iyo IL-18 waxay leeyihiin qaar ka mid ah reseptors cytokine kuwaas oo laga yaabo in ay joojiyaan saamaynta pro-bararka borotiinada kale [37].IL-10 waa mid ka mid ah cytokines ka-hortagga caabuqa ee ugu awoodda badan, waxay hoos u dhigi kartaa cytokines-ka-bararka sida IL-1, IL-6 iyo TNF-a, iyo kor u-habeeya cytokines-ka-hortagga caabuqa.Hababkan ka-hortagga sharciyeynta ayaa door muhiim ah ka ciyaara soo saarista iyo shaqada cytokines-ka-bararka.Intaa waxaa dheer, cytokines gaar ah ayaa laga yaabaa inay kiciyaan jawaabaha calaamadaha gaarka ah ee kicinaya fibroblasts, kuwaas oo muhiim u ah hagaajinta unugyada.Cytokines bararka TGFβ1, IL-1β, IL-6, IL-13, iyo IL-33 waxay kiciyaan fibroblasts si ay u kala saaraan myofibroblasts oo ay hagaajiyaan ECM [38].Taa baddalkeeda, fibroblasts-ku waxay qariyaan cytokines TGF-β, IL-1β, IL-33, CXC, iyo CC chemokines, kuwaas oo kor u qaadaya jawaabaha pro-bararka iyada oo la hawlgelinayo oo la qorayo unugyada difaaca sida macrophages.Unugyadan bararku waxay leeyihiin doorar badan oo ku yaal goobta boogta, ugu horrayn iyaga oo kor u qaadaya nadiifinta nabarrada - iyo sidoo kale biosynthesis ee kiimikooyinka, dheef-shiid kiimikaadka iyo arrimaha koritaanka, kuwaas oo lagama maarmaan u ah dib u habeynta unugyada cusub.Sidaa darteed, cytokines-ka ku jira PRP waxay door muhiim ah ka ciyaaraan kicinta jawaabaha difaaca ee dhexdhexaadiyaha ah ee nooca-unugga ah, oo wadida xallinta marxaladda bararka.Dhab ahaantii, cilmi-baarayaasha qaarkood ayaa u magacaabay geeddi-socodkan "bararka dib-u-kicinta", oo soo jeedinaya in marxaladda caabuqa, inkastoo bukaan-socodka bukaan-socodka, ay tahay tallaabo muhiim ah oo lagama maarmaan u ah habka dayactirka unugyada si loo gaaro gabagabo guul leh, iyada oo la siinayo hababka epigenetic ee calaamadaha caabuqa ay kor u qaadaan unugyada gacanta. caag.
3. Fibrin
Platelets waxay wataan dhowr arrimood oo la xiriira nidaamka fibrinolytic kuwaas oo laga yaabo inay hagaajiyaan ama hoos u dhigaan jawaabta fibrinolytic.Xidhiidhka ku meel gaadhka ah iyo ka qayb qaadashada qaybaha dhiiga iyo shaqada platelet ee hoos u dhaca xinjirowga ayaa ah arin mudan in si balaadhan looga hadlo bulshada dhexdeeda.Suugaantu waxay soo bandhigaysaa daraasado badan oo diiradda saaraya kaliya platelets, kuwaas oo loo yaqaan awoodda ay u leeyihiin inay saameyn ku yeeshaan habka bogsashada.Inkasta oo daraasado badan oo aad u fiican, qaybaha kale ee dhiig-baxa, sida arrimaha xinjirowga iyo nidaamka fibrinolytic, ayaa sidoo kale la ogaaday inay wax ku biirin muhiim ah u yihiin hagaajinta boogaha waxtarka leh.Qeexitaan ahaan, fibrinolysisku waa geedi socod bayooloji oo adag oo ku tiirsan firfircoonida enzymes qaarkood si loo fududeeyo xaalufka fibrin.Jawaabta fibrinolytic waxaa soo jeediyay qorayaasha kale in alaabooyinka hoos u dhaca fibrin (fdp) ay dhab ahaantii noqon karaan wakiilada molecular ee ka masuulka ah kicinta hagaajinta unugyada, isku xigxiga dhacdooyinka bayoolojiga ee muhiimka ah ka hor inta aan la dhigin fibrin iyo ka saarida angiogenesis, taas oo lagama maarmaan u ah bogsashada nabarrada.Sameynta xinjirowga ka dib dhaawaca wuxuu u shaqeeyaa sida lakab difaac ah oo ka ilaaliya nudaha dhiig-baxa, duulaanka wakiilada microbial, iyo sidoo kale waxay bixisaa matrix ku meel gaar ah kaas oo unugyadu ay u guuri karaan inta lagu jiro dayactirka.Xinjiraha waxaa sabab u ah kala-goynta fibrinogen ee borotiinka serine-ka iyo isku-darka platelets ee isku-xidhka isku-xiran ee isku-xidhka fibrin-ka.Dareen-celintani waxay bilaabeysaa polymerization ee monomers fibrin, dhacdada ugu weyn ee samaynta xinjirowga dhiigga.Xinjiraha sidoo kale waxay u dhaqmi karaan kayd ahaan cytokines iyo arrimaha koritaanka, kuwaas oo la sii daayo markay hoos u dhacaan platelets firfircoon.Nidaamka fibrinolytic waxaa si adag u habeeya plasmin wuxuuna door muhiim ah ka ciyaaraa kor u qaadida socdaalka unugyada, korriinka bioavailability factor, iyo nidaaminta hababka kale ee borotiinka ee ku lug leh caabuqa unugyada iyo dib u soo kabashada.Qaybaha muhiimka ah ee fibrinolysis, sida urokinase plasminogen activator receptor (uPAR) iyo plasminogen activator inhibitor-1 (PAI-1) ayaa loo yaqaanaa in lagu muujiyo unugyada tarma ee mesenchymal (MSCs) , nooc unug gaar ah oo lagama maarmaan u ah bogsashada nabarrada guuleysta.
4. Tahriibka unugga
Firfircoonida plasminogen iyada oo loo marayo ururka uPA-uPAR waa geedi socod kor u qaadaya guuritaanka unugyada bararka maadaama ay kor u qaadayso proteolysis ee ka baxsan unugyada.Mar haddii uPAR ay ka maqan tahay xayndaabyada transmembrane iyo intracellular, borotiinku wuxuu u baahan yahay la-qabayaal-qaatayaasha sida integrins iyo vitreins si loo xakameeyo socdaalka unugyada.Intaa waxaa dheer, isku-xidhka uPA-uPAR waxay keentay isku xidhnaanta uPAR ee isku xidhka vitreous iyo xuubka, kor u qaadida ku dheggan unugyada.Plasminogen activator inhibitor-1 (PAI-1) ayaa iyaduna ka saarta unugyada, baabi'inta upar-vitrein iyo integrin- marka ay ku xidho uPA ee kakanaanta uPA-upar-integrin ee dusha unugyada Isdhexgalka ee voxels galaas.
Marka la eego daawaynta dib-u-cusboonaysiinta, unugyada tarma ee mesenchymal ayaa laga soo abaabulay dhuuxa lafta iyada oo loo eegayo dhaawaca xubnaha daran sidaas awgeedna waxaa laga yaabaa in laga helo wareegga bukaanada leh jajabyo badan.Si kastaba ha ahaatee, xaalado gaar ah, sida heerka dhamaadka kelyaha ee shaqada, beerka-gabowga-dhammaadka, ama inta lagu jiro bilawga diidmada ka dib wareejinta wadnaha, unugyadan waxaa laga yaabaa inaan lagu ogaanin dhiigga [66].Waxa xiiso leh, kuwan dhuuxa lafta bini'aadamka ah ee ka soo jeeda unugyada hore ee mesenchymal (stromal) laguma ogaan karo dhiigga shakhsiyaadka caafimaadka qaba [67].Doorka uPAR ee abaabulka unugyada tarma ee mesenchymal ayaa sidoo kale hore loo soo jeediyay, oo la mid ah waxa ka dhaca abaabulka unugyada tarma ee hematopoietic (HSC).Varabaneni iyo al.Natiijooyinku waxay muujiyeen in isticmaalka cunsur-kicinta gumeysiga granulocyte ee jiirarka uPAR-yar ay sababtay guuldarada MSC-yada, mar kale xoojinta doorka taageerada ee nidaamka fibrinolytic ee socdaalka unugyada.Daraasado dheeraad ah ayaa sidoo kale muujiyay in glycosylphosylphosphatidylinositol-anchored uPA reseptors ay nidaamiyaan adhesion, hijrada, fidinta, iyo kala duwanaanta iyaga oo dhaqaajinaya qaar ka mid ah waddooyinka calaamadaynta gudaha gudaha, sida soo socota: fosphatidylinositol pro-survival 4,5-bissphate 3-kinase / Akt iyo waddooyinka ERK1 , iyo adhesion kinase (FAK).
MSC-yadu waxay muujiyeen muhiimad dheeraad ah marka la eego xaaladda bogsashada nabarrada.Tusaale ahaan, jiirarka plasminogen-ka-yar ayaa muujiyay dib u dhac aad u daran oo ku yimid dhacdooyinka bogsiinta boogaha, taasoo soo jeedinaysa in plasmin uu si ba'an ugu lug leeyahay habkan.Bini'aadamka, luminta plasmin waxay sidoo kale u horseedi kartaa dhibaatooyin bogsashada nabarka.Burburinta socodka dhiigga ayaa si weyn u joojin kara dib-u-soo-nooleynta unugyada, taas oo sharraxaysa sababta hababkan dib-u-soo-nooleynta ay aad ugu dhib badan yihiin bukaannada sonkorowga qaba.
5. Monocytes iyo Nidaamyada Dib-u-nooleynta
Sida laga soo xigtay suugaanta, waxaa jira doodo badan oo ku saabsan doorka monocytes ee bogsashada boogaha.Macrophages waxaa inta badan laga soo qaatay monocytes dhiigga waxayna ka ciyaaraan door muhiim ah daawada dib u soo kabashada [81].Maadaama neutrophils ay qarsoodi yihiin IL-4, IL-1, IL-6 iyo TNF-[alpha], unugyadani waxay caadi ahaan galaan goobta dhaawaca qiyaastii 24-48 saacadood ka dib dhaawaca.Platelets waxay sii daayaan trombobin iyo platelet factor 4 (PF4), laba kiimiko oo kor u qaada qoritaanka monocytes iyo kala soocidooda makrophages iyo unugyada dendritic.Muuqaal cajiib ah oo ka mid ah makrophages-ka ayaa ah caagnimadooda, ie, awooddooda inay u beddelaan phenotypes oo ay u beddelaan noocyada unugyada kale sida unugyada endothelial, kuwaas oo markaa soo bandhigaya hawlo kala duwan iyaga oo ka jawaabaya kicinta biochemical ee kala duwan ee microevironment nabarka.Unugyada bararku waxay muujinayaan laba nooc oo waaweyn, M1 ama M2, taas oo ku xidhan calaamadda molecular ee degaanka ee ah isha kicinta.M1 macrophages waxaa keena wakiilada microbial sidaas darteed waxay leeyihiin saameyno badan oo barar ah.Taas bedelkeeda, M2 macrophages waxaa sida caadiga ah soo saara jawaabta nooca 2 waxayna leeyihiin sifooyin anti-bararka, kuwaas oo sida caadiga ah lagu garto kororka IL-4, IL-5, IL-9, iyo IL-13.Waxa kale oo ay ku lug leedahay hagaajinta unugyada iyada oo loo marayo wax soo saarka arrimaha koritaanka.Kala-guurka M1 ilaa M2 isoforms waxaa si weyn u dhaqaajiya marxaladaha dambe ee bogsashada nabarrada, halkaasoo M1 macrophages ay kiciyaan apoptosis neutrophils oo ay bilaabaan nadiifinta unugyadaas).Phagocytosis by neutrophils waxay kicisaa silsilad dhacdooyin kaas oo wax soo saarka cytokine la damiyay, polarizing macrophages iyo sii daayo TGF-β1.Qodobka korriinka ayaa ah xakameynta muhiimka ah ee kala-soocidda myofibroblast iyo foosha nabarrada, taas oo u oggolaanaysa xallinta bararka iyo bilawga marxaladda fidinta ee bogsashada bogsashada [57].Borotiin kale oo aadka ugu xidhan oo ku lug leh hababka gacanta waa serine (SG).Granulan-kan unugyada hematopoietic-ka ah ee qarsoon ayaa la ogaaday inuu lagama maarmaan u yahay kaydinta borotiinnada qarsoon ee unugyada difaaca ee gaarka ah, sida unugyada masska, neutrophils, iyo cytotoxic T lymphocytes.Inkasta oo unugyo badan oo aan hematopoietic ah ay sidoo kale soo saaraan serotonin, dhammaan unugyada bararka waxay soo saaraan xaddi badan oo borotiinkan ah waxayna ku kaydiyaan granules si ay ula falgalaan dhexdhexaadiyeyaasha kale ee bararka, oo ay ku jiraan proteases, cytokines, chemokines, iyo factor koritaanka.Silsiladaha glycosaminoglycan (GAG) ee sida xun loo dallacay ee SG waxay u muuqdaan kuwo muhiim u ah granul homeostasis sirta ah, maadaama ay ku xidhi karaan oo ay fududayn karaan kaydinta qaybaha granule ee aadka loo dallacay ee qaab unug-, borotiin ah, iyo silsilad GAG gaar ah.Marka laga hadlayo ka-qaybgalkooda PRP, Woulfe iyo asxaabtiisu waxay hore u muujiyeen in yaraanta SG ay si xooggan ula xiriirto qaab-dhismeedka platelet oo la beddelay;cilladaha ku jira xuubka platelet 4, beta-thromglobulin, iyo kaydinta PDGF ee platelet;Isku-darka platelet-ka oo liita iyo dheecaanka in vitro iyo thrombosis ee vivo waxay sameeyaan cillado.Cilmi-baadhayaashu waxay sidaas darteed ku soo gabagabeeyeen in proteoglycan-kani uu u muuqdo inuu yahay maamulaha sare ee thrombosis.
Badeecadaha qaniga ku ah platelet waxa lagu heli karaa in la ururiyo oo la centrifeeyo dhiigga qofka oo dhan, kala saara isku darka lakabyo kala duwan oo ka kooban balaasma, platelets, leukocytes, iyo leukocytes.Marka fiirsashada platelet ay ka sarreyso qiyamka aasaasiga ah, korriinka lafaha iyo jilicsanaanta ayaa la dardargelin karaa iyada oo leh saameynaha ugu yar.Codsiga alaabada PRP ee iswada leh waa bayotechnoolajiyad cusub oo sii wadda inay muujiso natiijooyin rajo leh kicinta iyo bogsashada dhaawacyada unugyada kala duwan.Waxtarka habkan daaweynta beddelka ah waxaa loo aaneyn karaa gudbinta jirka ee arrimo badan oo koritaanka iyo borotiinada, ku dayashada iyo taageeridda bogsashada nabarrada jireed iyo hababka dayactirka unugyada.Intaa waxaa dheer, nidaamka fibrinolytic wuxuu si cad u leeyahay saameyn muhiim ah dayactirka unugyada guud.Marka lagu daro awoodda ay u leedahay inay beddesho qoritaanka unugyada unugyada bararka iyo unugyada tarma ee mesenchymal, waxay wax ka beddeleysaa dhaqdhaqaaqa borotiinka ee meelaha bogsashada nabarrada iyo inta lagu jiro dib-u-soo-nooleynta unugyada mesodermal oo ay ku jiraan lafaha, carjawda iyo murqaha, sidaas darteedna waa furaha qaybta daawada musculoskeletal.
Dardargelinta bogsashada ayaa ah yoolka aadka loo raadiyo ee ay leeyihiin xirfadlayaal badan oo dhanka caafimaadka ah, PRP-na waxay u taagan tahay aalad bayooloji oo togan oo sii wada bixinta horumarro rajo leh oo ku saabsan kicinta iyo tan si wanaagsan loo agaasimay ee dhacdooyinka dib-u-soo-nooleynta.Si kastaba ha noqotee, maadaama qalabkan daweyntu uu yahay mid adag, gaar ahaan maadaama ay sii deyso tiro badan oo arrimo noole ah iyo habab is dhexgalka kala duwan iyo saamaynta calaamadaha, daraasado dheeraad ah ayaa loo baahan yahay.
(Qoddobada maqaalkan dib ayaa loo daabacay, mana bixinno dammaanad cad ama dammaanad dhab ah oo sax ah, isku halaynta ama dhammaystirnaanta waxa ku jira maqaalkan, mas'uulna kama aha fikradaha maqaalkan, fadlan fahan.)
Waqtiga boostada: Jul-19-2022