ʻIke Hou no ka Platelet Rich Plasma (PRP) Therapy - Māhele II

PRP o kēia wā: “PRP Clinical”

I nā makahiki he 10 i hala iho nei, ua hoʻololi nui ʻia ka papahana lapaʻau o PRP.Ma o ka noiʻi hoʻokolohua a me ka noiʻi lapaʻau, ua ʻoi aku ka maikaʻi o kā mākou ʻike i ka platelet a me nā physiology cell ʻē aʻe.Eia kekahi, ua hōʻike ka nui o nā loiloi ʻōnaehana kiʻekiʻe, nā meta-analyses a me nā hoʻāʻo hoʻokele randomized i ka maikaʻi o ka biotechnology PRP i nā lāʻau lapaʻau he nui, e like me ka dermatology, ka ʻoki ʻana i ka naʻau, ka ʻoki plastik, ka ʻoki orthopedic, ka mālama ʻana i ka ʻeha, nā maʻi spinal, a me nā lāʻau lapaʻau. .

ʻO ka hiʻohiʻona o ka PRP i kēia manawa ʻo ia kona ʻano platelet paʻa, e hoʻololi ana mai ka wehewehe mua ʻana o PRP (me ka platelet concentration kiʻekiʻe aʻe ma mua o ka helu kumu) i ʻoi aku ma mua o 1 × 10 6/µ L a i ʻole 5 mau manawa o ka palena haʻahaʻa platelet ma nā platelets mai laina kumu.Ma ka loiloi nui a Fadadu et al.Ua loiloi ʻia nā ʻōnaehana PRP a me nā protocols 33.ʻO ka helu platelet o ka hoʻomākaukau PRP hope i hana ʻia e kekahi o kēia mau ʻōnaehana he haʻahaʻa ma mua o ke koko holoʻokoʻa.Ua hōʻike lākou i ka piʻi ʻana o ka platelet factor o PRP ma lalo o 0.52 me ka pahu wili hoʻokahi (Selphyl®).ʻO ka hoʻokaʻawale ʻana, ʻelua-rotation EmCyte Genesis PurePRPII ® ʻO ka pae platelet i hana ʻia e ka hāmeʻa ka mea kiʻekiʻe loa (1.6 × 10 6 /µL) .

ʻO ka ʻoiaʻiʻo, ʻaʻole ʻo ka in vitro a me nā ʻano holoholona ka wahi noiʻi kūpono no ka hoʻololi kūleʻa i ka hana lapaʻau.Pēlā nō, ʻaʻole kākoʻo ka haʻawina hoʻohālikelike ʻana i ka hoʻoholo ʻana, no ka mea, hōʻike lākou he ʻokoʻa loa ka pae platelet ma waena o nā polokalamu PRP.ʻO ka mea pōmaikaʻi, ma o ka ʻenehana a me ka nānā ʻana i ka proteomics, hiki iā mākou ke hoʻonui i ko mākou ʻike i nā hana cell i PRP e pili ana i nā hopena lapaʻau.Ma mua o ka ʻae ʻana i ka hoʻomākaukau ʻana a me ka hoʻomākaukau ʻana o ka PRP maʻamau, pono ʻo PRP e hahai i nā ʻōnaehana PRP lāʻau lapaʻau e hoʻolaha i nā mīkini hoʻoponopono kino nui a me nā hopena lapaʻau holomua.

PRP lāʻau lapaʻau

I kēia manawa, ua ʻike ʻia ka PRP lapaʻau maikaʻi (C-PRP) ma ke ʻano he hui paʻakikī o nā ʻāpana multicellular autologous i loko o ka plasma liʻiliʻi i loaʻa mai kahi ʻāpana o ke koko peripheral ma hope o ka centrifugation.Ma hope o ka centrifugation, hiki ke hoʻihoʻi hou ʻia ka PRP a me kāna mau ʻāpana cell non-platelet mai ka mea hoʻomohala e like me nā density cell like ʻole (ʻo ia ka haʻahaʻa o ka platelet density).

E hoʻohana i ka PurePRP-SP ® Cell density separation lako (EmCyte Corporation, Fort Myers, FL, USA) i hoʻohana ʻia no ke koko holoʻokoʻa ma hope o ʻelua mau kaʻina centrifugation.Ma hope o ke kaʻina hana centrifugation mua, ua hoʻokaʻawale ʻia ke koko holoʻokoʻa i ʻelua papa kumu, platelet (lean) plasma suspension a me ka ʻulaʻula ʻulaʻula.Ma A, ua pau ka lua o ka centrifugation.Hiki ke unuhi ʻia ka nui PRP maoli no ka noi maʻi.Hōʻike ka hoʻonui ʻana i ka B i ka hoʻonohonoho ʻia ʻana o nā ʻāpana erythrocyte sedimentation brown layer (e hōʻike ʻia e ka laina polū) ma lalo o ka mea hana, aia nā kiʻekiʻe o nā platelets, monocytes a me nā lymphocytes, e pili ana i ka gradient density.Ma kēia laʻana, e like me ka C-PRP hoʻomākaukau protocol me nā neutrophils maikaʻi ʻole, e unuhi ʻia ka hapa liʻiliʻi o nā neutrophils (<0.3%) a me nā erythrocytes (<0.1%).

Platelet granule

I ka hoʻohana mua ʻana o ka PRP, ʻo α- Granules ka mea maʻamau i ʻōlelo ʻia i loko o ka platelet internal structure, no ka mea, loaʻa iā lākou nā kumu coagulation, kahi nui o PDGF a me nā mea hoʻoponopono angiogenic, akā he liʻiliʻi ka hana thrombogenic.ʻO nā kumu ʻē aʻe e pili ana i nā ʻāpana chemokine a me nā cytokine i ʻike ʻole ʻia, e like me ka platelet factor 4 (PF4), pre-platelet basic protein, P-selectin (he mea hoʻoikaika o ka integrin) a me chemokine RANTES (hoʻoponopono ʻia e ka hoʻāla ʻana, e hōʻike ana i nā cell T maʻamau a me ka manaʻo paha. huna).ʻO ka hana holoʻokoʻa o kēia mau mea kikoʻī platelet granule ʻo ia ke kiʻi a hoʻōla i nā cell immune ʻē aʻe a i ʻole ka hoʻoulu ʻana i ka mumū o ka endothelial cell.

ʻO nā mea kikoʻī kikoʻī e like me ADP, serotonin, polyphosphate, histamine a me adrenaline i hoʻohana nui ʻia e like me nā regulators o ka platelet activation a me ka thrombosis.ʻO ka mea nui loa, ʻo ka nui o kēia mau mea i loaʻa ka hana o ka hoʻololi ʻana i nā cell immune.ʻIke ʻia ʻo Platelet ADP e P2Y12ADP receptor ma nā cell dendritic (DC), pēlā e hoʻonui ai i ka antigen endocytosis.He mea koʻikoʻi loa ka DC (antigen presenting cell) no ka hoʻomaka ʻana i ka pane immune cell T a me ka hoʻomalu ʻana i ka pane immune pale, kahi e hoʻopili ai i ka ʻōnaehana immune innate a me ka ʻōnaehana immune adaptive.Eia kekahi, hoʻouna ka platelet adenosine triphosphate (ATP) i nā hōʻailona ma o T cell receptor P2X7, e alakaʻi ana i ka hoʻonui ʻana i ka hoʻokaʻawale ʻana o nā pūnaewele kōkua CD4 T i nā pūnaewele proinflammatory T helper 17 (Th17).ʻO nā mea ʻē aʻe platelet dense granule (e like me ka glutamate a me ke serotonin) e hoʻoulu i ka neʻe ʻana o ka cell T a hoʻonui i ka ʻokoʻa monocyte i DC.I ka PRP, ua hoʻonui nui ʻia kēia mau immunomodulators i loaʻa mai nā ʻāpana paʻa a loaʻa i nā hana pale kino.

ʻO ka nui o nā pilina kūpono a pololei ʻole ma waena o nā platelets a me nā mea ʻē aʻe (receptor) he nui.No laila, hiki i ka hoʻohana ʻana o PRP i loko o ke kaiapuni pathological kūloko ke hoʻoulu i nā ʻano hopena inflammatory.

Pākuʻi platelet

Pono e loaʻa i ka C-PRP nā puʻupuʻu lapaʻau o nā platelet concentrated e hana i nā hopena therapeutic pono.Pono nā platelets ma C-PRP e hoʻoulu i ka hoʻonui ʻana o ka cell, ka synthesis o nā mesenchymal a me nā mea neurotrophic, e hoʻoikaika i ka neʻe ʻana o nā cell chemotactic a hoʻoulu i ka hana immunoregulatory, e like me ka mea i hōʻike ʻia ma ke kiʻi.

Hoʻopili ʻia nā platelets, hoʻokuʻu i ka PGF a me nā molekole adhesion i nā ʻano like ʻole o ke kelepona: chemotaxis, cell adhesion, migration, a me nā cell differentiation, a hoʻoponopono i nā hana hoʻoponopono immune.Hāʻawi kēia mau pāpili cell-cell platelet i ka angiogenesis a me ka hana inflammatory, a i ka hopena e hoʻoulu i ke kaʻina hana hoʻoponopono.Nā pōkole: BMA: iwi iwi aspirate, EPC: endothelial progenitor cell, EC: endothelial cell, 5-HT: 5-hydroxytryptamine, RANTES: hoʻoponopono ʻia o ka hōʻike cell T maʻamau a me ka huna huna, JAM: junction adhesion mole type type, CD40L: cluster 40 ligand, SDF-1 α： Stromal cell-derived factor-1 α， CXCL: chemokine (CXC motif) ligand, PF4: platelet factor 4. Hoʻololi ʻia mai Everts et al.

ʻO Marx ka mea mua i hōʻoia i ka hoʻōla ʻana o ka iwi a me ka ʻiʻo palupalu, a ʻo ka helu platelet haʻahaʻa he 1 × 10 6 /µL. 1.3 × Ma 106 platelets/µ L, ua hōʻike kēia haʻawina i ka hui ʻana.Eia kekahi, ʻo Giusti et al.Hōʻike ʻia 1.5 × ʻO ka mīkini hoʻoponopono kikoʻī ma kahi maʻa o 109 pono i nā platelets / mL e hoʻoulu i ka angiogenesis hana ma o ka hana cell endothelial.Ma ka haʻawina hope loa, ʻoi aku ka nui o ka hoʻohaʻahaʻa i ka angiogenesis o nā platelets i loko a puni nā follicles.Eia kekahi, ua hōʻike ʻia nā ʻike mua e pili ana ka hopena o ka PRP i nā hopena lapaʻau.No laila, i mea e hoʻoulu nui ai i ka pane angiogenesis a hoʻoulu i ka hoʻonui ʻana o ke kelepona a me ka neʻe ʻana o ke kelepona, pono e loaʻa iā C-PRP ma ka liʻiliʻi he 7.5 i loko o ka ʻōmole lapaʻau 5-mL PRP × 10 9 hiki ke hāʻawi i nā platelets.

Ma waho aʻe o ka hilinaʻi maʻamau, ʻo ka hopena o ka PRP i ka hana kelepona me he mea lā e hilinaʻi nui ʻia i ka manawa.ʻO Sophie et al.Hōʻike kēia mau hualoaʻa e hiki ke hoʻoulu i ka hoʻonui ʻana o ka iwi iwi a me ka chemotaxis.ʻO ka mea ʻē aʻe, ʻo ka ʻike lōʻihi i ka PRP e alakaʻi i nā pae haʻahaʻa o ka alkaline phosphatase a me ka hoʻokumu mineral.

ʻulaʻula koko

Na ke koko ʻulaʻula ke kuleana no ka lawe ʻana i ka oxygen i nā ʻiʻo a me ka hoʻoili ʻana i ka carbon dioxide mai nā ʻiʻo i ka māmā.ʻAʻohe o lākou nucleus a ua haku ʻia me nā molekole heme e hoʻopaʻa i nā protein.ʻO nā mea hao a me ka heme i loko o ke koko ʻulaʻula e paipai i ka hui pū ʻana o ka oxygen a me ke kalapona kalapona.ʻO ka maʻamau, ʻo ke kaʻina ola o nā ʻulaʻula ʻulaʻula ma kahi o 120 mau lā.Lawe ʻia lākou mai ke kahe ʻana e nā macrophages ma o kahi kaʻina i kapa ʻia ʻo RBC aging.Hiki ke hōʻino ʻia nā sela koko ʻulaʻula i loko o nā laʻana PRP ma lalo o nā kūlana shear (no ka laʻana, ke ʻoki koko holoʻokoʻa, ka hana immune-mediated, ke koʻikoʻi oxidative a i ʻole ke kūpono ʻole o ka PRP concentration scheme).No laila, hoʻoheheʻe ʻia ka membrane cell RBC a hoʻokuʻu i ka hemoglobin ʻona (Hb), ana ʻia e ka plasma free hemoglobin (PFH), heme a me ka hao.].ʻO ka PFH a me kāna mau huahana hoʻohaʻahaʻa (heme a me ka hao) e alakaʻi i nā hopena pōʻino a cytotoxic ma nā ʻiʻo, e alakaʻi ana i ke koʻikoʻi oxidative, ka nalowale o ka nitric oxide, ka hoʻāla ʻana o nā ala ʻeha a me ka immunosuppression.ʻO kēia mau hopena e alakaʻi i ka microcirculation dysfunction, vasoconstriction kūloko a me ka hōʻeha vascular, a me ka pōʻino kino nui.

ʻO ka mea nui loa, ʻo ia ke hāʻawi ʻia ʻo RBC i loko o ka C-PRP i ka ʻiʻo, e hana ia i kahi hopena kūloko i kapa ʻia eryptosis, kahi e hoʻomaka ai ka hoʻokuʻu ʻana i kahi cytokine kūpono a me ka macrophage migration inhibitor.Mālama kēia cytokine i ka neʻe ʻana o nā monocytes a me nā macrophages.Hoʻohana ʻo ia i nā hōʻailona pro-inflammatory ikaika i nā ʻiʻo a puni, ke kāohi nei i ka neʻe ʻana o nā cell stem a me ka hoʻonui ʻana o ka fibroblast, a alakaʻi i ka hana ʻino o ka cell kūloko.No laila, he mea nui e kaupalena i ka hoʻohaumia RBC i ka hoʻomākaukau PRP.Eia kekahi, ʻaʻole i hoʻoholo ʻia ke kuleana o ke koko ʻulaʻula i ka hoʻolaʻa hou ʻana o nā kiko.ʻO ka centrifugation C-PRP kūpono a me ke kaʻina hoʻomākaukau e hōʻemi a hoʻopau paha i ka noho ʻana o nā keʻena koko ʻulaʻula, pēlā e pale ai i nā hopena ʻino o ka hemolysis a me ka polycythemia.

Leukocytes ma C-PRP

ʻO ka loaʻa ʻana o nā keʻokeʻo keʻokeʻo i loko o ka hoʻomākaukau ʻana i ka PRP e pili ana i nā lako lapaʻau a me ka papa hana hoʻomākaukau.I loko o nā lako PRP e pili ana i ka plasma, ua hoʻopau loaʻia nā keʻokeʻo keʻokeʻo;Eia nō naʻe, ua hoʻopaʻa nui ʻia nā keʻokeʻo keʻokeʻo i ka hoʻomākaukau PRP o ka erythrocyte sedimentation brown layer.Ma muli o kāna mau hana pale pale a me nā mea hoʻokipa, hoʻopilikia nui ʻia nā keʻokeʻo keʻokeʻo i ka biology kūloko o nā maʻi ʻiʻo a me ka maʻi mau.E kūkākūkā hou ʻia kēia mau hiʻohiʻona ma lalo nei.No laila, hiki i ka loaʻa ʻana o nā leukocytes kikoʻī i ka C-PRP ke hoʻoulu i nā hopena cellular a me nā kiko.ʻOi aku ke kikoʻī, hoʻohana ʻia nā ʻōnaehana papa melemele PRP erythrocyte sedimentation brown-yellow i nā papa hoʻomākaukau like ʻole, pēlā e hana ai i nā ʻāpana like ʻole o nā neutrophils, lymphocytes a me nā monocytes i PRP.ʻAʻole hiki ke ana ʻia nā eosinophils a me nā basophils i ka hoʻomākaukau ʻana i ka PRP no ka mea ʻoi aku ka palupalu o ko lākou mau cell membranes e pale aku i nā ikaika hana centrifugal.

Neutrophils

He mau leukocytes koʻikoʻi nā Neutrophils ma nā ala ho'ōla.Hoʻohui kēia mau ala me nā protein antimicrobial i loko o nā platelets e hana i kahi pale paʻa i nā pathogens invasive.Hoʻoholo ʻia ka noho ʻana o nā neutrophils e like me ka pahuhopu mālama o C-PRP.Hiki ke koi ʻia ka piʻi ʻana o ka ʻāʻana o ka ʻiʻo i ka mālama ʻeha mau ʻana i ka biotherapy PRP a i ʻole i nā noi e pili ana i ka ulu ʻana o ka iwi a hoʻōla paha.ʻO ka mea nui, ua loaʻa nā hana neutrophil hou i loko o kekahi mau hiʻohiʻona, e hoʻoikaika ana i kā lākou kuleana i ka angiogenesis a me ka hoʻoponopono ʻana i nā kiko.Eia nō naʻe, hiki i nā neutrophils ke hana i nā hopena pōʻino, no laila ʻaʻole kūpono lākou no kekahi mau noi.Ua hōʻoia ʻo Zhou lāua ʻo Wang i ka hoʻohana ʻana i ka PRP waiwai i nā neutrophils hiki ke alakaʻi i ka hoʻonui ʻana i ka ratio o ke ʻano III collagen i ka type I collagen, pēlā e hoʻonui ai i ka fibrosis a me ka hoʻohaʻahaʻa ʻana i ka ikaika tendon.ʻO nā hiʻohiʻona ʻino ʻē aʻe i hoʻopili ʻia e nā neutrophils ʻo ia ka hoʻokuʻu ʻana o nā cytokine inflammatory a me matrix metalloproteinases (MMPs), hiki ke hoʻoikaika i ka mumū a me ka catabolism ke hoʻopili ʻia i nā ʻiʻo.

Leukomonocyte

I ka C-PRP, ʻoi aku ka nui o nā lymphocytes mononuclear T a me B ma mua o nā keʻokeʻo keʻokeʻo ʻē aʻe.Pili loa lākou i ka cell-mediated cytotoxic adaptive immunity.Hiki i nā Lymphocytes ke hoʻoulu i nā hopena cell e hakakā i ka maʻi a hoʻololi i nā mea hoʻouka.Eia kekahi, hoʻonui ka T-lymphocyte cytokines (interferon-γ [IFN-γ] A me interleukin-4 (IL-4) i ka polarization o macrophages. ke kumu hoʻohālike iole ma ka hoʻoponopono ʻana i ka ʻokoʻa o nā monocytes a me nā macrophages.

Monocyte - ke kelepona hoʻoponopono multipotent

Wahi a ka mea hoʻomākaukau PRP i hoʻohana ʻia, hiki i nā monocytes ke puka a ʻaʻole i loko o ka ʻōmole lapaʻau PRP.ʻO ka mea pōʻino, ʻaʻole i kamaʻilio ʻia kā lākou hana a me ka hana hou ʻana ma ka palapala.No laila, liʻiliʻi ka nānā ʻana i nā monocytes i ke ʻano hoʻomākaukau a i ʻole ke ʻano hope.He ʻokoʻa ka pūʻulu monocyte, mai nā pūnaewele progenitor i loko o ka iwi iwi, a lawe ʻia i nā ʻiʻo peripheral ma o ke ala ʻo hematopoietic stem cell e like me ka microenvironment stimulation.I ka wā o ka homeostasis a me ka mumū, haʻalele ka monocytes i ke kahe koko a lawe ʻia i nā ʻiʻo i hōʻeha ʻia a hoʻohaʻahaʻa paha.Hiki iā lākou ke hana ma ke ʻano he macrophages (M Φ) Effector cell a progenitor cell.ʻO nā monocytes, macrophages a me nā cell dendritic e hōʻike ana i ka mononuclear phagocytic system (MPS).I nā ʻiʻo degenerated, nā macrophages noho, nā mea ulu ulu kūloko, nā cytokine pro-inflammatory, apoptotic a necrotic cell a me nā huahana microbial e hoʻomaka i nā monocytes e hoʻokaʻawale i nā pūʻulu cell MPS.Inā paha e hoʻokomo ʻia ka C-PRP i loko o nā monocytes kiʻekiʻe i loko o ka microenvironment kūloko o ka maʻi, e ʻokoʻa paha nā monocytes i M Φ No ka hoʻololi ʻana i nā kelepona nui.

Mai ka monocyte i ka M Φ I ke kaʻina hana o ka hoʻololi, kikoʻī M Φ Phenotype.I nā makahiki he ʻumi i hala iho nei, ua hoʻomohala ʻia kahi kumu hoʻohālike, e hoʻohui pū ana i ka M Φ Ua wehewehe ʻia ka mīkini paʻakikī o ka hoʻoulu ʻana e like me ka polarization o nā mokuʻāina kūʻē ʻelua: M Φ Phenotype 1 (M Φ 1, Classic activation) a me M Φ Phenotype 2 (M Φ 2, ho'āla hou).Hōʻike ʻia ka M Φ 1 e ka inflammatory cytokine secretion (IFN-γ) A me ka nitric oxide e hana i ka hana pepehi pathogen kūpono.M Φ Hoʻopuka pū ka phenotype i ka mea ulu endothelial vascular (VEGF) a me ka fibroblast growth factor (FGF).M Φ Hoʻokumu ʻia ka phenotype me nā ʻāpana anti-inflammatory me ka phagocytosis kiʻekiʻe.M Φ 2 Hoʻopuka i nā ʻāpana matrix extracellular, angiogenesis a me chemokines, a me interleukin 10 (IL-10).Ma waho aʻe o ka pale pathogen, M Φ Hiki iā ia ke hōʻemi i ka mumū a hoʻoikaika i ka hoʻoponopono kino.ʻIke ʻia ua māhele ʻia ʻo M Φ 2 i M in vitro Φ 2a、M Φ 2b a me M Φ 2. Aia ma muli o ka hoʻoulu ʻana.He mea paʻakikī ka unuhi ʻana o kēia mau ʻano subtype in vivo no ka mea aia paha i loko o ka ʻiʻo nā hui M Φ hui ʻia.ʻO ka mea e mahalo ai, ma muli o nā hōʻailona kaiapuni kūloko a me nā pae IL-4, hiki ke hoʻohuli ʻia ka proinflammatory M Φ 1 e hoʻoikaika i ka hoʻoponopono ʻana M Φ 2. Mai kēia mau ʻikepili, he mea kūpono ke manaʻo ʻia aia nā kiʻekiʻe kiʻekiʻe o nā monocytes a me nā M Φ C-PRP hoʻomākaukau. Hiki ke kōkua i ka hoʻoponopono ʻana i ka ʻiʻo ʻoi aku ka maikaʻi no ka mea ua loaʻa iā lākou ka hoʻoponopono ʻana i ka ʻiʻo anti-inflammatory a me ka hiki ke hoʻololi i ka hōʻailona cell.

Ka wehewehe huikau o ka hakina koko keʻokeʻo ma PRP

ʻO ka loaʻa ʻana o nā keʻokeʻo keʻokeʻo i loko o nā ʻōmole lapaʻau PRP e pili ana i ka mea hoʻomākaukau PRP a loaʻa paha nā ʻokoʻa nui.Nui nā hoʻopaʻapaʻa e pili ana i ka noho ʻana o nā leukocytes a me kā lākou hāʻawi ʻana i nā huahana sub-PRP like ʻole (e like me PRGF, P-PRP, LP-PRP, LR-PRP, P-PRF a me L-PRF) Ma kahi loiloi hou, ʻeono randomized. nā ho'āʻo hoʻomalu (pae hōʻike 1) a me ʻekolu mau haʻawina hoʻohālikelike (pae hōʻike 2) i pili i nā maʻi 1055, e hōʻike ana he palekana like ka LR-PRP a me LP-PRP.Ua hoʻoholo ka mea kākau ʻaʻole pili pono ka hopena ʻino o ka PRP i ka neʻe ʻana o nā keʻokeʻo keʻokeʻo.Ma kekahi noiʻi ʻē aʻe, ʻaʻole i hoʻololi ʻo LR-PRP i ka interleukin inflammatory (IL-1) ma ke kuli OA β、 IL-6, IL-8 a me IL-17).Kākoʻo kēia mau hopena i ka manaʻo e hiki mai ana ke kuleana o nā leukocytes i ka hana olaola o PRP in vivo mai ke kamaʻilio ʻana ma waena o nā platelets a me nā leukocytes.Hiki i kēia pilina ke hoʻoikaika i ka biosynthesis o nā mea ʻē aʻe (e like me ka lipoxygen), hiki ke hoʻopau a hoʻoikaika paha i ka regression o ka mumū.Ma hope o ka hoʻokuʻu mua ʻana o nā molekole inflammatory (achidonic acid, leukotriene a me prostaglandin), hoʻokuʻu ʻia ka lipoxygen A4 mai nā platelets i hoʻāla ʻia e pale i ka hoʻoulu ʻana o neutrophil.Aia i loko o kēia kaiapuni ka M Φ Phenotype mai M Φ 1 E hoʻololi i ka M Φ 2. Eia kekahi, ke hoʻonui nei nā hōʻike e hiki ke hoʻokaʻawale i nā cell mononuclear e hoʻokaʻawale i nā ʻano ʻano cell non-phagocytic ma muli o ko lākou pluripotency.

E pili ana ke ʻano o ka PRP i ka moʻomeheu MSC.Ke hoʻohālikelike ʻia me nā laʻana PRP a i ʻole PPP maʻemaʻe, hiki i ka LR-PRP ke hoʻoulu i ka hoʻonui nui ʻana o nā MSC i loaʻa i ka iwi iwi iwi (BMMSCs), me ka hoʻokuʻu wikiwiki ʻana a me ka hana olaola PGF maikaʻi.He kūpono kēia mau hiʻohiʻona a pau i ka hoʻohui ʻana i nā monocytes i loko o ka ʻōmole lapaʻau PRP a ʻike i ko lākou hiki immunomodulatory a me ka hiki ke hoʻokaʻawale.

ʻO ka hoʻoponopono kino kino a me ka adaptive o PRP

ʻO ka hana physiological kaulana loa o nā platelets ke kāohi i ke koko.Hōʻiliʻili lākou ma ka pūnaewele hōʻino kino a me nā kīʻaha koko i hōʻino ʻia.Hoʻokumu ʻia kēia mau hanana e ka hōʻike ʻana o nā integrins a me nā koho e hoʻoulu ai i ka platelet adhesion a me ka hoʻohui.ʻO ka endothelium i pōʻino ke hoʻonui i kēia kaʻina hana, a ʻo ka collagen i hōʻike ʻia a me nā protein subendothelial matrix ʻē aʻe e hoʻoikaika i ka hoʻōla hohonu o nā platelets.I kēia mau hihia, ua hōʻoia ʻia ka hana nui o ka pilina ma waena o von Willebrand factor (vWF) a me glycoprotein (GP), ʻoi aku ka GP-Ib.Ma hope o ka hoʻoulu ʻana o ka platelet, platelet α-、 Dense, lysosome a me T-granules e hoʻoponopono i ka exocytosis a hoʻokuʻu i kā lākou mau mea i loko o ke kaiapuni extracellular.

ʻO ka molekele adhesion platelet

I mea e hoʻomaopopo maikaʻi ai i ke kuleana o ka PRP i nā ʻiʻo inflammatory a me nā platelets i ka pane immune, pono mākou e hoʻomaopopo i ke ʻano o nā ʻokoʻa platelet surface receptors (integrins) a me junction adhesion molecules (JAM) a me nā pilina pūnaewele hiki ke hoʻomaka i nā kaʻina hana koʻikoʻi i ka innate a me ka adaptive immunity.

ʻO ka Integrins nā molekele adhesion surface cell i loaʻa i nā ʻano cell like ʻole a hōʻike ʻia i ka nui ma nā platelets.Hoʻohui pū ʻia ka a5b1, a6b1, a2b1 LFA-2, (GPIa/IIa) a me aIIbb3 (GPIIb/IIIa).ʻO ka mea maʻamau, aia lākou ma kahi kūlana static a haʻahaʻa.Ma hope o ka hoʻoulu ʻana, hoʻololi lākou i ka mokuʻāina o ka pilina pili ligand kiʻekiʻe.Loaʻa i nā Integrins nā hana like ʻole ma nā platelets a komo i ka launa pū ʻana o nā platelets me nā ʻano o ke koko keʻokeʻo keʻokeʻo, nā ʻāpana endothelial a me ka matrix extracellular.Eia kekahi, hōʻike ʻia ka paʻakikī GP-Ib-V-IX ma ka membrane platelet a ʻo ia ka mea loaʻa nui no ka hoʻopaʻa ʻana me von vWF.Hoʻopili kēia pilina i ka pilina mua ma waena o nā platelets a me nā hale subendothelial i hōʻike ʻia.ʻO ka platelet integrin a me ka GP complex e pili ana i nā kaʻina hana inflammatory like ʻole a pāʻani i kahi hana koʻikoʻi i ka hoʻokumu ʻana o ka platelet-leucocyte complex.ʻO ka mea kikoʻī, pono ka integrin aIIbb3 e hana i kahi paʻa paʻa ma ka hoʻohui ʻana i ka fibrinogen me ka macrophage 1 antigen (Mac-1) receptor ma nā neutrophils.

Hōʻike nā platelets, neutrophils a me nā cell endothelial vascular i nā molekole adhesion cell, i kapa ʻia ʻo selectin.Ma lalo o nā kūlana inflammatory, hōʻike nā platelets i ka P-selectin a me ka neutrophil L-selectin.Ma hope o ka hoʻoulu ʻana o ka platelet, hiki i ka P-selectin ke hoʻopaʻa i ka ligand PSGL-1 e noho nei ma nā neutrophils a me nā monocytes.Eia kekahi, hoʻomaka ka hoʻopaʻa ʻana o PSGL-1 i ka hopena intracellular signal cascade, e hoʻāla ai i nā neutrophils ma o neutrophil integrin Mac-1 a me ka antigen 1 pili i ka hana lymphocyte (LFA-1).Hoʻopili ʻia ʻo Mac-1 i GPIb a i ʻole GPIIb/IIIa ma nā platelets ma o fibrinogen, no laila e hoʻopaʻa i ka pilina ma waena o nā neutrophils a me nā platelets.Eia hou, hiki i ka LFA-1 ho'āla ke hui pū me ka platelet intercellular adhesion mole 2 e hoʻopaʻa hou i ka paʻakikī neutrophil-platelet e hāpai i ka hoʻopili lōʻihi me nā cell.

He kuleana koʻikoʻi nā platelets a me nā leukocytes i nā pane kūlohelohe kūlohelohe

Hiki i ke kino ke ʻike i nā kino ʻē a me nā ʻiʻo ʻeha i nā maʻi ʻeha a i ʻole nā ​​​​maʻi maʻi e hoʻomaka ai i ka hoʻōla ʻana i ka ʻeha a me ke ala ʻeha.ʻO nā ʻōnaehana pale kino maoli a me ka adaptive pale i ka mea hoʻokipa mai ka maʻi, a he kuleana koʻikoʻi nā keʻokeʻo keʻokeʻo keʻokeʻo i ke kau ʻana ma waena o nā ʻōnaehana ʻelua.ʻO ke kikoʻī, ʻo nā monocytes, macrophages, neutrophils a me nā cell killer maoli ke kuleana nui i ka ʻōnaehana innate, aʻo nā lymphocytes a me kā lākou mau subsets e pāʻani like i ka ʻōnaehana immune adaptive.

ʻO ka pilina platelet a me ka leukocyte i loko o ka pilina pili kino.Hoʻopili ka Platelet me nā neutrophils a me nā monocytes, a ma hope me M Φ Interact, hoʻoponopono a hoʻonui i kā lākou mau hana effector.ʻO kēia mau pilina platelet-leucocyte e alakaʻi i ka mumū ma o nā ʻano hana like ʻole, me ka NETosis.Nā pōkole: MPO: myeloperoxidase, ROS: nā ʻano oxygen reactive, TF: kiko kiko, NET: neutrophil extracellular trap, NF- κ B: Nuclear factor kappa B, M Φ： Macrophages.

Pūnaehana kino kino

ʻO ke kuleana o ka ʻōnaehana immune innate ʻo ia ka ʻike ʻole ʻana i nā microorganism invasive a i ʻole nā ​​ʻāpana kiko a hoʻoulu i ko lākou ʻae ʻana.Ke hoʻohui ʻia kekahi mau hale molekala i kapa ʻia ʻo surface expression pattern recognition receptors (PRRs) me nā kumu molekala pili pathogen a me nā ʻano molekala pili i ka pōʻino, e hoʻāla ʻia ka ʻōnaehana pale kino.Nui nā ʻano PRR, e like me Toll-like receptor (TLR) a me RIG-1 like receptor (RLR).Hiki i kēia mau mea loaʻa ke hoʻāla i ka mea transcription nui kappa B (NF-κ B) Hoʻoponopono pū ia i nā ʻano he nui o ka pane kūlohelohe kūlohelohe a adaptive.ʻO ka mea mahalo, hōʻike pū nā platelets i nā ʻano molekole immunoregulatory receptor ma ko lākou ʻili a me ka cytoplasm, e like me P-selectin, transmembrane protein CD40 ligand (CD40L), cytokines (e like me IL-1 β, TGF-β) A me TLR kikoʻī platelet. . No laila, hiki i nā platelets ke launa pū me nā ʻano ʻokoʻa like ʻole.

Platelet-keʻokeʻo pilina pili i loko o ka innate immunity

Ke komo nā platelets i ke kahe o ke koko a i ʻole ka ʻiʻo, ʻo nā platelets kekahi o nā cell e ʻike mua i ka ʻeha endothelial a me nā pathogens microbial.Platelet aggregation a hoʻoikaika i ka hoʻokuʻu ʻana o nā platelet agonists ADP, thrombin a me vWF, ka hopena i ka hoʻoulu ʻana o ka platelet a me ka hōʻike ʻana o nā platelet chemokine receptors C, CC, CXC a me CX3C, no laila e hoʻoulu ai i nā platelets i ka wahi i hoʻopilikia ʻia a i ʻole ʻeha.

Hoʻonohonoho mua ʻia ka ʻōnaehana immune innate no ka ʻike ʻana i nā mea hoʻouka kaua, e like me nā maʻi virus, bacteria, parasites a me nā toxins, a i ʻole nā ​​ʻeha a me nā ʻeha.He ʻōnaehana kikoʻī ʻole ia, no ka mea, e ʻike ʻia kekahi pathogen he haole a i ʻole nona iho a loaʻa koke.Ke hilinaʻi nei ka ʻōnaehana pale kūlohelohe i kahi pūʻulu o nā protein a me nā phagocytes, ka mea e ʻike i nā ʻano i mālama maikaʻi ʻia o nā pathogens a hoʻōla koke i ka pane kūlohelohe e kōkua i ka hoʻopau ʻana i nā mea hoʻouka kaua, ʻoiai inā ʻaʻole i hōʻike ʻia ka host i nā pathogens ma mua.

ʻO nā neutrophils, monocytes a me nā cell dendritic ka mea maʻamau i loko o ke koko.Pono kā lākou hōʻiliʻili ʻana no ka pane ʻana i ka immune mua.Ke hoʻohana ʻia ʻo PRP i ka lāʻau lapaʻau hou, hoʻoponopono ka pilina platelet-keʻokeʻo i ka mumū, hoʻōla ʻeha a me ka hoʻoponopono ʻana i nā kiko.Hoʻoulu ka TLR-4 ma nā platelets i ka pilina platelet-neutrophil, kahi e hoʻoponopono ai i ka mea i kapa ʻia ʻo leukocyte oxidative burst ma ka hoʻoponopono ʻana i ka hoʻokuʻu ʻana o nā ʻano oxygen reactive (ROS) a me myeloperoxidase (MPO) mai nā neutrophils.Eia kekahi, ʻo ka pilina ma waena o platelet-neutrophil a me neutrophil degranulation alakaʻi i ka hoʻokumu ʻana o nā neutrophil-extracellular traps (NETs).Hoʻokumu ʻia nā NET me ka neutrophil nucleus a me nā mea ʻē aʻe neutrophil intracellular contents, hiki ke hopu i ka bacteria a pepehi iā lākou ma o NETosis.ʻO ka hoʻokumu ʻana i nā NETs kahi hana pepehi koʻikoʻi o nā neutrophils.

Ma hope o ka hoʻoulu ʻana o ka platelet, hiki i nā monocytes ke neʻe i nā ʻiʻo maʻi a me ka degenerative, kahi e hana ai lākou i nā hana adhesion a hūnā i nā molekole inflammatory e hoʻololi i ka chemotaxis a me nā waiwai proteolytic.Eia hou, hiki i nā platelets ke hoʻoulu i ka monocyte NF-κ B ho'āla e hoʻoponopono i ka hana effector o nā monocytes,ʻo ia ka mea hoʻolaha nui o ka pane inflammatory a me ka hoʻouluʻana a me ka hoʻokaʻawaleʻana o nā pūnaewele immune.Hoʻolaha hou nā platelets i ka puʻu oxidative endogenous o nā monocytes e hāpai i ka luku ʻana i nā pathogens phagocytic.Hoʻopili ʻia ka hoʻokuʻu ʻana o MPO e ka pilina pololei ma waena o platelet-monocyte CD40L-MAC-1.ʻO ka mea e mahalo ai, i ka wā e hoʻāla ai ʻo P-selectin i nā platelets ma lalo o nā kūlana inflammatory acute a me ka maʻi, nā chemokines i loaʻa i ka platelet PF4, RANTES, IL-1 β A hiki i ka CXCL-12 ke pale i ka apoptosis kūʻokoʻa o nā monocytes, akā hoʻolaha i ko lākou ʻokoʻa i loko o nā macrophages.

Pūnaehana palekana kūpono

Ma hope o ka ʻike ʻana o ka ʻōnaehana pale kino ʻole i ka pōʻino microbial a i ʻole ka ʻiʻo, e lawe ʻia ka ʻōnaehana immune adaptive kikoʻī.Loaʻa nā ʻōnaehana hoʻololi i nā lymphocytes B-binding antigen (B cell) a me nā lymphocytes T maʻamau (Treg) e hoʻonohonoho i ka wehe ʻana o nā pathogens.Hiki ke hoʻokaʻawale ʻia nā pūnaewele T i nā pūnaewele T kōkua (Th cell) a me nā pūnaewele T cytotoxic (nā pūnaewele Tc, ʻike ʻia hoʻi ʻo T killer cell).Hoʻokaʻawale houʻia nā pūnaewele Th i nā pūnaewele Th1, Th2 a me Th17, he mau hana koʻikoʻi i ka mumū.Hiki i nā pūnaewele ke hūnā i nā cytokine proinflammatory (eg IFN-γ、 TNF-β） A me kekahi mau interleukins (eg, IL-17). He mea pono loa ia i ka pale ʻana i ka maʻi maʻi intracellular a me ka maʻi bacteria. ʻO nā pūnaewele Tc he mau cell effector, hiki ke hoʻopau i nā microorganisms intracellular a me extracellular i manaʻo ʻia.

ʻO ka mea e mahalo ai, hoʻopuka nā pūnaewele Th2 i ka IL-4 a hoʻopili i ka M Φ Polarization, M Φ Guided regeneration M Φ 2 Phenotype, aʻo IFN-γ M Φ Hoʻololi i ka inflammatory M Φ 1 Phenotype, e pili ana i ka nui a me ka manawa o nā cytokines.Ma hope o ka ho'ā 'ia 'ana o ka IL-4, ho'oulu 'o M Φ 2 i nā pūnaewele Treg e ho'oka'awale i loko o nā pūnaewele Th2, a laila e ho'opuka i ka IL-4 hou aku (lopako mana'o maika'i).Hoʻololi nā pūnaewele Th M Φ Kuhi ʻia ka phenotype i ka phenotype regenerative i ka pane ʻana i nā mea ola kino o ke kumu kiko.Hoʻokumu ʻia kēia ʻano hana i nā hōʻike e hana nui ana nā cell Th i ka hoʻomalu ʻana i ka mumū a me ka hoʻoponopono ʻana i nā kiko.

Platelet-keʻokeʻo pilina pili i adaptive immunity

Hoʻohana ka ʻōnaehana immune adaptive i nā mea hoʻokipa antigen-specific a hoʻomanaʻo i nā pathogens i ʻike mua ʻia, a luku iā lākou i ka wā e hālāwai ai me ka mea hoʻokipa.Eia naʻe, ua ulu mālie kēia mau pane immune adaptive.Konias et al.Hōʻike ia i ka ʻāpana platelet e hāʻawi i ka ʻike pilikia a me ka hoʻoponopono ʻana i ka ʻiʻo, a ʻo ka launa pū ʻana ma waena o nā platelets a me nā leukocytes e hoʻoikaika i ka hoʻoulu ʻana o ka pane kūlohelohe adaptive.

I ka wā o ka adaptive immune response, hoʻolaha nā platelets i nā pane monocyte a me macrophage ma o DC a me NK cell maturation, e alakaʻi ana i nā pane kikoʻī T cell a me B.No laila, pili pono nā ʻāpana platelet granule i ka palekana adaptive ma o ka hōʻike ʻana i ka CD40L, he mole e pono ai no ka hoʻoponopono ʻana i ka pane ʻana i ka immune adaptive.ʻAʻole pāʻani wale nā ​​​​platelets ma CD40L i ka hōʻike antigen, akā pili pū kekahi i ka hopena cell T.Liu et al.Ua ʻike ʻia e hoʻoponopono nā platelets i ka pane ʻana o ka cell CD4 T ma kahi ala paʻakikī.ʻO kēia hoʻoponopono ʻokoʻa o nā ʻāpana cell CD4 T, ʻo ia ka mea e hoʻolalelale ai nā platelets i nā cell CD4 T e pane i nā hoʻoulu ʻana, no laila e hana i nā pane pro-inflammatory a anti-inflammatory ikaika.

Hoʻoponopono pū nā platelets i ka pane adaptive i hoʻopili ʻia e ka cell B cell i nā pathogens microbial.Ua ʻike maopopo ʻia ʻo CD40L ma nā pūnaewele CD4 T i hoʻāla ʻia e hoʻāla i ka CD40 o nā pūnaewele B, e hāʻawi ana i ka hōʻailona lua e pono ai no ka hoʻāla ʻana o ka lymphocyte B-cell-cell, ka hoʻololi ʻana o allotype ma hope, a me ka ʻokoʻa a me ka hoʻonui ʻana o nā cell B.Ma keʻano laulā, hōʻike maopopo nā hopena i nā hana like ʻole o nā platelets i ka adaptive immunity, e hōʻike ana i ka hoʻopili ʻana o nā platelets i ka pilina ma waena o nā cell T a me nā cell B ma o CD40-CD40L, no laila e hoʻonui ai i ka pane ʻana o ka cell T-cell B.Eia kekahi, waiwai nui nā platelets i nā mea hoʻokipa o ka ʻili, hiki ke hoʻoikaika i ka hoʻoulu ʻana o ka platelet a hoʻokuʻu i ka nui o nā molekele inflammatory a me ka biological i mālama ʻia i loko o nā ʻāpana platelet like ʻole, no laila e hoʻopili ai i ka pane kūlohelohe a me ka adaptive.

Hoʻonui i ka hana o ka serotonin i loaʻa i ka platelet ma PRP

He kuleana koʻikoʻi ko Serotonin (5-hydroxytryptamine, 5-HT) i loko o ka ʻōnaehana nerve waena (CNS), me ka hoʻomanawanui ʻana i ka ʻeha.Ua manaʻo ʻia ʻo ka hapa nui o ka 5-HT kanaka i hana ʻia i loko o ka ʻōpū o ka ʻōpū a laila ma o ke kahe koko, kahi e hoʻomoʻa ʻia e nā platelets ma o ka serotonin reuptake transporter a mālama ʻia i loko o nā ʻāpana paʻa i ke kiʻekiʻe kiʻekiʻe (65 mmol/L).ʻO 5-HT kahi neurotransmitter kaulana a me ka hormone e kōkua i ka hoʻoponopono ʻana i nā kaʻina neuropsychological like ʻole i CNS (central 5-HT).Eia nō naʻe, aia ka hapa nui o ka 5-HT ma waho o CNS (peripheral 5-HT), a pili ia i ka hoʻoponopono ʻana i nā hana ola kino ʻōnaehana a me ke kelepona o nā ʻōnaehana o nā mea he nui, e like me ka cardiovascular, lung, gastrointestinal, urogenital and platelet functional system.Loaʻa ka 5-HT i ka metabolism e hilinaʻi nui ʻia ma nā ʻano cell like ʻole, me nā adipocytes, nā epithelial cell a me nā keʻokeʻo keʻokeʻo.ʻO ka Peripheral 5-HT kekahi mea hoʻololi kino ikaika, hiki iā ia ke hoʻoulu a keʻakeʻa paha i ka mumū a hoʻopilikia i nā ʻano cell immune ma o kāna mea hoʻokipa 5-HT kikoʻī (5HTR).

Paracrine a me autocrine mechanical o HT

Hoʻopili ʻia ka hana o 5-HT e kona launa pū ʻana me 5HTRs, he ʻohana nui ia me ʻehiku mau lālā (5-HT 1 - 7) a ma kahi o 14 mau subtypes ʻokoʻa like ʻole, me ka lālā i ʻike hou ʻia ʻo 5-HT 7, kona peripheral a hana i ka hooponopono eha.I ke kaʻina hana o ka platelet degranulation, hoʻōla ʻia nā platelets i kahi helu nui o ka platelet i loaʻa i ka 5-HT, hiki ke hoʻoikaika i ka hoʻohaʻahaʻa vascular a hoʻoulu i ka hoʻoulu ʻana o nā platelets a me nā lymphocytes e pili ana ma o ka hōʻike ʻana o 5-HTR ma nā cell endothelial, nā ʻiʻo ʻiʻo maʻemaʻe a nā pūnaewele immune.Pacala et al.Ua aʻo ʻia ka hopena mitotic o 5-HT ma nā ʻāpana endothelial vascular, a ua hoʻoholo ʻia ka hiki ke hāpai i ka ulu ʻana o nā kīʻaha koko i hōʻino ʻia e ka hoʻoulu ʻana i ka angiogenesis.ʻAʻole maopopo loa ke ʻano o ka hoʻoponopono ʻana o kēia mau kaʻina hana, akā hiki ke komo i nā ala ala ʻelua ʻokoʻa i loko o ka microcircuit kiko e hoʻoponopono i nā hana o nā pūnaewele endothelial vascular a me nā ʻiʻo ʻiʻo maʻemaʻe, nā fibroblasts a me nā cell immune ma o nā mea loaʻa 5-HT kikoʻī ma kēia mau pūnaewele. .Ua wehewehe ʻia ka hana autocrine o ka platelet 5-HT ma hope o ka hoʻāla ʻana o ka platelet [REF].ʻO ka hoʻokuʻu ʻana o 5-HT e hoʻonui i ka hoʻoulu ʻana o nā platelets a me ka hoʻoulu ʻana o nā platelets circulating, e alakaʻi ana i ka hoʻāla ʻana o nā hopena cascade hōʻailona a me nā hopena upstream e kākoʻo ana i ka hana platelet.

Immunomodulatory 5-HT hopena

Hōʻike nā hōʻike hou aʻe e hiki i ke serotonin ke pāʻani i ka 5HTR ʻokoʻa ma ke ʻano he modulator immune.Wahi a ka 5HTR i hōʻike ʻia i loko o nā leukocytes like ʻole e pili ana i ka hopena inflammatory, hana ʻo 5-HT i loaʻa i ka platelet ma ke ʻano he mea hoʻoponopono pale i nā ʻōnaehana kūlohelohe a me ka adaptive.Hiki i ka 5-HT ke hoʻoulu i ka hoʻonui ʻana o Treg a hoʻoponopono i nā hana o nā cell B, nā mea pepehi maoli a me nā neutrophils ma o ka lawe ʻana i DC a me nā monocytes i ka pūnaewele inflammatory.Ua hōʻike ʻia nā haʻawina hou e hiki ke hoʻoponopono i ka hana o nā cell immune ma lalo o nā kūlana kikoʻī.No laila, me ka hoʻohana ʻana i ka C-PRP, ʻoi aku ka nui o ka platelet ma mua o 1 × 10 6/µ L hiki ke kōkua nui i ka lawe ʻana i ka neʻe o ka 5-HT i loaʻa mai nā platelets nui i ka ʻiʻo.I loko o ka microenvironment i hōʻike ʻia e nā ʻāpana inflammatory, hiki i ka PRP ke launa pū me kekahi mau cell immune e pāʻani i kahi koʻikoʻi i kēia mau pathologies, hiki ke hoʻopilikia i nā hopena lapaʻau.

Kiʻi e hōʻike ana i ka pane 5-HT multifaceted ma hope o ka hoʻāla ʻana o nā platelets PRP inflammatory.Ma hope o ka hoʻoulu ʻana o nā platelets, hoʻokuʻu nā platelets i kā lākou granules, me ka 5-HT i loko o nā granules paʻa, kahi ākea o nā hopena ʻokoʻa i nā ʻano like ʻole o nā cell immune, nā endothelial cell a me nā ʻiʻo ʻiʻo maʻemaʻe.Nā pōkole: SMC: nā ʻiʻo ʻiʻo maʻemaʻe, EC: endothelial cell, Treg: T lymphocytes maʻamau, M Φ: Macrophages, DC: dendritic cell, IL: interleukin, IFN-γ: Interferon γ。 Hoʻololi ʻia a hoʻololi ʻia mai Everts et al.a me Hull et al.

Ka hopena analgesic o PRP

E hoʻokuʻu nā platelets i hoʻoulu ʻia i nā mea hoʻolaha pro-inflammatory a me nā anti-inflammatory, ʻaʻole hiki ke hōʻeha wale i ka ʻeha, akā e hōʻemi hoʻi i ka ʻeha a me ka ʻeha.Ke hoʻohana ʻia, hoʻololi ka dynamics platelet maʻamau o PRP i ka microenvironment ma mua o ka hoʻoponopono ʻana a me ka hana hou ʻana ma o nā ala paʻakikī e pili ana i ka anabolism a me ka catabolism, ka hoʻonui ʻana o ka cell, ka ʻokoʻa a me ka hoʻoponopono ʻana i nā cell cell.Ke alakaʻi nei kēia mau hiʻohiʻona o ka PRP i ka hoʻohana ʻana i ka PRP i nā ʻano maʻi pathological like ʻole e pili pū ana me ka ʻeha mau loa (e like me ka hōʻeha haʻuki, ka maʻi orthopedic, ka maʻi spinal a me ka ʻeha maʻi paʻakikī), ʻoiai ʻaʻole i hoʻoholo piha ʻia ka mīkini pololei.

Ma 2008, Evertz et al.ʻO ia ka hoʻāʻo mua i hoʻopaʻa ʻia e hōʻike i ka hopena analgesic o ka hoʻomākaukau ʻana o PRP, i hoʻomākaukau ʻia mai ka papa brown o ka autologous erythrocyte sedimentation rate a hoʻāla ʻia me ka thrombin autologous ma hope o ka ʻoki ʻana i ka poʻohiwi.Ua ʻike lākou i ka hōʻemi nui ʻana o nā helu analogue scale, ka hoʻohana ʻana i nā analgesics e pili ana i ka opioid, a me ka hoʻoponopono hou ʻana ma hope o ka hana.He mea nui ia e hōʻike ana i ka hopena analgesic o nā platelets i hoʻāla ʻia a noʻonoʻo i ke ʻano o nā platelets e hoʻokuʻu ana i ka 5-HT.I ka pōkole, moe nā platelets i ka PRP i hoʻomākaukau hou ʻia.Ma hope o ka ho'āla ʻia ʻana o nā platelets pololei a ʻole paha (tissue factor), hoʻololi nā platelets i ke ʻano a hoʻopuka i ka wahaheʻe e hoʻoikaika i ka platelet aggregation.A laila, hoʻokuʻu lākou i ka intracellular α- A me nā ʻāpana paʻa.ʻO ka ʻiʻo i mālama ʻia me ka PRP hoʻāla ʻia e hoʻouka ʻia e PGF, cytokines a me nā lysosomes platelet ʻē aʻe.ʻOi aku ka kikoʻī, i ka wā e hoʻokuʻu ai nā mea kikoʻī i kā lākou ʻike, e hoʻokuʻu lākou i kahi nui o 5-HT e hoʻoponopono ai i ka ʻeha.I ka C-PRP, he 5 a 7 mau manawa ke kiʻekiʻe o ka platelet ma mua o ke koko peripheral.No laila, he astronomical ka hoʻokuʻu ʻana o 5-HT mai nā platelets.ʻO ka mea hoihoi, ʻo Sprott et al.Ua ʻike ʻia ka hōʻike ua hoʻomaha nui ʻia ka ʻeha ma hope o ka acupuncture a me ka moxibustion, ua hoʻemi nui ʻia ka pae o ka platelet i loaʻa iā 5-HT, a laila ua hoʻonui ʻia ka pae plasma o 5-HT.

Ma ka peripheral, platelets, mast cell a me endothelial cell e hoʻokuʻu i ka endogenous 5-HT i ka wā o ka hōʻeha kino a i ʻole ka hōʻeha hōʻeha.ʻO ka mea e mahalo ai, ua ʻike ʻia nā ʻano ʻokoʻa o 5-HT o nā neurons i ka ʻāpana peripheral, ka mea i hōʻoia e hiki i ka 5-HT ke hoʻopilikia i ka hoʻouna nociceptive i ka ʻāpana peripheral.Hōʻike kēia mau haʻawina e hiki i ka 5-HT ke hoʻopili i ka hoʻoili nociceptive o nā ʻiʻo peripheral ma o 5-HT1, 5-HT2, 5-HT3, 5-HT4 a me 5-HT7 nā mea hoʻokipa.

ʻO ka'ōnaehana 5-HT kahi pūnaewele ikaika e hiki ke ho'ēmi a hoʻonui i ke kiʻekiʻe o kaʻeha ma hope o ka hoʻouluʻana i nā meaʻino.Ua hōʻikeʻia ke kikowaena a me ke kikowaena o nā hōʻailona nociceptive a me nā loli i ka pūnaewele 5-HT i nā maʻi me kaʻeha mau.I nā makahiki i hala iho nei, ua nui ka nui o nā haʻawina i kālele ʻia i ke kuleana o 5-HT a me kāna mau mea loaʻa i ka hoʻoponopono ʻana a me ka hoʻoponopono ʻana i ka ʻike ʻino, ka hopena o nā lāʻau lapaʻau e like me selective serotonin reuptake inhibitors (SSRI).Hoʻopau kēia lāʻau lapaʻau i ka reuptake o ke serotonin i loko o nā neurons presynaptic ma hope o ka hoʻokuʻu ʻana o ke serotonin.Hoʻopilikia ia i ka lōʻihi a me ka ikaika o ke kamaʻilio serotonin a he lāʻau lapaʻau ʻē aʻe no ka ʻeha mau.Pono e noiʻi hou aʻe e hoʻomaopopo pono i ke ʻano molekala o ka hoʻoponopono ʻeha 5-HT i loaʻa i ka PRP i nā maʻi maʻi a me nā maʻi degenerative.

Hiki ke kiʻi ʻia nā ʻikepili ʻē aʻe no ka hoʻoponopono ʻana i ka hopena analgesic o ka PRP ma hope o ka hoʻāʻo ʻana o nā holoholona analgesic.He paʻakikī ka hoʻohālikelike ʻana i nā hopena helu helu ma kēia mau hiʻohiʻona no ka mea he nui loa nā ʻano like ʻole o kēia mau haʻawina.Eia naʻe, ua kamaʻilio kekahi mau noiʻi lapaʻau i nā hopena nociceptive a me analgesic o PRP.Ua hōʻike ʻia kekahi mau haʻawina e loaʻa ana i nā maʻi e lapaʻau ʻia no ka tendinosis a i ʻole nā ​​waimaka rotator cuff he liʻiliʻi ka hoʻomaha ʻeha.I ka hoʻokaʻawale ʻana, ua hōʻike kekahi mau haʻawina ʻē aʻe e hiki i ka PRP ke hōʻemi a hoʻopau paha i ka ʻeha o nā maʻi me ka degeneration tendon, OA, plantar fasciitis a me nā maʻi wāwae a me nā kuʻekuʻe wāwae.Ua ʻike ʻia ka hoʻopaʻa ʻana o ka platelet hope a me ka hoʻokumu ʻana o nā cell biological e like me nā hiʻohiʻona PRP nui, e kōkua i ka nānā ʻana i ka hopena analgesic mau ma hope o ka hoʻohana ʻana o PRP.ʻO nā mea hoʻololi ʻē aʻe e pili ana i ke ʻano hāʻawi PRP, ʻenehana noiʻi, protocol activation platelet, pae hana olaola o PGF a me nā cytokines i hoʻokuʻu ʻia, ʻano kiko o ka noi PRP a me ke ʻano ʻeha.

He mea noʻonoʻo ua hoʻoponopono ʻo Kuffler i ka hiki o PRP i ka hoʻohaʻahaʻa ʻana i ka ʻeha i nā poʻe maʻi me ka ʻeha neuropathic maʻi maʻi maʻi, ka lua i ke aʻalolo non-regenerative.ʻO ke kumu o kēia noiʻi ʻana e noiʻi inā hiki ke hōʻemi a hoʻohaʻahaʻa ʻia ka ʻeha neuropathic ma muli o ka PRP e hāpai ana i ka hoʻoulu hou ʻana axonal a me ka reinnervation nerve.ʻO ka mea kupanaha, i waena o nā poʻe maʻi e loaʻa ana i ka lāʻau lapaʻau, hoʻopau ʻia ka ʻeha neuropathic a hoʻemi ʻia ma kahi o ʻeono mau makahiki ma hope o ke kaʻina.Eia hou, ua hoʻomaka nā maʻi a pau e hoʻomaha i kaʻeha i loko oʻekolu pule ma hope o ka hoʻohanaʻana i ka PRP.

I kēia mau lā, ua ʻike ʻia nā hopena analgesic PRP like ma ke kahua o ka ʻeha postoperative a me ka mālama ʻili.ʻO ka mea mahalo, ua hōʻike nā mea kākau i nā ʻano physiological o ka ʻeha ʻeha e pili ana i ka hōʻeha vascular a me ka hypoxia ʻili.Ua kūkākūkā pū lākou i ke koʻikoʻi o ka angiogenesis i ka hoʻonui ʻana i ka oxygenation a me ka hāʻawi ʻana i nā meaʻai.Ua hōʻike kā lākou aʻo ʻana i ka hoʻohālikelike ʻia me ka pūʻulu hoʻomalu, ʻoi aku ka liʻiliʻi o ka ʻeha o nā maʻi e loaʻa ana i ka mālama PRP a hoʻonui nui ʻia ka angiogenesis.ʻO ka mea hope loa, ua hoʻokō ʻo Johal a me kāna mau hoa hana i kahi loiloi systematic a me meta-analysis a hoʻoholo e hiki i ka PRP ke hōʻemi i ka ʻeha ma hope o ka hoʻohana ʻana i ka PRP i nā hōʻailona orthopedic, ʻoi aku hoʻi i nā poʻe maʻi e loaʻa ana i ka epicondylitis waho a me ka mālama ʻana i ke kuli OA.ʻO ka mea pōʻino, ʻaʻole i wehewehe kēia haʻawina i nā hopena o nā keʻokeʻo keʻokeʻo keʻokeʻo, platelet concentration a i ʻole ka hoʻohana ʻana i nā mea hoʻoulu platelet exogenous, no ka mea e pili ana kēia mau ʻano i ka hopena holoʻokoʻa o ka PRP.ʻAʻole maopopo ka manaʻo o ka platelet PRP maikaʻi loa no ka hoʻomaha ʻana i ka ʻeha.Ma ke ʻano ʻiole o ka tendinosis, ʻo 1.0 × 10 6 / μ ka pae platelet ma L, hiki ke hoʻomaha loa ʻia ka ʻeha, ʻoiai ʻo ka hōʻeha ʻeha i hana ʻia e PRP me ka hapalua o ka platelet concentration e hoʻemi nui ʻia.No laila, paipai mākou i nā noiʻi lapaʻau hou aku e noiʻi i nā hopena analgesic o nā hoʻomākaukau PRP like ʻole.

PRP a me ka hopena angiogenesis

ʻO ka hoʻomākaukau ʻana o C-PRP i ka lāʻau lapaʻau regenerative pololei e ʻae i ka lawe ʻana i nā biomolecules i hoʻokuʻu ʻia e nā kiʻekiʻe kiʻekiʻe o nā platelets i hoʻāla ʻia ma nā wahi kikoʻī.No laila, ua hoʻomaka ʻia nā ʻano like ʻole o ka cascade, e kōkua ana i ka hoʻoponopono immune ma ka pūnaewele, ka hana inflammatory a me ka angiogenesis e hāpai i ka ho'ōla a me ka hoʻoponopono ʻana i nā kiko.

ʻO ka Angiogenesis kahi kaʻina hana multi-step e pili ana i ka germination a me nā microvessels kiko mai nā kīʻaha koko mua.Ua holomua ka Angiogenesis ma muli o nā ʻano hana olaola like ʻole, me ka neʻe ʻana o ka endothelial cell migration, proliferation, differentiation and division.ʻO kēia mau kaʻina cellular he mea pono no ke kūkulu ʻana i nā kīʻaha koko hou.Pono lākou no ka ulu ʻana o nā kīʻaha koko mua e hoʻihoʻi i ke kahe koko a kākoʻo i ka hana metabolic kiʻekiʻe o ka hoʻoponopono ʻana o ka ʻiʻo a me ka hana hou ʻana o ka ʻiʻo.Hāʻawi kēia mau kīʻaha koko hou i ka hāʻawi ʻana i ka oxygen a me nā meaʻai, a me ka wehe ʻana i nā huahana mai nā ʻiʻo i mālama ʻia.

Hoʻoponopono ʻia ka hana angiogenesis e ka hoʻoulu ʻana i ka angiogenic factor VEGF a me nā mea anti-angiogenic (e laʻa, angiostatin a me thrombospondin-1 [TSP-1]).I loko o ka microenvironment maʻi a hoʻohaʻahaʻa ʻia (me ka haʻahaʻa oxygen haʻahaʻa, ka pH haʻahaʻa a me ka pae kiʻekiʻe o ka lactic acid), nā mea angiogenic kūloko e hoʻihoʻi i ka hana angiogenesis.

Hiki i kekahi mau pāpaʻi hoʻoheheʻe platelet, e like me ka FGF kumu a me TGF-β A hiki i ka VEGF ke hoʻoulu i nā cell endothelial e hana i nā kīʻaha koko hou.Ua hōʻike ʻo Landsdown a me Fortier i nā hopena like ʻole e pili ana i ka haku mele PRP, me nā kumu intraplatelet o nā regulators angiogenic he nui.Eia hou, ua hoʻoholo lākou i ka hoʻonuiʻana o ka angiogenesis i ka ho'ōlaʻana i ka maʻi MSK ma nā wahi me ka vascularization maikaʻiʻole, e like me ka meniscus tear, tendon injury a me nā wahi'ē aʻe me ka maikaʻiʻole o ka vascularization.

Hoʻolaha a me nā waiwai platelet anti-angiogenic

I nā makahiki i hala iho nei, ua hōʻike ʻia nā haʻawina i paʻi ʻia he kuleana nui nā platelets i ka hemostasis mua, ka hoʻokumu ʻana o ka clot, ka ulu ulu a me ka hoʻokuʻu cytokine, a me ka hoʻoponopono angiogenesis ma ke ʻano o ke kaʻina hana hoʻoponopono.ʻO Paradoxically, PRP α- Aia i loko o nā granules kahi pūʻali o nā mea ulu pro-angiogenic, nā protein anti-angiogenic a me nā cytokines (e like me PF4, plasminogen activator inhibitor-1 a me TSP-1), a ke kuhikuhi nei i ka hoʻokuʻu ʻana i nā mea kikoʻī e pāʻani i kahi kuleana. .Ka hana i ka angiogenesis.No laila, hiki ke wehewehe ʻia ke kuleana o ka PRP i ka hoʻoponopono ʻana i ka angiogenesis e ka hoʻoulu ʻana o nā mea hoʻokipa ʻili o ke kelepona, TGF- β Hoʻomaka i ka pro-angiogenic a me ka anti-angiogenic reactions.Ua hōʻoia ʻia ka hiki o nā platelets e hana i ke ala angiogenesis i ka angiogenesis pathological a me ka angiogenesis tumor.

Platelet-i loaʻa i ka angiogenic ulu kumu a me ka anti-angiogenic ulu kumu, i loaʻa mai α- A me nā molekala paʻa a paʻa.ʻO ka mea nui, ua ʻae ʻia ka hopena holoʻokoʻa o nā platelets ma ka angiogenesis he pro-angiogenic a hoʻoulu.Manaʻo ʻia ʻo ka PRP therapy e hoʻomalu i ka induction o ka angiogenesis, ka mea e kōkua i ka hopena o ka mālama ʻana i nā maʻi he nui, e like me ka ho'ōla ʻana i ka ʻeha a me ka hoʻoponopono ʻana i nā kiko.ʻO ka hoʻoponopono ʻana i ka PRP, ʻoi aku ka maikaʻi o ka hoʻokele ʻana o ka PGF kiʻekiʻe a me nā cytokine platelet ʻē aʻe, hiki ke hoʻoulu i ka angiogenesis, angiogenesis a me arteriogenesis, no ka mea, hoʻopaʻa ʻia ka stromal cell-derived factor 1a i ka CXCR4 receptor ma nā cell progenitor endothelial.ʻO Bill et al.Manaʻo ʻia ʻo PRP e hoʻonui i ka ischemic neovascularization, ma muli paha o ka hoʻoulu ʻana o ka angiogenesis, angiogenesis a me arteriogenesis.I loko o kā lākou in vitro model, endothelial cell proliferation and capillary formation i hoʻoulu ʻia e ka nui o nā PDGs like ʻole, ʻo ia ka VEGF ka mea hoʻoikaika nui angiogenic.ʻO kekahi mea nui a koʻikoʻi no ka hoʻihoʻi ʻana i ke ala angiogenesis ʻo ka synergy ma waena o nā PGF he nui.ʻO Richardson et al.Ua hōʻike ʻia ʻo ka hana synergistic o ka angiogenic factor platelet-derived growth factor-bb (PDGF-BB) a me VEGF i alakaʻi i ka hoʻokumu wikiwiki ʻana o ka ʻoihana vascular oʻo i hoʻohālikelike ʻia me ka hana o kēlā me kēia ulu ulu.ʻO ka hopena hui o kēia mau mea i hōʻoia hou ʻia i kahi noiʻi e pili ana i ka hoʻonui ʻana i ka cerebral collateral circulation i nā ʻiole me ka hypoperfusion lōʻihi.

ʻO ka mea nui loa, ua ana ʻia kahi noiʻi in vitro i ka hopena proliferative o nā puʻu endothelial umbilical vein a me nā ʻano platelet like ʻole i ke koho ʻana i ka mea hoʻomākaukau PRP a me ka hoʻolālā platelet dose, a ua hōʻike ʻia nā hopena he 1.5 × 10 6 platelets / μ ka hopena platelet maikaʻi loa. 50. E paipai i ka angiogenesis.ʻO ka nui o ka platelet concentration hiki ke kāohi i ke kaʻina hana angiogenesis, no laila ua maikaʻi ka hopena.

ʻO kaʻelemakule pūnaewele, kaʻelemakule a me ka PRP

Hiki ke hoʻoulu ʻia ka senescence cell e nā ʻano hoʻoulu.He kaʻina hana kēia e hoʻōki ai i ka puʻunaue ʻana o nā cell a loaʻa i nā loli phenotypic kūʻokoʻa e pale ai i ka ulu ʻole ʻana o nā cell i pōʻino, kahi mea nui i ka pale ʻana i ka maʻi kanesa.Ma ke kaʻina o ka ʻelemakule physiological, e hoʻoikaika pū ka ʻelemakule replication cell i ka ʻelemakule cell, a e hōʻemi ʻia ka hiki ke hoʻolaʻa hou o MSC.

Nā hopena o ka ʻelemakule a me ka ʻelemakule cell

I loko o vivo, nui nā ʻano cell e ʻelemakule a hōʻiliʻili i loko o nā ʻiʻo like ʻole i ka wā o ka wā ʻelemakule, i waena o ia mau mea he nui o nā cell elemakule.Me he mea lā e piʻi aʻe ana ka hōʻiliʻili ʻana o nā cell elemakule me ka piʻi ʻana o ka makahiki, ka pōʻino o ka ʻōnaehana pale, ka pōʻino o ke kino a i ʻole nā ​​mea pili i ke kaumaha.Ua ʻike ʻia ke ʻano o ka ʻelemakule o ka cellular e like me ke kumu pathogenic o nā maʻi e pili ana i ka makahiki, e like me ka osteoarthritis, osteoporosis a me ka degeneration disc intervertebral.ʻO nā ʻano mea hoʻoulu e hoʻomāhuahua i ka ʻelemakule cell.I ka pane ʻana, e hūnā ka senescence-related secretory phenotype (SASP) i nā kiʻekiʻe kiʻekiʻe o nā cell protein a me nā cytokines.ʻO kēia phenotype kūikawā e pili ana i nā pūnaewele kahiko, kahi e hūnā ai lākou i nā kiʻekiʻe kiʻekiʻe o nā cytokine inflammatory (e like me IL-1, IL-6, IL-8), nā mea ulu (e like me TGF-β, HGF, VEGF, PDGF), MMP, a me cathepsin.Ke hoʻohālikelike ʻia me ka poʻe ʻōpio, ua hōʻike ʻia ka SAPS e hoʻonui i ka makahiki, no ka mea, ua luku ʻia ke kaʻina hana paʻa, e hopena i ka ʻelemakule cell a me ka hiki ke hoʻōla hou.ʻO ke kikoʻī, i nā maʻi hui a me nā maʻi ʻiʻo iwi.Ma kēiaʻano, ua manaʻoʻia ka hoʻololi nuiʻana o kaʻelemakule maʻamau i ka spectrum huna o nā pūnaewele immune, e hōʻike ana i ka piʻiʻana o ka TNF-a, IL-6 a me / a iʻole Il-1b, e alakaʻi ana i ka maʻi maʻi mau loa.He mea pono e hoʻomaopopo i ka pili pū ʻana o ka stem cell dysfunction i nā mīkini autonomous non-cellular, e like me nā cell aging, ʻoi aku ka hana ʻana o nā mea pro-inflammatory a anti-regenerative ma o SASP.

Ma kahi ʻē aʻe, hiki i ka SASP ke hoʻoulu i ka plastic plastic a me ka reprogramming o nā cell pili.Eia hou, hiki i ka SASP ke hoʻonohonoho i ke kamaʻilio me nā ʻano mediator immune ʻē aʻe a hoʻōla i nā cell immune e hāpai i ka hoʻomaʻemaʻe ʻana o nā cell aging.ʻO ka hoʻomaopopo ʻana i ke kuleana a me ka hana o nā cell elemakule e kōkua i ka ho'ōla a me ka hoʻoponopono hou ʻana o nā ʻiʻo MSK a me nā ʻeha mau.

He mea mahalo ia Ritcka et al.Ua hoʻokō ʻia kahi noiʻi nui, a ua ʻike ʻia ke kuleana nui a me ka pono o ka SASP i ka hoʻolaha ʻana i ka plastic plasticity a me ka hoʻoulu hou ʻana o ka ʻiʻo, a ua hoʻokomo ʻia ka manaʻo o ka lawe ʻana i ka mālama transient o nā cell elemakule.Ua ʻōlelo maikaʻi lākou ʻo ka ʻelemakule ka mea maʻamau a me ke kaʻina hana hou.

ʻO kaʻelemakule pūnaewele a me ka hiki o PRP

I ka emi ʻana o ka helu o nā pūnaewele pū, e hoʻopilikia ka ʻelemakule i ka hana o nā pūnaeau stem.Pēlā nō, i loko o ke kanaka, e emi iho ana nā hiʻohiʻona stem cell (e like me ka maloʻo, ka hoʻonui a me ka ʻokoʻa) me ka makahiki.Ua hōʻike ʻo Wang lāua ʻo Nirmala e hōʻemi ka ʻelemakule i nā ʻano o nā pūnaewele a me ka helu o nā mea hoʻokipa ulu.Ua hōʻike ʻia kahi noiʻi holoholona he kiʻekiʻe ke kiʻekiʻe o ka PDGF i nā lio ʻōpio.Ua hoʻoholo lākou i ka piʻi ʻana o ka helu o nā mea loaʻa GF a me ka helu o ka GF i loko o nā poʻe ʻōpio ʻoi aku ka maikaʻi o ka pane cellular i ka mālama ʻana i ka PRP ma mua o nā poʻe ʻōpio i nā ʻōpio.Hōʻike kēia mau ʻike i ke kumu e emi ai ka maikaʻi o ka mālama ʻana i ka PRP a i ʻole ka maikaʻi ʻole i nā poʻe maʻi ʻelemakule me ka liʻiliʻi o nā pūnaewele a me ka "maikaʻi ʻole".Ua hōʻike ʻia ua hoʻohuli ʻia ke kaʻina hana kahiko o ka cartilage kahiko a ua hoʻonui ʻia ka manawa hoʻomaha o nā chondrocytes ma hope o ka hoʻokele PRP.Jia et al.Hoʻohana ʻia ia e aʻo i ka ʻiole dermal fibroblasts in vitro photoaging, me ka mālama ʻole PRP, e wehewehe i ke ʻano o ka counteraction PGF i kēia kükohu.Ua hōʻike ka pūʻulu PRP i ka hopena pololei ma ka matrix extracellular, hoʻonui i ka collagen type I a hoʻemi i ka synthesis o metalloproteinases, e hōʻike ana e hiki i ka PRP ke counteract cell aging, a me ka maʻi MSK degenerative.

Ma kekahi noiʻi ʻē aʻe, ua hoʻohana ʻia ʻo PRP e hōʻiliʻili i nā pūnaewele iwi iwi mai nā ʻiole kahiko.Ua hoʻoholo ʻia e hiki i ka PRP ke hoʻihoʻi hou i nā ʻano hana pūlima mai ka wā ʻelemakule, e like me ka hoʻonui ʻana o ka cell a me ka hoʻokumu ʻana o ka colony, a kūkulu hou i nā māka e pili ana i ka ʻelemakule cell.

I kēia mau lā, ua aʻo nui ʻo Oberlohr a me kāna mau hoa hana i ka hana o ka ʻelemakule cell i ka hoʻonāwaliwali ʻana i ka hoʻōla hou ʻana o ka ʻiʻo, a loiloi i ka PRP a me ka platelet-poor plasma (PPP) ma ke ʻano he koho lapaʻau ola no ka hoʻoponopono ʻana i ka ʻiʻo iwi.Ua manaʻo lākou e hoʻokumu ʻia ka PRP a i ʻole ka PPP no ka hoʻoponopono ʻana i ka ʻiʻo iwi ma luna o nā kumu olaola i hoʻonohonoho ʻia no nā māka kelepona kikoʻī SASP a me nā kumu ʻē aʻe e alakaʻi ai i ka ulu ʻana o ka fibrosis.

He mea kūpono ke manaʻoʻiʻo ma mua o ka hoʻohana ʻana i ka PRP, hiki ke hoʻomaikaʻi i nā ʻano hana hou o ka lāʻau lapaʻau ma o ka hōʻemi ʻana i nā kumu SASP kūloko.Ua manaʻo ʻia ʻo kahi koho ʻē aʻe e hoʻomaikaʻi ai i nā hopena o ka mālama ʻana i ka PRP a me ka PPP no ka hoʻolaʻa hou ʻana i ka ʻiʻo iwi, ʻo ia ka wehe ʻana i nā cell elemakule me nā scavengers kahiko.ʻAʻohe mea kānalua i nā hopena noiʻi hou e pili ana i ka hopena o ka PRP i ka ʻelemakule a me ka ʻelemakule he mea hoihoi, akā aia nō lākou i ka pae mua.No laila, he mea kūpono ʻole ka hāʻawi ʻana i nā manaʻo i kēia manawa.

（Paʻi hou ʻia nā mea o kēia ʻatikala, ʻaʻole mākou e hāʻawi i ka hōʻoiaʻiʻo a i ʻole ka hōʻoia ʻana no ka pololei, hilinaʻi a i ʻole ka piha o nā mea i loko o kēia ʻatikala, a ʻaʻole kuleana no nā manaʻo o kēia ʻatikala, e ʻoluʻolu e hoʻomaopopo.)