Isicelo somtholampilo kanye nocwaningo lwe-PRP ku-Common Knee Disease

Isicelo somtholampilo kanye nocwaningo lwe-PRP ezifweni ezivamile zamadolo

I-Platelet-rich plasma (PRP) i-plasma eyakhiwe ikakhulukazi ama-platelet namangqamuzana egazi amhlophe atholwe nge-centrifugation yegazi le-autologous peripheral.Inani elikhulu lezici zokukhula kanye nama-cytokines agcinwa ku-α granules yamaplatelet.Lapho ama-platelet esebenza, ama-α granules awo akhulula inani elikhulu lezici zokukhula.Ucwaningo luye lwabonisa ukuthi lezi zici zokukhula kwamangqamuzana zingakhuthaza ukuhlukaniswa kwamaseli, ukwanda, i-matrix ye-extracellular kanye ne-collagen synthesis, ngaleyo ndlela kukhuthaze ukuvuselelwa nokulungiswa kwe-articular cartilage kanye ne-ligament kanyeokunyeizicubu.Ngesikhathi esifanayo, kungase futhi kuthuthukise impendulo yokuvuvukala kwendawo ye-lesion futhi kunciphise izimpawu zomtholampilo zeziguli.Ngaphezu kwalezi zici zokukhula kwamangqamuzana, i-PRP nayo iqukethe inani elikhulu lamaseli amhlophe egazi.Lawa maseli amhlophe egazi nama-platelet angakhulula izinhlobonhlobo zama-peptide e-antimicrobial ukuze abophe amagciwane, avimbele futhi abulale amagciwane, futhi adlale indima yokulwa namagciwane.

I-PRP isetshenziswe kabanzi emkhakheni wamathambo ngenxa yenqubo yayo yokukhiqiza elula, ukusetshenziswa okulula kanye nezindleko eziphansi, ikakhulukazi ekwelapheni izifo zamadolo eminyakeni yamuva.Lesi sihloko sizoxoxa ngesicelo somtholampilo kanye nocwaningo lwe-plasma ecebile nge-platelet ku-knee osteoarthritis (KOA), ukulimala kwe-meniscus, ukulimala kwe-cruciate ligament, i-knee synovitis nezinye izifo ezivamile zamadolo.

Ubuchwepheshe besicelo se-PRP

I-PRP engacushiwe kanye nokukhululwa kwe-PRP okucushiwe kuwuketshezi futhi kungajovwa, futhi i-PRP engacushiwe ingalawulwa ngokungeza ngokuzenzekelayo i-calcium chloride noma i-thrombin ukulawula isikhathi sokuhlanganisa ukuze ijeli yakheke ngemva kokufinyelela indawo okuhlosiwe, ukuze ukufeza inhloso yokukhululwa okuqhubekayo kwezici zokukhula.

Ukwelashwa kwe-PRP kwe-KOA

I-KOA yisifo samadolo esiwohlokayo esibonakala ngokubhujiswa okuqhubekayo kwe-articular cartilage.Iningi leziguli lineminyaka ephakathi kanye nabadala.Ukubonakaliswa komtholampilo kwe-KOA ubuhlungu bamadolo, ukuvuvukala, nokulinganiselwa komsebenzi.Ukungalingani phakathi kokuhlanganiswa nokubola kwe-articular cartilage matrix kuyisisekelo sokwenzeka kwe-KOA.Ngakho-ke, ukukhuthaza ukulungiswa kwe-cartilage nokulawula ibhalansi ye-cartilage matrix kuyisihluthulelo sokwelashwa kwayo.

Njengamanje, iziguli eziningi ze-KOA zikulungele ukwelashwa okuvamile.Umjovo ohlangene wamadolo we-hyaluronic acid, i-glucocorticoids nezinye izidakamizwa kanye nemithi yomlomo engeyona i-steroid eqeda ukuvuvukala ngokuvamile isetshenziswa ekwelapheni okuvamile.Ngokujula kocwaningo ku-PRP yizazi zasekhaya nezangaphandle, ukwelashwa kwe-KOA nge-PRP sekuye kwanda kakhulu eminyakeni yamuva.

Indlela yokwenza:

1. Khuthaza ukwanda kwama-chondrocyte:

Ngokulinganisa umphumela we-PRP ekusebenzeni kwama-chondrocyte onogwaja, u-Wu J et al.ithole ukuthi i-PRP ithuthukise ukwanda kwama-chondrocyte, futhi kucatshangelwa ukuthi i-PRP ingase ivikele ama-chondrocyte e-IL-1β-activated ngokuvimbela ukudluliselwa kwesignali ye-Wnt / β-catenin.

2. Ukuvinjelwa kokusabela kokuvuvukala kwe-chondrocyte nokuwohloka:

Uma icushiwe, i-PRP ikhulula inombolo enkulu yezinto ezilwa nokuvuvukala, njenge-IL-1RA, TNF-Rⅰ, ⅱ, njll. I-Il-1ra ingavimbela ukuqaliswa kwe-IL-1 ngokuvimbela i-IL-1 receptor, ne-TNF-Rⅰ kanye ⅱ ingavimba indlela yokusayina ehlobene ne-TNF-α.

Ucwaningo lokusebenza ngempumelelo:

Ukubonakaliswa okuyinhloko ukukhululeka kobuhlungu nokuthuthukiswa komsebenzi wamadolo.

U-Lin KY et al.kuqhathaniswa umjovo we-intra-articular we-LP-PRP nge-hyaluronic acid kanye nosawoti ovamile, futhi wathola ukuthi umphumela wokwelapha wamaqembu amabili okuqala wawungcono kuneqembu elivamile le-saline esikhathini esifushane, okuqinisekisile umphumela womtholampilo we-LP-PRP. kanye ne-hyaluronic acid, kanye nokubheka isikhathi eside (emva konyaka we-1) kubonise ukuthi umphumela we-LP-PRP wawungcono.Ezinye izifundo zihlanganise i-PRP ne-hyaluronic acid, futhi zathola ukuthi inhlanganisela ye-PRP ne-hyaluronic acid ayikwazanga ukukhulula ubuhlungu nokuthuthukisa umsebenzi kuphela, kodwa futhi iqinisekisa ukuvuselelwa kwe-articular cartilage nge-X-ray.

Nokho, uFilardo G et al.bakholelwa ukuthi iqembu le-PRP kanye neqembu le-sodium hyaluronate liphumelele ekuthuthukiseni ukusebenza kwamadolo kanye nezimpawu ngocwaningo olulawulwa ngokungahleliwe, kodwa akukho mehluko obalulekile owatholakala.Kutholakale ukuthi indlela yokuphatha ye-PRP ibe nomthelela othile emthelela wokwelapha we-KOA.Du W et al.waphatha i-KOA ngomjovo we-PRP we-intravarticular kanye nomjovo we-extraarticular, futhi wabheka amaphuzu e-VAS ne-Lysholm ngaphambi kwemithi kanye nezinyanga ezingu-1 nezi-6 ngemva kwemithi.Bathole ukuthi zombili izindlela zokujova zingathuthukisa izikolo ze-VAS neLysholm esikhathini esifushane, kodwa umphumela weqembu lomjovo we-intra-articular wawungcono kuneqembu lomjovo we-extraarticular ngemva kwezinyanga ezingu-6.Taniguchi Y et al.uhlukanise ucwaningo ekwelapheni kwe-KOA emaphakathi kuya kokuqina kumjovo we-intraluminal ohlanganiswe nomjovo we-intraluminal weqembu le-PRP, umjovo we-intraluminal weqembu le-PRP kanye nomjovo we-intraluminal weqembu le-HA.Ucwaningo lubonise ukuthi ukuhlanganiswa komjovo we-intraluminal we-PRP kanye nomjovo we-intraluminal we-PRP kwakungcono kunomjovo we-intraluminal we-PRP noma i-HA okungenani izinyanga ezingu-18 ekuthuthukiseni izikolo ze-VAS ne-WOMAC.

(Okuqukethwe yile ndatshana kuphrintwe kabusha, futhi asinikezeli nganoma yisiphi isiqinisekiso esicacile noma esishiwoyo sokunemba, ukwethembeka noma ukuphelela kokuqukethwe okuqukethwe kulesi sihloko, futhi asinasibopho ngemibono yalesi sihloko, sicela uqonde.)