“Usambokahadzika kuti boka duku revagari vemo vane pfungwa, vakazvipira rinogona kuchinja nyika.
Chinangwa cheCureus ndechekushandura iyo yakagara iripo modhi yekudhindisa yezvokurapa, umo kuendesa tsvakiridzo kunogona kudhura, kwakaoma, uye kutora nguva.
Platelet-rich plasma/prp, tissue regeneration, platelet activation, glucose proliferative therapy, maplatelet, proliferative therapy
Taura chinyorwa ichi se: Harrison TE, Bowler J, Reeves K, et al. (Chivabvu 17, 2022) Mhedzisiro yeglucose pakuverenga kweplatelet uye vhoriyamu: mhedzisiro yemushonga wekuvandudza. Kurapa 14(5): e25081. doi:10.7759/cureus.25081
Platelet-rich plasma (PRP) uye hypertonic glucose solutions inowanzoshandiswa pakuita jekiseni mumishonga yekudzorera, dzimwe nguva pamwe chete. Mhedzisiro yehypertonic glucose pane platelet lysis uye activation haina kumbotaurwa. Takaedza mhedzisiro yekukwira kweglucose yakakwira pane platelet uye erythrocyte kuverenga, pamwe nesero mavhoriyamu muPRP uye ropa rose (WB). Kukurumidza kuderedzwa kwechikamu cheplatelet count kwakaitika nemisanganiswa yese yeglucose yakasanganiswa nePRP kana ropa rose, zvinoenderana nechikamu chelysis. Mushure meminiti yekutanga, kuverenga kweplatelet kwakaramba kwakagadzikana, zvichikurudzira kukurumidza kwekugara kwemaplatelet akasara kusvika kune yakanyanyisa (> 2000 mOsm) hypertonicity. Mushure meminiti yekutanga, kuverenga kweplatelet kwakaramba kwakagadzikana, zvichikurudzira kukurumidza kwekugara kwemaplatelet akasara kusvika kune yakanyanyisa (> 2000 mOsm) hypertonicity. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю аккомодацию остаточных тромбильным мОсм) гипертонуса. Mushure meminiti yekutanga, nhamba yeplatelet yakaramba yakagadzikana, ichiratidza kukurumidza kwekugara kwemaplatelet akasara kusvika kune yakanyanyisa (> 2000 mOsm) hypertonicity.第一分钟后，血小板计数保持稳定，表明残余血小板迅速适应极端（> 2000 mOsm漸。2000 mOsm）高渗状态. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю адаптацию остаточных тромбильным мОсм) гиперосмолярному состоянию. Mushure meminiti yekutanga, nhamba yeplatelet yakaramba yakagadzikana, ichiratidza kukurumidza kugadziriswa kwemaplatelet akasara kusvika kune yakanyanyisa (> 2000 mOsm) hyperosmolar state.Glucose concentrations ye25% nepamusoro yakakonzera kuwedzera kukuru kwe mean platelet volume (MPV), zvichiratidza danho rekutanga rekushandiswa kweplatelet. Zvimwe zvidzidzo zvinodiwa kuti zvione kana platelet lysis kana activation inoitika uye kana jekiseni rehypertonic glucose riri roga kana kusanganiswa nePRP rinogona kupa humwe rubatsiro rwekiriniki.
Mumakore ekuma1950, chiremba wokuvhiya wekuAmerica George Hackett akawana kuti aikwanisa kubvisa zvachose kurwadziwa kwejoint nemusana muvarwere vakawanda nekubaya jekiseni rinowedzera gadziriso mumatendon nemarunda. Kuongorora kwake tsuro kwakaratidza kuti kurapa kwaakadana kuti proliferative therapy, kwakakonzera kuti marunda akure uye asimbiswe. Zvidzidzo zvehistological zvakasimbisa kuti collagen nyowani inogadzirwa panguva iyi [1].
Mukati memakumi mashoma amakore okutanga, mhinduro zhinji dzakasiana-siana dzokugovera dzakaedzwa. Pakazosvika ma1990, varapi vazhinji vaiona kuwanda kweglucose senzira yakachengeteka uye inoshanda zvakanyanya. Zvisinei, maitiro echiito anoramba asina kujeka.
Zvishoma zvidzidzo zvekiriniki zvakaitwa muzana ramakore rechi20 zvichitevera basa raHackett. Zvisinei, muZ2000s pakanga pane kufarira patsva uye miedzo yakawanda yekiriniki yakabudirira yeproliferative therapy yakapedzwa kuitira kurapwa kwemarwadzo ekudzokera shure [2], osteoarthritis yemabvi [3], uye lateral epicondylitis [4].
Kuvandudzwa kwetishu kunoda kubatanidzwa kwe stem cell. Naizvozvo, kuwanda kweglucose kunofanirwa neimwe nzira kukonzeresa kutama, kudzokorora, uye kusiyanisa masero e stem. Isu tinofungidzira kuti maplatelet anogona kuita senhume uye kuti huwandu hweglucose hwakanyanya hunogona kuita kuti maplatelet abudise ma cytokines uye kukura kwezvinhu, nekudaro achikurudzira maitiro ekugadzirisa, kunyanya stem cell kutama kunzvimbo dzepamusoro glucose.
Platelet activation nguva dzose inotangira kuwedzera intracellular calcium [5]. Liu et al. mu2008 yakaratidza kuti mazinga eglucose akakwirira anowedzera basa renguva pfupi yekugamuchira inogona kuva canonical type 6 (TRPC6) chiteshi mu membrane ye plasma, iyo inotungamirira mukukwira kwe calcium ions mumaplatelet [6]. Imwe ongororo yakaratidza kuti kuratidzwa kweiyo microtubule marginal zone kune calcium ions kunokonzera kuzorora, kuwedzera, uye deformation yenzvimbo yekumucheto, izvo zvinokonzeresa shanduko yechimiro kubva ku disc kuenda kuspherical, zvichikonzera kurevesa platelet volume (MPV) [7].
Pfungwa yedu muchidzidzo ichi ndeyekuti kuratidzwa kweplatelet kune yakakwira kuwanda kweglucose kunokanganisa iyo microtubule marginal zone uye intracellular nharaunda, zvichikonzera kuwedzera kweMPV.
Vese vatori vechikamu vakasaina fomu remvumo rine ruzivo mushure mekunge ruzivo rwechidzidzo rwatsanangurwa uye vasati vagamuchira sampuli. Muchidzidzo ichi, sampuli dzePRP chete dzine hematocrit yakakura kudarika 2% yakashandiswa kuitira kuti erythrocyte (erythrocyte) kuverenga uye zvinoreva corpuscular volume yemasero matsvuku eropa (MCV) inogona kubatanidzwa kuenzanisa.
Chidzidzo chacho chakaitwa muzvikamu zvina, chikamu chekutanga chaiva PRP uye zvikamu zvakasara zvaive ropa rose (Tafura 1). Sezvakatsanangurwa kare [8], ose ane simba centrifugal masimba (RCF, g-force) akaverengwa kubva pakati (Rmid, in cm) yeropa column mu centrifugal sirinji. Isu takasarudza kushandisa MPV sechiratidzo chekukurudzira kweplatelet uye kuverenga kweplatelet sechiratidzo chekugona kweplatelet lysis, ese ari maviri anogona kuyerwa nyore pane akajairwa hematology analyzer.
Muchikamu chekutanga, vazvipiri ve47 vakapa sampuli dzeropa-imwe tube ye ethylenediaminetetraacetic acid (EDTA) uye imwe yePRP yeropa rose (anticoagulated ne sodium citrate (NaCl, 3%)) (Tafura 1). Isa rocker muchubhu pakarepo. Kukwana kweropa kuverenga (CBC) kwakaitwa pamasampuli eEDTA mune katatu, uye masampuli eNaCl akaongororwa mumatatu eCBC kuongororwa, uyezve PRP yakagadzirirwa nenzira dzakasiyana-siyana dzakatsanangurwa pamusoro [8]. Zvose PRP samples dzakagadzirirwa ne centrifugation pa 900-1000 g. Sanganisa imwe neimwe sampu yePRP pane vortex mixer kwemasekonzi 5-10, wogovanisa mashanu 0.5 ml aliquots mumachubhu.
Kuongorora mhedzisiro yekuratidzwa kweplatelet pane yakakwira glucose concentration, yakaenzana (0.5 ml) ye0%, 5%, 12.5%, 25%, uye 50% glucose mumvura yakasanganiswa neplatelet samples kuti iwane 0%, 2.5% 6.25%, 12.5% ​​yeglucose musanganiswa uye 25% bvunzo chubhu musanganiswa weshubhu musanganiswa uye 25%. Maminitsi gumi nemashanu. Iyo TAC yemusanganiswa wega wega wakaongororwa mutatu mushure memaminitsi gumi nemashanu. Platelet count (PLT), RBC count, MCV, uye MPV yakaverengerwa pachubhu yega yega, uye zvinoreva platelet count, RBC count, MCV, uye MPV zvakaverengerwa ese PRP samples.
Mushure mekunge chikamu chekutanga chekuunganidza data chapera, takaona kuwedzera kukuru kweplatelet volume muPRP platelets mushure mekuwedzera kweD50W. PRP maplatelet haafanire kumiririra ese maplatelet muropa, uye PRP yepakati inosiyana kubva kuWB yepakati. Naizvozvo, takasarudza kuita chikamu chechipiri chekuedza kwemhedzisiro yekuwedzera D50W kuropa rose.
Pachikamu chechipiri, takasarudza saizi yemakumi matatu zvichienderana nemhedzisiro kubva muchikamu chekutanga, sezvakatsanangurwa muchikamu cheOngororo. Mune ino nhevedzano, vanozvipira makumi maviri vakapa masampu eropa (Table 1). Ropa rose (1.8 ml) rakadhonzwa mu3 ml sirinji uye anticoagulated ne 0.2 ml 40% NaCl. Sirinji yese yeropa yakasanganiswa kwemasekonzi mashanu nemuvhenganisi wevortex uye CBC yakaongororwa mune zvakapetwa katatu. Mushure mekuongorora, ropa rinopesana neropa rakawedzerwa ku 2 ml ye50% glucose mu 5 ml sirinji (yekupedzisira glucose concentration yaive inenge 25% (D25) uye yakaiswa muhubhu inozununguka kwemaminitsi 30. Mushure memaminitsi makumi matatu, D25 / CBC mumasirinji eWB akaongororwa katatu. RBC count, MCV, uye MPV zvakaverengerwa sampuli yega yega pamberi uye mushure mekuwedzera glucose.
Nemhaka yokuti maplatelet ari muropa rose anowanzosangana ne hypertonic glucose panguva yeproliferative glucose therapy nekuda kwejekiseni shoma shoma, uye hazviwanzoitiki kusanganisa PRP ne hypertonic glucose nguva isati yasvika, takasarudza kudzidza hypertonic glucose pamwe chete neWB muChikamu 1. Nhanho Yetatu nechina. Pachikamu chimwe nechimwe, vazvipiri makumi maviri vakapa 7-8 ml yeACD-A (asidhi ine trisodium citrate (22.0 g/l), citric acid (8.0 g/l) uye glucose (24.5 g/l), solution dextrose citrate) yeropa anticoagulants (Table 1). Musanganiswa chete weglucose mukuru kupfuura 12.5% ​​​​wakashandiswa kuona chikumbaridzo muzana chine chekuita nekuwedzera kweMPV. Padanho rechitatu, 1 ml yeropa inoiswa muchubhu yekuedza. Zvadaro sanganisa ropa pane vortex mixer kwemasekonzi gumi nekuwedzera 1 ml ye30% glucose, 40% glucose, kana 50% glucose kuchubhu kuti uwane yekupedzisira glucose concentration ye15%, 20%, uye 25%, maererano. Masampuli eropa reGlucose akaongororwa kuCBC pakarepo mushure mekusanganiswa uye akadzokororwa maminetsi maviri ega ega kwemaminitsi makumi matatu.
Panguva yekusanganiswa kwekutanga, kuwedzerwa kwe1: 1 hypertonic glucose uye WB kana PRP inofumura maplatelet kuhuwandu huri pamusoro pe25% kwemasekondi akawanda. Muchinhanho chechina, kuti tiongorore mhedzisiro yehypertonic glucose ine mashoma ekutanga peak concentrations uye kuyedza iyo yepamusoro muganhu wemhedzisiro yeglucose, isu takangowedzera shoma shoma yeropa kuD25W kana D50W. Isa 1 ml yeD25W kana D50W muchubhu wobva wawedzera 0.2 ml yeWB uchivhota sampuli kwemasekonzi gumi. Muzviitiko izvi, ropa rakaratidzwa kune glucose pahutano hunenge 20% pamusoro pekupedzisira, pane 50% pamusoro pekupedzisira kwekupedzisira semuChikamu 3, zvichiita kuti glucose iwedzere 20.8% uye 41.6%. Sampuli dzakasanganiswa dzakaongororwa panguva imwe chete sepadanho 3.
Muchinhanho chekutanga chega yega yega glucose dilution series, 30 samples dzakatorwa sezvo iyi yaive yakakodzera saizi yemuenzaniso wechidzidzo chemutyairi [9]. Pakupera kwechikamu chega chega (kusanganisira chikamu chekutanga), ongorora kukwana kwehukuru hwemuenzaniso uchishandisa chirevo chinoshandiswa kugadzirisa saizi yemuenzaniso inodiwa kuenzanisa zvinoreva kuenderera kwemhedzisiro inoshanduka muhuwandu hwevanhu. Formula n = Z2 x SD2 /E2. Mune iyi equation, Z ndiyo Z-score, SD ndiyo yakajairwa kutsauka, uye E ndiyo yaidiwa kukanganisa [10]. Alpha yedu ndeye 0.05, iyo inoenderana neiyo Z kukosha kwe1.96, uye isu tinotarisira kukanganisa kwe5 (mu muzana). Saka tinogadzirisa n = (1.962 x SD2)/52. Zvigumisiro zvakaratidza kuti saizi yemuenzaniso inodiwa padanho rega rega yaive diki pane nhamba chaiyo yakaunganidzwa.
Munguva yenguva 1, 3 uye 4 vachishandisa zvinopfuura imwe glucose concentration, mugumisiro wehuwandu hweglucose hwakasiyana hwakaongororwa nekuenzanisa kuchinja kwepakati pakati penguva 0 uye nguva imwe neimwe inotevera (chikamu 1 pamaminitsi e15, nguva 3 pamaminitsi e15). uye mana pamasekondi e15, ipapo maminetsi maviri oga oga.) Shanduko yemitengo yenguva imwe neimwe yakafananidzwa uchishandisa Mann-Whitney U-test nokuti data haina kutevera kugoverwa kwakajairika sezvakarongwa neShapiro-Wilk normality test. Sezvo 1-ku-1 kuongororwa kwemapoka akawanda (mashanu) akaitwa mumatanho ekutanga, echitatu uye echina (zvishanu zvakazara), kugadziriswa kweBonferroni kwakaitwa kugadzirisa iyo yaidiwa alpha kukosha ku ≤0.01 asi kwete ≤0.05.
Kuderedzwa kweplatelet count neyese ye hypertonic dextrose uye kuwedzera kweMPV muPRP maplatelet pa> 12.5% ​​dextrose concentration: PRP platelet counts yakasimuka kubva kune imwe kusvika kune kashanu kuenzaniswa kana ichienzaniswa nekutanga ropa rose, zvakasiyana nenzira (isina kuratidzwa). Kuderedzwa kwehuwandu hweplatelet nehuwandu hwese hypertonic dextrose uye kuwedzera kweMPV muPRP maplatelet pa> 12.5% ​​dextrose concentration: PRP platelet count yakasimuka kubva kune imwechete kusvika kashanu kusungwa ichienzaniswa nekutanga kweropa rose, zvakasiyana nenzira (isina kuratidzwa). Уменьшение количества тромбоцитов при всех концентрациях гипертонической декстрозы и увеличение MPV в тромбоцитах PRP прицентрациях гипертонической декстрозы и увеличение MPV в тромбоцитах PRP прицентрациях приконцикыт% количество тромбоцитов PRP увеличилось в 1-5 раз показано в зависимости от метода (не показано). Kuderera kweplatelet count pane ese hypertonic dextrose concentrations uye yakawedzera MPV muPRP maplatelet pa> 12.5% ​​dextrose concentration: PRP platelet count yakawedzera 1-5 nguva ichienzaniswa nekutanga kweropa rose, zvichienderana nenzira (isina kuratidzwa). ).在> 12.5% ​​的葡萄糖浓度下，所有浓度的高渗葡萄糖降低血小板计数，PRP 血小板中MPV增加：与基线全血相比，PRP 血小板计数从浓度的1 倍上升到5 倍，因方法而异（未漉。 Pa> 12.5% ​​glucose concentration, iyo yakakwirira yeglucose inoderedza kuwanda kweropa, PRP ropa MPV inowedzera: kana ichienzaniswa ne与基线全血, iyo PRP yeropa inowedzera kubva ku1 kusvika ku5 nguva iyo yekusungwa (isina kutsanangurwa). При концентрациях глюкозы >12,5% все концентрации гипертонической глюкозы снижали количество тромбоцитов, а MPV концентрации гипертонической глюкозы снижали количество тромбоцитов, а MPV повышам песни : тромбоцитов PRP увеличивалось от 1- до 5-кратных концентраций сравнению с исходными концентрациями цельной крови, в топи от видео, в концентрациями Paglucose concentrations> 12.5%, yose hypertensive glucose concentrations yakaderera maplatelet counts uye yakawedzera MPV muPRP platelets: PRP platelet count yakawedzera 1- kusvika 5-fold kana ichienzaniswa nekutanga kweropa rose, zvichienderana nenzira (sezvinotsanangurwa).Mufananidzo 1 unoratidza kuti nhamba yeplatelet yakaderera neinenge 75% mushure mekuderedzwa mumvura uye ne 20-30% mushure memaminitsi gumi nemashanu ekugadzirisa nekugadzirisa kwakasiyana kweglucose kana ichienzaniswa nekutanga PRP uye 1: 1 dilution yakagadziridzwa nokuda kwehuwandu (1- k1 nekugadzirisa inzwi). k -1 kubereka).1 kubereka).
Huwandu hwemasero mune imwe neimwe dilution inoratidzwa sechidimbu chenhamba yekutanga isati yadilurwa.
MPV yakadzikira zvishoma panguva yekugadzirwa kwePRP, pasina imwezve shanduko muhuwandu hwedilution kusvika ku12.5% ​​mumvura kana glucose (kusanganisira 25% PRP glucose misanganiswa) uye yakawedzera neanopfuura 20% mushure mekuderedzwa mu50% glucose solution (Fig. .2). ) Kusiyana neizvi, erythrocytes haana kuratidza kuchinja kukuru kwevhoriyamu pane chero dilution kunze kweH2O.
Avhareji yevhoriyamu yemasero mune yega yega dilution inoratidzwa sechikamu cheiyo vhoriyamu yepakutanga isati yanyungudutswa.
Kuderera kwakafanana asi kuduku kuduku kweplatelet count uye kuwedzera kweCVR kwakaonekwa muBC yakazarurirwa ku50% glucose (kuumba ne 25% glucose). Tafura 2 inoenzanisa nhamba dzemasero uye masero emasero muropa rose rakasvibiswa mu50% dextrose nechikamu chekutanga chePRP data yakasvibiswa mu50% dextrose. Shanduko muRBC count uye RBC MCV yanga isiri pachena uye yanga isiri iyo tarisiro yekutarisisa kwedu.
SD = kutsauka kwemaitiro, MD = zvinoreva kusiyana pakati pemapoka, SE = kutsauka kwemaitiro akasiyana, RBC = erythrocytes, PLT = maplatelet, PRP = platelet rich plasma, WB = ropa rose
Mushure mekuwedzera D50W kuWB, iyo yezana dilution-yakagadziriswa platelet kurasikirwa yaiva 7.7% (310±73 vs. 286±96) zvichienzaniswa ne17.8% yePRP dilution muD50W (664±348 vs. 544±277). MPV WB yakawedzera ne16.8% (kubva pa10.1 ± 0.5 kusvika 11.8 ± 0.6), nepo MPV PRP yakawedzera ne26% (9.2 ± 0.8 vs. 11.6 ± 0. 7). Kunyange zvazvo misiyano yepakati mune zvose platelet count kuderedza uye kuwedzera kweMPV kwainyanya kuwedzera nePRP, kuchinja kweplatelet count kuderedza mukati meWB kwave kunenge kwakakosha (310 ± 73 kusvika 286 ± 96 (-7.7%); p = .06) uye kuwedzera kweMPV kwakakosha (10.1 ± 0.5 kusvika 10.8 p. 10.8) <± 10.8 ± 10.8. Kunyange zvazvo misiyano yepakati mune zvose platelet count kuderedza uye kuwedzera kweMPV kwainyanya kuwedzera nePRP, kuchinja kweplatelet count kuderedza mukati meWB kwave kunenge kwakakosha (310 ± 73 kusvika 286 ± 96 (-7.7%); p = .06) uye kuwedzera kweMPV kwakakosha (10.1 ± 0.5 kusvika 10.8 p. 10.8) <± 10.8 ± 10.8.Kunyange zvazvo mutsauko wepakati mune zvose kuderedzwa kweplatelet count uye CVR kuwedzera kwaive kwakakura zvikuru nePRP, kuchinja kwehuwandu hweplatelet kuderera mukati meWB kwaive kwakakosha (310 ± 73 kusvika 286 ± 96 (-7.7%); p = 0.06).увеличение MPV было значительным (от 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) p < 0,001). kuwedzera kweMPV kwakakosha (kubva ku10.1 ± 0.5 kusvika ku11.8 ± 0.6 (+16.8) p <0.001).尽管PRP 在血小板计数减少和MPV 增加方面的平均差异显着更大，但WB内血小板计数减少的变化几乎是显着的（310 ± 73 至286 ± 96 (-7.7%);p = .06）和MPV 的增劝 ± 96.到11.8 ± 0.6 (+16.8) p <.001).尽管 PRP 在 血小板 计数 和 增加 方面的 平均 差异 显着 大 , 但 但 内血小板 话 平安显着 的 （（310 ± 73 至 286 ± 96 (-7.7%) ; p = .06）和MPV 的增加是显着的（10.1 ± 0.5 ± 0.5 ± 0.5 ± 0.5 ± 11.8 ± 6 p. .001.Shanduko mukuderedza kuverengeka kweplatelet mukati meWB yakada kukosha (kubva pa310 ± 73 kusvika 286 ± 96 (-7.7%); p = 0.06), kunyange zvazvo PRP yakanga ine misiyano yakakura zvikuru mukuderera kweplatelet count uye kuwedzera kweMPV. uye kuwedzera kweMPV kwakakosha.(от 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) р < 0,001). (kubva pa10.1 ± 0.5 kusvika 11.8 ± 0.6 (+16.8) p <0.001).
Mhedziso yekupedzisira ye20% glucose yaidiwa kuti ione kuchinja kukuru muMPV, asi kuchinja kweMPV kwainyanya kutaurwa pamusangano wekupedzisira we25%. Kurasikirwa kweplatelet kwakagadzikana mushure mekuderera kwekutanga. Takacherechedza kuderera kwakasimba kwekutanga muCVR, zvisinei, CVR yakakurumidza kudzorerwa pa25% yekupedzisira glucose concentration, iyo yakanga yakanyanya kukwirira kudarika CVR mazinga akaonekwa pamagumo eglucose e20% uye 15% (Fig. 3 uye kuruboshwe rweTafura 3; mabhokisi ane shaded). ratidza p-tsika ≤ alpha ine Bonferroni gadziriso ye0.01). Paivawo nekudonha kwekutanga kwakapinza kwenhamba yePLT, yakaonekwa muchikamu chekutanga che 0-15 s, uye yakaramba yakagadzikana (kubva pa15 s kusvika 30 min; kuruboshwe rwetafura 4).
Kuwedzerwa kwezvakasiyana-siyana zveglucose kuropa rose zvakakonzera kudzikira kwekutanga nekukurumidza muMPV kuchiteverwa nekudzoreredzwa kunotsamira kweanopfuura 20%. Iyo ngano inoratidza kusangana kweglucose mushure mekudzikiswa. D15, D20 neD25 dzakaitwa muchidimbu che1:1. D21 uye D41 yakaitwa pa1:5 dilution.
Tafura 4 inoratidza shanduko mukuverenga kweplatelet kana yakaderedzwa mu hypertonic glucose. Takaona hukama hunoenderana nedosi pakati pekudonha nekukurumidza kwenhamba dzePLT pa1: 1 dilution uye pa1: 5 dilution. Kuenzanisa 1: 1 dilutions seboka rimwechete ne1: 5 dilutions, boka re1: 1 rakave nekuderera kwekukurumidza kwehuwandu hweplatelet zvishoma pane 1: boka re5 66±48,000 (23%) maringe ne99±69,000 (37%). , p = 0.014) muboka re1:5. Mushure mekudonha kwekutanga pachiyero chekutanga chekuyera, iyo platelet inoverenga sechikamu cheglucose yakagadzikana (Fig. 4).
Kana ropa rose rawedzerwa kuglucose muchiyero che1: 1, nhamba yeplatelet inoderedzwa ne25%. Zvisinei, apo ropa rose rakawedzerwa pachiyero che1: 5, kuderedzwa kwaiva kukuru - inenge 50%.
41% glucose yakawedzera MPV nekukurumidza uye zvakanyanya kupfuura 25% kana 21%. Mhedzisiro yeMPV inoratidzwa muMufananidzo 3. Pane dzimwe dzose dilutions, hapana kuderera kwekutanga kweMPV kwakaonekwa mushure mekuwedzera kwe50% glucose. Paunenge uchishandisa 25% glucose (glucose concentration 20.8% pakuguma kwekupedzisira), kuchinja kweMPV kwakafananidzwa nekuchinja kwe20% glucose pa1: 1 dilution (Fig. 3). Kunyange zvazvo kuchinja kweMPV kwekutanga kwakakura pa41% yakasanganiswa yakasanganiswa pane 25%, musiyano muMPV pakati pe41% ne25% mushure memaminitsi e16 wakanga usisina kukosha (Tafura 3, kurudyi). Zvinonakidzawo kuti 25% glucose yakawedzera MPV zvakanyanya kupfuura 20.8%.
Ichi in vitro chidzidzo chakasimbisa chikamu chedu hypothesis. Yakaratidza zvingangoita chikamu cheplatelet lysis ne dextrose admixture, kukurumidza kugara kweplatelet kune yakanyanyisa hypertonicity, uye kukwira kukuru kweMPV mukupindura> 25% yehuwandu hwe hypertonic dextrose. Yakaratidza zvingangoita chikamu cheplatelet lysis ne dextrose admixture, kukurumidza kugara kweplatelet kune yakanyanyisa hypertonicity, uye kukwira kukuru kweMPV mukupindura> 25% yehuwandu hwe hypertonic dextrose. Он показал потенциальный частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию частичный лизис тромбоцитов примесью декстрозы. повышение MPV в ответ на гипертоническую концентрацию декстрозы > 25%. Yakaratidza zvingangoita chikamu cheplatelet lysis ne dextrose, kukurumidza kweplatelet accommodation kune yakanyanyisa hypertonicity, uye kuwedzera kukuru kweMPV mukupindura kumazinga e hypertonic dextrose> 25%.它显示出通过葡萄糖混合物潜在的部分血小板溶解，血小板快速适应极端高渗，2浓度的高渗葡萄糖时MPV 显着上升.它 显示 出 通速 适应 极端25% 浓度 高渗 葡萄糖 时 时 mpv 显着。。。. Он показывает потенциальный частичный лизис тромбоцитов смесями с глюкозой, быструю адаптацию тромбоцитов к экстремальпитом значительное увеличение MPV в ответ на концентрацию гипертонической глюкозы > 25%. Inoratidza zvingangoita chikamu cheplatelet lysis nemisanganiswa yeglucose, kukurumidza kushandiswa kweplatelet kune yakanyanyisa hypertonicity, uye kuwedzera kukuru kweMPV mukupindura hypertonic glucose> 25%.Kuwedzera kwekutanga kwaive kwakanyanya pa41.6% glucose exposure, asi kuwedzera kweMPV kwakasvika 25% glucose exposure inenge maminitsi makumi maviri mushure mekuratidzwa.
Kuwanda kwemaplatelet kunokonzerwa neglucose. Isu takaona kuti huwandu hwePLT hwakadzikira pane ese dilutions yeglucose. Kudonha kwakapinza kwenhamba yeplatelet muH2O (0%) dilutions yePRP series inogona kusanganiswa ne osmotic lysis. Neimwe nzira, ichi chinogona kunge chiri chigadzirwa chinokonzerwa neplatelet clumping, asi izvi zvinopesana nekushaikwa kweMPV shanduko paino dilution. Kuwana uku kunoreva kuti mamwe maplatelet anonyanya kunzwira hypoosmolarity.
Mune zvose 1: 1 dilutions yeglucose, chiyero chePLT chakaderera ne 20-30%, kunyange neD5W (hypotonic pa 252 mOsm), iyo inogona kuratidza humwe husina-osmotic effect yeglucose, sezvo zvose PLT neMPV zvakaramba zvisina kuchinjwa pakuwedzera katatu muhuwandu. glucose. kubva kuD5W kusvika kuD25W. Muchokwadi, kutariswa kwePLT kwaiwedzera kuwedzera zvishoma nekuwedzera osmolarity.
Kudzikira kwePLT pakati pe1: 1 uye 1: 5 dilutions zvinoreva kuti kunyungudika mhedzisiro kunoenderana nekutanga uye yekupedzisira kuiswa kweglucose. Kana yaivimba chete nekutanga kusungirirwa, saka munhu angatarisira kuona mutsauko mukuderedzwa kwePLT pakati pe1: 1. Asi isu hatidaro. Kana iyo lysis effect inoenderana chete nekupedzisira glucose concentration, saka hatitarisiri misiyano yakawanda pakati pe20% 1: 1 dilution uye 20.8% 1:5 dilution. Uye zvakadaro takazviita.
Kana kurasikirwa kweplatelet kunoitika nekuda kweplatelet lysis, chikamu che lysate chinoumbwa, mushure mezvo ma cytokines uye zvinhu zvinokura zvinobudiswa munzvimbo ye extracellular. Tsvakurudzo dzinoverengeka dzakaratidza kuti platelet lysate inenge yakabudirira sePRP semhinduro yekuwedzera [11]. PRP pachayo yakaratidzwa kuva mhinduro inoshanda yekurapa kupararira [12-14].
Maplatelet asingashande anotenderera muchimiro chedhisiki yakasimbiswa ne akati wandei maumbirwo emukati. Panguva yekushanda, vanotora imwe spherical kana amoeba chimiro, zvichiita kuti inzwi riwedzere. Kuwedzera kwehuwandu kunoda kuwedzera kwepamusoro penzvimbo, iyo inokonzerwa neextrusion ye-open tubule system (OCS) uye kuwedzerwa kwe exocytic granules kune membrane. Izvo zvinoramba zvichizivikanwa kana kuwedzera kweMPV kunokonzerwa ne hypertonic glucose kunosanganisira imwe chete kana mbiri idzi nzira, asi kana iyo yekupedzisira, ipapo kuwedzera kweMPV kunoratidza kuderera.
Ichi chidzidzo chakaratidza kuti kutarisana nepamusoro-soro yeglucose paPRP kana kuti maplatelet eropa rose zvakakonzera kuwedzera kweMPV mukati memaminitsi e15 neglucose concentration ye25% uye 41.6%, maererano.
Kuwedzera kweplatelet MPV kunogona kunge kuri nekuda kwekuwedzera kweakatenderedza microtubule tangles mukupindura kune calcium influx. Liu et al. Glucose yakaratidzwa kuti inopindirana ne calcium influx kuburikidza neplatelet TRPC6 channel [6]. Pfungwa yedu ndeyokuti glucose inokonzera kuzorora kwema microtubule tangles, zvichiita kuti kuwedzerwa kweMPV uye kukurudzirwa kweplatelet uye / kana kushandiswa. Zvisinei, tichitonga nemigumisiro yedu, ichi chinongova chikamu chenyaya. Mune bvunzo dzedu, hapana kusungwa pazasi D25W kwakakonzera kuwedzera kweMPV. Tichifunga kuti isu hatina kuyedza kuratidzwa kweglucose concentration pakati pe12.5% ​​ne25%, mhedzisiro yedu yechikamu chekutanga inoratidza kuti panogona kunge paine chikumbaridzo mumhando iyi yeglucose concentration inotungamira mukuwedzera kweMPV. Kuwedzera kuyedzwa mumatanho 3 uye 4 kwakaratidza kuti 20-25% glucose inoratidzika kunge iri chikumbaridzo cheizvi, asi zvinoramba zvisiri pachena kuti nei.
Isu takaonawo kuderera kwe ~ 9% muMPV mushure mekuita centrifugation. Hazvina kujeka kana kuderera uku kweMPV kunokonzerwa nemaplatelet akakura uye akaomarara akavharirwa muRBC layer yecentrifuge. Kucherekedza uku kungave kwakakosha kuvarapi sezvo zvichireva kuti PRP maplatelet idiki uye shoma shoma yeWB maplatelet.
Muchidzidzo chakapfuura, takaratidza kuti kugadzirira kwePRP nenzira dzemanyorero hakudhure [8]. Kana glucose inokurudzira maplatelet enyama kana PRP, zvichiita kuti zvive nyore kushandiswa, kana kuti PRP inogadzirwa ine chikamu che lysate, izvi zvinogona kuwedzera kuberekwa patsva uye kuderedza kudiwa kwekurapa. Nokudaro, kusanganiswa kwePRP uye glucose yakanyanyisa inogona kunge inodhura-inoshanda kupfuura PRP kana glucose chete.
Chidzidzo chedu chine zvikanganiso zvakawanda. Kutanga, isu tinoshandisa PRP inowanikwa kubva kune akati wandei nzira dzakasiyana. Izvi zvinogona kutungamirira kumigumisiro inopesana. Chechipiri, hatina kukwanisa kuita ongororo yebiochemical yeimwe yemasampuli edu kuti tinyatsoona kana platelet activation yakaitika. Tinoda kuyera P-selectin, maplatelet factor 4, monocytic platelet aggregates, kana zvimwe zvinocheresa maplatelet activation kuti tinzwisise zviri nani dhigirii kana kuvapo kwealpha granule degranulation, asi izvi zvinopfuura chiyero chechidzidzo ichi. Chechitatu, hatina kukwanisa kusimbisa ne electron microscopy kana dzimwe nzira kuti kuwedzera kweMPV muglucose-yakafumurwa maplatelet yakakonzerwa nemigumisiro ye microtubule tangles.
Kusanganiswa kweWB kana PRP ne 25% glucose yakawedzera MPV, zvichiratidza kutanga kweplatelet activation, kunyange zvazvo chidzidzo ichi chisina kuratidza kufambira mberi kwekuunganidza kana kuderedza. Iyo hypertonic glucose musanganiswa yakakonzera kurasikirwa kweplatelet, pamwe inomiririra lytic effect. Kuitwa kwechikamu kana lysis yemaplatelet kunogona kukonzera kuvandudzwa kwetishu mushure mejekiseni replatelet. Hazvisi pachena kuti ndezvipi migumisiro yekliniki shanduko idzi dzinogona kutungamirira. Zvimwe zvidzidzo zvakaratidza zviyero zvakanyatsojeka zvekugadzirisa kana lysis uye zvakaongorora zvakasiyana-siyana zvekliniki zvinokonzerwa ne hypertonic glucose yakasanganiswa neWB kana PRP.
Glucose proliferative therapy iri nyore uye isingadhure regenerative therapy iri kukurumidza kuwedzera nekutsigira tsvakiridzo yekiriniki. Ichi chidzidzo chinoratidza maitiro ehupenyu ayo, kana akasimbiswa, anogona kutibatsira kuti tinzwisise chikamu chekugadzirisa nzira yeproliferative therapy.
Biomedical uye Health Informatics paYunivhesiti yeMissouri, Kansas City Chikoro cheMishonga, Kansas City, USA.
Zvidzidzo Zvevanhu: Vese vakapinda muchidzidzo ichi vakapa kana kusapa mvumo. Sangano reInternational Society for Cellular Medicine rakapa ICMS-2017-003 mvumo. Iyi inotevera protocol yakabvumidzwa kuti ishandiswe zvakare neInstitutional Review Board yeInternational Society for Cellular Medicine: Musoro: Kuverengerwa kweplatelet-rich plasma drug goho zvichibva pane yekutanga CBC platelet count. Zvidzidzo zveMhuka: Vese vanyori vakasimbisa kuti hapana mhuka kana matishu akabatanidzwa muchidzidzo ichi. Kupesana Kwekufarira: Maererano neICMJE Uniform Disclosure Form, vanyori vose vanozivisa zvinotevera: Kubhadhara / ruzivo rwebasa: Vose vanyori vanotaura kuti havana kuwana rubatsiro rwemari kubva kune chero sangano rebasa rakatumirwa. Hukama Hwemari: Vese vanyori vanozivisa kuti ivo parizvino kana mukati memakore matatu apfuura vane hukama hwemari nechero sangano rinogona kufarira basa rakatumirwa. Humwe Hukama: Vese vanyori vanotaura kuti hapana humwe hukama kana zviitiko zvinogona kukanganisa basa rakatumirwa.
Harrison TE, Bowler J, Reeves K et al. (Chivabvu 17, 2022) Mhedzisiro yeglucose pakuverenga kweplatelet uye vhoriyamu: mhedzisiro yemushonga wekuvandudza. Kurapa 14(5): e25081. doi:10.7759/cureus.25081
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