Mapulateleti, monga zidutswa za maselo a m'mafupa a megakaryocyte, amadziwika ndi kusakhalapo kwa ma nuclei.Mapulateleti aliwonse amakhala ndi mitundu itatu ya tinthu tating'onoting'ono, tomwe ndi α Granules, matupi owundana ndi ma lysosomes okhala ndi kuchuluka kosiyanasiyana.Kuphatikizira α The granules ali olemera kuposa 300 mapuloteni osiyanasiyana, monga vascular endothelial activating factor, leukocyte chemotactic factor, activating factor, kukonzanso minofu yokhudzana ndi kukula ndi antibacterial peptide, yomwe imakhudzidwa ndi zochitika zambiri za thupi ndi matenda, monga machiritso a bala. , angiogenesis ndi anti-infection chitetezo chokwanira.
Thupi lowundana lili ndi kuchuluka kwa adenosine diphosphate (ADP), adenosine triphosphate (ATP), Ca2+, Mg2+ ndi 5-hydroxytryptamine.Lysosomes ali ndi mitundu yosiyanasiyana ya shuga, monga glycosidase, proteases, mapuloteni a cationic ndi mapuloteni omwe ali ndi bactericidal ntchito.GF izi zimatulutsidwa m'magazi pambuyo poyambitsa mapulateleti.
GF imayambitsa kuphulika pomanga ndi mitundu yosiyanasiyana ya ma cell membrane receptors, ndikuyambitsa ntchito zinazake popanganso minofu.Pakalipano, GF yophunzira kwambiri ndi platelet derived growth factor (PDGF) ndi kusintha kukula kwa chinthu (TGF- β (TGF- β) , Vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), connective tissue growth factor (CTGF) ndi insulin-like growth factor-1 (IGF-1) ma GF awa amathandiza kukonza minofu, tendon, ligament ndi minyewa ina polimbikitsa kuchulukana kwa maselo ndi kusiyanitsa, angiogenesis ndi njira zina, kenako kusewera udindo.
Kugwiritsa ntchito PRP ku Vitiligo
Vitiligo, monga matenda wamba autoimmune, komanso voliyumu mkhutu matenda a pakhungu, ali ndi zotsatira zoipa pa maganizo a odwala ndipo kwambiri kukhudza khalidwe la moyo wa odwala.Mwachidule, kuchitika kwa vitiligo ndi chifukwa cha kuyanjana kwa zinthu za chibadwa ndi zinthu zachilengedwe, zomwe zimapangitsa kuti ma melanocyte akhungu aziwukiridwa ndikuwonongeka ndi autoimmune system.Pakalipano, ngakhale pali mankhwala ambiri a vitiligo, sagwira ntchito bwino, ndipo mankhwala ambiri alibe umboni wa mankhwala ozikidwa pa umboni.M'zaka zaposachedwa, ndi kufufuza kosalekeza kwa pathogenesis ya vitiligo, njira zina zatsopano zothandizira zakhala zikugwiritsidwa ntchito nthawi zonse.Monga njira yothandiza yochizira vitiligo, PRP yakhala ikugwiritsidwa ntchito mosalekeza.
Pakalipano, 308 nm excimer laser ndi 311 nm yopapatiza band ultraviolet (NB-UVB) ndi matekinoloje ena a phototherapy akudziwika kwambiri chifukwa cha mphamvu zawo kwa odwala vitiligo.Pakali pano, kugwiritsa ntchito autologous PRP subcutaneous microneedle jekeseni pamodzi ndi phototherapy odwala ndi vitiligo khola wapita patsogolo kwambiri.Abdelghani et al.anapeza mu kafukufuku wawo kuti autologous PRP subcutaneous microneedle jekeseni pamodzi ndi NB-UVB phototherapy akhoza kwambiri kufupikitsa okwana mankhwala nthawi ya vitiligo odwala.
Khattab et al.anachiritsa odwala ndi khola non segmental vitiligo ndi 308 nm excimer laser ndi PRP, ndipo anapeza zotsatira zabwino.Zinapezeka kuti kuphatikiza ziwirizi kungathandize kusintha leucoplakia recolor rate, kufupikitsa nthawi ya chithandizo, ndikupewa zotsatira zoyipa zakugwiritsa ntchito nthawi yayitali 308 nm excimer laser radiation.Kafukufukuyu akuwonetsa kuti PRP yophatikizidwa ndi phototherapy ndi njira yabwino yochizira vitiligo.
Komabe, Ibrahim ndi maphunziro ena amasonyezanso kuti PRP yokha siigwira ntchito pochiza vitiligo.Kadry et al.adachita kafukufuku wosasinthika wokhudzana ndi chithandizo cha vitiligo ndi PRP kuphatikiza ndi carbon dioxide dot matrix laser, ndipo adapeza kuti PRP yophatikizidwa ndi carbon dioxide dot matrix laser ndi PRP yokha idapeza zotsatira zabwino za kubalana.Pakati pawo, PRP yophatikizidwa ndi carbon dioxide dot matrix laser inali ndi zotsatira zabwino kwambiri zobereketsa mtundu, ndipo PRP yokhayo inali itapeza kubereka kwapakati pamtundu wa leukoplakia.Mphamvu yobereketsa mtundu wa PRP yokha inali yabwino kuposa ya carbon dioxide dot matrix laser yokha pochiza vitiligo.
Opaleshoni Yophatikizidwa ndi PRP pa Chithandizo cha Vitiligo
Matenda a Vitiligo ndi mtundu wa matenda a pigment omwe amadziwika ndi kuchepa kwa mtundu.Njira zochiritsira zochiritsira zimaphatikizapo mankhwala osokoneza bongo, phototherapy kapena opaleshoni, kapena kuphatikiza njira zingapo zothandizira.Odwala ndi vitiligo khola ndi osauka zotsatira za ochiritsira mankhwala, opaleshoni mankhwala akhoza kukhala woyamba alowererepo.
Garg ndi al.adagwiritsa ntchito PRP ngati kuyimitsidwa kwa maselo a epidermal, ndipo adagwiritsa ntchito Er: YAG laser pogaya mawanga oyera, omwe adapeza chithandizo chabwino chochizira odwala okhazikika a vitiligo.Phunziroli, odwala 10 omwe ali ndi vitiligo okhazikika adalembedwa ndipo zilonda za 20 zinapezedwa.Mu zilonda za 20, zilonda za 12 (60%) zinawonetsa kuchira kwathunthu kwa pigment, zilonda za 2 (10%) zimasonyeza kuchira kwakukulu kwa pigment, zilonda za 4 (20%) zimasonyeza kuchira kwamtundu wa pigment, ndipo zilonda za 2 (10%) sizinawonetse kusintha kwakukulu.Kubwezeretsedwa kwa miyendo, mawondo a mawondo, nkhope ndi khosi ndizoonekeratu, pamene kuchira kwa malekezero kumakhala kovuta.
Inetha et al.adagwiritsa ntchito kuyimitsidwa kwa PRP kwa maselo a epidermal kukonzekera kuyimitsidwa ndi kuyimitsidwa kwa phosphate buffer ya epidermal cell kuti afananize ndikuwona kuchira kwawo kwa pigment kwa odwala omwe ali ndi vitiligo.Odwala 21 okhazikika a vitiligo adaphatikizidwa ndipo mawanga 42 oyera adapezeka.Nthawi yokhazikika ya vitiligo inali zaka 4.5.Odwala ambiri adawonetsa kuchira pang'ono mpaka oval discrete pigment pafupifupi miyezi 1-3 mutalandira chithandizo.M'miyezi 6 yotsatiridwa, kuchira kwa pigment kunali 75.6% mu gulu la PRP ndi 65% mu gulu losakhala la PRP.Kusiyana kwa malo obwezeretsa pigment pakati pa gulu la PRP ndi gulu losakhala la PRP kunali kofunikira kwambiri.Gulu la PRP linawonetsa bwino kuchira kwa pigment.Pofufuza kuchuluka kwa kuchira kwa pigment kwa odwala omwe ali ndi segmental vitiligo, panalibe kusiyana kwakukulu pakati pa gulu la PRP ndi gulu losakhala la PRP.
Kugwiritsa ntchito PRP ku Chloasma
Melasma ndi mtundu wa matenda akhungu omwe amapezeka pankhope, omwe amapezeka makamaka pankhope za amayi omwe nthawi zambiri amakhala ndi kuwala kwa ultraviolet ndipo amakhala ndi khungu lakuya.Matenda ake sanafotokozedwe bwino, ndipo ndizovuta kuchiza komanso zosavuta kubwereza.Pakali pano, chithandizo cha chloasma chimatengera njira yophatikizira yochizira.Ngakhale jekeseni wa subcutaneous wa PRP ali ndi njira zosiyanasiyana zothandizira chloasma, mphamvu ya odwala siili yokhutiritsa kwambiri, ndipo n'zosavuta kubwereranso pambuyo posiya mankhwala.Ndipo mankhwala amkamwa monga tranexamic acid ndi glutathione angayambitse kutsekula m'mimba, kusokonezeka kwa msambo, kupweteka mutu, komanso kupanga thrombosis yakuya.
Kufufuza chithandizo chatsopano cha chloasma ndi njira yofunikira pakufufuza kwa chloasma.Zimanenedwa kuti PRP imatha kusintha kwambiri zotupa zapakhungu za odwala omwe ali ndi melasma.Cay ı rl ı Et al.Adanenanso kuti mzimayi wazaka 27 adalandira jekeseni ya subcutaneous microneedle ya PRP masiku 15 aliwonse.Pamapeto pa chithandizo chachitatu cha PRP, zinawoneka kuti malo a epidermal pigment recovery ndi> 80%, ndipo panalibe kubwereza mkati mwa miyezi 6.Sirithanabadeekul et al.adagwiritsa ntchito PRP pochiza chloasma kuti achite mwamphamvu kwambiri RCT, yomwe idatsimikiziranso mphamvu ya jekeseni wa PRP wochizira matenda a chloasma.
Hofny ndi al.adagwiritsa ntchito njira ya immunohistochemical kuti apangitse TGF kudzera mu jekeseni wa subcutaneous microneedle wa PRP mu zotupa zapakhungu za odwala omwe ali ndi chloasma ndi ziwalo zodziwika bwino- β Kufananiza kwa puloteni kumasonyeza kuti musanayambe chithandizo cha PRP, zotupa zapakhungu za odwala omwe ali ndi chloasma ndi TGF kuzungulira khungu - β Mafotokozedwe a mapuloteni anali otsika kwambiri kuposa a khungu lathanzi (P <0.05).Pambuyo pa chithandizo cha PRP, TGF ya zilonda zapakhungu kwa odwala omwe ali ndi chloasma- β Kufotokozera kwa mapuloteni kunawonjezeka kwambiri.Chodabwitsa ichi chikuwonetsa kuti kusintha kwa PRP kwa odwala a chloasma kungapezeke mwa kuwonjezera TGF ya zotupa zapakhungu- β Mafotokozedwe a mapuloteni amapindula ndi chithandizo chamankhwala pa chloasma.
Photoelectric Technology Yophatikizidwa ndi Subcutaneous Injection ya PRP pochiza Chloasma
Ndi chitukuko chosalekeza cha teknoloji ya photoelectric, ntchito yake pochiza chloasma yakopa chidwi cha ofufuza.Pakalipano, ma lasers omwe amagwiritsidwa ntchito pochiza chloasma akuphatikizapo Q-switched laser, lattice laser, kuwala kwamphamvu kwambiri, cuprous bromide laser ndi njira zina zothandizira.Mfundo ndi yakuti kusankha kuwala kuphulika kumachitika chifukwa cha melanin particles mkati kapena pakati pa melanocytes kupyolera mu kusankha mphamvu, ndi ntchito ya melanocytes ndi inactivated kapena inhibited kudzera mphamvu otsika ndi kangapo kuphulika kuwala, ndipo nthawi yomweyo, angapo kuwala kuphulika kwa melanin particles. ikuchitika, Itha kupanga tinthu tating'onoting'ono tomwe timakhala tomwe timapanga melanin kuti tizitha kumezedwa ndikuchotsedwa ndi thupi.
Su Bifeng et al.mankhwala chloasma ndi PRP madzi jekeseni kuwala pamodzi ndi Q switched Nd: YAG 1064nm laser.Pakati pa odwala 100 omwe ali ndi chloasma, odwala 15 mu gulu la PRP + laser anachiritsidwa kwenikweni, odwala 22 anali bwino kwambiri, odwala 11 anali bwino, ndipo wodwala 1 anali wosagwira ntchito;Pagulu la laser lokha, milandu 8 idachiritsidwa kwenikweni, milandu 21 inali yothandiza kwambiri, milandu 18 idasinthidwa, ndipo 3 inali yosagwira ntchito.Kusiyana pakati pa magulu awiriwa kunali kofunikira kwambiri (P <0.05).Peng Guokai ndi Song Jiquan adatsimikiziranso mphamvu ya Q-switched laser yophatikizidwa ndi PRP pochiza chloasma ya nkhope.Zotsatira zinasonyeza kuti Q-switched laser pamodzi ndi PRP inali yothandiza pochiza chloasma ya nkhope
Malingana ndi kafukufuku wamakono pa PRP mu dermatoses ya pigmented, njira yotheka ya PRP pochiza chloasma ndikuti PRP imawonjezera TGF ya zotupa pakhungu- β Mafotokozedwe a mapuloteni amatha kusintha odwala a melasma.Kuwongolera kwa PRP pa zotupa zapakhungu za vitiligo kumatha kukhala kogwirizana ndi mamolekyu a α Adhesion opangidwa ndi ma granules amagwirizana ndi kusintha kwa chilengedwe chazotupa za vitiligo ndi ma cytokines.Kuyambika kwa vitiligo kumakhudzana kwambiri ndi chitetezo chamthupi cha zotupa zapakhungu.Kafukufuku wapeza kuti m'dera chitetezo abnormalities a vitiligo odwala ndi okhudzana ndi kulephera kwa keratinocytes ndi melanocytes pakhungu zotupa kukana kuwonongeka kwa melanocytes chifukwa cha zosiyanasiyana yotupa zinthu ndi chemokines anamasulidwa m`kati mwa oxidative kupsyinjika.Komabe, mitundu yosiyanasiyana ya kukula kwa mapulateleti opangidwa ndi PRP ndi ma cytokines osiyanasiyana odana ndi kutupa omwe amatulutsidwa ndi mapulateleti, monga soluble tumor necrosis factor receptor I, IL-4 ndi IL-10, omwe ndi otsutsa a interleukin-1 receptor, amatha. kuchitapo kanthu pakuwongolera chitetezo cham'deralo cha zotupa zapakhungu.
(Zomwe zili m'nkhaniyi zidasindikizidwanso, ndipo sitikupereka chitsimikizo chotsimikizika kapena chotsimikizika pakulondola, kudalirika kapena kukwanira kwa zomwe zili m'nkhaniyi, ndipo sitili ndi udindo pamalingaliro ankhaniyi, chonde mvetsetsani.）
Nthawi yotumiza: Nov-24-2022