Akuvamile Ngokwemibandela Yokuvuvukala
Ama-platelets amancane ajikeleza izingcezu zeseli ezidlala indima ebalulekile ku-hemostasis (inqubo yokuyeka ukuphuma ngemuva kokulimala). Ayinayo i-nucleus kodwa iqukethe i-cytoplasm nama-proteine abalulekile emsebenzini weplatelet. Ama-platelet akhiqizwa ama-megakaryocytes emnothweni wethambo.
Amaplanethi amaningi avame ukuphakama e- arthritis ye-rheumatoid .
Isimo samaplatelet aphakeme aziwa ngokuthi thrombocytosis.
Ku-arthritis ye-rheumatoid, amajoyina ayindawo eyinhloko yomonakalo. Yilapho ukuvuvukala kwendawo kwenzeka khona, kufaka phakathi amaseli egazi ahlanganisa neutrophils nama-macrophages. Lawo maseli nawo avuselela ukukhiqizwa kwe-platelet-activating factor, okuyinto eyabangela ukuqoqwa kwamaplatelet wegazi, okubenza bahlanganyele ekuphenduleni okuvuthayo emzimbeni.
Amapulangwe e-Rheumatoid Arthritis
Abantu abanempilo banenani leplatelet ebangeni elijwayelekile lika 150,000-400,000 / mm3. Ngesikhathi esidlule ngo-1972, kwaphawulwa ezincwadini zokwelapha ukuthi abacwaningi bathola izibalo zamapulangwe eziphakeme cishe cishe kwesithathu kwezilwane zezifo zesifo sofuba se-rheumatoid.
Lokhu kutholakala ukuthi kuhlobene ngokuqondile nomsebenzi wesifo. Abacwaningi bathola ukuhlanganiswa phakathi kwenani eliphakeme leplatelet ne- anemia , i-leukocytosis (inani elandayo lamaseli amhlophe egazi), nesici se-rheumatoid .
Kukhona ubudlelwane obuphambene phakathi kwe-hemoglobin ne-platelet count, okusho ukuthi, lapho i-hemoglobin iphansi, inani leplatelet liphakeme. Ukubambisana kwe-sideropenia (ukuntuleka kwensimbi) nokuphakama kokubala kweplatelet akutholakali kubalulekile.
Abanye abantu abane-arthritis ene-rheumatoid eqinile bangaba nezibalo ezingaphezu kwezigidi.
Uma lesi sifo silawulwa ngemithi, inani leplatelet libuyela emuva evamile.
Ama-platelet akhuliswa nje kuphela ku-arthritis ye-rheumatoid, kodwa nakwezinye izimo ezivuthayo ezifanayo. Ukulungiswa okuphawulekayo kwatholakala phakathi kwamaplatelet aphakeme kanye ne- vasculitis enomzimba. Ezinye izibonakaliso ezingavamile ze-arthritis ye-rheumatoid (okungukuthi, ezithinta izingxenye zomzimba ezingaphezu kwamalungu nje) zitholakala kaningi phakathi kwabantu abaye baphakamisa izibalo zeplatelet.
Izimbangela
Incazelo engcono kakhulu yeplatelet ephakeme ebalwa ngamathambo e-rheumatoid ibonakala sengathi ihlobene ne-anemia engapheli, isici esivamile sesifo samathambo. Ngokusho kwama- Annal of the Rheumatic Diseases , i-homeostasis platelet ilawulwa yi-thrombopoietin.
I-Thrombopoietin yilapho ilawula ngokuyinhloko ukukhula kwe-megakaryocyte nokuhlukanisa. Kucatshangwa ukuthi i-thrombopoietin ingahle ihlotshwe ngamakhemikhali ku-erythropoietin (i-hormone ehilelekile ekukhiqizeni kwegazi elibomvu), ikakhulukazi ngenxa yeziguli ezingapheliyo ezinama-anemic ne-reticulocytosis (inani elanda lamaseli egazi abomvu) futhi amazinga e-erythropoietin ayanda kakhulu kunezibalo ezivamile zeplatelet. Uma ama-erythropoietin ekhuphuka kubantu abane-anemia ne-rheumatoid arthritis, izibalo zamaplatelet eziphakanyisiwe zingabangela.
Okunye kungenzeka ukuthi ukukhiqizwa kweplatelet okwandisiwe kubangelwa ukubhujiswa kwamaplatelet noma ukusetshenziswa. Abacwaningi baphinde baphakamise ukuthi izibalo zamaplatelet eziphakeme zingaxhunyaniswa nezimpendulo ze-immunological ku-arthritis ye-rheumatoid-mhlawumbe ngenxa yezindwangu ezincane ngaphakathi kwe- synovium evuthayo .
Ngokusho kukaKelley's Textbook of Rheumatology , kunezimbangela ezintathu eziyinhloko zezibalo zamaplatelet eziphakeme ngezifo ze-rheumatic:
- I-thrombocytosis esebenzayo, eyesibili kwinqubo yokuvuvukala engapheli. Ezimweni ezinjalo, ama-cytokines (i-IL-1, i-IL-6, ne-TNF) ingaba ngabalamuleli abasebenzayo ekulawuleni ukukhiqizwa kweplatelet ngesikhathi senqubo yokuvuvukala.
- I-thrombocytosis ejwayelekile ingase ivele ngenxa yokuguqula izakhi zofuzo.
- I-thrombocytosis ye-Clonal (i- thrombocytosis eyinhloko noma ebalulekile) iyinto engavumelekile yokukhiqizwa kweplatelet ngenxa yokwanda kwe-megakaryocyte.
> Imithombo:
> Hutchinson RM et al. I-thrombocytosis e-arthritis ye-rheumatoid . Ama-Annal of the Rheumatic Diseases. (1976) 35: 138
> Kiraz S. et al. I-bloodstream thrombopoietin e-arthritis ye-rheumatoid ene-thrombocytosis, i-Rheumatology yezokwelapha. 2002 Nov; 21 (6): 453-6.
> Kelley's Bookbook of Rheumatology. I-Ninth Edition. Isahluko 17. Ama-Platelets kanye nama-Rheumatic Diseases. Amakhasi 249-251.
> I-thrombocytes e-Rheumatoid Arthritis. I-Scandinavia Journal of Rheumatology. Selroos, O. 1972 1: 136.