Maƙala
Amfani da methylene blue kullum da na dogon lokaci: me aka nazarta?
Bincike bai tabbatar da wani tsarin amfani da methylene blue kullum gaba ɗaya ga manya masu lafiya ba. An yi nazarin maimaita fallasar mutane, ciki har da ƙaramin gwajin tabin hankali na watanni shida. Akwai kuma gwaje-gwaje masu tsawo kan wani nau'in sinadari mai alaƙa amma wanda ya bambanta ta fuskar sinadarai. Babu ɗayan waɗannan rukunan da ya tabbatar cewa wani maganin kasuwa da ba a fayyace shi ba yana da aminci ko amfani idan ana ci gaba da amfani da shi ba tare da iyaka ba.
Tambayar da ta fi amfani ta fi “Shin wani ya taɓa nazartarsa na dogon lokaci?” takamaimai. Ita ce: wane sinadari ne, ta wace hanya aka bayar, ga wa, na tsawon wane lokaci, kuma waɗanne sakamako aka auna?
Karanta lokacin fallasa da bin diddigi daban
Lokacin fallasa yana bayyana lokacin da aka ba da magani. Bin diddigi yana bayyana lokacin da masu bincike suka sake duba mahalarta bayan haka. Bin diddigi na watanni uku bayan kwanaki biyar na magani ba yana nufin an yi dosing na watanni uku ba. Haka kuma, nazarin da ya ƙare lokacin da beraye suka kai watanni 30 ba lallai ba ne ya ƙunshi watanni 30 na magani.
Hoton murfin yana nuna wannan bambanci ta hanyar zane. Dige-digen da ke cikinsa na bayani ne, ba bayanan nazari da aka auna ba. Jadawalin da ke ƙasa yana ba da ainihin tsawon lokaci daga zaɓaɓɓun nazarce-nazarce. “Ba a bayar da rahoton wani bin diddigi na daban ba” yana nufin rahoton da aka ambata bai tabbatar da ƙarin lokacin lura ba tare da magani ba; ba yana nufin an tantance duk wani sakamako da zai iya faruwa daga baya kuma komai ya kasance al'ada ba.
Jadawalin tsawon nazari
| Nazari da samfurin bincike | Nau'in sinadari da hanyar bayarwa | Lokacin fallasa | Lura ko bin diddigi | Babban abin da aka auna |
|---|---|---|---|---|
| Rodriguez da abokan aiki: hoton kwakwalwar manya masu lafiya | USP methylene blue, methylthioninium chloride; ta baki | Bayarwa sau ɗaya | Ma'aunin farko da maimaita MRI da ya fara mintuna 60 bayan haka | Sauye-sauyen gaggawa a kwararar jinin kwakwalwa da hanyoyin sadarwar kwakwalwa, ba amincin amfani na dogon lokaci ba |
| Ibarra-Estrada da abokan aiki: marasa lafiya 91 masu septic shock | Methylene blue a cikin saline; ta jijiya | Infusion uku na kullum, kowanne yana ɗaukar sa'o'i shida | An tantance sakamakon asibiti har zuwa rana ta 28 | Amfani da vasopressor, sakamakon zaman asibiti, mace-mace da illolin gefe |
| Zoellner da abokan aiki: mahalarta 42 masu PTSD | Methylene blue; ta baki, tare da psychotherapy | Bayarwa bayan zaman imaginal-exposure guda biyar na kullum | Tantancewa har zuwa bin diddigi na watanni uku | Alamomi da yadda mutum ke gudanar da ayyuka bayan gajeriyar haɗaɗɗiyar intervention |
| Gureev da abokan aiki: berayen C57BL/6 | MB a matakan fallasa na kullum guda biyu da aka ruwaito; ba a fayyace hanyar bayarwa sosai a cikin methods ba | Makonni huɗu | Samfurin bayan gida kowane mako; gwajin maze a cikin kwanaki biyar na ƙarshe; ba a bayar da rahoton wani bin diddigin farfadowa na daban ba | Tsarin microbiome da aikin maze |
| Jena da Chainy: berayen Wistar mata | Methylene blue a cikin ruwan sha; ta baki | Kwanaki 30 | Samfurin jini, hanta da koda a ƙarshen nazari | Zaɓaɓɓun ma'aunin oxidative-stress da serum; dabbobi biyar a kowane rukuni |
| Alda da abokan aiki: mahalarta 37 masu bipolar disorder | Kapsul na methylene blue; ta baki; mafi girman active dose idan aka kwatanta da mafi ƙanƙanta | Crossover na makonni 26: lokutan magani guda biyu na makonni 12 tare da makonnin titration da crossover | Ziyarce-ziyarcen yau da kullum yayin magani; an tantance cognition a baseline, makonni 13 da 26 | Ragowar alamomin yanayi, cognition da tolerability tare da maganin da ake amfani da shi |
| Poudel da abokan aiki: tsufar ƙashi a beraye | MB a cikin ruwan sha ga tsofaffin berayen C57BL/6J mata; MB a cikin abinci ga berayen UM-HET3 maza da mata | Watanni shida ko 12 a tsofaffin mata; watanni 15 a berayen UM-HET3, daga watanni bakwai zuwa 22 | Ma'aunin ƙashi a wuraren ƙarshe da aka kayyade; babu wani bin diddigi na daban ba tare da magani ba | Tsarin ƙashi da ke da alaƙa da tsufa, ba cikakken tantance amincin mutane ba |
| Gauthier da abokan aiki: marasa lafiya 891 masu cutar Alzheimer | Leuco-methylthioninium bis(hydromethanesulfonate), LMTM; ta baki | Lokacin randomized treatment na watanni 15 | Tantancewar asibiti da aminci yayin gwajin | Cognition, ayyukan yau da kullum da adverse events; low-dose LMTM control |
| Auerbach da abokan aiki: berayen F344/N da berayen B6C3F1 | Methylene blue trihydrate a cikin methylcellulose; oral gavage | Shekaru biyu, kwanaki biyar a kowane mako | Sa ido kan rayuwa da pathology na kyallen jiki har zuwa ƙarshen nazarin | Chronic toxicity da carcinogenicity |
Waɗannan layukan ba shawarwarin dose ne da za a iya musanya da juna ba. Oral gavage yana kai sinadari kai tsaye cikin ciki; ruwan sha da abinci suna ba da hanyoyin cin sinadari daban-daban. Infusion ta jijiya yana wuce shayarwar hanji. Tsawon lokacin fallasa ba zai kawar da waɗannan bambance-bambancen ba.
Abin da maimaita amfani da shi a mutane ke nuna mana
Gwajin bipolar yana ba da bayanin da ya fi dacewa game da maimaita amfani da methylene blue ta baki fiye da scan na kwakwalwa guda ɗaya. Duk da haka, mahalarta 27 ne kawai daga cikin 37 suka kammala gwajin. Mahalarta suna da bipolar disorder, suna riga suna karɓar lamotrigine, kuma ana sa ido a kansu yayin magani. Kwatancen ya yi amfani da ƙaramin dose na methylene blue maimakon inert placebo. Wannan tsarin ba zai iya tabbatar da amincin ci gaba da amfani da shi a mutane masu lafiya ba ko kuma ya kawar da yiwuwar illolin da ba kasafai suke faruwa ba cikin dogaro.
Gwajin Alzheimer yana buƙatar ƙarin bambancewa. LMTM wani stabilized reduced methylthioninium formulation ne mai counterions daban, ba maganin methylene blue chloride na yau da kullum ba. Bai kamata a gabatar da tsawon watanni 15 ɗinsa a matsayin watanni 15 na gwajin wani samfurin methylene blue na masu amfani ba. Prespecified primary analysis bai nuna amfani a higher doses idan aka kwatanta da low-dose control ba. An ruwaito gastrointestinal da urinary adverse events da raguwar hemoglobin. Tsawon lokacin lura ya samar da bayanan aminci; bai tabbatar da rashin haɗari ba.
Abin da nazarin dabbobi ke ƙara mana
Nazarin dabbobi na iya bincika kyallen jiki da maimaita fallasa da zai yi wahala a bincika a mutane. Haka kuma suna nuna dalilin da ya sa sakamako mai kyau a ma'auni guda ɗaya bai isa ba.
A gwajin beraye na kwanaki 30, liver lipid peroxidation ya ƙaru yayin da ma'aunin koda ya ragu. Wasu ma'aunin antioxidant da dama ba su canza ba. Kiran dukkan nazarin “antioxidant protection” zai ɓoye wannan bambancin da ya shafi gaɓa. A gwajin beraye na makonni huɗu, mafi girman fallasa ya haifar da manyan sauye-sauye a microbiome. Nazarin bai tabbatar da ko waɗannan sauye-sauyen sun ci gaba bayan an dakatar ba.
Tsawon fallasa bai kuma haifar da amfanin da ake nufi kai tsaye ba. Gwaje-gwajen tsufar ƙashi ba su hana asarar ƙashi da ke da alaƙa da shekaru ba. Alaƙarsu da ikirarin tsawon rai ta dogara da endpoint: bone morphology, survival, da tsawon rayuwar ɗan adam tambayoyi ne daban-daban.
Binciken chronic na National Toxicology Program ya gano carcinogenic activity tare da matakan shaidu daban-daban bisa jinsi da nau'in dabba. Takardar shekaru biyu da ke da alaƙa da shi ta kuma ruwaito anemia a wasu rukunan da aka fallasa. Waɗannan sakamakon ba su ba da adadin haɗarin cancer ga tsarin amfani da samfurin kasuwa a mutum ba. Amma suna kawar da yiwuwar ɗaukar shekaru biyu na dosing a dabbobi a matsayin tabbacin aminci ba tare da matsala ba. Bayanin shaidun carcinogenicity yana nazarin waɗannan sakamakon daban.
Addiction, withdrawal, tolerance da cycling
Waɗannan kalmomin suna bayyana tambayoyi daban-daban.
- Addiction ya haɗa da rashin iya sarrafa amfani da ci gaba da amfani duk da cutarwa. Nazarce-nazarcen da ke sama ba su tabbatar da wani methylene blue addiction syndrome ba. Haka kuma ba a tsara su don tabbatar da rashin yiwuwar dependence a masu amfani na dogon lokaci ba tare da kulawa ba.
- Withdrawal yana nufin wani syndrome da ake iya maimaita ganowa bayan rage ko dakatar da wani sinadari. Ban gano controlled evidence da ke bayyana wani methylene blue withdrawal syndrome na musamman ba. Gajiya, damuwa ko rashin maida hankali bayan dakatarwa rahoto ne da ya kamata a bincika, ba hujja mai isa da kanta don tabbatar da withdrawal ba. Dawowar wata matsala ta asali, wasu sinadarai da sauye-sauyen barci na iya rikitar da fassara.
- Tolerance yana nufin raguwar martani ga fallasa iri ɗaya yayin da lokaci ya wuce. Raguwar wani “boost” da mutum ke ji ba ya bayyana dalilinsa ko nuna cewa mafi girman dose ya dace. Gwaje-gwaje za su buƙaci maimaita standardized outcomes da exposure measurements don gwada wannan ikirari.
- Cycling yana nufin tsararrun lokutan amfani da lokutan dakatarwa. Shaidun da aka ambata ba su tabbatar da wani jadawali da ke hana tolerance, dependence ko cumulative harm ba. Tsarin toxicology na dabbobi na kwanaki biyar a kowane mako tsarin gwaji ne, ba shawarar cycling ga mutane ba. Sakamakon bincike na iya kuma rikitar da sinadarin da ake bincika da sinadarin da ke haifar da dependence. Misali, wani gwaji kan opioid tolerance da withdrawal ya yi amfani da methylene blue a cikin cell model da aka fallasa wa opioids. Ba nazari ne kan withdrawal daga methylene blue ba.
Tambayoyin da har yanzu ba a warware ba
Ga manya masu lafiya da ke amfani da methylene blue akai-akai, binciken da aka ambata bai tabbatar da tsawon lokacin da amfani zai ci gaba da kasancewa ba, mafi kyawun lokacin dakatarwa, wani ingantaccen jadawalin cycling, ko amintattun rates na delayed adverse effects. Haka kuma bai tabbatar da ko sakamakon dakin gwaje-gwaje na gajeren lokaci da yake al'ada yana hasashen aminci bayan shekaru ba.
Cumulative risk da drug accumulation suna da alaƙa amma ba abu ɗaya ba ne. Maimaita fallasa na iya zama muhimmiyar al'amari ko da maganin ba ya taruwa ba tare da iyaka ba, kuma sabon magani da ke mu'amala da shi na iya canza haɗari bayan wani lokaci da bai samu matsala ba. Lakabin PROVAYBLUE na jijiya na yanzu yana rubuta serious serotonergic interactions, haɗarin hemolytic anemia da mafi girman exposure idan aikin koda ya lalace. Ba ya ba da izinin amfani ta baki ba tare da iyaka ba.
Don yanke shawara ga mutum ɗaya, bayanan da ke da amfani su ne ainihin formulation, route, amount, frequency, start date, sauran magunguna da duk wata alama. Duba tsawon lokacin da methylene blue ke zama a jiki tare da illolinsa da contraindications. Tarihin iya jure shi shaida ce game da fallasar da ta gabata, ba garanti ba ne game da ta gaba.