Shuɗin methylene da lafiyar zuciya: nazarin nama, gwaje-gwajen dabbobi, da mahallin amfani a asibiti

Mai karatu ya ga bayanai biyu a mako ɗaya. Ɗaya ya ce shuɗin methylene yana inganta numfashin sel a mitochondria na zukatan beraye masu ciwon sukari. Ɗayan ya ce ana amfani da shi a asibitoci a lokacin tiyatar zuciya. Fahimtar da za ta iya zuwa nan take ita ce shuɗin methylene yana ba zuciya fa'idodi wajen gazawar zuciya ko kariyar zuciya gaba ɗaya.

Wannan fahimtar tana haɗa ra'ayoyi uku daban-daban. Na farko shi ne tasirin sinadarai a cikin mitochondria da aka ware. Na biyu shi ne canjin sinadaran nama a wajen jiki. Na uku shi ne sakamakon jiyya ga mara lafiya, kamar raguwar alamomi, raguwar zuwa asibiti, ko tsawon rayuwa. Kowanne yana da nasa ƙa'idar aiki. Sakamako a mataki ɗaya ba ya komawa mataki na gaba kai tsaye.

Wannan labarin yana ware waɗannan matakai. Yana nazarin aikin mitochondria na zuciya, nazarin naman zuciya da jijiyoyin jini na ɗan Adam, nazarin dabbobi masu rai, da keɓaɓɓen mahallin asibiti inda shuɗin methylene yake shafar zagayawar jini.

Jadawalin shaidun da suka shafi zuciya

Wannan jadawalin shi ne babban taswirar wannan batu. Yana ware samfurorin nama da aka cire, dabbobi masu rai, da yanayin asibiti domin suna amsa tambayoyi daban-daban.

Da farko, karanta abin da ke ginshiƙi na ƙarshe. Wannan ginshiƙin yana gyara fahimtar da yawancin bayanai game da ikirarin fa'idodin shuɗin methylene ga zuciya suke bari.

Abin da mitochondria da aka ware daga zuciya suke nunawa

Nazarin zuciyar masu ciwon sukari ya gwada mitochondria da aka cire daga beraye masu lafiya da berayen da aka jawo musu ciwon sukari da streptozotocin. An auna amfani da oxygen da na'urar auna numfashin sel mai matuƙar ƙuduri. Gwaje-gwajen hasken fluorescence sun auna hydrogen peroxide da yadda ake sarrafa calcium.

Abin mamaki mai amfani shi ne yadda tasirin ya dogara da sinadarin da ake aiki a kansa. Da glutamate tare da malate, waɗanda suke ciyar da complex I, shuɗin methylene ya ƙara numfashin sel amma kuma ya ƙara sakin hydrogen peroxide. Da succinate, wanda yake ciyar da complex II, ya ƙara numfashin sel kuma ya rage hydrogen peroxide. Saboda haka, kiransa mai hana oksidashi ba ya bayyana duk halayensa. Ko nau'ikan oxygen masu saurin yin martani za su ƙaru ko su ragu ya dogara da hanyar numfashin sel da take aiki da kuma yanayin redox na coenzyme Q.

Wani nazarin beraye masu ciwon sukari mai alaƙa da wannan ya ƙara fayyace tsarin aikin. Shuɗin methylene yana aiki a matsayin madadin mai ɗaukar electron. Yana taimakawa wajen oksidashin NADH zuwa NAD, wanda yake ƙara aikin sirtuin 3, enzyme na mitochondria mai cire acetyl. Wannan enzyme yana cire rukunin acetyl daga ragowar lysine a sunadaran mitochondria. Nazarin sunadarai ya gano raguwar haɗuwar acetyl a sunadaran da suka shafi jigilar fatty acid da oksidashinsa, zagayen tricarboxylic acid, jigilar electron, sarrafa amino acid, da sunadaran jigila. Aikin zuciya ya inganta a berayen masu ciwon sukari da aka ba magani duk da cewa tushen matsalar complex I ya ci gaba da kasancewa.

Ka ɗauki wannan a matsayin sauya hanyar electrons maimakon kawar da radicals kawai. Jagorar jigilar electron a mitochondria tana sanya wannan ra'ayin sauya hanya a cikin babban sarkar aikin. Har yanzu bayani ne a matakin nama, ba umarnin magani ba.

Abin da naman zuciyar ɗan Adam yake ƙara wa shaida, da abin da ba zai iya ƙarawa ba

Nazarin ɗan Adam yana kusantar marasa lafiya da mataki ɗaya ba tare da zama gwajin jiyya ba. Likitocin tiyata sun tattara kitsen saman zuciya, wanda yake kai tsaye a kan zuciya, da kitsen kewaye da jijiyoyin jini, daga marasa lafiya masu gazawar zuciya. A ɗakin gwaje-gwaje, an ajiye samfurorin da shuɗin methylene mai ƙarancin taro na kwana ɗaya.

Naman biyu sun samar da enzymes na monoamine oxidase, galibi nau'in MAO-A. Waɗannan enzymes na iya samar da nau'ikan oxygen masu saurin yin martani a wurin. Shuɗin methylene ya rage samar da MAO kuma ya rage alamun damuwar oksidashi. Lokacin da masu bincike suka ƙara serotonin, sinadarin da MAO-A ke aiki a kansa, hydrogen peroxide ya ƙaru. Shuɗin methylene ya rage wannan ƙaruwa a wani ɓangare.

Wannan yana da muhimmanci saboda yanzu ana kallon kitsen kewaye da zuciya da jijiyoyin jini a matsayin tushen sakonni masu aiki da suka shafi kumburi da oksidashi a cututtukan zuciya da sarrafa sinadarai, ba kawai nama marar aiki da ya cika wuri ba. Nazarin ya gano yiwuwar tasirin shuɗin methylene a wannan yanki a ainihin naman ɗan Adam.

Har yanzu akwai wannan iyakar. Samfurorin tiyata ashirin da biyar, da aka yi wa wannan aiki a wajen jiki na tsawon sa'o'i 24, ba za su iya nuna cewa shuɗin methylene da aka haɗiye yana isa wannan yanki da taro mai tasiri, ya zauna a wurin cikin aminci, ya sauya aikin zuciya, ko ya sauya sakamakon jiyya ba. Don ƙa'idodin gaba ɗaya da suka sa aka kafa wannan iyaka, duba yadda ake karanta binciken shuɗin methylene.

Abin da nazarin motsa jikin dabba mai rai yake nunawa

Nazarin karnuka yana da amfani musamman saboda rashin tasirin da aka nema. Karnuka da suke a farke sun yi gudu a kan na'urar gudu a matakan wahalar aiki biyu. Wata ƙungiya ta karɓi ruwan gishiri. Wata ta karɓi adadin farko na shuɗin methylene tare da ci gaba da shigar da shi. Ta uku ta karɓi shuɗin methylene ba tare da motsa jiki ba.

Shuɗin methylene ya rage rabo tsakanin lactate da pyruvate a jinin jijiyoyin da ke fitar da jini daga zuciya, alamar da ke da alaƙa da daidaiton NADH da NAD. Ma'aunan adadin jinin da zuciya ke tura wa jiki, saurin bugun zuciya, matsin jini, da ƙarfin matsewar zuciya yayin hutawa sun canza kaɗan. Yayin motsa jiki, adadin jinin da zuciya ke tura wa jiki ya ninka sau biyu kuma amfani da oxygen a duk jiki ya ƙaru sau uku zuwa huɗu a ƙungiyar ruwan gishiri da ta shuɗin methylene. Shuɗin methylene bai canza alaƙar adadin jinin da zuciya ke tura wa jiki da amfani da oxygen ba.

Ta fuskar ra'ayi, tsarin redox ya sauya amma tsarin tura jini bai sauya ba. Sauyin sinadarai ba lallai ya canza martanin haɗin gwiwar sassan jiki ba, kamar adadin jinin da zuciya ke tura wa jiki yayin motsa jiki. Wannan bambanci yana da alaƙa kai tsaye da ikirarin cewa kyautatuwar ma'aunan mitochondria dole tana nufin zuciya mai ƙarfi yayin aiki.

Amfani a asibiti ya bambanta da magani na dogon lokaci

Asibitoci suna amfani da shuɗin methylene ta IV a yanayi uku waɗanda suke kama da sun shafi zuciya amma suke gwada tambayoyi daban-daban.

Na farko, vasoplegia bayan tiyatar zuciya yana nufin tsananin raguwar ƙarfin matsewar jijiyoyin jini duk da cewa zuciya tana tura jini yadda ya kamata. Gwaje-gwaje galibi sun yi amfani da kusan 1.5 zuwa 2 mg a kowace kg ta IV a matsayin shigar da magani sau ɗaya. Sakamakon da ya maimaitu shi ne ƙaruwa a matsakaicin matsin jini da juriyar jijiyoyin jini tare da raguwar buƙatar magungunan ɗaga matsin jini, ba tare da ƙaruwa mai daidaito a adadin jinin da zuciya ke tura wa jiki ba. Cikakken nazarin gwaje-gwajen yana cikin shafin shaidun vasoplegia da girgizar jiki sakamakon kamuwa da cuta mai tsanani.

Na biyu, ƙarin jiyya ga girgizar jiki sakamakon kamuwa da cuta mai tsanani yana amfani da tsare-tsaren IV daban-daban, ciki har da tsarin 2023 na shigar da 100 mg a cikin sa'o'i shida kowace rana har adadin magani uku. Lokacin tsakiya kafin daina magungunan ɗaga matsin jini ya ragu daga sa'o'i 94 zuwa 69, yayin da mace-mace da tsawon lokacin amfani da na'urar taimakon numfashi suka kasance kusan iri ɗaya. Binciken da ya haɗa sakamakon gwaje-gwaje daga baya ya nuna yiwuwar wani tasiri kan mace-mace na ɗan gajeren lokaci, amma ya ɗauki tabbacin a matsayin mai rauni kuma mai sauyawa bisa zaɓin gwaje-gwajen. Ikirarin da ya fi ƙarfi shi ne rage buƙatar magungunan ɗaga matsin jini, ba tabbatacciyar ƙaruwa a tsawon rayuwa ba.

Na uku, methemoglobinemia da aka samu daga baya ita ce cutar da aka amince da amfani da maganin ta IV dominta, yawanci 1 mg a kowace kg ta IV tare da maimaita adadin sau ɗaya idan an buƙata. A nan, shuɗin methylene yana dawo da aikin hemoglobin da isar da oxygen. Alamomin ƙirji suna sauƙaƙa saboda ɗaukar oxygen ya inganta, ba saboda shuɗin methylene yana sake fasalin zuciya ba.

Babu ɗaya daga cikin waɗannan yanayin da yake gwada shan shuɗin methylene ta baki kullum don gazawar zuciya ta dogon lokaci, cututtukan jijiyoyin zuciya, ko rigakafi. Jagororin kula da gazawar zuciya da cututtukan jijiyoyin zuciya na yanzu ba su lissafa shi a matsayin maganin dogon lokaci da ake ba da shawara ba. Shaidun matsin jini suna yin wannan bambancin hanyar bayarwa da mahallin amfani ga ƙarfin matsewar jijiyoyin jini: martanin matsin jini ga IV a lokacin girgizar jiki ba ya hasashen abin da na'urar auna matsin jini ta gida za ta nuna bayan amfani da samfurin da ake sha ta baki.

Duk wani haɗaɗɗen nazari na gaba kan ikirarin cututtuka na dogon lokaci zai buƙaci bayanai daga gwaje-gwajen da aka raba mahalarta bisa bazuwar zaɓi kan alamomi, aiki, kwantarwa a asibiti, da aminci da ainihin tsarin shan maganin ta baki, ba wani ƙarin gwajin mitochondria ba.

Tambayoyin aminci da masu karatu masu matsalar zuciya ya kamata su fara tantancewa

Marasa lafiyar zuciya sukan sha magunguna da yawa waɗanda suke hulɗa da juna. Ya kamata a yi binciken aminci guda uku kafin samun kyakkyawan fata game da tsarin aikin maganin.

Na farko, shuɗin methylene mai hana monoamine oxidase ne mai ƙarfi. Takardar bayanin maganin IV tana ɗauke da gargaɗi a cikin akwati game da ciwon serotonin idan an yi amfani da shi tare da SSRIs, SNRIs, masu hana MAO, da wasu magungunan opioid. Alamomi sun haɗa da tashin hankali, ruɗani, zazzaɓi, zufa, rashin daidaiton saurin bugun zuciya ko matsin jini, rawar jiki, taurin tsoka, da clonus, wato matsewar tsoka mai maimaituwa ba tare da son rai ba. Marasa lafiyar zuciya su kawo cikakken jerin magungunansu ga likita ko masanin magunguna, kuma kada su daina magungunan damuwa ko na ciwo da kansu.

Na biyu, ƙarancin glucose-6-phosphate dehydrogenase dalili ne na hana amfani da shi saboda shuɗin methylene na iya haifar da tsananin rushewar jajayen ƙwayoyin jini. Sakamakon na'urar auna oxygen na jini da yake daidai ba zai iya kawar da yiwuwar wannan haɗari ba. Shuɗin methylene kuma na iya karkatar da karatun na'urar auna oxygen da wasu na'urorin sa ido yayin maganin sa barci, wanda yana daga cikin dalilan da ake ci gaba da sa ido yayin amfani da shi a asibiti.

Na uku, fahimtar hanyoyin aikin sinadarai ba jagorar adadin magani ba ce. Nitrates suna aiki ta hanyar nitric oxide da cyclic GMP. Shuɗin methylene na iya rage sassautawar jijiyoyin jini da nitric oxide ke haifarwa a gwaje-gwaje, amma hakan bai nuna cewa zai iya dakile tasirin nitrate cikin aminci ko maye gurbin maganin zuciya da likita ya rubuta ba. Tasirin matsin jini da aka ruwaito da shuɗin methylene ta IV ya haɗa da hawan matsin jini da saukar matsin jini, tare da saurin bugun zuciya da rashin daidaiton bugun zuciya, don haka sa ido yana da muhimmanci.

Ƙa'idar aiki mai sauƙi ce. Sakamakon nazarin nama da dabbobi dalilai ne na gudanar da gwaje-gwaje cikin tsanaki, ba dalilan yin maganin matsalar zuciya da kai ba. Duk wanda yake da gazawar zuciya, cututtukan jijiyoyin zuciya, rashin daidaiton bugun zuciya, ko na'urar zuciya ya kamata ya tattauna duk wani amfani da shuɗin methylene da ƙungiyar ƙwararrun zuciya, tare da rubuta samfurin, taron sinadarin, adadi, hanyar amfani, lokacin amfani, da alamomi.