Tuhinga
Te kahurangi metilīni me te mate Alzheimer: te whakamārama i ngā whakamātautau
Ki te rapu koe mō te kahurangi metilīni me te mate Alzheimer, ka kitea e koe ngā kōrero e rua i te wā kotahi. E ai ki tētahi, nā tētahi waikano kahurangi kua kotahi rau tau e whakamahia ana i pōturi ai te ngaronga mahara. E ai ki tērā atu, i rahua ngā whakamātautau whai muri. E tohutoro ana ngā kōrero e rua ki ngā pepa rangahau tūturu. Ko te pūtake o te pōhēhētanga, ko te whakaaro he rongoā kotahi ngā pūhui rerekē.
Ehara ēnei i te rongoā kotahi. I whakamātauria i te whakamātautau tuatahi te methylthioninium chloride kua hāoratia, arā, te pūhui kahurangi e mōhiotia whānuitia ana. I ngā whakamātautau Alzheimer katoa i muri mai, i whakamātauria tētahi āhua whakaheke kua whakapūmautia, ko te leuco-methylthioninium, e kīia ana ināianei ko te hydromethylthionine mesylate (HMTM). He rerekē ngā horopeta, te ngongo ki te tinana, tae atu ki ngā rōpū whakataurite o ngā hōtaka e rua. Ki te wehewehea ngā pūhui, ka mārama te pānui i ngā pūrongo whakamātautau, ā, kāore aua pūrongo e tohu ana kia whakamahia hei tāpiringa.
Ngā pūhui e rua
Ko te kahurangi metilīni i roto i te pounamu, ko te methylthioninium chloride te nuinga o te wā, ko MTC tōna whakarāpopototanga. Ko tōna wāhanga hohe ko te katote methylthioninium kua hāoratia, ko MT+, he rāpoi ngota whai utanga hiko, he kahurangi hōhonu. He raruraru tō te utanga hiko i roto i te whēkau. Kia pai te whakawhiti a MT+ i te pakitara o te whēkau, me whakaheke tuatahi ki te āhua leuco kūpapa, kāore ōna tae. He rerekē te haere o taua hipanga whakaheke, ā, i ngā horopeta teitei ake, ka herea te memeha me te ngongo o MTC e te nui o te horopeta. Koinei tētahi take i pā ai ngā raruraru hanga rongoā ki te hōtaka Alzheimer tuatahi.
Ka karo te rongoā whai muri i taua hipanga. Ko LMTM, ko TRx0237 hoki tōna waehere, ā, e kīia whānuitia ana ināianei ko HMTM, ka tuku tika i te rāpoi ngota kua whakahekea hei tote mesylate tioata pūmau. Ka hāoratia anō te methylthioninium whakaheke herekore, ka hoki ki te kahurangi i roto i ngā meneti ruarua i te hau. Nō reira, mā te āhua tote e taea ai te rokiroki hei rongoā, kaua hei mea whakamīharo noa o te taiwhanga. Hei whakarāpopoto: ko MTC te rongoā tōmua kahurangi kua hāoratia, he rerekē tōna ngongo ki te tinana; ko LMTM/HMTM te āhua whakaheke kua whakapūmautia, i hangaia kia matapaetia ai te nui e tae ana ki te tinana. E kore ngā kerēme whaihua mō tētahi e whakawhiti ki tērā atu, ā, e kore ngā kerēme mō tētahi o ēnei e whakawhiti ki ngā wairewa waikano e hokona ana me te kore whakahaunga. He mea pai kia mārama ki te matū o ngā āhua hāora me ngā āhua whakaheke i mua i te pānui i tētahi kupu matua mō ngā whakamātautau.
He whāiti ake hoki te tukanga e whakamātauria ana i tā ngā pūrongo pāpāho e tohu ai. E aro ana te hōtaka ki te whakaputu o te tau, arā, te putu o te pūmua tau hei kaka me ngā pōkai i roto i ngā pūtau io, kaua ki ngā putunga amyloid. Nā tēnei he huarahi rerekē i ngā paturopi anti-amyloid. Kei tōna taha anō ngā rangahau motuhake i mua i ngā whakamātautau ki te tangata mō ngā ara whakawātea amyloid me ngā arotake whānui ake mō ngā whakapae e pā ana ki ngā mitochondria me te tiaki pūtau io. Kaua ēnei e pōhēhētia he taunakitanga haumanu.
Ngā pūhui i ia whakamātautau
Koinei te ripanga hei tohuwāhi māu. Kei ia rārangi te ingoa o te pūhui ake, ngā horopeta, ngā inenga hua, me te tautohu whakamātautau, nā te mea ko ēnei taipitopito te wāhi e hē ai te nuinga o ngā whakarāpopototanga.
| Whakamātautau (pūhui) | Ngā horopeta i whakamātauria | Tautohu whakamātautau | Ngā inenga hua matua | Hua o te tohatoha matapōkere |
|---|---|---|---|---|
| Rember, wāhanga 2 (MTC, kahurangi metilīni kua hāoratia) | 69, 138, 228 mg/day e ōrite ana ki te MT, ki te rongoā horihori, 24 wiki | NCT00515333 | ADAS-cog i te 24 wiki; ko ADCS-CGIC, MMSE, me te rere toto SPECT ngā inenga tuarua | Kāore he urupare whānui e ai ki te horopeta. I te rōpū iti he āhua waenga te mate, i pai ake te ADAS-cog mā te 5.4 ira i te 138 mg/day, ki te rongoā horihori (p kua whakatikahia = 0.047); he iti rawa te heke o te hunga he māmā te mate i te rongoā horihori, nō reira kāore i taea te whakataurite; he raruraru ngongo tō te horopeta teitei rawa |
| TRx237-015, wāhanga 3 (LMTM) | 150, 250 mg/day ki te rongoā whakataurite hohe 8 mg/day, 65 wiki | NCT01689246 | Ko ngā panonitanga ADAS-Cog me ADCS-ADL tae noa ki te wiki 65 ngā inenga matua takirua | Kāore i angitu. Kāore i tino pai ake ngā horopeta teitei i te rongoā whakataurite 8 mg/day i tētahi o ngā tauine |
| TRx237-005, wāhanga 3 (LMTM) | 200 mg/day ki te rongoā whakataurite hohe 8 mg/day, 78 wiki | NCT01689233 | Ko ADAS-cog11 me ADCS-ADL23 i te 78 wiki ngā inenga matua takirua | Kāore i angitu i te tātari e ai ki te tohatoha matapōkere (he heke +6.41 ki te +6.27 ira ADAS-cog; he ōrite te āhei ki ngā mahi). I kitea he painga i ngā tātari rōpū iti maimoatanga kotahi kāore i tohaina matapōkeretia anake |
| Lucidity, wāhanga 3 (hōtaka HMTM 16 mg/day) | 16 mg/day, 8 mg/day, me te rōpū whakataurite MTC iti rawa, 52 wiki me te tīmatanga whakaroa tae noa ki te 104 wiki | NCT03446001 | Ko ADAS-cog11 me ADCS-ADL23 i te 52 wiki ngā inenga matua takirua | I eke te rōpū whakataurite ki ngā taumata rongoā hohe kāore i tūmanakohia, nō reira kāore i taea he whakataurite mārama o te rongoā ki te rongoā horihori; ka whakawhirinaki ngā tātari i pūrongotia ki te panonitanga mai i te tīmatanga, te tīmatanga whakaroa, me ngā whakataurite tohu koiora |
Ngā whakaputanga katoa: te pūrongo Rember wāhanga 2, te whakamātautau LMTM wāhanga 3 tuatahi, te tātari ā-rōpū o te wāhanga 3 tuarua, te tātari anō i te hononga o te nui rongoā i te tinana ki te urupare, me te pepa hoahoa Lucidity.
Te pānui i ia hua i runga i te tirohanga a ngā kaihoahoa
Me whakaaro tuatahi ki Rember. He rongoā horihori tūturu tōna, he mea pai tēnā, engari nā te waikano kahurangi ka uaua te huna i ngā rōpū maimoatanga. Ka kitea pea ko wai e kai ana i te rongoā hohe mā te panoni tae o te mimi me te tūtae, ā, i whakaae ngā kairangahau kāore taua tohu i te rōpū rongoā horihori. I wehewehea e rātou ngā kaiaromatawai haumaru me ngā kaiaromatawai whaihua, ā, i tohu hoki ki ngā raraunga whakaahua hei tautoko. Heoi, e mau tonu ana tētahi tūraru ka kitea te tohatoha maimoatanga. Ki te tāpiri atu te tohu i kitea i te rōpū iti anake me te rahunga o te horopeta teitei rawa, ko te whakatau tika, he mea whakamere engari he taunakitanga ngoikore. Nā reira i neke ai te hōtaka ki tētahi pūhui hou, kaua ki tētahi whakamātautau MTC nui ake.
I whakatika ngā whakamātautau LMTM wāhanga 3 e rua i te huna maimoatanga mā tētahi atu huarahi, ā, ka puta he raruraru hou. Kia panoni tonu te tae o te mimi i te rōpū whakataurite, i hoatu e ngā whakamātautau e rua te LMTM tūturu 8 mg/day ki aua rōpū. Mēnā he hohe tonu te 8 mg/day, he whakataurite te horopeta teitei ki te rōpū whakataurite i ngā maimoatanga e rua. Nō reira, e kore te hua kore rerekētanga e wehe i te kōrero “he whaihua ngā mea e rua” i te kōrero “kāore tētahi e whaihua ana.” E ai ki ngā tātari o muri mō te maimoatanga kotahi me ngā taumata i te toto, he hohe tonu te horopeta iti. Ka matapakihia hoki tēnei raruraru whakawhiti i te rangahau ki te haumanu i roto i ngā arotake rangahau kaumātuatanga. Heoi, kāore aua tātari e pupuri i te tohatoha matapōkere. Ko te kai a te tūroro i te LMTM anake, i te LMTM rānei me ngā rongoā Alzheimer tikanga, i ahu mai i tōna whakahaunga o mua, ehara i te maka moni matapōkere. Nō reira, ka whakamārama pea ngā rerekētanga whakahaunga me te hauora i te tīmatanga i tētahi wāhanga o te āputa. Ka whakakaha te rangahau mō te hononga o te nui rongoā i te tinana ki te urupare i te whakamārama koiora, engari kāore e whakarato i te whakataurite ngaro ki tētahi rongoā horihori kāore e hohe ana.
Kātahi ka tuaruatia taua tauira e Lucidity i ngā horopeta iti ake. He horopeta MTC iti kei te rōpū whakataurite, e rua ngā wā i te wiki, hei hoatu tae noa iho ki te mimi. Heoi, he tokomaha o te rōpū whakataurite i whakaemi i ngā taumata rongoā e whai pānga ā-rongoā ana. I kī mārika te kaitautoko kāore i taea te whakataurite i whakaritea ki tētahi rongoā horihori kāore e hohe ana. Ka aro ngā pūrongo o muri ki ngā whakataurite tohu koiora me te tīmatanga whakaroa. He mōhiohio ēnei mō te koiora o te mate, engari kāore e ōrite ana ki tētahi angitu ki te rongoā horihori i raro i tētahi whakamātautau i whakaritea i mua. I te 2024 ki te 2025, he pūhui rangahau tonu tēnei: kua tukuna he tono whakaaetanga ki te UK, ā, e haere tonu ana te arotake ā-hoa mō te pepa tohu koiora whakaū.
He aha te tikanga o tēnei mā te kaipānui e whakaaro ana ki te kahurangi metilīni
E toru ngā take hei whakaaro whaihua.
Tuatahi, ehara ngā rongoā o ngā whakamātautau i te tāpiringa. He tote rongoā HMTM kua purea, he āhua kotahi, ā, i te hōtaka o nāianei ka hoatu i te 8 ki te 16 mg/day. Ko te kahurangi metilīni i roto i te pounamu, ko te chloride kua hāoratia te nuinga o te wā, he rerekē te mā, ka inea mā te taputapu whakatōpata, ā, he rerekē tōna ngongo ki te tinana me ngā poke kei roto. Kāore te āhei o te hunga whakamātautau ki te kawe i ngā horopeta HMTM iti e whakaatu ana i tētahi mea mō te tango takitahi i ngā wairewa waikano mō te wā roa.
Tuarua, me aro nui tonu ki ngā tohu mō te haumaru mai i te wā o ngā horopeta teitei, ahakoa he iti ake ngā horopeta o nāianei. I te hōtaka wāhanga 3 nui, i pā te korere ki tētahi o ia tokowhā pea o ngā tūroro horopeta teitei. I piki mārama hoki te whakapairuaki, te ruaki, me te hiahia ohorere ki te mimi. I aukatia te hunga he hapa G6PD, nā te mea ka taea e ngā rongoā methylthioninium te whakaoho i te pakaru o ngā pūtau toto whero i taua rōpū. He tūturu ā-rongoā te pāhekoheko ki ngā rongoā whakaheke pōuritanga e pā ana ki te serotonin, nā te mea he aukati MAO-A kaha te kahurangi metilīni, ā, ka taea taua aukati te whakahoki whakamuri. Heoi, i ngā whakamātautau Alzheimer, he tohu rangitahi anake i tuhia mō te tokoiti o ngā kaiwhakamahi SSRI, kaua he mate serotonin kua whakaūngia. Me whai tirotiro haumanu te tangata e whakakotahi ana i ēnei rongoā; ka whakamāramatia tēnei take ki te aratohu haumaru me ngā pāhekoheko.
Tuatoru, me whakarite ngā tūmanako kia hāngai ki te taumata o ngā taunakitanga. Ko tētahi tohu i te rōpū iti, me ngā whakataurite matapōkere e rua kāore i angitu, me tētahi rōpū whakataurite kua raruraru tōna whakamāramatanga, he whakapae rangahau, ehara i te tūtohutanga maimoatanga. Mā ngā whānau e whiriwhiri ana i ngā kōwhiringa, he nui ake ngā mōhiohio hei mahi mā rātou i te āhua tūturu o te whakatau i ngā take tiaki Alzheimer, i tētahi tikanga whakamahi waikano e horapa ana ki te ipurangi.
Ka taea te kī te whakatau matua ki te rerenga kotahi. I puta i te kahurangi metilīni kua hāoratia tētahi tohu ngoikore i te wāhanga 2, me ngā here mō te huna maimoatanga me te ngongo ki te tinana; i rahua tana kairīwhi whakaheke i ngā whakataurite horopeta matapōkere e rua; ā, kāore anō te hōtaka horopeta iti kia whakaputa i tētahi angitu mārama i te whakamātautau me te rōpū rongoā horihori. Ka rerekē pea tēnei i ngā whakaputanga ā muri ake nei, i te arotake a ngā mana whakahaere rānei. Kia pērā rā anō, ko te kahurangi metilīni mō te mate Alzheimer kei te kāwai o te pūtaiao whai take kāore anō kia noho hei rongoā.