Te kikorangi metilīni me te hauora o te manawa: rangahau kiko, tauira kararehe, me te horopaki haumanu

Ka kitea e tētahi kaipānui ngā kōrero e rua i te wiki kotahi. E kī ana tētahi ka whakapai te kikorangi metilīni i te hā pūtau o ngā mitokōria i ngā manawa kiore mate huka. E kī ana tētahi atu ka whakamahia i ngā hōhipera i te wā o te pokanga manawa. Ko te whakatau ka puta noa, he painga tō te kikorangi metilīni mō te manawa, hei āwhina i te ngoikore o te manawa, hei tiaki whānui rānei i te manawa.

Ka whakahanumi taua whakatau i ngā ariā motuhake e toru. Ko te tuatahi he pānga matū koiora i roto i ngā mitokōria kua wehea. Ko te tuarua he panonitanga o te matū o te kiko i waho i te tinana. Ko te tuatoru he putanga haumanu i tētahi tūroro, pērā i te iti ake o ngā tohumate, te iti ake o ngā haerenga ki te hōhipera, te roa ake rānei o te ora. He mātāpono whakahaere motuhake tō tēnā, tō tēnā. Kāore tētahi hua i tētahi taumata e whakawhiti aunoa ki te taumata whai muri.

Ka wehe tonu tēnei tuhinga i aua taumata. Ka arotake i ngā rangahau mitokōria manawa, ngā rangahau kiko manawa me ngā ia toto o te tangata, ngā rangahau kararehe ora katoa, me te horopaki hōhipera motuhake e pā ai te kikorangi metilīni ki te rere toto.

He ripanga taunakitanga mō te manawa

Ko te ripanga te mahere matua mō tēnei kaupapa. Ka wehe i ngā whakaritenga kiko kua wehea, ngā kararehe ora katoa, me ngā horopaki haumanu, nā te mea he rerekē ngā pātai ka whakautua e ia momo.

Pānuitia te tīwae whakamutunga i te tuatahi. Kei taua tīwae te whakatikatika i te tauira whakaaro ka mahue i te nuinga o ngā kōrero mō ngā kerēme manawa a te kikorangi metilīni.

He aha ka whakaaturia e ngā mitokōria manawa kua wehea

I whakamātauria e te rangahau manawa mate huka ngā mitokōria i tangohia mai i ngā kiore hauora me ngā kiore i whakatupuria ai te mate huka mā te streptozotocin. I ine te ine hā pūtau taumira teitei i te whakamahinga hāora. I ine ngā whakamātautau kōrekoreko i te hauwai waikurate me te whakahaere konupūmā.

Ko te kitenga ohorere whai hua, ko te whakawhirinaki ki te tïpako. Ki te glutamate me te malate, e whāngai ana i te matatini I, i whakapiki te kikorangi metilīni i te hā pūtau, engari i whakapiki hoki i te tukunga hauwai waikurate. Ki te succinate, e whāngai ana i te matatini II, i whakapiki i te hā pūtau, ā, i whakaiti i te hauwai waikurate. Nō reira kāore te kupu ārai whakahāora e whakaahua ana i te whanonga katoa. Ko te pikinga, ko te hekenga rānei o ngā momo hāora tauhohe e whakawhirinaki ana ki te ara hā pūtau e hohe ana, me te āhua whakahāora-whakaheke o te whākōkī āpiti Q.

Ka āta whakamārama ake tētahi rangahau kiore mate huka e pā ana i te tikanga mahi. Ka mahi te kikorangi metilīni hei kaikawe irahiko kē. Ka āwhina ki te whakahāora i te NADH hei NAD, ka whakapiki ai i te hohe o te whākōkī tango rōpū acetyl o ngā mitokōria, arā, te sirtuin 3. Ka tango taua whākōkī i ngā rōpū acetyl i ngā toenga lysine o ngā pūmua mitokōria. I kitea e te rangahau pūmua he iti ake te tāpiritanga rōpū acetyl puta noa i te kawe me te whakahāoratanga waikawa ngako, te huringa waikawa tricarboxylic, te kawe irahiko, te pākia waikawa amino, me ngā pūmua kawe. I pai ake te mahi a te manawa i ngā kiore mate huka i maimoatia, ahakoa i mau tonu te hapa matatini I taketake.

Whakaarohia tēnei hei whakawhiti i ngā irahiko ki tētahi ara kē, kaua hei hopu noa i ngā rāpoi tuwhena. Ka whakatakoto te aratohu ki te kawe irahiko i ngā mitokōria i tēnei whakaaro whakawhiti ara ki roto i te mekameka whānui ake. He whakamārama tonu tēnei i te taumata kiko, ehara i te whakahau rongoā.

He aha ka tāpirihia e te kiko manawa tangata, ā, he aha kāore e taea te tāpiri

Ka whakatata atu te rangahau tangata ki ngā tūroro, engari kāore e noho hei whakamātautau maimoatanga. I kohia e ngā mātanga pokanga te ngako kei runga tonu i te mata o te manawa, me te ngako e karapoti ana i ngā ia toto, mai i ngā tūroro ngoikore manawa. I te taiwhanga, i puritia ngā tauira ki tētahi kukūtanga iti o te kikorangi metilīni mō te rā kotahi.

I whakapuaki ngā kiko e rua i ngā whākōkī monoamine oxidase, ko te momo MAO-A te nuinga. Ka taea e ēnei whākōkī te whakaputa momo hāora tauhohe ki taua wāhi. I whakaiti te kikorangi metilīni i te whakapuakitanga MAO me ngā tohu taumahatanga whakahāora. I te tāpiritanga a ngā kairangahau i te serotonin, he tïpako MAO-A, i piki te hauwai waikurate. I whakaiti te kikorangi metilīni i tētahi wāhanga o taua pikinga.

He mea nui tēnei nā te mea e whakaarohia ana ināianei te ngako huri noa i te manawa me ngā ia toto hei pūtake hohe o ngā tohu mumura me ngā tohu whakahāora i ngā mate manawa-pākia, ehara i te kīanga kiko hāngū noa. Ka tautuhi te rangahau i tētahi pānga kikorangi metilīni e āhei ana pea ki te puta i taua wāhanga, i roto i te kiko tangata tūturu.

Ka mau tonu te rohe o te taunakitanga. Kāore e taea e ngā tauira pokanga e rua tekau mā rima, i maimoatia i waho i te tinana mō te 24 hāora, te whakaatu ka tae te kikorangi metilīni kua horomia ki taua wāhanga i tētahi kukūtanga whai pānga, ka noho haumaru ki reira, ka panoni i te mahi manawa, ka whakarerekē rānei i ngā putanga. Mō ngā ture whānui e whakamārama ana i taua rohe, tirohia me pēhea te pānui i ngā rangahau kikorangi metilīni.

He aha ka whakaaturia e te rangahau korikori kararehe ora katoa

Ko te tino uara o te rangahau kurī, he hua kāore i kitea te pānga i tūmanakohia. I oma ngā kurī e oho ana i runga i te mīhini oma i ngā taumata kawenga e rua. I whiwhi tētahi rōpū i te wairewa tote. I whiwhi tētahi i te pota tīmatanga kikorangi metilīni me te whaowhia tonutanga. I whiwhi te rōpū tuatoru i te kikorangi metilīni, engari kāore i korikori.

I whakaiti tonu te kikorangi metilīni i te ōwehenga lactate ki te pyruvate i te toto iatuku, he tohu e hono ana ki te taurite NADH ki te NAD. He iti noa ngā panonitanga o te putanga toto o te manawa, te auau manawa, te pēhanga, me ngā inenga kaha kōpeketanga i te wā whakatā. I te wā korikori, i rearua te putanga toto o te manawa, ā, i piki te whakamahinga hāora o te tinana katoa kia toru ki te whā ngā whakareatanga i ngā rōpū wairewa tote me te kikorangi metilīni. Kāore te hononga i waenga i te putanga toto o te manawa me te whakamahinga hāora i panoni nā te kikorangi metilīni.

Ki te tirohia mā ngā ariā, i panoni te āhuatanga whakahāora-whakaheke, engari kāore te āhuatanga papu toto i panoni. Kāore tētahi panonitanga matū koiora e whakarerekē tonu i tētahi urupare whakakotahi, pērā i te putanga toto o te manawa i te wā korikori. E hāngai tika ana taua wehenga ki ngā kerēme e mea ana, mēnā he pai ake ngā inenga mitokōria, me kaha ake hoki te manawa i te wā whakapakari tinana.

He ariā rerekē te whakamahinga hōhipera i te maimoatanga mauroa

Ka whakamahi ngā hōhipera i te kikorangi metilīni IV i ngā horopaki e toru e āhua pā ana ki te manawa, engari he rerekē ngā pātai ka whakamātauria.

Tuatahi, ko te vasoplegia whai muri i te pokanga manawa he ngaronga nui o te tōnuitanga o ngā ia toto, ahakoa e rawaka ana te papu toto. I te nuinga o ngā whakamātautau, i whakamahia te āhua 1.5 ki te 2 mg mō ia kg IV hei whaowhia kotahi. Ko te kitenga auau, he teitei ake te pēhanga toharite me te ātete o ngā ia toto, he iti ake hoki te hiahia ki ngā rongoā whakapiki pēhanga toto, engari kāore he pikinga pūmau o te putanga toto o te manawa. Kei te whārangi taunakitanga mō te vasoplegia me te ru sepsis te arotake taipitopito o ngā whakamātautau.

Tuarua, he huhua ngā whakaritenga IV mō te maimoatanga tāpiri i te ru sepsis, tae atu ki tētahi whakaritenga o 2023, arā, te 100 mg ka whaowhia i roto i ngā hāora e ono ia rā, mō ngā pota e toru. I heke te wā tauwaenga kia mutu ngā rongoā whakapiki pēhanga toto i te 94 ki te 69 hāora, engari i rite tonu te mate me te wā whakamahi mīhini hā. E tohu ana ngā tātari whakakotahi o muri mai tērā pea he pānga ki te mate i te wā poto, engari ka whakatauria he iti te tino māramatanga o te taunakitanga, ā, ka rerekē i runga i te kōwhiringa whakamātautau. Ko te kerēme kaha ake, he whakaiti i te hiahia ki ngā rongoā whakapiki pēhanga toto, ehara i te pikinga o te ora kua whakamāramatia.

Tuatoru, ko te methemoglobinemia kua pā mai te whakamahinga IV whai raihana, ko te tikanga he 1 mg mō ia kg IV, me tētahi pota tukurua kotahi mēnā e hiahiatia ana. I konei ka whakahokia e te kikorangi metilīni te mahi a te hemoglobin me te tuku hāora. Ka pai ake ngā tohumate uma nā te pai ake o te kawe hāora, ehara nā te hanga anō a te kikorangi metilīni i te manawa.

Kāore tētahi o ēnei horopaki e whakamātau ana i te kikorangi metilīni ā-waha ia rā mō te ngoikore manawa mauroa, te mate ia toto manawa, te ārai mate rānei. Kāore ngā ara maimoatanga o nāianei mō te ngoikore o te manawa me te mate ia toto manawa e whakarārangi ana i tēnei hei maimoatanga mauroa e taunakitia ana. He rite anō te wehenga o te ara hoatu me te horopaki i roto i ngā taunakitanga pēhanga toto mō te tōnuitanga o ngā ia toto: kāore tētahi urupare pēhanga IV i te wā ru e matapae ana i te inenga pēhanga toto ā-whare mai i tētahi hua ā-waha.

Mō tētahi whakahiatotanga ā muri ake o ngā kerēme mate mauroa, me whai raraunga matapōkere mō ngā tohumate, te mahi, te urunga ki te hōhipera, me te haumaru o te whakaritenga ā-waha tūturu, kaua ko tētahi atu whakamātautau mitokōria.

Ngā pātai haumaru me whakatau e ngā kaipānui whai mate manawa i te tuatahi

He maha ngā tūroro manawa ka tango i ētahi rongoā e pāhekoheko ana. Me matua whakahaere ngā arowhai haumaru e toru i mua i te ngākau pai ki te tikanga mahi.

Tuatahi, he kaha te kikorangi metilīni hei aukati monoamine oxidase. Kei te tapanga IV tētahi whakatūpato pouaka mō te mate huinga serotonin i te whakamahinga tahi ki ngā SSRI, ngā SNRI, ngā aukati MAO, me ētahi rongoā opioid. Kei roto i ngā tohumate te āmaimai, te pōraruraru, te kirikā, te werawera, te auau manawa, te pēhanga rānei kāore e tau, te wiri, te mārō o ngā uaua, me ngā kōpeketanga uaua toutou. Me kawe ngā tūroro manawa i tētahi rārangi rongoā katoa ki tētahi mātanga hauora, ki tētahi kaiwhakarite rongoā rānei, ā, kaua e whakamutu i ā rātou rongoā pōuritanga, rongoā mamae rānei i runga i tā rātou ake whakatau.

Tuarua, he take kia kaua e whakamahia te kikorangi metilīni te korenga o te whākōkī glucose-6-phosphate dehydrogenase, nā te mea ka taea e te kikorangi metilīni te whakaputa pakarutanga kino o ngā pūtau toto whero. Kāore tētahi inenga noa o te pūrere ine hāora mā te pātukituki e whakakore i tēnei tūraru. Ka taea hoki e te kikorangi metilīni te whakapōhēhē i ngā inenga hāora me ētahi pūrere aroturuki whakamoe, koinei tētahi take ka aroturukihia tonutia tōna whakamahinga i te hōhipera.

Tuatoru, ehara te whakaaro mā ngā ara matū i te aratohu pota. Ka mahi ngā nitrate mā te waikura hauota me te GMP ā-huringa. Ka taea e te kikorangi metilīni te whakaiti i te whakangāwari o ngā ia toto nā te waikura hauota i ngā whakamātautau, engari kāore tērā e whakaatu ana ka taea te whakahē haumaru i tētahi nitrate, te whakakapi rānei i tētahi rongoā manawa kua whakahaua. Ko ngā pānga pēhanga toto kua pūrongotia mō te kikorangi metilīni IV, ko te pēhanga toto teitei me te pēhanga toto iti, me te auau manawa tere me ngā manawataki hē, nō reira he mea nui te aroturuki.

He māmā te ture hei whai. He take ngā kitenga kiko me ngā kitenga kararehe kia whakahaerehia he whakamātautau āta tūpato, ehara i te take kia maimoatia ake e te tangata tōna mate manawa. Ko te tangata whai ngoikore manawa, mate ia toto manawa, manawataki hē, pūrere manawa rānei, me kōrero ki tōna tīma mātanga manawa mō te pānga mai o te kikorangi metilīni, me te tuhi i te hua, te kukūtanga, te rahinga, te ara hoatu, te wā, me ngā tohumate.