Tuhinga
Te kikorangi metilīni me te mumura: he aha tā ngā taunakitanga e ine ai
Ka taea e te kikorangi metilīni te whakaheke i ētahi tohu mumura i raro i ngā āhuatanga whakamātautau. Kāore tēnei e whakaū ana he maimoatanga whānui tēnei mō te mumura i te tangata. E tautoko ana ngā rangahau e arotakengia ana i konei i tōna mahi koiora, me ētahi painga i ngā kararehe, me ētahi kitenga tangata whāiti, tino motuhake hoki. Kāore ēnei e whakaū ana mā te tango kikorangi metilīni e pai ake ai ngā tohumate o ia rā e kīia ana nā te “mumura mauroa”.
He pātai whāiti ake te pātai whai hua: ko tēhea tukanga mumura i rerekē, i roto i tēhea tauira, ā, nā taua panonitanga i pai ake ai tētahi putanga whai tikanga ki te tūroro? He rerekē ngā pātai e whakautua ana e te kukū o tētahi cytokine, te āhua o tētahi pūtau, me te roa o te maimoatanga i te wāhanga tiaki tino māuiui. Ka whakatakotoria ēnei kitenga ki te taha o ētahi atu whakamahinga hauora kua marohitia i tā mātou arotake whānui mō ngā painga o te kikorangi metilīni i te rangahau tangata.
He aha te hua ka kiia he whakaheke mumura?
Ka whakarite te mumura i ngā urupare ki te whakapokenga me te wharanga. Ka whai wāhi pea ki te tūkino, engari ka tautoko hoki ētahi mahi mumura i te whakamaru me te whakatika. Nō reira, kāore e oti te kōrero “he iti ake te mumura” ki te kore e tautuhia te wāhi, te take whakaoho, te wā i inea ai, me te putanga.
He pūmua karere te cytokine. Ka ine pea ngā kairangahau i te nui o taua pūmua i roto i te wē whakatipu pūtau, i te toto rānei. Ka ine kē pea rātou i te whakapuakitanga o tētahi whākōkī mumura, te āhua whakahohe o tētahi pūmua karere, ngā panonitanga rānei o te āhua o tētahi pūtau ārai mate. Ka whakaatu pea ēnei inenga i tētahi pānga o te rongoā, me te kore e whakaatu kua pai ake te mamae, te ngenge, te hinengaro, te kaha mahi rānei o tētahi mate.
Ko te lipopolysaccharide, e whakapotohia ana i te nuinga o te wā hei LPS, he wāhanga huakita e whakamahia ana hei whakaoho i tētahi urupare mumura. He maha ngā rangahau kikorangi metilīni e whakamahi ana i tēnei take whakaoho ka āta whakahaerehia. He whai hua te whakamātautau whakaoho mā te LPS hei whakamātau i tētahi tikanga mahi, engari kāore e whakaputa anō i ngā āhuatanga katoa o tētahi mate mauroa o te tangata. Ka pā anō taua herenga ina hoatu te rongoā i te taha o te take whakaoho: he rerekē te ārai i tētahi panonitanga i whakaaweawehia mā te whakamātautau i te whakahoki whakamuri i tētahi mate kua pūmau kē.
Te ripanga taunakitanga: te tauira, te take whakaoho, te putanga i inea, te hāngaitanga
E whakarāpopoto ana tēnei ripanga i ētahi rangahau tuatahi kua tīpakohia. Ka mau i ia rārangi te rerekētanga i waenga i ngā mea i inea e ngā kairangahau me te tikanga e tūmanakohia ana pea e te kaipānui mō te kitenga.
| Te rangahau me te tauira | Te take whakaoho mumura, te horopaki rānei | Te putanga i inea me te kitenga | Te hāngaitanga haumanu |
|---|---|---|---|
| Huang me ōna hoa, 2015: ngā pūtau macrophage o te kiore me ngā kiore | LPS me te interferon-gamma, tētahi rānei o ēnei, i ngā pūtau whakatipu; endotoxemia i ngā kiore | I heke te whakapuakitanga o te nitric oxide synthase ka whakaohohia, arā, te iNOS | E tautoko ana i tētahi pānga ki te whākōkī mumura; kāore e ine i ngā tohumate o te tangata |
| Ahn me ōna hoa, 2017: ngā pūtau macrophage me ngā pūtau THP-1 tangata | Te whakahohe whakamātautau i ētahi inflammasome | I heke te tukunga IL-1β me ngā mahi e pā ana ki te inflammasome | He taunakitanga mō te tikanga mahi; ehara tētahi rārangi pūtau tangata i te whakamātautau ki ngā tūroro |
| Ahn me ōna hoa, 2017: ngā kiore | He whakamātautau whakaoho mā te LPS; he whakamātautau whakaoho motuhake mā te Listeria | I pai ake te ora tonutanga i muri i te LPS, ā, i heke te IL-1β i te peritoneum i raro i ngā āhuatanga whakamātautau | Kei roto tētahi putanga kararehe tua atu i te tohu koiora; kāore e whakaatu ana i te pai ake o te ora tonutanga o te tangata |
| Li rāua ko Ying, 2023: ngā kiore | He werohanga LPS tukurua mō ngā rā e toru | I heke te IL-6 i te serum, i iti ake te whakahohe STAT3 i te roro me te kiri, ā, i iti ake te ngaronga taumaha | E whakaatu ana i te tuku karere me tētahi urupare o te kararehe katoa; kāore he inenga o ngā tohumate tangata, o te tāmitanga rānei o te mate |
| Aburel me ōna hoa: ngā tauira kiko mōmona o te pūnaha manawa me ngā ia toto o te tangata | He kiko i kohia i te wā o te pokanga i ngā tūroro 25 he ngoikore te manawa; he whakatipu i te taiwhanga, tae atu ki tētahi whakamātautau whakaoho mā te serotonin | I heke te whakapuakitanga monoamine oxidase me ngā inenga o te ahotea hāoratanga | He hāngaitanga ki te kiko tangata, engari kāore te ahotea hāoratanga e ōrite ana ki te mumura, ā, kāore ngā tūroro i maimoatia i tēnei whakamātautau |
| Stelmashook me ōna hoa, 2026: ngā whakatipuranga pūtau glia o te uho roro o te kiore nui | Te whakapā ki te LPS mō te 24 hāora | I te taha o te kikorangi metilīni, he maha ake ngā toronga o ngā pūtau microglia, ā, he iti ake te āhua o te tinana pūtau i tō ngā pūtau i whakapā ki te LPS anake | He kitenga mō te āhua o te pūtau, kāore he taunakitanga mō te pai ake o te mahara, te whanonga, ngā tohumate tangata rānei |
| Memis me ōna hoa, 2002: ngā tūroro 30 he sepsis taumaha | He whāngai mā te ia toto mō te ono hāora, ka whakatauritea ki te wairewa tote i tētahi whakamātautau matapōkere | Kāore he pānga hira ā-tauanga ki ngā taumata cytokine i inea i te wē toto | Kāore te whakamātautau tika ki te tangata i whakaū i te whakahekenga cytokine i raro i taua kawa |
| Ibarra-Estrada me ōna hoa, 2023: ngā tūroro 91 i tātarihia, he ru nā te sepsis | He kikorangi metilīni mā te ia toto ka whakatauritea ki te rongoā horihori, hei tāpiritanga ki te maimoatanga i te wāhanga tiaki tino māuiui | I poto ake te wā whakamahi vasopressor; kāore ngā cytokine i inea | He kitenga haumanu motuhake, kāore tōna tikanga mahi i whakaūngia mā te whakamātau tohu mumura |
E toru ngā wehewehenga e whakarerekē ana i te whakamāramatanga
Ehara te iti ake o te tuku karere i te tohu aunoa o te pai ake o te mahi
I tirotirohia e te rangahau iNOS o 2015 te āhua o te whakaheke a te kikorangi metilīni i te whakaputanga o tētahi whākōkī e whai wāhi ana ki te koiora nitric oxide. Ka āwhina tēnei ki te whakamārama i tētahi mahi ka taea pea e te rongoā. Kāore e whakaū ana ka whai painga te whakaheke i taua whākōkī ki ia tangata he mate mumura tōna.
Waihoki, i tūhonotia e te rangahau kiore o 2023 ngā panonitanga IL-6 i te toto ki ngā panonitanga tuku karere i te kiko. Ka tāpirihia e tōna kitenga ngaronga taumaha he mōhiohio whai hua mō te kararehe katoa. Heoi anō, kāore te taumaha i te wā o tētahi whakamātautau whakaoho whakapeka e ōrite ana ki te hinengaro, te kounga o te oranga, te whakahaere pūmau rānei i te mate mauroa. Ka whakamārama te kōrero taipitopito ake mō ngā inflammasome, te IL-6, me te STAT3 i ngā ara mahi, me te kore e whakakapi i ngā putanga hauora ki aua ara.
He inenga kotahi noa te āhua o te pūtau
He pūtau ārai mate ngā microglia i te pūnaha io pokapū. Ka panoni pea ō rātou toronga peka me ō rātou tinana pūtau i runga i te taiao. I te rangahau whakatipu pūtau o 2026, i whakarerekē te kikorangi metilīni i te āhua o ngā pūtau i whakapā ki te LPS kia tata ake ki te tauira o te rōpū whakataurite.
Ka whakaatu te uhi i tēnei whakataurite hei hoahoa. Ehara i te whakaahua karu whakarahi, i te whakaputanga anō ā-rahinga rānei o te whakamātautau. Kāore te maha ake o ngā peka e whakaū takitahi ana ka whakamaru tētahi pūtau i ngā pūtau io, ka whakakore tōtika i ngā tukumate, ka whakapai ake rānei i te mahi a te roro. Me whai inenga anō aua kerēme. Ka tirohia taua horopaki i roto i ngā taipitopito atu i te arotake mō ngā microglia, ngā astrocyte, me te mumura.
Ehara te kiko tangata i te tangata kua maimoatia
I whakamahia e te rangahau kiko mōmona o te pūnaha manawa me ngā ia toto he tauira nō te tangata, nō reira e hāngai ana ki te koiora tangata. I whakapāngia e ngā kairangahau aua tauira ki te kikorangi metilīni i waho o te tinana mō te 24 hāora. Ka taea e tēnei whakaritenga te whakaū i tētahi urupare i te kiko i tīpakohia, engari ka hipa i te ngongo, te tohatoha, te pākia, me ngā pāhekoheko i waenga i ngā whēkau.
I ine hoki taua rangahau i te ahotea hāoratanga me te whakapuakitanga monoamine oxidase. Ka pāhekoheko pea aua tukanga ki te mumura, engari ehara te hekenga o ngā momo hāora tauhohe i a ia anō i te taunakitanga kua heke te mate mumura. He mea matua taua wehewehenga ki te pānui rangahau pūtau, kararehe, kiko, me te rangahau haumanu.
He aha tā ngā rangahau haumanu e whakaatu ai, e kore ai hoki e whakaatu?
He whakamātautau tika te sepsis mō te whakaaro me whakaheke rawa te kikorangi metilīni i ngā cytokine mumura i te tangata. Kāore te whakamātautau matapōkere iti mō te sepsis taumaha i kite i tētahi pānga cytokine hira ā-tauanga. Kāore tērā e whakaū ana e kore rawa e taea he pānga i raro i tētahi atu hōtaka maimoatanga, tūāhuatanga rānei. Heoi, e whakaatu ana he aha e kore ai e tika te whakaaro he putanga tangata whānui ngā kitenga pai i ngā pūtau.
I te whakamātautau o 2023 mō te ru nā te sepsis, ko te wā tauwaenga tae noa ki te whakamutu i ngā vasopressor he 69 hāora mō te kikorangi metilīni, he 94 hāora mō te rongoā horihori. Ka tautoko ēnei rongoā i te pēhanga toto. Kāore he rerekētanga hira ā-tauanga o te matenga, ā, he iti rawa te rangahau hei whakatau i taua putanga. I āta pūrongo ngā kaituhi kāore rātou i ine i ngā cytokine hei whakaū i tētahi tikanga mahi. Nō reira, kāore tētahi painga ki te rere toto i te wāhanga tiaki tino māuiui e whakaū ana i te maimoatanga mō te mumura whānui, e whakamana ana rānei i te whakawhiti i taua hōtaka maimoatanga ki te whakamahi i te kāinga.
He aha e tautoko ai i tētahi kerēme hauora whānui ake?
Me whai te kerēme whakapono i tētahi taupori tūroro kua āta tautuhia, tētahi mea whakataurite e tika ana, tētahi hanganga rongoā me tētahi ara tuku ka taea te tāruarua, me tētahi putanga pērā i ngā tohumate, te āheinga mahi, te kaha mahi o te mate, ngā raruraru rānei. Me roa rawa te aroturuki hei aromatawai i te painga e marohitia ana me ōna kino. Ka tautoko pea tētahi tohu koiora pai i aua taunakitanga; kāore e taea te whakakapi i aua taunakitanga.
Ko ngā kerēme mō te MCAS me te kore manawanui ki te histamine me whai i ā rātou ake taunakitanga e hāngai pū ana ki aua mate. Kāore ngā rangahau cytokine whānui e whakaū ana ka whakahaere te kikorangi metilīni i ngā tohumate pūtau mast.
He utu tūturu hoki tō te whakapae he maimoatanga haumaru tētahi pānga whakamātautau. E whakarārangi ana ngā mōhiohio tuku rongoā o nāianei o te US mō te ProvayBlue mā te ia toto i te methemoglobinemia ā-whiwhi hei take whakamahi. E whakatūpato ana mō te mate serotonin taumaha ina whakamahia me ngā rongoā serotonergic me ngā opioid, ā, e rāhuitia ana te whakamahi ki te tangata he ngoikoretanga G6PD tōna, nā te mōrea o te hemolytic anemia. Kāore tētahi whakapae whakaheke mumura e tango i ēnei pānga rongoā.
Mō ngā kaipānui e aromatawai ana i tētahi kerēme hua, pātaihia ko tēhea rangahau tūroro kei muri i te putanga e oati ana. Ki te mutu ngā taunakitanga ki tētahi cytokine, tētahi tauira kiko, tētahi whakaahua pūtau rānei, kāore tonu te painga haumanu e kerēmetia ana kia whakaūngia.