Ubururu bwa metilene kuri MCAS no kutihanganira histamine: ibimenyetso

Ubururu bwa metilene si umuti wemejwe wa sindorome yo gukanguka kw'uturemangingo twa mast (MCAS) cyangwa wo kutihanganira histamine. Inyandiko z'ubushakashatsi zabonetse mu gutegura iyi ngingo ntizatanze igerageza ku barwayi rifite itsinda rigereranywa n'irivurwa, rigaragaza inyungu iramba kuri kimwe muri ibyo bibazo. Ibyabonetse birimo amagerageza yo muri laboratwari na raporo y'umurwayi mu gihe gikikije kubagwa, bisubiza ibibazo bifite imbibi nto kurushaho.

Iri tandukaniro ni ingenzi kuko “kugabanya ububyimbirwe,” “kubuza uturemangingo twa mast gukanguka,” na “gukuraho histamine” bisobanura ingaruka zitandukanye. Ibimenyetso bishyigikira kimwe ntibishobora guhita byitirirwa ibindi.

Amagambo atatu agomba gukomeza gutandukanywa

MCAS ireba ibihe bigaruka byo kurekura ibinyabutabire bitanga ubutumwa biva mu turemangingo twa mast, bikagira ingaruka ku mubiri muri rusange. Histamine ni kimwe muri ibyo binyabutabire, ariko uturemangingo twa mast tunakora ibindi bintu bitanga ubutumwa. Ishyirahamwe ry'Abanyamerika ry'Aleriji, Asima n'Ubumenyi bw'Ubudahangarwa risobanura isuzuma rya MCAS rishingiye ku guhuza ibitero bifite ibimenyetso byihariye, ukwiyongera kw'ibinyabutabire birebwa mu gihe cy'ibimenyetso ugereranyije n'urwego rwabyo rusanzwe, n'uko umurwayi yitabira ubuvuzi bugamije kurwanya ibyo binyabutabire. Kugira ibimenyetso byinshi byonyine ntibihagije kugira ngo hemezwe iyo ndwara.

Aleriji yihuse iterwa na IgE ibamo uko ubudahangarwa bw'umubiri bwitabira ikintu runaka gitera aleriji. Iyo icyo kintu gifashe kuri IgE iri ku turemangingo twa mast, gishobora gutuma turekura ibinyabutabire bitanga ubutumwa. Ubu buryo bumenyerewe bwa aleriji bushobora kubamo uturemangingo twa mast, ariko ntibivuze ko buri muntu ufite aleriji aba afite MCAS idafite impamvu izwi. “Aleriji” inakubiyemo ubundi buryo butari ubu bwihuse.

Kutihanganira histamine ni imvugo ikoreshwa kenshi ku ngaruka mbi zikekwa ko ziterwa na histamine iri mu biribwa. Ntibisobanura kimwe na aleriji y'ibiribwa cyangwa MCAS. Amabwiriza yo mu 2021 y'amashyirahamwe menshi ku bijyanye na histamine yinjira mu mubiri binyuze mu byo kurya asobanura ko ibimenyetso bihuza histamine umuntu arya n'ibimenyetso bishobora kongera kugaragara mu bihe bimwe ari bike kandi bivuguruzanya. Anaburira ko gupima diamine oxidase mu gice cy'amazi cy'amaraso bidashobora kwemeza icyo kibazo. Iyi mvugo igaragaza igitekerezo cy'impamvu y'ibimenyetso; kugira ingaruka ziturutse ku biribwa byonyine ntibyemeza ko histamine idasenywa bihagije.

Icyo amagerageza ku turemangingo twa mast yapimye mu by'ukuri

Ibyabonetse mu magerageza yakozwe ku turemangingo ubwabwo ntibishyigikira igisobanuro cyoroshye kivuga ko ubururu bwa metilene bubuza mu buryo bwizewe uturemangingo twa mast kurekura ibinyabutabire.

Mu bushakashatsi bwa Kimura na bagenzi be bwo mu 1999 ku gutembera kw'amaraso mu mitsi mito y'imbeba, abashakashatsi barebye uturemangingo twa mast turi iruhande rw'imitsi mito ijyana amaraso ku mutima iri mu gice gifashe amara, bakoresheje mikorosikopi ireba ibice by'umubiri ukiri muzima. Gutembesha ubururu bwa metilene bwa 50 micromolar hejuru y'aho basuzumaga byatumye uturemangingo dusohora utubumbe tw'ibinyabutabire tubitse. Uturemangingo twera tw'amaraso na two twarushijeho gufata ku rukuta rw'imbere rw'umutsi kandi tugenda tuzunguruka buhoro kurushaho. Gukoresha ketotifen mbere yaho byabujije uko gusohora utubumbe. Iri ryari igerageza ku nyamaswa risuzuma itangwa ry'ubutumwa rifitanye isano na nitric oxide, ntabwo ryari ubuvuzi bwo kunywa umuti ku bantu bafite MCAS.

Ubushakashatsi bwo mu 2001 ku turemangingo twa basofile tw'abantu no ku turemangingo twa mast two mu nda y'imbeba bwapimye mu buryo butaziguye irekurwa rya histamine. Mu bihe byageragejwe, ubururu bwa metilene ntibwahinduye irekurwa risanzwe cyangwa iryatewe no gukangurwa n'ubudahangarwa mu turemangingo twa basofile tw'abantu. Uturemangingo twa basofile ni uturemangingo tw'ubudahangarwa dufitanye isano n'uturemangingo twa mast, ariko ntidushobora gufatwa nk'uturemangingo twa mast turi mu ngingo.

Irindi gerageza ryakoresheje ubwoko bw'uturemangingo tw'imbeba bwitwa RBL-2H3 ntiryabonye ingaruka z'ubururu bwa metilene ku irekurwa risanzwe rya histamine cyangwa ku ryatewe na L-arginine. Ubwoko bw'uturemangingo bukurirwa muri laboratwari, uturemangingo twatandukanyijwe n'ibindi bice by'umubiri, n'uturemangingo twa mast turi mu gice cy'imitsi mito y'umubiri ukiri muzima, bitandukaniye ku butumwa bubikikije no ku byo bihura na byo mu magerageza. Yaba kutabona ingaruka cyangwa kubona isohorwa ry'utubumbe muri ubu buryo bw'igerageza, nta na kimwe gihanura uko buri muntu azabyitabira. Iyo ibi bisuzumwe hamwe, biragora gushyigikira imvugo rusange ivuga ko ari “umuti ubuza uturemangingo twa mast gukanguka.”

Ibipimo rusange by'ububyimbirwe birushaho kuba kure y'ikibazo cy'ubuvuzi. Ihinduka rya cytokine cyangwa poroteyine itanga ubutumwa ntiryakwemeza ko isohorwa ry'utubumbe mu turemangingo twa mast ryagabanutse, keretse ari ryo ryapimwe. Ndetse no kugaragaza ko irekurwa ry'ibinyabutabire bitanga ubutumwa ryagabanutse byakomeza gukenera ibimenyetso ku barwayi kugira ngo hemezwe ko ibitero byagabanutse cyangwa ko ubushobozi bwo gukora ibikorwa bya buri munsi bwateye imbere. Itandukaniro hagati y'ubutumwa bw'ububyimbirwe n'ibisubizo ku buzima rirareba n'iki kibazo.

Raporo y'umurwayi wo mu bitaro isubiza ikindi kibazo

Raporo yo mu 2017 y'umurwayi wabazwe kugira ngo akurwemo ikibumbe cyafunze umutsi w'ibihaha isobanura umurwayi waketsweho ikibazo cy'uturemangingo twa mast, wagize shoke iterwa no kwaguka kw'imitsi nyuma yo kubagwa. Uwo murwayi yahawe imiti ibuza H1 na H2 gukora, imiti ya steroyide, n'ubururu bwa metilene, maze imikorere y'itembera ry'amaraso irushaho kumera neza.

Icyo ni icyabonetse mu buvuzi, ariko igisubizo cyari ukugaruka kw'itembera ry'amaraso mu bihe bigoye byo kubagwa. Hatanzwe imiti myinshi, nta tsinda ryari rihari ryo kugereranya na ryo, kandi indwara ntiyari yemejwe neza. Iyo raporo ntishobora gutandukanya uruhare rw'ubururu bwa metilene n'urw'indi miti, kwerekana ko bwahagaritse irekurwa ry'ibinyabutabire bitanga ubutumwa, cyangwa kwemeza ko kubukoresha kenshi bigabanya ingaruka z'ibiribwa zimaze igihe. Kugabanya ingaruka ku muvuduko w'amaraso zituruka ku gitero no gukumira icyo gitero ni intego ebyiri zitandukanye z'ubuvuzi.

Kugereranya ikibazo n'igisubizo gipimwa

Koresha iri gereranya kugira ngo umenye ibikenewe mu by'ukuri kugira ngo inyungu ivugwa yemezwe. Ibisabwa ku bimenyetso byatanzwe hano hasi ni incamake y'umwanditsi ihuza itandukaniro ry'isuzuma n'iry'amagerageza ryasobanuwe haruguru, ntabwo ari igikoresho cy'isuzuma cyemejwe.

Ingaruka ivugwa	Ikibazo cyangwa inzira bireba	Ibimenyetso byayishyigikira	Icyakomeza kutaba cyemejwe
Bibuza uturemangingo twa mast gukanguka	Irekurwa ry'ibinyabutabire bitanga ubutumwa mu turemangingo twa mast mu buryo bw'igerageza busobanuwe	Ibipimo by'isohorwa ry'utubumbe n'ibinyabutabire birebwa, bifite ibyo bigereranywa na byo kandi bikagenzura ko uturemangingo tukiri tuzima	Inyungu ku bantu bafite MCAS yemejwe
Bigenzura MCAS	Ibihe bigaruka bigira ingaruka ku mubiri muri rusange, byasobanuwe binyuze mu isuzuma ry'ubuvuzi	Ibisubizo ku barwayi bigereranywa n'iby'itsinda ritavuwe kimwe, nk'inshuro ibitero biba, ubukana bwabyo, ubushobozi bwo gukora ibikorwa, n'ingaruka mbi, hamwe n'isuzuma rikwiye ry'ibinyabutabire bitanga ubutumwa	Ko iyo nyungu iterwa no gusenya histamine vuba kurushaho
Bigabanya ingaruka za histamine zifitanye isano n'ibiribwa	Ibimenyetso bishobora kongera kuboneka mu bihe bimwe, bifitanye isano na histamine yinjijwe mu mubiri binyuze mu byo kurya, nyuma yo gusuzuma izindi mpamvu zishoboka	Igereranya ry'ibimenyetso rikurikiranwa n'ababishinzwe, aho abarebwa batamenya ikigeragezwa bahawe, mu bihe byashyizwe ku murongo umwe	Kubura DAO nk'impamvu y'ibanze cyangwa inyungu kuri aleriji iterwa na IgE
Byihutisha gukuraho histamine	Ihindurwa rya histamine mu mubiri	Ibipimo byemejwe by'uko umubiri ukora kuri histamine, mu gihe ingano iwugeramo igenzurwa, hamwe n'ibimenyetso byihariye kuri buri anzime	Kugabanuka kw'ibimenyetso cyangwa kw'ibitero by'uturemangingo twa mast
Bigabanya shoke cyangwa ububyimbirwe muri rusange	Kunanirwa kw'itembera ry'amaraso cyangwa inzira y'ububyimbirwe yasobanuwe	Ibisubizo ku mikorere y'itembera ry'amaraso cyangwa igipimo nyacyo cy'ububyimbirwe, hamwe n'ikintu gikwiye cyo kubigereranya na cyo	Gukumira aleriji, ibitero bya MCAS, cyangwa kutihanganira ibiribwa

Gusenya histamine si ukubangamira MAO

Histamine ifite inzira ebyiri z'ingenzi z'ihindurwa mu mubiri, zirimo diamine oxidase (DAO) na histamine N-methyltransferase (HNMT). Izi anzime zitandukanye na monoamine oxidase A (MAO-A). Ishusho y'igifuniko itandukanya irekurwa ry'ibinyabutabire bitanga ubutumwa n'izi nzira zo kubisenya; amazina ya anzime ari kuri iyo shusho agaragaza inzira, ntabwo agaragaza ibikomoka kuri histamine.

Ramsay na bagenzi be bagaragaje ko ubururu bwa metilene bubangamira MAO-A, igisubizo gifite akamaro ku bijyanye n'uburozi bwa serotonine. Kubangamira MAO-A si ikimenyetso cy'uko imikorere ya DAO cyangwa HNMT yiyongera, kandi ntibyerekana ko histamine ikurwaho vuba kurushaho. Amazina ya anzime asa ntasobanura ko zifite ingaruka zimwe mu buvuzi.

Hari n'itandukaniro mu bushakashatsi rishobora kwirengagizwa byoroshye. Ubushakashatsi bwo mu 2020 ku gupima DAO, bwitabiriwe n'abarwayi 22 n'abantu 22 bo kugereranya na bo, bwakoze ubururu bwa metilene nk'ikintu gifite ibara cyavuye mu ihinduka ry'ibinyabutabire muri laboratwari, ryakoreshejwe mu kugereranya imikorere ya anzime. Abitabiriye ntibavurwaga n'ubururu bwa metilene. Bityo, kubona ayo magambo yombi mu nyandiko y'ubushakashatsi ntibisobanura byanze bikunze ko ari ubushakashatsi ku buvuzi.

Impamvu ihinduka ry'ibimenyetso ridashobora kwemeza uburyo ibintu bikorwa

Ikiganiro cyo ku rubuga cyatumye iki kibazo kibazwa kirimo abantu bavuze ko igogorwa ryabo ryateye imbere kandi ko kumva bakeneye kwihutira kwihagarika byagabanutse nyuma yo gukoresha ubururu bwa metilene. Ibyo bavuze bisobanura impinduka bumvise. Ntibipima ingano ya histamine, ntibyemeza MCAS, kandi ntibyerekana ko ibice by'uruhago byabaye ibidashobora kugirwaho ingaruka na histamine.

Ibimenyetso bishobora guhindagurika mu gihe indyo, kafeyine, amazi umuntu anywa, imiti, n'ibindi ahura na byo bihinduka. Icyabonetse gishobora kuba ari ukuri nubwo igisobanuro cy'impamvu yacyo kitari cyo. Kumva ukeneye kwihutira kwihagarika na byo bisaba isuzuma ryabyo bwite: ibimenyetso by'uruhago n'ubwandu bw'inzira z'inkari bwemejwe ni ibintu bitandukanye. Kugabanuka kw'ibimenyetso byonyine ntigushobora kwerekana ko ubwandu cyangwa imikorere y'uturemangingo twa mast ari byo byabiteye.

Ubwivumbure bukabije bw'umubiri buracyagomba kwitabwaho

Ubururu bwa metilene ubwabwo bushobora gutera ubwivumbure bukabije bw'umubiri. Amakuru yo kwandika umuti wa PROVAYBLUE uterwa mu mutsi asobanura anafilagisi kandi abuza kuwukoresha nyuma y'ubwivumbure bukabije bwatewe n'igicuruzwa cyo mu bwoko bw'ubururu bwa metilene. Anaburira ku bijyanye na sindorome ya serotonine iyo ukoreshejwe hamwe n'imiti igirana na wo imikoranire, kandi abuza kuwukoresha mu gihe cya G6PD idahagije. Aya makuru agaragaza ibyago bikomeye; ntabwo apima urugero rwa buri cyago ku gicuruzwa cyo kunywa kitigeze gikorwaho ubushakashatsi.

Ibimenyetso ntibishyigikira gusimbuza ubururu bwa metilene imiti irwanya histamine yanditswe na muganga cyangwa ubundi buvuzi bwemejwe. Guhumeka bigoranye, kubyimba mu muhogo, cyangwa kugwa hasi bisaba ubufasha bwihutirwa bw'abaganga, ntabwo ari ukugerageza ikinyabutabire gitanga ibara. Mu gutegura ikiganiro n'umuganga, zana imvugo nyayo ivuga inyungu ziteganyijwe, igicuruzwa, imiti ukoresha ubu, n'amateka y'ibimenyetso byawe, wifashishije ibi bibazo wabaza ku bururu bwa metilene. Ikibazo gifatika ni ukumenya indwara n'igisubizo ubuvuzi buteganyijwe bugamije, no kumenya niba hari ibimenyetso bishyigikira ubwo buryo bwihariye bwo kubukoresha.