Chinyorwa
Methylene blue yeMCAS nekusashivirira histamine: zvinoratidzwa nehumbowo
Methylene blue haisi nzira yekurapa yakasimbiswa yemast cell activation syndrome (MCAS), kureva chirwere chekumutswa kwemasero emast, kana yekusashivirira histamine. Zvinyorwa zvetsvakurudzo zvakawanikwa zvechinyorwa chino hazvina kupa miedzo yevarwere ine mapoka ekuenzanisa inoratidza kubatsirwa kunogara kwenguva refu kune chimwe chezvirwere izvi. Zvakawanikwa zviripo zvinosanganisira kuyedza murabhoritari nemushumo wemurwere panguva yakapoteredza kuvhiyiwa, zvinopindura mibvunzo ine muganhu wakamanikana.
Musiyano uyu wakakosha nokuti “zvinoderedza kuzvimba kunokonzerwa nekuita kwemuviri,” “zvinodzikamisa masero emast,” uye “zvinobvisa histamine” zvinotsanangura migumisiro yakasiyana. Humbowo hwechimwe hahungotorwi huchinzi hunoshandawo kune zvimwe.
Mazwi matatu anofanira kuramba akasiyana
MCAS ine chekuita nezviitiko zvinodzokororwa zvinobata muviri wose, apo masero emast anoburitsa zvinhu zvinofambisa mashoko mumuviri. Histamine chimwe chezvinhu izvi, asi masero emast anogadzirawo zvimwe zvinhu zvinotumira mashoko. American Academy of Allergy, Asthma & Immunology inotsanangura kuongororwa kweMCAS ichishandisa mubatanidzwa wezviitiko zvine zviratidzo zvinozivikanwa, kuwedzera kwezvinhu izvi panguva yezviratidzo zvichienzaniswa nemwero wazvo wenguva dzose, uye kuita kwemuviri kurapwa kunonangana nazvo. Kuva nezviratidzo zvakawanda chete hakusimbisi kuti munhu ane chirwere ichi.
Allergy inoitika pakarepo ichitungamirirwa neIgE inosanganisira kuita kwemasoja emuviri kune chimwe chinhu chinokonzera allergy. Kubatana kwechinhu ichocho neIgE iri pamasero emast kunogona kukonzera kuburitswa kwezvinhu zvinofambisa mashoko. Nzira iyi inozivikanwa yeallergy inogona kusanganisira masero emast pasina kureva kuti munhu wese ane allergy ane MCAS isina chikonzero chinozivikanwa. “Allergy” inosanganisirawo nzira dzisiri iyi inoitika pakarepo.
Kusashivirira histamine kunowanzoshandiswa kureva kuita kwakashata kwemuviri kunofungidzirwa kuti kunokonzerwa nehistamine iri muchikafu. Hakufaniri kunzi kwakafanana neallergy yezvokudya kana MCAS. Nhungamiro ya2021 yemasangano akawanda pamusoro pehistamine inomedzwa inotsanangura humbowo hushoma uye hunopesana hunobatanidza kudyiwa kwayo nezviratidzo zvinokwanisa kudzokororwa, uye inoyambira kuti kuyera diamine oxidase iri muserum hakugoni kusimbisa chirwere ichi. Izwi iri rinoratidza tsananguro inofungidzirwa yezviratidzo; kuita kwemuviri kune chikafu hakuratidzi pachako kuti kuputswa kwehistamine kwakaderera.
Zvakayerwa chaizvo mukuyedzwa kwemasero emast
Zvakawanikwa mukuyedza kwakanangana nemasero hazvitsigiri tsananguro iri nyore yokuti methylene blue inodzivirira zvakavimbika kuburitswa kwezvinhu nemasero emast.
Muchidzidzo chaKimura nevamwe cha1999 chemitsinga midiki yeropa mumakonzo, vaongorori vakaona masero emast pedyo netsinga diki dzinodzosa ropa dziri mumesentery vachishandisa maikorosikopu pamatishu emhuka mhenyu. Kuisa methylene blue panzvimbo iyoyo nokuyerera kwemushonga pamusoro payo pa50 micromolar kwakakonzera kuburitswa kwezviri mumagranule. Masero machena eropa akanamirawo zvakanyanya kumadziro emukati etsinga uye akaumburuka zvishoma nezvishoma. Kushandisa ketotifen kusati kwaiswa methylene blue kwakadzivisa kuburitswa kwezviri mumagranule. Uku kwaiva kuyedza pamhuka kuchiongorora kutumirana mashoko kune chekuita nenitric oxide, kwete kurapa vanhu vane MCAS nemushonga unonwiwa.
Chidzidzo cha2001 chemasero ebasophil evanhu nemasero emast emudumbu remakonzo chakayera kuburitswa kwehistamine zvakananga. Methylene blue haina kuchinja kuburitswa kwenguva dzose kana kwakakurudzirwa nemasoja emuviri kubva mumasero ebasophil evanhu pasi pemamiriro akaedzwa. Masero ebasophil masero emasoja emuviri ane hukama nemasero emast, asi haana kufanana nemasero emast ari mumatishu.
Kumwe kuyedza kwakashandisa mutsara wemasero emakonzo weRBL-2H3 hakuna kuwana kuchinja kwakakonzerwa nemethylene blue pakuburitswa kwehistamine kwenguva dzose kana kwakakonzerwa neL-arginine. Mutsara wemasero, masero akaparadzaniswa, uye masero emast ari mumatishu ane mitsinga midiki yeropa emhuka mhenyu zvinosiyana pamashoko azvinogamuchira kubva kuzvakazvipoteredza nezvazvinoiswa mazviri mukuyedza. Kusawana kuchinja kana kuwana kuburitswa kwezviri mumagranule mumiedzo iyi hakufanotauri kuita kwese kungaitika muvanhu. Pamwe chete, zvinowanikwa izvi zvinoita kuti zvive zvakaoma kutsigira chirevo chakakura chokuti methylene blue “inodzikamisa masero emast.”
Zviyero zvakajairika zvekuzvimba kunokonzerwa nekuita kwemuviri zviri kure zvikuru nemubvunzo une chekuita nekurapa varwere. Kuchinja kwecytokine kana puroteni inotumira mashoko hakungasimbisi kuti kuburitswa kwezviri mumagranule emasero emast kwaderera, kunze kwekunge izvozvo zvayerwa. Kunyange kana kuderera kwekuburitswa kwezvinhu zvinofambisa mashoko kwaratidzwa, humbowo kubva kuvarwere hungaramba huchidiwa kuratidza kuderera kwezviitiko kana kuvandudzika kwekuita mabasa ezuva nezuva. Musiyano pakati pezviratidzo zvekuzvimba kunokonzerwa nekuita kwemuviri nemigumisiro yehutano unoshanda pano.
Mushumo wemurwere muchipatara unopindura mumwe mubvunzo
Mushumo wemurwere wa2017 wekuvhiyiwa kubvisa chakavhara tsinga yeropa yemapapu unotsanangura murwere aifungidzirwa kuti ane chirwere chemasero emast, akazoita shock inokonzerwa nekutambanuka kwetsinga dzeropa mushure mekuvhiyiwa. Murwere akapiwa mishonga inopikisa H1 neH2, steroid, uye methylene blue, kufamba kweropa kukavandudzika.
Izvozvo zvakacherechedzwa pakurapa murwere, asi mugumisiro wacho waiva kudzoreredzwa kwekufamba kweropa mumamiriro ekuvhiyiwa akaoma. Mishonga yakawanda yakapiwa, pakanga pasina boka rekuenzanisa, uye chirwere chacho chakanga chisina kunyatsosimbiswa. Mushumo uyu haugoni kuratidza yoga yakaitwa nemethylene blue, kuratidza kuti yakamisa kuburitswa kwezvinhu zvinofambisa mashoko, kana kusimbisa kuti kuishandisa kakawanda kunovandudza kuita kwemuviri kune zvokudya kunogara kwenguva refu. Kuvandudza migumisiro pabhlood pressure inotevera chiitiko uye kudzivirira chiitiko chacho zvinangwa zviviri zvakasiyana zvekurapa.
Kuenzanisa chirwere nemugumisiro unoyerwa
Shandisa kuenzanisa uku kuona kuti kubatsirwa kunotaurwa kungada chii chaizvo. Zvinodiwa pahumbowo zviri pazasi mubatanidzwa wakagadzirwa pano wemisiyano iri pamusoro yekuongorora chirwere nekuyedza, kwete mudziyo wakasimbiswa wekuongorora chirwere.
| Mugumisiro unotaurwa | Chirwere kana muitiro une chekuita nawo | Humbowo hungaoutsigira | Zvingaramba zvisina kusimbiswa |
|---|---|---|---|
| Inodzivirira kumutswa kwemasero emast | Kuburitswa kwezvinhu zvinofambisa mashoko nemasero emast mumuedzo wakanyatsotsanangurwa | Kuyera kuburitswa kwezviri mumagranule nezvinhu zvinofambisa mashoko zvakakodzera mumamiriro anodzorwa, paine zviyero zvekuenzanisa zvinoratidza kuti masero achiri kurarama | Kubatsirwa kwevanhu vane MCAS yakasimbiswa |
| Inodzora MCAS | Zviitiko zvinodzokororwa zvinobata muviri wose, zvakatsanangurwa nekuongororwa kwekurapa | Migumisiro kuvarwere ine mapoka ekuenzanisa, yakadai sekuti zviitiko zvinoitika kakawanda sei, kuoma kwazvo, kuita mabasa, nemigumisiro yakaipa, pamwe nekuongororwa kwakakodzera kwezvinhu zvinofambisa mashoko | Kuti kubatsirwa kunobva pakuputswa kwehistamine nokukurumidza |
| Inovandudza kuita kwemuviri kuhistamine ine chekuita nechikafu | Zviratidzo zvinokwanisa kudzokororwa zvine chekuita nehistamine inomedzwa, mushure mekuongorora dzimwe tsananguro | Kuenzanisa zviratidzo mumamiriro akaenzaniswa, kuchitarisirwa nenyanzvi uye vatori vechikamu vasingazivi zvavapiwa | Kushaikwa kweDAO kuri chikonzero chezviratidzo kana kubatsirwa kune allergy inotungamirirwa neIgE |
| Inokurumidzisa kubviswa kwehistamine | Kushandurwa kwehistamine mumuviri | Zviyero zvakasimbiswa zvemabatirwo ehistamine mumuviri pasi pemamiriro ekupinzwa kwayo anodzorwa, pamwe nehumbowo hunonangana neenzayimu yacho | Kuderedzwa kwezviratidzo kana kwezviitiko zvemasero emast |
| Inovandudza shock kana kuzvimba kunokonzerwa nekuita kwemuviri zvakazara | Kutadza kwekufamba kweropa kana nzira yakatsanangurwa yekuzvimba kunokonzerwa nekuita kwemuviri | Migumisiro yekufamba kweropa kana mugumisiro chaiwo wekuzvimba unoyerwa, paine chekuenzanisa nacho chakakodzera | Kudzivirirwa kweallergy, zviitiko zveMCAS, kana kusashivirira zvokudya |
Kuputswa kwehistamine hakusi kudziviswa kweMAO
Histamine ine nzira mbiri huru dzekushandurwa mumuviri dzinosanganisira diamine oxidase (DAO) nehistamine N-methyltransferase (HNMT). Aya maenzayimu akasiyana nemonoamine oxidase A (MAO-A). Mufananidzo webutiro unosiyanisa kuburitswa kwezvinhu zvinofambisa mashoko nenzira idzi dzekuputswa kwazvo; mazita emaenzayimu ari pauri anoratidza nzira, kwete zvinhu zvinogadzirwa kubva kuhistamine.
Ramsay nevamwe vakaratidza kuti methylene blue inodzivisa MAO-A, zvakawanikwa zvine chekuita nehuturu hunokonzerwa neserotonin. Kudzivisa MAO-A hakusi humbowo hwokuti kushanda kweDAO kana HNMT kunowedzera, uye hakuratidzi kukurumidza kubviswa kwehistamine. Kufanana kwemazita emaenzayimu hakusimbisi kuti ane mugumisiro wakafanana pakurapa.
Panewo musiyano wetsvakurudzo unogona kusacherechedzwa nyore. Chidzidzo cha2020 chekuongorora DAO chaisanganisira varwere 22 nevanhu 22 vekuenzanisa navo chakagadzira methylene blue sechinhu chine ruvara chakabuda mukuita kwemakemikari murabhoritari kwaishandiswa kufungidzira kushanda kweenzayimu. Vatori vechikamu vakanga vasiri kurapwa nemethylene blue. Saka kuwana mazwi ose ari maviri muchinyorwa chetsvakurudzo hakurevi nguva dzose kuti itsvakurudzo yekurapa.
Nei kuchinja kwezviratidzo kusingagoni kusimbisa mashandiro acho
Hurukuro yepaforamu yakamutsa mubvunzo uyu inosanganisira mishumo yekuvandudzika kwekugaya zvokudya nekuderera kwekunzwa kuda kuita weti nokukurumidza mushure mekushandisa methylene blue. Mishumo iyoyo inotsanangura kuchinja kwakaonekwa nevanhu. Haiyeri kuwanda kwehistamine, haisimbisi MCAS, uye hairatidzi kuti matishu edundira akanga asisabatwi nehistamine.
Zviratidzo zvinogona kuwedzera kana kuderera apo zvokudya, caffeine, mvura mumuviri, mishonga, nezvimwe zvinosangana nemuviri zvinenge zvichichinja. Zvakacherechedzwa zvinogona kuva zvechokwadi kunyange kana tsananguro inopiwa isiri iyo. Kunzwa kuda kuita weti nokukurumidza kunodawo kuongororwa kwako kwakasiyana: zviratidzo zvedundira nehutachiona hwenzira yeweti hwakasimbiswa zvinhu zvakasiyana. Kurerukirwa kwezviratidzo chete hakugoni kuratidza kuti hutachiona kana kushanda kwemasero emast ndiko kuri kuzvikonzera.
Kuita kwakanyanya kweallergy kunoramba kuchikosha
Methylene blue pachayo inogona kukonzera kuita kwakanyanya kweallergy. Mashoko ekunyorerwa kwePROVAYBLUE inopinzwa mutsinga anotsanangura anaphylaxis uye anorambidza kushandiswa kwayo kana munhu akambova nekuita kwakanyanya kweallergy kune chigadzirwa chemuboka remethylene blue. Anoyambirawo nezveserotonin syndrome kana ichishandiswa nemishonga inodyidzana nayo, uye anorambidza kushandiswa kwayo kana paine kushomeka kweG6PD. Mashoko aya anosimbisa njodzi dzakakosha; haatauri mwero wenjodzi imwe neimwe yechigadzirwa chinonwiwa chisina kuongororwa.
Humbowo hahutsigiri kutsiva mishonga yeantihistamine yakanyorerwa nemethylene blue kana kutsiva kumwe kurapwa kwakasimbiswa. Kunetseka kufema, kuzvimba kwehuro, kana kudonha kunoda rubatsiro rwechimbichimbi rwekurapa, kwete kuyedza dhayi. Kana uchironga hurukuro nenyanzvi yezvekurapa, uya nechirevo chaicho chiri kutaurwa, chigadzirwa, mishonga yauri kushandisa, nenhoroondo yezviratidzo, uchishandisa iyi mibvunzo yekubvunza pamusoro pemethylene blue. Mubvunzo unokosha ndewokuti kurapwa kuri kutaurwa kwakanangana nechirwere chipi nemugumisiro upi, uye kana paine humbowo hwekushandiswa ikoko chaiko.