Methylene blue muyedzo dzeG6PD murabhoritari: zviri kunyatsoitwa nedhayi

Mudzidzi anotarisa machubhu maviri mushure mekuchengetwa patembiricha yakatarwa. Rimwe rashanduka kuva ruvara rwanga rwakatarisirwa. Rimwe harina. Mudzidzi anogumisa kuti murwere wechipiri ane kushomeka kweglucose-6-phosphate dehydrogenase. Mhedziso iyoyo inogona kuva yechokwadi, asi kufunga uku kunosvetuka pfungwa inoita kuti bvunzo ishande. Hapana chiri muchubhu chinoyera enzayimu yacho zvakananga. Chubhu inoyera zvinogadzirwa neenzayimu, ichishandisa methylene blue semurevereri.

Kana nzira iyi yekuyera zvisina kunanga yava pachena, maitirwo ebvunzo, zvienzaniso zvekudzora, uye rondedzero refu yemigumisiro yenhema zvinorega kuita sezvinhu zvakangosarudzwa pasina hwaro.

Mhinduro pfupi

Methylene blue muyedzo dzeG6PD chiratidzi cheredox. Enzayimu yeG6PD inogadzira NADPH, uye nzira dzinotsamira paNADPH dzinoderedza methylene blue yebhuruu kuita chimiro chayo cheleuco chisina ruvara (kana kuishandisa kutakura maerekitironi). Kushanda kwakajairika kweenzayimu kunoita kuti kuderedzwa uku kufambe zvakanaka. Kushanda kwakashomeka kunoita kuti kuderedzwa kunonoke kana kusapedziswe. Ndicho chiratidzo chose chinoyerwa.

Nzira mbiri dzekare dzinoshandisa dhayi imwe chete asi dzinosiyana pachiratidzo chekupedzisira. Kana ukadzisiyanisa, kuvhiringidzika kwakawanda kunopera.

Bvunzo mbiri, dhayi imwe chete, zviratidzo zvekupedzisira zvakasiyana

Yekutanga ibvunzo yekuderedzwa kwemethylene blue zvakananga, yakatsanangurwa naSass nevamwe uye yakazoongororwa naGibbs. Pano chiratidzo chekupedzisira idhayi yacho pachayo: methylene blue yebhuruu iri muchimiro chine oksidheshoni inoderedzwa ichienda kuleucomethylene blue isina ruvara, uye kumhanya kwekuchinja uku kunoratidza kukwanisa kugadzira NADPH. Gwaro rekutanga rekuongorora uku rakanyorwa muPubMed pasi paSass nevamwe (1966).

Yechipiri ibvunzo yeBrewer yekuderedzwa kwemethemoglobin. Sodium nitrite inotanga kuita oksidheshoni pahemoglobin ichiiita methemoglobin yebhurawuni. Methylene blue inozoshanda semurevereri wekutamiswa kwemaerekitironi: methylene blue yakaderedzwa inoendesa simba rekuderedza kumethemoglobin, ichiidzosera kuhemoglobin tsvuku. Saka chiratidzo chekupedzisira chinooneka ibhurawuni kana tsvuku, kwete bhuruu kana kusava neruvara. Nzira yekutanga yakabudiswa muBulletin of the World Health Organization (Brewer nevamwe, 1960).

Kudana bvunzo yeBrewer kuti ibvunzo yekubvisa ruvara mudhayi hakuna kunyatsorurama panyaya yemakemikari. Dhayi inotenderera ichichinja mamiriro; hemoglobin ndiyo inochinja ruvara. Dhayagiramu iri pasi apa inoratidza nzira dzose dziri mbiri.

Kuitika kwemakemikari kuri pahwaro

G6PD inobatsira kufambisa danho rekutanga reoksidheshoni munzira yepentose phosphate:

Glucose-6-phosphate + NADP+ becomes 6-phosphogluconolactone + NADPH + H+

Masero matsvuku eropa akura anotsamira zvikuru panzira iyi kuti awane NADPH, sezvakadzokororwa muBlood naLuzzatto nevamwe (2020). NADPH inochengeta glutathione iri muchimiro chakaderedzwa uye inodzivirira sero pakukuvadzwa neoksidheshoni. Methylene blue inopinda muhurongwa uhwu semugamuchiri wemaerekitironi. G6PD yakakwana inopa NADPH yakakwana, iyo inoita kuti kuderedzwa kufambe zvakanaka. G6PD yakaderera inodambura cheni iyi pachinobatanidza chekutanga.

Funga nezvedhayi sechiyereso chemafuta, kwete injini. Inoratidza kuwanikwa kweNADPH. Chero chimwe chinhu chinoshandura kuwanikwa ikoko, kana chinoratidzwa nebvunzo, chinogona kufambisa tsono pasina kuchinja kupi nokupi mujeni.

Maitirwo ebvunzo yerudzi rweBrewer

Mabikirwo emakemikari ebvunzo akasiyana mumakumi emakore apfuura, saka tsananguro yekudzidzisa haifaniri kutorwa senzira yekutevera pakuyedza varwere. Rabhoritari imwe neimwe inotevera nzira yayo yakajairwa yakasimbiswa kuti inoshanda. Uchifunga nezveyambiro iyoyo, kurongwa kwechinyakare kwemachubhu kunoshanda seizvi, sezvakanyorwa nemachubhu matatu uye kuchengetwa kwemaawa 3 mumaitirwo aya akabudiswa:

1. Chubhu yemurwere: ropa rose pamwe neglucose, sodium nitrite, uye methylene blue. Nitrite inogadzira methemoglobin, glucose inotsigira kushandurwa kwezvinhu mumasero matsvuku eropa, uye dhayi inopa nzira yekutakura maerekitironi inotsamira paNADPH.
2. Chienzaniso chekudzora chine oksidheshoni: ropa pamwe nenitrite neglucose asi pasina methylene blue. Chinoratidza ruvara rwekupedzisira rwemethemoglobin yebhurawuni, chimiro chinoratidza kushomeka.
3. Chienzaniso chekudzora chehemoglobin: ropa pamwe nemvura. Chinoratidza ruvara rwekupedzisira rwehemoglobin tsvuku, chimiro chakajairika.
4. Chengetai patembiricha yakatarwa machubhu ose pedyo ne37 C, kazhinji kwemaawa 3, muchiasanganisa zvinyoronyoro.
5. Deredzai kusimba kwechikamu chidiki chinobva muchubhu imwe neimwe muchichiisa mumvura yakacheneswa nekufashaidzwa nekutonhodzwa kwemhute, kuti masero aputike uye kuenzanisa mavara kuve nyore kuona.
6. Enzanisai chubhu yemurwere nezvienzaniso zviviri zvekudzora. Kudzokera kuruvara rutsvuku kunoratidza simba rekuderedza rakakura. Kuramba kuri pedyo nebhurawuni kunoratidza mukana wekushomeka kwakanyanya.

Imwe nzira yekare yekugadzira musanganiswa yaishandisa ropa rinenge 1 mL pamwe nemakemikari ebvunzo aiva pedyo ne180 mM sodium nitrite, 280 mM dextrose, uye 0.4 mM methylene blue. Torai nhamba idzi semuenzaniso unobva muzvinyorwa, kwete semutemo unoshanda kwose kwose.

Kuverenga mugumisiro

Kuongorora kwekutanga kunongoratidza mhando yemugumisiro kunonyatsosiyanisa pedyo ne30 kusvika ku40 muzana yekushanda kwakajairika, sezvinokurukurwa muongororo iyi yeMalaria Journal pamusoro pezvisingabatwi nekuona G6PD. Saka mugumisiro wakajairika wekuongorora kwekutanga unoreva kuti bvunzo haina kuona kushomeka kwakanyanya. Hausimbisi kuti kushanda kweenzayimu kwakajairika zvizere.

Nei kuongorora kwekutanga kuchitsausa

Kuwanda kwemareticulocyte mushure mekuparara kwemasero matsvuku eropa ndiko kunowanzopa mugumisiro wenhema unoratidzika kunge wakajairika. Masero matsvuku eropa madiki nemareticulocyte ane G6PD yakawanda kupfuura masero akwegura. Panguva yechiitiko chinongoerekana chauya chekuparara kwemasero matsvuku eropa, masero akwegura zvikuru uye ane kushomeka kukuru angave atoparadzwa, zvichisiya boka remasero madiki ane kushanda kunoyerwa kuchioneka kwakajairika. Maitiro mamwe chete aya emuviri anotsausawo bvunzo dzinoyera nenhamba, kwete kuongorora kwekutanga kunoshandisa dhayi chete.

Kuisirwa ropa nguva pfupi yapfuura kunovanza kushomeka nokuti masero matsvuku eropa emupi anounza enzayimu yawo mumuenzaniso weropa. Mayo Clinic Laboratories inonyora kuisirwa ropa pakati pezvinokonzera migumisiro yeenzayimu isingavimbiki, pamwe nekuwanda kwemareticulocyte uye kukanganiswa nemasero machena eropa.

Vakadzi vane maareri maviri akasiyana ejeni reG6PD ndivo vanonyanya kuoma kuongorora. Kuvharwa kwekushanda kweX-chromosome kunoitika pasina kurongeka kunogadzira musanganiswa wemasero matsvuku eropa akajairika neane kushomeka, uye kushanda kwawo pamwe chete kunogona kuva chero papi kubva pakushomeka kwakanyanya kusvika pakuratidzika kunge kwakajairika. Kuongorora kwekutanga kusingayeri nenhamba kunowanzotadza kuona maphenotype epakati. Zvinyorwa zveWHO pamusoro pebvunzo dzeG6PD zvinokurukura muganhu uyu zvakadzama.

Nguva yagara muenzaniso weropa, tembiricha yekuchengetwa, kusiyana kwevanhu pakududzira ruvara rwekupedzisira, hematocrit, uye kunaka kwemakemikari ebvunzo zvinowedzera kuvhiringidzika pakuyera pamusoro pemaitiro aya emuviri.

Kuongorora kwekutanga hakusi kusimbisa chirwere

Mugumisiro wekuongorora kwekutanga unoratidza kushomeka, uri pakati, kana usingaenderani nezvinoonekwa pakurapa unoda bvunzo yeenzayimu yeG6PD inoyera nenhamba. WHO inoona spectrophotometry inoyera nenhamba uye inodzorwa tembiricha senzira yekuenzanisira. Mubvunzo iyoyo, musanganiswa unobva pakuputika kwemasero matsvuku eropa unopiwa glucose-6-phosphate neNADP+, uye NADPH inogadzirwa inoteverwa nekuwedzera kwekutorwa kwechiedza pa340 nm. Kumhanya kwekuchinja uku kunoenderana nekushanda kweenzayimu, kazhinji kuchigadziriswa maererano nehemoglobin semayuniti pagiramu. Maitiro azvino mumarabhoritari ekuongorora varwere akapfupikiswa muchinyorwa chekatarogu yebvunzo yeMayo chekushanda kweG6PD.

Kududzira kunoshandisa mwero wekuenzanisira wakasimbiswa nerabhoritari, kazhinji uchienzaniswa nekushanda kwakajairika muboka revanhu, kushomeka kuchiwanzokurukurwa pedyo nemuganhu we30 muzana uye kushanda kwepakati kuri pamusoro pawo. Zvinodiwa neWHO pazvigadzirwa zvinotarisirwa zveyedzo dzeG6PD (2022) zvinotsanangura hwaro ihwohwo hwekuongorora. Kana kuparara kwemasero matsvuku eropa kana kuisirwa ropa kwakaitika nguva pfupi yapfuura kuchiita kuti kuongorora phenotype kusavimbike, dzokororai bvunzo mushure mekunge boka remasero matsvuku eropa radzokera pakuenzana, uye bvunzo dzemamorekuru dzinogona kuwedzera ruzivo pasina kutsiva kuyera enzayimu.

Musiyano wakakosha kuchengetedza

Methylene blue mubvunzo idzi ikemikari yemurabhoritari inoshandiswa kunze kwemuviri. Chokwadi ichocho chiri mune imwe hurukuro yakasiyana neyekuchengeteka kwekupa murwere methylene blue, iyo inotsanangurwa mugwara remamiriro asingafaniri kushandiswa methylene blue. Mashandiro emakemikari mumuviri anozvibatanidza, nokuti mushonga wacho unotsamirawo pakuderedzwa kunotsamira paNADPH, asi dhayi iri muchubhu yebvunzo haisi dhosi riri muropa rinotenderera. Kuti unzwisise mashandiro edhayi pakusvibisa masero mune imwe nzvimbo, ona nheyo dzekusvibisa masero nemethylene blue, uye nezveboka remakemikari rainopinda mariri, madhayi eredox murabhoritari.

Kuongorora kwekutanga kunobvunza kana simba rekuderedza richioneka rakakwana. Kusimbisa kunobvunza kuti enzayimu iripo yakawanda sei chaizvo. Dhayi inopindura mubvunzo wekutanga zvakanaka, chero bedzi pasina munhu anoikumbira kupindura wechipiri.