Isihloko
I-methylene blue ne-testosterone: ukuhlola izimangalo
I-methylene blue ayikafakazelwa njengokwelapha noma okwandisa i-testosterone emadodeni. Ukusesha okwenziwe kulungiselelwa lesi sihloko akutholanga ucwaningo olulawulwayo kubantu olubonisa ukuthi i-methylene blue ephuzwa ngomlomo inyusa i-testosterone emadodeni aphile kahle noma yelapha ukuntuleka kwe-testosterone. Ubufakazi obufanele buhlanganisa izindlela zokuhlola ukulimala ezilwaneni, ukuhlolwa kwendlala ye-pituitary kumagundane, okutholakele kokuhlola i-prolactin kubantu, nokuchayeka ngokuqondile kwamangqamuzana esidoda sabantu ngaphandle komzimba.
Lezo zifundo zifanele ukunakwa, kodwa imiphumela yazo ayikwazi ukuhlanganiswa ibe isimangalo esivamile sokuthi i-methylene blue inyusa i-testosterone, yehlisa i-estrogen ne-prolactin, futhi ithuthukisa ikhono lokuzala. Isimangalo ngasinye sidinga umphumela waso olinganisiwe.
Yini ebhekwa njengobufakazi bokwanda kwe-testosterone?
Ucwaningo oluwusizo kubantu lungacacisa ababambiqhaza, indlela umkhiqizo owenziwe ngayo, indlela ofakwa ngayo emzimbeni, okuqhathaniswa nakho, isikhathi socwaningo, nendlela yokuhlola amahomoni. Lungahlukanisa i-testosterone iyonke ku-testosterone ekhululekile, futhi lulinganise ukuthi noma yiluphi ushintsho luqhubekile yini. Izimpawu, ikhwalithi yesidoda, nemiphumela engemihle kungadinga ukuhlolwa ngokwehlukana.
Ukuzizwa uphapheme kakhudlwana akukulinganisi i-testosterone. Ukuthuthuka kokunyakaza kwamangqamuzana esidoda nakho akukulinganisi i-testosterone. Amasende anamangqamuzana e-Leydig akhiqiza i-testosterone phakathi kwamashubhu lapho amangqamuzana esidoda akhula khona. Le misebenzi iyasebenzisana, kodwa umphumela womunye awufakazeli omunye. Ukubuyekezwa okubanzi kwezinzuzo ze-methylene blue ocwaningweni lwabantu kudingida izimangalo zempilo ezivamile, kuhlanganise nezimangalo eziqondiswe emadodeni.
Ithebula lobufakazi bezimangalo nge-testosterone
Leli thebula lihlukanisa okutholakele nalokho okungadingeka ukuze kusekelwe isimangalo esiqondiswe kumthengi. Amanani asetshenziswe ekuhloleni achaza izifundo, hhayi uhlelo lokusetshenziswa ngabantu.
| Isimangalo noma umbuzo | Iqembu elifundwayo nendlela yokuhlola | Indlela yokufakwa emzimbeni nokuchayeka | Umphumela olinganisiwe nokutholakele | Lokho ubufakazi obukusekelayo |
|---|---|---|---|---|
| Inyusa i-testosterone ngemva kokulimala kwamasende | Amagundane esilisa e-Wistar angu-35 emaqenjini amahlanu, kuhlanganise nokulimala okubangelwa i-cisplatin | Imijovo emgodini we-peritoneum; i-methylene blue engu-2 noma 4 mg/kg izinsuku eziyisikhombisa | Kwabikwa ukuthi i-testosterone ku-serum nezilinganiso zesidoda zaziphakeme lapho kusetshenziswa i-methylene blue kunalapho kusetshenziswa i-cisplatin kuphela | Inkomba yomphumela wokuvikela endleleni yokuhlola ukulimala okubangelwa ukwelashwa ngamakhemikhali; akukho kwanda okufakazelwe emadodeni aphile kahle |
| Ihlale izuzisa amasende | Amagundane amadala angu-30 ocwaningweni lomjovo endaweni ethile | Umjovo ezicutshini zamasende noma phakathi kwezingqimba ezimboze amasende; ukuhlolwa ngemva kwamasonto amabili | Umjovo ojulile ezicutshini wehlisa i-testosterone ku-serum nokuminyana kwamangqamuzana esidoda ku-epididymis; iqembu elajovwa phakathi kwezingqimba ezimbozayo alizange libonise ushintsho oluphawulekayo kulezo zilinganiso | Indawo echayeka ngokuqondile ibalulekile; akunakucatshangwa ukuthi kunomphumela ozuzisayo ojwayelekile kumahomoni |
| Yehlisa i-prolactin | Amagundane esilisa achayeka ku-estradiol benzoate, kanye namaqembu okuqhathanisa | I-methylene blue engu-0.5% ekudleni amasonto amathathu | Yehlisa ukwanda kwe-prolactin egazini okuhlobene ne-estradiol; i-methylene blue iyodwa ayizange yehlise i-prolactin egazini | Ukusabela ohlelweni lwamahomoni olushintshwe ngenhloso yokuhlola |
| Ishintsha i-prolactin kubantu | Iziguli eziyishumi ezinobuhlungu bemizwa obungaphenduli ekwelashweni, amadoda ayisishiyagalombili nabesifazane ababili | Ukufakwa emthanjeni emizuzwini engu-60; 2 mg/kg kuqhathaniswa no-0.02 mg/kg | Isilinganiso esiqhathanisayo se-prolactin sehla ngemva kwakho kokubili ukuchayeka; kwabikwa umehluko phakathi kwezindlela ezimbili zokwelashwa | Okutholakele kokuhlola inkomba yemvelo ezigulini ezinobuhlungu, hhayi ukwelashwa okufakazelwe kwe-prolactin ephezulu |
| Ithuthukisa ikhono lokuzala emadodeni | Amasampula esidoda avela emadodeni angu-20 aphile kahle | Ukuxutshwa ngokuqondile nezixazululo zikadayi wokuhlinza nezixazululo ezihlanjululiwe ngaphandle komzimba | Ukunyakaza kwamangqamuzana esidoda kwehla kakhulu ngokushesha ngemva kokuchayeka ku-methylene blue | Okutholakele elabhorethri ngokuchayeka kwamangqamuzana esidoda, hhayi ucwaningo lwekhono lokuzala ngokuphuzwa ngomlomo noma isilinganiso se-testosterone |
| Yehlisa i-estrogen noma ishintsha i-DHT emadodeni | Akukho cwaningo olulawulwayo kubantu lwemiphumela yamahomoni olutholakele kulokhu kusesha | Akukho ukungenelela ngokuphuzwa ngomlomo okuqinisekisiwe ngale miphumela | Akutholakalanga ukuthi umphumela uya ngakuphi noma mkhulu kangakanani ngendlela efakazelwe emtholampilo | Kudingeka ubufakazi obuhlukile nge-estradiol ne-dihydrotestosterone |
| Inyusa i-testosterone ngokuvimba i-enzyme | Ukuhlolwa kokusebenzisana kwemithi elabhorethri okuchazwe emininingwaneni yokunqunywa komuthi | Ukuchayeka ngaphandle komzimba; i-testosterone isetshenziswa njenge-substrate ye-CYP3A4/5 | Kwabonwa ukuvinjelwa kwe-enzyme | Ukuhlolwa kokucutshungulwa kwezinto emzimbeni, hhayi umphumela we-testosterone emtholampilo |
Izifundo ezisekela le migqa zihlolwa ngezansi. Umtapo wocwaningo lwe-methylene blue uhlela ubufakazi ngokweqembu elifundwayo nendlela ukuhlolwa okwaklanywa ngayo.
Lokho ukuhlolwa kwe-cisplatin okukubonisa ngempela
Ocwaningweni lwamagundane lukaGholami Jourabi nozakwabo, olwashicilelwa ku-inthanethi ngo-2020 nakuyi-Andrologia ngo-2021, i-cisplatin yehlisa i-testosterone ku-serum nezilinganiso zesidoda. Ababhali babika ukuthuthuka lapho kusetshenziswa i-methylene blue uma kuqhathaniswa neqembu le-cisplatin, kanye nokutholakele ekuhlolweni kwezicubu okwakuhambisana nokuncipha kokulimala.
Ukuqhathanisa okubalulekile kungokwezilwane ezilinyazwe ngamakhemikhali. Isilinganiso esiphakeme kuneseqembu lokuqhathanisa elilimele asibona ubufakazi bokuthi ukwelashwa kunyusa izinga eliyisisekelo lomuntu ophile kahle. Ucwaningo lwaluhlanganisa neqembu elathola i-methylene blue kuphela, kodwa isifinyezo salo siqhathanisa i-testosterone neqembu le-cisplatin, hhayi ukwanda okufakazelwe ngaphezu kwamaqembu aphile kahle angalashwanga. Lokhu kuhlolwa kwesikhashana ngemijovo akufakazeli ukungenelela ngokuphuzwa ngomlomo emadodeni noma indlela yokugcina ikhono lokuzala ngesikhathi sokwelashwa komdlavuza.
Ubufakazi buphinde bubonise okuphambene ngaphansi kwezimo ezihlukile. Ekuhlolweni kukaMazroa nozakwabo kwemijovo endaweni ethile ngo-2016, ukujova i-methylene blue ezicutshini zamasende amagundane kwabangela ukulimala okubanzi kwesakhiwo sezicubu ne-testosterone ephansi ku-serum. Ukujova phakathi kwezingqimba ezimboze amasende kwabangela ukulimala kwendawo okulinganiselwe kakhudlwana. Lokhu akubikezeli umphumela wokuchayeka ngokuphuzwa ngomlomo, kodwa kuvimbela isimangalo sokuthi ivikela amasende kuzo zonke izimo.
I-prolactin, i-estrogen, ne-DHT kuyimibuzo ehlukene
Okutholakele nge-prolactin okuvame ukucashunwa kuvela ohlelweni lwamahomoni olwashintshwa ngamabomu. Ekuhlolweni kukaSchreiber nozakwabo ngo-1993, amagundane esilisa athola imijovo ye-estradiol benzoate, i-methylene blue ekudleni, kokubili, noma akukho kokubili. Inhlanganisela yehlisa ukwanda kwe-prolactin ejikeleza egazini okuhlobene ne-estradiol. I-methylene blue iyodwa ayizange ishintshe i-prolactin egazini.
Umehluko phakathi kwegazi nezicubu nawo ubalulekile: ukwelashwa akuzange kuvimbele ukwanda kwenani le-prolactin engxenyeni engaphambili yendlala ye-pituitary. Ngakho ucwaningo alubonisi ukuvinjelwa okulula nokufanayo kwe-prolactin kuwo wonke umzimba.
Ucwaningo lwango-2015 ezigulini eziyishumi ezinobuhlungu bemizwa, ezabelwa amaqembu ngokungahleliwe futhi lapho iziguli nabacwaningi babengazi ukuthi ubani uthola yiphi indlela yokwelashwa, lunikeza inkomba elinganiselwe kubantu. Umphumela walo oyinhloko wawuwubuhlungu. Abacwaningi baphinde balinganisa amaprotheni ngaphambi nangemva kokufakwa kwe-methylene blue emthanjeni, beqhathanisa amazinga amabili okuchayeka. I-prolactin yehla ngemva kwakho kokubili, kwaba nomehluko phakathi kwezindlela zokwelashwa. Ukuhlolwa kwanikeza izilinganiso eziqhathanisayo zamaprotheni, hhayi amazinga aphelele amahomoni asetshenziswa emtholampilo. Lokhu okutholakele kokuhlola akufakazeli ukwehla okuqhubekayo kwe-prolactin, ukwelashwa kwe-hyperprolactinemia, noma inzuzo ku-testosterone.
Ukunciphisa ukusabela ku-estradiol enikeziwe nakho akufakazeli ukuthi i-methylene blue yehlisa i-estrogen ejikeleza egazini noma ivimba i-aromatase emadodeni. I-DHT, noma i-dihydrotestosterone, ingomunye umphumela wehomoni ohlukile. Okutholakele nge-testosterone akukwazi ukuvala isikhala somphumela we-DHT ongekho. Izimangalo nganoma iyiphi yalezi homoni zidinga izilinganiso eziqondile ngaphansi kwezimo zokusetshenziswa okuhlongozwayo.
Ubufakazi bamangqamuzana esidoda sabantu abulona ucwaningo lwamahomoni
Ekuhlolweni kukaSheynkin nozakwabo kwamangqamuzana esidoda sabantu ngo-1999, abacwaningi baxuba izingxenye ezilinganisiwe zesidoda nezinto ezisetshenziswa ekuhlinzeni okuphathelene nokuzala. I-methylene blue yabangela ukwehla okukhulu nokusheshayo kokunyakaza kwamangqamuzana esidoda, kuhlanganise nasezixazululweni ezihlanjululiwe ezahlolwa. Isixazululo sikaRinger esine-lactate asizange sithinte ukunyakaza.
Lobu ubufakazi belabhorethri obususelwa kokuthathwe kubantu. Ababambiqhaza abazange baphuze i-methylene blue ngomlomo, futhi abacwaningi abazange balinganise i-testosterone yabo egazini, ukukhulelwa, noma ukuzalwa kwabantwana abaphilayo. Lokhu okutholakele akukwazi ukufakazela inzuzo noma ingozi ekhonweni lokuzala yokuchayeka okuhlukile okuthinta umzimba wonke. Nokho, kubonisa ukuthi kungani amazwi athi “ihlolwe emangqamuzaneni esidoda sabantu” kungafanele afushaniselwe athi “ithuthukisa ikhono lokuzala emadodeni.”
Ukushiwo kwe-testosterone kungasho into ehluke ngokuphelele
Imininingwane yokunqunywa kwe-ProvayBlue ichaza ukuvinjelwa okungenzeka kwe-CYP3A4/5 okuncike esikhathini ngaphandle komzimba, kusetshenziswa i-testosterone njenge-substrate. Lapha, i-testosterone iyinto esetshenziselwa ukuhlola umsebenzi we-enzyme. Ukuvela kwayo kuleso sigaba akufakazeli ukwanda kokukhiqizwa kwehomoni noma amazinga aphakeme egazini leziguli.
Ngokufanayo, incazelo yendlela amandla emangqamuzaneni asebenza ngayo ayikwazi ukuthatha indawo yocwaningo lwamahomoni. Kusadingeka ibonise ukuthi ukuchayeka okuhlongozwayo kushintsha umphumela ofanele eqenjini elihlosiwe.
Uma okukhathazayo kuyi-testosterone ephansi
Umsebenzi osebenzayo uwukuthola ukuthi kukhona yini ukuntuleka kwe-testosterone nokuthi kubangelwa yini. Izincomo zokuxilonga ze-Endocrine Society zidinga izimpawu ezihambisanayo ne-testosterone elinganisiwe ehlala iphansi, ngokuphinda ukuhlolwa ekuseni umuntu engakadli. Ukuhlola okwengeziwe kuhlukanisa izimbangela ezivela emasendeni kulezo ezivela endlaleni ye-pituitary noma ku-hypothalamus. Umphumela owodwa noma ushintsho emandleni akwanele.
I-methylene blue akufanele ithathe indawo yokwelashwa kwamahomoni okunqunyiwe noma yokuhlolwa kwe-prolactin noma i-testosterone engavamile. Inzuzo yayo engaqinisekisiwe kumahomoni ayisusi izingozi zayo ezifakazelwe: imininingwane yokunqunywa komuthi ixwayisa nge-serotonin syndrome uma isetshenziswa nemithi ethinta i-serotonin futhi iyakwenqabela ukusetshenziswa lapho kukhona ukuntuleka kwe-G6PD ngenxa yengozi yokubhidlika kwamangqamuzana abomvu egazi. Umhlahlandlela wokuphepha kwe-methylene blue uchaza lezo zingozi ngokwengqikithi yazo.
Kunoma yisiphi isimangalo nge-testosterone, buza ukuthi yini eyalinganiswa, kubani, ngayiphi indlela yokufakwa emzimbeni, futhi yaqhathaniswa nani. Njengamanje, leyo mibuzo iholela kokutholakele ekuhloleni, hhayi emphumeleni ofakazelwe wokwandisa i-testosterone emadodeni.