Zvinokonzera IBD Ingangosanganisira Genetics uye Environment
Masayendisiti haazive chinokonzera kuvhiringidza marwere (IBD) , iyo inosanganisira ulcerative colitis, chirwere cheCrohn, uye indeterminate colitis. Inonzi inonzi "idiopathic" chirwere, kana chirwere chine chikonzero chisingazivikanwi. Zvisinei, pane mazano akawanda pamusoro pekwakabva kweBD, pamwe chete nemamiriro ezvinhu angakonzera kukura kwayo.
Hatisati tanyatsoziva chinokonzera IBD, zvisinei, tine zvimwe zvinyorwa, uye zvinyorwa zvakawanda. Zvinowanzofungidzirwa kuti kune chidimbu chebhuku kuBD, uye kuti chimwe chinhu (kana kupfuura chimwe chinhu chimwe) mumamiriro edu ezvinhu chinokanganisa maitiro anosangana neBD. Izvi zvinogona "kutungamirira" IBD, uye kutanga kwezviratidzo. Nepo vatsvakurudzi vakadzidza zvakawanda nezvemajeni angangosanganiswa neBD, ndicho chikamu chinokonzera chakaoma kupinza pasi. Iko zvino inofungidzirwa kuti pangave neve mazana emhando dzakasiyana dzeBD, kunyange zvazvo tichiri kuisa zvikamu zvitatu kuti tizvipore nemishonga. Ikoko kunogona, chaizvoizvo, zvakare kuva mazana kana zviuru zvezvinhu zvinokonzera. Imwe tsvakurudzo yakaratidza pane zvishoma zvingaita kuti chikonzero vamwe vanhu vane mabhii eBD vanokurudzira IBD uye vamwe vanhu havaiti.
Genetics uye IBD
Makore apfuura, zvaifungidzirwa kuti IBD inogona kumhanya mumhuri, asi kuwirirana kwaiita sekunetseka nekuti yakanga isiri yemwana mubereki-kumwana, sezvazvakaitika kune dzimwe nzvimbo dzakagara nhaka.
Nekuwanikwa kwemazana zana emajini anokwanisa kubatanidzwa neBD, yakave yakajeka kuti kune chikamu chinowanikwa nhaka yeBD. Kutanga-nhamba yemhuri yevanhu vane IBD vane mikana yekuwana chirwere ichi. Zvisinei, ruzhinji rwevanhu vane IBD havana nhoroondo yemhuri , saka havasi vose vane nhengo yemhuri vane chirwere ichi.
Saka nepo IBD iri pachena inomhanya mumhuri, haisi iyo chete iyo inofanira kutorwa pakufunga painoona zvikonzero zvinokonzera IBD. Panofanira kuva nechimwe chinhu chiri kuita kuti vamwe vanhu vane maitiro akafanana vaite IBD, asi vamwe vasingaiti.
IBD's Inflammatory Response
IBD inowanzonzi autoimmune chirwere , chirwere chinokonzerwa nechirwere chemuviri, asi chakanyanyisa kutaura kuti iyo inopindurwa nemaviri. Nguva dzekupararira- nguva yekutenga kana yekupura-dzimwe nguva inowanikwa kune vanhu vane IBD. Imwe nyanzvi ndeyokuti iyi iGE-mediated response allergenic .
Izvozvo zvinogadzirisa zvinokonzerwa neketani yezviitiko zvinokonzera kuwedzerwa kweeosinophils (masero anoedza kurwisa zvinokonzera kugadzikana) mumuviri. Aya eosinophils anosunungura makemikari mana anonyangadza, matatu ayo anowanika muhuwandu hwezvakawandisa muzvigaro zvevarwere veBDD. Izvi zvinotungamirira vamwe vanotsvakurudza kugumisa kuti kugadzirisa zvinokonzeresa kunogona kuita basa mukugadzirwa kweBD.
Cytokines
Imwe nzvimbo yakasimba yekutsvakurudza ndiyo iyo inoshandiswa nemaktokine mukugadzirwa kweBD. Masero anonzi tumor necrosis factor (TNF, kanawo dzimwe nguva inonzi tumor necrosis factor-alpha) ane mutoro wekutonga mhinduro dzekuzvidzivirira mumuviri, pakati pemamwe mabasa.
TNF inowanikwa muhuwandu hwakawanda muchitsiko chevanhu vane IBD kupfuura kune vanhu vasina IBD (kuburikidza ne fecal calprotectin test). Kutanga nekutenderwa kweRicicade muna 1998, mishonga yakawanda inorwisa-TNF (inowanzonzi biologics) yakagadzirwa kuti iite BD. Kubudirira kwemishonga iyi kunokonzera humwe mushure mokuti pfungwa yekuti TNF inobatanidzwa mune chimwe chinhu chinokonzera IBD kana kuputika kunobatanidza neBD flare-ups.
Environmental Factors muBDD
Pane zvimwe zvakajeka mamiriro epidemiology yeBD iyo inogona kureva chimwe kana zvimwe zvinokonzera zvisikwa. IBD inowanzotanga kuitika kakawanda munyika dzakabudirira uye pakati pevaya vane hupfumi hwehupfumi hwevanhu.
IBD inofanirwa kuitika kakawanda munharaunda dzemaguta enyika dzakabudirira. Izvi zvinoita kuti vatsvakurudzi vafunge kuti pangava nehumwe hukama pakati peBD uye mararamiro kana hupenyu hwevanhu vanogara munyika dzakabudirira, kunyange zvazvo pasina munhu anoziva kuti izvi zvinogona kuva chii.
Imwe nzira yakakurudzira pfungwa ndeyokuti nyika dzakabudirira "dzakachena kwazvo" , uye nokuti vana nevechiri kuyaruka vanoratidzwa mabhakitiriya mashomanana, maitiro avo ezvirwere zvezvirwere zvinogona kunge asina kukwana, izvo zvinoita kuti zvirwere zvisingagadziriswi.
Tsananguro Inobva
Hatizivi chaizvo chinokonzera IBD, asi tinoziva kuti haisi kukonzerwa nekudya kana kushushikana. Pane zvakajeka chimiro chinowanzoita mumhuri, asi icho chikamu chechipiri, chimwe chinhu chakakomberedza icho chiri "kukonzera" mazamu ari kuedza zvakaoma kuwana. Nhau dzakanaka ndeyokuti tinoziva zvakawanda zvakawanda ikozvino pamusoro peBD kupfuura zvatakaita kunyange makore gumi apfuura. Kutsvakurudza kwakawanda kuri kuitika, uye masayendisiti ari kuswedera pedyo nekusvika pakunzwisisa maitiro atingaita zvirwere izvi nekubudirira uye kuvadzivirira mumarudzi anotevera.
Sources:
Bernstein CN, Fried M, Krabshuis JH, et al. "World Gastroenterology Organisation Practice Guidelines for Kuziva uye Kutungamirirwa kweBD muna 2010." Inflamm Bowel Dis 2010 Jan; 16: 112-124.
Crohn's uye Colitis Foundation yeAmerica. "Nezve Epidemiology yeBD." CCFA.org 2009.
National Institute of Diabetes and Digestive and Kidney Diseases. "Ulcerative Colitis." National Institutes of Health Feb 2006.
Peterson CG, Sangfelt P, Wagner M, Hansson T, Lettesjö H, Carlson M. "Fecal mahara emakemikari eukocyte anoratidzira chirwere chezvirwere kune varwere vane chironda chekurwara." Scand J Clin Lab Invest 2007; 67: 810-820.
Saitoh O, Kojima K, Sugi K, Matsuse R, et al. "Zvipembenene zvinonzi Fecal eosinophil-derived zvinoratidza zvirwere zvezvirwere muzvirwere zvinoputika." Am J Gastroenterol 1999 Dec; 94: 3513-3520.
Stensen WF, Snapper SB. " Zvinetso muBD Research: Kuongorora Kufambira Mberi nekugadzirisa zvakare Chirongwa Chekuongorora ." Mumwedzi weBlue Dis 2008; 14: 687-708.