Zvidzidzo zveChikamu 2 Pfupa Nyaya Yakakwirira Estriol May Ive Inobatsira muSMS
Vakadzi vane pamuviri vane multiple sclerosis vane 70 kubva muzana vakakonzera njodzi yekudzokazve munguva yechitatu yemamiriyoni, uye nyanzvi dzinofunga kuti mukadzikadzi wehomoni yesriol angaita basa rinokosha mukuchengetedzwa uku.
Estriol rudzi rwewesrogen iyo yakasiyana nekuita pamuviri. Inogadzirwa ne-placenta uye inosvika pamatunhu ayo akakwirira munguva yechitatu yemitatu.
Mashoko anofadza ndeokuti vasayendisiti vari kutarisa pedyo nekushandisa isriol kuti vabate vanhu vane MS, mune tarisiro inotadzisa chirwere chavo.
Sayenzi Inoshandisa Using Estriol Kuderedza MS Inodzokorora
Kune zvikamu zviviri zvechikamu chechipiri chechipiri chinoratidza kuti isriol inogona kuva yakakosha mukuderedza kushandiswa kweMMS. Chikamu chechipiri chechipiri chakaitwa kuti chiongorore kuchengetedzwa kwemishonga uye kuti kana kwete iyo inogona kubatsira. Zvidzidzo zveChikamu chechitatu, izvo zvakakura uye zvakasara, zvinotarisirwa kugamuchirwa nemishonga neUnited States Food and Drug Administration (FDA). Saka izvi ndizvo zvose zvakatotanga dheinhau, asi zvisinei zvakadaro.
Mumakore maviri egore re2016 kudzidza muThe Lancet Neurology , vakadzi vane 164 vane reWing-remitting MS (vane makore 18 kusvika ku50) vakashandurwa kuti vawane 8mg yeestriol zuva rega rega kana piritsi ye placebo zuva rega rega. Havazi ivo vatori vechikamu kana vatsvakurudzi vekudzidza vakaziva kuti mapiritsi akanga ari kugoverwa kune mukadzi upi. Vadzidzi vacho vakatora piritsi yeestriol yemapiritsi kana mapiritsi e-placebo pamwe chete nemazuva avo ezuva nezuva 20mg injection yeCopaxone (glatiramer acetate) -ivo vatori vese vachangobva kutanga.
Migumisiro yenyaya yacho yakaratidza kuti mushure memwedzi gumi nemaviri, kuve nekuderera kukuru kwegore rezvekudzoka kwemaitiro kune avo vatora nhengo dzinotora Copaxone uye estriol, zvichienzaniswa nevaya vanotora Copaxone ne placebo. Asi pamagumo emakore maviri, kuderera kwehuwandu hwekudzoka kwemakore kune avo vari kutora estriol uye avo vanotora placebo vaingova nehuwandu hunokosha (kana zvachose).
Kunyange zvazvo zvidzidzo zvekudzidza zvakatanga kuvimbisa, hazvisi pachena kuti nei kuderedza kudengenyeka kwakadaro kusina kuonekwa pashure pemakore maviri, sekuonekwa kwegore rimwe. Nyanzvi dzinoratidza kuti kudzokorora chidzidzo nenhamba huru yevatori vechikamu ingabatsira.
Pane imwe chinyorwa, boka reCopaxone ne-estriol rakagadziridzwa zvikuru nekuneta kwavo, zvichienzaniswa neCopaxone chete boka.
Mashoko akanaka ndeokuti Estriol yakanyatsorambidzwa mukudzidza. Semuenzaniso, maererano nekutarisa mazamu e fibrocystic , kenza yemazamu, kana kuvhara kwekuita uterine (zvinetso zvose zvekutora maitiro e estrogen), pakanga pasina kusiyana kukuru pakati pevakadzi vakatora estriol nevaya vasina. Kuparadzaniswa kukuru chete pakati pemapoka acho maviri kwaiva kuti kusafamba kwenguva kwepanguva yekuenda kumwedzi kwaiwanzoonekwa kune vakadzi vaiwana isriol kupfuura vakadzi vasina. Vaginal zvirwere zvakanga zvisinganyanyi kuonekwa mukati mevakadzi vakatora estriol kupfuura vakadzi vasina.
Mune zvimwe zvidzidzo zviduku zve 2002 muna The Annals of Neurology, vakadzi vane gumi vasina mimba vane MS vakarapwa ne 8mg zuva reEstriol uye vakawana mazano emwedzi maRisiti. Zvigumisiro zvakaratidza kuderera kukuru kwehuwandu hwezvigunwe zvegadolinium-enhancing mumwedzi 6 panguva yekurapwa neestriol, zvichienzaniswa nemwedzi mitanhatu isati yasati yasvika isriol.
Mukuwedzera, apo chirongwa chevakadzi chemaestriol chakaregwa kwemwedzi mitanhatu, nhamba yezvipembenene zvegadolinium-enhancing yakadzokera kuhutachiwana kana mazinga ekutanga. Asi mushure mekunge mwedzi mina ichitangazve isriol, nhamba yavo yezvipembenene zvakare yakaderedzwa muuropi MRI-iyi shure uye mberi kuongorora inonyanya kusimbisa kubatsirwa kweEliriol mune zvidzidzo zviduku.
Kunzwisisa basa re Estriol mu MS
Estrogen ndiyo hormone yepabonde inowanzobudiswa nevakadzi vaviri mazai uye inokonzera kukura nhengo dzaro dzinobereka (uterus, vagina, fallopian tubes, ovaries). Estrogen inotorawo basa rinokosha mukuenda kumwedzi, kunyatsokura, kunyanya, uye bone utano.
Kune marudzi matatu akasiyana eesrogen anobudiswa mumuviri:
- estradiol
- estrone
- estriol
Kusiyana ne-estradiol uye estrone, estriol yakasiyana nekuita pamuviri uye inosunga zvishoma kuti isrogen receptors (nzvimbo dzinoshandiswa) dziri mukati memasero mumuviri.
Mukutaura kwekubatsira multiple sclerosis, masayendisiti anotenda kuti isriol inobatsira zvikuru pakudzivirira nheyo yenheyo. Izvi zvinoratidzwa nezvidzidzo zvinoratidza esriol kusungira kune estrogen receptors mumuviri wemuviri, brain, uye musipinha. Kutaura zvazviri, kupa isriol kumakonzo ane uongorori hwemigodhi inomphalitis, kana EAE (iyo mhando yemhando yeMS), yakawanikwa kudzivirira musana wechipfu kuvhunika uye myelin kurasikirwa-myelin kuva mutsara unodzivirira wakaipa muSMS.
Izvo zvinotaurwa, nyanzvi dzinofunga kuti isriol inowedzera neuroprotective uye isingarwi-kupisa-inoreva kuti inochengetedza uropi nemutsipa wesipinha kubva ku myelin uye nerve fiber (axon) kurasikirwa, asi hazvidziviri kupisa mukati mehutano hwenheyo. Ndicho chikonzero nei zvichida kuti mishonga inopesana nekuputira (semumwe wezvirwere zvino-kuchinja marapirwo) zvaizodiwa pamwe chete nesriol mukurapa MS.
Izvi Zvinorevei Kwandiri?
Zvakakosha kuziva kuti isriol haisi ikozvino yakabvumirwa kushandiswa muUnited States, kunyange zvazvo inoshandiswa kurapa zviratidzo zvemamopaopausal semafuta anopisa uye kuoma kwechikadzi muEurope neAsia.
Iko kutora mharidzo kumusha pano ndeyokuti kunyange zvazvo mupiki anotarisira mushonga weE MS, sayenzi shure kwesriol uye basa rayo mukuchengetedza zvirwere muSMS haina kunyatsorodzwa kunze. Kutsvakurudza kwakawanda kunoda kuzadzikiswa kutanga, kusanganisira chidzidzo chechitatu. Mishonga inotora nguva yekukura, iyo chinhu chakanaka pamagumo ehutano hwako nekuchengeteka.
Sources:
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Confavreux C, Hutchinson M, Maawa MM, Cortinovis-Tourniaire P, Moreau T. Nhamba yekutora pamuviri-inodzokorora zvakare mune multiple sclerosis. Kubata mu Multiple Sclerosis Group. N Engl J Med 1998 Jul 30; 339 (5): 285-91.
Spence RD, uye Voskuhl RR: Neuroprotective migumisiro ye estrogen uye androgens muKSS kuvhiringidza uye neurodegeneration. Front Neuroendocrinol 2012; 33: pp. 105-115.
Sicotte et al. Kurapa kwe multiple multiple sclerosis pamwe nekudzivirira hormone estriol. Ann Neurol 2002 Oct; 52 (4): 421-8.
Voskuhl RR et al. Estriol inobatanidza ne-glatiramer acetate kuvakadzi vanezve kudzoka-remitting multiple sclerosis: randomized, placebo-controlled, phase 2 test. Lancet Neurol . 2016 Jan; 15 (1): 35-46.