Tiri Tiri Pedyo neMushonga weShuga Here?
Avo vane chirwere cheshuga cheshuga (chirwere cheshuga cheshuga) havaiti chero insulini-masero e-beta anobudisa beta (β-seli) mumapancasi avo haashande zvakanaka nokuda kwezvikonzero zvisiri zana zvezana zvakajeka. Senzira yekugadzirisa mashiga eropa, vanovimba nesululin yakagadzirwa nevanhu, injova insulin kakawanda zuva nezuva kana kupfeka insulin pump, carbohydrates kuverenga , uye nguva dzose kuedza shuga yavo yeropa .
Zvisinei, masayendisiti ari kutsvaga kusika vanhu islet masero (insulin-making cells) kubva pamasero emadziro, nechinangwa chekushandura masero aya kubatsira avo vane chirwere cheshuga vanosiya insulin. Kudyara islet masero anokonzerwa kubva mumasero emadziro inzvimbo inosimudzira tsvakurudzo uye ikozvino inoshandiswa mukudzidza kwezvipfuwo. Zvisinei, maererano neNational Institutes of Health, pane mamwe maviri emamwe emamwe akaiswa islet cell transplantation ayo ari kushandiswa mukunyatsosarudzwa vanhu vane chirwere cheshuga.
Chii Chinonzi Islet Cell Transplantation?
Pancreatic islet cell transplant, iyo inozivikanwawo sebhea cell transplant, inoshandiswa nemasero epa beta, zvichibva kuvanhu vanopa kana masero akaiswa mubasa racho, inoshandiswa kuva munhu ane chirwere cheshuga chechirwere cheshuga. Tariro ndeyokuti vanovhara insulini uye vanobatsira kutarisa ropa rinokonzerwa neropa, semasikirini ese anoshanda-beta.
Kusvika iye zvino, varwere vanofambiswa nevakafa vanopa masero masero vanogona kuitwa insulini yakazvimiririra kwemakore akawanda.
Zvisinei, urongwa uhwu hwakakonzerwa nekuda kwekushaiwa uye unhu hwekupa masero masero. Mukuwedzera, zvakakosha kucherechedza kuti cell transplantation inzira yekuedza uye ichave yakanyorwa saiyo kusvika pakugadzirwa kwekombiyuta inonzi inobudirira zvakakwana kunyoreswa kurapwa.
Parizvino, mavara maviri ekupemwa kunepo.
Allo-Kukura
Iko rudzi rwekugadziriswa kunosanganisira kutora majekiseni kubva kumunhu akafa uye kuvatsvenesa. Mushure mekuchenesa, masero anogadziriswa uye anotamirwa mumugamuchiri.
Mhando iyi yekushandura yakashandiswa kune vamwe varwere vane chirwere cheshuga chechirwere cheshuga avo vane shuga dzakaoma kwazvo kuzvidzora. Zvakanaka, kuiswa kwemavara kunokonzera maitiro evhuga eropa rega yega pasina kushandisa insulin injection kana infusions, kana kuti zvishoma zvingaderedza kuwandisa kweshuvha inodiwa. Imwe chinangwa ndechokuderedza hypoglycemia unwareness -iyo mungozi umo vanhu havagoni kuona kuti ropa ravo risati rakasviba.
Kudyara varwere vanowanzogamuchira maviri maviri nevanokwana 400,000 kusvika ku500 000 zviwi zvepukisi. Kana ikasimwa, masero e beta ari muzviwi izvi anotanga kuita uye anosunungura insulini.
Paunenge uchigamuchira masero, unofanirwa kuva nemishonga inofanirwa kugadzirisa zvirwere kuti urege kurambwa. Izvi zvinogona kukonzera chirwere cheshuga nokuti nekufamba kwenguva idzi mhando dzemishonga, dzakadai seorticticosteroids, dzinogona kuwedzera insulin kusagadzikana, zvichiita kuti kuwedzerwa muropa shuga. Mamwe maitiro eumunosuppressive zvinodhaka anogona kuderedza beta cell kukwanisa kusunungura insulini.
Uye pakupedzisira, marudzi aya emishonga anoderedza zvirwere zvemuviri, zvinogona kuwedzera njodzi yehutachiona. Nokudaro, zvakajeka kuti izvi hazviuye pasina zvipingamupinyi uye kusava nechokwadi.
Allo-transplants haisi kuitwa muzvipatara zvose-zvipatara zvinofanira kuva nemvumo kubva kuUnited States Food and Drug Administration (FDA) yekutsvakurudza kwechipatara pane chinoshandiswa kupora. Chiremba anoona mukufungidzira kwezvokurapa, anonzi radiologist, ndiye anowanzoita kuchinja. Anoshandisa x-rays uye imaging ultrasound kuti inotungamira kuiswa kwecatheter (tsvuku, plastiki tube) kuburikidza nekudhonza zvishoma mudumbu rekumusoro kusvika muchitinha chemukova (chinosuruvarisa chinopa ropa kuchiropa).
Kana imwechete catheter ichiiswa munzvimbo yakakodzera iyo nhengo dzemajeri dzinowedzerwa zvishoma nezvishoma. Kazhinji, varwere vanopiwa nzvimbo yeAnethesia uye vanoita sedative munguva yekuita.
Vatsvakurudzi vanotenda kuti varwere vanoda mamiriyoni 350 kusvika ku 750 mamiriyoni ekumisa kushandiswa kwe insulini zvachose. Saka, vazhinji varwere vanoda kuwanda kwezvipembenene.
Auto-Transplantation
Izvi zvinoshandiswa mushure mekubviswa zvachose kwepancreas (pancreatectomy) kune varwere vane chirwere chakasimba uye chisingaperi chisingagoni kutarisirwa nedzimwe mishonga. Iko pfungwa ndeyokuchengetedza insulini yekugadzira nekuvhara ropa nokuti kubviswa kwepancreas kunogona kutungamirira munhu kukura chirwere cheshuga.
Varwere vane chirwere cheshuga chechirwere cheshuga havagoni kuwana rudzi urwu rwekushandura.
Pros
Inofananidzwa nehutano hwechigadzirwa, islet cell allo-transplants inowedzera kuderera. Kubudirira kwechirongwa chema-allo-transplantation kwaizovandudza ropa glucose kudzora uye kunogadzirisa kana kuderedza kushandiswa kwemisulini kwenguva yakareba. Izvi zvinoreva kuti varwere havazofaniri kuvhara insulin kana kupa insulini kuburikidza nepombi kakawanda pazuva. Kurapa kwemashuga eropa kunogona kuderedza kana kuderedza dambudziko rekushaya chirwere cheshuga sehutano hwepfungwa, chirwere cheshuga-neuropathy (nervous damage), uye retinopathy (kukuvara kweziso).
Uyezve, ne-allo-transplantation, kunyange musarudzo mushure mekugadziriswa kunogona kuderedza hypoglycemia unwareness, kubatsira varwere kunzwa zviratidzo zvakadai sokuputika, kuzununguka, kuwedzera kwemwoyo, kushungurudzika, kana nzara, uye kuvabata zvakakodzera.
Ngozi
Nzira yekufambisa inogona kuwedzera dambudziko rekubuda ropa uye neropa. Panewo mukana wekuti masero akatemwa anogona kushanda zvakanaka kana zvachose. Mukuwedzera, ose masero haafaniri kushanda pakarepo uye angatora nguva kuti atange kushanda zvakanaka. Saka, vanogamuchira vangada kutora insulini kusvikira masero atanga kushanda zvakanaka.
Panewo mungozi yokuti mhinduro yekuzvimirira iyo yakatanga kuparadza masero emunhu wemunhu anogona kukonzerwa zvakare, zvichiguma nekurwisa mumasero matsva. Vanotsvakurudza vari kuedza kuongorora kana kushandisa dzimwe nhengo dzomuviri yekugadzirisa zvinogona kudzivirira izvi kuti zvirege kuitika.
Kuti udzivise kurambwa kwemasero, unofanirwa kutora mishonga yemununuuppressive iyo inodzivirira masimba ezvirwere. Iyi mishonga inogonawo kuwedzera shuga yeropa. Immunosuppressive mishonga haifaniri munyaya ye auto-transplant nokuti inokonzera masero anouya kubva mumuviri pachake.
Zvikanganiso
Chimwe chipingamupinyi chikuru ndechekuti pane kushayikwa kweiyo masero kubva kune vanopa-kazhinji apo hapine masero ehutano akakwana kuti adzokere uye pasina vanopa vanokwana.
Sezvaunogona kufungidzira, rudzi urwu rwehutano hunodhurawo. Kunyange zvazvo varwere vangave vari kuchengetedza mari pa insulin, mari yekugadzirisa, maitiro, uye mishonga yeunununuuppressive inoita zvipingamupinyi zvemari zvinodzivirira kushandiswa kwekushandiswa kwesero allo-transplantation.
Ramangwana Anotarisira
Masayendisiti vari kushanda nesimba kuti vakwanise islet cell transplantation. Pakave nekutsvakurudza kunoratidza kukwanisa kusika masero evanhu beta kubva mumasero emadziro mubazi. Zvinotendwa kuti masero aya aizoudza huwandu hwakawanda hwehutachiona hunoita masero. Uye kunyange zvazvo pave nekufambira mberi kwakawanda, basa rakawanda rinofanira kuitwa munharaunda iyi isati yashandurwa inova nzira yekurapa. Kuzadzisa iyi nzira kunogona kutitorera imwe danho riri pedyo nekurapa chirwere cheshuga.
Shoko Rinobva
Islet cell transplantation, kunyanya allo-transplantation, ikozvino inoshandiswa pane kunyanya kusarudzwa kwevanhu vane chirwere cheshuga chechirwere cheshuga vane nguva yakaoma zvikuru kuchengeta ropa ravo rega kana kuti vane chirwere chakaipa chekunyengedza kwehugoglycemia. Kuputika kunongowanikwa muzvipatara zvekuongorora zvipatara izvo zvakagamuchirwa neDFA.
Zvidzidzo zvezvipfuwo zvakaratidza kuti masero e beta akasikwa kubva pamasero emadziro uye anoshandiswa mukugadzirisa anopa insulin nokukurumidza. Iyi nzira ye beta sekugadzirwa kwemasero inogona kupa zvakanyanya kuvimbika uye inogona kunge yakawedzera mari inoshandisika sekiini inofananidzwa nekuenzaniswa nezvipo zvevanhu. Kwete izvi zvingangowedzera nhamba ye islet cell transplant procedures, asi inogonawo kuwedzera kuwanika kwemasero evanhu beta nokuda kwekutsvakurudza.
Kushandisa masero emasero kunogona kubatsira mamiriyoni evanhu, asi masayendisiti ane basa rakawanda rokuita asati agadzirisa iyi nzira.
> Sources:
> National Institute of Diabetes and Digestive and Kidney Disease. Pancreatic Islet Transplantation.
> Pagliuca FW, et. al. Chizvarwa chebasa revanhu pancreatic β masero mu vitro. Cell. 2014 Oct 9; 159 (2): 428-39. doi: 10.1016 / j.cell.2014.09.040.
> Kubatanidzwa Islet Transplant Registry mushumo wegore wechinomwe. Sangano Rokubatanidza Kudyara Registry. https://web.emmes.com/study/isl//reports/01062012_7thAnnualReport.pdf
> American Diabetes Association. Zvokutsvaga Dhiyabhorosi Dhiyabhorosi uye Nhamba Dzechirwere Cheshuga
> JDRF. Nzira Yutsva yeBeta Maselo.