Ukugquma okwexeshana okulinganisa iziphumo zotyando lwe-gastric bypass kunokunceda ukunyanga isifo seswekile esi-2
Utyando lwe-gastric bypass lukhetho oluqhelekileyo kwizigulana ezinoxinzelelo lwegazi, imiba yokulawula ubunzima kunye iswekile. Olu tyando lubuyisela umva ukutyeba ngokwenza isigulana silahlekelwe sisixa esikhulu sobunzima kwaye lunceda nasekulawuleni uhlobo lwe-2 sikashukela ngendlela ezimeleyo. Ngenxa yolu tyando oluyimpumelelo noluqondwa kakuhle, kukho ukuphucuka okubonakalayo kwindlela yokuphila kunye nokuphezulu iswekile uxolelo kumashumi eminyaka adlulileyo. Nangona kunjalo, olu hlobo lotyando alulona khetho lokuqala lokulandela izigulane ezininzi ngenxa yeengozi ezibandakanyekayo kwaye olu tyando lunokubangela utshintsho olungenakuguqulwa kwi-anatomy yesisu somguli. Ubalo lubonisa ukuba kuphela i-1% ukuya kwi-2% yezigulane ezifanelekileyo ukwenza olu tyando ziya kuthi zonke zivume.
Ipilisi entsha "yokunyanga" i-Type 2 yeswekile
Abaphandi kwisibhedlele saseBrigham kunye neSibhedlele sabaseTyhini eBoston kunye neZiko loLawulo lobunzima kunye noTyando lweMetabolic baye basebenzisana ukufumana unyango oluncinci kodwa olusebenzayo olulinganayo kakhulu lokubuyisela uhlobo lwesi-2. iswekile. Indlela enjalo inokubonelela ngezibonelelo ezifanayo kunye notyando lwe-gastric bypass kwaye iya kusebenza kwezinye iindawo zonyango. Kumsebenzi wabo opapashwe kwi Izinto zendalo baye banika iinkcukacha ngophononongo lwaphambi kweklinikhi apho i-arhente yomlomo yayingeniswa kwiimpuku ezinjongo yazo yayikukuzisa 'into' eyayiza kuthi emva koko igqume amathumbu empuku ukuthintela nakuphi na ukudibana phakathi kwezakhamzimba zesondlo (ezisuka ekutyeni) kunye nolwelwesi olungaphakathi kwizibilini. ukusebenza njengomqobo. Oku kugquma ke kunceda ukunqanda naziphi na ii-spikes kwiswekile esegazini eyenzeka ngokubanzi emva kokutya. Injongo kukuba ekugqibeleni ube nepilisi yomlomo apho isigulane sohlobo lwesi-2 iswekile ingathatha phambi kokutya ukutya kwaye oku kugquma okwexeshana amathumbu kunokuba luncedo ekuphindaphindeni iziphumo zotyando.
Ukwenziwa kolu hlobo lwepilisi yomlomo kufuna intsebenziswano phakathi kweengcali zotyando kunye ne-bioengineers ezinokuthi emva koko ziphuhlise izinto ezifanelekileyo ezinokuthi zisetyenziswe ngendlela yekliniki kwisigulane. Xa befuna imathiriyeli efanelekileyo, abaphandi bagcina engqondweni iimpawu ezithile ezaziyimfuneko enkulu. Ezi zibandakanya ukuba neempawu ezintle zokubambelela ukukwazi ukunamathela okanye "ukunamathela" emathunjini amancinci kunye nokukwazi ukunyibilika kwiiyure ezimbalwa njengoko kuya kuba yingubo yesikhashana kuphela. Emva kokuhlola abaviwa abanokuthi babe luluhlu lweekhompawundi ezivunyiweyo nezikhuselekileyo, badwelisa into ebizwa ngokuba yi-sucralfate. Lo mxube lichiza elivunyiweyo elisetyenziselwa ukunyanga izilonda zesisu ngokwenza intlama encangathi kwindawo eneasidi yesisu kwaye ibophelela kwiindawo zolwelo lwesisu naphi na apho lufuneka khona ngenxa yokungasebenzi kakuhle kwangoku. Abaphandi baye benza le khompawundi ibe yimathiriyeli entsha enokugquma umgca wamathumbu njengoko befunwa kwaye benze njalo ngaphandle kokufuna iasidi yesisu. Le nto inoveli okanye 'i-luminal coating' ebhalwe LuCI (Luminal Coating of the Intestine) nayo ingalungiswa ngendlela eyomileyo yamandla enokuthi yenziwe ibe yipilisi. Kulingo lwangaphambi kweklinikhi, i-LuCI yafakwa kwiimpuku kwaye yakuba ifikile emathunjini yagquma amathumbu ngaloo ndlela yenza umqobo obhityileyo njengoko unqwenela. Ke, i-LuCI yenza umqobo olinganisa owona mba ubalulekileyo wotyando lwe-gastric bypass kodwa ngendlela engangeneleli. Ngokwesiqhelo emva kokutya ukutya iswekile yegazi iyenyuka kwaye ihlala iphezulu kangangexesha elithile. Kodwa ngale lining yindawo, i-spike yathintelwa kwaye amanqanaba eswekile yegazi athotywa phantse ngama-50 ekhulwini kwiyure enye yokuthatha i-LuCI. Injongo yayikukuba nedyasi yethutyana, kwaye nje ukuba le nto yokwambathisa inyibilika kwiiyure ezi-1, isiphumo seswekile yegazi siyaphela kwaye amanqanaba abuyele esiqhelweni.
Uvavanyo lubonise ukuba le ngubo ikhuselekile kwaye ayinayo impembelelo embi kwi-lining yamathumbu amancinci okwenza ukuba ihambelane kakuhle ne-mucosa yesisu. Abaphandi ngoku bavavanya ukusetyenziswa kwe-LuCI - zombini ixesha elifutshane kunye nexesha elide - kwiimodeli zegundane ezityebileyo kwaye zine iswekile. Uvavanyo oluzimeleyo lubonisa ukuba ukuqulunqwa kwe-LuCI okunjalo kunokusetyenziswa ukuhambisa iiprotheni zonyango kwindlela yesisu ngendlela efanayo. Ingasetyenziselwa ukufunxa izondlo kunye nokukhusela iimolekyuli ekuthotyweni sisisu esiswini kunye nolwelo lwamathumbu kunye nokuthotywa kweasidi yesisu kunye nolunye ulwelo lwamathumbu. Ukulawula uhlobo lwesi-2 iswekile, le pilisi inokuthathwa ngaphambi kokuba kutyiwe inexabiso elikhulu kwizigulana.
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{Unokufunda iphepha lokuqala lophando ngokunqakraza ikhonkco le-DOI elinikwe ngezantsi kuluhlu lwemithombo ecatshulweyo (s)}
Umthombo (s)
ULee Y et al. 2018. I-Therapeutic luminal coating of the intestine. Izinto zendalo. https://doi.org/10.1038/s41563-018-0106-5
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