By Cocer Peptides 
kwanaki 27 da suka gabata
DUKKANIN LABARI DA BAYANIN KYAUTATAWA DA AKE BAYAR A WANNAN SHAFIN KAWAI DOMIN WATSA BAYANI NE DA MANUFOFIN ILIMI.
Kayayyakin da aka bayar akan wannan gidan yanar gizon an yi niyya ne kawai don binciken in vitro. Binciken in vitro (Latin: *a cikin gilashi*, ma'ana a cikin gilashin gilashi) ana gudanar da shi a wajen jikin mutum. Waɗannan samfuran ba magunguna ba ne, Hukumar Abinci da Magunguna ta Amurka (FDA) ba ta amince da su ba, kuma dole ne a yi amfani da su don hanawa, magani, ko warkar da duk wani yanayi na likita, cuta, ko cuta. Doka ta haramta shigar da waɗannan samfuran cikin jikin mutum ko dabba ta kowace hanya.
Dubawa
Karancin Hormone na Girma (GHD) cuta ce ta girma da ci gaba da ke haifar da rashin isashshen ɓoye ko rashin aiki na Hormone Girma (GH). GH, hormone peptide wanda glandan pituitary na baya ya ɓoye, yana taka muhimmiyar rawa a girma da ci gaban yara. Maganin maye gurbin Peptide, azaman jiyya na farko don GHD, an karɓe shi sosai a cikin aikin asibiti.
Hoto 1 Tasirin hormone girma da sauran kwayoyin halitta akan kashi.
Ayyukan Physiological na Hormone Girma
(1) Inganta Ci gaba da Ci gaba
Girman kwarangwal: GH yana aiki kai tsaye a kan faranti girma na kasusuwa, yana ƙarfafa haɓakawa da bambance-bambancen ƙwayoyin guringuntsi, inganta haɓakawa da ƙididdiga na matrix na guringuntsi, don haka yana sauƙaƙe haɓakar ƙashi na tsaye. Alal misali, a lokacin girma na dogayen kasusuwa, GH yana inganta ci gaba da rarraba ƙwayoyin guringuntsi na epiphyseal, yana ƙara yawan ƙwayoyin guringuntsi, kuma ta haka yana motsa ƙashi.
Ci gaban Gabas: GH kuma yana haɓaka haɓakar kyallen takarda da gabobin jiki daban-daban a cikin jiki. Yana ƙarfafa haɓakar ƙwayoyin tsoka da haɓakar furotin, ƙara yawan ƙwayar tsoka; yana inganta girma da haɓakar gabobin ciki kamar hanta da koda, suna kiyaye ayyukansu na yau da kullun. Alal misali, a cikin ƙwayar tsoka, GH yana daidaita maganganun kwayoyin halitta masu dacewa, inganta haɓaka da haɓakar ƙwayar tsoka.
(2) Ka'idar Tsarin Halitta
Glucose metabolism: Tsarin GH na glucose metabolism yana da rikitarwa. Yana iya hana ɗaukar nama na gefe da kuma amfani da glucose, yana haifar da haɓakar matakan glucose na jini; Hakanan yana iya haɓaka rushewar glycogen hanta, yana ƙara haɓaka matakan glucose na jini. Ayyukan GH na dogon lokaci na iya haɓaka haɓakar insulin a kaikaice ta hanyar haɓaka haɓakar ƙwayar insulin-kamar girma factor-1 (IGF-1), don haka rage matakan glucose na jini.
Fat metabolism: GH yana inganta rushewar mai, yana ƙara sakin fatty acids kyauta don samar da makamashi ga jiki. Har ila yau, yana rage yawan kitsen nama, yana taimakawa wajen kula da rarraba kitsen jiki na al'ada. A wasu nazarin, yaran da ke da ƙarancin girma na hormone (GHD) sun sami raguwa mai yawa a cikin abubuwan kitse na jiki bayan sun karɓi maganin maye gurbin GH, wanda ke da alaƙa da rawar GH don haɓaka haɓakar mai.
Protein metabolism: GH shine muhimmin mai sarrafa furotin. Yana inganta shigar amino acid cikin sel, yana hanzarta haɗin furotin, kuma yana hana rushewar sunadaran, ta haka yana ƙara yawan furotin na jiki. A lokacin girma da ci gaba na yara, wannan sakamako yana taimakawa wajen ci gaba da ci gaba na al'ada da gyaran kyallen takarda kamar tsokoki da kasusuwa.
Rashin Girman Hormone a Yara
(1) Cutar cututtuka
Abubuwan da aka haifa: Wasu marasa lafiya na GHD suna haifar da su ta hanyar kwayoyin halitta. Wasu maye gurbi na iya shafar haɗin GH, ɓoyewa, ko tafiyar matakai. Lalacewar kwayoyin halitta na yau da kullun sun haɗa da maye gurbi a cikin kwayar halittar hormone girma (GH1), wanda zai iya haifar da haɓakar haɗin GH; maye gurbi a cikin kwayoyin halittar da ke da alaƙa da ci gaban pituitary, irin su PROP1 da POU1F1, na iya shafar ci gaban al'ada na glandan pituitary na gaba, wanda ke haifar da rashin isasshen ƙwayar GH.
Abubuwan da aka samo: Abubuwan da aka samo kamar su ciwace-ciwacen kwakwalwa, cututtuka, da rauni kuma na iya haifar da GHD. Ciwon daji na kwakwalwa, irin su craniopharyngiomas, na iya damfara glandan pituitary ko hypothalamus, yana shafar ɓoyewar GH; cututtukan intracranial kamar encephalitis ko meningitis na iya lalata ƙwayoyin neuroendocrine na glandan pituitary ko hypothalamus, wanda ke haifar da ɓarna na GH mara kyau; ciwon kai, musamman waɗanda ke da alaƙa da lalacewa ga shingen pituitary ko hypothalamus, na iya rushe hanyoyin da aka tsara don ɓoyewar GH, wanda ke haifar da GHD.
Abubuwan idiopathic: Wani ɓangare na marasa lafiya na GHD ba su da wani dalili mai ganewa kuma ana rarraba su azaman masu GHD na idiopathic. Wadannan marasa lafiya na iya samun rashin daidaituwa mai sauƙi a cikin aikin hypothalamic-pituitary, amma waɗannan rashin lafiyar ba su da tsanani don tabbatar da ganewar asali. A halin yanzu an yarda cewa GHD idiopathic na iya haɗuwa da rushewa a cikin neurotransmitter hypothalamic ko aikin neuro-regulatory.
(2) Bayyanar cututtuka
Ragewar girma: Wannan shine fitaccen bayyanar asibiti na GHD. Girman tsayin yaron yana da hankali fiye da na takwarorinsu, tare da yawan ci gaban shekara sau da yawa ƙasa da 5 cm. Yayin da yaron ya tsufa, bambancin tsayi daga abokansa yana karuwa a hankali, kuma gajeren tsayi yana ƙara bayyana. Misali, yayin da yara na yau da kullun suke girma kusan 5-7 cm a kowace shekara kafin balaga, marasa lafiya na GHD na iya girma cm 2-3 kawai.
P gina jiki mai daidaituwa: Ko da yake yaran da ke da GHD gajeru ne a tsayi, ginin jikin su yawanci daidai ne. Wannan ya bambanta da ɗan gajeren tsayin iyali, inda yara za su iya nuna tsayin gaɓoɓin gaɓoɓi. Yara masu GHD sau da yawa suna da kamannin fuska kamar yara, tare da babban kai wanda bai dace da girman jikinsu ba. Wasu yara masu GHD kuma suna iya samun rashin daidaituwa na rayuwa, kamar ƙara yawan kitsen jiki da rage yawan tsoka; wasu na iya samun jinkirin haɓakar jima'i, wanda ke nuna jinkirin fara balaga da jinkirin haɓaka halayen jima'i na biyu; Bugu da ƙari, yara masu GHD na iya samun matsalolin jijiya kamar matsalolin ilmantarwa da rashin kulawa, waɗanda ke da alaƙa da tasirin hormone girma akan ci gaban jijiya.
(3) Hanyoyi
Gwajin gwaje-gwaje
Growth hormone stimulating gwajin: Tun da GH aka boye a cikin bugun jini, bazuwar samfurin jini don auna GH matakan ba zai iya daidai daidai da secretion matsayi. Sabili da haka, ana buƙatar gwajin haɓakar haɓakar hormone girma. Magungunan da aka saba amfani da su sun haɗa da insulin, arginine, da clonidine. Ta hanyar yin amfani da miyagun ƙwayoyi na motsa jiki, ana lura da amsawar GH. Gabaɗaya, kololuwar GH da ke ƙasa da 10 μg/L yana nuna rashi na GH, kuma kololuwar GH da ke ƙasa 5 μg/L yana nuna cikakken rashi na GH.
Insulin-like Growth Factor-1 (IGF-1) da kuma Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) Ma'auni: IGF-1 da IGFBP-3 matakan suna da alaƙa da ɓoyewar GH kuma suna da kwanciyar hankali, ba su da tasiri ta hanyar ɓoyewar pulsatile. A cikin yara masu GHD, IGF-1 da IGFBP-3 matakan suna yawanci ƙasa da kewayon al'ada don shekarun su. Har ila yau, matakan IGF-1 suna tasiri ta hanyar abubuwa kamar shekaru da matsayi na abinci, don haka dole ne a yi la'akari da su gaba ɗaya yayin ganewar asali.
Maganin Maye gurbin Peptide
Zaɓin magani don maganin maye gurbin hormone girma
Recombinant mutum girma hormone (rhGH): rhGH a halin yanzu shine mafi yawan amfani da maganin peptide don magance GHD a cikin aikin asibiti. An samar da shi ta amfani da fasahar injiniyan kwayoyin halitta, tare da jerin amino acid mai kama da na GH na halitta. rhGH yana samuwa a cikin nau'i-nau'i daban-daban, ciki har da busassun foda injections da na tushen ruwa. A wasu nazarin, yin amfani da recombinant ci gaban mutum hormone ruwaye mafita ga zalunta yara tare da GHD ya samar da kyau warkewa sakamakon, tare da wani gagarumin karuwa a cikin kudi na tsawo girma a cikin marasa lafiya.
Hormone mai girma mai tsayi: Don inganta ƙimar haƙuri, an haɓaka hormone girma mai tsayi. Ana samar da hormones masu girma masu tsayi ta hanyar gyare-gyaren rhGH ta hanyar sinadarai don tsawaita rabin rayuwar sa a cikin jiki, don haka rage yawan allura. Polyethylene glycol-modified recombinant hormone girma na ɗan adam (PEG-rhGH) yana buƙatar allura ɗaya kawai a kowane mako, yana rage nauyin allurar akan marasa lafiya. PEG-rhGH yana nuna irin wannan inganci da aminci ga allurar yau da kullun na rhGH a cikin kula da yara tare da GHD.
Ci gaban bincike a kan sauran magungunan peptide: Baya ga rhGH da tsarin aikin sa na dogon lokaci, yawancin magungunan peptide da yawa a halin yanzu suna ci gaba. Misali, wasu abubuwan peptide waɗanda ke haɓaka siginar GH ko haɓaka aikin GH na iya fitowa azaman sabbin zaɓuɓɓukan magani don GHD.
(2) Sakamakon Magani
Girman Tsawo: Girman tsayi shine mafi nuna alama kai tsaye don tantance ingancin maganin maye gurbin hormone girma. Ta hanyar auna tsayin yaro akai-akai, ƙididdige girman girman tsayi, da kwatanta shi da matakan riga-kafi. Gabaɗaya, a cikin watanni 6-12 na farko na jiyya, girman girman girma yana ƙaruwa sosai, sannan a hankali a hankali. A cikin nazarin, marasa lafiya na GHD da aka bi da su tare da hormone girma na watanni 6 sun ga girman girman girman su ya karu daga 3 cm a kowace shekara kafin jiyya zuwa 8 cm a kowace shekara.
Canje-canjen shekarun kashi: Shekarun kasusuwa shine muhimmiyar alamar balaga kwarangwal. Girman maganin hormone na iya samun wani tasiri akan shekarun kashi. A lokacin jiyya, yakamata a auna shekarun kashi akai-akai don lura da yawan girman shekarun kashi. Girman shekarun kashi yakamata yayi daidai da tsayin tsayi don gujewa ci gaban shekarun kashi da bai kai ba wanda zai haifar da farkon rufe farantin girma, wanda zai iya shafar tsayin manya na ƙarshe.
Matakan IGF-1: Matakan IGF-1 sune mahimman alamun kwayoyin halitta don tantance ingancin maganin haɓakar hormone girma. Bayan haɓakar maganin hormone girma, matakan IGF-1 yawanci suna ƙaruwa kuma suna da alaƙa da alaƙa da ingancin magani. Gabaɗaya, kiyaye matakan IGF-1 a babban iyaka na al'ada na al'ada ko dan kadan sama da kewayon al'ada yana nuna ingantaccen ingantaccen magani.
Baya ga lura da canje-canje a cikin alamomin jiki, ya kamata kuma a tantance tasirin maganin haɓakar haɓakar ƙwayar cuta akan rayuwar ɗan yaro. Wannan ya haɗa da yanayin tunanin yaron, ƙwarewar zamantakewa, da aikin ilimi. Bayan ingantaccen maganin hormone girma, amincewar yaron ya inganta, ayyukan zamantakewa suna karuwa, aikin ilimi ya inganta, kuma ingancin rayuwa yana inganta sosai.
Kammalawa
Rashin ƙarancin hormone girma a cikin yara wani mummunan yanayi ne wanda ke tasiri sosai ga girma da ci gaba, tare da hadaddun hanyoyin da ke da mahimmanci da bayyanar asibiti daban-daban. Maganin maye gurbin Peptide, musamman haɓakar maye gurbin hormone girma, ya zama jiyya na farko don GHD.
Sources
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[4] Wang C, Huang H, Zhao C, et al. Tasirin pegylated recombinant maye gurbin hormone girma ɗan adam akan glucose da lipid metabolism a cikin yara masu raunin hormone girma [J]. Annals of Palliative Medicine, 2021,10(2):1809-1814.DOI:10.21037/apm-20-871.
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