Na Cocer Peptides 
27 lā aku nei
ʻO nā ʻatikala a me nā ʻike huahana i hāʻawi ʻia ma kēia pūnaewele pūnaewele wale nō no ka hoʻolaha ʻana i ka ʻike a me nā kumu hoʻonaʻauao.
ʻO nā huahana i hāʻawi ʻia ma kēia pūnaewele i manaʻo wale ʻia no ka noiʻi in vitro. Hana ʻia ka noiʻi in vitro (Latin: *i ke aniani*, ʻo ia hoʻi i ka ipu aniani) ma waho o ke kino kanaka. ʻAʻole kēia mau huahana he lāʻau lapaʻau, ʻaʻole i ʻae ʻia e ka US Food and Drug Administration (FDA), a ʻaʻole pono e hoʻohana ʻia no ka pale ʻana, mālama, a hoʻōla paha i kekahi maʻi olakino, maʻi, a i ʻole maʻi. Ua pāpā loa ʻia e ke kānāwai ke hoʻokomo i kēia mau huahana i loko o ke kino kanaka a holoholona paha ma kekahi ʻano.
Nānā nui
ʻO ka Growth Hormone Deficiency (GHD) kahi maʻi ulu a me ka ulu ʻana ma muli o ka lawa ʻole o ka huna ʻana a i ʻole ka hana ʻole o Growth Hormone (GH). ʻO GH, he hormone peptide i hūnā ʻia e ka pituitary gland anterior, he kuleana koʻikoʻi i ka ulu a me ka ulu ʻana o nā keiki. Ua hoʻohana nui ʻia ka lāʻau lapaʻau peptide, ʻo ia ka lāʻau lapaʻau mua no GHD.
Kiʻi 1 Ka hopena o ka hormone ulu a me nā hormones ʻē aʻe ma ka iwi.
Nā Hana Pilikino o ka Hormone Ulu
(1) Hoʻoikaika i ka ulu a me ka hoʻomohala ʻana
Ka ulu ʻana o ka iwi: GH e hana pololei i nā papa ulu o nā iwi, e hoʻoulu i ka hoʻonui a me ka hoʻokaʻawale ʻana o nā cell cartilage, e hoʻoikaika ana i ka synthesis a me ka calcification o ka cartilage matrix, a laila e hoʻomaʻamaʻa i ka ulu ʻana o ka iwi longitudinal. No ka laʻana, i ka wā o ka ulu ʻana o nā iwi lōʻihi, hoʻoikaika ʻo GH i ka hoʻokaʻawale mau ʻana o nā pūnaewele cartilage epiphyseal, e hoʻonui ana i ka nui o nā pūnae cartilage, a ma laila e hoʻoikaika ai i ka elongation iwi.
Hoʻoulu ʻo Organ: Hoʻoikaika pū ʻo GH i ka ulu ʻana o nā ʻiʻo a me nā ʻāpana like ʻole ma ke kino. Hoʻoulu ia i ka hoʻonui ʻana o nā ʻiʻo ʻiʻo a me ka synthesis protein, hoʻonui i ka nui o ka ʻiʻo; hoʻoikaika ia i ka ulu a me ka uluʻana o nā'ōpū o loko e like me ke ake a me nā puʻupaʻa, e mālama ana i kā lākou mau hana maʻamau. No ka laʻana, i loko o ka ʻiʻo ʻiʻo, hoʻoponopono ʻo GH i ka hōʻike ʻana o nā genes kūpono, e hāpai ana i ka ulu a me ka hypertrophy o nā ʻiʻo ʻiʻo.
(2) Hoʻoponopono i nā Kaʻina Metabolic
Glucose metabolism: He paʻakikī ka hoʻoponopono ʻana o ka glucose metabolism. Hiki iā ia ke pale i ka lawe ʻana o ka ʻiʻo peripheral a me ka hoʻohana ʻana i ka glucose, e alakaʻi ana i ke kiʻekiʻe o ka glucose koko; Hiki iā ia ke hoʻoikaika i ka haki ʻana o ka glycogen ate, e hoʻonui hou i ke kiʻekiʻe o ka glucose koko. Hiki i ka hana GH lōʻihi ke hoʻonui i ka naʻau o ka insulin ma o ka hoʻolaha ʻana i ka huna ʻana o ka insulin-like growth factor-1 (IGF-1), a laila e hoʻohaʻahaʻa i nā pae glucose koko.
Fat metabolism: Hoʻoikaika ʻo GH i ka haʻihaʻi ʻana o ka momona, hoʻonui i ka hoʻokuʻu ʻana i nā momona momona manuahi e hāʻawi i ka ikehu no ke kino. Hoʻemi pū ia i ka hōʻiliʻili ʻana o ka momona, e kōkua ana i ka mālama ʻana i ka hāʻawi ʻana i ka momona o ke kino. Ma kekahi mau noiʻi, ʻike nā keiki me ka ulu ʻana o ka hormone deficiency (GHD) i ka emi nui o ka momona o ke kino ma hope o ka loaʻa ʻana o ka GH replacement therapy, kahi pili pili i ka hana a GH i ka hoʻoikaika ʻana i ka momona momona.
ʻO ka protein metabolism: ʻO GH kahi mea hoʻoponopono koʻikoʻi o ka synthesis protein. Hoʻoikaika ia i ke komo ʻana o nā amino acids i loko o nā cell, hoʻolalelale i ka synthesis protein, a ke kāohi i ka haki ʻana o ka protein, a laila e hoʻonui ai i ka ʻike protein o ke kino. I ka wā o ka wā kamaliʻi a me ka ulu ʻana, kōkua kēia hopena i ka mālama ʻana i ka ulu maʻamau a me ka hoʻoponopono ʻana i nā ʻiʻo e like me nā ʻiʻo a me nā iwi.
ʻO ka nele o ka Hormone Growth i nā keiki
(1) Pathogenesis
Nā kumu hānau: Hoʻokumu ʻia kekahi mau maʻi GHD e nā kumu genetic. Hiki i kekahi mau hoʻololi gene ke hoʻopili i ka GH synthesis, huna, a i ʻole kaʻina hana. ʻO nā hemahema genetic maʻamau ka hoʻololi ʻana i ka gene hormone ulu (GH1), hiki ke alakaʻi i ka synthesis GH impaired; nā hoʻololi i nā genes e pili ana i ka ulu ʻana o ka pituitary, e like me PROP1 a me POU1F1, hiki ke hoʻopili i ka ulu maʻamau o ka pituitary gland anterior, e hopena i ka lawa ʻole o ka huna ʻana o GH.
Nā mea i loaʻa: ʻO nā mea i loaʻa e like me ka lolo o ka lolo, nā maʻi, a me ka ʻeha hiki ke hoʻoulu i ka GHD. Hiki i nā lolo lolo, e like me craniopharyngiomas, ke hoʻopaʻa i ka pituitary gland a i ʻole hypothalamus, e pili ana i ka huna ʻana o GH; ʻO nā maʻi intracranial e like me ka encephalitis a me ka maningitis hiki ke hōʻino i nā cell neuroendocrine o ka pituitary gland a i ʻole hypothalamus, e alakaʻi ana i ka huna ʻana o GH; ʻO ka ʻeha o ke poʻo, ʻoi aku ka poʻe e pili ana i ka pōʻino i ke kumu pituitary a i ʻole hypothalamus, hiki ke hoʻopau i nā ala hoʻoponopono no ka huna ʻana o GH, e alakaʻi ana i ka GHD.
Nā kumu idiopathic: ʻAʻohe kumu ʻike ʻia o kahi hapa o nā maʻi GHD a ua helu ʻia ʻo ia he idiopathic GHD. Hiki i kēia mau maʻi ke loaʻa nā mea ʻino ʻole i ka hana hypothalamic-pituitary, akā ʻaʻole paʻakikī kēia mau mea ʻino e hōʻoia ai i kahi hōʻailona maopopo. Ke manaʻoʻiʻo ʻia i kēia manawa hiki ke pili i ka idiopathic GHD me nā pilikia i ka hypothalamic neurotransmitter a i ʻole ka hana neuro-regulatory.
(2) Nā hōʻike hōʻailona
Hoʻopau i ka ulu ʻana: ʻO kēia ka hōʻike lapaʻau koʻikoʻi o GHD. ʻOi aku ka lohi o ke kiʻekiʻe o ke keiki ma mua o nā hoa, me ka nui o ka ulu makahiki ma lalo o 5 knm. Ke ulu aʻe ke keiki, piʻi mālie ka ʻokoʻa kiʻekiʻe mai nā hoa, a ʻike ʻia ke kino pōkole. No ka laʻana, ʻoiai e ulu ana nā keiki maʻamau ma kahi o 5-7 cm i kēlā me kēia makahiki ma mua o ka wā ʻōpio, hiki i nā mea maʻi GHD ke ulu i 2-3 knm wale nō.
Hoʻokumu kino kino : ʻOiai he pōkole ke kino o nā keiki me GHD, maʻamau ka like ʻana o ko lākou kino. He ʻokoʻa kēia me ke kino pōkole ʻohana, kahi e hōʻike ai nā keiki i ka lōʻihi o nā lālā like ʻole. ʻO nā keiki me ka GHD he mau hiʻohiʻona like me ke kamaliʻi, me ke poʻo nui ʻano like ʻole i ko lākou nui kino. Hiki i kekahi mau keiki me ka GHD ke loaʻa nā maʻi kūlohelohe, e like me ka hoʻonui ʻana i ka pākēneka o ka momona o ke kino a me ka emi ʻana o ka nui o ka ʻiʻo; hiki i kekahi ke ʻike i ka lohi ʻana o ka hoʻomohala ʻana i ka moekolohe, i hōʻike ʻia e ka lohi ʻana o ka hoʻomaka ʻana o ka wā ʻōpio a me ka lohi ʻana o ka ulu ʻana o nā ʻano moe lua; Eia kekahi, loaʻa i nā keiki me ka GHD nā pilikia neurological e like me nā pilikia aʻo a me nā hemahema o ka nānā ʻana, e pili ana i ka hopena o ka hormone ulu i ka ulu ʻana o ka neurological.
(3) Nā ʻano hana
Nā hoʻokolohua Laboratory
ʻO ka hoʻāʻo hoʻoulu ʻana i ka hormone ulu: No ka mea ua hūnā ʻia ʻo GH i loko o nā pulses, ʻaʻole hiki ke hōʻike pololei i ke ʻano o ke koko maʻamau e ana i nā pae GH i kona kūlana huna. No laila, pono ka ho'āʻo hoʻoulu ʻana i ka hormone ulu. ʻO nā lāʻau hoʻoikaika maʻamau i hoʻohana ʻia me ka insulin, arginine, a me clonidine. Ma ka lawelawe ʻana i ka lāʻau hoʻoulu, ʻike ʻia ka pane huna o GH. ʻO ka mea maʻamau, ʻo kahi kiʻekiʻe GH ma lalo o 10 μg/L e hōʻike ana i ka hemahema GH hapa, a ʻo kahi kiʻekiʻe GH ma lalo o 5 μg/L hōʻike i ka hemahema GH piha.
ʻO ka Insulin-like Growth Factor-1 (IGF-1) a me ka Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) Ana: ʻO nā pae IGF-1 a me IGFBP-3 pili pili i ka huna huna GH a paʻa paʻa, ʻaʻole i hoʻopilikia ʻia e ka huna huna pulsatile. I nā keiki me GHD, IGF-1 a me IGFBP-3 mau pae ma lalo o ka pae maʻamau no ko lākou mau makahiki. Hoʻopili pū ʻia nā pae IGF-1 e nā mea e like me ka makahiki a me ke kūlana meaʻai, no laila pono e noʻonoʻo ʻia kēia mau mea i ka wā o ka maʻi.
ʻO ka lāʻau lapaʻau hoʻololi peptide
Ke koho lāʻau lapaʻau no ka ulu ʻana o ka hormone replacement therapy
ʻO ka hormone ulu kanaka hou (rhGH): ʻO ka rhGH ka lāʻau peptide i hoʻohana nui ʻia no ka mālama ʻana iā GHD i ka hana lapaʻau. Hana ʻia ia me ka hoʻohana ʻana i ka ʻenehana ʻenekinia, me kahi kaʻina amino acid e like me ka GH maoli. Loaʻa ka rhGH i nā ʻano hana like ʻole, me ka hoʻoheheʻe ʻana i ka pauka maloʻo maloʻo maloʻo a me nā injections wai. I kekahi mau haʻawina, ʻo ka hoʻohana ʻana i nā hopena wai hoʻoulu kanaka recombinant no ka mālama ʻana i nā keiki me ka GHD ua hāʻawi i nā hopena therapeutic maikaʻi, me ka piʻi nui o ka piʻi ʻana o ka ulu kiʻekiʻe o nā maʻi.
ʻO ka hormone ulu lōʻihi: No ka hoʻomaikaʻi ʻana i ka mālama ʻana i ka maʻi, ua kūkulu ʻia ka hormone ulu lōʻihi. Hoʻokumu ʻia nā hormones ulu lōʻihi e ka hoʻololi kemika rhGH e hoʻolōʻihi i kona hapalua o ke ola i loko o ke kino, a laila e hōʻemi i ke alapine o nā injections. ʻO ka polyethylene glycol-modified recombinant human growth hormone (PEG-rhGH) pono hoʻokahi wale nō injection i kēlā me kēia pule, e hōʻemi nui ana i ke kaumaha o ka injection i nā maʻi. Hōʻike ka PEG-rhGH i ka maikaʻi a me ka palekana i nā injections i kēlā me kēia lā o ka rhGH i ka mālama ʻana i nā keiki me GHD.
Ka holomua o ka noiʻi ʻana i nā lāʻau peptide ʻē aʻe: Ma waho aʻe o ka rhGH a me kāna mau hana lōʻihi, ke kūkulu ʻia nei kekahi mau lāʻau peptide hou. No ka laʻana, hiki ke puka mai kekahi mau mea peptide e hoʻoikaika i ka huna ʻana o GH a i ʻole hoʻomaikaʻi i ka hana GH ma ke ʻano he koho lapaʻau hou no GHD.
(2) Nā hopena lapaʻau
Loaʻa kiʻekiʻe: ʻO ka loaʻa kiʻekiʻe ka hōʻailona pololei loa no ka loiloi ʻana i ka pono o ka ulu ʻana o ka hormone replacement therapy. Ma ke ana mau ʻana i ke kiʻekiʻe o ke keiki, me ka helu ʻana i ke kiʻekiʻe o ka ulu ʻana, a me ka hoʻohālikelike ʻana me nā pae ma mua o ka mālama ʻana. ʻO ka mea maʻamau, i loko o nā mahina 6-12 mua o ka mālama ʻana, ʻoi aku ka wikiwiki o ka ulu ʻana o ke kiʻekiʻe, a ma hope o ka hoʻomau ʻana. Ma nā haʻawina, ʻike nā maʻi GHD me ka hormone ulu no nā mahina 6 i ko lākou kiʻekiʻe kiʻekiʻe o ka ulu ʻana o ka piʻi ʻana mai 3 cm i kēlā me kēia makahiki ma mua o ka mālama ʻana i 8 cm i kēlā me kēia makahiki.
Hoʻololi ka makahiki iwi: He hōʻailona koʻikoʻi ka makahiki iwi o ka oʻo ʻana o ka iwi. Hiki ke loaʻa kekahi hopena i ka makahiki o ka iwi. I ka wā o ka mālama ʻana, pono e ana mau ʻia ka makahiki o ka iwi e nānā i ka nui o ka ulu ʻana o ka iwi. Pono e kūlike ka ulu ʻana o ka iwi me ka ulu kiʻekiʻe e pale aku i ka piʻi ʻana o ka iwi iwi mua a hiki i ka pani ʻana o nā papa ulu, hiki ke hoʻopilikia i ke kiʻekiʻe o ke kanaka makua.
Nā pae IGF-1: He hōʻailona biochemical koʻikoʻi nā pae IGF-1 no ka loiloi ʻana i ka pono o ka lāʻau homoni ulu. Ma hope o ka ulu ʻana o ka hormone therapy, piʻi pinepine nā pae IGF-1 a pili pono i ka pono o ka mālama ʻana. ʻO ka mea maʻamau, ʻo ka mālama ʻana i nā pae IGF-1 ma ka palena kiʻekiʻe o ka pae maʻamau a i ʻole ma luna iki o ka laulā maʻamau e hōʻike ana i ka maikaʻi o ka mālama ʻana.
Ma waho aʻe o ka nānā ʻana i nā loli i nā hōʻailona kino, pono e loiloi ʻia ka hopena o ka therapy hormone ulu i ka maikaʻi o ke ola o ke keiki. Hoʻopili kēia i ke kūlana noʻonoʻo o ke keiki, nā mākau pilikanaka, a me ka hana hoʻonaʻauao. Ma hope o ka hoʻomaʻamaʻa hormone ulu maikaʻi, hoʻomaikaʻi ka hilinaʻi o ke keiki iā ia iho, piʻi ka hana kaiaulu, hoʻomaikaʻi ka hana hoʻonaʻauao, a hoʻomaikaʻi nui ʻia ka maikaʻi o ke ola.
Ka hopena
ʻO ka nele o ka hormone ulu i nā keiki he maʻi koʻikoʻi ia e hoʻopilikia nui i ka ulu a me ka hoʻomohala ʻana, me nā mīkini kumu paʻakikī a me nā hōʻike lapaʻau like ʻole. ʻO ka lāʻau lapaʻau peptide, ʻoi aku ka ulu ʻana o ka hormone replacement therapy, ua lilo i mea lapaʻau mua no GHD.
Nā kumu
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[2] Sävendahl L, Battelino T, Højby RM, et al. Hoʻololi GH maikaʻi me ka Somapacitan i hoʻokahi pule i kēlā me kēia lā i nā keiki me GHD: Nā hopena 3 makahiki mai REAL 3 [J]. Nūpepa o Clinical Endocrinology & Metabolism, 2022,107(5):1357-1367.DOI:10.1210/clinem/dgab928.
[3] Caballero-Villarraso J, Aguado R, Cañete MD, et al. Hormone replacement therapy i nā keiki me ka ulu ʻana o ka hormone deficiency: ka hopena i ka ʻike immune [J]. Nā waihona o Physiology a me Biochemistry, 2021,127(3):245-249.DOI:10.1080/13813455.2019.1628070.
[4] Wang C, Huang H, Zhao C, et al. ʻO ka hopena o ka pegylated recombinant human growth hormone replacement therapy ma ka glucose a me ka lipid metabolism i nā keiki me ka hemahema o ka hormone ulu [J]. Nā moʻolelo o ka Lapaʻau Palliative, 2021,10(2):1809-1814.DOI:10.21037/apm-20-871.
[5] Witkowska-Sędek E, Stelmaszczyk-Emmel A, Kucharska AM, et al. Hui ma waena o Vitamin D a me Carboxy-Terminal Cross-Linked Telopeptide o Type I Collagen i nā keiki i ka wā Growth Hormone Replacement Therapy.[J]. Nā holomua i ka lāʻau lapaʻau hoʻokolohua a me ka biology, 2018,1047: 53-60. https://api.semanticscholar.org/CorpusID:27770255.
