Los ntawm Cocer Peptides 
27 hnub dhau los
Tag nrho cov kab lus thiab cov ntaub ntawv ntawm cov khoom lag luam muab rau ntawm lub vev xaib no tsuas yog rau cov ntaub ntawv tshaj tawm kev tshaj tawm thiab cov hom phiaj kev kawm.
Cov khoom muab rau hauv lub vev xaib no yog npaj tshwj xeeb rau kev tshawb fawb hauv vitro. Kev tshawb fawb hauv vitro (Latin: * hauv iav *, lub ntsiab lus hauv iav) yog ua los ntawm tib neeg lub cev. Cov khoom no tsis yog tshuaj, tsis tau txais kev pom zoo los ntawm US Food and Drug Administration (FDA), thiab yuav tsum tsis txhob siv los tiv thaiv, kho, lossis kho txhua yam mob, kab mob, lossis mob. Nws raug txwv nruj raws li txoj cai los qhia cov khoom no rau hauv tib neeg lossis tsiaj lub cev hauv txhua daim ntawv.
Txheej txheem cej luam
Kev Loj Hlob Hormone Deficiency (GHD) yog ib qho kev loj hlob thiab kev loj hlob tsis zoo uas tshwm sim los ntawm kev tso tawm tsis txaus lossis tsis ua haujlwm ntawm Growth Hormone (GH). GH, peptide hormone secreted los ntawm anterior pituitary caj pas, ua lub luag haujlwm tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov menyuam yaus. Peptide hloov kho, raws li kev kho mob tseem ceeb rau GHD, tau siv dav hauv kev kho mob.
Daim duab 1 Cov nyhuv ntawm kev loj hlob hormone thiab lwm yam tshuaj hormones ntawm cov pob txha.
Physiological Functions ntawm Kev Loj Hlob Hormone
(1) Txhawb kev loj hlob thiab kev loj hlob
Kev loj hlob ntawm pob txha: GH ncaj qha ua rau cov pob txha loj hlob ntawm cov pob txha, txhawb kev loj hlob thiab kev sib txawv ntawm cov pob txha mos, txhawb cov synthesis thiab calcification ntawm pob txha mos matrix, yog li txhawb kev loj hlob ntawm cov pob txha ntev. Piv txwv li, thaum lub sij hawm loj hlob ntawm cov pob txha ntev, GH txhawb nqa kev faib ua ntu zus ntawm cov pob txha mos epiphyseal, nce cov pob txha pob txha, thiab yog li tsav cov pob txha elongation.
Organ Growth: GH kuj txhawb kev loj hlob ntawm ntau yam ntaub so ntswg thiab kab mob hauv lub cev. Nws txhawb kev loj hlob ntawm cov leeg hlwb thiab cov protein synthesis, ua kom cov leeg nqaij; nws txhawb kev loj hlob thiab kev loj hlob ntawm cov kab mob hauv nruab nrog cev xws li daim siab thiab ob lub raum, tswj lawv cov haujlwm ib txwm muaj. Piv txwv li, nyob rau hauv cov leeg nqaij, GH upregulates qhov kev qhia ntawm cov noob muaj feem xyuam, txhawb kev loj hlob thiab hypertrophy ntawm cov nqaij fibers.
(2) Kev tswj cov txheej txheem metabolic
Glucose metabolism: GH txoj cai ntawm cov piam thaj metabolism yog qhov nyuaj. Nws tuaj yeem inhibit peripheral cov ntaub so ntswg uptake thiab siv cov piam thaj, ua rau kom cov ntshav qabzib nce siab; Nws tseem tuaj yeem txhawb nqa lub siab glycogen tawg, ntxiv cov ntshav qabzib ntxiv. Kev ua haujlwm ntev GH tuaj yeem txhim kho qhov tsis txaus ntseeg ntawm insulin los ntawm kev txhawb nqa kev tso tawm ntawm insulin zoo li kev loj hlob factor-1 (IGF-1), yog li txo qis cov ntshav qabzib.
Cov metabolism hauv rog: GH txhawb kev rog rog, ua kom cov rog dawb tso tawm kom muaj zog rau lub cev. Nws kuj txo cov rog cov ntaub so ntswg, pab tswj kom lub cev muaj roj faib. Hauv qee qhov kev tshawb fawb, cov menyuam yaus uas muaj kev loj hlob hormone deficiency (GHD) tau ntsib qhov txo qis hauv lub cev rog cov ntsiab lus tom qab tau txais GH hloov kho, uas cuam tshuam nrog GH lub luag haujlwm hauv kev txhawb cov roj metabolism.
Protein metabolism: GH yog ib qho tseem ceeb regulator ntawm protein synthesis. Nws txhawb kev nkag mus ntawm cov amino acids rau hauv cov hlwb, ua kom cov protein synthesis, thiab inhibits protein ntau, yog li ua rau lub cev muaj protein ntau. Thaum lub sij hawm me nyuam loj hlob thiab kev loj hlob, cov nyhuv no pab tswj kev loj hlob zoo thiab kho cov ntaub so ntswg xws li cov leeg thiab pob txha.
Loj hlob Hormone Deficiency nyob rau hauv cov me nyuam
(1) Pathogenesis
Congenital yam: Qee cov neeg mob GHD yog tshwm sim los ntawm caj ces. Qee qhov kev hloov pauv ntawm cov noob tuaj yeem cuam tshuam rau GH synthesis, zais cia, lossis cov txheej txheem ua haujlwm. Cov kab mob caj ces feem ntau suav nrog kev hloov pauv hauv cov noob caj noob ces (GH1), uas tuaj yeem ua rau GH synthesis tsis zoo; Kev hloov pauv hauv cov noob ntsig txog kev loj hlob ntawm pituitary, xws li PROP1 thiab POU1F1, tuaj yeem cuam tshuam rau kev loj hlob ntawm lub caj pas pituitary, uas ua rau GH tsis txaus.
Tau txais yam: Tau txais yam xws li qog hlwb, kab mob, thiab kev raug mob tuaj yeem ua rau GHD. Cov qog nqaij hlav hauv hlwb, xws li craniopharyngiomas, tuaj yeem ua rau cov qog pituitary lossis hypothalamus, cuam tshuam rau GH secretion; Cov kab mob intracranial xws li encephalitis lossis meningitis tuaj yeem ua rau cov hlwb neuroendocrine ntawm lub caj pas pituitary lossis hypothalamus, ua rau muaj qhov txawv txav ntawm GH secretion; Lub taub hau raug mob, tshwj xeeb tshaj yog cov uas cuam tshuam nrog kev puas tsuaj rau pituitary stalk lossis hypothalamus, kuj tseem tuaj yeem cuam tshuam txoj kev tswj hwm rau GH secretion, ua rau GHD.
Idiopathic yam: Ib feem ntawm cov neeg mob GHD tsis muaj qhov laj thawj txheeb xyuas tau thiab raug cais raws li muaj idiopathic GHD. Cov neeg mob no yuav muaj qhov txawv txav me me hauv kev ua haujlwm hypothalamic-pituitary, tab sis cov kev txawv txav no tsis hnyav txaus los lav qhov kev kuaj mob. Tam sim no ntseeg tau tias idiopathic GHD tuaj yeem cuam tshuam nrog kev cuam tshuam hauv hypothalamic neurotransmitter lossis neuro-regulatory muaj nuj nqi.
(2) Clinical manifestations
Kev loj hlob retardation: Qhov no yog qhov tseem ceeb tshaj plaws kev kho mob tshwm sim ntawm GHD. Tus me nyuam qhov siab loj hlob qeeb qeeb dua li cov phooj ywg, nrog rau kev loj hlob txhua xyoo feem ntau tsawg dua 5 cm. Raws li cov menyuam yaus hnub nyoog, qhov siab sib txawv ntawm cov phooj ywg maj mam nce, thiab luv luv stature yuav tshwm sim. Piv txwv li, thaum cov me nyuam ib txwm loj hlob li ntawm 5-7 cm ib xyoo ua ntej puberty, GHD cov neeg mob tsuas loj hlob 2-3 cm.
P roportional lub cev tsim: Txawm hais tias cov me nyuam nrog GHD yog luv luv, lawv lub cev tsim yog feem ntau proportionate. Qhov no txawv ntawm tsev neeg luv luv stature, qhov uas cov menyuam yaus tuaj yeem pom qhov ntev ntawm ceg ceg tsis sib npaug. Cov menyuam yaus uas muaj GHD feem ntau muaj lub ntsej muag zoo li menyuam yaus, nrog lub taub hau loj uas tsis sib haum rau lawv lub cev loj. Qee cov menyuam yaus uas muaj GHD kuj tseem muaj cov kabmob metabolic, xws li cov rog hauv lub cev ntau dua thiab txo cov leeg nqaij; Qee tus yuav ntsib kev sib deev qeeb, uas tshwm sim los ntawm kev ncua sijhawm ntawm kev puberty thiab kev loj hlob qeeb ntawm cov yam ntxwv ntawm kev sib deev; Tsis tas li ntawd, cov menyuam yaus uas muaj GHD tej zaum yuav muaj teeb meem neurological xws li kev kawm nyuaj thiab kev saib xyuas tsis zoo, uas cuam tshuam rau kev loj hlob hormone ntawm kev loj hlob ntawm neurological.
(3) Cov txheej txheem
Kev sim kuaj
Kev loj hlob hormone stimulation test: Txij li thaum GH yog secreted nyob rau hauv pulses, random kuaj ntshav los ntsuas GH qib tsis tuaj yeem cuam tshuam nws qhov kev tso tawm. Yog li ntawd, yuav tsum muaj kev ntsuam xyuas kev loj hlob hormone stimulation. Feem ntau siv cov tshuaj stimulation muaj xws li insulin, arginine, thiab clonidine. Los ntawm kev tswj cov tshuaj stimulation, GH secretion teb tau pom. Feem ntau, GH ncov qis dua 10 μg / L qhia tias GH tsis txaus ib nrab, thiab GH ncov qis dua 5 μg / L qhia tias GH tsis txaus.
Insulin-like Growth Factor-1 (IGF-1) thiab Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) Kev Ntsuas: IGF-1 thiab IGFBP-3 qib muaj feem cuam tshuam nrog GH secretion thiab kuj ruaj khov, tsis cuam tshuam los ntawm pulsatile secretion. Hauv cov menyuam yaus uas muaj GHD, IGF-1 thiab IGFBP-3 qib feem ntau yog qis dua qhov qub rau lawv lub hnub nyoog. IGF-1 qib kuj cuam tshuam los ntawm cov yam ntxwv xws li hnub nyoog thiab khoom noj khoom haus, yog li cov no yuav tsum tau txiav txim siab dav dav thaum kuaj mob.
Peptide Replacement Therapy
Kev xaiv tshuaj rau kev loj hlob hormone hloov kho
Recombinant human growth hormone (rhGH): rhGH yog tam sim no cov tshuaj peptide siv dav tshaj plaws rau kev kho GHD hauv kev kho mob. Nws yog tsim los ntawm genetic engineering technology, nrog rau cov amino acid ib ntus zoo ib yam li GH ntuj. rhGH muaj nyob rau hauv ntau yam formulations, xws li khov-qhuav hmoov txhaj tshuaj thiab dej-raws li txhaj tshuaj. Hauv qee qhov kev tshawb fawb, kev siv cov tshuaj recombinant tib neeg txoj kev loj hlob hormone aqueous daws rau kev kho cov menyuam yaus nrog GHD tau ua rau cov txiaj ntsig kho tau zoo, nrog rau kev nce siab hauv cov neeg mob.
Ntev-acting loj hlob hormone: Txhawm rau txhim kho cov neeg mob ua raws, kev loj hlob hormone ntev tau tsim. Cov tshuaj hormones loj hlob ntev yog tsim los ntawm kev hloov kho rhGH kom ntev nws ib nrab-lub neej hauv lub cev, yog li txo qhov zaus ntawm kev txhaj tshuaj. Polyethylene glycol-modified recombinant human growth hormone (PEG-rhGH) tsuas yog yuav tsum tau txhaj ib lub lis piam xwb, txo qhov kev txhaj tshuaj rau cov neeg mob. PEG-rhGH qhia tau hais tias zoo sib xws thiab kev nyab xeeb rau kev txhaj tshuaj txhua hnub ntawm rhGH hauv kev kho cov menyuam yaus nrog GHD.
Kev tshawb nrhiav kev vam meej ntawm lwm cov tshuaj peptide: Ntxiv rau rhGH thiab nws cov qauv ua haujlwm ntev, ntau cov tshuaj peptide tshiab tam sim no tab tom txhim kho. Piv txwv li, qee yam tshuaj peptide uas txhawb nqa GH tso tawm lossis txhim kho GH kev ua haujlwm yuav tshwm sim los ua kev kho mob tshiab rau GHD.
(2) Cov txiaj ntsig kho mob
Height Gain: Qhov siab nce yog qhov taw qhia ncaj qha tshaj plaws rau kev ntsuas qhov ua tau zoo ntawm kev loj hlob hormone hloov kho. Los ntawm kev ntsuas tus me nyuam qhov siab tsis tu ncua, xam qhov siab loj hlob tus nqi, thiab muab piv nrog rau qib kev kho mob ua ntej. Feem ntau, hauv thawj 6-12 lub hlis ntawm kev kho mob, qhov siab loj hlob sai sai, tom qab ntawd maj mam stabilization. Hauv kev tshawb fawb, GHD cov neeg mob tau kho nrog kev loj hlob hormone rau 6 lub hlis pom lawv qhov siab loj hlob ntawm 3 cm ib xyoos ua ntej kev kho mob mus rau 8 cm hauv ib xyoos.
Lub hnub nyoog hloov ntawm pob txha: pob txha hnub nyoog yog ib qho tseem ceeb qhia txog kev loj hlob ntawm pob txha. Kev loj hlob hormone kho yuav muaj qee yam cuam tshuam rau cov pob txha hnub nyoog. Thaum kho, cov pob txha muaj hnub nyoog yuav tsum tau ntsuas tsis tu ncua los soj ntsuam tus nqi ntawm cov pob txha hnub nyoog loj hlob. Cov pob txha muaj hnub nyoog loj hlob yuav tsum tau ua raws li qhov siab loj hlob kom tsis txhob muaj pob txha ntxov ntxov ntxov ua rau kev loj hlob sai ntawm daim phiaj, uas tuaj yeem cuam tshuam rau cov neeg laus qhov siab kawg.
IGF-1 qib: IGF-1 qib yog ib qho tseem ceeb ntawm biochemical qhia rau kev ntsuam xyuas qhov ua tau zoo ntawm kev loj hlob hormone kho. Ua raws li kev kho cov tshuaj hormones loj hlob, IGF-1 qib feem ntau nce thiab sib raug zoo nrog kev kho mob. Feem ntau, kev tswj hwm IGF-1 qib ntawm qhov txwv siab tshaj ntawm qhov ib txwm muaj lossis me ntsis siab dua qhov ib txwm muaj qhia tau tias muaj txiaj ntsig zoo.
Ntxiv nrog rau kev saib xyuas cov kev hloov pauv hauv lub cev, qhov cuam tshuam ntawm kev loj hlob hormone kho rau tus me nyuam lub neej zoo yuav tsum tau soj ntsuam. Qhov no suav nrog tus menyuam lub xeev puas siab puas ntsws, kev txawj ntse, thiab kev kawm. Tom qab kev kho cov tshuaj hormones zoo, tus menyuam txoj kev ntseeg siab ntawm tus kheej zoo dua, kev ua haujlwm hauv zej zog nce, kev kawm tau zoo, thiab lub neej zoo tau txhim kho.
Xaus
Kev loj hlob hormone deficiency nyob rau hauv cov menyuam yaus yog ib qho mob hnyav uas cuam tshuam rau kev loj hlob thiab kev loj hlob, nrog rau cov txheej txheem hauv qab thiab ntau hom kev kho mob. Peptide replacement therapy, tshwj xeeb tshaj yog kev loj hlob hormone hloov kho, tau dhau los ua kev kho mob tseem ceeb rau GHD.
Qhov chaw
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