▎ Okunoonyereza ku Cerebrolysin
Ensibuko y’okunoonyereza ku Cerebrolysin eri etya?
Omusingi gw’okunoonyereza ogwasooka: Ku ntandikwa y’ekyasa eky’amakumi abiri, bannassaayansi baatandika okussaayo omwoyo ku ngeri ebintu ebimu eby’enjawulo ebiri mu bwongo gye bikwata ku butoffaali bw’obusimu. Mu kiseera ekyo, kyali kimanyiddwa nti waliwo ebintu eby’enjawulo ebikola obulamu mu bwongo, ebyakola kinene mu kukula, okukula, okuddaabiriza, n’okulabirira obutoffaali bw’obusimu.
Okunoonyereza kuno okwasooka kwassaawo omusingi gw’enzikiriziganya ogw’okunoonyereza n’okukulaakulanya cerebrolysin okwaddirira, ekyaleetera abanoonyereza okugezaako okuggya n’okwawula ebitundu ebikola obulamu okuva mu bitundu by’obwongo okujjanjaba endwadde z’obusimu.
Enkulaakulana ya Tekinologiya w’okuggyamu: Olw’enkulaakulana egenda mu maaso mu tekinologiya wa biochemistry ne molecular biology, abanoonyereza balina engeri ez’omulembe ennyo ez’okuggya n’okulongoosa ebintu ebikola obulamu okuva mu bitundu by’obwongo.
Okuva mu myaka gya 1960 okutuuka mu myaka gya 1970, ttiimu ezimu ez’abanoonyereza zaasobola bulungi okuggya ebitabuddwa ebizibu okuva mu bitundu by’obwongo bw’ebisolo ng’obwongo bw’embizzi, nga bino byali birimu amino asidi ez’enjawulo, peptides, n’ebitundu ebirala ebikola obulamu. Ebitundu bino byalaga ebikolwa ebimu eby’emmere n’obukuumi ku butoffaali bw’obusimu mu kugezesa ebisolo era nga bisobola okutumbula okukula n’okuddaabiriza obutoffaali bw’obusimu.
Okunoonyereza ku butonde n’enkola y’emirimu: Oluvannyuma lw’okunoonyereza okumala emyaka mingi, okutegeera okw’amaanyi ku butonde n’enkola y’okukola kwa cerebrolysin kufunibwa. Kizuuliddwa nti cerebrolysin erimu ebirungo eby’enjawulo ebisookerwako eby’obusimu obutambuza obusimu, ensonga eziyamba obusimu, n’ebirungo ebirala ebikola omubiri (bioactive peptides). Ebitundu bino bisobola okusala ekiziyiza omusaayi n’obwongo ne biyingira mu bitundu by’obwongo, ne bikola ku butoffaali bw’obusimu, ne bitumbula enkyukakyuka y’obutoffaali bw’obusimu, okukola puloteyina, n’okufulumya ebirungo ebitambuza obusimu, bwe kityo ne bitereeza enkola y’obutoffaali bw’obusimu n’okukola omulimu ogw’obukuumi n’okuddaabiriza obutoffaali bw’obusimu obwonooneddwa.
Okunoonyereza ku nkozesa y’obujjanjabi: Okusinziira ku birungi by’ekola mu kugezesa ebisolo, cerebrolysin ebadde ekozesebwa mpolampola mu kunoonyereza mu bujjanjabi. Mu kusooka, yasinga kukozesebwa kujjanjaba ndwadde ezimu ezikendeeza ku busimu bw’obusimu, gamba ng’obulwadde bwa Alzheimer, obulwadde bwa Parkinson, n’obuzibu bw’okukola kw’obusimu obuva ku buvune ku bwongo, endwadde z’emisuwa gy’obwongo, n’ebirala Okunoonyereza mu bujjanjabi kulaga nti cerebrolysin esobola, okutuuka ku kigero ekimu, okulongoosa enkola y’abalwadde ey’okutegeera, okujjukira, obusobozi bw’olulimi, n’enkola y’okutambula kw’ebitundu by’omubiri, n’okulongoosa omutindo gw’abalwadde wa bulamu.
Enkola ya Cerebrolysin ekola ki?
1. Kirina ekikolwa ekikuuma obusimu
Okukendeeza ku Hypoxic Damage: Mu bikolwa mu vitro, nga PC12 cell model ejjanjabiddwa ne cobalt chloride (CoCl2), Cerebrolysin eraga ekikolwa eky’okukuuma obusimu [1] . Okusingira ddala, ekuuma dayamita y’obutoffaali bwa PC12 obutaawuddwamu oluvannyuma lw’okujjanjabwa CoCl2, ekendeeza ku kukendeera kw’obutoffaali; ekendeeza ku mirimu gya pro-apoptotic Caspase mu butoffaali bwa PC12 obutayawulwa wansi w’okunyigirizibwa kwa CoCl2; ezzaawo emirimu gy’okukyusakyusa ebiriisa y’obutoffaali bwa PC12 obutaawuddwamu n’obwawuddwamu obwonooneddwa CoCl2; era mu kiseera kye kimu kikendeeza ku mutindo gwa superoxide ogwetegerezeddwa oluvannyuma lw’okukwatibwa CoCl2. Enkola yaayo ey’okukola eyinza okuba nga eyita mu kwongera ku phosphorylation ya GSK3β, bwe kityo ne kiziyiza emirimu gya GSK3β. Kino kiyinza okuba n’amakulu mu bujjanjabi eri obulwadde bwa Alzheimer, kubanga emirimu gya GSK3β gikwatagana n’okukola amyloid β.
Omulimu mu Ischemic Stroke: Mu balwadde abalina ischemic stroke, Cerebrolysin eyinza okukola omulimu gw’okukuuma obusimu okuyita mu makubo agawera. Mu kugezesebwa okw’obujjanjabi okusooka, nga basoma omuwendo gw’abantu abakoseddwa obutono, olw’okuteebereza okulungi okutwalira awamu okw’omuwendo guno, wayinza okubaawo ebikosa wansi oba waggulu, ekivaamu obutaba na njawulo eraga wakati w’ebibinja by’obujjanjabi [2] . Wabula, okwekenneenya mu bibinja ebitonotono ku balwadde abakoseddwa ennyo kwalaga nti Cerebrolysin yalina akakwate akalungi akanene ku kwongera okuwona, era obunene bw’ekikolwa kyayo bweyongera n’obuzibu bw’okusannyalala. Okugatta ku ekyo, Cerebrolysin esobola okugattibwa mu ngeri ey’obukuumi n’obujjanjabi obw’okulongoosa omusaayi (thrombolytic therapy). Tekirina kikolwa kya kukuuma busimu kyokka wabula kirina obusobozi bw’okuwona obusimu era kiraga obulungi mu balwadde abalina stroke ey’ekigero oba ey’amaanyi [2, 3]..
2. Ng’ekirungo ekiddaabiriza obusimu
Okutumbula Empuliziganya wakati w’obutoffaali bw’obusimu: Cerebrolysin ye nsengekera y’amazzi eyesigamiziddwa ku puloteyina erimu ebitundu 85% ebya amino acids ez’obwereere ne 15% bioactive low-molecular-weight amino acid sequences, omuli low-molecular-weight neuropeptides [4, 5] . Obusimu buno obw’obwongo obukola busobola okuyingira mu kiziyiza ky’omusaayi n’obwongo ne bukozesebwa obusimu obuyitibwa neurons okuwuliziganya ne bannaabwe.
Effect on Neurodevelopmental Disorders: Mu baana neuropsychiatry, Cerebrolysin etwalibwa nga peptidergic substance nga erina enkola multimodal of action era ekola nga nerve repair agent. Mu buzibu bw’enkulaakulana obubunye (PDD) omuli autism ne Asperger’s syndrome, enkola empya ey’obujjanjabi nga Cerebrolysin efuyirwa ng’ekitundu ekikulu eky’obujjanjabi yalaga nti obubonero bwa autistic bw’abalwadde bonna abajjanjabwa bwalongooka era ne bukendeera nnyo, era obubonero obukulu obw’ autistic obw’abalwadde abamu bwabula ddala awatali buzibu bwonna [5]..
3. Enkola y’obujjanjabi ku kusannyalala oluvannyuma lw’okusannyalala
Okulongoosa ebiraga ebikwatagana n’okusannyalala: Okuyita mu kunoonyereza ku mulwadde ow’emyaka 56 alina obulwadde bwa stroke obutawona, Cerebrolysin yafukibwa mu binywa mu kitundu ky’omubiri ekizimba ku ddoozi ya 10 mL buli lunaku okumala ennaku 30. Oluvannyuma lw’okujjanjabwa, ebiraga ebivaamu ebikwata ku kusannyalala nga Manual Muscle Test (MMT) byalongooka ebitundu 70%, ate Modified Ashworth Scale (MAS) byakendeera obubonero 2 [6] . Omulwadde era yategeeza nti ebirungi bikola ku muudu n’okukubiriza.
4. Enkosa ku buvune bw’ekibumba
Okulongoosa Ebiraga obuvune bw’ekibumba: Mu balwadde abalina endwadde ezitawona, obujjanjabi bw’ebintu ebiyinza okutta obulamu bwabwe buzibu. Ku balwadde ba stroke abajjanjabwa ne Cerebrolysin, singa wabaawo okweyongera mu aspartate aminotransferase (AST) ne/oba alanine aminotransferase (ALT), okunoonyereza mu bujjanjabi kulaga nti Cerebrolysin esobola okulongoosa emiwendo gya AST gy’abalwadde abasinga obungi aba stroke abalina obuvune mu kibumba [7]..
Reversing the Inhibition of Neurogenesis: Mu mouse model of non-alcoholic fatty liver disease (NAFLD), nga twekenneenya ebiva mu nneeyisa n’ebitundu by’omubiri, kyazuulibwa nti Cerebrolysin esobola okuzzaawo enneeyisa eringa okweraliikirira naye yalemererwa okulongoosa okujjukira okw’ekiseera ekitono oba okununula okukula kw’obutoffaali mu hippocampus oluvannyuma lw’okulya emmere ya MCD [7].
Ebikozesebwa bya Cerebrolysin bye biruwa?
Okukozesebwa mu Pediatric Neuropsychiatry:
Okutumbula Okusikirizibwa kw’Obutoffaali bw’Obusimu: Mu 1949, munnasayansi Gerhart Harrer okuva mu Yunivasite y’e Innsbruck mu Austria yategeeza nti Cerebrolysin, amazzi aga puloteyina agakolebwa enziyiza y’okusengejja amazzi mu bitundu by’obwongo, gasobola okusitula obutoffaali bw’obusimu. Cerebrolysin ye nsengekera y’amazzi eyesigamiziddwa ku puloteyina nga erimu ebitundu 85% ebya amino asidi ez’obwereere ne 15% ensengekera za amino asidi ezikola ebiramu ezirina obuzito bwa molekyu entono, omuli ne neuropeptides ezirina obuzito bwa molekyu entono. Neuropeptides zino mulimu ensonga eva mu bwongo, ensonga ekwata obusimu obuva mu layini y’obutoffaali bwa glial, ensonga y’okukula kw’obusimu, n’ensonga y’obusimu obuyitibwa ciliary neurotrophic factor [4]..
Enkola y’okukola mu ngeri ez’enjawulo: Cerebrolysin etwalibwa ng’ekintu kya peptide ekirina enkola y’okukola ey’engeri nnyingi. Obusimu obuyitibwa neuropeptides obw’obwongo obukola obulimu busobola okuyingira mu kiziyiza omusaayi n’obwongo ne bukozesebwa obusimu obuyitibwa neurons okuwuliziganya ne bannaabwe. Obukuumi bwayo, okugumiikiriza, n’obulungi bwayo bibadde bizuuliddwa mu kunoonyereza okw’okugezesa n’okugezesebwa mu malwaliro. Cerebrolysin ekwatagana n’eddirisa ly’obudde ery’obujjanjabi erigazi era esobola okukozesebwa ng’ekirungo ekikuuma obusimu n’ekizimba obusimu, ekiyamba okulwawo okukula kw’endwadde z’obwongo [4]..
Enkozesa mu Bujjanjabi bwa Stroke:
Ebikosa abalwadde abalina obuzibu obw’enjawulo: Mu bujjanjabi bwa stroke, okugezesebwa mu malwaliro okwasooka kwasinga kukolebwa mu bantu abaakosebwa obutono, abatera okuba n’okuteebereza okulungi. Naye olw’okulonda kuno, wayinza okubaawo ebikosa wansi oba waggulu mu bipimo by’okudda engulu eri emisango emitono, ekizibu okulaga emigaso egyeyoleka wakati w’ebibinja by’obujjanjabi. Okwawukana ku ekyo, okwekenneenya mu bibinja ebitonotono ku balwadde abakoseddwa ennyo kwalaga nti Cerebrolysin yalina akakwate akalungi akanene ku kwongera okuwona. Okusinziira ku bivudde mu kunoonyereza okungi, kyeyoleka bulungi nti obunene bw’ekikolwa kya Cerebrolysin bweyongera n’obuzibu bw’okusannyalala [2]..
Okukozesa awamu n’obujjanjabi bwa Thrombolytic: Okunoonyereza okulala okufugibwa kulaga nti Cerebrolysin esobola okugattibwa mu ngeri ey’obukuumi n’obujjanjabi bwa thrombolytic. Gye buvuddeko, Cerebrolysin teyakeberebwa ku busimu bwayo obw’okukuuma obusimu bwokka wabula n’obusobozi bwayo obw’okuddamu obusimu era eraga nti ekola bulungi mu balwadde abalina stroke ey’ekigero oba ey’amaanyi [2]..
Effect on Functional Recovery: Cerebrolysin eraga emigaso mu balwadde abalina ischemic stroke ey’ekigero oba ey’amaanyi. Bwe kikozesebwa nga kigatta wamu n’okuddaabiriza obusimu bw’ogeraageranya n’okuddaabiriza obusimu kwokka, okutwalira awamu kirina kinene kye kikola ku kudda engulu mu nkola. Kino kiwa obulagirizi eri enteekateeka z’okunoonyereza ezisingako obukakafu mu biseera eby’omu maaso.
Enkozesa mu Bujjanjabi bwa Acute Ischemic Stroke:
Enkosa ku kufa n’ebizibu ebibaawo: Obujulizi obw’omutindo ogw’ekigero bulaga nti Cerebrolysin eyinza okuba n’omugaso mutono mu kuziyiza okufa olw’ensonga zonna oba omuwendo gwonna ogw’ebizibu eby’amaanyi mu acute ischemic stroke. Mu kiseera kye kimu, obujulizi obw’omutindo ogw’ekigero era bulaga nti okukozesa Cerebrolysin kuyinza okwongera okubeerawo kw’ebizibu eby’amaanyi ebitali bya kufa [8] . Okusingira ddala, mu kibinja ekitono nga balina ddoozi ya 30 mL okumala ennaku 10 (dozi ekuŋŋaanyiziddwa eya 300 mL), okweyongera kw’ebizibu eby’amaanyi ebitali bya kufa kwali kwa maanyi nnyo [8]..
Enkosa ku biraga ebirala: Tewali n’emu ku kugezesebwa okwali kwalaga bivudde mu mirimu embi ebitegeezeddwa ng’okufa oba okwesigama ku nkomerero y’ekiseera ky’okugoberera, okufa amangu (mu wiiki bbiri oluvannyuma lw’okutandika okusannyalala), obudde bw’okudda ku busobozi bw’emirimu, n’omutindo gw’obulamu n’ebiraga ebirala. Okugezesebwa kumu kwokka kwalaga bulungi ebivaako okufa, omuli okusannyalala kw’obwongo, okulemererwa kw’omutima, okuzimba amawuggwe, n’ekifuba, n’ebirala, naye tewaaliwo njawulo ntono mu nsasaanya wakati w’ekibinja kya Cerebrolysin n’ekibinja kya placebo [8]..
Enkozesa mu Bujjanjabi bw’Obuzibu bw’Okutegeera:
Okulongoosa Enkola y’Okutegeera n’Okulwawo Okukulaakulana: Obuzibu mu kutegeera y’emu ku nsonga enkulu mu by’obulamu eby’omulembe guno. Mu kiseera kino, abantu abasoba mu bukadde 55 mu nsi yonna abatawaanyizibwa obulwadde bw’okubulwa amagezi. Obulwadde bw‟okubulwa amagezi kye kimu ku bisinga okuvaako obulemu n‟okwesigamira ku bakadde mu nsi yonna. Abalwadde bangi abalina obuzibu obutono mu kutegeera balina obulabe obweyongedde obw’okukulaakulana okutuuka ku bulwadde bw’okusannyalala bw’ogeraageranya ne bannaabwe. Olw’okukosa COVID-19, n’omuwendo gw’abalwadde abalina obuzibu mu kutegeera gweyongedde. Cerebrolysin ddagala teriyinza kukoma ku kulongoosa nkola ya kutegeera wabula n’okukendeeza ku nkulaakulana yaalwo [9]..
Okukozesebwa mu balwadde abalina obuzibu mu kutegeera oluvannyuma lwa Stroke:
Okulongoosa eddaala ly’okutegeera: Okunoonyereza okwakolebwa emabega kwalaga nti Cerebrolysin eyinza okulongoosa eddaala ly’okutegeera kw’abalwadde abali mu mbeera ey’okutegeera okutono oluvannyuma lw’okusannyalala. Mu kunoonyereza kuno, abalwadde abali mu mbeera etali ya kutegeera nnyo oluvannyuma lw’okusannyalala okuva mu ischemic ne/oba hemorrhagic stroke baasomesebwa, era abalwadde bano beekenneenyezebwa okusinziira ku Revised Coma Recovery Scale (CRS-R). Abalwadde bonna baafunye obujjanjabi obw’okuddaabiriza obujjuvu omuli obujjanjabi bw’omubiri n’obujjanjabi obw’emirimu. Abalwadde abaafunye obujjanjabi bwa Cerebrolysin baageraageranyizibwa ku bataafuna bujjanjabi bwa Cerebrolysin. Ebivuddemu biraga nti oluvannyuma lw’okutereeza ensonga ezitabula, ekibinja ky’obujjanjabi bwa Cerebrolysin kyalina enkulaakulana ey’amaanyi mu bubonero bwa CRS-R naddala mu subscales z’enkola y’omu kamwa n’okusikirizibwa [10]..
Okukozesebwa mu balwadde abalina obuvune ku kibumba:
Enkola y’obujjanjabi ku balwadde abalina obuvune ku kibumba: Ku balwadde abalina endwadde ezitawona, okujjanjaba ebizibu eby’amaanyi ebiyinza okutta obulamu kizibu kubanga abasawo balina okulowooza ku bikolwa by’eddagala eririna enkola eziwera. Ku bikwata ku Cerebrolysin, nga amplifier y’ekkubo ly’obubonero bwa Sonic Hedgehog era nga lye limu ku ddagala ettono erikkirizibwa erijjanjaba obusimu eri abalwadde ba stroke, waliwo okweraliikirira nti okukola ennyo ekkubo lya Hedgehog kuyinza okwanguya okukula kw’obulwadde bw’ekibumba obutali bwa masavu (NAFLD) okutuuka ku cirrhosis. Kizuuliddwa nti Cerebrolysin mu bujjanjabi yalongoosa emiwendo gya aspartate aminotransferase (AST) mu balwadde abasinga obungi abaali bafunye obuvune mu kibumba. Mu mbeera y’okugezesa, Cerebrolysin yasobola okuzzaawo enneeyisa eringa okweraliikirira mu nkola y’ebibe ey’obulwadde bw’ekibumba obw’amasavu obutali bwa mwenge naye teyalongoosa kujjukira kwa bbanga ttono oba okununula obutoffaali okukula mu hippocampus oluvannyuma lw’okulya emmere ya MCD [7]..
Mu kumaliriza, Cerebrolysin esobola okutumbula okuddaabiriza n’okuzza obuggya obutoffaali bw’obusimu, okulungamya bbalansi y’obusimu okulongoosa okutambuza obubonero, okuwa ebiriisa eri obutoffaali bw’obusimu n’okutumbula okugumiikiriza kwabwo okwonooneka, era n’okutumbula enkula y’obusimu. Mu bujjanjabi, cerebrolysin ekozesebwa nnyo mu kujjanjaba endwadde ez’enjawulo ez’obusimu ng’okulumwa obwongo n’ebiddirira endwadde z’emisuwa gy’obwongo, ekiyinza okulongoosa obubonero bw’abalwadde n’omutindo gw’obulamu. Mu kiseera kye kimu, era kikozesebwa kikulu mu kunoonyereza ku sayansi w’obusimu, ekiyamba okufuna okutegeera okw’obwegendereza ku mirimu gy’omubiri gw’obutoffaali bw’obusimu n’enkola y’enkulaakulana n’okuddaabiriza enkola y’obusimu, okuwa endowooza n’ebirowoozo ku kukola eddagala eppya erikuuma obusimu n’okuddaabiriza, era kya makulu nnyo mu bitundu by’okujjanjaba endwadde z’obusimu n’okunoonyereza ku ssaayansi w’obusimu.
Ebikwata ku Muwandiisi
Ebintu ebyogeddwako waggulu byonna binoonyerezeddwako, birongooseddwa era ne bikung’aanyizibwa kkampuni ya Cocer Peptides.
Omuwandiisi wa Scientific Journal
Ziganshina LE munoonyereza alina akakwate n’ebitongole ebiwerako eby’amaanyi. Mu bino mulimu ekitongole ky’ebyobulamu ekya Russian Medical Academy of Continuous Professional Education (RMANPO), Peoples Friendship University of Russia, Kazan State Medical University, Russian Medical Academy of Continuous Professional Education, Minisitule y’ebyobulamu eya Russia Federation, Cochrane Russia, Kazan Federal University, Minisitule y’ebyobulamu eya Republic of Tatarstan, Kazan State Medical Academy, ne SV Kurashov Med Inst. Enkolagana ye n’ebitongole eraga nti alina obumanyirivu obw’amaanyi mu ssaayansi w’obusawo n’ebyobulamu.
Okunoonyereza kwe kukwata ku masomo ag’enjawulo. Alina obukugu mu General & Internal Medicine, Pharmacology & Pharmacy, Public, Environmental & Occupational Health, Neurosciences & Neurology, ne Research & Experimental Medicine. Omulimu gwe mu bintu bino gulaga okumanya kwe okungi n’ebintu by’akola mu kutumbula ssaayansi w’obusawo n’enkola z’ebyobulamu. Ziganshina LE ewandiikiddwa mu kiwandiiko ekijuliziddwa [8].
