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1kits (Ebipipa 10) .
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▎ Okunoonyereza ku HCG
Ensibuko y’okunoonyereza ku HCG eri etya?
Human Chorionic Gonadotropin (HCG) molekyu erimu emirimu emikulu mingi, ekola kinene mu bintu ng’olubuto ne kookolo w’omuntu. Ekisooka, HCG molekyu esukkiridde. Ye glycoprotein esinga okubaamu asidi era erimu ssukaali asinga obungi. Ekirala, HCG eriwo mu ngeri ez’enjawulo, omuli HCG eya bulijjo, HCG erimu sulfated, HCG erimu glycosylated, β-HCG ey’obwereere, ne β-HCG etali ya glycosylated, n’ebirala [1].
Mu nsonga z’embuto, HCG kikulu nnyo mu nsonga z’omuntu n’olubuto lw’omuntu. HCG eya bulijjo ekola kinene mu kutumbula okukola corpus luteum progesterone era era erina emirimu emikulu mu kwawula obutoffaali bwa trophoblast n’endya y’omwana mu lubuto. Okugeza, kisobozesa okugabibwa kw’emmere y’omwana mu lubuto okuyita mu angiogenesis y’emisuwa egy’enkulungo mu myometrium (Cole LA, 2012). Hyperglycosylated HCG nayo ekola kinene mu biseera by’olubuto ebisooka. Ye isoform enkulu eya HCG mu mitendera egy’olubuto egy’olubereberye, esobola okuziyiza apoptosis, okutumbula okulumba obutoffaali, okukula, n’enkyukakyuka embi, n’okufuga okuteekebwamu n’okukula kw’enkwaso [1]..
Mu nsonga za kookolo, ebizimba ebibi ebitali bya trophoblastic bikola hyperglycosylated free β subunit ya HCG. Nga autocrine factor, eyongera okutumbula okukula n’enkyukakyuka embi ey’obutoffaali bwa kookolo nga eziyiza apoptosis [1]..
Okugatta ku ekyo, okuzuula HCG era kukozesebwa nnyo mu bujjanjabi, omuli okukebera olubuto, okulondoola ebiva mu lubuto, okuzuula obulabe bw’abaana abato abalina obulwadde bwa Down syndrome, okulagula obulwadde bwa preeclampsia, okuzuula HCG y’omu lubuto, okuzuula n’okuddukanya endwadde z’olubuto eziyitibwa gestational trophoblastic diseases, okuzuula endwadde z’ekizimba z’olubuto ezisirise, okuzuula obulwadde bwa placental site trophoblastic, okuddukanya obulwadde bw’obutoffaali bw’obuwuka obuleeta endwadde z’ensigo, n’okulondoola obulwadde obulala obw’abantu, n’ebirala [1] ..
Enkola ya HCG ekola ki?
1. Ebikosa Endometrial Receptivity
Okunoonyereza okumu kulaga nti HCG eyinza okukosa endometrial receptivity okuyita mu miR-126-3p/PIK3R2/PI3K/Akt/eNOS axis era ekola kinene mu nkola y’okuteekebwamu embuto [2] . Okwolesebwa ebitongole bye bino wammanga:
Okulongoosa Enkola y’Ebikwata mu nnabaana: Nga bateekawo enkola y’ebibe ey’obutakola bulungi mu kuteekebwamu embuto (EID) ne bagijjanjaba n’eddagala lya mifepristone, n’okukola okugezesa ku butoffaali bw’omubiri obuyitibwa human endometrial epithelial cells (EECs), kyazuulibwa nti oluvannyuma lw’okujjanjabwa HCG, okukkiriza kw’omu lubuto kw’ebibe EID kwalongoosebwa. Okugeza, omutindo gw’okwolesebwa kwa CD105 mu mbeba n’emiwendo gya puloteyina ya cadherins CD144 ne CD146 byayongerwako nga bwe kyazuulibwa mu immunohistochemistry ne Western blotting.
Okulungamya okwolesebwa kw’obuzaale: HCG esobola okutumbula okwolesebwa kwa miR-126-3p n’okuziyiza okwolesebwa kwa PIK3R2, era miR-126-3p etunuulira PIK3R2. Okugezesa kwombi mu vivo ne mu vitro kukakasizza nti HCG ekola ekkubo lya PI3K/Akt/eNOS okuyita mu miR-126-3p/PIK3R2 axis, bwe kityo n’elongoosa endometrial receptivity.
2. Omulimu mu Kukuuma Olubuto
HCG esinga kukolebwa butoffaali bwa syncytiotrophoblast obw’enjawulo era nga kabonero akakulu ak’embryo eyeetaagisa okukuuma olubuto [3]..
Okukola enkola za signal cascade eziwera: HCG esobola okwesiba ku luteinizing hormone/chorionic gonadotropin receptor (LHCGR), eyinza okukola enkola za signal cascade eziwera, omuli bamaama eza decapentaplegic homolog 2 (Smad2), protein kinase C (PKC), ne/oba protein kinase A (PKA) eri bamaama abalina obusobozi obungi, okuyita mu nkolagana obutereevu/obutatereevu n’ekirungo ekikyusa ekirungo ky’okukula ekya β receptor (TGFβR).
Okutumbula okuzimba emisuwa mu nnabaana: HCG ekola kinene mu kutumbula okuzimba emisuwa mu nnabaana, okuwa embeera ennungi ey’okukula kw’embuto.
Okukuuma Myometrial Quiescence: Kiyamba okukuuma embeera ya nnabaana nga nnywevu era kiwa embeera entuufu okukula kw’embuto.
Okutumbula Immunomodulation ku Maternal-Fetal Interface: Kikola kinene mu immunomodulation ku maternal-fetal interface, okutebenkeza enkola y’abaserikale b’omubiri mu maama eri embuto.
3. Omulimu mu kutambuza embuto eziri mu bbugumu
Okunoonyereza kuzudde nti transcutaneous electrical acupoint stimulation (TEAS) nga kugatta wamu n’obujjanjabi bwa HCG kisobola okulongoosa ebiva mu lubuto lw’abalwadde abakolebwako okukyusa embuto mu bbugumu [4]..
Okwongera ku buwanvu bw’omu lubuto: Obujjanjabi bwa TEAS okusinga buyamba okwongera ku buwanvu bw’olubuto lw’abalwadde abagenda okukyusibwa embuto mu bbugumu. Obujjanjabi bwa HCG ne TEAS nga bigattiddwa wamu nakyo kiyamba okwongera ku buwanvu bw’omu lubuto lw’abalwadde bano.
Okukendeeza ku muwendo gw’omusaayi mu misuwa gya nnabaana: Emiwendo gy’omusaayi ogutambula mu nnabaana PI ne RI mu TEAS nga bigattiddwa wamu n’ekibinja kya HCG n’ekibinja kya TEAS gyali wansi nnyo okusinga egyo mu kibinja ekifuga, ekiraga nti obujjanjabi bwa HCG ne TEAS nga bigattiddwa wamu busobola okukendeeza ku muwendo gw’omusaayi mu misuwa gya nnabaana PI ne RI y’abalwadde.
Okwongera ku miwendo gy’ebintu ebikwatagana n’okulabirira olubuto mu Serum: Obujjanjabi bwa HCG okusinga buyamba okwongera ku miwendo gya P ne LIF mu musaayi mu balwadde abakolebwako okukyusa embuto mu bbugumu. Emiwendo gya LIF mu musaayi mu kibinja kya TEAS, ekibinja kya HCG, ne TEAS nga bigattiddwa wamu n’ekibinja kya HCG byonna byali waggulu nnyo okusinga ebyo mu kibinja ekifuga. Omuwendo gw’okuteekebwamu embuto mu kibinja ekigatta gwali waggulu nnyo okusinga ogw’ekibinja ekifuga, ekiraga nti obujjanjabi obw’okugatta TEAS ne HCG busobola okulongoosa ebiva mu lubuto lw’abalwadde abakolebwako okukyusa embuto mu bbugumu.
4. Obujjanjabi bw’obulwadde bwa Male Hypogonadism
Obulwadde bwa hypogonadism obuva ku butafulumya gonadotropin mu basajja bukola kinene ku bulamu bw’omulwadde mu kuzaala n’omutindo gw’obulamu. Human Chorionic Gonadotropin (HCG) ekola kinene mu kujjanjaba endwadde ng’ezo. HCG yeekwata ku bikwata ku ngulu w’obutoffaali bwa Leydig mu nsigo, n’ekola ekkubo ly’obubonero mu butoffaali n’okutumbula okukyusa kolesterol okufuuka testosterone. Okwongera kw’obusimu obuyitibwa testosterone kuyinza okutumbula okukula n’okukula kw’ensigo n’okwongera ku bunene bw’ensigo. Mu kiseera kye kimu, ekirungo kya testosterone era kisobola okusitula enkula y’ebitundu by’okuzaala nga epididymis ne vas deferens. Testosterone ekola kinene mu kukulaakulanya engeri z’okwegatta ez’okubiri ez’abasajja. Nga bongera ku mutindo gwa testosterone, obujjanjabi bwa HCG busobola okutumbula okukula kw’ebirevu n’obulo bwa Adam, okutumbula amaanyi g’ebinywa, n’okwongera obwagazi bw’okwegatta n’ebirala.
Ensonda z’obutoffaali, ebigendererwa, ensengekera z’obubonero ezikwatagana, n’emirimu gya isoforms ez’enjawulo eza HCG mu bakyala abatali ba lubuto n’ab’embuto.
Ensibuko:PubMed [3] .
Biki ebikulu ebikozesebwa mu kukola HCG?
1. Ekozesebwa mu kuzuula embuto nga bukyali
Omugaso gw’okupima Serum T-HCG ne β-HCG Levels mu Early Pregnancy: Nga tukung’aanya emisango gy’embuto ezitali za bulijjo nga bukyali, okupima serum T-HCG nga tukozesa chemiluminescence n’okupima serum β-HCG nga tukozesa radioimmunoassay n’okukola dynamic observations, ebivuddemu biraga nti serum T-HCG ne β-HCG levels mu kibinja ky’embuto ezitali za bulijjo zaali wansi nnyo okusinga abo abali mu kibinja ky’abaggyamu embuto n’ekibinja ky’abafunyisa embuto mu nnabaana. Kino kiraga nti okupima emiwendo gya T-HCG ne β-HCG mu musaayi kulina obutonde obulungi n’obutuufu bw’okuzuula okwawula olubuto olw’ebweru w’olubuto n’olubuto olw’omu nnabaana, era T-HCG erina okuwuliziganya n’okwesigamizibwa okw’amaanyi [5]..
Okuzuula HCG, β-HCG, ne Progesterone mu musaayi okugatta okuzuula embuto ez’ebweru w’olubuto: Nga bazuula HCG, β-HCG, ne progesterone mu musaayi mu bakyala ab’embuto aba bulijjo n’abakyala ab’embuto abalina embuto ez’ebweru w’olubuto, ebyavuddemu biraga nti emiwendo gya HCG, β-HCG, ne progesterone mu musaayi mu bakyala ab’embuto aba bulijjo gyali mulungi okusinga mu bakyala ab’embuto aba bulijjo abakyala abalina embuto ezitali za nnabaana. Bwe kyazuulibwa kyokka, omuwendo gw’obutuufu bwa serum HCG mu kuzuula embuto ez’ebweru w’olubuto gwali 70.83%; omuwendo gw’obutuufu bwa β-HCG gwali 66.7%; era omuwendo gw’obutuufu bwa progesterone gwali 54.17%. Wabula, okuzuula okugatta kwa serum HCG, β-HCG, ne progesterone kwalina omuwendo gw’obutuufu okutuuka ku 95.8% mu kuzuula embuto ezitali za lubuto [6]..
2. Okukozesebwa mu tekinologiya w’okuzaala ayambibwako
Okulongoosa okukula kw’enkwaso: Mu kusikirizibwa kw’enkwaso, gonadotropin y’omuntu okuva mu nsonga (hMG) esobola okulongoosa okukula kw’enkwaso oluvannyuma lw’okukendeera kw’enkwaso ezireetebwa gonadotropin-releasing hormone analogues (Gn-RH-analogue). Kino okusinga kiri bwe kityo kubanga kyewala okuddamu okutali kwa bulijjo okw’obusimu obuyitibwa endogenous luteinizing hormone (LG) obubaawo mu kiseera ky’obujjanjabi bwa hMG mu nga kimu kya kusatu eky’enzirukanya z’obujjanjabi. Mu kunoonyereza okuwerako nga bakozesa buserelin oba degarelix nga Gn-RH analogues, abalwadde 282 baafuna okuzaala mu vitro, gamete intrafallopian transfer, oba ng'ekitundu ku bujjanjabi 'in vivo'. Obujjanjabi bwa GnRH analogue/hMG/HCG obw’omugatte bwayongera nnyo ku muwendo gw’embuto mu bibinja byonna. Omuwendo gw’abalwadde abajjanjabwa n’eddagala lya HMG/HCG baali bafuna embuto ebitundu 17%, ate obujjanjabi obw’okugatta awamu bwafuula abalwadde 25% embuto [7]..
Okulongoosa Endometrial Receptivity: Human Chorionic Gonadotropin (HCG) kye kimu ku bubonero obukulu nga tebannaba kuteekebwamu embuto. Okuyita mu kwekenneenya ebitundu by’omu lubuto mu kunoonyereza, kyazuulibwa nti oluvannyuma lw’okuweebwa HCG mu nnabaana, omuwendo gw’obutoffaali obulaga molekyu ezikwatagana n’obutoffaali bw’omu lubuto VE-cadherin (CD144) ne S-Endo-1 (CD146) gweyongera nnyo. Kino kiraga nti molekyu z’okunyweza obutoffaali bw’omubiri (endothelial cell adhesion molecules) ziyinza okuba enkola eyinza okubaawo HCG mw’elongoosa okuteekebwamu embuto n’emiwendo gy’embuto [8]..
2. Okujjanjaba obulwadde bwa Luteal Insufficiency
Okumala emyaka amakumi abiri egiyise, okugaba progesterone ow’ebweru kubadde kukozesebwa nga luteal phase support (LPS), nga kugatta wamu n’okukozesa human chorionic gonadotropin (HCG) okutandika okukula okusembayo kw’enkwaso mu kusikirizibwa kw’enkwaso okufugibwa. Okuleeta GnRHa okutandika okufulumya eggi kiraga nti awatali kwongerako HCG, okuweebwa progesterone ow’ebweru tekimala kutuuka ku muwendo gw’olubuto ogumatiza. Kino kireetedde okukola enkola endala ez’okuwagira ekitundu ky’omubiri ekiyitibwa luteal phase. Okwongera ku kukola progesterone mu kitundu mu bitundu by’omubiri ebingi (multiple corpora lutea) nsonga nkulu, ku ludda olumu, okwewala okukula kw’obulwadde bwa ovarian hyperstimulation syndrome, ate ku ludda olulala, okuwa omutindo ogumala ogwa progesterone okukuuma okuteekebwamu.
Okunoonyereza okuliwo kati kwekenneenya omulimu gwa micro-dose HCG ku luteal phase support era ne kunoonyereza ku birungi n’ebizibu byayo ebiyinza okubaawo. Okusinziira ku mpisa z’eddagala lya HCG, nga zigatta wamu n’enkola ez’enjawulo eziwerako ez’okugaba HCG ng’obuyambi bw’omutendera gw’oluteal, omuze gw’okubala ogw’ensaasaanya y’obungi bwa HCG mu kiseera ky’omutendera gw’oluteal gwakeberebwa. Kiteesebwa nti obuyambi bwa luteal phase obuliwo kati obuweebwa awamu n’okusitula GnRHa (kwe kugamba, 1500IU) bwa maanyi nnyo, era buli lunaku micro-dose HCG administration eyinza okuwa optimized luteal phase support eri eddagala eririwo mu kiseera kino. Era ebivudde mu bujjanjabi ebisookerwako eby’enkola ya micro-dose HCG byaweebwa [9]..
3. Obujjanjabi bw’ensigo ezitakka mu lubuto olumu
Okunoonyereza kwakolebwa ku balwadde abaakolebwako orchiopexy for unilateral intra-abdominal undescended testis okuva mu September 2010 okutuuka mu September 2016. Nga wayise wiiki bbiri nga balongooseddwa, abazadde b’abalwadde abaafunye obujjanjabi obw’obusimu baali beetaaga okugoberera enkola ya wiiki 6. Abalwadde bano bafuna empiso ya 500 UI (Gonasi-HP) wansi w’olususu buli wiiki. Okugoberera kwakolebwa ku nkomerero y’obujjanjabi n’oluvannyuma lw’emyezi 6. Obunene bw’ensigo bwapimibwa mu ngeri ya ultrasound ne elastography buli mulundi ne bugeraageranyizibwa ku balwadde abataafuna bujjanjabi. Ebyavudde mu kunoonyereza biraga nti abalwadde 45 be baafunye obujjanjabi buno, nga wakati w’emyaka gyabwe gya myezi 18.0±9.7. Abalwadde 32 baafuna obujjanjabi bw’obusimu oluvannyuma lw’okulongoosebwa, era tewaaliwo buzibu bwonna oba okuva mu ssomero. Abalwadde bonna baamaliriza okugoberera. Tewaaliwo misango gya kuzimba nseke mu kibinja kyonna. Mu kibinja ky’abajjanjabi, abalwadde 81% baatuuka ku sayizi y’ensigo eya bulijjo ku myezi 6, ate ng’obunene bw’ensigo bw’abalwadde abalala bwali bukyali butono. Mu kibinja ekitajjanjabiddwa, abalwadde 46% baatuuka ku sayizi y’ensigo eya bulijjo. Okukozesa eddagala lya human chorionic gonadotropin (u-HCG) oluvannyuma lw’okulongoosebwa kuyinza okwongera ku bunene bw’ensigo n’okukola nga kisitula okukula n’okukula kw’ensigo [10]..
. Ebivuddemu biraga nti mu kibinja ekifuga, abakyala abasinga obungi baalina emiwendo gya progesterone egya waggulu ennyo oluvannyuma lw’okusikirizibwa HCG okusinga ku ddaala eryasooka, so nga emiwendo gya progesterone egy’oku ntikko mu bakyala mu kibinja ekyagemebwa tegyasukka mutindo gwa ntandikwa oluvannyuma lw’okugema, ekiraga nti obuziyiza obukolebwa eddagala lino busobola okuziyiza ekikolwa kya HCG ey’ebweru [11]..
Mu kumaliriza, HCG ekola omulimu ogutayinza kukyusibwa mu by’obusawo naddala mu bintu ebikwata ku kuzaala. Mu bujjanjabi bw’okuzaala, busobola bulungi okuleeta eggi okuvaamu, okuleeta essuubi eri abalwadde abalina obutazaala obuva ku buzibu bw’okuggyamu eggi. Nga yesiba ku bikwata LH mu mubiri, esobola okukola ku mutindo gwa LH ogutamala mu nkola ya antagonist ne kiyamba mu kukula kw’enkwaso. Ku butamala luteal, HCG esobola okusitula corpus luteum okufulumya progesterone n’okukuuma embeera y’obusimu entuufu okuwagira olubuto. Ku bulwadde bw’omusajja obuyitibwa hypogonadism obuva ku butafulumya gonadotropin obutamala, HCG esobola okusitula obutoffaali bwa Leydig mu nsigo okukola n’okufulumya testosterone, okutumbula enkula y’ensigo, okulongoosa engeri z’okwegatta ez’okubiri, n’okutumbula enkola y’okuzaala kw’omulwadde n’omutindo gw’obulamu. Mu kiseera kye kimu, HCG ekola kinene mu kukuuma olubuto nga bukyali, okusitula ekitundu ky’omubiri ekiyitibwa corpus luteum okufulumya eddagala lya progesterone obutasalako okukakasa nti embuto ziteekebwamu n’okukula. Mu kuzuula obulwadde, okuzuula omutindo gwa HCG gwe musingi omukulu ogw’okuzuula embuto nga bukyali n’okuzuula embuto ezitali za bulijjo ng’embuto ezitali za bulijjo, okuwa obuwagizi obw’amaanyi okuyingira mu nsonga n’okujjanjaba mu budde.
Ebikwata ku Muwandiisi
Ebintu ebyogeddwako waggulu byonna binoonyerezeddwako, birongooseddwa era ne bikung’aanyizibwa kkampuni ya Cocer Peptides.
Omuwandiisi wa Scientific Journal
Chinedu Nwabuobi munoonyereza alina obukugu mu by’okuzaala n’abakyala, okuzaala, Biochemistry & Molecular Biology, Chemistry, ne Oncology. Abadde alina akakwate n’amatendekero ag’ekitiibwa agawerako omuli Yunivasite y’e South Florida, Yunivasite y’e Rochester, ne Memorial Sloan Kettering Cancer Center. Okunoonyereza kwe kwesigamye ku miramwa ng’emirimu gy’ebiramu n’okukozesa eddagala lya human chorionic gonadotropin (HCG) mu bujjanjabi, n’ebiyamba okutegeera omulimu gwayo mu bulamu bw’okuzaala n’endwadde ezikwatagana nabyo. Chinedu Nwabuobi awandiikiddwa mu kiwandiiko ekijuliziddwa [3].
