Bya Cocer Peptides 
omwezi gumu emabega
EBINTU BYONNNA N’AMAWULIRE GW’EBINTU EBIweereddwa KU MUTINDO GUNO BIKOZESEBWA KU KUSASANYA AMAWULIRE N’EBIKOLWA BY’OKUSOMESA.
Ebintu ebiweereddwa ku mukutu guno bigendereddwamu kunoonyereza mu kisenge (in vitro research) byokka. Okunoonyereza mu vitro (Olulattini: *mu ndabirwamu*, ekitegeeza mu bikozesebwa mu ndabirwamu) kukolebwa ebweru w’omubiri gw’omuntu. Ebintu bino si bya ddagala, tebikkiriziddwa kitongole kya Amerika ekivunaanyizibwa ku by’emmere n’eddagala (FDA), era tebirina kukozesebwa kuziyiza, kujjanjaba oba kuwonya mbeera yonna ya bujjanjabi, bulwadde oba bulwadde. Kikugirwa nnyo mu mateeka okuyingiza ebintu bino mu mubiri gw’omuntu oba ebisolo mu ngeri yonna.
1. Okukubaganya ebirowoozo
Tadalafil, nga eddagala eriziyiza phosphodiesterase-5 (PDE-5) ekola ebbanga eddene, liwa emikutu emipya egy’okujjanjaba embeera ez’enjawulo n’okulongoosa omutindo gw’omubiri.
Ekifaananyi 1 Enkyukakyuka eza wakati okuva ku ntandikwa, nga zirina 95% confidence intervals (CIs), mu ddakiika 6 ez’okutambula mu wiiki 16 mu bibinja bya tadalafil ne placebo.
2. Ebikosa Entambula y’Omusaayi
Enkola y’okugaziya emisuwa: Mu mubiri gw’omuntu, ekkubo ly’obubonero erya nitric oxide (NO) - cyclic guanosine monophosphate (cGMP) - PDE5 likola kinene mu kulungamya ebinywa ebiseeneekerevu eby’emisuwa. Obutoffaali bw’omubiri bwe bufulumya NO nga busikirizibwa, NO ekola guanylate cyclase, okutumbula okukyusa guanosine triphosphate (GTP) okufuuka cGMP. Nga omubaka owookubiri mu butoffaali, cGMP ekola protein kinase G (PKG), ekivaako okugaziwa kw’emisuwa gy’ebinywa ebiseeneekerevu eby’emisuwa, okweyongera mu buwanvu bw’emisuwa, n’okutumbula okutambula kw’omusaayi. Enkola y’okukola kwa Tadalafil kwe kuziyiza emirimu gya PDE5, okukendeeza ku kuvunda kwa cGMP, bwe kityo ne kikuuma emiwendo gya cGMP egy’oku ntikko mu butoffaali n’okuyimirizaawo ebikolwa byayo eby’okugaziya emisuwa okulongoosa entambula y’omusaayi.
Ebikosa Ebitanda by’Emisuwa eby’enjawulo
Entambula y’omusaayi mu mawuggwe: Mu ntambula y’omusaayi mu mawuggwe, Tadalafil ekozesebwa nnyo okujjanjaba puleesa y’emisuwa gy’amawuggwe (PAH). Mu balwadde ba PAH, okweyongera kw’obuziyiza bw’emisuwa gy’amawuggwe kivaako okweyongera kw’omulimu gw’omusuwa ogwa ddyo, nga kino nakyo kikosa enkola y’omutima n’entambula y’omusaayi mu nkola. Tadalafil egaziya emisuwa gy’amawuggwe, ekendeeza ku buziyiza bw’emisuwa gy’amawuggwe, ekendeeza ku right ventricular afterload, erongoosa hemodynamics y’okutambula kw’amawuggwe, eyongera ku cardiac output, bwe kityo n’eyongera ku balwadde okugumiikiriza dduyiro n’omutindo gw’obulamu. Abalwadde ba PAH abafuna 40 mg za Tadalafil omulundi gumu buli lunaku baafuna enkulaakulana ey’amaanyi mu busobozi bw’okukola dduyiro era ne balwawo okusajjuka mu bujjanjabi.
Entambula y’omusaayi mu nkola: Mu ntambula y’omusaayi mu nkola, Tadalafil era ekola ebirungi ku misuwa. Kigaziya emisuwa egy’okumpi, kikendeeza ku buziyiza bw’emisuwa egy’okumpi, n’okulongoosa omusaayi gw’ebitundu by’omubiri. Ku balwadde abalina endwadde z’emisuwa egy’okumpi, gamba ng’okuzimba emisuwa egy’ekiseera ekigere, Tadalafil esobola okwongera omusaayi mu binywa by’ebitundu ebya wansi, okukendeeza ku bubonero bwa ischemia nga bakola dduyiro, n’okulongoosa ebanga ly’okutambula n’obusobozi bw’okukola dduyiro. Tadalafil era eyinza okulongoosa ekifo ekitereka omusaayi mu misuwa gy’omutima era ayinza okutumbula okufuyira kw’omusaayi mu misuwa gy’omutima mu balwadde abalina obulwadde bw’emisuwa gy’omutima, wadde ng’okunoonyereza okulala kwetaagibwa okukakasa ebikolwa bino.
Microcirculation: Microcirculation kifo kikulu nnyo mu kuwanyisiganya ebintu wakati w’ebitundu by’omubiri by’omuntu n’omusaayi. Tadalafil alongoosa okugaziwa kw’emisuwa emitonotono, ayongera ku muwendo gw’emisuwa emiggule, n’okutumbula okufulumira kw’omusaayi mu bitundu by’omubiri n’okuweebwa omukka gwa oxygen. Mu kunoonyereza okumu, kyazuulibwa nti oluvannyuma lw’okujjanjabwa Tadalafil, sipiidi y’okutambula kw’omusaayi mu bitundu by’olususu n’ebinywa mu microcirculatory yayanguwa, ne kyanguyiza okutuusa ebiriisa mu ngeri ennyangu n’okuggya kasasiro mu metabolic, bwe kityo ne kiyamba okukuuma emirimu gya bulijjo egy’omubiri egy’ebitundu.
3. Enkozesa mu kulongoosa omulimu gw’omubiri
Okwongera okugumiikiriza dduyiro
Abalwadde abalina obulwadde bw’omutima obuzaalibwa: Ku balwadde abalina obulwadde bw’omutima obuzaalibwa naddala abo abalina enkola y’omusuwa gumu abalongooseddwa Fontan, okugumiikiriza dduyiro oluvannyuma lw’okulongoosebwa kutera okukendeera. Tadalafil, okuyita mu bikolwa byayo eby’okugaziya emisuwa, ekendeeza ku buziyiza bw’emisuwa gy’amawuggwe n’obuziyiza bw’emisuwa egy’enkola, erongoosa enkola y’omusaayi mu mutima, n’okwongera ku bungi bw’omutima, bwe kityo n’ewa ebinywa omukka omungi n’ebiriisa mu kiseera ky’okukola dduyiro. Mu balwadde 16 abalongoosebwa Fontan, oluvannyuma lw’okufuna obujjanjabi bwa Tadalafil (mu kusooka 10mg omulundi gumu buli lunaku, oluvannyuma 10mg buli ssaawa 12 oluvannyuma lwa wiiki 2, okumala omugatte gw’emyezi 6), ebanga ly’okutambula ery’eddakiika 6 erya wakati lyalinnya okuva ku mmita 418.75 okutuuka ku mmita 439.06, ate omukka ogusinga obunene (VO2 max) gweyongera okuva ku 0.84 L/min okutuuka ku 1.07 L/min, ekiraga okulongoosa okw’amaanyi mu kugumiikiriza dduyiro.
Abantu abalamu: Tadalafil era eyinza okuba n’akakwate akalungi ku kugumiikiriza dduyiro mu bantu abalamu. Wadde ng’okunoonyereza okunene mu bantu abalamu mu kiseera kino kutono, okunoonyereza okumu okutonotono kulaga nti Tadalafil esobola okulongoosa entambula y’omusaayi mu kiseera ky’okukola dduyiro, okusobozesa ebinywa okufuna omukka gwa oxygen ogumala nga bikola dduyiro, okulwawo okutandika kw’obukoowu, n’okusobola okutumbula omutindo gw’emizannyo. Mu mizannyo egimu egy’okugumiikiriza, bannabyamizannyo baategeeza nti okussa kwalongooka n’okugumira dduyiro okunywezebwa oluvannyuma lw’okukozesa Tadalafil; wabula, okunoonyereza okulala okw’amaanyi okwa ssaayansi kwetaagibwa okukakasa ebizuuliddwa bino.
Okulongoosa mu nkola y’ebinywa: Enkola y’ebinywa eya bulijjo esinziira ku musaayi ogumala n’okuweebwa omukka gwa oxygen. Nga alongoosa entambula y’omusaayi, Tadalafil esobola okuwa ebinywa omukka omungi n’ebiriisa, okutumbula okukyusakyusa amaanyi. Era kiyinza okukwata obulungi emirimu gy’okukonziba n’okuwummulamu kw’ebinywa nga kitereeza amakubo g’obubonero mu butoffaali. Mu kugezesa ebisolo, ebisolo ebyajjanjabwa ne Tadalafil byalaga amaanyi g’ebinywa n’okugumiikiriza okweyongera. Ku balwadde abalina endwadde z’ebinywa oba okukendeera kw’ebinywa okuva ku kuwummula ku kitanda okumala ebbanga, Tadalafil eyinza okulongoosa entambula y’omusaayi mu kitundu, okutumbula okuddaabiriza n’okuddamu okukola ebinywa, n’okutumbula enkola y’ebinywa.
Okulongoosa mu nkola y’omubiri buli lunaku: Ku balwadde abalina obuzibu bw’okusituka (ED), Tadalafil tekoma ku kulongoosa nkola ya kusituka wabula era alina akakwate akalungi ku nkola y’omubiri okutwalira awamu n’omutindo gw’obulamu. Abalwadde ba ED batera okufuna situleesi mu birowoozo olw’embeera yaabwe, ekikosa okwagala kwabwe okukola emirimu gya buli lunaku n’okukola emirimu gy’omubiri. Tadalafil alongoosa entambula y’omusaayi mu kitundu ky’obusajja ekiyitibwa penile corpus cavernosum, n’azzaawo enkola y’okusituka, ate n’ayongera okwekkiririzaamu kw’abalwadde, n’ebasobozesa okubeera abayiiya mu bulamu obwa bulijjo. Okugatta ku ekyo, eri abalwadde abalina obulwadde bwa benign prostatic hyperplasia (BPH) n’obubonero bw’omusulo ogwa wansi (LUTS), Tadalafil esobola okulongoosa enkola y’omusulo ng’ewummuza ebinywa ebiseeneekerevu eby’ensingo y’enseke n’ekibumba, okukendeeza ku buzibu mu mubiri obuva ku buzibu bw’omusulo, era bwe kityo n’ayongera ku mutindo gw’omubiri gw’abalwadde ogwa buli lunaku n’omutindo gw’obulamu.
4. Mu bufunze
Tadalafil eraga ebikolwa ebinene mu kulongoosa entambula y’omusaayi n’okukola emirimu gy’omubiri. Ka kibeere mu kujjanjaba endwadde z’emisuwa nga puleesa y’emisuwa gy’amawuggwe n’obulwadde bw’emisuwa egy’okumpi, oba mu kwongera okugumiikiriza dduyiro, okulongoosa enkola y’ebinywa, n’okwongera ku mutindo gw’omubiri ogwa buli lunaku mu balwadde abalina obulwadde bw’omutima obuzaalibwa, kikola kinene.
Ensonda
[1] Kaku Y, Chiba K, Sato K, n’abalala. Ebikolwa by’obukuumi ebya tadalafil ku buzibu bw’ensigo obuleetebwa cisplatin[J]. Empuliziganya y’okunoonyereza ku biramu n’ebiramu, 2022,603:123-129.DOI:10.1016/j.bbrc.2022.02.113.
[2] Kwak D, Yoo B. Dozi ya buli lunaku eya 5 mg Tadalafil Etereeza Enziyiza Enzirukanya y’Emirimu gy’Okusituka n’Emirimu gy’Ekibumba mu Banywa sigala[J]. Ekitabo ky’ebyobulamu by’abasajja, 2022,18:150.DOI:10.31083/j.jomh1807150.
[3] Yang Z, Wang L, Tian L, n’abalala. Tadalafil-loaded PLGA microspheres okuweebwa mu mawuggwe: okuteekateeka n’okwekenneenya[J]. Brazilian Journal of Sayansi w’Eddagala, 2019. https://api.semanticscholar.org/CorpusID:214115397. Enkola y’okukuuma obutonde bw’ensi.
[4] Mónica FZ, De Nucci G. Tadalafil okujjanjaba obulwadde bw’okuzimba enseke ezitali za bulabe[J]. Endowooza y'abakugu ku ddagala, 2019,20 (8): 929-937.DOI: 10.1080 / 14656566.2019.1589452.
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[6] ENG, Brundage BH, Ghofrani H. A., n’abalala. Obujjanjabi bwa Tadalafil ku puleesa y’emisuwa gy’amawuggwe[J]. Okusaasaanya, 2009,119:2894-2903. https://api.semanticscholar.org/CorpusID:9916876. Enkola y’okukuuma obutonde bw’ensi.
[7] Coward RM, Carson C. Tadalafil mu kujjanjaba obuzibu bw’okusituka[J]. Obujjanjabi n'okuddukanya akabi mu bujjanjabi, 2008,4:1315-1330. https://api.semanticscholar.org/CorpusID:7054657. Enkola y’okukuuma obutonde bw’ensi.
Ekintu ekiriwo okukozesebwa mu kunoonyereza kwokka:
