Na Cocer Peptides 
hashize iminsi 27
INGINGO ZOSE N'AMAKURU Y’IBICURUZWA BITANZWE KURI URU RUBUGA BISANZWE KUBONA AMAKURU N'INTEGO Z'UBUREZI.
Ibicuruzwa byatanzwe kururu rubuga bigenewe gusa mubushakashatsi bwa vitro. Mu bushakashatsi bwa vitro (Ikilatini: * mu kirahure *, bisobanura mu bikoresho by'ibirahure) bikorwa hanze y'umubiri w'umuntu. Ibicuruzwa ntabwo ari imiti, ntabwo byemejwe n’ikigo cy’Amerika gishinzwe ibiryo n’ibiyobyabwenge (FDA), kandi ntigomba gukoreshwa mu gukumira, kuvura, cyangwa gukiza indwara iyo ari yo yose y’ubuvuzi, indwara, cyangwa indwara. Birabujijwe rwose n'amategeko kwinjiza ibyo bicuruzwa mumubiri wabantu cyangwa inyamaswa muburyo ubwo aribwo bwose.
Incamake
Gukura kwa Hormone Kubura (GHD) niterambere no gukura biterwa no gusohora bidahagije cyangwa imikorere mibi ya Growth Hormone (GH). GH, imisemburo ya peptide isohoka na glande y'imbere ya pitoito, igira uruhare runini mu mikurire y'abana no gukura. Ubuvuzi bwa peptide, nkubuvuzi bwibanze bwa GHD, bwakoreshejwe cyane mubikorwa byubuvuzi.
Igicapo 1 Ingaruka za hormone zo gukura nizindi misemburo kumagufwa.
Imikorere ya Physiologique yo Gukura Hormone
(1) Guteza imbere Gukura no Gutezimbere
Gukura kw'amagufa: GH ikora mu buryo butaziguye ku isahani yo gukura kw'amagufwa, itera ikwirakwizwa no gutandukanya ingirabuzimafatizo, guteza imbere guhuza no kubara matrise ya karitsiye, bityo bikorohereza gukura kw'amagufwa maremare. Kurugero, mugihe cyo gukura kwamagufwa maremare, GH iteza imbere igabana ryama selile ya epiphyseal karitsiye, ikongera umubare wingirabuzimafatizo, bityo bigatuma amagufwa arambura.
Gukura kw'ingingo: GH itera kandi gukura kw'ingirangingo n'ingingo zitandukanye mu mubiri. Itera ikwirakwira ry'ingirangingo z'imitsi hamwe na sintezamubiri ya poroteyine, byongera imitsi; iteza imbere no gukura kwingingo zimbere nkumwijima nimpyiko, ikomeza imirimo isanzwe. Kurugero, mubice byimitsi, GH igenga imvugo ya genes zifitanye isano, igatera imbere gukura na hypertrophyie yimitsi.
(2) Amabwiriza yuburyo bukoreshwa
Glucose metabolism: GH igenga glucose metabolism iragoye. Irashobora kubuza gufata ingirabuzimafatizo no gukoresha glucose, bigatuma glucose yiyongera; irashobora kandi guteza umwijima glycogene kumeneka, bikongera umuvuduko wamaraso glucose. Ibikorwa birebire bya GH birashobora kongera mu buryo butaziguye sensulitifike iteza imbere gusohora kwa insuline imeze nkikura-1 (IGF-1), bityo bikagabanya urugero rwa glucose yamaraso.
Metabolisme yibinure: GH itera kugabanuka kwamavuta, byongera irekurwa rya acide yubusa kugirango itange imbaraga kumubiri. Igabanya kandi ibinure byamavuta, bifasha kugumana ibinure bisanzwe mumubiri. Mu bushakashatsi bumwe na bumwe, abana bafite imisemburo ikura (GHD) bagize igabanuka rikabije ry’ibinure mu mubiri nyuma yo guhabwa imiti yo gusimbuza GH, ibyo bikaba bifitanye isano rya hafi n’uruhare rwa GH mu guteza imbere metabolism.
Intungamubiri za poroteyine: GH ni ingirakamaro mu kugenzura poroteyine. Itera kwinjiza aside aside amine mu ngirabuzimafatizo, yihutisha intungamubiri za poroteyine, kandi ikabuza poroteyine gusenyuka, bityo bikongera intungamubiri za poroteyine z'umubiri. Mugihe cyo gukura no gukura mubana, iyi ngaruka ifasha kugumana imikurire isanzwe no gusana ingirangingo nkimitsi namagufwa.
Gukura kwa Hormone Kubura
(1) Indwara
Impamvu zavutse: Bamwe mu barwayi ba GHD biterwa nimpamvu zishingiye ku ngirabuzima fatizo. Imiterere ihindagurika ya gene irashobora kugira ingaruka kuri synthesis ya GH, gusohora, cyangwa ibikorwa. Inenge zikomoka ku ngirabuzima fatizo zirimo ihinduka ry’imisemburo ikura ya gene (GH1), ishobora gutera intungamubiri za GH; ihinduka ryimiterere ya genes zijyanye niterambere rya pituito, nka PROP1 na POU1F1, birashobora kugira ingaruka kumikurire isanzwe ya glande yimbere, bikavamo gusohora kwa GH bidahagije.
Ibintu byabonetse: Ibintu byabonetse nkibibyimba byubwonko, kwandura, nihungabana nabyo bishobora gutera GHD. Ibibyimba byo mu bwonko, nka craniopharyngioma, birashobora guhagarika glande ya pitoito cyangwa hypothalamus, bikagira ingaruka ku myanya ndangagitsina ya GH; Indwara zandurira mu nda nka encephalite cyangwa meningite zirashobora kwangiza selile ya neuroendocrine ya pitoito gland cyangwa hypothalamus, biganisha ku gusohora kwa GH bidasanzwe; ihahamuka ry'umutwe, cyane cyane ririmo kwangirika kwa pitoito cyangwa hypothalamus, birashobora kandi guhungabanya inzira zigenga amabanga ya GH, biganisha kuri GHD.
Ibintu bya Idiopathique: Igice cyabarwayi ba GHD ntampamvu igaragara kandi bashyizwe mubikorwa byo kugira GHD idasanzwe. Aba barwayi barashobora kugira ibintu bidasanzwe byoroheje mumikorere ya hypothalamic-pituito, ariko ibyo bidasanzwe ntabwo bikomeye kuburyo byemeza ko hasuzumwa neza. Kugeza ubu abantu bemeza ko GHD idasanzwe ishobora kuba ifitanye isano no guhungabana muri hypothalamic neurotransmitter cyangwa imikorere ya neuro.
(2) Kugaragara kwa Clinical
Gukura kudindira: Ubu ni bwo buryo bugaragara bwo kuvura kwa GHD. Iterambere ry'uburebure bw'umwana riratinda cyane ugereranije n'urungano, hamwe n'ubwiyongere bw'umwaka buri munsi ya cm 5. Uko umwana asaza, itandukaniro ry'uburebure na bagenzi be rigenda ryiyongera buhoro buhoro, kandi uburebure buke bugenda bugaragara. Kurugero, mugihe abana basanzwe bakura hafi cm 5-7 kumwaka mbere yubugimbi, abarwayi ba GHD barashobora gukura cm 2-33.
P roportional umubiri wubaka: Nubwo abana bafite GHD ari mugufi, uburebure bwumubiri bwabo buragereranijwe. Ibi bitandukanye nuburebure bwumuryango, aho abana bashobora kwerekana uburebure bwingingo zingana. Abana bafite GHD bakunze kugira isura isa nabana, bafite umutwe munini ugereranije utagereranije nubunini bwumubiri wabo. Bamwe mu bana barwaye GHD bashobora kandi kugira metabolike idasanzwe, nko kongera ibinure byumubiri no kugabanya imitsi; bamwe bashobora gutinda gukura kwimibonano mpuzabitsina, kurangwa no gutinda gutangira ubwangavu no gutinda gukura kwimiterere yimibonano mpuzabitsina ya kabiri; byongeye kandi, abana barwaye GHD barashobora kugira ibibazo byubwonko nkikibazo cyo kwiga hamwe no kubura ibitekerezo, bifitanye isano ningaruka za hormone zo gukura kumikurire yimitsi.
(3) Uburyo
Ibizamini bya laboratoire
Ikizamini cyo gukura imisemburo ya hormone: Kubera ko GH isohoka mumisemburo, gutoranya amaraso kugirango bipime urugero rwa GH ntibishobora kwerekana neza uko isohoka. Kubwibyo, hakenewe ikizamini cyo gukangura imisemburo ya hormone. Imiti ikunze gukoreshwa harimo insuline, arginine, na clonidine. Mugutanga imiti ikangura, igisubizo cya GH kiragaragara. Muri rusange, impinga ya GH iri munsi ya 10 μg / L yerekana kubura igice cya GH, naho impinga ya GH iri munsi ya 5 μg / L yerekana ibura rya GH ryuzuye.
Gukura kwa Insuline-Gukura-1 (IGF-1) hamwe na Insuline imeze nkikura rya Protein-3 (IGFBP-3) Igipimo: Urwego rwa IGF-1 na IGFBP-3 bifitanye isano rya bugufi n’isohoka rya GH kandi birasa neza, bitatewe no gusohora kwa pulsatile. Ku bana bafite GHD, IGF-1 na IGFBP-3 mubisanzwe bari munsi yurwego rusanzwe kumyaka yabo. Urwego rwa IGF-1 narwo ruterwa nimpamvu nkimyaka n'imirire, bityo rero bigomba gusuzumwa neza mugihe cyo gusuzuma.
Ubuvuzi bwa Peptide
Guhitamo imiti yo gukura imisemburo ya hormone
Imisemburo ikura ya recombinant (rhGH): rhGH kuri ubu niwo muti wa peptide ukoreshwa cyane mu kuvura GHD mu buvuzi. Yakozwe hifashishijwe tekinoroji yubuhanga, hamwe na aside amine ikurikirana ihwanye na GH karemano. rhGH iraboneka muburyo butandukanye, harimo inshinge zumye zumye hamwe ninshinge zishingiye kumazi. Mu bushakashatsi bumwe na bumwe, gukoresha imisemburo ikura y’imisemburo y’amazi yo kuvura abana barwaye GHD byatanze umusaruro mwiza wo kuvura, hamwe n’ubwiyongere bukabije bw’umuvuduko ukabije w’abarwayi.
Imisemburo ikura igihe kirekire: Kugira ngo abarwayi bubahirize, imisemburo yo gukura ikora igihe kirekire. Imisemburo ikura igihe kirekire ikorwa no guhindura imiti ya rhGH kugirango yongere ubuzima bwayo igice cyumubiri, bityo bigabanye inshuro inshinge. Polyethylene glycol-yahinduwe na recombinant imisemburo ikura yumuntu (PEG-rhGH) isaba inshinge imwe gusa mucyumweru, bikagabanya cyane umutwaro wo gutera abarwayi. PEG-rhGH yerekana imbaraga n'umutekano bisa inshinge za buri munsi za rhGH mukuvura abana barwaye GHD.
Iterambere ryubushakashatsi ku bindi biyobyabwenge bya peptide: Usibye rhGH nuburyo bukora, imiti myinshi ya peptide yubu irimo gukorwa. Kurugero, ibintu bimwe na bimwe bya peptide biteza imbere GH cyangwa byongera ibikorwa bya GH bishobora kuvuka nkuburyo bushya bwo kuvura GHD.
(2) Ibisubizo byo Kuvura
Kwiyongera k'uburebure: Kwiyongera k'uburebure nicyo kimenyetso cyerekana neza uburyo bwo gusuzuma imikorere yo kuvura imisemburo ikura. Mugupima buri gihe uburebure bwumwana, kubara umuvuduko wo gukura, no kubigereranya ninzego zabanje kuvurwa. Mubisanzwe, mumezi 6-12 yambere yo kuvurwa, umuvuduko wubwiyongere bwihuta cyane, ugakurikirwa buhoro buhoro. Mu bushakashatsi, abarwayi ba GHD bavuwe na hormone yo gukura mumezi 6 babonye umuvuduko wo gukura kwabo kuva kuri cm 3 kumwaka mbere yo kuvurwa kugera kuri cm 8 kumwaka.
Imyaka yamagufa ihinduka: Imyaka yamagufa nikimenyetso cyingenzi cyo gukura kwa skeletale. Gukura imisemburo ya hormone irashobora kugira ingaruka runaka kumyaka yamagufwa. Mugihe cyo kuvura, imyaka yamagufa igomba gupimwa buri gihe kugirango harebwe igipimo cyikura ryamagufwa. Gukura kw'amagufwa kugomba guhuza no gukura kugirango wirinde gukura kw'amagufwa imburagihe biganisha ku gufunga hakiri kare amasahani yo gukura, bishobora kugira ingaruka ku burebure bwa nyuma.
Urwego rwa IGF-1: Urwego rwa IGF-1 ni ikimenyetso cyingenzi cya biohimiki yo gusuzuma akamaro ko kuvura imisemburo ikura. Nyuma yo kuvura imisemburo ikura, urwego rwa IGF-1 rusanzwe rwiyongera kandi bifitanye isano rya bugufi nubuvuzi bwiza. Mubisanzwe, gukomeza urwego rwa IGF-1 kurwego rwo hejuru rwurwego rusanzwe cyangwa hejuru gato yurwego rusanzwe byerekana uburyo bwiza bwo kuvura.
Usibye gukurikirana impinduka zerekana ibipimo bifatika, hagomba no gusuzumwa ingaruka zo kuvura imisemburo ikura ku mibereho y’umwana. Ibi birimo imitekerereze yumwana, ubumenyi bwimibereho, hamwe namasomo. Nyuma yo kuvura neza imisemburo ya hormone ikura, kwigirira icyizere k'umwana biratera imbere, ibikorwa byimibereho byiyongera, imikorere yamasomo iratera imbere, kandi ubuzima bwarazamutse cyane.
Umwanzuro
Gukura imisemburo ya hormone kubana ni ibintu bikomeye bigira ingaruka zikomeye kumikurire no gukura, hamwe nuburyo bukomeye bwibanze hamwe nubuvuzi butandukanye. Ubuvuzi bwo gusimbuza peptide, cyane cyane imiti yo gusimbuza imisemburo ikura, yabaye ubuvuzi bwibanze kuri GHD.
Inkomoko
[1] Verrico A, Crocco M, Casalini E, n'abandi. LGG-40. Gukura imisemburo ya hormone mubana bavura hamwe na Vemurafenib kuri Glioma yo hasi [J]. Neuro-Oncology, 2022,24 (Umugereka_1): i97.DOI: 10.1093 / neuonc / noac079.352.
[2] Sävendahl L, Battelino T, Højby RM, n'abandi. Gusimbuza GH neza hamwe na rimwe mucyumweru Somapacitan vs Daily GH mubana bafite GHD: Ibisubizo byimyaka 3 Kuva KOKO 3 [J]. Ikinyamakuru cya Clinical Endocrinology & Metabolism, 2022,107 (5): 1357-1367.DOI: 10.1210 / ivuriro / dgab928.
[3] Caballero-Villarraso J, Aguado R, Cañete MD, n'abandi. Ubuvuzi bwo gusimbuza imisemburo kubana bafite imisemburo ikura: ingaruka kumwirondoro [J]. Ububiko bwa Physiology na Biochemie, 2021,127 (3): 245-249.DOI: 10.1080 / 13813455.2019.1628070.
[4] Wang C, Huang H, Zhao C, n'abandi. Ingaruka zo kuvura imisemburo ya pegylated recombinant ikura ya hormone yo gusimbuza glucose na metabolisme ya lipide kubana bafite imisemburo ikura [J]. Umwaka w'ubuvuzi bwa Palliative, 2021,10 (2): 1809-1814.DOI: 10.21037 / apm-20-871.
[5] Witkowska-Sędek E, Stelmaszczyk-Emmel A, Kucharska AM, n'abandi. Ihuriro Hagati ya Vitamine D na Carboxy-Terminal Yambukiranya Telopeptide yo mu bwoko bwa I Collagen mu bana mugihe cyo gukura kwa Hormone yo kuvura. [J]. Iterambere mubuvuzi bw'igeragezwa na Biologiya, 2018,1047: 53-60. https://api.semanticscholar.org/CorpusID:27770255.
