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Research Ubushakashatsi bwa HCG
Ni ubuhe bushakashatsi bwakozwe na HCG?
Chorionic Gonadotropin yumuntu (HCG) ni molekile ifite imirimo myinshi yingenzi, igira uruhare runini mubice nko gutwita na kanseri yabantu. Ubwa mbere, HCG ni molekile ikabije. Ni glycoproteine ya acide cyane kandi irimo isukari nyinshi. Icya kabiri, HCG ibaho muburyo butandukanye, harimo HCG isanzwe, sulfate HCG, hyperglycosylated HCG, ubuntu β-HCG, na hyperglycosylated free β-HCG, nibindi [1].
Kubijyanye no gutwita, HCG ningirakamaro mugihe cyimihango yumuntu no gutwita kwabantu. HCG isanzwe igira uruhare mukuzamura umusaruro wa corpus luteum progesterone kandi ikagira kandi ibikorwa byingenzi mugutandukanya selile trophoblast no kugaburira inda. Kurugero, ituma imirire yimirire itanga binyuze muri angiogenezi yimitsi ya spiral muri myometrium (Cole LA, 2012). Hyperglycosylated HCG nayo igira uruhare runini mugihe cyambere cyo gutwita. Niyo isoform nyamukuru ya HCG mugihe cyambere cyo gutwita, ishobora kubuza apoptose, gutera kwibasira ingirabuzimafatizo, gukura, no guhinduka nabi, no kugenzura iyatewe no gukura kw'ibibyimba [1].
Ku bijyanye na kanseri, ibibyimba bitari trophoblastique bibyara hyperglycosylated free β subunit ya HCG. Nka autocrine, itera kandi gukura no guhindura nabi ingirabuzimafatizo za kanseri mu kurwanya apoptose [1].
Byongeye kandi, gutahura HCG bikoreshwa cyane mu bikorwa by’amavuriro, harimo gupima inda, gukurikirana ingaruka z’inda zitwite, kumenya ibyago by’inda zanduye syndrome de Down, guhanura preeclampsia, gutahura indwara ya pitoito HCG, gutahura no gucunga indwara ziterwa na trophoblastique, gusuzuma indwara zifata imyanya ndangagitsina ya trophoblastique, kugenzura ibibyimba bya mikorobe ya selile na virusi ,.
Ni ubuhe buryo bwo gukora bwa HCG?
1. Ingaruka ku Kwakira Endometrale
Ubushakashatsi bumwe bwerekanye ko HCG ishobora kugira ingaruka ku iyakirwa rya endometrale binyuze muri miR-126-3p / PIK3R2 / PI3K / Akt / eNOS kandi ikagira uruhare runini mugikorwa cyo gutera urusoro [2] . Kugaragara byihariye ni ibi bikurikira:
Kunoza imikorere ya reseptor ya Endometrale: Mugushiraho imbeba yimbeba yo kudakora neza (EID) no kuyivura hamwe na mifepristone, no gukora ubushakashatsi kuri selile epithelale yumuntu (EECs), byagaragaye ko nyuma yo kuvura HCG, imitekerereze ya endometrale yimbeba ya EID yatejwe imbere. Kurugero, urwego rwo kwerekana CD105 mu mbeba hamwe na poroteyine ya cadherine CD144 na CD146 byariyongereye nkuko byagenwe na immunohistochemie na Western blotting.
Kugena imiterere ya Gene: HCG irashobora guteza imbere imvugo ya miR-126-3p kandi ikabuza imvugo ya PIK3R2, na miR-126-3p intego za PIK3R2. Haba muri vivo no mubushakashatsi bwa vitro byagenzuye ko HCG ikora inzira ya PI3K / Akt / eNOS inyuze muri miR-126-3p / PIK3R2, bityo bigatuma imitekerereze ya endometrale yakira.
2. Uruhare rwo gukomeza gutwita
HCG ikorwa ahanini ningirabuzimafatizo zitandukanye za syncytiotrophoblast kandi ni ikimenyetso cyingenzi cyo gusama gikenewe kugirango ukomeze gutwita [3].
Gukora ibintu byinshi byerekana ibimenyetso bya Cascade: HCG irashobora guhuza imisemburo ya luteinizing / reseptor ya chorionic gonadotropin (LHCGR), ishobora gukora ibimenyetso byinshi byerekana ibimenyetso, harimo na decapentaplegic homologique 2 (Smad2), protein kinase C (PKC), hamwe na / cyangwa protein kinase A (PKA) kubabyeyi bafite ubushobozi butaziguye / β (TGFβR).
Guteza imbere Uterine Endothelial Angiogenezi: HCG igira uruhare runini mugutezimbere nyababyeyi endoteliyale angiogenez, itanga ibidukikije byiza byo gukura kwa urusoro.
Kubungabunga Myometrial Quiescence: Ifasha kugumana imiterere ihamye ya nyababyeyi kandi itanga ibidukikije bikwiye kugirango iterambere rya urusoro.
Guteza imbere ubudahangarwa ku mubiri wa nyababyeyi-Uruhinja: Ifite uruhare runini mu gukingira indwara ku nda ya nyababyeyi, ikomatanya uburyo umubiri w’ubudahangarwa bw'umubiri wakira urusoro.
3. Uruhare rwo kwimura Embryo Yimuwe
Ubushakashatsi bwerekanye ko amashanyarazi akoreshwa mu gukwirakwiza amashanyarazi (TEAS) hamwe no kuvura HCG bishobora guteza imbere inda z’abarwayi batewe no kwimura urusoro [4].
Kongera umubyimba wa Endometrale: Kuvura TEAS bifasha cyane cyane kongera umubyimba wa endometrale w'abarwayi barimo kwimura urusoro rwahagaritswe. Kuvura hamwe hamwe na HCG na TEAS bifasha kandi kongera umubyimba wa endometrale w'aba barwayi.
Kugabanya Urutonde rwamaraso ya Uterine: Indangagaciro zamaraso ya endometrale yamaraso PI na RI muri TEAS ifatanije nitsinda rya HCG hamwe nitsinda rya TEAS ryaragabanutse cyane ugereranije nabari mumatsinda agenzura, byerekana ko kuvura hamwe HCG na TEAS bishobora kugabanya umuvuduko wamaraso wa nyababyeyi PI na RI yabarwayi.
Kongera urwego rwibintu bifitanye isano no gufata neza inda muri Serumu: Ubuvuzi bwa HCG bufasha cyane cyane kongera serumu ya P na LIF ku barwayi barimo kwimura urusoro rwakonje. Urwego rwa serumu LIF mu itsinda rya TEAS, itsinda rya HCG, hamwe na TEAS ihujwe nitsinda rya HCG byose byari hejuru cyane ugereranije nabari mumatsinda yo kugenzura. Igipimo cyo gutera urusoro mu itsinda ryahujwe cyari hejuru cyane ugereranije n’itsinda rishinzwe kugenzura, byerekana ko kuvura hamwe TEAS na HCG bishobora kuzamura ingaruka z’inda z’abarwayi batewe no kwimura urusoro.
4. Kuvura Hypogonadism Yumugabo
Hypogonadism iterwa no gusohora kwa gonadotropine idahagije kubagabo igira ingaruka zikomeye kubuzima bwimyororokere yumurwayi ndetse nubuzima bwiza. Chorionic Gonadotropin yumuntu (HCG) igira uruhare runini mukuvura izo ndwara. HCG ihuza reseptors hejuru yutugingo ngengabuzima twa Leydig muri testis, igakora inzira yerekana ibimenyetso byerekana inzira no guteza imbere ihinduka rya cholesterol muri testosterone. Ubwiyongere bwa testosterone burashobora guteza imbere imikurire niterambere rya testis no kongera ubwinshi bwa testis. Muri icyo gihe, testosterone irashobora kandi gutera imbaraga mu mikurire yimyororokere nka epididymis na vas deferens. Testosterone igira uruhare runini mugutezimbere igitsina gabo cya kabiri. Mu kongera urwego rwa testosterone, kuvura HCG birashobora guteza imbere ubwanwa na pome ya Adamu, kongera imbaraga imitsi, no kongera irari ry'ibitsina, nibindi.
Inkomoko ya selile, intego, bifitanye isano na kasade yerekana ibimenyetso, n'imikorere ya isoforms zitandukanye za HCG kubagore badatwite kandi batwite.
Inkomoko: Byatangajwe [3]
Ni ubuhe buryo bukenewe bwa HCG?
1. Yakoreshejwe mugusuzuma hakiri kare
Agaciro ko gupima Serumu T-HCG na β-HCG Urwego rwo Gutwita hakiri kare: Mugukusanya ibibazo byo gutwita bidasanzwe, gupima serumu T-HCG ukoresheje chemiluminescence no gupima serumu β-HCG ukoresheje radioimmunoassay no gukora ubushakashatsi bugaragara, ibisubizo byerekanaga ko serumu T-HCG na β-HCG murwego rwo gutwita kwa ectopique. Ibi byerekana ko gupima urugero rwa serumu T-HCG na β-HCG bifite umwihariko kandi wo gusuzuma neza gutandukanya inda ya ectopique no gutwita imbere, kandi T-HCG ifite sensibilité kandi yizewe [5].
Kumenyekanisha hamwe na Serumu HCG, β-HCG, na Progesterone yo gusuzuma indwara yo gutwita kwa Ectopique: Mu kumenya serumu HCG, β-HCG, na progesterone ku bagore basanzwe batwite ndetse n'abagore batwite batwite ba ectopique, ibisubizo byagaragaje ko urwego rwa serumu HCG, β-HCG, na progesterone ku bagore batwite basanzwe ari beza kurusha abo mu bagore batwite. Iyo bigaragaye byonyine, igipimo cyukuri cya serumu HCG mugupima inda ya ectopique cyari 70.83%; igipimo cyukuri cya β-HCG cyari 66.7%; kandi igipimo cyukuri cya progesterone cyari 54.17%. Nyamara, kumenya hamwe serumu HCG, β-HCG, na progesterone byari bifite igipimo kigera kuri 95.8% mugupima inda ya ectopique [6].
2. Porogaramu muburyo bwa tekinoroji yimyororokere ifashwa
Kunoza imikurire ya Follicular: Mugukangura intanga ngore, menopausal gonadotropin (hMG) irashobora gukura neza mumyanya ndangagitsina nyuma yo guterwa na pituito iterwa na gonadotropine irekura imisemburo ya hormone (Gn-RH-analogue). Ibi biterwa ahanini nuko birinda imisemburo idasanzwe ya endogenous luteinizing hormone (LG) ibaho mugihe cyo kuvura HMG hafi kimwe cya gatatu cyinzira yo kuvura. Mu bushakashatsi bwinshi bwifashishije buserelin cyangwa degarelix nk'ikigereranyo cya Gn-RH, abarwayi 282 bakiriye mu gusama kwa vitro, kwimura gamete intrafallopian, cyangwa mu rwego rwa 'mu kuvura vivo '. Ubuvuzi bwa GnRH analogue / hMG / HCG bwongereye cyane igipimo cyo gutwita mumatsinda yose. Umubare w'inda z'abarwayi bavuwe na HMG / HCG wari 17%, mu gihe ubuvuzi hamwe bwatumye 25% by'abarwayi batwite [7].
Kunoza kwakirwa kwa Endometrale: Chorionic Gonadotropine yumuntu (HCG) nikimwe mubimenyetso byingenzi mbere yo gutera urusoro. Binyuze mu isesengura ryimyanya ndangagitsina mu bushakashatsi, byagaragaye ko nyuma yubuyobozi bwa intrauterine ya HCG, umubare w’utugingo ngengabuzima tugaragaza molekile ya endoteliyale selile molekile VE-cadherin (CD144) na S-Endo-1 (CD146) wiyongereye ku buryo bugaragara. Ibi byerekana ko molekile ya selile ya endothelia ishobora kuba uburyo bushoboka HCG iteza imbere urusoro no gutwita [8].
2. Kuvura Luteal idahagije
Mu myaka mirongo ibiri ishize, ubuyobozi bwa progesterone exogenous bwakoreshejwe nkibikoresho bya luteal phase (LPS), bifatanije no gukoresha chorionic gonadotropine ya muntu (HCG) kugirango bikure bikure byanyuma mumyanya myororokere. Itangizwa rya GnRHa kugirango itere ovulation yerekana ko hatabayeho kongerwaho HCG, ubuyobozi bwa progesterone exogenous budahagije kugirango ugere ku gipimo gishimishije cyo gutwita. Ibi byatumye habaho ingamba zindi zo gushyigikira icyiciro cya luteal. Kongera umusaruro wa progesterone ya endogenous ya corpora lutea nyinshi ningingo yingenzi, kuruhande rumwe, kugirango wirinde iterambere rya syndrome de ovarian hyperstimulation, kurundi ruhande, kugirango itange urugero ruhagije rwa progesterone kugirango ikomeze guterwa.
Ubushakashatsi buriho bwasuzumye uruhare rwa micro-dose HCG yo gushyigikira icyiciro cya luteal kandi yiga ibyiza byayo nibibi. Hashingiwe ku miterere ya farumasi ya HCG, ihujwe nuburyo butandukanye bwo kuyobora HCG nkubufasha bwicyiciro cya luteal, hasuzumwe uburyo bwimibare yo gukwirakwiza HCG mugice cya luteal. Birasabwa ko inkunga yicyiciro cya luteal itangwa hamwe na GnRHa itera (ni ukuvuga 1500IU) irakomeye cyane, kandi ubuyobozi bwa micro-dose ya buri munsi HCG bushobora gutanga ubufasha bwiza bwa luteal kumiti iboneka ubu. Ibisubizo byambere byubuvuzi byuburyo bwa micro-dose ya HCG byatanzwe [9].
3. Kuvura Intangangore Yimbere-Inda Idahumanye
Ubushakashatsi bwakorewe ku barwayi batewe na orchiopexy yo kwisuzumisha mu nda imwe-imwe mu nda itabonetse kuva muri Nzeri 2010 kugeza muri Nzeri 2016. Nyuma y'ibyumweru bibiri nyuma yo kubagwa, ababyeyi b'abarwayi bavuwe na hormone bakeneye gukurikiza protocole y'ibyumweru 6. Buri cyumweru abarwayi bahawe inshinge 500 UI (Gonasi-HP) buri cyumweru. Ibikurikiranwa byakozwe nyuma yubuvuzi nyuma y amezi 6. Ingano ya testis yapimwe na ultrasound na elastografiya buri gihe ugereranije niy'abarwayi batahawe imiti. Ibisubizo byagaragaje ko abarwayi 45 bahawe imiti, impuzandengo y’amezi 18.0 ± 9.7. Abarwayi 32 bahawe imiti ivura imisemburo nyuma yo kubagwa, kandi nta reaction mbi cyangwa abata ishuri. Abarwayi bose barangije gukurikirana. Nta kibazo cya testicular atrophy muri buri tsinda. Mu itsinda ry’ubuvuzi, 81% by’abarwayi bageze ku bunini busanzwe bwa testis mu mezi 6, mu gihe ingano ya testis y’abandi barwayi yari ikiri nto. Mu itsinda ritavuwe, 46% by'abarwayi bageze ku bunini bwa testis. Gukoresha nyuma ya oporisiyo ya chorionic gonadotropine yumuntu (u-HCG) irashobora kongera ubwinshi bwimikorere ya testis hamwe nimikorere itera imikurire niterambere rya testis [10].
. Ibisubizo byerekanye ko mu itsinda rishinzwe kugenzura, abagore benshi bari bafite urwego rwo hejuru rw’imisemburo ya progesterone nyuma yo gukanguka kwa HCG kurenza urwego rw’ibanze, mu gihe urugero rwa progesterone ku bagore bo mu itsinda ryakingiwe rutarenze urwego rw’ibanze nyuma yo gukingirwa, byerekana ko antibodiyite zakozwe nuru rukingo zishobora gukumira ingaruka za HCG zidasanzwe [11].
Mu gusoza, HCG igira uruhare rudasubirwaho mubuvuzi, cyane cyane mubice bijyanye n'imyororokere. Mu kuvura imyororokere, irashobora gutera intanga ngabo, bikazana ibyiringiro kubarwayi bafite ubugumba buterwa n'indwara ya ovulation. Muguhuza reseptor ya LH mumubiri, irashobora kuzuza urwego rwa LH rudahagije muri protocole ya antagonist kandi igafasha gukura neza. Kubura luteal, HCG irashobora gukangura corpus luteum kugirango isohore progesterone kandi ikomeze ibidukikije bikwiye kugirango itwite. Kubwa hypogonadism yabagabo iterwa no gusohora kwa gonadotropine idahagije, HCG irashobora gukangurira selile Leydig muri testis guhuza no gusohora testosterone, guteza imbere testis, kunoza imiterere yimibonano mpuzabitsina, no kuzamura imikorere yimyororokere yumurwayi nubuzima bwiza. Muri icyo gihe, HCG igira uruhare runini mu gukomeza gutwita hakiri kare, itera corpus luteum guhora isohora progesterone kugira ngo urusoro rushobore gutera imbere. Mu isuzuma ry’amavuriro, kumenya urwego rwa HCG ni ishingiro ry’ingenzi mu kumenya gutwita hakiri kare no kumenya inda zidasanzwe nko gutwita kwa ectopique, gutanga inkunga ikomeye yo gutabara no kuvurwa ku gihe.
Ibyerekeye Umwanditsi
Ibikoresho byavuzwe haruguru byose byakorewe ubushakashatsi, byahinduwe kandi byakozwe na Cocer Peptides.
Umwanditsi w'ikinyamakuru
Chinedu Nwabuobi ni umushakashatsi ufite ubuhanga mu bijyanye no kubyara & Gynecology, Imyororokere y’ibinyabuzima, Biochemie & Molecular Biology, Chemistry, na Oncology. Yifatanije n’ibigo byinshi bizwi, birimo kaminuza y’amajyepfo ya Floride, kaminuza ya Rochester, n’ikigo cy’urwibutso rwa Sloan Kettering. Ubushakashatsi bwe bwibanze ku ngingo nk'imikorere y'ibinyabuzima no gukoresha amavuriro ya chorionic gonadotropine ya muntu (HCG), atanga umusanzu mu gusobanukirwa uruhare rwayo mu buzima bw'imyororokere hamwe na patologi bifitanye isano. Chinedu Nwabuobi yanditse kurutonde rwerekana [3].
