Ama-antibodies kuma-insulin receptors: okujwayelekile kokuhlaziywa

Ayini ama-insulin antibodies? Lawa ama-autoantibodies umzimba womuntu awakhiqizayo ngokumelene ne-insulin yawo. I-AT to insulin iyimpawu ekhomba kakhulu isifo sikashukela sohlobo 1 (lolu hlobo lwashukela lwakamuva), kanti izifundo ziye ziqokwe lapho kutholakala khona isifo uqobo.

Isifo sikashukela sohlobo lwe-Type 1 sikashukela senzeka ngenxa yokulimala kwe-autoimmune eziqhingini ze-Langerhans gland. Le pathology izohola ekuphepheni ngokuphelele kwe-insulin emzimbeni womuntu.

Yilokhu uhlobo 1 lwesifo sikashukela okuphikisana nohlobo 2 lwesifo sikashukela, olungakuhlanganisi ukubaluleka kangako kwezifo zokugoma. Ukuxilongwa okuhlukile kwezinhlobo zesifo sikashukela kubaluleke kakhulu ekuqapheleni phambili nasekusetshenzisweni kwezindlela zokwelapha ezisebenzayo.

Unganquma kanjani uhlobo lwesifo sikashukela

Ukuze kutholakale ukuhlukaniswa kohlobo lwesifo sikashukela, ama-autoantibodies aqondiswe ngokumelene nama-islet beta cell ayahlolwa.

Umzimba wohlobo lwesifo sikashukela sohlobo olu-1 ukhiqiza amasosha omzimba ezithweni zamanyikwe. Kubantu abanesifo sikashukela sohlobo 2, ama-autoantibodies afanayo awasebenzi.

Ngohlobo 1 sikashukela, i-hormone i-insulin isebenza njenge-autoantigen. I-insulin iyi-autoantigen eqondile eqinile ye-pancreatic.

Le mahormoni ihlukile kwamanye ama-autoantigens atholakala kulesi sifo (zonke izinhlobo zamaprotheni eziqithi zeLangerhans kanye ne-glutamate decarboxylase).

Ngakho-ke, umaki oqondile kakhulu we-autoimmune pathology ye-pancreas kuhlobo lwe-1 sikashukela uthathwa njengesivivinyo esihle sama-antibodies e-insulin ye-hormone.

Ama-Autoantibodies kuya ku-insulin atholakala egazini lengxenye yesifo sikashukela.

Kuhlobo lwesifo sikashukela sohlobo loku-1, amanye ama-antibodies nawo atholakala emithanjeni yegazi athunyelwa kumaseli we-beta we-pancreas, ngokwesibonelo, ama-antibodies kuma-glutamate decarboxylase nabanye.

Okwamanje lapho kwenziwa khona lesi sifo:

• Ama-70% eziguli anezinhlobo ezintathu noma ngaphezulu zama-antibodies.
• Uhlobo olulodwa lubonwa ngaphansi kwama-10%.
• Awekho ama-autoantibodies athile ku-2-4% yeziguli.

Kodwa-ke, ama-antibodies kuma-hormone esifo sikashukela awayona imbangela yokwanda kwalesi sifo. Zibonisa kuphela ukubhujiswa kwesakhiwo se-pancreatic cell. Ama-antibodies kuma-insulin e-hormone ezinganeni ezinesifo sikashukela sohlobo 1 angabhekwa kaningi kakhulu kunabantu abadala.

Nakani! Imvamisa, ezinganeni ezinesifo sikashukela sohlobo loku-1, ama-antibodies okuthi i-insulin avele kuqala futhi okuhlushwa kakhulu. Umkhuba ofanayo kuthiwa izingane ezingaphansi kweminyaka engu-3 ubudala.

Ngokucabanga ngalezi zici, isivivinyo se-AT namuhla sibhekwa njengokuhlaziywa kweLabhorathri engcono kakhulu ukuthola ukutholakala kwesifo sikashukela sohlobo 1 ezinganeni.

Ukuthola ulwazi oluphelele kakhulu ekutholakalweni kwesifo sikashukela, hhayi kuphela ukuhlaziya ama-antibodies, kodwa futhi nokuba khona kwezinye izici ze-autoantibodies zesifo sikashukela.

Uma ingane ngaphandle kwe-hyperglycemia inophawu lwe-autoimmune lesion of Langerhans islet cell, lokhu akusho ukuthi isifo sikashukela sikhona ngohlobo 1 lwezingane. Njengoba isifo sikashukela siqhubeka, izinga lama-autoantibodies liyancipha futhi lingabonakali ngokuphelele.

Ingozi yokudluliselwa kwesifo sikashukela sohlobo 1 ngefa

Ngaphandle kokuthi ama-antibodies ku-hormone aqashelwa njengophawu lwesifo sikashukela sohlobo lokuqala, kunamacala lapho kutholakala khona la makhambi omzimba ohlobo 2 sikashukela.

Kubalulekile! Uhlobo 1 sikashukela luzuzwa ikakhulu njengefa. Abantu abaningi abanesifo sikashukela bangabathwali bezindlela ezithile zohlobo olufanayo lwe-HLA-DR4 ne-HLA-DR3. Uma umuntu enezihlobo ezinesifo sikashukela sohlobo 1, ingozi yokuthi izogula inyuka ngezikhathi eziyi-15. Isilinganiso sobungozi ngu-1: 20.

Imvamisa, ama-pathologies we-immunological ngesimo sokumaka kokulimala kwe-autoimmune kumaseli ezinqola zama-Langerhans atholakala isikhathi eside ngaphambi kokuvela kwesifo sikashukela sohlobo 1. Lokhu kungenxa yokuthi ukwakhiwa okugcwele kwezimpawu zesifo sikashukela kudinga ukubhujiswa kwesakhiwo sama-80-90% amaseli we-beta.

Ngakho-ke, ukuhlolwa kwe-autoantiever kungasetshenziswa ukukhomba ubungozi bokukhula kwesifo sikashukela sohlobo lokuqala kubantu abanomlando walesi sifo. Ukuba khona komaka weseli le-autoimmune lesion lamaLasgenhans islet kulezi ziguli kukhombisa ubungozi obukhuphukile abangama-20% bokuthola isifo sikashukela eminyakeni eyi-10 ezayo yokuphila kwabo.

Uma ama-antibodies ama-2 noma ngaphezulu ama-insulin antibodies abonakala njengohlobo 1 sikashukela egazini, amathuba okuvela kwalesi sifo eminyakeni eyi-10 elandelayo kulezi ziguli anda ngamaphesenti angama-90.

Naphezu kweqiniso lokuthi ucwaningo lwama-autoantibodies alukhuthaziwe njengokuhlolelwa isifo sikashukela sohlobo 1 (lokhu kuyasebenza nakwamanye amapharamitha welebhu), lokhu kuhlaziywa kungasiza ekuhlolweni kwezingane ezinezici ezinezici eziphathelene nesifo sikashukela sohlobo 1.

Ngokuhambisana nokuhlolwa kokubekezelela kwe-glucose, kuzokuvumela ukuthi uhlole isifo sikashukela sokuqala ngaphambi kokuvela kwezimpawu zomtholampilo, kufaka phakathi isifo sikashukela sikashukela. Isimo se-C-peptide ngesikhathi sokuxilongwa naso siyaphulwa. Leli qiniso libonisa amanani amahle omsebenzi osele we-beta-cell.

Kuyaqapheleka ukuthi ingozi yokuthola isifo kumuntu ngokuhlolwa okuhle kwe-insulin antibodies kanye nokungabikho komlando omndeni ompofu wohlobo lwesifo sikashukela sohlobo 1 akufani nobungozi balesi sifo ebantwini.

Umzimba weningi leziguli ezithola imijovo ye-insulin (i-recombinant, i-insulin engaphandle), ngemuva kwesikhashana iqala ukukhiqiza amasosha omzimba aye e-hormone.

Imiphumela yezifundo kulezi ziguli izoba mihle. Ngaphezu kwalokho, akuxhomeki ekutheni ukuthuthukiswa kwamasosha omzimba ukuya e-insulin kuyinto eyindabuko noma cha.

Ngalesi sizathu, ukuhlaziywa akulungile ekuxilongeni okuhlukile kwesifo sikashukela sohlobo 1 kulabo bantu asevele basebenzise amalungiselelo e-insulin. Isimo esifanayo senzeka lapho kusolwa ushukela kumuntu owatholakala enesifo sikashukela sohlobo 2 ngephutha, futhi welashwa nge-insulin yangaphandle ukuze alungise i-hyperglycemia.

Izifo ezihambisana nazo

Iziguli eziningi ezinesifo sikashukela sohlobo 1 zinesifo esisodwa noma ngaphezulu se-autoimmune. Esikhathini esiningi kungenzeka ukuthola:

• i-autoimmune thyroid ukuphazamiseka (isifo seGraves, i-Hashimoto's thyroiditis);
• Isifo sika-Addison (ukungasebenzi kahle kwe-adrenal);
• isifo se-celiac (i-celiac enteropathy) kanye ne-anemia eyingozi.

Ngakho-ke, uma kutholwa umaki we-autoimmune pathology yamaseli we-beta futhi kuqinisekiswe uhlobo lwesifo sikashukela, kufanele kunikezwe ukuhlolwa okwengeziwe. Ziyadingeka ukuze kungafakwa lezi zifo.

Kungani kudingeka ucwaningo

1. Ukungafaki isifo sikashukela sohlobo 1 bese uthayipha isifo sikashukela esigulini.
2. Ukubikezela ukukhula kwalesi sifo kulezi ziguli ezinomlando wenzalo eyifa, ikakhulukazi ezinganeni.

Uyokwabela Nini Ukuhlaziywa

Ukuhlaziywa kunqunyelwe lapho isiguli siveza izimpawu zomtholampilo ze-hyperglycemia:

1. Khuphula ivolumu yomchamo.
2. Umile.
3. Ukwehla kwesisindo okungachaziwe
4. Ukwanda kwesifiso sokudla.
5. Kwehliswe ukuzwela kwemikhawulo engezansi.
6. Ukulimazeka kokubonakalayo.
7. Izilonda ezi-trophic emilenzeni.
8. Amanxeba okuphulukisa amade.

Njengoba kufakazelwa yimiphumela

Imvelo: 0 - 10 Amayunithi / ml.

Inkomba enhle:

• Uhlobo 1 sikashukela;
• Isifo sikaHirat (AT insulin syndrome);
• polyendocrine autoimmune syndrome;
• ukuba khona kwama-antibodies kumalungiselelo we-insulin asendulo futhi aphindayo.

Umphumela uba mubi:

• ejwayelekile;
• ukuba khona kwezimpawu ze-hyperglycemia kukhombisa ukuthi kungenzeka ukuthi unesifo sikashukela sohlobo oluphezulu.