I-Neuroinflammation kanye nokulimala kwentambo yomgogodla: ukwembula ukusebenzisana okuyinkimbinkimbi

Ukulimala komgogodla (SCI) kuyisenzakalo esibi esiholela ekujuleni kwamangqamuzana omzimba omzimba kusuka ekulahlekeni ngokomzimba nangokwengqondo. Ngalé komonakalo osheshayo wokusebenza, kuqubuka izinqubo zesibili, ezihlanganisa ukusebenzisana okuyinkimbinkimbi phakathi kwabadlali abahlukahlukene bamangqamuzana namangqamuzana. Phakathi kwalezi zinqubo zesibili, i-neuroinflammation ivela njengomhlanganyeli obalulekile kuyo yonke i-pathophysiological ye-SCI. Lokhu kusebenzisana okuyinkimbinkimbi phakathi kwe-neuroinflammation kanye ne-SCI kuyisihloko socwaningo olujulile futhi kunemithelela ebalulekile ekuthuthukisweni kokungenelela okunamandla kokwelapha.

Izindlela ze-Neuroinflammation ku-Sci

Lapho umgogodla uthola ukulimala okubuhlungu, uchungechunge lwezenzakalo luqala, okuholela ku-neuroinflammation. Omunye wabalingisi abayinhloko kule nqubo i-microglia, amangqamuzana omzimba ahlala e-central nervous system. Lapho kulimala, i-microglia iqala ukusebenza futhi ibe nezinguquko ze-morphological. Bakhulula uhla lwama-cytokines ane-pro-inflammatory, okuhlanganisa i-interleukin-1 (IL-1), i-interleukin-6 (IL-6), ne-tumor necrosis factor-alpha (TNF-alpha), ehlela impendulo yokuvuvukala. Lokhu kusebenza kokuqala kokuzivikela komzimba kusetha isiteji se-cascade yemicimbi yeselula ethinta indawo yokulimala kanye nezicubu ezizungezile. Esinye isici esibalulekile esikhumbeni se-neu-inflammatory ukuphazamiseka kwesivimbeli segazi nobuchopho (BBB), isixhumi esibonakalayo esivikelayo esivame ukuvimbela ukudlula kwamangqamuzana omzimba nama-molecule asuka egazini aye esimisweni sezinzwa esimaphakathi. I-SCI ibeka engcupheni ubuqotho be-BBB, ivumela igazi le-peripheral ukuthi lingene endaweni elimele. Lawa maseli omzimba, ikakhulukazi ama-macrophage, aqhubekisela phambili ukusabela kokuvuvukala futhi abe nomthelela ekulimaleni kwezicubu. Ama-astrocyte, amaseli e-glial amise okwenkanyezi, nawo adlala indima ekuphenduleni kwe-neuroinflammatory. Ngokusabela ku-SCI, ama-astrocyte angena inqubo ebizwa ngokuthi i-astrogliosis, lapho eba yi-hypertrophic futhi asebenze. Lesi simo sokusebenza sibonakala ngokukhishwa kwama-molecule ahlukahlukene, okuhlanganisa ama-cytokines nama-chemokines, angakhuthaza noma alungise ukuvuvukala. Ngokuya ngomongo, ama-astrocyte angabonisa kokubili izakhiwo ze-neuroprotective ne-neurotoxic.

Abalamuli abaPro-inflammatory kanye Nezinqubo Zokulimala Kwesibili

Ukukhululwa kwama-cytokines nama-chemokines abangela ukuvuvukala ngamaseli omzimba acushiwe kanye nama-astrocyte kukhulisa isimo sokuvuvukala. Lokhu, futhi, kusetha isiteji sochungechunge lwezinqubo zokulimala kwesibili eziphinde zibeke engozini ubuqotho bezicubu. I-Excitotoxicity ingenye yenqubo enjalo. I-Glutamate, i-neurotransmitter eyinhloko ejabulisayo ohlelweni lwezinzwa oluphakathi, iqoqa endaweni yokulimala. Amazinga amaningi e-glutamate angaholela ekuvuthweni kwama-neurons, okuholela entweni ebizwa ngokuthi i-excitotoxicity. Lokhu kuvuselela ngokweqile kubangela uchungechunge lwezenzakalo, okuhlanganisa ukukhuphuka kwamazinga e-calcium e-intracellular, ukungasebenzi kahle kwe-mitochondrial, futhi ekugcineni nokufa kwamangqamuzana e-neuronal. I-Apoptosis, noma ukufa kweseli okuhleliwe, kungomunye umphumela we-neuroinflammation elandela i-SCI. Indawo yokuvuvukala ingakhuthaza ukwenziwa kusebenze kwezindlela ze-apoptotic kuzo zombili izinzwa namaseli e-glial. Lolu hlobo lokufa kwamangqamuzana lunomthelela ekulahlekeni kwezicubu ze-neural kanye nokuphazamiseka kokusebenza kwe-neural circuits. I-Demyelination ingomunye umphumela wempendulo yokuvuvukala. I-Myelin, igobolondo le-insulating elizungeze imicu yezinzwa, isengozini yokulimala endaweni yokuvuvukala. I-Demyelination iphazamisa ukudluliswa kwesignali, okuholela ekukhulumisaneni okuphazamisayo phakathi kwama-neurons futhi kuqhubekisele phambili ukusilela kokusebenza.

Ukulungiswa Kwe-Neuroinflammation kanye Namasu Okwelapha

Kuyathakazelisa ukuthi impendulo ye-neuroinflammatory ayiqhubeki unomphela. Kunezindlela ezikhona ezihlose ukudambisa ukuvuvukala nokukhuthaza ukulungiswa kwezicubu. Amanye amangqamuzana omzimba ashintshashintsha esuka ku-pro-inflammatory kuya ku-phenotype elwa nokuvuvukala, esiza ekuxazululeni ukuvuvukala nokuqala kwezinqubo zokulungisa izicubu. Ukwengeza, abalamuli abakhethekile abaxazulula i-lipid badlala indima ebalulekile ekuqedeni ukuvuvukala futhi bakhuthaze ukusulwa kwemfucumfucu yamaselula. Amasu okwelapha aqondise ku-neuroinflammation ku-SCI ayaphenywa. Izidakamizwa ezilwa nokuvuvukala, njenge-corticosteroids kanye nezidakamizwa ezingezona ukuvuvukala (ama-NSAID), ziye zahlolwa ukuze kulungiswe ukusabela kokuvuvukala kanye nokunciphisa umonakalo wesibili. Kodwa-ke, ukusetshenziswa kwabo kuvame ukuhlotshaniswa nemiphumela emibi engaba khona kanye nokusebenza okulinganiselwe ekuthuthukiseni imiphumela yokusebenza. Ama-Neuroprotective agents, okuhlanganisa ama-antioxidants kanye nama-compounds aphikisana nengcindezi ye-oxidative, ayafundwa njengezinyathelo ezingase zibe khona ukuze kukhawulwe ukulimala kwezicubu ezibangelwa ukuvuvukala. I-stem cell therapy iyindlela ethokozisayo yokwelapha i-SCI. Amaseli e-stem anamandla okuhlukana abe izinhlobo ezahlukene zamaseli, okuhlanganisa ama-neurons namaseli e-glial. Baphinde babe nemiphumela ye-immunomodulatory engasiza ekulawuleni impendulo yokuvuvukala futhi ikhuthaze ukulungiswa kwezicubu. I-Immunomodulation, ngokungenelela okushintsha impendulo ngaphandle kokucabanga ngokuphelele, ithola ukunakwa. Le ndlela ithinta ukulingana phakathi kokuvuvukala okuqhubekayo nokulondoloza imisebenzi ebalulekile yesistimu.

Indlela Engaphambili

Emdansweni oyinkimbinkimbi phakathi kokuvuvukala nokulimala komgogodla izigxobo ziphezulu. I-Neuroinflamm ngenkathi iqalwa njengempendulo ye-pro, ingaba inkemba ephindwe kabili, ibambe iqhaza ku-d yesibili futhi ivimbe ukusebenzisana okuyinkimbinkimbi kokululama phakathi kwama-immune cytokines, amaseli e-glial, nabaxhumanisi be-mol kuveza ukuphunyuka okuyinselele ukuze uzulazule. Ukuqonda izindlela ezilele neuroinflammation ku-SCI ukuthuthukiswa kwamasu okwelapha asebenzayo. Ngokuguqula impendulo yokuvuvukala, nokukhuthaza ukuphindaphinda kwezicubu ukusebenzisa amandla okuvuselela umgogodla, abacwaningi balwela ukuthuthukisa imiphumela yemikhuba ethintekile yi-SCI. Njengoba ukuqonda kwethu kujula, ithemba lemikhuba kanye nokuhlangana okuyinkimbinkimbi phakathi kokuvuvukala nomgogodla akubi nje ukuphela kwesayensi kodwa futhi kube isibani sethemba kulabo abazama ukubuyisela imisebenzi elahlekile nokuphila kwabo.

Umthombo: iphayona (Umbhali, uDkt. Shyam K. Jais ongumeluleki wezifo zezinzwa ezibhedlela, e-Banjara Hills, e-Hyder)