Kachilumba kotchedwa Langerhans kinafotokozedwa koyamba mu 1869. Wotulutsa ma khemedwe ofunikira omwe amapezeka mu kapamba (makamaka mu gawo lachithunzu) anali wophunzira wachinyamata wa Rudolf Virchow - Paul Langerhans. Anali iye amene adasanthula koyamba pansi pa makina oonera microscope maselo omwe mu mawonekedwe awo a morphological amasiyana ndi ma pancreatic minofu ena.

Zinakhazikitsidwanso kuti zisumbu za Langerhans zimagwira ntchito ya endocrine. Kupeza kumeneku kunapangidwa ndi K.P. Ulezko-Stroganova. Mu 1889, kulumikizana pakati pa kugonjetsedwa kwa zisumbu za Langerhans ndi chitukuko cha matenda a shuga kudayambitsidwa koyamba.

Chingakhale chiyani chidutswa cha Langerhans?

Pakadali pano, mtunduwu waphunziridwa kale bwino. Tsopano ndikudziwika bwino kuti mapangidwe awa ali ndi mitundu. Otsatirawa adadziwika pano:

maselo alpha
maselo a beta
maselo a delta
maselo a pp
ma epsilon ma cell.

Tili othokoza chifukwa chosiyanasiyana kuti ma cell a zilumba za Langerhans amakwaniritsa ntchito zonse zomwe apatsidwa.

Ma cell a Alfa

Mitundu iyi imakhala pafupifupi 15-20% ya zisumbu zonse zomwe zilipo ku Langerhans. Ntchito yayikulu ya maselo a alpha ndikupanga glucagon. Hormoni iyi ili ndi chilengedwe cha lipid ndipo ndi mtundu wa okana insulin. Akamasulidwa, glucagon amapita ku chiwindi, komwe, polumikizana ndi ma receptors apadera, amawongolera kupanga kwa glucose kudzera mukuwonongeka kwa glycogen.

Maselo a Beta

Zisumbu za Langerhans zamtunduwu ndizofala kwambiri. Amapanga pafupifupi 65-80% yathunthu. Tsopano zakhazikitsidwa kuti ntchito yawo yayikulu ndikupanga imodzi mwa mahomoni ofunikira kwambiri - insulin. Izi ndizotsutsana ndi glucagon. Zimathandizira kutsegula kwa mapangidwe a glycogen ndikusunga kwake m'maselo a chiwindi ndi minofu. Chifukwa cha izi, pali kuchepa kwa kuchuluka kwa shuga m'magazi.

Maselo a Delta

Zilumba za Pancreatic za Langerhans zamtunduwu sizofala kwambiri. Pali 2-10% yokha yonse. Tsopano magwiridwe antchito awo amadziwika bwino. Zinapezeka kuti ma cell amenewa amapanga somatostatin. Ntchito ya chinthu ichi yogwira pophika imapondereza kupanga kwa kukula kwa mahomoni, chithokomiro cha kukula kwa thupi lanu ndi kukula kwa timadzi timene timapanga. Ndiye kuti, imagwira ntchito mwachindunji pa hypothalamus, komanso gland ya anterior pituitary.

Chilumba chilichonse cha mtundu uwu wa Langerhans chimatulutsa pancreatic polypeptide. Mpaka kumapeto, ntchito yake sinaphunzire. Pakadali pano, ali ndi mbiri yoletsa kupangira madzi a kapamba. Kuphatikiza apo, zotsatira zake zimathandizira kupumula kwa minofu yosalala ya ndulu. M'zaka zaposachedwa, kudalira kwa msinkhu wopanga chinthuchi pakupanga ma neoplasms oyipidwa kwakhala kuphunzira kwambiri. Zotsatira zake, zidapezeka kuti ndi chitukuko chawo, mulingo wa pancreatic polypeptide umakwera. Chifukwa chake zinthu zothandizidwadi titha kuziona ngati zisonyezo zabwino za vuto loipa la kapamba.

Maselo a Epsilon

Zilumba zoterezi za Langerhans ndizosowa kwambiri. Mwa onse, chiwerengero chawo chimakhala chochepera 1%. Ntchito yayikulu ya maselo oterewa ndi kupanga mahomoni otchedwa ghrelin. Ichi chogwira ntchito chimakhala ndi ntchito zambiri, koma mayendedwe ake pakukonda amaphunzira kwambiri.

Zokhudza matenda a zisumbu za Langerhans

Kugonjetsedwa kwa zinthu zofunika izi kumakhala ndi zotsatira zoyipa mthupi. Zikachitika kuti ma antibodies a is is a Langerhans akapangidwa, kuchuluka kwa otsiriza kumayamba kuchepa. Kugonjetsedwa kwa maselo opitilira 90% kumachepetsa kupanga insulini kukhala wotsika kwambiri. Zotsatira zake ndikukula kwa matenda owopsa monga matenda a shuga. Ma antibodies kuma cell a mabwinja a Langerhans nthawi zambiri amawoneka odwala ang'onoang'ono.

Pancreatitis, njira yotupa mu kapamba, imatha kuwononga kwambiri kuchuluka kwa maselo opanga mahomoni amenewa.

Momwe mungasungire maselo a islet?

Kuti muchite izi, muyenera kusamalira kapamba konse. Choyamba, ndikofunikira kusiya zakumwa zoledzeretsa. Chowonadi ndi chakuti ali pakati pa zakudya zonse zomwe zimakhala ndi zotsutsa kwambiri kapamba. Pankhani ya zakumwa zoledzeretsa kwa nthawi yayitali, munthu amakula ndikuyenda pancreatitis, yomwe pakapita nthawi imatha kuwononga maselo a islet.

Kuphatikiza pa zakumwa zoledzeretsa, chakudya chochuluka chomwe chili ndi mafuta a nyama chimakhala ndi zotsutsana ndi kapamba. Mwakutero, zinthu zidzakukulani ngati wodwalayo sanadye chilichonse kwanthawi yayitali phwando lisanachitike.

Pochitika kuti pali njira yotupa yopatsirana kale m'matumbo a pancreatic, ndikofunikira kukaonana ndi katswiri - wothandizira kapena gastroenterologist. Madokotala a zamtunduwu amapereka malangizo othandizira omwe amachepetsa kwambiri kusintha kwa matenda. M'tsogolomu, chaka chilichonse, kuyezetsa kwa mapangidwe a kapamba kumayenera kuchitidwa, komwe kumachitika limodzi ndi ziwalo zina zam'mimbamo. Kuphatikiza apo, ndikofunikira kuyesa magazi a biochemical pazomwe zili amylase mmenemo.

Kuti mudziwe chiyambi cha kukhazikika kwa matenda a kapamba, kuwonjezera pa maphunziro a labotale komanso othandizira, chipatala chithandizanso. Chizindikiro chachikulu cha matendawa ndi kupezeka kwa zowawa mu hypochondrium yamanzere. Nthawi yomweyo, kuwawa kumeneku kumakhala ndi chikhalidwe chomangirira ndipo kumachitika nthawi zambiri ndikatha kudya chakudya chochuluka chamafuta aminyama. Kuphatikiza apo, wodwala atatha kudya amatha kusokonezedwa ndikumverera kosalekeza m'mimba. Zizindikiro zonsezi zimangomusiya msanga kapena kuchepetsa kuwawa kwawo pakumwa mankhwala okhala ndi pancreatin. Pakati pawo, mankhwala omwe anali odziwika kwambiri anali a Creon, Mezim, ndi Pancreatin. Ngati njira yotupa ikupezeka m'matumbo a pancreatic, ndibwino kusiya kotheratu mowa. Chowonadi ndi chakuti, ngakhale pang'ono pokha kamatha kukulitsa zovuta za m'magazi, mwakutero zimapweteketsa thupilo.

Kodi chidutswa cha Langerhans ndi chiyani: komwe mukupita

Maselo a Endocrine amapezeka thupi lonse. Amodzi mwa malo omwe amapezeka ndi kapamba. Zilumba za Langerhans zili mchira wa limba. Ndi magulu am'magazi omwe amapanga zinthu zofunikira kwachilengedwe - mahomoni. Tanthauzo la zisumbu za Langerhans ndizambiri. Amakhala mukupanga kuchuluka kwa mahomoni ofunikira kwa kagayidwe kazinthu. Zilumba za Pancreatic za Langerhans zimakhala ndi ntchito zotsatirazi:

Glycemic control.
Kuongolera ntchito ya enzyme.
Kutenga mbali mu mafuta kagayidwe.

Chifukwa cha kagwiridwe kabwino kakang'ono ka zida zam'mbuyomu, zinthu monga matenda a shuga ndi hypoglycemia sizimakula. Kuwonongeka kwa ma cell kumachitika mu kutupa kwachangu komanso kupweteka - kapamba.

Kapangidwe kakale ka zisumbu

Kachilumba kotchedwa Langerhans kanapezeka m'zaka za m'ma 1800. Ndi mndandanda wa zinthu za endocrine. Mu ana, mapangidwe awa amakhala pafupifupi 6% ya gawo lonse la chiwalo. Mwa kukalamba, gawo la endocrine limatsika ndipo limangokhala 2% yokha. Pafupifupi miliyoni miliyoni ya Langerhans ili mchala parenchyma. Amakhala ndi magazi ndi magazi ambiri. Chilumba chilichonse chimakhala ndi ma lobules, omwe amakutidwa ndi minofu yolumikizana. Kuphatikiza apo, ili kunja kwa mapangidwe a endocrine. Maselo omwe ali mkati mwa mabwalowa amapangidwa mwaluso. Zochita za endocrine zochuluka zimaperekedwa ndi nyansi ndi mitsempha yachisoni. Pakati pa lobule ndi maselo osalimba. Amatsitsa shuga. Mu gawo loyandikira la lobules ndi maselo a alpha ndi delta. Woyamba amatulutsa timadzi tothandizirana - glucagon. Chachiwiri ndichofunikira pakuyang'anira ntchito ya endocrine ndi exocrine.

Kodi maselo a islets a Langerhans ndi ati?

Pazilumba za Langerhans, mitundu ingapo ya maselo imapangidwa. Onsewa amaphatikizidwa ndi kutulutsidwa kwa zinthu zazamoyo - ma peptides ndi mahomoni. Zisumbu zambiri za Langerhans zimayimiriridwa ndi maselo a beta. Amapezeka pakatikati pa lobule lililonse. Maselo amenewa ndi ofunika kwambiri chifukwa amapanga insulin.

Chachiwiri chofunikira kwambiri ndi maselo a alpha a kapamba. Amakhala kotala pachilumbachi. Maselo a alfa ndi ofunikira pakupanga kwa glucagon. Hormone iyi ndiyotsutsana ndi insulin.

M'mphepete mwa zilumba za Langerhans, ma PP ndi maselo a delta amapangidwa. Chiwerengero choyamba ndi pafupi 1/20 ya gawo. Ntchito yamagulu awa ndikupanga pancreatic polypeptide. Maselo a Delta amafunikira kuti apange somatostatin. Izi zimakhudzidwa ndi kayendedwe ka chakudya.

Maselo a Islet ndiovuta kubwezeretsanso. Chifukwa chake, ngati izi zidawonongeka, nthawi zambiri zimakhala zosatheka kubwezeretsanso ntchito yawo.

Zochitika za mahormoni a Langerhans

Ngakhale kuti kachigawo kena ka Langerhans kakang'ono ndipo kamangokhala gawo laling'ono la kapamba, kufunikira kwa chidutsachi ndikwabwino. Mmenemo, mapangidwe mahomoni ofunikira kwambiri omwe amakhudzidwa ndi njira za metabolic. Zilumba za Langerhans zimatulutsa insulin, glucagon, somatostatin ndi pancreatic polypeptide.

Ma mahoni awiri oyamba ndiofunikira pamoyo. Insulin imayambitsa kugawika kwa glucose m'magulu ang'onoang'ono a ma cell. Zotsatira zake, kuchuluka kwa shuga m'magazi kumatsitsidwa. Kuphatikiza apo, insulin imakhudzidwa ndi kagayidwe ka mafuta. Chifukwa cha zochita za timadzi timeneti, glycogen imadziunjikira m'chiwindi ndi minofu ya minofu. Insulin imakhala ndi anabolic pamatenda ambiri, ndiye kuti imathandizira njira zonse.

Glucagon ali ndi zosiyana. Hormone iyi imapangidwa yaying'ono poyerekeza ndi insulin. Amaphatikizidwa ndi gluconeogeneis. Shuga ndiofunikira m'thupi, chifukwa ndi gwero lamphamvu.

Somatostatin amawongolera kapangidwe ka michere yam'mimba ndi mahomoni. Mothandizidwa ndi izi, kupanga glucagon ndi insulin kumachepa. Pali maselo ochepa kwambiri a PP mu zisumbu za Langerhans, koma polypeptide yofunikira pakhungu. Amakhudzidwa ndi kayendetsedwe ka katulutsidwe ka zotupa m'mimba (chiwindi, m'mimba). Ndi vuto la kuchepa kwa mahomoni, nthenda zazikulu zimayamba.

Zowonongeka kwa ma pancreas a endocrine

Kusokonekera kwa zochitika za ma islet cell kungachitike pazifukwa zosiyanasiyana. Nthawi zambiri kulephera kwa zinthu izi kumatanthauza obadwa nako obadwa nawo (ma genetic pathologies). Zilonda zopezeka kuzilumba za Langerhans zimayamba chifukwa cha matenda amtundu komanso bakiteriya, kuledzera kosalekeza, matenda amitsempha.

Kuperewera kwa insulin kumayambitsa matenda amtundu wa 1 shuga. Matendawa amapezeka paubwana komanso ana. Kuwonjezeka kwa shuga m'magazi kumabweretsa kuwonongeka kwa mitsempha yamagazi ndi mitsempha. Ndi kuchepa kwa maselo ena okhala ndi ma selet, ma hypoglycemic state amakula, amapanga kuchuluka kwa timadziti tam'mimba. Kupanga kwakukulu kwa mahomoni kumachitika ndi zotupa za mchira wa kapamba.

Kuyika kwa Langerhans

Njira zochizira matenda ashuga ndi insulin. M'zaka zaposachedwa, njira zina zapangidwa. Izi zikuphatikiza kuphatikiza kwa ma pancreas opanga ndi kufalikira kwa maselo ofanana. Mwakuchita, zidapezeka kuti zida zopanga ma hormone zimazika mizu m'thupi latsopano. Pankhaniyi, kagayidwe kazachilengedwe kamatha kuchira. Kuyika kwa zisumbu za Langerhans sikunalandire ntchito ponseponse.

Zilumba za Pancreatic (Langerhans)

Zikondamoyo zimakhala ndi mbali za exocrine ndi endocrine. Gawo lazopanda tanthauzo limafotokozeredwa mu gawo "Ziwalo zogaya". Gawo la endocrine limapangidwa ndimagulu a ma pancreatic islets (islets of Langerhans), omwe amapangidwa ndi masango okhala ndi ma capillaries ambiri. Chiwerengero chonse cha zisumbu chimasiyana pakati pa 1-2 miliyoni (1-2% ya unyinji wonse wa michereyo), ndipo mainchesi ake aliyense amakhala mkati mwa ma micons. Ichi ndi chipangizo chovuta kupangira, chokhala ndi masentimita am'magazi amitundu yosiyanasiyana: mahomoni am'magazi, owongolera kagayidwe kazakudya komanso mafuta a metabolism (amapangidwanso m'matumbo am'mimba) amapangidwa m'maselo a alpha, ndipo insulin imayang'anira kagayidwe kazachilengedwe m'maselo a beta, metabolism ya protein ndi metabolism yamafuta, mu ma D-maselo (maselo otsimikizika), mwachiwonekere, mahomoni atatu amapangidwa - somatostatin, pancreagastrin ndi secretin. Maselo a Islet ali ndi ma granile ambiri okhala ndi ulusi. Maselo a Beta (60-80%), maselo a alpha kuyambira 10 mpaka 30%), ma D-cell - pafupifupi 10%).

Pancreatic islets yomwe imayang'anira ntchito yake ya endocrine imamwazikana pancreatic parenchyma. Chilumba chilichonse chokhwima, kuphatikiza ma alpha, beta, ndi maselo a delta, zimakhala ndi maselo a PP (kupanga pancreatic polypeptide).

Mitundu yonse ya maselo imatulutsa timaselo tina tomwe timagwira.

Zisumbu zomwe zikubwera zimakhala ndi maselo osakhazikika omwe amapanga mahomoni ena owonjezera a peptide, kuphatikiza gastrin, VIP, ACTH.

Chotupa chikhoza kupezeka kuchokera ku mtundu uliwonse wa khungu.

Ma tumamu ochokera ku maselo a islet nthawi zambiri amakhala ndi mahomoni amodzi kapena zingapo ndikuwonetsa ma syndromes (tebulo. 95.2).

Kodi zisumbu za Langerhans ndi ziti

Zilumba za Langerhans zomwe zimapezeka mu kapamba ndizodzikongoletsa za maselo amtundu wa endocrine omwe amachititsa kuti mahomoni azikhala. Mkati mwa zaka za XIX, wasayansi Paul Langerhansk anapeza magulu athunthu a maselo, motero masango adatchulidwa pambuyo pake.

Masana, zisumbu zimatulutsa 2 mg ya insulin.

Maselo amtundu wa Islet amakhala makamaka m'mapapo a kapamba. Unyinji wawo ndi 2% ya kulemera kwathunthu kwa chiwalo. Chiwerengero chonse cha ma islets omwe ali parenchyma ndi pafupifupi.

Chosangalatsa ndichakuti mwa ana akhanda, zisumbu zochuluka zimakhala ndi 6% ya kulemera kwa kapamba.

Pazaka zambiri, kuchuluka kwa ziwalo zamthupi zomwe zimakhala ndi endocrine ntchito ya kapamba kumachepa. Pazaka 50 za kukhalapo kwaumunthu, zilumba zochepa zokha mwa 1-2% zomwe zilipo

Kodi maselo ndimtundu wanji?

Zisumbu za Langerhans zimakhala ndi maselo okhala ndi magwiridwe antchito osiyanasiyana komanso morphology.

Matenda a 'endocrine pancreas' ali ndi:

glucagon wopanga ma cell a alpha. Homoniyo ndi wotsutsana ndi insulin ndipo amalimbikitsa shuga. Ma cell a Alfa amakhala 20% yamaselo omwe atsala,
maselo a beta ndi omwe amayang'anira kuphatikizika kwa chimbudzi ndi insulin, amakhala ndi 80% ya kulemera kwa chilolezo,
kupanga somatostatin, komwe kungalepheretse chinsinsi cha ziwalo zina, amaperekedwa ndi maselo a delta. Unyinji wawo kuyambira 3 mpaka 10%,
Maselo a PP ndi ofunikira kuti apange pancreatic polypeptide. Homoniyo amalimbikitsa ntchito zachinsinsi zam'mimba ndipo imachepetsa kubisalira kwa parenchyma,
ghrelin, yomwe imayambitsa kugona mwa munthu, imapangidwa ndi maselo a epsilon.

Kodi zisumbu zimapangidwa bwanji?

Ntchito yayikulu yomwe ma isls a Langerhans amachita ndikusunga kuchuluka kwa chakudya chamagulu mthupi ndikuwongolera ziwalo zina za endocrine. Zilumbazi zimakhala ndi chisoni komanso mitsempha ya vagus ndipo zimaperekedwa mokwanira ndi magazi.

Zisumbu za Langerhans mu zikondamoyo zili ndi mawonekedwe ovuta. M'malo mwake, aliyense wa iwo ndi maphunziro ogwira ntchito mokwanira. Kapangidwe ka chilumbachi kamapereka kusinthana pakati pa zinthu zotheka pa parenchyma ndi zina. Izi ndizofunikira kuti khungu likhale ndi insulin.

Maselo a islet ali osakanikirana, ndiye kuti, amapangidwa mwanjira ya mosaic. Kalovu okhwima mu kapamba ali ndi gulu loyenera. Kachilomboka kamakhala ndi maubongo omwe amazungulira minofu yolumikizana, ma capillaries amwazi amapita mkati mwa maselo.

Maselo a Beta ali pakatikati pa lobules, pomwe ma alpha ndi ma delta amapezeka m'chigawo chakutali. Chifukwa chake, kapangidwe ka zisumbu za Langerhans kwathunthu kumatengera kukula kwawo.

Chifukwa chiyani ma antibodies amapangidwa motsutsana ndi ma islets? Kodi ntchito yawo ya endocrine ndi yotani? Likukhalira kuti kulumikizana kwa maselo a islet kumayambitsa makina amachitidwe, kenako maselo amakhudza maselo ena omwe amakhala pafupi.

Insulin imayendetsa ntchito ya maselo a beta ndikuletsa ma cell a alpha.
Ma cell a Alpha amathandizira glucagon, ndipo amathandizira pama cell a delta.
Somatostatin amalepheretsa ntchito yama cell a alpha ndi beta.

Zofunika! Pakapanda kulephera kwa chitetezo cha mthupi, matupi oyang'anira mthupi la beta amapangika. Maselo amawonongeka ndikuwatsogolera ku matenda oyipa omwe amatchedwa shuga mellitus.

Kuika ndi chiyani ndipo chifukwa chiyani kofunikira

Njira ina yoyenera yonyamulira chithokomiro cha tiziyeto tambiri ndikuika chiwiya chaching'ono. Poterepa, kukhazikitsa chiwalo chongogwiritsa ntchito sikofunikira. Kuika kumapereka mwayi kwa anthu odwala matenda ashuga kuti abwezeretse mawonekedwe a maselo a beta ndipo kafotokozedwe ka kapamba sikofunikira konse.

Kutengera ndi maphunziro azachipatala, zinatsimikiziridwa kuti mwa odwala omwe ali ndi matenda a shuga 1, omwe amapereka maselo a islet, malamulo a kuchuluka kwa carbohydrate amabwezeretsedwa kwathunthu. Pofuna kupewa kukanidwa ndi minofu yaopereka, odwala oterewa adalandira chithandizo champhamvu cha immunosuppressive.

Kubwezeretsa zilumba, pali chinthu chinanso - masentimita a tsinde. Popeza malo omwe amasungidwe a maselo aopereka alibe malire, njira ina ndiyofunika kwambiri.

Ndikofunikira kwambiri kuti thupi libwezeretse chitetezo cha mthupi, apo ayi maselo omwe angobwezeretsedwawo adzakanidwa kapena kuwonongedwa pakapita nthawi.

Masiku ano mankhwala obwezeretsa akukhala mwachangu, amapereka njira zatsopano m'malo onse. Xenotransplantation ikuwonjezeranso - kufalikira kwa munthu kwa nkhumba kapamba.

Zowetcha nkhumba parenchyma zimagwiritsidwa ntchito pochiza matenda ashuga ngakhale insulin isanapezeke. Zidachitika kuti tiziwalo ta anthu ndi nkhumba timasiyana mu amino acid m'modzi.

Popeza matenda ashuga amakula chifukwa cha kuwonongeka kwa zilumba za Langerhans, kuphunzira kwawo kuli ndi chiyembekezo chachikulu chothandizira bwino matendawa.

Ntchito ndi matenda a mabungwe am'midzi ya Langerhans: kulephera kwamafuta obisika 🏥💉

Pancreatic minofu imayimiriridwa ndi mitundu iwiri yamapangidwe am' cell: acinus, yomwe imatulutsa ma enzymes ndikuchita nawo gawo logaya chakudya, ndi islet ya Langerhans, yomwe ntchito yake yayikulu ndikupanga mahomoni.

Pali magawo ochepa mu gland yomweyo: amapanga 1-2% ya kuchuluka kwa chiwalo. Maselo a zisumbu za Langerhans amasiyanasiyana machitidwe ndi kagwiridwe kake. Pali mitundu isanu ya izo. Amabisalira zinthu zina zomwe zimayendetsa kagayidwe kazakudya, chimbudzi, ndipo amatha kutenga nawo mbali pazochitikira pakakhala kupsinjika.

Mitundu yama cell a islet ndi ntchito zawo

Ma cell a OL amasiyana pamapangidwe a morphological, amagwira ntchito, komanso kutulutsa. Pazilumbazi ali ndi mawonekedwe okongola. Chilumba chilichonse chili ndi gulu lolinganizidwa. Pakati pake pali maselo omwe amabisa insulin. M'mphepete - maselo ofikira, kuchuluka kwake komwe kumatengera kukula kwa OL. Mosiyana ndi acini, OL sikhala ndi ma ducts ake - mahomoni amalowa m'magazi mwachindunji kudzera mwa capillaries.

Pali mitundu yayikulu 5 ya maselo a OL. Aliyense wa iwo amapanga mtundu wina wa mahomoni, kuyang'anira chimbudzi, chakudya ndi michere ya mapuloteni:

Pancreatic islet ya Langerhans. Zilumba za Langerhans: Mitundu yamitundu, mawonekedwe ndi kapangidwe kake

Zikondamoyo zimawerengedwa kuti ndi chimodzi mwazinthu zofunika kwambiri. Sangotenga nawo gawo logaya chakudya, komanso ali ndi ntchito za endocrine. Kubisala kwamkati kumachitika chifukwa cha maselo apadera omwe amakhala mchira wa anatomical mapangidwe awa. Malo omwe mahomoni a pancreatic amapangidwira amatchedwa chisumbu cha Langerhans. Kapangidwe kameneka ndikofunika kwambiri pantchito. Chifukwa cha izo, kagayidwe kazakudya umaperekedwa.

Kodi ndimazinthu ziti zomwe zimatulukira mumayendedwe aslet?

Owerenga athu ambiri ali osangalala ndi kusinthaku atatha kuthana ndi kapamba! Izi ndi zomwe Galina Savina akuti: "Njira yokhayo yothana ndi kapamba ndi mankhwala achilengedwe: Ndinapanga supuni ziwiri za usiku ..."

Kugonjetsedwa kwa maselo a OL kumabweretsa zotsatira zoyipa. Ndikakonza njira ya autoimmune ndikupanga ma antibodies (AT) kupita ku ma cell a OL, kuchuluka kwa zinthu zonsezi kapangidwe kake kamachepa kwambiri. Kugonjetsedwa kwa 90% ya maselo kumayendetsedwa ndi kuchepa kwambiri kwa kaphatikizidwe ka insulin, komwe kumayambitsa matenda a shuga mellitus. Kupanga kwa ma antibodies kupita ku ma islet cell a kapamba kumachitika makamaka mwa achinyamata.

Pancreatitis, njira yotupa m'matumba a pancreatic, imabweretsa zotsatira zoyipa chifukwa cha kuwonongeka kwa ma islets. Nthawi zambiri zimachitika mozama kwambiri mu mawonekedwe a pancreatic necrosis, momwe mumakhala kufa kwathunthu kwa maselo a ziwalo.

Kutsimikiza kwa ma antibodies kupita ku zisumbu za Langerhans

Ngati, pazifukwa zina, kusagwira bwino ntchito m'thupi kumachitika ndipo kupangika kwamphamvu kwa chitetezo chathupi kumayambira, izi zimabweretsa zotsatirapo zoyipa. Maselo a beta akapezeka ndi ma antibodies, mtundu I shuga mellitus umalumikizidwa ndi insulin yokwanira kupanga. Mtundu uliwonse wa antibody umatulutsa motsutsana ndi mtundu wina wa mapuloteni. Pankhani ya ma islets a Langerhans, awa ndi ma cell a beta omwe amapanga insulin. Mchitidwewo umapitilira pang'onopang'ono, maselo amafa kotheratu, kagayidwe kazakudya kamasokoneza thupi, ndipo ndikamadwala bwino, wodwalayo amatha kufa ndi njala chifukwa cha kusintha kosasintha kwa ziwalo.

Njira zakuzindikiritsa zakonzedwa kuti zidziwike kukhalapo kwa ma antibodies a insulin mthupi la munthu. Zowonetsa phunziroli ndi:

mbiri yakale ya kunenepa,
matenda aliwonse a kapamba, kuphatikizapo kuvulala,
matenda oopsa: ambiri tizilombo, omwe angayambitse kukula kwa njira ya autoimmune,
kupsinjika kwakukulu, kupsinjika kwa malingaliro.

Pali mitundu itatu ya ma antibodies chifukwa mtundu wa matenda a shuga amandipeza:

glutamic acid decarboxylase (imodzi mwazinthu zofunika za amino acid m'thupi),
kupanga insulin,
ku OL cell.

Awa ndimakalata achilendo omwe ayenera kuphatikizidwa mu ndondomeko yoyeserera ya odwala omwe ali ndi zoopsa zomwe zingachitike. Kuchokera pazomwe zalembedwa, kuchuluka kwa ma antibodies ku glutamine amino acid ndi chizindikiritso cha matenda ashuga. Amawonekera pomwe matenda azachipatala adakalibe. Amatsimikiziridwa makamaka ali aang'ono ndipo amatha kugwiritsidwa ntchito kuzindikira anthu omwe ali ndi chiyembekezo chakukula kwa matendawa.

Islet cell transplantation

Kuika maselo a OL ndi njira ina yosinthira kapamba kapena gawo lake, komanso kukhazikitsa chiwiya chongopanga. Izi ndichifukwa cha kukhudzika kwambiri komanso kukhudzika kwa minofu ya pancreatic pazotsatira zilizonse: imavulazidwa mosavuta ndikuletsa kubwezeretsanso ntchito zake.

Kuphatikizika kwa Islet masiku ano kumapangitsa kuchitira mtundu wa matenda ashuga a mtundu woyamba ngati milandu ya insulin ilibe malire ndipo singathe kugwira ntchito. Njira yoyamba idagwiritsidwa ntchito ndi akatswiri aku Canada ndipo imakhala ndikuyambitsa maselo othandizira a endocrine mu cellal portal ya chiwindi pogwiritsa ntchito catheter. Cholinga chawo ndikupanga kuti maselo anu a beta azigwira ntchito, nawonso.

Chifukwa cha kugwira ntchito kwa zinthu zinaika, kuchuluka kwa insulini kofunikira kukhala ndi shuga wamagazi pang'ono kumapangidwa pang'onopang'ono. Zotsatira zimachitika mwachangu: ndi opaleshoni yopambana, pakatha milungu iwiri mkhalidwe wa wodwalayo wayamba kusintha, mankhwala obwezeretsawa amatha, kapamba amayamba kudzipangira yekha insulin.

Kuopsa kwa opaleshoni ndikukana maselo omwe asinthidwa. Zipangizo za Cadaveric zimagwiritsidwa ntchito, zomwe zimasankhidwa mosamala kutengera magawo onse a kuphatikizika kwa minofu. Popeza pali njira 20 zotere, ma antibodies omwe amapezeka mthupi amatha kubweretsa chiwonongeko cha minofu ya kapamba. Chifukwa chake, gawo lofunikira limasewera ndimankhwala oyenera omwe amathandizira kuchepetsa mayankho a chitetezo cha mthupi. Mankhwalawa amasankhidwa mwanjira yoti angalepheretse ena mwazo, zomwe zimakhudza kupanga kwa ma antibodies, kupita ku maselo obwezeretsereka a Langerhans. Izi zimachepetsa chiopsezo ku kapamba.

Muzochita, kufalikira kwa maselo a pancreatic mu mtundu I shuga mellitus akuwonetsa zotsatira zabwino: palibe olemba omwe anafa pambuyo pa opaleshoni. Ambiri mwa odwala adachepetsa kwambiri insulin, ndipo gawo la odwala omwe adachitidwa adasiya kufunikira. Ntchito zina zosokonekera za chiwalo zimabwezeretsedwa, ndipo mkhalidwe waumoyo udayamba kuyenda bwino. Gawo lofunika labwereranso m'moyo wabwino, womwe umatipatsa chiyembekezo chotsimikizika.

Monga kuphatikizira kwa ziwalo zina, opaleshoni ya pancreatic, kuwonjezera pa kukana, ndiowopsa ndi zotsatira zina chifukwa chophwanya magawo osiyanasiyana a chinsinsi cha kapamba. Milandu yayikulu, izi zimabweretsa:

ku matenda am'mimba,
kusanza ndi kusanza
kusowa kwamadzi kwambiri,
Zizindikiro zina za dyspeptic,
kutopa kwathunthu.

Pambuyo pa njirayi, wodwalayo ayenera kulandira mosalekeza mankhwala a immunosuppression moyo wake wonse kuti aletse kukanidwa kwa ma cell achilendo. Kuchita kwa mankhwalawa cholinga chake ndikuchepetsa mayankho mthupi - kupanga ma antibodies. Chifukwa chake, kusowa kwa chitetezo chokwanira kumawonjezera mwayi wokhala ndi matenda aliwonse, ngakhale osavuta, omwe amatha kukhala ovuta komanso amabweretsa zovuta.

Kafukufuku wokhudza kupatsirana kwa kapamba kuchokera kwa nkhumba kukupitilira - xenograft. Amadziwika kuti anatomy ya gland ndi porcine insulin ndi omwe ali pafupi kwambiri ndi anthu ndipo amasiyana nawo mu amino acid imodzi. Asanatuluke kwa insulin, pancreatic pig idagwiritsidwa ntchito pochiza matenda oopsa a shuga.

Chifukwa chiyani amasintha?

Minofu yowonongeka ya pancreatic sikukonza. Pankhani yovuta ya matenda a shuga, pamene wodwala akakhala ndi insulin yambiri, njira zoterezi zimapulumutsa wodwalayo, zimapatsa mwayi kubwezeretsa kapangidwe ka maselo a beta. M'maphunziro angapo azachipatala, maselo awa adasinthidwa kuchokera kwa opereka. Zotsatira zake, kuwongolera kwa kagayidwe kazachilengedwe kunabwezeretsedwanso. Kuphatikiza apo, odwala ayenera kuchita immunosuppress chithandizo champhamvu kuti minofu yaopereka isakanidwe.

Si odwala onse omwe ali ndi mtundu wa matenda a shuga omwe amawonetsedwa ndikusintha kwa maselo. Pali mayeso okhwima:

kusowa kwa zotsatira zochizira zosagwiritsidwa ntchito,
insulin kukana
kutchulidwa kagayidwe kachakudya mthupi,
zovuta zovuta za matenda.

Kodi opareshoni imachitidwa kuti ndipo imawononga ndalama zingati?

Njira yolowera m'malo mwa Langerhans imachitika kwambiri ku United States - motero kuchitira mtundu uliwonse wa matenda ashuga koyambirira. Izi zikuchitidwa ndi imodzi mwazipembedzo zofufuzira za shuga ku Miami. Sizingatheke kuchiritsa matenda ashuga mwanjira iyi, koma njira yabwino yochizira imatheka, ndipo kuopsa kwa zovuta zazikulu kumachepetsedwa.

Mtengo wa kulowererapo ndi pafupifupi $ 100,000. Kubwezeretsa kwa postoperative ndi chithandizo cha immunosuppressive kuyambira pa 5 mpaka 20 $. Mtengo wa mankhwalawa pambuyo pakuchita opaleshoni zimadalira momwe thupi limayankhira maselo omwe adasinthidwa.

Pafupifupi atangochotsa, kapamba amayamba kugwira ntchito modziyimira pawokha, ndipo pang'onopang'ono ntchito yake imayamba kuyenda bwino. Njira yochira imatenga pafupifupi miyezi iwiri.

MUNGATANI KUTI MUKAYAMULIRE PANCREATIS POPANDA?

Pofuna kupewa komanso kuchiza matenda a kapamba, owerenga athu amalimbikitsa tiyi wa Monastic. Kuphatikizika kwapadera, komwe kumaphatikizapo 9 mankhwala opangira pancreas, omwe aliwonse omwe samangothandiza, komanso kuwonjezera zochita za wina ndi mnzake. Kugwiritsa ntchito, simumangochotsa zisonyezo zonse za kutukusira kwa England, komanso ndikuchotsa zomwe zimapangitsa kuti zichitike kosatha.

kusiya mowa ndi kusuta,
kupatula zakudya zopanda pake
zolimbitsa thupi
Kuchepetsa kupsinjika kwambiri ndi kuchuluka kwa malingaliro.

Chovulaza chachikulu kwambiri cha kapamba chimayamba chifukwa cha mowa: chimawononga minyewa ya kapamba, chimayambitsa matenda a chamba - kufa kwathunthu kwamitundu yonse yamaselo omwe sangabwezeretsedwe.

Kugwiritsa ntchito kwambiri mafuta ndi nyama yokazinga kumadzetsa zotsatirazi, makamaka ngati izi zimachitika pamimba yopanda kanthu komanso pafupipafupi. Katundu pa kapamba amachulukirachulukira, kuchuluka kwa ma enzyme omwe amafunikira kuti mafuta ambiri azimbidwa ndikuchotsa chiwalo. Izi zimabweretsa ma fibrosis ndikusintha kwa maselo otsala a gland.

Chifukwa chake, pakakhala chizindikiro chochepa kwambiri chokhala ndi vuto logaya chakudya, tikulimbikitsidwa kukaonana ndi gastroenterologist kapena othandizira ndi cholinga chokonzanso panthawi yake kusintha komanso kupewa mavuto.

Kunyalanyaza kapena kulandira chithandizo choyipa cha kapamba kumabweretsa zotsatira zoyipa:

matenda ashuga
chiwindi ndi matenda a impso,
oncology, yomwe imawopseza kuchotsedwa kwina kapena kwathunthu kwa kapamba.

Osanenapo, kudya mosamalitsa, kuchuluka kwa michere ndi kutalika kwa nthawi, pomwe kulibe mphamvu yokhala ndi moyo. "Koma kuiwala za kapamba ndizotheka," akutero mkulu wa gastroenterologist wa Russian Federation.

Mbiri yakale

A Paul Langerhans, monga wophunzira zachipatala, akugwira ntchito ndi Rudolf Virchow, mu 1869 adafotokoza maselo omwe amapezeka m'matumba a kapamba omwe anali osiyana ndi minofu yoyandikana nayo, pambuyo pake adamupatsa dzina. Mu 1881, K.P. Ulezko-Stroganova adafotokoza koyamba za endocrine gawo la maselo amenewa. Ntchito yowonjezera pancreatic idatsimikiziridwa ku Strasbourg (Germany) mu chipatala cha wamkulu wa matenda ashuga Naunin Mering ndi Minkowski mu 1889 - matenda a shuga a pancreatic adatsimikiziridwa koyamba.Wasayansi waku Russia a L. V. Sobolev (1876-1919) mu dissertation yake "Pa morphology ya kapamba ndi nyambo ya chimbudzi chake mu matenda ashuga ndi zina zina" adawonetsa kuti kukakamiza kwa kuchotsedwa kwa kapamba kumabweretsa ku dipatimenti ya atcinous (exocrine), pomwe zilumba zapanchipisi zimakhalabe zolimba. Kutengera ndi kuyesaku, a L. V. Sobolev anazindikira kuti: "magawo a ma pancreatic is the regulation of carbohydrate metabolism in the body. Imfa ya ma pancreatic islets ndipo kuchepa kwa ntchitoyi kumadzetsa vuto - shuga mellitus. "

Mtsogolomo, chifukwa cha kafukufuku wambiri omwe amachitika ndi akatswiri azakuthambo ndi ma pathophysiologists m'maiko osiyanasiyana (pancreatectomy, kusankha pancreatic beta-cell necrosis ndi mankhwala a alloxan), chidziwitso chatsopano chinapezeka pancreatic extmental function.

Mu 1907, Lane & Bersley (University of Chicago) adawonetsa kusiyana pakati pa mitundu iwiri ya maselo a islet, omwe amawatcha mtundu A (ma alpha cell) ndi mtundu B (maselo a beta).

Mu 1909, ofufuza ku Belgian a Jan de Meyer adasankha kuyitanitsa kutulutsa kwa maselo a beta a islets a Langerhans insulin (kuyambira lat. insula - islet). Komabe, umboni wapadera wakupanga kwa mahomoni omwe amakhudza kagayidwe kazachilengedwe sakanapezeka.

Mu 1921, dokotala wachinyamata wa ku Canada Frederick Bunting ndi mnzake wothandizira wa chipatala Charles Best adakwanitsa kudzipatula ku insulin mu labotale ya Zanyama za Profesa J. Macleod ku Yunivesite ya Toronto.

Mu 1962, Marlin et al adapeza kuti madzi amkati a kapamba amatha kuwonjezera glycemia. Thupi lomwe limayambitsa hyperglycemia limatchedwa "hyperglycemic glycogenolytic factor." Zinali glucagon - imodzi mwazomwe zimatsutsa insulin.

Mu 1967, a Donatan Steiner et al. (University of Chicago) anapeza puloteni ya progenitor insulin. Adawonetsa kuti kapangidwe ka insulin ndi maselo a beta amayamba ndi kupangidwa kwa molekyulu ya proinsulin, komwe pambuyo pake, pakufunika, C-peptide ndi molekyulu ya insulin imapukusika.

Mu 1973, a John Ensik (University of Washington), komanso asayansi angapo ochokera ku America ndi ku Europe, adagwira ntchito yoyeretsa komanso kapangidwe ka glucagon ndi somatostatin.

Mu 1976, Gudworth & Bottaggo anapeza vuto la majini mu molekyulu ya insulin mwa kupeza mitundu iwiri ya mahomoni: abwinobwino komanso osagwira ntchito. chotsirizacho ndichotsutsana ndi insulin yabwino.

Mu 1979, chifukwa cha kafukufuku wa Lacy & Kemp ndi olemba anzawo, zidatulutsa timawu tating'ono ndi ma cell a beta, ndizotheka kupatula zisumbu kuchokera kumbali ya zigawo zikuluzikulu ndi kuziwonjezera poyesera. Mu 1979-1980 pakukula kwa maselo a beta, chotchinga china cha mitundu chinagonjetsedwa (maselo aminyama yamoyo yathanzi adayikidwa munyama wodwala wamtundu wina).

Mu 1990, pancreatic ispell transplant yoyamba idachitidwa kwa wodwala matenda ashuga.

Kodi ma kapamba amapanga mahomoni ati?

Kasitomala amatenga mbali makamaka popanga timadziti tam'mimba, timene timakhala ndi ma enzymes amphamvu. Ma Enzyms amatulutsidwa m'matumbo ang'onoang'ono mutatha kudya kuti apukute chakudya chomwe chikubwera.

Iron imapanganso mahomoni osiyanasiyana omwe amawongolera kuchuluka kwa glucose m'magazi.

Gland imapanga mahomoni ochokera ku ma cell a endocrine - maselowa amaphatikizidwa m'magulu amodzi omwe amatchedwa islets of Langerhans ndikuwongolera ndi thandizo lawo zomwe zimachitika m'magazi.

Maselo amatha kutulutsa mahomoni mwachindunji m'magazi pakafunika.

Makamaka, shuga m'magazi akakwera, maselo amatulutsa mahomoni, makamaka ma insulin.

Chifukwa chake, kapamba amatulutsa insulin.

Homoni iyi imathandizira thupi kutsitsa magawo a shuga m'magazi ndikuwongolera shuga kwa mafuta, minofu, chiwindi ndi minofu ina ya mthupi, komwe angagwiritsidwe ntchito kupanga mphamvu pakafunika.

Ma cell a Alfa omwe amakhala m'masukulu a Langerhans amapanga mahomoni ena ofunika, glucagon. Imakhala ndi zotsatira zotsutsana ndi insulin, kuthandiza kutulutsa mphamvu m'magazi, kukweza shuga.

Glucagon ndi insulin amagwira ntchito limodzi kuti athe kuwononga kuchuluka kwa shuga m'magazi.

Makhalidwe wamba

Ntchito yayikulu ya kapamba ndikupanga ma pancreatic enzymes. Imayang'anira ndi thandizo lawo njira za chimbudzi.

Amathandizira kuphwanya mapuloteni, mafuta ndi chakudya chamagulu omwe amabwera ndi chakudya. Kuposa 97% ya ma cell a gland ndi omwe amapangitsa kuti apangidwe.

Ndipo pafupifupi 2% yokha ya voliyumu yake imakhala ndi ziwalo zapadera, zotchedwa "zilumba za Langerhans." Ndi gulu laling'ono la maselo omwe amapanga mahomoni.

Masango awa amapezeka ndendende pancreas yonse.

Ma cell a endocrine gland amatulutsa mahomoni ena ofunikira. Ali ndi kapangidwe kapadera komanso mathupi.

Magawo awa a gland komwe mabwalo a Langerhans amapezeka alibe zimbudzi. Mitsempha yambiri yokha, pomwe mahomoni adalandira mwachindunji, amawazungulira.

Ndi mitundu yambiri ya kapamba, masango awa a endocrine maselo nthawi zambiri amawonongeka. Chifukwa cha izi, kuchuluka kwa mahomoni omwe amapangidwa amathanso kuchepa, omwe amawonongera molakwika momwe thupi limakhalira.

Kapangidwe ka zisumbu za Langerhans ndi kopambana. Asayansi adagawa maselo onse omwe amapanga mitundu inayi ndikupeza kuti iliyonse imapanga mahomoni ena:

pafupifupi 70% ya kuchuluka kwa ma islets a Langerhans amakhala ndi ma cell a beta omwe amapanga insulin,
pamalo wofunikira kwambiri ndi maselo a alpha, omwe amapanga 20% ya izi, amapanga glucagon,
maselo a delta amatulutsa somatostatin, amapanga malo ochepera 10% a malo omwe kuli maselo a Langerhans,
koposa zonse, pali maselo a PP omwe amayang'anira ntchito yopanga pancreatic polypeptide,
Kuphatikiza apo, pang'ono, gawo la pancreas limapanga mahomoni ena: gastrin, thyroliberin, amylin, c-peptide.

Mavuto omwe angakhalepo m'thupi

Pakati pa chakudya, kapamba samatulutsa insulini, ndipo izi zimapangitsa kuti thupi lithe kutulutsa mphamvu pang'onopang'ono m'magazi momwe zimafunikira.

Magazi a shuga m'magazi amakhalabe okhazikika nthawi iliyonse, zomwe zimapangitsa kuti thupi lizikhala ndi mphamvu nthawi zonse. Mphamvu izi ndizofunikira kwa iye kuphatikiza kagayidwe, masewera olimbitsa thupi komanso mawonekedwe a "mafuta" muubongo, omwe "amagwira ntchito" pagulu.

Izi zikuwonetsetsa kuti thupi silikhala ndi njala pakati pa chakudya.

Komanso mahomoni omwe amatulutsidwa panthawi yamavuto akulu, monga adrenaline, amaletsa kutulutsa kwa insulin, zomwe zimapangitsa kuti magazi azikhala ndi magazi ambiri.

Maselo a pancreatic opanga insulini akayamba kugwira ntchito, kapena kusiya kugwira ntchito konse, osapanga insulin yokwanira, amayambitsa matenda a shuga.

Ichi ndiye timadzi tofunikira kwambiri ta pancreatic yomwe imakhudza kagayidwe kazakudya m'thupi. Ndiye amene amachititsa kuchuluka kwa shuga m'magazi ndi kuchuluka kwa maselo osiyanasiyana. Sizokayikitsa kuti munthu wamba, kutali ndi mankhwala, amadziwa zomwe ma kapamba amapanga, koma aliyense amadziwa za mbali ya insulin.

Hormoni iyi imapangidwa ndi ma cell a beta, omwe ndi ochuluka kwambiri kuzilumba za Langerhans. Sipangidwa kwina kulikonse m'thupi. Ndipo munthu akamakalamba, maselo amenewa amafa pang'onopang'ono, motero kuchuluka kwa insulin kumachepa. Izi zitha kufotokozera kuti chiwerengero cha anthu odwala matenda a shuga chikuwonjezereka ndi zaka.

Hemeni wa insulin ndi phula mapuloteni - polypeptide yochepa. Sipangapangidwe nthawi zonse chimodzimodzi.

Zimathandizira kupanga kuwonjezeka kwa kuchuluka kwa shuga m'magazi. Inde, popanda insulin, glucose sangatengeredwe ndi maselo a ziwalo zambiri.

Ndipo ntchito zake zazikulu ndizotsimikizika kuti tifulumizitse kusamutsa kwa mamolekyulu a shuga m'maselo. Iyi ndi njira yovuta, yoonetsetsa kuti glucose sapezeka m'magazi, koma amayenda komwe amafunikira kwenikweni - kuwonetsetsa momwe maselo amagwirira ntchito.

Udindo wamahomoni

Insulin, mahomoni akuluakulu a kapamba, amalamulidwa mwamphamvu mthupi lamunthu wathanzi kuti athe kugawa chakudya komanso zosowa za thupi.

Insulin imayang'anira kagayidwe, kamalimbikitsa kuyamwa kwa chakudya chamagulu. Glucose yemwe amatengedwa ndi minofu amasinthidwa kukhala glycogen kudzera glycogeneis, kapena mafuta (triglycerides) kudzera lipo lipois.

Zochita za mahomoni pamlingo wa kagayidwe ka anthu zimaphatikizapo:

kuchuluka kwa zinthu zama cell, zomwe zimadziwika kwambiri pakumata kwa glucose ndi minofu ndi minyewa ya adipose (pafupifupi magawo awiri mwa atatu a maselo onse amthupi),
kuchulukitsa kwa kubwereza kwa DNA ndi kaphatikizidwe ka mapuloteni mwa kuwongolera kuyamwa kwa amino acid,
kusintha kwa ntchito yama enzyme ambiri.

Zochita za insulin, mwachindunji komanso m'njira zina:

kukondoweza kwa matenda a shuga - insulini imachepetsa kuchuluka kwa shuga m'magazi chifukwa cha kupezeka kwa shuga m'maselo a khungu,
induces glycogen kaphatikizidwe - pamene shuga wambiri ndi wokwera, insulini imapangitsa mapangidwe a glycogen mwa kuyambitsa enzyme ya hexokinase. Kuphatikiza apo, insulin imayambitsa ma enzymes phosphofructokinase ndi glycogen synthases, omwe amachititsa kuti glycogen aphatikizidwe,
kuchuluka kwa potaziyamu - kukondoweza kwa maselo kuti achulukitse zomwe zili mumadzi amkati,
kutsika kwa gluconeogenesis ndi glycogenolysis, komwe kumachepetsa kupanga kwa glucose kuchokera kumagulu osagwiritsa ntchito carbohydrate, makamaka m'chiwindi.
kuchuluka kwa lipid - insulin imapangitsa kuti maselo am'magazi adye shuga a m'magazi, omwe amasintha kukhala triglycerides, kuchepa kwa insulin kumayambitsa zotsatira zotsutsana.
kuchuluka kwa mafuta acids - tsitsa adipose minofu kuti apange mafuta osagwira (mwachitsanzo, triglycerides), kuchepa kwa insulin kumayambitsa zotsatira zotsutsana.
lipolysis yafupika - njira yogawa mafuta mu michere yawo yamafuta mwa zochita za lipase enzyme
proteinolysis yachepa - kuchepa kwa mapuloteni,
kuchepa kwa autophagy - kuchepa kwa milingo ya ziphuphu zowonongeka za ma organelles,
kuchuluka kwa ma amino acid - kumapangitsa maselo kuyamwa ma amino acid, kuchepa kwa insulini kutsekemera,
ochepa minofu toning - imakakamiza minofu yakhoma kuti isamasuke, ichulukitse magazi, makamaka m'mitsempha yaying'ono, kuchepa kwa insulin kumalola minofu kuti ilowe,
kuchuluka katulutsidwe wa hydrochloric acid wama cell a parietal m'mimba,
Anachepetsa aimpso masodium.

Insulin imakhudzanso ntchito zina za thupi, monga kutsata kwamitsempha ndi luso la kuzindikira. Insulin ikangolowa mu ubongo wa munthu, imasintha kuphunzira ndikuphunzira pamawu amakumbukiro amunthu.

Horm imakhalanso ndizolimbikitsa pakumasulidwa kwa hormone gonadotropin kuchokera ku hypothalamus, yomwe imakondweretsa ntchito yobereka.

Mahomoni pancreatic polypeptide ndi somatostatin opangidwa ndi kapamba amati amathandizira pakuwongolera komanso kukonza bwino ma cell a insulin ndi glucagon.

Ichi ndiye chachiwiri chofunikira kwambiri cha pancreatic. Amatulutsa maselo a alpha, omwe amakhala pafupifupi 22% mwa kuchuluka kwa zilumba za Langerhans. Mwapangidwe, imafanana ndi insulin - imakhalanso ndi polypeptide yochepa. Koma ntchitoyo imachita chimodzimodzi. Sizimachepetsa, koma zimachulukitsa kuchuluka kwa glucose m'magazi, ndikulimbikitsa kutuluka kwake kuchokera malo osungira.

Pancreas amabisa glucagon pamene kuchuluka kwa glucose m'magazi kumachepera. Kupatula apo, iyo, limodzi ndi insulin, imalepheretsa kupanga kwake. Kuphatikiza apo, glucagon synthesis imawonjezeka ngati pali matenda m'magazi kapena kuwonjezeka kwa cortisol, ndikulimbitsa thupi kowonjezereka kapena kuwonjezeka kwa kuchuluka kwa mapuloteni.

Pancreatic Polypeptide

Palinso ma horoni osafunikira kwenikweni a pancreatic, omwe amapangidwa pang'ono. Chimodzi mwa izo ndi pancreatic polypeptide.

Zinapezeka posachedwa, motero ntchito zake sizimamvetsetseka bwino. Hormone iyi imapangidwa kokha ndi kapamba - maselo ake a PP, komanso m'miyendo.

Amabisala ndikamadya chakudya chamafuta ambiri kapena mafuta, ndimphamvu zolimbitsa thupi, kufa ndi njala, komanso ndi hypoglycemia.

Hemidoli ikalowa m'magazi, kupanga ma enzymes a pancreatic kumatsekedwa, kumasulidwa kwa bile, trypsin ndi bilirubin kumachepetsedwa, komanso kupumula kwa minofu ya ndulu. Likukhalira kuti pancreatic polypeptide imapulumutsa ma enzymes ndikuletsa kutayika kwa bile.

Kuphatikiza apo, amawongolera kuchuluka kwa glycogen m'chiwindi. Amadziwika kuti ndi kunenepa kwambiri komanso ma metabolic ena a metabolic, kusowa kwa timadzi timeneti kumawonedwa.

Ndipo kuwonjezeka kwa msinkhu wake kungakhale chizindikiritso cha matenda osokoneza bongo kapena zotupa zamagetsi.

Kuchepa kwa mahormone

Njira zotupa ndi matenda ena a kapamba angawononge ma cell omwe ma mahomoni amapangidwa. Izi zimabweretsa kuwoneka kwa ma pathologies osiyanasiyana ogwirizana ndi zovuta zama metabolic. Nthawi zambiri, ndi hypofunction ya maselo a endocrine, kusowa kwa insulin kumawonedwa ndipo matenda a shuga amayamba. Chifukwa cha izi, kuchuluka kwa glucose m'magazi kumakwera, ndipo sangathe kumizidwa ndi maselo.

Pozindikira matenda a endocrine pancreatic pathologies, kuyezetsa magazi ndi mkodzo wama glucose kumagwiritsidwa ntchito. Ndikofunika kwambiri kufunsa dokotala kuti amupimitse pokayikira pang'ono pakamwa.

Kutsimikiza kosavuta kuchuluka kwa shuga m'magazi sikuti nthawi zonse kumasonyeza kukula kwa shuga. Ngati matendawa akuwakayikira, kuyesa kwa biochemistry, kuyesa kwa glucose ndi zina zimachitika.

Koma kukhalapo kwa shuga mumkodzo ndi chizindikiro cha matenda oopsa.

Kuperewera kwa mahomoni ena a pancreatic ndizochepa. Nthawi zambiri izi zimachitika pamaso pa zotupa zomwe zimadalira mahomoni kapena kufa kwa maselo ambiri a endocrine.

Zikondazo zimagwira ntchito zofunika kwambiri mthupi. Sangopereka chakudya chabwinobwino. Ma mahomoni opangidwa ndi maselo ake ndiofunikira kuteteza kuchuluka kwa shuga ndikuonetsetsa kuti kagayidwe kazachilengedwe kameneka.

M'nkhaniyi, ndikuwuzani kuti ndi maselo ati omwe ali gawo laling'ono la ispancreas? Ntchito yawo ndi chiyani ndipo amateteza ma mahomoni ati?

Pakatikati

M'matumba a pancreatic mulibe acini okha, komanso ma islets a Langerhans. Maselo amtunduwu samatulutsa ma enzyme. Ntchito yawo yayikulu ndikupanga mahomoni.

Ma cell a endocrine amapezeka koyamba m'zaka za zana la 19. Wasayansi yemwe ulemu womwe mabungwewa adatchulapo anali akadali wophunzira.

Palibe zilumba zambiri zachitsulo zokha. Mwa unyinji wonse wa chiwalo, madera a Langerhans amapanga 1-2%. Komabe, udindo wawo ndi wabwino. Ma cell a endocrine gland amatulutsa mitundu isanu ya mahomoni yomwe imayendetsa chimbudzi, carbohydrate metabolism, komanso kuyankha kwa kupsinjika. Ndi matenda a zigawo zodabwitsazi, amodzi mwa matenda ofala kwambiri m'zaka za zana la 21 akupanga - matenda a shuga. Kuphatikiza apo, matenda a maselo amenewa amachititsa kuti Zollinger-Ellison syndrome, insulin, glucoganoma ndi matenda ena osowa.

Lero ndikudziwika kuti ma pancreatic islets ali ndi mitundu isanu ya maselo. Tilankhula kwambiri za ntchito zawo pansipa.

Kodi mabulogu ndi ati?

Malo opangira ma pancreatic sindiwo kudziunjikira kwamapangidwe amomwewo, amaphatikizanso maselo omwe amasiyana mu magwiridwe antchito ndi morphology. Mphepete mwa endocrine imakhala ndi maselo a beta, mphamvu zawo zonse zimakhala pafupifupi 80%, zimasokoneza ma insulin ndi insulin.

Maselo a pancreatic alpha amatulutsa glucagon. Katunduyu amagwira ntchito ngati wotsutsana ndi insulin, amathandizira kukula kwa shuga m'magazi a magazi. Amakhala pafupifupi 20% poyerekeza ndi unyinji wonse.

Glucagon imakhala ndi magwiridwe antchito ambiri. Zimakhudza kapangidwe ka shuga m'chiwindi, kumapangitsa kutsekeka kwa minofu ya adipose, kumachepetsa kuchuluka kwa mafuta m'thupi.

Komanso, chinthuchi chimalimbikitsa kukonzanso kwa maselo a chiwindi, chimathandizira insulin kuti ichoke m'thupi, komanso imathandizira kufalikira kwa impso. Insulin ndi glucagon zimakhala ndi ntchito zosiyana, komanso zosiyana. Zinthu zina monga adrenaline, mahomoni okula, cortisol amathandizira kuwongolera izi.

Maselo a Pancreatic Langerhans amapangidwa ndi magulu awa:

Kudzikundikira kwa "delta" kumapereka kubisala kwa somatostatin, komwe kungalepheretse kupanga zina. Mwa kuchuluka kwathunthu kwamafuta am'madzi awa pafupifupi 3-10%,
Maselo a PP amatha kubisa pancreatic peptide, yomwe imathandizira katulutsidwe ka m'mimba komanso imachepetsa kwambiri zochita zamagulu am'mimba,
Gulu la Epsilon limapanga chinthu chapadera chomwe chimayambitsa njala.

Langerhans Islands ndi mtundu wovuta komanso wopangidwira kwambiri womwe umakhala ndi kukula, mawonekedwe, komanso kapangidwe kogawa zigawo za endocrine.

Ndondomeko yam'manja yomwe imakhudza kulumikizana kwa ma cell ndi ma paracrine, omwe amathandiza kuti insulini imasulidwe.

Kapangidwe ka magwiridwe antchito a pancreatic islets

Zikondazo ndi chiwalo chophweka molingana ndi kapangidwe kake, koma magwiridwe akewo ndi ochulukirapo. Chiwalo chamkati chimapanga insulin ya mahomoni, yomwe imayang'anira shuga m'magazi. Ngati kuperewera kwa wachibale kapena matenda athunthu kumawonedwa, ndiye kuti matenda am'thupi apezeka - lembani matenda a shuga 1.

Popeza kapamba ndi gawo la chimbudzi, chimatenga gawo mwachangu pakupanga michere ya pancreatic yomwe imathandizira kutsika kwa chakudya, mafuta ndi mapuloteni kuchokera ku chakudya. Potsutsana ndi ntchitoyi, kapamba amadziwika.

Kugwira kwakukulu kwa ma isanc a pancreatic ndikusunga kuchuluka kwa mafuta azakudya ndikuwongolera ziwalo zina zamkati. Kudzikundikira kwamaselo kumaperekedwa mokwanira ndi magazi, amadziwika ndi mitsempha yachifundo komanso ya vagus.

Kapangidwe ka zisumbu ndizovuta kwambiri. Titha kunena kuti kuchulukana konse kwa maselo ndi mapangidwe athunthu ndi ake omwe amagwira ntchito. Chifukwa cha kapangidwe kameneka, kusinthana pakati pazigawo za parenchyma ndi gland zina kumatsimikizika.

Maselo a mabwalidwewa amakhala ndimapangidwe amitundu, ndiye kuti, mosakhalitsa. Pachithunzi chokhwima chimadziwika ndi gulu loyenera. Amakhala ndi lobules, amazunguliridwa ndi minyewa yolumikizana, mitsempha yaying'ono kwambiri yam'mimba yomwe imadutsa mkati. Maselo a Beta ali pakatikati pa lobules; ena amakhala pamunsi. Kukula kwa zilumbazi kumatengera kukula kwa masango omaliza.

Zigawo za zisumbu zikayamba kulumikizana, izi zimawonekera m'maselo ena omwe amapezeka pafupi nawo. Izi zitha kufotokozedwa ndi mfundo zotsatirazi:

Insulin imalimbikitsa chinsinsi cha maselo a beta, koma nthawi yomweyo imalepheretsa magwiridwe antchito a alpha.
Nawonso maselo a alpha "gluconagon" m'mawu, ndipo imagwira ntchito m'maselo a delta.
Somatostatin imalepheretsa magwiridwe antchito a maselo onse a beta ndi alpha.

Ngati chibadwa cha tchenicho chikuoneka kuti mwabadwa ndi vuto lomwe lalumikizidwa ndi matenda okhudzana ndi chitetezo cha mthupi, ndiye kuti ma cell a beta amatsutsidwa chifukwa chodziteteza.

Amayamba kugwa, zomwe zimayambitsa matenda oopsa komanso oopsa - matenda ashuga.

Kupatsidwa ma cell

Ndi matenda osachiritsika komanso osachiritsika. Endocrinology sinabwere ndi njira yochiritsira munthu kwamuyaya. Kupyola muzochita zamankhwala komanso moyo wathanzi, mutha kukwanitsa kulipira chindapusa cha matendawa, koma osatinso.

Maselo a Beta alibe luso lokonza. Komabe, mdziko lamakono, pali njira zina zowathandizira "kubwezeretsa" - m'malo. Pamodzi ndi kufalikira kwa kapamba kapenanso kukhazikitsa chiwalo cha mkati, ma cell a pancreatic amawayika.

Uwu ndi mwayi wokhawo wa odwala matenda ashuga kubwezeretsa mawonekedwe a zilumba zowonongeka. Kuyesa kambiri pa zasayansi kwachitika panthawi yomwe ma cell a beta kuchokera kwa omwe adapereka adasinthidwa kuti alembe matenda ashuga.

Zotsatira za kafukufuku zawonetsa kuti kulowererapo kwa maopaleshoni kumathandizira kubwezeretsa kuchuluka kwa mafuta mthupi la munthu. Mwanjira ina, pali yankho lavuto, lomwe ndi kuphatikiza kwakukulu. Komabe, moyo wonse immunosuppressive chithandizo ndi chopanda tanthauzo - kugwiritsa ntchito mankhwala omwe amaletsa kukana kwa owerenga zachilengedwe.

Monga njira ina yopezera wopereka, maselo a stem amaloledwa. Izi ndi zoyenera, popeza ma pancreatic mabungwe opereka ali ndi malo ena osungira.

Mankhwala obwezeretsa amakula ndi masitepe othamanga, koma muyenera kuphunzira momwe mungasungitsire maselo okha, komanso kupewa kuti awonongeke, zomwe zimachitika mulimonsemo mthupi la odwala matenda ashuga.

Pali lingaliro lenileni pakuphatikizira mankhwala kwa kapamba kuchokera kwa nkhumba. Asanapange insulini, zowonjezera zochokera ku zofunikira za nyama zimagwiritsidwa ntchito. Monga mukudziwa, kusiyana pakati pa insulin ya anthu ndi porcine mu amino acid imodzi.

Kafukufuku wamapangidwe ndi magwiridwe azilumba za pancreatic amadziwika ndi chiyembekezo chachikulu, chifukwa nthenda "yokoma" imayamba chifukwa cha kuwonongeka kwa kapangidwe kake.

Kansa ikufotokozedwa mu kanema munkhaniyi.

Zilumba za kapamba, zomwe zimadziwikanso kuti zisumbu za Langerhans, ndi timagulu tating'onoting'ono tamaselo tomwe timamwazikana pancreas. Chikondamoyo ndi chiwalo chokhala ndi mawonekedwe a kutalika kwa 15-20 cm, omwe amakhala kumbuyo kwa m'mimba.

Zilumba za pancreatic zimakhala ndi mitundu ingapo ya maselo, kuphatikiza ma cell a beta omwe amapanga insulin. Zikondazo zimapanganso ma enzyme omwe amathandizira kugaya chakudya komanso kuthira chakudya.

Mitsempha yamagazi ikakwera pambuyo kudya, zikondamoyo zimayankha ndikutulutsa insulin m'magazi. Insulin imathandizira maselo mthupi lonse kuyamwa glucose m'magazi ndikuigwiritsa ntchito kuti ipange mphamvu.

Matenda a shuga amapezeka pamene kapamba satulutsa insulin yokwanira, maselo a thupi sagwiritsa ntchito timadzi tambiri tomwe timagwira bwino ntchito kapena pazifukwa zonsezi. Zotsatira zake, glucose amadziunjikira m'magazi, ndipo samatengedwa ndi maselo amthupi.

Mtundu woyamba wa matenda ashuga, maselo a pancreatic beta amaletsa kupanga insulini, chifukwa chitetezo cha mthupi chimazunza ndikuziwononga. Chitetezo cha mthupi chimateteza anthu ku matenda mwa kuzindikira ndi kuwononga mabakiteriya, ma virus ndi zinthu zina zomwe zingakhale zowopsa zakunja. Anthu omwe ali ndi matenda a shuga a mtundu woyamba ayenera kumwa insulin tsiku lililonse.

Type 2 shuga mellitus nthawi zambiri amayamba ndi matenda otchedwa insulin, pomwe thupi limalephera kugwiritsa ntchito bwino insulin. Popita nthawi, kupangika kwa timadzi timeneti kumachepanso, kotero odwala ambiri omwe ali ndi matenda amtundu wa 2 m'kupita kwa nthawi adzayenera kulandira insulin.

Kodi kuyambitsidwa ndi ma pancreatic ndi chiyani?

Pali mitundu iwiri ya kusamutsa (kufalikira) kwa ma isanc pancreatic:

Kugawidwa kwa magawo onse a Langerhans ndi njira yomwe zigawenga zochokera ku zikondwerero za wakufayo zimatsukidwa, kukonzedwa ndikugulitsa kwa munthu wina. Pakadali pano, kuchuluka kwa ma pancreatic islets ndi njira yoyesera, popeza ukadaulo wawo wogulitsa sunakhale wopambana mokwanira.

Pa gawo lililonse lanyumba, asayansi amagwiritsa ntchito ma enzymes apadera kuti awachotsere kapamba ka munthu amene wamwalira. Kenako timisamba timatsukidwa ndikuwerengedwa mu labotale.

Mwawamba, olandila amalandila kawiri-kawiri, uliwonse uli ndi zilumba 400,000 mpaka 500,000. Pambuyo podzilowetsa, maselo a beta a ma isles awa amayamba kupanga ndikupanga insulin.

Langerhans islet allotransplantation imapangidwa kwa odwala omwe ali ndi matenda amtundu wa 1 omwe samayendetsa bwino magazi. Cholinga cha kuziika ndikuthandizira odwala kuti azitha kukhala ndi glucose wambiri malinga ndi jakisoni wa tsiku ndi tsiku kapena wopanda jakisoni.

Chepetsani kapena muchepetse chiopsezo cha hypoglycemia wosazindikira (mkhalidwe wowopsa momwe wodwalayo samadziona nawo chizindikiro cha hypoglycemia). Munthu akamaona njira ya hypoglycemia, amatha kuchita zambiri pokweza shuga m'magazi kuti azichita bwino.

Pancreatic islet allotransplantation imachitika kokha mu zipatala zomwe zalandira chilolezo chakuyesedwa kwamankhwala mwanjira iyi. Zogulitsa zimachitika nthawi zambiri ndi akatswiri a radiology - madokotala omwe amakhazikika pakulingalira kwamankhwala. Katswiri wama radiology amagwiritsa ntchito ma x-ray ndi ma ultrasound kutsogoza kulowetsa kwa catheter yosinthika kudzera pakayang'anidwe kakang'ono khoma lakum'mimba mu khomo lachiwindi la chiwindi.

Mitsempha ya portal ndi chotengera chachikulu cha magazi chomwe chimanyamula magazi kupita ku chiwindi. Zilumbazo zimayendetsedwa pang'onopang'ono m'chiwindi kudzera mu catheter woyikidwa mu portal mtsempha. Monga lamulo, njirayi imachitidwa pansi pa opaleshoni wamba.

Odwala nthawi zambiri amafunika kumuwonjezera kawiri kapena kupitilira apo kuti akwaniritse ntchito yaying'ono kuti athetse kapena kuthetsa kufunika kwa insulini.

Pancreatic islet autotransplantation imachitika pambuyo pancreatectomy kwathunthu - opaleshoni yochotsa chamba chonse - mwa odwala omwe ali ndi chifuwa chachikulu kapena kapamba kaamba kwakanthawi, komwe sikothandiza m'njira zina. Njirayi siziwoneka ngati yoyesa. Langenhans islet autotransplantation sizichitika mwa odwala omwe ali ndi matenda a shuga 1.

Mchitidwewu umachitika mu chipatala pansi pa opaleshoni yotupa. Choyamba, dokotalayo amachotsa kapamba, pomwe ma zipu zikuluzikuluzo amaziwachotsa. Patangotha ola limodzi, mabwalo oyeretsedwa amayamba kudzera mu catheter m'chiwindi cha wodwalayo. Cholinga cha kufalikira kotero ndikupereka thupi ndi malo okwanira a Langerhans kuti apange insulin.

Chimachitika ndi chiani pambuyo pochulukitsidwa kwa ma pancreatic islets?

Zisumbu za Langerhans zimayamba kutulutsa insulin posachedwa kufalikira. Komabe, kugwira ntchito kwawo kokwanira komanso kukula kwa mitsempha yatsopano ya magazi kumatenga nthawi.

Othandizira ayenera kupitiliza jakisoni wa insulin ntchito isanayambe. Angathenso kukonzekera mwapadera isanachitike komanso ikatha zomwe zimathandizira pakukonzekera bwino komanso magwiridwe anthawi yayitali a zisumbu za Langerhans.

Komabe, kuyankha kwa autoimmune komwe kumawononga khungu la eni ake a beta kukhozanso kuukira zisumbu zomweaziyika. Ngakhale chiwindi ndi malo achikhalidwe operekera kulowetsedwa, asayansi akufufuza malo ena, kuphatikiza minofu ya minofu ndi ziwalo zina.

Zilumba za Langerhans: endocrine ntchito ndi ma antibodies a cell pancreatic

Monga mukudziwa, ntchito yayikulu ya zisumbu za zikondamoyo za Langerhans ndikuzindikira ntchito ya endocrine ya kapamba. Choyamba, izi ndizobisalira za mahomoni akuluakulu otchedwa insulin ndi glucagon, omwe amawongolera kuchuluka kwa shuga m'magazi. Chifukwa chake, insulini imachepetsa kuchuluka kwake ngati zikuwonetsa kuposa zomwe zikuwonekera, ndipo glucagon, m'malo mwake, imachulukana.

Ndikofunika kudziwa kuti ngati ma cell a endocrine amapezeka kuti sangakwanitse kugwira ntchitoyo mokwanira, ndipo mwakutero, mahomoni omwe thupi limafunikira samasungidwa moyenera, ndiye kuti matenda a shuga amatha. Matendawa amapezeka chifukwa cha shuga wambiri m'thupi, ndipo chifukwa cha mankhwalawa, kupatsidwa insulin nthawi zonse ndikofunikira. Mtundu 1 wa nthendayi ndiowopsa kwambiri, chifukwa pamenepa ma cell a endocrine amawonongeka kwambiri, ndipo, chifukwa chake, wodwalayo akuwonjezeka pang'onopang'ono, koma mwachangu, ndipo amafunikira chithandizo chamanthawi zonse. Pakhoza kukhala zifukwa zambiri pamenepa, mwachitsanzo, kupanga ma antibodies m'thupi motsutsana ndi matenda oyamba ndi chitetezo cha mthupi.

Chofunikira, pali njira yochizira ndikukhazikitsa ntchito za ma pancreas pancreas pogulitsa masisamba a Langerhans. Koma pankhaniyi, ndikofunikira kuyamba kuwunika ma antibodies kuti ma endocrine cell a kapamba azikhala, chifukwa njira ya kupatsirana ikhoza kukhala yogwira mtundu wina wa matenda ashuga okha. Koma ndi khansa kapena matenda ena a pancreatic, samapereka zotsatira zomwe mukufuna.

Langerhans islet cell transplant ndi mtundu 1 shuga

Masiku ano, mabwalo amtundu wa Langerhans amapereka mwayi wowerengetsa matenda amtundu woyamba wa shuga, chifukwa cha kufalikira kwawo. Njira iyi idapezeka osati kale kwambiri ndi akatswiri aku Canada, ndipo ngakhale imafunikira ndalama zochulukirapo, ndipo njirayo imakhala yovuta komanso yowopsa, ndi yeniyeni ndipo imapereka mwayi wobwezeretsa pang'onopang'ono ntchito ya endocrine ya kapamba, ndipo, motero, kupulumutsidwa kwa odwala kuchokera ku matenda owopsa.

Chofunika kwambiri cha kusinthaku ndikuti maselo amtundu wa endocrine omwe amapezeka kuchokera kwa operekayo amalowetsedwa mthupi la munthu yemwe ali ndi matenda a shuga 1 kudzera m'njira ya catheter, chifukwa chake, chifukwa cha mphamvu yawo, kuchuluka kwa insulini yofunikira kuti shuga ipitirire m'magazi imayamba kupangidwa moyenera. Ndikofunikira kumvetsetsa kuti mabwalo amtundu wa Langerhans kuti asamutsidwe ndi wodwala yemwe ali ndi matenda ashuga amachotsedwa pokhapokha mtembo womwe umakumana mokwanira ndi magawo onse ofunikira, omwe amachepetsa chiopsezo chokana, makamaka popeza ma antibodies omwe alipo mthupi amafuna kupha matupi akunja. Chofunika ndikusinthika kwa maselo am'mimba am'mimba a pancreatic amathandiza kwambiri, koma chifukwa patatha milungu ingapo wodwala wokhala ndi matenda ashuga 1 akuyamba kusintha.

Ndikofunikira kumvetsetsa kuti kuphatikiza zisumbu za Langerhans kuli pachiwopsezo chakuti ma antibodies omwe ali mthupi la wodwala omwe ali ndi matenda osokoneza bongo angayambitse kukana gland. Ichi ndichifukwa chake, pakuchita bwino kwa njirayi, gawo lofunikira kwambiri limachitika ndimankhwala osokoneza bongo, omwe cholinga chake ndikulepheretsa kwakanthawi zochitika zina zomwe zingayambitse chitetezo cha m'thupi, zomwe zingayambitse kuwonongeka kwa minofu.Komanso, mankhwala ochizira wodwala amasankhidwa mwanjira yoti asangokhala kwathunthu, koma amalepheretsa pang'ono zochitika zina zokhudzana ndi chitetezo, makamaka, zomwe zimapanga ma antibodies ku maselo a isanger a Langerhans, omwe adalola kuchepetsa chiopsezo cha endocrine pancreatic function.

Mwakuchita izi, njirayi idawonetsa zotsatira zabwino kwa odwala, makamaka popeza kunalibe kufa chifukwa chakuchotsa maselo a pancreatic gland komanso kukana kwawo komwe mothandizidwa ndi ma antibodies. Komanso, odwala ena ambiri sankafunanso chithandizo cha insulini konse, pomwe ena amafunikirabe, koma zambiri za zokhudzana ndi endocrine ntchito ya kapamba zinayenda bwino kwambiri, zomwe zidapangitsa kuti akhale ndi chiyembekezo chodzakhala ndi tsogolo labwino mtsogolo.

Komabe, ndikofunikira kudziwa kuti pankhani iyi pali zovuta zina zomwe ziyenera kukumbukiridwa. Chifukwa chake, motsogozedwa ndi ma antibodies kupita ku zilumba za Langerhans, pali chiopsezo chachikulu cha mitundu yonse yazotsatira zoyipa mwa odwala, monga, kusokonezeka pakupanga madzi a pancreatic, kutsegula m'mimba, kuchepa kwa madzi, komanso zovuta zina zowopsa. Kuphatikiza apo, ngakhale atatha kuchita njirayi, amafunika kwa moyo wonse kuti amwe mankhwalawa omwe amafunikira kuti kukana kwa maselo omwe adalowetsedwa sikungayambe m'thupi. Ndipo chifukwa chakuti mankhwalawa akufuna kupewetsa chitetezo chamthupi, makamaka ma antibodies ena, kudya kwawo kumawonjezera chiopsezo cha matenda onse.

Chifukwa chake, ma pancreatic islets amagwira ntchito ya endocrine yofunika thupi lonse, ndikupanga kupanga mahomoni ofunikira kagayidwe kake ndikuwongolera kuchuluka kwa shuga m'magazi. Ichi ndichifukwa chake odwala omwe ali ndi matenda a shuga 1, nthawi zina, kupatsirana kwa maselo amtundu wa endocrine kumakhala koyenera, komwe kumapangitsa kuti thupi lizigwira ntchito, ndipo mwakutero, insulin yofunika kwambiri imapangidwa moyenera.

Kodi maubwino ndi zovuta za pancreatic islet allotransplantation ndi ziti?

Ubwino wa Langerhans islet allotransplantation umaphatikizanso kuwongolera kwa shuga wamagazi, kuchepetsedwa kapena kuthetsa jakisoni wa insulin, komanso kupewa hypoglycemia. Njira ina yothanirana ndi ma pancreatic isp ndi ma transplanc ose, omwe nthawi zambiri amachitika ndi kupatsirana kwa impso.

Ubwino wakuza kanyengoyi sikungodalira insulini komanso kugwira ntchito nthawi yayitali. Choipa chachikulu cha kufalikira kwa kapamba ndikuti ndi ntchito yovuta kwambiri yokhala ndi chiopsezo chazovuta zambiri ngakhale kufa.

Pancreatic islet allotransplantation ingathandizenso kupewa hypoglycemia wosazindikira. Kafukufuku wa asayansi awonetsa kuti ngakhale magawo omwe amagwira ntchito pang'ono atatha kupatsidwa amatha kupewa izi zowopsa.

Kupititsa patsogolo kayendedwe ka shuga m'magazi kudzera mu islet allotranspolation kumatha kuchepetsanso kapena kulepheretsa zovuta zomwe zimachitika chifukwa cha matenda ashuga, monga mtima ndi matenda a impso, mitsempha ndi vuto la maso. Kafukufuku akupitiliza kufufuza izi.

Zoyipa za pancreatic islet allotransplantation zimaphatikizapo zoopsa zomwe zimakhudzana ndi njiridwe imodzimodzi - makamaka, magazi kapena thrombosis. Zisumbu zogulitsa zitha kusiya pang'ono kapena kusiya kugwira ntchito. Ziwopsezo zina zimakhudzana ndi mavuto obwera chifukwa cha mankhwala a immunosuppress omwe odwala amakakamizidwa kuti ateteze chitetezo cha mthupi kuti chokana ma islets omwe adaika.

Ngati wodwalayo ali kale ndi impso yolocha kale ndipo akutenga kale mankhwala a immunosuppress, zoopsa zokhazokha zimayambitsa kulowetsedwa ndi zotsatira zoyipa za mankhwala a immunosuppress omwe amaperekedwa panthawi ya kuchuluka. Mankhwalawa safunikira kuti munthu azingokhala nawo mthupi lake, chifukwa maselo omwe amalowetsedwa amatengedwa m'thupi la wodwalayo.

Kodi kupindulitsa kwa zisumbu za Langerhans ndi kotani?

Kuyambira 1999 mpaka 2009 ku United States, allotransplantation of pancreatic islets inachitika kwa odwala 571. Nthawi zina, njirayi inkachitika molumikizana ndi kuphatikizira impso. Odwala ambiri amalandira inflet imodzi imodzi kapena ziwiri. Pakutha kwa zaka khumi, anthu ochepa kwambiri omwe amapezeka nthawi imodzi ndi 463,000.

Malinga ndi ziwerengero, chaka chatha kuchoka, pafupifupi 60% ya omwe adalandira adalandira ufulu kuchokera ku insulin, zomwe zikutanthauza kuti kuyimitsa jakisoni wa insulin kwa masiku osachepera 14.

Pakutha kwa chaka chachiwiri pambuyo pakuwonjezera, 50% ya omwe adalandira amatha kuyimitsa jakisoni kwa masiku osachepera 14. Komabe, kudziyimira pawokha kwa t-insulin kumakhala kovuta kusamalira, ndipo pamapeto pake ambiri mwa odwala adakakamizidwa kuti atengerenso insulin.

Zomwe zimaphatikizidwa ndi zotsatira zabwino kwambiri zamalonda zidadziwika:

Zaka - zaka 35 ndi okulirapo.
Ochepetsa kuchuluka kwa triglycerides m'mwazi musanaikidwe.
Mlingo wotsika wa insulin musanaikidwe.

Komabe, umboni wa asayansi ukusonyeza kuti ngakhale magawo ochepa ophatikizika a Langerhans amatha kusintha kayendedwe ka glucose komanso kuchepetsa ma insulin.

Kodi ma immunosuppressants ndi chiyani?

Mankhwala a Immunosuppress amafunika kupewa kukanidwa, lomwe limakhala vuto lililonse pazilala zilizonse.

Asayansi akwanitsa kuchita bwino pantchito yakuchotsa zilumba za Langerhans m'zaka zaposachedwa. Mu 2000, asayansi aku Canada adasindikiza protocol yawo (Edmonton Protocol), yomwe yasinthidwa ndi malo azachipatala ndi kafukufuku padziko lonse lapansi ndipo ikupitabe patsogolo.

Edmonton Protocol imayambitsa kugwiritsa ntchito mitundu yatsopano ya mankhwala a immunosuppressive, kuphatikizapo daclizumab, sirolimus ndi tacrolimus. Asayansi akupitiliza kukonza ndikusintha ma protocol awa, kuphatikizapo njira zabwino zochizira zomwe zimathandizira kuwonjezera kupambana. Izi ziwembu m'malo osiyanasiyana zitha kukhala zosiyana.

Zitsanzo za ma immunosuppressants ena omwe amagwiritsidwa ntchito ku Langerhans isplplantation akuphatikizapo antithymocyte globulin, belatacept, etanercept, alemtuzumab, pakuximab, everolimus, ndi mycophenolate mofetil. Asayansi akufufuzanso mankhwala omwe si a gulu la immunosuppressants, monga exenatide ndi sitagliptin.

Mankhwala a Immunosuppress ali ndi zovuta zoyipa, ndipo zotsatira zake zazitali sizimamvetsetseka kwenikweni. Zotsatira zoyipa zapompopompo zimaphatikizapo zilonda zam'mlomo komanso mavuto am'mimba (monga m'mimba ndikukwiyitsidwa). Odwala atha kukhala:

Kuchuluka magazi cholesterol.
Kuthamanga kwa magazi.
Anemia (kuchepa kwa maselo ofiira am'magazi ndi hemoglobin m'magazi).
Kutopa
Anachepetsa magazi oyera.
Ntchito yeniyeni.
Kuchulukana kwadzaoneni kumatenda a bacteria ndi ma virus.

Kutenga ma immunosuppressants kumawonjezeranso mwayi wokhala ndi zotupa ndi khansa.

Asayansi akupitilizabe kupeza njira zololera chitetezo cha mthupi kuti chisalemo malo ena, momwe chitetezo chamthupi sichizindikira kuti ndi alendo.

Kulekerera kwakukulu kungathandizire kugwiritsidwa ntchito kwa magawo obwezeretsedwa popanda kumwa mankhwala a immunosuppress. Mwachitsanzo, njira imodzi ndikutsitsa ma islets omwe amangidwa mu kupikika kwapadera komwe kungathandize kupewa kukana.

Kodi ndi zovuta ziti zomwe zikupangika kuti ma pancreatic islets azikumana?

Kuperewera kwa opereka oyenera ndikutchinga lalikulu pakugwiritsidwira ntchito kwa ziwengo zambiri za zisumbu za Langerhans. Kuphatikiza apo, siopereka onse opereka omwe ali oyenera kuchotsedwa kwa islet, chifukwa samakwaniritsa njira zonse zosankhira.

Tiyeneranso kukumbukiranso kuti pokonzekera ma islets kuti achiwike, nthawi zambiri amawonongeka. Chifukwa chake, zosowa zochepa kwambiri zimachitika chaka chilichonse.

Asayansi akuphunzira njira zosiyanasiyana kuti athane ndi vutoli. Mwachitsanzo, gawo lokhalo la kapamba wochokera kwa wopereka wamoyo ndi lomwe limagwiritsidwa ntchito; ma pancreatic islets a nkhumba amagwiritsidwa ntchito.

Asayansi adasinthanitsa nkhumba zazingwe ku nyama zina, kuphatikiza anyani, ndikuzitsekera m'chipewa chapadera kapena kugwiritsa ntchito mankhwala kuti zisakanidwe. Njira ina ndikupanga ma maslets kuchokera m'maselo amtundu wina - mwachitsanzo, kuchokera ku maselo a tsinde.

Kuphatikiza apo, zopinga zachuma zimalepheretsa anthu ambiri kupeza. Mwachitsanzo, ku United States, ukadaulo wopanga umaonedwa ngati woyesera, umawonedwa ngati ndalama, chifukwa inshuwaransi siifotokoza njira ngati izi.

Zakudya Zabwino Komanso Zakudya

Munthu yemwe adayatsidwa masisamba a pancreatic ayenera kutsatira zakudya zopangidwa ndi madokotala ndi akatswiri azakudya. Mankhwala a Immunosuppression omwe atengedwa pambuyo pakuwonjezera angayambitse kulemera. Chakudya chopatsa thanzi ndichofunikira pakuwongolera kunenepa kwa thupi, kuthamanga kwa magazi, cholesterol yamagazi, komanso kuchuluka kwa shuga m'magazi.

Timayesetsa kukupatsani chidziwitso chofunikira komanso chothandiza kwa inu ndi thanzi lanu. Zinthu zomwe zili patsamba lino ndizachidziwitso ndipo cholinga chake ndi kuphunzitsa. Alendo otsamba sayenera kuwagwiritsa ntchito ngati malangizo azachipatala. Kudziwa dokotala komanso kusankha njira zamankhwala ndikungokhala dokotala! Sikuti tili ndi vuto lililonse chifukwa chogwiritsa ntchito zidziwitso zomwe zalembedwa patsamba lino