Ngokungafani nesifo se-celiac, ukuzwela kwe-gluten akubonakali kudinga izakhi zofuzo eziqondile
Nakuba ukucwaninga kobuzwe obuningi be-celiac gluten kungukuqala kanye nezifundo ezibonisa ukuthi isimo esihlukile singakaze sichazwe, imiphumela yokuqala ibonisa ukuthi awudingi ukuthwala noma yikuphi okuthiwa yi- celiac isifo sofuzo ukuze kuthuthukiswe i-gluten ukuzwela.
Labo abanesifo se-celiac , abaqondwa kangcono ngezinhlobo eziyisihlanu ze-gluten "ukungezwani komzimba," cishe njalo baphatha enye yezakhi zofuzo eziqondile kakhulu.
Eqinisweni, odokotela bavame ukusebenzisa ukuhlolwa kofuzo ukuze baphathe isifo se-celiac - uma ungenalo igesi edingekayo ukuze uthuthukise leliacac, bathi, cishe awukho isimo.
Izakhi ze-non-celiac gluten ukuzwela zicacile kakhulu.
Indlela i-Genetics edla ngayo indima e-Celiac Disease
"Izifo zesifo se-celiac" zivela cishe ku-35 kuya ku-40% yabantu bonke, nokuthi iqiniso lokuthi unezinhlobo zezakhi zofuzo akusho ukuthi uzokuthuthukisa isifo se-celiac - kusho ukuthi usuke unamandla okwenza lokho.
Izakhi zofuzo ezikubeka esibhedlela se-celiac ziyaziwa ngokuthi izakhi zofuzo ze-HLA-DQ, futhi ziyatholakala kwi-HLA-class II complex of DNA yethu. Wonke umuntu uthole ikhophi eyodwa yegciwane le-HLA-DQ kusuka kumama wayo kanye nekhophi yesibili yegciwane le-HLA-DQ evela kubaba.
Kunezinhlobo ezine ezijwayelekile zemizimba ye-HLA-DQ, eyaziwa ngokuthi i-HLA-DQ1, i- HLA-DQ2 , i-HLA-DQ3 ne-HLA-DQ4. I-HLA-DQ1 ibuye ihlelwe phansi ibe yi-HLA-DQ5 ne-HLA-DQ6, kanti i-HLA-DQ3 ibuye ihlelwe phansi ku- HLA-DQ7 , HLA-DQ8 ne-HLA-DQ9.
Njengoba wonke umuntu athola amajethi amabili e-HLA-DQ (owodwa kusuka kumama wakhe nenye evela koyise), umuntu angaba nanoma iyiphi inhlanganisela eminingi yezinhlobo eziningi. Eminye yalezi zakhi zofuzo ibeka ekutheni isifo se-celiac, kuyilapho ucwaningo lokuqala lubonisa ezinye izakhi zofuzo ezingakunciphisa ukuzwela kwe-gluten.
Siyazi ukuthi iningi labantu abanesifo se-biopsy-esiqinisekisiwe se-celiac sithatha i-HLA-DQ2 noma i-HLA-DQ8 (i-subset ye-HLA-DQ3). Kodwa-ke, kusukela ku-35% noma ku-40% wabantu kuthwala eyodwa noma zombili zalezi zinhlobo zesifo se-celiac, ukuthi izakhi zofuzo azisho ukuthi uzothola i-celiac - kunezinye izinto ezingaboniwe.
Izidalwa ezifakiwe ku-Gluten Ukuzwela
Uma kuziwa nokuzwela kwe-gluten, kubonakala sengathi izakhi zofuzo ze-celiac azikho ukudlala, ngokusho kocwaningo oluthile.
Esifundweni socwaningo lwe - gluten socwaningo olukhishwe ngasekuqaleni kuka-2011 ngumcwaningi we-University of Maryland uDkt. Alessio Fasano, abalobi bacubungula izakhi zofuzo zalabo abatholakala benokuzwela kwe-gluten, futhi bawaqhathanisa namanye amaqembu abantu bonke ababizwa ngokuthi "igolide standard " isifo seliliac ukuxilongwa ngokusebenzisa igazi nokuhlolwa kanye biopsy.
Abacwaningi bathola ukuthi u-56% kuphela kulabo abathintekayo njenge-gluten sensitive abaphatha i-DQ2 noma i-DQ8, okubonisa ukuthi lezo zakhi zofuzo azibandakanye kakhulu ekuthuthukiseni ukuzwela kwe-gluten kunokuba kuthuthukiswe isifo se-celiac. Kodwa-ke, izakhi zofuzo zivele zivame kakhulu kulabo abanokuzwela kwe-gluten kunabo bonke abantu, ngakho-ke mhlawumbe bangadlala indima ekuzweleni kwe-gluten - akucaci ukuthi yiyiphi indima abangayidlala ngayo.
Yiqiniso, odokotela abaningi bafuna ukubona izimpendulo zikaDkt. Fasano zichazwe ngaphambi kokuba zivumelane nokuthi ubuzwe be-gluten bukhona. UDkt. Fasano okwamanje usebenzela ukukhomba ama-biomarker angaholela ekuvivinyeni kokuzwela kwe-gluten .
Ezinye iziGenesis zingase zibandakanyeke ku-Gluten ukubekezelelana
UDkt. Kenneth Fine, owasungula inqubo yokuhlola ukuzwela kwe - EnteroLab gluten , uthi ukholelwa ukuthi wonke umuntu onezinhlayiya ze-HLA-DQ2 ne-HLA-DQ8 "uzoletha i-gluten kwisistimu yesimiso sokuzivikela - okungukuthi, yi-gluten sensitive".
Kodwa labo abane-HLA-DQ2 ne-HLA-DQ8 akubona bodwa ekuzweleni kwabo kwe-gluten, kusho uDkt. Fine.
Ukholelwa ukuthi wonke umuntu ophethe i-HLA-DQ1 ne-HLA-DQ3 naye uhlelwe ukuthi abe nokuzwela kwe-gluten. Lokhu kusho ukuthi abantu abanamakhophi amabili e-HLA-DQ4 (ngaphansi kuka-1% wabantu base-US) abavikelekile ekuzweleni kwe-gluten, ngokusho kukaDkt. Fine. Ngokombono wakhe, bonke abanye banezindlela zokukhiqiza izakhi zokuthuthukisa isimo.
Abantu abanamakhophi amabili wezakhi zofuzo ezithile, njenge-HLA-DQ7 (ifomu le-HLA-DQ3 elifana ne-HLA-DQ8), ukusabela okunamandla kakhulu ku-gluten, njengoba nje nabantu abanekhophi amabili ye-HLA-DQ2 bangakha i-celiac enamandla kakhulu isifo, uthi.
Khumbula, ucwaningo lukaDkt. Fine aluzange luchazwe abanye abafunda i-genetics ye-celiac ne-gluten ukuzwela, ngakho-ke akucaci ukuthi kuzoqinisekiswa noma cha. Kodwa-ke, uma izibikezelo zakhe zibonisa ukuthi zinembile, lokho kusho ukuthi cishe wonke umuntu wase-US unezinye izakhi zofuzo eziyisisekelo ezidingekayo ukuze kuthuthukiswe ukuzwela kwe-gluten. Kodwa-ke, ngoba akuwona wonke umuntu onenkinga (bheka isihloko sami ukuthi Bangaki Abantu Abanokubaluleka Kokubaluleka? ), Kumele kube nezinye izici kanye nezakhi zofuzo ezihilelekile.
Okubalulekile
Abanye abacwaningi basadingeka ukuthi baqinisekise lezi ziphumo zokuqala kanye nezizathu zokuthi zamukeleke kakhulu emphakathini wezokwelapha, futhi kunokuningi kokungabaza phakathi kodokotela ngokuthi ngabe ukuzwela kwe-gluten kukhona nhlobo. Ngokusekelwe kukho konke lokhu, ukuhlolwa kwegciwane lokuzwela kwe-gluten akunakwenzeka ukuba kube usizo noma okusebenzayo ezweni langempela ngalesi sikhathi, uma kwenzeka.
Noma kunjalo, bobabili uDkt. Fasano noDkt. Fine, phakathi kwabanye, baqhubeka befunda umagazini we-gluten we-genetic genetics. Ukucwaninga kwabo kubonisa ukuthi noma ngabe ukuhlolwa kwakho kofuzo lwe-celiac kwakungalungile, usengenenkinga nge-gluten .
Imithombo
Ishidi langempela le-EnteroLab: Imibuzo Ebuzwa Ngokuphindaphindiwe Ngokuhunyushwa Kwemiphumela.
A. Fasano et al. Ukuphazamiseka kokugwinya kwamagciwane kanye nomzimba wegciwane lomzimba we-immunosity mucosal ngezimo ezimbili ezihlobene nezilwanyana: isifo se-celiac ne-gluten ukuzwela. BMC Medicine 2011, 9:23.