Tom qab Excluding Genetic Factors, Yam Dab Tsi Yuav cuam tshuam rau Chav Kawm ntawm IgAN?

Nws paub zoo tias cov chav kawm, hom, thiab cov lus teb rau cov tshuaj ntawm immunoglobulin A (IgA) nephropathy muaj feem xyuam rau cov yam ntxwv ntawm caj ces. Qhov xwm txheej ntawm IgA nephropathy sib txawv hauv ntau lub teb chaws thiab cheeb tsam, nrog qhov tshwm sim siab tshaj plaws ntawm IgA nephropathy hauv Asia (kwv yees li 40% txog 50% ntawm cov neeg mob uas muaj tus kab mob glomerular). Nyob rau hauv cov nqe lus ntawm qhov kwv yees glomerular filtration rate (eGFR), eGFR ntawm txawv teb chaws IgA nephropathy cov neeg mob feem ntau qis dua li ntawm Suav IgA nephropathy cov neeg mob. Hais txog kev faib tawm pathological, Suav IgA nephropathy cov neeg mob muaj ntau hom M1 thiab C1+C2. Thaum kawg, Kev Tshawb Fawb Kev Tshawb Fawb thiab Kev Tshawb Fawb STOP IgAN pom tias glucocorticoids tuaj yeem ua haujlwm zoo dua rau cov neeg mob IgA nephropathy hauv Suav teb lossis thaj av Asia-Pacific. Yog xav paub meej txog qhov sib txawv no, thov mus saib Xib Fwb Zhang Hong tsab ntawv ceeb toom kev kawm ntawm WCN hauv 2023.

Nyem rau Cistanche rau mob raum

Yog li ntawd, cov kws tshawb fawb feem ntau poob rau hauv cov lus nug, dab tsi cuam tshuam ib puag ncig lossis epigenetic yam cuam tshuam rau IgA nephropathy? Tam sim no muaj pov thawj me me, thiab nws tsis tuaj yeem txiav txim siab seb tus cwj pwm tshwj xeeb thiab ib puag ncig twg tuaj yeem cuam tshuam rau IgA nephropathy. Nws tseem tsis tau paub meej tias cov tshuaj twg tshwm sim lossis cov txheej txheem tuaj yeem ncua sijhawm IgA nephropathy, tom qab txiav txim siab txog caj ces.

Thaum Lub Peb Hlis 22, 2024, cov kws tshawb fawb los ntawm Nyij Pooj tau tshaj tawm cov ntaub ntawv ntawm tus menyuam ntxaib zoo ib yam nrog IgA nephropathy hauv CKJ. Nws yog tsim nyog sau cia tias tom qab 20 xyoo ntawm kev soj ntsuam ntawm qhov teeb meem no, nws tau pom tias vim qhov sib txawv ntawm kev ua neej nyob, kev paub dhau los, thiab kev siv tshuaj ntawm ob tus neeg mob, muaj qhov sib txawv ntawm lub raum ua haujlwm thiab kev faib tawm ntawm cov kab mob pathological ntawm ob. cov neeg mob. Qhov no tuaj yeem muab kev nkag siab tshiab rau cov kws kho mob los cuam tshuam rau kev ua neej nyob ntawm cov neeg mob IgA nephropathy.

Case qhia

Cov no yog ib khub niam txiv ntxaib zoo tib yam uas tam sim no nyob rau hauv lawv cov 40s. Lawv loj hlob ua ke, mus rau tib lub tsev kawm ntawv kom txog rau thaum lawv muaj 15 xyoos, thiab ob leeg tau sib yuav nyob ib ncig ntawm 30 xyoo. Cov menyuam ntxaib tau kuaj pom tias muaj IgA nephropathy nyob rau hauv lawv cov hluas tab sis muaj ntau yam kev kho mob sib txawv. Tus muam hlob qhov hnyav yog 2330g thiab tus niam yau yog 2745g. Ob leeg ntawm lawv tsis muaj keeb kwm ntawm mob tonsillitis.

Qhov zoo siab, hauv thawj lub raum biopsy, tsis muaj qhov sib txawv ntawm cov txiaj ntsig ntawm ob tus viv ncaus (glomerular ntim: 1.58 × 106 μm rau tus muam laus thiab 1.61 × 106 μm rau tus viv ncaus), tab sis cov txiaj ntsig pathological ntawm lub raum biopsy thib ob pom tias tus muam tus mob hnyav dua yuav tsum muaj kev kho mob hnyav ntxiv, suav nrog 2 zaug ntawm kev kho glucocorticoid thiab tonsillectomy. Tshwj xeeb, tus muam lub glomerular ntim tau nce los ntawm 1.17 thiab 1.73 npaug ntawm lub sijhawm thib ob thiab thib peb lub raum biopsies, feem. Tsis tas li ntawd, tus poj niam laus cov proteinuria qib ({15}}.98±{17}}.64g/d) tau siab dua li ntawm tus muam (0.36±0.18gd). Kev sib piv ntawm lwm cov kev ntsuas, xws li cov xwm txheej tshwj xeeb ntawm cov tshuaj, eGFR proteinuria qib, hematuria qib serum IgA qib, IgA / C3 piv, ntshav siab, lub cev hnyav, qhov tso zis ntsev, thiab noj cov protein ntau tau qhia hauv daim duab hauv qab no.

Nws yog tsim nyog sau cia tias ob tus viv ncaus muaj keeb kwm ntawm kev txiav tawm ntawm angiotensin receptor II antagonists (ARB), tab sis tus viv ncaus lub sij hawm txiav tawm tau ntev dua, thaum tus muam laus txiav cov tshuaj ob zaug vim yug tau ob tug me nyuam. . Tom qab ob tug me nyuam yug los, kuv tus muam lub proteinuria qib nce ntxiv. Yog li ntawd, thaum rov pib kho ARB, kuv tus muam pib kho nrog angiotensin-hloov enzyme inhibitor (ACEi) thiab sodium-glucose co-transporter 2 inhibitors (SGLT-2i). Kuv tus viv ncaus tus mob tau mob me me, tshwj xeeb tshaj yog thaum lub sijhawm txiav tawm ntawm ARB, thiab nws qib proteinuria tseem qis. Lub sij hawm nruab nrab ntawm lwm yam uas yuav cuam tshuam qhov kev loj hlob ntawm IgA nephropathy, suav nrog qhov hnyav, ntshav siab, thiab noj cov protein ntau, tsis txawv ntawm cov menyuam ntxaib.

rooj sib tham

Cov ntaub ntawv no qhia tau tias txawm tias cov menyuam ntxaib zoo ib yam nrog cov khoom siv caj ces zoo ib yam tuaj yeem muaj qhov sib txawv tseem ceeb hauv chav kawm thiab tshwm sim ntawm IgA nephropathy. Thoob plaws hauv chav kawm ntawm tus kab mob, kuv tus muam muaj cov proteinuria ntau dua, uas tej zaum yuav yog vim muaj kev sib xyaw ua ke. Txij li thaum lawv yog cov menyuam ntxaib zoo ib yam, cov xwm txheej no tsuas yog qhov sib txawv ntawm ib puag ncig lossis epigenetic yam.

Kev yug me nyuam muaj feem cuam tshuam nrog tus lej nephron, thiab qis dua qhov hnyav hauv cov viv ncaus piv nrog cov viv ncaus tuaj yeem kwv yees tus lej nephron qis hauv cov viv ncaus. Txawm li cas los xij, tsis muaj qhov sib txawv tseem ceeb hauv glomerular ntim tau pom ntawm ob tus viv ncaus thaum lub sijhawm thawj lub raum biopsy, qhia tias qhov sib txawv ntawm qhov hnyav thaum yug los tsis txaus cuam tshuam rau cov glomerular units hauv ob tus viv ncaus, tsawg kawg ntawm lub sijhawm. ntawm thawj lub raum biopsy.

Thoob plaws hauv chav kawm ntawm tus kab mob no, tus muam laus lub qib IgA thiab IgA / C3 piv tau qis dua tus muam (P<0.05), which may be related to the elder sister's receipt of glucocorticoid treatment and tonsillectomy surgery.

Nws yog ib qho tsim nyog sau cia tias txawm hais tias tus kab mob ua haujlwm ntawm kuv tus viv ncaus IgA nephropathy tau txo qis, qhov ntim glomerular tau maj mam nce. Tsis tas li ntawd, qhov ua rau muaj proteinuria ntxiv tom qab txiav tawm ntawm ARB txhais tau hais tias tus muam lub raum ua haujlwm tsis zoo. Qhov tseeb no txhais tau hais tias ACEi thiab ARB tuaj yeem cuam tshuam rau hemodynamics thiab yog li ncua kev poob ntawm lub raum ua haujlwm hauv cov neeg mob IgA nephropathy. Tsis tas li ntawd, ACEi + SGLT-2Kuv zoo li tuaj yeem txo qis proteinuria hauv cov neeg mob nrog IgA nephropathy, thiab nws cov txheej txheem cuam tshuam txog kev txo qis glomerular hyperfiltration. Thaum kawg, cov ntaub ntawv no tseem lees paub tias cev xeeb tub ua rau muaj lub nra hnyav rau tus neeg mob lub raum thiab cuam tshuam rau kev siv tshuaj, yog li tag nrho cuam tshuam (ua kom nrawm dua) ntawm IgA nephropathy.

Zuag qhia tag nrho, nyob rau hauv cov ntaub ntawv no, tus kab mob kev ua ntawm IgA nephropathy muaj feem xyuam rau glucocorticoids thiab tonsillectomy phais, thiab kev khaws cia ntawm lub raum muaj nuj nqi kuj muaj feem xyuam rau cov tshuaj txhawb (ACEi, ARB, SGLT-2i). Tsis tas li ntawd, cov ntaub ntawv no qhia tau hais tias cev xeeb tub yuav ua rau kom muaj kev loj hlob ntawm lub raum kab mob hauv cov poj niam uas muaj IgA nephropathy. Nws kuj tau hais tias txij li ob tus menyuam ntxaib yog ob leeg neeg Nyij Pooj, lawv yuav nyob ze rau cov ntaub ntawv caj ces ntawm cov neeg mob suav ntau dua li cov neeg nyob sab Europe thiab Asmeskas, uas yuav muab qee qhov kev siv rau kev tswj hwm ntawm IgA nephropathy hauv kuv lub tebchaws.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rauraumnoj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tshuab.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.