Waqtiga akhriska ee la qiyaasay: 19 daqiiqo
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Waxaan aaminsanahay in isticmaalka cuntooyinka ketogenic ee daaweynta dhibaatooyinka isticmaalka maandooriyaha laga yaabo inay si xun uga faa'iidaystaan shakhsiyaadka iyo xarumaha daaweynta. Waxaan filayaa in tani ay tahay dhibaato iman karta. Ma jiraan arrimo qotodheer oo cilmi-nafsi-bulsho ah oo keena cilladaha isticmaalka maandooriyaha? Dhab ahaantii. Miyaan soo jeedinayaa inaan loo baahnayn teraabiyada cilminafsiga iyo taageerada bulshada? Maya. Waxaan filayaa inay noqon karaan kuwo qiimo leh. Laakiin dhakhaatiirta cilmu-nafsiga ee kiliinikada iyo dhakhaatiirta cilmi nafsiga, iyo si daacad ah, dhammaan dadka kale ee u ordaya xarumaha daweynta ee soo kabashada qabatinka, runtii waxay u baahan yihiin inay fahmaan sida cuntooyinka ketogenic ay u wanaajin karaan fursadaha ay dadku uga soo kaban karaan cilladaha isticmaalka maandooriyaha.
Waxaa jira cilmi aad u wanaagsan oo muujinaya sida cuntooyinka ketogenic ay uga caawin karaan ka soo kabashada balwadda. Marka, maqaalkan looma qorin oo keliya khabiirka cilmi-nafsiga ee kiliinikada, khabiirka qabatinka, ama xirfadlaha kale ee caafimaadka dhimirka ee isbahaysiga ah ee raadinaya inay kor u qaadaan tiirka bayoolojiga ee qaab-dhismeedkooda biopsychosocial. Xataa looma qorin kaliya MD ama qore kale daawooyin badan oo aan isticmaalno si aan uga caawino dadka dhimista rabitaanka ama maamulida saameynta ka-noqoshada taasoo qayb ka ah soo kabashadooda. Maqaalkan waxa kale oo loo qoray qofka qaba cillad la’aanta balwadda iyo dadka jecel.
Waxaan dooneynaa inaan wax ka baranno isbeddellada cilmu-nafsiga ee maskaxda ee aan ku aragno cilladaha isticmaalka maandooriyaha, sida cuntooyinka ketogenic ay u noqon karaan daaweyn, iyo tijaabooyin caafimaad oo xiiso leh oo, waqtiga qoraalkan, ay qorayaan ka qaybgalayaasha. Ugu dambeyntii, waxaanu sidoo kale soo bandhigi doonaa arrimaha suurtagalka ah, inkastoo aan ku jirin suugaanta wakhtigan, waxay u baahan doonaan in la sii darso sida cuntooyinka ketogenic sida daaweynta cilladda isticmaalka maandooriyaha oo noqda mid caan ah oo la heli karo.
Soo celinta Tamarta Maskaxda: Cuntooyinka Ketogenic iyo Dhibaatooyinka Isticmaalka Walaxda
Qaadashada khamriga ba'an ayaa la og yahay inay u beddesho habka maskaxdu u isticmaasho shidaalka. Waxa jira isbeddel ka socda gulukoosta oo loo beddelo acetate, dheef-shiid kiimikaad aalkolo ah. Kuwa qaba khalkhalka Isticmaalka Khamriga, isbeddelkani wuxuu sii socdaa wixii ka dambeeya xilliga sakhradda wuxuuna noqdaa il shidaal oo la aqbalay oo ay maskaxdu filayso oo loo habeeyey. Dhibaatada Isticmaalka Khamriga (AUD), waxaa jira xaalad joogto ah oo joogto ah oo ah gulukoos maskaxeed oo hooseeya iyo dheef-shiid kiimikaad sare leh. Tani ma aha xog cusub. Waxaan ognahay in dheef-shiid kiimikaadka gulukooska uu wiiqay khalkhalka isticmaalka aalkolada ilaa 1966 markii Roach iyo asxaabtoodu ay daabaceen talobixintoodii ugu horaysay ee ah in dheef-shiid kiimikaadka gulukooska ee daciifka ahi ay sabab u tahay khamriga.
Marka qof uu ku jiro ka saarista khamriga oo uu joojiyo isticmaalka aalkolada, maskaxdu waxay joojisaa helitaanka shidaalka ay filayso oo ay u qalabayso inay xakamayso.
Sidaa daraadeed, waxaanu qiyaasaynaa in xaalad tamar-yarida maskaxdu ay soo baxdo inta lagu jiro khamriga sunta marka heerarka acetate ee plasma ay hoos u dhacaan iyo in tani ay gacan ka geysato ka-noqoshada calaamadaha iyo neurotoxicity ee bukaanka AUD.
Wiers, CE, Vendruscolo, LF, Van der Veen, JW, Manza, P., Shokri-Kojori, E., Kroll, DS, … & Volkow, ND (2021). Cunnada ketogenic waxay hoos u dhigtaa calaamadaha ka-goynta khamriga ee bini'aadamka iyo qaadashada khamriga ee jiirka. Horumarka Sayniska, 7(15), eabf6780.
Waa maxay sababta maskaxda aalkoladu ay si aan kala go 'lahayn ugu noqon wayday dheef-shiid kiimikaad gulukoosta? Cilmi-baadhayaashu ma sheegaan, laakiin waxaan ka shakin lahaa in mishiinadaasi hoos loo dhigay ama la dhaawacay sababtoo ah heerarka sare ee cadaadiska oksida ee ka dhaca deegaanka cilladaha isticmaalka maandooriyaha.
Ma aragno naafonimadan dheef-shiid kiimikaadka gulukooska ee isticmaalka khamriga. Sidoo kale waa arrin ku saabsan isticmaalka opioid.
Daaweynta Morphine waxay hoos u dhigi kartaa heerka muujinta enzymes-ka dheef-shiid kiimikaadka, oo ay ku jiraan PDH, LDH, iyo NADH, oo sidaas darteed wax u dhimaya dheef-shiid kiimikaadka tamarta.
Jiang, X., Li, J., & Ma, L. (2007). Ensaymes dheef-shiid kiimikaad ayaa isku xira ka bixitaanka morphine iyo cilladda dheef-shiid kiimikaadka. Cilmi-baarista Unugyada, 17(9), 741-743. Jiang, X., Li, J. & Ma, L. Insaymamka dheef-shiid kiimikaadka waxay ku xidhaan ka bixitaanka morphine iyo cilladda dheef-shiid kiimikaadka. Cell Res 17, 741-743 (2007). https://doi.org/10.1038/cr.2007.75
Daaweynta Morphine, tusaale ahaan, waxay hoos u dhigi kartaa heerka muujinta enzymes-ka dheef-shiid kiimikaadka, oo ay ku jiraan PDH, LDH (lactate dehydrogenase), iyo NADH. Xeerkan hoos-u-dhaca ayaa wax u dhimi kara dheef-shiid kiimikaadka tamarta gulukooska ee maskaxda. PDH, gaar ahaan, ayaa muhiim u ah u beddelashada pyruvate ee acetyl-CoA, iyo carqaladaynta hawsheeda waxay si xun u saameyn kartaa wax soo saarka tamarta gulukooska.
Isticmaalayaasha methamphetamine ee tan iyo markii ay noqdeen ka-hortagga waxay sidoo kale muujiyaan aagagga hypometabolism maskaxda.
Gabagabadii, waxaan soo sheegnay in isticmaalayaasha MA-ga ah ay hoos u dhigeen rCMRglc walxaha cad ee hore iyo daciifinta hawlaha fulinta ee hore…
Kim, S., Lyoo, I., Hwang, J. al et. Hypometabolism gulukooska hore ee Isticmaalayaasha Methamphetamine-ka Neuropsychopharmacol 30, 1383-1391 (2005). https://doi.org/10.1038/sj.npp.1300699
Jidhka Ketone, oo ay ku jiraan beta-hydroxybutyrate iyo acetoacetate, ayaa gaar u ah awoodda ay u leeyihiin inay ka gudbaan xannibaadda dhiigga-maskaxda oo ay isticmaalaan unugyada maskaxda. Waxay awood u leeyihiin inay dhaafaan mashiinada qaada gulukoosta ee jaban. Marka maskaxda la galo, ketones ayaa loo beddelaa acetyl-CoA, ka dib waxay gashaa wareegga citric acid si ay u soo saarto ATP, taas oo ah tamar maskaxdu ay isticmaali karto. Waxaa laga yaabaa inaad maqashay in maskaxdu ay u baahan tahay tamar badan, taasina waa run. Waxay u baahan tahay tamar aad u badan si loo ilaaliyo shaqada maskaxda. Ketones waa il samatabbixin buuxda oo loogu talagalay aagagga maskaxda ee noqday hypometabolic cilladaha isticmaalka walaxda oo aan hadda si hufan u isticmaali karin gulukoosta.
Natiijooyinkani waxay soo jeedinayaan in ketones ay dhab ahaantii yihiin tamarta la door bidayo maskaxda sababtoo ah waxay galaan maskaxda iyada oo loo eegayo feejignaantooda balaasmaha iyada oo aan loo eegin helitaanka gulukooska; Haddii baahida tamarta maskaxda ay si sii kordheysa u buuxiyaan ketones, qaadashada gulukooska ayaa hoos u dhacda si waafaqsan.
Cunnane, SC, Courchesne-Loyer, A., Vandenberghe, C., St-Pierre, V., Fortier, M., Hennebelle, M., … & Castellano, CA (2016). Ketones ma caawin karaa samatabbixinta sahayda shidaalka maskaxda nolosha dambe? Saamaynta caafimaadka garashada xilliga gabowga iyo daaweynta cudurka Alzheimers. Xuduudaha ee neerfaha neerfaha, 53. https://doi.org/10.3389/fnmol.2016.00053
Marka la eego guusha cuntooyinka ketogenic ee wax ka qabashada hypometabolism maskaxda ee cudurrada neurodegenerative, waa macquul in la tixgeliyo faa'iidooyinka suurtagalka ah ee cilladaha isticmaalka maandooriyaha (SUDs). Saamaynta neerfaha ee SUDs waxay la mid yihiin kuwa lagu arko jirrooyinka dhimirka iyo xanuunada neerfaha, (kuwaas oo sidoo kale si fiican uga jawaaba cuntooyinka ketogenic) waxayna soo jeedinayaan in cuntooyinka ketogenic ay bixin karaan hab cusub oo lagu taageerayo dheef-shiid kiimikaadka maskaxda.
Marka loo beddelo isha tamarta aasaasiga ah ee maskaxda habkan, cuntooyinka ketogenic waxay u muuqdaan inay yareeyaan tamarta yaraanta maskaxda ee soo baxda inta lagu jiro sunta khamriga. Maxay tani uga dhigan tahay dadka isku dayaya inay bogsadaan? Khalkhalka isticmaalka aalkolada, waxaan ognahay in ay la macno tahay hoos u dhac ku yimaadda calaamadaha ka-noqoshada iyo rabitaanka.
Qodob aad muhiim u ah daaweynta.
Iyo SUD-yada kale ee muujinaya aagagga hypometabolism maskaxda, waxaan ku sharxayaa inay kaa dhigayso inaad la yaabto sida cuntada ketogenic ay u caawin karto, sidoo kale.
Xanuunka Neuroinflammation ee Isticmaalka Walaxda: Sida Cunnada Ketogenic u Bixiso Gargaarka
Neuroinflammation wuxuu door muhiim ah ka ciyaaraa horumarinta iyo horumarka cilladaha isticmaalka maandooriyaha (SUDs) oo saameyn xun ku leh shaqada garashada iyo wadista isbeddellada cudur-sidaha ee dhismayaasha maskaxda. Dadka qaba cilladaha isticmaalka maandooriyaha, qaybo ka mid ah hab-dhiska difaaca waxay noqon karaan kuwo firfircoon oo barar maskaxda ah. Caabuqani wuxuu markaa kordhin karaa heerarka calaamadaha gaarka ah ee jirka ee gacan ka geysta caabuqa, sida TNF-a, IL-1, iyo IL-6.
Tani waxay muhiim u tahay daaweynta sababtoo ah bararka maskaxda ayaa saameyn weyn ku yeelan kara sida maskaxdu u shaqeyso, tani waxay saameyn kartaa fikradaha, dareenka iyo dabeecadaha qofka. Dadka qaba cilladaha isticmaalka muqaadaraadka, bararkani wuxuu wax ku biirin karaa rabitaanka iyo adkeynta joojinta isticmaalka walxaha. Waxa kale oo ay saamayn kartaa xusuusta, go'aan qaadashada, iyo habaynta shucuureed, taas oo ka dhigaysa mid aad u adag in lala qabsado walaaca iyo kiciyeyaasha kale ee keeni kara soo noqoshada. Caabuqa maskaxdu wuxuu ka dhigi karaa safarka soo kabashada mid aad u adag isagoo saameeya awoodda qofka si uu si cad u fekero, u qaato go'aamo wanaagsan, oo uu maamulo damaca iyo dareenka.
Si kale haddii loo dhigo, khalkhalkan calaamadaha ka imanaya bararka maskaxda ee aan la xakamayn waxay saameeyaan sida maskaxdu u shaqeyso waxayna gacan ka geysataa calaamadaha iyo horumarka cilladaha isticmaalka maandooriyaha. Cytokines bararka ee nooca aan ku aragno xanuunadan waxay keeni kartaa isbeddel joogto ah oo ku yimaada ganglia basaska iyo dopamine (DA), oo lagu garto raaxo la'aan, daal, iyo dhimis maskaxeed. Waxa kale oo ay noqon kartaa qalab horseed u ah hoos u dhaca jawaabaha neerfaha ee abaal-marinnada hedonic, hoos u dhaca dheef-shiid kiimikaadka DA, kordhinta dib-u-qaadista, iyo hoos u dhaca isbeddelka presynaptic DA. Jawaabaha bararka ayaa laga yaabaa inay gacan ka geystaan abaal-marinnada daroogada ay keentay iyo soo noqoshada daroogada.
Basal ganglia iyo dopamine (DA) waa qaybo muhiim ah oo ka mid ah nidaamka abaal-marinta maskaxda, kaas oo mas'uul ka ah dareenka raaxada iyo dhiirigelinta.
Marka meelahan ay saameeyaan caabuqa, waxay carqaladeyn kartaa shaqada caadiga ah ee nidaamka abaalmarinta. Waxay u horseedaan raaxo la'aan ka timaadda waxqabadyada markii hore lagu raaxaysan jiray (anhedonia), daalka la soo marayna wuxuu sii yareeyaa dhiirigelinta qofka si uu u galo hawlo lagu farxo. Dhammaanteen waan aragnay nafteena ama kuwa kale ee qaba SUD sidaan oo kale u xanuunsanayaan markay isku dayaan inay joojiyaan isticmaalka.
Ma rabo inaad u maleyso in dhibaatada ku socota cilladaha isticmaalka maandooriyaha ay dhamaantood ku saabsan yihiin dopamine. Waa muhiim in la fahmo in ganglia basal ay sidoo kale ku lug leeyihiin garashada iyo dareenka. Caabuqa ayaa suurtogal ah inuu saameyn ku yeesho hababkan, isagoo gacan ka geysanaya cilladaha garashada iyo cilladaha shucuureed ee aan ku aragno kuwa qaba xanuunkan.
Ma rabo inaan kaa tago aragtida ah in Khamrigu Isticmaalka Khamrigu uu yahay cilladda Isticmaalka Maandooriyaha kaliya ee gacan ka geysata caabuqa neuroinflammation ee joogtada ah. Maskaxda leh cilladaha kale ee isticmaalka maandooriyaha (SUDs) marka laga reebo khalkhalka isticmaalka aalkolada (AUD) waxay sidoo kale muujin kartaa calaamadaha caabuqa. Waxyaabo badan oo xadgudub ah, sida opioids, kokain, iyo methamphetamine, ayaa lagu muujiyay suugaanta cilmi-baarista si loo kordhiyo neuroinflammation.
Nasiib wanaag, cuntada ketogenic (KD) ayaa lagu muujiyay inay ka ciyaareyso doorka neuroprotective ee SUDs iyadoo la yareynayo xanuunka neuroinflammation.
Shakhsiyaadka qaba AUD ee u hoggaansamay cuntada ketogenic (KD) - cunto ay ku badan tahay dufanka iyo karbohaydraytyada hoose - waxay soo bandhigeen heerarka hoose ee calaamadaha bararka marka la barbardhigo kuwa raacay cuntada caadiga ah ee Maraykanka (SA). Tani waxay tusinaysaa in KD laga yaabo inay wax ku ool u tahay yaraynta bararka maskaxda.
Ka sokow inay yihiin substrates tamarta, KBs sidoo kale waxay u firfircoon yihiin dhexdhexaadiyeyaasha calaamadaha unugyada gudaha, kuwaas oo ka qaybqaata calaamadaynta calaamadaha gudaha oo nidaamiya neerfaha si toos ah ama si aan toos ahayn, gaar ahaan βHB
Jiang, Z., Yin, X., Wang, M., Chen, T., Wang, Y., Gao, Z., & Wang, Z. (2022). Saamaynta cuntada ketogenic ee xanuunka neuroinflammation ee cudurada neurodegenerative. Gabow iyo cudur, 13(4), 1146. https://doi.org/10.14336/AD.2021.1217
Dheef-shiid kiimikaad waa hab aan sax ahayn. Gaar ahaan haddii aad ku tiirsan tahay shidaalka sida gulukooska. Cuntooyinka ketogenic waxay u beddelaan dheef-shiid kiimikaad ku tiirsanaanta gulukooska si ay u isticmaalaan ketones sida ilaha tamarta aasaasiga ah, taas oo macnaheedu yahay hoos u dhigista wax soo saarka dhexdhexaadiyeyaasha pro-bararka iyo kororka aadka loogu baahan yahay soo saarista dhexdhexaadiyeyaasha ka hortagga caabuqa. Dheef-shiid kiimikaadka ketone waa “nadiifiye,” waxay ka dhigaysaa wax ka yar qaska ROS, waxayna u abuurtaa dhaawac yar oo maskaxda ku dhibtoonaysa inay wax ka qabato.
Cuntooyinka ketogenic sidoo kale waxay leeyihiin saameyn toos ah oo ka hortagga bararka kuwaas oo runtii awood leh. Waxay tan ku sameeyaan iyagoo bedelaya dariiqooyin calaamadineed oo kala duwan. Mid ka mid ah tusaale ahaan waa awoodda cuntada si loo joojiyo dariiqa NF-κB oo la yareeyo wax soo saarka cytokines pro-inflammatory sida tumor necrosis factor-alpha (TNF-α) iyo interleukin-6 (IL-6), kuwaas oo ku lug leh jawaabta bararka.
βHB waxay ku xidhi kartaa HCA2 si ay u sii joojiso soo saarista cytokines pro-inflammatory iyo enzymes iyada oo loo marayo dariiqa NF-κB ee microglia aasaasiga ah ee firfircoon ee hore loo sii daayay βHB oo lagu kiciyay lipopolysaccharide (LPS)
Jiang, Z., Yin, X., Wang, M., Chen, T., Wang, Y., Gao, Z., & Wang, Z. (2022). Saamaynta cuntada ketogenic ee xanuunka neuroinflammation ee cudurada neurodegenerative. Gabow iyo cudur, 13(4), 1146. https://doi.org/10.14336/AD.2021.1217
Microbiome-ka mindhicirka ayaa sidoo kale door muhiim ah ka ciyaara xakameynta bararka. Bakteeriyada mindhicirka qaarkood waxay soo saari kartaa dheef-shiid kiimikaad leh saamaynta anti-bararka, halka kuwa kalena ay soo saari karaan dheef-shiid kiimikaad kuwaas oo leh saameyn-bararka. Cunnada ketogenic waxay si daacad ah caan ugu tahay awoodda ay u leedahay inay wax ka beddesho halabuurka microbiome ee mindhicirka, taas oo saameynaysa soo saarista dheef-shiid kiimikaadkan ka dibna beddela caabuqa. Cuntada ayaa lagu muujiyey inay kordhiso tirada badan ee bakteeriyada faa'iidada leh ee soo saarta asiidh dufan ah oo gaaban (SCFAs) si ay uga caawiso soo saarida saameynta anti-bararka.
Hoos u dhigista caabuqa waxay si toos ah u saameyneysaa heerka cadaadiska oksaydhka ee maskaxdu ay tahay inay u adkaysato, taas oo noo keenta qaybta xigta ee maqaalkan. Haddii aad wax yar ku wareersan tahay farqiga u dhexeeya bararka iyo walbahaarka oksaydhka iyo sida ay u xidhiidhsan yihiin, waxaan aad ugu talinayaa maqaalkan inuu kaa caawiyo nadiifinta ka hor intaadan u dhaqaaqin akhrintaada boostada.
La-dagaalanka Cadaadiska Oxidative iyo cillad la'aanta Mitochondrial: Doorka Ilaalinta ee Cuntada Ketogenic ee Dhibaatooyinka Isticmaalka Maandooriyaha
Cadaadiska Oxidative wuxuu dhacaa marka ay jirto dheellitirnaan la'aan u dhaxaysa soo saarista ROS iyo awoodda jidhku u leeyahay inuu sunta ka saaro unugyadan waxyeellada leh. Isku dheelli tirka u dhexeeya soo saarista noocyada ogsijiinta falcelinta (ROS) iyo awoodda jidhku u leeyahay in uu wax ka qabto dhaawaca ay sababaan waxa loo yaqaan stress oksida.
Miyaan ku aragnaa diiqada oksaydhka ee cilladaha isticmaalka walaxda? Waxaad sharad ku tahay inaan samayno!
Falanqayntayadu waxay muujisay in dadka qaba SUD ay muujinayaan calaamado oksaydhiyeyaasha sare leh iyo calaamado ka hooseeya antioxidant marka loo eego kontaroolada caafimaadka qaba.
Viola, TW, Orso, R., Florian, LF, Garcia, MG, Gomes, MGS, Mardini, EM, … & Grassi-Oliveira, R. (2023). Saamaynta khalkhalka isticmaalka maandooriyaha ee calaamadaha cadaadiska oksaydhka iyo antioxidative: Dib-u-eegis nidaamsan iyo falanqayn-meta. Cilmi-baarista walxaha, 28(1), e13254. https://doi.org/10.1111/adb.13254
Markaa, waa dhiirigelin in la ogaado in cuntada ketogenic ay saameyn togan ku leedahay nidaamka difaaca jirka ee antioxidant, oo ay ku jiraan kor u qaadista superoxide dismutase (SOD2). Superoxide dismutase (SOD) waa qoys ka kooban enzymes kuwaas oo kicinaya kala-goynta superoxide ee oksijiinta iyo hydrogen peroxide. La yaab ma leh, SOD2 (loo yaqaan MnSOD) waa nooc ka mid ah SOD oo ku nool mitochondria, shaqadeeda oo dhanna waa inay ka ilaaliso mitochondria diiqada oksaydhka. Marka, adoo kor u qaadaya SOD2, cuntada ketogenic waxay ka caawisaa inay nadiifiso radicals superoxide, kuwaas oo ah isha ugu weyn ee diiqada oksaydhka, iyo ilaalinta shaqada mitochondrial.
Sida haddii taasi aysan ku filneyn, cuntada ketogenic ayaa la muujiyay inay kordhiso wax soo saarka glutathione. Glutathione waa antioxidant aad u awood badan oo uu abuuray jidhkaaga kaas oo hubinaya inaad haysato difaaca gacanta ee ka hortagga cadaadiska oksaydhka.
Glutathione wuxuu ka kooban yahay saddex amino acids: cysteine, glycine, iyo glutamate. Waxay leedahay shaqooyin badan! Waxay ka caawisaa in ay kaxayso sun-saarida walxaha waxyeelada leh, ilaalinta dheelitirka redox-ka gacanta, iyo ilaalinta unugyada waxyeelada ay keenaan xagjirrada xorta ah iyo peroxides.
NADPH, dhanka kale, waa coenzyme ka ciyaara door muhiim ah dheef-shiid kiimikaadka jirka. Waxay ku lug leedahay biosynthesis ee acids dufanka iyo steroids, iyo sidoo kale dib u soo kabashada glutathione. Korodhka NADPH wuxuu hubinayaa sahayda ku filan ee coenzyme-kan si ay u taageerto hababka difaaca antioxidant ee jirka. Waana sidaas oo kale in cilmi-baaristu ay ogaatay in cuntooyinka ketogenic ay kor u qaadaan kororka NADPH.
Si wada jir ah, qaybahani waxay si wada jir ah u shaqeeyaan si ay u abuuraan nidaam difaac xoog leh oo ka caawiya ilaalinta sharafta gacanta iyo ka hortagga waxyeelada cadaadiska oksaydhka, taas oo sii iftiiminaysa hababka asaasiga ah ee cuntada ketogenic ay ku caawiso shakhsiyaadka leh SUDs. Iyaga oo kor u qaadaya awooddooda antioxidant-ka iyo ka ilaalinta waxyeelada oksaydhka, cuntada ketogenic waa qalab si loo bixiyo heer ilaalin ah oo aan dawooyinka hadda jira aanay awoodin.
Marka lagu daro saameyntan runtii cajiibka ah ee antioxidants, cuntada ketogenic waxay sidoo kale wanaajisaa shaqada mitochondrial waxayna yaraynaysaa cadaadiska oksaydhka. Cuntadu waxay kicisaa waddooyin badan, kor u qaadida borotiinnada muhiimka ah ee ku lug leh nidaamka fosforyaalka oksaydhka, wareegga Krebs, iyo oksaydhka aashitada dufanka leh. Tani waxay keenaysaa kororka dhaqdhaqaaqa mitochondrial guud ahaan iyo, gaar ahaan, kororka borotiinka isku-xidhka mitochondrial (UCPs), kaas oo ka ilaaliya mitochondria dhaawaca oksaydhka iyo cilladda.
Korodhkan UCP-yada, oo ay weheliso kor u qaadida soo-dhoweeyaha proliferator-activated peroxisome γ (PPARγ) coactivator 1α (PGC-1α), waxay taageertaa caafimaadka mitochondrial iyo shaqada. Haddi aanad garanayn waxa maraq alifbeetada macnihiisu yahay, ha welwelin. Dulucda PPARγ iyo PGC-1a waa labada nooc ee qodobbada qoraalka, taas oo macnaheedu yahay inay yihiin borotiinno caawiya inay shidiyaan ama damiyaan hiddo-wadaha gaarka ah iyagoo ku xiraya DNA-da u dhow. Waxa ugu fiican ayaa ah in ay yihiin modulators awood u leh cadaadiska oksaydhka. Marka la hawlgeliyo, PPARγ waxay kordhin kartaa muujinta enzymes-ka antioxidant waxayna yareyn kartaa wax soo saarka cytokines-ka-bararka, taas oo gacan ka geysaneysa dhimista cadaadiska oksaydhka iyo bararka jirka. PGC-1α waxay u shaqeysaa sidii nidaamiye nidaamyada antioxidant si loo hubiyo in difaacayaasha antioxidant ay diyaar u yihiin inay wax ka qabtaan cadaadis kasta oo oksaydh ah oo soo bixi kara.
Laakiin waxay u badan tahay inaadan i rumaysan doonin markaan kuu sheego inuu jiro hannaan kale oo ay cuntooyinka Ketogenic (KD) gacan ka geystaan ilaalinta cadaadiska oksaydhka. Waxaa sidoo kale lagu muujiyay inay wax ka beddelaan heerarka adenosine ee maskaxda, iyagoo siinaya saameyn neuroprotective iyo antiepileptogenic. Adenosine waa neurotransmitter muhiim ah oo ka caawiya ka hortagga suuxdinta iyo ka ilaalinta maskaxda waxyeellada. Kordhinta heerarka adenosine-ka, KD waxay wanaajisaa hababka difaaca dabiiciga ah ee maskaxda waxayna ka ilaalisaa walwalka dareemayaasha, iyada oo ku daraysa lakab kale faa'iidooyinka dhinacyo badan leh ee KD ee la dagaallanka diiqada oksaydhka iyo taageeridda maskaxda isku dayaysa inay ka soo kabsato SUD.
Neurotransmitters iyo Nidaamyada Abaalmarinta ee SUDs: Xeerka Dheelitirka Cuntada Ketogenic
Cilladaha isticmaalka maandooriyaha (SUDs) waa xaalado adag oo ku lug leh isdhexgalka arrimaha hidde-sideyaasha, deegaanka, iyo neerfaha. Waxaan ognahay in nidaamka abaalmarinta maskaxdu uu door ka ciyaaro horumarinta iyo dayactirka SUDs. Neurotransmitters (NTs) waa farriyaal kiimiko ah oo gudbiya calaamadaha dhaqaajiya nidaamka abaal-marinta maskaxda, iyo isbeddelada hababkaas waxay gacan ka geysan karaan horumarinta SUDs.
Qabatinku waa habka ugu muhiimsan ee hoosta ka xarriiqa cilladaha isticmaalka maandooriyaha, iyo cilmi-baaris la adeegsanayo moodooyinka xayawaanka iyo bini'aadamka ayaa daaha ka qaaday aragtiyo muhiim ah oo ku saabsan wareegyada neerfaha iyo molecules ee dhexdhexaadiya balwadda.
Kalin, NH (2020). Dhibaatooyinka isticmaalka maandooriyaha iyo qabatinka: hababka, isbeddellada, iyo saameynta daaweynta. Somali Journal of psychiatry, 177(11), 1015-1018. https://doi.org/10.1176/appi.ajp.2020.20091382
Waxaan horay uga wada hadalnay Dopamine (DA) meelaha kale ee maqaalkan, laakiin waxaan mar kale ku soo qaaday dood ku saabsan doorkeeda marxaladaha hore ee qabatinka sababtoo ah waxay muhiim u tahay saameynta abaal-marinta ba'an ee walxaha. Marka isticmaalka walaxda uu sii socdo, saadaasha glutamatergic waxay noqotaa mid caan ah. Glutamate, NT kicinta aasaasiga ah ee maskaxda, waxay ku lug leedahay isbeddelada neuroplasticity ee hoos u dhigaya qiimaha abaal-marinnada dabiiciga ah, hoos u dhigaya xakamaynta garashada, iyo kor u qaadida dabeecadaha daroogada-raadinta ee khasabka ah. Nidaaminta glutamate homeostasis waa habka muhiimka ah ee neurometabolic ee SUDs.
Qadar gaar ah oo glutamate ah ayaa loo malaynayaa in lagu farsameeyo gudbiyaha xannibaadda GABA, laakiin isbeddelada hababka GABAergic ee inta badan lagu arko SUD waxay u horseedi kartaa walaac iyo walbahaar kordhay, taasoo ka sii dari karta xanuunka. Jahwareerkan heerka guud ee dhaqdhaqaaqa xannibaadda ee maskaxda, oo muhiim u ah ilaalinta dheelitirka u dhexeeya kicinta iyo ka-hortagga, waxay gacan ka geysataa isticmaalka walxaha xun. Nidaamyada NT ee dheeraadka ah, sida serotonin, epinephrine, iyo norepinephrine, ayaa sidoo kale lagu khalkhaliyay SUDs, taasoo keentay walaac iyo walaac sii kordhaya iyo wax ku biirinta wareegga qabatinka.
Mar labaad, saamaynta badan ee cuntada ketogenic waxay bixin kartaa rajo. Iyada oo la beddelayo heerarka NT-yada iyo xasilinta dheef-shiid kiimikaadka tamarta maskaxda, cuntada ketogenic waxay gacan ka geysan kartaa soo celinta dheelitirka wareegga abaalmarinta maskaxda waxayna yaraynaysaa rabitaanka walxaha xadgudubka. Tusaale ahaan, cuntada ayaa lagu muujiyay inay kordhiso shaqada GABA, taas oo kaa caawin karta yaraynta welwelka iyo walbahaarka iyo hagaajinta niyadda. Waxa kale oo la muujiyay in la beddelo glutamate, serotonin, iyo dopamine heerarka, kuwaas oo laga yaabo inay dejiyaan niyadda oo ay yareeyaan cilladda shucuureed ee inta badan lagu arko SUDs.
Sidee u sameeyaa tan? Ma garanayno gebi ahaanba, laakiin waxaan ognahay in cuntooyinka ketogenic ay saameyn ku yeeshaan kontoroolka korantada ee maskaxda ee neerfaha, taas oo si toos ah ula xiriirta shaqeynta hababka neurotransmitter. Xakamaynta korantada ee neerfayaasha ayaa lama huraan u ah shaqada maskaxda ee caadiga ah waxaana soo saara kanaalada ion iyo reseptors synaptika. Dhaqdhaqaaqyadan korantada ayaa ah habab aasaasi ah oo awood u siinaya sii deynta iyo soo dhaweynta neurotransmitters ee synapses.
Tusaale ahaan, marka awoodda falku gaadho synapse, waxay kicisaa sii-deynta neurotransmitters, ka dibna ku xidha soo-qabayaasha synaptika ee neuron postsynapti. Isku-xidhkaani wuxuu keenayaa isbeddel ku yimaada awoodda xuubka iyo calaamadinta koronto oo dheeraad ah. Shaqada saxda ah ee nidaamkan ayaa muhiim u ah wareegga abaalmarinta maskaxda, kaas oo inta badan lagu habeeyo SUDs.
Cuntadu waxay saamaysaa xakamaynta korantada ee maskaxda, oo ay ku jiraan ATP-xasaasiyaha K + kanaalka, kanaalka Ca2 + ku-tiirsanaanta, AMPA-nooca glutamate reseptors, iyo adenosine A1 reseptors, iyo kuwo kale. Ha u oggolaan dhammaan ereyadan quruxda badan ee laga yaabo inaad ama aanad garanayn inay ku mashquuliyaan. Kuwani waa nidaamiyayaal awood leh oo wada shaqeeya si ay u kiciyaan xannibaadda neerfayaasha iyo hagaajinta dheecaanka xuubka unugyada, taasoo horseedaysa calaamadaynta neurotransmitter ee waxtarka leh. Tani waa mid ka mid ah siyaabaha saameynta cuntooyinka ketogenic ay si toos ah ula xiriiraan shaqeynta hababka neurotransmitter, caawinta si loo hubiyo in si sax ah loo sii daayo iyo soo dhaweynta neurotransmitters ee synapses.
Marka, markaan kuu sheego in cuntada ketogenic ay bixiso hab dhinacyo badan leh oo wax looga qabanayo isku dheelitir la'aanta NT iyo cilladaha lagu arkay SUDs, ma aad yaabtid, markan, la yaabi doontid. Jiritaanka caddaynta sii kordheysa ee taageeraya faa'iidooyinka cuntada ketogenic ee lagu daaweynayo xaaladaha kale ee neerfaha iyo dhimirka ayaa sii xoojinaya awooddeeda ku aaddan wax ka qabashada is-dhexgalka kakan ee cilladaha NT ee SUDs.
Ugu Dambeyn
Haddii adiga ama qof aad jeceshahay uu la ildaran yahay SUDs, waxaad garanaysaa culayska ay saarayso shakhsiyaadka, qoysaska, iyo bulshada guud ahaan. Waxay noqonaysaa lama huraan inaan sahamino oo aan hirgelinno waxqabadyo wax ku ool ah oo runtii wax ka bedeli kara nolosha kuwa ay saamaysay. Cuntada ketogenic, oo leh saameynteeda badan ee maskaxda, waxay bixisaa rajo. Kaliya maaha isbeddel xagga cuntada ah, laakiin waa qalab daawayn awood leh oo wax ka qaban kara sababaha asaasiga ah ee jireed ee SUDs oo fududayn kara soo kabsasho waarta.
Sidaa darteed, waa dooddayda in cuntada ketogenic lagu bixiyo qayb ka mid ah daaweynta caadiga ah ee xarun kasta oo daaweynta mukhaadaraadka. Intaa waxaa dheer, waa lagama maarmaan in qorayaasha iyo la-taliyayaasha balwadda ay helaan waxbarasho joogto ah oo ku saabsan faa'iidooyinka iyo hirgelinta cuntada ketogenic ee daaweynta SUDs. Tani waxay hubin doontaa inay si fiican u qalabaysan yihiin inay u fidiyaan faragelintan qiimaha leh ee bukaankooda, ugu dambeyntiina gacan ka geysata natiijooyin badan oo guul leh ee daaweynta SUDs.
Cunnada ketogenic waxay ka dhigan tahay isbeddelka isbeddelka ee habkayaga daaweynta SUDs. Iyadoo wax laga qabanayo isku-dheellitir la'aanta dheef-shiid kiimikaadka iyo cilladaha kuwaas oo gacan ka geysta horumarinta iyo dayactirka SUDs, cuntada ketogenic waxay bixisaa faragelin dhamaystiran oo wax ku ool ah oo run ahaantii wax ka bedeli karta nolosha kuwa ay saameeyeen. Waxaan rajeynayaa in maqaalkan qeexaya habkan caddaynta ku salaysan uu noqon doono qalab ugu dambeyntii la qabsigiisa ballaaran iyo isdhexgalka heerka daryeelka SUDs, ugu dambeyntii gacan ka geysanaya mustaqbal ifaya oo loogu talagalay kuwa la halgamaya balwadda.
Haddii adiga, ama qof aad jeceshahay, aad jeclaan lahayd inaad ka qayb qaadato tijaabooyinka caafimaad ee halkan ku qoranaya:
https://clinicaltrials.gov/search?cond=Substance%20Use%20Disorder&intr=Ketogenic%20Diet
Laakin ha dareemin inaad sugto tijaabo caafimaad si aad uga faa'iidaysato. Waxaad rajayn kartaa inaad hesho xarun daawaynta agtaada ah (ama aan kuugu dhowayn) adoo isticmaalaya cuntooyinka ketogenic ee Dhibaatada Isticmaalka Maandooriyaha (SUD), ama waxaad isku keeni kartaa kooxdaada daawaynta ee dhakhaatiirta daawaynta dheef-shiid kiimikaadka ee jira, xirfadlayaasha caafimaadka dhimirka, iyo caafimaadka xirfadle kaa caawin kara dawooyinka.
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Sideen ku helaa xarun daawaynta ii dhow oo isku xidha Keto? Mahadsanid
Hi Katherine, ma aqaan midna! Laakiin waxaan rajeynayaa in qof uu sameeyo liis marka ay bilaabaan inay soo baxaan. Waxaadna la shaqayn kartaa dhakhtar shakhsi ah ka hor ama inta lagu jiro soo kabashada. Xarun daawaynta ayaa noqon doonta mid ku habboon, laakiin helitaanka qore yaqaan kaas oo yaqaan saamaynta cuntooyinka ketogenic iyo la shaqaynta qof si toos ah uga caawin kara cuntada ayaa si fiican u shaqayn karta.