Uphando luchaza izibonakaliso
Uphando kwi-non-celiac gulen sensitivity - eyaziwa nangokunyamezelana kwe-gluten - ngokugqithiseleyo ibonisa ukuba unokufumana iimpawu ezinzulu kwi-gluten ingestion ngaphandle kokufumana isifo se-celiac .
Kuhlolisiso oluphawulekayo lwe-gluten sensitivity ekhishwe ngasekuqaleni kuka-2011, umphandi oqaqambileyo we-caliac uDkt. Alessio Fasano wagqiba ekubeni "ubunene bendalo" bubonisa imeko ehluke ngokupheleleyo kwisifo se-celiac, kwaye uninzi lwabantu abanobunzima be-gluten aluyi kuphuhlisa i-celiac.
Nangona uphando lwakhe lunomdla kwiindawo zonyango, kubalulekile ukuba uqaphele ukuba uphando lwakhe alukabizwa kwakhona kwaye ke uluntu lwaseburhulumenteni ngokubanzi lubona le ngcamango yophuhliso.
UDkt. Fasano kunye neqela elenziwe ngabaphandi abaphefumlelweyo besifo se-celiac, kuquka noDkt. UPeter Green (intloko yeziko le-Columbia University Celiac Disease Centre) kunye noDkt. Marios Hadjivassiliou (i-neurologist nomcebisi kwi- gluten ataxia ), walandelwa ukufundisisa okokuqala ngesivumelwano esivumelwane ngoFebruwari 2012 ukuphakamisa iindlela zokwahlula phakathi kwesifo se-celiac, gluten uvakalelo, kunye ne-gluten ataxia.
Abaphandi abongezelelweyo baye baqhelaniswa neziphumo. Ezinye izifundo zibonisa ukuba abanye abantu abanomdla-gulen banamaprofayili afanayo okuxilongwa kwi-celiacs, ebonisa ukuba kunokukho imeko engaphambili. Olunye uphando emva kokufunyanwa kukaDkt. Fasano ukuba i-gluten inokubangela iimpawu kubantu abangenayo isifo se-cecic disease.
Uphando lwe-gluten sensitivity luya kuphuthuma ngokukhawuleza. Ukongeza, ngokuphindaphindiweyo nangakumbi, abantu abanesifo esihle sesifo se-celiac yegazi kodwa i- biopsy engenazo i-diagnosis ye-gluten sensitivity.
Kwezinye iimeko, ugqirha wabo uthi bangadla i-gluten ngokumodareyitha, okanye baxelelwe ukuba balandele ukutya okungahambisani ne-gluten kodwa ukuba akudingeki ukuba baqaphele njengezigulane ze-celiac.
Abanye baxelelwa ukuba "iziganeko" zezigulane zezifo ze-celiac, kwaye uhlolisise emva konyaka okanye ngaphezulu ukwenzela ukuvavanywa kooninzi ukuze ubone ukuba baye bavelisa imeko.
Uphando olungakumbi luya kufuneka ukuze kutholakale ukuba abantu abanobuncwane ben gluten banokwenza ubuncinci be-gluten ngaphandle komonakalo, okanye ukuba iqela elithile leentlobo ze-gluten liza kuqhubeka lihlakulele isifo se-celiac.
Funda okunye kwimingcipheko yempilo ebonakalayo kwi-gluten sensitivity: I- Gluten Sensitivity Health Risks
U. we-Maryland Pegs 'Gluten Sensitivity' njengoMoya oyiNqobo
Uphando lukaDkt Fasano olusisiseko lwe-gluten yocwaningo, olupapashwe nge-Intanethi ngo-Matshi 2011 kwi- BMC Medicine , abaphandi bafumanisa ukungafani phakathi kwesifo se-celiac kunye nobutyebi be-gluten kwiqondo le-molecule, nangona iimpawu zeemeko ezimbini zigqithiswe kakhulu.
UDkt. Fasano kunye nabanye abaphandi baseYunivesithi baseMelika baqhathanise ama-celiacs angama-42 anesifo seMarsh 3 okanye iMarsh 4 emonakalo emathunjini nabantu abangama-26 abathumbu babo abonakalisa umonakalo omncinci okanye ongabikho monakalo, kodwa ngubani othe waphendula ngokucacileyo kwi-gluten.
Kulowo nalowo nxaxheba, abaphandi banqume izinga lokunyameka kwamathumbu emathunjini (kwisifo se-celiac, amathumbu akho ayenzeka kakhulu, anokuvumela iiprotheni ukuba zibalekele kumlambo wegazi).
Baye bajonga i-genetics, kunye neentetho zegesi kwiimathumbu amancinci.
Uphononongo lufumene ukungafani kwimizimba yamathambo phakathi kwamaqela abantu, kunye neentlukwano kwiimpawu zengqungquthela ezilawula ukumelana nomzimba. Okubonisa ubunene be-gluten yimeko ehlukile kunezifo zeliliac , ngokutsho kukaDkt. Fasano.
Ukwahlukana kwi-Celiac, Gluten Ukuzwela Isisombululo Kwiimpendulo zeNkqubo ze-Immune System
Ukwahluke phakathi kwezi zimbini izimo zivela kwiimpendulo zeendlela zokuzikhusela komzimba, uDkt. Fasano uthi.
Kwi-gluten sensitivity, isistim e-immune system - inxalenye endala ye-immune system kunye nomzila wokuqala wokuzikhusela ngabahlaseli-ukuphendula ukungena kwe-gluten ngokulwa ne-gluten ngokuthe ngqo.
Oko kudala ukuvuvukala ngaphakathi nangaphandle kwenkqubo yokutya, ngokutsho kukaDkt. Fasano.
Okwangoku, isifo se-celiac sichaphazela indlela yokuzikhusela e-innate kwaye i-immune system system, uthi. Isistim e-immune system ehamba phambili sisona siphumelele ngakumbi, sinobuchule besistim somzimba, kwaye ukungahambelani phakathi kwamaseli e-immune eguquguqukayo okukhokelela loo maseli ukulwa nezicubu zomzimba wakho, ukudala i -atrophy ekhohlakeleyo ebonwe kwisifo se-celiac.
Abantu abanobuncwane be-gluten abafumani i-atrophy ekhohlakeleyo, nangona banokukwazi ukufumana iimpawu ezinjenge- celiac, ezibandakanya intlungu, ukubetha, isisu, isisu, intlungu , ingqondo kunye ne-migraines, ngokutsho kukaDkt. Fasano. (Funda oku ngakumbi kwiimpawu apha: i- Gluten Sensitivity Symptoms .)
Nangona kunjalo, kuphela abo bantu abaneempendulo zendlela yokuzikhusela egazini kwiimpawu ze-celiac ezisemngciphekweni wokuphucula i-intestinal lymphoma kunye nezinye iimeko ezinxulumene ne-celiac, njenge- osteoporosis , uDkt. Fasano uthi.
Abanye abantu abanobuchule be-gluten abandakanyeka kwisifundo sikaDkt. Fasano babenomonakalo omncinci wamathumbu omzimba (obizwa ngokuthi iMarh 1 okanye 2 ), kodwa loo monakalo yayinezinto ezahlukahlukeneyo zezinto ezibonakalayo kunokuba zibonwe kwisifo se-celiac.
'Ubunokwenzeka' Abagulane bamaCeliac Yabelana ngeMinwelic fingerprint ngeCeliacs
Kukho olunye uphando olubonisa abanye abantu abhalwe ngokuthi "i-gluten-sensitive", eneneni, enokuqala ukuba nesifo se-celiac.
Uphando olupapashwe ngoDisemba ka-2010 I- Journal of Proteome Research ibona ukuba " izigulane " ezinokuthi zineengxaki ezifanelekileyo zegazi kodwa i-biopsies ezingenayo ingenayo efanayo impawu zeminwe njengoko zifunyenwe zi-celiacs. Aba bantu "banobuqili" bangabonakalisa isigaba esingaphambi kwimeko ngaphambi kokuba kubangele umonakalo omkhulu emathunjini, abaphandi bathi.
Isifundo sasebenzisa ukuprofetha kwamagnetic refontic metabolic ukuhlalutya iimpawu zamachiza ezinokwakheka kwemvelo kwi-urine kunye negazi lezigulane ezili-141: 61 kunye nezifo ze-celiac ezixilongwa, 29 kunye nokuhlolwa kwegazi oluhle kodwa i-biopsies engathandekiyo, kunye ne-51 yokulawula impilo.
Bafumanise ukuba abo abanezifo ezibizwa ngokuba "zikhona" ze-celiac zikwabelana ngesiprofayili esifanayo kunye ne-celiacs, kodwa iiprofayili ze-biochemical zolawulo oluphilileyo zihluke ngokuphawulekayo.
Iziphumo zethu zibonisa ukuba ukuguqulwa kwamagciwane kunokubangela ukuphuhliswa kwe-atrophy encinci yamathumbu emathunjini kunye nokubonelela ngengqiqo yeziko le-GFD [ukutya okungenanto kwe-gluten] kwizigulane ezine-CD [izilonda eziphethwe yi-CD]. "
Ubuninzi be-Gluten Okubonakalayo kwizigulane ezine-Biopsies eziMida
Olunye uphando lubhekise kwizigulane ezineempawu zesifo esiqhekezayo esiswini samathumbu emathumbu asityhilekanga okungaqhelekanga, njengesi- Marsh I okanye ii-II zilonda .
Amagqirha amaninzi akayi kuhlola ukuba isifo se-celiac ngaphandle kokuba umonakalo wamathumbu ufike kumgangatho we Marsh III okanye iMarsh IV .
Kule sifundo, izigulane ezingama-35 zazinomonakalo ophantsi kwaye zacetyiswa ukuba zilandele ukutya okungekho gulen nanini. Iigulane ezingama-23 kuphela ezihambelanayo nokutya kunye nabaphandi bathatha i-biopsies yokulandelelana kuwo wonke umntu emva kokutya emva kweenyanga ezi-8 ukuya kwezi-12.
Zonke izigulane ezingama-23 ezalandela ukutya "zaziphuculwe ngokukrakra kweempawu," kwaye abaninzi babone ukuphulukiswa okupheleleyo okanye okuncinci kwe-intestinal villi yabo.
Izigulane ezili-11 ezigulane ezingavumi ukulandela ukutya okungekho i-gluten zavavanywa kwiinyanga ezili-8 ukuya kwezi-12 kamva. Phakathi kwezi zinto, ezithandathu zazingenakushintsha iimpawu kunye nomonakalo emathunjini kwaye kwakhona zatsho ukuqala ukutya okungahambisani ne-gluten. Omnye wabona ukwanda komonakalo kwi-intestinal villi (ukusuka kuMarh I ukuya kuMarh IIIa) kwaye wakhetha ukuqala ukutya.
Ababhali beengxelo baphetha ngelithi izigulane ezingakhange zihlangabezane neendlela ezibhekiselele kwizifo ezingapheliyo zichazwe ngokucacileyo kwaye zixhamle kwi-gluten-free diet.
"Nangona iilesi ze-Marsh I-II zingenakulinganiswa njengezilonda ze-celiac, iimpawu zezigulane ekuboniseni kunye nokuphuculwa okucacileyo kweempawu xa kwi-GFD [ukutya okungekho gluten-free], okanye ngaphandle kokuphucula izilonda ze-hertologic, kuxhasa ukucinga ukuba ezi gulane abaphethwe yi-gluten kwaye banokuthethelela unyango nge-GFD, "abaphengululi baphetha.
Ubutyebi bukaGluten buya kuthintela omnye kwi-14 Abantu
Ukukhathazeka kweGluten (okanye ukunganyamezelani) kunokuchaphazela malunga no-6% ukuya kwi-7% yabemi, ngokutsho kukaDkt. Fasano. Abanye kwiindawo zonyango baye babeka ipesenteji yabantu abangenakuxhomekeka kwi-gluten - ndibone ukuqikelela ukusuka kwi-10% ukuya kwi-50% yabantu.
Funda oku ngakumbi kule manani: Bangaphi abantu abaye bafumana ubuGulane boBuntu?
Akunakwenzeka ukuxelela ukuba bangaphi abantu abanokwenene nokuvelisa ubuninzi be-gluten ngaphandle kophando olongezelelweyo kwaye bamkela iimvavanyo zogulane . Kodwa ngokucacileyo, nokuba ngaba amanani aphantsi kwicala eliphantsi, aya kufaka inani le-celiacs, abenza malunga ne-1% yabemi.
Abaninzi kwiindawo ezixhamlekileyo ze-gluten bakholelwa ukuba izifo ezibangelwa i-gluten ngokwayo "kwibala" ezinxulumene ne- gluten , nezifo ezinama-celiac, gluten ataxia (umonakalo we-neurological gluten) kunye nobutyebi bukaGlututen bonke abawela kwindawo ethile kuloo ndawo.
UDkt. Fasano uthi isinyathelo esilandelayo kukubonakaliswa kumakishi wezinto eziphilayo, okanye "i-biomarker", ngenxa yobuninzi be-gluten . Uvavanyo lwekliniki lokwenza oku kuqhubekayo ngoku, kunye noDkt. Fasano uthi "abathembekileyo" abaphandi baya kuxela ukuba i-biomarker. Ukusuka apho, abaphandi banokuvelisa uvavanyo ukuze bafumene ubukhulu bentlobo-enokufumaneka kwizorhwebo kwiminyaka emininzi ezayo.
> Imithombo:
> Bernini P. et al. Ngaba izigulane ezinezifo ezibangelwa yiCeliac zikhona? Impendulo yeMetabonomics. Umbhalo weProteome Research. Ishicilelwe kwi-intanethi ngoNovemba 19, 2010. INGXELO: 10.1021 / pr100896s.
> J. Biesiekierski et al. Iinjongo zeGluten Iimpawu zoBuncwane kwiZifundo ezingekho phantsi kwezifo ezi-Celiac: I-Trial-Blind i-Randomized Trial-Controled Trial. I-American Journal ye-Gastroenterology iqhubela phambili ukushicilelwa kwikhompyutha, uJan 11, 2011; i-doi: 10.1038 / ajg.2010.487.
> A. Fasano et al. Ukuchithwa kwe-Gut Ukuthetheka kunye ne-Mucosal Gene Immression Expression kwiimeko ezimbini ezidibeneyo zeGluten: Izifo eziCeliac kunye ne-Gluten Sensitivity. I-BMC Medicine 2011, 9:23. i-doi: 10.1186 / 1741-7015-9-23.
> Fasano A. et. al. I-Spectrum yeengxaki ezinxulumene neGluten: UkuBonisana kwiNqununu yeNtsha kunye noHlelo. BMC Medicine. I-BMC Medicine 2012, 10:13 i-doi: 10.1186 / 1741-7015-10-13. Ishicilelwe: 7 Februwari 2012
> Tursi A. et al. I-Symptomatic ne-Histologic Response kwi-Gluten-I-Food Diet kwi-Patients. Umbhalo we-Clinical Gastroenterology. 2003 uJan; 36 (1): 6-7.