Mokhoa oa ho Theha Uric Acid
Asiti ea uric ke e 'ngoe ea lihlahisoa tsa ho qetela tsa metabolism ea purine ho batho. Ntho ena e atisa ho buisanoa ka eona hobane maemo a holimo maling a ka baka hyperuricemia 'me a lebisa ho thehoeng ha majoe a gout le liphio. Leha ho le joalo, asiti ea uric ha se feela "ntho e kotsi" - maemong a tloaelehileng, ke karolo ea lits'ebetso tsa 'mele tsa' mele 'me e bile e sebetsa e le antioxidant maling. Ho utloisisa hore na ke hobane'ng ha maemo a uric acid a ka eketseha le ho baka mathata, re hloka ho utloisisa mokhoa oa ho thehoa ha eona: ho tsoa mohloling oa li-purine, tsela ea ho senyeha ha 'mele, li-enzyme tsa bohlokoa le mokhoa oa ho felisoa.
1. Purine e le thepa e tala bakeng sa ho thehoa ha uric acid
Ho thehoa ha asiti ea uric ho qala ka li-purine. Li-purine ke likarolo tsa li-nucleotide (adenine le guanine) tse fumanoang ho DNA le RNA. Li-purine li tsoa mehloling e 'meli e meholo:
1. Purine ea tlhaho (e tsoang ka hare ho 'mele)
'Mele o ntse o nchafatsa lisele khafetsa. Ha lisele li e-shoa 'me likarolo tsa khubu ea sele li robehile, li-nucleotide tsa DNA/RNA lia sebelisoa hape kapa lia robeha. Ts'ebetso ena ea ho robeha e hlahisa li-purine tse lokolohileng, tse ka fetoloang ho ba uric acid.
2. Purine ea kantle (e tsoang lijong/linong)
Lijo tse nang le li-purine tse ngata—tse kang nama ea litho, mefuta e meng ea lijo tsa leoatleng, nama e itseng e khubelu, moro o matlafetseng le lihlahisoa tse itseng tse belisitsoeng—li ka eketsa moroalo oa purine. Lino tse tahang le lino tse nang le fructose e ngata le tsona li tlatsetsa, eseng hobane li na le li-purine tse ngata ka tlhaho, empa hobane li ka susumetsa tlhahiso ea uric acid le ho thibela ho felisoa ha eona.
Leha ho ja dijo tse nang le seabo, maemong a mangata keketseho ya uric acid e susumetswa haholo ke tlhahiso ya tlhaho mme haholoholo ho senyeha ha ho ntshwa ha liphio.
2. Kakaretso ea metabolism ea purine
Li-purine tse nkiloeng ho senyeha ha li-nucleotide li feta mekhahlelong e 'maloa ea biochemical. Ka bokhutšoanyane, tsela ke e latelang:
– Nucleotide (AMP/GMP) → nucleoside (adenosine/guanosine) → motheo wa purine (adenine/guanine)
– Adenine le guanine ebe di fetolwa hore e be metsoako e mahareng e qetellang e lebisa ho hypoxanthine le xanthine.
– Hypoxanthine le xanthine li oxidized ho ba uric acid
Ho batho, uric acid ke "sehlahisoa sa ho qetela" hobane batho ha ba na enzyme ea uricase (urate oxidase), eo ho liphoofolo tse ngata e fetolang uric acid ho ba allantoin e qhibilihang haholoanyane. Ho hloka uricase hona ho etsa hore batho ba be kotsing ea ho kenngoa ha kristale ea uric acid ha maemo a le holimo.
3. Mehato ea ho thehoa ha uric acid ka botlalo
a) Ho senyeha ha Nucleotide: ho tsoa ho AMP le GMP
Li-purine li fumaneha ka bongata ka mokhoa oa li-nucleotide: AMP (adenosine monophosphate) le GMP (guanosine monophosphate). Ha lisele li senyeha kapa li nkeloa sebaka, li-nucleotide tsena lia senyeha.
– AMP e ka fetoloa ho ba adenosine, ebe ho ba inosine. Inosine e aroloa hore e be hypoxanthine.
– GMP e fetoloa guanosine, ebe guanine, eo ebe e ntshwang xanthine.
Mothating ona, litsela tse 'maloa li ka kopana. Sephetho sa ho qetela hangata se kopana limolek'huleng tse peli tsa bohlokoa: hypoxanthine le xanthine.
b) Karolo ea enzyme ea xanthine oxidoreductase (XOR)
Mohato oa bohlokoa ho thehoeng ha uric acid ke ho oxidation ha hypoxanthine le xanthine. Ts'ebetso ena e susumetsoa ke sehlopha sa li-enzyme tse atisang ho bitsoa xanthine oxidoreductases, tse ka bang teng ka mefuta e 'meli e sebetsang:
– Xanthine dehydrogenase (XDH)
– Xanthine oxidase (XO)
Likarabelo tse latellanang tse hlahang:
1. Hypoxanthine → Xanthine
2. Xanthine → Asiti ea Uric
Tlas'a maemo a itseng (joalo ka khatello ea oxidative kapa ho ruruha), mofuta oa XO o matla haholo 'me o ka hlahisa li-free radicals (mefuta ea oksijene e arabelang). Lena ke le leng la mabaka a etsang hore hyperuricemia ka linako tse ling e amane le lits'ebetso tsa ho ruruha le mathata a metabolism.
c) Tsela ea "pholoso": ho sebelisa hape purine e thibelang ho thehoa ha uric acid
Hase li-purine tsohle tse qetellang e le uric acid. 'Mele o na le mokhoa oa ho "boloka" o bitsoang purine salvage pathway, o khutlisetsang metheo ea purine ho li-nucleotide. Li-enzyme tsa bohlokoa tseleng ena li kenyelletsa:
– HGPRT (hypoxanthine-guanine phosphoribosyltransferase): e sebelisa hape hypoxanthine le guanine.
– APRT (adenine phosphoribosyltransferase): e sebelisa adenine hape.
Haeba tsela ea pholoso e sebetsa hantle, li-purine tse ngata lia sebelisoa hape, e leng se fokotsang tlhahiso ea uric acid. Ka lehlakoreng le leng, haeba ho na le tšitiso (joalo ka khaello ea HGPRT maemong a itseng a liphatsa tsa lefutso), li-purine tse ngata li kena tseleng ea ho senyeha ho ea ho uric acid, e leng se eketsang maemo a eona.
4. Ke hobane'ng ha maemo a uric acid a ka eketseha?
Ka mokhoa oa mechine, maemo a uric acid maling a khethoa ke ho leka-lekana pakeng tsa tlhahiso le ho ntšoa ha mali.
a) Keketseho ea tlhahiso
Tlhahiso ea asiti ea uric e eketseha ha:
– Ho ja purine e ngata ka nako e telele.
– Ho hlaha ho senyeha ho hoholo ha lisele (mohlala, maemong a itseng a eketsang phetoho ea lisele).
– Metabolism e itseng ea matla e eketsa ho thehoa ha li-purine le ho senyeha ha tsona.
– Ho noa joala ho ka eketsa tlhahiso ea lactate le phetoho ea metabolism e le hore urate e eketsehe.
– Fructose e ka eketsa ho senyeha ha ATP sebeteng, ea hlahisa li-precursor tsa purine tse qetellang li eketsa uric acid.
b) Ho fokotseha ha ho ntšoa ha mali (ho tloaelehile haholo mesebetsing ea bongaka)
Bongata ba uric acid bo ntšoa ka liphio, 'me tse setseng li ntšoa ka tsela ea tšilo ea lijo. Liphiong, uric acid e feta lits'ebetsong tse latelang:
1. Ho sefa ka har'a glomerulus
2. Ho monya hape ka har'a tubule e haufi
3. Ho ntsha lero ho kgutlela ka hara tube
4. Ho monya hape ka karolo e itseng
Sena se bolela hore taolo ea uric acid liphiong e fetoha haholo. Ts'ebetso ea liphio e sa sebetseng hantle, ho felloa ke metsi 'meleng, ho hanyetsa insulin, kapa meriana e itseng e ka fokotsa ho ntšoa ha urate, e leng se lebisang ho eketseheng ha maemo a mali.
5. Ho tloha ho uric acid ho ea ho likristale: qalo ea mathata a gout
Asiti ea uric e qhibiliha maling ho isa bohōleng bo itseng. Ha maemo a feta moeli oa ho qhibiliha, haholo-holo mochesong o tlase (mohlala, manonyellong a kantle joalo ka monoana o moholo oa leoto), asiti ea uric e ka etsa likristale tsa monosodium urate. Likristale tsena li tsejoa ke sesole sa 'mele e le "tse kotsi," e leng se bakang ho ruruha ho matla, bohloko, bofubelu le ho ruruha ho bakoang ke tlhaselo ea gout.
Ntle le manonyellong, ho ka boela ha hlaha liphio, e leng se eketsang kotsi ea majoe a uric acid.
6. Mabaka a susumetsang mokhoa oa ho thehoa ha uric acid
Mabaka a mang a ka fetolang litsela tsa ho thehoa le maemo a uric acid a kenyelletsa:
– Liphatsa tsa lefutso: mefuta e fapaneng ea liphatsa tsa lefutso tsa urate transporter ka har'a li-enzyme tsa metabolism ea liphio kapa purine.
– Lijo: purine e ngata, joala, lino tse monate tse nang le fructose e ngata.
– Boemo ba ho noa metsi: ho hloka ho noa ho tsepamisa moroto le ho fokotsa ho ntšoa ha uric.
– Boima ba 'mele le ho hanyetsa insulin: ho amahanngoa le ho fokotseha ha ho ntšoa ha urate.
– Mosebetsi oa liphio: ha mosebetsi oa liphio o fokotseha haholo, kotsi ea hyperuricemia e eketseha.
– Meriana e itseng: meriana e meng e ka fokotsa ho ntšoa ha urate kapa ea ama metabolism.
7. Qetello
Mokhoa oa ho thehoa ha uric acid ho batho ke sephetho sa ho qetela sa metabolism ea purine, haholo-holo ka tsela ea ho senyeha e kenyeletsang hypoxanthine, xanthine, le enzyme xanthine oxidoreductase, e leng se fellang ka ho thehoa ha uric acid. 'Mele o na le tsela ea purine recycling (salvage) e ka thibelang tlhahiso ea uric acid, empa botsitso bo ntse bo susumetsoa haholo ke ho kenngoa ha uric acid, ho fetoha ha lisele, le bokhoni ba liphio ba ho ntša urate. Ha tlhahiso e eketseha kapa ho ntšoa ha uric acid ho fokotseha, maemo a uric acid a ka feta moeli oa ho qhibiliha 'me a baka pula ea kristale, e leng se lebisang ho gout kapa majoe a liphio. Ka ho utloisisa mokhoa, thibelo le taolo ea maemo a uric acid li ka shejoa haholoanyane - ka lijo, mokhoa oa bophelo le mekhoa ea bongaka, haeba ho hlokahala.
