Mipako ya muda inayoiga athari za upasuaji wa njia ya utumbo inaweza kusaidia kutibu kisukari cha aina ya 2
Upasuaji wa njia ya utumbo ni chaguo la kawaida kwa wagonjwa wanaougua shinikizo la damu, maswala ya kudhibiti uzito na ugonjwa wa kisukari. Upasuaji huu hurekebisha unene kwa kumfanya mgonjwa apunguze uzito mkubwa na pia husaidia katika usimamizi wa aina 2 kisukari kwa namna ya kujitegemea. Kwa sababu ya upasuaji huu wa mafanikio na unaoeleweka vizuri, kumekuwa na uboreshaji mkubwa katika mtindo wa maisha na juu ugonjwa wa kisukari msamaha katika miongo iliyopita. Hata hivyo, aina hii ya upasuaji sio chaguo la kwanza kwa wagonjwa wengi kwa sababu ya hatari zinazohusika na upasuaji huu unaweza kusababisha mabadiliko yasiyoweza kutenduliwa kwa anatomy ya utumbo wa mgonjwa. Takwimu zinaonyesha kuwa ni 1% hadi 2% tu ya wagonjwa wanaofaa kufanyiwa upasuaji huu kila mmoja atakubali.
Kidonge kipya cha "kutibu" kisukari cha Aina ya 2
Researchers at the Brigham and Women’s hospital in Boston and its Centre for Weight Management and Metabolic Surgery collaborated to find a less invasive but still a highly equivalent effective treatment for reversing type 2 ugonjwa wa kisukari. Such a method could provide same benefits as with gastric bypass surgery and would also be applicable in other areas of therapy. In their work published in Vifaa vya asili they have detailed a preclinical study in which an oral agent was administered in rats whose purpose was to deliver a ‘substance’ which would then neatly coat the rat’s intestine to prevent any contact between dietary nutrients (from meals) and the lining in proximal bowel by acting as a barrier. This coating then helps to prevent any spikes in blood sugar which generally happens after eating meals. The goal is to ultimately have an oral pill which a patient of type 2 ugonjwa wa kisukari can take before consuming a meal and this temporary coating of the gut could be helpful in somewhat replicating the results of surgery.
Uundaji wa aina hii ya vidonge vya kumeza ulihitaji ushirikiano kati ya madaktari wa upasuaji na wahandisi wa viumbe ambao wangeweza kutengeneza nyenzo inayofaa ambayo inaweza kutumika kwa njia ya kimatibabu kwa mgonjwa. Wakati wa kutafuta nyenzo zinazofaa, watafiti hukumbuka sifa fulani ambazo zilikuwa hitaji kuu. Hizi ni pamoja na kuwa na sifa nzuri za kushikamana ili kuweza kuambatana au "kushikamana" na utumbo mwembamba na uwezo wa kuyeyuka ndani ya masaa machache kwani ingekuwa koti ya muda tu. Baada ya kukagua watahiniwa watarajiwa ambao walikuwa ni orodha ya misombo iliyoidhinishwa na salama, waliorodhesha dutu inayoitwa sucralfate. Dutu hii ni dawa iliyoidhinishwa inayotumika kutibu vidonda vya utumbo kwa kutengeneza dondoo yenye kunata katika mazingira ya asidi ya tumbo na hufungamana na sehemu za utando wa tumbo popote inapohitajika kwa sababu ya utendakazi wa sasa. Watafiti walitengeneza kiwanja hiki kuwa nyenzo mpya ambayo inaweza kufunika utando wa matumbo kama inavyotaka na kufanya hivyo bila kuhitaji asidi ya tumbo. Dutu hii ya riwaya au 'mipako ya mwanga' iliyoandikwa LuCI (Luminal Coating of the Intestine) inaweza pia kutayarishwa katika mfumo mkavu wa nguvu ambao unaweza kutengenezwa kuwa kidonge. Katika jaribio la kimatibabu, LuCI iliwekwa kwenye panya na mara ilipofika kwenye utumbo ilifunika utumbo na hivyo kutengeneza kizuizi chembamba kama inavyotaka. Kwa hivyo, LuCI inaunda kizuizi kinachoiga kipengele muhimu zaidi cha upasuaji wa bypass ya tumbo lakini kwa njia isiyo ya uvamizi. Kawaida baada ya kula, sukari ya damu hupanda na kukaa juu kwa muda fulani. Lakini pamoja na eneo hili, ongezeko liliepukwa na viwango vya sukari ya damu vilipunguzwa kwa karibu asilimia 50 ndani ya saa 1 baada ya kuchukua LuCI. Kusudi lilikuwa kuwa na koti ya muda, na mara tu mipako hii inayeyuka ndani ya masaa 3, athari kwenye sukari ya damu hupotea na viwango vilirudi kawaida.
Tests have shown that this coating is safe and it has no adverse effect on the lining of small intestine making it favourably compatible with the gastrointestinal mucosa. Researchers are currently testing the use of LuCI – both short and long term – on rat models who are obese and have ugonjwa wa kisukari. Independent tests show that such LuCI formulations could also be used to deliver therapeutic proteins into the gastrointestinal tract in a similar way. It could be used in nutrient absorption and to protect molecules from getting degraded by the stomach acids and intestinal fluids and degradation by stomach acid and other intestinal fluids. For controlling type 2 ugonjwa wa kisukari, this pill which could be taken before meal is of tremendous value to patients.
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{Unaweza kusoma karatasi asili ya utafiti kwa kubofya kiungo cha DOI kilichotolewa hapa chini katika orodha ya (vyanzo) vilivyotajwa}
Chanzo (s)
Lee Y na wengine. 2018. Mipako ya luminal ya matibabu ya utumbo. Vifaa vya asili. https://doi.org/10.1038/s41563-018-0106-5
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