Iingcali ezininzi zezempilo zincoma kakhulu ukuba izigulana ezine imultiple sclerosis, okanye iMS, ziphephe zobisi. Izifundo zophando ezininzi zibonise unxulumano oluphezulu phakathi kwe-MS kunye nobisi, ngakumbi ubisi lwenkomo. Ngokomzekelo, ezinye iiproteni kubisi lwenkomo zijoliswe kwiiseli zokhuselo lomzimba kwizigulana ezinemultiple sclerosis. Ezi ziquka i-butyrophilin kunye ne-albumin ye-bovine serum, okanye i-BSA. Ngaphaya koko, ukutofwa kwa ezo proteni zobisi lwenkomo zinye kwizilwanyana zovavanyo kubangele ukuba kuvele izilonda kwiinkqubo zabo zemithambo-luvo.
Ezinye iiproteni kubisi lwenkomo zixelisa inxalenye ye-myelin oligodendrocyte glycoprotein, okanye i-MOG, icandelo le-myelin ekukholelwa ukuba liqalise ukusabela kwe-autoimmune ehambelana ne-multiple sclerosis. Ngapha koko, oku kunokukhohlisa amajoni omzimba ukuba aqalise uhlaselo kwi-MOG, emva koko kubangele ukuphelelwa lithemba. Olunye uphononongo lophando olubandakanya ngaphezulu kwe-135,000 yamadoda nabafazi e-United States yafumanisa unxibelelwano phakathi kobisi lwenkomo kunye nesifo se-neurological disorder, i-Parkinson's Disease. Abaphandi baye baqikelela ukuba iimveliso zobisi, ngakumbi ubisi lwenkomo, zinokuba nefuthe eliyingozi kwizicubu zemithambo-luvo.
Ukunganyamezeli kweLactose kuxhaphakile kubo bonke abantu, kwaye kuxhaphake kakhulu kwiMeditera, Asia, kunye nabemi baseAfrika. Abantu abanokunganyamezeli i-lactose bafumana iimpawu ezahlukahlukeneyo, kuquka ukuqunjelwa, ukuqaqanjelwa, urhudo kunye nesicaphucaphu. Ukunikezelwa kwemingcipheko ephezulu enokubakho kubantu abane-MS abasebenzisa iimveliso zobisi, ngaphandle kokungabikho kobungqina obubambekayo, abaqeqeshi bezempilo bancomela ukunqanda ukusetyenziswa kweemveliso zobisi, phakathi kwezinye iintlobo zokutya. Injongo yale nqaku ingezantsi kukuxoxa ngeenyaniso zesondlo kwi-multiple sclerosis, kubandakanywa neziphi iintlobo zokutya izigulane ezine-MS kufuneka zigweme, ezifana nobisi.
Contents
Umbuzo wokuba imilinganiselo yokutya kunye nendlela yokuphila inempembelelo kwikhosi ye-multiple sclerosis (MS) isengumcimbi wengxoxo, kwaye okwangoku, unyango lwe-MS aluhambelani naluphi na ulwazi malunga nokutya kunye nendlela yokuphila. Apha sibonisa ukuba imiba yokutya kunye nendlela yokuphila inokwandisa okanye iphucule iimpawu ze-MS ngokumodareyitha imeko yokukrala kwesi sifo zombini kwi-MS ephindaphindayo kunye nakwi-MS ephambili. Oku kuphunyezwa ngokulawula zombini iindlela ze-metabolic kunye nokuvuvukala kwiseli yomntu kunye nokubunjwa kwe-commensal gut microbiota. Yintoni eyandisa ukuvuvukala kukutya kwe-hypercaloric ye-Western-style, ebonakaliswa yityuwa eninzi, i-fat fat, inyama ebomvu, iziphuzo ezinoshukela ezinoshukela, ukutya okuthosiweyo, i-fiber ephantsi, kunye nokungabikho kokuzivocavoca umzimba. Ukuzingisa kolu hlobo lokutya kulawula i-metabolism yeeseli zomntu ukuya kwiindlela ze-biosynthetic ezibandakanya ezo molekyuli ze-proinflammatory kwaye zikhokelela kwi-dysbiotic gut microbiota, ukuguqulwa kokugonywa kwamathumbu, kunye ne-low-grade systemic inflammation. Ngakolunye uhlangothi, ukuzivocavoca kunye nokutya okuphantsi kweekhalori ezisekelwe kwingcamango yemifuno, iziqhamo, imifuno, intlanzi, i-prebiotics, kunye ne-probiotics zisebenza kwii-receptors zenyukliya kunye ne-enzymes ezilawula imetabolism ye-oxidative, ukunciphisa ukuhlanganiswa kwee-molecule ezivuthayo, kunye nokubuyisela okanye ukugcina i-symbiotic enempilo. microbiota emathunjini. Ngoku ukuba siyazi iindlela ze-molecular apho izinto zokutya kunye nokuzivocavoca zichaphazela isimo sokuvuvukala kwi-MS, sinokulindela ukuba ukungenelela okunomsoco kunye nokutya okuchasayo kunye nezongezo zokutya kunokunciphisa iziphumo ezinokuthi zenzeke kwi-immune-modulatory drug kunye neempawu ezingapheliyo. fatigue syndrome kwaye ke ukuthanda impilo yesigulana.
Internet: iyeza elilolunye olongezelelweyo, i-gut microbiota, ukuvuvukala, indlela yokuphila, i-multiple sclerosis, isondlo
I-Multiple sclerosis (MS) sisifo esingapheliyo, esivuthayo, kunye ne-autoimmune yenkqubo ye-nervous central (CNS), ekhokelela ekuthotyweni okubanzi kwe-myelin sheath, i-axonal eguquguqukayo kunye nokulimala kwe-neuronal, kunye nokukhubazeka kubantu abadala abancinci, uninzi lwabasetyhini. Esi sifo sibonakaliswe ngeenkqubo ezisasazwayo kunye ne-heterogeneous perivascular inflammatory kwi-blood-brain barrier (BBB), ngokubandakanyeka kweeseli ze-T ezizenzekelayo, i-B lymphocytes, i-macrophages, kunye neeseli ze-microglial ezichasene nengqondo kunye nentambo yomgogodla (McFarland noMartin, 2007; UConstantinescu kunye noGran, i-2010; Kutzelnigg kunye neLassmann, i-2014).
Ama-Antibodies (Krumbholz et al., 2012), umncedi osebenzayo (Ingram et al., 2014), i-cytokines, i-mitochondrial dysfunction (Su et al., 2009), iintlobo ze-oksijini ezisebenzayo (ROS; Gilgun-Sherki et al., 2004), kunye ne-matrix metalloproteinases (MMPs; Liuzzi et al., 2002; Rossano et al., 2014) banokusebenzisana ukuvelisa i-pathology.
Ukusuka kwimbono yeklinikhi, kukho ubuncinane ezimbini iindlela eziphambili zesifo: i-MS ebuyisela i-relapsing (RRMS; malunga ne-85% yeemeko zeklinikhi) kunye ne-MS ye-primary-progressive (PPMS; malunga ne-15% yeemeko zeklinikhi) (UDutta noTrapp, 2014; Lublin et al., 2014). Kwi-RRMS, ehlala iguqukela kwi-MS (SPMS) yesibini, ukuphindaphinda kunxulunyaniswa nokwanda kokudumba kwenkqubo kunye nokwakheka kwezilonda ebuchotsheni, kulandelwa kukukhululwa okungaphezulu okanye okungaphantsi, ngelixa i-pathogenesis ye-PPMS ibonakala ngomonakalo oqhubekayo we-neurological endaweni yoko. kunokubuyela umva kunye nokuxolelwa.
Okwangoku, kukho ubuncinane i-10 yonyango yokuguqula izifo eziye zafunyanwa ukuba zicothe ukuqhubela phambili kwesifo kunye nokukhusela ezinye iimpawu zokukhubazeka, kodwa kuphela kwimeko ye-RRMS. Nangona kunjalo, njengoko isifo sinzima kwindalo kwaye siyingqayizivele kwikhosi yomntu, akukho sigulane siphendula unyango ngendlela efanayo (Loleit et al., 2014). Ngokufanayo, azikho ii-biomarkers ezithembekileyo ezivumela wonke umntu ukuba ahlole ukusebenza kwonyango kwaye ngoko ke kubalulekile ukufumanisa iimpawu zenoveli zesi sifo (Fernandez et al., 2014).
Ukungabikho kwempendulo kwi-immune-modulatory therapies kwimeko ye-PPMS, ngenye indlela esebenzayo kunyango lwe-RRMS, inokuba ngenxa yeendlela ezahlukeneyo ze-pathogenic ezisebenza kwi-RRMS kunye ne-PPMS. Nangona kunjalo, oku akuyonyani malunga nokuvuvukala: Umbutho obalulekileyo phakathi kokuvuvukala kunye ne-neurodegeneration iye yabonwa kwingqondo kungekuphela nje kwi-MS ebukhali kunye ne-relapsing kodwa nakwi-MS yesibini kunye ne-primary progressive MS (Frischer et al., 2009; Lassmann, 2013), kunye nezilonda ze-MS ezisebenzayo zihlala zihambelana nokuvuvukala (Kutzelnigg noLassmann, 2014). Ngaloo ndlela, ukuvuvukala kufuneka kube yinjongo yonyango lweendlela zombini zesifo.
Yintoni ebangela iinkqubo ezivuthayo kwi-MS? I-MS sisifo esiyinkimbinkimbi, kwaye i-genetic kunye ne-immunological components akwanele ukucacisa imvelaphi yayo. Ngokwenyani, i-MS inobume bezinto ezininzi kunye nezinto ezahlukeneyo zokusingqongileyo okanye iimeko zemetabolism zinokuba nendima ekuphuhlisweni kwayo (Ascherio, 2013): usulelo lwentsholongwane (Ascherio et al., 2012; Venkatesan noJohnson, 2014), ityhefu enzima (Latronico et. al., 2013; Zanella noRoberti di Sarsina, 2013), ukutshaya (Jafari kunye noHintzen, 2011), ukutyeba kwabantwana (uMunger, i-2013), isimo esiphantsi se-vitamin D (Ascherio et al., 2014), okanye indlela yokuphila engalunganga, kuquka engalunganga imikhwa yokutya (Riccio, 2011; Riccio et al., 2011; Riccio and Rossano, 2013).
Akukho nanye kwezi zinto zikhankanywe ngasentla zokusingqongileyo zodwa ezinokuchaza isifo; nangona kunjalo, ezi ngqwalasela zilandelayo zenza umdla ngakumbi ukubandakanyeka kwi-MS yeendlela zokutya kunye nendlela yokuphila, kunokuba usulelo okanye ukutshaya, njengezinto ezinokuchaphazela ikhosi yesifo:
Ukuqwalaselwa okuchazwe ngasentla kubonisa ukuba imeko yesondlo inokuchaphazela ikhosi ye-MS. Nangona kunjalo, umbuzo uvela malunga nendlela iimolekyuli zokutya ezinokuzenza zibe mandundu okanye ziphucule iimpawu ze-MS, kwaye ngokubanzi zinokuthi zithande okanye zithobe njani ukudumba kwinqanaba leemolekyuli. Ngokukodwa, kubalulekile ukucacisa ukuba zeziphi iinjongo zeemolekyuli zokutya kunye neendlela ze-molecular ezibandakanyekayo, ukuba zikhona.
Ngokusisiseko, sinokuthi ukutya esikutyayo kunempembelelo ebanzi kuphuhliso lwethu, indlela yokuziphatha, imeko yezempilo, kunye nobomi ngokusebenza kwiinjongo ezimbini eziphambili: (A) iiseli zomzimba wethu kunye (B) ne-commensal gut microbiota (Figure). 1).
Kwimpilo, kukho ubudlelwane obusondeleyo kunye ne-symbiotic phakathi kwe-gut microbiota kunye nabantu, kwaye i-gut microbiota ibonelela ngenani lemisebenzi eluncedo ye-metabolic, ikhusela ngokuchasene ne-enteropathogens, kwaye inegalelo kwimisebenzi eqhelekileyo yomzimba. Le yimeko eqhelekileyo ye-intestinal microbiota, ebizwa ngokuba yi-eubiosis. Ukuphazamiseka kwi-eubiosis, edityaniswa nokuncipha kwezinto eziphilayo zamathumbu kunye nokwanda kwebhaktheriya ye-pathogenic, ibizwa ngokuba yi-dysbiosis. Umphumo oqhelekileyo we-dysbiotic gut microbiota kukuguqulwa kwe-mucosal immune system kunye nokunyuka kwezifo ezivuthayo, ezikhuselayo, ze-metabolic, okanye eziphazamisayo (i-Chassaing kunye ne-Gewirtz, i-2014).
Iindidi ezahlukeneyo kunye nenani lezinto ezityiwayo zibangela ukuba kukhethwe uhlobo oluthile lwentsholongwane yentsholongwane emathunjini kunye nenani leentlobo ezincinci zentsholongwane ukuya kwi-eubiosis okanye i-dysbiosis, zisebenza ngokulula ngokutya okukhethekileyo komnye okanye kwezinye iintsholongwane. Ukuba ukutya kwethu kuthanda utshintsho kwi-dysbiotic gut microbiota, oku kunokukhokelela ekudumbeni kwamathumbu, ukuguqulwa kokugonywa kwamathumbu emathunjini, kunye nokudumba kwenkqubo kunye nezifo ezingapheliyo zokudumba.
Ukuqonda indlela iimolekyuli zokutya zinokuchaphazela ngokuthe ngqo imetabolism yeeseli zomntu, kuyimfuneko ukuchaza kuqala ukuba zeziphi i-enzymes kunye nezinto ezibhaliweyo ezibandakanyekayo kwi-catabolism okanye i-anabolism kwiseli.
Njengoko kuboniswe ngakwesobunxele kwi-Figure 2, i-metabolism ye-oxidative ilawulwa yi-enzymes ezimbini kunye ne-nuclear receptor. I-enzymes yi-AMP-activated protein kinase (AMPK; i-Steinberg kunye ne-Kemp, i-2009) kunye ne-Sirtuins (SIRT), iqela le-histone deacylating enzymes, eyenziwa yi-NAD + (Zhang et al., 2011; I-Rice et al., 2012). I-receptor yenyukliya imelwe yi-isotypes ye-peroxisome proliferator-activated receptors (i-PPARs; i-Desvergne kunye ne-Wahli, i-1999; i-Burns kunye ne-VandenHeuvel, i-2007).
I-isotypes ye-PPAR ilawula ukukhutshelwa kwezakhi zofuzo ezibandakanyekayo kwi-beta-oxidation ye-fatty acids kwi-mitochondria kunye ne-peroxisomes kwaye yenza inethiwekhi kunye neendlela ze-AMPK kunye ne-Sirtuins. Indlela ye-AMPK-Sirtuins-PPAR iqaliswe yindlela yokuphila esekelwe kwi-calorie restriction kunye nokuzivocavoca umzimba, kunye nezinye iimolekyuli ze-bioactive (i-polyphenols, ezifumaneka kwimifuno kunye neziqhamo, kunye ne-omega-3 (n-3) i-long-chain chain polyunsaturated fatty. iiasidi [PUFA], ezifumaneka kwintlanzi). I-Ligand-activated PPAR isotypes yenza i-heterodimeric complexes kunye ne-retinoid X-receptor (RXR), leyo, yona, isebenze nge-9-cis-retinoic acid (RA).
Ngokuchaseneyo, njengoko kubonisiwe ngasekunene kuMfanekiso 2'njengesinye isitya sokulinganisela okucingelwayo-ukutya okuphezulu kwezondlo ezixineneyo zamandla kukhokelela ekulawuleni i-anabolism, kubandakanywa i-lipogenesis kunye nokukhula kweeseli, ngokusetyenziswa kwento yokulawula i-sterol- iiprotheni ezibophayo, i-SREBP-1c kunye ne-SREBP-2 (Xu et al., 2013), kunye ne-carbohydrate ephendulayo ye-protein-binding-protein, i-ChREBP (Xu et al., 2013). I-SREBP-1c kunye ne-SREBP-2 ziphantsi kolawulo lwe-nyukliya ze-nyukliya ezibizwa ngokuba yi-receptors yesibindi X (LXR; Mitro et al., 2007; Nelissen et al., 2012). I-LXR isotypes, eyenziwa yi-cholesterol derivatives oxysterols kunye ne-glucose, inendima efanelekileyo kwi-synthesis ye-lipids ngokuvula i-SREBP-1c kunye ne-triacylglycerols, ngelixa inqanda i-SREBP-2 kunye ne-cholesterol synthesis.
Okubalulekileyo ekuqondeni ikhonkco phakathi kokutya kunye nokuvuvukala zizinto ezimbini ezibhaliweyo ezibandakanya ukuvuvukala kunye nokuzimela: i-nuclear transcription factor-kB (NF-kB) kunye neprotheni ye-activator (AP-1; Yan kunye neGreer, 2008). Kwi-MS, zombini i-NF-kB kunye ne-AP-1 ziyasebenza kwaye zikhuthaza ukubonakaliswa kweejeni ezininzi ze-proinflammatory kunye nokuveliswa kwee-molecule ze-proinflammatory. Isizathu sokusebenza kwabo kwi-MS akwaziwa kodwa, njengoko kubonisiwe kwi-Figure 2 ye-NF-kB, le nto inokuthi isebenze kungekuphela nje ngeentsholongwane, i-cytokines, kunye noxinzelelo lwe-oxidative kodwa kunye nezinye izinto zokutya ezifana ne-saturated fatty acids okanye i-trans unsaturated. i-fatty acids, ngoko ke inokuthathwa njenge-proinflammatory.
Ukunciphisa i-proinflammatory NF-kB inokufezekiswa ngokubophelela kwe-inhibitory ye-RA-activated form of retinoid X-receptor isotypes (RXRs; P�rez et al., 2012; Zhao et al., 2012; Fragoso et al. , 2014).
Njengoko kubonisiwe embindini we-Figure 2 kunye nangaphezulu ngokweenkcukacha kwi-Figure 3, iifom ezisebenzayo ze-RA-RXR zi-heterodimers ezibangelwa kubudlelwane bazo kunye ne-ligand-activated nuclear receptors, ezizezi PPARs, LXRs, kunye ne-vitamin D receptor (VDR).
Zontathu izamkeli zenyukliya-PPAR, LXR, kunye ne-VDR-kufuneka zivulwe zii-ligands ezithile. Njengoko kubonisiwe kwi-Figure 2, i-ligands ingaba yimiba ethile yokutya kwaye oku kucacisa indlela iiseli ezisabela ngayo kwiinguqu kwimeko yesondlo kunye nokulawula i-homeostasis yamandla kodwa imele isitshixo se-molecular ekuqondeni ukuba izondlo zinokuchaphazela njani ikhosi yezifo ezingapheliyo ezivuthayo (Heneka et al. ., 2007; Zhang-Gandhi kunye noDrew, 2007; Krishnan noFeldman, 2010; Cui et al., 2011; Schnegg kunye noRobbins, 2011; Grey et al., 2012).
Ke ngoko, nganye kwezi zintathu ii-receptors zenyukliya-PPAR, LXR, kunye ne-VDR zikhuphisana ngokubophelela kwi-RA-RXR kwaye zenze i-hetero-complexes ezinokunqanda i-NF-kB kwaye zenze ulawulo oluluqilima ekubonakalisweni kofuzo oluvuthayo, ngaloo ndlela kudityaniswa imetabolism. kunye nomqondiso ovuthayo. Kucacile ukuba kukho ukhuphiswano phakathi kwee-receptors ezintathu ze-PPAR, i-LXR, kunye ne-VDR-D, ngokubopha i-RA-RXR, kodwa olu khuphiswano kufuneka lube nefuthe kuphela kwi-metabolism kwaye kungekhona ekudumbeni, kuba akukaziwa ukuba yeyiphi. kweeheterodimers ezintathu zisebenza ngakumbi ekuthinteleni i-NF-kB.
Ngokucacileyo, ukuveliswa kweeamolekyu ze-proinflammatory ngexesha lokubuyela kwakhona yinkqubo ye-biosynthetic: Igcinwa ngokutya kwe-hypercaloric kunye nokuchasana nezidlo eziphantsi kweekhalori. Ngokomgaqo, yintoni ethanda i-anabolism iya kukhuthaza iinkqubo zokuvuvukala, ngelixa oko kuthandwa yi-catabolism kuya kuhluke (Umfanekiso 4).
Ukubunjwa kwe-intestinal microflora kuxhomekeke kumntu kwaye kuphenjelelwa zizinto ezininzi ezifana nokutya, umsebenzi womzimba, uxinzelelo, amayeza, ubudala, njalo njalo. Ngamnye wethu uneseti ekhethekileyo ubuncinane ye-100 ukuya kwi-150 yeentlobo zebhaktheriya.
Indlela elula yokuxoxa malunga nefuthe lokutya kunye nendlela yokuphila kwi-microflora yamathumbu kukukhawulela ushwankathelo kuphela kumacandelo amabini alawulayo ebhaktiriya - i-Bacteroidetes kunye ne-Firmicutes ibalwa malunga ne-90% yetotali, njengoko kubonisiwe ukuba umlinganiselo. I-Bacteroidetes/Firmicutes (B/F) iphenjelelwa yimikhwa yokutya kwexesha elide (Cani noDelzenne, 2009; Wu et al., 2011; Lozupone et al., 2012; Tremaroli kunye neB�ckhed, 2012; Panda et al., 2014).
Uphononongo oluthelekisayo lukaDe Filippo et al. (2010) kubantwana baseFlorence naseBurkina Faso e-Afrika babonise ukuba imikhwa yexesha elide yokutya inemiphumo ebalulekileyo kwi-gut microbiota yabantu.
Kolu phononongo, ukutya kwaseBurkina Faso kwakusekwe ekusetyenzisweni kweepolysaccharides zezityalo ezifana ne-millet namazimba (10 g fibers/day and 662-992 kcal/day), kanti ukutya kwabantwana base-Italiya yayisisitayile saseNtshona, esekwe kwiiproteni, amafutha ezilwanyana, iziselo ezinoshukela-ushukela, kunye ne-carbohydrates ecocekileyo (5.6 g fibers / ngosuku kunye ne-1,068�1,512 kcal / ngosuku). Uhlalutyo lweesampulu ze-fecal kubantwana abavela e-Afrika lubonise ukuxhaphaka kwee-Bacteroidetes (73%) �ikakhulu i-Prevotella ne-Xylanibacter�kunye namanqanaba aphantsi e-Firmicutes (12%). Ngokuchasene noko, ukuxhaphaka kwe-Firmicutes (51%) ngaphezu kwe-Bacteroidetes (27%) kwabonwa kubantwana base-Italiya, kodwa i-Bacteroidetes yasuka kwi-Prevotella kunye ne-Xylanibacter ukuya kwi-Bacteroides. Ezi mva zivame ukukhethwa phakathi kwe-Bacteroidetes kuba zingasebenzisa kwakhona iishukela ezilula ngaphezu kwe-glycans eziyinkimbinkimbi, kunye neeshukela ezilula zizinto eziqhelekileyo zokutya zaseNtshona.
Ukuququmbela, umlinganiselo we-B / F uyanda ngokubambisana nokutya okucebileyo kwi-carbohydrates eyinkimbinkimbi (engenakudliwa yi-enzymes yethu) ngenxa yokuba i-symbiotic kwaye ngokuqhelekileyo i-Bacteroidetes engenabungozi, njenge-Prevotella kunye ne-Xylani bacter, ithanda ukuba ne-glycans eyinkimbinkimbi yokutya. Iintsholongwane ezidla i-glycans eziyinkimbinkimbi zivelisa i-butyrate, ephantsi ilawula ukusebenza kwe-NF-kB ye-proinflammatory (Figure 3).
Ngakolunye uhlangothi, ukutya okuseNtshona, okunamandla okutshintsha iprofayili ye-gut microbiota kunye nokwandisa abantu baseFirmicutes (kubandakanywa ne-Mollicutes), efanelekileyo kakhulu ukukhupha nokuvuna amandla, kodwa ngokuphindaphindiweyo i-pathogenic (Moschen et al., 2012).
Kwi-dysbiotic gut microbiota, umlinganiselo we-B / F uphantsi kwaye i-Firmicutes enokwenzeka ye-pathogenic inqoba i-Bacteroidetes (Umfanekiso 5). Ukungaphumeleli kwe-microbial balance kunye nokuncipha kwezinto eziphilayo ezenzeka kwi-dysbiosis kukhokelela ekuphazamisekeni kwe-complex interplay phakathi kwe-microbiota kunye ne-host host yayo kunye negalelo kwi-endotossemia ephantsi, kunye nokuvuvukala okungapheliyo kwamathumbu kunye nenkqubo. Ngokuqala kokuvuvukala kwenkqubo, umngcipheko wezifo ezingapheliyo ezivuthayo kunye ne-immune-mediated ziyanda (Tilg et al., 2009; UBrown et al., 2012; Maynard et al., 2012).
Enyanisweni, phambi kwe-dysbiotic microbiota, i-gut endotoxin / lipopolysaccharide (LPS) iyanda, iiseli ze-T ezilawulayo (i-Treg) zineziphene, kwaye i-aryl hydrocarbon receptors kunye neeseli ze-Th17 ze-proinflammatory ziyasebenza (Cani et al., 2008; Veldhoen et et. al., 2008).
I-LPS ikhokelela ekungasebenzi kakuhle komqobo we-mucosal kwaye ichaphazela ezinye izicubu xa izinga layo le-plasma linyuka ngaphezu kwe-200 pg / ml serum. Ukunyuka kwe-gut permeability ngenxa ye-dysbiotic gut microbiota kunokubonakaliswa ngokugqithiswa kwe-IgA kunye ne-IgG ye-antibodies echasene ne-gluten kunye ne-gliadin, ekwabonwa kwizigulane ze-MS (i-Reichelt kunye ne-Jensen, i-2004).
Kumsebenzi wethu wangaphambili, sicebise ukuba imodeli edibanisa utshintsho lwe-microbiota ngenxa yokutya kwaseNtshona kunye nendlela yokuphila kunye nokusilela konxibelelwano oluchanekileyo phakathi kwe-microbiota kunye namathumbu, okukhokelela kwi-endotoxemia ephantsi kunye ne-systemic autoimmune ukudumba, kunokuba semthethweni. kunye ne-pathogenesis ye-MS (uFern�ndez et al., 2012; Riccio, 2011). Ngapha koko, i-MS yabelana nezinye izifo ezingapheliyo zokukrala iindlela eziqhelekileyo, zonke zisekwe ekuzingiseni kwe-endotoxemia yomgangatho ophantsi onxulumene nendlela engalunganga yokuphila kunye nemikhwa yokutya kunye ne-dysbiosis efihlakeleyo. Ngaphezu koko, ubukho be-gut microbiota-brain axis, ngoku engaphezulu kwengcamango evelayo, icebisa ukuba ungenelelo kwi-gut microbiota inokuba sisicwangciso esineziqhamo kunyango lwexesha elizayo lweengxaki ze-CNS ezinzima (uCryan noDinan, i-2012).
Ikhonkco elinokwenzeka ngqo phakathi kwe-gut microbiota kunye ne-MS iboniswe ngovavanyo nguBerer et al. (2011). Ukusebenzisa iimpuku eziguquguqukayo, uBerer et al. baye babonisa ukuba iibhaktheriya ze-gut commensal zingabangela ukuphindaphinda kwesifo se-autoimmune esiqhutywa yi-myelin-specific CD4+ T cells kunye ne-demyelination, ngenxa yokufumaneka kwe-MOG'the autoantigen myelin oligodendrocyte glycoprotein. Kwesinye isifundo, kwaboniswa ukuba unyango lwe-antibiotic olujoliswe ekutshintsheni i-microflora yamathumbu icinezela uvavanyo lwe-encephalomyelitis (EAE; Yokote et al., 2008).
Ezi ziphumo zibonisa ukuba i-gut microbiota inokudlala indima ebalulekileyo kwisigaba sokuqala se-MS kwaye inokuthi ibeke phambili ukuchaphazeleka kwezinye izifo ze-CNS autoimmune kunye nokuphazamiseka kwe-neuropsychiatric njenge-autism, ukudakumba, ixhala kunye noxinzelelo. Ingcamango entsha ye-gut microbiota-brain axis iyavela (Wang kunye noKasper, 2014).
Ngaloo mihlaba, ukuqonda indima ye-gut microbiota kwimpilo kunye nesifo kunokubeka isiseko sokunyanga izifo ezingapheliyo ngokuguqula ukubunjwa kwe-gut microbiota ngokukhetha indlela yokuphila echanekileyo, kubandakanywa nemikhwa yokutya. Ngaphezu koko, ukunyangwa ngokuthe ngqo kwe-gut microbiota kunokuphucula impendulo yokuzivikela komzimba kunye nokunciphisa ukukhuselwa kokuvuvukala. Ngokomzekelo, ngenxa yokuba indima ethile yeeseli ze-intestinal Th17 ziye zacetyiswa kwi-MS immunopathology (Sie et al., 2014), ukukhuthaza ukuhlukana kweeseli ze-Treg kunye nokunciphisa iiseli ze-Th17 ze-pathogenic kunokuthintela ukuphindaphinda kwe-autoimmunity kwizigulane ze-MS (Issazadeh-Navikas et al. , 2012).
Ngaloo mihlaba, ukufumanisa ukuba i-defect ye-Treg / Th17 balance ebonwe kwiimodeli ze-MS ikhona kwizigulane ze-MS, inokuba nemiphumo ebalulekileyo yeklinikhi, njengoko esi siphene sinokuguqulwa ngotshintsho kwi-microbiota composition, leyo iphinde iguqulwe. ngotshintsho lokutya (uDavid et al., 2014).
Amacandelo okutya okufuneka kulawulwe ukuthintela ukunyuka kweenkqubo ezivuthayo kwi-MS, kunye nezinye izifo ezingapheliyo ezivuthayo, zilandelayo:
Amafutha e-asidi eyomileyo yemvelaphi yezilwanyana, afumaneka kukutya okunje ngobisi olupheleleyo, ibhotolo, itshizi, inyama, kunye neesoseji, zizinto zokutya ezithathelwa ingqalelo rhoqo ngenxa yempembelelo yazo eyingozi kwikhosi ye-MS.
Kwi-1950, u-Swank ucebise ukuba ukusetyenziswa kwamanqatha ezilwanyana ezihluthayo kuhambelana ngokuthe ngqo kunye nokuphindaphinda kwe-MS, kodwa ikhonkco phakathi kokunyanzeliswa kwezilwanyana zezilwanyana kunye nokuxolelwa kwe-MS kwabikwa kuphela kwi-2003 (i-Swank ne-Goodwin, i-2003). Ngokutsho kukaSwank kunye noGoodwin, ukutya okunamafutha aphezulu kukhokelela ekudibaneni kwe-lipids yokugcina kunye ne-cholesterol kwaye kubangele ukuncipha kwe-membrane fluidity kunye nokuphazamiseka okunokwenzeka kwee-capillaries, kunye nokuqala okanye ukwanda kokuvutha.
Olunye uphando lwamva nje lubonisa ukuba isenzo samafutha ahluthayo silawulwa kwinqanaba lokubhaliweyo kwaye zinefuthe zombini imbonakalo yemfuza, i-cell metabolism, uphuhliso, kunye nokwahlula kweeseli. Ngokubanzi, ukucingelwa kwamanqatha ezilwanyana kudla ngokudibaniswa ne-calorie-calorie intake, eyona nto iyingozi kwizifo ezininzi ezingapheliyo ezivuthayo. Ekugqibeleni, njengoko kuchazwe kamva kweli nqaku, ukugqithiswa kwamanqatha ezilwanyana kukhokelela kwi-dysbiotic intestinal microbiota, ukungasebenzi kakuhle kwamathumbu emathunjini, kunye nokuvutha kwenkqubo ephantsi kwaye kubonisa unobangela wokuphazamiseka okungapheliyo komntu.
I-Trans fatty acids (i-TFAs) i-acids e-unsaturated fatty acids equkethe ubuncinane enye ibhondi ephindwe kabini e-nonconjugated kwi-trans configuration (Bhardwaj et al., 2011).
Njengemveliso ye-hydrogenation ye-oyile yemifuno, yaziswa ngeminyaka yoo-1960 ukuba ithathe indawo yamafutha ezilwanyana, kodwa emva kwexesha elithile kwafunyaniswa ukuba inefuthe elifanayo elibi kwimetabolism kwaye, njenge-fatty acids, yonyusa amanqanaba e-cholesterol. kunye nokukhuthaza ukubunjwa kwamafutha esiswini kunye nokuzuza ubunzima. Ukuthathwa kwe-TFAs kufunyenwe kuhambelana ngokufanelekileyo nokuvuvukala kwamathumbu kunye nokulawulwa kwe-citokines ye-proinflammatory kwi-Th17 cell polarization (Okada et al., 2013). Ngaphezu koko, ii-TFAs ziphazamisana nemetabolism yendalo ye-unsaturated fatty acids, ene-cis configuration.
I-TFAs zifumaneka kwimajarini kunye namanye anyangwayo (i-hydrogenated) amafutha emifuno, kwinyama kunye neemveliso ezidliwayo ezivela kwi-ruminants nakwi-snacks. Basenokubakho nakwiifries zesiFrentshi kunye nokunye ukutya okuqhotsiweyo, njengoko zenziwe kwakhona kwi-frying.
Inyama ebomvu iqulethe i-iron heme eninzi kunenyama emhlophe. Intsimbi i-nitrosylated ngokulula kwaye oku kuququzelela ukubunjwa kwe-nitroso-compounds engapheliyo (NOCs; Joosen et al., 2010). Ukutya kwenyama ebomvu kubonisa ngokwenene unxulumano lwethamo nolwakhiwo lwee-NOC, ngelixa kungekho budlelwane bunjalo kwinyama emhlophe. I-NOCs i-mutagenic: yenza i-nitrosylation kunye nomonakalo we-DNA. Inyama ebomvu esetyenzisiweyo (i-nitrite-egcinwe) inyusa umngcipheko. I-Heterocyclic amines yenziwa ngexesha lokupheka kwenyama kumaqondo aphezulu, kodwa oku akukona ngokuthe ngqo kwinyama ebomvu (Joosen et al., 2010).
Iidiphozithi zetsimbi ezingaqhelekanga zifunyenwe kwiindawo zokuvuvukala kwi-MS (Williams et al., 2012) kunye nokusetyenziswa kwenyama ebomvu kuhambelana namazinga aphezulu e-?-GT kunye ne-hs-CRP (Montonen et al., 2013).
Kuyaphawuleka, asinayo i-N-glycolylneuraminic acid (Neu5Gc), i-asilic acid enkulu, kuba i-mutation engasebenziyo kwi-gene ye-CMAH yaphelisa ukubonakaliswa kwayo ebantwini. Ukufakwa kwe-Metabolic ye-Neu5Gc evela kwimithombo yokutya-ingakumbi inyama ebomvu kunye neemveliso zobisi-inokudala iingxaki, njengoko abantu bejikeleza i-anti-Neu5Gc antibodies kwaye oku kuthetha ukunxulumana okunokwenzeka kunye nokudumba okungapheliyo (uPadler-Karavani et al., 2008).
Ekugqibeleni, inyama iqukethe i-arachidonic acid (i-omega-6 (n-6) PUFA, eyona nto iphambili ye-proinflammatory eicosanoids [prostaglandins, thromboxanes, kunye ne-leukotrienes]) kwaye isebenze indlela ye-Th17 (i-Stenson, i-2014).
Ukutya okuphezulu kwe-sugar-sweetened drinks kunye ne-cereals ecocekileyo, kunye nomxholo we-fiber ephantsi, kwandisa ngokukhawuleza inani leekhalori kunye nezinga le-glucose. Ukunyuka okulandelayo kwemveliso ye-insulin kulawula iindlela ze-biosynthetic kwaye phakathi kwezinye izinto ukuveliswa kwe-arachidonic acid kunye ne-proinflammatory derivatives.
Ukunyuka kwetyuwa yokutya kunokuba ngumngcipheko wokusingqongileyo kuphuhliso lwezifo ezizimele, njengoko kufunyenwe ukuba kunokubangela iiseli ze-Th17 ze-pathogenic kunye ne-proinflammatory cytokines kwi-EAE (Kleinewietfeld et al., 2013; Wu et al., 2013) . Iiseli ze-Th17 ziye zabandakanyeka ekuphuhliseni i-MS.
Amafutha obisi asasazwa ngendlela efanayo kwaye akhuselwe kwi-oxidation, enkosi kwinwebu eyenziwe ngeelipids kunye neeproteni ezithile ezibizwa ngokuba ziiproteni ze-milk fat globule membrane (MFGM; Riccio, 2004). Ezi proteni, ezibalelwa kwi-1% kuphela yeeprotheni zobisi, zinolwazi kunokuba zibe nexabiso lesondlo. Ekuncanciseni komntu, ziyafuneka ukuze kuqulunqwe ngokuchanekileyo inkqubo yokugaya, i-nervous, kunye ne-immune system kwiintsana. Oku kuqukunjelwa kolwazi ngokucacileyo akubalulekanga, okanye akufuneki kwaphela, xa umntu emdala kwaye, ngokunjalo, kwimeko yobisi lwenkomo oluthatyathelwa ukondleka komntu. Kwiminyaka yobudala, iiproteni zeMFGM zobisi lwenkomo azisenandima yolwazi kwaye zinokukhutshwa ekutyeni kunye namafutha obisi.
Ukususwa kweeproteni ze-MFGM kubisi lwenkomo epheleleyo kubaluleke ngakumbi kwimeko ye-MS. Iprotheni ye-MFGM emele kakhulu (i-40% yeeprotheni ze-MFGM zizonke), i-butyrophilin (BTN), ngokwenene ikrokrelwa ukuba inendima kwi-MS, njengoko ifana kakhulu ne-MOG, enye ye-autoantigen yomviwa kwi-MS. I-BTN kunye ne-MOG yabelana ngokuziphatha okufanayo kwiimodeli zokulinga ze-MS, kwaye i-MOG / BTN i-anti-reactive antibodies ifunyenwe kwi-MS, kwi-autism kunye nesifo senhliziyo (CHD; Riccio, 2004). Ngesi sizathu, isigulana esine-MS kufuneka sikuphephe ukusela ubisi lwenkomo epheleleyo kwaye sikhethe ubisi oluncitshisiweyo, olungenawo amanqatha esilwanyana.
Enye imbono ye-Swanson et al. (2013). Baye bafumanisa ukuba i-BTN okanye i-BTN-i-molecule efana ne-BTN inokuba nendima yokulawula kwi-immunity kwaye ngoko ke bacebisa ukuba i-BTN okanye i-molecule efana ne-BTN ingaba luncedo ukubangela ukuphuhliswa kwe-Treg.
Emva kwesidlo ngasinye, sinokufumana uxinzelelo lwe-oxidative oludlulayo kunye noluphakathi kunye nempendulo yokuvuvukala okuphakathi ngokuxhomekeka kuhlobo kunye nobuninzi bokutya. Imikhwa yokutya esekwe kujoliso oluthe gqolo noluzingisileyo ekutyeni ngokutya okuphezulu kwetyuwa / amanqatha esilwanyana kunye namafutha agqithisiweyo / iswekile-iziselo ezinoshukela zigxininisa inkqubo yethu yokuzikhusela komzimba / yemetabolism kunye nokusilela okunokwenzeka kwe-homeostasis kunokukhokelela ekuphazamisekeni komzimba kunye nokuphazamiseka kwemetabolism yendalo eyahlukeneyo. .
Kuthatyathwe kunye, uxinzelelo oluxhomekeke ekutyeni lunokuthi lube ngenxa yezizathu ezilandelayo: (a) i-calorie intake: iphezulu iikhalori, ngakumbi uxinzelelo lwe-oxidative olubangelwa; (b) Umthwalo we-glycemic wesidlo: i-acute postprandial glycemic peaks inokubangela ukukhutshwa kwe-insulin ephezulu kakhulu kunokuba kuyimfuneko; (c) iphethini ye-lipid: i-fat saturated fat, i-fatty acids, kunye ne-omega-6 (n-6) i-long-chain PUFA ikhuthaza ukuvuvukala kwe-postprandial. Njengoko kuchazwe kula macandelo alandelayo, ukuvuvukala kwe-postprandial kunqanyuliwe okanye kucinezelwe yi-n-3 PUFA kunye ne-polyphenols, ukukhawulwa kwekhalori, kunye nokuzivocavoca umzimba.
Iimolekyuli ezithile ze-bioactive dietary ziyakwazi ukuchasana nemiphumo ye-pathogenic microbial agents kunye nokunciphisa ukubonakaliswa kwee-molecule ezivuthayo. Phakathi kwazo, iikhompawundi ezibaluleke kakhulu ziyi-polyphenols kunye ne-carotenoids evela kwimifuno, i-n-3 PUFA evela kwintlanzi, iivithamini D kunye ne-A, i-thiol compounds ezifana ne-lipoic acid, kunye ne-oligoelements ezifana ne-selenium kunye ne-magnesium.
Uninzi lwezikhompawundi ezikhankanywe ngasentla, ngaphandle kwe-PUFA, engeyiyo i-antioxidant, iyaziwa ngokuba yi-antioxidant properties. Ingqiqo yokusetyenziswa kwe-antioxidants kwi-MS isekelwe ekuqwalaseleni ukuba uxinzelelo lwe-oxidative yenye yezona zinto zibalulekileyo zenkqubo yokuvuvukala ekhokelela ekuthotyweni kwe-myelin kunye nomonakalo we-axonal. Nangona kunjalo, ngoku iyaziwa ukuba i-antioxidants yokutya ineepropathi ezongezelelweyo zebhayoloji ezihamba ngaphaya komsebenzi olula we-antioxidant. Enyanisweni, bayakwazi ukuchasana nemiphumo emibi ye-microbial agents kunye ne-saturated okanye i-trans fatty acids, ukunciphisa ukubonakaliswa kwee-molecule ze-proinflammatory, uxinzelelo lwe-oxidative, kunye ne-angiogenesis.
Zonke iipolyphenols ezifumaneka kwimifuno, iicereals, iimbotyi, iziqholo, imifuno, iziqhamo, iwayini, iijusi zeziqhamo, iti kunye nekofu, zine-anti-inflammatory, immune-modulatory, anti-angiogenic, kunye ne-antiviral properties kwaye zivuselela iindlela ze-catabolic. (Gupta et al., 2014; Wang et al., 2014). Zifumaneka kwizityalo ngendlela ye-glycosides, esters, okanye iipolymers, ezinkulu kakhulu ukuba zingene kwi-membrane yamathumbu. I-Aglycons ekhutshwe kwi-gut microbiota idityaniswe kwi-glucuronides kunye ne-sulfates emathunjini kunye nesibindi. I-solubility yabo kunye ne-bioavailability ihlupheke kakhulu (�M; Visioli et al., 2011).
Ukususela kumbono wesakhiwo, iipolyphenols ziquka i-flavonoids kunye ne-nonflavonoids molecules (Bravo, 1998). Eyona nto ibalulekileyo i-flavonoids yi-quercetin (i-anyanisi, ii-apile, iziqhamo zesitrasi, kunye newayini; i-Min et al., i-2007; i-Sternberg et al., i-2008), i-catechins (i-tea eluhlaza; i-Friedman, i-2007), kunye ne-daidzein kunye ne-genistein (soy; i-Castro et al., 2013; Zhou et al., 2014). Eyona nto ibalulekileyo i-nonflavonoids i-resveratrol (itshokolethi, i-peanuts, amajikijolo, iidiliya ezimnyama, kunye newayini ebomvu; i-Das kunye ne-Das, i-2007; i-Cheng et al., i-2009; i-Shakibaei et al., i-2009), i-curcumin (i-spice turmeric ye-ginger yentsapho, i-curry ; Prasad et al., 2014), kunye ne-hydroxytyrosol (ioli yeoli; Hu et al., 2014).
Kufunyenwe ukuba i-anti-inflammatory effect ye-polyphenols in vitro inokuxhomekeka kwisakhiwo sabo samakhemikhali (Liuzzi et al., 2011). Ngaloo ndlela, umxube we-flavonoids kunye ne-nonflavonoids unokusebenza ngakumbi kunokuncedisa nge-polyphenol enye kuphela.
Imizekelo emibini yeepolyphenols ezifundiswa kakhulu yi-quercetin kunye ne-resveratrol. I-Quercetin ikhona ikakhulu njengeglucoside. Uninzi lweziphumo zalo zongeza kwezo ze-interferon-?. I-Quercetin ayinayo ityhefu, kodwa imveliso yayo ye-oxidation, i-quercetin quinone, iyasebenza kakhulu kumaqela e-SH yeeprotheyini kunye ne-glutathione kwaye ingaba yingozi (I-Boots et al., 2008). Ukongezwa kwe-lipoic acid okanye i-N-acetylcysteine inokunciphisa iziphumo ezinobuthi.
I-Resveratrol i-glucuronated esibindini kwaye ifakwe kule fomu ngokukodwa kwi-duodenum kodwa kuphela kwixabiso elincinci kakhulu. Ngokuxhomekeke ekugxininiseni kwayo, i-resveratrol inokubangela ukufa kweeseli ezininzi nge-necrosis okanye i-apoptosis. Kule nkalo, kuyamkelwa ngokuqhelekileyo ukuba i-resveratrol ineempembelelo ze-neuroprotective; nangona kunjalo, kuye kwaxelwa kwakhona ukuba kunokunyusa ukuvavanya izifo ezifana ne-MS (Sato et al., 2013). Ezi zintlukwano zinokuthi zifakwe kwiimpawu ezihlukeneyo ezisetyenziswe kwi-vitro okanye i-bioavailable in vivo, njengoko i-resveratrol ineempembelelo ezichaseneyo kwi-concentrations ye-10?5 M (ukwanda kweeseli ze-mesenchimal zabantu) kunye ne-10?4 M (ukuthintela ukwanda). Kumava ethu, i-resveratrol inempembelelo ye-neurotrophic kwi-cortical neurons kwinkcubeko kuphela kwindawo ephantsi kakhulu, ngelixa i-concentration ephezulu, inokuba nefuthe eliyingozi. Kodwa kwimeko yoxinzelelo lwe-oxidative, i-resveratrol ineempawu ze-neuroprotective nazo kwiindawo eziphezulu.
Ezinye iikhompawundi kunye nezinto ezinokuba luncedo njengezongezelelo kwi-MS ziivithamini D, A, E, C, B12 (Mastronardi et al., 2004), kunye ne-niacin (Penberthy noTsunoda, 2009), kunye ne-oligoelements njenge-selenium (Boosalis , 2008) kunye ne-magnesium (Galland, 2010).
I-Vitamin D ineendima ze-immune-modulatory kwaye imele i-molecule yokutya ethembisayo yonyango lwezifo ezingapheliyo ezivuthayo ezifana ne-MS (Smolders et al., 2008; Pierrot-Deseilligny, 2009; Cantorna, 2012; Ascherio et al., 2014). Njengoko sele kukhankanyiwe, kukholelwa ngokubanzi ukuba ukuhanjiswa okukhethekileyo kwendawo ye-MS kwihlabathi kunokubangelwa kukuncitshiswa kokufumaneka kwevithamini D3, ngenxa yokungafumani ngokwaneleyo ukukhanya kwelanga kwamanye amazwe, kunye nokungabikho kwevithamin D esebenzayo kunokuba yenye into. unobangela onokwenzeka wemvelaphi yokusingqongileyo yeMS. Nangona kunjalo, amanqanaba aphantsi e-vitamin D esebenzayo anokuba ngenxa yokuguqulwa kwemetabolism okanye umsebenzi kungekhona nje ekukhanyeni kwelanga. Enyanisweni, ukungaphumeleli kwe-vitamin D3 (i-cholecalciferol) yokuncedisa ukubonisa imiphumo enenzuzo kwisisindo somzimba okanye ekuhambeni kwezifo ezivuthayo zibangelwa ukunyamezela kokungabikho kwayo nangona ulawulo lwayo.
I-Vitamin D3 (i-cholecalciferol), eyakhiwe emva kokukhanya kwelanga, i-hydroxylated esibindi kwi-25- (OH) D3 (calcidiol) yi-P450 enzymes CYP27A1 okanye i-CYP2R1, kwaye emva koko isebenze kwintso nge-CYP27B1 kwi-1-25 (?, OH)2 D3 (calcitriol). Le yokugqibela, ifom esebenzayo ye-vitamin D, ingasebenzi yi-CYP24A1 kwi-1?, 24,25- (OH) 3 D3 (calcitroic acid). Oku kuthetha ukuba amanqanaba e-vitamin D esebenzayo axhomekeke kwimilinganiselo ehambelanayo ye-synthesis yayo nge-CYP27B1 kunye nokuguqulwa kwayo nge-CYP24A1 (Schuster, 2011). Inkcazo ephezulu ye-CYP24A1, eyenziwa yi-endogenous compounds kunye ne-xenobiotics, inokukhokelela kumazinga aphantsi e-vitamin D kwaye ibangele okanye ikhulise izifo ezingapheliyo ezivuthayo kunye nomhlaza. Kule mihlaba, kubalulekile ukulandelela inqanaba le-vitamin D ngexesha lolawulo lwe-vitamin D. Ukuba amanqanaba e-vitamin D ahlala ephantsi, ukubonakaliswa kwe-CYP24A1 mRNA kufuneka kuhlolwe, kwaye ukuzimisela kwe-CYP27B1 kunye ne-CYP24A1 imisebenzi kunye nokuvinjelwa kwabo kufuneka kuhlolwe (Chiellini et al., 2012, KISA et al., 2013).
Omnye umba obalulekileyo malunga neVDR. I-metabolite esebenzayo ye-vitamin D�1?, i-25-dihydroxyvitamin D�ibophelela kwi-VDR, kwaye i-VDR-D eyinkimbinkimbi ilawula ukubonakaliswa kweentlobo ezininzi zofuzo ezibandakanyekayo kwiinkqubo ezinokuthi zibe nokufaneleka kwizifo ezingapheliyo. Njengoko imelwe kwiMifanekiso ye-2 kunye ne-3,3, i-VDR-D i-complex ikhuphisana ne-ligand-activated PPARs okanye ii-LXR zokubophelela kwi-RA-RXR. I-heterodimeric complexes ibophelela kwi-proinflammatory transcription factor NFkB kunye nokunciphisa i-synthesis ye-proinflammatory molecules. Kulo mxholo, xa uvavanya ukuphumelela kwe-vitamin D supplementation ngexesha le-MS, umntu kufuneka athathele ingqalelo i-polymorphisms ekugqibeleni echaphazela i-VDR, esandul 'ukunxulunyaniswa nokukhuluphala, ukuvuvukala, kunye nokuguqulwa kwe-gut permeability (Al-Daghri et al. , 2014).
Ngaphezu koko, ukufumanisa ukuba i-VDR-D isebenze i-Sirtuin SIRT-1 (An et al., 2010; Polidoro et al., 2013) icebisa ukuba ivithamin D inefuthe nakwimetabolism yeeseli kwaye ke inokuba neempawu ezifanayo nezo ezinye izongezo zokutya zendalo ezininzi: nyusa i-oxidative metabolism kunye nokunciphisa ukuvuvukala.
Ekugqibeleni, kufuneka kuthathelwe ingqalelo ukuba kukho umahluko phakathi kwedatha ebantwini kunye neemodeli zovavanyo. Ngokwenyani, ebantwini, ngokungafaniyo neempuku, ukutyeba kakhulu kunxulunyaniswa nesimo esibi se-vitamin D (Bouillon et al., 2014).
Phakathi kwe-carotenoids, eyona nto ibalulekileyo yi-lycopene (itamatato, i-melon yamanzi, kunye neziqhamo zomdiliya opinki; uRao noRao, ngo-2007). Ngaphandle kokuba i-antioxidant enamandla kakhulu, i-lycopene inokunika i-beta-carotene kunye ne-retinoic acid, kwaye le yokugqibela ingenza i-RXR receptor (Umfanekiso 2). Nangona ukuthathwa okuphezulu kwe-carotenoids yokutya, i-vitamin C, kunye ne-vitamin E ayizange inciphise umngcipheko we-MS kubasetyhini (Zhang et al., 2001), ukufaneleka kwe-lycopene kunye ne-vitamin A ngokuchasene nokuvuvukala akunakunakwa.
I-n-3 i-fatty acids ebalulekileyo (i-EFA) kunye ne-PUFA imele enye indlela esebenzayo kwi-saturated fatty acids yemvelaphi yezilwanyana.
I-oyile yemifuno kunye nemifuno iqulethe i-fatty acids i-linoleic acid (n-6) kunye ne-linolenic acid (n-3). I-n-6 kunye ne-n-3 i-fatty acids ineempembelelo ezichaseneyo kwaye ubukho babo ekudleni kufuneka bulingane (Schmitz kunye no-Ecker, 2008). Nangona kunjalo, kwizidlo zaseNtshona, umlinganiselo we-n-6 / n-3 unyuswe ukusuka kwi-6 ukuya kumaxesha e-15 kwaye oku kukhokelela kwiziganeko eziphezulu ze-cardiovascular and inflammatory disease. Enyanisweni, i-linoleic acid ikhokelela ekubunjweni kwe-arachidonic acid (20: 4), i-precursor ye-proinflammatory eicosanoids prostaglandins-2, i-leukotrienes-4, kunye ne-thromboxanes-2. I-synthesis yale eicosanoids ithandwa yi-insulin, kwaye ivinjelwe yi-aspirin, kunye ne-n-3 ye-long-chain PUFA EPA (eicosapentaenoic acid) kunye ne-DHA (docosahexaenoic acid), ephuma kwi-n-3 linolenic acid.
Zombini i-DHA kunye ne-EPA zifumaneka kwiintlanzi zaselwandle kunye neoli yeentlanzi. Zombini zibonisa imisebenzi echasene nokudumba, i-anti-thrombotic, kunye ne-immune-modulatory, xa kuthelekiswa nezo ze-statins (Calder, 2006; Farooqui et al., 2007). n-3 I-PUFA inqanda iinkqubo ezivuthayo kunye ne-synthesis ye-fatty acids kunye ne-cholesterol, kwaye endaweni yoko zivuselela i-oxidation ye-fatty acids. Ngesi siseko, kwizifo ezingapheliyo ezivuthayo ezifana ne-MS, i-n-3 i-fatty acids (EFA) kunye ne-n-3 PUFA kufuneka iphumelele ekutyeni ngaphezu kwe-n-6 fatty acids. Kuyathakazelisa ukuqaphela ukuba i-DHA ikhona kwiindawo eziphezulu zengqondo kwaye amanqanaba ayo ayancipha kwizigulane ezine-MS.
Kwiiseli ze-microglial ezikhuliswe yi-LPS, ioli yeentlanzi isebenza njenge-interferon-? ekuvimbeleni ukubonakaliswa kwe-MMP-9 (gelatinase B), umlamli obalulekileyo we-neuro-inflammation (Liuzzi et al., 2004, 2007). Ngaphezu koko, i-n-3 PUFA yehla kakhulu amanqanaba e-MMP-9 kwizilingo ezimbalwa zeklinikhi, ebonisa ukuba i-n-3 PUFA inokumela unyango oluncedisayo olufanelekileyo kwikhosi ye-MS (Weinstock-Guttman et al., 2005; Mehta et al., 2009) ; Shinto et al., 2009). Ioyile yeentlanzi iye yafunyanwa kwakhona ekuphuculeni ukusebenza kweemoto kwiipups eziphilileyo zegundane (Coluccia et al., 2009).
n-3 I-PUFA yenza kwi-synergy kunye ne-aspirin kwi-AMPK kunye ne-COX enzymes kodwa ngeendlela ezahlukeneyo. Kuyaphawuleka, phambi kwe-aspirin, i-EPA kunye ne-DHA zenza iimolekyuli ezintsha ezichasayo ezichasene nokuvuvukala ezibizwa ngokuba yi-resolvins, i-proteinins, kunye ne-maresins, ezikwazi ukunciphisa ukuvuvukala kwamaselula kunye neentlungu ezivuthayo (Xu et al., 2010; Hong noLu, 2013; USerhan noChiang, ngo-2013). Oku kunokuba ngumba ochaphazelekayo onxulumene nongenelelo lwesondlo kwi-MS. Enyanisweni, iinkqubo zokukrala ezinxulumene ne-MS zinokuba ngenxa yomlinganiselo ophantsi we-omega-3 (anti-inflammatory)/omega 6 (ukudumba) PUFA kwaye ngoko ke ukuveliswa kwexabiso elaneleyo leemolekyuli ezibangela isisombululo, i-lipoxins, i-resolvins, kunye izikhuseli ezicinezela ukudumba. Ke, ukulawulwa kwe-omega-3 PUFA kunye ne-aspirin okanye ngokuthe ngqo kwi-lipoxins, i-resolvins, kunye ne-protections inokwenza indlela entsha yokuthintela kunye nonyango lwe-MS kunye nezinye izifo ze-neuroinflammatory. Ngaphezu koko, ezinye i-eicosanoids ezichasayo kunye ne-antiangiogenic nazo zinokuveliswa yi-P450 CYP enzymes esuka kwi-EPA kunye ne-DHA (Yanai et al., 2014). Kulo mongo, kufuneka kuthathelwe ingqalelo ukuba i-statins inokuphazamisa kakubi imetabolism ye-n-3 kunye ne-n-6, njengoko inokunciphisa umlinganiselo we-n-3 / n-6. Ngaloo ndlela, unyango kunye ne-statins kufuneka ludibaniswe ne-n-3 PUFA supplementation (Harris et al., 2004).
Imbewu yeoli, ukusuka kwi-sunflower, i-corn, i-soy, kunye ne-sesame, iqulethe i-n-6 i-fatty acids ngaphezu kwe-n-3 i-fatty acids kwaye ngoko ke ukucinga kwabo kufuneka kuncitshiswe kwi-MS, ukwenzela ukunciphisa izinga lokuvelisa i-proinflammatory eicosanoid. Ngakolunye uhlangothi, ioli yekhokhonathi inomxholo ophezulu we-saturated fatty acids. Phakathi kweoli yemifuno, ioli yeoli kufuneka ikhethwe kumlinganiselo omhle phakathi kwe-saturated kunye ne-unsaturated fatty acids, kwaye ngenxa yokuba iqulethe i-antioxidant hydroxytyrosol.
Iikhompawundi eziqulethe amaqela e-thiol (�SH) afana ne-?-lipoic acid (ALA), i-glutathione, kunye ne-N-acetylcysteine (NAC) kufuneka ithathelwe ingqalelo njengezongezo zokutya ezinokuthi zisetyenziswe kunyango oluhambelanayo lwe-MS.
Njenge-polyphenols, i-ALA (i-Salinthone et al., i-2008; izityalo eziluhlaza kunye nokutya kwezilwanyana) zinezixhobo zokulwa ne-immunomodulatory kunye ne-anti-inflammatory. I-ALA izinzisa ingqibelelo ye-BBB kwaye ivuselela ukuveliswa kwe-cAMP kunye nomsebenzi we-protein kinase A. Kwakhona i-NAC ingaba luncedo kwiingxaki ze-neurological. Idlula kwi-BBB kwaye ikhusela ekudumbeni (Bavarsad Shahripour et al., 2014).
Uphononongo olutshanje olucwangcisiweyo kunye nohlalutyo lwe-meta lwezilingo zongenelelo lubonelela ubungqina bokuba iipatheni zokutya zaseMedithera zinciphisa ukuvuvukala kunye nomngcipheko wokufa kwentliziyo kunye nokuphucula imisebenzi yokuphela (Schwingshackl noHoffmann, 2014). Ezi ziphumo zikhuthaza njengoko ucinga ukuba ukutya kweMeditera okwenyani kuhluke kancinane kwinto echazwe ngoku.
Kuyavunywa ngokubanzi ukuba ukutya kweMeditera kusekwe ekusetyenzisweni kweoyile yomnquma enyulu, iisiriyeli ezingacocwanga, iimbotyi, imifuno eyahlukeneyo (ingakumbi itumata) kunye neziqhamo, iimveliso zobisi (ubukhulu becala itshizi yepecorino, ricotta, mozzarella, kunye neyogathi), intlanzi kunye neemveliso zokuloba, kunye nokusetyenziswa okuphantsi kwamafutha ezilwanyana kunye nenyama. Nangona kunjalo, okwangoku, ukutya kweMeditera kutyekele ekusetyenzisweni okuphezulu kwepasta kunye nesonka, oku kuthetha ukutya okuphezulu kwe-gluten.
Ngesinye isikhathi, kwisidlo sokwenyani saseMeditera, eMazantsi eItali, inyama yayityiwa kabini okanye kathathu ngeveki, yayisetyenziselwa ukupheka ioli yomnquma kuphela (umgangatho ongeyontombi kunye neyona nto iluhlaza), kodwa ngokuphawulekayo ukutya kwegluten kwakumalunga. isiqingatha xa kuthelekiswa nokuthathwa kwangoku. I-pasta yayidliwa kunye ne-classic ye-tomato sauce eyenziwe ekhaya, kodwa ngenye indlela, yayihlala ixutywe kunye nokunye ukutya okungekho gluten. Iindlela zokupheka eziqhelekileyo zaziyi-pasta kunye namazambane; i-pasta kunye neembotyi eziluhlaza, okanye i-artichokes, i-zucchini, isitshalo seqanda, i-turnips, okanye iklabishi; i-pasta kunye nomxube wemifuno kunye nemifuno (i-minestrone: isobho semifuno); kunye nepasta eneeertyisi, iimbotyi, okanye iilentile. Iziselo zanamhlanje ezineswekile zazingaziwa. Ukucingelwa okuphezulu kokutya okutyebileyo kwe-gluten kunokukhokelela kwi-nonceliac asymptomatic gluten sensitivity, umonakalo we-mucosal intestinal, utshintsho kwi-gut microbiota, kunye nenqanaba elisezantsi lokudumba kwamathumbu. Ukuqukumbela, ukutya kweMeditera kulungile, kodwa ukutya kwe gluten kufuneka kulinganiselwe kwaye kufuneka kube ziinkozo ezipheleleyo.
Izifundo ezimbalwa kuphela eziye zenziwa kwimpembelelo yokutshaya kwikhosi ye-MS kwaye iziphumo ziphikisana, mhlawumbi ngenxa yokuba imiphumo yayo inzima ukuyifumana kwaye i-enucleate kwezinye izinto. Weiland et al. (2014) abafumananga unxulumano phakathi kokutshaya kunye nesantya sokuphindaphinda okanye umsebenzi wesifo, kodwa ungafaki ngaphandle ukuba abantu abatshayayo banokuba nomgangatho ophantsi kakhulu wobomi obunxulumene nempilo kunabangabhemi, kanti uManouchehrinia et al. (2013) yafumanisa ukuba ukutshaya kuhambelana nesifo esibi kakhulu.
Nangona kunjalo, njengoko kuboniswe kwi-Figure 2, kunokulindelwa ukuba umsi we-cigarette unokuba nzima ngakumbi kwikhosi ye-MS, njengoko inokuthintela umsebenzi ochasayo we-Sirtuins (Caito et al., 2010). Uxinzelelo lwe-oxidative kunye ne-carbonyl olubangelwa ngumsi wecuba lunokuguqulwa nge-resveratrol (Liu et al., 2014).
Uphononongo lwakutsha nje lubonisa ukuba ukusetyenziswa kotywala (ibhiya, iwayini, okanye utywala) akuhambelani nomngcipheko we-MS (uMassa et al., 2013; Hedstrm et al., 2014). Nangona kunjalo, njengoko kuboniswe kwi-Figure 2, utywala bunokuthintela i-Sirtuin SIRT1 kwaye isebenze umsebenzi wokubhaliweyo we-SREBP-1c (Wena et al., 2008), ngaloo ndlela ikhuthaza i-biosynthesis ye-lipids kunye nokuvuvukala kwindleko ye-oxidative metabolism.
Kukho eminye imiba emibini ye-ethanol ekufuneka iqwalaselwe. Okokuqala, imetabolism ye-ethanol iguqula inani elikhulu leemolekyuli ze-NAD+ kwi-NADH, inciphisa ukufumaneka kwe-NAD+ efunekayo kumsebenzi we-Sirtuins. Okwesibini, njenge-substrate ye-P450 enzymes, i-ethanol inokuphazamisa i-metabolism yamachiza, eguqulwa yi-enzyme efanayo. Isiphumo sinokuba kukwandiswa kunye nokwandiswa kwesenzo sechiza. Lilonke, utywala kufuneka buthathwe njengemolekyuli ephazamisana nemetabolism eqhelekileyo kwaye iququzelele inkqubo yokuvuvukala, inzima amathuba okuphucula impilo-ntle yesigulane.
Ukutya okunekhalori ephezulu kunye nesidlo esityebileyo kwi-carbohydrates esulungekileyo kunye neswekile yonyusa inqanaba le-insulin kwaye ithanda i-biosynthesis, kubandakanya ukuveliswa kweeamolekyuli ze-proinflammatory kunye nokuveliswa kweeradicals zamahhala. Isithintelo seCalori, esifunyenwe ngokunciphisa ukutya okanye ngokuzila ukutya okuphakathi (ngolunye usuku kunye nolunye alukho), ukunyusa izinga le-SIRT1 (Zhang et al., 2011), ukwandisa izinga le-AMP kunye nokulawula i-AMPK, ukwandisa amanqanaba e-adiponectin kunye nokulawula okanye isebenze i-receptors yayo (u-Lee no-Kwak, i-2014), kwaye iyancipha umonakalo we-oxidative, i-activation lymphocyte, kunye nokuqhubela phambili kweemodeli zokulinga ze-MS (Piccio et al., 2008, 2013). Imiphumo yokukhawulelwa kwekhalori inokulinganiswa ngama-agonists (i-resveratrol kunye nezinye ii-polyphenols), esebenza kwiithagethi ezifanayo (SIRT1, AMPK).
Umthambo ngoku yinto ephantse yamkelwe nakwizigulana ze-MS kwaye idla ngokusetyenziswa ukuze kuthotywe iimpawu zokudinwa okungapheliyo kwaye kuthintelwe okanye kucothise ukuqala kokukhubazeka. Nangona kunjalo, ukubaluleka kokuzivocavoca umzimba kudlulela ngaphaya komsebenzi we-muscle olula kwaye kufuneka kuthathelwe ingqalelo kwimeko epheleleyo apho ukutya, ukuzivocavoca, unyango, kunye nokutshintshana kwezentlalo, zonke zidlala indima kwimpilo yezigulane ze-MS (Gacias kunye neCasaccia, 2013).
Ukulawulwa kokutya kunye nokuzilolonga kuye kwacetywa yi-WHO (2010) ukunciphisa okanye ukukhusela izifo ezingapheliyo zabantu.
Ukusuka kwimbono yemolekyuli, umthambo womzimba wenza isiphumo sawo esiluncedo ngokusebenza kwiprotein kinase AMPK axis kunye ne-AMPK�Sirtuins�PPAR-? inethiwekhi, ukulungelelanisa imetabolism ye-oxidative kunye nokunciphisa iindlela ze-biosynthetic kunye nokuvuvukala (Narkar et al., 2008). Njengoko i-AMPK inendima ephambili kwibhalansi yamandla, kubalulekile ukukhankanya ii-agonists zayo. I-Resveratrol kunye ne-AMPK agonists ezifana ne-metformin, iziyobisi ezisetyenziselwa uhlobo lwe-2 yeswekile, zinokulingisa okanye ziphucule umphumo womsebenzi womzimba kwaye zisebenza ngempumelelo kwi-encephalitis yovavanyo (Nath et al., 2009).
Ukuzivocavoca umzimba kuchaphazela umgangatho wobomi kwaye kunokukhuthaza ukuveliswa kwee-cytokines ezichasayo (uFlorindo, 2014). Ngaphezu koko, ukuzivocavoca umzimba kunciphisa amanqanaba e-plasma ye-leptin kwaye kunciphisa ukubonakaliswa kwemfuza ye-leptin receptors kwisibindi (Yasari et al., 2009), ngelixa ukwandisa amanqanaba e-adiponectin kunye nomsebenzi we-adiponectin receptors (uLee noKwak, i-2014).
Umbutho wokuzivocavoca umzimba kunye nokunciphisa ikhalori kukhokelela ekunciphiseni okuphawulekayo kwamanqaku okuvuvukala (Reed et al., 2010).
Uphononongo lwakutsha nje olwenziwe kubantu abadala i-C57BL/6 J iimpuku zamadoda zibonise ukuba umthambo uvuselela umsebenzi wengqondo ye-mitochondrial, unokuba ne-neuroplasticity, kwaye unxulunyaniswa nokuphucula imo, njengoko kunciphisa isimilo esifana nexhala kwindawo evulekileyo kwaye yenze imiphumo efana ne-antidepressant emsileni. uvavanyo lokumiswa (Aguiar et al., 2014). Olunye uphando olwenziwe kwiigundane lubonise ukuba umthambo unokutshintsha ukubunjwa kunye nokwahlukana kweebhaktheriya zamathumbu (Petriz et al., 2014).
Ngesi sizathu, izigulane ze-MS kufuneka zenze umthambo omncinci womzimba (ukuhamba ngokukhawuleza, ukudada, okanye ukudanisa), ukuba kunokwenzeka ngexesha lenkqubo yokubuyisela.
Ngelishwa, izilingo zeklinikhi zesondlo kwi-MS zimbalwa kakhulu. Ezinye zazo zazisekwe kukutya okuncinci kumafutha ahluthayo, nokuba ngaphandle kwezongezelelo (i-Swank kunye neGoodwin, i-2003) okanye nge-omega-3 yezongezelelo zamafutha (Nordvik et al., 2000; Weinstock-Guttman et al., 2005). Olunye ulingo lwezonyango lwalusekelwe kulawulo lwezongezo zokutya ezilodwa kuphela: nokuba yi-vitamin D, okanye ioli yeentlanzi (n-3 PUFA), okanye i-lipoic acid. Izilingo zeklinikhi ezine-polyphenols enye zenziwa kuphela kumhlaza. Izongezo zokutya azikaze zisetyenziswe kunye kwaye azizange zidibaniswe nomyalelo wokutya.
Kuthatyathwe kunye, iinzame zeklinikhi zokucacisa indima yesondlo kwi-MS zibhekwa njengesithembiso kuphela somgangatho ophantsi okanye akukho ziphumo ezicacileyo (Farinotti et al., 2007, 2012). Ngokukodwa, njengoko kuchazwe nguFarinotti et al. ekuphononongweni kwabo kwe-Cochrane (2012), izongezelelo ezifana ne-n-3 PUFA zibonakala zingenayo impembelelo enkulu kwisiphumo esiphambili seklinikhi kwi-MS, kodwa inokunciphisa ukuphindaphinda kokuphindaphinda kwiminyaka eyi-2. Idatha ekhoyo ithathwa njengenganelanga okanye ikhwalithi engaqinisekanga yokuvavanya umphumo wangempela ovela kwi-PUFA supplementation. Kwezinye izifundo, izibonelelo ezincinci ezinokubakho kwiziphumo zokuphinda zifunyenwe nge-omega-6 fatty acids, kodwa idatha ibonakaliswe ngokunciphisa ukuqinisekiswa kokuphela. Ngokubanzi, umgangatho wovavanyo ufunyenwe usezantsi. Izifundo malunga ne-vitamin supplementation azizange zihlalutywe njengoko kungekho namnye odibana neendlela zokufaneleka, ngokukodwa ngenxa yokungabikho kweziphumo zonyango. Ngaloo ndlela, ubungqina malunga neenzuzo kunye neengozi ze-vitamin supplementation kunye ne-antioxidant supplements kwi-MS ziyasilela.
Ekugqibeleni, injongo yokungenelela okunomsoco kwi-MS kufuneka ibe ukulawula ukuvuvukala kwaye oku, njengoko kuboniswe kolu hlaziyo, kunokufezekiswa ngokukodwa ngokulawula ukuvuvukala kwe-postprandial, ukubunjwa kwe-gut microbiota kunye nokuvuvukala kwamathumbu kunye nenkqubo, kunye nokukhuseleka. Oku kunokufezekiswa ngokungenelela kwexesha elide lokutya, kunye nokutya kwe-hypocaloric, i-prebiotics, i-probiotics, kunye nezongezelelo zokutya.
Njengoko kuchazwe kweli nqaku, iimolekyuli zokutya okunempilo, ukukhawulwa kweekhalori, kunye nokuzivocavoca ziyakwazi ukuqondisa i-cell metabolism kwi-catabolism kunye nokunciphisa i-anabolism kunye nokuvuvukala ngokusebenzisana kumanqanaba ahlukeneyo kunye ne-enzyme ethile, i-nuclear receptors, kunye nezinto ezibhaliweyo. Ngapha koko, ngokunxulumana nefiber, banokutshintsha i-dysbiosis yamathumbu ibe yi-eubiosis.
Ngenxa yoko, ukutya okunekhalori ephantsi (1,600�1,800 kcal) esekwe kwimifuno, ukutya okuziinkozo, iimbotyi, iziqhamo, kunye nentlanzi kunokucothisa ukuqhubela phambili kwesi sifo kwaye kuphucule impilo yezigulana ze-MS, ngelixa ukutya okune-hypercaloric kunye nokutya okuninzi. ityuwa, amanqatha ezilwanyana ezihluthisiweyo, ukutya okuthosiweyo, kunye neziselo ezinoshukela ezinoshukela zinokukhokelela ekuqalekeni kokudumba kwe-postprandial kunye nokudumba kwe-systemic low-grade.
Ukutya kufuneka kuhlanganiswe ne-prebiotics, i-probiotics, iivithamini ezithile (D, A, B12, kunye ne-nicotinic acid), i-oligoelements (i-magnesium kunye ne-selenium), kunye nezongezo zokutya ezifana ne-polyphenols, n-3 PUFA, kunye ne-lipoic acid.
I-prebiotics ye-MS kufuneka ibandakanye i-inulin, i-bran, i-lactosucrose, kunye ne-oligofructose, izondlo ezikhethiweyo ze-colonocytes kwaye ziyakwazi ukuvala i-NF-kB. Iiprobiotics, ezifana ne-lactococcus lactis, i-bifidobacterium lactis, kunye ne-clostridium butyricum, enokuphucula i-intestinal microbial balance, ingasetyenziselwa ukutshintsha ukubunjwa kwe-colonic microbiota. Ukudibanisa i-prebiotics kunye ne-probiotics kucetyiswa kakhulu. Imisebenzi yamathumbu kunye nobunzima kufuneka buhlale buphantsi kolawulo.
Indlela yonyango engqongqo ngakumbi ejolise ekubuyiseleni i-eubiosis yamathumbu kunye nokunciphisa ukuvuvukala kunokumelwa yi-fecal microbiota transplantation (FMT; Smits et al., 2013). Indlela ibonakala isebenza kakhulu kodwa iseyiyokuqala, ayikhuselekanga ngokupheleleyo, kwaye ngendlela eyonyanyekayo. Intsimi kufuneka ihambe ngaphaya kofakelo lwe-fecal transplants, ichonge izinto eziphilayo ezinokubaluleka kwimeko ethile, kwaye ibonelele ngezo ziphilayo ngendlela elula kakhulu kune-FMT (�Iimbono eziBalulekileyo kwiGastroenterology & Hepatology,� 2014).
Izongezo zokutya, ngaphandle kwe-omega-3 PUFA kuphela, eziyinxalenye eqhelekileyo yomzimba wethu, ziluncedo ekuqaleni kongenelelo lwezondlo, okanye ngexesha lokubuyela umva, ukuququzelela ukubuyiswa kwemeko esempilweni, kodwa ukusetyenziswa kwazo. kufuneka ithintelwe kuphela kwixesha eliqingqiweyo (3�4 iinyanga). Oku kusebenza ngokukodwa kwiipolyphenols. Iipolyphenols azikho iimolekyuli ezaziwayo-kakuhle malunga nokufumaneka kwazo ngebhayoloji kunye neziphumo zazo zebhayoloji kunye nezilumkiso ezikhethekileyo kufuneka zisetyenziswe xa kufakwa ukutya kunye nazo. Ngakolunye uhlangothi, banokunciphisa ukuhlanganiswa kwee-molecule ze-proinflammatory ngexesha leenkqubo zokuvuvukala; kwelinye icala, banokuvuselela umsebenzi weeseli kwiiseli eziphumleyo, kodwa ukuvuselela okuzingileyo kunokubangela i-apoptosis yeeseli ezisempilweni. Kuthatyathwe kunye, ezi ngqwalasela zibonisa ukuba ukulawulwa kwee-polyphenols ezihlanjululweyo kufuneka zenziwe ngesiseko sezilingo zokuqala zeklinikhi ukuvavanya ukusebenza kwazo njengezongezo zokutya kunye nokuqinisekisa ukhuseleko lwabo lwexesha elide kunye nedosi efanelekileyo.
Ngokubanzi, ungenelelo lwesondlo kunye nokutya okuchasene nokudumba kunye nezongezelelo zokutya kunciphisa i-biosynthesis yeekhompawundi ze-proinflammatory kwaye ngaloo ndlela zenza ukuba kusebenze ngakumbi ukusetyenziswa kweziyobisi eziguquguqukayo, kwaye ekugqibeleni kunokunciphisa imiphumo emibi enokubakho, ukunciphisa iimpawu zesifo esingapheliyo sokukhathala, kwaye uthanda ukuba sempilweni komonde. Nangona kunjalo, ukutya kunye nezongezo zokutya akufuneki ziphathwe njengeziyobisi kwaye zithathe indawo yonyango. Ngokufanayo, ukutya okune-proinflammatory akutyhefu kwaye akukho mfuneko yokuyikhupha ngokupheleleyo. Ungatya i-steak entle okanye ukutya okuqhotsiweyo ngaphandle komngcipheko okanye ityala, ukuba ukwimeko esempilweni. Eyona nto ibuhlungu kukutya ngendlela engafanelekanga ekuhambeni kwexesha.
I-Multiple sclerosis, okanye i-MS, sisifo esingapheliyo, esiqhubekayo esibandakanya umonakalo kwi-myelin sheaths yeeseli ze-nerve. I-epidemiology ye-MS ibonisa ukuba izinto ezahlukeneyo zihlala zibandakanyeka kwinkcazo yeklinikhi yomcimbi wezempilo. Nangona kunjalo, uphando oluninzi luye lwavavanya indima yokutya ekuphuhliseni i-multiple sclerosis. Kangangeminyaka emininzi, iingcali zezempilo zikholelwa ukuba kukho unxibelelwano phakathi kokusetyenziswa kobisi kwizigulana ezine-multiple sclerosis. Ngokwezifundo ezahlukeneyo zophando, unxulumano olubalulekileyo phakathi kobisi lwenkomo kunye nokuxhaphaka kwe-multiple sclerosis yafunyanwa, iphakamisa indima enokwenzeka yeemveliso zobisi kwi-multifactorial etiology ye-MS. UDkt Alex Jimenez DC, i-CCST
Ke, ekuqaleni, i-MS ibonakala ngathi ayinazo naziphi na iimpawu zezifo ezingapheliyo zokudumba, ezinokunxulumana nemikhwa engalunganga yokutya kunye nendlela yokuphila, okanye nakwi-dysbiotic gut microbiota. Kubonakala ngathi akukho nto ekwandiseni isifo esinokuthi sidibaniswe nokutya okanye imeko ye-intestinal microbiota. Enyanisweni, xa saqala izifundo zethu malunga nefuthe lesondlo kwi-MS, kwakungekho nencinci into enokuthi ibekho ikhonkco lokwenyani phakathi kwabo, kwaye ingcamango yokubandakanyeka kwe-gut microbiota kwi-MS yayithathwa njengento eqikelelwayo kakhulu. Ukuza kuthi ga ngoku, uluvo lokuba imikhwa yokutya inokuphembelela ikhosi ye-MS isatsala nzima ukuziseka. Akunjalo kwizifo ze-cardiovascular and other chronic inflammatory conditions, apho impembelelo yemikhuba yokutya iphantse yamkelwa, kwaye ingabikho nomhlaza, oye uthathwa njengengxaki ye-metabolic (Seyfried et al., 2014).
Okwangoku, unyango lwe-MS aluhambelani naluphi na uhlobo oluthile lokutya, mhlawumbi ngenxa yokungabikho kolwazi malunga nemiphumo yesondlo kwisifo. Nangona kunjalo, uninzi lwezigulane ezine-MS zifuna unyango oluncedisayo kunye nolunye unyango (CAM), kwaye ngokukodwa luzama ukutshintsha indlela yokutya, phantse ngaphandle kweengcebiso zogqirha (Schwarz et al., 2008; Leong et al., 2009 ). Uphononongo lwakutsha nje olusekwe kwidatha enikezelwe ngabaguli be-MS ekuphenduleni imibuzo kwimikhwa yabo yokutya kubonakala ngathi ixhasa umbutho obalulekileyo wokutya okunempilo kunye nomgangatho wobomi obungcono bomzimba kunye nempilo yengqondo kunye nezinga eliphantsi lokukhubazeka (Hadgkiss et al. ., 2014). Ezi nkcukacha zomeleza ingcamango yesidingo solingo olulawulwa ngokungahleliwe longenelelo lwesondlo kubantu abane-MS. Kufuneka igxininiswe into yokuba unyango lwezondlo kufuneka luncedisane, kodwa lungabi yindlela yonyango, lube yinxalenye yendlela epheleleyo kwaye lwenziwe phantsi kolawulo lonyango.
Njengoko kungekho datha efumanekayo kwiimvavanyo zeklinikhi okwangoku, umsebenzi wethu ujolise ekulungelelaniseni ukhetho lokutya ngokusekelwe kwimiphumo eyaziwayo kunye nokusekwa kwezinto zokutya kunye nendlela yokuphila kwinqanaba le-molecular. Idatha echazwe kwi-Figure 2 ngokucacileyo ayiphelelanga kodwa inokuba luncedo ukunika izikhokelo zongenelelo lwesondlo. Ngokomgaqo, ukutya okune-proinflammatory kulawula iindlela ze-biosynthetic kunye nokuvuvukala, njengoko kuboniswe ngakwesokudla kunye nezantsi kwi-Figure 2, kanti ukutya okuchasayo kulawula i-oxidative metabolism kunye nokunciphisa i-anabolism kunye nokuvuvukala.
Njengoko kuboniswe kweli nqaku, ukufumanisa ukuba ukukhawulwa kweekhalori, ukuzivocavoca, kunye nezinto ezithile zokutya kunokuchaphazela izinga leempendulo ezivuthayo ngokusebenza kuzo zombini i-metabolism yeselula (Umfanekiso 2) kunye nokwakhiwa kwe-gut microbiota (Umfanekiso 5), ucebisa ukuba isondlo esifanelekileyo. ukungenelela kunokuphucula ikhosi yesifo kwaye ngoko ke kunokuqwalaselwa njengento yonyango eyongezelelweyo kwi-MS. Njengoko ukuvuvukala kukho kuzo zombini i-RRMS kunye ne-PPMS, iingcebiso zesondlo ziboniswa kuzo zombini iintlobo zesifo. Oku kubaluleke ngakumbi kwimeko ye-PPMS, ekungafumanekiyo iyeza layo ngoku. Ngokwahlukileyo, njengoko imikhwa ethile yokutya inokuba yingozi kwaye inokukhuthaza imeko engapheliyo yokudumba kwinqanaba eliphantsi, ukutya okungalunganga kunokuthathwa njengento enokuba ngunobangela wokuphinda ubuyele kwi-MS.
Sithathiwe kunye, ngoku sinolwazi olungcono malunga nefuthe elinokubakho lezinto zokutya kwi-cell metabolism kunye ne-gut microbiota, kunye nemiphumo yazo enokwenzeka kwisifo, kodwa, ngokucacileyo, siqala ukuqonda indima yesondlo kunye ne-gut microbiota. kwi-MS kunye nomsebenzi omninzi uhleli malunga nokuqonda ubunjani bentsebenziswano ye-gut microbiota kunye ne-immune system host, ngakumbi kwiindawo ezikude ukuya emathunjini.
Ngaloo mihlaba, ithemba lexesha elizayo kuphando lwe-MS kufuneka liqwalasele la manqaku alandelayo: (a) ukuvavanya ukubunjwa kwe-gut microbiota; (b) avavanye iziphene kwinkqubo yokuzikhusela emathunjini; (c) ukucacisa indima ye-polyphenols kunye ne-vitamin D metabolism; (d) funda impembelelo yezinto zokutya, imifuno, kunye neziyobisi kwi-AMPK, i-Sirtuins, i-PPAR, okanye ngokuthe ngqo kwi-NF-kB. Kuyaphawuleka ukuba ezinye iziyobisi ezisetyenziselwa ukunyanga isifo seswekile se-II, njenge-PPAR-? i-agonists thiazolidinediones (uBernardo et al., 2009), kunye ne-AMPK agonist metformin (Nath et al., 2009) ineempembelelo ezichasayo ezifaniswa nezo ze-anti-inflammatory factor; (e) ukuchaza ukuphazamiseka okunokwenzeka phakathi kwezongezo zokutya kunye neziyobisi ze-MS; (f) ukukhuthaza iphulo elijolise ekufundiseni ngokubaluleka kokulandela ukutya okunempilo ngexesha lonyango, umzekelo, ukukhuthaza izigulane ukuba zifake i-fiber okanye i-carbohydrates eyinkimbinkimbi ekudleni kwabo, ukuncedisa i-probiotics, ukukhetha i-n-3 amafutha ngaphezu kwe-proinflammatory n-6 fats. , kunye nokunciphisa ukusetyenziswa kwenyama kunye namafutha ezilwanyana. Ukukhethwa kweendlela zokupheka ezilungileyo, njengalezo zichazwe nguMollie Katzen (2013), zinokwenza ukutya kwamkeleke ngakumbi.
Ngokubanzi, unyango lwe-MS lwe-immune-modulatory luphantse lwaba yimpumelelo; nangona kunjalo, amachiza anokukhusela kwaye athande iindlela zokulungisa akakakabikho. Singagqiba ekubeni sincede abantu bahlale besempilweni ngokunika isikhokelo sesondlo kunye namathuba omsebenzi womzimba. Okwangoku, kukho amathuba amahle kuphela okuphucula impilo-ntle yezigulana ezine-MS. Sisekuqaleni kwebali kuphela.
Njengoko zombini i-MS ebuyisela umva-i-MS kunye ne-MS ephambili-inkqubela phambili zizifo ezivuthayo, zinokuphenjelelwa yimikhwa ye-proinflammatory okanye yokuchasa ukudumba kunye nendlela yokuphila ngesenzo sabo kwi-cell metabolism kunye ne-gut microbiota. Iingcebiso ngezondlo kwizigulana ze-MS zinokuthanda impilo yazo.
Ababhali bhengeze ukuba akukho nto ingabangela ukuxabana ngokubhekiselele kuphando, ukubhala, kunye / okanye ukupapashwa kweli nqaku.
Ababhali badize ukufumana le nkxaso-mali ilandelayo yophando, ububhali, kunye/okanye ukupapashwa kweli nqaku: Lo msebenzi uxhaswa yi-Italian Foundation ye-Multiple Sclerosis (FISM) kunye nezibonelelo ze-2007/R/15 zeProjekthi �Esempilweni kwaye Ukutya okuSebenzayo kwizigulana ze-MS,� 2010/R/35 yeProjekthi �Isiseko seMolekyuli soNgenelelo lweZondlo kwi-Multiple Sclerosis,� kunye no-2014/S/2 (2014�2015) kwiprojekthi �Iinyaniso zeSondlo kwi-Multiple Sclerosis Zibalulekile kwaye kufuneka ziLawulwe njani kwi-PR
Oogqirha abaninzi bacebisa kakhulu ukuba abaguli abane-multiple sclerosis, okanye i-MS, baluphephe ubisi kuba izifundo ezahlukeneyo zophando zibonise unxulumano oluphezulu phakathi kwe-MS kunye nobisi, ngakumbi ubisi lwenkomo. Oku kubangelwe ubukhulu becala kwinto yokuba iiproteni ezikubisi lwenkomo zijoliswa ngokubanzi kumajoni omzimba kwizigulana ezinemultiple sclerosis. Ngapha koko, ezinye iiproteni kubisi lwenkomo zixelisa inxalenye ye-myelin oligodendrocyte glycoprotein, okanye i-MOG, icandelo le-myelin elibangela impendulo ye-autoimmune kwi-multiple sclerosis enokukhohlisa amajoni omzimba ukuba ahlasele kwaye atshabalalise i-MOG. Ulwazi olubhekiselele kwiZiko leSizwe loLwazi lweBiotechnology (NCBI). Ubungakanani bolwazi lwethu lukhawulelwe kwi-chiropractic kunye nemiba yempilo yomgogodla. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha915-850-0900 .
Ikhutshwe nguDkt. Alex Jimenez
U khankanywe kwi: Ncbi.nlm.nih.gov/pmc/articles/PMC4342365/
Umqolo obuhlunguSesinye sezona zinto zixhaphakileyo zokukhubazeka kunye neentsuku eziphosiweyo emsebenzini kwihlabathi liphela. Iimpawu ezibuhlungu zangasemva kwisizathu sesibini esiqhelekileyo sokutyelelwa kweofisi kagqirha, ngaphezulu kwenani losulelo oluphezulu lokuphefumla. Ngokumalunga neepesenti ezingama-80 zabemi baya kuba neentlungu zentlungu emva kanye ebomini babo. Umqolo sisakhiwo esintsonkothileyo esenziwe ngamathambo, amalungu, iigaments, kunye nezihlunu, phakathi kwezinye izicwili ezithambileyo. Ukwenzakala kunye / okanye iimeko ezixhonyiweyo, ezinje ngedisni, ekugqibeleni inokukhokelela kwiimpawu zentlungu emva. Ukulimala kwezemidlalo okanye ukulimala kwengozi yemoto kudla ngokuba yimbangela eqhelekileyo yeentlungu zangasemva, nangona kunjalo, ngamanye amaxesha ukunyakaza okulula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ukhetho olulolunye unyango, olufana nokunyamekela kwe-chiropractic, lunokunceda ukunciphisa intlungu emva kokusetyenziswa kohlengahlengiso lomqolo kunye nokunyanzeliswa kwezandla, ekugqibeleni kuphuculwe intlungu. �
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Umgangatho wobuchule wokuSebenza *
Ulwazi olulapha ku "Iimpawu Zondlo Kwi-Multiple Sclerosis"Akujoliswanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo okanye ugqirha onelayisensi kwaye akusiyo isiluleko sonyango. Sikhuthaza ukuba wenze izigqibo zezempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nochwepheshe bezempilo abaqeqeshiweyo.
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Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.
Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kumacandelo ahlukeneyo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo lokwenzakala okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.
Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda zibandakanya imiba yezonyango, imiba, kunye nezihloko eziyelelene kwaye zixhase ngokuthe ngqo okanye ngokungathanga ngqo umda wokuziqhelanisa wethu.
I-ofisi yethu izamile ngokufanelekileyo ukubonelela ngeengcaphulo ezixhasayo kwaye ichonge uphando olufanelekileyo lophando okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.
Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez, DC, okanye qha ga mshelana nathi 915-850-0900.
Silapha ukunceda wena kunye nosapho lwakho.
Iintsikelelo
UDkt Alex Jimenez D.C., I-MSACP, RN*, I-CCST, IFMCP*, I-CIFM*, I-ATN*
email: qeqeshi@elpasofunctionalmedicine.com
Ilayisenisi njengoGqirha weChiropractic (DC) kwi Texas & New Mexico*
Texas DC Ilayisensi # TX5807, New Mexico DC Ilayisensi # I-NM-DC2182
Unikwe Ilayisensi njengoMongikazi oBhalisiweyo (RN*) in Florida
Florida License RN Ilayisensi # I-RN9617241 (Nombolo yolawulo. 3558029)
Ubume obubambeneyo: ILayisensi yeeNkcazo ezininzi: Ugunyaziswe Ukuziqhelanisa I-40 States*
UGqr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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