Meelaynta bukaan-socodka ee Citicoline waxay runtii ku socotaa isbeddel muhiim ah, oo si tartiib tartiib ah uga soo baxaya "daroogada adjuvant" ee dhaqameed ilaa "wakiilka neuroprotective ee asaasiga ah". Isbeddelkani maaha mid aan sal lahayn, laakiin wuxuu ku salaysan yahay ururinta joogtada ah ee caddaynta caddaynta daawada ku salaysan, faham qoto dheer oo ku saabsan habka waxqabad ee bartilmaameedka badan, iyo aqoonsiga muhiimka ah ee "daaqadaha wakhtiga" ee daaweynta dhaawaca dareemaha degdega ah. Kuwa soo socda ayaa ah aasaaska muhiimka ah iyo falanqaynta taageeraya isbeddelkan:

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1. Xoogga waditaanka muhiimka ah: Caddayn adag laga bilaabo habka ilaa ku dhaqanka bukaan-socodka

Dib u baadhida habka ficilka (oo ka baxsan 'caawinta'):

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Xudunta dayactirka fosfolipid Membrane: Cytophosphatidylcholine waa horudhac toos ah oo loogu talagalay isku-darka phospholipids xuubka unugyada, sida phosphatidylcholine. Hoosudhaca phospholipid ee membrane waa dhacdo dhaawac hore oo halis ah ka dib ischemia/hypoxia neuronal. Phosphatidylcholine waxay si toos ah u kabi kartaa walxaha isku-dhafka fosfolipid endogenous, waxay kor u qaaddaa hagaajinta xuubabka unugyada dareemayaasha ee dhaawacan iyo xasilloonida, taas oo ah saldhigga aasaasiga ah ee ilaalinta neuroprotection.

Saamaynta neuroprotective ee bartilmaameedka badan:

Iska yaree excitotoxicity: jooji siidaynta xad dhaafka ah iyo sunta glutamate.

Cadaadiska Antioxidant: waxay kordhisaa heerarka glutathione waxayna nadiifisaa xagjiryada xorta ah.

Hagaajinta shaqada mitochondrial: ilaalinta dheef-shiid kiimikaadka tamarta iyo yaraynta apoptosis unugga.

Kor u dhexgalka neurotransmitter: kordhinta heerarka acetylcholine, dopamine, iwm, hagaajin habdhiska dareemayaasha.

Iska yaree xanuunka neuroinflammation: joojiso sii deynta cytokines pro-bararka.

Farsamaynta ayaa go'aamisa inay noqoto doorka udub-dhexaadka ah ee "faragelinta hore iyo ilaalinta firfircoon", halkii ay ka ahaan lahayd caawinta nafiska calaamadaha. ?

Ururinta caddaynta tayada sare leh ee ku salaysan caddaynta (ka-jabinta aragtida "kaaliye"):

Ischaemic stroke (AIS):

Daraasadda ICTUS (2012): Inkasta oo barta ugu dambeysa ee aasaasiga ahi ay xun tahay, koox-hoosaadyadii hore loo go'aamiyay (dhexdhexaad ilaa madax-dhiigfuranka daran, daawaynta hore) waxay muujiyeen faa'iidooyin muhiim ah, oo soo jeedinaya in waqtiga daaweynta iyo xulashada dadweynaha ay muhiim tahay.

Daraasadda ECCO 2 (2023): RCT weyn oo lagu sameeyay dadka Shiinaha (3947 bukaannada AIS ayaa ku jira). Natiijooyinku waxay muujiyeen in iyada oo lagu saleynayo xididdada xididdada xididdada dhiigga iyo / ama daaweynta endovascular, hore (24 saacadood gudahood ka dib bilawga) isticmaalka xididka ee fosfatidylcholine ee 14 maalmood ayaa si weyn u kordhay saamiga 90 maalmood ee madax-bannaanida shaqada (mRS 0-1) (43.5% vs 40.0%), iyo badbaadadu waxay ahayd mid wanaagsan. Xaqiiji saamaynta isku-dhafka ah ee ku salaysan daaweynta caadiga ah ee dib-u-celinta. ?

Falanqaynta maadada-badan: waxay taageertaa waxtarkeeda hagaajinta natiijooyinka neerfaha iyo awoodaha nolol maalmeedka, gaar ahaan bilawga daaweynta marxaladaha hore ee bilawga (

Dhaawaca Maskaxda ee Naxdinta leh (TBI):

Daraasadda COBRIT: Natiijadu waa muran, laakiin falanqaynta ka dib waxay soo jeedinaysaa in kooxo-hoosaadyo gaar ah (dhexdhexaad ilaa daran TBI) ay faa'iido u leeyihiin.

Cilmi-baarista adduunka dhabta ah & falanqaynta meta: Daraasado badan ayaa muujiyay in ay hagaajin karto natiijooyinka neerfaha iyo soo kabashada miyir-qabka ee bukaannada TBI.

Cudurada Neurodegenerative (hoos sahaminta):

Waxyeellada garashada xididdada dhiigga (VCI) / waallida xididdada dhiigga (VaD): Daraasaduhu waxay muujiyeen inay hagaajin karaan shaqada garashada (fiiri, fulinta, xusuusta).

Cudurka Alzheimers (AD)/Cudurka Parkinson (PD): Sida cudurro wax ka beddeli kara, cilmi-baarisyada yaryar qaarkood waxay soo jeedinayaan horumarinta garashada iyo dabeecadda.

Cilmi-baaris lagu sameeyay qaybaha kale sida glaucoma iyo dhaawaca laf-dhabarka ayaa sidoo kale muujiyay suurtagalnimada neuroprotective.

2. Qodobka muhiimka ah ee isbeddelka meelaynta: laga bilaabo "kaaliyaha" ilaa "core"

Hore u qaadista wakhtiga daawaynta (faragelinta udub dhexaadka ah ee "daaqadaha wakhtiga dahabiga ah"):

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Furaha ilaalinta neerfaha waxay ku jirtaa 'hore'. Dhaawaca maskaxda ka dib (sida istaroogga, TBI), jawaab celinta dhaawaca cascade waxa la bilaabaa dhawr daqiiqo ilaa dhawr saacadood ka dib.

Habka ficilka ee fosfatidylcholine ayaa go'aaminaya in loo isticmaalo marxaladaha hore ee falcelinta dhaawaca cascade (sida 24 saacadood gudahood ka dib bilawga istaroogga, horraantii way ka fiican tahay) si loo xiro waddada dhaawaca iyo ilaalinta unugyada neerfaha ee khatarta ah ilaa inta ugu badan ee suurtogalka ah. Tani gabi ahaanba way ka duwan tahay meelaynta dhaqameed ee "daawoyinka kaabayaalka ah ee baxnaaninta".

Guusha cilmi-baarista ECCO 2 waxay ku saleysan tahay naqshadeynta borotokoolka maamulka xididdada hore.

Meesha xudunta u ah istaraatiijiyada daawaynta (oo lagu daray daawaynta reperfusion):

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Hal-abuurnimada habka daaweynta ee istaroogga degdega ah ee ischaemic: Daaweynta caadiga ah waa dib-u-kicinta xididdada xididada (thrombolysis, thrombectomy), laakiin qayb aad u badan oo bukaanno ah ayaa weli leh saadaal liidata ka dib dib-u-kicinta (dhaawaca dib-u-celinta, wax soo noqnoqda, iwm.).

Habka neuroprotective ee phosphatidylcholine (xasilinta xuubka unugyada, antioxidant, anti apoptotic) ayaa buuxin kara oo la qabsan kara daaweynta dib-u-celinta, yaraynta dhaawaca soo noqnoqda iyo ilaalinta unugyada maskaxda ka dib dib-u-celinta.

Cilmi-baadhista ECCO 2 ayaa xaqiijisay qiimaheeda inay tahay qayb ka mid ah neerfaha xudunta u ah istiraatijiyadda "dib-u-kicinta xididdada dhiigga+", oo aan hadda ahayn wax dheeraad ah oo ikhtiyaari ah.

Hagaajinta dariiqyada maamulka (ku daba-galka noolaha):

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Fosfatidylcholine ee afka laga helo waxay leedahay bioavailability hoose (

Cirbadeynta xididku waxay ku siin kartaa bioavailability sare, si dhakhso ah u gaadho fiirsashada daawada dhiigga ee waxtarka leh, oo daboolaysa baahiyaha neuroprotection degdeg ah ee marxaladda ba'an.

U wareejinta dhinaca meelaynta "core" waxaa lama huraan ah inay la socoto talada foomamka qiyaasta xididka ee loo isticmaalo marxaladda degdega ah.

3. Cusboonaysiinta habraacyada/isku-raaca (oo ka tarjumaya isbeddelka meelaynta)

Shiinaha:

"Hagaha ka hortagga iyo daaweynta Stroke ee Shiinaha" iyo dukumeentiyada kale waxay muujiyeen saameynteeda neuroprotective.

Iyada oo ku saleysan natiijooyinka ka soo baxa cilmi-baarista ECCO 2, waxaa la filayaa in heerka talada iyo meelaynta fosfatidylcholine (gaar ahaan qaababka xididada ee loo isticmaalo marxaladda ba'an) ee tilmaamaha Shiinaha si weyn loo wanaajin doono mustaqbalka. ?

Caalami:

Tilmaamaha AHA / ASA ee Maraykanka weli si cad looguma talin, laakiin waxay u furan yihiin cilmi-baaris ku saabsan wakiilada neuroprotective.

Qaar ka mid ah tilmaamaha wadamada Yurub waxay leeyihiin qiimeyn aad u wanaagsan oo fosfatidylcholine ah (sida Spain, Portugal).

4. Muhiimadda isbeddelka meelaynta bukaan-socodka

Cusbooneysii fikradda daawaynta: Kahortagga neerfaha waa tiir isku mid ah oo muhiim u ah daaweynta dhaawaca ba'an ee maskaxda sida dib u soo kabashada xididada.

Kor u qaad daaweynta isku dhafka ah ee fosfatidylcholine (xididka) sida daaweynta caadiga ah (sida thrombolysis / thrombectomy) ee marxaladda hyperacute / ba'an ee istaroogga / TBI iyo cudurrada kale.

Hagaajinta saadaasha bukaanka: Iyadoo loo marayo neuroprotection hore oo waxtar leh, waxaa la filayaa in ay sii wanaajiso heerka badbaadada iyo heerka soo kabashada shaqada ee bukaanada qaba dhaawaca maskaxda ee daran, iyo in la yareeyo naafanimada.

Kobcinta cilmi baarista iyo jihada horumarinta: Kor u qaad daraasado caafimaad oo tayo sare leh oo sahamiya hababka gaarsiinta daawada cusub ee ilaalinta neuroprotection ba'an.

Kooban iyo Muuqaalka

Beddelka fosfatidylcholine ee "daroogada adjuvant" una gudubta "wakiilka neuroprotective asaasiga ah" waa natiijada qoto-dheeraynta cilmi-baarista aasaasiga ah, horumarka caddaynta bukaan-socodka (gaar ahaan cilmi-baarista ECCO 2), iyo fikradaha daaweynta ee la cusboonaysiiyay. Udub dhexaadkeedu waxa uu ku yaalaa:

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Wax ka qabadka hore: Xooga saar daawada inta lagu jiro daaqada wakhtiga dahabiga ah (wajiga degdega ah/marxaladda hore ee subacute) marka falcelinta cascade ee dhaawaca neerfaha la bilaabo.

Mudnaanta xididka: Marxaladda degdega ah ee ficil degdeg ah loo baahan yahay, maamulka xididku waa dariiqa ugu muhiimsan ee lagu sameeyo saamaynta ilaalinta asaasiga ah.

Kobcinta waxtarka wadajirka ah: Sida qayb muhiim ah oo muhiim ah oo ka mid ah neuroprotection oo ku saleysan daaweynta dib u soo celinta xididdada xididada (stroke) ama daaweyn dhamaystiran (TBI), ma aha gunno dheeraad ah.

Isbeddelkani waxa uu calaamad u yahay aqoonsiga dib loo cusbooneysiiyay iyo kor u qaadista qiimaha fosfatidylcholine ee daaweynta cudurrada neerfaha, gaar ahaan qaabka daaweynta istaroogga ischaemic ba'an. Iyada oo qayb muhiim ah ka ah istaraatiijiyada "daaweynta reperfusion standard+coreprotection neuroprotection", waxay helaysaa taageero adag oo sii kordheysa oo ku salaysan caddaynta iyo aqoonsiga caafimaad. Mustaqbalka, iyada oo la horumarinayo cilmi-baaris tayo sare leh iyo cusbooneysiinta hab-raacyada, booskeeda asaasiga ah waa la sii xoojin doonaa.