Erythropoietin (EPO) yog glycoprotein hormone uas tswj tus nqi ntawm erythropoiesis hauv tib neeg lub cev. Cov khoom uas tau nthuav tawm yog synthesized tsuas yog nyob rau hauv lub raum, ib tug me me (kwv yees li 10 feem pua) yog tsim nyob rau hauv daim siab. Cov tshuaj hormone erythropoietin activates kev faib thiab sib txawv ntawm erythroid precursors. Cov theem ntawm endogenous hormone nyob rau hauv cov ntshav plasma ntawm cov neeg noj qab haus huv sib txawv nyob rau hauv ntau yam thiab yog inversely cuam tshuam rau cov concentration ntawm hemoglobin thiab qib ntawm cov ntaub so ntswg oxygenation. Kev ua haujlwm ntawm kev sib cais thiab tsim cov tshuaj hormone no rau kev kho mob yog qhov txiaj ntsig zoo heev.
qauv thiab lub ntsiab lus ntawm cov tshuaj hormone
Cov tshuaj hormone molecule muaj cov amino acids. Nrog rau qhov tsis txaus ntawm endogenous erythropoietin, qhov txo qis hauv qib ntawm hemoglobin thiab erythrocytes hauv cov ntshav tau pom, thiaj li hu ua erythropoietin deficiency anemia tshwm sim. Ua ntejTsis ntev los no, kev kho tshuaj ntawm cov kab mob ntshav qab zib no tseem tsis tuaj yeem ua tsis tau vim tsis muaj ib tus kws kho mob tsim nyog. Niaj hnub no, nrog rau qhov tsis txaus ntawm cov tshuaj hormones saum toj no hauv tib neeg lub cev, cov kws kho mob tau sau tshuaj erythropoietin recombinant. Cov tshuaj yog tau los ntawm cov tsiaj hlwb mus rau hauv uas tib neeg EPO noob code yog qhia. Recombinant human erythropoietin zoo tib yam hauv cov amino acid thiab carbohydrate muaj pes tsawg leeg rau cov tshuaj hormones ntuj, ua kom cov qe ntshav liab, reticulocytes, thiab activates hemoglobin biosynthesis hauv hlwb. Kev ua haujlwm lom neeg ntawm cov khoom tsim tawm tsis txawv ntawm cov tshuaj hormones endogenous. Recombinant erythropoietin tsis pom cov teebmeem cytotoxic thiab tsis cuam tshuam rau leukopoiesis. Cov kws tshawb fawb qhia tias EPO cuam tshuam nrog cov erythropoietin-sensitive receptors uas nyob hauv thaj chaw ntawm lub xov tooj ntawm tes.
Txoj kev ntxuav kom huv rau tib neeg erythropoietin
Recombinant human EPO yog ib qho ntawm cov khoom siv dav siv ntau tshaj plaws uas tsim los ntawm ntau lub tuam txhab tshuaj lom neeg thiab tshuaj thoob ntiaj teb rau kev kho tshuaj. Cov ntaub ntawv nthuav tawm yog tsim los ntawm Suav hamster zes qe menyuam (CHO) hlwb siv DNA recombinant. Ib qho polypeptide saw ntawm recombinant EPO muaj 165 amino acids, kwv yees qhov hnyav ntawm molecular uas yog 24,000 Da, thiab pom qhov hnyav molecular ntawm glycosylated protein yog 30,400 Da. Kev sib cais ntawm erythropoietin los ntawm impurities yog ua los ntawm kev sib pauv ion thiab affinity.chromatography. Tib neeg recombinant EPO yog 98% ntshiab.
Recombinant erythropoietins thiab lawv cov analogues
Txhawm rau txhawb cov txheej txheem ntawm erythropoiesis, cov kws kho mob siv cov tshuaj sib txawv:
- Aranesp;
- Aeprin;
- YEpobiocrine;
- YBioein;
- Vepox;
- "Binocrit";
- "Epocrine";
- Gmax;
- "Epogen";
- Eprex;
- "Epovitan";
- Epomax;
- "Hloov siab";
- Eralfon;
- Erythrostim;
- "Recormon";
- Epostim;
- Eposino;
- YEpoetin Beta.
Ua ntej hloov erythropoietin recombinant nrog analogues, koj yuav tsum sab laj nrog koj tus kws kho mob.
Cov lus qhia rau kev siv
Erythropoietin deficiency anemia (EDA) yog ib qho teeb meem tshwm sim rau cov kws kho mob. Cov pab pawg no suav nrog cov kab mob hauv qab no:
- ntshav qab zib hauv malignant neoplasms;
- mob ntshav qab zib thaum ntxov hauv cov menyuam mos ntxov ntxov (ua ntej 34 lub lis piam gestation) hnyav 750 txog 1500 g;
- nephrogenic anemia;
- mob ntshav qab zib hauv cov kab mob ntev (hepatitis C, rheumatoid mob caj dab, kab mob HIV, kab mob ntawm cov kwj deg alimentary).
Ib yam tshwj xeeb ntawm cov ntshav ntshav saum toj no yog tias lawv tsis kho nrog cov tshuaj ntxiv hlau. Txog thaum tsis ntev los no, kev hloov ntshav yog tib txoj kev kho tau zoo. Vim qhov tseeb tias hom kev kho mob no muaj ntau yam kev mob tshwm simthiab muaj kev pheej hmoo siab ntawm kev sib kis los ntawm cov ntshav ntawm cov kab mob ntawm ntau yam kab mob txaus ntshai (HIV, kab mob siab, thiab lwm yam) txoj kev no yog siv tsis tau hauv cov tshuaj niaj hnub no. Recombinant human erythropoietin pab txhim kho lub neej zoo rau cov neeg mob uas kuaj pom muaj erythropoietin deficiency anemia. Biosynthesis thiab kev taw qhia ntawm recombinant tib neeg EPO rau hauv kev xyaum tau qhib lub sijhawm tshiab hauv kev kho mob ntawm erythropoietin-dependent anemia.
YContraindications
Cov kws kho mob tsis pom zoo kom siv cov erythropoietin recombinant (cov lus qhia ceeb toom txog qhov no) nyob rau hauv lub xub ntiag ntawm cov kab mob hauv qab no:
- thromboembolism;
- drug hypersensitivity;
- tsis muaj peev xwm ntawm kev kho mob anticoagulant zoo;
- dhau los cerebral stroke lossis myocardial infarction;
- tsis ruaj tsis khov angina;
- tsis muaj kev kub ntxhov;
- mob xeeb thiab pub niam mis;
- refractory arterial hypertension.
Kev noj tshuaj
Cov koob tshuaj, kev tswj hwm thiab lub sijhawm ntawm kev kho mob yog teem rau ntawm tus kheej nruj me ntsis, nyob ntawm seb qhov mob hnyav ntawm tus mob ntshav qab zib, qhov xwm txheej ntawm tus neeg mob thiab qhov xwm txheej ntawm pathology. Cov kev npaj yog npaj rau kev siv parenteral. Thawj koob tshuaj yog los ntawm 50 mus rau 150 IU / kg. Cov koob tshuaj yuav tsum tau hloov raws li lub hnub nyoog ntawm tus neeg mob. Recombinant erythropoietin feem ntau yog siv 3 zaug hauv ib hnublub lim tiam. Nrog ib tug overdose ntawm cov tshuaj, muaj ib tug nce nyob rau hauv cov kev mob tshwm sim. Cov txiaj ntsig tau pom ntau dua lossis tsawg dua tom qab 2-3 lub lis piam ntawm kev siv.
Side effect
Koj puas tau sau tshuaj recombinant human erythropoietin? Cov lus qhia rau kev siv tsis suav nrog kev txhim kho cov kev mob tshwm sim. Nov yog:
- myalgia;
- kiv taub hau;
- hyperthermia;
- drowsy;
- ntua;
- mob taub hau;
- mob plab;
- arthralgia;
- mob ntshav siab;
- mob plab;
- thrombocytosis;
- tachycardia;
- kev kub ntxhov siab;
- txhawj xeeb;
- hepatosis;
- nce qib ntawm kev ua haujlwm ntawm AST, ALT hauv cov ntshav;
- RBC aplasia;
- eczema;
- angioedema;
- pob khaus thiab khaus;
- asthenia;
- urticaria, hyperemia thiab kub hnyiab ntawm qhov chaw txhaj tshuaj;
- hyperkalemia;
- txo qis hauv plasma ferritin protein concentration;
- hyperphosphatemia.
Erythropoiesis stimulators hauv kev ua si
Tsis ntev los no, cov tshuaj "Epovitan" (recombinant human erythropoietin) feem ntau siv. Cov cuab yeej nthuav tawm no feem ntau siv hauv kev ua kis las (kev ua kis las, kev tsim lub cev, ua luam dej, biathlon). Cov tshuaj no activates lub biosynthesis ntawm erythrocytes, uas, nyob rau hauv lem, ua rau ib tug nce nyob rau hauv cov pa cov ntsiab lus nyob rau hauv ib chav tsev ntawm cov ntshav thiab, raws li, nce nyob rau hauv oxygen muaj peev xwm ntawm cov ntshav thiab xa. O2 rau lub cev thiab cov ntaub so ntswg. Qhov no mechanism ntawm kev txiav txim nce lub aerobic endurance ntawm cov neeg ncaws pob. Ib qho txiaj ntsig zoo sib xws tau pom thaum tus neeg ncaws pob ua haujlwm hauv nruab nrab roob, thaum tsis muaj O 2hauv huab cua provokes kev loj hlob ntawm hypoxia, uas, dhau los, ua kom lub biosynthesis ntawm endogenous. erythropoietin muaj nuj nqi. Kev npaj EPO yog siv ua ke nrog insulin, somatotropin (GH, kev loj hlob hormone) thiab stanazolol.
Kev siv ntau dhau, tsis tswj hwm cov tshuaj "Erythropoietin" hauv kev ua kis las tuaj yeem ua rau cov ntshav txhaws, uas feem ntau ua rau tuag taus. Nws yog qhov nyuaj heev los kuaj xyuas EPO recombinant, txij li cov qauv ntawm cov khoom sib txuas yog zoo tib yam rau nws cov khoom siv lub cev, yog li no biocompound tseem siv tsis raug cai hauv kev ua kis las ua yeeb yam.
