amakuru

Indwara ya Alzheimer, indwara ikunze kugaragara ku bageze mu zabukuru, yibasiye abantu benshi.

Imwe mu mbogamizi mu kuvura indwara ya Alzheimer ni uko gutanga imiti ivura ingirangingo z'ubwonko bigarukira ku nzitizi y'amaraso n'ubwonko. Ubushakashatsi bwagaragaje ko ultrasound yayobowe na MRI ishobora gukingura byimazeyo inzitizi y’ubwonko bw’amaraso ku barwayi barwaye indwara ya Alzheimer cyangwa izindi ndwara zifata ubwonko, harimo indwara ya Parkinson, ibibyimba mu bwonko, na sclerose ya amyotrophique.

Ubushakashatsi buherutse gukorwa mu kigo cya Rockefeller Institute for Neuroscience muri kaminuza ya Virijiniya y’Uburengerazuba bwerekanye ko abarwayi bafite indwara ya Alzheimer bahawe infusion ya aducanumab ifatanije na ultrasound yibanze byafunguye by'agateganyo inzitizi y’ubwonko bw’amaraso byagabanije cyane ubwonko bwa amyloide beta (Aβ) ku ruhande rw’ibizamini. Ubushakashatsi bushobora gufungura imiryango mishya yo kuvura indwara zubwonko.

Inzitizi yamaraso-ubwonko irinda ubwonko ibintu byangiza mugihe ituma intungamubiri zingenzi zinyuramo. Ariko inzitizi y'amaraso n'ubwonko nayo irinda gutanga imiti ivura ubwonko, ikibazo kikaba gikomeye cyane mugihe cyo kuvura indwara ya Alzheimer. Uko isi igenda isaza, umubare w’abantu barwaye Alzheimer uragenda wiyongera uko umwaka utashye, kandi uburyo bwo kuvura ni buke, bishyira umutwaro uremereye ku buvuzi. Aducanumab ni beta amyloide beta (Aβ) ihuza antibody ya monoclonal yemejwe n’ikigo cy’Amerika gishinzwe ibiryo n’ibiyobyabwenge (FDA) cyo kuvura indwara ya Alzheimer, ariko kwinjira mu nzitizi y’amaraso n'ubwonko ni bike.

Ultrasound yibanze itanga imashini ikora itera ihungabana hagati yo kwikuramo no guhindagurika. Iyo batewe mumaraso hanyuma bagahura numurima wa ultrasonic, ibibyimba biragabanuka kandi bikaguka kuruta inyama n'amaraso bikikije. Ihungabana ritera guhangayikishwa no gukuta urukuta rw'amaraso, bigatuma amasano akomeye hagati ya selile endothelia arambura kandi akingura (Ishusho hepfo). Kubera iyo mpamvu, ubusugire bwinzitizi yamaraso-ubwonko burahungabana, bigatuma molekile ikwirakwira mubwonko. Inzitizi yubwonko bwamaraso ikiza yonyine mumasaha agera kuri atandatu.

Igishushanyo cyerekana ingaruka za ultrasound yerekeza kurukuta rwa capillary mugihe ibibyimba bingana na micrometero biboneka mumitsi. Bitewe no kugabanuka kwinshi kwa gaze, ibibyimba biragabanuka kandi bikaguka cyane kuruta ibice bikikije, bigatera guhangayikishwa na selile ya endoteliyale. Ubu buryo butera guhuza gukomeye kandi birashobora no gutuma amaherezo ya astrocyte agwa kurukuta rwamaraso, bikabangamira ubusugire bwinzitizi yubwonko bwamaraso kandi bigatera gukwirakwiza antibody. Byongeye kandi, selile endoteliyale yibasiwe na ultrasound yibanze byongera ibikorwa byogutwara vacuolar no guhagarika imikorere ya pompe efflux, bityo bigabanya ubwonko bwa antibodi. Igicapo B cerekana ingengabihe yo kuvura, ikubiyemo ibarwa rya tomografiya (CT) hamwe na magnetic resonance imaging (MRI) kugira ngo hategurwe gahunda yo kuvura ultrasound, 18F-flubitaban positron emission tomografiya (PET) kuri baseline, kwinjiza antibody mbere yo kuvura ultrasound no kwanduza mikorobe mu gihe cyo kuvura, hamwe no gukurikirana acoustic ya microcicular ikwirakwiza ultrasound ikoreshwa mu kugenzura imiti. Amashusho yabonetse nyuma yo kuvura ultrasound yibanze harimo T1 ifite uburemere bwa T1 ifite uburemere bwa MRI, bwerekanaga ko inzitizi yubwonko bwamaraso yari ifunguye ahantu havuwe ultrasound. Amashusho yakarere kamwe nyuma yamasaha 24 kugeza 48 yo kuvura ultrasound yerekanwe gukira byimazeyo inzitizi yubwonko bwamaraso. Isuzuma rya 18F-flubitaban PET mugihe cyo gukurikirana umwe mubarwayi nyuma yibyumweru 26 yerekanye ko Aβ yagabanutse mubwonko nyuma yo kuvurwa. Igicapo C cerekana MRI iyobowe na ultrasound mugihe cyo kuvura. Ingofero ya hemispherical transducer ikubiyemo amasoko arenga 1.000 ya ultrasound ihurira kumurongo umwe wibanze mubwonko ukoresheje ubuyobozi bwigihe cya MRI

Mu 2001, ultrasound yibanze yerekanwe bwa mbere kugira ngo hafungurwe inzitizi y’amaraso n’ubwonko mu bushakashatsi bw’inyamaswa, kandi ubushakashatsi bwakozwe mbere y’ibanze bwerekanye ko ultrasound yibanze ishobora kongera imiti no gukora neza. Kuva icyo gihe, byagaragaye ko ultrasound yibanze ishobora gukingura neza inzitizi yubwonko bwamaraso kubarwayi barwaye Alzheimer batakira imiti, kandi ishobora no gutanga antibodies kuri metastase ya kanseri yamabere.

Uburyo bwo gutanga Microbubble

Microbubbles nigikoresho cyo gutandukanya ultrasound gikunze gukoreshwa mugukurikirana amaraso nimiyoboro yamaraso mugupima ultrasound. Mugihe cyo kuvura ultrasound, fosifolipide yubatswe na pyrogenic bubble ihagarikwa rya octafluoropropane yatewe inshinge (Ishusho 1B). Microbubbles zifite polydispers cyane, hamwe na diametre kuva munsi ya 1 mm kugeza kuri 10 mm. Octafluoropropane ni gaze ihamye idakoreshwa kandi irashobora gusohoka mu bihaha. Igikonoshwa cya lipid gifunga kandi kigakomeza ibibyimba bigizwe na lipide eshatu zabantu zisanzwe zihinduranya muburyo busa na fosifolipide endogenous.

Igisekuru cya ultrasound yibanze

Ultrasound yibanze ikorwa n'ingofero ya transducer yingofero ikikije umutwe wumurwayi (Ishusho 1C). Ingofero ifite ibikoresho 1024 byigenga byigenga byitwa ultrasound, mubisanzwe byibanda hagati yisi. Izi soko ya ultrasound itwarwa na sinusoidal radio-yumurongo wa voltage kandi ikanasohora imiraba ya ultrasonic iyobowe na magnetic resonance imaging. Umurwayi yambaye ingofero kandi amazi yangiritse azenguruka mumutwe kugirango byorohereze kwanduza ultrasound. Ultrasound inyura mu ruhu no mu gihanga kugera ku bwonko.

Imihindagurikire yubunini bwa gihanga nubucucike bizagira ingaruka ku gukwirakwiza ultrasound, bikavamo igihe gitandukanye gato kugirango ultrasound igere kuri lesion. Uku kugoreka kurashobora gukosorwa mugushakisha amakuru yimibare ihanitse ya tomografi kugirango ubone amakuru kubyerekeranye na gihanga, ubunini, n'ubucucike. Moderi yo kwigana mudasobwa irashobora kubara icyiciro cyahinduwe kuri buri kimenyetso cya disiki kugirango igarure icyerekezo gikaze. Mugucunga icyiciro cyikimenyetso cya RF, ultrasound irashobora kuba yibanze kuri elegitoronike kandi igashyirwa kugirango itwikire ingirabuzimafatizo nyinshi itimuye ultrasound isoko. Ahantu hagenewe tissue igenwa na magnetic resonance yerekana amashusho mumutwe wambaye ingofero. Ingano yintego yuzuyemo gride-itatu-ya gride ya ultrasonic anchor point, isohora imiraba ya ultrasonic kuri buri cyuma cya ms 5-10 ms, igasubirwamo buri masegonda 3. Imbaraga za ultrasonic ziyongera buhoro buhoro kugeza igihe ibimenyetso bifuza gusasa byamenyekanye, hanyuma bigakomeza amasegonda 120. Iyi nzira isubirwamo kurindi meshes kugeza igihe intego igenewe.

Gufungura inzitizi yubwonko bwamaraso bisaba amplitione yumuraba wijwi kugirango urenze urwego runaka, urenze aho ubwikorezi bwa bariyeri bwiyongera hamwe no kongera umuvuduko ukabije w’umuvuduko kugeza igihe ibyangiritse byangiritse, bikagaragara nka erythrocyte exosmose, kuva amaraso, apoptose, na necrosis, ibyo byose bikunze kuba bifitanye isano no gusenyuka kwinshi (bita cavité inertial). Irembo riterwa nubunini bwa microbubble hamwe nigikonoshwa. Mugushakisha no gusobanura ibimenyetso bya ultrasonic bikwirakwijwe na mikorobe, imurikagurisha rishobora kubikwa ahantu hizewe.

Nyuma yo kuvura ultrasound, MRI ifite uburemere bwa T1 hamwe na agent itandukanye yakoreshejwe kugirango hamenyekane niba inzitizi yubwonko bwamaraso yafunguye ahabigenewe, naho amashusho afite uburemere bwa T2 yakoreshejwe kugirango hemezwe niba gukabya cyangwa kuva amaraso byabayeho. Ibyo kureba bitanga ubuyobozi bwo guhindura ubundi buvuzi, nibiba ngombwa.

Isuzumabumenyi hamwe nicyizere cyo kuvura

Abashakashatsi bagaragaje ingaruka zo kuvura ku bwonko Aβ umutwaro bagereranya 18F-flubitaban positron yoherejwe na tomografiya mbere na nyuma yo kuvurwa kugirango barebe itandukaniro riri hagati yubunini bwa Aβ hagati y’ahantu havuwe n’ahantu hasa ku rundi ruhande. Ubushakashatsi bwibanze bwakozwe nitsinda rimwe bwerekanye ko kwibanda gusa kuri ultrasound bishobora kugabanya gato Aβ urwego. Igabanuka ryagaragaye muri uru rubanza ryarushijeho kuba ryinshi kuruta mu bushakashatsi bwabanje.

Mu bihe biri imbere, kwagura imiti ku mpande zombi z'ubwonko bizaba ingenzi mu gusuzuma akamaro kayo mu gutinda gutera indwara. Byongeye kandi, hakenewe ubushakashatsi bwinshi kugirango hamenyekane umutekano wigihe kirekire ningirakamaro, kandi ibikoresho bivura bikoresha amafaranga bidashingiye kubuyobozi bwa MRI kumurongo bigomba gutezwa imbere kugirango biboneke neza. Nubwo bimeze bityo ariko, ibyagaragaye byateje icyizere ko imiti n’ibiyobyabwenge bisiba Aβ amaherezo bishobora kudindiza iterambere rya Alzheimer.