Kwv yees li ntawm lub sijhawm nyeem ntawv: 19 feeb
Introduction
Kuv ntseeg tias kev siv cov khoom noj ketogenic raws li kev kho mob rau kev siv tshuaj yeeb dej caw tuaj yeem ua rau tsis zoo los ntawm cov tib neeg thiab cov chaw kho mob. Kuv xav tias qhov no yog ib qho teeb meem tshwm sim. Puas muaj qhov cuam tshuam txog kev puas siab puas ntsws uas cuam tshuam rau kev siv yeeb tshuaj? kiag li. Kuv puas tau hais tias kev kho mob hlwb thiab kev txhawb nqa tsis yog xav tau? Tsis yog. Kuv xav tias lawv tuaj yeem muaj nuj nqis. Tab sis cov kws kho mob puas siab puas ntsws thiab kws kho mob hlwb, thiab hais ncaj ncees, tag nrho lwm tus neeg ua haujlwm hauv chaw kho mob rau kev rov qab los ntawm kev quav tshuaj, yuav tsum nkag siab tias kev noj zaub mov ketogenic tuaj yeem txhim kho txoj hauv kev uas tib neeg tuaj yeem rov qab los ntawm kev siv tshuaj yeeb dej caw.
Muaj qee qhov kev tshawb fawb zoo heev uas qhia tias kev noj haus ketogenic tuaj yeem pab rov qab los ntawm kev quav tshuaj. Yog li, tsab xov xwm no tau sau tsis yog rau tus kws kho mob puas siab puas ntsws, tus kws kho mob tshwj xeeb, lossis lwm tus kws tshaj lij kev puas siab puas ntsws tab tom nrhiav los txhim kho cov kab mob lom neeg ntawm lawv cov qauv biopsychosocial ntawm kev coj ua. Nws tseem tsis tau sau cia rau MD lossis lwm tus kws kho mob ntawm ntau cov tshuaj uas peb siv los pab tib neeg txo qis kev ntshaw lossis tswj kev tshem tawm cov teebmeem uas yog ib feem ntawm lawv txoj kev rov qab los. Kab lus no kuj yog sau rau tus neeg uas raug kev quav yeeb quav tshuaj thiab cov neeg uas hlub lawv.
Peb yuav kawm txog cov kev hloov pauv hauv lub hlwb uas peb pom hauv kev siv tshuaj yeeb dej caw, kev noj zaub mov ketogenic tuaj yeem kho li cas, thiab qee qhov kev sim tshuaj ntsuam xyuas zoo siab uas, thaum lub sijhawm sau ntawv, tab tom nrhiav neeg tuaj koom. Thaum kawg, peb tseem yuav qhia txog qee qhov teeb meem uas, thaum tsis nyob hauv cov ntaub ntawv nyob rau lub sijhawm no, yuav tsum tau kawm ntxiv raws li kev noj zaub mov ketogenic raws li kev kho mob rau kev siv tshuaj yeeb tshuaj kom paub ntau dua thiab siv tau.
Restoring hlwb zog: Ketogenic noj cov zaub mov thiab tshuaj siv tsis zoo
Kev haus dej haus cawv yog paub los hloov txoj kev uas lub hlwb siv roj. Muaj kev hloov pauv ntawm qabzib mus rau acetate, cawv metabolite. Hauv cov neeg uas muaj Cwj Pwm Tsis Txaus Siab, qhov kev hloov pauv no txuas ntxiv dhau lub sijhawm qaug cawv thiab dhau los ua qhov lees txais roj uas lub hlwb xav tau thiab hloov kho rau. Hauv Kev Siv Dej Cawv (AUD), muaj qhov mob ntev thiab tsis tu ncua ntawm lub paj hlwb qis thiab siab acetate metabolism. Qhov no tsis yog cov ntaub ntawv tshiab. Peb tau paub tias cov piam thaj metabolism tsis zoo hauv kev siv cawv txij li xyoo 1966 thaum Roach thiab lawv cov npoj yaig tau tshaj tawm lawv cov lus qhia thawj zaug uas cuam tshuam cov metabolism hauv qabzib tuaj yeem yog qhov ua rau qaug cawv.
Thaum ib tug neeg mus los ntawm kev haus cawv thiab txwv tsis pub haus cawv, lub hlwb nres tau txais cov roj uas nws xav tau thiab nruab los daws.
Yog li, peb xav tias qhov tsis txaus ntseeg lub zog tsis txaus ntseeg hauv lub hlwb tshwm sim thaum lub sijhawm haus cawv detoxification thaum qib acetate hauv cov ntshav txo qis thiab qhov no ua rau cov tsos mob tshem tawm thiab neurotoxicity hauv cov neeg mob AUD.
Wiers, CE, Vendruscolo, LF, Van der Veen, JW, Manza, P., Shokri-Kojori, E., Kroll, DS, … & Volkow, ND (2021). Kev noj haus ketogenic txo cov tsos mob ntawm kev haus cawv hauv tib neeg thiab haus cawv hauv cov nas. Kev Txhawb Kev Tshawb Fawb, 7(15), ib., 6780.
Vim li cas ho tsis haus cawv lub hlwb cia li hloov mus rau cov metabolism hauv qabzib? Cov kws tshawb fawb tsis tau hais, tab sis kuv xav tias cov tshuab no yog downregulated los yog puas vim qhov siab ntawm oxidative kev nyuaj siab uas tshwm sim nyob rau hauv ib puag ncig ntawm kev siv yeeb tshuaj.
Peb tsis tsuas yog pom qhov tsis zoo ntawm cov piam thaj metabolism hauv kev siv cawv. Nws kuj yog ib qho teeb meem hauv kev siv opioid.
Morphine kev kho mob tuaj yeem txo qis- tswj cov theem qhia ntawm qee cov enzymes metabolic, suav nrog PDH, LDH, thiab NADH, thiab yog li cuam tshuam lub zog metabolism.
Jiang, X., Li, J., Ma, L. (2007). Metabolic enzymes txuas morphine tshem tawm nrog metabolic teeb meem. Kev tshawb fawb ntawm tes, 17(9), 741-743. Jiang, X., Li, J. & Ma, L. Metabolic enzymes txuas morphine tshem tawm nrog metabolic teeb meem. Cell Res 17, 741-743 (2007). https://doi.org/10.1038/cr.2007.75
Kev kho mob Morphine, piv txwv li, tuaj yeem txo qis-tswj cov qib qhia ntawm qee yam metabolic enzymes, suav nrog PDH, LDH (lactate dehydrogenase), thiab NADH. Cov kev cai qis no tuaj yeem cuam tshuam lub zog metabolism ntawm cov piam thaj hauv lub hlwb. PDH, tshwj xeeb, yog qhov tseem ceeb rau kev hloov pauv pyruvate rau hauv acetyl-CoA, thiab kev cuam tshuam hauv nws txoj haujlwm tuaj yeem cuam tshuam tsis zoo rau kev tsim hluav taws xob los ntawm cov piam thaj.
Cov neeg siv tshuaj methamphetamine uas tau dhau los ua abstinent kuj qhia txog thaj chaw ntawm lub hlwb hypometabolism.
Hauv kev xaus, peb tshaj tawm tias cov neeg siv MA abstinent tau txo qis rCMRglc nyob rau hauv pem hauv ntej dawb teeb meem thiab impaired frontal executive functions…
Kim, S., Li, Y., Hwang, J. et al. Frontal Glucose Hypometabolism nyob rau hauv Abstinent Methamphetamine Cov neeg siv. Neuropsychopharmacol 30, 1383-1391 (2005). https://doi.org/10.1038/sj.npp.1300699
Ketone lub cev, suav nrog beta-hydroxybutyrate thiab acetoacetate, yog qhov tshwj xeeb hauv lawv lub peev xwm hla cov ntshav-hlwb teeb meem thiab siv los ntawm hlwb hlwb. Lawv muaj peev xwm bypass tawg qab zib uptake machinery. Ib zaug hauv lub hlwb, ketones hloov mus rau hauv acetyl-CoA, uas tom qab ntawd nkag mus rau lub voj voog citric acid los tsim ATP, uas yog lub zog lub hlwb siv tau. Tej zaum koj yuav tau hnov tias lub hlwb xav tau ntau lub zog, thiab qhov ntawd yog qhov tseeb tiag. Nws yuav tsum muaj ntau lub zog los tswj lub hlwb ua haujlwm. Ketones yog qhov chaw cawm siav rau thaj chaw ntawm lub hlwb uas tau dhau los ua hypometabolic hauv kev siv yeeb tshuaj thiab tsis tuaj yeem siv cov piam thaj kom zoo.
Cov txiaj ntsig no qhia tias ketones yog qhov nyiam lub zog substrate rau lub hlwb vim tias lawv nkag mus rau hauv lub hlwb hauv kev faib ua feem rau lawv cov ntshav plasma tsis hais txog qhov muaj cov piam thaj; Yog tias lub zog xav tau ntawm lub paj hlwb tau nce ntxiv los ntawm ketones, cov piam thaj nce ntxiv yuav txo qis.
Cunnane, SC, Courchesne-Loyer, A., Vandenberghe, C., St-Pierre, V., Fortier, M., Hennbelle, M., … & Castellano, CA (2016). Ketones puas tuaj yeem pab cawm lub hlwb roj hauv lub neej tom ntej? Qhov cuam tshuam rau kev paub txog kev noj qab haus huv thaum muaj hnub nyoog thiab kev kho mob Alzheimer's. Frontiers hauv molecular neuroscience, 53. https://doi.org/10.3389/fnmol.2016.00053
Muab qhov ua tiav ntawm kev noj zaub mov ketogenic hauv kev hais txog lub hlwb hypometabolism hauv cov kab mob neurodegenerative, nws tsim nyog xav txog lawv cov txiaj ntsig zoo hauv kev siv tshuaj yeeb (SUDs). Cov kev cuam tshuam neurological ntawm SUDs sib piv nrog cov neeg pom hauv kev puas siab puas ntsws thiab kev puas siab puas ntsws, (uas kuj teb tau zoo rau cov khoom noj ketogenic) thiab qhia tias cov khoom noj ketogenic tuaj yeem muab txoj hauv kev tshiab los txhawb lub hlwb lub zog metabolism.
Los ntawm kev hloov lub hlwb lub zog tseem ceeb hauv txoj kev no, cov khoom noj ketogenic tshwm sim los txo qis lub zog hauv lub hlwb uas tshwm sim thaum haus cawv detoxification. Qhov no txhais li cas rau cov neeg sim rov qab los? Hauv kev siv cawv, peb paub tias nws txhais tau hais tias muaj kev txo qis hauv cov tsos mob thiab kev ntshaw.
Ib qho tseem ceeb heev hauv kev kho mob.
Thiab nrog rau lwm cov SUDs uas qhia txog thaj chaw ntawm lub hlwb hypometabolism, kuv twv nws ua rau koj xav paub tias kev noj zaub mov ketogenic tuaj yeem pab lawv li cas.
Neuroinflammation hauv Kev Siv Tshuaj: Yuav Ua Li Cas Ketogenic Diet Muab Kev Pabcuam
Neuroinflammation plays lub luag haujlwm tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm kev siv tshuaj yeeb tshuaj (SUDs) nrog rau kev cuam tshuam loj ntawm kev paub txog kev ua haujlwm thiab kev hloov pauv pathogenic hauv lub hlwb. Hauv cov neeg uas muaj teeb meem kev siv yeeb tshuaj, qee qhov ntawm lub cev tiv thaiv kab mob tuaj yeem ua dhau los thiab ua rau mob hauv lub hlwb. Qhov mob no tuaj yeem nce qib ntawm cov cim tshwj xeeb hauv lub cev uas ua rau muaj qhov mob, xws li TNF-α, IL-1, thiab IL-6.
Qhov no yog qhov tseem ceeb rau kev kho mob vim qhov mob hauv lub hlwb tuaj yeem cuam tshuam rau lub hlwb ua haujlwm li cas, thiab qhov no tuaj yeem cuam tshuam rau tib neeg txoj kev xav, kev xav, thiab kev coj cwj pwm. Rau cov neeg uas muaj teeb meem siv yeeb tshuaj, qhov mob no tuaj yeem ua rau muaj kev xav tau thiab ua rau nws nyuaj rau tsis siv tshuaj. Nws tseem tuaj yeem cuam tshuam rau kev nco, kev txiav txim siab, thiab kev tswj hwm kev xav, ua rau nws nyuaj rau kev tiv thaiv kev ntxhov siab thiab lwm yam kev cuam tshuam uas tuaj yeem ua rau rov qab los. Kev mob hlwb tuaj yeem ua rau txoj kev mus rau kev rov qab los nyuaj dua los ntawm kev cuam tshuam rau tus neeg lub peev xwm los xav kom meej, txiav txim siab zoo, thiab tswj kev ntshaw thiab kev xav.
Hauv lwm lo lus, qhov kev cuam tshuam ntawm cov teeb liab los ntawm qhov tsis tau kuaj xyuas lub hlwb o tuaj yeem cuam tshuam li cas lub hlwb ua haujlwm thiab ua rau cov tsos mob thiab kev loj hlob ntawm kev siv yeeb tshuaj. Inflammatory cytokines ntawm hom peb pom nyob rau hauv cov kab mob no tuaj yeem ua rau muaj kev hloov pauv tsis tu ncua hauv basal ganglia thiab dopamine (DA) muaj nuj nqi, uas tsis muaj kev txaus siab, qaug zog, thiab psychomotor qeeb. Nws kuj tseem tuaj yeem ua qhov tseem ceeb hauv kev ua rau txo qis cov lus teb rau cov khoom plig hedonic, txo DA metabolites, nce rov ua dua, thiab txo qis ntawm presynaptic DA. Cov lus teb inflammatory no tuaj yeem ua rau muaj txiaj ntsig los ntawm kev siv tshuaj yeeb thiab tshuaj rov qab los.
Lub basal ganglia thiab dopamine (DA) yog qhov tseem ceeb ntawm lub hlwb cov nqi zog, uas yog lub luag haujlwm rau kev zoo siab thiab kev txhawb siab.
Thaum cov cheeb tsam no cuam tshuam los ntawm kev mob, nws tuaj yeem cuam tshuam kev ua haujlwm ntawm qhov khoom plig. Lawv ua rau tsis muaj kev txaus siab los ntawm kev ua ub ua no uas ib zaug muaj kev lom zem (anhedonia), thiab kev nkees nkees ntxiv yuav txo tau tus neeg lub siab los koom nrog kev ua ub ua no. Peb txhua tus tau pom peb tus kheej lossis lwm tus nrog SUD raug kev txom nyem li no thaum lawv sim txwv tsis pub siv.
Kuv tsis xav kom koj xav tias qhov kev txom nyem uas mus nrog kev siv yeeb tshuaj yog txhua yam hais txog dopamine. Nws yog ib qho tseem ceeb kom nkag siab tias basal ganglia tseem koom nrog kev paub thiab kev xav. Kev mob tshwm sim tuaj yeem cuam tshuam rau cov txheej txheem no, ua rau muaj kev xav tsis zoo thiab kev xav tsis zoo uas peb pom hauv cov neeg raug kev txom nyem los ntawm cov teeb meem no.
Kuv tsis xav tso koj tseg nrog qhov kev xav tias Kev Siv Dej Haus Dej Haus yog tib yam Kev Siv Khoom Siv Teebmeem uas ua rau muaj kev cuam tshuam rau cov mob neuroinflamation. Lub paj hlwb nrog lwm yam kev siv tshuaj yeeb dej caw (SUDs) dhau li ntawm kev siv cawv (AUD) tuaj yeem pom cov tsos mob ntawm o. Ntau yam kev tsim txom, xws li opioids, cocaine, thiab methamphetamine, tau pom nyob rau hauv cov ntaub ntawv tshawb fawb kom nce neuroinflamation.
Hmoov zoo, kev noj zaub mov ketogenic (KD) tau pom tias ua lub luag haujlwm tiv thaiv neuroprotective hauv SUDs los ntawm kev txo qis neuroinflammation.
Cov tib neeg nrog AUD uas tau ua raws li kev noj zaub mov ketogenic (KD) - noj zaub mov muaj rog thiab qis hauv carbohydrates - pom cov qib qis ntawm cov cim inflammatory piv rau cov uas ua raws li kev noj haus American (SA). Qhov no qhia tau hais tias KD tuaj yeem ua tau zoo hauv kev txo cov mob hlwb.
Dhau li ntawm lub zog substrates, KBs kuj tseem ua haujlwm zoo li intracellular signaling mediators, uas koom nrog hauv intracellular signaling cascades thiab tswj neuroinflammation ncaj qha lossis tsis ncaj, tshwj xeeb tshaj yog βHB.
Jiang, Z., Yin, X., Wang, M., Chen, T., Wang, Y., Gao, Z., & Wang, Z. (2022). Kev cuam tshuam ntawm kev noj haus ketogenic ntawm neuroinflamation hauv cov kab mob neurodegenerative. Kev laus thiab kab mob, 13(4), 1146. https://doi.org/10.14336/AD.2021.1217
Metabolism yog cov txheej txheem ntxhov siab. Tshwj xeeb tshaj yog tias koj tso siab rau cov roj xws li qabzib. Ketogenic noj cov zaub mov hloov cov metabolism los ntawm kev cia siab rau cov piam thaj mus rau kev siv ketones ua lub zog tseem ceeb, uas txhais tau hais tias txo qis hauv kev tsim cov tshuaj tiv thaiv kab mob thiab kev xav tau ntau ntxiv hauv kev tsim cov tshuaj tiv thaiv kab mob. Ketone metabolism yog "ntxhiab," ua kom tsawg ntawm ROS mess, thiab tsim kev puas tsuaj tsawg rau lub hlwb uas muaj teeb meem nrog.
Kev noj haus ketogenic kuj muaj cov tshuaj tiv thaiv kab mob ncaj qha uas muaj zog heev. Lawv ua qhov no los ntawm kev hloov kho ntau yam kev mob tshwm sim. Ib qho piv txwv yog lub peev xwm ntawm kev noj zaub mov kom txwv tsis pub txoj hauv kev NF-κB thiab txo cov kev tsim tawm ntawm cov cytokines xws li qog necrosis factor-alpha (TNF-α) thiab interleukin-6 (IL-6), uas koom nrog. cov inflammatory teb.
βHB tuaj yeem khi rau HCA2 ntxiv rau inhibit kev tsim cov cytokines thiab enzymes ntawm txoj kev NF-κB hauv kev ua haujlwm thawj microglia pretreated nrog βHB thiab txhawb nqa nrog lipopolysaccharide (LPS)
Jiang, Z., Yin, X., Wang, M., Chen, T., Wang, Y., Gao, Z., & Wang, Z. (2022). Kev cuam tshuam ntawm kev noj haus ketogenic ntawm neuroinflamation hauv cov kab mob neurodegenerative. Kev laus thiab kab mob, 13(4), 1146. https://doi.org/10.14336/AD.2021.1217
Lub plab microbiome kuj tseem ua lub luag haujlwm tseem ceeb hauv kev tswj kev mob. Qee cov kab mob hauv plab tuaj yeem tsim cov tshuaj metabolites uas muaj cov tshuaj tiv thaiv kab mob, thaum lwm tus tuaj yeem tsim cov metabolites uas muaj cov teebmeem inflammatory. Kev noj zaub mov ketogenic yog qhov muaj npe nrov rau nws lub peev xwm los hloov cov kab mob hauv plab microbiome, cuam tshuam rau kev tsim cov metabolites thiab tom qab hloov kho qhov mob. Kev noj zaub mov tau pom tias muaj ntau cov kab mob uas muaj txiaj ntsig zoo uas tsim cov kab mob luv luv fatty acids (SCFAs) los pab tsim cov tshuaj tiv thaiv kab mob.
Kev txo qis hauv qhov mob muaj qhov cuam tshuam ncaj qha rau theem ntawm oxidative kev nyuaj siab lub hlwb yuav tsum tau nyiaj, uas coj peb mus rau ntu tom ntej ntawm tsab xov xwm no. Yog tias koj tsis meej pem me ntsis txog qhov sib txawv ntawm qhov mob thiab oxidative kev nyuaj siab thiab lawv cuam tshuam li cas, kuv xav kom tsab xov xwm no los pab tshem tawm ua ntej koj mus nrog koj nyeem nws cov lus.
Sib ntaus sib tua Oxidative Stress thiab Mitochondrial Dysfunction: Lub luag haujlwm tiv thaiv ntawm Ketogenic noj zaub mov hauv kev siv tshuaj tsis zoo
Kev ntxhov siab oxidative tshwm sim thaum muaj qhov tsis sib xws ntawm kev tsim cov ROS thiab lub cev muaj peev xwm los tshem tawm cov teeb meem molecules. Qhov sib npaug ntawm kev tsim cov pa oxygen reactive (ROS) thiab lub cev muaj peev xwm los daws qhov kev puas tsuaj uas lawv ua yog hu ua oxidative stress.
Peb puas pom oxidative kev nyuaj siab hauv kev siv yeeb tshuaj? Koj bet peb ua!
Peb qhov kev soj ntsuam tau pom tias cov neeg uas muaj SUD pom cov cim oxidant siab dua thiab cov cim antioxidant qis dua li kev tswj hwm kev noj qab haus huv.
Viola, TW, Orso, R., Florian, LF, Garcia, MG, Gomes, MGS, Mardini, EM, … & Grassi-Oliveira, R. (2023). Cov txiaj ntsig ntawm kev siv tshuaj tsis zoo ntawm oxidative thiab antioxidative stress markers: Kev tshuaj xyuas thiab kev tshuaj xyuas meta. Tshuaj Biology, 28(1), e13254. https://doi.org/10.1111/adb.13254
Yog li, nws txhawb kom paub tias kev noj zaub mov ketogenic muaj txiaj ntsig zoo rau lub cev tiv thaiv kab mob antioxidant, suav nrog kev txhim kho ntawm superoxide dismutase (SOD2). Superoxide dismutase (SOD) yog ib tsev neeg ntawm cov enzymes uas catalyze dismutation ntawm superoxide rau oxygen thiab hydrogen peroxide. Tsis yog qhov xav tsis thoob, SOD2 (aka MnSOD) yog ib daim ntawv ntawm SOD uas nyob hauv mitochondria, thiab nws txoj haujlwm tag nrho yog los tiv thaiv mitochondria los ntawm oxidative kev nyuaj siab. Yog li, los ntawm kev tswj hwm SOD2, kev noj zaub mov ketogenic pab txhawm rau txhawm rau tshem tawm cov superoxide radicals, uas yog lub hauv paus loj ntawm oxidative kev nyuaj siab, thiab tiv thaiv mitochondrial muaj nuj nqi.
Raws li yog tias qhov tsis txaus ntseeg txaus, kev noj zaub mov ketogenic tau pom tias yuav ua rau muaj glutathione ntau ntxiv. Glutathione yog ib qho muaj zog antioxidant tsim los ntawm koj lub cev uas ua kom koj muaj kev tiv thaiv ntawm tes tiv thaiv oxidative kev nyuaj siab.
Glutathione muaj peb cov amino acids: cysteine, glycine, thiab glutamate. Nws muaj ntau txoj haujlwm! Nws pab tsav lub detoxification ntawm cov teeb meem tshuaj, kev saib xyuas ntawm cellular redox tshuav nyiaj li cas, thiab tiv thaiv cov hlwb los ntawm kev puas tsuaj los ntawm dawb radicals thiab peroxides.
NADPH, ntawm qhov tod tes, yog coenzyme uas ua lub luag haujlwm tseem ceeb hauv lub cev metabolism. Nws koom nrog hauv biosynthesis ntawm fatty acids thiab steroids, nrog rau kev tsim kho ntawm glutathione. Qhov nce hauv NADPH ua kom muaj cov khoom txaus ntawm cov coenzyme no los txhawb lub cev tiv thaiv kab mob antioxidant. Thiab nws tsuas yog tshwm sim uas kev tshawb fawb tau pom tias cov khoom noj ketogenic upregulate nce hauv NADPH.
Ua ke, cov khoom no ua haujlwm sib koom ua ke los tsim kom muaj lub zog tiv thaiv kab mob uas pab tswj cov cellular kev ncaj ncees thiab tiv thaiv kev puas tsuaj los ntawm oxidative kev nyuaj siab, ntxiv illuminating lub hauv paus mechanisms uas ketogenic noj zaub mov pab cov tib neeg nrog SUDs. Los ntawm kev txhawb nqa lawv lub peev xwm antioxidant thiab tiv thaiv kev puas tsuaj oxidative, kev noj haus ketogenic yog qhov tseem ceeb hauv kev muab qib kev tiv thaiv uas tam sim no kws tshuaj tsis tuaj yeem.
Ntxiv nrog rau cov kev cuam tshuam tiag tiag ntawm cov tshuaj tua kab mob antioxidant, cov zaub mov ketogenic kuj txhim kho mitochondrial muaj nuj nqi thiab txo oxidative kev nyuaj siab. Kev noj zaub mov txhawb ntau txoj hauv kev, txhawb nqa cov protein tseem ceeb koom nrog hauv oxidative phosphorylation system, Krebs cycle, thiab fatty acid oxidation. Qhov no ua rau muaj kev nce hauv mitochondrial kev ua ub no thiab, tshwj xeeb tshaj yog, kev nce hauv mitochondrial uncoupling proteins (UCPs), uas tiv thaiv mitochondria los ntawm oxidative raug mob thiab ua tsis taus pa.
Qhov no nce hauv UCPs, nrog rau kev txhim kho ntawm peroxisome proliferator-activated receptor γ (PPARγ) coactivator 1α (PGC-1α), txhawb nqa mitochondrial kev noj qab haus huv thiab kev ua haujlwm. Yog tias koj tsis paub tias cov ntawv sau ntawv txhais li cas, tsis txhob txhawj. Lub ntsiab lus ntawm nws yog PPARγ thiab PGC-1α yog ob hom kev hloov pauv, uas txhais tau hais tias lawv yog cov proteins uas pab tig cov noob tshwj xeeb rau lossis tawm los ntawm kev khi rau DNA nyob ze. Qhov txias tshaj plaws yog tias lawv yog cov muaj zog modulators ntawm oxidative kev nyuaj siab. Thaum ua haujlwm, PPARγ tuaj yeem ua rau kom muaj kev nthuav tawm ntawm cov enzymes antioxidant thiab txo qis kev tsim cov cytokines pro-inflammatory, yog li ua rau txo qis oxidative kev nyuaj siab thiab mob hauv lub cev. PGC-1α ua haujlwm ua tus tswj hwm ntawm cov kab mob antioxidant kom ntseeg tau tias cov tshuaj tiv thaiv antioxidant tau npaj los daws cov kev ntxhov siab oxidative uas yuav tshwm sim.
Tab sis tej zaum koj yuav tsis ntseeg kuv thaum kuv qhia koj tias tseem muaj lwm txoj hauv kev los ntawm kev noj zaub mov Ketogenic (KD) pab txhawm rau khaws oxidative kev nyuaj siab hauv kev txheeb xyuas. Lawv tau pom ntxiv los hloov cov qib adenosine hauv lub hlwb, sib tham txog cov teebmeem neuroprotective thiab antiepileptogenic. Adenosine yog ib qho tseem ceeb neurotransmitter uas pab tiv thaiv qaug dab peg thiab tiv thaiv lub hlwb los ntawm kev puas tsuaj. Los ntawm kev nce qib adenosine, KD txhim kho lub hlwb cov txheej txheem tiv thaiv ntuj thiab tiv thaiv los ntawm cov kev ntxhov siab hauv paj hlwb, ntxiv rau lwm txheej rau cov txiaj ntsig zoo ntawm KD hauv kev tawm tsam oxidative kev nyuaj siab thiab txhawb lub hlwb sim rov qab los ntawm SUD.
Neurotransmitters thiab Reward Systems hauv SUDs: Txoj Cai Sib npaug ntawm Ketogenic Noj Qab Haus Huv
Kev siv tshuaj tsis zoo (SUDs) yog cov xwm txheej nyuaj uas muaj kev sib cuam tshuam ntawm caj ces, ib puag ncig, thiab neurobiological yam. Peb paub tias lub hlwb cov nqi zog ua lub luag haujlwm hauv kev txhim kho thiab kev saib xyuas ntawm SUDs. Neurotransmitters (NTs) yog cov neeg xa xov chemical uas xa cov teeb liab uas tsav cov nqi zog hauv lub hlwb, thiab kev hloov pauv hauv cov tshuab no tuaj yeem pab txhawb kev txhim kho SUDs.
Kev quav yeeb quav tshuaj yog cov txheej txheem tseem ceeb uas cuam tshuam txog kev siv tshuaj yeeb dej caw, thiab kev tshawb fawb siv cov qauv tsiaj thiab tib neeg tau nthuav tawm cov kev nkag siab tseem ceeb rau hauv neural circuits thiab molecules uas kho kev quav yeeb quav tshuaj.
Kalin, NH (2020). Kev siv tshuaj tsis haum thiab kev quav tshuaj: cov txheej txheem, cov qauv, thiab kev cuam tshuam kev kho mob. American Journal of Psychiatry, 177(11), 1015-1018. https://doi.org/10.1176/appi.ajp.2020.20091382
Peb twb tau tham txog Dopamine (DA) hauv lwm qhov chaw ntawm tsab xov xwm no, tab sis kuv coj nws rov qab los hauv kev sib tham txog nws lub luag haujlwm hauv cov theem pib ntawm kev quav tshuaj vim nws yog ib qho tseem ceeb ntawm cov txiaj ntsig zoo ntawm cov tshuaj. Raws li kev siv yeeb tshuaj nce ntxiv, glutamatergic projections ua kom pom tseeb. Glutamate, thawj excitatory NT nyob rau hauv lub hlwb, koom nrog hauv cov kev hloov pauv hauv neuroplasticity uas txo qis tus nqi ntawm cov khoom plig, txo qis kev txawj ntse, thiab txhawb kev coj cwj pwm nrhiav tshuaj. Dysregulation ntawm glutamate homeostasis yog ib qho tseem ceeb neurometabolic feature ntawm SUDs.
Qee tus nqi ntawm glutamate yuav tsum tau ua tiav rau hauv inhibitory transmitter GABA, tab sis kev hloov pauv hauv GABAergic systems feem ntau pom hauv SUD tuaj yeem ua rau muaj kev ntxhov siab thiab kev ntxhov siab, ua rau muaj kev cuam tshuam ntau ntxiv. Qhov kev cuam tshuam ntawm tag nrho cov theem ntawm inhibitory kev ua si hauv lub hlwb, tseem ceeb heev rau kev tswj kom muaj qhov sib npaug ntawm excitation thiab inhibition, pab txhawb rau kev siv tshuaj tsis zoo. Ntxiv NT systems, xws li serotonin, epinephrine, thiab norepinephrine, kuj cuam tshuam rau SUDs, ua rau muaj kev ntxhov siab thiab ntxhov siab thiab ua rau lub voj voog ntawm kev quav tshuaj.
Ib zaug ntxiv, kev noj zaub mov ketogenic ntau yam tuaj yeem ua rau muaj kev cia siab. Los ntawm kev hloov kho cov qib ntawm cov NTs no thiab txhim kho lub hlwb lub zog metabolism, cov khoom noj ketogenic tuaj yeem pab rov qab sib npaug hauv lub hlwb cov nqi zog circuitry thiab txo qis kev ntshaw rau cov khoom tsim txom. Piv txwv li, kev noj zaub mov tau pom tias ua kom GABA muaj nuj nqi, uas tuaj yeem pab txo kev ntxhov siab thiab ntxhov siab thiab txhim kho lub siab. Nws kuj tau pom tias yuav hloov kho glutamate, serotonin, thiab dopamine qib, uas tuaj yeem ua rau lub siab tsis zoo thiab txo cov kev xav tsis zoo uas feem ntau pom hauv SUDs.
Nws ua li no li cas? Peb tsis paub tag nrho, tab sis peb paub tias cov khoom noj ketogenic muaj kev cuam tshuam rau lub hlwb kev tswj hluav taws xob hauv cov neurons, uas ncaj qha cuam tshuam rau kev ua haujlwm ntawm cov kab mob neurotransmitter. Kev tswj hluav taws xob hauv cov neurons yog qhov tseem ceeb rau kev ua haujlwm ntawm lub hlwb thiab yog tsim los ntawm ion channels thiab synaptic receptors. Cov dej num hluav taws xob no yog cov txheej txheem tseem ceeb uas ua rau kev tso tawm thiab txais cov neurotransmitters ntawm synapses.
Piv txwv li, thaum muaj peev xwm ua tau mus txog lub synapse, nws ua rau kev tso tawm ntawm cov neurotransmitters, uas tom qab ntawd khi rau synaptic receptors ntawm postsynaptic neuron. Qhov kev khi no ua rau muaj kev hloov pauv hauv daim nyias nyias thiab cov khoom siv hluav taws xob ntxiv. Kev ua haujlwm zoo ntawm cov kab ke no yog qhov tseem ceeb rau lub hlwb cov nqi zog circuitry, uas feem ntau dysregulated hauv SUDs.
Kev noj zaub mov cuam tshuam rau cov tswj hluav taws xob hauv lub hlwb, suav nrog ATP-sensitive K + channels, voltage-dependent Ca2+ channels, AMPA-type glutamate receptors, thiab adenosine A1 receptors, thiab lwm yam. Tsis txhob cia tag nrho cov lus zoo nkauj no koj tuaj yeem lossis tsis paub cuam tshuam koj. Cov no yog cov tswj hwm muaj zog uas ua haujlwm ua ke txhawm rau txhawm rau cuam tshuam neuronal inhibition thiab txhim kho cov kua dej ntawm cov cell membranes, ua rau muaj txiaj ntsig zoo dua neurotransmitter signaling. Qhov no yog ib txoj hauv kev los cuam tshuam cov khoom noj ketogenic cuam tshuam ncaj qha rau kev ua haujlwm ntawm cov kab mob neurotransmitter, pab kom ntseeg tau tias kev tso tawm thiab txais cov neurotransmitters ntawm synapses.
Yog li, thaum kuv qhia koj tias kev noj zaub mov ketogenic muaj ntau txoj hauv kev los hais txog NT qhov tsis sib xws thiab kev ua haujlwm tsis zoo uas pom hauv SUDs, koj yuav tsis, ntawm qhov no, xav tsis thoob. Lub cev loj hlob ntawm cov pov thawj txhawb nqa cov txiaj ntsig ntawm kev noj zaub mov ketogenic hauv kev kho lwm yam mob hlwb thiab mob hlwb ntxiv ntxiv rau nws cov peev xwm hauv kev hais txog kev sib cuam tshuam ntawm NT tsis ua haujlwm hauv SUDs.
xaus
Yog tias koj lossis ib tus neeg koj hlub raug kev txom nyem los ntawm SUDs, koj paub txog lub nra uas nws ua rau tib neeg, tsev neeg, thiab tib neeg tag nrho. Nws dhau los ua qhov tseem ceeb uas peb tshawb nrhiav thiab siv cov kev cuam tshuam zoo uas tuaj yeem ua rau muaj kev sib txawv hauv lub neej ntawm cov neeg cuam tshuam. Kev noj haus ketogenic, nrog rau nws cov kev cuam tshuam ntau yam ntawm lub hlwb, muaj kev cia siab. Nws tsis yog tsuas yog hloov pauv kev noj haus xwb, tab sis yog lub cuab yeej kho mob muaj zog uas tuaj yeem hais txog lub hauv paus ntawm lub cev ua rau SUDs thiab pab txhawb kev rov qab mus ntev.
Yog li ntawd, nws yog kuv qhov kev sib cav hais tias cov khoom noj ketogenic yuav tsum tau muab los ua tus qauv kev kho mob hauv txhua qhov chaw kho mob. Tsis tas li ntawd, nws yog ib qho tseem ceeb uas cov kws kho mob thiab cov kws pab tswv yim txog kev quav yeeb quav tshuaj tau txais kev kawm txuas ntxiv ntawm cov txiaj ntsig thiab kev siv cov khoom noj ketogenic hauv kev kho mob ntawm SUDs. Qhov no yuav ua kom ntseeg tau tias lawv tau txais txiaj ntsig zoo los muab qhov kev cuam tshuam tseem ceeb rau lawv cov neeg mob, thaum kawg ua rau muaj txiaj ntsig zoo dua hauv kev kho mob SUDs.
Kev noj zaub mov ketogenic sawv cev rau kev hloov pauv hauv peb txoj hauv kev los kho SUDs. Los ntawm kev hais txog qhov cuam tshuam ntawm metabolic tsis txaus thiab ua haujlwm tsis zoo uas ua rau muaj kev txhim kho thiab kev saib xyuas ntawm SUDs, ketogenic noj zaub mov muaj kev cuam tshuam zoo thiab muaj txiaj ntsig uas tuaj yeem ua qhov sib txawv hauv lub neej ntawm cov neeg cuam tshuam. Nws yog kuv qhov kev cia siab tias tsab xov xwm no piav qhia txog cov pov thawj raws li txoj hauv kev no yuav yog qhov tseem ceeb hauv nws qhov kev hloov pauv dav dav thiab kev koom ua ke rau hauv tus qauv kev saib xyuas rau SUDs, thaum kawg pab txhawb rau lub neej yav tom ntej zoo rau cov neeg tawm tsam nrog kev quav yeeb quav tshuaj.
Yog tias koj, lossis ib tus neeg koj hlub, xav koom nrog hauv kev sim tshuaj uas nrhiav cov neeg ntawm no:
https://clinicaltrials.gov/search?cond=Substance%20Use%20Disorder&intr=Ketogenic%20Diet
Tab sis tsis txhob xav tias koj yuav tsum tau tos qhov kev sim tshuaj kom tau txais txiaj ntsig. Koj tuaj yeem cia siab tias yuav nrhiav tau lub chaw kho mob nyob ze koj (lossis tsis nyob ze koj) siv cov khoom noj ketogenic rau Kev Siv Khoom Siv Teebmeem (SUD), lossis koj tuaj yeem rub ua ke koj tus kheej pab pawg kho mob los ntawm cov kws kho mob ketogenic metabolic, cov kws kho mob hlwb, thiab kev kho mob. tus kws tshaj lij uas tuaj yeem pab kho cov tshuaj.
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Kuv yuav nrhiav tau lub chaw kho mob nyob ze kuv li cas uas koom nrog Keto? Ua tsaug
Nyob zoo Katherine, Kuv tsis paub dab tsi! Tab sis kuv vam tias ib tug neeg tsim ib daim ntawv teev npe thaum lawv pib tawm. Thiab koj tuaj yeem ua haujlwm nrog tus kws kho mob ua ntej lossis thaum rov qab los. Lub chaw kho mob yuav zoo tagnrho, tab sis nrhiav tus kws kho mob uas paub txog qhov cuam tshuam ntawm kev noj zaub mov ketogenic thiab ua haujlwm nrog ib tus neeg tuaj yeem pab ncaj qha rau kev noj zaub mov tuaj yeem ua haujlwm tau zoo.