ʻOi aku ka nui o ka pōʻino o ka lolo i nā maʻi COVID-19 ma mua o nā maʻi o Alzheimer

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ʻO nā mea maʻi i mālama ʻia i ka haukapila no COVID-19 he kiʻekiʻe kiʻekiʻe ma luna o ka manawa pōkole o nā protein koko i ʻike ʻia e piʻi me ka pōʻino neurological ma mua o nā mea maʻi non-COVID-19 i loaʻa i ka maʻi o Alzheimer, kahi noiʻi hou i ʻike ai.

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ʻO ka mea nui, ʻo ka hōʻike o kēia manawa, i paʻi ʻia ma ka pūnaewele Ianuali 13 ma Alzheimer's & Dementia: The Journal of the Alzheimer's Association, i mālama ʻia ma mua o ʻelua mau mahina ma mua o ka maʻi maʻi (Malaki-Mei 2020). ʻO ka hoʻoholo ʻana o ka poʻe maʻi me COVID-19 i ka nui o ka pilikia no ka maʻi o Alzheimer e hiki mai ana, a i ʻole ke ola hou ʻana i ka manawa, pono e kali i nā hopena o nā haʻawina lōʻihi.

Alakaʻi ʻia e nā mea noiʻi ma NYU Grossman School of Medicine, ua ʻike ka noiʻi hou i nā pae kiʻekiʻe o ʻehiku mau hōʻailona o ka pōʻino o ka lolo (neurodegeneration) i nā maʻi maʻi COVID-19 me nā hōʻailona neurological ma mua o ka poʻe me ka ʻole o lākou, a ʻoi aku ka nui o nā pae kiʻekiʻe o nā maʻi i make i ka haukapila. i ka poʻe i hoʻokuʻu ʻia a hoʻouna ʻia i ka home.

Ua ʻike ʻia kahi loiloi ʻelua i kahi ʻāpana o nā hōʻailona hōʻino i nā mea maʻi i hoʻopaʻa ʻia me COVID-19, i ka wā pōkole i ʻoi aku ka kiʻekiʻe ma mua o nā mea maʻi i loaʻa i ka maʻi Alzheimer, a i hoʻokahi hihia ʻoi aku ma mua o ʻelua mau manawa. 

"Ke hōʻike nei kā mākou ʻike i ka poʻe maʻi i hoʻokipa ʻia no COVID-19, a ʻoi aku hoʻi i ka poʻe e ʻike nei i nā hōʻailona neurological i ka wā o ko lākou maʻi maʻi maʻi, hiki ke loaʻa nā pae o nā hōʻailona hōʻeha lolo e like me ke kiʻekiʻe, a ʻoi aku paha ma mua o ka poʻe i ʻike ʻia i nā maʻi me ka maʻi o Alzheimer," wahi a ka mea kākau alakaʻi ʻo Jennifer A. Frontera, MD, ke kaukaʻi ma ka 'Oihana Neurology ma NYU Langone Health. 

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Ua ʻike ʻia ka noiʻi o kēia manawa he 251 mau mea maʻi, ʻoiai he 71 mau makahiki ma ka awelika, ʻaʻohe moʻolelo a i ʻole nā ​​​​hōʻailona o ka emi ʻana o ka cognitive a i ʻole dementia ma mua o ka hale hoʻokipa no COVID-19. Ua hoʻokaʻawale ʻia kēia mau maʻi i nā pūʻulu me ka ʻole o nā hōʻailona neurological i ka wā o ko lākou maʻi maʻi COVID-19, i ka wā i hoʻōla ai nā mea maʻi a hoʻokuʻu ʻia, a make paha.

ʻO ka hui noiʻi pū kekahi, inā hiki, hoʻohālikelike i nā pae hōʻailona ma ka hui COVID-19 i nā mea maʻi i ka NYU Alzheimer's Disease Research Center (ADRC) Clinical Core cohort, kahi hoʻopaʻa hoʻomau lōʻihi ma NYU Langone Health. ʻAʻohe o kēia 161 mau maʻi hoʻomalu (54 cognitively maʻamau, 54 me ka haʻahaʻa cognitive impairment, a me 53 i loaʻa i ka maʻi o Alzheimer) i COVID-19. Ua ana ʻia ka ʻeha o ka lolo me ka hoʻohana ʻana i ka ʻenehana hoʻokahi molecule array (SIMOA), hiki ke nānā i nā minuke koko o nā māka neurodegeneration i nā picograms (hoʻokahi trillionth o ka gram) no ka mililita o ke koko (pg/ml), kahi i hiki ʻole ai i nā ʻenehana kahiko.

ʻEkolu o nā hōʻailona noiʻi - ubiquitin carboxy-terminal hydrolase L1 (UCHL1), total tau, ptau181 - i ʻike ʻia nā ana o ka make a i ʻole ke kīnā ʻana o nā neurons, nā cell e hiki ai i nā ala nerve ke lawe i nā leka. Hoʻonui ka pae o ka neurofilament light chain (NFL) me ka pōʻino i nā axons, nā hoʻonui o nā neurons. ʻO Glial fibrillary acidic protein (GFAP) kahi ana o ka pōʻino i nā pūnaewele glial, e kākoʻo ana i nā neurons. ʻO Amyloid Beta 40 a me 42 nā protein i ʻike ʻia e kūkulu ʻia i nā maʻi maʻi Alzheimer. Ua hoʻopaʻapaʻa nā hualoaʻa o nā haʻawina i hala, ʻo ka nui o ka tau a me ka phosphorylated-tau-181 (p-tau) kekahi mau ana kikoʻī o ka maʻi o Alzheimer, akā ʻo kā lākou kuleana i ka maʻi e hoʻopaʻapaʻa. 

Ua ana ʻia nā māka koko i loko o ka hui maʻi COVID i ka serum koko (ʻo ka ʻāpana wai o ke koko i hana ʻia e hoʻopaʻa ʻia), aʻo ka poʻe i loko o ke aʻo ʻana a Alzheimer ua ana ʻia i loko o ka plasma (ka ʻāpana koko wai e waiho ʻia i ka wā e pale ʻia ai ka clotting). No nā kumu ʻenehana, ʻo ka ʻokoʻa ka manaʻo e hiki ke hoʻohālikelike ʻia nā pae NFL, GFAP, a me UCHL1 ma waena o ka hui COVID-19 a me nā mea maʻi i ke aʻo ʻana o Alzheimer, akā hiki ke hoʻohālikelike ʻia ka huina tau, ptau181, Amyloid beta 40, a me ka amyloid beta 42 i loko. ka hui maʻi COVID-19 (nā hōʻailona neuro a i ʻole; make a hemo paha).

Eia kekahi, ʻo ke ana nui o ka pōʻino neurological i nā maʻi maʻi COVID-19 he toxic metabolic encephalopathy, a i ʻole TME, me nā hōʻailona mai ka huikau a coma, a i hoʻokumu ʻia i ka wā o nā maʻi koʻikoʻi e nā toxins i hana ʻia e like me ka overreacts o ka ʻōnaehana pale (sepsis), hāʻule nā ​​​​kiʻi (uremia) , a ua pilikia ka hāʻawi ʻana o ka oxygen (hypoxia). ʻO keʻano kūikawā,ʻo ka piʻiʻana o ka pākēneka maʻamau i nā pae o nā hōʻailonaʻehiku no nā poʻe maʻi maʻi me ka TME i hoʻohālikelikeʻia me ka poʻe me kaʻole o nā hōʻailona neurological (helu 2 i ka haʻawina) he 60.5 pakeneka. No nā hōʻailona like i loko o ka hui COVID-19, ʻoi aku ka nui o ka pākēneka i ka hoʻohālikelike ʻana i ka poʻe i hoʻokuʻu ʻia i ka home mai ka haukapila i ka poʻe i make i ka haukapila he 124 pakeneka.

Ua hele mai kahi lua o nā ʻike mai ka hoʻohālikelike ʻana i nā pae NFL, GFAP a me UCHL1 i ka serum o nā mea maʻi COVID-19 e kūʻē i nā pae o nā hōʻailona like i ka plasma o nā mea maʻi non-COVID Alzheimer (kiʻi 3). ʻO ka NFL ma luna o ka manawa pōkole 179 pakeneka kiʻekiʻe (73.2 versus 26.2 pg / ml) i nā mea maʻi COVID-19 ma mua o nā maʻi maʻi o Alzheimer. ʻO GFAP he 65 pākēneka kiʻekiʻe (443.5 versus 275.1 pg/ml) i nā maʻi maʻi COVID-19 ma mua o nā maʻi maʻi o Alzheimer, ʻoiai ʻo UCHL1 he 13 pākēneka kiʻekiʻe (43 versus 38.1 pg/ml).

"ʻO kaʻeha lolo traumatic, i pili pū me ka piʻiʻana o kēia mau biomarkers,ʻaʻole ia he manaʻo e ulu ka mea maʻi i ka Alzheimer a iʻole ka dementia pili ma hope aku, akā e hoʻonui i ka pilikia o ia mea," wahi a ka mea kākau kiʻekiʻeʻo Thomas M. Wisniewski, MD, ka Gerald J. a me Dorothy R. Friedman Polofesa ma ka 'Oihana o Neurology a me ka luna o ka Center for Cognitive Neurology ma NYU Langone. "Inā loaʻa kēlā ʻano pilina i ka poʻe e ola ana i ka COVID-19 he nīnau a mākou e pane koke ai me ka nānā mau ʻana i kēia mau maʻi."

Me Dr. ʻO Frontera a me Wisniewski, NYU Langone Health nā mea kākau i komo i ka mea kākau mua ʻo Allal Boutajangout, Arjun Masurkarm, Yulin Ge, Alok Vedvyas, Ludovic Debure, Andre Moreira, Ariane Lewis, Joshua Huang, Sujata Thawani, Laura Balcer, a me Steven Galetta. ʻO Rebecca Betensky kekahi mea kākau ma New York University School of Global Public Health. Hāʻawi kālā ʻia kēia haʻawina e kahi haʻawina mai ka National Institute on Aging COVID-19 administrative supplement 3P30AG066512-01.

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