Neurogenic kuvhiringidzika, kana kuti NI, ndiyo nzira yehupenyu apo vamiririri vanobudiswa zvakananga kubva mumitsipa yakagadzikana kuti vatange kupinduka kwekupindura. Izvi zvinoguma mukusika kwemaitiro ekuvhiringidza kwemukati kusanganisira, erythema, kurerema, kuwedzera kwekushisa, kusuruvara, uye kurwadziwa. Zvakanaka zvisingatauri zvakasiyana-siyana zvinokonzerwa neC-fibers, iyo inopindura kune yakadzika masimba uye makemikari anokurudzira, inonyanya kukonzera kusunungurwa kwevanoratidzirwa.

 

Kana yakagadziriswa, idzi nerve dzemigwagwa mumutsara unocheka unobudisa nerpetic neuropeptides, kana kuti p P uye calcitonin gene inonzi peptide peptide (CGRP), nekukurumidza kupinda mu microenvironment, zvichikonzera ruzhinji rwemhinduro dzinoputika. Pane kusiyanisa kwakanyanya mukuputika kwemumunogenic, iyo ndiyo yekutanga yekudzivirirwa uye yekugadzirisa mhinduro inogadzirwa nehutachiona hwemuviri apo pathogen inopinda mumuviri, asi kuputika kweurophenesi kunosanganisira kuwirirana kwakananga pakati pehutano hwemagetsi nemhinduro dzinopisa. Kunyange zvazvo kuora kweurophenesi uye kuzvirwisa kwezvirwere zvinogona kuitika panguva imwe chete, izvo zviviri hazvisi zvekliniki zvisingazivikanwi. Chinangwa chechinyorwa chiri pasi apa ndechekukurukurirana maitiro ekutsvaira kweyeurogenic uye nhengo dzenherera dzenheyo dzemuitiro wekuchengetedzwa kwemauto uye immunopathology.

 

Neurogenic Kuzvimba Iyo Peripheral Inotyisa Sisitimu Iri Basa Mukuchengetedza Kudzivirira uye Immunopathology

 

ngovepo

 

Izvo zvese zvinotyisa uye zvirwere zvekudzivirira zvirwere zvinowanzofungidzirwa sekushumira mabasa akasiyana. Uyu mutsara, zvisinei, unowedzera kuwirirana nehutsva hutsva muhutachiona hwekurohwa. Nociceptor neurons inowanzova nemafungiro eomwechete ekuzivikanwa nzira dzengozi semasero ezvirwere zvekuzvidzivirira uye pakupindura njodzi, chirwere chendangariro chinopararira chinotaura zvakananga nemusununguko wechirwere chemuviri, zvichiumba maitiro akadzivirira ekudzivirira. Dense innervation yekubatanidza kwehutano nehutongi hwemagetsi mumakumbo ehutachiona uye nekukurumidza kwevheinural transduction inobvumira kutsvaga kwepakati uye systemic neurogenic kutengesa kwezvirwere. Peripheral neurons inoratidzika kuti inobatsira zvikuru mukudzivirira kwezvirwere mumuviri wega uye zvirwere zvinotapukira. Nokudaro, kunzwisisa kutaurirana kwakarongeka kweperiipheral neuron nema immune masero kunogona kufambisa nzira dzekurapa yekuwedzera vagadzivirira nekudzivisa immunopathology.

 

ziviso

 

Makore zviuru zviviri apfuura, Celsus akatsanangura kuzvimba sekusanganisa mana makadhiin'i -Doror (kurwadziwa), Calor (kupisa), Rubor (kutsvuka), uye Tumor (kuzvimba), kucherechedzwa kunoratidza kuti kumisikidza kwenzira kwakazivikanwa sekubatanidzwa kuzvimba. Zvisinei, kurwadziwa kwave kuchinyanya kufungidzirwa kubvira ipapo, chete sechiratidzo, uye kwete kutora chikamu muchizvarwa chekuputika. Mune maonero aya, isu tinoratidza kuti yekumusoro huta system inoitisa yakanangana uye inoshanda basa mukugadzirisa hutachiona hwekuzvarwa nehunhu, zvekuti immune system uye hunyanzvi masisitimu anogona kuve neakajairika akabatanidzwa ekudzivirira basa mune yekudzivirira yekuchengetedza uye mhinduro kune kukuvara kwetishu, yakaoma kudyidzana uko zvakare kunogona kutungamira kuchirwere muzvirwere zvemuviri uye zvemuviri.

 

Kupona kwezvinhu zvipenyu kunoenderana zvakanyanya nekwaniso yekumisikidza dziviriro kubva kukuvara kunogona kubva kukuvara kwetishu uye hutachiona. Kudzivirirwa kwevaenzi kunosanganisira maitiro ekudzivirira kubvisa kusangana nenjodzi (inotyisa) nharaunda (a neural function), uye kushaya neutachiona hwehutachiona (immune immune). Pachivanhu, basa rema immune pakurwisa hutachiona uye kugadzirisa kukuvara kwemasuru kwave kutariswa kwakasiyana chaizvo neiyo yehurongwa hwetsinga, iyo inokanganisa zviratidzo zvinokuvadza zvemukati uye zvemukati kuita zvemagetsi kuburitsa manzwiro nemafungiro (Fig. 1). Isu tinopa zano kuti maviri masystem ari chaizvo zvikamu zveyakabatana yekudzivirira mashandiro. Iyo somatosensory nervous system yakaiswa zvakanaka kuti ione njodzi. Chekutanga, matishu ese anoratidzwa pachena nekunze kwenzvimbo, senge epithelial huso hweganda, mapapu, weti uye yekugaya nzira, zvakadzvanywa zvakanyanya neanociceptors, kukwirira kwakanyanya kunogadzira marunda ekufunga. Chechipiri, kutapurirana kwekutyisa kwekunze kwekunze kunenge kuri kwechinguva, mirairo yehukuru inokurumidza kupfuura kuunganidzwa kwema immune system, uye nekudaro anogona kunge ari wekutanga kupindura- mukuchengetedza kwekuchengetedza.

 

 

Mukuwedzera kune zvigadzirwa zve orthodromic kumutsipa wepelinha uye uropi kubva kumativi, zviito zvinogona kuitika mu nociceptor neurons zvinogonawo kutapurirwa antidromically pamatavi emapazi kumashure kusvika kumativi, axon reflex. Izvi pamwechete pamwe nekusimbiswa kwekudzora kwemunharaunda kunotungamira mukuburitswa nekukurumidza kwenzvimbo kwevamiririri veeural kubva kune ese maheriziponi uye ma terminals (Fig. 2) 1. Kuedza kwekare kwakaitwa naGoltz (muna 1874) uye naBayliss (muna 1901) kwakaratidza kuti magetsi anokurudzira midzi yepashure induces ganda vasodilation, iyo yakatungamira kune iyo pfungwa ye neurogenic kuzvimba , yakazvimiririra kune iyo inogadzirwa ne immune immune (Fig. 3).

 

 

 

Neurogenic kuzvimba inopindirana nekuburitswa kweiyo neuropeptides calcitonin gene yakabatana peptide (CGRP) uye chinhu P (SP) kubva kune nociceptors, iyo inoshanda zvakananga pavascular endothelial uye yakatsetseka mhasuru masero 2�5. CGRP inogadzira vasodilation mhedzisiro 2, 3, nepo SP inowedzera capillary permeability inotungamira kune plasma extravasation uye edema 4, 5, zvichikonzera rubor, calor uye bundu reCelsus. Nekudaro, ma nociceptors anoburitsa akawanda ekuwedzera neuropeptides (online database: www.neuropeptides.nl/), kusanganisira Adrenomedullin, Neurokinins A uye B, Vasoactive intestinal peptide (VIP), neuropeptide (NPY), uye gastrin inoburitsa peptide (GRP), pamwe nevamwe vamiririri vema molecular akadai se glutamate, nitric oxide (NO) uye cytokines senge eotaxin 6.

 

Isu tava kukoshesa kuti varevereri vakaburitswa kubva kunzwi retsinga munzvimbo iyo kwete kungoita pane iyo vasculature, asi zvakare inokwezva zvakananga nekumisikidza masero ekuzvidzivirira emuviri (masero masero, dendritic maseru), uye anogadzikana maseru ekudzivirira (T lymphocyte) 7 12. Mumamiriro akaoma ekukuvara kwetishu, isu tinofungidzira kuti neurogenic kuzvimba inodzivirira, kufambisa muviri kupora ronda uye kudzivirira immune kuzvirwere nemaitiro nekumisikidza maseru ekudzivirira. Nekudaro, akadaro neuro-immune kutaurirana zvakare anogona kutamba makuru mabasa mune iyo pathophysiology yeanoriki uye autoimmune hosha nekukudziridza pathological kana maladaptive immune mhinduro. Mune mhando dzemhuka dzerheumatoid arthritis semuenzaniso, Levine nevamwe vaakashanda navo vakaratidza kuti kuderedzwa kwejojo ​​kunotungamira mukudzora kunoshamisa mukuzvimba, izvo zvinoenderana nereural expression yezvinhu P 13, 14. Mune ongororo dzichangoburwa dzeanogadzirisa mweya nzira yekuzvimba, colitis uye psoriasis, primary sensory neurons inoita chinzvimbo chepakati mukutanga uye kuwedzera kuisirwa kwehutachiona hwemuzvarirwo uye hunogadzikana 15-17.

 

Isu tinosarudza naizvozvo, kuti chirwere chendaneti chinongogara chisina kungoita basa rekuchengetedzwa kwevanhu vekuzvidzivirira (kuonekwa kwezvinhu zvinotyisa uye kutanga kwekudzivisa kutsika), asiwo kushanda nesimba mumakonti nemagadzirirwo ezvirwere mumuviri mukugadzirisa mhinduro uye kurwisana kwekukuvadza zvinokurudzira, basa iro rinogona kukanganiswa kuti rive nerutano kune zvirwere.

 

Kugoverwa Nengozi Kuzivikanwa Nzira Munharaunda yePeriipheral Nervous uye Innate Systems Immune

 

Peripheral sensory neurons inogadziriswa kuti ione ngozi kune mhuka nekuda kwekunzwa kwavo kune zvakasimba zvemagetsi, zvinopisa uye zvinopesana nemakemikari anopisa (Fig. 1). Mutambo wekutambira unogona (TRP) ion channels ndiyo inonyanya kudzidzwa maserevereri vedarecheni ye nociception, ichiita chisina kusarudzwa chemashoko ekugadziriswa nekushandiswa nemaitiro akasiyana-siyana anonyadzisa. TRPV1 inoshandiswa nemazinga ekupisa, pasi pH uye capsaicin, iyo vallinoid inogumbura chikamu chechipiri pepper 18. TRPA1 inopindirana nekuonekwa kwemakemikari anogadzirisa zvinosanganisira kuvhiringidza kwekuchengetedza kwemhepo kwakadai sekuderedza gasi uye indasitiri isothiocyanates 19, asi zvinokosha, inoshandiswawo panguva yekukuvara kwemavara nemagetsi emagetsi anogumira kusanganisira 4-hydroxynonenal uye prostaglandin 20, 21.

 

Zvinonakidza kuti zvinonzi neuron zvinokonzera mazana ematenjini akafanana uye zvinokonzera kukura kwema molecular maitiro semakirini emasine innine, anovabatsira kuti vaonewo zvirwere (Fig. 1). Muzvirwere zvekudzivirirwa kwemasikirwo emakemikari, majekiseni emakemikari anowanikwa ne germine encoded pattern recognition receptors (PRRs), iyo inoziva zvakanyanya kuchengetedza pathogen-inobatanidza maseroti (PAMPs). IPRRs yokutanga kuonekwa yaiva nhengo dzemhuri yefodya-like receptor (TLR), iyo inosunga mbiriso, mabhakitiriya akawanikwa masero emadziro-masvingo uye virusi RNA 22. Kutevera PRR kushandiswa, nzira dzekudzika dzinoyerera dzinoshandiswa dzinoita kuti kugadzirwa kwe cytokine uye kushandiswa kwekuchengetedzwa kwechirwere. Mukuwedzera kune maTLRs, masero ezvirwere zvemajena anoshandiswa mukati mekukuvara kwechigunun'una nemagetsi anogadziriswa akawanikwa, anozivikanwa sekukuvadza-kunobatanidza maitiro emadziro (DAMP) kana kunotyisa 23, 24. Izvi zviratidzo zvinokuvadza zvinosanganisira HMGB1, uric acid, uye kupisa kunokonzera mapuroteni akabudiswa nemasero ekufa panguva yecroseis, achiita masero emunodzivirira panguva dzisina kupindira kupinduka mhinduro.

 

PRRs dzinosanganisira TLRs 3, 4, 7, uye 9 dzinoratidzirwa ne nociceptor neurons, uye kukurudzira neTLR ligands kunotungamira mukuburitswa kwemukati mairi uye kukurudzira kweanociceptors kune mamwe marwadzo anokanganisa 25-27. Kupfuurirazve, kumisikidza kwenzwi neuroni neTLR7 ligand imiquimod inotungamira mukumisikidza kweiyo itch yakanangana yenzira yenzira 25. Mhedzisiro iyi inoratidza kuti hutachiona hunosanganisirwa nehutachiona uye kuvaviwa kungave kuri pamwe nekuda kwekutangisa kumisikidzwa kweeuroni nezvakakonzerwa nehutachiona, izvo zvinobva zvaitika. shandisa maseru ekudzivirira kuburikidza neparipheral kuburitswa kwemauronal signaling mamorekuru.

 

Yakakura DAMP / alarmin yakaburitswa panguva yekukuvara kwemaseru ndeye ATP, inozivikanwa neepurinergic receptors pane ese nociceptor neurons uye maseru ekudzivirira 28-30. Purinergic receptors inoumbwa nemhuri mbiri: P2X receptors, ligand-gated cation chiteshi, uye P2Y receptors, G-protein akabatanidza anogamuchira. Mune nociceptor neurons, kuzivikanwa kweATP kunoitika kuburikidza neP2X3, zvichitungamira kukurumidza kudzikisira cation mafungu uye kurwadziwa 28, 30 (Fig. 1), nepo maP2Y receptors achibatsira kune nociceptor activation nekukurudzira kweTrP nemagetsi-gated sodium chiteshi. Mune macrophages, ATP inosunga kune P2X7 receptors inotungamira kune hyperpolarization, uye yakadzika yekumisikidza kweiyo inflammasome, mamorekuru akaomarara akakosha muchizvarwa cheIL-1beta uye IL-18 29. Naizvozvo, ATP chiratidzo chakasimba chengozi chinogonesa maviri eperiipheroni mauroni uye nemukati dziviriro panguva yekukuvara, uye humwe humbowo hunotoratidza kuti ma neurons anoratidza zvikamu zveiyo inflammasome mamorekuru muchina.

 

Iyo flip yechipfuva chekuisa mungozi mu nociceptors inobatanidzwa neTPP mishonga mu immune cell activation. TRPV2, a homologue ye TRPV1 inoshandiswa nekupisa kunotyisa, inoratidzirwa pamatunhu akakwirira mumasero emunununu asingazivikanwi 32. Genetic ablation ye TRPV2 yakakonzera kukanganisa mu macrophage phagocytosis uye kubvumirwa kwepabhakitiriya zvirwere 32. Mast maseve anoratidzawo zvirwere zveTrPV, izvo zvinogona kupindirana zvakananga ne degranulation yavo 33. Inoramba ichigadziriswa kana zviratidzo zvinogadziriswa zvinogadzirisa zvirwere zvemusununguko zvakafanana nema nociceptors.

 

Imwe nzira yakakosha yekutaurirana pakati pemasero ekudzivirira uye nociceptor neurons ari kuburikidza nema cytokines. Pakushandiswa kwecytokine receptors, chiratidzo chekuchinjisa nzira dzinoitwa mu sensory neurons inotungamira kuzasi phosphorylation ye membrane mapuroteni anosanganisira TRP nemagetsi-gated chiteshi (Fig. 1). Iko kunoguma kwekusimudzira kweanociceptors kunoreva kuti kazhinji zvisina mhosva mashini uye kupisa kupisa kunogona ikozvino kumisikidza nociceptors. Interleukin 1 beta uye TNF-alpha ndiwo maviri akakosha ma cytokines akaburitswa nemasero emukati ekuzvimba. IL-1beta uye TNF-alpha zvinonzwisiswa zvakananga ne nociceptors iyo inoratidza iyo inogamuchira receptors, inokonzeresa kumisikidza kwep38 mepu kinases inotungamira mukuwedzera membrane kunakidzwa 34-36. Tsinga yekukura chinhu (NGF) uye prostaglandin E (2) zvakare makuru evamiririri vamiririri vanoburitswa kubva kumaseru emunodzivirira anoshanda akananga pamupendero sensory neurons kukonzera kukurudzira. Chinhu chakakosha che nociceptor sensitization nema immune zvinhu ndiko kuwedzera kuburitswa kweeuropeptides kumahombekombe ekumusoro ayo anowedzera kumisikidza maseru emunodzivirira, nekudaro achikurudzira mhinduro yakanaka chiuno chinotyaira uye chinobatsira kuzvimba.

 

Sensory Nervous System Kudzora kusinganzwisisiki uye kusagadzikana

 

Mumatanho ekutanga ekuzvimba, sensory neurons chiratidzo kune tishu inogara mast masero uye dendritic maseru, ayo ari maune immune maseru akakosha mukutanga immune immune (Fig. 2). Zvidzidzo zveAnatomical zvakaratidza kuiswa kwakananga kwema terminals ane mast mast, pamwe nema dendritic maseru, uye maeuropeptides akaburitswa kubva kune nociceptors anogona kukonzera kudzikisira kana kugadzirwa kwecytokine mumaseru aya 7, 9, 37. Uku kudyidzana kunoita basa rakakosha mune isina kugadzikana yemhepo. kuzvimba uye dermatitis 10 12.

 

Pakati pechikamu chekukonzeresa kwekuzvimba, maseru ekudzivirira anofanirwa kutsvaga nzira yavo kune yakatarwa nzvimbo yekukuvara. Murevereri mazhinji akaburitswa kubva kune sensory neurons, neuropeptides, chemokines, uye glutamate, ari chemotactic yema neutrophils, eosinophils, macrophages, uye T-maseru, uye inosimudzira endothelial adhesion iyo inofambisa immune cell homing 6, 38-41 (Fig. 2). Uyezve, humwe humbowo hunoreva kuti mauron anogona kutora chikamu chaicho muchikamu chekuita, sezvo maeuropeptides pachawo anogona kuve nemabasa anorwisa antimicrobial 42.

 

MaNeuronally akatorwa ekuisa chiratidzo mamorekuru anogona zvakare kutungamira mhando yekuzvimba, nekupa mukusiyanisa kana kudoma kwemhando dzakasiyana dzeanogadzirisa immune T masero. Iyo antigen iri phagocytosed uye inogadziriswa nemasero emukati emunodzivirira, ayo anozoenda kune iyo lymph node iri padyo oburitsa antigenic peptide kune na ve T masero. Zvichienderana nerudzi rweantigen, anodhura emamorekuru pane yemagen immune immune, uye kusanganiswa kweakanyanya cytokines, na ve T maseru anokura kuita chaiwo subtypes ayo anonyanya kushandira iyo yekuedza yekuedza kubvisa iyo pathogenic kukurudzira. CD4 T masero, kana T anobatsira (Th) maseru, anogona kuganhurwa muzvikamu zvina zvemitemo, Th1, Th2, Th17, uye T anotonga masero (Treg). Masero eT1 anonyanya kuve nechekuita nekupindura immune immune kune intracellular microorganisms uye nhengo-yakanangana autoimmune hosha; Th2 yakakosha pakudzivirira hutachiona kubva kune mamwe maseru epasi, senge helminths, uye anokonzeresa kurwara kwezvirwere; Th17 maseru anoita basa repakati mukudzivirira kubva kumatambudziko ehutachiona, senge mabhakitiriya ekunze uye fungi; Treg maseru anobatanidzwa mukuchengetedza wega kushivirira uye kugadzirisa immune mhinduro. Iyi T yekutsvaira maseru maitiro inoita kunge inokanganiswa zvakanyanya neanonzwa neuronal vamiririri. Neuropeptides, senge CGRP neVIP, inogona kutsvetera masero edendriti akananga kune hutachiona hweT2-mhando uye inoderedza hutachiona hweT1-rudzi nekusimudzira kugadzirwa kwemamwe ma cytokines nekudzivirira mamwe, pamwe nekuderedza kana kuwedzera dendritic sero kutamira kune ma lymph node emuno , 8, 10. Sensory neurons inobatsirawo zvakanyanya kune allergic (kunyanya Th43 inotyairwa) kuzvimba 2. Pamusoro pekugadzirisa Th17 uye Th1 maseru, mamwe mauropeptides, akadai seSp neHemokinin-2, anogona kutyaira mhinduro yekuzvimba zvakanyanya kuT1 kana Treg. 17, 44, zvinoreva kuti maNeuron anogona zvakare kuve nechekuita mukugadzirisa kusagadzikana kugadzirisa. Mune immunopathologies senge colitis uye psoriasis, kuvharirwa kwevamiririri veeuronal sechinhu P kunogona kudzikisira zvakanyanya T cell uye immune mediated kukuvara 45-15, kunyangwe kupesana nemurevereri mumwe kunogona kungoita iwo maitiro mashoma pane neurogenic kuzvimba.

 

Tichifunga kuti kujekesa mafungiro emakemikari akabudiswa kubva kune dzimwe nhengo dzenzara dzeropa dzinodzora kwete kwete midzi midzi yeropa chete, asiwo chemotaxis, homing, kusasuka, uye kushandiswa kwemasero emumunwe, zvinova pachena kuti neuro-immune interactions yakaoma kunzwisisa kupfuura yakambofungidzirwa (muonde . 2). Uyezve, zvinenge zvichifungidzirwa kuti haisi munhu mumwechete wevanoratidzi vehurumende asi zvinosanganiswa zvakananga zvekuisa chiratidzo chemaserosi akabudiswa kubva kune nociceptors anokonzera matanho akasiyana uye maitiro ezvirwere zvekuzvidzivirira.

 

Autonomic Reflex Kudzora Rusununguko

 

Basa reiyo cholinergic autonomic nervous system reflex dunhu mumutemo weparipheral immune mhinduro dzinoonekwawo dzakakurumbira 46. Iyo vagus ndiyo huru parasympathetic tsinga inobatanidza iyo brainstem nenhengo dzevisceral. Shanda naKevin Tracey nevamwe vanonongedzera kune ane simba akajairwa anti-anogumbura mhinduro mune septic kuvhunduka uye endotoxemia, inokonzereswa neakafanira vagal nerve chiitiko chinotungamira mukubvisa kweanoperera macrophages 47-49. Iyo vagus inomutsa periipheral adrenergic celiac ganglion neurons isingafadzi spleen, inotungamira mukuburuka kwerwizi kweacetylcholine, inosunga kune alpha-7 nicotinic receptors pane macrophages muple uye gastrointestinal turakiti. Izvi zvinokonzeresa kumisikidza kweJAK2 / STAT3 SOCS3 nzira yekuratidzira, iyo inodzvinyirira zvine simba TNF-alpha kudhindwa 47. Iyo adrenergic celiac ganglion zvakare inotaurirana zvakananga nesetset yeacetylcholine inoburitsa ndangariro T maseru, ayo anodzvinyirira ekuputira macrophages 48.

 

Invariant natural Killer T masero (iNKT) ichinyorwa chinokosha chemasero eT anoona microbial lipids mumamiriro eCD1d pane peptide antigens. NKT masero inhengo yakakosha yemazuva ano inobatanidzwa mukurwa kwezvirwere zvinopararira uye kurongeka kwehutachiona hwehutachiona. NKT masero anogarako uye anotengesa zvikuru kuburikidza nemashizha uye sinusoids zvepleen uye chiropa. Kunzwira tsitsi beta-adrenergic nerve mukati mechiropa zviratidzo zvakajeka kuenzanisa NKT cell activity 50. Munguva yemutambo wepinyoyo yekurohwa (MCAO), somuenzaniso, chiropa chekunyengera NKT cell chakanga chichidzivirirwa chichibviswa, icho chakashandurwa kuburikidza nekunzwira tsitsi kutongesa kana beta-adrenergic vanopikisa. Uyezve, basa iri risina kugadziriswa neradrenergic neuron pa NKT masero rinotungamirira kukura mune utachiona hwehutachiona uye kukuvara kwepapu. Nokudaro, zviratidzo zvinoshamisa kubva kunezvioni zvezvigoni zvinogona kupindirana nekunyanyisa kwekudzivirira muviri.

 

Dr. Alex Jimenez's Insight

Neurogenic kuvhiringidzika ndechekupindura kwemukati kunokonzerwa nenheyo yenheyo. Inotendwa kuti inotora basa rinokosha mumapathogenesis emhando dzakasiyana-siyana dzeutano, kusanganisira, migraine, psoriasis, asthma, fibromyalgia, eczema, rosacea, dystonia uye multiple chemical sensitivity. Kunyange zvazvo kuputika kweurosigenic kunobatanidza nehutachiona hwehutachiona hwave hwakanyatsotsvakurudzwa, pfungwa yekurohwa neurogenic mukati memutambo wenheyo inoda kuwedzera kutsvakurudza. Maererano neongororo dzakawanda dzekutsvakurudza, zvisinei, kushaya simba kwemagesium kunotendwa kuti ndicho chikonzero chikuru chekuvhiringidza kweurostenic. Nyaya inotevera inoratidzira mhedziso yehutano hwehuputi hwehutano muhutachiona hwehutano, hunogona kubatsira vashandi vehutano hwehutano vachiona nzira yakanakisisa yekurapa yekutarisa zvakasiyana-siyana zvehutano zvine chokuita nehutachiona hwehurongwa.

 

mhedziso

 

Ndeapi akanangana neakatarwa masomososory uye autonomic huta masisitimu mukugadzirisa kuzvimba uye immune system (Fig. 4)? Kumisikidza kweanociceptors kunotungamira kune emunharaunda axon reflexes, ayo emunharaunda anotora nekumisikidza immune maseru uye nekudaro, kunyanya pro-yekuzvimba uye yekunze yakavharirwa. Mukupesana, kuzvimiririra kwekusimudzira kunotungamira kune systemic immunosuppression nekukanganisa madziva emaseru ekudzivirira muropa uye spleen. Maitiro anoratidzira ekuratidzira munharaunda anotungamira mukukonzeresa kweiyo immunosuppressive vagal cholinergic reflex redunhu haina kunzwisiswa. Nekudaro, 80-90% yeiyo vagal fibers ndiyo yakasarudzika yemafibisi ekufunga, uye nekudaro zviratidzo kubva ku viscera, mazhinji anogona kutungamirwa nemaseru ekudzivirira muviri, anogona kutungamira mukugadziriswa kwema interneurons mu brainstem uye kuburikidza navo kune inobuda mune inoshanda vagal fibers 46.

 

 

Kazhinji, nguva yenguva uye chimiro chekuvhiringidza, pasinei nehutachiona, kutarisa kweaigergia, kana kuti ma-immune-pathologies, inotsanangurwa nemhando dzemasero omusununguko anobatanidzwa. Zvichave zvakakosha kuzive kuti zvipi zvakasiyana-siyana zvemasero emunodzivirira anotungamirirwa nezviratidzo zvekuona uye kuzviona. Kuongorora kwakarongeka kwevanopindirana vanogona kusunungurwa kubva kuNociceptors uye neonon autonomic uye kutaura kwezvinogamuchirwa nekuda kweizvi nenzira dzakasiyana-siyana dzenhengo dzakasiyana-siyana uye dzinogadzirisa zvirwere zvinogona kubatsira kugadzirisa mubvunzo uyu.

 

Munguva yekushanduka-shanduka, njodzi yakafanana yekuona mamorekuru nzira dzakagadzirirwa zvese hutachiona hwekuzvarwa uye nociception kunyangwe iwo maseru aine mitsara yekuvandudza zvakasiyana. Nepo maPRR uye anotyisa e-ligand-gated ion chiteshi achidzidzwa zvakasiyana nemaununologist uye neurobiologists, mutsetse uripakati peminda miviri iyi uri kuwedzera kusanzwisisika. Munguva yekukuvara kwetishu uye hutachiona hwehutachiona, kuburitswa kwemasaini enjodzi kunogona kutungamira kune kumisikidza kuenzanisira kweese maviri eperiipheroni maseru uye maseru ekudzivirira ane kutaurirana kwakadzama kweabidirectional, uye yakasunganidzwa inomiririra inomiririra. Iyo anatomical kumisikidzwa kweanociceptors pane inoenderana nemamiriro ekunze, kumhanyisa kweiyo neural kutapurirana uye kugona kwavo kuburitsa zvine simba mbatya dzevamiririri-vanoita muyananisi inobvumira iyo yekumusoro tsinga system yekushandura modhi iyo yekuzvarwa immune mhinduro uye kurongedza pasi pemvura adaptive hutachiona. Zvakare, ma nociceptors anonyanya kutarisisa kune vamiririri vemuviri, ayo anoita uye anosimudzira maeuron. Neurogenic uye immune-Mediated kuzvimba haisi, nekudaro, masangano akazvimiririra asi anoita pamwechete semidziyo yekutanga yambiro. Nekudaro, iyo yekunze yehutachiona system zvakare inoita basa rakakosha muhutachiona, uye pamwe etiology, yezvirwere zvakawanda zvemuviri senge asthma, psoriasis, kana colitis nekuti kugona kwayo kuita immune system kunogona kuwedzera kuzvimba kuzvimba 15-17. Kurapa kwezvirwere zvemuviri kungangoda kusanganisira, nekudaro, kunongedzwa kweanociceptors pamwe nemaseru ekudzivirira.

 

KUTENDA

 

Tinoonga NIH kutsigira (2R37NS039518).

 

Mukupedzisa,Kunzwisisa basa rehutachiona hwehutachiona kana zvasvika pakubata dziviriro uye immunopathology kwakakosha pakuronga nzira yekurapa kwakaringana kweakasiyana ehurongwa hwehurongwa hwehurongwa. Nekutarisa kusangana kweanoperera neuroni nemasero ekudzivirira muviri, vashandi vezvehutano vanogona kufambisira mberi nzira dzekurapa dzekuenderera mberi nekubatsira kuwedzera dziviriro yevagari pamwe nekudzvinyirira immunopathology. Chinangwa chechinyorwa chiri pamusoro ndechekubatsira varwere kuti vanzwisise kiriniki yeuropiyasi yeuropathy, pakati pezvimwe zvinokuvadza zvehutano. Ruzivo rwunotsanangurwa kubva kuNational Center yeBiotechnology Ruzivo (NCBI). Chiyero cheruzivo rwedu chinogumira kuchiropractic pamwe nekukuvara kwepamuviri nemamiriro. Kuti ukurukure nyaya yacho, ndapota inzwa wakasununguka kubvunza Dr. Jimenez kana kuti tibate isu pa 915-850-0900 .

 

Yakarongedzwa naDkt Alex Jimenez

 

 

Zvimwe Zvinyorwa: Kubva Painini

 

Kutambudzika shure ndechimwe chezvikonzero zvakakosha zvikuru zvekuremara uye mazuva asina kukwana kubasa pasi rose. Sezvakangoitika, kurwadziwa kwekudzokera shure kwave kuchiitwa sechipiri chikonzero chikuru chechiremba chekushanyira, chakanyanya kupfurikidza nehutachiona hwepamusoro-kuporesa. Inenge 80 muzana yevanhu vanozoona rumwe rudzi rwemarwadzo emutsipa kamwechete kamwe chete muupenyu hwavo hwose. Iyo musana inorongwa yakaoma yakaumbwa nemapfupa, mafundo, magirasi nemasumbu, pakati pezvimwe zvinyoro zvishoma. Nemhaka yeizvi, kukuvadzwa uye / kana mamiriro ezvinhu akawandisa, akadai herniated discs, zvinogona kutungamirira kune zviratidzo zvekurwadziwa shure. Kukuvara kwemitambo kana kukuvara kwepamberi yemotokari kazhinji kunowanzokonzera kukonzera kurwadziwa, zvisinei, dzimwe nguva kufamba kwakanyanya kunogona kuva nemigumisiro inorwadza. Nenzira yakanaka, nzira dzakasiyana dzokurapa, dzakadai sechiropractic, dzinogona kubatsira kuderedza marwadzo shure kuburikidza nekushandurwa kwepelinha nekugadzirisa maitiro, pakupedzisira kunatsiridza marwadzo ekurwadziwa.

 

 

 

 

NHAURWA INOKOSHA INOKOSHA: Low Back Pain Management

 

DZIMWE NYAYA: DZIMWE DZIMWE DZIDZISO: ronicKusingaperi Kurwadziwa & Marapirwo