{"id":3121,"date":"2025-03-02T00:03:16","date_gmt":"2025-03-01T22:03:16","guid":{"rendered":"https:\/\/santamonica.lv\/?page_id=3121"},"modified":"2025-03-05T22:45:33","modified_gmt":"2025-03-05T20:45:33","slug":"dikloroatsetaat","status":"publish","type":"page","link":"https:\/\/santamonica.lv\/et\/tervisele\/dikloroatsetaat\/","title":{"rendered":"Dikloroatsetaat"},"content":{"rendered":"\n
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Algusest peale kasutati ravimit nimega dikloroatsetaat suhteliselt haruldase ainevahetush\u00e4ire (laktatsidoosi) raviks lastel. Seej\u00e4rel sai Kanadast p\u00e4rit uurimisr\u00fchm teada, et seda ainet saab kasutada ka v\u00e4hiravis. DCA toimib peamiselt energiaaktivaatorina rakkude mitokondrites, kuid kasvajakoes on see metabolism h\u00e4iritud.<\/p>\n<\/div>\n<\/div>\n\n\n\n

Dikloroatsetaati kasutatakse v\u00e4hi raviks.<\/strong> Teadaolevalt on kasvajarakkudes h\u00e4iritud normaalne energiavahetus, mida elusorganism saab toitainetest hapniku juuresolekul. Kasvajarakud on \u00f5ppinud kasutama suhkrut hapniku puudumisel. Selle tulemusena kaotavad nad suure osa keha olemasolevast energiast ja v\u00e4hk k\u00e4ivitab primitiivse elluj\u00e4\u00e4mismehhanismi. DCA suudab v\u00e4hemalt osaliselt taastada normaalse mitokondriaalse funktsiooni. Selle tulemusena toimub taas normaalne loomulik rakkude surm \u2013 apoptoos. DCA-l on ka v\u00e4hirakkudele taastav toime ehk, nagu eksperdid \u00fctlevad, taasdiferentseeriv toime. Meditsiinis v\u00f5imaldab see kombineerida DCA-d teiste sarnaselt toimivate ravimeetoditega, nagu madala s\u00fcsivesikute sisaldusega dieet, terapeutiline h\u00fcpertermia ja teised.<\/p>\n\n\n\n

Dikloroatsetaadi v\u00e4hivastaseid omadusi on kirjeldatud paljudes kirjandusallikates, kuid selle kliinilist efektiivsust kasvajate ravis ei ole kinnitatud, kuna ulatuslikud kliinilised uuringud ei ole lubatud. Selle p\u00f5hjenduseks on toodud ravimite soovimatud k\u00f5rvalm\u00f5jud, nagu neurotoksilisus ja v\u00f5imalik kantserogeenne toime. Vaatamata \u00fclaltoodud faktidele on DCA kasutamist viimastel aastatel siiski laiemalt kirjeldatud, kuna tuntakse huvi selle ravimi v\u00f5ime vastu m\u00f5jutada v\u00e4hirakkude metabolismi.<\/p>\n\n\n\n

DCA toimemehhanismi anal\u00fc\u00fcs aitab paremini m\u00f5ista ja hinnata, miks see on v\u00e4hirakkude vastu nii selektiivselt t\u00f5hus. Edukaks on tunnistatud ka DCA kasutamist koos traditsiooniliste v\u00e4hiravimeetoditega \u2013 keemiaravi, kiiritusravi ja koos teiste ravimitega, sh bioloogiliste ainetega. DCA-d soovitatakse kasutada koos teiste bioloogiliselt aktiivsete ainetega, et soodustada selle biosaadavust ja kudedesse imendumist. \u00dclalkirjeldatud tulemused DCA t\u00f5hususe kohta julgustavad uusi uuringuid suuremas ulatuses. DCA-l on teadaolevalt v\u00f5ime toimida ning kasvaja t\u00fcvirakke maha suruda ja tappa, et peatada kasvaja kasvu ja rakkude proliferatsiooni. Nende uuringute t\u00f5ttu kasutatakse DCA-d j\u00e4tkuvalt v\u00e4hiravis.<\/p>\n\n\n\n

Eespool kirjeldatud DCA aktiivsus viitab otseselt asjaolule, et see \u00fchend on v\u00f5imeline muutma kasvajarakkude metaboolseid omadusi. Vaatamata hapniku olemasolule on v\u00e4hirakud \u00f5ppinud ellu j\u00e4\u00e4ma, saades energiat mittet\u00e4ielikust gl\u00fckol\u00fc\u00fcsist, mis on tingitud mitokondriaalse aktiivsuse v\u00e4henemisest. Teadlased nimetavad seda Warburgi efektiks. Selle tulemusena suureneb piimhappeproduktide (laktaadi) moodustumine. Laktaatide tekkest tingitud gl\u00fckol\u00fc\u00fcsi liigne aktiivsus kasvaja l\u00e4heduses p\u00f5hjustab metaboolset atsidoosi (happereaktsiooni mikrokeskkond). Teisest k\u00fcljest soodustavad \u00fcmbritsevates kudedes olevad laktaadid v\u00e4hirakkude vohamist ja p\u00e4rsivad kasvajarakkude apoptoosi mehhanisme. Selle m\u00e4\u00e4ravad gl\u00fckol\u00fc\u00fcsi protsessis osalevad ens\u00fc\u00fcmid, mis suudavad seda alla suruda ja p\u00e4rssida. DCA toimemehhanism p\u00f5hineb ainevahetuse muutmisel kasvajarakkudes \u2013 p\u00fcruvaatdeh\u00fcdrogenaasi kinaasi aktiivsust alla surudes muundub suurenenud gl\u00fckol\u00fc\u00fcsil p\u00f5hinev metabolism oks\u00fcdatiivseks fosfor\u00fc\u00fclimiseks. PDH aktiveerimine soodustab p\u00fcruvaadi oks\u00fcdatsiooni mitokondrites, p\u00f5hjustades seel\u00e4bi v\u00e4hirakkudes metaboolseid h\u00e4ireid. Selle tulemusena tekib kasvaja kudedes v\u00e4ljendunud energiapuudus. Lisaks v\u00e4hendab laktaadi tootmise v\u00e4henemine atsidoosi v\u00e4hikoes, p\u00e4rssides seel\u00e4bi kasvaja kasvu ja levikut. P\u00fcruvaadi sissevool mitokondritesse soodustab ts\u00fctokroom C ja teiste apoptoosi soodustavate tegurite vabanemist, mis v\u00e4hendavad oluliselt v\u00e4hirakkude elluj\u00e4\u00e4mist.<\/p>\n\n\n\n

Kliiniliseks kasutamiseks on farmaatsiaettev\u00f5tted v\u00e4lja t\u00f6\u00f6tanud DCA preparaadid nii suukaudseks kui ka parenteraalseks kasutamiseks. Soovitatavad annused on 10\u201350 mg\/kg p\u00e4evas. DCA kasutamisel puuduvad viited selle p\u00f5hjustatud toksiliste k\u00f5rvalm\u00f5jude kohta, mis p\u00f5hjustavad v\u00e4ljendunud muutusi vere koostises, maksa- ja neerun\u00e4itajates ning kardiotoksilisuses. See t\u00e4hendab, et DCA kasutamine patsientidele on ohutu. Seedetrakti h\u00e4ired on harvad. K\u00f5ige sagedamini piirab selle preparaadi kasutamist kliinilistes uuringutes t\u00e4heldatud perifeerne pol\u00fcneuropaatia. DCA-st p\u00f5hjustatud pol\u00fcneuropaatia v\u00e4hendamiseks on soovitatav paralleelselt manustada antioks\u00fcdante, samuti kohandada manustatavat DCA annust individuaalselt, arvutades seda kehakaalu kilogrammi kohta. Seda toimet v\u00e4hendab ka preparaadi parenteraalne kasutamine.<\/p>\n\n\n\n

Levinud strateegia v\u00e4hiravis on kombineerida erinevaid ravimeid, et saavutada v\u00f5imalikult suur efekt. See v\u00f5imaldab suurendada efektiivsust, v\u00e4hendades kogu manustatavat annust, samuti v\u00e4ltida toksilist toimet. DCA-d kombineeritakse sageli teiste keemiaravis kasutatavate ravimitega. Samuti p\u00e4rsivad nad kasvajarakkude resistentsuse teket keemiaravi ravimite suhtes. N\u00e4iteks DCA-d kombineeritakse paklitakseeliga kopsuv\u00e4hi raviks. Seda kasutatakse sageli ka koos doksorubitsiini ja tsisplatiiniga. Selliseid kombinatsioone kasutatakse p\u00f5iev\u00e4hi ja hepatotsellulaarse kartsinoomi ravis, kui on tekkinud resistentsus.<\/p>\n\n\n\n

Keskmine suukaudne annus on 15 mg\/kg p\u00e4evas. P\u00e4rast kahen\u00e4dalast kasutamist tehakse n\u00e4dalane paus ja seej\u00e4rel v\u00f5ib i\/v manustamist alustada annusega 30 mg\/kg kaks korda n\u00e4dalas prep lahjendades.<\/p>\n\n\n\n

Kasutatud kirjandus:<\/strong>
https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6885244\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Algusest peale kasutati ravimit nimega dikloroatsetaat suhteliselt haruldase ainevahetush\u00e4ire (laktatsidoosi) raviks lastel. Seej\u00e4rel sai Kanadast p\u00e4rit uurimisr\u00fchm teada, et seda ainet saab kasutada ka v\u00e4hiravis. DCA toimib peamiselt energiaaktivaatorina rakkude mitokondrites, kuid kasvajakoes on see metabolism h\u00e4iritud. Dikloroatsetaati kasutatakse v\u00e4hi raviks. Teadaolevalt on kasvajarakkudes h\u00e4iritud normaalne energiavahetus, mida elusorganism saab toitainetest hapniku juuresolekul. Kasvajarakud on \u00f5ppinud…<\/p>\n","protected":false},"author":3,"featured_media":2163,"parent":2090,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"footnotes":""},"class_list":["post-3121","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"\nDikloroatsetaat - Santa Monica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/santamonica.lv\/et\/tervisele\/dikloroatsetaat\/\" \/>\n<meta property=\"og:locale\" content=\"et_EE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dikloroatsetaat - Santa Monica\" \/>\n<meta property=\"og:description\" content=\"Algusest peale kasutati ravimit nimega dikloroatsetaat suhteliselt haruldase ainevahetush\u00e4ire (laktatsidoosi) raviks lastel. Seej\u00e4rel sai Kanadast p\u00e4rit uurimisr\u00fchm teada, et seda ainet saab kasutada ka v\u00e4hiravis. DCA toimib peamiselt energiaaktivaatorina rakkude mitokondrites, kuid kasvajakoes on see metabolism h\u00e4iritud. Dikloroatsetaati kasutatakse v\u00e4hi raviks. Teadaolevalt on kasvajarakkudes h\u00e4iritud normaalne energiavahetus, mida elusorganism saab toitainetest hapniku juuresolekul. 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Seej\u00e4rel sai Kanadast p\u00e4rit uurimisr\u00fchm teada, et seda ainet saab kasutada ka v\u00e4hiravis. DCA toimib peamiselt energiaaktivaatorina rakkude mitokondrites, kuid kasvajakoes on see metabolism h\u00e4iritud. Dikloroatsetaati kasutatakse v\u00e4hi raviks. Teadaolevalt on kasvajarakkudes h\u00e4iritud normaalne energiavahetus, mida elusorganism saab toitainetest hapniku juuresolekul. 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