Umqondo wokuthi i-oxytocin enikezwa ngesikhathi sokuzalwa ingavimbela i-autism uye waqoqa izihloko kanye nokungabaza ngokulinganayo. Phakathi kwemibono yebhayoloji ebambekayo, imiphumela ehlukene kubantu, kanye nokutholwayo okuthembisayo kumamodeli ezilwane, umbuzo ufuna ukubheka okuzolile ebufakazini obutholakalayo. ukuthukuthela kodwa ngaphandle kokulahlekelwa umbono amathuba ocwaningo.
Kulokhu kuhlaziya siqoqa ukuthi imithombo engcono kakhulu esezivele ithini ithini: ukubuyekezwa kwe-neurobiology of attachment, indima eyinhloko ye-oxytocin (OT) kanye ne-vasopressin ekuziphatheni komphakathi, idatha mayelana nokusetshenziswa kwayo okukhulu kokubelethisa, ukuthi kungathinta kanjani ukuncelisa kanye ne-neonatal reflexes, kanye Ubufakazi be-Epidemiological ngobudlelwano bayo ne-ASD kanye ne-ADHDFuthi sifaka imiphumela yakamuva yezilwane—efana nesiphakamiso sama-microdroplets ekhala evikini lokuqala lokuphila—kanye nezincomo zokusebenzisa kahle emtholampilo ukuze kuncishiswe izingozi.
Iyini i-oxytocin futhi kungani inentshisekelo ku-neurodevelopment?
I-Oxytocin iyi-nonapeptide ehlanganiswe ku-hypothalamus (i-paraventricular ne-supraoptic nuclei) futhi ikhishwe egazini nge-neurohypophysis.. Kwakuhlotshaniswa nakudala nokufinyela kwesibeletho kanye nokuphuma kobisi, kodwa namuhla siyazi ukuthi, kanye ne-vasopressin, ilawula ukuziphatha okubalulekile komphakathi: isibopho sikamama nengane, ukuqashelwa emphakathini kanye nobulili.
Ngesikhathi sokubeletha ngokomzimba, ukugcinwa kwe-OT okungapheli kuyanyakaza futhi kuyanda., nenani eliphakeme kakhulu ehoreni lokuqala ngemva kokuzalwa kokubili kumama futhi, ngokungaqondile, kusana olusanda kuzalwa. Lesi sikhathi "sensitive" ye-neurohormonal sibonakala sithanda ukuqala kokuhlangana nokuncelisa.Lesi siqongo asenzeki ezigabeni ezihleliwe zokuhlinzwa ngaphandle kokubeletha, futhi ukuziphatha komama okusabela kancane kuye kwachazwa ezilwaneni ezincelisayo uma ukuphakama kokuphila kwe-OT kungekho.
Enganeni yomuntu, ukuziphatha kokuqala kokunamathela (ukufuna ibele, ukuthintana kwamehlo, ukukhasela engonweni) Zibonwa emahoreni okuqala okuphila futhi zibonakala ziqondiswa yiziyingi lapho i-oxytocin idlala indima evelele. Lesi siqalo singalungiswa ngokuhlangenwe nakho kokubeletha., ngemiphumela, ngokwezibonelo zezilwane, ezingase ziqhubeke ngokusebenzisa izindlela ze-epigenetic.
Ukusetshenziswa komtholampilo kwe-synthetic oxytocin: izinzuzo, imikhawulo kanye nemiphumela engenzeka
I-exogenous oxytocin ingenye yezidakamizwa ezisetshenziswa kakhulu ekubelethweni ukunxenxa noma ukuqinisa ukufinyela, nokuvimbela ukopha kwangemva kokubeletha. Nakuba iyasebenza futhi iphephile uma kuqhathaniswa nemithamo enconyiwe, Futhi kuwumuthi wokubelethisa othinteka kakhulu emiphumeleni emibi engagwemeka.Ukulethwa kwayo okuqhubekayo kuyahluka kuphethini ye-physiological pulsatile, futhi lokho kubalulekile.
Kungenzekani uma "siphoqa" uhlelo lwe-oxytocinergic perinatal? Ama-hypotheses ahlanganisa: ukuphazanyiswa kwe-pulsatility kanye nempendulo enhle ye-uterine-pituitary; i-receptor deensitization (OXTR) ngokuchayeka isikhathi eside noma ukugxila okuphezulu; futhi ukuguqulwa kwebhalansi ye-OT/vasopressin ku-dyad kamama nengane, enemiphumela engaba khona ekunceliseni ibele kanye nokuxhumana kusenesikhathi.
- Imiphumela ebonwayo: ukuvinjelwa kwe-myometrial, ukuvimbela i-atony kanye ne-hemorrhage, ukukhishwa kobisi.
- Ukusabela okungavamile okungajwayelekile kodwa okuhlobene: i-hyperstimulation yesibeletho, izinguquko ze-hemodynamic, i-hyponatremia ngemithamo ephezulu, kanye nezinkinga ezinkulu uma zifakwe ngokungalawuleki.
- Imiphumela emaphakathi engaqondile: Nakuba i-plasma OT ingaweli kalula umgoqo wegazi nobuchopho omdala, umongo we-fetus uhlukile (bona ngezansi).
Izincomo ze-WHO (2018) ziphikelela ekugwemeni ukungenelela ukuze kusheshiswe ukuzala ngaphambi kuka-5 cm uma umama nombungu bephilile., futhi weluleke ngokumelene "namaphakheji" okuphatha asebenzayo. Lungisa umthamo ube sezingeni eliphansi elisebenzayo futhi uhloniphe ukuhlukahluka komzimba kwenqubekelaphambili yokwelula. kunciphisa izingozi ezingadingekile.
Ingabe i-oxytocin yangaphandle ingafinyelela umbungu kanye nobuchopho bayo?
Kunezithiyo ezimbili ezidlalwayo: i-placenta kanye ne-fetus blood-brain barrier (BBB).I-placenta iveza ama-oxytokinase alulaza i-peptide, kodwa Izifundo zokusabalalisa (u-Malek et al.) zibonise ukuthutha kukamama→i-fetus; okusho ukuthi, Ingxenye ye-OT kamama ingase ifinyelele ukujikeleza kwe-fetus.
I-BBB yengane ingeneka kakhulu kuneyomuntu omdala, ikakhulukazi ngaphansi kokucindezeleka kwe-perinatal okwandisa ama-cytokines nokuqina. Kuye kwaphakanyiswa ukuthi, ngesikhathi sokuzalwa, i-OT yokubeletha yangaphandle ingawela ebuchosheni bomntwana., ikakhulukazi ezimweni ze-anoxia, ukuvuvukala noma ukungavuthwa komgoqo. Uma i-OT izungeza kakhulu, iba nkulu ingozi yethiyori i-receptor deensitization uma ukuchayeka kuqhubeka.
Okutholakele kokuhlola kusekela isixwayiso: Emasikweni e-rat neuronal progenitor, i-OT emazingeni omtholampilo iguqule inkulumo ye-OXTR kanye okushintshiwe ukukhetha kohlu lweseli (ama-neurons amaningi, i-glia encane). Ezinganeni ezisanda kuzalwa, inhlanganisela ye-OT yomama kanye ne-anoxia ukuguqulwa kobuchopho (i-ATP ne-lactate), ngobufakazi bokubi kakhulu kokuthuka kwe-hypoxic uma kuqhathaniswa ne-anoxia yodwa.
Ukuncelisa ibele kanye ne-neonatal reflexes: yiziphi izifundo ezibonile
Ukuqaliswa nokugcinwa kokuncelisa kuncike ekuphumeni kwe-pulsatile kwe-OT kuqalwa ukumuncwa. Ukuphathwa kwe-Intrapartum kwe-OT exogenous kuhlotshaniswe nokuphansi I-Endogenous OT ngosuku lwesibili ngemva kokubeletha kanye ne-prolactin ephakeme, iphethini engase ivale i-ejection reflex kanye nokunamathiselwe kukamama nengane ekondleni.
Kubantu, izifundo ezimbalwa zeqoqo kanye ne-retrospective zihlole ubudlelwano phakathi kwe-OT yokwenziwa kanye nokuncelisa.. Imiphumela ayifani: izifundo ezilawula kahle iziduli azitholi mehluko ezinyangeni ezi-1-6, Kodwa-ke, amazinga okubambelela amabi kakhulu ehoreni lokuqala kanye nezimo zokuphendula umthamo ziye zabonwa. ekunceliseni ibele kuphela lapho ukuchayeka e-intrapartum kwakuphezulu.
Izifundo ezimbili ezigxile kuma-primitive reflexes Bachaza ukuthi, ngemuva kokuchayeka kwe-intrapartum ku-OT, ama-reflexes e-rhythmic kanye ne-antigravity ahlobene nokumunca nokugwinya anciphileNakuba omunye wayengumshayeli wendiza kanti omunye eyiqembu elinemikhawulo, Zombili zikhomba emthelela wesikhathi esifushane ongase ube khona ekhonweni lomlomo losana olusanda kuzalwa., okunomthelela ongaba khona ekuqaleni kokuncelisa.
- Izici ezididayo Ukufunda lezi zifundo: uhlobo lokulethwa, ukusetshenziswa kwe-epidural, imithamo ephelele kanye namaphethini okugcwala, ukulingana, i-BMI, nezinqubomgomo zesikhumba kuya esikhumbeni.
- Okutholakele okungaguquki: ukuthintana ngokushesha kwesikhumba nesikhumba kanye nokwesekwa kochwepheshe ekuhusheni kusenesikhathi nciphisa ubunzima futhi uthuthukise amanani alandelayo.
I-Oxytocin ne-ASD: Okushiwo Izifundo Ezinkulu Zabantu
Umbuzo obalulekile: Ingabe ukungeniswa noma ukwandiswa komsebenzi nge-OT kuyayinyusa ingozi ye-ASD? Ubufakazi besibalo sabantu buyinuances. Ucwaningo olucashunwe kabanzi eNyakatho Carolina luthole izinhlangano ezinesizotha (izilinganiso zezinkinga ezingaba ngu-1.1–1.2) phakathi kwezigaba zokungeniswa/zokwandisa nokuxilongwa okulandelayo, nomphumela ophawuleka kakhudlwana emadodeniKodwa-ke, ukuhlelwa kwe-methodological kuphawule ukulinganiselwa: ukuchayeka okuxubene namanye amasu okungenisa, izinguquko kuzinqubo zokuxilonga, kanye nokuguquguquka okungaba khona okungabanjwanga.
Amaqembu akamuva futhi aqinile aseScandinavia anikeza ukufunda okuqinisekisa kakhulu.Ukuhlaziywa kwamarejista kazwelonke avela e-Denmark (abazalwa abangu-577) nase-Finland (abazalwa abangu-380) bathola ukusetshenziswa kwe-OT ku-31% naku-46% wabantwana abazalwa ngokulandelana futhi, ngemva kokulungiswa kwezici eziningi (unyaka, ubudala bokubeletha, imfundo, isimo somshado, ukulingana, ukubhema, ukungeniswa, iminyaka yokukhulelwa kanye nokukhula kwe-intrauterine), i-OT ehlotshaniswa nokunyuka okuncane: 1,03 ye-ADHD kanye ne-1,05 ye-ASD. Ababhali baphethe ngokuthi akunakwenzeka ukukhombisa ubudlelwano obuyimbangela. futhi wacela ukuthula mayelana nokusetshenziswa kokubelethisa.
Ubufakazi bokuhlola obuvela ekuqhathanisweni kwezelamani/abazala e-Sweden nabo abusekeli imbangela.Kuleli qoqo elikhulu, inhlangano etholwe ekuhlaziyeni inani labantu yanyamalala lapho ilawula izici zomndeni ezabiwe, ukuphakamisa ukudideka ngenkomba noma ngezici zikamama/zofuzo ngaphezu komphumela oqondile we-OT.
Ngakho-ke, ingabe i-oxytocin iyayivimbela noma ibangele i-ASD? Akukho okukodwa noma okunye ngokuya ngedatha yomuntu: Alukho uphawu oluqinile lokuvimbela noma lwembangelaOkuvelayo isidingo sezinqubo ezimbili ezinhle: ukusisebenzisa kuphela uma kukhonjisiwe futhi nge imihlahlandlela ehlonipha umzimba, futhi uqinisekise ukuthintana kwesikhumba nesikhumba kanye nokusekelwa kokuncelisa ukuze kuthuthukiswe i-neurodevelopment kusenesikhathi.
Amawindi epulasitiki, i-epigenetics, kanye ne-GABA “switch”
Esinye isizathu esenza ukuthi i-oxytocin ibe nentshisekelo enjalo ku-ASD indima yayo njenge-neuromodulator yomphakathi.. Ngaphezu kwalokho, ngesikhathi sokubeletha, i-OT kamama ibamba iqhaza entweni evikelayo: ishintsha isenzo se-GABA sisuka ekusaseni siye ekuvimbeleni kuma-neurons engane, ukuthulisa ubuchopho kanye nokunciphisa ukuba sengozini ku-hypoxia. Phakamisa lowo mdanso omuhle ngenxa yokuchayeka ngaphandle kwesikhathi, ngokombono, kungashiya umkhondo osebenzayo noma we-epigenetic.
Amamodeli ezilwane anikeza izinkomba: kumagundane omphakathi, ukuguqulwa kwe-perinatal yesistimu ye-oxytocinergic Bashintsha ukukhwelana, ukukhulisa izingane, kanye nokuziphatha kokuphendula ingcindezi impilo yonke., ngokuhlukana ngokobulili. Kwamasiko, ukuchayeka isikhathi eside ku-OT kunciphisa ukutholakala kwama-receptors (internalization/deensitization), okukhuthaza ukuqapha ekufakweni okude ngemithamo ephezulu.
Iziphakamiso zokuvimbela: ama-microdrops akhala evikini lokuqala (imodeli yezilwane)
Umugqa wakamuva wocwaningo oluvivinywe ukuphatha amaconsi ekhala e-OT kumagundane asanda kuzalwa ane-DiGeorge syndrome., isimo esinezinguquko zokuvinjwa komzimba nobuchopho begazi ezihambisana nezinkinga ze-neurodevelopmental (isb., ASD, ADHD, schizophrenia). Yelashwa nsuku zonke phakathi nesonto lokuqala, izilwane zabonisa ukuthuthukiswa okuhlala njalo ekuziphatheni futhi a ibhalansi yokuzivikela ezinzile ebuchosheni nasemaceleni maqondana nobusha be-murine.
I-hypothesis iyakhanga: I-OT ingaqinisa i-BBB engavuthiwe noma "engenayo"., ukunciphisa ukungena kwama-molecule angaba yingozi ezigabeni ezibucayi. Kodwa kusewucwaningo lwangaphambi komtholampilo; azikho izilingo zomuntu ezinganeni ezisanda kuzalwa. Ngaphambi kokukhuluma ngokuvimbela i-ASD ezinganeni, Kuzodingeka izifundo zokuphepha, umthamo kanye nokusebenza ngempumelelo
Kuthiwani uma i-oxytocin nayo bekuwumuthi we-ASD?
Kubantu abadala abane-ASD, ukwakheka kwe-OT kwangaphakathi kwangaphakathi kuhlolwe ukuze kudambise izimpawu zenhlalo.Imiphumela yokuqala ichaze ukuthuthukiswa okusobala ekuziphatheni okuphindaphindayo noma ekugcinweni kwezimpawu zomphakathi, kodwa Abalona “ikhambi” futhi imiphumela ibonakala incike efasiteleni lesikhathi nomongo. Ithiyori yengqondo nobunkimbinkimbi be ASD yenza kungenzeki ukuthi i-OT iyodwa izokwenza ushintsho olukhulu lomtholampilo kwabaningi.
Ngale kwe-ASD: I-ADHD, i-Bipolar Disorder, kanye neminye imiphumela
Ucwaningo olukhulu lwesi-Danish-Finnish oselubaluliwe lubone ukunyuka okuncane kwe-ADHD (1,03) kanye ne-ASD (1,05) ngemuva kokulungiswa kwezici eziningi, ukucabangela ubudlelwano obuyimbangela engenakwenzekaKweminye imisebenzi, ukuchayeka ku-OT ngesikhathi sokubeletha akazange abonise umehluko ocacile ekuthuthukisweni kwezinzwa eminyakeni emi-5, enemiphumela ehlukahlukene encike kumongo wokubelethisa.
Iqembu lomlando laseCalifornia libike ukuhlangana phakathi kokungeniswa kwe-OT kanye nengozi eyengeziwe ye-bipolar disorder kubantu abadala. kanye namaphuzu okuqonda ezingane kancane ezivivinyweni ezingasho lutho; futhi, ukuqapha: idatha endala, izihlanganisi eziningi, nosayizi womphumela onesizotha. Uphawu lucela uphenyo, hhayi ukuphetha ngesizathu.
Okunamathiselwe, uhlobo lokuzalwa kanye nobuchopho kamama
I-neurobiology yokunamathiselwe ikhombisa ukuthi ukuphakama kwangemva kokubeletha kwe-OT kumama nengane kusiza ukuhlangana.Izifundo ze-Neuroimaging kwabesifazane zithole ukuthi, Ngemva kokuhlinzwa okuhleliwe ngaphandle kokubeletha, impendulo yobuchopho ekukhaleni komntwana ingase ibe ngaphansi. kunangemva kokubeletha kwesitho sangasese sowesifazane, okuhambisana nokungabi bikho kwenani eliphakeme lomzimba we-OT namanye ama-catecholamine okucindezeleka okuhle kokuzalwa.
Ezilwaneni, ukuvimba isignali ye-OT ngemva kokuzalwa kunciphisa ukuziphatha komama, kuyilapho ukuyinikeza maphakathi kungase "kuvuse" ukunakekelwa kwabesifazane abamsulwa. Kubantu, imikhuba efana nesikhumba nesikhumba, indawo yokuhlala, nokusekela ukuncelisa Basebenza njengabalawuli abanamandla besistimu ye-oxytocinergic, benciphisa imiphumela engenzeka yokungenelela okudingekayo kokubelethisa.
Ukubuyekezwa okuhlelekile kwakamuva kumazinga e-plasma
Ukubuyekezwa okuhlelekile okuvulekile (BMC Pregnancy and Childbirth, 2023) kuhlole amazinga e-OT kumama nosana olusanda kuzalwa lapho kusetshenziswa i-OT yokwenziwa. ngaphambi, ngesikhathi noma ngemva kokubeletha. Ababhali baxoxa ngemiphumela yokusebenza kwesistimu ye-oxytocinergic kanye nobunkimbinkimbi bokubheka imiphumela emaphakathi kusuka kumazinga weperipheral, okuqinisa umqondo we Ubuhlakani be-Dosimetric nokuhlonipha i-physiology.
Yiziphi izinqubo zokubeletha ezinganciphisa izingozi?
Akukhona mayelana nokukhipha i-oxytocin, kodwa mayelana nokuyisebenzisa kahle.Uma ikhonjisiwe, isindisa izimpilo futhi ivimbele ukuhlinzwa kokuhlinzwa okungadingekile; uma isetshenziswa ngokwejwayelekile noma ngokweziqondiso ze-unphysiological, kwandisa amathuba okuba nemiphumela engadingekiLezi zinyathelo ziqondisa umtholampilo kanye ne-neurobiological:
- Inkomba enembile kanye nesilinganiso esincane esisebenzayo, ukugwema ukucwiliswa isikhathi eside nokulungiswa njalo emizuzwini engu-20-30, ukuhlola amandla e-fetus kanye nokuphila kahle.
- Ungasheshisi ngokuzenzakalelayo ngaphambi kuka-5 cm Uma i-dyad izinzile, hlonipha ukuhlukahluka okuvamile kokuvuleka okusebenzayo.
- Ukuthintana kwesikhumba nesikhumba ngokushesha futhi okungaphazamiseki, ukuma kwebhayoloji nosizo lokubamba lochwepheshe ngehora lokuqala.
- Gwema ukuhlukana okungadingekile futhi, uma kungenakugwema, khuthaza ukuthintana kwesikhumba nesikhumba nomunye umzali kanye nokukhipha icolostrum kusenesikhathi.
- Buyekeza ukungenelela okuhlanganyelwe (i-analgesia, i-tocolytics njengabaphikisi be-OXTR) kanye nokusebenzisana kwabo okungenzeka ne-OT.
Ingabe i-oxytocin enikezwa ngesikhathi sokuzalwa ingavimbela i-autism?
Ngedatha yomuntu yamanje, cha. Ukubhaliswa kwabantu abaningi, okuhlanganisa imiklamo elawulwa umndeni, ungasekeli umphumela wokuvimbela noma umphumela ocacile wembangela ngomqondo ongemuhle. Ezilwaneni, ukuqondiswa kwezingane ezisanda kuzalwa kuguqule i-BBB (njengamamodeli we-DiGeorge) ubonise izinzuzo ezihlala njalo, kodwa Ukuhumusha lokhu ezinganeni ezisanda kuzalwa kudinga indlela yocwaningo lomtholampilo. okuqinisekisa ukuphepha futhi kuthethelele inzuzo/ingozi esele.
Esingakunqanda namuhla ukulahleka kwamathuba ebhayoloji.: thuthukisa i-hormonal-neural cascade ngesikhathi sokuzalwa, gwema ukungenelela okungadingekile, Sebenzisa i-oxytocin enekhanda elicacile neshayela, futhi ivikele ukuqala kokuhlangana nokuncelisa ibele, okuwumhlabathi ovundile we-neurodevelopment enempilo.
I-Oxytocin iyingxenye emaphakathi yephazili yokuzala: i-hormone ne-neuromodulator enamandla phezu kokubeletha, ukuncelisa, kanye nobudlelwane. Uma isetshenziswa ngendlela efanele, iwumngane; esetshenziswa ngokungafanele, ingafiphaza izinqubo ezinhle.Ucwaningo oluqhubekayo (ebantwini nasezilwaneni) luzositshela ukuthi amandla ayo okwelapha asekuqaleni afinyelela kude kangakanani. Okwamanje, Ubuhlakani bomtholampilo, inhlonipho ye-physiology, kanye nokwesekwa okujulile kokuhlangana nokuncelisa ibele ziyimephu yomgwaqo engcono kakhulu.