{"id":31992,"date":"2019-01-28T01:33:34","date_gmt":"2019-01-27T22:33:34","guid":{"rendered":"https:\/\/bilimvegelecek.com.tr\/?p=31992"},"modified":"2019-01-27T23:56:11","modified_gmt":"2019-01-27T20:56:11","slug":"alzheimerin-recetesi-disinizi-fircalayip-dogru-yataga","status":"publish","type":"post","link":"https:\/\/bilimvegelecek.com.tr\/index.php\/2019\/01\/28\/alzheimerin-recetesi-disinizi-fircalayip-dogru-yataga","title":{"rendered":"Alzheimer\u2019\u0131n re\u00e7etesi: Di\u015finizi f\u0131r\u00e7alay\u0131p do\u011fru yata\u011fa!"},"content":{"rendered":"

G\u00fcn ge\u00e7miyor ki bilim dergilerinde Alzheimer\u2019la ilgili yeni bir \u00e7al\u0131\u015fma, yeni sonu\u00e7lar, insanl\u0131\u011f\u0131 bu illetten kurtarma vaadi ta\u015f\u0131yan yeni umutlar ba\u015fl\u0131klara ta\u015f\u0131nmas\u0131n. Biliminsanlar\u0131n\u0131n bu hummal\u0131 \u00e7abas\u0131 bo\u015funa de\u011fil. Alzheimer t\u00fcm d\u00fcnyada milyonlarca ki\u015fiyi etkiliyor; \u00f6zellikle ya\u015fl\u0131 n\u00fcfusu artan toplumlarda mevcut say\u0131lar\u0131n gelecek 25 y\u0131lda ikiye katlanmas\u0131 bekleniyor. Hal b\u00f6yleyken 2019\u2019un ba\u015f\u0131ndan beri, yani hepsi hepsi bir ay i\u00e7inde bilim d\u00fcnyas\u0131 Alzheimer i\u00e7in ne yapm\u0131\u015f, bize hangi m\u00fcjdeleri vermi\u015f, \u00fc\u00e7 ba\u015fl\u0131kl\u0131 bir se\u00e7ki yapt\u0131k. Say\u0131 k\u00fc\u00e7\u00fck fakat \u00e7al\u0131\u015fmalardan her birinin etkisi Alzheimer\u2019\u0131n gelecekteki seyrini de\u011fi\u015ftirecek kadar b\u00fcy\u00fck g\u00f6r\u00fcn\u00fcyor.<\/p>\n

Demans sizi ne zaman vuracak bilmek ister misiniz?<\/strong>
\nAlzheimer hastal\u0131\u011f\u0131 yava\u015f ve kendini belli etmeden ilerler. \u00d6yle ki beynimiz, hastal\u0131\u011f\u0131n unutkanl\u0131k, zihinsel bulan\u0131kl\u0131k gibi bariz semptomlar\u0131n\u0131n kendini g\u00f6stermeye ba\u015flamas\u0131ndan \u00e7ok evvel de\u011fi\u015fmeye, n\u00f6ronlar yava\u015f yava\u015f y\u0131k\u0131ma u\u011framaya ba\u015flar. Almanya\u2019da bulunan N\u00f6rodejeneratif Hastal\u0131klar Merkezi, Hertie Beyin Ara\u015ft\u0131rmalar\u0131 Enstit\u00fcs\u00fc, Tubingen Hastanesi \u00dcniversitesi ve ABD\u2019den Washington \u00dcniversitesi T\u0131p Fak\u00fcltesi\u2019nin ba\u015f\u0131n\u0131 \u00e7ekti\u011fi 16 y\u0131ll\u0131k dev bir proje Alzheimer\u2019\u0131n bu \u00f6zelli\u011finden yararlanarak tedavi s\u00fcrecinde \u00e7ok i\u015fe yarayacak bir bulguya imza att\u0131: Beyindeki tahribat\u0131n g\u00f6stergesi olabilecek, dolay\u0131s\u0131yla klinik semptomlar kendini g\u00f6stermeden y\u0131llar \u00f6nce \u00f6nlem almay\u0131 m\u00fcmk\u00fcn k\u0131lacak bir protein saptand\u0131. Bu proteinin ad\u0131 n\u00f6rofilament; n\u00f6ronlar\u0131n i\u00e7 iskeletenin par\u00e7as\u0131 olan yap\u0131sal bir molek\u00fcl. Beyinde \u015fu veya bu sebeple n\u00f6ron y\u0131k\u0131m\u0131 ger\u00e7ekle\u015fti\u011finde, n\u00f6rofilament, beyin-omurilik-s\u0131v\u0131s\u0131 arac\u0131l\u0131\u011f\u0131yla kana ge\u00e7iyor. Y\u0131k\u0131m\u0131n tek \u00fcr\u00fcn\u00fc bu molek\u00fcl de\u011fil elbette, ba\u015fka at\u0131k maddeler de kana kar\u0131\u015f\u0131yor fakat n\u00f6rofilament bunlardan farkl\u0131 olarak varl\u0131\u011f\u0131n\u0131 diren\u00e7le devam ettiriyor; bu da onu n\u00f6ron hasar\u0131n\u0131n varl\u0131\u011f\u0131na ili\u015fkin m\u00fckemmel bir belirtece d\u00f6n\u00fc\u015ft\u00fcr\u00fcyor.
\nNature Medicine<\/em> dergisinin 21 Ocak\u2019ta yay\u0131mlad\u0131\u011f\u0131 \u00e7al\u0131\u015fma, Dominantly Inherited Alzheimer Network (Bask\u0131n Kal\u0131t\u0131ml\u0131 Alzheimer Toplulu\u011fu) isimli uluslararas\u0131 bir ekip taraf\u0131ndan y\u00fcr\u00fct\u00fclm\u00fc\u015f. Ad\u0131ndan da anla\u015f\u0131laca\u011f\u0131 \u00fczere bu ekip vas\u0131tas\u0131yla \u00e7al\u0131\u015fmaya dahil edilen 400 kadar g\u00f6n\u00fcll\u00fc denek, ailelerinde nadir g\u00f6r\u00fclen bir gen dizisinden dolay\u0131 Alzheimer\u2019a normalden daha erken ya\u015flarda maruz kal\u0131yor. \u00c7ocuk e\u011fer ebeveyninden ilgili geni alm\u0131\u015fsa hastal\u0131ktan ka\u00e7\u0131\u015f\u0131 olmad\u0131\u011f\u0131 gibi, onunla ayn\u0131 ya\u015flarda semptom vermeye ba\u015fl\u0131yor. Ara\u015ft\u0131rmac\u0131lar i\u015fte bu bilgiden yararlanarak, Alzheimer\u2019\u0131 kesin olarak ne zaman ya\u015famaya ba\u015flayacaklar\u0131n\u0131 bildikleri bu ki\u015filerde n\u00f6rofilament d\u00fczeylerini 16 y\u0131l \u00f6ncesinden g\u00f6zlem alt\u0131na alm\u0131\u015flar ve ileride kendini g\u00f6sterecek bili\u015fsel de\u011fi\u015fikliklerin ve n\u00f6ron kayb\u0131 d\u00fczeylerinin bu belirte\u00e7 sayesinde y\u0131llar \u00f6ncesinden saptanabilece\u011fini g\u00f6stermi\u015fler.
\n\u015eimdi s\u0131ra bu proteinin hangi miktarda bulunmas\u0131n\u0131n ki\u015fide Alzheimer riski te\u015fkil etti\u011fini anlamak ve bulgular\u0131n ge\u00e7 ba\u015flayan Alzheimer durumunda da ge\u00e7erli oldu\u011funu teyit etmek \u00fczere yap\u0131lacak \u00e7al\u0131\u015fmalarda. S\u00fcre\u00e7 tamamland\u0131\u011f\u0131 an piyasada zaten haz\u0131r bulunan bir n\u00f6rofilament tespit kiti rutin laboratuvar testlerine eklenecek. \u015eimdilik \u00fc\u00e7 vakte kadar demans geli\u015ftireceksiniz denemiyor. Ama ona ad\u0131m ad\u0131m yakla\u015f\u0131l\u0131yor!<\/p>\n

G\u00fcnd\u00fczleri ne kadar uyukluyorsunuz?<\/strong>
\nDiyelim ki bu testi yapt\u0131rd\u0131k ve Alzheimer\u2019a ya da n\u00f6ron y\u0131k\u0131m\u0131yla seyreden bir hastal\u0131\u011fa yakalanma riskimizin oldu\u011funu \u00f6\u011frendik. Ne yapmal\u0131? Yukar\u0131daki n\u00f6rofilament \u00e7al\u0131\u015fmas\u0131n\u0131n y\u00fcr\u00fct\u00fcc\u00fclerinden Washington T\u0131p Fak\u00fcltesi ara\u015ft\u0131rmac\u0131lar\u0131n\u0131n bu soruya basit bir cevab\u0131 var: Yat\u0131n ve g\u00fczel bir uyku \u00e7ekin! \u00c7\u00fcnk\u00fc insanlarda ve farelerde yap\u0131lan ara\u015ft\u0131rmalar derin uyku olarak da bilinen yava\u015f dalga uykusunun kesintiye u\u011frad\u0131\u011f\u0131, kalitesiz gece uykusunun s\u00fcrekli tekrar etti\u011fi durumlarda beyin hasar\u0131na ve bili\u015fsel i\u015flev kayb\u0131na yol a\u00e7an tau isimli bir proteinin artt\u0131\u011f\u0131n\u0131 g\u00f6steriyor. Alzheimer\u2019\u0131n olmazsa olmaz g\u00f6stergelerinden olan bu protein asl\u0131nda sa\u011fl\u0131kl\u0131 bireylerde do\u011fal olarak bulunan bir molek\u00fcl. Ancak baz\u0131 durumlarda y\u0131\u011f\u0131nlar olu\u015fturup doku hasar\u0131na neden olabiliyor, ki k\u00f6t\u00fc bir uyku, i\u015fte bu durumlardan biri.
\n9 Ocak\u2019ta Science Translational Medicine<\/em> dergisinde yay\u0131mlanan \u00e7al\u0131\u015fmaya 60 ya\u015f \u00fczeri, %80\u2019i sa\u011fl\u0131kl\u0131, %20\u2019si \u00e7ok hafif bili\u015fsel sorunlar ya\u015fayan 119 birey al\u0131nm\u0131\u015f ve kat\u0131l\u0131mc\u0131lar\u0131n uyku performans\u0131 belli bir s\u00fcre izlenmi\u015f. Sonu\u00e7lar, gecenin ilk saatlerinde ortaya \u00e7\u0131kan, r\u00fcya g\u00f6r\u00fclmeyen ve toplam uykunun b\u00fcy\u00fck b\u00f6l\u00fcm\u00fcn\u00fc olu\u015fturan derin uyku evresinin bir defaya mahsus bozulmas\u0131n\u0131n dahi beyinde y\u00fcksek tau d\u00fczeyiyle ili\u015fkili oldu\u011funu ortaya koyuyor. \u00c7al\u0131\u015fman\u0131n fare aya\u011f\u0131 da farkl\u0131 \u015feyler s\u00f6ylemiyor. Fareler gece ya\u015fay\u0131p g\u00fcnd\u00fcz daha pasif konuma ge\u00e7en canl\u0131lar. \u00d6l\u00e7\u00fcmler beyin tau d\u00fczeylerinin gece iki kat\u0131na \u00e7\u0131kt\u0131\u011f\u0131n\u0131, g\u00fcnd\u00fcz istirahat halinin bozulmas\u0131 halinde ise ikiye katland\u0131\u011f\u0131n\u0131 g\u00f6steriyor. T\u0131pk\u0131 b\u00fct\u00fcn gece uykusuz b\u0131rak\u0131lan 8 kat\u0131l\u0131mc\u0131 bireyde oldu\u011fu gibi. G\u00f6r\u00fcnen o ki tau d\u00fczeylerindeki art\u0131\u015f\u0131n uykusuzlu\u011fun getirdi\u011fi stresle veya davran\u0131\u015f de\u011fi\u015fikli\u011fiyle de ilgisi yok. Zira ara\u015ft\u0131rmac\u0131lar bunu kan\u0131tlamak \u00fczere zarars\u0131z bir maddenin etkisiyle saatlerce uykusuz kalabilen geneti\u011fi de\u011fi\u015ftirilmi\u015f fareler \u00fcretmi\u015fler ve tau\u2019nun bunlarda da y\u00fckseldi\u011fini g\u00f6rm\u00fc\u015fler. G\u00fcnd\u00fcz faaliyetleriyle y\u00fckselip gece uykusuyla temizlenen bu tau d\u00f6ng\u00fcs\u00fcn\u00fc bozmak proteinin zararl\u0131 plaklar olu\u015fturma ihtimalini art\u0131r\u0131yor. Alzheimer\u2019l\u0131 ki\u015filerde tau y\u0131\u011f\u0131nlar\u0131 beynin haf\u0131zadan sorumlu yerlerinde g\u00f6r\u00fcl\u00fcyor, sonra da adeta mantar gibi t\u00fcm beyne yay\u0131l\u0131yor. Daha da \u00f6nemlisi sorun 24 saat i\u00e7inde toplam ne kadar uyudu\u011funuz de\u011fil, derin uykuyu toplamda ne kadar uyudu\u011funuz. Yani tau d\u00fczeyi y\u00fcksek deneklerin g\u00fcnd\u00fcz kestirmeleriyle durumu telafi etmeleri m\u00fcmk\u00fcn olmam\u0131\u015f. T\u00fcm bunlar hem iyi uykunun \u00f6nemine hem de uyku kalitesindeki azalman\u0131n normalden normal d\u0131\u015f\u0131ya ge\u00e7i\u015fin bir g\u00f6stergesi olabilece\u011fine i\u015faret ediyor. Demek ki \u015fu basit soru belki de Alzheimer sinyali olabilir: G\u00fcnd\u00fczleri ne kadar uyukluyorsunuz?<\/p>\n

Di\u015f\u00e7iye gitmemek pahal\u0131ya malolabilir<\/strong>
\nAlzheimer\u2019dan korunman\u0131n bir yolu daha var. Biraz tuhaf g\u00f6r\u00fcnebilir fakat dikkate de\u011fer: Di\u015flerimize iyi bakmak! Uyar\u0131y\u0131 San Francisco\u2019da konu\u015flanm\u0131\u015f, Alzheimer\u2019\u0131n seyrini de\u011fi\u015ftirmek \u00fczere klinik denemeler y\u00fcr\u00fcten \u00f6zel bir ila\u00e7 firmas\u0131 yap\u0131yor: Ad\u0131, Cortexyme Inc. Cortexyme b\u00fcnyesinde bir araya gelen uluslararas\u0131 bir ekibe g\u00f6re hastal\u0131\u011f\u0131n beyinde yaratt\u0131\u011f\u0131 hasar\u0131n hi\u00e7 tahmin edemeyece\u011finiz bir sorumlusu var: Porphyromonas gingivalis<\/em>. 23 Ocak\u2019ta Science Advances<\/em> dergisinde tan\u0131t\u0131lan bu gram-negatif bakteriyi kronik periodontitis isimli hastal\u0131kla tan\u0131yoruz, yani basit\u00e7e s\u00f6ylemek gerekirse, di\u015feti iltihab\u0131! Ara\u015ft\u0131rmac\u0131lar\u0131n belirtti\u011fine g\u00f6re fareler \u00fczerinde yap\u0131lan deneyler a\u011f\u0131zdaki Porphyromonas gingivalis <\/em>bakterisinin beyni istila edip, salg\u0131lad\u0131\u011f\u0131 toksik bir enzim (gingipain) arac\u0131l\u0131\u011f\u0131yla amiloid beta proteininin \u00fcretimini art\u0131rd\u0131\u011f\u0131n\u0131 g\u00f6steriyor. Bu protein de t\u0131pk\u0131 tau gibi, Alzheimer semptomlar\u0131n\u0131n geli\u015fmesinden \u00e7ok \u00f6nce beyinde birikerek plak olu\u015fturan bir molek\u00fcl.<\/p>\n

\"\"
Bir Alzheimer hastas\u0131n\u0131n beyin dokusu g\u00f6r\u00fcnt\u00fcs\u00fc: Ye\u015fil renklendirilmi\u015f k\u0131s\u0131m amiloid beta proteinini, k\u0131rm\u0131z\u0131 noktalar ise bakterinin sald\u0131\u011f\u0131 toksik gingipain enzimini g\u00f6steriyor. Kaynak: S. Dominy ve ark., Science Adanvances 5, 2019.<\/figcaption><\/figure>\n

Cortexyme ara\u015ft\u0131rmac\u0131lar\u0131 makalelerinde Alzheimer patolojisinden sorumlu bir adaya i\u015faret etmekle kalm\u0131yor, \u00e7\u00f6z\u00fcm niteli\u011finde bir molek\u00fcl de \u00f6neriyorlar. Do\u011frudan Porphyromonas gingivalis<\/em>\u2019i hedef alan ve \u015fimdilik COR388 kod ad\u0131yla bilinen bu molek\u00fcl\u00fcn klinik denemelerde n\u00f6roinflamasyonu azaltt\u0131\u011f\u0131, amiloid beta \u00fcretimini bloke etti\u011fi ve Alzheimer\u2019da en fazla zarar g\u00f6ren, bellekle ili\u015fkili beyin b\u00f6lgesi hipokamp\u00fcsteki n\u00f6ronlar\u0131n korunmas\u0131n\u0131 sa\u011flad\u0131\u011f\u0131 belirtiliyor. Dahas\u0131 g\u00f6n\u00fcll\u00fc Alzheimer hastalar\u0131ndan y\u00fcr\u00fct\u00fclen 28 g\u00fcnl\u00fck ila\u00e7 denemesinin ard\u0131ndan bili\u015fsel testlerde de ilerleme sa\u011fland\u0131\u011f\u0131 kaydediliyor. T\u00fcm bunlar \u00fc\u00e7 a\u015famal\u0131 klinik deneme evresinin ilk aya\u011f\u0131yd\u0131. \u015eimdi s\u0131ra 2019\u2019un ilerleyen aylar\u0131nda y\u00fcr\u00fct\u00fclecek 2. ve 3. evre denemelerde.
\nCortexyme\u2019in \u00e7al\u0131\u015fmas\u0131 Alzheimer ile viral\/bakteriyel patojenler aras\u0131nda ili\u015fki kuran ilk ara\u015ft\u0131rma de\u011fil asl\u0131nda. Nitekim Alzheimer\u2019l\u0131 hastalar\u0131n beyninde daha \u00f6nce de spiroket bakterisi ya da herpes vir\u00fcs\u00fc gibi patojenlere rastlanm\u0131\u015f; amiloid beta proteininin ise beyni bu istilac\u0131lardan korumak i\u00e7in \u00e7ok fazla \u00fcretildi\u011fi ve neticede Alzheimer\u2019\u0131n alametifarikas\u0131 plak olu\u015fumunun ortaya \u00e7\u0131kt\u0131\u011f\u0131 s\u00f6ylenmi\u015fti. Di\u015feti iltihab\u0131 ve Alzheimer aras\u0131ndaki nedensellik tart\u0131\u015fmal\u0131 da olsa bir ili\u015fki oldu\u011fu, en az\u0131ndan hastal\u0131\u011f\u0131n geli\u015fimi a\u00e7\u0131s\u0131ndan risk fakt\u00f6r\u00fc olu\u015fturdu\u011fu art\u0131k kesin. O y\u00fczden ne yap\u0131yoruz…di\u015fimizi f\u0131r\u00e7al\u0131yoruz!<\/p>\n

Kaynaklar:<\/strong><\/p>\n

1) \u201cEarly Prediction of Alzheimer\u2019s Progression in Blood\u201d, Ortak bas\u0131n a\u00e7\u0131klamas\u0131: German Center for Neurodegenerative Diseases\u00a0 & Hertie Institute for Clinical Brain Research & University Hospital T\u00fcbingen, T\u00fcbingen\/Germany, 21 Ocak 2019.<\/p>\n

2) Tamara Bhandari, \u201cDecreased deep sleep linked to early signs of Alzheimer\u2019s disease\u201d, Washington University School of Medicine in St. Louis News Release, 9 Ocak 2019.<\/p>\n

3) Jocelyn Kaiser, \u201cGum disease\u2013causing bacteria could spur Alzheimer\u2019s\u201d, Science<\/em>, 23 Ocak 2019.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

G\u00fcn ge\u00e7miyor ki bilim dergilerinde Alzheimer\u2019la ilgili yeni bir \u00e7al\u0131\u015fma, yeni sonu\u00e7lar, insanl\u0131\u011f\u0131 bu illetten kurtarma vaadi ta\u015f\u0131yan yeni umutlar ba\u015fl\u0131klara ta\u015f\u0131nmas\u0131n. Biliminsanlar\u0131n\u0131n bu hummal\u0131 \u00e7abas\u0131 bo\u015funa de\u011fil. Alzheimer t\u00fcm d\u00fcnyada milyonlarca ki\u015fiyi etkiliyor; \u00f6zellikle ya\u015fl\u0131 n\u00fcfusu artan toplumlarda mevcut say\u0131lar\u0131n gelecek 25 y\u0131lda ikiye katlanmas\u0131 bekleniyor. Hal b\u00f6yleyken 2019\u2019un ba\u015f\u0131ndan beri, yani hepsi hepsi […]<\/p>\n","protected":false},"author":184,"featured_media":31993,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[19],"tags":[4475,4472,4474,4473,4471],"class_list":["post-31992","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bilim-gundemi","tag-amiloid-beta-proteini","tag-derin-uyku-alzheimer-iliskisi","tag-diseti-iltihabi-alzheimer-iliskisi","tag-norofilament-proteini","tag-tau-proteini"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t