gverdiTi amiotrofuli sklerozi.

progresirebadi, qronikuli fataluri da-

avadebaa, romelic xasiaTdeba centraluri da periferiuli motoneironebis dazia-
nebiT. gverdiTi amiotrofuli sklerozi miekuTvneba mamoZravebeli neironebis da-
avadebis jgufs, roca SerCeviTad ziandeba centraluri (qerqovani) da periferiuli
mamoZravebeli neironebi. iTvleba, rom daavadebis mizezia Cu/Zn-damokidebuli su-
perosiddismutazas (sod-1) masinTezirebel genSi momxdari mutaciebi.
gverdiTi amiotrofuli sklerozis SemTxvevaSi motoneironebSi swrafad iSle-
ba citoConCxi. aqsonebSi xSirad SeiniSneba neirofilamenturi grovebis gafarToe-
bebi, Tumca ar aris nanaxi cvlilebebi intersticialur da damxmare sayrden qso-
vilSi (astrocitebi, oligodendrocitebi) da mikrogliaSi. gverdiTi amiotrofuli
sklerozis damaxasiaTebeli Tvisebaa mxolod motoneironebis dazianeba. cns-is sxva
struqturebis neironebSi cvlilebebi ar aRiniSneba, Tuca SeiniSneba ubiqvitinis
grovebi (degeneraciis niSani). daavadebis procesSi sxva neironebis CarTulobaze
metyvelebs aseve cvlilebebi glukozis metabolizmSi. SesaZlebelia, rom neirone-
bis daRupvis mizezi iyos amagznebeli mediatori glutamati. am mediatoris toqsi-
kuri moqmedebisagan neironebi daculia sod-1-iT, fermentiT, romelic uzrunvel-
yofs superoqsidis radikalis gauvnebelyofas.

IV.4.2. nervuli sistemis autoimunuri daavadebebi

autoimunuri daavadebebis mizezia im meqanizmis darRveva, romlis daxmarebiTac

moqmedebs organizmis imunuri sistema. am paTologiebis klasikuri magaliTia mias-
tenia da gafantuli sklerozi.
gafantuli sklerozi. gafantuli sklerozi qronikuli autoimunuri daavade-
baa, romlis drosac ziandeba Tavis tvinisa da zurgis tvinis nervuli boWkoebis mi-
elinuri garsi. mielinuri garsis dazianeba xorcieldeba imunuri ujredebiT, rasac
sabolod mosdevs neironis daRupva. miuxedavad imisa, rom termini `sklerozis~ qveS
igulisxmeba xandazmul asakSi mexsierebis darRveva, dasaxeleba `gafantuli skle-
rozi~ ar aris kavSirSi arc xandazmulobasTan da arc mexsierebis darRvevebTan. ga-
fantuli sklerozisaTvis damaxasiaTebelia mTels nervul sistemaze mravlobiTi
(gafantuli) kerebis arseboba — nervuli qsovilis Canacvleba SemaerTebeli qsovi-
liT da, Sesabamisad, nawiburebis (sklerozuli struqturebis) warmoqmna.
daavadeba Tavs iCens axalgazrda da saSualo asakSi (15-40weli). daavadebis Tavise-
burebaa nervuli sistemis sxvadasxva ganyofilebis erTdrouli dazianeba, rasac mos-
devs gansxvavebuli paTologiuri nevrologiuri simptomebi. daavadebis morfologi-
uri safuZvelia Tavis tvinisa da zurgis tvinSi mielinis dazianeba. Sedegad, warmoebs
gafantuli sklerozuli laqebis gaCena. laqebis zoma ramdenime milimetridan ramde-
nime santimetramdea. daavadebis progresirebasTan erTad izrdeba laqebis zomac.
gafantuli sklerozis ganviTarebis mizezi zustad cnobili ar aris. dReisaTvis
yvelaze miRebulia mosazreba imis Sesaxeb, rom daavadeba SesaZlebelia viTardebodes
sxvadasxva arasasurveli gare da Sida faqtorebis zemoqmedebiT. arasasurvel gare
faqtorebs miekuTvneba virusuli da baqteriuli infeqciebi, toqsikuri naerTebisa
da radiaciis zemoqmedeba, kvebis Tavisebureba, travmebi, xSiri stresuli situaciebi.
miastenia gravisi. miasteniis mizezia nerv-kunTovani gadacemis Sesusteba. ner-
v-kunTovani gadacemis neirotransmiters warmoadgens acetilqolini. daavadebul
pacientTa 90%-is SardSi aRiniSneba postsinafsur membranaze ganTavsebuli ace-
tilqolinis nikotinuri receptoris mimarT warmoqmnili antisxeulebi, romlebic

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urTierTqmedebs receptorTan da iwvevs maTi acetilqolinTan dakavSirebis unaris
Semcirebas, an darRvevebs ionebis transportirebaSi. pacientebSi aseve Semcirebu-
lia uSualod receptorebis raodenobac. daavadebis gamomwvevi mizezebi ucnobia.
endokrinuli jirkvali Timusi, romelic monawileobs antisxeulebis warmoqmnaSi,
CarTulia daavadebis ganviTarebis procesSi. TimusSi nanaxia acetilqolinis io-
notropuli receptoris antisxeulebi. pacientebma, daavadebis bunebidan gamomdi-
nare, SesaZlebelia Caitaron mxolod erTi saxis mkurnaloba, kerZod, moaxdinon
ferment acetilqolinesTerazas aqtivobis inhibireba. amisaTvis iyeneben piridos-
tigminis bromids. acetilqolinerTerazas inhibireba iwvevs acetilqolinis raode-
nobis matebas da, Sesabamisad, acetilqolinuri stimulis gaZlierebas. mkurnalobis
sxva SesaZleblobaa imunosupresiuli medikamentebis da steroidebis miReba an Ti-
musis qirurgiuli amokveTa.
miastenia gravisis garda, samedicino praqtikaSi xSirad gvxvdeba aseve autoimu-
nuri daavadeba, romelsac lambert-itonis miasTeniuri sindromi ewodeba. daavade-
bis mizezs warmoadgens organizmSi presinafsuri membranis potencialdamokidebu-
li Ca2+-arxebis mimarT antisxeulebis gamomuSaveba. rogorc cnobilia, ujredis de-
polarizacia iwvevs maT gaxsnas da sinafsur terminalSi Ca-is ionebis raodenobis
matebas, rasac Cveulebriv mosdevs sinafsuri vezikulebis presinafsur membranas-
Tan Sewyma da neirotransmiterebis sinafsur napralSi gadmosvla. am arxebis mimarT
antisxeulebis warmoqmna nerv-kunTovani sinafsebis neironebSi axdens Ca2+-arxebis
muSaobis blokirebas, ris gamoc ioni ver xvdeba sinafsur terminalSi da, Sesabami-
sad, ver asrulebs Tavis funqcias. acetilqolinis raodenoba, romelic nerv-kun-
Tovani sinafsis ZiriTadi neirotransmiteria, maqsimalurad mcirdeba. neirotran-
smiteris koncentraciis Semcirebis Sedegad kunTSi ar xdeba moqmedebis potencia-
lis warmoqmna da kunTis muSaoba minimalizdeba.
Sizofrenia. Sizofrenia (Zv. berZnulidan σχίζω – vapob da φρήν – goneba) poli-
morfuli fsiqikuri darRveva an fsiqikuri darRvevebis jgufia, romelic dakavSi-
rebulia azrovnebis procesebis da emociuri reaqciebis moSlasTan. avadmyofobis
yvelaze xSiri gamovlinebebia smeniTi halucinaciebi, paranoidaluri an fantasti-
kuri bodva, aseve, metyvelebisa da azrovnebis dezorganizebuloba mniSvnelovani
socialuri disfunqciisa da muSaobis unaris darRvevis fonze. Sizofreniis gamom-
wvevi mizezebi ucnobia, Tumca ganixileba sxvadasxva faqtorebi, kerZod, fsiqolo-
giuri, socialuri, anatomiuri, bioqimiuri da sxva, romlebic savaraudod ganapiro-
bebs am paTologiis warmoqmnas. fiqroben, rom Sizofreniis CamoyalibebaSi CarTu-
lia Tavis tvinis prefrontaluri qerqisa da saferTqlis zeda da Sida qerqis wile-
bi, aseve hipokampi.
arsebobs Sizofreniis bioqimiuri meqanizmebis sxvadasxva Teoria. kerZod, ganixi-
leba acetilqolinis, noradrenalinis, opiatebis, peptidebisa da sxvadasxva biolo-
giurad aqtiuri molekulebis monawileoba am daavadebis formirebaSi. Tumca, bolo
xanebSi mecnierTa yuradReba miipyro dofaminma. gairkva, rom SizofreniiT daavade-
buli pacientebi, romlebic samkurnalod iyenebdnen neiroleptikur preparatebs,
avaddebodnen parkinsonizmiT, rac, savaraudod, gamowveuli unda iyos am preparate-
bis gavleniT dofaminis raodenobaze. Sizofreniis dofaminuri Teoriis mixedviT,
daavadebis mizezia hiperdofaminergia (im dros, roca parkinsonizmi ganixileba, ro-
gorc hipodofaminerguli mdgomareoba). dofaminis raodenobis gazrdis paralelu-
rad, qsovilebSi gazrdilia aseve dofaminis D2-tipis receptorebis raodenobac. daa-
vadebis samkurnalod gamoyenebuli farmakologiuri perparatebi, ZiriTadad, ori ka-
tegoriisaa — tipuri (qlorpromazini, haloperidoli da sxv.) da atipuri (klozapini,

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risperidoni da sxv.) antifsiqozuri preparatebi. am preparatebis moqmedebis meqa-
nizmi gansxvavebulia. haloperidolis farmakologiuri efeqti ganisazRvreba misi
urTierTqmedebiT dofaminis D2-receptorTan. haloperidolisa da misi msgavsi prepa-
ratebis moqmedeba ganpirobebulia maTi supresoruli efeqtiT receptoris aqtivo-
baze, kerZod, mastabilizebeli zegavleniT araaqtiur D2-receptorze.
sapirispiro efeqts iwvevs farmakologiuri preparati klozapini, romelic
mniSvnelovnad aZlierebs dofaminis gamoTavisuflebas Tavis tvinis prefronta-
lur ubanSi da adrenoreceptorebis antagonistia. es efeqti SesaZlebelia, aseve,
iwvevdes dofaminis raodenobis gazrdasac.
Sizofreniis mkurnalobaSi gansakuTrebuli interesi gamoiwvia glutamatma da
daavadebis mimdinareobisas misi NMDA-receptoris raodenobis Semcirebam. dadge-
nilia, rom Sizofreniis dros Tavis tvinSi araadekvaturadaa Semcirebuli NMDA-
receptoris raodenoba. is nivTierebebi, romlebic iwveven glutamaturi aqtivobis
Semcirebas (fenciklidini, ketamini), Sizofreniismagvar simptomebis mizezi xdeba.
is faqti, rom glutamats SeuZlia gavlena moaxdinos dofaminergul sistemaze da
orive es sistema dakavSirebulia SizofreniasTan, metyvelebs glutamaturi sasig-
nalo gzebis monawileobaze daavadebis CamoyalibebaSi.

IV.5. sensoruli procesebi

IV.5.1. mxedvelobis procesis molekuluri meqanizmi

mxedveloba — cocxali organizmebis arsebobis aucilebeli Semadgeneli nawilia.

mxedvelobis procesi mimdinareobs Tvalis saSualebiT, romelsac rTuli agebule-
ba aqvs (sur.IV.44).
mxedvelobis procesSi TvalSi Sesuli sinaTlis sxivi gaivlis rqovanas, wina ka-
meras, romelic Seicavs e.w. wylovan nams, brols, minisebur sxeuls da sabolood
fokusirdeba baduraze. badura tvinis nawilia, romelic mas gamoeyo evoluciis ad-
reul stadiebze da dakavSirebulia tvinTan mxedvelobis nervis saSualebiT. badu-
ra Seicavs 125 milionamde sinaTlisadmi mgrZnobiare, e.w. fotoreceptorul ujre-
debs — Cxirebsa da kolbebs.

suraTi IV.44. adamianis Tvali

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