最新再将新颖锁阳、生姜、喷鼻菇、羊肉一教学讲义PPT.ppt

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1、再将新颖锁阳、生姜、喷鼻菇、羊肉一Whydiabetes(type1)andCD?Commongeneticbackground(HLA-markerDQ2,DQ8))Bothhaveincreasedgutpermeability(causedbyaproteinmodulatorcalledzonulin),presenteveninpre-diabetes(70%),severalyearsbeforeonset(inaverage3.5years).SaponeA.Diabetes2006;55:1443-49.AlltfrånSchoberEarly(<3

2、months)introductionofglutenincreasedriskofdevelopingdiabetes6-to9-fold.Norris,JM.JAmMedAssoc2003;290:1713-20.ZieglerAG.JAmMedAssoc2003;290:1721-28.Late(>6months)introductionofglutenisariskfactorfordevelopingantibodiesprecedingdiabetesWahlbergJ.BrJNutrition2006;95:603-08.22;022Zonulin-ke

3、epingthingsinandoutoforderinthegutBloodvesselIntestineEndothelialcellsTightjunctionCholerabacteriaZottoxinDiarrhea!!➠BacteriaareflushedoutThezonulinsystemBloodvesselIntestineZonulinDiarrhea!!Activatedby:PrematurityAnybacteria(evendead!)Toxins(foodpoisoning)RadiationChemotherapyFasan

4、oA.Gut2001;49:159-62.90%ofabsorbedproteinsareconvertedtopeptidesthattheimmunesystemwillnotreacttoWhitebloodcell22;023TheCDIcebergModelMostcasesofCDareundiagnosedUNDIAGNOSEDDIAGNOSEDGeneticbackgroundCDdefinitionSilentdisease(relatives)Others?DiseaseawarenessDiagnosticfacilitiesGlutenin

5、takeGastrointestinalinfectionsOthers?SlidefromESchoeber22;027OnsetofceliacdiseaseinfirstyearoflifeChronicdiarrhoeaàFailuretothriveàAbdominaldistensionTypicalsymptoms:HeightWeight22;028OnsetofceliacdiseaseinfirstyearoflifeBiopsyfromintestinalcellwallliningwithWatson´scapsulePremedicatio

6、nbutnotgeneralanesthesiaDiagnosis:HeightWeight22;029AtypicalsymptomsofceliacdiseaseSecondarytomalabsorptionAnaemiaduetoirondeficiencyShortstature,growthfailureBoneloss(osteopenia)RecurrentabdominalpainFlatulenceFattyliver22;0210AtypicalsymptomsofceliacdiseaseIndependentofmalabsorptionDe

7、ntalenameldeficiencyAtaxia(unsteadygait)Alopecia(localisedhairloss)InfertilityLaboratoryabnormalities(transaminases)RecurrentaphthousstomatitisEpilepsy(withorwithoutcalcificationsonCTscan)Polyneuropahty(peripheralneuronaldisease)Heartproblems(dilativecardiomyopathy)22;0211CDand