{"id":9173,"date":"2022-07-25T18:52:22","date_gmt":"2022-07-25T11:52:22","guid":{"rendered":"https:\/\/easymed.vn\/?p=9173"},"modified":"2022-07-25T18:52:22","modified_gmt":"2022-07-25T11:52:22","slug":"bai-giang-mien-dich-hoc-cua-sua-me","status":"publish","type":"post","link":"https:\/\/easymed.vn\/en\/bai-giang-mien-dich-hoc-cua-sua-me\/","title":{"rendered":"B\u00c0I GI\u1ea2NG MI\u1ec4N D\u1ecaCH H\u1eccC C\u1ee6A S\u1eeeA M\u1eb8"},"content":{"rendered":"

S\u1eefa<\/strong> m\u1eb9 l\u00e0 m\u1ed9t ch\u1ea5t ti\u1ebft \u0111\u1eb7c bi\u1ec7t c\u1ee7a t\u00ecnh th\u01b0\u01a1ng y\u00eau kh\u00f4ng m\u01b0u c\u1ea7u l\u1ee3i \u00edch c\u1ee7a m\u1eb9 d\u00e0nh cho con.<\/strong><\/span><\/p>\n

Khi nu\u00f4i con b\u1eb1ng s\u1eefa m\u1eb9, ng\u01b0\u1eddi m\u1eb9 ra s\u1ee9c b\u1ea3o v\u1ec7 \u0111\u1ee9a tr\u1ebb m\u00e0 kh\u00f4ng m\u01b0u c\u1ea7u b\u1ea5t c\u1ee9 m\u1ed9t l\u1ee3i \u00edch c\u00e1 nh\u00e2n n\u00e0o cho ng\u01b0\u1eddi m\u1eb9.<\/span><\/p>\n

Kh\u00f4ng nh\u1eefng trong s\u1eefa m\u1eb9 c\u00f3 m\u1ed9t n\u1ed3ng \u0111\u1ed9 r\u1ea5t cao IgA, 10-100 l\u1ea7n nhi\u1ec1u h\u01a1n trong huy\u1ebft t\u01b0\u01a1ng, m\u00e0 c\u00e1c kh\u00e1ng th\u1ec3 c\u00f3 trong s\u1eefa m\u1eb9 c\u00f2n c\u00f3 m\u1ed9t kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 r\u1ea5t r\u1ed9ng, th\u1ec3 hi\u1ec7n \u0111\u1ed3ng th\u1eddi k\u00fd \u1ee9c mi\u1ec5n d\u1ecbch c\u1ee7a ng\u01b0\u1eddi m\u1eb9 c\u0169ng nh\u01b0 c\u00e1c nhi\u1ec5m tr\u00f9ng kh\u00f4ng h\u1ec1 t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn tuy\u1ebfn v\u00fa. C\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01b0\u1ee3c ti\u1ebft ra trong s\u1eefa m\u1eb9 ph\u1ea3n \u00e1nh s\u1ef1 ho\u1ea1t h\u00f3a c\u00e1c m\u00f4 lympho li\u00ean \u0111\u1edbi v\u1edbi ni\u00eam m\u1ea1c (Mucosa-Associated Lymphoid Tissue) (MALT) c\u1ee7a m\u1eb9 trong \u0111\u01b0\u1eddng ru\u1ed9t v\u00e0 \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, l\u00e0 c\u00e1c t\u00e1c nh\u00e2n th\u01b0\u1eddng t\u1ea5n <\/span>c\u00f4<\/span>ng tr\u1ebb nh\u1ea5t trong nh\u1eefng ng\u00e0y \u0111\u1ea7u khi tr\u1ebb v\u1eabn c\u00f2n \u0111ang trong qu\u00e1 tr\u00ecnh th\u00edch nghi v\u1edbi m\u00f4i tr\u01b0\u1eddng ngo\u00e0i t\u1eed cung. C\u00f3 th\u1ec3 v\u00ed ng\u01b0\u1eddi m\u1eb9 nh\u01b0 m\u1ed9t nh\u00e0 m\u00e1y s\u1ea3n xu\u1ea5t kh\u00e1ng th\u1ec3 \u0111\u1ec3 cung c\u1ea5p cho con khi \u0111\u1ee9a tr\u1ebb ch\u01b0a th\u1ec3 t\u1ef1 s\u1ea3n xu\u1ea5t \u0111\u01b0\u1ee3c kh\u00e1ng th\u1ec3 cho m\u00ecnh, \u0111\u1ed3ng th\u1eddi bi\u1ebft r\u00f5 nhu c\u1ea7u mi\u1ec5n d\u1ecbch c\u1ee7a con c\u1ea7n \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 kh\u1ecfi t\u00e1c nh\u00e2n n\u00e0o.<\/span><\/p>\n

Ngo\u00e0i 90% l\u00e0 IgA, trong s\u1eefa m\u1eb9 c\u00f2n c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a IgG v\u00e0 IgM v\u1edbi n\u1ed3ng \u0111\u1ed9 th\u1ea5p h\u01a1n, v\u00e0 m\u1ed9t s\u1ed1 t\u00e1c nh\u00e2n b\u1ea3o v\u1ec7 kh\u00e1c. N\u1ed3ng \u0111\u1ed9 IgA trong s\u1eefa non \u1edf ng\u01b0\u1eddi > 1 g\/L. IgA, v\u00e0 \u0111\u01b0\u1ee3c duy tr\u00ec \u1edf t\u1ed1c \u0111\u1ed9 s\u1ea3n xu\u1ea5t kho\u1ea3ng 0.5 g\/ng\u00e0y.<\/span><\/p>\n

\"\"<\/p>\n

H\u00ecnh 1: Bi\u1ebfn thi\u00ean n\u1ed3ng \u0111\u1ed9 IgA trong s\u1eefa m\u1eb9<\/span><\/p>\n

Tr\u1ee5c ho\u00e0nh t\u00ednh theo \u0111\u01a1n v\u1ecb ng\u00e0y h\u1eadu s\u1ea3n. Tr\u1ee5c tung l\u00e0 n\u1ed3ng \u0111\u1ed9 t\u00ednh b\u1eb1ng mg\/mL c\u1ee7a sIgA (\u0111\u1ecf) v\u00e0 c\u1ee7a\u00a0 Lactoferrin (xanh)<\/span><\/p>\n

IMMUNOGLOBULIN A<\/strong><\/h3>\n

IgA trong s\u1eefa m\u1eb9 l\u00e0 sIgA (secretory Immunoglobulin A ).<\/b><\/p>\n

C\u00f3 2 lo\u1ea1i IgA l\u00e0 IgA huy\u1ebft t\u01b0\u01a1ng v\u00e0 IgA ch\u1ebf ti\u1ebft.\u00a0 IgA trong s\u1eefa m\u1eb9 ch\u1ee7 y\u1ebfu l\u00e0 IgA ch\u1ebf ti\u1ebft (secretory IgA – sIgA), l\u00e0 c\u00e1c IgA c\u1ee7a bi\u1ec3u m\u00f4, \u0111\u01b0\u1ee3c ch\u1ebf ti\u1ebft t\u1eeb bi\u1ec3u m\u00f4. sIgA g\u1ed3m 2 th\u00e0nh t\u1ed1 li\u00ean k\u1ebft v\u1edbi nhau b\u1eb1ng m\u1ed9t chu\u1ed7i J (J chain) l\u00e0 polypeptid gi\u00e0u cystein s\u1ea3n xu\u1ea5t t\u1eeb t\u1ebf b\u00e0o bi\u1ec3u m\u00f4, v\u00e0 th\u00e0nh ph\u1ea7n ch\u1ebf ti\u1ebft bi\u1ec3u m\u00f4 (secretory component).<\/span><\/p>\n

Nh\u1edd \u0111\u00f3, sIgA c\u00f3 c\u1ea5u tr\u00fac c\u0169ng nh\u01b0 t\u00ednh n\u0103ng kh\u00e1c h\u1eb3n c\u00e1c globulin mi\u1ec5n d\u1ecbch kh\u00e1c.<\/span><\/p>\n

\"\"<\/span><\/p>\n

H\u00ecnh 2: sIgA<\/span><\/p>\n

S\u01a1 \u0111\u1ed3 c\u1ea5u tr\u00fac c\u1ee7a sIgA v\u1edbi chu\u1ed7i J v\u00e0 th\u00e0nh ph\u1ea7n ch\u1ebf ti\u1ebft<\/span><\/p>\n

Nguy\u00ean li\u1ec7u c\u1ee7a sIgA \u0111\u01b0\u1ee3c cung c\u1ea5p t\u1eeb t\u01b0\u01a1ng b\u00e0o, v\u1edbi kh\u00e1ng nguy\u00ean t\u1eeb h\u1ec7 th\u1ed1ng MALT.<\/b><\/p>\n

T\u1ebf b\u00e0o tuy\u1ebfn v\u00fa d\u00f9ng nguy\u00ean li\u1ec7u Ig t\u1eeb t\u01b0\u01a1ng b\u00e0o \u0111\u1ec3 l\u1eafp gh\u00e9p sIgA.<\/b><\/p>\n

Gi\u1ea3 thuy\u1ebft v\u1ec1 con \u0111\u01b0\u1eddng \u201cru\u1ed9t-tuy\u1ebfn v\u00fa\u201d gi\u1ea3i th\u00edch s\u1ef1 h\u00ecnh th\u00e0nh IgA trong s\u1eefa m\u1eb9 l\u00e0 m\u1ed9t l\u00fd thuy\u1ebft \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn r\u1ed9ng r\u00e3i.\u00a0<\/span><\/p>\n

C\u00e1c kh\u00e1ng nguy\u00ean trong \u0111\u01b0\u1eddng ru\u1ed9t \u0111\u01b0\u1ee3c \u0111\u01b0\u1ee3c b\u1eaft b\u1edfi c\u00e1c m\u1ea3ng Peyer (Peyer patches), m\u1ed9t trong c\u00e1c m\u00f4 lympho li\u00ean \u0111\u1edbi v\u1edbi ni\u00eam m\u1ea1c (Mucosa-Associated Lymphoid Tissue) (MALT) c\u1ee7a m\u1eb9 trong \u0111\u01b0\u1eddng ru\u1ed9t, v\u00e0 \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n \u0111\u1ebfn c\u00e1c h\u1ea1ch lympho m\u1ea1c treo. T\u1ea1i h\u1ea1ch lympho m\u1ea1c treo, <\/span>ch\u00fa<\/span>ng \u0111\u01b0\u1ee3c b\u1eaft b\u1edfi c\u00e1c t\u1ebf b\u00e0o lympho B, c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb nguy\u00ean b\u00e0o lympho.<\/span><\/p>\n

\"\"<\/p>\n

H\u00ecnh 3: Con \u0111\u01b0\u1eddng ru\u1ed9t-tuy\u1ebfn v\u00fa c\u1ee7a IgA<\/span><\/p>\n

S\u01a1 \u0111\u1ed3 tr\u00ean tr\u00ecnh b\u00e0y m\u1ed9t c\u00e1ch kh\u00e1i qu\u00e1t con \u0111\u01b0\u1eddng ru\u1ed9t-tuy\u1ebfn v\u00fa.H\u1ec7 MALT \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quan tr\u1ecdng. H\u00ecnh ph\u1ea3i l\u00e0 c\u1ea5u tr\u00fac m\u1ed9t MALT.<\/span><\/p>\n

V\u1edbi s\u1ef1 h\u1ed7 tr\u1ee3 c\u1ee7a c\u00e1c cytokine t\u1eeb lympho T, c\u00e1c lympho B ho\u00e0n t\u1ea5t qu\u00e1 tr\u00ecnh bi\u1ec7t h\u00f3a v\u00e0 th\u00e0nh t\u1ea1o c\u00e1c t\u01b0\u01a1ng b\u00e0o (plasma cell) v\u1edbi kh\u1ea3 n\u0103ng s\u1ea3n xu\u1ea5t kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u.\u00a0<\/span><\/p>\n

\"\"<\/span><\/p>\n

H\u00ecnh 4: Ti\u1ebfn tr\u00ecnh th\u00e0nh t\u1ea1o t\u01b0\u01a1ng b\u00e0o, ngu\u1ed3n g\u1ed1c c\u1ee7a c\u00e1c IgA<\/span><\/p>\n

T\u01b0\u01a1ng b\u00e0o s\u1ebd \u0111\u1ebfn tuy\u1ebfn v\u00fa, \u0111\u1ec3 t\u1ea1i \u0111\u00f3 <\/span>ch\u00fa<\/span>ng tham gia v\u00e0o ti\u1ebfn tr\u00ecnh t\u1ed5ng h\u1ee3p sIgA.<\/span><\/p>\n

IgA t\u1eeb t\u01b0\u01a1ng b\u00e0o, \u0111\u01b0\u1ee3c g\u1eafn v\u1edbi th\u00e0nh ph\u1ea7n ch\u1ebf ti\u1ebft v\u00e0 \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n trong t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 \u0111\u1ec3 \u0111i \u0111\u1ebfn b\u1ec1 m\u1eb7t bi\u1ec3u m\u00f4 v\u00fa.<\/span><\/p>\n

Khi \u0111\u1ebfn bi\u1ec3u m\u00f4 tuy\u1ebfn v\u00fa, c\u00e1c t\u01b0\u01a1ng b\u00e0o s\u1ebd ph\u00f3ng th\u00edch c\u00e1c IgA \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p<\/span> tr\u01b0\u1edbc <\/span>\u0111\u00f3. C\u00e1c dimer IgA \u0111\u01b0\u1ee3c g\u1eafn k\u1ebft v\u1edbi nhau b\u1eb1ng chu\u1ed7i J s\u1ebd di chuy\u1ec3n v\u1ec1 ph\u00eda c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 tuy\u1ebfn v\u00fa.\u00a0<\/span><\/p>\n

Trong tuy\u1ebfn v\u00fa, secretory component c\u1ee7a IgA \u0111\u01b0\u1ee3c s\u1ea3n s\u1ea3n xu\u1ea5t t\u1eeb ph\u1ee9c b\u1ed9 Golgi v\u00e0 l\u01b0\u1edbi n\u1ed9i sinh ch\u1ea5t,<\/span> sau \u0111\u00f3 <\/span>\u0111\u01b0\u1ee3c \u0111\u01b0a ra ngo\u00e0i \u0111\u1ec3 g\u1eafn v\u00e0o ph\u00e2n t\u1eed dimeric c\u1ee7a IgA. Ph\u1ee9c b\u1ed9 sIgA ho\u00e0n ch\u1ec9nh s\u1ebd \u0111\u01b0\u1ee3c chuy\u1ec3n v\u00e0o n\u1ed9i b\u00e0o, v\u00e0 \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n b\u1edfi c\u00e1c n\u1ed9i th\u1ec3 (endosome) v\u1ec1 ph\u00eda b\u1ec1 m\u1eb7t c\u1ee7a bi\u1ec3u m\u00f4 v\u00e0 \u0111\u01b0\u1ee3c ph\u00f3ng th\u00edch ra ngo\u00e0i.\u00a0<\/span><\/p>\n

IgA s\u1ebd \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n xuy\u00ean t\u1ebf b\u00e0o \u0111\u1ec3 \u0111\u01b0a v\u00e0o l\u00f2ng tuy\u1ebfn s\u1eefa.<\/span><\/p>","protected":false},"excerpt":{"rendered":"

S\u1eefa m\u1eb9 l\u00e0 m\u1ed9t ch\u1ea5t ti\u1ebft \u0111\u1eb7c bi\u1ec7t c\u1ee7a t\u00ecnh th\u01b0\u01a1ng y\u00eau kh\u00f4ng m\u01b0u c\u1ea7u l\u1ee3i \u00edch c\u1ee7a<\/p>","protected":false},"author":21,"featured_media":9177,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[73],"tags":[],"class_list":["post-9173","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-san-khoa"],"_links":{"self":[{"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/posts\/9173","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/users\/21"}],"replies":[{"embeddable":true,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/comments?post=9173"}],"version-history":[{"count":1,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/posts\/9173\/revisions"}],"predecessor-version":[{"id":9178,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/posts\/9173\/revisions\/9178"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/media\/9177"}],"wp:attachment":[{"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/media?parent=9173"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/categories?post=9173"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/easymed.vn\/en\/wp-json\/wp\/v2\/tags?post=9173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}