He mate kiri roa te Rosacea, ā, ko tōna āhua he whero me te pupuhi o te mata. E pāngia ana e te 5% o te taupori o te ao, ahakoa e mōhiotia ana ngā take, kāore i te tino mōhiotia whānuitia. E kiia ana he mate kiri roa tēnei, ā, ko te nuinga ka pā ki ngā wāhine Pākehā/Caucasian neke atu i te 30 tau te pakeke. He maha ngā momo momo rosacea, ā, ka pā ki te katoa.
E rangahauhia ana te whakamahinga o te rama whero hei rongoā i ngā mate kiri pēnei i te whakaora kiri, te mumura whānui, te collagen i roto i te kiri, me ngā mate kiri e pā ana pēnei i te hakihaki.Kua piki ake te hiahia ki te whakamahi i te rama whero mō te rosacea. I roto i tēnei tuhinga ka tirohia e tātou mēnā ka taea e te whakaora rama whero (e mōhiotia ana ko te photobiomodulation, te whakaora LED, te whakaora laser, te reera makariri, te whakaora rama, LLLT, me ētahi atu) te āwhina i te rongoā i te rosacea.
Ngā momo Rosacea
He rerekē, he ahurei hoki ngā tohu o te katoa e pāngia ana e te rosacea. Ahakoa e hono ana te rosacea ki te whero o te mata huri noa i te ihu me ngā paparinga, he maha atu anō ngā tohu ka taea te wehewehe me te whakarōpū ki ngā 'momo iti' o te rosacea:
Ko te momo iti 1, e kiia nei ko te 'Erythematotelangiectatic Rosacea' (ETR), ko te rosacea tino noa e puta mai ana me te whero o te mata, te mumura o te kiri, ngā oko toto e tata ana ki te mata me ngā wā e whero ana. I ahu mai te erythema i te kupu Kariki erythros, ko tōna tikanga he whero – ā, e pā ana ki te kiri whero.
Momo iti 2, Acne rosacea (ingoa pūtaiao – papulopustular), he rosacea e honoa ai te kiri whero me ngā pupuhi tonu, ā-wā rānei, he rite ki te hakihaki (ngā pustules me ngā papules, ehara i te pango). Ka taea e tēnei momo te whakaputa i te kare wera, te ngau rānei.
Ko te momo iti 3, arā, ko te rosacea phymatous, ko te rhinophyma rānei, he momo onge ake o te rosacea, ā, ka uru atu ki ngā wāhanga o te mata ka matotoru haere, ka nui haere – ko te ihu (ihu rīwai) te nuinga. He mea noa tēnei i roto i ngā tāne kaumātua, ā, ka tīmata hei momo rosacea anō.
Ko te momo iti 4 ko te rosacea o te kanohi, ko te rosacea ocular rānei, ā, ka uru atu ki ngā kanohi whero, ngā kanohi waiwai, te kare o tetahi mea i roto i te kanohi, te wera, te mākūkū me te kiripaka.
He mea nui te mōhio ki ngā momo āhua o te rosacea hei whakatau mēnā kei a koe tēnei mate. Ki te kore he mahi hei rongoā i te rosacea, ka kino haere i te roanga o te wā. Waimarie, kāore te whakamahinga o te rongoā rama whero hei rongoā i te rosacea e rerekē ana i te momo āhua. Ko te tikanga ka mahi te tikanga rongoā rama whero kotahi mō ngā momo āhua katoa. He aha ai? Me titiro tātou ki ngā take o te rosacea.
Te Take Tuturu o te Rosacea
(…me te aha hoki ka āwhina ai te rongoā mārama)
I ngā tekau tau kua pahure ake nei, i whakaponohia tuatahitia ko te rosacea te hua o te mate huakita. I te mea i whai hua ngā paturopi (tae atu ki te tetracycline) ki te whakahaere i ngā tohu, i te āhua nei he ariā pai….engari i kitea wawetia kāore he huakita i roto.
Ko te nuinga o ngā tākuta me ngā tohunga mō te rosacea i ēnei rā ka kī atu he mea ngaro te rosacea, ā, kāore anō kia kitea te pūtake. Ka tohu ētahi ko ngā mite Demodex te pūtake, engari he tata ki te katoa te mate nei, ā, ehara i te katoa te mate rosacea.
Kātahi ka whakarārangihia e rātou ngā 'pūtake' hei whakakapi i te pūtake, ka kī rānei ko ngā ira me ngā āhuatanga taiao kāore i te whakahuatia te pūtake. Ahakoa ka taea e ngā āhuatanga ira, epigenetic rānei te whakararu i te tangata ki te pāngia e te rosacea (e pā ana ki tētahi atu tangata), kāore rātou e whakatau - ehara rātou i te pūtake.
He maha ngā āhuatanga e whai wāhi ana ki te kaha o ngā tohumate rosacea (te kawheine, ngā mea kakara, ētahi kai, te rangi makariri/werawera, te ahotea, te waipiro, me ētahi atu), engari ehara i te mea koinei te pūtake.
Nā, he aha te mea?
Ngā tohu mō te take
Ko te tohu tuatahi ki te take ko te mea ka puta te rosacea i muri i te 30 tau. Koinei te tau ka kitea ngā tohu tuatahi o te koroheketanga. Ka kite te nuinga o te tangata i ō rātou makawe hina tuatahi me ngā kita kiri iti tuatahi i tēnei tau.
Ko tētahi atu tohu ko te āwhina a ngā paturopi ki te whakahaere i ngā tohumate – ahakoa kāore he mate pāwera (tohutohu: ka pā he pānga ārai-mumura mō te wā poto ki ngā paturopi).
E 3 ki te 4 ngā wā teitei ake te rere o te toto ki te kiri e pāngia ana e te rosacea i tō te kiri noa. Ka puta tēnei pānga hyperemia ina kore e taea e ngā kiko me ngā pūtau te tango i te hāora mai i te toto.
E mōhio ana tātou ehara te rosacea i te mea he raruraru āhua noa iho, engari he nui ngā panonitanga tipu fibrotic ki te kiri (nō reira te ihu rīwai i te momo 3) me te tipu o ngā uaua toto (nō reira ngā uaua/whero). Ina puta ēnei tohu ōrite ki ētahi atu wāhi o te tinana (hei tauira, ngā fibroids uterine) me tirotirohia nui, engari i roto i te kiri ka whakakorehia hei raruraru āhua hei 'whakahaere' mā te 'ārai i ngā mea e whakaoho ana', ā, i muri mai ka taea te pokanga hei tango i te kiri matotoru.
He take nui te rosacea nā te mea ko te pūtake o ngā tukanga ā-tinana kei roto i te tinana. Ehara i te mea ko te kiri anake te pānga o te āhua ā-tinana e hua mai ai ēnei huringa kiri – engari ko te tinana katoa anō hoki.
Ka kitea wawetia te whero, te tipu/te urutomo o ngā oko toto me te matotoru o te kiri i roto i te rosacea, nā te mea e kitea ana i roto i te kiri - te mata o te tinana. He manaakitanga te whiwhi tohu rosacea, nā te mea e whakaatu ana kei te hē tetahi mea i roto. He rite tonu te ngaro o te makawe tāne, arā, he tohu ki te koretake o te whakahaeretanga o ngā homoni.
Ngā hapa mitochondrial
Ko ngā kitenga me ngā inenga katoa e pā ana ki te rosacea e tohu ana ko ngā raruraru mitochondrial te pūtake o te rosacea.
Kāore e taea e ngā mitochondria te whakamahi tika i te hāora ina pakaru. Ka piki ake te rere o te toto ki te kiko nā te korenga e taea te whakamahi i te hāora.
Ka whakaputahia e ngā mitochondria te waikawa lactic ina kore e taea te tiki me te whakamahi i te hāora, ka hua ake te whakawhanui tonu o ngā oko toto me te tipu o ngā fibroblasts. Mēnā ka roa tēnei raruraru mō tētahi wā, ka tīmata te tipu o ngā oko toto hou.
Ka taea e ngā āhuatanga homoni me te taiao te whai wāhi ki te ngoikore o te mahi mitochondrial, engari i roto i te horopaki o te rongoā rama whero, ko te pānga nui rawa atu ko te ngota ngota e kiia nei ko te Nitric Oxide.
Te Whakaora Rama Whero me te Rosacea
Ko te ariā matua e whakamārama ana i ngā pānga o te whakaora mārama e ahu mai ana i tētahi ngota e kiia nei ko te Nitric Oxide (NO).
He ngota ngota tēnei ka pā ki te tinana, pērā i te aukati i te whakaputanga pūngao, te whakanui/te whakawhānui i ngā oko toto, me ērā atu mea. Ko te mea e tino hiahia ana mātou ki te rongoā mārama ko te here o tēnei NO ki tētahi wāhi matua o tō mekameka kawe irahiko mitochondrial, ka aukati i te rere o te pūngao.
Ka ārai i ngā wāhanga whakamutunga o te tauhohenga manawa, ā, ka aukati i a koe ki te whiwhi i te wāhanga matua o te pūngao (ATP) me te hauhā waro mai i te huka/hāora. Nō reira, ina he iti ake te tere o te pākia o te tangata i a rātou e pakeke haere ana, e pāngia ana rānei e te ahotea/te hiakai, ko tēnei NO te take. He mea tika ina whakaarohia, i roto i te taiao, i te oranga rānei, me whai tikanga koe hei whakaiti i tō tere pākia i ngā wā e iti ana te kai/kaora. Kāore i te tino tika i te ao hou, ina pāngia ngā taumata NO e ngā momo waikawa amino motuhake i roto i te kai, te parahanga o te hau, te pokepokea ai, ētahi atu āhuatanga kai, te mārama horihori, me ētahi atu. Ko te kore o te hauhā waro i roto i tō tātou tinana ka whakanui ake i te mumura.
Ka whakanuia e te rongoā mārama te whakaputanga o te pūngao (ATP) me te hauhā waro (CO2). Ka āraihia e te CO2 ngā momo cytokine me ngā prostaglandin e whakaoho ana i te mumura. Nō reira, ka whakaitihia e te rongoā mārama te nui o te mumura i roto i te tinana/rohe.
Mō te rosacea, ko te mea nui ko te whakaiti i te mumura me te whero o te wāhi mā te rongoā mārama, ā, ka whakatau hoki i te raruraru o te iti o te hāora e pau ana (nāna i tupu ai ngā uaua toto me te tipu o te fibroblast).
Whakarāpopototanga
He maha ngā momo me ngā whakaaturanga o te rosacea
He tohu koroheketanga te Rosacea, pērā i ngā kita me te makawe hina
Ko te pūtake o te rosacea he whakaiti i te mahi mitochondrial i roto i ngā pūtau
Ka whakahokia mai e te rongoā rama whero te mitochondria me te whakaiti i te mumura, ka ārai i te rosacea