Karaciğerin, kendini birçok hastalıktan sonra yenileyebilen bir organdır. Fakat bazı durumlarda, karaciğer geri dönülemez bir biçimde zarar görebilmektedir. Bu durum; kalıtsal anormalliklerin, aşırı alkol ve ilaç kullanımının, kanser ya da hepatite (karaciğer iltihabına) sebep olan bulaşıcı virüslerin sonucunda olabilir.
HEPATİT
İki tip Hepatit vardır. Akut Hepatit, hepatitin yeni başladığı anlamına gelmektedir. Kronik Hepatit, hepatit’in 6 aydan fazla süredir var olduğu anlamına gelmektedir.
Karaciğerin en sık görülen hastalığıdır. Temel olarak karaciğer hücrelerinin hasarına sebep olan inflamatuar (yangılı) bir hastalıktır. Sıklıkla da virüsler sebep olur. A,B,C Hepatitleri olarak sıralanan bu tür hepatitler bulaşıcıdır.
Toksik (zehirlenmeye bağlı) hepatitler ise, bazı ilaçlar, kimyasallar ve zehirli mantarlarla karşılaşma sonucu gelişir. Karaciğerin en önemli görevlerinden biri bazı ilaç ve kimyasalların kandan uzaklaştırılarak vücuttan atılmasının sağlanmaktır. Bu görevini yaparken, toksinlerin dönüşümü ile açığa çıkan yan ürünler karaciğerde belirgin bir hasara yol açar ve Toksik Hepatit oluşur. Karaciğerin yenilenme kapasitesi bu hasarla başa çıkamadığı zamanlarda geri dönüşü olmayan zararlar meydana gelebilir.
SİROZ
Karaciğer hücresi herhangi bir nedenle zehirlenir ya da ölürse, bu hücre bağışıklık sistemi tarafından antijen olarak algılanır, bu hücreye karşı antikor salgılanır. Kandaki antijen-antikor etkileşimi daha çok hücrenin ölümüyle sonuçlanır. Karaciğer hücresi, kendisine zarar veren bir etken karşısında ölen hücrelerin yerini bağ dokuyla doldurur. Hücre ve damarlar bağ dokusu arasında sıkışarak organın beslenmesi ve oksijenlenmesi bozulur. Sürekli çoğalan bu siroz hücreleri (bağ doku hücreleri), adeta bir tümör gibi her yanı sarar ve dokunun tüm besinini tüketir.
KİST ve TÜMÖR
Karaciğerin kistleri ve adenom hemanjiyom gibi iyi huylu tümörleri ve karsinom, anjiyosarkom gibi kötü huylu tümörleri vardır. Ayrıca birçok organ ve dokunun kanserinin metastazı da karaciğerde hasara yol açar.
KARACİĞER HASTALIKLARININ BELİRTİLERİ
Karaciğer hastalıklarının belirtileri birbirinden ayrı, izole ve klinik olarak sessiz veya kan testlerinde hızla ilerleyen karaciğer yetmezliğine kadar değişkenlik gösterebilir. Bu farklı seyirler ve klinikler, karaciğer hasarı yapan etkenlerin çok çeşitli olması yanında, karaciğerin rezerv kapasitesinin çok geniş olması nedeni ile olası hasarın maskelenmesinden de kaynaklanabilir. Karaciğerin son dönem-ileri hastalığı olan siroz durumunda hastaların yaklaşık %40’ında bir şikayet gelişmeyebilir. Bulgular geliştiğindeyse genellikle tablo vahim bir hal almıştır.
Karaciğer hastalığında sebep ne olursa olsun ortak belirtiler vardır. Karaciğer hücre kaybı oranına bağlı olarak hastalık şikayetsiz rastlantısal tespit edilmiş karaciğer kan testleri bozukluğu ile ortaya çıkabileceği gibi, yorgunluk, kilo kaybı, iştahsızlık, kötü bellek, konsantrasyon bozukluğu, kadınlarda adet döngüsü bozukluğu, ellerde ve ayak tabanlarında sıcaklık artışı, kızarıklık, ciltte kırmızı renkli ve örümcek ağını andıran oluşumlar, şeker metabolizmasında bozulma, kusma, bulantı, erkekte meme büyümesi cinsel istek azalması, ciltte, gözde ve idrarda sarılık, kaşıntı, karında şişkinlik gibi belirtilerle ortaya çıkabilir.
Karaciğer hastalığı sebeplerinde kişinin yaşına ve cinsine, sosyo ekonomik durumuna göre farklılıklar vardır. 20 Yaş altı hastalarda akut viral hepatitler (hepatit B ve hepatit C ) ve genetik bozukluklar sıklıkla sebeptir. Orta yaş hastalarda Alkole Bağlı Karaciğer Hasarı, Safra Yolu Hastalığı ve Kronikleşmiş Viral Hepatitler sıktır. 55 Yaş üzerindeki hastalarda ise Siroz, Safra Yolu Hastalığı, Tümöral sebepler vardır.
Kadın hastalarda orta yaş itibari ile Otoümmin Hepatit ve Primerbiliyer Siroz daha sıktır. Gebeliğin Akut Yağlı Karaciğeri ve HELP sendromu kadınlarda doğurganlık döneminin ek sebepleridir.
Bazı genetik hastalıklarda aile öyküsü vardır. Karaciğerde demir ve bakır birikimi ile karakterize karaciğer hastalıkları bu gruptadır.
Alkol kullanımı, kullanım yoğunluğu arttıkça 8-10 yıla yayılan zaman içinde Karaciğer yetmezliği geliştirebilir. Kadın hastalarda daha az alkol dozlarında daha hızlı hastalık gelişimi vardır.
Toplumda, kilo fazlalığı, kan lipid düzeyi yüksekliği, şeker metabolizması bozukluğunda oluşan karaciğer yağlanması siroza ilerleyebilecek, görülme sıklığı gittikçe artan bir durumdur.
Pek çok ilaç ve kimyasal ya da doğal toksin kalıcı karaciğer hasarı sebebidir.
RESVERATROLÜN KARACİĞER ÜZERİNE ETKİLERİ
Çoklu yağ asitlerinin oksidatif yıkımı olan lipit peroksidasyonu serbest radikallerin uyardığı hücre yıkımında önemli bir mekanizmadır. Birçok hastalıkta doku yıkımı serbest radikaller ve lipit peroksidasyonu sonucu oluşur.
Serbest radikaller lipit peroksidasyonunu başlatan temel maddelerdir. Güçlü bir serbest radikal süpürücüsü olan Resveratrol, Trigliserit düzeylerini düşürmeye ve karaciğeri Lipit Peroksidasyonuna karşı korumaya yardımcıdır. Bu özelliğiyle Resveratrol Karaciğerin korunmasına ve normal fonksiyonlarını yerine getirmesine destek olur.
Vücudun oksidatif stresi düzenlemesine yardımcı olarak, kızarıklığı ve şişliği azaltarak ve karaciğerdeki hücre ölümünü hafifleterek karaciğeri korur. [1]
GLUTATYONUN KARACİĞER ÜZERİNE ETKİLERİ
Glutatyon vücudumuzun ne önemli detoks organı olan karaciğerdeki FAZ 2 detoks sürecinde başroldedir.. Vücutta biriken ağır metalleri ve kimyasalların temizliğinde de Glutatyon çok aktif bir rol oynar. Arsenik, bakır, kadmiyum ve nörotoksik cıva gibi ağır metallerin temizlenmesi, meyve ve sebzelerdeki kimyasal atıklar, et ve süt ürünlerindeki hormonlar ya da antibiyotiklerden vücudumuzu arındırmak için de Glutatyon ihtiyaç duyduğumuz en önemli moleküldür.
Günümüzde obezite sıklığının artması, kötü beslenme ve sık rastladığımız insülin direnci alkole bağlı olmayan karaciğer yağlanması riskini arttırmaktadır.
Araştırmalar glutatyon takviyesinin karaciğer hasarını engellediğini ve alkole bağlı olmayan karaciğer yağlanmasını gerilettiğini gösteriyor (2-3)
Glutatyon, karaciğer hastalığına yol açabilecek oksidatif stresi nötralize ederek karaciğeri sağlıklı tutar. Karaciğeri detoks etmede ve kükürt bakımından zengin antioksidan yollarını korumada önemli bir rol oynar. Zararlı maddeler ile karşılaştığı zaman, glutatyon karaciğer hasarı önlemde destek olur.
KUERSETİN’İN KARACİĞER ÜZERİNE ETKİLERİ
Kuersetin, asetaminofen kaynaklı karaciğer toksisitesini , reaktif oksijen ve azot türlerini azaltarak hafifletebilir . (4) Kueretin, karaciğerdeki mitokondriyal oksidatif metabolizmayı uyararak obeziteye bağlı yağlı karaciğer hastalığına karşı korur (5).
Karaciğer vücudumuzun en çok enerji harcayan organlarından olduğu için enerji üretiminde aktif rol oynayan Glutatyon, Resveratrol ve Koenzim Q10’a ihtiyaç duyar ve eksiklikleri durumunda fonksiyonel bozukluklar oluşabilir.
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