• Rezultati Niso Bili Najdeni

HORMONSKI MOTILCI

In document Kemikalije v okolju in rak (Strani 29-51)

HORMONSKI MOTILCI

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POVZETEK +RUPRQVNL PRWLOHF R]LURPD NHPLþQL SRY]URþLWHOM KRUPRQVNLK PRWHQM .3+0 MH RG ]XQDM YQHVHQD VQRY R]LURPD ]PHV VQRYL NL SUHN VSUHPHPE Y GHORYDQMX KRUPRQVNHJD VLVWHPD SRY]URþL ãNRGOMLYH XþLQNH QD ]GUDYMH Y LQWDNWQHP RUJDQL]PX QMHJRYHP SRWRPVWYX R]LURPD VXESRSXODFLMLMDK =D VNRUDM NHPLNDOLM MH ELOR SRWUMHQR GD SUHN KRUPRQVNHJD QDþLQD GHORYDQMD ODKNR ãNRGLMR ]GUDYMX Y LQWDNWQHP RUJDQL]PX .3+0 QDMGHPR Y åLYLOLK ]GUDYLOLKSUHGPHWLKVSORãQHUDEHNHPLþQLKSULSUDYNLK]D]DWLUDQMHãNRGOMLYFHYJRULYLKSUHPD]LK SURGXNWLKJRUHQMD.3+0SULSLVXMHMRãWHYLOQHãNRGOMLYHXþLQNHQD]GUDYMHRGEROH]QLUHSURGXN WLYQLKRUJDQRYLQ]PDQMãDQHSORGQRVWLPRWHQMGHORYDQMDãþLWQLFHLQUD]YRMåLYþHYMDVODGNRUQH EROH]QLLQPHWDEROQHJDVLQGURPDGRSRUDVWDKRUPRQVNRRG]LYQLKUDNRY1DUD]YRMKRUPRQVNR RGYLVQLKUDNRYYSOLYDMRãWHYLOQLQHYDUQRVWQLGHMDYQLNLYNOMXþQRV.3+06OHGQMLPSULSLVOMLYHJD GHOHåDUDNRYWUHQXWQRQLPRJRþHGRORþLWL]DUDGLSRPDQMNDQMDYHURGRVWRMQLKUD]LVNDYSULL]SR VWDYOMHQLK SUHGYVHP Y NULWLþQLK UD]YRMQLK REGREMLK 3ULþDNXMHPR GD VH ER WHåLãþH SULKRGQMLK UD]LVNDY SUHPDNQLOR UDYQR Y VPHUL SRVOHGLF ]DUDGL L]SRVWDYOMHQRVWL Y UD]YRMQLK REGREMLKin utero Y RWURãWYX LQ DGROHVFHQFL =DUDGL REãLUQRVWL LQ NRPSOHNVQRVWL WHPH VH Y SULVSHYNX RVUHGRWRþDPR QD GHILQLFLMH SRWUHEQH ]D UD]XPHYDQMH .3+0 WHU SRJODYLWQH QHJRWRYRVWL LQ NRQWURYHU]QRVWL 1DVHPLQDUMX ERPR SUHGVWDYLOL WXGL QHNDM NRQNUHWQLK SULPHURY SRYH]DY PHG .3+0LQKRUPRQVNRRG]LYQLPLUDNL

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1D 1DFLRQDOQHP LQãWLWXWX ]D MDYQR ]GUDYMH SRGURþMH .3+0 VSUHPOMDPR Y RNYLUXWRNVLNRYLJLODQFHåHGREULKSHWQDMVWOHW=HSLGHPLRORãNHJDLQNOLQLþQHJD YLGLNDVHV.3+0XNYDUMDMRNROHJL]2QNRORãNHJDLQãWLWXWDLQ8QLYHU]LWHWQHJD NOLQLþQHJD FHQWUD /MXEOMDQD 7HPHOMQLP UD]LVNDYDP .3+0 VH SRVYHþDMR Y DNDGHPVNLKNURJLKSUHGYVHPQDIDNXOWHWL]DIDUPDFLMRYHWHULQDUVNLPHGL FLQVNLLQELRWHKQLþQLIDNXOWHWLWHUQDUD]LVNRYDOQLKLQãWLWXWLKNRWVR1DFLRQDOQL

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.HPLþQLSRY]URþLWHOMKRUPRQVNLKPRWHQM

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9 VNODGX ] GHILQLFLMR 6=2 MH ]D XPHVWLWHY HNVRJHQH NHPLNDOLMH R] ]PHVL PHG .3+0 SRWUHEQD Y]URþQD SRYH]DYD PHG L]SRVWDYOMHQRVWMR LQWDNWQHJD RUJDQL]PDNHPLNDOLMLLQãNRGOMLYLPXþLQNRPSRKRUPRQVNHPQDþLQXGHORYDQMD

+RUPRQVNRDNWLYQDVQRY

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âNRGOMLYLXþLQHN

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1DþLQLQPHKDQL]HPGHORYDQMD

1DþLQ GHORYDQMD DQJmode of action MH ] UREXVWQLPL HNVSHULPHQWDOQLPL RSD]RYDQML LQ PHKDQLVWLþQLPL SRGDWNL SRGSUWR ELRORãNR YHUMHWQR VRVOHGMH NOMXþQLKGRJRGNRY]DþHQãL]LQWHUDNFLMRNHPLNDOLMHVFHOLFRNLSUHNIXQNFLR QDOQLKLQDQDWRPVNLKVSUHPHPEYRGLYRSD]RYDQHXþLQNH.OMXþQLGRJRGHN DQJkey event MH GHILQLUDQ NRW HPSLULþQR RSDåHQL SUYL NRUDN NL MH QXMQL HOHPHQWQDþLQDGHORYDQMDR]LURPDMHR]QDþHYDOFHQXMQHJDHOHPHQWD>@

=DUD]OLNRRGQDþLQDGHORYDQMDLPSOLFLUDPHKDQL]HPGHORYDQMDDQJmechanism of actionQDWDQþQHMãHUD]XPHYDQMHPROHNXODUQLKRVQRYWRNVLþQHJDXþLQND>@

+RUPRQVNLHQGRNULQLVLVWHP

+RUPRQMHVQRYNLL]YLUDL]GRORþHQHJDWNLYDLQXþLQNXMHQDGUXJDWNLYDGR NDWHULK SULVSH V NUYMR +RUPRQVNL HQGRNULQL VLVWHP YNOMXþXMH HQGRNULQH RUJDQH LQ WNLYD NL XUDYQDYDMR SUHVQRYR UDVW UD]YRM WHU GHORYDQMH WNLY LQ RUJDQRYLQWDNRYSOLYDQDSUDNWLþQRYVDNRFHOLFRRUJDQL]PD3ULWHPVRGHOX MHMRãWHYLOQHWHOHVXODVWQHNHPLþQHVQRYLPHGWHPNRVHIL]LRORãNRUDYQRYHVMH Y YHþLQL SULPHURY Y]GUåXMH ] QHJDWLYQLPL SRYUDWQLPL ]DQNDPL 9H]DYD QD KRUPRQVNHUHFHSWRUMHSRY]URþLVSUHPHQMHQRL]UDåDQMHJHQRYDOLVSUHPHPEH Y EHOMDNRYLQDK NDU YSOLYD QD GHORYDQMH FHOLF ýH MH KRUPRQRY SUHYHþ DOL SUHPDORR]LURPDþHQLGRYROMUHFHSWRUVNLKYH]DYQLKPHVWODKNRQDVWDQHMR KRUPRQVNRQHUDYQRYHVMHLQ]QMLPSRYH]DQHPRWQMHLQEROH]QL>@

7ULSRPHPEQH HQGRNULQH RVLVR KLSRWDODPLþQRKLSRIL]QRJRQDGQD KLSRWD ODPLþQRKLSRIL]QRQDGOHGYLþQD LQ KLSRWDODPLþQRKLSRIL]QRãþLWQLþQD RV Y]GROå NDWHULK SRWHNDMR NRPSOHNVQH YHUWLNDOQH NRPXQLNDFLMH NRW WXGL QDY]NULåQH KRUL]RQWDOQH NRPXQLNDFLMH PHG HQGRNULQLPL åOH]DPL LQ GUXJLPL RUJDQVNLPL VLVWHPL9QHNDWHULKSULPHULKNRWVRL]ORþDQMHLQ]XOLQDL]WUHEXãQHVOLQDYNH PLQHUDORNRUWLNRLGRY L] QDGOHGYLþQH åOH]H R]LURPD SDUDWKRUPRQD L] REãþLW QLþQLKåOH]YKRPHRVWDWVNLK]DQNDKQHVRGHOXMHWDKLSRWDODPXVLQKLSRIL]D DPSDN MH UDYHQ QDãWHWLK KRUPRQRY RGYLVQD RG NRQFHQWUDFLMH JOXNR]H QDWULMDLQNDOLMDR]LURPDNDOFLMDLQIRVIRUMDYVHUXPX>@=YVHYHþMLPUD]X PHYDQMHP UHFHSWRUVNHJD VLJQDOL]LUDQMD LQ PROHNXODUQH ELRORJLMH VH EULãHMR PHMHPHGKRUPRQVNLPåLYþQLPLQLPXQVNLPVLVWHPRP=DWRVHYGRORþHQLK NRQWHNVWLK N HQGRNULQHPX VLVWHPX SROHJ NODVLþQR GHILQLUDQHJD SULãWHYDMR

tudi druge vrste signaliziranja, ki poteka prek receptorjev [9], kar dodatno zapleta interpretacijo vplivov KPHM in HAS.

1$ý,1,'(/29$1-$KPHM,1HAS

.HPLNDOLMH LPDMR ODKNR UD]OLþQH QDþLQH GHORYDQMD QD KRUPRQVNL VLVWHP = vezavo na hormonske receptorje lahko delujejo kot agonisti ali antagonisti.

Poleg tega lahko vplivajo na:

x GHMDYQLNH NL SRVUHGXMHMR XþLQNH DNWLYLUDQLK KRUPRQVNR UHFHSWRUVNLK kompleksov;

x FHOLþQLSULY]HPVQRYLSRWUHEQLK]DVLQWH]RKRUPRQRY

x GHORYDQMHHQFLPRYYSOHWHQLKYVLQWH]RSUHVQRYRLQRþLVWHNKRUPRQRY x L]ORþDQMHKRUPRQRYL]HQGRNULQLKWNLY

x YH]DYRKRUPRQRYQDWUDQVSRUWQHEHOMDNRYLQH

x nevro-endokrino signalizacijo in uravnavanje endokrinih funkcij [3, 9].

1HJOHGHQDQDþLQGHORYDQMDMHSRPHPEQRGDUD]OLNXMHPRKRUPRQVNRDNWLY QRVWRGKRUPRQVNHPRWQMH+RPHRVWDWVNDNDSDFLWHWDNLY]GUåXMHIL]LRORãNR GLQDPLþQRUDYQRYHVMHMHSRPHPEQD]QDþLOQRVWKRUPRQVNHJDVLVWHPDýH NDNãQD HNVRJHQD NHPLNDOLMD ]DþDVQR VSUHPHQL GHORYDQMH KRUPRQVNHJD VLVWHPD]QRWUDMKRPHRVWDWVNHNDSDFLWHWHRUJDQL]PDSRVOHGLFDQHERãNRG OMLYLXþLQHNDPSDN]JROMVSUHPHPED]QRWUDMIL]LRORãNHJDUD]SRQD>@

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Pri ljudeh in drugih organizmih so raziskovalci v raznih predelih sveta XJRWRYLOL VSUHPHPEH ãWHYLOD LQ NYDOLWHWH VHPHQþLF SRQHNRG VR XJRWRYLOL XSDG GUXJRG SRUDVW VSUHPHQMHQR UD]PHUMH PHG VSRORPD SUL QHNDWHULK YUVWDKYSULGPRãNLKSRWRPFHYSULGUXJLKåHQVNLKSRUDVWSRMDYOMDQMDDQR PDOLM VSROQHJD WUDNWD SUL PRãNLK SRUDVW EROH]QL UHSURGXNWLYQHJD WUDNWD SUL åHQVNDKSRUDVWQHSORGQRVWLPRWHQMGHORYDQMDãþLWQLFHPRWHQMQHYURORãNHJD razvoja in delovanja imunskega sistema ter porast hormonsko odvisnih UDNRY NRW VR UDN GRMNH SURVWDWH PRG LQ ãþLWQLFH >@ =DUDGL XJRWRYOMHQLK SRYH]DY PHG QDãWHWLPL XþLQNL LQ L]SRVWDYOMHQRVWMR NHPLþQLP VQRYHP VH MH razmahnilo intenzivno raziskovanje z namenom, da se pojasnijo vzroki in SULGRELMRGRGDWQLSRGDWNLLQ]QDQMHRPHKDQL]PLKXþLQNRYGDVHL]EROMãDMR PHWRGRORãNL SULVWRSL UD]ãLUL LQ L]EROMãD VSUHPOMDQMH GD VH QDGDOMXMH LGHQWLILNDFLMD .3+0 Y]SRVWDYLMR PHGQDURGQL VH]QDPL LQ ED]H SRGDWNRY RFHQLWYHJDQMHLQVSUHMPHMRXVWUH]QLXNUHSL]D]PDQMãHYDQMHWYHJDQMD 3UYRWQH UD]LVNDYH VR VH RVUHGRWRþDOH QD YSOLYH QD VSROQH LQ ãþLWQLþQH KRUPRQHWHUVWHURLGRJHQH]R>±@PHGWHPNRMHY]DGQMHPGHVHWOHWMX YVHYHþUD]LVNDYWXGLRYSOLYXNHPLNDOLMQDGUXJHKRUPRQVNHSRWLLQ]QMLPL

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KONTROVERZNOSTI IN NEGOTOVOSTI

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3UDJXþLQND

3UDJXþLQNDMHYRGLOQDNRQWURYHU]QRVWY]YH]LV .3+0LQ+$66OREUD]OL NXMHELRORãNLHNVSHULPHQWDOQLLQPDWHPDWLþQLSUDJ%LRORãNLSUDJMHRGPHUHN SRGNDWHULPVQRYQHSRY]URþLQREHQLKãNRGOMLYLKXþLQNRY(NVSHULPHQWDOQL SUDJ MH RGPHUHN SRG NDWHULP XþLQNL QLVR RSDåHQL 0DWHPDWLþQL SUDJ MH RGPHUHN SRG NDWHULP MH XþLQHN PDWHPDWLþQR QLþ 9HQGDU Y åLYLK VLVWHPLK RGPHUHN SUL NDWHUHP MH XþLQHN PDWHPDWLþQR YHþML RG QLþ QL DYWRPDWLþQR ELRORãNRUHOHYDQWHQR]LURPDMHELRORãNDUHOHYDQWQRVWSUHML]MHPDNRWSUDYLOR

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