๐Ÿ“Training Article/Jaetiger

[Jaetiger์นผ๋Ÿผ1] ์œ ์‚ฐ์†Œ ํŠธ๋ ˆ์ด๋‹์˜ ์ด์ ์— ๋Œ€ํ•œ ๊ณ ์ฐฐ

Physical Coach 2020. 12. 21. 10:54

 

ํ•ด๋‹น ์•„ํ‹ฐํด์€ ์ด์ „์— CHIRONconsulting๋ธ”๋กœ๊ทธ์— ์˜ฌ๋ผ์˜จ ์ €์˜ ๊ธ€์„ ์˜ฎ๊ธด ๊ฒƒ์ž…๋‹ˆ๋‹ค.

 

์œ ์‚ฐ์†Œ ํŠธ๋ ˆ์ด๋‹์— ๋Œ€ํ•ด์„  ๋งŽ์€ ์˜คํ•ด๋“ค์ด ์žˆ๋‹ค.

๊ทธ์ค‘ ํ•˜๋‚˜๊ฐ€ '์œ ์‚ฐ์†Œ ์šด๋™์„ ํ•˜๋ฉด ๊ทผ์œก์ด ๋น ์ง„๋‹ค' ๋Š” ๊ฒƒ์ด๋‹ค.

โ€‹

์ด๋Ÿฐ ์˜คํ•ด๋“ค๋กœ ์ธํ•ด ์œ ์‚ฐ์†Œ์šด๋™์„ ๊ธฐํ”ผํ•˜๋Š” ์‚ฌ๋žŒ๋“ค๋„ ์žˆ์ง€๋งŒ, ๊ฑฐ์˜ ๋ชจ๋“  ์Šคํฌ์ธ ์—์„œ ์ ์ ˆํ•œ ์œ ์‚ฐ์†Œ ํŠธ๋ ˆ์ด๋‹์„ ํ•˜๋Š” ๊ฒƒ์ด ์˜คํžˆ๋ ค ๋” ํšจ์œจ์ ์ธ ํŠธ๋ ˆ์ด๋‹์œผ๋กœ ๊ฐˆ ์ˆ˜ ์žˆ๋Š” ๊ธธ์ด๋‹ค.

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์œ ์‚ฐ์†Œ ์šด๋™(aerobic exercise)์€ ์‹ฌ๋ฐ•์ˆ˜๋ฅผ ๋†’์ด๊ณ  ๋Œ€๊ทผ์œก๊ตฐ์„ ์žฅ์‹œ๊ฐ„ ์ง€์†์ ์œผ๋กœ ์›€์ง์ด๋Š” ์‹ ์ฒดํ™œ๋™์ด๋‹ค. ์œ ์‚ฐ์†Œ ์šด๋™์€ ์‹ ์ฒดํ™œ๋™ ๋™์•ˆ ๊ทผ์œก์กฐ์ง์— ์ถฉ๋ถ„ํ•œ ์–‘์˜ ์‚ฐ์†Œ๋ฅผ ํšจ์œจ์ ์œผ๋กœ ์šด๋ฐ˜ํ•˜๋Š” ์‹ฌํ์ง€๊ตฌ๋ ฅ์„ ํ–ฅ์ƒ์‹œํ‚จ๋‹ค.16

โ€‹

๋˜ํ•œ ๊ทœ์น™์ ์ธ ์œ ์‚ฐ์†Œ ์šด๋™์€ ๊ณจ๊ฒฉ๊ทผ ๋‚ด์˜ ๋ฏธํ† ์ฝ˜๋“œ๋ฆฌ์•„ ์ˆ˜์™€ ํฌ๊ธฐ๋ฅผ ์ฆ๊ฐ€์‹œ์ผœ ์ง€์งˆ๋Œ€์‚ฌ ์ž‘์šฉ๊ณผ ์šด๋™ ๋Šฅ๋ ฅ์„ ๊ธ์ •์ ์ธ ๋ฐฉํ–ฅ์œผ๋กœ ํ–ฅ์ƒ์‹œํ‚จ๋‹ค.32

<๊ทธ๋ฆผ1> ์‹ฌ์žฅ๋ฐ•๋™์— ๋”ฐ๋ฅธ ์šด๋™์˜ ๊ตฌ๋ถ„

๊ฑฐ์˜ ๋Œ€๋ถ€๋ถ„์˜ ์Šคํฌ์ธ ์—์„œ๋Š” ์‹ฌํ๊ธฐ๋Šฅ์ด ์šฐ์ˆ˜ํ•œ ์„ ์ˆ˜๋“ค์ด ๊ทธ๋ ‡์ง€ ์•Š์€ ์„ ์ˆ˜๋“ค์— ๋น„ํ•ด ์šฐ์›”ํ•œ ๊ฒฝ๊ธฐ์ˆ˜ํ–‰๋ ฅ์„ ๊ฐ€์ง„ ๊ฒƒ์œผ๋กœ ๊ฐ„์ฃผ๋˜๋ฉฐ, ํŠนํžˆ ์ง€๊ตฌ๋ ฅ์„ ์š”๊ตฌํ•˜๋Š” ๊ฒฝ๊ธฐ์ข…๋ชฉ์—์„œ ์‹ฌํ๊ธฐ๋Šฅ์€ ๋งค์šฐ ์ค‘์š”ํ•˜๊ฒŒ ์—ฌ๊ฒจ์ง„๋‹ค.5

โ€‹

๊ทธ๋ฆฌ๊ณ  ์ง€๊ตฌ๋ ฅ์„ ์š”๊ตฌํ•˜์ง€ ์•Š๋Š” ๊ฒฝ๊ธฐ์ข…๋ชฉ์—์„œ๋„ ์œ ์‚ฐ์†Œ ์šด๋™์€ ํฐ ์ด์ ์„ ๊ฐ€์ ธ์˜จ๋‹ค.

โ€‹

๋ฐ”๋กœ ๊ทผ์„ฌ์œ ๋‚ด ๋ชจ์„ธํ˜ˆ๊ด€์˜ ๋ฐ€๋„ ๋ฐ ์ˆ˜์˜ ์ฆ๊ฐ€ ์ฆ‰, ํ˜ˆ๊ด€์‹ ์ƒ์ด๋‹ค.

โ€‹

ํ˜ˆ๊ด€์‹ ์ƒ(angiogenesis)์€ ๊ธฐ์กด์— ์กด์žฌํ•˜๋˜ ํ˜ˆ๊ด€์—์„œ ์ƒˆ๋กœ์šด ํ˜ˆ๊ด€์ด ํ˜•์„ฑ๋˜๋Š” ๊ฒƒ์ด๋‹ค.

์ธ์ฒด๋Š” ํ˜ˆ์•ก์ˆœํ™˜์„ ํ†ตํ•ด ๊ฐ ์กฐ์ง์—์„œ ๋‹ค๋ฅธ ์กฐ์ง์œผ๋กœ ์‚ฐ์†Œ์™€ ์˜์–‘๋ถ„์„ ๊ณต๊ธ‰ํ•˜๊ณ  ๋Œ€์‚ฌ ๋…ธํ๋ฌผ์„ ์šด๋ฐ˜ํ•˜์—ฌ ์ธ์ฒด์˜ ํ•ญ์ƒ์„ฑ์„ ์œ ์ง€ํ•œ๋‹ค. ์ด์™€ ๊ด€๋ จํ•ด์„œ ํ˜ˆ๊ด€์ด ๋” ๋งŽ์„์ˆ˜๋ก, ํ˜ˆ๊ด€ ์ด ํ‘œ๋ฉด์ ์ด ๋” ํด์ˆ˜๋ก ์‚ฐ์†Œ์˜ ๊ณต๊ธ‰๊ณผ ๋Œ€์‚ฌ ๋…ธํ๋ฌผ์˜ ์ œ๊ฑฐ๊ฐ€ ๋” ๊ฐ•๋ ฅํ•˜๊ฒŒ ์ด‰์ง„๋˜๋ฏ€๋กœ ๊ณจ๊ฒฉ๊ทผ ์กฐ์ง์€ ๋ฌผ์งˆ๋Œ€์‚ฌ์˜ ์ž‘์šฉ์„ ์ด‰์ง„ํ•˜๊ธฐ ์œ„ํ•ด ํ˜ˆ๊ด€์‹ ์ƒ์ด ์ฆ๊ฐ€ํ•˜์—ฌ์•ผ ํ•˜๋ฉฐ, ๊ทธ ๊ฒฐ๊ณผ ์ธ์ฒด์˜ ์œ ์‚ฐ์†Œ์„ฑ ์‹ฌํ์ง€๊ตฌ๋ ฅ๋„ ํ–ฅ์ƒ๋œ๋‹ค.19

<๊ทธ๋ฆผ2> ์ผํ•˜๋Š” ์‚ฌ๋žŒ์ด ๋งŽ์„์ˆ˜๋ก ๋” ํฐ ์ž‘์šฉ์ด ๊ฐ€๋Šฅํ•˜๋‹ค.

์ด๋Ÿฌํ•œ ๊ฒƒ๋“ค์€ ์œ ์‚ฐ์†Œ ์šด๋™์— ์˜ํ•œ ๊ทผ์„ฌ์œ ๋‚ด ์กฐ์ง, ํ™”ํ•™์  ๋ณ€ํ™”์˜ ํŠน์ง• ์ค‘ ํ•˜๋‚˜์ด๋ฉฐ,

์ด๋Ÿฌํ•œ ์ ์‘ ๋ฐ˜์‘์€ ํ™œ๋™ํ•˜๋Š” ๊ทผ์„ธํฌ์— ์ถฉ๋ถ„ํ•œ ์‚ฐ์†Œ์™€ ์—๋„ˆ์ง€๋ฅผ ํšจ์œจ์ ์œผ๋กœ ๊ณต๊ธ‰ํ•จ์œผ๋กœ์จ ์šด๋™ ์ˆ˜ํ–‰ ๋Šฅ๋ ฅ์„ ํ–ฅ์ƒ์‹œํ‚จ๋‹ค.33

 

"ํ˜ˆ๊ด€์‹ ์ƒ์„ ํ†ตํ•ด ์ƒˆ๋กœ์šด ์ผ๊พผ๋“ค์ด ๋” ๋งŽ์ด ์ƒ๊ธธ์ˆ˜๋ก ๋” ๋น ๋ฅธ ์‚ฐ์†Œ ๊ณต๊ธ‰, ๋…ธํ๋ฌผ ์ œ๊ฑฐ ๋“ฑ์ด ๊ฐ€๋Šฅํ•ด์ง€๋ฉฐ ์ด๋ฅผ ํ†ตํ•ด ์šด๋™์ˆ˜ํ–‰๋Šฅ๋ ฅ์ด ํ–ฅ์ƒ๋œ๋‹ค."

 

๊ทธ๋ ‡๋‹ค๋ฉด ํ˜ˆ๊ด€์‹ ์ƒ์€ ์–ด๋–ค ์ž‘์šฉ์„ ํ†ตํ•˜์—ฌ ์ผ์–ด๋‚˜๋Š” ๊ฒƒ์ผ๊นŒ?

โ€‹

์ด์™€ ๊ฐ™์€ ๋ชจ์„ธํ˜ˆ๊ด€์˜ ์ƒ์„ฑ ๋ฐ ์„ฑ์žฅ์€ ์„ธํฌ๋‚ด ์‚ฐ์†Œ์•• ๋ฐ ์‚ฐ์†Œ ํฌํ™”๋„์˜ ๊ฐ์†Œ์— ๋”ฐ๋ฅธ ๊ตญ๋ถ€์  ์ €์‚ฐ์†Œ์ฆ๊ณผ ํ˜ˆ๋ฅ˜๋Ÿ‰์˜ ์ฆ๊ฐ€์— ๋”ฐ๋ฅธ ๋ชจ์„ธํ˜ˆ๊ด€๋‚ด shear stress ๋ฐ wall tension์˜ ์ฆ๊ฐ€์— ์˜ํ•ด ์œ ๋„๋  ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ์—๋„ˆ์ง€ ๋Œ€์‚ฌ ๊ณผ์ •์˜ ๋ณ€ํ™”์— ์˜ํ•ด์„œ๋„ ์œ ๋ฐœ๋œ๋‹ค.18, 19

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๊ทธ๋ฆฌ๊ณ  ์ด๋Ÿฌํ•œ ๋ณ€ํ™”๋“ค์€ plasminogen, plasminogen activator(PA), plasminogen activator inhibitor(PAI)์™€ ๊ฐ™์€ ๋‹จ๋ฐฑ ๋ถ„ํ•ด ํšจ์†Œ์˜ ํ™œ์„ฑ์„ ์ฆ๊ฐ€์‹œ์ผœ ์„ธํฌ๋‚ด ๊ธฐ์งˆ์˜ ๋ณ€ํ™”๋ฅผ ์œ ๋ฐœํ•จ์œผ๋กœ์จ ๋‚ดํ”ผ์„ธํฌ(endotheial cell)์˜ ์ฆ์‹ ๋ฐ ์ด์ฃผ๋ฅผ ์ž๊ทนํ•˜์—ฌ ํ˜ˆ๊ด€์˜ ์ƒ์„ฑ ๋ฐ ์„ฑ์žฅ์„ ์ด‰์ง„ํ•˜๋Š” ํ˜ˆ๊ด€ ์„ฑ์žฅ ์ธ์ž(angiogenic growth factor)๋“ค์˜ ๋ฐœํ˜„์„ ์œ ๋„ํ•˜๊ฒŒ ๋œ๋‹ค.12, 18, 25

<์‚ฌ์ง„3> VEGF์™€ VEGF ์ˆ˜์šฉ์ฒด์˜ ์ข…๋ฅ˜์™€ ๊ทธ ๊ธฐ๋Šฅ

์ด๋Ÿฌํ•œ ๋ณ€ํ™”์— ์˜ํ•ด ์œ ๋„๋˜๋Š” ํ˜ˆ๊ด€ ์„ฑ์žฅ ์ธ์ž๋“ค์—๋Š” vascular endothelial growth factor(VEGF), Angiopoietin, transforming growth factor-β(TGF-β), insulin-like growth factor-โ…ก(IGF-โ…ก)๋“ฑ์ด ์žˆ๋Š”๋ฐ ์ด๋Ÿฌํ•œ ์ธ์ž ์ค‘ VEGF๋Š” ๋‚ดํ”ผ์„ธํฌ์— ๋งค์šฐ ํŠน์ด์ ์œผ๋กœ ์ž‘์šฉํ•˜๋Š” ๊ฐ•๋ ฅํ•œ ์œ ์‚ฌ๋ถ„์—ด๋ฌผ์งˆ๋กœ์„œ ํ˜ˆ๊ด€์˜ endothelium์— ์กด์žฌํ•˜๊ณ  ์žˆ๋Š” VEFGR-1(flt-1) ๋ฐ VEGFR-2(flk-1)์™€ ๊ฐ™์€ receptor์˜ ์กฐ์ ˆ์— ์˜ํ•ด ํ˜ˆ๊ด€ ์นจํˆฌ์„ฑ(vascular permeability)๋ฅผ ์ฆ๊ฐ€์‹œ์ผœ ๋ชจ์„ธํ˜ˆ๊ด€์˜ ์„ฑ์žฅ์„ ์œ ๋„ํ•  ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ๋‚ดํ”ผ์„ธํฌ์˜ ์ฆ์‹๊ณผ ๋ถ„ํ™”๋ฅผ ์ด‰์ง„ํ•จ์œผ๋กœ์จ ์ƒˆ๋กœ์šด ๋ชจ์„ธํ˜ˆ๊ด€์˜ ์ƒ์„ฑ์— ๋งค์šฐ ์ค‘์š”ํ•œ ์—ญํ• ์„ ๋‹น๋‹ดํ•˜๊ณ  ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ์•Œ๋ ค์ง€๊ณ  ์žˆ๋‹ค.8, 10, 11, 20

โ€‹

๋˜ํ•œ ํ˜ˆ๊ด€์‹ ์ƒ์—๋Š” MMPs๊ฐ€ ์—ฐ๊ด€๋˜์–ด์žˆ๋Š”๋ฐ,

MMPs๋Š” ์„ธํฌ์™ธ๊ธฐ์งˆ์„ ์šฉํ•ดํ•˜๋Š” ํšจ์†Œ์ด๋ฉฐ ์„ธํฌ์™ธ๊ธฐ์งˆ ๋ฆฌ๋ชจ๋ธ๋ง์„ ํ†ตํ•œ ํ˜ˆ๊ด€์‹ ์ƒ์— ์ค‘์š”ํ•œ ์—ญํ• ์„ ํ•œ๋‹ค.24

๊ทธ๋ฆฌ๊ณ  MMP๋Š” VEGF์™€ FGF์™€ ๊ฐ™์€ ํ˜ˆ๊ด€์‹ ์ƒ ์ด‰์ง„์ธ์ž์— ์˜ํ•ด ๋ถ„๋น„๊ฐ€ ์œ ๋„๋œ๋‹ค.21

 

"์ฆ‰, ํ˜ˆ๊ด€์‹ ์ƒ ์ด‰์ง„์ธ์ž๋“ค(VEGF๋“ฑ)์ด ์ˆ˜์šฉ์ฒด์™€ ๊ฒฐํ•ฉํ•˜์—ฌ ์ฃผ๋ณ€ ํ˜ˆ๊ด€๋‚ดํ”ผ์„ธํฌ๋“ค์ด ํ™œ์„ฑํ™”๋˜๊ณ  ํ˜ˆ๊ด€ ํˆฌ๊ณผ์„ฑ์ด ์ฆ๊ฐ€๋˜๋ฉฐ, VEFG๋“ฑ์— ์˜ํ•ด ๋ถ„๋น„๊ฐ€ ์œ ๋„๋œ MMPs๊ฐ€ ๊ธฐ์ €๋ง‰(basement membrane)๊ณผ ์„ธํฌ์™ธ๊ธฐ์งˆ์„ ๋ถ•๊ดด์‹œํ‚จ๋‹ค.
๊ทธ๋ฆฌ๊ณ  ์ด๋ ‡๊ฒŒ ์ด๋™ํ•˜์—ฌ ์ฆ์‹ํ•œ ํ˜ˆ๊ด€๋‚ดํ”ผ์„ธํฌ๋“ค์ด ์„œ๋กœ ์ผ๋ ฌ๋กœ ์—ฐ๊ฒฐ๋˜์–ด ์ƒˆ๋กœ์šด ํ˜ˆ๊ด€์ด ์ƒ์„ฑ๋œ๋‹ค."

 

๊ทธ๋ฆฌ๊ณ  ๋ฐ‘์˜ ๋‹ค์–‘ํ•œ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ๋“ค์ด ์šด๋™์„ ํ†ตํ•œ VEGF์™€ MMPs์˜ ์ฆ๊ฐ€์— ๋Œ€ํ•˜์—ฌ ์ด์•ผ๊ธฐํ•ด์ฃผ๊ณ  ์žˆ์œผ๋ฉฐ,

์ด๋Ÿฌํ•œ ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋“ค์€ ์šด๋™์ด ๋ฌผ์งˆ๋Œ€์‚ฌ๊ฐ€ ํ™œ๋ฐœํ•œ ๊ณจ๊ฒฉ๊ทผ์œผ๋กœ ์ถฉ๋ถ„ํ•œ ํ˜ˆ๋ฅ˜๋Ÿ‰๊ณผ ์‚ฐ์†Œ๊ณต๊ธ‰์„ ์œ„ํ•ด ๊ณจ๊ฒฉ๊ทผ์—์„œ์˜ MMPs ์ž‘์šฉ์— ์˜ํ•œ ํ˜ˆ๊ด€์‹ ์ƒ์„ ์ด‰์ง„์‹œํ‚จ๋‹ค๋Š” ๊ฒƒ์„ ์‹œ์‚ฌํ•˜๊ณ  ์žˆ๋‹ค.

 

VEGF์˜ ๋ฐœํ˜„์€ ์šด๋™์ด๋‚˜ ํŠธ๋ ˆ์ด๋‹์„ ํ†ตํ•œ ๊ณจ๊ฒฉ๊ทผ ๋‚ด ์ €์‚ฐ์†Œ์ฆ ๋“ฑ์— ์˜ํ•ด ์œ ๋„๋˜์–ด ๋ชจ์„ธํ˜ˆ๊ด€์˜ ์ƒ์„ฑ ๋ฐ ์„ฑ์žฅ์„ ์ด‰์ง„ํ•œ๋‹ค.9, 13,15, 27, 30, 34

โ€‹

๊ฑด๊ฐ•ํ•œ ์ Š์€ ๋‚จ์„ฑ์„ ๋Œ€์ƒ์œผ๋กœ ํ•œ 4์ฃผ ๋™์•ˆ์˜ ๊ทœ์น™์ ์ธ ์šด๋™์€ ์šด๋™์‹œ์ž‘ ์ „์— ๋น„ํ•ด ๋‹ค๋ฆฌ ๊ณจ๊ฒฉ๊ทผ์—์„œ์˜ VEGF ๋‹จ๋ฐฑ์งˆ์˜ ์–‘๊ณผ MMP-2์™€ MMP-9 mRNA๊ฐ€ ์ฆ๊ฐ€๋˜์—ˆ์œผ๋ฉฐ, ํ—ˆ๋ฒ…์ง€ ๊ณจ๊ฒฉ๊ทผ ์ชฝ์œผ๋กœ์˜ ํ˜ˆ๋ฅ˜๋Ÿ‰๊ณผ ์‚ฐ์†Œ ์œ ์ž…๋Ÿ‰์ด ์ฆ๊ฐ€๋˜์—ˆ๋‹ค.17

โ€‹

VEGF mRNA ๋ฐ protein์ด ์šด๋™์— ์˜ํ•ด ์œ ๋„๋˜์–ด ๋‚ดํ”ผ์„ธํฌ์˜ ์ฆ์‹๊ณผ ๋ถ„ํ™”๋ฅผ ์ด‰์งํ•จ์œผ๋กœ์จ ๊ทผ์„ฌ์œ ๋‚ด ๋ชจ์„ธํ˜ˆ๊ด€์˜ ์ƒ์„ฑ ๋ฐ ์„ฑ์žฅ์„ ์œ ๋„ํ•  ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ํ˜ˆ๊ด€์˜ ๊ตฌ์กฐ์™€ ๊ธฐ๋Šฅ์˜ ๋ณ€ํ™”์— ๋งค์šฐ ์ค‘์š”ํ•œ ์—ญํ• ์„ ๋‹ด๋‹นํ•˜๊ณ  ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋ณด๊ณ ํ•œ ๋ฐ”๊ฐ€ ์žˆ๋‹ค.1

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์ Š์€ ์‚ฌ๋žŒ(19~30์„ธ, ํ‰๊ท  24±1์„ธ)๊ณผ ๋‚˜์ด๋“  ์‚ฌ๋žŒ(56~74์„ธ, ํ‰๊ท  64±2์„ธ) ๋ชจ๋‘์—์„œ 8์ฃผ ๋™์•ˆ์˜ ์œ ์‚ฐ์†Œ ์šด๋™์€ ์œ ์‚ฐ์†Œ ์šด๋™์„ ์‹ค์‹œํ•˜๊ธฐ ์ „์— ๋น„ํ•ด ๊ณจ๊ฒฉ๊ทผ์—์„œ์˜ VEGF mRNA ๋ฐœํ˜„์ด ์ฆ๊ฐ€๋˜์—ˆ๋‹ค.14

โ€‹

โ€‹

๊ทธ๋ฆฌ๊ณ  ์ด์— ๋ฐ˜๋Œ€๋˜๋Š” ํ˜ˆ๊ด€์‹ ์ƒ์–ต์ œ์ธ์ž๊ฐ€ ์กด์žฌํ•œ๋‹ค.

โ€‹

VEGF-A๊ฐ€ ๊ณจ๊ฒฉ๊ทผ ํ˜ˆ๊ด€์‹ ์ƒ์˜ ์‹œ์ž‘์„ ์œ„ํ•ด ์ค‘์‹ฌ์ ์ธ ์—ญํ• ์„ ํ•˜๋Š” ๋ฐ˜๋ฉด, ํ˜ˆ๊ด€์‹ ์ƒ ์–ต์ œ์ธ์ž์ธ TSP-1์€ ๋ชจ์„ธํ˜ˆ๊ด€ ํ™•์žฅ(capillary expansion)์— ๋Œ€ํ•œ ์ƒ๋ฆฌ์ ์ธ ์–ต์ œ๋ฅผ ์œ„ํ•ด ํ•„์ˆ˜์ ์ด๋‹ค.26

โ€‹

TSP-1์€ MMP์˜ ํ™œ์„ฑํ™”์™€ ํ˜ˆ๊ด€๋‚ดํ”ผ์„ธํฌ์˜ ์ด๋™์„ ์ €ํ•ดํ•˜๊ณ , ํ˜ˆ๊ด€๋‚ดํ”ผ์„ธํฌ์˜ ์„ธํฌ ์ž์—ฐ์‚ฌ(apoptosis)๋ฅผ ์ฆ๊ฐ€์‹œํ‚ค๋Š” ์กฐ์ ˆ๊ธฐ์ž‘์„ ํ†ตํ•ด ํ˜ˆ๊ด€์‹ ์ƒ์„ ์–ต์ œํ•˜๋Š” ๊ฒƒ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค.22, 23

โ€‹

ํ˜ˆ๊ด€์‹ ์ƒ์—์„œ ๋ชจ์„ธํ˜ˆ๊ด€์˜ ๋ถˆ์•ˆ์ •ํ™”๋ฅผ ์œ„ํ•œ ์„ธํฌ์™ธ๊ธฐ์งˆ ๋ฆฌ๋ชจ๋ธ๋ง์— ์ค‘์š”ํ•œ ์—ญํ• ์„ ํ•˜๋Š” MMP์˜ ์ž‘์šฉ์€ TSP-1๊ณผ TIMP์™€ ๊ฐ™์€ ํ˜ˆ๊ด€์‹ ์ƒ ์–ต์ œ์ธ์ž์— ์˜ํ•ด ์–ต์ œ๋œ๋‹ค๊ณ  ๋ณด๊ณ ๋˜๊ณ  ์žˆ๋‹ค.7, 22, 23

โ€‹

๋˜ํ•œ TIMP๋Š” MMP์˜ ์ž‘์šฉ์„ ์–ต์ œํ•˜์—ฌ ์„ธํฌ์™ธ ๊ธฐ์งˆ์˜ ํŒŒ๊ดด๋ฅผ ์ œํ•œํ•จ์œผ๋กœ์จ ์„ธํฌ์™ธ๊ธฐ์งˆ์˜ ํŒŒ๊ดด์™€ ์žฌํ˜•์„ฑ ๊ฐ„์˜ ๊ท ํ˜•์„ ์กฐ์ ˆํ•˜๋Š” ํ˜ˆ๊ด€์‹ ์ƒ ์–ต์ œ์ธ์ž๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค.7

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โ€‹

ํ•˜์ง€๋งŒ ์ด๋Ÿฌํ•œ ํ˜ˆ๊ด€์‹ ์ƒ์–ต์ œ์ธ์ž ๋˜ํ•œ ์šด๋™์„ ์‹ค์‹œํ•œ ๊ฒฝ์šฐ ๊ฐ์†Œ๋˜์—ˆ๋‹ค.

โ€‹

์šด๋™์„ ์‹ค์‹œํ•œ ๊ฑด๊ฐ•ํ•œ ์ Š์€ ๋‚จ์„ฑ์—์„œ์˜ ๊ณจ๊ฒฉ๊ทผ์˜ MMP-9 mRNA ๋ฐœํ˜„์€ ์šด๋™ ์ „์— ๋น„ํ•ด ์ฆ๊ฐ€ํ•œ ๋ฐ˜๋ฉด, TIMP-1 mRNA ๋ฐœํ˜„์€ ๊ฐ์†Œ๋˜์—ˆ๋‹ค.29

 

โ€‹"์ฆ‰, ์šด๋™์„ ํ†ตํ•ด ํ˜ˆ๊ด€์‹ ์ƒ์ธ์ž๋“ค์˜ ๋ถ„๋น„๋ฅผ ์ด‰์ง„์‹œํ‚ค๊ณ , ํ˜ˆ๊ด€์‹ ์ƒ์–ต์ œ์ธ์ž๋“ค์˜ ๋ฐœํ˜„์„ ๊ฐ์†Œ์‹œ์ผœ ๋” ์›ํ™œํ•œ ํ˜ˆ๊ด€์‹ ์ƒ์„ ์œ ๋„ํ•  ์ˆ˜ ์žˆ๋‹ค."

 

<์‚ฌ์ง„4> ์œ ์‚ฐ์†Œ์šด๋™์„ ๋ณ‘ํ–‰ํ•˜๋Š” ๊ฒƒ๊ณผ ๊ทธ๋ ‡์ง€ ์•Š์€๊ฒƒ. ๋ฌด์—‡์ด ๋” ์ข‹์„๊นŒ?

 

์œ„์™€ ๊ฐ™์€ ์—ฐ๊ตฌ ๋“ฑ์„ ํ†ตํ•ด ๊ณจ๊ฒฉ๊ทผ ๋‚ด ์ €์‚ฐ์†Œ์ฆ์„ ์ผ์œผํ‚ค๋Š” ์œ ์‚ฐ์†Œ ํŠธ๋ ˆ์ด๋‹์ด ํ˜ˆ๊ด€ ์‹ ์ƒ์„ ์ด‰์ง„์‹œํ‚ค๊ณ  ํ˜ˆ๊ด€ ๊ธฐ๋Šฅ์„ ํ–ฅ์ƒ์‹œํ‚ค๋ฉฐ14, 28 , ํ˜ˆ๊ด€์‹ ์ƒ์œผ๋กœ ์ธํ•˜์—ฌ ์šด๋™์ˆ˜ํ–‰๋Šฅ๋ ฅ์ด ํ–ฅ์ƒ๋œ๋‹ค33 ๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค.

โ€‹

์ด์ฒ˜๋Ÿผ ๋‹ค์–‘ํ•œ ์—ฐ๊ตฌ๋“ค์„ ํ†ตํ•˜์—ฌ ์œ ์‚ฐ์†ŒํŠธ๋ ˆ์ด๋‹์˜ ์ด์ ์— ๋Œ€ํ•ด์„œ ์•Œ ์ˆ˜ ์žˆ๋‹ค.

โ€‹

๊ทธ๋ฆฌ๊ณ  ์œ ์‚ฐ์†ŒํŠธ๋ ˆ์ด๋‹์˜ ์œ ๋ฌด๋กœ ์‹คํ—˜๊ตฐ๊ณผ ๋น„๊ต๊ตฐ์„ ๋‚˜๋ˆˆ ์‹คํ—˜๋“ค๋กœ ์œ ์‚ฐ์†Œ ํŠธ๋ ˆ์ด๋‹์„ ํ•˜๋Š” ๊ฒƒ์ด ๋‹จ์ˆœํžˆ ๊ทผ๋ ฅ์šด๋™๋งŒ์„ ์ง„ํ–‰ํ•˜๋Š” ๊ฒƒ์— ๋น„ํ•ด ์–ด๋–ค ์ฐจ์ด๊ฐ€ ์žˆ์—ˆ๊ณ  ์–ผ๋งˆ๋‚˜ ํšจ์œจ์ ์ธ์ง€ ๋‹ค์‹œํ•œ๋ฒˆ ๋˜์งš์–ด์ค€๋‹ค.

โ€‹

1์ฃผ์— 3์ผ(์›”, ์ˆ˜, ๊ธˆ) 80๋ถ„๊ฐ„์˜ ๊ทผ๋ ฅ ํ›ˆ๋ จ๊ณผ ์œ ์‚ฐ์†Œ ์šด๋™(HRmax์˜ 70~80%)์ธ ๋Ÿฐ๋‹๊ณผ ์ค„๋„˜๊ธฐ๋ฅผ 30๋ถ„๊ฐ„ ์‹ค์‹œํ•œ ์ค‘ํ•™๊ต ์—ญ๋„์„ ์ˆ˜ ์ค‘์— ์‹คํ—˜๊ตฐ 7๋ช…๊ณผ 110๋ถ„๊ฐ„์˜ ๊ทผ๋ ฅ ํ›ˆ๋ จ๋งŒ ์‹ค์‹œํ•œ ๋น„๊ต๊ตฐ 7๋ช…์„ ๋Œ€์ƒ์œผ๋กœ 10์ฃผ๋™์•ˆ ์‹ค์‹œ ํ•œ ํ›„ ๋ณ€ํ™”๋ฅผ ์กฐ์‚ฌํ•œ ๊ฒฐ๊ณผ, ์‹คํ—˜๊ตฐ์€ ๊ฐ๊ทน๋ ฅ, ๋ฐฐ๊ทผ๋ ฅ, ์™„๋ ฅ์ด ์œ ์˜ํ•˜๊ฒŒ ์ฆ๊ฐ€ํ•˜์˜€๊ณ , ๋น„๊ต๊ตฐ์€ ๊ฐ๊ทผ๋ ฅ๋งŒ ์œ ์˜ํ•˜๊ฒŒ ์ฆ๊ฐ€ํ•˜์˜€๋‹ค. ํŒ”๊ฟˆํ˜€ํŽด๊ธฐ์™€ ์œ—๋ชธ์ผ์œผํ‚ค๊ธฐ๋กœ ํ™•์ธํ•œ ๊ทผ์ง€๊ตฌ๋ ฅ์˜ ๋ณ€ํ™”์—๋„ ์‹คํ—˜๊ตฐ์€ ์œ ์˜ํ•˜๊ฒŒ ์ฆ๊ฐ€ํ•˜์˜€์œผ๋ฉฐ, ๋น„๊ต๊ตฐ์€ ์ฐจ์ด๊ฐ€ ์—†์—ˆ๋‹ค.3

์œ ์‚ฐ์†Œ์šด๋™ ํ›„ ์œ ์—ฐ์„ฑ, ์ง€๊ตฌ๋ ฅ, ๋ฏผ์ฒฉ์„ฑ, ์ˆœ๋ฐœ๋ ฅ ๋“ฑ ๊ธฐ์ดˆ๋Šฅ๋ ฅ ํ–ฅ์ƒ์ด ๋˜์—ˆ๋‹ค๋Š” ๊ฒƒ์„ ์‹คํ—˜๊ตฐ์—์„œ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค.6

โ€‹

โ€‹

๊ทธ๋ ‡๋‹ค๊ณ  ๋ฌด์กฐ๊ฑด ์œ ์‚ฐ์†ŒํŠธ๋ ˆ์ด๋‹์„ ๋งŽ์ด ํ•˜๋ผ๋Š” ๊ฒƒ์€ ์•„๋‹ˆ๋‹ค.

โ€‹

์ค‘์š”ํ•œ ๊ฒƒ์€ ๋‚˜์˜ ๋ชฉ์ ์— ๋”ฐ๋ฅธ ์œ ์‚ฐ์†Œ ์šด๋™์˜ '๋น„์œจ ์„ค์ •'์ด ๋  ๊ฒƒ์ด๋‹ค.

์ด๊ฒƒ์€ ํŠนํžˆ๋‚˜ ์šด๋™์„ ์ˆ˜์—๊ฒŒ๋Š” ์ค‘์š”ํ•œ ์ผ์ด๋ฉฐ, ์Šคํฌ์ธ ์— ๋”ฐ๋ผ ๊ฐœ์ธ์˜ ์ƒํ™ฉ์— ๋”ฐ๋ผ ๋‹ฌ๋ผ์งˆ ๊ฒƒ์ด๋‹ค.

โ€‹

โ€‹

ํ˜น์‹œ ์œ ์‚ฐ์†ŒํŠธ๋ ˆ์ด๋‹์„ ํ•˜์ง€ ์•Š๊ฑฐ๋‚˜, ๋ฐฉ๋ฒ•์„ ๋ชจ๋ฅธ๋‹ค๋ฉด ์ „๋ฌธ๊ฐ€์˜ ์ง€๋„ ํ•˜์— ์‹ค์‹œํ•˜์—ฌ ๋” ๋‚˜์€ ํผํฌ๋จผ์Šค๋ฅผ ๋ฐœํœ˜ํ•˜๊ธธ ๋ฐ”๋ž๋‹ˆ๋‹ค.

โ€‹

๊ทธ๋ฆฌ๊ณ  ์šด๋™ ์ „๋ฌธ๊ฐ€ ๋˜ํ•œ ์ด๋Ÿฌํ•œ ๊ณผ์ •์„ ์–ด๋А์ •๋„ ์•Œ๊ณ  ์ง€๋„ํ•˜๋Š” ๊ฒƒ๊ณผ ๋ชจ๋ฅด๊ณ  ์ง€๋„ํ•˜๋Š” ๊ฒƒ์€, ์ง€๋„๊ณผ์ •์—์„œ์˜ ์•„์ด๋””์–ด๋‚˜ ๋ฐฉ๋ฒ•์˜ ์งˆ์ด ํฌ๊ฒŒ ๋‹ฌ๋ผ์งˆ ๊ฒƒ์ž…๋‹ˆ๋‹ค.

 

 

์ฐธ๊ณ ๋ฌธํ—Œ

1. ๊น€์žฌ์ฒ (2002). ๊ณ ๊ฐ•๋„ ์œ ์‚ฐ์†Œ ์šด๋™์— ์˜ํ•œ ์‹ฌ์žฅ๊ทผ ๋ฐ ๊ณจ๊ฒฉ๊ทผ๋‚ด Angiogenic growth factor์˜ ๋ฐœํ˜„. ํ•œ๊ตญ์ฒด์œกํ•™ํšŒ์ง€, Vol.41, No.4, 461-469.

2. ๊น€ํ˜•๋ˆ, ์ด๊ฐ•๊ตฌ(2009). ์„ฑ์ธ๋‚จ์„ฑ์˜ ํก์—ฐ๊ณผ ์šด๋™์Šต๊ด€์ด ์‹ฌํ˜ˆ๊ด€๊ณ„ ์œ„ํ—˜์ธ์ž์™€ ์‹ฌํ๋Šฅ๋ ฅ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ. ์šด๋™๊ณผํ•™, 18(2)๏ผš163-172.

3. ๊น€ํ˜•๋ฌต(1998). ์œ ์‚ฐ์†Œํ›ˆ๋ จ์ด ์—ญ๋„์„ ์ˆ˜์˜ ๊ทผ๋ ฅ, ๊ทผ์ง€๊ตฌ๋ ฅ๊ณผ ์ฒด์ง€๋ฐฉ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ. ๊ต์œก๊ณผํ•™์—ฐ๊ตฌ, 11(3) : 261-280.

4. ์ •๋ณด๊ฒฝ, ์ดํšจ์ข…, ๊น€๊ทœ์›(2006). ํ˜ˆ๊ด€์ƒ์„ฑ์— ๊ด€๋ จ๋œ VEGF์™€ VEGF ์ˆ˜์šฉ์ฒด์˜ ์ข…๋ฅ˜์™€ ๊ทธ ๊ธฐ๋Šฅ. BioWave, Vol.8 , No.20.

5. ์ •ํ˜„์ง„, ์ด๋Œ€ํƒ(2012). ํก๊ธฐ๊ทผ์œก ํ›ˆ๋ จ๊ณผ ์œ ์‚ฐ์†Œ์šด๋™์˜ ๋™์‹œ์ ์šฉ์ด ์‹ฌํ๋ฐ˜์‘๊ณผ ํ๊ธฐ๋Šฅ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ. ์šด๋™๊ณผํ•™, 21(3) : 374-384.

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