Poyang'anizana ndi zopinga zomwe zimapanga chithandizo chachilombo ka HIV , asayansi akhala akuikapo chidwi kwambiri m'zaka zaposachedwapa pozindikira njira zowonongeka za thupi zomwe zingathandize thupi kumenyana, kapena kupewa, kuteteza kachirombo ka HIV.
Umboni wa njirayi ndi wolimba. Ife tikudziwa kale, kuti pali gulu la anthu omwe amatchedwa olamulira akuluakulu omwe amawoneka kuti akhoza kuthana ndi HIV popanda kugwiritsa ntchito mankhwala osokoneza bongo.
Poyang'anitsitsa anthuwa, ofufuza akhala akutha kusiyanitsa zifukwa zingapo zokhudzana ndi chitetezo cha chilengedwe.
Mmodzi mwa awa ndi mtundu wa mapuloteni a chitetezo cha m'thupi omwe amachititsa kuti anthu asamangokhala ndi ma antibodies , omwe kawirikawiri amawoneka m'manja olamulira akuluakulu ndipo, mosiyana ndi ma antibodies, amatha kuthetsa mavuto osiyanasiyana a HIV .
Mu November 2016, asayansi a National Institutes of Health adalengeza kuti adapeza bNAb yatsopano, yotchedwa N6, yomwe inatha kuthetsa 98 peresenti ya zovuta zonse za HIV m'mayesero am'mbuyomu. Wopanga chitetezochi, wolekanitsidwa ndi wolamulira wamkulu wa kachirombo ka HIV, amanenedwa kuti ali ndi kachilombo koyambitsa kachilombo koyambitsa kachilombo ka HIV kuposa nthawi ina iliyonse yomwe imadziwika kuti BNAb.
Kumvetsetsa Mosasintha Ma Antibodies
Ma antibodies ali mapuloteni ofanana ndi Y omwe amapangidwa ndi chitetezo cha mthupi kuti athandize kulimbana ndi tizilombo toyambitsa matenda monga mabakiteriya kapena mavairasi.
Kawirikawiri, ambiri akukonzekera kuti amenyane ndi mtundu wina wa tizilombo toyambitsa matenda ndi tizilombo toyambitsa matenda okhawo. Vutoli limapangitsa kuti HIV ikhale yosasintha nthawi zonse ndipo imatha kupeŵa kuzindikira mosavuta chifukwa chosazindikiridwa ndi wodwalayo.
Mosiyana ndi zimenezi, bNAbs imatha kufufuza kachilombo ka HIV ngakhale kuti imatha kusintha, kutulukira kachilombo koyambitsa matenda koma osati ndi mapangidwe a kachilombo koyambitsa matendawa (omwe amatchedwa CD4 kumanga malo), omwe sungasinthe kwambiri.
Ngakhale kuti mabBB amakhala nthawi zambiri okhudzana ndi ulamuliro wapamwamba, iwo adzakhala ndi anthu onse omwe ali ndi HIV, ngakhale pang'onopang'ono.
Kwa olamulira ambiri akuluakulu, kupezeka kwa mabBbs kumaonedwa kuti ndi kosavuta, kutanthauza kuti iwo alipo panthawi ya matenda. Mu mabungwe osakhala olemekezeka, mabNA amabwera kawirikawiri mkati mwa zaka 2-3 za matenda oyambirira, omwe nthawi yomweyo kachilombo kamene kadzalowetsa m'maselo ndi minofu yomwe imatchedwa malo osungiramo malo , kumene idzabisika kwambiri ku chitetezo cha mthupi.
Asayansi tsopano akukhulupirira kuti ngati atha kupangitsa chitetezo cha mthupi kutulutsa ma bBb "ngati akufuna," akhoza kupewa matenda kapena kuchepetsa matenda, popanda mankhwala kapena popanda mankhwala.
Mbiri Yachilengedwe Yopanda Kuteteza Antibodies
Ngakhale kuti asayansi anayamba kuyamba kuzindikira mabBB kumayambiriro kwa zaka za m'ma 1990, mu 2009 panalibe anthu ochita chidwi kwambiri omwe athandizidwa pafupipafupi. Zina mwa izo zinali VRC01, bNAb yomwe idali yolekanitsidwa ndi mwamuna wa ku America wa America ndipo kenako inawonetsedwa kuti iwonongeke 90 peresenti ya mitundu yonse ya HIV-1.
VRC01 imagwira ntchito yokhazikika pa tsamba la kumangiriza CD4 pamwamba pa kachilomboka, kuteteza kachilombo ka HIV kuti asalowe mumsasa wowonongeka.
Mayesero oyambirira a zinyama kufufuza VRC01 anatsimikizira lonjezo, ndi majeremusi oyamwa ndi ma antibodies omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda kwa miyezi isanu ndi umodzi.
Zovuta za anthu, mosiyana, zakhala zikukhumudwitsa kwambiri. Kuphunzira kwa 2016 kuchokera ku AIDS Clinical Trial Group kunasonyeza kuti matenda oopsa a VRC01, ngakhale atalekerera, sanachite zochepa kuti athe kutenga kachilombo koyambitsa matendawa kwa omwe adachotsedwa. Majekeshoni ambiri sanathe kusintha pa zotsatirazi.
Kupeza kwa watsopano wa N6 wodwalayo kumaonedwa kuti ndi kwakukulu pakati pa omwe amauona wolowera zachilengedwe kwa VRC01, onse mu ma genetic ndi potency.
Ndipo pali umboni wamphamvu wovomereza malingaliro awa.
Pambuyo pa N6, anthu ambiri omwe amafunsidwa ndiBNAb akhala ovuta kwambiri koma ocheperapo (monga momwe zinalili ndi VRC01) kapena zolimba kwambiri koma zochepa. N6 imawonekera, makamaka m'mayesero am'mbuyomu, kuti ikhale yogwira pambali zonsezi, kusokoneza 98 peresenti ya 181 zosiyana ndi matenda a HIV (kuphatikizapo 16 mwa makumi asanu ndi awiri (20) makumi asanu ndi awiri (20) aliwonse amatetezedwa ku bNAB ena a m'kalasi yake).
Zambiri zokhudzana ndi kachilombo ka HIV zimatchulidwa kuti zimakhala zosazolowereka, zomwe zimawatchinjiriza kuti asatengere mavitamini ena kuti asatenge kachilomboka.
Kodi N6 Adzatsegula Chipatala ku HIV?
Kodi N6 iyenera kupeza zotsatira zofanana ndi ziyeso zaumunthu, ndizomwe zikanakhala zoyamba kutsogolera zosiyana siyana za HIV, pokhapokha payekha komanso pa chiwerengero cha anthu.
Izi sizikutanthauza kuti sizingagonjetsenso zovuta zomwe zinayesedwa kuyambirira kwa VRC01, momwe mayendedwe amodzi mwachindunji alephera kufotokozera ubwino wolamulira wamkulu. Mofananamo, pali umboni wochepa wosonyeza kuti tikhoza kupangitsa chitetezo cha mthupi kutulutsa ma antibodieswawokha, pamtingo wambiri mokwanira kuti tiwone ngati oteteza.
Chimodzi mwa mavuto aakulu omwe ofufuza akukumana nacho ndi chakuti kudulidwa kwa bNAb umodzi kwatsimikizira kuti kuli kovuta kwambiri. Kawirikawiri kulankhula, pamene asayansi amayesa kukopa yankho, thupi lidzayankha ndi yankho losemphana, lomwe limachepetsa mphamvu. Momwemonso ndiyo njira ya thupi "yoika mabaki" pa chitetezo cha mthupi kuti awonetsetse kuti sichimayambitsa (monga zimachitika ndi matenda omwe amachititsa kuti munthu asatenge thupi ) kapena kuti asagwire ntchito (monga zimachitika ndi matenda osokoneza thupi).
Nkhani zina zovuta kwambiri ndizo malo osungira kumene HIV ingakhale yotetezedwa kuti isadziwike kwa zaka ndi zaka zambiri. Vuto ndi ili: kachilombo koyamba kokha kamene kamatha kusokonezedwa ndi bNAbs; Zomwe zimabisika muzipinda zamakono sizingatheke. Ndiko "kukankha" kachilombo ka HIV kuti asabisike kuti mabBB ali ndi mwayi wokhala ndi mankhwala osatha. Njira yowonongeka, yomwe imadziwika kuti "kupha," lero ndi yofunika kwambiri pakati pa magulu otsogolera omwe akutsogolera HIV.
Tsogolo la BNAb Research
Kaya asayansi angathe kuthana ndi zovuta izi sizikuwoneka. Zomwe tikudziwa ndizomwe N6 imaposa mabungwe ena onse omwe akuwongosoledwa panopa, ponseponse pokhapokha ndi m'kati mwake.
Chifukwa cha potency yake, N6 imawoneka kuti ili ndi mwayi woposa VRC01 monga momwe ingayesedwere subcutaneously, osati ndi IV. Kuwonjezera apo, kuthekera kwake kuthetsa pafupifupi mitundu yonse ya HIV imatanthawuza kuti ingagwiritsidwe ntchito ngati njira zothandizira komanso kuteteza matenda.
Ngakhale wina akuyenera kuyandikira kafukufukuyo mosamala, pamapepala onse akuwoneka ngati akulonjeza. Gawo lotsatila lidzapitirira ku mayesero a zinyama, mwina kuyamba nthawi kumayambiriro kwa 2017.
Panthawiyi, mayesero awiri a Phase II ayambira mu 2017, pofufuza kugwiritsa ntchito VRC01 ngati njira yothetsera HIV (yotchuka ndi HIV pre-exposure prophylaxis, kapena PrEP ).
Mayesero akuluakulu a umunthu adziwone ngati VRC01 ingapereke chithandizo choteteza anthu omwe alibe kachilombo ka HIV kamene kanapereka mankhwala opatsirana awiri. Yoyamba idzachitika mu malo 24 ku Brazil, Peru, ndi United States, ndi kulembedwa kwa amuna 2,700 ndi transgender anthu omwe amagonana ndi amuna . Wachiwiri adzalandira akazi 1,500 ku Botswana, Kenya, Malawi, Mozambique, South Africa, Tanzania, ndi Zimbabwe.
> Zotsatira:
> Bar, K .; Harrison, L .; Overton, E .; et al. "ACTG 5340: Zotsatira za VRC01 pa Viral Kinetics Pambuyo pa Kusokonezeka Kwambiri kwa Chithandizo." Msonkhano wa Retroviruses ndi Matenda Opondereza (CROI); Boston, Massachusetts; February 22-25, 2016; Nkhani yosamalitsa 32LB.
> Chun, T .; Wowononga, M .; Seamon, C .; et al. "Mmene Mungayankhire Anti Anti VRC01 pa HIV Plasma Rebound." Msonkhano wa Retroviruses ndi Matenda Opondereza (CROI); Boston, Massachusetts; February 22-25, 2016; Chidziwitso cha 311LB.
> Eroskin, A .; LeBlanc, A .; Masabata, D .; et al. "BNAber: deta ya ma antibodies ambiri omwe amaletsa." Nucleic Acid Research. January 2014; 42 (Nkhani yachinsinsi): D1133-1139.
> Zokambirana za HIV Zowonongeka (HPTN). "HPTN Studies: Study List - HVTN 704 / HPTN 085 ndi HVTN 703 / HPTN 081." Washington, DC.
> Huang, J .; Kang, B ;; Ishida, E .; et al. "Kuzindikiritsa CD4-Binding Site Antibody kwa HIV yomwe Inayambitsa Near-Pan Neutralization Mkate." Chitetezo chokwanira. November 15, 2016; 45 (5): 1108-1121; DOI: 10.1016 / j.immuni.2016.10.027.