Mankhwala Osokoneza Bongo Akufunikiratu Chithandizo Choyamba Chachidule
Integrase inhibitors (omwe amadziwikanso kuti integrase strand transfer inhibitors, kapena INSTIs) ndi gulu lamphamvu la mankhwala opatsirana pogonana omwe amaletsa HIV kuti iphatikize ma genetic (genome) mu DNA ya selo yogonjera. Icho chimatero mwa kutseka puloteni yotchedwa integrase ndipo, pochita izi, zimapangitsa kukhala kovuta kuti kachilombo ka HIV kasinthe.
Isentress (ratelgravir) inali yoyamba INSTI yovomerezedwa ndi US Food and Drug Administration (FDA) pa October 12, 2007.
Zonse zanenedwa, pakali pano pali mamolekyu osokoneza bongo a INSTI atatu ndi mankhwala anayi osakaniza mankhwala omwe INSTI ndi gawo
- Isentress (ratelgravir)
- Tivicay (dolutegravir)
- Vitekta (elvitegravir)
- Triumeq (dolutegravir + abacavir + lamivudine)
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine)
- Genvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine)
Ngakhale mankhwala a combination of integrase, Dutrebis (ratelgravir + lamivudine), amavomerezedwa ndi US Food and Drug Administration, sizimapezeka ku US pakadali pano.
Omwe akugwiritsa ntchito mankhwala osokoneza bongo ViiV ndi Janssen Pharmaceuticals akugwirizanitsa ndi mankhwala ena omwe angagwirizane ndi dolutegravir ndi mankhwala Edurant (rilpilvirine) . Wosankhidwa wina wa INSTI, cabotegravir, akuyesa ziyeso za anthu a Phase III.
Monga kalasi ya mankhwala, integrase inhibitors amaonedwa kuti ndi opindulitsa pochiza matenda a HIV, ndi zovuta zofunikira kuika magazi, zoyipa zochepa, zotsatira zowonjezereka, komanso kupirira kwambiri.
Momwemonso, INSTIs amadziwika kuti ndi imodzi mwa njira zosankhika zomwe zimasankhidwa mu njira zambiri za HIV, kuphatikizapo za US
Utsogoleri wamakono kuchokera ku Dipatimenti ya Zaumoyo ndi Zaumunthu ku United States imapanga integrase inhibitors monga wothandizira, wothandizira mzere woyamba kwa anthu omwe angotengedwera kachilombo ka HIV. Ndipotu, mwazigawo zisanu ndi chimodzi zomwe mwasankha pakadali pano kwa odwala atsopano, asanu ali ndi integrase inhibitor monga msana wawo wa mankhwala.
Kodi Interhibse Inhibitors Zimagwira Ntchito Motani?
HIV imaphatikizapo kachilombo ka HIV m'kati mwa chipinda cha DNA mu njira zisanu:
- Nthendayi yotchedwa integrase imamangiriza ku DNA ya DNA, yomwe imamangidwanso mwachitsulo chomwe chimatchedwa kusintha .
- DNA ya DNA imakonzedwa kuti iyanjanitsidwe pamtundu wotchedwa cleaving, womwe umatulutsa kachilombo koyambitsa matenda a mavairasi, ndikusiya mipata yotseguka.
- Chingwe chotsekedwacho kenaka chimalowetsedwa muchisumbu cha cell cell yomwe ikugwiritsidwa ntchito kupyolera mu nyukiliya ya nyukiliya .
- Mukalowa mkatikati, kachilombo ka HIV kamene kamasamutsidwa kupita ku DNA yomwe imakhala mkati mwawo ndi chomwe chimatchedwa kutsetsereka. Pachigawo chino, kachilombo ka DNA kamenyana ndi DNA yeniyeniyo, kugawanitsa mgwirizano womwe umagwirizanitsa DNA pamodzi ndikudziphatika kudzera m'magulu a mankhwala a DNA.
- Kuwopsa kumeneku kumalimbikitsa kuteteza kutetezedwa kwachibadwa komwe kumatchedwa kukonza gala , momwe selo yolandiridwayo lidzakonzeretseratu kuwonongeka kwa DNA, motsogolere kutenga zolembera zamtunduwu.
Mwachidule mwa kulepheretsa mavitamini a integrase, njira yonse yoyanjanitsa imayimitsidwa, kuthetsa moyenera ma ARV. Komabe, monga mgwirizano ndi chimodzi mwa magawo angapo a moyo wa kachirombo ka HIV, mankhwala ena amatengedwa kuti athetse magawo ena, kuteteza kachilombo ka HIV kuti asawerenge ndikuonetsetsa kuti ntchito yokhudzana ndi kachilombo ka HIV imachotsedweratu.
Zotsatira Zotsatira
Mosiyana ndi magulu ena a kachilombo ka HIV, integrase inhibitors amagwira ntchito mwachindunji njira zowononga okha osati mmaselo. Izi zimakhala zochepa kwambiri, makamaka kutsegula m'mimba, kunyowa, kutopa, kupweteka mutu, ndi kusowa tulo.
Zambiri za zotsatirazi, komabe, zimakhala zochepa ndipo nthawi zambiri zimathetsa okha. Ndikumanenedwa kuti, ngati mutakumana ndi vuto lililonse mukatenga mankhwala a integrase inhibitor, alangizeni dokotala kapena chipatala mwamsanga. Musati muime mankhwala popanda kulankhula ndi katswiri wodziwa bwino. Kusunga ndi kusintha kusanathe nthawi kungapweteke kwambiri kuposa zabwino.
Mofananamo, ngakhale integrase inhibitors sizingatheke kuti musakane mankhwala osokoneza bongo , muyenera kupeĊµa kuchepa kwa mankhwala kapena mipata yochizira. Kukanika kumachitika pamene mankhwala amagazi mumagazi amayamba kugwa, zomwe zimalola kuti mavairasi otuluka mumtunduwu awoneke ndikukula. Izi zikachitika, mankhwala anu sangathe kugwira ntchito komanso kale ndipo nthawi zina amalephera.
Popeza integrase inhibitors amakhalabe m'magazi kwa nthawi yaitali, amatha kupondereza HIV mutants ngakhale ngati nthawi zina amasiya. Koma nkofunika kumvetsetsa kuti kusokonezeka kwa nthawi yaitali sikulangizidwa komanso kuti kumatira tsiku ndi tsiku kumakhala kofunika kwambiri pa kupambana kwa mankhwala.
Zotsatira:
US Food and Drug Administration (FDA). "Kuvomerezeka kwa Mankhwala Osokoneza Bongo - Dzina la Mankhwala: Isentress (ratelgravir) Mapiritsi 400mg." Silver Spring, Maryland; October 12, 2007.
National Institute of Allergy and Infectious Diseases (NIAID) "Kukula kwa Mankhwala Osokoneza Bongo ka HIV / AIDS." Bethesda, Maryland; zasinthidwa pa July 21, 2015.
Dipatimenti ya Zaumoyo ndi Zaumunthu (DHHS). "Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Rockville, Maryland; zasinthidwa pa January 28, 2017; yafika pa March 24, 2017.
Craigie, R. ndi Bushman, F. "HIV DNA Integration." Cold Spring Harbor Zochitika mu Mankhwala. July 2012; 2 (7): a006890.
Bushman, F .; Fujiwara, D .; ndi Craigie, R. "Mapulogalamu a DNA omwe amagwiritsidwa ntchito ndi Retroviral, omwe amayendetsedwa ndi mapuloteni a m'thupi mwa HIV." Science. September 28, 1990; 249 (4976): 1555-1558.