Mankhwala osokoneza bongo ndi kalasi ya mankhwala a mphumu omwe amasonyezedwa kwa odwala omwe ali ndi vuto la mphumu yovuta. Monga chithandizo chowonjezera cha mphumu yanu, imadzimadzi ndi mankhwala olamulira osati mankhwala amphindi ochepa kuti athetse vuto la mphumu . Kwa pafupifupi pafupifupi theka la odwala asayansi omwe sagonjera steroid kapena osamva bwino, munthu amene ali ndi kachilombo ka HIV akhoza kupereka chiyembekezo cha mphumu yabwino ya mphumu.
Xolair , anti-monoclonal antibody, ndiyo yokha yomwe ikuvomerezedwa ndi mankhwala opatsirana pogonana. Izi zimakhala zoyenera kuti odwala omwe ali ndi vuto la mphumu lopitirirabe ali ndi:
- Kuyezetsa khungu koyenera kapena kuyezetsa magazi kumasonyeza kuti munthu akudwala matenda a mphumu omwe amadziwika, monga fumbi, ntchentche, kapu kapena ntchentche.
- Zizindikiro zomwe sizitha kuyendetsedwa ndi corticosteroids zozembetsa .
Mankhwala ena amodzi omwe amagwiritsidwa ntchito masiku ano pochita zozizwitsa ndi zochitika zapachilombo masiku ano ndi Cinryze, chithandizo cha kutupa kobwerezabwereza nkhope ndi khosi zotchedwa angioedema.
Momwe Omwe Amasamadzimadzi Amadzimadzi Amagwira Ntchito
Mankhwala osokoneza bongo amachepetsa zizindikiro zonse za mphumu komanso kufunika kwa systemic corticosteroids . Needing systemic corticosteroids kawiri pa chaka ndi chizindikiro cha kupuma kwa mphumu yosauka. Amadzimadzi amadzimadzi amatha kuchepetsa kutupa pogwiritsa ntchito malo osiyanasiyana m'malo odwala matenda a mphumu , kuphatikizapo:
- Basophils
- Eosinophils
- Lymphocytes
- Macrophages
- Maselo akuluakulu
- Neutrophils
- Matenda a Monoclonal
- Ikani
- T-maselo
- Makina a Cytokines
- Interleukins
Kachilombo ka HIV kamangomangiriza ku IgE ndikuchiletsa kuti isamangidwe ndi maselo amodzi ndi maselo akuluakulu. Kuonjezera apo, chitetezo cha mthupi chimachepetsa chiwerengero cha kuzungulira basophils ndipo chimateteza maselo kuti asamatulutse zinthu zomwe zingayambitse zizindikiro zanu.
Mmene Omwe Amasamalidwira Madzi Amadzimadzi Amathandizira
Nthawi zina amadziwika kuti steroid-sparing mankhwala omwe amachititsa kuti maulendo apansi ndi mapapo azigwira ntchito. Kuonjezera apo, chitetezo cha thupi chimachepetsa zizindikiro za mphumu monga:
- Kupuma
- Chimake cha chifuwa
- Kupuma pang'ono
- Chifuwa chachikulu
Chithandizo ndi immunomodulator chagwirizanitsidwa ndi kuchepa kwafupipafupi kwa kuphumuka kwa mphumu ndi maulendo obwera mwadzidzidzi komanso kusintha kwa mapapu ndi khalidwe la moyo. Kawirikawiri, chitetezo cha mthupi sichidzachotsa mankhwala ena a mphumu, koma adzawonjezeredwa. Kuonjezera kwa thupi loteteza thupi kumagwirizanitsa ndi kuchepa kwa 25% pa ntchito ya steroid.
Zochitika Zowopsa
Ngakhale kuti chitetezo chanu cha thupi chiyenera kulekerera, pali zotsatira zambiri zomwe zimawoneka ndi zotsatira zosazolowereka kuti zidziwe, kuphatikizapo:
- Mchitidwe wa Urticaria ndi anaphylactic -Urticaria, kapena ming†™ oma, ndizosachitidwa zomwe zingakhale ndi zotsatira zoyipa ngati sizikuchitidwa mwamsanga komanso moyenera. Dokotala wanu adzakufunsani kuti muziyang'aniridwa kwa nthawi mu ofesi mutatha jekeseni uliwonse. Ngakhale kuti machitidwe ambiri amapezeka pakatha maola awiri kapena awiri pambuyo pa jekeseni yoyamba, zotsatira zowopsa zakhala zikuchitika pambuyo pa jekeseni zambiri ndi maola ochuluka kuchokera pamene analandira jekeseni.
- Khansara - Ngakhale kuti sichidziwikiratu panthawiyi, khansa inali yowonjezereka pakati pa odwala omwe amalandira Xolair. Komabe, chifukwa chake chiyanjano pakati pa khansara ndi immunomodulator chinawonetsedwa sichimamvetsetsatu.
- Kupweteka kwa tsamba lajeremusi -Kodi ngati jekeseni iliyonse, kupweteka pa malo opangira jekeseni ndi mbali yodziwika bwino ndipo ikhoza kupezeka mpaka 20 peresenti ya odwala omwe akulandira immunomodulator.
- Matenda opatsirana opatsirana kwambiri - Onetsetsani kuti mukukambirana ndi dokotala zomwe muyenera kuchita komanso ngati mukuyenera kusamala ngati mukuwona zizindikirozi.
- Pakhosi ndi kupwetekedwa - Ngati zizindikirozi sizikugwirizana ndi njira zowonongeka, monga mankhwala ochepetsa ululu ndi mankhwala, ndiye kuti muyankhule ndi dokotala wanu.
Mankhwala Osokoneza Matenda M'kupita patsogolo
Zina mwazidzidzidzi zomwe zimayambitsa magawo osiyanasiyana a tizilombo toyambitsa matenda a mphumu zili muipiipi:
- Daclizumab ndi anti-monoclonal antibody yomwe imakhudza malo angapo mumphuno ya mphumu. Adayesedwa mu mayesero a zachipatala odwala matenda a mphumu 115, koma amasonyeza kusintha kokha kokha m'mapapu komanso kulamulira kwa mphumu.
- Lebrikizumab ndi munthu wodwala wodwalayo omwe amamanga ndi kulepheretsa ntchito ya interleukin-13, mbali ina ya matenda a mphumu. Mayesero awiri a kachipatala, VERSE ndi LUTE, amasonyeza kuchepa kwa kuphumuka kwa mphumu komanso kupuma kwa mapupa kwa odwala (popanda vuto lalikulu la chitetezo) ali ndi mphumu yovuta kwambiri yomwe ili ndi vuto lopanda mphamvu ngakhale kuti masiku ano amatha kusamalidwa bwino. Odwala omwe amadziwika kwambiri kuti apindule mu maphunzirowa anali ndi periostin yambiri, mapuloteni omwe amadziwika kuti akuwonjezeka kwambiri.
- Reslizumab ndi kulumikizana kwa humanozed monoclonal anti-interleukin-5 (IL-5). M'mayesero a zachipatala, akhala akugwiritsidwa ntchito kwa odwala akuluakulu komanso achinyamata omwe ali ndi matenda opatsirana a m'magazi, ngakhale kuti corticosteroid yovunda imachokera ku regimen. Reslizumab inasonyeza kuti kuphulika kwa mphumu kunachepetsedwa komanso kuti mapapu apangidwe amatha kuyesedwa m'zigawo zapakati pa 1,3 achinyamata komanso akuluakulu. Malingana ndi mayesero, ziyembekezeredwa kuti zizindikiro zidzakhala zofanana ndi za Xolair. Reslizumab ikuyang'aniridwa ndi FDA ndi TEVA inagwira ntchito yawo mu 2016. Makampani ena osokoneza bongo, monga AstraZeneca, ali ndi mankhwala ofanana ndi amenewa m'mipope yawo.
- Eculizumab (Soliris®) ndi wodwala wodwala wosakanizidwa wa monoclonal wothandizira njira yowonjezerapo ndipo tsopano akuvomerezedwa ndi FDA kuti azitsatira kanyumba kameneka kameneka kameneka kameneka kameneka kameneka kamene kamatulutsa mazira. Chiyeso chaching'ono chachipatala chinasonyeza kusintha kwa mapapu ndi zizindikiro zowonongeka. Komabe, mankhwalawa akugwiritsidwa ntchito ndi matenda opatsirana oopsa omwe amawopsa kwambiri. Zotsatira zake, mankhwalawa ndi oletsedwa ndipo madokotala amafunika kulemba kuti alembe.
- Suplatast yasonyezeranso zotsatira zabwino, koma katatu patsiku amaika masamba omwe akuda nkhaŵa ndi kugonana kwa mphumu.
- Matenda amtundu wa alpha (TNF-α) ndi immunomodulator omwe amachitanso m'malo ambiri pa matenda a mphumu. Zina kusiyana ndi kuyendetsa bwino mthupi mwa odwala opatsirana kwambiri odwala mphumu (omwe amadziwika kuti ali ndi TNF-α overxpression), TNF-α siinachepetse kuchulukitsa kapena kupuma kwa mapapo. Makamaka, Infliximab (Remicade®) ndi etanercept (Enbrel®) ndizimene zimagwiritsidwa ntchito pa matenda ena, monga nyamakazi ya nyamakazi. Mankhwalawa akuphatikizidwa ndi ngozi zoopsa za matenda.
- Puloxisome proliferator yowonjezera receptor-gamma (PPAR-γ) ndi gulu lina la mankhwala akuphunzira. Mankhwalawa akugwiritsidwa kale ntchito pochiza matenda a shuga, kumene anapeza kuti anali ndi zotsatira zotsutsa zotupa. Nkhumba za Guinea zomwe zimagwiritsidwa ntchito ndi rosiglitazone zimapezeka kuti zimakhala zochepa kwambiri m'magazi a IL-5 ndi IgE. Zinyama zikagwedezeka, til-5 ndi IgE zinapezedwanso kuti zimachepa m'mapapu. Ofufuza otsogolera akuganiza kuti mwina ndi mankhwala othandiza a mphumu, nayenso.
- Syk kinase ndi mapuloteni otchedwa tyrosine kinase omwe amachititsa kuti tizilombo toyambitsa matenda tiwonongeke. Mankhwalawa amapezeka kuti amachepetsanso mphuno yamphuno ndi kutulutsa, kupopera, kuyabwa kwa mphuno ndi kummero, kupweteka kwa msana, chifuwa, kupweteka mutu, ndi kupweteka kwa nkhope kwa odwala omwe ali ndi vuto lopwetekedwa m'thupi. Kafukufuku wogwiritsa ntchito mankhwala osokoneza bongo akukonzekera odwala a asthma.
Zotsatira:
National Heart, Lung, ndi Blood Institute. Report of Panel Panel 3 (EPR3): Malangizo Othandizira Kuzindikira ndi Kusamalira Khunyu.
Dimov VV, Casale TB. Mankhwala osokoneza bongo chifukwa cha mphumu. Kutsekula kwa mphumu ya Immunol Res. 2010; 2 (4): 228-234.
Kuthamanga WW, Israel E, Nelson HS, Baker JW, Wachikondi BL, Young DY, et al. Daclizumab imathandiza kuti odwala apitirize kukhala ndi mphumu yambiri yosavuta. Am J Respir Amatsutsa Care Med. 2008; 178 (10): 1002-1008.
Menzella F, Lusuardi M, Galeone C, Zucchi L. Mankhwala Othandizira Kuti Akhale ndi Nthenda Yaikulu Yophulika. Mitundu Yambiri Yopumiritsa Mankhwala; 10 (1) 201.