Maselo ammitsempha amakhala pamtundu wina wotchedwa myelin. Myelin amathandiza maganizo a magetsi kuyenda m'mitsempha. Multiple sclerosis (MS) ndi matenda osokoneza bongo omwe thupi limagonjetsa makola a myelin a ubongo ndi msana kumayambitsa odwala omwe ali ndi MS kuti awononge kusokonezeka kwa maso, kufooka kwa minofu, mavuto amalingaliro, ndi zina zotero.
Mofanana ndi matenda ambiri, amakhulupirira kuti MS imakhudzidwa ndi chilengedwe ndi chibadwa.
Mu ndondomeko yowonongeka ya December 2017 yomwe imatchedwa "Kuwonetsa mankhwala ndi chiopsezo cha multiple sclerosis," Yong ndi alembi ena amafufuza ngati mankhwala oyenera-omwe ali ndi chilengedwe-akhoza kuwonetsa chiopsezo cha MS. Phunziro ili, ofufuzawa adapeza maphunziro 13 apamwamba kuti awononge. Maphunziro 13wa anafufuza makalasi asanu ndi awiri osokoneza bongo. Tiyeni tiwone zotsatira za gulu lililonse la mankhwala pa MS.
Amiloride
Amiloride (Midamor) ndi potaziyamu yokhala ndi diuretic yomwe imagwiritsidwa ntchito pochiza matenda oopsa kapena kuthamanga kwa magazi. Mwapadera, Midamor amalepheretsa njira yowonongeka ndi asidi 1 (ASIC-1). Mu zitsanzo zamtundu wa MS, ASIC-1 iliponseponse, kutanthauza kuti kuwonjezeka kwa maselo ku ASIC-1. Kuwonjezeka kwazowonjezeraku kumapezeka m'zigawo za pakatikati zamanjenje zomwe zawonongeka (ie, plaques). Zinyamazi, kutetezedwa kwa ASIC-1 kumawonetseredwa kuti kuchepetsa kuperewera kwa matendawa, njira yomwe imakhudzidwa ndi kufooka kwa odwala omwe ali ndi MS.
Ngakhale kuti athandiza kuchepetsa kufooka kwa nyama, Yong ndi anzake adapeza kuti panalibe mgwirizano pakati pa ntchito ya Midamor ndi mafupipafupi a MS muchitsanzo cha Denmark. (Denmark imakhala ndi mabungwe ambirimbiri omwe amawunikira, zomwe zimapangitsa kuti zosavuta kupanga maphunziro a anthu akuwonetsetse thanzi labwino.) Mwachidziŵikire, chitsanzo ichi cha ku Denmark chinali anthu omwe anali atangoyamba kumene MS, omwe ochita kafukufukuwo amafotokoza ngati MS omwe apanga kwa anthu a zaka 60 kapena Zambiri.
Kumapeto kwa MS kumangokhudza 5 peresenti ya anthu omwe ali ndi MS; Choncho, zotheka kuti zotsatilazi sizikugwira ntchito kwa anthu ambiri a MS. Mwa kuyankhula kwina, sizidziwika ngati mphamvu za Midamor zamoyo za MS mwa anthu omwe ali ndi MS koma osati mofulumira-kutuluka MS.
Pazowonjezereka, ochita kafukufukuwa adapezanso kuti palibe mphamvu ya thiazide diuretics, yomwe ngati Midamor imagwiritsidwanso ntchito pochiza magazi, pa MS.
Valproic Acid
Valproic acid (Valproic) ndi mankhwala osokoneza bongo omwe amagwiritsidwa ntchito pochiza khunyu . "Valproic acid imalepheretsa histone deacetylase yomwe ingabweretse kusintha kwa mapuloteni enieni omwe amawoneka mu selo ndi kusungunula kwanga," alembe Yong ndi olemba anzawo. Komabe, pogwiritsa ntchito kafukufuku wa Danish, anthuwa sanapeze mgwirizano pakati pa Valproic ndi MS.
TNF Inhibitors
Malingana ndi American College of Rheumatology, "TNF inhibitors ndi mtundu wa mankhwala ogwiritsidwa ntchito padziko lonse kuti azichiza matenda opweteka monga nyamakazi ya nyamakazi (RA), psoriatic nyamakazi, ana a nyamakazi, nyamakazi yotupa (Crohn's ndi ulcerative colitis), ankylosing spondylitis, ndi psoriasis. Amachepetsa kutupa ndi kuletsa matenda kupititsa patsogolo mwa kulumikiza mankhwala othandiza kutupa otchedwa Tumor Necrosis Factor (TNF). "
Yong ndi olemba awiriwa adayang'ananso maphunziro a ku Denmark kuti aone ngati pali mgwirizano pakati pa TNF inhibitors ndi MS. Maphunziro onse awiriwa anali owonetsetsa komanso okhudzana ndi zitsanzo za anthu omwe adatsatiridwa ndi nthawi.
Yong ndi anzake adapeza kuti palibe mgwirizano pakati pa mankhwala ndi TNF zomwe zimayambitsa matenda opatsirana ndi kutukula kwa MS. Mwapang'onopang'ono, ngakhale kuti pangakhale kuwonjezeka kowonjezereka kwa chiopsezo cha kukhala ndi MS mwa omwe amatenga nthenda ya TNF chifukwa cha kutupa kwa matumbo, kuwuka kumeneku kunali kosiyana ndi chiopsezo chinai chomwe anthu omwe ali ndi matenda opatsirana kale amasonyeza kale zochitika zowonongeka monga MS.
Ofufuzawa anapeza kuti amuna omwe amalandira matenda a TNF odwala matenda a nyamakazi komanso amuna ndi akazi omwe amalandira TNF omwe amawathandiza kuti asatuluke ndi matendawa, amakhala ndi chiopsezo chachikulu kwa MS atatha kuchipatala. Zindikirani, kuteteza kwa spondylitis kumakhala kofala kwambiri mwa amuna.
Chiwerengero chimodzi cha maphunziro a Danish omwe adafukulidwa ndikuti sankadziwa kuti mitundu ya TNF inhibitors idagwiritsidwa ntchito, ndipo mitundu yosiyanasiyana ya TNF inhibitors imakhudza kutupa m'njira zosiyanasiyana.
Malingana ndi a Yong ndi olemba mabukuwa: "Powonjezeredwa, kuyang'ana koyambirira kumadzetsa nkhaŵa chifukwa cha chitetezo cha anti-TNFα [TNF inhibitors] chokhudzana ndi vuto la MS, koma ntchito yowonjezera ikufunika. Zidzakhalanso zothandiza kudziwa ngati zotsatira ndi mankhwala omwe amadziwika bwino kapena omwe amawonekera kwa gulu lonse lochiritsira. "
Maantibayotiki
Maphunziro aŵiri a mayeso-wina ku UK ndi wina ku Denmark-anafufuza mgwirizano pakati pa kugwiritsa ntchito maantibayotiki ndi MS. Kafukufuku wotsutsana ndi odwala akufanizira odwala omwe ali ndi zotsatira kapena matenda (mwachitsanzo, milandu) ndi iwo omwe sali (mwachitsanzo, kulamulira). Pokhala ndi kafukufuku wotsogolera, ochita kafukufuku akuyang'ana mmbuyo mobwerezabwereza kuti atsimikizidwe kuti ali ndi zifukwa zoopsa. Mu maphunziro a ku UK ndi Denmark, milandu yokhudza odwala omwe anapezeka kuti ali ndi MS, ndipo chiopsezo chotenga chidwi ndicho kugwiritsa ntchito maantibayotiki.
Kuphunzira ku UK, odwala 163 omwe ali ndi MS adayanjanitsidwa ndi anthu 1523 opanda MS malinga ndi zaka, kugonana, ndi zina. Ofufuzawa anapeza kuti ntchito yonse ya antibiotic sinali yogwirizana ndi MS. Komabe, penicillin amagwiritsira ntchito kwa milungu yoposa iwiri kapena tetracycline ntchito kwa mlungu umodzi wokha.
Ofufuza a ku Denmark anayesa kufotokoza zomwe akatswiri a ku Britain anapeza pogwiritsa ntchito kukula kwazitsanzo zapadera (3259 milandu). N'zochititsa chidwi kuti ofufuza a ku Denmark adapeza kuti mitundu yambiri yogwiritsira ntchito maantibayotiki inkagwiritsidwa ntchito ndi chiopsezo chachikulu cha MS-ngakhale odwala omwe amamwa mankhwala amodzi okha masiku asanu ndi awiri. Mfundo yakuti ma antibiotic ambiri amagwiritsidwa ntchito ndi MS zikuwoneka kuti matenda eni enieni-osati mankhwala opha tizilombo okha-adagwirizanitsidwa ndi chitukuko cha MS.
Zonsezi, zikuwoneka kuti maantibayotiki samagwirizanitsidwa ndi MS ambiri amafufuza, koma kufufuza kwina kumafunika kuti uchitidwe.
Inhaled Short-acting Beta2-adrenergic Receptor Agonists
Mankhwalawa amatchedwa "fenoterol" (Berotec N) ndi salbutamol (ProAir HFA) omwe amachititsa kuti agonist-acrenergic receptor agonist agwiritsidwe ntchito pochiza matenda a mphumu komanso matenda osokoneza bongo. Mu kafukufuku wotsutsa milandu, anthu ochita kafukufuku ku Taiwan anafufuza ngati mankhwalawa adayambitsa vuto la MS. Iwo adapeza kuti ngakhale kuti pangakhale pangozi ya MS kwa iwo amene amatenga Berotec N, chiopsezo chokhala ndi MS sichinagwirizane ndi ProAir HFA.
Akatswiri ofufuza ku Taiwan ananena kuti Berotec N ikhoza kuteteza chitetezo chifukwa cha luso lake loletsa mphamvu ya superoxide ndi degranulation. Mwachiwonekere, ProAir HFA si bwino kuchita zinthu izi; Choncho, sichitha kuteteza.
Kuwonjezera pamenepa, pamene mukuganiza kuti okalamba omwe amagwiritsa ntchito nthawi yayitali, a Yong ndi olemba anzawo amafotokoza izi: "Akatswiri a agonist-acrenergic agonistic omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda timene timalepheretsa interleukin-12, mavitamini 1 amathandiza. "Malingaliro, akatswiri amasonyeza kuti maselo a T (mtundu wa selo loyera la magazi) amathandiza kwambiri kuwononga ma sheaths omwe amatsogolera ku MS.
Antihistamines
Pogwiritsa ntchito kayendedwe ka kampeni, akatswiri a ku UK anafufuza ngati antihyistamine yosagwedezeka ndi yosagwira ntchito ikugwirizana ndi chitukuko cha MS. Zinthu monga matenda owopsa (mwachitsanzo, mphumu, chizungu, ndi chiwindi) ndi kusuta kunasinthidwa. Ofufuzawa adapeza kuti ngakhale kuti antihistamines osakhala ndi mankhwala osagwiritsidwa ntchito mosagwiritsidwa ntchito, sanagwirizane ndi vuto la MS.
Akatswiri amanena kuti chifukwa chokhala ndi antihistamines chingakhale chitetezo choterechi-mosiyana ndi antihistamines-mankhwala osokoneza ubongo amatsutsana ndi ubongo wa ubongo ndipo amachititsa kuti ubongo ndi msana zisagwire bwino ntchito.
Kulankhulana kwapakhomo
Yong ndi anzake aganiziranso maphunziro asanu omwe amayang'ana mgwirizano pakati pa kugwiritsira ntchito mankhwala opatsirana pakamwa ndi chiopsezo cha MS. Zonsezi, panalibe mgwirizano pakati pa mitundu iwiriyi.
Zambiri Zokhudza Za Multiple Sclerosis
Multiple sclerosis imakhala ndi chiwonongeko chotsalira cha myelin m'maselo a mitsempha ya pakatikati ya mitsempha ya ubongo (ubongo ndi msana). Sichimakhudza maselo a mitsempha omwe ali m'thupi la mitsempha (mwachitsanzo, mitsempha ndi ganglia zili kunja kwa ubongo ndi msana). Matendawa amatanthauza kuti thupi limadziukira palokha.
Kuwonjezera pa mankhwala osokoneza bongo, omwe atangodziwika posachedwapa monga chinthu chodziwika bwino, zinthu zina zomwe zimayambitsa matendawa zakhala zikuphatikizidwa mu matenda opatsirana pogonana a MS kuphatikizapo zotsatirazi:
- Kusintha nthawi
- Kusuta
- Kusokonezeka maganizo
- Matenda opatsirana monga Epstein-Barr Virus
- Kusokonezeka maganizo
- Kuchepetsa kuwala kwa dzuwa
- Mavitamini otsika a Vitamini D
Padziko lonse, MS imakhudza anthu mamiliyoni 2.5, ndipo ku United States, anthu oposa 400,000 ali ndi matendawa.
Kuyambika kwa MS kungakhale kophweka kapena pang'onopang'ono. Zizindikiro zoyamba zikhoza kukhala zonyenga kwambiri kuti munthu yemwe ali ndi MS sangathe kuzizindikira ngakhale kwa miyezi kapena zaka. Nazi zizindikiro zina za MS:
- Kufooka
- Zizindikiro zodabwitsa
- Kusokonezeka koonekera
- Kusokonezeka ndi kugwirizanitsa
- Kufunika kwachangu
- Nthawi zambiri
- Kutopa
- Magalimoto mavuto
Zizindikirozi zimatha kupangidwa ndi sera ndipo zimakhala ndi zida zomwe zimakhalapo kwa milungu kapena miyezi ndikutsatiridwa. Zizindikiro zimatha kuwonjezereka ndi kutentha, kutopa, kuchita masewera olimbitsa thupi, kapena kupanikizika.
Potsirizira pake, MS ndi matenda omwe amatha kupezeka, zomwe zimatanthawuza kuti zimapezeka ngati matenda ena, monga mimba ya msana kapena kupatsirana koopsa kwa matendawa. Pamene mukupeza MS, mbiri ndi zofufuza zakuthupi komanso zotsatira za MRI zimathandiza. Kusintha kwa zitsamba zamakono mu cerebrospinal fluid nazonso.
Tsoka ilo, palibe mankhwala a MS. Komabe, pali mankhwala omwe alipo, kuphatikizapo corticosteroids ndi kusintha kwa plasma kwa mankhwala ovuta kwambiri, komanso njira zochizira matenda monga beta interferons pofuna kupewa zitsulo za MS.
Mawu Ochokera
Kumbukirani kuti ndondomekoyi yowonongeka ndi Yong ndi olemba anzawo ndi oyamba kuyang'ana zokhudzana ndi mankhwala osiyanasiyana pa MS. Zotsatira za ndemanga zowonongekazi zimatanthawuza kuwunikira ma pathogenesis a MS-matenda omwe sitikumvetsa zomwe zimayambitsa.
Panthawi imeneyi, palibe wodwala amene angagwiritse ntchito izi pofuna kupeza chithandizo. Chidziwitso chirichonse chochokera ku ndondomekoyi yowonongeka chikuyenera kutsimikiziridwa ndi kubwerezedwa. Ngati mukugwiritsa ntchito mankhwalawa ndikudandaula za momwe amachitira zovuta za MS, muzimasuka kukambirana zomwe mwaphunzira ndi dokotala wanu. Komabe, musasiye kumwa mankhwala (kapena kuyamba kumwa) malinga ndi zomwe mwawerenga m'nkhani ino-komanso opanda phindu kuchokera kwa dokotala wanu.
> Zotsatira:
> Multiple Sclerosis. Mu: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson J, Loscalzo J. eds. Buku la Harrison la Harrison la 19, New York, NY: McGraw-Hill.
> Multiple Sclerosis. MedlinePlus.
> TNF Inhibitors. American College of Rheumatology.
> Yong HY et al. Kupezeka kwa mankhwala ndi chiopsezo cha multiple sclerosis: Kuwongolera mwatsatanetsatane. Pharmacoepidemiol Drug Saf. 2017; 1-7.