ZMapp, Favipiravir, Kuletsa Matenda, ndikuyembekeza zambiri
Yankho losavuta: sitikudziwa, koma tili ndi chiyembekezo.
Ebola isanafalikire kumadzulo kwa Africa mu 2013 mpaka 2015, palibe mankhwala omwe anayesedwa bwino mwa anthu. Mliriwu utatha, nthawi zambiri mankhwalawa amaperekedwa kuti azisonyeza chifundo. Odwala adalandira mankhwala ndipo apindula. Komabe, chiwerengero cha odwala chakhala chaching'ono, mankhwala ambiri omwe nthawi zina amagwiritsidwa ntchito, ndipo chifukwa chodziwika bwino sizinayambe kufaniziridwa ndi placebo.
Kuchiza kwa odwala omwe akugwirizana ndi kusintha kwaphatikizapo: ZMapp, favipiravir, komanso magazi kwa opulumuka. Kafukufuku wina wa TKM-Ebola analephera kusonyeza phindu lililonse. Komabe, poyamba zisanayambe kupezeka, anthu 10 adalandira ZMapp ku US, Liberia, Spain, ndi UK. Awiri okha anafa. Osachepera amalandira favipiravr (ku France) ndi TKM (ku US) ndipo apulumuka. Odwala ena adayamba Brincindofovir- mmodzi anamwalira. Komabe kuchokera ku izi, n'zovuta kunena za mankhwalawa popanda zovuta zenizeni, kaya mankhwala kapena chisamaliro chothandiza, chinapangitsa kusiyana.
Komabe, tili ndi chiyembekezo. Mliri wa Ebola (EBOV, Zaire) umene ukufalikira ku West Africa ndi wapamwamba kwambiri. Poyamba ankaganiza kuti ndi oposa 80-90% (monga momwe akuwonera m'mabvuto a m'madera ena). Zikuwoneka kuti ndi 45-60% ku West Africa. Kusamalira bwino kumachepetsa kufa kwa 1 mpaka 3.
Zimakhalanso zovuta kuyerekeza mitengo ya moyo monga momwe nthawi zambiri zimachedwerapo pofunafuna chisamaliro kapena kusamutsidwa kusamalira.
Vuto ndilo: Masitolo a ZMapp anatuluka.
Koma tsopano zowonjezereka zikupezeka - koma changu chadutsa.
Bungwe la WHO (World Health Organization) ndi mabungwe a boma, kuphatikizapo US FDA (Federal Drug Administration), akuthandizira kugwiritsa ntchito chifundo ndi kuyesa mankhwalawa.
Komabe, popanda umboni wakuti mankhwala ndi opulumutsa moyo, pali nkhawa kuti zomwe zimawoneka kuti ndizipulumutsa moyo zingakhale zovulaza - kapena zimangopotoza ku chisamaliro chopulumutsa moyo.
Kotero kodi izo zimachokera kuti?
Serum yokondwerera
Njira yoyamba yothetsera Ebola inayamba ndi kuika magazi kwa opulumuka kwa omwe ali ndi kachilombo koyambitsa matendawa. Wofufuza wina anapulumuka pambuyo pa matenda a Ebola mu 1976 (ndi dokotala yemwe ali ndi kachirombo ka 2014) atapatsidwa magazi koma sankadziwa ngati seramu yathandiza. Kenaka mu 1995, odwala 8 anapatsidwa magazi ndipo 7 anapulumuka, pamene ambiri (80%) anafa. Kufufuza kobwerezabwereza, komabe, kunasonyeza kuti palibe phindu la kuikidwa magazi (kupitirira kumawonjezereka panthawi yomwe chiwopsezo chimachitika ndi kuphulika koyamba). Komabe, bungwe la World Health Organization lachita chidwi ndi kufufuza za kuikidwa magazi, monga opulumuka, mosiyana ndi mankhwala osokoneza bongo, amapangidwa ndi mliliwo (ngakhale ndalama zogula magazi zingakhale zochepa).
Kuika magazi magazi kwagwiritsidwa ntchito ku West Africa, komanso kwa odwala atatu omwe ali ku US.
Monoclonal Antibody
Ma antibodies, omwe amachokera ku labotale m'malo moika magazi, akhala akuchiritsidwa kwambiri kuposa pano. Mankhwala amodzi, ZMapp ochokera ku Mapp Biopharmaceutical, ndi osakanikirana ndi ma antibodies atatu (omwe amadziwika kwambiri) omwe amatsutsana ndi ma glycoprotein.
Mankhwalawa, kudzera mu katemera wa mankhwala atatu, amawoneka bwino. Mwamwayi, mankhwala osokoneza bongo adatha, ngakhale kuti mankhwala opangidwa ndi mankhwala osokoneza bongo akukonzekera (kupyolera mu zomera za fodya zomwe zidzakula mankhwala). A FDA avomereza ntchito pa pempho la odwala Ebola omwe alibe mankhwalawa ngati alipo.
Mankhwala osokoneza bongo
Mankhwala amathanso kumenyana ndi HIV. Pali mankhwala ambiri opatsirana pogonana: TKM-Ebola (Tekmira Corporation), BCX4430, (Biocryst Corporation), AVI-7537 (Sarepta), Favipiravir (Fujifilms)
Mankhwala ena samawoneka akugwira ntchito. Chiyeso cha TKM-Ebola chinaimitsidwa mu June 2015 chifukwa sichinali chowoneka kuti chinali chothandiza Iwo anali kuyembekezera kuti pogwiritsa ntchito mtundu wa RNA (njira zochepa zosokoneza RNA zomwe zimatchedwa siRNA) zomwe zingalepheretse kufala kwa HIV.
Amagwiritsa ntchito RNA iwiri yopindika kuti asiye mavitamini atatu a Ebola (Zaire Ebola L polymerase, Viral Protein 24 (VP24), ndi VP35). Lab ndi maphunziro a zinyama apambana (kuphatikizapo kachilombo kofanana, Marburg). Kuda nkhawa ndi kuopsa koyambitsa chitetezo cha mthupi kunachepetsanso kuyesa, koma FDA tsopano ikufulumizitsa izi.
BCX4430 imakhala ngati chimanga cha DNA / RNA (adenosine nucleoside analog) kuimitsa kubwereza kachilombo; zakhala zikuyendera bwino mu chiyeso cha monkey. 401.
F avipiravir , mankhwala omwe amavomerezedwa ndi matenda a chiwindi ku Japan akhala othandiza kwambiri pa zinyama ndipo aperekedwa ngati mankhwala a Ebola. Mankhwalawa mwachiwonekere ndi a nucleotide analog omwe amalepheretsa kubwereza kwa tizilombo.
Brincidofovir (BCV, CMX001) sichikuyesedwa kwa Ebola. Kafukufuku tsopano akuyang'ana pa mavairasi ena, monga Adenovirus ndi CMV.
Ndipotu, BCV inapangidwa kuti igwiritsidwe ntchito ndi mavairasi a DNA - CMV (Cytomegalovirus), Adenovirus. Ebola ndi kachilombo ka RNA, osati kachilombo ka DNA. Mankhwalawa amakhala cidofovir mkati mwa maselo. Mankhwala awa agwiritsidwa ntchito bwino ndi CMV ndi ma ARV ena, monga mapillomaviruses. Cidofovir ndi analog ya nucleotide; imatsanzira DNA ndipo imayambitsa DNA yowonjezera m'magazi a DNA. Sizinagwiritsidwe ntchito makamaka m'ma ARVs monga Ebola. Komabe, kampani yomwe imapanga Brincindofovir, Chimerix, imafotokoza kafukufuku wa ma laboratory ku CDC, NIH inasonyeza ntchito yotsutsana ndi Ebola, yomwe inali uthenga wabwino kwambiri monga mankhwala ogwiritsidwa ntchito mosamala kwa anthu kale, ngakhale ntchito yake yotsutsa Ebola isanatsimikizidwe zinyama kapena anthu panobe. Kungakhale mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana, omwe amachititsa ngozi za singano ndi Ebola, angakhale akulonjeza. (Brincindofovir imaphatikizapo mankhwala, kapena mafuta, omwe amagwirizana ndi cidfovir, yomwe imalola kuti mankhwalawa awonongeke, osati jekeseni).
AVI-7537 amagwiritsa ntchito makompyuta a RNA osinthidwa kuti awonenso puloteni ya VP24.
Mankhwala ololedwa
Njira yosavuta yothandizira Ebola ndiyo kupeza mankhwala omwe amadziwika kuti ndi otetezeka omwe amathandiza Ebola. Kuwonetsetsa kale kuti mankhwala ovomerezeka a Ebola amavomerezedwa kale ndikumvetsetsa kuti S electrogen receptor modulators (SERMs), monga Clomiphene ndi Torimefene amagwiritsidwa ntchito pa chithandizo cha khansa ya abambo ndi ya m'mawere, monga mankhwala ochiritsira.
Mankhwala ena amatha. Ebola imakhudza kutsekemera kwa khungu kumapangitsa kuti tizilombo toyambitsa matenda tizikhala ndi magazi. Dokotala watsopano (mankhwala) omwe angasokoneze nthenda ya RNAPC2 anawerengedwanso komanso mankhwala odziwika, rhAPC (Procombinant activated protein C) yomwe ili ndi chiyembekezo. Mofananamo, ena amanena kuti mankhwala ochepetsa mafuta m'thupi amatha kupatsirana pogwiritsa ntchito mankhwala enaake. Mofananamo, interferon yayang'aniratu kuti igwiritsidwe ntchito mu Ebola. Dokotala wina wagwiritsira ntchito mankhwala osokoneza bongo, Lamivudine, nucleoside analog, odwala Ebola omwe angapangitse kuti apitirize kuphunzira.
Mankhwala Amphongo
A FDA adachenjeza za kugwiritsa ntchito mankhwala osavomerezeka. Mankhwala ambiri amawoneka bwino - amakhulupirira - koma popanda kuyesedwa, sakudziwa ngati ali othandiza kapena owopsa.
Katemera
Katemera woteteza matenda angakhale abwino. Pakalipano pali katemera yemwe ayesedwa ndipo akuwoneka bwino.
Pambuyo pa mliri wa 2013-2015, pakhala pali katemera omwe adapangidwa chifukwa cha Ebola, koma sanayesedwe mokwanira. Chithandizo chimodzi chinayesedwa pa wodwala mmodzi; Izi zikhoza kuthandiza pambuyo pa kafukufuku wa Ebola 2009. Katemera uwu, katemera wa VSV (recombinant vesicular stomatitis virus vector yosonyeza kachilombo ka Ebola glycoprotein) wakhala akuyesedwa kwambiri pa zinyama (koma osati kwa anthu ena onse) ndipo wasonyezedwa kukhala othandiza ngakhale mpaka maola 24 mutatha kuwonekera. Anali katemera wa VSV womwe unayesedwa ndikuwonetseredwa kuti ukuwoneka bwino ku Guinea.
Kumayambiriro kwa mliriwu, kunali magulu ndi maboma ambiri amene anagwira ntchito kuyesa ndi kugwiritsa ntchito katemera. Boma la Canada lapereka kupereka ndalama zomwe zilipo za katemera uyu. NIH adayesa kuyesa mwamsanga munthu wina wodwala katemera. Panthawiyi boma la China linayamba kuyesa katemera, pogwiritsa ntchito adenovirus-vector.
Pamapeto pake pakhoza kukhala katemera wambiri. Mwamwayi, zochuluka za mayesero zidzakhala mochedwa kwambiri kuti zithandize zikwi zambiri zakufa mu 2013-2015. Ndikovuta kwambiri kuyesa katemera pamene pali zochepa zochepa.