Mankhwala ambili a IBD Ma Tarineti a TNF Oyenera Kutentha
Matenda a tumorcocis (TNF) ndi mtundu wa mapuloteni amtundu wotchedwa cytokine omwe amapangidwa ndi maselo oyera a magazi . TNF ndi yofunika kwambiri kwa thupi chifukwa imathandiza kuti chitetezo cha chitetezo cha mthupi chitengeke ku chinthu china, makamaka ku chotupa cha kansa. Amalimbikitsa kutupa, amapanga maselo ena ogwira ntchito yotupa, ndipo amathandiza maselo kuchiza.
Nthaŵi zina TNF imatchedwa chifuwa cha necrosis-alpha.
Chifukwa chiyani TNF-alpha ndi yofunika kwambiri ku IBD
TNF ndi nkhani yofunika kwambiri yochizira matenda opatsirana (IBD). TNF imapezeka mwa anthu ambiri omwe ali ndi matenda a Crohn kusiyana ndi anthu omwe alibe matenda a Crohn. TNF imapezedwanso, pamlingo wocheperapo, m'malo mwa anthu omwe ali ndi zilonda zam'mimba. Chifukwa cha mgwirizanowu, akuganiza kuti TNF imathandizira pa chitukuko ndi / kapena kupitiriza matenda a Crohn ndi matenda a ulcerative. Ichi ndi chifukwa chake mankhwala osokoneza bongo otchedwa biologics apangidwa kuti athetse matenda a IBD ndi zina zotupa. Kuwongolera TNF kumapindulitsa odwala ena kuchepetsa zizindikiro za IBD ndi kuchiritsa kutupa m'matumbo.
Fecal calprotectin ndi lactoferrin ndi zizindikiro ziwiri zomwe zimagwiritsidwa ntchito poyesa kutupa kwa anthu omwe ali ndi IBD. Mapuloteni awiriwa akhoza kuyesedwa poyesa chinyama.
Zapezeka kuti pamene pali mapuloteni ambiri mu mpando, palinso kutupa kwambiri m'matumbo a anthu omwe ali ndi IBD. Pamene kuchuluka kwa mapuloteniwa ndi otsika muchitetezo, pakhoza kukhala machiritso akuchitika m'matumbo. Pakati pa fecal calprotectin ndi lactoferrin ndalama zingatanthauze kuti mankhwala akugwira ntchito komanso kuti wodwalayo akuyandikira, kapena akukhululukidwa.
Kafukufuku wasonyeza kuti fecal calprotectin ndi makilogalamu a lactoferrin ndi otsika kwa odwala omwe atenga mankhwala oletsa anti-TNF.
Mitundu ya TNF
Kafukufuku wamagetsi asonyeza kuti pali mitundu yosiyanasiyana ya TNF, ndipo TNF imatengedwa kuti ndi "yopambana." Mitundu yambiri ya TNF yakhala ikugwirizanitsa ndi matenda enaake omwe amachititsa kuti munthu azidwala matenda a khansa, khansa, ndi shuga. Kupeza mitundu ya TNF-yogwirizana ndi zinthu zina zingathandize popanga mankhwala kuti athetse matendawa.
Sikuti aliyense amene ali ndi IBD amayankha mankhwala omwewo mofanana. Izi zikhoza kukhala, ndipo tsopano zikuganiza kuti ndizoona ndi akatswiri, kuti pali zambiri za IBD. TNF ingathandizenso izi, chifukwa anthu ena omwe ali ndi IBD amayankha bwino mankhwala osokoneza bongo a TNF, pamene ena samatero. Nthendayi ya TNF ya wodwalayo ingagwirizane ndi yankho lalikulu kapena laling'ono kwa mankhwala ena oletsa anti-TNF. Izi ndizofukufuku, ndipo palinso zambiri zoti zizimveke za TNF zisanagwiritsidwe ntchito pa chisamaliro cha odwala.
TNF-alpha Mu Khansara ya Colon
TNF ingakhalenso ndi ntchito yofunikira yopanga khansara ya coloni ndi ena khansa yapamimba. Kafukufuku wokhudzana ndi zotsatira za TNF akadakalipobe, koma angaperekenso zizindikiro zina zogwirizana ndi khansa ya ulcerative ndi khansa ya coloni.
Mankhwala oletsa anti-TNF-alpha
Njira zina zamankhwala zothandizira Crohn's disease zikuphatikizapo kulandira mapuloteni a TNF ndi kulimanga. Pamene mapuloteni ali omangidwa, sangathe kutulutsa. Mankhwala ena odana ndi TNF ndi Remicade (infliximab), Huma (adalimumab), Cimzia (certolizumab pegol), Enbrel (etanercept), ndi Simponi (golimumab).
Chidziwitso Chochokera
Pali zambiri zomwe sizikudziwikanso zokhudza TNF ndi ubale wake ndi zinthu zotupa monga IBD. Komabe, mankhwala ambiri otsutsa-TNF apangidwa kuti agwiritsidwe ntchito kwa anthu omwe ali ndi IBD, ndipo akhoza kukhala ndi zotsatira zabwino pa matendawa.
> Zotsatira:
> Sipponen T, Savilahti E, Kärkkäinen P, ndi al. "Fecal calprotectin, lactoferrin, ndi matenda otchedwa endoscopic ntchito poyang'anira anti-TNF-alpha mankhwala a Crohn's disease." Inflamm Bowel Dis. 14: 1392-1398.
> Subramaniam K, Richardson A, Dodd J, et al. "Kukonzekera koyambirira kwa colectomy ndi kukonzanso kwa nthawi yayitali matenda opatsirana ndi zilonda zam'mimba odwala amatha kugwiritsa ntchito kugwiritsa ntchito mankhwala opatsirana pogonana ndi necrosis." Intern Med J. 2014 May 44: 464-470. lembani: 10.1111 / imj.12397.
> Taylor KD, Plevy SE, Yang H, et al. "Bungwe la ANCA ndi LTA ali ndi mgwirizano wathandizira ku matenda a anti-TNF pa matenda a Crohn." Gastroenterology . 2001 May; 120: 1347-1355.
> Yang JP, Hyun MH, Yoon JM, et al. "Mgwirizano pakati pa TNF-α-308 G / A mavitamini a jini ndi chiopsezo cha khansa ya m'mimba: kuyang'anitsitsa mwatsatanetsatane ndi kusanthula meta." Cytokine . 2014 Dec; 70: 104-114. lembani: 10.1016 / j.cyto.2014.07.005.