Chikhumbo chogonjetsa khansara chimayankhula ku zikhumbo zofunikira za umunthu. Zikuimira chizindikiro cha munthu wamtendere monga kuyenda kumwezi kapena kupeza njira yothetsera njala ya padziko lapansi.
Ndikutsimikiza kuti ambiri a ife amaganiza kuti, ngati ochita kafukufuku adatha kupeza chithandizo cha khansa , kufufuza kosintha kwa dziko lapansi kudzakhala zaka mazana ambiri. Ndipotu khansara ndi matenda owopsa, osiyanasiyana komanso ovuta-matenda omwe tili nawobe zambiri zoti tiphunzire.
Komabe, ofufuza a Duke University Medical Center atulukira zodabwitsa: Anthu ena omwe ali ndi glioblastoma multiforme, omwe amakhala ndi khansa ya ubongo, matenda a poliovirus amachititsa kuti chitetezo cha mthupi chiphe.
Kodi Glioblastoma Multiform N'chiyani?
Glioblastoma multiforme (GBM) ndi khansa yomwe ikukula mofulumira yomwe imachokera ku maselo am'mlengalenga mu gawo la ubongo (zigawo zapakati ndi zam'mbali). Maselo amtunduwu amathandiza nthawi zambiri maselo a ubongo, koma pamene kukula kwawo kumapitirira haywire, monga momwe ziliri ndi Gulu la IV GBM, khansayo imapha anthu ambiri mkati mwa miyezi pafupifupi 15. Matenda a GBM angathe kuwirikiza pawiri masabata awiri.
Gulu la GBM limakhudza anthu awiri kapena atatu pa 100,000 ndipo amawerengera 52 peresenti ya ziwalo zoyambirira za ubongo (GBM kawirikawiri imakhala ndi metastasizes kapena imafalikira). Pakati pa 2005 ndi 2009, zaka zapakati pa imfa ya khansa ya ubongoyi inali 64.
Tsoka ilo, kwa anthu omwe ali ndi GBM, kupambana kwa njira zamakono zothandizira kuphatikizapo opaleshoni, chemotherapy, ndi radiotherapy zimayesedwa mu miyezi yambiri yokhala ndi moyo wowonjezera, ndipo miyezi yambiri yowonjezera imapangitsa moyo wabwino kukhala wosauka.
Zizindikiro za GBM zimakhudzana ndi kutupa ndi kusunthira kwa ziwalo za ubongo (kuchuluka kwa mitsempha) zomwe zimayambitsa chifuwacho komanso kugwirizana kwa edema kapena kutupa. Chotupacho, chomwe chingakhale kukula kwa mpira wa galasi, imakanikiza pazinthu zina za ubongo zomwe zimayambitsa:
- Mutu
- Kutaya njala
- Masomphenya obisika
- Kugonjetsa
- Kuthamanga
- Zovuta ndi kulankhula
- Zovuta ndi kuzindikira
Mbiri Yachidule ya Virus Oncolytic
Ziribe kanthu momwe zingakhalire zovuta kwambiri, njira yogwiritsira ntchito mavairasi kuti athe kuchiritsa anthu ndi khansara sizatsopano ndipo poyamba inanenedwa kumayambiriro kwa zaka za zana la makumi awiri. M'zaka zoyambirira za matenda a khansa (njira yisanayambe ya OSHA), sitinali ndi njira yabwino yothandizira khansa, kotero madokotala ndi odwala khansa anali okonzeka kuyesa chirichonse kuphatikizapo kutulukira minofu yothandizira kapena madzi a thupi. Mwachitsanzo, mu 1949, anthu omwe ali ndi matenda a Hodgkin, omwe ali ndi khansara yamakono, anali ndi kachilombo ka HIV.
Monga momwe zingatheke kuyerekezera, kulandira anthu omwe ali ndi mavairasi osasamala sikunathandize miyoyo ya anthu omwe ali ndi khansa (ngakhale kuti nthawi zina inapha ziwalo za mitsempha kapena zinachititsa kuti matendawa asakhalenso ochepa).
Kuyambira m'ma 1950, tidziwa zambiri zokhudza mavairasi; ife tsopano tikumvetsa bwino iwo kuposa zamoyo zina zonse. Timadziwanso momwe tingabweretsere ndi ma geneti kuyendetsa mavairasi mu malo opangira ma laboratory. Choncho, tikhoza kuteteza mavairasi kuti asakhale mankhwala osokoneza bongo kapena othandizira mankhwala omwe amachotsa chitetezo cha mthupi. Chofunika kwambiri, mavairasi oncolyticwa amafunika kupha maselo am'mimba okha osati kusokoneza maselo oyenera aumunthu.
Immunotherapy: Pamene Mabungwe Athu Amapha Kupha Matenda a Polio
Maselo ammimba ndi oopsa chifukwa amapewa chitetezo cha mthupi lathu. Cancer immunotherapy ndi munda wamankhwala womwe umayesa momwe mungasamutsire khansara ngati mlendo, ndipo motero amagwiritsa ntchito chitetezo cha thupi kuti chiteteze khansa. Kugwiritsiridwa ntchito kwa tizilombo toyambitsa matenda PVS-RIPO kwa anthu omwe ali ndi GBM ndikumodzi komwe kuli kofunika kwambiri komanso kokondweretsa kwambiri mpaka lero mu matenda a khansa ya immunotherapy.
Katemera utaperekedwa ku chotupa, matsenga amapezeka. Malinga ndi ndemanga yowonjezera yolembedwa ndi akatswiri a Duke ndipo inafalitsidwa ku Cancer mu November 2014, njirayi ikuphatikizapo:
- Vuto lachinsinsi la cytotoxicity
- Kutsegula mankhwala osokoneza bongo
- Kupwetekedwa kwapopalmatory proinflammatory
- Kugwiritsa ntchito mayankho ogwiritsira ntchito chitetezo cha mthupi.
Kwenikweni, pambuyo pa PVS-RIPO (oncolytic poliovirus) imafalitsa chifuwa cha GBM (ubongo), matupi athu amadziwa "chotupa cha polio" ngati poizoni. Kuzindikiritsa izi kumapangitsa kuti alamu apite ku nkhondo ndi chotupa cha polio. Chizindikiro cha nkhondo imeneyi ndi kutupa, kuteteza thupi kumatenda.
Zotsatira Kuyambira PVS-RIPO Phase I Trial
Pa Duke's Preston Robert Tisch Brain Tumor Center, ofufuza akhala zaka zambiri za ntchito ya benchi yopanga ndi kuyesa PVS-RIPO. Mwachindunji, ochita kafukufukuwa atenga moyo, amachepetsa poliovirus ndipo amachotsa ribosome yomwe imayambitsa polio chifukwa cha rhinovirus yosazirala. Kenaka, mu kafukufuku wamakono wa PVS-RIPO Phase 1, ochita kafukufukuwa anadandaula (njira yotchedwa intratumoral-enhanced delivery delivery ndi cathterter) izi zowonongeka poliovirus m'magazi oyambirira a ubongo akuluakulu omwe ali ndi GBM.
Matenda omwe analandira jekeseni wa poliovirus anali 1 mpaka 5 centimita, zotupa za GBM zowononga masentimita osachepera 1 sentimenti kuchokera mu ubongo wa ventricles. Kuphatikiza pa kukhala ndi zotupa zazing'ono, PVS-RIPO Phase I ofufuza kafukufuku anapeza GBM yomwe inabwereranso pambuyo pa chithandizo cham'mbuyomu (opaleshoni, chemotherapy, ndi radiotherapy), sadali kulandira chithandizo chotero, ndipo anali ndi ziwalo zabwino ndi ntchito tsiku ndi tsiku (KPS wamkulu kuposa kapena wofanana ndi 70). Pomaliza, ophunzira ayenera kuti adatemera katemera wa polio. Mwachidule, kachilombo koyambitsa matenda a PVS-RIPO kamayesedwa ngati chithandizo chotsiriza pa akuluakulu ogwira ntchito omwe ali ndi zotupa za ubongo zomwe zimakhala zochepa.
Kunena zoona, zimatengera zaka khumi zofufuza za sayansi zamankhwala (zomwe zimachitika pa Petri mbale ndi zinyama) komanso mamiliyoni ambiri a madola kuti akatswiri azindikire kuti PVS-RIPO ingathe kulandira bwino GBM. Mwachindunji, PVS-RIPO ili ndi kutentha kapena kugwirizana kwa molekyu-monga molekyu 5 (Necl5), molecule yothandizira maselo yomwe imayikidwa mu maselo a galasi a GBM osati m'maselo oyenera a maselo. Kuwonjezera apo, Necl5 imasonyezedwanso m'matumbo ena osiyanasiyana monga colorectal carcinoma, mapapu adenocarcinoma, khansa ya m'mawere, ndi khansa ya khansa, yomwe imasonyeza kuti PVS-RIPO ingakhale yothandiza pochiza khansa zina.
Pambuyo pa poliovirus poliovirus imatenga, ziphuphu za GBM za ophunzira mu phunziro zimayang'aniridwa pogwiritsa ntchito serial 3-D MRI. Poyamba, zithunzi za MRI zimasonyeza kutupa kwa chotupacho, chizindikiro chakuti chitetezo cha mthupi chidzamenyana ndi chotupa cha polio. Kutupa uku ndi kugwirizana kwa edema (kutukumula) kumawonjezera zizindikiro za GBM monga mavuto a kulankhula, kuzindikira ndi kuchepa kwachinsinsi. Zotsatira zina zoipa za mankhwala ndi kutsegula m'mimba.
Ambiri mwa odwala omwe adakali ndi moyo atalandira chithandizo ndi PVS-RIPO, chinthu chodabwitsa chikuchitika patangotha miyezi yochepa chithandizo. Matendawa amayamba kufooka, ndipo odwala awiri oyambirira anabweranso mu 2012, zotupa zatha!
Nazi zowonjezera zowunika kuchokera ku PVS-RIPO Phase I mayeso ochizira:
- Mwa anthu 22 omwe aperekedwa kucolytic poliovirus PVS-RIPO, 11 akadali amoyo.
- Munthu mmodzi adafa pochotsa catheter atanyamula PVS-RIPO.
- Odwala awiri oyambirira omwe amapatsidwa PVS-RIPO mu 2012 adakali moyo! Pakafika chaka cha 2015, buku loyambirira la chiyambi ichi, akhala zaka zitatu ndikuwerengera.
- Ofufuza tsopano akukhulupirira kuti mlingo wamakono wa PVS-RIPO ndi wabwino kwambiri.
- Anthu ambiri amwalira atalandira mlingo waukulu wa PVS-RIPO.
- Kupulumuka kwapakati pa odwala omwe ali ndi GBM omwe amalandira pacolytic poliovirus ndi miyezi isanu ndi umodzi. (Median ndi chizindikiro cha pakatikati.)
Tiyenera kukumbukira kuti chifukwa cha matenda ena alionse, pafupifupi 50 peresenti ya imfa ya anthu amawoneka kuti ndi yovuta. Komabe, mwa anthu omwe ali ndi GBM, imodzi mwa mitundu yoipa kwambiri ya kansa kunja uko, chifukwa theka la anthu akadali amoyo pambuyo pa chithandizo ndi PVS-RIPO n'zodabwitsa kwambiri. Ndipo kupulumuka kwa zaka 3 kapena kupitilira patatha chithandizo chamayesero, monga momwe zilili ndi anthu awiri ochita kafukufuku, sizimveka.
Ngakhale zotsatira zomwe tikuziwona ku mayeso a kachipatala, ndizochepa, zolimbikitsa kwambiri, tiyenera kukumbukira kuti zotsatirazi zikuimira kukula kwakukulu. Tifunika zotsatira zowonjezereka kuti titsimikize kuti zofufuza zoyambirirazo sizinali zochepa kapena zimangokhala chidutswa cha anthu onse.
M'choonadi chonse, ofufuza a Duke akadali pachilendo choyambirira cha ulendo wawo, atangotsimikizira kuti ndi ofunika kwambiri. Pali mafunso ambiri omwe ndi chifukwa chake kufufuza kwina kuli mu ntchito, ndipo maphunzirowa mosakayikira adzawunikira kuti ndani angapindule ndi mankhwala a PVS-RIPO. Mwachidziwitso, timadziwa kuti poliovirus yakhala ikugwira ntchito pa anthu akuluakulu omwe ali ndi GBM, koma ana amalandira GBM, ndipo akhoza kupindula ndi mankhwalawa. Komanso, sitikudziwa zomwe zimachitika pamene PVS-RIPO yodwala tizilombo toyambitsa matenda tiyambitsa matendawa imayambitsidwa nthawi yayitali panthawi yachipatala ya GBM.
Mu mankhwala, mawu oti "machiritso" amanyamula ndi zizindikiro. Komabe, kwa odwala awiri omwe analandira pacolytic poliovirus mu 2012 ndipo tsopano alibe chiwonetsero chowoneka cha khansara ya ubongo (ali mu chikhululukiro chokhazikika), izo zowoneka ngati ngati PVS-RIPO ndi mankhwala. Ngakhale zodabwitsa kwambiri kuposa mankhwala a kansa ya ubongo yakupha, ndiye kuti PVS-RIPO ingagwiritsidwe ntchito pochiza (mankhwala) mitundu ina ya khansara monga colorectal carcinoma, mapapu adenocarcinoma, khansa ya m'mawere, ndi khansa ya khansa.
Nthawi ndi opulumuka ambiri a GBM adzanena ngati PVS-RIPO ingathe kuchiza GBM. Tikuyembekeza kuti PVS-RIPO ikalandira thandizo la GBM ingadzatenge kachilombo koyambitsa matenda a FDA yomwe idzakupatseni mwayi wochuluka wa mankhwalawa pa chithandizo cha poliovirus. Apanso anthu amalandira chithandizo ndipo amakhalabe mu chikhululukiro, mankhwalawa adzakhala ndondomeko yoyenera ya zochita za PVS-RIPO.
Dziwani kwa wowerenga: Ndinali cholinga changa chodzafunsira kafukufuku wa khansa ku yunivesite ya Duke yomwe ikuyesa chiyeso cha PVS-RIPO Phase I. Ndimatsimikiza kuti nkhaniyi ndiyikhazikika pakutanthauzira kwanga kafukufuku wochepa komanso kufotokozera nkhaniyi. Pofuna kuti owerenga akhale ndi mphamvu zogwira mtima, zogwirizana ndi zovomerezeka za PVS-RIPO pa GBM, Ndikufuna akatswiri othandizira. Mwamwayi, potsata chidwi cha atolankhani onse kumapeto kwa 60 Mphindi zomwe zimafotokozera za kafukufuku wa khansa ya Dukoma, sindinathe kufunsa mafunso asanayambe kufotokoza panthawi yake. Chifukwa chake, ndinasonkhanitsa zonse zomwe ndikudziŵa ndikuchita zomwe ndikuwerenga pa mutuwo. Kodi ndiyenera kuyankhulana ndi nthumwi ya gulu la kafukufuku wa khansa ya Duke, ndikukonzekera kufalitsa ndondomeko yowonjezera pazomwe ndikupezazi.
Zosankhidwa:
Nkhani yowonongeka yomwe imatchedwa "Oncolytic Vilio Therapy of Cancer" ndi MC Brown ndi alembi a ku Cancer mu 2014.
Zina mwazina zotchedwa "ONCOLYTIC POLIO / RHINOVIRUS RECOMBINANT (PVSRIPO) MU ZOKHUDZA GLIOBLASTOMA (GBM): PHADWO LOYAMBA ICHIKHALIDWE CHOYENERA KUCHITA ZOCHITIKA
UTSOGOLERI "ndi A. Desjardins ndi olemba mabuku omwe anafalitsidwa mu Neuro-Oncology mu 2014.
Nkhani yonena kuti "Kukonzekera zovuta zowonjezera poliovirus zomwe zimagwiritsidwa ntchito pothandizidwa ndi glioblastoma multiforme" ndi C Goetz ndi M Gromeier omwe amafalitsidwa mu ndemanga za Cytokine ndi Growth Factor mu 2010.
Nkhani yotchedwa "History of Oncolytic Viruses: Genesis mpaka Genetic Engineering" ndi E Kelly ndi S Russell kuchokera ku Mankhwala Opangira Magazini omwe anafalitsidwa mu 2007.
Mphindi 60 yapadera Kupha Khansa yomwe inafotokoza pa March 29, 2015. Scott Pelley (mlembi), Michael Radutzky (wofalitsa) ndi Denise Schrier Cetta (wofalitsa)