Mayeso a magazi amayesa kuopsa kwa matenda okhudza ubongo wa MS
Mapulogalamu apamwamba kwambiri a leukoencephalopathy (PML) ndi nthendayi yochepa ya ubongo. Kuopsa kwa PML nthawi zina kumawonjezeka mwa anthu omwe amatenga Tysabri (natalizumab) , mankhwala osokoneza matenda omwe amachititsa kuti anthu asakhale ndi matenda ambiri (sclerosis) .
PML imayambitsidwa ndi kachilombo ka John Cunningham (JC virus), matenda omwe amatenga kachilombo kawirikawiri omwe amatetezedwa ndi chitetezo cha mthupi.
Komabe, ngati chitetezo cha m'thupi chimafooka, kachilombo ka HIV kamatha kuyambitsa komanso kuyambitsa kutupa koopsa kwa ubongo.
Pofuna kupewa izi mwa anthu omwe ali ndi MS, madokotala adzachita mayeso a antibody kuti ayang'ane umboni wa kachilombo m'magazi a munthu.
PML ndi JC Virus
Kafukufuku akusonyeza kuti pafupifupi 70 peresenti ya anthu a ku United States ali ndi kachirombo ka JC. Anthu ambiri sakudziwa kuti ali ndi kachirombo ka HIV, ndipo ndi ochepa amene amadwala chifukwa cha matendawa.
Ndipokhapokha ngati chitetezo cha mthupi chimasokonekera kuti matendawa athe kukhala "opatsirana." Izi zimangotanthauza kuti thupi liribe njira zotetezera, ndipo kachilombo kamene kamagwiritsa ntchito mwayi wopangitsa matenda.
Tikuwona izi mwa anthu omwe ali ndi kachilombo ka HIV . Ndi HIV, kachilombo kameneka kamadwalitsa chitetezo cha mthupi pang'onopang'ono ndipo imayika thupi kuti likhale ndi matenda osiyanasiyana.
PML ndi imodzi mwa ma OIs ndipo imakhala ngati chikhalidwe cha Edzi mwa anthu omwe ali ndi HIV.
Ndi MS, vutoli ndilosiyana kwambiri. Pachifukwa ichi, kusamalidwa kwa thupi kumayambitsidwa ndi mankhwala omwe amachiza MS. Mankhwalawa akuphatikizapo Tysabri, Tecfidera (dimethyl fumarate), ndi corticosteroids.
Kamodzi kachiwiri, kachilombo kamene kamatha kupyola mwazi / ubongo wa ubongo umene umalekanitsa dongosolo lalikulu la mitsempha kuchokera ku thupi lonse.
Pamapeto pake, peresenti ya anthu omwe amatenga Tysabri idzakhazikitsa PML ndipo izi zimakhudza anthu omwe ali ndi zifukwa zotsatirazi:
- Zakale kapena zamakono zowonjezera mankhwala ena osokoneza bongo (monga azathioprine, cyclophosphamide, dimethyl fumarate, methotrexate, mitoxantrone, kapena mycophenolate mofetil)
- Kugwiritsa ntchito Tysabri kwa zaka zoposa ziwiri
- Kuyesera zabwino kwa JC HIV antibody
JC Virus Antibody Blood Test
Ma antibodies ali ndi mapuloteni oteteza thupi ku chitetezo cha m'thupi chifukwa cha tizilombo toyambitsa matenda monga JC. Mankhwalawa amadziwika bwino kwa tizilombo toyambitsa matenda komanso tizilombo toyambitsa matenda okhawo. Kamodzi kamatulutsidwa, anti-antibodyyo amakhalabe mu thupi kuti ayankhe ngati chowopsacho chikubwerera.
Kuti titsimikizire matendawa, tidzakhala ndi mayeso ochepa a magazi omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Zotsatira za mayesero zingatiuze chimodzi mwa zinthu ziwiri:
- Zotsatira zabwino zikutanthauza kuti munthu watulukira kachilomboka.
- Chotsatira chosamveka chimatanthauza kuti palibe umboni wa kuwonetsa.
Chovuta apa, ndithudi, ndi chakuti anthu ambiri adzakhala ndi kachilombo ka JC.
Choncho, ngakhale zotsatira zabwino zingasonyeze kuti chiopsezo cha PML chiwonjezeka, sizotsutsana ndi mankhwala. M'malo mwake, amalola dokotala kuyang'ana izi ndi zina zomwe zimapangitsa kuti asankhe ngati Tysabri ndi yoyenera kapena ngati pali njira zina zomwe zingatheke.
Pa nthawi yomweyi, mayesero a anti-antibody sali abwino, ndipo pali magawo atatu omwe ali ndi mwayi kuti angapereke zotsatira zabodza. Ichi ndi chimodzi mwa zifukwa zomwe mayeso a anti-antibody amachitira asanayambe Tysabri ndikubwereza miyezi isanu ndi umodzi kenako kuti ayang'ane ntchito iliyonse ya tizilombo.
Mawu Ochokera
Ngakhale kuti JC HIV anti antibody test ndi yothandiza pozindikira yemwe angakhale pachiopsezo chachikulu chokhala ndi PML pamene akugwiritsa ntchito TB, sayenera kuchepetsa kufunika kwa mankhwala poletsa kubwezeretsa kwa MS.
Pamapeto pake, chisankho chomwe chingagwiritse ntchito Tysabri kapena ayi ndi munthu mmodzi ndipo chiyenera kupangidwa mogwirizana ndi dokotala wazatswiri. Ngati mankhwala atchulidwa, kufufuza nthawi zonse n'kofunika kuti tisamangoganizira za momwe mankhwala amathandizira koma tipewe zotsatira zomwe zingatheke.
> Zosowa
> Gorelik, L .; Lerner, M ;; Bixler, S. et al. "Anti-JC HIV antibodies: zomwe zimapangitsa kuti PML iwonongeke." Annals of Neurology. 2010; 68 (3): 295-303.
> Schwab, N .; Schneider-Hohendorf, T .; Pignolet, B. et al. "Therapy ndi natalizumab imagwirizanitsidwa ndi mkulu wa JC seroconversion ndi kukwera kwa chiwerengero cha JCV." Neurology: Neuroimmunology & Neuroinflammation. 2016; 3 (1): e195.