Ofufuza Akufufuza Njira Zowonjezera Zotsutsana ndi HIV
Munali mu 1984 pamene Mlembi wa Health and Human Services, Margaret Heckler, adalengeza molimba mtima kuti katemera wa Edzi "udzakonzekera zaka ziwiri."
Tsopano, patatha zaka zoposa 35 mliliwu, sitiyenera kuona chilichonse chomwe chikuyandikira munthu wodalirika, kaya kuteteza kuteteza kwa tizilombo kapena kupereka anthu omwe ali ndi kachilombo ka HIV kuti athetse vutoli popanda kugwiritsa ntchito mankhwala osokoneza bongo.
Kodi izi zikutanthauza kuti sitinapezepo nthawi zonse? Ngakhale zikhoza kuwoneka choncho, ndi zovuta zosaoneka bwino za anthu, choonadi ndi chakuti tinali ndi zipangizo zochepa kwambiri m'ma 1980 ndi 90 kuti titsegule zinsinsi za kachilombo ka HIV.
Masiku ano, tili ndi zida zambiri zomwe tili nazo-kuchokera ku 3D electron microscopy kupita ku generation-gene gene editing-kodi tili pafupi kupeza chithandizo chovuta cha HIV?
Mavuto ndi Zolephera za Kafukufuku Woyamba
Chowonadi n'chakuti, ngakhale mu 1984, ofufuza ankadziŵa bwino mavuto omwe anakumana nawo popanga katemera wothandiza. Mu lipoti la Congression lovomerezedwa ndi Office of Technology Assessment, ofufuza anati:
"Palibe katemera wamoyo wodwala wa Edzi, kapena makonzedwe onse osakanikirana omwe ali ndi kachilombo ka HIV, tsopano ali ndi lonjezano lambiri," ponena kuti "ngati kusintha kwa majeremusi (kachilombo ka HIV) kuli kofunikira kwambiri ... zidzakhala zovuta kukula katemera wothandiza. "
Kuwonjezera pa vutoli ndiye kuti njira zamakono zamakono zogwirira katemera zimayesedwa panthawiyi, makamaka njira za DNA zomwe zimagwiritsidwa ntchito popenda katemera wamakono.
Koma ngakhale zolephera zoyambirirazi, ochita kafukufuku adadziŵa zambiri zokhudza kuchepetsa katemera wa chikhalidwe, chomwe ndi
- omwe amatchedwa "ophedwa onse" (omwe kachilombo ka HIV amaonongeka ndi mankhwala opha tizilombo, mankhwala, kutentha kapena kutentha kwa dzuwa) sagwiritse ntchito chitetezo cha mthupi.
- kuti kumangoteteza thupi lachilengedwe sikukwanira kuyambira pamene kachilombo ka HIV kamapha maselo omwe amachititsa kuti chitetezo cha mthupi chitetezedwe ( CD4 T-cells ).
- kuti kuchuluka kwa kusintha kwa thupi kumapereka kachilombo ka HIV ndi mitundu yosiyanasiyana yambiri ya jini yomwe imapangitsa kupanga katemera umodzi womwe ungathetseretu mitundu yonse yosiyanasiyana ya HIV - mosakayikira zovuta, ngati zosatheka.
Kuchiza kwachidule
M'zaka zaposachedwa, kafukufuku wambiri wagwiritsidwa ntchito pa chitukuko cha katemera wothandizira. Mwachidule, ngati munthu yemwe ali ndi katemera sangakwanitse kuteteza kachilombo ka HIV, akhoza kuchepetsa kapena kuleka kupitirira kwa matendawa . Kuti chithandizo chamachiritso chikhale chogwira ntchito, akuluakulu a boma akuganiza kuti ziyenera kuimitsa osachepera 50% mwa opatsirana.
Takhala tikuyandikira pafupi ndi cholinga chomwechi m'zaka zaposachedwa, palibe kenanso kuposa mayeso a RV144 mu 2009. Kuphunzira kwa Thai kumeneku, kuphatikizapo odwala awiri osiyana ndi omwe amadzipangira okha, anawonetsa kuchepa kwa 31%. pakati pa ophunzira mu gulu la katemera motsutsana ndi omwe ali gulu la placebo.
Mayeserowa adatsatidwa ndi RV505 , yomwe idakonzedwa kuti iwonjezeke pa zotsatirazi mwa kuphatikiza katemera wa "priming" ndi katemera wothandizira okhala ndi olumala adenovirus . Koma mmalo mwake, chiyesocho chinaimitsidwa msanga mu April 2013 pamene adanenedwa kuti anthu ambiri omwe ali ndi katemera ali ndi kachilombo kusiyana ndi omwe sagwira katemera.
Pambuyo pake, anthu ambiri mu kafukufuku adawonetsa nkhaŵa zokhudzana ndi zopanda kanthu zomwe zinasiyidwa ndi RV505, kutanthauza kuti zikhoza kubwezeretsanso ndondomeko ya katemera kwazaka zambiri.
Kodi Tsogolo Labwino la Kafukufuku wa HIV Ndi Chiyani?
Ngakhale kuti RV505 inalephera, mayesero ang'onoang'ono anapitirizabe kufufuza njira zosiyanasiyana zoyambira.
Yoyamba mwa izi, RV305 , yatumizira anthu 167 omwe alibe kachilombo ka HIV kuchokera pachiyambi cha RV144 ku Thailand. Cholinga cha kafufuzidwe ndi kudziwa ngati zina zolimbikitsira inoculations zidzakulitsa chitetezo kupitirira 31%.
Phunziro lachiwiri, lotchedwa RV306 , lidzafufuza momwe ntchito zosiyanasiyana zothandizira katemera zimathandizira pogwiritsa ntchito katemera woyamba wa RV144.
Pakalipano, kafufuzidwe kafukufuku waposachedwapa wakhala akugwiritsidwa ntchito pazinthu zomwe zimatchedwa "kupha". Njira yokambiranayi ikufuna kugwiritsa ntchito ogwiritsa ntchito mankhwala osokoneza bongo kuti atenge kachilombo ka HIV kuchokera m'malo ake osungiramo zipangizo zamagetsi pamene wothandizira (kapena wothandizira) wachiwiri amapha kachilombo koyambitsa.
Pakhala pali kupambana pochotsa zida za mavairasi, kuphatikizapo kugwiritsa ntchito HDAC inhibitors (mtundu wa mankhwala omwe amadziwika ngati antipsychotic). Ngakhale tili ndi zambiri zoti tiphunzire za momwe zida zobisikazi zikufalikira, njirayo ikuwoneka kuti ikudalira.
Mofananamo, asayansi apanga mutu pakukula kwa ma immunologic agents omwe angathe kupangitsa chitetezo cha thupi kuti chiteteze mthupi. Pakati pa njirayi ndiyomwe imatchedwa antiutral antibiotics (mabNabs) - mapuloteni enieni omwe amatha kuthetseratu mitundu yambiri ya HIV subtypes (mosiyana ndi ma antibodies omwe sangathe kupha munthu).
Powerenga olamulira omwe ali ndi kachilombo ka HIV (anthu omwe ali ndi kachilombo koyambitsa matenda a HIV), asayansi amatha kuzindikira ndi kulimbikitsa zolemba zambiri zaBNA. Komabe, funso lalikulu lidalipobe: kodi wasayansi angayankhe moyenera kuti aphe HIV popanda kumupweteka? Pakadali pano, kupita patsogolo kwakhala kotsimikizika, ngati kuli koyenera.
Zonsezi, mayeserowa amawoneka ofunika kwambiri pamene amamanga pa maphunziro omwe anaphunziranso pa zolephera za katemera, zomwe ndizo:
- Kulephera kumatanthauza kutayika. Katemera wa AIDVAX, womwe unalephera m'mayesero awiri aumunthu mu 2003, unakonzedwanso bwino ngati katemera wothandizira pa maphunziro a RV144.
- 50 peresenti sizingatheke. Ndipotu phunziro la Thai likuwonetsa kuti kuchuluka kwa ma katemerawa kunali kwakukulu kwambiri pa 60 peresenti chaka choyamba, kupitirira pang'onopang'ono pamene nthawi ikupita. Izi zikusonyeza kuti njira zina zowonjezera kapena njira zowonjezera zingapangitse chitetezo chachikulu komanso chokhazikika.
- Tiyenera kupeza njira zothetsera mpikisano. Kafukufuku wam'tsogolo wasonyeza kuti masewera olimbana nawo angakhale pamtima pa kulephera kwa RV505. Mankhwalawa amasonyeza kuti katemerawo sanagwiritse kokha kuti apangidwe ndi ma antibodies a immunoglobulin G (IgG), monga momwe anafunira, komanso amachititsa kuti maselo a immunoglobulin A (IgA) apitirire, zomwe zinafooketsa chitetezo. Kupeza iwo kumatanthauza kuthana kapena zotsatira za mpikisano zingakhale zovuta kwambiri kupita patsogolo.
- N'zosatheka kuti tisapeze katemera mmodzi. Akatswiri ambiri amavomereza kuti zingatenge njira imodzi yogwiritsira ntchito kachilombo ka HIV kapena kupereka mankhwala "ochiritsira." Pogwiritsa ntchito katemera wamakono ndi njira zowonongeka , ambiri amakhulupirira kuti tikhoza kutenga kachilombo ka HIV, zonse zomwe zimatha kupha komanso kuthekera kwake kuzibisa.
Kodi Katemera Wopindulitsa Ndi Wofunika Kwambiri Mabiliyoni Amakhala Operekera?
Panthawi yomwe ndalama za HIV zimakhala shrunken kapena kuimitsidwa, ena ayamba kukayikira ngati njira yowonetsera umboni pang'onopang'ono mwa kuyesa ndi zolakwika-imalimbikitsa $ 8 biliyoni omwe agwiritsidwa kale ntchito katemera. Ena amaganiza kuti ndizowononga anthu ndi ndalama pamene ena monga Robert Gallo adatsutsa kuti zitsanzo za katemera zowonongeka sizongokwanira kuti zikhale zovuta.
Komabe, pamene tikuyamba kumvetsa zambiri zokhudza chitetezo cha m'kati mwa maselo komanso kuchititsa kuti thupi likhale lopanda mphamvu, ena amakhulupirira kuti chidziwitso chingagwiritsidwe ntchito mosavuta pazinthu zina za kafukufuku wa HIV.
Pakafukufuku wa 2013 ndi nyuzipepala ya Guardian , Françoise Barre-Sinoussi , yemwe amadziwika kuti ndi wotsutsa HIV, adalonjeza kuti chithandizo cha mankhwala chikhoza kuoneka mkati mwa "zaka 30 zotsatira."
Kaya kuneneratu kumadzetsa chiyembekezo kapena kuchepetsa chiyembekezo, zikuonekeratu kuti kupita patsogolo ndi njira yokhayo yeniyeni. Ndipo kuti kulephera kwenikweni kwenikweni ndi kumene sitikuphunzirapo kanthu.
> Zotsatira:
> Office of Technology Assessment. "Ndemanga ya Bungwe la Public Health Service Yankho la AIDS." Washington, DC: US Congress; February 2005: p. 28. Laibulale ya Buku la Congress Catalog Card 85-600510.
> Mabomba-Ngarm, S .; Pitisuttithum, P .; Nitayaphan, S .; et al. "Katemera ndi ALVAC ndi AIDSVAX pofuna kuteteza HIV ku 1 ku Thailand." New England Journal of Medicine. December 3, 2009; 361 (23): 2209-20.
> Bungwe la National Institute of Allergy and Infectious Diseases (NIAID). "NIH imaletsa katemera ku HIV Vaccine." Washington, DC: Ma National Institutes of Health (NIH). April 25, 2013.
> Ndondomeko Yowunika Kafukufuku Wachirombo wa US ku United States (MHRP). "RV144 Kuphunzira Kuphunzira RV305 Kuyamba ku Thailand." Walter Reed Medical Center, Washington, DC; Media Release: April 11, 2012.
> Kudzala Mtengo Wathu wa Chiyembekezo -Positive Prevention Users Guide (IAVI). "Kupita Patsogolo pa Katemera wa Edzi." New York, New York; Media Release: June 2012.
> Tomaras, G. "E103 Katemera wa HIV-1 Anapanga IgA ndi IgG Antibody Specificities." Journal of Deficiency Immune Deficiency Syndromes. April 2013; 62 (1): 52.
> MacNeil, J .; Johnson, M ;; Mbalame, D; ndi Traumont, E. "Kuyezetsa HIV kumayesedwa." Sayansi. February 13, 2004: 303 (5660): 961.
> Connor, S. "Chithandizo cha HIV tsopano chiri chotheka." The Independent. Lofalitsidwa May 19, 2013.