Omalizumab kwa Treatment of Chronic Idiopathic Urticaria
Kodi Urticaria Ndi Chiyani?
Urticaria , dzina lachipatala la ming'oma, ndilo vuto limene lingakhudze munthu mmodzi mwa asanu pa nthawi ina pa moyo wawo. Kuthamanga kwa urticaria nthawi zambiri kumakhala kovuta, kofiira komanso kovuta. Ziphuphuzo zingakhale kukula kwa udzudzu wa udzudzu kuti ukhale wolemera kapena ndalama zazikulu, ndipo akhoza kugwirizanitsa pamodzi kukhala maonekedwe osasinthasintha, omwe amatchedwa coalescing.
Kuthamanga kudzabwera ndikupita mkati mwa maola angapo, kuchoka pamalo amodzi mpaka thupi kupita ku lina.
Kutupa kumene nthawi zina kumayenda ndi urticaria, yotchedwa angioedemia , kungachititse kuti kutupa kwa nkhope, manja ndi mapazi. Angioedema kawirikawiri si yofiira kapena yowopsya, koma imawombera ndi kuwotcha, ndipo imatha kufotokozedwa ngati "kufooka." Kuvulala kumeneku kungakhale koopsa, ndipo ngati kumakhudza mphamvu ya munthu kuti apume, ikhoza kuopseza moyo.
Onse a urticaria ndi angioedema ndi zotsatira za histamine ndi mankhwala ena otulutsidwa kuchokera ku maselo akuluakulu pakhungu ndi mucous membranes. Izi zikhoza kuchitika mwa njira yowopsa kapena imodzi yomwe maselo amatulutsa mankhwala popanda IgE kukhala nawo.
Milandu ya urticaria ndi angioedema ikhoza kukhala yovuta, yokhalitsa yosapitirira masabata asanu ndi limodzi, kapena osapitirira masabata asanu ndi limodzi. Mosiyana ndi urticaria yapamwamba, pafupi 5 mpaka 10 peresenti ya urticaria ndi angioedemia amayamba chifukwa cha matenda.
Chifukwa cha urticaria sichitha kudziwika nthawi zonse, chomwe chimatchedwa kuti idiopathic urticaria (CIU). CIU zambiri zimakhala zokhudzana ndi zifukwa zomwe zimayambitsa vutoli kusiyana ndi zilonda. Mu mawonekedwe a mtundu wa CIU, munthu nthawi zambiri amachititsa antibodies motsutsana ndi gawo la maselo awo ammimba (mwina kwa maselo amtundu wa maselo a IgE, kapena kuti IgE yeniyeniyo yafika ku selo), zomwe zimayambitsa kumasulidwa kwa histamine ndi kuwonetsa zizindikiro.
Chithandizo chachikulu cha CIU chiri ndi mankhwala antihistamines . Izi kawirikawiri zimaperekedwa m'mawonekedwe a m'kamwa, ndipo zingafunikire kupatsidwa mankhwala aakulu kapena kawirikawiri kuti athetse zizindikiro. Komabe, anthu oposa 50% omwe ali ndi CIU sangayankhire mankhwala ndi kachitidwe ka mankhwala ka oral antihistamines. Zowonjezera zowonjezera za CIU nthawi zambiri zimafunidwa, koma sizivomerezedwa ndi US Food and Drug Administration (FDA) chifukwa chaichi. Choncho, mankhwala owonjezera a CIU, omwe amavomerezedwa ndi FDA, amafunikira kuti anthuwa asamayesedwe ndi mankhwala omwe amamwa mankhwala oletsa antihistamines.
Kodi Xolair ndi chiyani?
Xolair (omalizumab) ndi mankhwala ojambulidwa omwe amavomerezedwa ndi FDA kuti athetse matenda oopsa a asthma omwe ali ndi zaka 12 kapena kuposerapo. Majekeseni amaperekedwa mu ofesi ya dokotala masabata awiri kapena 4, malingana ndi kulemera kwake kwa munthu ndi chiwerengero cha anti-antibody (IgE). Xolair ndi anti-IgE anti-anti-IgE, yomwe imamangiriza ku IgE m'magazi, kuti thupi lichotse. Izi zimalepheretsa IgE kusagwirizana ndi maselo akuluakulu (motero amachokera ku zovuta) zomwe zimadzetsa kumasulidwa kwa histamine ndi mankhwala ena. Ndi mankhwala awa omwe amachititsa kuti mphumu yowonongeka komanso zizindikiro zina zowopsa, kuphatikizapo urticaria ndi angioedema.
Kodi Xolair Ingagwiritsidwe Ntchito Kuchitira Uchira Wamakono?
Maphunziro oyambirira alidi odalirika. Kafukufuku wosiyanasiyana anafufuza phindu la Xolair pochiza CIU. Kafukufuku waposachedwapa anafufuza odwala oposa 300 omwe ali ndi CIU omwe adakali ndi zizindikiro ngakhale kuti amamwa mankhwala oletsa antihistamines. Ankapatsidwa Xolair m'mayeso osiyanasiyana milungu iwiri iliyonse. Anthu makumi anai ndi anayi omwe amalandira dola Xolair yapamwamba, ndipo 22 peresenti ya anthu omwe amalandira mlingo wa dola Xolair, anali ndi kuthetsa kwathunthu kwa mng'oma mkati mwa masabata awiri kapena awiri. Zizindikirozo zinapitirira pang'onopang'ono pambuyo pa Xolair ataimitsidwa, kotero panalibe chizindikiro chokhala ndi phindu lokhalitsa.
Maphunziro ena adapeza mapindu ofanana, ndi mitengo ya "kukhululukidwa" pa Xolair pafupifupi 30% a anthu omwe ali ndi CIU. Deta yabwino kwambiri ikuwoneka kuti ikuchokera kuphunziro laling'ono komwe dola ya Xolair inali yofanana ndi momwe amaperekedwa kwa munthu amene ali ndi mphumu. Odwala mu phunziroli anali ndi umboni wa CIU wodalirika wofanana ndi kuchuluka kwa maantiantibodies (antibodies against yourself) potsutsa mahomoni a chithokomiro. Anthu makumi asanu ndi awiri mwa anthu 100 alionse amene amalandira Xolair anali atasintha kwathunthu zizindikiro zawo za CIU.
Choncho, kafukufuku amasonyeza kuti Xolair ndi mankhwala otetezeka komanso othandiza kwa odwala omwe ali ndi CIU, ndipo kuyankha kuchipatala kumawoneka kuti sichidalira kuchepa kwa munthu, mlingo wa IgE wa seramu, kapena chikhalidwe chake chokha. Zopindulitsa za Xolair mwina zimangokhala pamene mankhwala akugwiritsidwa ntchito, kutanthauza kuti sikutheka kuti pakhale nthawi yaitali kuchotsedwa kwa Xolair kwa anthu omwe ali ndi CIU. Mwamwayi, popeza Xolair ndi yokwera mtengo kwambiri, ndipo anthu ambiri omwe ali ndi CI akhoza kulamulidwa ndi mankhwala opatsirana a antihistamines, anthu ochepa okha amalandira Xolair kwa CIU. Boma la US Food and Drug Administration linalola kugwiritsa ntchito Xolair kwa CIU mu March 2014.
Zotsatira:
Casale TB. Omalizumab kwa Chronic Urticaria. J Zachilombo ka Immunol Pract. 2014; 1: 118-9.
Kahn DA. Njira Zina Zotsutsana ndi Urticaria Chronic: Chiwonetsero ndi Malingaliro pa Kusankhidwa ndi Kugwiritsa kwawo. J Zachilombo ka Immunol Pract. 2013; 1: 443-40.