Buza Isazi: Ukuqonda Isimo Sokwelashwa kwe-Ankylosing Spondylitis

-Delile

• Ingabe i-ankylosing spondylitis ingelashwa?
• Yiziphi izindlela zokwelashwa ezithembisa kakhulu ekuhlolweni kwemitholampilo?
• Ngazi kanjani ukuthi ngiyakufanelekela yini ukuhlolwa kwasemtholampilo?
• Yiziphi izindlela ezintsha zokwelapha i-ankylosing spondylitis?
• Yiziphi izindlela zokwelapha ezihambisanayo ozincomayo? Yiziphi izivivinyo ozincomayo?
• Ingabe ukuhlinzwa kuyindlela yokwelapha i-ankylosing spondylitis?
• Ngabe ubona kanjani ukwelashwa kwe-ankylosing spondylitis kushintsha eminyakeni eyishumi ezayo?
• Ucabanga ukuthi intuthuko elandelayo yokwelashwa kwe-ankylosing spondylitis izoba yini?
• Ubuchwepheshe besimanje busiza kanjani ekuthuthukiseni ukwelashwa?

Ingabe i-ankylosing spondylitis ingelashwa?

Njengamanje, alikho ikhambi le-ankylosing spondylitis (AS). Kodwa-ke, iziguli eziningi ezine-AS zingaphila impilo ende, ekhiqizayo.

Ngenxa yesikhathi esiphakathi kokuqala kwezimpawu nokuqinisekiswa kwalesi sifo, ukuxilongwa kusenesikhathi kubalulekile.

Ukuphathwa kwezokwelapha, izindlela zokwelapha ezisizayo, kanye nokuzivocavoca okubhekiswe kuzo kunganikeza iziguli ikhwalithi yempilo ethuthukisiwe. Imithelela emihle ifaka ukukhululeka kobuhlungu, ukunyakaza okunyukayo, nokukhuphuka kwamandla okusebenza.

Yiziphi izindlela zokwelashwa ezithembisa kakhulu ekuhlolweni kwemitholampilo?

Izilingo zomtholampilo ezithembisa kakhulu yilezo ezihlola ukusebenza nokuphepha kwe-bimekizumab. Kungumuthi ovimbela zombili i-interleukin (IL) -17A ne-IL-17F - amaprotheni amancane afaka isandla kwizimpawu ze-AS.

IFilgotinib (FIL) iyisithiyo esikhethiwe sikaJanus kinase 1 (JAK1), enye iphrotheni enenkinga. I-FIL okwamanje isathuthukiselwa ukwelashwa kwe-psoriasis, i-psoriatic arthritis, ne-AS. Ithathwe ngomlomo futhi inamandla kakhulu.

Ngazi kanjani ukuthi ngiyakufanelekela yini ukuhlolwa kwasemtholampilo?

Ukufaneleka kwakho ukubamba iqhaza esivivinyweni somtholampilo se-AS kuya ngenhloso yesivivinyo.

Izilingo zingahlola ukusebenza nokuphepha kwezidakamizwa zokuphenya, ukuqhubeka kokubandakanyeka kwamathambo, noma inkambo yemvelo yesifo. Ukubuyekezwa kwezinqubo zokuxilonga ze-AS kuzoba nomthelela ekwakhiweni kokuhlolwa kwemitholampilo ngokuzayo.

Yiziphi izindlela ezintsha zokwelapha i-ankylosing spondylitis?

Izidakamizwa zakamuva ezigunyaziwe ze-FDA zokwelashwa kwe-AS yilezi:

• ustekinumab (Stelara), i-IL12 / 23 inhibitor
• i-tofacitinib (Xeljanz), i-JAK inhibitor
• secukinumab (Cosentyx), i-IL-17 inhibitor kanye ne-humanized monoclonal antibody
• ixekizumab (Taltz), i-IL-17 inhibitor

Yiziphi izindlela zokwelapha ezihambisanayo ozincomayo? Yiziphi izivivinyo ozincomayo?

Izindlela zokwelapha ezihambisanayo engizincomayo njalo zifaka:

• ukubhucungwa umzimba
• ukutshopa
• acupressure
• izivivinyo ze-hydrotherapy

Ukuvivinya umzimba okuqondile kubandakanya:

• ukuzelula
• ukuhlala odongeni
• amapulangwe
• kwesilevu tuck in isikhundla recumbent
• ukunweba isinqe
• izivivinyo zokuphefumula okujulile nokuhamba

Ukusetshenziswa kwamasu we-yoga namayunithi we-transcutaneous electrical nerve stimulation (TENS) nawo ayakhuthazwa.

Ingabe ukuhlinzwa kuyindlela yokwelapha i-ankylosing spondylitis?

Ukuhlinzwa akuvamile ku-AS. Kwesinye isikhathi, lesi sifo siqhubekela ezingeni lokuphazamisa imisebenzi yansuku zonke ngenxa yobuhlungu, ukulinganiselwa kokunyakaza, nobuthakathaka. Kulezi zimo, kungahle kunconywe ukuhlinzwa.

Kunezinqubo ezimbalwa ezinganciphisa ubuhlungu, zizinzise umgogodla, zithuthukise ukuma, futhi zivimbele ukucindezelwa kwemizwa. Ukuhlanganiswa komgogodla, ama-osteotomies, nama-laminectomies enziwa odokotela abahlinzayo abanekhono kakhulu kungasiza kwezinye iziguli.

Ngabe ubona kanjani ukwelashwa kwe-ankylosing spondylitis kushintsha eminyakeni eyishumi ezayo?

Kungumqondo wami ukuthi ukwelashwa kuzokwenzelwa ngokuya ngokuthola okuthize komtholampilo, izindlela ezithuthukisiwe zokucabanga, kanye nanoma iziphi izinkulumo ezihambisana nalesi sifo.

I-AS iwela ngaphansi kwesambulela sesigaba esibanzi sezifo ezibizwa nge-spondyloarthropathies. Lokhu kufaka phakathi i-psoriasis, i-psoriatic arthritis, isifo sokuvuvukala kwamathumbu, kanye ne-spondyloarthropathy esebenzayo.

Kungaba nezethulo ze-crossover zalawa ma-subsets futhi abantu bazohlomula ngendlela ebhekiswe ekwelashweni.

Ucabanga ukuthi intuthuko elandelayo yokwelashwa kwe-ankylosing spondylitis izoba yini?

Izakhi zofuzo ezimbili ezithile, i-HLA-B27 ne-ERAP1, zingabandakanyeka ekubonisweni kwe-AS. Ngicabanga ukuthi intuthuko elandelayo ekwelapheni i-AS izokwaziswa ngokuqonda ukuthi basebenzisana kanjani nokuhlangana kwabo nezifo ezivuthayo zamathumbu.

Ubuchwepheshe besimanje busiza kanjani ekuthuthukiseni ukwelashwa?

Intuthuko eyodwa enkulu iku-nanomedicine. Lobu buchwepheshe busetshenziselwe ukuphatha ngempumelelo ezinye izifo ezivuthayo ezifana ne-osteoarthritis ne-rheumatoid arthritis. Ukuthuthukiswa kwezinhlelo zokulethwa ezisuselwa ku-nanotechnology kungahle kube ukwengeza okuthokozisayo ekuphathweni kwe-AS.

UBrenda B. Spriggs, MD, FACP, MPH, unguProfesa Wezokwelapha u-Emerita, i-UCSF, iRheumatology, umeluleki wezinhlangano eziningana zokunakekelwa kwezempilo, kanye nombhali. Izintshisekelo zakhe zifaka phakathi ukwethenjelwa kweziguli kanye nentshisekelo yokunikeza ukubonisana kochwepheshe be-rheumatology kodokotela nabantu abangagcinwanga kahle. Ungumbhali-mbumbulu wencwadi ethi “Gxila Kwezempilo Yakho Engcono Kakhulu: Umhlahlandlela Ohlakaniphile Wokunakekelwa Kwezempilo Okufanele.”