Ingabe Zisebenza Kanjani Izindlela Zokwelapha Ngomlomo ze-MS?

-Delile

• Indima yamaseli B nama-T cells
• I-Cladribine (Mavenclad)
• I-Dimethyl fumarate (iTecfidera)
• I-Diroximel fumarate (Ubuningi)
• I-Fingolimod (Gilenya)
• I-Siponimod (Mayzent)
• I-Teriflunomide (Aubagio)
• Ezinye izidakamizwa eziguqula izifo
• Ingcuphe engaba khona yemiphumela emibi evela kuma-DMTs
• Ukuphatha ubungozi bemiphumela emibi
• Ukuthatha
• Yilokhu Okuzwayo Ukuthanda Ukuphila ne-MS

I-Multiple sclerosis (MS) yisifo esizimele lapho amasosha akho omzimba ehlasela okokuvikela okuzungeze izinzwa ezisesimisweni sakho sezinzwa esiphakathi (CNS). I-CNS ifaka ubuchopho bakho nentambo yomgogodla.

Imithi yokwelapha ekuguquleni izifo (i-DMTs) iyindlela yokwelashwa enconywayo yokusiza ukunciphisa ukukhula kwe-MS. Ama-DMTs angasiza ukubambezela ukukhubazeka nokunciphisa imvamisa yama-flares kubantu abanalesi simo.

Ukuphathwa Kwezokudla Nezidakamizwa (i-FDA) kuvume ama-DMTs amaningi ukwelapha amafomu abuyayo e-MS, kufaka phakathi ama-DMTs ayisithupha athathwa ngomlomo njengamaphilisi noma amaphilisi.

Funda ukuze ufunde kabanzi ngama-DMTs omlomo nokuthi asebenza kanjani.

Indima yamaseli B nama-T cells

Ukuze uqonde ukuthi i-DMTS yomlomo isiza kanjani ukuphatha i-MS, udinga ukwazi ngendima yamaseli athile omzimba ku-MS.

Izinhlobo eziningi zamaseli omzimba nama-molecule zibandakanyeka ekuphenduleni okungavamile komzimba okudala ukuvuvukala nokulimala ku-MS.

Lokhu kufaka phakathi amaseli we-T namaseli B, izinhlobo ezimbili zamangqamuzana amhlophe egazi abizwa ngama-lymphocyte. Akhiqizwa ohlelweni lomzimba wakho lwe-lymphatic.

Lapho amaseli we-T esuka ohlelweni lwakho lwe-lymphatic engena egazini lakho, angaya ku-CNS yakho.

Izinhlobo ezithile zamaseli e-T zikhiqiza amaprotheni aziwa ngokuthi ama-cytokines, abangela ukuvuvukala. Kubantu abane-MS, ama-cytokines ane-pro-inflammatory adala umonakalo kuma-myelin namaseli ezinzwa.

Amaseli we-B nawo akhiqiza ama-cytokines ane-pro-inflammatory, angasiza ukuqhuba imisebenzi yamaseli we-T abangela izifo ku-MS. Amaseli we-B nawo akhiqiza ama-antibodies, angadlala indima ku-MS.

Ama-DMTs amaningi asebenza ngokunciphisa ukusebenza, ukusinda, noma ukunyakaza kwamaseli we-T, amaseli we-B, noma kokubili. Lokhu kusiza ukunciphisa ukuvuvukala nokulimala ku-CNS. Amanye ama-DMTs avikela amangqamuzana ezinzwa ekulimaleni ngezinye izindlela.

I-Cladribine (Mavenclad)

I-FDA ivume ukusetshenziswa kwe-cladribine (Mavenclad) ukwelapha amafomu abuyayo e-MS kubantu abadala. Kuze kube manje, azikho izifundo eziphothuliwe ngokusetshenziswa kweMavenclad ezinganeni.

Lapho othile ethatha lo muthi, ungena kumaseli we-T nama-B emzimbeni wakhe futhi uphazamise amandla amaseli okuhlanganisa nokulungisa i-DNA. Lokhu kubangela ukuthi amangqamuzana afe, kunciphisa inani lamaseli T kanye namaseli B kumasosha omzimba.

Uma uthola ukwelashwa ngeMavenclad, uzothatha izifundo ezimbili zomuthi eminyakeni emibili. Inkambo ngayinye izobandakanya amasonto amabili okwelashwa, ahlukaniswe ngenyanga engu-1.

Phakathi nesonto ngalinye lokwelashwa, udokotela wakho uzokweluleka ukuthi uthathe isilinganiso esisodwa noma ezimbili zomuthi nsuku zonke izinsuku ezi-4 noma ezi-5.

I-Dimethyl fumarate (iTecfidera)

I-FDA ivume i-dimethyl fumarate (Tecfidera) yokwelapha amafomu abuyayo e-MS kubantu abadala.

I-FDA ayikagunyazi iTecfidera yokwelapha i-MS ezinganeni. Kodwa-ke, odokotela banganikeza izingane lo muthi ngomkhuba owaziwa ngokuthi "ukusetshenziswa kwelebula".

Yize kudingeka olunye ucwaningo, izifundo kuze kube manje zikhombisa ukuthi lo muthi uphephile futhi uyasebenza ekwelapheni i-MS ezinganeni.

Ochwepheshe abazi kahle ukuthi iTecfidera isebenza kanjani. Kodwa-ke, abacwaningi bathole ukuthi lo muthi unganciphisa ubuningi bezinhlobo ezithile zamaseli we-T namaseli we-B, kanye nama-cytokines aqinisa ukuvuvukala.

I-Tecfidera nayo ibonakala isebenzisa iprotheyini eyaziwa njenge-nuclear factor erythroid 2-factor (NRF2). Lokhu kudala izimpendulo zamaselula ezisiza ukuvikela amangqamuzana ezinzwa ekucindezelekeni kwe-oxidative.

Uma unikezwe i-Tecfidera, udokotela wakho uzokweluleka ukuthi uthathe imithamo emibili ye-120-milligram (mg) ngosuku ngezinsuku zokuqala eziyi-7 zokwelashwa. Ngemuva kwesonto lokuqala, bazokutshela ukuthi uthathe imithamo emibili ye-240-mg ngosuku ngokuqhubekayo.

I-Diroximel fumarate (Ubuningi)

I-FDA ivume i-diroximel fumarate (Vumerity) ukwelapha amafomu abuyayo e-MS kubantu abadala. Ochwepheshe okwamanje abazi ukuthi lo muthi uphephile noma uyasebenza yini ezinganeni.

Ukubalwa kuyingxenye yesigaba esifanayo semithi njengeTecfidera. NjengeTecfidera, kukholelwa ukuthi kusebenze iprotheni NRF2. Lokhu kusetha izimpendulo zamaselula ezisiza ukuvimbela ukulimala kwamangqamuzana ezinzwa.

Uma uhlelo lwakho lokwelashwa lubandakanya ukubalwa kwamanani, udokotela wakho uzokweluleka ukuthi uphuze ama-231 mg womuthi kabili ngosuku ngezinsuku eziyi-7 zokuqala. Kusukela lapho, kufanele uthathe i-462 mg yomuthi kabili ngosuku.

I-Fingolimod (Gilenya)

I-FDA ivume i-fingolimod (i-Gilenya) yokwelapha amafomu abuyayo e-MS kubantu abadala kanye nezingane ezineminyaka eyi-10 noma ngaphezulu.

I-FDA ayikayivumeli le mithi yokwelapha izingane ezincane, kodwa odokotela bangayinikeza ukuthi ilebula ezinganeni ezingaphansi kweminyaka eyi-10.

Lo muthi uvimba uhlobo lwe-molecule yokusayina eyaziwa ngokuthi i-sphingosine 1-phosphate (S1P) kusuka ekubophezeleni kuma-T cell namaseli we-B. Ngokulandelayo, lokhu kuvimbela lawo maseli ukuba angene egazini futhi aye e-CNS.

Lapho lawo maseli emiswa ukuhambela i-CNS, awakwazi ukudala ukuvuvukala nokulimala lapho.

I-Gilenya ithathwa kanye ngosuku. Kubantu abanesisindo esingaphezu kwamakhilogremu angama-88 (ama-40 kilograms), umthamo wansuku zonke onconywayo ngu-0.5 mg. Kulabo abanesisindo esingaphansi kwalesi, umthamo wansuku zonke onconywayo ngu-0.25 mg.

Uma uqala ukwelashwa ngalo muthi bese uyeka ukuwusebenzisa, ungahle uthole ukuqaqamba okukhulu.

Abanye abantu abane-MS bahlakulele ukwanda okukhulu kokukhubazeka kanye nezilonda zobuchopho ezintsha ngemuva kokuyeka ukuthatha lo muthi.

I-Siponimod (Mayzent)

I-FDA ivume i-siponimod (iMayzent) yokwelapha amafomu abuyela emuva e-MS kubantu abadala. Kuze kube manje, abacwaningi abakaqedi noma yiziphi izifundo ngokusetshenziswa kwalo muthi ezinganeni.

UMayzent usesigabeni esifanayo semithi njengeGilenya. NjengoGilenya, ivimba i-S1P ekubopheni kuye kumaseli we-T namaseli B. Lokhu kumisa lawo maseli omzimba ekuhambeni ebuchosheni nasentanyeni yomgogodla, lapho angadala khona umonakalo.

UMayzent uthathwa kanye ngosuku. Ukunquma isilinganiso sakho sansuku zonke esifanele, udokotela wakho uzoqala ngokukuhlolela umaki wofuzo ongakusiza ukubikezela impendulo yakho kulo muthi.

Imiphumela yakho yokuhlolwa kofuzo iphakamisa ukuthi lo muthi ungakusebenzela kahle, udokotela wakho uzokunikeza umthamo omncane ozoqala. Bazokhuphula kancane kancane umthamo wakho obekiwe kunqubo eyaziwa ngokuthi yi-titration. Umgomo ukwandisa izinzuzo ezingaba khona ngenkathi kunciphisa imiphumela emibi.

Uma uthatha lo muthi bese uyeka ukuwusebenzisa, isimo sakho singase sibe sibi kakhulu.

I-Teriflunomide (Aubagio)

I-FDA ivume ukusetshenziswa kwe-teriflunomide (Aubagio) ekwelapheni amafomu abuyayo e-MS kubantu abadala. Azikho izifundo ezishicilelwe kuze kube manje ngokusetshenziswa kwalesi sidakamizwa ezinganeni.

I-Aubagio ivimba i-enzyme eyaziwa ngokuthi yi-dihydroorotate dehydrogenase (DHODH). Le enzyme iyabandakanyeka ekukhiqizeni i-pyrimidine, ibhulokhi yokwakha ye-DNA edingeka ekuhlanganisweni kwe-DNA kumaseli we-T namaseli B.

Lapho le enzyme ingakwazi ukufinyelela i-pyrimidine eyanele yokuhlanganisa i-DNA, ikhawulela ukwakheka kwamaseli amasha we-T namaseli B.

Uma uthola ukwelashwa nge-Aubagio, udokotela wakho angakunikeza umthamo wansuku zonke we-7 noma 14-mg.

Ezinye izidakamizwa eziguqula izifo

Ngaphezu kwale mishanguzo yomlomo, i-FDA igunyaze ama-DMTs amaningi ajovwe ngaphansi kwesikhumba noma anikezwe nge-infusion emithanjeni.

Kubandakanya:

• i-alemtuzumab (Lemtrada)
• i-glatiramer acetate (iCopaxone, iGlatect)
• i-interferon beta-1 (Avonex)
• i-interferon beta-1a (Rebif)
• i-interferon beta-1b (iBetaseron, i-Extavia)
• i-mitoxantrone (Novantrone)
• i-natalizumab (Tysabri)
• ocrelizumab (Ocrevus)
• i-peginterferon beta-1a (iPlegridy)

Khuluma nodokotela wakho ukuze ufunde kabanzi ngale mithi.

Ingcuphe engaba khona yemiphumela emibi evela kuma-DMTs

Ukwelashwa ngama-DMTs kungadala imiphumela emibi, kwesinye isikhathi ebucayi.

Imiphumela engemihle yokwelashwa iyahluka ngokuya ngohlobo oluthile lwe-DMT oyithathayo.

Eminye imiphumela emibi ejwayelekile ifaka phakathi:

• ikhanda
• isicanucanu
• ukuhlanza
• isifo sohudo
• ukuqubuka kwesikhumba
• ukulahleka kwezinwele
• ukushaya kwenhliziyo okuhamba kancane
• ukuqhuma ebusweni
• ukungakhululeki esiswini

Ama-DMTs nawo axhumene nengozi eyengeziwe yokutheleleka, njenge:

• umkhuhlane
• i-bronchitis
• isifo sofuba
• amasongo
• izifo ezithile zefungal
• i-leukoencephalopathy eqhubekayo ehlukahlukene, uhlobo olungavamile lokutheleleka kobuchopho

Ingozi eyengeziwe yokutheleleka yingoba le mithi iguqula amasosha akho omzimba futhi yehlise inani lamaseli amhlophe alwa nezifo emzimbeni wakho.

Ama-DMTs angadala eminye imiphumela emibi, njengokulimala kwesibindi kanye ne-allergen enkulu. Amanye ama-DMTs angadala ukuthi umfutho wegazi lakho ukhuphuke. Ezinye zingadala ukushaya kwenhliziyo yakho kwehle.

Khumbula ukuthi udokotela wakho uzoncoma i-DMT uma bekholelwa ukuthi izinzuzo ezingaba khona zidlula izingozi.

Ukuphila ne-MS engalawulwa kahle nakho kunezingozi ezinkulu. Khuluma nodokotela wakho ukuze ufunde kabanzi ngemiphumela emibi engaba khona kanye nezinzuzo zama-DMTs ahlukile.

Ama-DMTs ngokuvamile athathwa njengaphephile kubantu abakhulelwe noma abancelisayo.

Ukuphatha ubungozi bemiphumela emibi

Ngaphambi kokuba uqale ukwelashwa nge-DMT, udokotela wakho kufanele akuhlolele izifo ezisebenzayo, ukulimala kwesibindi, nezinye izinkinga zempilo ezingakhuphula ubungozi bokuthatha umuthi.

Udokotela wakho angakukhuthaza futhi ukuthi uthole imigomo ethile ngaphambi kokuqala ukwelashwa nge-DMT. Kungase kudingeke ukuthi ulinde amasonto ambalwa ngemuva kokuthola imigomo ngaphambi kokuqala ukuthatha umuthi.

Ngenkathi uthola ukwelashwa nge-DMT, udokotela wakho angakweluleka ukuthi uvikele imishanguzo ethile, izithasiselo zokudla okunempilo, noma eminye imikhiqizo. Babuze ukuthi ikhona yini imishanguzo noma eminye imikhiqizo engasebenzisana noma iphazamise i-DMT.

Udokotela wakho kufanele futhi akuqaphele izimpawu zemiphumela emibi ngesikhathi nangemva kokwelashwa nge-DMT. Isibonelo, kungenzeka ba-ode ukuhlolwa kwegazi okujwayelekile ukuze kuhlolwe isibalo sakho samaseli egazi nama-enzyme wesibindi.

Uma ucabanga ukuthi ungahle ube nemiphumela emibi, yazisa udokotela wakho khona manjalo.

Ukuthatha

Ama-DMTs amaningi avunyelwe ukwelapha i-MS, kufaka phakathi izinhlobo eziyisithupha zokwelashwa ngomlomo.

Eminye yale mithi ingahle iphephe noma ifaneleke kangcono kubantu abathile kunabanye.

Ngaphambi kokuba uqale ukuthatha i-DMT, buza udokotela wakho ngezinzuzo nezingozi zokuyisebenzisa. Bangakusiza uqonde ukuthi ukwelashwa okuhlukile kungawuthinta kanjani umzimba wakho nombono wesikhathi eside nge-MS.

Yilokhu Okuzwayo Ukuthanda Ukuphila ne-MS