Ukwelapha Umdlavuza: Izindlela zokwelapha ukuze uhlale uneso

-Delile

• I-Immunotherapy
• Imigomo
• Ukwelashwa kwe-T-cell
• Amasosha omzimba angama-monoclonal
• Izithiyo zokuvikela izivikeli mzimba
• Ukwelashwa kwe-Gene
• Ukuhlelwa kwe-Gene
• I-Virotherapy
• Ukwelashwa kweHormone
• Ama-Nanoparticles
• Hlala unolwazi

Sisondele kangakanani?

Umdlavuza yiqembu lezifo elibonakala ngokukhula kwamaseli okungajwayelekile. Lawa maseli angahlasela izicubu ezahlukene zomzimba, okuholele ezinkingeni ezinkulu zempilo.

Ngokusho kwalokhu, umdlavuza uyimbangela yesibili yokufa kwabantu e-United States ngemuva kwesifo senhliziyo.

Ingabe likhona ikhambi lomdlavuza? Uma kunjalo, sisondele kangakanani? Ukuphendula le mibuzo, kubalulekile ukuqonda umehluko phakathi kokwelashwa nokuxolelwa:

• Aikhambi iqeda yonke imikhondo yomdlavuza emzimbeni futhi iqinisekise ukuthi ngeke isabuya.
• Ukuthethelelwa kusho ukuthi zimbalwa ngaphandle kwezimpawu zomdlavuza emzimbeni.
• Qedela ukuxolelwa kusho ukuthi azikho izimpawu ezitholakalayo zezimpawu zomdlavuza.

Noma kunjalo, amangqamuzana omdlavuza angahlala emzimbeni, noma ngabe esexolelwe ngokuphelele. Lokhu kusho ukuthi umdlavuza ungabuya. Uma lokhu kwenzeka, imvamisa kungaphakathi kokwokuqala ngemuva kokwelashwa.

Abanye odokotela basebenzisa igama elithi "kwelashwa" lapho bebhekisa kumdlavuza ongabuyi kungakapheli iminyaka emihlanu. Kodwa umdlavuza usengabuya emuva kweminyaka emihlanu, ngakho awukaze welapheke ngokweqiniso.

Njengamanje, alikho ikhambi langempela lomdlavuza. Kepha intuthuko yakamuva kwezokwelapha nakwezobuchwepheshe iyasisiza ukusisondeza kunanini ngaphambili ekwelashweni.

Funda ukuze ufunde kabanzi ngalezi zindlela zokwelashwa ezivelayo nokuthi zingasho ukuthini ngekusasa lokwelashwa komdlavuza.

I-Immunotherapy

I-Cancer immunotherapy wuhlobo lwezokwelapha olusiza amasosha omzimba ukulwa namaseli omdlavuza.

Amasosha omzimba akhiwa izitho ezahlukahlukene, amaseli, nezicubu ezisiza umzimba ukulwa nabahlaseli bakwamanye amazwe, kubandakanya amabhaktheriya, amagciwane kanye nezinambuzane.

Kepha amangqamuzana omdlavuza awawona abahlaseli bakwamanye amazwe, ngakho amasosha omzimba angadinga usizo oluthile ukuwahlonza. Kunezindlela eziningana zokunikeza lolu sizo.

Imigomo

Uma ucabanga ngemithi yokugoma, mhlawumbe ucabanga ngayo ngokwesimo sokuvimbela izifo ezithathelwanayo, njengesimungumungwane, isifo sokuqina kwemisipha kanye nomkhuhlane.

Kepha eminye imigomo ingasiza ukuvimbela - noma ngisho ukwelapha - izinhlobo ezithile zomdlavuza. Isibonelo, umuthi wokugomela i-human papilloma virus (HPV) uvikela ezinhlotsheni eziningi ze-HPV ezingadala umdlavuza wesibeletho.

Abaphenyi bebelokhu besebenzela ukwenza umuthi wokugoma osiza amasosha omzimba alwe ngqo namaseli omdlavuza. Lawa maseli avame ukuba nama-molecule ezindaweni zawo ezingekho kumaseli avamile. Ukuphatha umuthi wokugoma oqukethe la ma-molecule kungasiza amasosha omzimba ukuthi abone kangcono futhi aqede amangqamuzana omdlavuza.

Munye kuphela umuthi wokugoma njengamanje ovunyelwe ukwelapha umdlavuza. Ibizwa ngokuthi yi-Sipuleucel-T. Isetshenziselwa ukwelapha umdlavuza wesibeletho osezingeni eliphakeme ongaphendulanga kwezinye izindlela zokwelapha.

Lo mgomo uhlukile ngoba wumuthi wokugoma owenziwe ngendlela oyifisayo. Amaseli omzimba ayasuswa emzimbeni futhi athunyelwe elabhorethri lapho eguqulwa khona ukuze akwazi ukubona amangqamuzana omdlavuza wesinye. Ngemuva kwalokho ziphinde zifakwe emzimbeni wakho, lapho zisiza khona amasosha omzimba ukuthola nokucekela phansi amangqamuzana omdlavuza.

Abaphenyi njengamanje basebenza ekwakheni nasekuhloleni imigomo emisha yokuvikela nokwelapha izinhlobo ezithile zomdlavuza.

Ukwelashwa kwe-T-cell

Amaseli we-T awuhlobo lwamaseli omzimba. Bacekela phansi abahlaseli bangaphandle abatholakala amasosha akho omzimba. Ukwelashwa kwe-T-cell kubandakanya ukufaka la maseli nokuwathumela kubhu. Amaseli abonakala ephendula kakhulu kumangqamuzana omdlavuza ahlukanisiwe futhi akhula ngobuningi. Lawa maseli T abuye ajovwe abuyele emzimbeni wakho.

Uhlobo oluthile lokwelashwa kwe-T-cell lubizwa ngokuthi yi-CAR T-cell therapy.Ngesikhathi sokwelashwa, kukhishwa amaseli we-T futhi aguqulwe ukwengeza i-receptor ebusweni bawo. Lokhu kusiza ama-T cell ukuthi abone kangcono futhi aqede amangqamuzana omdlavuza lapho ephinda efakwa emzimbeni wakho.

Ukwelashwa kwe-CAR T-cell njengamanje kusetshenziselwa ukwelapha izinhlobo eziningana zomdlavuza, njenge-lymphoma yabantu abadala engeyona i-Hodgkin's kanye ne-acute lymphoblastic leukemia.

Ukuhlolwa kwemitholampilo kuyaqhubeka ukuthola ukuthi izindlela zokwelapha ze-T-cell zingakwazi kanjani ukwelapha ezinye izinhlobo zomdlavuza.

Amasosha omzimba angama-monoclonal

Ama-antibodies amaprotheni akhiqizwa ngamaseli we-B, olunye uhlobo lwamaseli omzimba. Bayakwazi ukubona izinhloso ezithile, ezibizwa ngama-antigen, futhi bazibophezele kuzo. Lapho nje i-antibody ibopha i-antigen, ama-T cell angathola futhi abhubhise i-antigen.

Ukwelashwa nge-monoclonal antibody kuhilela ukwenza ama-antibodies amaningi aqaphela ama-antigen atholakala ezindaweni zamaseli womdlavuza. Bese bejovwa emzimbeni, lapho bengasiza khona futhi banciphise amangqamuzana omdlavuza.

Kunezinhlobo eziningi zama-antibody monoclonal aklanyelwe ukwelashwa komdlavuza. Ezinye izibonelo zifaka:

• I-Alemtuzumab. Le antibody ibophezela kuphrotheni ethile kumaseli we-leukemia, iwaqondise ekubhujisweni. Isetshenziselwa ukwelapha i-lymphocytic leukemia engapheli.
• Ibritumomab tiuxetan. Le antibody inezinhlayiya ezinemisebe enamathiselwe kuyo, evumela ukuthi i-radioactivity ithunyelwe ngqo kumaseli womdlavuza lapho i-antibody ibopha. Isetshenziselwa ukwelapha ezinye izinhlobo ze-non-Hodgkin's lymphoma.
• I-Ado-trastuzumab emtansine. Le antibody inomuthi wamakhemikhali onamathele kuyo. Lapho nje i-antibody isinamathele, ikhipha umuthi kumaseli womdlavuza. Isetshenziselwa ukwelapha ezinye izinhlobo zomdlavuza webele.
• Blinatumomab. Lokhu empeleni kuqukethe amasosha omzimba amabili ahlukene monoclonal. Enye inamathela kumaseli womdlavuza, kanti enye inamathela kumaseli omzimba. Lokhu kuhlanganisa amaseli omzimba nawomdlavuza ndawonye, ​​okuvumela amasosha omzimba ukuthi ahlasele amangqamuzana omdlavuza. Isetshenziselwa ukwelapha i-acute lymphocytic leukemia.

Izithiyo zokuvikela izivikeli mzimba

Ama-inhibitors okuvikela amasosha omzimba akhulisa ukuphendula kwamasosha omzimba kumdlavuza. Amasosha omzimba aklanyelwe ukunamathisela abahlaseli bangaphandle ngaphandle kokubhubhisa amanye amaseli emzimbeni. Khumbula, amangqamuzana omdlavuza awaveli njengokungajwayelekile kumasosha omzimba.

Imvamisa, ama-molecule e-checkpoint asezingxenyeni zamaseli avimbela ama-T cell ukuthi angawahlaseli. I-Checkpoint inhibitors isiza amangqamuzana e-T ukuthi agweme lezi zindawo zokubheka, ewavumela ukuthi ahlasele kangcono amaseli omdlavuza.

Ama-immune checkpoint inhibitors asetshenziselwa ukwelapha izinhlobo ezahlukene zomdlavuza, kubandakanya umdlavuza wamaphaphu nomdlavuza wesikhumba.

Nakhu okunye ukubheka i-immunotherapy, ebhalwe ngumuntu ochithe amashumi amabili eminyaka efunda futhi ezama izindlela ezahlukahlukene.

Ukwelashwa kwe-Gene

Ukwelashwa kwe-Gene kuyindlela yokwelapha izifo ngokuhlela noma ngokuguqula izakhi zofuzo ezingaphakathi kwamaseli omzimba. Izakhi zofuzo ziqukethe ikhodi ekhiqiza izinhlobo eziningi zamaprotheni. Amaprotheni nawo athinta indlela amangqamuzana akhula ngayo, aziphathe ngayo, futhi axhumane ngayo.

Endabeni yomdlavuza, izakhi zofuzo ziba nenkinga noma zonakaliswe, okuholele ekutheni amanye amaseli akhule angalawuleki bese enza isimila. Inhloso yokwelashwa kofuzo lomdlavuza ukuphatha izifo ngokushintsha noma ukuguqula lolu lwazi lofuzo olonakele ngekhodi enempilo.

Abaphenyi basacwaninga izindlela eziningi zokwelapha zofuzo kumalebhu noma ezivivinyweni zokwelashwa.

Ukuhlelwa kwe-Gene

Ukuhlelwa kwezakhi zofuzo kuyinqubo yokwengeza, ukususa, noma ukuguqula izakhi zofuzo. Kubizwa nangokuthi ukuhlelwa kwe-genome. Ngokwesimo sokwelashwa komdlavuza, kuzofakwa isakhi esisha samangqamuzana omdlavuza. Lokhu kungadala ukuthi amangqamuzana omdlavuza afe noma awavimbele ukuthi akhule.

Ucwaningo lusesezigabeni zokuqala, kodwa kukhonjiswa isithembiso. Kuze kube manje, ucwaningo oluningi mayelana nokuhlelwa kwezakhi zofuzo lubandakanye izilwane noma amaseli angawodwa, kunamaseli womuntu. Kepha ucwaningo luyaqhubeka nokuthuthuka futhi luguquke.

Uhlelo lwe-CRISPR luyisibonelo sokuhlelwa kofuzo okuthola ukunakwa okuningi. Lolu hlelo luvumela abacwaningi ukuthi bakhombe ukulandelana okuthile kwe-DNA besebenzisa i-enzyme nocezu olushintshiwe lwe-nucleic acid. I-enzyme isusa ukulandelana kwe-DNA, ikuvumela ukuthi ithathelwe indawo ngokulandelana okwenziwe ngokwezifiso. Kufana nokusebenzisa umsebenzi othi "thola bese ushintsha" kuhlelo lokucubungula amagama.

I-protocol yokuqala yokuhlolwa komtholampilo yokusebenzisa i-CRISPR isanda kubuyekezwa. Esivivinyweni somtholampilo esizayo, abaphenyi bahlongoza ukusebenzisa ubuchwepheshe be-CRISPR ukuguqula amaseli we-T kubantu abane-myeloma ephakeme, i-melanoma, noma i-sarcoma.

Hlangana nabanye babaphenyi abasebenza ukwenza ukuhlelwa kofuzo kube ngokoqobo.

I-Virotherapy

Izinhlobo eziningi zamagciwane zibhubhisa amangqamuzana azo okusingathwa njengengxenye yomjikelezo wazo wokuphila. Lokhu kwenza ukuthi amagciwane abe ukwelashwa okukhangayo komdlavuza. I-Virotherapy ukusetshenziswa kwamagciwane ukukhetha ukubulala amaseli womdlavuza.

Amagciwane asetshenziswa ku-virotherapy abizwa ngama-oncolytic virus. Ziguqulwa ngokwezakhi zofuzo ukukhomba kuphela nokuziphindaphinda ngaphakathi kwamaseli womdlavuza.

Ochwepheshe bakholelwa ukuthi lapho igciwane le-oncolytic libulala ingqamuzana lomdlavuza, kukhishwa ama-antigen ahlobene nomdlavuza. Ama-antibody angabopha kulawa ma-antigen bese enza impendulo yesistimu yomzimba.

Ngenkathi abacwaningi bebheka ukusetshenziswa kwamagciwane amaningi walolu hlobo lwezokwelapha, yinye kuphela evunyelwe kuze kube manje. Ibizwa nge-T-VEC (talimogene laherparepvec). Yigciwane le-herpes eliguquliwe. Isetshenziselwa ukwelapha umdlavuza wesikhumba we-melanoma ongeke ususwe ngokuhlinzwa.

Ukwelashwa kweHormone

Umzimba ngokwemvelo ukhiqiza ama-hormone, asebenza njengezithunywa ezicutshini nasemangqamuzaneni omzimba wakho. Basiza ukulawula imisebenzi eminingi yomzimba.

Ukwelashwa kweHormone kuhilela ukusebenzisa umuthi ukuvimba ukukhiqizwa kwamahomoni. Eminye imidlavuza iyazwela emazingeni ama-hormone athile. Izinguquko kula mazinga zingathinta ukukhula nokusinda kwala maseli omdlavuza. Ukwehlisa noma ukuvimba inani lehomoni edingekayo kunganciphisa ukukhula kwalezi zinhlobo zomdlavuza.

Ukwelashwa kweHormone kwesinye isikhathi kusetshenziselwa ukwelapha umdlavuza webele, umdlavuza wendlala yesinye, nomdlavuza wesibeletho.

Ama-Nanoparticles

Ama-nanoparticles yizakhiwo ezincane kakhulu. Mancane kunamaseli. Ubungako bawo bubavumela ukuba bahambe emzimbeni wonke futhi basebenzisane namaseli ahlukene nama-molecule ezinto eziphilayo.

AmaNanoparticles angamathuluzi athembisayo okwelashwa komdlavuza, ikakhulukazi njengendlela yokuletha izidakamizwa endaweni yesimila. Lokhu kungasiza ekwenzeni ukwelashwa komdlavuza kuphumelele kakhulu ngenkathi kuncishiswa imiphumela emibi.

Ngenkathi lolo hlobo lokwelashwa kwe-nanoparticle lusesigabeni sokuthuthuka, izinhlelo zokulethwa ezisuselwa kunanoparticle zivunyelwe ukwelashwa kwezinhlobo ezahlukahlukene zomdlavuza. Okunye ukwelashwa komdlavuza okusebenzisa ubuchwepheshe be-nanoparticle njengamanje kusezivivinyweni zokwelashwa.

Hlala unolwazi

Izwe lokwelashwa komdlavuza likhula njalo futhi liyashintsha. Hlala usesikhathini ngalezi zinsiza:

• . INational Cancer Institute (NCI) igcina leli sayithi. Ibuyekezwa njalo ngezindatshana ezikhuluma ngocwaningo lwakamuva lomdlavuza kanye nezindlela zokwelapha.
• . Lesi isizindalwazi eseshekayo semininingwane mayelana nokuhlolwa komtholampilo okusekelwa yi-NCI.
• Ibhulogi yeCancer Cancer. Le bhulogi yeCancer Cancer Institute. Kuvuselelwa njalo ngezindatshana ezikhuluma ngentuthuko yakamuva yocwaningo.
• I-American Cancer Society. I-American Cancer Society inikeza imininingwane esesikhathini ngemihlahlandlela yokuhlola umdlavuza, ukwelashwa okutholakalayo, kanye nezibuyekezo zocwaningo.
• ClinicalTrials.gov. Ngezivivinyo zokwelashwa zamanje nezivuliwe emhlabeni wonke, hlola i-U.S. National Library of Medicine's database yezifundo ezizimele nezizimele zomphakathi.