Izinguquko Ezithembisayo Ekuhlelweni Kokwelashwa Kwe-MS

-Delile

• Inhloso yokwelashwa
• Ukwelashwa
• I-Gilenya (fingolimod)
• I-Teriflunomide (Aubagio)
• I-Dimethyl fumarate (iTecfidera)
• I-Dalfampridine (Ampyra)
• I-Alemtuzumab (Lemtrada)
• Inqubo yememori yendaba eguquliwe
• Ama-peptide kaMyelin
• Ikusasa Lokwelashwa kwe-MS

I-Multiple sclerosis (MS) yisifo esingelapheki esithinta isistimu yezinzwa emaphakathi. Izimbambo zigaqwe esembozweni esivikelayo esibizwa ngokuthi i-myelin, esheshisa nokudluliswa kwezimpawu zezinzwa. Abantu abane-MS bahlangabezana nokuvuvukala kwezindawo ze-myelin nokuwohloka okuqhubekayo nokulahleka kwe-myelin.

Imithambo ingasebenza ngokungajwayelekile lapho i-myelin yonakele. Lokhu kungadala izimpawu eziningi ezingalindelekile. Lokhu kufaka phakathi:

• ubuhlungu, ukugedlezela, noma imizwa evuthayo emzimbeni wonke
• ukulahleka kombono
• ubunzima bokuhamba
• ukuqina kwemisipha noma ukuqina
• ubunzima ngokulinganisela
• inkulumo engahambi kahle
• inkumbulo engasebenzi kahle nokusebenza kwengqondo

Iminyaka yocwaningo oluzinikele iholele ekwelashweni okusha kwe-MS. Alisekho ikhambi lalesi sifo, kepha izindlela zemithi kanye nokwelashwa kokuziphatha kuvumela abantu abane-MS ukuthi bajabulele impilo engcono.

Inhloso yokwelashwa

Izinketho eziningi zokwelashwa zingasiza ukuphatha inkambo nezimpawu zalesi sifo esingalapheki. Ukwelashwa kungasiza:

• ukubambezela ukuqhubeka kwe-MS
• ukunciphisa izimpawu ngesikhathi se-MS exacerbations noma i-flare-ups
• ukuthuthukisa ukusebenza ngokomzimba nangokwengqondo

Ukwelashwa ngendlela yamaqembu okusekela noma ukwelashwa kokukhuluma nakho kunganikeza ukusekelwa okudingeka kakhulu ngokomzwelo.

Ukwelashwa

Noma ngubani otholakala enefomu ebuyela emuva ye-MS cishe uzoqala ukwelashwa ngomuthi oguqula izifo ovunyiwe yi-FDA. Lokhu kufaka phakathi abantu abahlangabezana nomcimbi wokuqala wokwelashwa ohambisana ne-MS. Ukwelashwa ngomuthi olungisa izifo kufanele kuqhubeke unomphela ngaphandle kokuthi isiguli sinempendulo engeyinhle, sihlangabezane nemiphumela emibi engabekezeleleki, noma singathathi umuthi njengoba kufanele. Ukwelashwa kufanele futhi kushintshe uma kutholakala indlela engcono.

I-Gilenya (fingolimod)

Ngo-2010, uGilenya waba yisidakamizwa sokuqala somlomo sezinhlobo ezibuyela emuva ze-MS ukuze zivunyelwe yi-Food and Drug Administration (FDA). Imibiko ikhombisa ukuthi singanciphisa ukubuyela emuva ngesigamu futhi sinciphise ukuqhubeka kwesifo.

I-Teriflunomide (Aubagio)

Inhloso enkulu yokwelashwa kwe-MS ukunciphisa ijubane ukuqhubeka kwesifo. Izidakamizwa ezenza lokhu zibizwa ngemithi yokuguqula izifo. Omunye wemithi enjalo yisidakamizwa somlomo i-teriflunomide (Aubagio). Kwavunyelwa ukusetshenziswa kubantu abane-MS ngo-2012.

Ucwaningo olushicilelwe kuThe New England Journal of Medicine luthole ukuthi abantu abane-MS ebuyela emuva abathathe i-teriflunomide kanye ngosuku bakhombise ukukhula kwamazinga okuhamba kancane kwezifo nokubuyela emuva okumbalwa kunalabo abathathe i-placebo. Abantu abanikezwe umthamo ophakeme we-teriflunomide (14 mg vs. 7 mg) babone ukwehla kwesifo okuqhubekayo. I-Teriflunomide kuphela kwaba yimithi yesibili yokuguqula isifo somlomo evunyelwe ukwelashwa kwe-MS.

I-Dimethyl fumarate (iTecfidera)

Umuthi wokuguqula isifo somlomo wesithathu utholakale kubantu abane-MS ngoMashi ka-2013. I-Dimethyl fumarate (Tecfidera) phambilini ibiyaziwa nge-BG-12. Imisa amasosha omzimba ekuzihlaseleni nasekucekeleni phansi i-myelin. Kungaba nomphumela wokuvikela emzimbeni, ofana nomphumela ama-antioxidants anawo. Umuthi utholakala ngefomu le-capsule.

I-Dimethyl fumarate yenzelwe abantu abane-MS ebuyisela emuva kabusha (RRMS). I-RRMS iyindlela yesifo lapho umuntu eya khona ekuxolelweni isikhathi esithile ngaphambi kokuba izimpawu zabo zibe zimbi kakhulu. Abantu abanalolu hlobo lwe-MS bangazuza emithamo ephindwe kabili yezinsuku zalo muthi.

I-Dalfampridine (Ampyra)

Ukubhujiswa kwe-myelin okubangelwa yi-MS kuthinta indlela izinzwa ezithumela futhi zamukele ngayo amasiginali. Lokhu kungathinta ukunyakaza nokuhamba. Iziteshi ze-potassium zifana nama-pores ebusweni bezintambo zezinzwa. Ukuvimba iziteshi kungathuthukisa ukuqhutshwa kwezinzwa emithanjeni ethintekile.

IDalfampridine (Ampyra) isivimbeli sesiteshi se-potassium. Ucwaningo lushicilelwe lathola ukuthi i-dalfampridine (eyayibizwa nge-fampridine) yandisa isivinini sokuhamba kubantu abane-MS. Ucwaningo lwasekuqaleni luhlolisise isivinini sokuhamba ngesikhathi sokuhamba ngezinyawo ezingama-25. Akukhombisanga ukuthi i-dalfampridine inenzuzo. Kodwa-ke, ukuhlaziywa kwangemuva kokufunda kuveze ukuthi ababambiqhaza bakhombise ukwanda kwejubane lokuhamba ngesikhathi sokuhlolwa kwemizuzu eyisithupha lapho bethatha i-10 mg yomuthi nsuku zonke. Ababambiqhaza abathole ukukhuphuka kwesivinini sokuhamba baphinde babonisa amandla esimbaqa omlenze.

I-Alemtuzumab (Lemtrada)

I-Alemtuzumab (i-Lemtrada) iyi-antibody monoclonal humanized (ilebhu ekhiqize amaprotheni aqeda amangqamuzana omdlavuza). Kungenye i-ejenti yokuguqula izifo evunyelwe ukwelapha amafomu abuyayo e-MS. Ikhomba iprotheni ebizwa nge-CD52 etholakala ebusweni bamaseli omzimba. Yize kungaziwa kahle ukuthi i-alemtuzumab isebenza kanjani, kukholelwa ukuthi ibophezela ku-CD52 kuma-lymphocyte ka-T no-B (amaseli egazi amhlophe) futhi kubangele i-lysis (ukuwohloka kweseli). Lesi sidakamizwa savunywa kuqala ukwelapha i-leukemia ngomthamo ophakeme kakhulu.

U-Lemtrada wakuthola kunzima ukuthola ukuvunywa kwe-FDA e-United States. I-FDA yasenqaba isicelo sokuvunywa kweLemtrada ekuqaleni kuka-2014. Bacaphuna isidingo sokuhlolwa okwengeziwe kwemitholampilo okukhombisa ukuthi inzuzo idlula ubungozi bemiphumela emibi kakhulu. I-Lemtrada yabuye yamukelwa yi-FDA ngoNovemba 2014, kepha iza nesixwayiso mayelana nezimo ezibucayi zokuzivikela komzimba, ukusabela kwe-infusion, kanye nobungozi obandayo bezimpawu ezimbi ezifana ne-melanoma neminye imidlavuza. Kuqhathaniswe nomuthi we-MS we-EMD Serono, uRebif, ezilingo ezimbili zesigaba III. Izilingo zithole ukuthi bekungcono ekwehliseni izinga lokubuyela emuva kanye nokuwohloka kokukhubazeka ngaphezu kweminyaka emibili.

Ngenxa yephrofayili yayo yezokuphepha, i-FDA incoma ukuthi inikezwe kuphela iziguli ezinempendulo enganele emithini yokwelashwa emibili noma ngaphezulu ye-MS.

Inqubo yememori yendaba eguquliwe

I-MS ithinta nokusebenza kwengqondo. Kungathinta kabi inkumbulo, ukugxila, nemisebenzi ephezulu njengokuhlela nokuhlela.

Abaphenyi abavela eKessler Foundation Research Center bathole ukuthi inqubo yememori eguquliwe (mSMT) ingasebenza kubantu ababhekana nemiphumela yokuqonda evela ku-MS. Izindawo zokufunda nezememori zobuchopho zikhombise ukwenziwa okuningi kokuskena kwe-MRI ngemuva kwezikhathi ze-mSMT. Le ndlela yokwelashwa ethembisayo isiza abantu ukuthi bagcine izinkumbulo ezintsha. Kuyasiza nabantu ukuthi bakhumbule imininingwane emidala ngokusebenzisa ubudlelwane obususelwa endabeni phakathi kwezithombe nomongo. Inqubo yememori yezindaba eguquliwe ingasiza umuntu one-MS ukuthi akhumbule izinto ezahlukahlukene ohlwini lwezitolo, ngokwesibonelo.

Ama-peptide kaMyelin

I-Myelin ilimala ngokungenakulungiseka kubantu abane-MS. Ukuhlolwa kokuqala okubikwe ku-JAMA Neurology kusikisela ukuthi ukwelashwa okusha okungenzeka kunesithembiso. Iqembu elilodwa elincane lezifundo lathola ama-myelin peptides (izingcezu zamaprotheni) ngesiqeshana esigqokwa esikhunjeni sabo isikhathi esingangonyaka. Elinye iqembu elincane lathola i-placebo. Abantu abathole ama-pepelide e-myelin babhekana nezilonda ezimbalwa kakhulu futhi babuyela emuva kunabantu abathola i-placebo. Iziguli zikubekezelele ukwelashwa kahle, futhi bekungekho izehlakalo ezimbi kakhulu.

Ikusasa Lokwelashwa kwe-MS

Imithi yokwelapha esebenzayo ihlukahluka kuye ngomuntu. Okusebenza kahle komunye umuntu ngeke nakanjani kusebenzele omunye. Umphakathi wezokwelapha uyaqhubeka nokufunda kabanzi ngalesi sifo nokuthi singaselapha kanjani kangcono. Ucwaningo oluhlanganiswe nokuzama nokwenza amaphutha kungukhiye ekutholeni ikhambi.