Imiphumela ibonisa ukuthi lesi sidakamizwa singanciphisa isifo se-Alzheimer
Angikuthandi izihloko zokubhala mayelana nesifo sengqondo sokugula kanye nesifo se-Alzheimer . Isifo se-Alzheimer isifo esibuhlungu. Iqhubeka ngokuqhubekayo. Izidakamizwa ezigunyazwe yi-FDA zokwelapha lesi sifo njengo-Aricept, Nemenda, noCognex benza okuncane ukuphuza inkambo yezokwelapha.
Iningi lama-neurologists liyazi ukuthi imithi ayinani elilinganiselwe iziguli zabo ezine-Alzheimer's disease.
Noma kunjalo, abathandekayo bacela le mithi ngethemba lokuthi le midlalo ingasiza ngandlela-thile encane. Ekugcineni, ukwelashwa okungcono kakhulu kulabo abane-Alzheimer's isifo sokunakekelwa ngokwemvelo okungagcini nje ukugcina izinga elihle lokuphila lomuntu onesifo kepha futhi izinga lokuphila lomnakekeli ngokwakhe.
Naphezu kokuphazamiseka kwami okujwayelekile kokubhala izihloko mayelana nesifo se-Alzheimer, ngivumelene nami ukumboza lesi sifo kuphela uma isilingo sesinye sezidakamizwa somtholampilo sikisela ukunciphisa ukuncipha kwengqondo kulabo abanesifo. Muva nje, imiphumela embi kakhulu ekuhloleni okubandakanya i-adoganumab ye-Biogen ibonisa ukuthi le-anti-monoglonal i-antioclonal ingavimbela ukuqhubeka komtholampilo wesifo se-Alzheimer.
Isifo se-Alzheimer yisimo esivame kakhulu sokuwohloka komqondo. E-United States, kulinganiselwa ukuthi abayizigidi ezingu-5 baseMelika abaneminyaka engama-65 nangaphezulu bahlala nesifo. Inkambo yesifo se-Alzheimer ihamba kancane futhi ingenakuphika.
Ngokuhamba kwesikhathi, inkumbulo ye-Alzheimer's memory, ukucabanga, nokucabanga. Ekugcineni, umuntu onalesi sifo esibuhlungu esisele akakwazi ukwenza ngisho nemisebenzi elula nemisebenzi yokuphila kwansuku zonke.
Incazelo yethu yamanje mayelana ne- pathology ye-Alzheimer's disease ikhawulelwe "hypothesis" yama-amyloid . Ngokucacile, i-neurodegeneneration ivela kwidiphodi yama-amyloid-beta (Aß) e-plaque-tissu plaques.
Ukuqoqwa kwe-Aß kuqhuba i-alzheimer's disease pathogenesis. Esinye isici esibangelwayo sihilela izintambo ze-neurofibrillary ezakhiwe ngamaprotheni. Ukungafani phakathi kokukhiqizwa kwe-Aß no-Aß imvume kuholela ekubunjweni kwalezi zingxube.
Kuze kube manje, i-bevy ye-antibodies ehlukene iye yasungulwa ukuze ilwa nesifo se-Alzheimer ngokubhekelela ama-amyloid. Ngokuqondile, i-antibody aducanumab isebenza ngokususa i-phagocytosis e-Fc-receptor-mediator ye-Aß plaques. Ngamanye amazwi, i-aducanumab igqugquzela ama-phagocytes omzimba wethu ukumba i-Aß.
Eminyakeni yamuva, "i-hypothesis" ye-amyloid ibuzwe ngokungathí sina futhi ibhalwe ochwepheshe abaningi njengokwedlulele. Asisenaso ukuqinisekiswa kwemitholampilo ye-hypothesis, futhi abaningi bakholelwa ukuthi ukuqoqwa kwe-Aß kungahle kube yingxenye yenqubo ekhudlwana futhi engaqondakali edala ukungena kwemvelo. Ngokuqondile, kulabo abanesifo se-Alzheimer, i-Aß ibeka phambili ekunciphiseni kwengqondo ngeminyaka eyi-10 kuya kwengu-15 ngaleyo ndlela ihlanganisa ukuphakanyiswa kobudlelwane obulula nezimbangela. Ngaphezu kwalokho, ukugcoba umzimba kwamaprotheni we-amyloid (APP) akubanga nje i-Aß kodwa futhi nezinye izingcezu ezingadlala indima e-Alzheimer's pathogenesis.
Ngokusekelwe emiphumeleni yesikhashana yesigaba se-Phase 1b sokuhlolwa komtholampilo we-aducanumab okuthiwa yi-PRIME, i-Biogen izinikele ekuvivinyweni komtholampilo wesiGaba sesi-3 somuthi.
Nawa amanye ala miphumela yesikhashana:
- Ukwelashwa nge-aducanumab kwaholela ekunciphiseni amakhekhe ama-amyloid kubantu abane-prodromal noma abano-Alzheimer's disease mild.
- Ukunciphisa emaceleni kwakuboniswa ngeso lengqondo ngokusebenzisa izithombe ze-PET, futhi lokhu kuncishiswa kwakuyi-dose-futhi kuncike isikhathi.
- Ngemuva konyaka owodwa wezokwelapha, abahlanganyeli abanesifo sokuqala se-Alzheimer babonisa ukwehliswa komzimba ekubhekaneni nokukhubazeka kwengqondo njengoba kuhlolwe yi-Mini-Mental Status Examination (MMSE) kanye neCognitive Dementia Rating.
- Ukuphepha nokubekezela kwesineke kwe-aducanumab kwamukelekile. Eminye imiphumela emibi ihlanganisa ubuhlungu bekhanda kanye ne-ARIA (okungafani nokufanekisa okuhlobene nama-amyloid).
Ukuze imithi ye-Alzheimer noma enye imithi emisha ezovunyelwa yi-FDA, kufanele idlule ngezivivinyo zesigaba sesi-3. Njengoba kuxoxwa esihlokweni esanda kuqukethe esithi "Izivivinyo eziphambili ze-b-secretase inhibitors e-Alzheimer's" ezivela ku- Nature Biotechnology , abanye abakhiqizi bemithi yezidakamizwa ze-Alzheimer baqhubekela ekuvivinyweni kweSigaba 3. Lo mkhuba ubungozi ngoba imiphumela engakabaluleki emtholampilo kusukela esilingo sesigaba sesi-3 izovala ukuthuthukiswa kwezidakamizwa. Phela, akekho ofuna ukutshala imali emshini "wokushiswa".
Ngenxa yokuthi umuthi uhluleka ukubonisa imiphumela emitholampilo ngesikhathi esivivinyweni esithile seSigaba sesi-3 akusho ukuthi umuthi awusebenzi. Isibonelo, kungenzeka ukuthi isidakamizwa singasebenza ngempumelelo kumazinga ahlukile kulabo ahlolwe. Noma, ezinye izidakamizwa zisebenza kangcono kunabantu abathile. Esikhundleni sokudlula i-Rubicon nokuya esivivinyweni sesigaba sesi-3, kuwumqondo omuhle ukwenza isilingo sokuhlola esiGabeni sesi-2 futhi uqonde kangcono imithi nemiphumela yayo. Ngokuphambene nalokho, i-Biogen inqume ukuqhubeka nezivivinyo zokwelapha zesigaba sesi-3 ngaphandle kokugqugquzela imiphumela yesikhashana kusuka ekuhlolweni kweSigaba 1b kusuka (ezincane).
Uma wena noma othandekayo ehlushwa isifo se-Alzheimer, sicela ufunde lesi sihloko ngaphakathi komongo futhi ngaphandle kwethemba elingamanga. I-Biogene isengakapheli isikhathi sokuthola imvume ye-aducanumab, futhi sisadinga imiphumela eminingi yemitholampilo eminingi. Nakuba imiphumela yokuqala ephathelene ne-aducanumab iyathembisayo, izidakamizwa ze-Alzheimer ziyaziwa ngokuthi zihluleka ukusika isardadi, futhi asikaze sithole ukwelashwa okuphumelelayo ngempela okuhloswe ukunciphisa ukuqhubeka kwalesi sifo.
Imithombo ekhethiwe
Isihloko esithi "I-Hypothesis Yama-Amyloid yezifo ze-Alzheimer: Intuthuko Nezithembiso Emgwaqweni Wezokwelapha" nguJ Hardy no-DJ Selkoe eshicilelwe eSayensi ngo-2002. Ukutholakala ngo-3/2/2015.
Ropper AH, Samuels MA, Klein JP. Isahluko 39. Izifo ezithathelwanayo zesimiso sezinzwa. Ku: Ropper AH, Samuels MA, Klein JP. ama-eds. I-Adams ne-Victor's Principles of Neurology, 10e . ENew York, NY: McGraw-Hill; 2014. Kufinyelelwe kuMashi 22, 2015
Isihloko esithi "Izivivinyo ezibalulekile ze-ß-secretase inhibitors e-Alzheimer's Cormac Sheridan enyatheliswa ku- Nature Biotechnology ngonyaka ka-2015. Itholakale ngo-3/22/2015.