Imithi yokwehlisa i-COX kungenzeka ingabi into enhle
Ubuhlungu nokuvuvukala, isikhalazo esiyinhloko sabantu abaningi esikhathini esithile empilweni yabo kanye nesenzakalo esivamile nsuku zonke kubantu abaningi abane-arthritis, ngokuyinhloko kubangelwa i-cyclooxygenase, noma i-COX, okwesikhashana.
I-COX iyi-enzyme eyenza i-prostanoids- i- prostaglandins , i-prostacyclins, ne-thromboxanes-okuyiyona yonke into enomthwalo wokuvuvukala.
Kuvela ukuthi i-COX akuyona yonke into embi, kudingekile ngisho nezinqubo ezivamile zeselula.
Izidakamizwa ezihloswe ukuvimbela i-COX yokukhulula ukuvuvukala, kubonakala sengathi ingumqondo omuhle, kodwa ngokuvimbela i-COX, kunesici.
I-COX-1 ne-COX-2
Ngawo-1990, kwatholakala ukuthi kunezinhlobo ezimbili ze-enzyme COX-1 ne-COX-2. Lezi zinsuku yizinto ezithandeka kakhulu kulabo ababili. I-COX-1 iyaziwa ukuthi ikhona ezinhlobonhlobo eziningi. Esikhathini samathumbu emathunjini, i-COX-1 igcina i-lining evamile yesisu futhi ivikela isisu kusuka emajusi wokugaya. I-enzyme nayo ihilelekile ekusebenzeni kwezinso nezinhlamvu. I-COX-2 itholakala ngokuyinhloko kumasayithi wokuvuvukala.
Kokubili i-COX-1 ne-COX-2 ingabangela ubuhlungu nokuvuvukala, kodwa kusukela i-COX-1 iyi-enzyme enenzuzo, ukusebenzisa izidakamizwa ukuvimbela kungenzeka ukuthi ingabi umbono omuhle kangaka.
Ama-NSAID ayavimbela i-COX
Izidakamizwa eziphikisayo ezingezona ukuvuvukala (ama-NSAID), ngokuvamile azinqunyelwe ukuphatha i-arthritis, ukusebenza ngokuvimbela i-prostaglandins. I-NSAID yendabuko, njenge-ibuprofen ne-naproxen, ingabangela izinkinga zamathumbu kubandakanya izilonda .
Lawa ma-NSAID ayinqamuki, okusho ukuthi ayavimbela kokubili i-COX-1 ne-COX-2. Ukuvinjelwa kwe-COX-2 nge-NSAID yendabuko kuyasiza ngemiphumela yayo yokulwa nokuvuvukala, kodwa ukuphazamiseka ukuvimbela kwe-COX-1 kungabangela imiphumela emibi njengezilonda, isikhathi sokuphuza isikhathi eside nezinkinga zezinso.
I-COX-2 I-NSAID Ekhethiwe
Ngasekupheleni kweminyaka yama-1990, izinkampani zezidakamizwa zakha imithi eminingana eyayihlose i-COX-2 kuphela, la ma-NSAID ayeyiCelebrex, i-Vioxx no-Bextra.
Kulawa, i-Celebrex yiyona kuphela imithi ehlala emakethe e-United States futhi ibhokisi elimnyama lixwayisa ukuthi lifaka ingozi yokuhlaselwa inhliziyo kanye nokushaywa yisifo.
Kusukela ekuhoxisweni kwe-Vioxx ngo-2004, i-US Food and Drug Administration ihlolisise lonke iklasi yezidakamizwa, kuhlanganise wonke ama-NSAID kanye ne-COX-2 inhibitors ezathengiswa ngaphezulu kwe-counter noma ngomshwalense, futhi wanezela izixwayiso zamabhokisi amnyama ezimisweni ezibekiwe .
Ezinye ezimbili ze-COX-2 inhibitors, i-Arcoxia ne-Prexige, ezisetshenziswa kwamanye amazwe, zenqatshelwe yi-FDA. I-Prexige isuswe emakethe e-Australia naseCanada ngenxa yokucindezeleka kwesibindi.
Abanye abacwaningi bakholelwa ukuthi, ngemuva kokuthola amazinga aphansi e-COX-2 kwezinye izicubu ezingezona ezibulalayo, i-COX-2 ingase ibe nendima emisebenzini ethile evamile yomzimba ngaphandle kokuvuvukala. Abacwaningi base-UK bathole ukuthi i-COX-2 ingase ivikele ukulwa ne-atherosclerosis, inkulumo yezokwelapha ngokuqina kogu, ukugxila nokugqoka.
Nakuba ama-NSAID kanye ne-COX-2 inhibitors kubhekwa njengendlela yokwelashwa okuphawulekayo yeziguli ze-arthritis , inzuzo kanye nezingozi kumele kucatshangelwe isiguli ngasinye. Ingozi ye-cardiac kanye nenhlobo engcono kakhulu ye-NSAID okufanele isetshenziswe kufanele ihlolwe.
> Imithombo
> I-Arthritis Foundation. Ama-NSAID.
> Bathon, uJoan M. Ukuxoxisana nge-Specific COX-2 Inhibitors. Isikhungo se-Arthritis sikaJohn Hopkins.
> Kirkby N, Lundberg M, Wright W, Warner T, Paul-Clark M, Mitchell, J. COX-2 Uvikela Ukuvimbela I-Atherosclerosis Ngokuzimela kwe-Local Vascular Prostacyclin: Ukukhomba kwe-COX-2 Associated Pathways Implicate Rgl1 neLymphocyte Networks. PLOS One. Juni 2, 2014.