Indlela Immunotherapy Ingasiza Ngayo Izindlela Zethu Zokuzivikela Ngomzimba Ukulwa Nomdlavuza
Uma uzizwa udidekile ngokuqondile ukuthi i-immunotherapy isebenza kanjani ukuphatha umdlavuza, kunesizathu esihle. I-Immunotherapy akuyona nje uhlobo olulodwa lwezokwelapha; Kunalokho kunezinhlobo eziningana zokwelapha ezihlukene kakhulu eziwela ngaphansi kwalesi sihloko. Okuvamile ukuthi lezi zokwelapha zingasebenzisa isimiso somzimba sokuzivikela, noma izimiso zokuphendula komzimba, ukulwa nomdlavuza.
Ngamanye amazwi, lezi zonyango, ezibizwa ngokuthi yi-biologic therapy, zisetshenziselwa ukushintsha amasosha omzimba noma ukusebenzisa izinto ezenziwe yisistimu yomzimba wokulwa nomdlavuza.
Kungani I-Immunotherapy Inenjabulo Kakhulu?
Uma usufunde iphephandaba maduzane, mhlawumbe uke wabona izihloko ezinemiyalezo ephawulekayo njengokuthi "ukwelashwa kuseduze" lapho kuchaza i-immunotherapy. Ingabe lokhu kuyinto enokuthakazelisa ngayo, noma ingabe i-media hype nje?
Ngenkathi sesiqala ukufunda ngalezi zindlela zokwelapha, futhi ngokuqinisekile azisebenzi kuwo wonke amagciwane, insimu ye-immunotherapy iyinto engayithokozisa ngayo. Empeleni, i-immunotherapy yabizwa ngokuthi ngumdlavuza we-2016 wonyaka odlule yi-American Society of Clinical Oncology. Kulabo abaphila nomdlavuza, le nsimu, kanye nentuthuko yezokwelapha ezifana nemithi ehlosiwe, izizathu zokuzizwa unethemba-hhayi nje ngekusasa, kodwa okwamanje.
Ngokungafani nentuthuko eminingi ye-oncology eyenza ukwelashwa kwangaphambili, i-immunotherapy iningi indlela entsha ngokuphelele yokwelapha umdlavuza (ama-immunator-immune modulators anjenge-interferon asekudlule amashumi ambalwa eminyaka). Uma kuqhathaniswa nezinye eziningi zokwelashwa:
- Ezinye zalezi zelashwa zingasebenza kuwo wonke uhlobo lomdlavuza (ngamanye amazwi, izidakamizwa zingasebenza, zithi, i-melanoma nomdlavuza wamaphaphu).
- Ezinye zezokwelapha zingase zisebenze kakhulu kakhulu futhi zinkimbinkimbi kakhulu ukuphatha ukwelashwa (isibonelo, zingase ziphumelele kumdlavuza njengomdlavuza wamaphaphu ophakeme noma umdlavuza we-pancreatic).
- Kwezinye izimo, imiphumela ihlala njalo-yiziphi izacologists ezibhekisela kuzo ngokuthi "impendulo ehlala njalo." Iningi lemithi yomdlavuza yezinambuzane eziqinile, njenge-chemotherapy kanye nezidakamizwa ezibhekisela ekuguquleni okwenziwe ngofuzo emangqamuzaneni omdlavuza, zilinganiselwe; Amaseli omdlavuza ekugcineni abe yimithi yokwelashwa. Ngenkathi kungekho muntu ozama ukuhlehlisa igama elithi "ukwelashwa" okwamanje, kunethemba lokuthi kubambalwa abantu abanezinye izinhlobo zemithi kancane-le mithi inganikeza ithuba lokulawula isikhathi eside umdlavuza wabo.
Umlando we-Immunotherapy
Umqondo we-immunotherapy uye waba khona isikhathi eside. Ekhulwini leminyaka edlule, udokotela owaziwa ngokuthi uWilliam UColey waphawula ukuthi ezinye iziguli, lapho zitheleleke ngamabhaktheriya, zibonakala zilwa namagciwane azo. Omunye udokotela ogama lakhe linguSteven Rosenberg kuthiwa ubuza imibuzo ngesimo esihlukile ngomdlavuza. Ngezikhathi ezingavamile, umdlavuza ungase uphume ngaphandle kokwelapha. Lokhu kuxoxwa okuzenzekelayo noma ukuvuselelwa komdlavuza kuye kwabhalwa, nakuba kuyinto engavamile kakhulu.
Umbono kaDkt. Rosenberg wukuthi isisombululo sakhe somzimba sesiguli sasihlasela futhi sawuqeda umdlavuza.
Ithiyori Behind Immunotherapy
Imfundiso ye-immunotherapy iwukuthi amasosha omzimba ethu awazi kakade ukulwa nomdlavuza. Njengoba nje imizimba yethu iyakwazi ukubona, ukubeka uphawu, nokubeka impendulo yomzimba ngokumelene nama-bacterium kanye nama-virus ahlasela imizimba yethu, amangqamuzana omdlavuza nawo angafakwa njengomuntu ongavamile futhi aqedwe amasosha omzimba.
Khona-ke Kungani Amasistimu Wethu Okuzivikela Emzimbeni Akulwa NamaKhansela?
Ukufunda mayelana nokusetshenziswa kwezidakamizwa ze-immunotherapy kumbuza lo mbuzo: "Uma amasosha omzimba ethu ekwazi ukulwa nomdlavuza, kungani?
Kwenzeka kanjani ukuba owesilisa kwababili namunye kwabafazi abathathu bahlakulele umdlavuza esikhathini sokuphila kwabo? "
Okokuqala, amasosha omzimba ethu asebenze kahle kakhulu ekuhlanzeni amangqamuzana awonakele angagcina abe namagciwane omdlavuza. Sinezifo eziningana ezakhiwe e-DNA yethu, eyaziwa ngokuthi i- tumor suppressor geni , ehlinzeka uhlelo lweprotheyini elungisa futhi lahlehla umzimba wamaseli awonakele. Mhlawumbe umbuzo ongcono ungase ube, "kungani sonke singakha umdlavuza kaningi?"
Akekho owazi kahle ukuthi kungani amanye amangqamuzana omdlavuza ebalekela ukutholakala nokubhujiswa amasosha omzimba. Ingxenye yesizathu, kucatshangwa, yilawo amangqamuzana omdlavuza angase abe nzima ukuthola ukwedlula amabhaktheriya noma ama-virus ngenxa yokuthi avela kumaseli abhekwa njengesijwayelekile ngamasosha ethu omzimba. Amangqamuzana omzimba aklanyelwe ukwahlukanisa lokho abakubonayo njengeyedwa noma engeyona eyedwa, futhi njengoba amangqamuzana omdlavuza avela emangqamuzaneni avamile emizimbeni yethu, angase ahambe ngokujwayelekile. Umthamo omkhulu wamangqamuzana omdlavuza nawo ungadlala indima, nenani lamangqamuzana omdlavuza emzimbeni onamandla okwenza inani elincane lamaseli omzimba omzimba.
Kodwa isizathu mhlawumbe sinesisindo ngaphezu kokuqaphela noma izinombolo-noma okungenani, amangqamuzana omdlavuza akhathazekile. Ngokuvamile amangqamuzana omdlavuza avimbela isimiso somzimba sokuzivikela ngokuziqhenya ngokuthi "afane" njengamaseli avamile. Amanye amangqamuzana omdlavuza ahlolisise izindlela zokuzifihla, ukufaka imaski uma uthanda. Ngokufihla ngale ndlela bangakwazi ukuphunyuka ukuthola. Eqinisweni, uhlobo olulodwa lwe-immunotherapy drug lusebenza ngokuyisisekelo ekukhipheni imaski kusuka kumangqamuzana omzimba.
Njengombhalo wokugcina, kubalulekile ukuqaphela ukuthi isimiso somzimba sokuzivikela sine-balance balance of checks kanye nezilinganiso. Ngakolunye uhlangothi kubalulekile ukulwa nabahlaseli bangaphandle. Ngakolunye uhlangothi, asifuni ukulwa namaseli emzimbeni wethu, futhi empeleni, izifo ezizimele njenge-arthritis ye-rheumatoid zihlobene "nesistimu yomzimba yokuzivikela ngokweqile."
Ukulinganiselwa kwe-Immunotherapy
Njengoba ufunda, kubalulekile ukuqaphela ezinye izilinganiso ze-immunotherapy kuleli sigaba sokuthuthukiswa. Omunye we-oncologist ukhulume ngale ndlela ngale ndlela: imithi yokugoma i-immunotherapy iwukukwelashwa komdlavuza njengoba iWright Brothers kuqala ukushayela indiza. Insimu ye-immunotherapy isencane.
Siyazi ukuthi lezi zokwelapha azisebenzi kuwo wonke umuntu, noma ngisho naseningi labantu abane-kansa eminingi. Ngaphezu kwalokho, asikho isibonakaliso esicacile sokuthi ngubani ozozuza ngokuqondile kulezi zidakamizwa. Ukusesha ama-biomarker, noma ezinye izindlela zokuphendula lo mbuzo, kuyindawo esebenzayo yocwaningo ngalesi sikhathi.
Ukubukezwa Okufishane kohlelo lwe-Immune kanye neCanscer
Ukuze uqonde kancane mayelana nokuthi lezi zindlela zokwelashwa zisebenza kanjani, kungasiza ukubuyekezwa kafushane ukuthi uhlelo lwamasosha omzimba lusebenza kanjani ukulwa nomdlavuza. Isivikeli sethu somzimba sakhiwa ngamaseli amhlophe egazi kanye nezicubu zesimiso se-lymphatic ezifana namagciwane lymph. Ngenkathi kunezinhlobo eziningi ezahlukene zamaseli kanye nezindlela zamangqamuzana eziholela ekususweni kwamangqamuzana omdlavuza, "izibhamu ezinkulu" emdlalweni wokulwa nomdlavuza yi- T-cell (T lymphocytes) namaseli okubulala emvelo . Lo mhlahlandlela ophelele wokuqonda amasosha omzimba inikeza ingxoxo ejulile yezinto eziyisisekelo zokuphendula ngegciwane lesigciwane.
Indlela Yokuzivikela Ngomzimba Ilwa Nesifo SeKhansela?
Ukuze silwe namaseli omdlavuza, kunemisebenzi eminingi yezivikeli zethu zomzimba ezidingekayo. Ngokulula, lezi zihlanganisa:
- Ukuqapha: Isivikelo somzimba sokuzivikela kufanele kuqala sithole futhi sibone amaseli omdlavuza. Amasosha omzimba wethu adinga kokubili ukuhlola wonke amaseli phakathi kwawo futhi akwazi ukubona amangqamuzana omdlavuza njengengewona. Ukufaniswa kwakuyoba isisebenzi sehlathi esihamba ehlathini efuna izihlahla ezigulayo.
- Ukumaketha: Uma sekutholakale, isimiso sethu somzimba sokuzivikela sisidinga ukuphawula noma ukubeka amaleli amangqamuzana omdlavuza wokubhujiswa. Ukulandela ukufanisa, isisebenzi sehlathi kufanele sidinge noma sithele izihlahla ezigulayo ngopende lwe-orange spray.
- Ukubonisa: Uma amangqamuzana omdlavuza ephawulwe, amasosha omzimba ethu adinga ukuzwakala i-alamu, akhange amasosha omzimba alwa nomdlavuza esifundeni lapho atholakala khona. Ukuqhubeka nokufanekisa, isisebenzi sehlathi kufanele sibuyele ehhovisi lakhe kanye nefoni, umbhalo, kanye ne-imeyli isevisi yomuthi ukuza nokususa izihlahla ezigulayo.
- Ukulwa: Uma amangqamuzana omdlavuza ebonakala futhi ephawulwa, futhi amasosha omzimba aphendule i-alamu futhi athuthela esakhiweni, amangqamuzana e-cytotoxic T kanye namangqamuzana ombulali wemvelo ahlasela futhi asuse amangqamuzana omdlavuza emzimbeni. Ekugcineni, ekufanekiseni, izisebenzi zomsebenzi wesihlahla ziyonquma futhi zisuse izihlahla ezigulayo.
Lesi sihloko sendlela ama-T alwela ngayo ukulwa nomdlavuza uchaza indlela lezi zinyathelo ezenzeka ngayo, futhi lesi sihloko ngomjikelezo wokuvikela umkhuhlane sinikeza imidwebo yamanyathelo ngabanye.
AmaKhansela E-Cancer Afihla Kanjani Amasimu Omzimba?
Kungasiza futhi ukwazi ukuthi amangqamuzana omdlavuza avame ukugwema ukutholakala noma ukuhlaselwa amasosha omzimba wethu. Amaseli e-Cancer angafihla nge:
- Ukwehlisa ukubonakaliswa kwama-antigens ebusweni bamaseli. Lokhu kungafana nezihlahla ezisusa izimpawu zesifo sabo emagatsheni noma emaqabunga awo.
- Ukuveza izinto ezingaphezulu kweseli ezivimbela isimiso somzimba sokuzivikela. Amaseli e-Cancer angakhipha ama-molecule anciphisa ukuphendula kwamagciwane. Ngokufana, izihlahla zaziyokwenza okuthile ukuxosha abasebenzi basehlathini kanye nensizakalo yomuthi.
- Amaseli e-Cancer angabangela futhi amangqamuzanzana angewona umdlavuza oseduze ukuba akhiphe izinto ezinciphisa ukusebenza komzimba omzimba. Le ndlela ibizwa ngokuthi iguqula i-microenvironment, indawo ezungeze amangqamuzana omdlavuza. Ukunciphisa lesi sifaniso, izihlahla ezigulayo ziyocela abadobi namaLila ukuthi bahlanganyele ukuze basize abasebenzi behlathi.
Uma udidekile ngokunye okungafani phakathi kwamangqamuzana omdlavuza, nokuthi yini eyenza amangqamuzana omdlavuza ayingqayizivele, izihloko ezilandelayo zixoxa ngalokho okwenza iseli umdlavuza weselula , futhi umehluko phakathi kwamangqamuzana omdlavuza namaseli avamile .
Izinhlobo nezinqubo ze-Immunotherapy
Kungenzeka ukuthi wezwa i-immunotherapy echazwe njengendlela yokwelapha "eqinisa" isimiso somzimba sokuzivikela. Lezi zokwelapha empeleni ziyinkimbinkimbi kakhulu kunokuba nje ukunikeza amasosha omzimba amandla. Ake sibheke ezinye zezindlela ezisebenza ngayo i-immunotherapy, kanye nezigaba zokwelapha ezisetshenziswayo noma ezifundwe namhlanje.
Izindlela ze-Immunotherapy
Ezinye izindlela lapho imithi yokugoma i-immunotherapy ingaphatha umdlavuza ihlanganisa:
- Ukusiza amasosha omzimba aqaphele umdlavuza
- Ukuvuselela nokukhulisa amaseli omzimba
- Ukukwazi ukufihla ikhanda lomdlavuza we-cancer (de-masking)
- Ukungena nge-microenvironment yamangqamuzana omdlavuza ngokushintsha izibonakaliso zesifo somdlavuza
- Ukusebenzisa izimiso zamasosha omzimba wethu njengesifanekiso sokuklama imithi yomdlavuza
Izinhlobo ze-Immunotherapy
Izindlela ze-Immunotherapy ezivunyelwe noma ezihlolwe ezivivinyweni zomtholampilo zibandakanya:
- Ama-antibodies omzimba
- I-inhibitors yokuhlola
- Imishanguzo yegciwane
- Izindlela zokwelapha zeselula ezithathayo ezifana ne-CAR T-cell therapy
- Ama-virus we-oncolytic
- Ama-Cytokines
- I-Adjuvant immunotherapy
Kubalulekile ukuthi uqaphele ukuthi kukhona ukweqa okuphawulekayo phakathi kwalezi zindlela zokwelapha. Isibonelo, imithi esetshenziselwa i-inhibitor yokuhlola ingase ibe i-antibody monoclonal.
Ama-Antibodies aMonoclonal (Antibodies Therapeutic)
Ama-antibodies omzimba asebenza ngokuwenza amangqamuzana omdlavuza ahlose futhi asetshenzisiwe isikhathi esithile, ikakhulukazi ngamanqamu anjengezinhlobo ezithile ze-lymphoma.
Uma amasosha omzimba ethu ehlangana nama-bacterium kanye namagciwane, imiyalezo ithunyelwa okuholela ekwakheni ama-antibodies. Khona-ke, uma umhlengi ofanayo ekhombisa futhi, umzimba ulungele. Ukugonywa okunjengomkhuhlane wokuguqula umkhuhlane ngokubonisa isimiso somzimba sokuvikela igciwane lesifo somkhuhlane (isibhamu) noma igciwane lesandulela ngculaza (i-spray), ukuze likwazi ukukhiqiza amakhemikhali futhi lilungele uma igciwane lesifo esibukhoma singena emzimbeni wakho.
Ama-antibodies ezithintekayo noma ayenziwa yi-monoclonal asebenza ngendlela efanayo kodwa kunalokho lezi "zenziwe" ngamagciwane okuhloswe ukuhlasela amangqamuzana omdlavuza kunokuba ama-microorganisms. Ama-antibodies axhumene nama-antigens (amaprotheni markers) ebusweni bamangqamuzana omdlavuza, njengesihluthulelo singangena esakhiweni. Lapho nje amakhemikhali omdlavuza ephawulwe noma emakwe, amanye amaseli emasosha omzimba ayaziswa ngokubhubhisa iseli. Ungacabanga ngama-antibodies e-monoclonal afana nepeyinti ye-orange spray ongayibona emthini ogulayo. Lelebula isignali ukuthi iseli (noma isihlahla) kufanele sisuswe.
Olunye uhlobo lwe-anti-monoglonal antibody lungase luhlanganise nesifo se-antigen esitokisini somdlavuza ukuze kuvimbele isignali yokukhula ekufinyeleleni. Kulesi simo, kufana nokubeka ukhiye ekukhiyeni, ukuze omunye ukhiye-isignali yokukhula-ayikwazanga ukuxhuma. Imithi ye-Erbitux (cetuximab) kanye neVectibix (panitumumab) ngokuhlanganisa nokuvimbela i-EFGR receptor (i-antigen) kumaseli omdlavuza. Ngenxa yokuthi umamukeli we-EGFR "uvinjelwe" isignali yokukhula ayikwazi ukunamathela nokutshela iseli lomdlavuza ukuba lihlukanise futhi likhule.
I-anti-monoglonal esetshenziswa kabanzi kakhulu yi-lymphoma imithi i-Rituxan (rituximab). Lezi zinselo zomzimba zibophezela ku-antigen ebizwa ngokuthi i- CD20-isifo se-tumor esitholakala phezulu kwe-B lymphocyte engumdlavuza kwezinye ze-B cell lymphomas.
Ama-antibodies wamonoclonal okwamanje avunyelwe amakhemikhali amaningana. Izibonelo zifaka:
- I-Avastin (i-bevacizumab)
- I-Herceptin (i-trastuzumab)
- I-Rituxan (rituximab)
- I-Vectibix (i-panitumumab)
- I-Erbitux (ceuximab)
- I-Gazyva (obinutuzumab)
Olunye uhlobo lwe-anti-monoglonal antibody luyi-antipecific antibody. Lezi zinselo zomzimba zibophezela kuma-antigens amabili ahlukene. Omunye ubeka umlenze wesifo somdlavuza kanti omunye usebenza ukuze athole isilwane se-T bese uletha bobabili ndawonye. Isibonelo iBlincyto (blinatumomab).
Ama-Antibodies ahlanganisiwe aMonoclonal
Ama-antibodies angama-monoclonal angaphezu kokusebenza yodwa, kodwa amakhomikhali angase afakwe kumuthi we-chemotherapy, i-toxic substance, noma uhla lwe-radioactive ngendlela yokwelapha okuthiwa i- conjugated antibolonal antibodies . Izwi elithi conjugated lisho ukuthi "kufakwe." Kulesi simo, "inkokhelo" ihanjiswa ngqo esitokisini somdlavuza. Ngokuthola i-antibody ehambelana ne-antigen kumakhalekhukhwini wesifo somdlavuza futhi ikhulule "ubuthi" (izidakamizwa, i-toxin, noma i-particle e-radioactive) ngqo emthonjeni, kungahle kube nomonakalo omncane kuzicubu ezinempilo. Eminye imithi yalesi sigaba evunywe yi-FDA ihlanganisa:
- I-Kadcyla (i-ado-trastuzumab): lena i-anti-monoglonal antibody ehlanganiswe nomuthi we-chemotherapy ukuze ukwelaphe umdlavuza webele
- I-Adcetris (i-brentuximab vedotin ): le-antibody nayo ifakwe emthini we-chemotherapy
- I-Zevalin (ibritumomab tiuxetan): le-antibody inamathele kuyi-particle ye-radioactive
- Ontak ( denileukin i-difitox ): lesi sidakamizwa sihlanganisa i-antibody monoclonal ene-toxin evela kubhaktheriya obangela i-diphtheria
I-Immune Checkpoint Inhibitors
I-inhibitors yokuhlola i-immune isebenza ngokuthatha ama-brakes amasistimu omzimba omzimba.
Njengoba kuphawuliwe ngenhla, amasosha omzimba ahlolisise futhi alinganiselwe ukuze angabi ngaphezulu noma angaphili kahle. Ukuze uyigcine ekudleni okungaphezulu kwe-overperforming-futhi edala isifo se-autoimmune-kunezinhloli zokuvimbela ezivimbelayo emgwaqeni wokuzivikela omzimba olawulwa, njengoba nje amabhuleki asetshenziselwa ukunciphisa noma ukuyeka imoto.
Njengoba kuphawuliwe ngenhla, amangqamuzana omdlavuza angase akhohlise futhi akhohlise amasosha omzimba. Enye indlela abenza ngayo lokhu ngamaprotheni wokuhlola. Amaprotheni angama-checkpoint yizinto ezisetshenziselwa ukucindezela noma ukunciphisa amasosha omzimba. Njengoba amangqamuzana omdlavuza avela emangqamuzaneni avamile, anakho ukwenza lezi ziprotheyini kodwa azisebenzise ngendlela engavamile yokubalekela isistimu yomzimba. I-PD-L1 ne-CTLA4 ziyi-protein esibhekene nombolo enkulu kakhulu eminye yamaseli omdlavuza Ngamanye amazwi, amanye amangqamuzana omdlavuza athola indlela yokusebenzisa la "maprotheni ajwayelekile" ngendlela engavamile; Ngokungafani nentsha engase ibe nomkhondo ohamba phambili emotweni yemoto, la ma-protein abeka unyawo oluhamba phambili emabhulabhisi omzimba omzimba.
Imithi ebizwa ngokuthi i-checkpoint inhibitors ingakwazi ukubopha ngalezi amaprotheni zokuhlola ezifana ne-PD-L1, ngokuyisisekelo ekhulula ama-brake, ngakho-ke isimiso somzimba sokuzivikela singabuyela emsebenzini futhi silwe namaseli omdlavuza.
Izibonelo zama-inhibitors wokuhlola okusetshenziswe njengamanje zihlanganisa:
- I-Opdivo (nivolumab)
- I-Keytruda (i-pembrolizumab)
- I-Yervoy (ipilimumab)
Ucwaningo manje lubheka izinzuzo zokuhlanganisa izidakamizwa ezimbili noma ngaphezulu kulesi sigaba. Isibonelo, ukusebenzisa i-PD-1 ne-CTLA-4 inhibitors ndawonye (i-Opdivo ne-Yervoy) kubonisa isithembiso.
Ukudluliselwa Kwamaselula Okuthandayo kanye ne-CAR T-cell Therapy
Iseli elithathayo kanye ne-CAR T-cell zokwelashwa yizindlela zokuzivikela ezithuthukisa amasosha ethu omzimba. Ngokulula, zenza amangqamuzana ethu okulwa nomdlavuza abe ama-fighters angcono ngokwandisa ikhono labo lokulwa noma izinombolo zabo.
Ukudluliswa Kwamaselula Okuthandayo
Njengoba kuphawuliwe ekuqaleni, esinye sezizathu izivikelo zethu zokuvikela omzimba azilwanyanga izicubu ezinkulu ukuthi zivele zinamandla futhi zingaphezu kwamanani. Njengomfanekiso, ungase ucabange ngokuba namasosha ayishumi emigqeni engaphambili ephikisana nabaphikisi abayizinkulungwane eziyikhulu (amangqamuzana omdlavuza). Lezi zelashwa zisebenzise ngokunenzuzo isenzo sokulwa samasosha kodwa engeza amasosha amaningi emgqeni wangaphambili.
Ngalezo zokwelashwa, odokotela basusa kuqala ama-T akho amangqamuzana avela esifundeni ezungeze isisu sakho. Uma seliqoqiwe amaseli akho e-T, ahlwanyela kulabhu (futhi asebenze nge-cytokines). Ngemuva kokuphindwa ngokwanele, bese bejova emuva emzimbeni wakho. Le ukwelashwa empeleni kubangele ukwelashwa kwabanye abantu abane-melanoma.
I-CAR T-cell Therapy
Ukuqhubeka nokufanekisa kwezimoto ezivela phezulu, ukwelashwa kwe-CAR T-cell kungacatshangwa ngokuthi isimiso somzimba samasosha omzimba "siphumelele." I-CAR imelela isitholi se-chimeric antigen. IsiZulu igama elisho "ukuhlanganiswa ndawonye." Kulolu cwaningo, i-antibody ihlanganiswe kanye (ehlanganiswe) ne-receptor ye-T.
Njengokudluliswa kweselula, ama-T-amaseli avela esifundeni se-tumor yakho aqoqwe kuqala. Ama-T akho amangqamuzana azoguqulwa ukuveza iphrotheni ebizwa ngokuthi i-chimeric antigen receptor noma i-CAR. Le receptor kuma-T akho amaseli avumela ukuba banamathisele kuma-receptors ebusweni bamangqamuzana omdlavuza ukuze abhubhise. Ngamanye amazwi, lisiza ama-T-cells akho ekuqapheliseni amangqamuzana omdlavuza.
Awekho okwelashwa kwe-CAR T-cell avunyelwe, kodwa bahlolwa ezivivinyweni zomtholampilo ngemiphumela ekhuthazayo, ikakhulukazi ngokumelene ne-leukemia ne-melanoma.
I-Vaccines Treatment Treatment
Imithi yokugoma i-Cancer igonywa ngokusebenza ngokugxila ekuziphenduleleni komzimba kumdlavuza. Ungase uzwe ngemigomo engasiza ekuvimbeleni umdlavuza, njenge-hepatitis B ne-HPV, kodwa imishanguzo yokwelashwa yomdlavuza isetshenziselwa umgomo ohlukile-ukuhlasela umdlavuza osevele usukhona.
Uma ugonywa ukuphikisa, uthi, i-tetanus, isimiso sakho somzimba sokuzivikela sitholakale esincane se-tetanus ebulawe. Uma ubona lokhu, umzimba wakho uyakuqaphela ukuthi ungowokunye, uyifaka ku- B-cell (i-B-lymphocyte) eyabe ikhiqiza amasosha omzimba. Uma uphinde utholakale ku-tetanus, njengokungathi uhamba ngesilumpi esinomsoco, isimiso sakho somzimba sokuzivikela sigxiliwe futhi silungele ukuhlasela.
Kunezindlela ezimbalwa lapho lezi zitofu zikhiqizwa khona. Imithi yokugoma ingenziwa ngokusebenzisa ama cell tumor, noma izinto ezikhiqizwa ngamangqamuzana omzimba.
Isibonelo somuthi wokugoma komdlavuza osetshenziswa e-United States Isibonelelo (i-sipuleucel-T) yomdlavuza we-prostate. Imithi yokugoma i-Cancer manje ihlolwe amakhemikhali amaningana, kanye nokuvimbela ukuphindaphinda komdlavuza webele.
Ngomdlavuza wamaphaphu, imishanguzo emibili ehlukene, i-CIMAvax EGF neVaxina (racotumom-alum), iye yafundiswa eCuba ngenxa yomdlavuza ongasona omncane wamaphaphu. Lezi zitofu, ezitholakale ukwandisa ukuqhubeka okuqhubekayo okuqhubekayo kwabanye abantu abanomdlavuza wamaphaphu okungewona omncane , baqala ukufundiswa e-United States futhi. Le migomo isebenza ngokwenza amasosha omzimba enze amasosha omzimba ngokumelene ne-epidermal growth factor receptors (EGFR). I-EGFR iyi-protein emaphethelweni amangqamuzana aphethwe ngokweqile kwabanye abantu abanomdlavuza wamaphaphu.
Virus Oncolytic
Ukusetshenziswa kwama-viral oncolytic kuye kwahunyushwa ngokufanayo ngokuthi "i-dynamite yamaseli omdlavuza." Uma sicabanga ngamagciwane, ngokuvamile sicabanga okuthile okubi. Ama-virus afana nomkhuhlane ovamile ahlasela amangqamuzana ethu ngokufaka amangqamuzana, aphindise, futhi ekugcineni abangele amaseli aqhume.
Ama-virus we-oncolytic asetshenziselwa "ukuthelela" amangqamuzana omdlavuza. Lezi zindlela zokwelashwa zibonakala zisebenza ngezindlela ezimbalwa. Bangena esitokisini somdlavuza, banda futhi babangele ukuthi iseli liqhume, kodwa futhi likhulule ama-antigen egazini elidonsela amangqamuzana amaningi omzimba ukuba afike ahlasele.
Ayikho imithi yokwelashwa ye-oncolytic okwamanje evunyelwe e-United States, kodwa ifundiswa ekuvivinyweni kwemitholampilo yamanqamu amaningana.
Ama-cytokines (i-Immune System Modulators)
Izivikeli ze-immune system zihlobo lwe-immunotherapy elitholakale iminyaka eminingi. Lezi zindlela zokwelapha zibizwa ngokuthi "imithi engavamile." Ngamanye amazwi, basebenza ukuze basize amasosha omzimba avikele noma yimuphi umhlaseli, kuhlanganise nomdlavuza. Lezi zinto- cytokines zokuzivikela-ezihlanganisa ama-interleukin (i-ILs) nama-interferon (i-IFNs) zikhuthaza amandla omzimba omzimba ukulwa nomdlavuza.
Izibonelo zifaka i-IL-2 ne-IFN-alpha esetshenziselwa umdlavuza wezinso nama-melanomas phakathi kwamanye amagciwane.
I-Adjuvant Immunotherapy
I-BCG yinye uhlobo lwe-adjuvant immunotherapy okwamanje elivunyelwe ukwelapha umdlavuza. I-BCG imelela iBillill Calmette-Guerin futhi iyigciwane elisetshenziswa kwezinye izingxenye zomhlaba njengesivikelo ngokulwa nesifo sofuba. Kungasetshenziswa futhi ukuphatha umdlavuza wesibeletho. Umuthi wokugoma, kunokuba unikezwe njengomuthi wokugoma, esikhundleni salokho ujojowe kulesi sifo. Esikhathini sesisu, umuthi wokugoma uveza impendulo engapheli kahle eyenza ukulwa nomdlavuza.
Okuqhamuka uma udla imishanguzo
Enye yezinethemba, ngoba imithi ye-immunotherapy yamakheli ngokuqondile, ukuthi lezi zindlela zokwelashwa ziyoba nemiphumela emibi kakhulu kunezidakamizwa zendabuko. Njengazo zonke izindlela zokwelapha umdlavuza, noma kunjalo, imithi ye-immunotherapy ingabangela ukusabela okubi, okuhlukahluka kuye ngokuthi isigaba se-immunotherapy kanye nemithi ethile. Eqinisweni, enye yezindlela ezichazwa ngayo lezi zinto "yinoma yini ene-itis" - "itis" isho ukuvuvukala okusho ukuvuvukala.
Ikusasa
Insimu ye-immunotherapy iyathandeka, nokho sinokuningi okumele sikufunde. Ngokujabulisayo, isikhathi esithathayo sokuba lezi zindlela zokwelapha zisetshenziswe kubantu abano-mdlavuza nakho kuthuthuka, kanti esikhathini esidlule kwakukhona isikhathi eside phakathi kokutholakala kwesidakamizwa nesikhathi esasetshenziswa emtholampilo. Ngemithi efana nalokhu, lapho izidakamizwa zithuthukiswa khona zibhekene nezinkinga ezithile zokwelashwa komdlavuza, leso sikhathi sokuthuthukiswa sivame ukufinyeleleka kakhulu.
Njengalokhu, ukusetshenziswa kwezilingo zomtholampilo nakho kuyashintsha. Esikhathini esedlule, ukuhlolwa kwesigaba 1-ukuhlolwa kokuqala lapho umuthi omusha uhlolwe khona kubantu-kwakubhekwa njengengxenye yomzamo "wokugcina". Zakhiwe njengendlela yokuthuthukisa ukunakekelwa kwezempilo kulabo esikhathini esizayo kunokuba umuntu ahlanganyele ekuvivinyweni. Manje lezi zivivinyo ezifanayo zinganikeza abanye abantu ithuba elilodwa lokutholakala nesifo sabo. Thatha isikhashana ukuze ufunde kabanzi mayelana nokuvivinywa kwemitholampilo , nokuthi abantu bathola kanjani izilingo zomtholampilo ngomdlavuza .
> Imithombo:
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