Kusesekuqaleni kakhulu ukutshela, kepha ukwelashwa okuthakazelisayo kungenzeka kube khona
Ucwaningo lwaseCanada olwanyatheliswa eNew England Journal of Medicine luveza ukuthi abantu abane- multiple sclerosis emitholampilo (okuthiwa i-CIS) abayithatha imithi ye-antibiotic minocycline bangase babe nomngciphezi ophansi wokuba ne-multiple sclerosis egcwele amandla.
Ngokuqinisekile, kunesikhalazo esikhulu sokuthatha i-minocycline njengendlela yokwelashwa kwe-CIS, njengoba engabizi, kulula ukuyithatha (ingumuthi womlomo), futhi uneprofayili enhle yokuphepha.
Noma kunjalo, uqhathanisa kanjani nezinye izifo eziguqula isifo njengoBheaseron noma i-Avonex? Ngaphezu kwalokho, isifundo esibonisa ukusebenza kwayo sincane, kudingeke ukuba kuvivinye ukulingwa okukhulu ukuze kutholakale ukuthi kunenzuzo.
Ake sibheke ngokucophelela le thrafikhi ephuthumayo. Ngenkathi kungenzeka noma ingasebenzi, ukuqonda ukuthi "kungani" ngemuva kokuthi i-antibiotic ingakwazi kanjani ukuvimbela ukuthuthukiswa kwe-MS kuyamangalisa ngokwayo.
I-Minocycline njengendlela yokwelashwa okungenzeka i-CIS
Ngaphambi kokuba uthathe isifundo esifundweni se-minocycline njengokwelashwa kwe-CIS, kubalulekile ukuqonda ukuthi yini i-MS syndrome ehlukanisiwe emitholampilo, futhi ukuthi i-minocycline ingabhekwa kanjani njengokwelapha okungenzeka.
Kuyini OkuseMtholampilo Isolated Syndrome?
I-syndrome ye-clinically isolated kuya multiple sclerosis, noma i-CIS, ibhekisela kubantu abathola "izimpawu ze-MS" okungenani amahora angu-24, futhi lezi zimpawu zingase zingenakulinganiswa nezilonda ezibonwe kwi-MRI.
Umqambi wukuthi ngaphandle kwalesi siqephu sokuqala, azikho ezinye izinkomba umuntu ayenayo ngaphambili ze- MS , noma ngomlando wabo noma nge- MRI yabo (azikho ezinye izilonda zobuchopho ezihlobene ne-MS).
Ngamanye amazwi, umuntu umane nje akanalo ubufakazi obanele bokutholwa komzimba noma we-radiographic ukuthola ukuxilongwa kwe-MS.
Enye inselelo ngokuthola i-CIS ukuthi udokotela kumele aqinisekise ukuthi izimpawu zomuntu "ezinjengama-MS" (isibonelo, i- optic neuritis ) empeleni ngenxa yokulahlekelwa kwe-myelin-ukuzivikela okuvimbela amangqamuzana omgogodla ebuchosheni nomgogodla.
Lokhu kungadinga ukuhlolwa okuqhubekayo njengendlela yokukhishwa kwe-lumbar noma ikhono lokukhishwa , kanye nokulawula ezinye izimo ze-MS ezifana nokutheleleka noma ezinye izifo ezizimele (isibonelo, uhlelo lwe-systemic lupus erythematosus).
Yilapho izinto zingase zikhohlise, njengoba isazi sezinzwa kufanele sisebenzise isinqumo sakhe sokunquma ukuthi ngabe umuntu one-syndrome eyimithi ehlukaniswe nomzimba ku-MS kufanele athole ukwelashwa ngesifo sokuguqula isifo.
Ngokuvamile, ukwelashwa kunconywa uma umuntu onesi-CIS enesifo se-MRI esichaza izilonda ezibonwa ngokujwayelekile ku-MS.
Kuyini i-Minocycline?
I-Minocycline iyi-antibiotic, ngakho-ke imithi esetshenziselwa ukuvimbela ukukhula kwama-bacterium. Isetshenziselwa ukwelapha izimo eziningi zezokwelapha ezinjengama-acne, noma amaphaphu, ubulili, nezifo zesikhumba.
Ungase uzibuze ukuthi ukuthatha i-minocycline kungase kuzuze kanjani omunye umuntu engozini yokuthuthukisa i-MS. Eqinisweni, ososayensi bathole i-minocycline ukuba ibe nezindawo zokulwa nokuvuvukala, ngakho-ke kunganciphisa isimiso somzimba sokuzivikela komuntu, ngaphezu kokuvimbela ukusabalala kwama-bacterium.
Kungenzeka ukuthi impahla elwa nokuvuvukala ye-minocycline ibangelwa ikhono layo lokushintsha amabhaktheriya emathunjini omuntu ngoba la ma-bacteria adlala indima ebalulekile ekulawuleni amasosha omzimba omuntu.
I-Minocycline nayo ikholelwa ukuthi ivimbela ukufuduka kwamangqamuzana omzimba omzimba omzimba ahlasela i-myelin ebuchosheni nasendlini yomgogodla.
Okokugcina, ucwaningo lubonisa ukuthi i-minocycline ingavikela amangqamuzana omzimba ngokuvimbela ukufa kwabo. Lena enye indlela engabasiza ngayo labo abane-CIS.
Isifundo Sembulani?
Phakathi neminyaka engama-4, abahlanganyeli abangu-142 abane-CIS abavela emitholampilo engu-12 yaseCanada eMelika babelwa ngezikhathi ezithile ukuthola i-100mg ye-minocycline kabili ngosuku noma i-placebo.
Bonke abahlanganyeli babenezibonakaliso zabo zokuqala ze-CIS ezinsukwini ezingu-180 ngaphambi kokuqala isifundo. Iningi labahlanganyeli kwakungabesifazane (amaphesenti angu-68), futhi lokhu kuyinto ejwayelekile ye-CIS (okuvame kakhulu kwabesifazane), abaneminyaka yobudala beminyaka engaba ngu-36.
Ucwaningo lwaluyimpumputhe kabili, okusho ukuthi abahlanganyeli noma abaphenyi babengazi ukuthi babethola i-minocycline noma i-placebo.
Abahlanganyeli baqhubeka bethatha imithi (noma i-placebo) kuze kube yilapho bebonwa khona abane-MS noma izinyanga ezingu-24 ngemuva kokuthi baqale ukuthatha i-minocycline (noma i-placebo).
Imiphumela yabonisa ukuthi zingakapheli izinyanga eziyisithupha abahlanganyeli beqala ukuthatha i-minocycline, amaphesenti angu-33 aqala i-MS, uma kuqhathaniswa namaphesenti angu-61 abahlanganyeli abathatha indawo ye-placebo. Lena umehluko wokuphazamisa amaphuzu angu-28 amaphesenti.
Ngemuva kokulungiswa kwenani lezilonda ze-MS ezisekelwe phansi, umehluko wehla ku-18.5%, okwamanje uyanzima kakhulu. Isizathu salolu lungiso siwukuthi izindlela zokuhlola i-MS zibukeziwe ngenkathi kulesi sifundo. Ngokusho kwe-McDonald 2010, ukutholakala komuntu kungatholakala ukuthi une-MS uma ebufakazi be-MRI besifo se-brain, ngisho noma bengenayo izimpawu ezihlobene nalezo zilonda.
Ngenkathi ingozi yokuguqula i-CIS ibe yi-MS yayingaphansi kakhulu kulabo abathatha i-minocycline ezinyangeni ezingu-6 uma kuqhathaniswa ne-placebo, ngeshwa, lokhu kwakungagcinwa ezinyangeni ezingu-24.
I-Minocycline Iqhathanisa Kanjani Neminye Imithi Ye-CIS?
Imiphumela yalolu cwaningo ifana nezinye izifo ezisetshenziselwa i-CIS njengeBetaseron (interferon beta-1b), i-Avonex (i-interferon beta-1a), ne-Aubagio (teriflunomide), okusho ezinyangeni ezingu-6, lezi zindlela zonke zibonisa izingozi ezincane ezifanayo zokuthuthukisa MS.
Kodwa-ke, ayikho inhloko ekhanda ukuhlolwa ukuhlola i-minocycline kwenye yalezi zindlela ezingenhla, ngakho kusengaphambili ukutshela indlela efanisa ngayo ngempela.
Kuzo zonke, ngenkathi i-minocycline ibonakala njengezindleko eziphansi nemithi ephephile, isifundo sokuhlola inzuzo yaso njengesiphakamiso se-CIS sasincane futhi sineminye imikhawulo ehlobene nokutadisha.
Izifundo eziningi zisadingeka ukuthi zibheke lokhu ukwelashwa okuzuzisa ngempela futhi okuphumelelayo.
Ingabe Kukhona Ukunciphisa Ukuthatha i-Minocycline?
Ungase uzibuze ukuthi kukhona yini ukuphazamiseka ukuthatha i-minocycline, njengokuthi noma kuphephile noma kubangele noma yikuphi ukukhathazeka. Lokhu kubalulekile ngoba ukunamathela emithini emibili ngosuku kungaba inselele ngokwanele, futhi uma kukwenza uzizwe ungakhululekile, lokho kunamathela kunzima nakakhulu.
Imiphumela emibi evamile engase ivele nge-minocycline ihlanganisa:
- Uhudo
- Ukuzivocavoca noma ubukhulu obunzima
- Izinwele
- Ukuguqulwa kwamazinyo (njengokubamba amazinyo nomlomo)
- Ukuzwela elangeni (ungathola okungaphezu kokushisa kwelanga evamile)
- Izifo ze-fungal (isibonelo, izifo zesisu zesisu)
Kukhona nezinye izinkinga ezingavamile kepha ezinzima ezingase zenzeke nge-minocycline njenge- pseudotumor cerebri . Ngaphezu kwalokho, i-minocycline iphikisana nokukhulelwa nokuhlengikaza, futhi inganciphisa ukusebenza kwamaphilisi okulawula ukuzalwa.
Kodwa-ke, naphezu kwale miphumela emibi, kusho i-minocycline iphrofayili enhle yokuphepha futhi abantu bavame ukwenza kahle.
Yiqiniso, njenganoma yimiphi imithi, udinga ukukhuluma ngokucophelela nodokotela wakho mayelana nezingozi ezingenzeka zokuthatha i-minocycline ngokumelene nenzuzo yayo (uma ike yavunyelwa ukusetshenziswa ku-CIS), futhi ibukeze yonke imiphumela emibi engaba khona.
Izwi elivela
Ngenkathi imiphumela yalolu cwaningo oluthile luthandeka, kumane nje isinyathelo somntwana ekuqondeni empeleni ukuvimbela i-MS ukuba ivele kubantu abathintekayo abanezimpawu zokuqala. Ucwaningo olwengeziwe luyadingeka ku-minocycline, ikakhulukazi njengoba ucwaningo lusalokhu luxubene nemiphumela.
Ngokwesibonelo, isifundo esisodwa sabonisa ukuthi i-minocycline eyanikezwa nge-Beta-Seron ayizange ikhulise ukulawulwa kwezifo kubantu abane-relapsing-remitting multiple sclerosis. Lolu cwaningo oluphikisanayo lubonisa ukuthi ucwaningo olwengeziwe luzodingeka lwenziwe ngaphambi kokuba izinzwa zezinzwa ziqale ukunikeza iziguli zabo nge-MS tetracyticline.
> Imithombo:
> Marcus JF, Waubant EL. Ukubuyekezwa kwi-syndrome ehlukanisiwe emtholampilo kanye ne-diagnostic criteria ye-multiple sclerosis. I-Neurohospitalist . 2013, 3 (2): 65-80.
> Metz LM et al. Isivivinyo se-minocycline esikhungweni se-clinic esisodwa se-multiple sclerosis. N Eng J Med. 2017 Jun 1; 376 (22): 2122-33.
> Multiple Sclerosis Society of Canada. (Meyi 2017). I-Minocycline ye-FAQ ye-Clinically Isolated Syndrome (CIS).
> Sørensen PS et al. I-Minocycline yengezwe i-interferon β-1a emathandeni amaningi: ukuhlolwa okungahleliwe kwe-RECYCLINE. I-Eur J Neurol. 2016 Meyi; 23 (5): 861-70.