I-immunomodulator yisigaba semithi ye-asthma eboniswa iziguli ezine-asthma ezinzima ukulawula. Njengokwelapha okungeziweko kwe-asthma yakho, i-immunomodulator imithi yesilawuli kunokuba imithi ephathekayo emifushane yokukhululeka okukhulu kwezimpawu ze-asthma . Ngenxa yesiguli esisodwa seyesithathu seziguli ezingazange ziphendule ama-steroids angenayo noma ziphendule kahle, i-immunomodulator inganikeza ithemba lokulawula i-asthma engcono.
I-Xolair , i-antibody monoclonal, iyona kuphela yokwelashwa kwe-immunomodulator etholakalayo okwamanje etholakala nge-asthma. Lo mzimba wokuzivikela kufanelekile iziguli eziphikisanayo eziphikisanayo eziqhubekayo noma ezinzima ezikhona:
- Ukuhlolwa kwesikhumba okuhle noma ukuhlolwa kwegazi okukhombisa ukungezwani komzimba ku-asthma trigger eyaziwayo, njengezinhlayiya, inja, ikati noma i-cockroach dander.
- Izimpawu ezingalawulwa ngendlela engafanele nge- corticosteroids engatholakali .
Elinye i-immunomodulator evame ukusetshenziswa emikhankasweni yokungezwani nemithi kanye ne-immunology namuhla i-Cinryze, ukwelashwa kokuvuvukala okuqhubekayo ebusweni nasentanyeni okuthiwa i-angioedema yefa.
Indlela Abasebenzisi Bama-Immunomodulators Abasebenza Ngayo
Ama-immunomodulators anciphisa kokubili izimpawu ze-asthma kanye nesidingo se- corticosteroids ye- systemic . Ukwelapha i-corticosteroids ye-systemic ngaphezu kokuphindwe kabili ngonyaka kuyisibonakaliso sokulawulwa kwe-asthma empofu. Ama-immunomodulators anganciphisa ukuvuvukala ngokuthinta izindawo eziningana ezihlukahlukene emzimbeni we-asthma , kuhlanganise:
- Basophils
- Ama-Eosinophils
- Lymphocytes
- Macrophages
- Amaseli amancane
- Neutrophils
- Ama-Antibodies aMonoclonal
- IgE
- T-amaseli
- Ama-Cytokines
- Ama-interleukins
I-immunomodulator ibophezela ku-IgE futhi iyayivimbela ekubopheleleni kuma-basophil kanye namaseli amancane. Ukwengeza, i-immunomodulator inciphisa inani lokusakaza i-basophils futhi ivimbela amangqamuzana amantombazane ukuba akhulule izinto ezizokwenza izimpawu zakho zibe nzima nakakhulu.
Indlela Abasebenzisi Bama-Immunomodulators Usizo
I-immunomodulator ngezinye izikhathi ibizwa ngokuthi yi-steroid-sparing drug that improves the airway and lung function. Ukwengeza, i-immunomodulator izokwehlisa izimpawu ze-asthma ezifana nalezi:
- Ukushisa
- Ukuqina kwesifuba
- Ukuphelelwa umoya
- Ukukhwehlela okungapheliyo
Ukwelashwa nge-immunomodulator kuye kwahlotshaniswa nokuvinjelwa kwe- asthma ukukhwabanisa nokuvakasha kwegumbi lokuphuthumayo kanye nokuthuthukiswa komsebenzi wamaphaphu kanye nekhwalithi yokuphila. Ngokuvamile, i-immunomodulator ngeke ishintshe enye imithi yokwelapha i-asthma, kodwa izofakwa kuyo. Ukwengezwa kwe-immunomodulator kuye kwahlanganiswa nokunciphisa amaphesenti angu-25 ekusetshenzisweni kwe-steroid.
Imiphumela emibi engenzeka
Ngenkathi i-immunomodulator yakho kufanele ibekezeleleke kahle, kunemiphumela emibi ejwayelekile kanye nemiphumela emibi engavamile ukuze ikwazi, kuhlanganise:
- I-Urticaria ne-anaphylactic ukusabela -Urticaria, noma imifuba, isenzo esiphendukayo esingaba nemiphumela emibi uma singaphathwa ngokushesha futhi ngokufanele. Udokotela wakho uzokudinga ukuba uhlolwe isikhathi esithile ehhovisi ngemuva kwejozi ngayinye. Ngenkathi ukusabela okuningi kwenzeka esikhathini esingamahora amabili kuya kweyodwa emva kokujola kokuqala, ukuphendula okweqile kwenzeka ngemuva kokujova okuningi namahora amaningi kusukela kokuthola umjovo.
- I-Cancer- Nakuba ingekho ecacile ngalesi sici, umdlavuza wawuvame kakhulu phakathi kweziguli ezithola i-Xolair. Kodwa-ke, isizathu sokuthi kungani lobu buhlobo phakathi komdlavuza kanye ne-immunomodulator kubonakala akukaqondwa ngokuphelele.
- Ubuhlungu besayithi lokungenwa -Njengoba kunoma yimuphi umjovo, ubuhlungu endaweni yomjovo kuyimpembelelo yocala eyaziwa futhi kungase kwenzeke kumaphesenti angu-20 weziguli ezithola i-immunomodulator.
- Izifo ezithathelwanayo zokuphefumula -Qinisekisa ukuthi uxoxisana nodokotela wakho ukuthi wenzeni futhi uma kufanelekile ukufuna ukunakekelwa uma uhlangabezana nalezi zimpawu.
- Umphimbo obuhlungu nobuhlungu - Uma lezi zimpawu zingaxazululwa ngezinyathelo eziqaphayo, njengemithi yokwelapha ephuzile futhi ngaphezulu, kufanele ukhulume nodokotela wakho.
Ama-immunomodulators kuNtuthuko
Ezinye izinambuzane ezizimele ezibhekene nezigaba ezahlukene ze-pathogenesis ye-asthma zingamapayipi:
- I-Daclizumab i-anti-monoplonal antibody efaka impendulo eziningana zezindawo ezikhungweni ze-asthma. Ihlolwe ekuhlolweni komtholampilo kweziguli eziyi-115 ze-asthma, kodwa kuboniswa kuphela ukuthuthukiswa okuncane emisebenzini yamaphaphu nokulawula isifo se-asthma.
- I-Lebrikizumab i-antibody monoclonal antibody ehlanganisa futhi ivimbele umsebenzi we-interleukin-13, enye ingxenye ye-pathophysiology ye-asthma. Izivivinyo ezimbili zomtholampilo, i-VERSE ne-LUTE, zibonise izinga elinciphile lokulimazeka kwe-asthma nokusebenza kwamaphaphu athuthukisiwe kwiziguli (ngaphandle kokukhathazeka okuphawulekayo kokuphepha) abane-asthma enesimo esibucayi abanezinkinga ezimbi naphezu kokwelashwa okujwayelekile okwenziwe kahle. Iziguli ezibhekwe kakhulu ukuze zizuze kulezi zifundo zazinamazinga aphezulu e-periostin, iphrotheni eyaziwa ukwandisa amazinga okuvuvukala.
- I-Reslizumab i-interleukin-5 (i-IL-5) ekuhloswe ngayo i-monoclonal antibody. Ezilingo zomtholampilo, isetshenziselwe iziguli ezikhulile nezikhukhumayo ezinegazi eliphakeme eliphezulu le-eosinophils, naphezu kwe-corticosteroid esekelwe ngokomthetho. I-Reslizumab yabonisa ukukhushulwa kwesimo se-asthma nokuphucula umsebenzi we-lung emisebenzini yokuhlolwa kwemigomo yesigaba III ezingaphezu kuka-1,700 iziguli ezineminyaka eyishumi nambili nezikhulile. Ngokusekelwe ezinkulingweni, kulindeleke ukuthi izinkomba zizofana nalezo ze-Xolair. I-Reslizumab ibhekwa yi-FDA ne-TEVA ithathe isinyathelo ekusebenziseni kwabo emuva ngo-2016. Izinkampani eziningana zezidakamizwa, njenge-AstraZeneca, zinemithi efanayo emipayipi yazo, futhi.
- I-Eculizumab (Soliris®) i-anti-monoglonal i-humocised anti-monoglonal eqondisa uhlelo lokuxhaswa futhi okwamanje ivunyiwe yi-FDA yokwelapha i-hemoglobinuria ye-paroxysmal nocturnal. Ucwaningo oluncane lwezomtholampilo lwabonisa ukuthuthukiswa komsebenzi wamaphaphu kanye nezimpawu zokugula. Kodwa-ke, lesi sidakamizwa siye sahlotshaniswa nokutheleleka kokuphila komuntu futhi okubulalayo. Ngenxa yalokho, lo muthi uvinjelwe futhi odokotela kudingeka babhalise ukuze bakwazi ukuyibeka.
- I-Suplatast ibonise imiphumela emihle futhi, kodwa izikhathi ezintathu ngosuku zihamba ngokukhathazeka ngokuhambisana nesimo se-asthma.
- I-tumor necrosis factor-alpha (i-TNF-α) i-immunomodulator esebenza ezindaweni eziningana ekuziphatheni kwe-asthma. Ngaphandle kokulawula okuthuthukisiwe ochungechungeni lweziguli ze-asthma ezikhulu kakhulu (isimo esaziwayo esiholela ku-TNF-α ngokweqile kakhulu), i-TNF-α ayizange iyanciphise amandla okuphuthumayo noma umsebenzi ophuthumayo wephunga. Ngokuqondile, i-Infliximab (Remicade®) ne-etanercept (Enbrel®) i-immunomodulator njengamanje isetshenziselwa ezinye izifo, njenge-arthritis ye-rheumatoid. Lezi zidakamizwa zihlotshaniswa nezingozi ezengeziwe zokutheleleka.
- I-proeroferator ye-Peroxisome esebenze i-receptor-gamma (PPAR-γ) yinye isigaba semithi ngaphansi kokucwaninga. Lezi zidakamizwa sezivele zisetshenziselwa ukwelashwa kwesifo sikashukela, lapho kutholakala khona ukuthi zinezinyathelo ezinamandla zokulwa nokuvuvukala. Izingulube zaseGuinea eziphathwe nge-rosiglitazone zitholakale zinciphisa kakhulu emazingeni egazi ka-IL-5 no-IgE. Lapho izilwane zixutshwe, i-TIL-5 ne-IgE nazo zatholakala zinciphisa emaphashini. Abaphenyi abathintekayo bacabanga ukuthi kungase kube ukwelashwa kwesifuba esiwusizo, futhi.
- I-Syk kinase yiprotheni ye-intracellular tyrosine kinase evimbela ukudonswa kwama-mast cells. Isidakamizwa sitholakale ukunciphisa ukuhlanganiswa kwesisu nokukhipha, ukukhipha, ukucheka emakhaleni nasemphinjeni, ukugcoba ngemuva, ukukhwehlela, ikhanda, nobuhlungu obubukeka ezigulini ezinesifo sofuzo esimweni sobubhuli. Ucwaningo olwenziwe nge-formulated formulation luhlelelwe iziguli ze-asthma.
Imithombo:
I-National Heart, Lung, ne-Blood Institute. Umbiko wePhaneli Wabachwepheshe 3 (EPR3): Izinkombandlela Zokuthola Ukuhlolwa Nokuphathwa Kwe-Asthma.
UDimov VV, i-Casale TB. Ama-Immunomodulators for Asthma. Ukuphefumula kwesifo sofuba Immunol Res. 2010 Okthoba; 2 (4): 228-234.
Busse WW, Israel E, Nelson HS, Baker JW, Charous BL, Young DY, et al. I-Daclizumab ithuthukisa ukulawula i-asthma ezigulini ezinezilinganiso ezibhekene nezifo ezinzima eziqhubekayo: isilingo esingahleliwe, esilawulwayo. Am J Respir Crit Care Med. 2008; 178 (10): 1002-1008.
UMenzella F, uLusuardi M, Galeone C, Zucchi L. Ukwelashwa Okuthandwa Ngayo Isifo Esibucayi Esikhulu. Imithi Yokuphefumula Eminingi Ehlukahlukene; 10 (1) 201.