Amasu amaningi adingekayo ukuvimbela, ukuqeda ukutheleleka
Umlando wokuthuthukiswa kokugonywa kwegciwane lesandulela ngculaza kuye kwaphawulwa izinkinga eziningi kanye nokudumazeka, kanti ngamunye "kubonakala" okuveza ukuthi kunzima kakhulu ukuletha izinselelo nezinkinga zokunqoba. Ngokuvamile kubonakala sengathi ngesinyathelo esisodwa abaphenyi abazithatha, isithiyo esingalindelekile sibabuyisela emuva ngisho nangamanyathelo amabili.
Ngandlela-thile, kuhlolwe kahle, ngenxa yokuthi asikaze sibone ukhetho olufanele lokugoma.
Ngakolunye uhlangothi, ososayensi baye benza izinyathelo ezinkulu eminyakeni yamuva, bathola ukuqonda okukhulu ngezinkinga eziyinkimbinkimbi zokutheleleka ngegciwane lesandulela ngculaza kanye nokuphendula komzimba kuleso sifo. Okuvusa amadlingozi lokhu okunye abanye abakakholelwa ukuthi ukugoma kungase kwenzeke phakathi neminyaka engu-15 elandelayo (phakathi kwabo, umlingisi weNobel Prize laureate kanye ne-HIV abazitholile uFrançoise Barré-Sinoussi ).
Kungakhathaliseki ukuthi umgomo onjalo ungabizi, uphephile, futhi kulula ukuphatha nokusabalalisa emasimini omhlaba wonke okumele ubonwe. Kodwa lokho esikwaziyo ngokuqinisekile ukuthi inani lezithiyo eziyinhloko kuzodingeka lixazululwe uma noma ubani ozokhethwa uyobe ehamba ngaphesheya kwesigaba sokuqinisekisa.
Izindlela 3 I-HIV iqinisa imizamo yokugoma
Kusukela ekubambeni okuyisisekelo, imizamo yokuthuthukisa umgomo wokugoma i-HIV iye yavinjelwa ukuhlukana kofuzo ngokwayo. Umjikelezo wokuphindaphinda we-HIV awusizo nje kuphela (amahora angaba ngu-24) kodwa ujwayele ukuphoqwa kwamaphutha, ukukhishwa amakhophi ashintshiwe ngokwawo abuyele emithanjeni emisha njengoba igciwane lidluliswa kusuka komuntu kuya komuntu.
Ukwakhiwa komuthi owodwa wokugoma okwazi ukuqeda izimbangela ezingaphezu kwezingu-60 kanye nezinqwaba zezinkinga eziphindaphindiwe-futhi ezingeni lomhlaba wonke-kuba nzima kakhulu uma imigomo evamile ingakhusela kuphela inani elilinganiselwe lezinkinga zegciwane.
Okwesibili, ukulwa negciwane lesandulela ngculazi kufuna ukuphendula okunamandla ohlelweni lokuzivikela komzimba, futhi lokhu futhi lapho amasistimu ehluleka khona.
Ngokwesiko, amangqamuzana egazi amhlophe ayingqayizivele ebizwa ngokuthi i- CD4 T-cell aqala ukuphendula ngokusayinisa amangqamuzana abulalayo endaweni yesifo. Okumangalisa ukuthi lawa yiwona amangqamuzana anesifo se-HIV sokutheleleka. Ngokwenza kanjalo, i-HIV idonsa ikhono lomzimba lokuzivikela njengoba inani le-CD4 lihlehlisiwe ngendlela ehlelekile, okuholela ekuqhekekeni kokugcina kwezivikelo ezibizwa ngokuthi ukukhulelwa komzimba .
Okokugcina, ukuqedwa kwegciwane lesandulela ngculazi kuphazamiseka yilokho igciwane 'likwazi ukufihla emzimbeni wokuvikela omzimba. Ngokushesha emva kokutheleleka, kanti enye i-HIV isakaza ngokukhululekile egazini, i-subset yegciwane (elibizwa ngokuthi i- provirus ) lizibandakanya emingcwabeni efihliwe yamaselula (abizwa ngokuthi ama- reservoir ). Uma ungaphakathi lala maseli, i-HIV ivikelekile ekutholeni. Esikhundleni sokutheleleka nokubulala isilwane esithintekayo, igciwane lesandulela ngculaza elilindile livele lihlukanise eceleni komphathi kanye nezinto zalo zofuzo. Lokhu kusho ukuthi ngisho noma ngabe i-HIV isakaza mahhala iphela, igciwane "elifihlekile" lingakwazi ukusebenza futhi liqale ukutheleleka kabusha.
Izithiyo Zokunqoba
Kuye kwacaca eminyakeni yamuva ukuthi ukubhekana nalezi zithiyo kuzodinga isu eliziningi futhi ukuthi indlela eyodwa ngeke kufezekise imigomo edingekayo yokuthuthukisa umgomo wokugoma.
Ngakho-ke izingxenye eziyinhloko zalolu hlelo, kufanele zibheke:
- izindlela zokunciphisa ubuningi bezinkinga zegciwane lesandulela ngculaza
- izindlela zokwenza izimpendulo ezifanelekile zokuvikela omzimba ezidingekayo ukuze kuvikelwe
- izindlela zokugcina ubuqotho bamasosha omzimba
- izindlela zokusula nokubulala amagciwane angenalutho
Intuthuko yenziwa ngamasu amaningi ahlongozwayo, ngezinga elihlukene lokuphumelela nokuphumelela, futhi lingachazwa ngendlela elandelayo:
Ukukhuthaza "Ukunciphisa Ngokukhululekile" Ukuphendula Ngomzimba
Phakathi kwabantu abaphila negciwane lesandulela ngculaza, kukhona i-subset yabantu abaziwa ngokuthi abalawuli abakhulu (ECs) ababonakala benokumelana nokumelana ne-HIV .
Eminyakeni yamuva, ososayensi sebeqalile ukukhomba ukushintshashintsha kwezakhi zofuzo bakholelwa ukuthi bazinikela kulo mbuzo wemvelo, ovikelayo. Phakathi kwazo kukhona i-subset yamaprotheni akhethekile avikelayo aziwa ngokuthi ama-antibodies (noma ama-bNAbs) amaningi .
Ama-antibodies avikela umzimba ngokumelene nesinye isifo esibangela isifo (pathogen). Iningi liyi-antibodies engenamandla kakhulu, okusho ukuthi libulala eyodwa kuphela noma izinhlobo eziningana ze-pathogen. Ngokuphambene nalokho, ama-bNA anokukwazi ukubulala ukuhlukahluka kwegciwane lesandulela ngculaza-kufika ku-90% kwezinye izimo-ngaleyo ndlela kunciphisa ikhono legciwane ukuthi lilalele futhi lisakaze.
Kuze kube manje, ososayensi abakakaze babone izindlela eziphumelelayo zokubamba impendulo ye-BNAb emazingeni lapho kungabhekwa njengesivikelo, nokuthi impendulo enjalo ingathatha izinyanga noma ngisho neminyaka ukuthuthukisa. Ukuphoqa izinto ngokuqhubekayo yiqiniso lokuthi asazi ukuthi ukuvuselelwa kwalezi zinhlobo ze-bNA kungase kube yingozi-kungakhathaliseki ukuthi kungase kusebenze ngokumelene namaseli omzimba futhi kunganaki noma yikuphi ukwelashwa okuzuzayo okungase kuvune.
Njengoba kukhulunywa lokho, ukugxila okuningi kugcizelelwa ngokuqondile kwe-bNAbs kubantu abanesandulela ngculaza. Enye ye-BNAb, eyaziwa ngokuthi i-3BNC117, ayiveli nje ukuvimbela ukutheleleka kwamangqamuzana amasha kepha ukususa amaseli one-HIV. Indlela enjalo ingase ivumele olunye usuku ukuthi lusetshenziswe ngendlela ehlukile noma ehambisanayo yokwelashwa kubantu abasesandulele igciwane.
Ukugcina noma Ukubuyisela Ubuqotho Bamasosha
Ngisho noma ososayensi bakwazi ukwenza kahle ukukhiqizwa kwe-bnAbs, kungase kudingeke ukuthi kube nesimangaliso sokuzivikela emzimbeni. Lokhu kubhekwa njengenselele enkulu njengoba i-HIV ngokwayo ibangela ukuvinjelwa kwamagciwane ngokubulala ngokuzibulala "CD4 T-cell" "umsizi".
Ngaphezu kwalokho, ikhono lomzimba lokulwa ne-HIV nalabo okuthiwa "umbulali" i-CD8 T-cells ihamba kancane kancane ngokuhamba kwesikhathi njengoba umzimba uthola lokho okubizwa ngokuthi ukukhulelwa komzimba . Phakathi nokutheleleka okungapheli, isimiso somzimba samasosha omzimba sizozilawula njalo ukuze kuqinisekiswe ukuthi akusikho okungaphezu kokuqeda amandla (okubangela isifo se-autoimmune) noma ukugxilongwa (ukuvumela ukuthi amagciwane ahlakazeke ngokunganaki).
Ikakhulukazi ngesikhathi sokutheleleka kwegciwane lesandulela ngculazi isikhathi eside, ukuguqulwa kwegazi kungabangela ukuthi amangqamuzana e-CD4 ahlulwe kancane kancane futhi umzimba ungakwazi ukukwazi ukubona i-pathogen (isimo esifana nesesiguli esinomdlavuza). Uma lokhu kwenzeka, isimiso somzimba sokuvikela omzimba ngokungenakuziphendulela "sibeka ama-brakes" ekuphenduleni okufanele, okwenza kube lula ukuzivikela.
Ososayensi e-Emory University sebeqalile ukuhlola ukusetshenziswa kwama-antibodies ahlanganisiwe okuthiwa i- ipilimumab , engase ikwazi "ukukhulula amabhuleki" nokuvuselela ukukhiqizwa kwamaseli e-CD8 T.
Esinye sezicucu zocwaningo ezitholakale ngentshiseko, njengamanje ezivivinyweni zokugonywa, kuhilela ukusebenzisa "igobolondo" elikhubazekile le- herpes virus ebizwa ngokuthi i-CMV lapho efakwe khona izingcezu ezingezona izifo ze-SIV (i-primate version ye-HIV) . Uma izihloko zingenwa nge-CMV ye-genetically modified, umzimba wamukela ukutheleleka "okuhlekisayo" ngokusheshisa ukukhiqizwa kwe-CD8 T-cell ukulwa nalokho abakakholelwa ukuthi yi-SIV.
Okwenza imodeli ye-CMV iphoqele ngokukhethekile ukuthi i-herpes virus ayikhiphi emzimbeni, njengegciwane elibandayo, kodwa liqhubeka liphindaphinda njalo. Kungakhathaliseki ukuthi lokhu kuqinisekisa ukuvikelwa kokuzivikela komzimba isikhathi eside akufanele kunqunywe, kodwa kuhlinzeka ngokufakazela ubufakazi obunamandla.
Ukuhlanza nokubulala i-HIV evamile
Esinye sezivimbelo ezinkulu kakhulu ekuthuthukiseni igciwane lesandulela ngculazi yisisindo esenza ijubane likwazi ukusungula izibhamu ezilindelekile ukuvikela ukutholakala kwamagciwane. Kukholelwa ukuthi lokhu kwenzeka ngokushesha masinyane amahora amane uma kwenzeka ukuhanjiswa kwesandulela ngculazi- ukuhamba masinyane esakhiweni sokutheleleka ukuya emantanjeni-kuze kube yizinsuku ezine kwezinye izinhlobo zokudluliswa ngokocansi noma okungezona ngokocansi .
Kuze kube manje, asiqiniseki ngokuphelele ukuthi ngabe lezi zinqolobane zingase zibe ziningi kangakanani noma zikhulu kangakanani noma zingakwazi ukuveza ukuguqulwa kwamagciwane (okungukuthi, ukubuyiswa kwegciwane) kulabo abakholelwa ukuthi banokutheleleka.
Ezinye zezicucu zocwaningo kakhulu namuhla zihilela isenzo okuthiwa "ukukhahlela" ngokusebenzisa ama-agent avuselelayo angakwazi "ukukhahlela" i-HIV engavamile ngaphandle kokufihla, ngaleyo ndlela avumela i-agent yesibili noma isu "ukubulala" igciwane elisha.
Kulokhu, ososayensi baye baphumelela ngokusebenzisa izidakamizwa ezibizwa ngokuthi i-HDAC inhibitors, eziye zasetshenziselwa ukuphatha izifo zesifo sokuwa nesifo senhliziyo. Ngenkathi izifundo zibonise ukuthi izidakamizwa ezintsha ze-HDAC zikwazi "ukuvusa" igciwane elidliwayo, akekho owakwazi ukusula izikhumba noma ngisho nokwehlisa usayizi wabo. Amathemba aphethwe njengamanje ekusetshenzisweni okuhlangene kwe-HDAC namanye ama-agent wezidakamizwa zamanoveli (faka i- PEP005 , esetshenziselwa ukuphatha uhlobo lomdlavuza wesikhumba ohlobene nelanga).
Nokho, kunenkinga enkulu, ukuthi i-HDAC inhibitors ingahle ibangele uketshezi nokunciphisa izimpendulo zamasosha omzimba. Ngenxa yalokho, ososayensi nabo babheka ekilasini lezidakamizwa, okuthiwa i-TLA agonists, ebonakala sengathi iyakwazi ukuvuselela impendulo yamagciwane esikhundleni sokuthi "ulandele" igciwane ngaphandle kokufihla. Izifundo zokuqala ze-primate ziye zathembisa, ngaphandle kokuncipha okulinganiselwe kwamagumbi okugcina kodwa ukunyuka okukhulu kwe-CD8 "killer" esebenzayo.
> Imithombo:
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