Abacwaningi Ukuhlola Amasu Okuhlanganiswa Noveli Ukuqeda i-HIV
Kwakukhona ngo-1984 lapho uNobhala wezeMpilo kanye noMnyango WezeMisebenzi uMargaret Heckler esho ngesibindi ukuthi umuthi wokugoma we- AIDS "uzobe ulungele ukuhlolwa eminyakeni emibili."
Manje, eminyakeni engaphezu kwengu-35 kulesi sifo, asikaze sibone noma yini esondela kumuntu omele ukhetho, noma ukuvimbela ukudluliswa kwegciwane noma ukunikeza abantu abane-HIV amandla okulawula igciwane ngaphandle kokusebenzisa izidakamizwa.
Ingabe lokhu kusho ukuthi asikho ndawo ngaso sonke leso sikhathi? Ngenkathi kungase kubonakale ngaleyo ndlela, nge-string engapheliyo yokuhluleka komphakathi, iqiniso liwukuthi sasinamathuluzi ambalwa kakhulu emuva eminyakeni yama-1980 no-90 ukuvula izimfihlo zofuzo zegciwane.
Namuhla, ngokuningi kwalokhu amathuluzi esinawo-kusuka ekuthuthukisweni kwe-3D electron microscopy kuya ku-generation generation generation generation-ingabe sisondelene nokuthola ukwelashwa okungenakuqhathaniswa kwe-HIV?
Izinselelo kanye nokulinganiselwa koPhando Lokuqala
Iqiniso liwukuthi, ngisho no-1984, abacwaningi babezi kahle izinselele ababhekana nazo ekuthuthukiseni umgomo wokugoma. Embikweni we-Congressional owethulwe yi-Office of Technology Assessment, uphenyo wathi:
"Akuyona imishanguzo yegciwane lesandulela ngculazi, noma wonke amalungiselelo angenakusebenza aphethe isifo segciwane lesandulela ngculaza, okwamanje unesithembiso esikhulu," ngenkathi enezela ukuthi "uma ukushintshashintsha kwezakhi zofuzo (nge-HIV) kubalulekile ngokwanele ... kuyoba nzima ukuthuthukisa umuthi wokugoma ophumelelayo. "
Ukwengeza kule nkinga kwakuwukuthi ubuchwepheshe obuningi obudingekayo ukuthuthukisa umuthi wokugoma kwakuyiningi ngesikhathi sokuhlola, ikakhulukazi amasu e- DNA aphindaphindiwe asetshenziselwa ukucwaninga okwamanje.
Kodwa ngisho nalezi zihluleka zakuqala, abacwaningi bathola ulwazi olunzulu mayelana nokukhawulelwa komklamo wendabuko wokugoma, okungukuthi
- lokho okubizwa ngokuthi "imishanguzo ebulawe ngokuphelele" (lapho i-HIV ebhujiswa ngokomzimba noma ngama-antibiotics, amakhemikhali, ukushisa noma ukushisa ama-radiation) akukhuthazi izimpendulo eziphathelene nomzimba.
- ukuthi ukumane nje kusebenze ukuzivikela komzimba komzimba kunganele kusukela i-HIV ibulala amangqamuzana ahlanganisa izimpendulo zamagciwane (i- CD4 T-cells ), eshiya umzimba ungakwazi ukukhuphula ukuvikela okusebenzayo.
- ukuthi izinga eliphezulu lokuguqulwa kwegciwane lesandulela ngculaza linikeza i-HIV ngezohlukana ezihlukahlukene zezakhi zofuzo ezenza ukugoma okulodwa-okuyinto enganciphisa zonke izinhlobo ezihlukahlukene zegciwane lesandulela ngculaza- okungafani neze kunzima, uma kungenakwenzeka.
Imishanguzo Yokuphulukisa Yezokwelapha
Emashumini eminyaka amuva, ucwaningi oluningi luye lwagxila ekuthuthukiseni imithi yokwelapha. Ngamafuphi, uma umfakisicelo wokugoma engakwazi ukuvimbela ngokugcwele ukutheleleka, kunganciphisa ngisho nokuyeka ukuqhubeka kwesifo kulabo asebevele benesifo. Ukuze umuthi wokugoma uphethwe njengendlela ephumelelayo, iziphathimandla ziphakamisa ukuthi kuzodingeka ukuthi ziyeke okungenani ama-50% ezokutheleleka kulabo abafakwe ngaphakathi.
Sifinyelele eduze nalokhu kuhloswe eminyakeni yamuva, akukho okunye ngaphezu kwesilingo se- RV144 ngo-2009. Lolu cwaningo lwesiThai, olunezikhalazo ezimbili ezihlukene zokugomela umgomo wokugonywa (zombili zazo ezazizimele ngokwazo), zabonisa ukunciphisa okunciphisa 31% kwezifo phakathi kwabahlanganyeli eqenjini lokugoma ngokumelene nalabo abaseqembu le-placebo.
Leli cala lilandelwa maduzane yi- RV505 , okwakusetshenziselwa ukwandisa kulowo miphumela ngokuhlanganisa umgomo wokugoma "wokukhushulwa" ohlala ngaphakathi kwe- adenovirus ekhubazekile (uhlobo olujwayelekile lwegciwane oluhambisana nokubandayo). Kodwa esikhundleni salokho, lolu cala lwavalwa ngaphambi kuka-Ephreli 2013 lapho kwabikwa ukuthi abahlanganyeli abaningi begciwane bathelelekile kunabathile abangenawo umgomo wokugoma.
Ngemuva kwalokho, abaningi emphakathini wocwaningo babonisa ukukhathazeka mayelana nokushiya okushiywe yi-RV505, okuphakamisa ukuthi kungenzeka ukuthi ubuyele kahle izinhlelo zokugoma ngamashumi eminyaka.
Iyini ikusasa le-HIV Vaccine Research?
Naphezu kokuhluleka kwe-RV505, ukuhlolwa okuncane okuqhubekayo kwaqhubeka nokuphenya amasu ahlukahlukene wokuqala / okusizayo.
Owokuqala kulawa, i- RV305 , uye wabamba abahlanganyeli abangu-167 abangenayo i- HIV kusukela ekuqaleni kwecala le-RV144 eThailand. Inhloso yocwaningo ukucacisa ukuthi ngabe i-booster eyengeziwe inoculations izokwandisa ukuvikeleka ngaphesheya kwamaphesenti angu-31.
Ucwaningo lwesibili, owaziwa ngokuthi i- RV306 , luzophenya ukusebenza kwezinhlobo ezehlukene zokugoma ze-booster lapho zisetshenziselwa ngokuhambisana nemigomo yokuqala yaseRV144.
Okwamanje, ucwaningo oluningi luye lwagxila kumasu okuthiwa "ukuhlaselwa". Indlela yokuhlanganiswa ihlose ukusebenzisa ama-agent ekhemikhali ekhethekile ukukhahlela i-HIV emagodini ayo afihliwe amaselula ngenkathi i-agent yesibili (noma i-agent) ibulala igciwane lesandulela-ngculazi ngokuphumelelayo.
Kube nempumelelo ekuqedeni izikhungwane zamagciwane, kuhlanganise nokusetshenziswa kwe-HDAC inhibitors (uhlobo lomuthi oluhlukaniswe njenge-antipsychotic). Ngenkathi sinokuningi okumele sikufunde mayelana nokusabalalisa lezi zindawo zokugcina ezifihlekile, kungenzeka ukuthi indlela ibonakala iyethembisayo.
Ngokufanayo, ososayensi baye benza izingqinamba ekuthuthukiseni ama-immunologic agents akwazi ukukhuthaza ukuvikelwa komzimba kwemvelo. Okuphakathi kwalolu cwaningo kuthiwa yi- antibodies ejwayelekile (ne-BNab) -i- proteins ekhethekile ekwazi ukuqeda ububanzi obubanzi be-HIV subtypes (uma kuqhathaniswa nama-antibodies angenawo wonke amandla okukwazi ukubulala uhlobo olulodwa).
Ngokutadisha abalawuli be-HIV abakhulu (abantu abane-HIV ngokumelene ne-HIV), ososayensi baye bakwazi ukubona futhi bakhuthaza ukukhiqizwa eziningana zeBNAbs ezithembisayo. Kodwa-ke, umbuzo oyinhloko uhlala: Usosayensi angashukumisa kanjani impendulo enhle yokubulala i-HIV ngaphandle kokulimaza umuntu ogulayo? Kuze kube yimanje, ukuthuthuka sekuthembisile, uma kuthobekile.
Ekugcineni kwabo, lezi zivivinyo zibhekwa njengeziphawulekayo njengoba zakha phezu kwezifundo ezitholakala ekuhlulekeni kokugonywa kwangaphambilini, okungukuthi:
- Ukwehluleka akusho njalo ukunqotshwa. Umgomo we-AIDVAX, owahluleka ukuhlolwa kwabantu ababili ngo-2003, wawuhloswe ngokuphumelelayo njengesivivinyo "se-booster" se-RV144.
- Amaphesenti angu-50 awakwazi ukuwafinyelela. Eqinisweni, ukutadisha kwe-Thai kubonise ukuthi izinga lokuphumelela lemishanguzo lalihamba phambili emigqeni yamaphesenti angama-60 ngonyaka wokuqala, iqhubeka kancane kancane njengoba isikhathi siqhubeka. Lokhu kusikisela ukuthi inoculation eyengeziwe noma amasu okuthuthukisa anganikeza ukuvikelwa okukhulu nakakhulu.
- Sidinga ukuthola izindlela zoku "ukunciphisa umncintiswano." Ucwaningo lwamuva luveze ukuthi ama-antibodies okuncintisana angase abe enhliziyweni yokuhluleka kwe-RV505. I-genetic modeling ibonisa ukuthi imishanguzo ayikwenzanga kuphela ukukhiqizwa kwamagciwane okuvikela i-immunoglobulin G (IgG), njengoba kuhloswe, kodwa futhi yaholela ekukhuleni kwamagciwane okuvikela i-immunoglobulin A (IgA), okwehlisa umphumela wokuzivikela. Ukuthola kusho ukusinqoba noma lo mphumela wokuncintisana cishe uzoba yinselele enkulu ekuqhubekeni phambili.
- Kungenzeka singeke sithole umgomo owodwa. Iningi labachwepheshe liyavuma ukuthi kungathatha inhlanganisela indlela yokwenza ukukhishwa kwegciwane lesandulela ngculaza noma ukuhlinzeka "ukwelashwa" kokwelapha. Ngokuhlanganisa umuthi wokugoma wendabuko kanye nezindlela zokuzivikela nge-immunologic , abaningi bakholelwa ukuthi singakwazi ukugqoka i-HIV, kokubili ikhono layo lokutheleleka kanye nokukwazi kwalo ukuzifihla ekutholeni.
Ingabe Ukuhlolwa Kwamathuba Okugonywa Kufanele Ukuba Amabhiliyoni Aphethwe?
Ngesikhathi izimali ze-HIV ziba shrunken noma ziqondiswa kabusha, abanye baye baqala ukungabaza ukuthi indlela yokwandisa-ukuqoqa ubufakazi kancane kancane ngesilingo nesiphambeko-iqinisekisa u-$ 8 billion asetshenzisiwe kakade ekucwaningweni kokugoma. Abanye bakholelwa ukuthi kuyincithakalo yabantu kanye nezemali ngenkathi abanye njengoRobert Gallo bephikisana ngokuthi amamodeli wamanje wokugoma awakwazi ngokwanele ukunikeza indlela eyengeziwe.
Ngakolunye uhlangothi, njengoba siqala ukuqonda kabanzi mayelana nokuzivikela komzimba kanye nokugqugquzelwa kwama-antibodies amaningi, abanye bakholelwa ukuthi ulwazi lungasetshenziswa kalula kwezinye izici zocwaningo lwe-HIV.
Ngenkulumweni ka-2013 nephephandaba i- Guardian , uFrançoise Barre-Sinoussi , obizwa ngokuthi u-disco-cover of HIV, wabonisa ukuqiniseka ukuthi ukwelashwa okusebenzayo kungenzeka kube khona "phakathi neminyaka engu-30 elandelayo."
Kungakhathaliseki ukuthi ukubikezela kuphakamisa ukulindela noma kunciphise ithemba, kuyacaca ukuthi ukuqhubeka phambili kuyona kuphela okukhethwa kukho. Futhi ukuthi ukuhluleka okuwukuphela kweqiniso kungenye okungeke sikufunde lutho.
> Imithombo:
> I-Office of Technology Assessment. "Ukubuyekezwa kwempendulo yoMnyango WezeMpilo Kahulumeni." Washington, DC: US Congress; NgoFebruwari 2005: iphe. 28. Umtapo Wezincwadi ZaseCongress Inombolo Yekhadi 85-600510.
> Izintambo-Ngarm, S .; I-Pitisuttithum, i-P .; I-Nitayaphan, iS .; et al. "Ukugonywa ne-ALVAC ne-AIDSVAX ukuvimbela ukutheleleka kwe-HIV-1 eThailand." I-New England Journal of Medicine. Ngo-Disemba 3, 2009; 361 (23): 2209-20.
> I-National Institute ofergy and Infectious Diseases (NIAID). "I-NIH Inqamuleli Ukugonywa Kwesifundo Se-HIV Umgomo." Washington, DC: Izikhungo Zikazwelonke Zempilo (NIH). Ngo-Ephreli 25, 2013.
> Uhlelo lwe-US Military Research Research (MHRP). "I-RV144 Yokufunda Isifundo RV305 Iqala eThailand." I-Walter Reed Medical Centre, eWashington, DC; I-Media Release: Ngo-Ephreli 11, 2012.
> I-AIDS International Vaccine Initiative (IAVI). "Intuthuko Emgwaqweni Wokuthola I-AIDS Vaccine." ENew York, eNew York; Ukukhishwa kwemidiya: Juni 2012.
> I-Tomaras, G. "I-E103 Igciwane lesandulela ngculaza-1 lenze i-IgA ne-IgG Antibody Specificities." I-Journal ye-Immune Deficiency Deficiency Syndromes. Ephreli 2013; 62 (1): 52.
> MacNeil, J .; Johnson, M .; I-Birx, D; kanye no-Traumont, E. "Ukuhlolwa kwegciwane lesandulela ngculazi kulungiswe." Isayensi. Ngo-February 13, 2004: 303 (5660): 961.
> Connor, S. "Ukwelapha i-HIV manje kungenzeka ukuthi kungenzeka." I-Independent. Ishicilelwe uMeyi 19, 2013.