Ukufakelwa kwesitembu se-stem yinkambu yokuhlola kanye neyasanda kuqhutshwa yocwaningo lwe- Multiple Sclerosis (MS) , futhi imiphumela yocwaningo lwesayensi manje isethembisile. Lokhu kuthiwa, ochwepheshe baqaphele, njengoba lolu hlobo lwezokwelapha lukhokhisa emzimbeni, futhi ludinga ukulinganisa ngokucophelela kwezinto ezihambisana nalokho.
Ukufakelwa Kwama-Stem Cell in Multiple Sclerosis
Esikhathini esedlule, ukuguqulwa kwe-stem cell kwagcinwa kulabo abanezinhlobo ezithile zomdlavuza wegazi noma umnyosa wethambo, njenge-leukemia, i-lymphoma, noma i-myeloma eminingi.
Kodwa eminyakeni eminingi edlule, ukuguqulwa kwe-stem cell kuye kwaphenywa ekwelapheni ezinye izimo zezokwelapha ezihlobene nomzimba, kuhlanganise ne-multiple sclerosis.
Ukufakelwa kwe-stem cell ukuphathwa kwe-MS kuqala ngenqubo ebizwa ngokuthi ukuvunwa kwe-stem cell. Le nqubo ihlanganisa ukukhipha amangqamuzana omuntu womuntu kusuka egazini lakhe legazi (elifinyeleleke nge-vein) noma umthambo wabo wamathambo (otholakala ngenaliti emgodleni).
Ithimu lezokwelapha elihlelekile kulokhu yi-autologous transplant cell-transplant-autologous okusho ukuthi amasosha omuntu siqu asetshenziselwa futhi i-hematopoietic echaza igazi-cell cell forming.
Uma ama-stem cells eqoqwa futhi agcinwa, umuntu uyoba nesisombululo sakhe sokuzivikela (esibizwa ngokuthi ukufakelwa okungekho myeloablative) noma ukucinywa (okubizwa ngokuthi ukufakelwa kwe-myeloablative). Lokhu kukhishwa noma ukusula kutholakala ngezidakamizwa zamakhemikhali kanye nama-immune-depleting antibodies.
Umehluko phakathi kokucindezelwa kwe-immune system kanye ne-ablation (ukuqothula) ukuthi ukusula kudingekile ukuthi kunezinga eliphakeme kakhulu, elinomuthi onobuthi we-chemotherapy, uma kuqhathaniswa nokususwa, okudinga ukulinganisa okuncane, okuncane kakhulu.
Emva kwalesi sigaba sekuphelile, umuntu uzophumula izinsuku ezimbalwa ngaphambi kokuba abe ngaphansi kwe-stem cell infusion-inqubo lapho amangqamuzana ama-stem anikezwa khona kumuntu nge-vein.
Uma sekufakwe, lokhu kubonakala ukuthi amangqamuzana ahamba esuka egazini eya emnothweni we-bone lapho akhiqiza khona futhi akha uhlelo lokuzivikela omzimba omusha-umqondo wokuthi lesi simiso somzimba omusha nesithuthukisiwe sizoba nesiphephelo futhi ngeke sihlasele umgogodla we-myelin ebuchosheni nasemgodleni cord.
I-Science Behind Stem Cell Transplantation e-MS
Esifundweni sase-Canada e- Lancet ngo-2016 , abathintekayo abadala abangu-12 ngokuvuselela izifo eziningi ngokuphindaphindiwe kanye neziguli ezingu-12 ezine-MS ezihamba phambili ezitholwa yi-stem cell transplantation. Laba babambiqhaza babe nezifo ezinonya futhi isifo esiphezulu kakhulu, okusho ukuthi babe nama-MS amaningi aqala ukukhubazeka okuqhubekayo, naphezu kokwelashwa kwe-MS.
Imiphumela yalolu cwaningo yayithembisa noma kunjalo. Kulabo abangu-24 abahlanganyeli, abangu-17 (amaphesenti angu-70) babengenalo umsebenzi wesifo se-MS eminyakeni emithathu ngemuva kokufakelwa kabusha. Ayikho imisebenzi yesifo se-MS esho:
- akukho MS entsha ebuyela kabusha
- ayikho izilonda ezintsha ze-MS ku-MRI
- akukho bufakazi bokuthuthuka kwesifo
Ngaphezu kwalokho, eminyakeni engama-7.5 emva kokufakelwa, amaphesenti angu-40 abahlanganyeli ayephuthumayo ekukhubazekeni kwabo okuhlobene ne-MS. Eqinisweni, abanye babahlanganyeli babe nokutholakala okuphawulekayo kubandakanya:
- isinqumo se-nystagmus ne- ataxia
- buyela emsebenzini noma esikoleni
- ukushada noma ukuhlanganyela
- ukuba nezingane esebenzisa iqanda / umdlandla okhishiwe noma owenziwe
Konke lokhu kushiwo, kubalulekile ukuqaphela ukuthi kwabahlanganyeli abangu-24, omunye wabulawa ngenxa yesifo, ukuhlukunyezwa okuhlobene nokuguqulwa kwe-cell cell. Omunye umhlanganyeli wabuye wahlakulela izinkinga ezihlobene nesibindi futhi wangena esibhedlela isikhathi eside. Futhi, kwakukhona nemiphumela emibi ehlobene nokufakelwa kwezitshalo , njengemfiva ye- neutropenic kanye ne-toxicities ehlobene ne-chemotherapy.
Ucwaningo oluthe xaxa lwe-Stem Cell Transplant Research ku-MS
Esifundweni sika-2015 ku- JAMA , abathintekayo abangu-123 abane-MS kanye nabangu-28 ababambe iqhaza nge-MS eyayihamba phambili, babene-transplantation ye-stem cell.
Abahlanganyeli balandelwa ngokwesilinganiso iminyaka engu-2.5. Ngokungafani nesifundo esandulele, amasosha omzimba kulezi ziguli ayexoshwa, ngokuphambene nokucinywa ngaphambi kwe-stem cell infusion-ebizwa ngokuthi ukufakelwa kwe- non-myeloablative stem cell cell .
Imiphumela iphakamisa kokubili ukwehla kwenombolo yokubuyiselwa kabusha nenombolo ye -MS-gonolinium-enhanced MS lesions kuwo wonke ama-MRIs wokufakelwa kwe-cell-stem. I-Brain MRIs yayigcwaliswe ezinyangeni ezingu-6 emva kokufakelwa futhi ngonyaka.
Futhi, kube nokuthuthukiswa ngamaphuzu owodwa noma ngaphezulu ku- EDSS score ngamaphesenti angu-50 wabathintekayo eminyakeni emibili namaphesenti angu-64 wabathintekayo eminyakeni emine. Izinyathelo ze-EDSS ezinyathelo ze-MS ukuqina nokuqhubeka kokukhubazeka. Kodwa lokhu kuthuthukiswa kubonakala kuphela kulabo abane-MS ekubuyiseleni kabusha (hhayi kulabo abane-MS okuqhubekayo), futhi kulabo abane-MS iminyaka eyishumi noma ngaphansi.
Lolu cwaningo lwalube nemiphumela emibi kakhulu embi-hhayi ukufa noma izifo ezinzima. Lokhu kungenzeka ukuthi kubangelwa ukususwa ngokuqothula amasistimu omzimba ngaphambi kokuba amangqamuzana amancane abekwe.
Izwi elivela
Nakuba lokhu kuwukucwaninga okuthakazelisayo, ochwepheshe basalokhu beqaphele. Lezi zivivinyo zincane futhi azikwazi ukulawula amaqembu. Izifundo ezinkulu neziningi zesikhathi eside zidinga ukuqonda ngempela inzuzo nokuphepha kokufakelwa kwezitshalo ze-stem ekuphatheni i-MS. Futhi, izingozi zezempilo ze-stem cell transplantation zingokoqobo. Ngakho ukuthola izindlela zokunciphisa lezi zingozi kuyinselele yamanje neyokucindezela.
Ngaphezu kwalokho, noma ngabe ukuguqulwa kwe-stem cell kuvunyelwe i-MS, kungaba yindlela yokwelashwa egcinelwe kulabo abane-MS enamandla kakhulu abaye bahluleka ukwelashwa kwendabuko njenge-interferons noma i-Copaxone-hhayi ukuthi ngeke isebenze kulabo abanesifo esibi , kodwa nje ukuthi izingozi zingase zingafaneleki.
Imithombo:
I-American Cancer Society. Ukuguqulwa Kwamaselula E-Stem for Cancer.
Atkins et al. I-Immunoablation kanye ne-autologous stem-cell transplantation ye-multiple sclerosis ehlukumezayo: isivivinyo sesi-2 seqembu elilodwa elilodwa. I-Lancet. 2016. 2016 Jun 8. pii: S0140-6736 (16) 30169-6.
Burt RK et al. Inhlangano ye-hematopoietic stem cell transplantation engeyona iseliablative enokukhubazeka kwezinzwa ezigulini ezine-sclerosis ephindaphindiwe. I-JAMA . 2015 Jan20; 313 (3): 275-84.