Ukuhlolwa kwegazi kuhlola ingozi yezifo zobuchopho ezihlobene ne-MS
I-leukoencephalopathy ye-multifocal i-protifistal (PML) iyisifo esingavamile segciwane lobuchopho. Ingozi ye-PML ngezinye izikhathi ingakhuphuka kubantu abathatha i- Tysabri (natalizumab) , isisetshenziswa esishintsha isifo esetshenziswa ukuvimbela ukuphindaphinda kubantu abane- multiple sclerosis (MS) .
I-PML ibangelwa igciwane likaJohn Cunningham (i-JC virus), ukutheleleka kwesandulela ngculaza okuvame ukugcinwa ngaphansi kokulawulwa yisistimu yomzimba.
Kodwa-ke, uma isimiso somzimba sokuzivikela sisinciphile, igciwane lingakwazi ukuvuselela futhi libangele ukuvuvukala okungathí sina kwengqondo.
Ukuze ugweme lokhu kubantu abane-MS, odokotela bazokwenza uhlolo lwe-antibody ukuze bahlole ubufakazi begciwane emlonyeni womuntu.
I-PML ne-JC Virus
Ucwaningo lubonisa ukuthi cishe amaphesenti angama-70 abantu base-US anesifo se-JC. Abantu abaningi abazi ukuthi bane-HIV, futhi bambalwa ababhekana nokugula ngenxa yokutheleleka.
Kuyinto kuphela uma izivikeli zomzimba zomuntu zikhubazeka ukuthi lesi sifo singaba "sithonya." Lokhu kusho ukuthi umzimba awunawo izindlela zokuzivikela ngokwawo, futhi igciwane lixhaphaza ithuba lokubangela izifo.
Sibona lokhu kubantu abanesifo se- HIV esithuthukisiwe . Ngegciwane lesandulela ngculazi, igciwane liyahlanza kancane kancane amasosha omzimba futhi libeka umzimba emzimbeni wezifo ezithandanayo (OIs).
I-PML iphakathi kwama-OIs futhi ihlukaniswa njengesimo esichaza i- AIDS kubantu abane-HIV.
Nge-MS, imbangela ihluke kakhulu. Kulesi simo, ukuguqulwa kwamagciwane kubangelwa imithi ethile esetshenziselwa ukuphatha i-MS. Le mithi ihlanganisa i-Tysabri, i-Tecfidera (i-dimethyl fumarate), ne-corticosteroids.
Uma usuvuselelekile, igciwane lingadlula emkhakheni wegazi / wengqondo ohlukanisa isimiso sezinzwa esivela kuwo wonke umzimba.
Ekugcineni, amaphesenti amancane kakhulu abantu abathatha i-Tysabri bazokwakha i-PML futhi ihlose ukuchaphazela labo abanezici ezilandelayo:
- Ukuvezwa kwamuva noma kwamanje kwezinye izidakamizwa ezicindezelayo zokuzivikela (njenge azathioprin, cyclophosphamide, dimethyl fumarate, methotrexate, mitoxantrone, noma i-mycophenolate mofetil)
- Ukusebenzisa i-Tysabri iminyaka engaphezu kwengu-2
- Ukuhlola okuhle ku-JC virus antibody
I-JC Virus Antibody Blood Test
Ama-antibodies avikela ama-proteine omzimba avikelelwa yisistimu yomzimba ngokuvikela isifo samagciwane esihlasela isifo njenge-JC virus. I-antibody ngayinye iqondene nalokho okuyi-pathogen kanye ne-pathogen eyedwa. Uma ushicilelwe, lowo antibody uzohlala emzimbeni ukuphendula uma kwenzeka i-pathogen ibuya.
Ukuqinisekisa ukutheleleka, sizokwenza ukuhlolwa kwegazi okulindelekile ukuthola izinsiza ezithile ze-antibodies. Umphumela wesivivinyo ungasitshela enye yezinto ezimbili:
- Umphumela omuhle usho ukuthi umuntu uye wahlushwa igciwane.
- Umphumela omubi kusho ukuthi abukho ubufakazi bokuthi kuvezwe.
Inselelo lapha, ukuthi abantu abaningi bazobe benesandulela ngculazi ye-JC.
Ngakho-ke ngenkathi umphumela omuhle ungase ukhombise ingozi yokwandiswa kwe-PML, akuyona inkinga yokwelapha. Kunalokho, kuvumela udokotela ukuthi abheke lokhu kanye nezinye izici eziyingozi ukuze anqume ukuthi i-Tysabri iyadingeka yini noma uma ezinye izinketho ezikhona zikhona.
Ngesikhathi esifanayo, ukuhlolwa kwe-antibody akuphelelanga, futhi kunamathuba amathathu wamaphesenti ukuthi angaletha umphumela ongamanga. Lesi esinye sezizathu zokuthi kungani ukuhlolwa kwe-antibody kusenziwa ngaphambi kokuqala i-Tysabri futhi kuphindwe izinyanga eziyisithupha kamuva ukuhlola noma yikuphi umsebenzi wegciwane.
Izwi elivela
Nakuba i-JC virus antibody test iyasiza ekunqumeni ukuthi ubani ongase abe engozini enkulu yokuthuthukisa i-PML uma usebenzisa i-Tysabri, akufanele ilahle phansi ukubaluleka kwesidakamizwa ekuvimbeleni ukuphindaphinda kwe-MS.
Ekugcineni, isinqumo sokuthi usebenzise i-Tysabri noma cha ingumuntu oyedwa futhi kufanele senziwe ngokubonisana nodokotela ochwepheshe. Uma ukwelashwa kunqunywe, ukulandelwa okujwayelekile kuyadingeka ukuba ungabheki kuphela ukuphumelela kokwelashwa kodwa ugweme noma yimiphi imiphumela emibi.
> Imithombo
> Gorelik, L .; ULerner, uM .; Bixler, S. et al. "Anti-JC virus antibodies: impikiswano yokunciphisa ingozi ye-PML." Ama-Annal of Neurology. 2010; 68 (3): 295-303.
> Schwab, N .; Schneider-Hohendorf, T .; I-Pignolet, B. et al. "Ukwelapha nge-natalizumab kuhlotshaniswa ne-JC ephezulu ye-seroconversion nokuphakama kwamazinga we-JCV." I-Neurology: I-Neuroimmunology ne-Neuroinflammation. 2016; 3 (1): e195.