Ukulinganisa Ubufakazi Ekusekeleni Ukwelashwa
I-immunoglobulin engathandeki (IVIG) uhlobo lokwelapha lapho inhlanganisela yamagciwane (i-immunoglobulins) ingenwa ngayo emthanjeni ngenjongo yokuthuthukisa umzimba womuntu. Ama-antibodies ngamaprotheni avikelayo akhiqizwa umzimba ngokuphendula isifo.
I-IVIG ikholelwa ukuthi isebenza ngezifo ze-neurolo ngokukhuthaza ezinye izingxenye zesimiso sokuzivikela komzimba nokucindezela abanye.
Akekho owazi kahle ukuthi isebenza kanjani, futhi, ngaleyo ndlela, i-IVIG inqunywe ngaphandle-ilebula (ngaphandle kwemvume ecacile ye-FDA) yezifo lapho amasosha omzimba omuntu ehlaselwe khona kakhulu.
Lezi zingabandakanya i-nepsatal sepsis, igciwane lesandulela ngculazi, kanye namacala athile we- HIV ethuthukile . Ibuye isetshenziswe njengokwelashwa kwemigqa yesibili yokwelapha ekubuyiseleni kabusha-ukukhipha isifo se-multiple sclerosis (RRMS) .
Ukusetshenziswa kwe-IVIG ku-Multiple Sclerosis
I-IVIG isetshenziswa ku- multiple sclerosis (MS) ukuqhubekela phambili kancane kwesifo nokunciphisa ukukhubazeka okubangelwa yisifo. Nakuba kungekho ukuvumelana okucacile mayelana nokuthi i-IVIG ibaluleke kangakanani, ibonise isithembiso ezindaweni eziningana:
- Ukuvimbela i- MS kubuya ekukhulelweni kokubeletha
- Ukwelapha abantu abahlulekile ukwelashwa kwemigqa yokuqala ye-RRMS futhi abakwazi ukubekezelela izidakamizwa zendabuko eziguqula izifo
- Ukwelapha i- MS yesibili eqhubekayo (nakuba kusekhona impikiswano mayelana nokusebenza kwayo)
Okunye ucwaningo luye lwaphakamisa nokuthi i-IVIG enikezwe ngesikhathi sokuqala kwesifo se-MS (esibizwa ngokuthi i- syndrome eyimilaphi, noma i-CIS ) inganciphisa ithuba lomuntu lokuguqula ukuxilongwa okucacile kwe-MS. Iningi lolo cwaningo luye lahlangatshezwa nokungaqiniseki noma ukungabaza.
Ukusebenza kwe-IVIG
Ngalesi sikhathi, akekho owazi kahle ukuthi i-IVIG ephumelelayo kanjani ekwelapheni noma ekunciphiseni ukuqhubekela phambili kwe-MS.
Iningi lobufakazi lusekelwe emiphumeleni yalo kwezinye izifo ze-neurological, ezifana no- Guillain-Barré syndrome kanye ne- myasthenia gravi s. Izifundo ezigxile kwi-IVIG kanye ne-MS zixutshwe kahle.
Olunye ucwaningo lwase-Australia lubonise ukuthuthukiswa okuncane kodwa okuphawulekayo kokukhubazeka njengoba kulinganiswa nesilinganiso sokukhubazeka kwesimo sokukhubazeka (EDSS) . Abanye baye babonisa ukuthuthukiswa okuncane esayizi noma inombolo yezilonda zobuchopho ku-MRI.
Abanye, okwamanje, ababonisi umehluko ekusebenzeni kwe-IVIG kuqhathaniswa nama-placeboes ekwelapheni i-RRMS.
Mhlawumbe indawo eyodwa yesithembiso iyisisetshenziswa se-IVIG ngemva nje kokubeletha, umkhuba oye wabonisa ekunciphiseni kakhulu izinga lokuphindaphinda emama omusha.
Isilinganiso Nokuphatha
Ngenkathi ukulinganisa kanye nokuvama kokulinganisa akuzange kusungulwe ku-RRMS, abakwa-prescribers abaningi batusa umthamo wesigamu esisodwa kilogram yesisindo somzimba esinikezwa njalo ngenyanga. Abanye bayomisa inkambo ka 400 mg / kg ngosuku ngezinsuku ezinhlanu.
Okuqhamuka uma udla imishanguzo
Umphumela ovame kakhulu ohlangothini lwe-IVIG uyinhloko yekhanda (okungajwayele ukuphathwa nge-painkiller ngaphezulu kwe-counter like Tylenol). Eminye imiphumela emibi ingase ihlanganise umkhuhlane, ubuhlungu obuhlangene, ubuhlungu besifuba, nokuhlanza. Ngokuvamile, ukuqhuma okuhlobene nezidakamizwa kungase kuthuthuke.
Iminye imiphumela emibi kodwa engavamile yabuye yaphawulwa, kuhlanganise ne- aseptic meningitis , ukuhlasela kwenhliziyo, ukushaya isisu, ukucindezeleka okukhulu kwe-vein, ukungasebenzi kwezinso, nokuhluleka kwezinso.
Ukusebenzisana nokulingana
I-IVIG akufanele isetshenziswe kubantu abanezinkinga zezinso noma ukungabi nalutho kwe-IgA (isifo sofuzo esibonakala ukungabi nalutho lwe-antibody oluvikela izifo emlonyeni, e-airways, nangendlela yokugaya ukudla). A
Okwamanje, IVIG kufanele isetshenziswe ngokucophelela kubantu abane:
- Izinkinga zenhliziyo
- Isifo sikashukela
- Ukuzwela kuma-immunoglobulins
- Ukuzwela ku-maltose noma i-sucrose (izithako ezisetshenziswa kwezinye izinhlobo ze-IVIG)
Ukuxhumana okucacile kuphela ne-IVIG kuhilela imishanguzo ephilayo. Ama-immunoglobulins anganikeza umuthi wokugoma awusizo futhi awukho isidingo sokuvikela umgomo wokugoma.
Izindleko zokwelapha
I-IVIG iye yaba yabiza ngokweqile ku-$ 100 ngesigamu ngasinye. Ngomuntu onesisindo esingamakhilogremu angu-70, umthamo wenyanga ophakanyisiwe uzoqeda izindleko ezizungeze u-$ 7,000 ngokukhipha, ngaphandle kokufaka izindleko zokuphatha nezindleko zokuhlengikaza.
Ezinye izinkampani zomshuwalense zingase zihlanganise izindleko, kodwa ngokuvamile kunzima ukugqugquzela ukwelashwa futhi ngokuvamile kudinga inqubo yezikhalazo ekugcineni ukuthola imvume. Uma kuvunyelwe, ukukhokhelwa kwe-inshuwalense kungaba phezulu kakhulu. Kodwa-ke, abakhiqizi abathile be-IVIG banikeza izinhlelo zokusiza iziguli (PAPs ) ukuze zilahle noma zimboze ngokuphelele izindleko zokwelashwa.
Izwi elivela
Uma kuphakanyiswa i-IVIG, kungase kudingeke uzivikele ukuze uthole imvume yomshuwalense wakho. Uma kuthiwa, kubalulekile ukuqonda izinzuzo kanye nokulinganiselwa kokwelashwa okuhlongozwayo-ikakhulukazi lokho ucwaningo lusitshela khona futhi alusitsheli.
Uma ungenakucaca ngalokhu ngalokhu, ungangabazi ukufuna umbono wesibili kuchwepheshe oqeqeshiwe.
> Imithombo:
> Bayry, J .; I-Hartung, H .; no-Kaveri, S. "I-IVIg yokuphindaphinda-ukulungisa izifo eziningi ze-sclerosis: izithembiso nokungaqiniseki." Amathrendi Pharm Sci. 2015; 36 (7): 419-421.
> Gilardin, uL .; Bayry, R .; kanye noKaveri, S. "I-immunoglobulin engathandeki njengendlela yokwelapha emitholampilo emitholampilo." I-CMAJ. 2015; 187 (4): 257-264.