I-Omalizumab ye-Treatment of Chronic Idiopathic Urticaria
Iyini i-Urticaria engapheli?
I-Urticaria , i-term medical yezinyosi, yisimo esingathinta umuntu oyedwa kubantu abayisihlanu ngesikhathi esithile sokuphila kwabo. Ukuqhuma kwe-urticaria kuvame ukuqhuma, kubomvu nokukhwabanisa. Ama-bumps angaba usayizi wokulunywa umiyane ukuze usayizi wesinhlamvu noma ukhulu, futhi ungaqoqa ndawonye zibe ngobunjwa obungavamile, okubizwa ngokuthi i-coalescing.
Ukuqhuma kuzovame ukuza nokuhamba phakathi kwamahora ambalwa, ukusuka endaweni eyodwa emzimbeni kuya kwenye.
Ukuvuvukala okuvame ukuhamba nge-urticaria, okubizwa nge- angioedema , kungaholela ekuvupheni ubuso, izandla nezinyawo. I-Angioedema ngokuvamile ayibomvu noma inhlanhla, kodwa ijwayele ukugaya nokushisa, futhi ingachazwa ngokuthi "ukuphazamiseka." Lokhu kuvuvukala kungaba nzima, futhi uma kuthinta ikhono lomuntu lokuphefumula, kungasongela ukuphila.
Kokubili i-urticaria ne-angioedema ziwumphumela we- histamine namanye amakhemikhali akhishwe kusuka kumasipha omzimba esikhumbeni nasezingxenyeni zamangcwaba. Lokhu kungase kwenzeke ngokusebenzisa inqubo yokwelapha noma eyodwa lapho amangqamuzana amantombazane akhipha amakhemikhali ngaphandle kwe- IgE ehilelekile.
Amacala e-urticaria ne-angioedema angaba acute, ahlale engaphansi kwamasonto ayisithupha, noma angapheli, ahlala isikhathi esingaphezu kwamasonto ayisithupha. Ngokungafani ne-urticaria enamandla, amaphesenti angaba ngu-5 kuya kwezingu-10 kuphela e-urticaria engapheli nangama-angioedema abangelwa yi-allergies.
Isizathu se-urticaria esingapheli asikwazi ukukhonjwa ngaso sonke isikhathi, esibizwa ngokuthi i-idiopathic urticaria engapheli (CIU). I-CIU kungenzeka kakhulu ukuthi ihlobene nezimbangela ezizenzakalelayo kunezifo. Efomu le-autoimmune i-CIU, umuntu ngokuvamile wenza ama-antibodies ngokumelene nengxenye yamasethini awo omzimba (mhlawumbe e-receptor ye-mast cell for IgE antibodies, noma kwi-IgE yangempela eboshelwe esitokisini sesisindo), okubangela ukukhululwa kwe-histamine nokudala izimpawu.
Ukwelashwa okuyinhloko kwe-CIU kunama- antihistamine omlomo. Lezi zivame ukunikezwa ngamafomu omlomo, futhi kungadingeka ukuthi zinikezwe ngezikhathi ezinkulu noma ezivamile ukulawula izimpawu. Kodwa-ke, abantu abangaphezu kuka-50% abane-CIU bangase bangaphenduli ekwelashweni nge-dosing evamile yama-antihistamine omlomo. Izindlela zokwelashwa ezengeziwe ze-CIU zivame ukudingwa, kepha azivunyelwe yi-US Food and Drug Administration (FDA) ngale njongo. Ngakho-ke, ukwelashwa okwengeziwe kwe-CIU, okuvunyiwe yi-FDA, kuyadingeka kulabo bantu abangaphenduli emithethweni evamile yama-antihistamine omlomo.
Kuyini i-Xolair?
I-Xolair (i-omalizumab) iyimithi ejojelwayo evunyelwe yi-FDA ukuphatha ngokulinganayo ukucindezeleka okukhulu kwesifo se-asthma kubantu abaneminyaka engu-12 ubudala nangaphezulu. Ama-injection anikezwa ehhovisi likadokotela njalo ngemva kwamasonto amabili kuya kwangu-4, kuye ngesisindo somuntu kanye ne-antiergic antibody (IgE). I-Xolair i-anti-IgE anti-monoglon anti-IgE, ehlanganisa i-IgE egazini, okwenza umzimba uwasuse. Lokhu kuvimbela i-IgE ukuthi ingaxhunyiwe kumaseli amancane (ngakho-ke ekubophezelweni kwezilwane) okuyinto ekugcineni iphumela ekukhululweni kwe-histamine namanye amakhemikhali. Yilawa amakhemikhali abangela ukwanda kwe-asthma nezinye izibonakaliso zokungena emzimbeni, kuhlanganise ne-urticaria ne-angioedema.
Ingabe I-Xolair Ingasetshenziswa Ukuphatha U-Urticaria Okuvamile?
Izifundo zakuqala ziqinisekile. Ucwaningo oluningana luhlolisise inzuzo ye-Xolair yokwelashwa kwe-CIU. Ucwaningo lwamuva luhlolisise iziguli ezingaphezu kuka-300 ezine-CIU ezazingenayo izimpawu naphezu kokuthatha ama-antihistamines. Zazilawulwa i-Xolair ezinyangeni ezihlukahlukene njalo emavikini amane. Amaphesenti angu-40 abantu abathola i-Xolair ye-high-dose, kanti abantu abangu-22% abathola i-dose-dose Xolair, babenombono ophelele wezinyosi zingakapheli amasonto amabili ukwelashwa. Izimpawu zanda kancane emva kwe-Xolair, ngakho-ke kwakungekho uphawu lwezinzuzo zesikhathi eside.
Ezinye izifundo zithole izinzuzo ezifanayo, namazinga "okukhululwa" ku-Xolair cishe abantu abangu-30% abane-CIU. Idatha engcono kunazo zonke ibonakala ivela esicwaningweni esincane lapho umthamo we-Xolair wawufana nokuthi unikezwa kanjani umuntu onesifo se-asthma. Iziguli kulolu cwaningo zinebufakazi be-autoimmune CIU ngokusekelwe kwesilinganiso se-autoantibodies (ama-antibodies ngokumelene nawe) ngokumelene namahomoni wegciwane. Amaphesenti angamashumi ayisikhombisa abantu abathola i-Xolair banesinqumo esiphelele sezimpawu zabo ze-CIU.
Ngakho-ke, ucwaningo lubonisa ukuthi i-Xolair iyindlela yokwelashwa ephephile futhi ephumelelayo yeziguli ezine-CIU, futhi impendulo yokwelashwa ibonakala ingaphansi kwesisindo somuntu, izinga le-IgE ye-serum, noma isimo se-autoimmune. Izinzuzo ze-Xolair cishe zihlala kuphela lapho izidakamizwa zithathwa, okusho ukuthi akunakwenzeka ukuthi kube nokukhululwa kwesikhathi eside okwenziwe i-Xolair kubantu abane-CIU. Ngeshwa, kusukela i-Xolair iyabiza kakhulu, futhi abantu abaningi abane-CIU bangalawulwa ngokulinganisa okuphezulu kwe-antihistamines yomlomo, bambalwa kakhulu abantu abangathola i-Xolair ye-CIU. I-US Food Administration and Drug Administration igunyaze ukusetshenziswa kwe-Xolair ye-CIU ngoMashi 2014.
Imithombo:
I-Casale TB. I-Omalizumab ye-Urticaria Engapheli. J Allergy Clin Immunol Pract. 2014; 1: 118-9.
I-DA ye-Kahn. Ama-Alternative Agents E-Urticaria Eyingozi Yokwenyama: Ukufakaza nokucabangela ekukhetheni kwabo nokusetshenziswa kwabo. J Allergy Clin Immunol Pract. 2013; 1: 443-40.