AIDS da Tsarin Dama da Kwayoyin Duka zai iya haifar da mummunar damuwa
Kwanan nan, saboda gabatar da sababbin kwayoyin rigakafin rigakafi da kuma karuwa a yawan adadin suturar jiki, mun ga mutane da yawa wadanda ba su da kariya ko kare rayukansu.
Tsarin kwayoyin halitta shine tarin dukkan kwayoyin halitta, kyallen takalma, da kuma gabobin da ke taimakawa jiki wajen kawar da kamuwa da cuta. Idan ba tare da wani tsari ba, wani mutum ya ci ganima ga duniya.
Mafi yawan magungunan immunosuppressant magani, duk da haka, suna da dalili guda daya da yasa mutane suka zama immunosuppressed ko immunocompromised. Hakika, wasu abubuwa mara kyau zasu iya rushe tsarin rigakafi, har ma da cutar AIDS da cututtuka.
Menene Tsarin Rashin Gida?
Tsarinka na rigakafi ya wanzu don hana ko cutar kamuwa da cuta. Kwayoyin da hanyoyi na tsarin na rigakafi suna da rikitarwa da bambanci kuma sun wadata dukkan sassa na jiki.
Ga waɗannan nau'ukan daban-daban na tsarin rigakafi:
- Rashin kasusuwan shi ne inda dukkan fun zasu fara. Kullun kasusuwan yana dauke da kwayoyin kwayoyin da suke ci gaba da zama nau'o'in kwayoyin halitta (B, sel na T, lymphocytes, da sauransu).
- Ba wai kawai fata ce ta farko ta kare ba daga zalunci daga kasashen waje, amma wasu launi na fata (kamar dermis) suna da wadata a cikin sel. Bugu da ƙari, fata kuma yana samar da sunadaran antimicrobial.
- Akwai kuri'a na kwayoyin da ba a yaduwa a cikin jini. A gaskiya, ana amfani da gwaje-gwaje na jini don saka idanu kan rigakafi.
- Tsarin lymphatic yana cike da kwayoyin jikinsu. Tsarin kwayoyin lymphatic ya zubar da jini tare da kyallen takarda da ke cikin jiki kuma yana aiki ne a matsayin hanyar haya don hawa da sassan kwayoyin cutar. Wadannan kwayoyin jikinsu sunyi juyawa a cikin ƙwayoyin lymph. A cikin ramuka na lymph, an amsa amsawar rigakafi lokacin da aka gano microbes.
- Kwayar da ke cikin kwayar halitta wanda ke ba mu damar daidaitawa zuwa barazanar da kamuwa da kamuwa da cuta ke ciki shine T-cell. Kodayake an fara samar da kwayoyin t-T a cikin kasusuwan kasusuwa, suna ci gaba da girma cikin thymus.
- Mutane suna rayuwa ba tare da yaduwa ba (rashin lafiya ne na likitancin likita saboda rashin aikin yalwa ko splenen). Duk da haka, jaririn yana taimakawa wajen shirya jikin don kamuwa da cuta, kuma mutane ba tare da yaduwa ba sun fi dacewa su haifar da kamuwa da cuta tare da wasu pathogens kamar meningococci (tunanin meningitis), Streptococcus pneumoniae (tunanin pneumonia) da Haemophilus influenzae , ko H. influenza . Lura cewa duk da sunansa, H. influenza bazai haifar da mura ba kuma a maimakon haka yana haifar da kamuwa da cututtuka a cikin yara. Jirgin ya yi aiki kamar yadda tace tace jiki, da kuma ɓangaren kwayoyin da ke cikin kwayar cutar jini don alamun kamuwa da cuta. Idan kamuwa da cuta ba ya kasance ba, toshe yana kunna amsawar ba tare da wata matsala ba.
- Kamar fatar jiki, nau'in mucosal, irin su wanda yake samuwa da gastrointestinal da na respiratory tracts, kuma maɗaukaki ne na farko na kare da zai hana germs daga samun ƙofar jiki. Kamar yadda irin wannan, nau'in mucosal yana da wadata a cikin kwayoyin halitta.
Jihar Nasa na Immunosuppression
Tsarin tsarin tsarin rigakafi ya dogara da dalilai da dama. A sakamakon haka, tsarin mutum na immunosuppression ya kasance bayanan bayan la'akari da wadannan masu canji:
- irin immunosuppression (na biyu zuwa magani ko rashin lafiya)
- duration of immunosuppression
- tsanani na immunosuppression
- sashi da nau'i na magungunan immunosuppressant ko kwayoyi
- ƙananan marasa lafiya (cututtukan da suka haɗu da rikici tare da tsarin marasa lafiya)
- abubuwan da ke haifar da raunuka (kamar ƙananan ƙwararren ƙwayar ƙwayar ƙwayar cuta don tiyata ko radiation)
- kamuwa da cuta (tunanin HIV ko CMV)
Immunosuppression Daga sakamakon Magunguna
Ƙwayoyin magunguna sun rushe tsarin rigakafi. Wadannan magungunan immunosuppressant na iya rushe hanyoyi daban-daban na amsawar rigakafi ko manufa kowane nau'i na kwayoyin rigakafi.
Ga wadansu magunguna 3 da zasu iya rushe tsarin rigakafi:
- Corticosteroids . Wadannan magunguna an tsara su ne don irin nau'in mota, rashin lafiyar, da kuma yanayin kumburi, irin su cututtuka na rheumatoid, cututtukan zuciya mai fuka, fuka, da kuma atopy. A cikin gajeren lokaci, waɗannan magunguna suna tsangwama tare da aikin salula. Musamman, corticosteroids sun ƙididdige lambobin lymphocytes da monocytes da kuma kawar da hijira da kuma aiki na phagocyte. Yawancin lokaci na waɗannan magungunan sun hada da sutura da fata da gyaran jiki, duka biyu zasu iya kara damuwa immunosuppression. Mutanen da suke kan maganin masu ciwon sukari sun fi kamuwa da kamuwa da cuta da kwayoyin halitta, irin su Pneumocystis jirovecii , wanda ke haifar da cutar Pneumocystis da ciwon huhu , da Strongyloides , wanda kuma yana iya mutuwa kuma ya haifar da roundworms. Bugu da ƙari, mutanen da suka raunana tsarin rigakafi na biyu don amfani da steroid suna da haɗari na sakewa da tarin fuka ko sauran cututtuka na latent.
Rituximab. Ana amfani da wannan ƙwayar cuta guda daya zuwa CD20 don magance lymphoma ba na Hodgkin, arthritis na rheumatoid, da cutar cutar sankarar lymphocytic na kullum. A lokacin gwajin gwagwarmaya, rituximab ba nasaba da haɗarin kamuwa da cuta. Tun da rituximab ya kasance a kasuwa, duk da haka, akwai rahotanni (anecdotal) dangane da haɗin ginin rituximab zuwa irin cututtuka irin su ci gaba da ciwon kwayar cuta mai yawa, wanda ke haifar da kwayar cutar JC, da kuma tsarkakakken kwayar cutar kwayoyin jini, wadda ke hade da kamuwa da parvovirus. . Bugu da ƙari, magungunan immunosuppression na biyu zuwa gundumar rutiximab zai iya haifar da sake farfadowa da cutar rashin ciwon ƙwayar cutar hepatitis B.
Necrosis Factor-Alpha (TNF-α) Masu hanawa. Wadannan magunguna ne cytokines; Kwayoyin cytokines sukan samar da kwayoyin jikinsu. Masu hawan TNF-α sun hada da kwayoyi irin su infliximab, certolizumab pegol, da kuma wasu kwayoyin cuta guda daya kuma ana amfani da su don biyan yanayin yanayin kai kamar cututtukan cututtuka na rheumatoid da cutar Crohn. Bayanan kula, rashin tallafi daga sakamakon wadannan kwayoyi ya buɗe ƙofar zuwa kamuwa da cuta tare da Listeria monocytogenes , abincin da ke da abinci wanda zai iya haifar da mutuwar tayi a cikin mata masu ciki.
Immunosuppression Sakamakon daga Asplenia
Ana cire shinge mai sauƙi "splenectomy". Akwai dalilai da dama da ya sa mutum zai iya kawar da ita daga ciki, ciki har da ciwon daji, cututtuka, da kuma jini (kamar tsabtace ƙwayar cuta na thrombotic). Maganar likita "ƙaddara" ba wai kawai tana nufin cire tumɓir ba ta hanyar splenectomy amma har asarar aiki na splenic na biyu zuwa yanayin kamar malamin sickle cell anemia.
Mutanen da ke da matsala suna fuskantar haɗarin kamuwa da cuta tare da kwayoyin halitta, irin su Streptococcus pneumoniae , Haemophilus influenzae , da wasu siffofin Neisseria meningitides . A cikin waɗannan mutane, kamuwa da cuta mai tsanani zai iya saita sauri - musamman ma a cikin yanayin sikila ko kamuwa da jini. Sepsis yafi kowa a cikin mutanen da ke fama da ciwon daji (malignancy) fiye da wadanda suke da raunin su bayan an samu hatsari (trauma). Na bayanin kula, hadarin kamuwa da cuta tare da kwayoyin halitta wanda ya fi girma a cikin 'yan shekarun farko bayan bin splenectomy.
Immunosuppression Bayan Gyara
Akwai nau'i biyu na transplants: kara kwayoyin transplants da m organ transplants. Dukkan wadannan nau'i-shuken suna haifar da immunosuppression.
An yi amfani da tsire-tsire-tsire-tsire-tsire-tsire-tsalle a matsayin kututtukan kasusuwan jini saboda ƙwayoyin jiki, ko ƙwayoyin da ba a kula da su ba wanda ke iya samar da kwayoyin jini daban-daban, an girbe su ne kawai daga kasusuwa. Saboda ci gaban ci gaban maganin, yanzu zamu iya yaduwar kwayoyin jini daga jini. An yi amfani da sakon kwayoyin halitta a matsayin magani ga wasu nau'in cutar jini, ciki har da cutar sankarar lymphocytic mai tsanani, yawanci, mutanen da ke cikin wadannan cututtuka sun riga sun bayyana ga ciwon daji na ciwon daji kuma an riga an riga sun riga sun riga sun riga sun riga sun riga sun kamu.
Tsarin ginin jiki mai kyau ya nuna zuwa ga sassan jiki kamar zuciya, koda, ko hanta. Mutanen da suke karɓar shinge mai tsabta sukan buƙaci magani na rayuwa tare da magungunan immunosuppressant don rage haɗarin kin amincewar.
A cikin watan farko na dawowa daga suturar jiki, mai karɓar mai karɓa ya fi sauƙi ga kamuwa da cuta da ke da alaka da tiyata. Kwayoyin cuta masu yawa a wannan lokacin sun hada da cututtukan urinary, cututtukan fata, kuma zasu ciwo. Tsakanin watanni 2 da 6 bayan an tilastawa, masu karɓar masu karɓa suna fuskantar haɗari ga cututtuka na neman ra'ayi tare da sakewa da cutar ta herpes ko wasu cututtuka. Watanni shida bayan an dasa su kuma bayan haka, masu karɓa suna da mafi saukin kamuwa da cututtuka na al'umma kamar wadanda cutar kwayoyin halitta ke haifarwa (tunanin Streptococcus pneumoniae da Haemophilus influenzae ).
Immunosuppression Caused by Ingantacciyar Immunficiency
Wasu lokuta mutane suna samun cututtuka na kwayoyin halitta wadanda zasu haifar da tsarin rashin ƙarfi. Yawancin wadannan marasa lafiya na farko basu da yawa kuma sun kamu da cutar a lokacin tsufa, irin su rashin lafiya da haɗari da ciwo mai tsanani. Duk da haka, rashin daidaituwa mai mahimmanci (CVID) na yau da kullum yafi kowa kuma yana bayarwa a matashi da matasa.
Tare da CVID, ƙwayoyin marasa ƙarfi sun kasa samar da immunoglobulins wajibi ne don sauke amsawar ba tare da wata matsala ba. Sakamakon haka, mutanen da ke tare da CVID sun fi fama da cututtuka da kuma cututtuka kamar giardia lamblia .
Kula da CVID yana da wuya kuma yana buƙatar kulawa ta musamman saboda mutane da wannan yanayin basu amsa maganin rigakafi kuma a maimakon haka suna buƙatar jiko na immunoglobulin a cikin asibiti.
Immunosuppression Ya faru da Kamuwa da cuta
Immunosuppression ba wai kawai sakamako ne a cikin yawan haɗarin kamuwa da cuta ba amma har ma wasu cututtuka zasu iya haifar da su. Alal misali, cytomegalovirus (CMV), wadda yawanci yakan haifar da ko dai babu alamar cututtuka ko maganin ƙwayoyin cuta na kwayoyin cuta a cikin mutanen da ke da tsarin kulawa na yau da kullum, zai iya ci gaba da kawar da tsarin rigakafi a cikin waɗanda aka rigaya sun rigaya. Musamman, Maganin CMV tare da ƙwayoyin T, waɗanda ke da hannu a cikin amsawar na rigakafi.
Wani irin kamuwa da cuta wanda zai iya haifar da rigakafin cutar HIV shine (cutar ɗan adam). An cigaba da ci gaba da cutar HIV a kan cutar ta AIDS mai tsanani . Wannan yaduwar cutar tana faruwa ne yayin da kwayar cutar HIV ta kashe ɗakunan tarin mataimakan T - CD4 da CD8 - wajibi ne don sauke amsa. Da zarar isa wadannan kwayoyin sun mutu, mutum zai zama mai saukin kamuwa da cututtuka da dama, wanda ya hada da:
- Candidiasis
- Coccidioidomycosis
- Cryptococcosis
- Cytomegalovirus cuta
- Hanyoyin cutar, HIV
- Herpes simplex
- Histoplasmosis
- Sarcoma Kaposi
- Tarin fuka
- Pneumocystis carinii ciwon huhu
- Toxoplasmosis na kwakwalwa
Don Allah a fahimci cewa ba duk mutanen da ke dauke da kwayar cutar HIV ba ne, ko kuma suna da AIDS. Abin farin ciki, ci gaba a magani ya sa maganin cutar HIV ya fi tasiri sosai. A zamanin yau, mutanen da suke yin aiki da hankali ga maganin rigakafi na iya rayuwa mai tsawo ba tare da yada cutar AIDS ba.
Takaitaccen
Har ila yau, ƙara yawan jima'i na immunosuppression tsakanin jama'ar Amirka shine alamar ci gaba. Godiya ga ci gaba a bincike, yanzu muna da maganin da ke da kariyar maganin rigakafi wanda zai iya magance yawancin yanayi. Bugu da ƙari kuma, muna kuma yin karin suturar jiki wanda ya haifar da immunosuppression.
Sabanin haka, cigaba a magani yana da yiwuwar rage karfin mimuwa tsakanin membobin jama'a. Musamman, mutanen da ke dauke da kwayar cutar HIV wadanda ke bin hankali ga tsarin mulkin su suna iya rayuwa mai tsawo da farin ciki ba tare da maganin rigakafi ba. Abin baƙin ciki shine, duk da ci gaba da maganin cutar HIV, kawai 3 daga cikin 10 na Amirkawa suna da HIV.
Sources:
Hammond SP, Baden LR. Babi na 198. Ciwo na Mai watsa shiri na Ƙarshe. A cikin: McKean SC, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. eds. Ka'idoji da Ayyukan Magunguna . New York, NY: McGraw-Hill; 2012. Samun shiga Afrilu 12, 2016.
Nayeri U, Thung S. Babi na 15. Congenital Fetal cututtuka. A: DeCherney AH, Nathan L, Laufer N, Roman AS. eds. CURRENT ganewa & jiyya: Obstetrics & Gynecology, 11e . New York, NY: McGraw-Hill; 2013. An shiga Afrilu 13, 2016.