Fahimtar ROS1 Gene Gyarawa a Cikin Ciwon Ƙwayar Ciwon Kwayoyin Cutar Kwayoyin Cutar
Tsarin ROS1 wani nau'i ne a cikin kwayar cuta wanda zai iya faruwa a cikin kwayoyin cutar kanjamau irin su kwayoyin cutar kanjamau. Chromosomes-da kwayoyin da suka hada da chromosomes-suna dauke da lambar don abubuwa kamar launi na idanunmu. Sun kuma rubuta (aiki a matsayin tsari) don sunadarin sunadarai da girma da rabuwa na sel. Lokacin daya daga cikin wadannan kwayoyin halitta ko chromosomes sun lalace, sun canza, ko kuma sun sake gina su, sun yi amfani da furotin maras kyau, wanda zai iya yin ayyuka mara kyau, irin su tayar da ciwon ciwon daji.
Hanyar da za ta yi tunani a kan wata halitta shine ɗaukar jerin harufan da suka fassara kalmomi. Lokacin da waɗannan haruffa suka haɗu, kalmomin sun fito ba daidai ba. Idan an sake jigilar kwayoyin halitta a cikin wani samfurori cikin sifofi daban-daban, kalmomin sun fito daidai ne. Idan kun ji kalmar "juyiyar juyawa," wannan yana nufin cewa haruffa na ROS1 din suna da haɗuwa da wani nau'i, kuma yana haifar da haɗuwa a cikin abin da haruffan "ƙira."
ROS1 Gene Gyarawa
Ba dukkanin maye gurbin mutun da gyara ba daidai yake. Wasu lamba don sunadaran da ke aiki kamar direbobi. Ka'idojin ROS1 na furotin da ke aiki a matsayin direba shine wanda zai iya nuna wasan kwaikwayo idan yazo da girma da kuma rabuwa. Lokacin da aka sake rayar da shi, ƙwayar ƙarancin zai iya haifar da ciwo mai mahimmanci da rabuwa na tantanin halitta.
Wannan furotin yana daya daga cikin yawan sunadaran (enzymes) da ake kira tyrosine kinases. Wadannan sunadarai sun aika sakonni zuwa cibiyar ci gaban kwayar halitta ta sanar da shi lokacin da zai raba da ninka.
ROS1 an sake dawowa a cikin mutanen da ba tare da ƙananan ciwon huhu na huhu ba, kuma, irin wannan, kawai mutane da adinocarcinoma na huhu . Ba'a samo shi a cikin mutane waɗanda suke da maye gurbin a cikin EGFR ko KRAS ko ALK ba.
Idan aka kwatanta da wasu cututtukan ciwon huhu na huhu, bincike na 2015 ya gano cewa:
- Matsakaicin shekarun mutane tare da ROS1 canje-canje ya kasance 50.5. (Zamanin shekaru na ciwon huhu na huhu , a gaba ɗaya, shine 72.)
- Yayi kadan a cikin mata a cikin kashi 64.5 cikin dari na mata. (Ciwon daji na huhu a cikin maza shi ne dan kadan fiye da mata.)
- Mafi yawan kashi-67.7 bisa dari-ba su taba shan taba ba. (Kwayar cutar huhu tana faruwa ne a cikin wadanda basu taba shan taba ba, tare da akalla kashi 20 na cutar kanjamau a cikin mata a cikin masu shan taba.)
- Daga cikin mutane tare da adinocarcinoma na huhu, kashi 3.1 cikin dari na da raya ROS1.
Tambaya idan mai hana magunguna na tyrosine kinase da ke aiki don wani ciwon daji na sake haifar da ciwon huhu tare da maye gurbin ALK ko ALK-tabbatacciyar ciwon huhu na huhu - zai iya aiki don toshe tasirin abin gina jiki wanda ya samo asalin ROS1? To, masu bincike sun yi amfani da magani wanda aka samu nasarar amfani da shi ga mutanen da ke dauke da cutar Kanjamau. Abin mamaki shine, ya yi aiki da cutar daji na ROS1 mai tsanani sosai.
Gwajin gwaji
Akwai wasu hanyoyi da za a iya jarraba wadanda ke fama da ciwon huhu a cikin huhu don ganin idan suna da gyaran ROS1. An gwada gwajin a kan samfurin nama daga kwayar cutar ta huhu ko kuma tiyata a kan tarin huhu. Ana fatan cewa a cikin gwajin nan gaba za'a samuwa ta hanyar ruwa-biopsy-gwajin da aka yi a kan jini wanda za'a iya samuwa tare da zane mai sauƙi.
Hanyoyin gwaji sun haɗa da immunohistochemistry da furotin da ke cikin wuri (FISH). Nazarin yana gudana don ƙayyade hanyoyin mafi kyau na gwaji.
Tunda mutanen da suke da ROS1 canje-canje basu da KRAS da maye gurbin EGFR ko ALK sake fasalin (akalla ba a gwajin da aka yi ba a kwanan wata,) ana gwajin gwaji don mutanen da basu da kyau ga wadannan maye gurbin da sabuntawa. Kuna iya jin wannan ake kira "ciwon kwakwalwa guda uku" marasa ciwon ƙwayar cutar, ba tare da rikita rikici ba tare da ciwon nono guda uku wanda ya bambanta. A cikin binciken daya, an gano cewa, daga marasa lafiya waɗanda suka gwada gwaji ga KRAS da EGFR, kashi 25 cikin dari sun kasance tabbatacce ga wani ALK ko ROS1 fusion.
Ana tsammanin cewa duk wanda ke fama da ciwon huhu na ƙananan ciwon ƙwayoyin cuta, musamman macin adenocarcinoma, ya kamata a gwada kwayoyin halitta (kwayoyin maganin cutar ) akan ciwon huhu na huhu. Gwaji yana da mahimmanci ga matasa da ciwon huhu na huhu , wadanda suke da mummunar tasiri na maye gurbi kuma zasu iya amsawa da daya daga cikin magunguna a cikin ɓangaren magungunan tyrosine kinase. Bugu da ƙari, yana da mahimmanci cewa masu shan taba ba su gwada gwaje-gwaje, kamar yadda a cikin masu shan taba ba su da babban tasiri da maye gurbin su.
ROS1 Ciwon Cutar Kyau mai kyau
ROS1 tabbatacciyar ciwon huhu na huhu shine kututtukan huhu ne wanda gwajin gwagwarmaya ta tabbata ga hanyar ROS1, daya daga cikin '' maye gurbin '' wanda aka gano a cikin ciwon huhu na huhu. ROS1 kwayar cutar ciwon huhu ta kwayar cutar ta samu kashi daya cikin 100 zuwa kashi biyu cikin kwayar cutar kanjamau. Amma, idan akai la'akari da yadda cutar ciwon huhu yake da ita, har yanzu yana wakiltar mutane da yawa da wannan cuta.
ROS1 an sake gano sabbin abubuwa a glioblastoma multiforme, irin ciwon daji na kwakwalwa, kuma an samu su a wasu cututtuka, ciki har da ciwon daji na ovarian, carcinoma na cin hanci, ciwon daji, da cholangiocarcinoma.
Yana da mahimmanci don jaddada cewa irin ragowar ginin da muke magana game da shi shine samun canjin yanayi. Sabanin wasu maye gurbin kwayoyin da kuma sake fasalin da aka haife su tare da, wasu daga cikinsu zai iya haifar da mutane zuwa ciwon daji, farfadowar ROS1 din ba ta kasance ba daga haihuwa. Ba za ku damu da cewa 'ya'yanku zasu sami gado ba.
Jiyya
- Tiyata - Ga mutanen da ke da mataki Na shiga mataki na IIIA, tiyata mai ciwon huhu na iya zama wani zaɓi. Ba dukkan ciwon sukari na wadannan matakai suna iya aiki ba, amma idan sun kasance, tiyata zai iya ba da damar samun magani.
- Chemotherapy -Besides cike da farfadowa, wasu magunguna na chemotherapy ma tasiri a ROS1 tabbatacce ciwace-ciwacen ƙwayoyi. ROS1 tabbatacciyar rigakafi na huhu yana nuna damuwa sosai ga maganin likitan shan magani na Alimta (kimanin kashi 50) na mutanen da ke amsa maganin miyagun ƙwayoyi a binciken daya.
- Magunguna da aka ƙayyade -Xalkori (crizotinib) wani mai hana gwanin tyrosine kinase wanda aka rigaya ya amince da cutar Kanjamau. Ana ba da shawarar layin farko - wato, kafin wani magani (ko da yake wasu jiyya za a iya amfani da su a lokaci ɗaya) da kuma duk wanda ya riga ya jiyya don cutar. An amince da wannan maganin don cutar Kanjamau mai kyau na ALK a shekara ta 2013 kuma ya haifar da tashin hankali bayan haka lokacin da na fara gwaji tare da mutanen dake fama da cutar kanjamau na ROS1 har ma sun fi dacewa da miyagun ƙwayoyi. A cikin wadannan gwaji, yawan mutanen da suka amsa wa miyagun ƙwayoyi sun kasance tsakanin 70 zuwa 80 bisa dari. An ba da miyagun ƙwayoyi wartsakewa don magance kwayar cutar huhu ta ROS1 a watan Afrilu na 2015. Loratinib idan an yarda da wadanda ciwon daji ke ci gaba a Xalkori. Ignyta (entretinib) ba ya yin aiki a waɗanda wadanda Xalkori bai yi nasara ba, amma yana iya zama da amfani ga wadanda ke da kwakwalwar ƙwayar cuta.
- Gwaje-gwaje-gwaje - Wasu magunguna, musamman magungunan maganin, ana binciken su a gwajin gwaji don mutanen da ke fama da ciwon huhu na ROS1. Wasu daga cikin wadannan sun hada da Zykadia (ceritinib), wani magani mai kama da crizotinib da aka yarda da cutar ta hanyar ALK. Wasu magunguna da ake nazarin kwayar cutar huhu sunyi kyau don gyarawar ROS1 sun hada da Cometriq (cabozantinib) da sauransu. Don ƙarin koyo game da gwaji na asibiti don ciwon huhu a cikin mahaifa, la'akari da tuntuɓar sabis na gwadafin gwaji na kyauta wanda yake samuwa ga dukan marasa lafiya na huhu.
Brain Metastases
ROS1 tabbataccen kwayar cutar ciwon daji yana da yaduwa zuwa kwakwalwa. An kiyasta cewa kashi 25 cikin kashi 40 cikin 100 na mutanen da aka gano tare da cutar kanjamau marasa ciwon ƙwayar cuta za su ci gaba da cin ganyayyaki a cikin kwakwalwa a cikin shekaru biyu na jiyya.
Abin takaici, Xalkori (crizotinib) ba ya aiki sosai ga ƙwayoyin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta a cikin mutanen da ke fama da cutar kanjamau na ROS1. Wannan magani, kamar yadda mutane da yawa, ba ya ƙetare shinge na kwakwalwar jini sosai. Harkokin jini-kwakwalwa shine tsarin sarrafawa na ƙwararrun ƙirar da ke aiki don hana ƙwayar magunguna (da kuma magungunan ƙwayar cuta) daga shigar da yanayi mai kwakwalwa na kwakwalwa.
Tsarin radiation ga ƙwayoyin cuta zuwa kwakwalwa ga mutanen dake fama da ciwon huhu na huhu zai iya aiki sosai. Kuma an gano cewa mutane da gyaran ROS1 suna da ciwace-ciwacen da zai iya kasancewa musamman ga waɗannan jiyya. Za'a iya ba da radiation a hanyoyi daban-daban:
- Tsarin radiotherapy na Stereotactic -Idan wannan hanya, wadda za a ji ana kira "cyberknife" ko wuka gamma, ana kawo radiation ga wuraren da aka gano a kwakwalwa.
- Cikakken rediyo na kwakwalwa gaba daya -Ya kasance da kwakwalwa na kwakwalwar kwakwalwa gaba daya, ana kwantar da kwakwalwa tare da radiation.
Hanya tsakanin waɗannan jiyya guda biyu wani yanki ne na muhawara. Tsarin radiotherapy na stereotactic - tun da yake kawai ya bi wani ƙananan ɓangare na kwakwalwa-yana da ƙananan sakamako masu illa. Amma duk da haka, kwakwalwar rediyo na kwakwalwa zai iya rage yiwuwar ciwon ƙwayar ƙwayar ƙwaƙwalwar ƙwaƙwalwar kwakwalwa - wani abu da yake da kyau a cikin mutanen da suka riga sun sami ƙwayar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta.
Yawan "spots" kuma suna taka rawar a cikin wannan yanke shawara. Mutanen da ke da matakan har zuwa uku ko hudu metastases-ana iya sauƙin sauƙaƙe tare da hanyar tsaka-tsaki fiye da waɗanda suke da ƙananan metastases.
Drug Resistance
Yawancin mutane sun zama masu tsayayya ga Xalkori (crizotinib) saboda sabon maye gurbin da aka samu. Sabon magani a cikin wannan rukuni, Cometriq (cabozantinib), yana da alamar gaske a binciken farko. Yana da alama zai iya rinjayar juriya daga waɗannan maye gurbin biyu a farkon binciken.
Tsanaki game da Vitamin E da Crizotinib
Nazarin a 2017 da 2018 ya nuna cewa wani ɓangaren bitamin E wanda ake kira a-tocopherol zai iya rage tasiri na crizotinib. Tun da yawancin kariyar bitamin E, da kuma bitamin E dauke da bitamin E ne ko kuma yawancin tocopherol, dole ne a kauce wa wadannan kariyan nan sai dai idan likitanku ya umurce ku.
Faɗakarwa
ROS1 kwayoyin cutar da ke dauke da kwayar cutar sun kasance masu tasowa da girma kuma suna yadawa sosai, amma kuma suna amsawa a hanyar da ba a taɓa gani ba don maganin farfadowa. Tun da yake kwanan nan ba a yarda da magani ba, yana da wuya a san abin da ran mutum zai kasance a matsakaici. Amma, amsoshin da aka gani a yanzu suna ƙarfafawa.
A cikin nazarin daya yawan lokacin da Xalkori ya yi aiki (lokacin da ya dakatar da aiki ga rabin mutanen amma yana ci gaba da yin aiki na rabin rabi) ya kasance watanni 17; yawancin mutanen da aka bi sun amsa da miyagun ƙwayoyi.
Ana fatan cewa lokacin da mutane suka zama magungunan wannan magani don wasu za su sami samfurin, amincewa, ko a gwaje-gwajen gwaji wanda zai maye gurbin magani wanda ya daina aiki. Kamar yadda aka lura, akwai alamun cewa wannan zai iya kasancewa al'amarin.
A nan gaba, da fatan, ciwon huhu na huhu tare da waɗannan maye gurbi da kuma sake fasalin za a bi da su kamar cutar mai cututtuka, kamar yadda muke bi da ciwon sukari. Ko da ma ciwon daji ba tukuna ba ne, zai yi fatan za a iya sarrafawa.
Taimako da Ƙungiyar
Ƙungiya mai ban mamaki na mutanen da kwayar cutar ta huhu ta ROS1 sun taru. ROS1Ders an haɗa su don inganta bincike a cikin jiyya don ROS1 tabbatacciyar ciwace-ciwacen ƙwayoyi. Tun da yake wannan sanannen ƙwayoyin kwayoyin halitta ne na ƙwayar cutar, yawancin masu ilimin likitancin al'umma ba su san sababbin bincike da kuma gwaji na gwaji ba. A kan shafin su suna da alaka da manyan likitoci da masu bincike da ke nazarin kwayar cutar huhu ta ROS1 idan likitanku yana so ya tuntube wani a zuciyar binciken. Shirin ROS1 Global shine haɗin gwiwa wanda ke haɗa masu bincike, marasa lafiya, masu kulawa, da kuma likitoci a dukan duniya don inganta sakamakon haƙuri kuma da hanzarta bincike.
Kalma Daga
Babu wanda ya kamata ya shiga ta hanyar ciwon huhu kawai. Idan an gano wanda kake ƙauna tare da ciwon huhu na huhu, duba waɗannan tunani game da lokacin da mai ƙaunataccen cutar kanjamau yake .
Kasancewa a cikin ƙwayar cutar ciwon huhu na iya zama mai taimako, koda ga waɗanda suke yin watsi da kungiyoyin. Tun da kwayar cutar huhu ta ROS1 mai kyau ba ta sani ba, yana da wuya cewa za ku sami mutane da yawa a cikin al'ummarku waɗanda suke fuskantar matsaloli na jiki da na kalubale da kuke ciki.
A shekara ta 2015, a taron LUNGevity HOPE, ƙungiya ta kafa wadda ta kunshi dukkanin mutane masu fama da cutar kanjamau na ROS1. Wannan lokacin farin ciki ne ga mutanen da ke fama da ciwon huhu, kamar yadda marasa lafiya suke aiki tare da likitoci ba kawai don fahimtar cutar ba, amma don ba da labari kan bincike da har yanzu ana bukatar a yi.
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> Uchihara, Y., Kidokoro, T., Tago, K. et al. Wani Babban Magunguna na Vitamin E, a-Tocopherol Ya hana aikin maganin tumuttuka na Crizotinib akan Sel din da EML4-ALK ya canza. Turai Journal of Pharmacology . 2018 Feb 11. (Epub gaba da bugu).