Abunomodulator wani nau'i ne na maganin fuka wanda aka nuna wa marasa lafiya da ƙwayar cuta mai wuya-to-control. Yayin da ake ci gaba da maganin fuka, mai rigakafi mai magani ne mai magani amma maimakon maganin ƙwayar maganin fuka-fuka . Ga kusan kashi ɗaya bisa uku na marasa lafiya na asthmatic wanda ko dai ba su amsa maganin steroid ba ko kuma suna da mummunar amsawa, mai yiwuwa immunomodulator na iya ba da bege ga mafi kyawun magungunan fuka.
Xolair , wanda yake daya daga cikin magunguna, shine kawai yanayin rigakafi da aka samu na fuka. Wannan immunomodulator ya dace wa marasa lafiya masu ciwon haɗari masu tsanani ko kuma masu ciwo mai tsanani:
- Kyakkyawan gwajin fata ko wani gwaji na jini yana nuna rashin lafiyar wani tarkon fuka-fuka, irin su mites, dog, cat ko cockroach dander.
- Kwayar cututtuka da ba su da kyau a sarrafa su tare da corticosteroids inhaled .
Wani mawuyacin rigakafin da ake amfani dasu a cikin yanayin rashin lafiya da rigakafi a yau shine Cinryze, magani don ci gaba da kumburi a fuska da wuyansa wanda ake kira angioedema.
Ta yaya Immunomodulators Work
Immunomodulators na rage yawan bayyanar cututtukan fuka da kuma buƙatar ƙwayoyin corticosteroids . Samun bukatar corticosteroids fiye da sau biyu a kowace shekara alama ce ta kula da asibiti mara kyau. Abunomodulators na iya rage ƙananan kumburi ta hanyar tasiri da dama wurare daban-daban a cikin pathophysiology na fuka , ciki har da:
- Basophils
- Eosinophils
- Lymphocytes
- Macrophages
- Mast Cells
- Neutrophils
- Monoclonal Antibodies
- IgE
- T-sassan
- Cytokines
- Interleukins
Wani immunomodulator yana ɗauka zuwa IgE kuma yana hana shi daga daura zuwa basophils da ƙwayoyin mast. Bugu da ƙari, wani rigakafi yana rage yawan adadin basophils kuma yana hana ƙwayoyin mast daga abubuwa masu rarraba da zasu sa mummunan cututtuka ya fi muni.
Ta yaya Immunomodulators Taimaka
An yi amfani da immunomodulator a wasu lokuta a matsayin mai maganin maganin maganin steroid-wanda ya inganta aikin iska da kuma aikin huhu. Bugu da ƙari, mai amfani da immunomodulator zai rage yawan bayyanar cututtukan fuka kamar:
- Wheezing
- Chest tightness
- Rawancin numfashi
- Tari tari
Jiyya tare da immunomodulator an hade shi tare da rage yawan tarin fuka da ƙwaƙwalwa na gaggawa da kuma inganta kayan aikin huhu da ingancin rayuwa. Kullum, immunomodulator ba zai maye gurbin sauran magunguna ba, amma za a kara da shi. Bugu da ƙari da wani immunomodulator an hade da kamar yadda kashi 25 kashi rage a amfani da steroid.
Hanyoyin Kayan Yanayi
Yayin da ya kamata a yi haƙuri a kan rigakafinka, akwai yawan abubuwan da ke faruwa na kowa da kuma abubuwan da ba a sani ba don sanin, ciki har da:
- Urticaria da anaphylactic reactions -Urticaria, ko kuma hives, wani abu ne mai rashin lafiyan wanda zai iya haifar da mummunan sakamako idan ba a bi da shi ba da sauri. Dole likitanku na buƙatar ku kula da dan lokaci a cikin ofishin bayan kowace allura. Yayinda yawancin halayen zasu faru a cikin sa'o'i biyu zuwa sa'o'i biyu bayan daya daga cikin injections na farko, rashin halayen haɗari sun faru bayan da yawa injections da sa'o'i masu yawa tun lokacin karbar allura.
- Ciwon daji - Duk da cewa ba a bayyana a fili ba a wannan lokaci, ciwon daji yafi kowa a cikin marasa lafiya da ke karɓar Xolair. Duk da haka, dalilin da ya sa wannan dangantaka tsakanin ciwon daji da kuma immunomodulator da aka gani ba a fahimci gaba daya ba.
- Injin ciwon inji -Ya kasance tare da allurar, ciwo a wurin ginin yana da tasiri da aka sani kuma zai iya faruwa a cikin kashi 20 cikin dari na marasa lafiya da ke karɓar immunomodulator.
- Rashin ciwon suturar jini na sama -Ka tabbata ka tattauna da likitanka abin da za ka yi kuma lokacin da ya dace ya nemi kulawa idan ka fuskanci wannan bayyanar.
- Ciwon makogwaro da ciwon kai - Idan waɗannan bayyanar cututtuka ba su warware matsalolin rikitarwa, kamar ruwa da magani mai magunguna, to sai kuyi magana da likitan ku.
Immunomodulators a Development
Yawancin wasu magungunan rigakafin da ke kan hanyoyi daban-daban na fuka-fuka na cikin asibiti :
- Daclizumab shi ne wanda yake da alaka da kwayar cutar guda daya wanda yake tasiri ga wasu wurare a cikin tarin fuka. An jarraba shi a gwaji na asibiti na asibiti 115, amma ya nuna kawai ƙananan ƙaruwa a cikin aikin huhu da kuma kula da fuka.
- Lebrikizumab shi ne wani ɗan adam wanda yake da alaka da mutum guda daya wanda ke ɗaukar wani abu na interleukin-13, kuma wani ɓangare na pathophysiology na asma. Gwajin gwaji guda biyu, VERSE da LUTE, sun nuna ragowar ƙananan ƙwayoyin fuka da kuma inganta aikin kwantar da hankali a marasa lafiya (ba tare da wani damuwa mai tsanani ba) tare da ciwon sukari mai tsaka-tsakin da ke da iko mara kyau duk da ingantattun kulawa na yau da kullum. Masanan da aka fi sani da su don samun amfani a cikin waɗannan nazarin suna da matsayi mai girma na periostin, sunadarin sunadaran da aka sani sun kara yawan ƙumburi.
- Reslizumab ne mai cin mutunci wanda ake kira interleukin-5 (IL-5). A gwaje-gwaje na asibiti, an yi amfani dasu a cikin marasa lafiya da masu tarin fuka da ƙwayoyin jini, duk da tsarin da ake ciki na corticosteroid. Reslizumab ya nuna raguwar ƙwayar ƙwayar fuka da kuma inganta tsarin yaduwa a cikin gwaji na asibiti na III a cikin fiye da 1,700 matasa da marasa lafiya. Bisa ga gwaji, ana sa ran alamun zasu kasance kamar na Xolair. Reslizumab ana duba shi ne ta hanyar FDA kuma TEVA ta dauki mataki a kan aikace-aikacen su a shekara ta 2016. Wasu kamfanonin magani, irin su AstraZeneca, suna da magungunan irin wannan a cikin matayensu.
- Eculizumab (Soliris®) wani ɓangare ne wanda ke da alaka da tsarin da ya dace kuma a halin yanzu an yarda da ita ta FDA domin kula da halayyar haemoglobinuria na maraice ta paroxysmal. Ƙananan gwaje-gwaje na asibiti sun nuna alamu a cikin aikin huhu da kuma rashin lafiyar cututtuka. Duk da haka, wannan magani yana da alaka da cututtukan rai da cututtuka na meningococcal. A sakamakon haka, an ƙuntata miyagun ƙwayoyi kuma likitoci sun buƙaci rijista don su iya rubuta shi.
- Suplatast ya nuna sakamako mai kyau, amma sau uku a kowace rana yana nuna damuwa game da yarda da fuka.
- Tumor necrosis factor-alpha (TNF-α) wani immunomodulator ne wanda yake aiki a wurare da yawa a cikin ilimin cututtukan fuka. Baya ga magunguna mafi kyau a cikin jerin marasa lafiya na asibitoci (sanannen sanannen da ke haifar da TNF-α overexpression), TNF-α ba ta rage yawan haɓaka ba ko inganta aikin sutura. Musamman mahimmanci, Infliximab (Remicade®) da kuma hanzari (Enbrel®) su ne masu amfani da cututtuka da ake amfani da su a yanzu don cututtuka daban-daban, irin su rheumatoid arthritis. Wadannan magungunan suna haɗuwa da haɗarin ƙari na kamuwa da cuta.
- Mai yaduwar kwayar halitta mai amfani da kwayar cutar mai amfani (PPAR-γ) wani bangare ne na magani a ƙarƙashin nazarin. Wadannan magunguna an riga an yi amfani da su wajen maganin ciwon sukari, inda aka gano cewa suna da matakan da za su iya magance cutar. Guinea aladu da aka bi da shi tare da rosiglitazone musamman an gano cewa suna da raguwa sosai a matakan jini na IL-5 da IgE. Lokacin da aka yi wa dabbobi girma, tIL-5 da kuma IgE an samu su a rage a cikin huhu. Wannan jagorar masu binciken sunyi zaton cewa yana iya zama magungunan asibiti mai mahimmanci.
- Cincin Syk din shine gina jiki mai gina jiki mai gina jiki wanda zai hana degranulation na kwayoyin mast. An samo miyagun ƙwayoyi don rage gizon hanci da fitarwa, sneezing, sanyaya daga hanci da ƙura, ƙwaƙwalwar ƙwayar jini, tari, ciwon kai, da kuma ciwon fuska a cikin marasa lafiya da ke jurewa da rashin lafiyar rhinitis a cikin layi. Ana yin nazari ta hanyar yin amfani da inhaled a kan marasa lafiya na asali.
Sources:
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Dimov VV, Casale TB. Immunomodulators ga Asthma. Allergy Asthma Immunol Res. 2010 Oktoba; 2 (4): 228-234.
Busse WW, Isra'ila E, Nelson HS, Baker JW, Mawallafan BL, Young DY, et al. Daclizumab inganta kula da asibiti a marasa lafiya tare da matsananciyar ciwon sukari mai tsauri: ƙaddamarwa, gwajin sarrafawa. Am J Reshir Crit Care Med. 2008; 178 (10): 1002-1008.
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