Binciken Masu Mahimmanci wanda Zai Yarda Yarda Da Kwayar Ciwon Kwayar ku
Manufar yin amfani da tsarin rigakafi na mutum don yaki da ciwon daji ba rubutun ba ne, amma samun wannan ra'ayi don fassarar aikin likita ya zama rikici.
Labari mai dadi shine cewa tare da nasarar da ake yi na kwanan nan da ake kira kwayoyin da ake kira masu hana masu bincike , ba a yi amfani da rigakafi don magance ciwon daji ba. Yanzu, baya ga bunkasa masu zanga-zangar rashin kulawar rigakafi, masu bincike sun gano hanyoyin da za su iya gano mafi kyawun 'yan takara don irin wannan kwayoyi.
A wasu kalmomi, masana suna so su haɗu da juna wanda marasa lafiya zasu iya amfani da su daga irin wannan immunotherapy, ma'anar wanda ciwon daji zai iya raguwa ko ma ya ɓace saboda sakamakon wannan magani.
Amsoshin ba su da hanzari, saboda haka yana da daraja yin ɗan lokaci don fahimtar mahimmancin wannan bincike na ci gaba.
Amsar da za a ba da Blockade Bincike: Masu ba da alamar kasuwanci
Masu bincike suna binciken hanyoyin da za su gano abin da immunotherapies zai fi tasiri ga kowane mai haƙuri. Ainihin haka, likitan ilimin likita (likita wanda ya kwarewa wajen magance ciwon daji) yana so ya gwada kwayoyin halittar ciwon daji na mutum don mai tantance halitta (ko magunguna masu yawa).
Wadannan 'yan halitta zasu hango yiwuwar mutum yana iya amsawa ga wani rigakafin immunotherapy. Wannan hanya, lokaci da kuma yiwuwar mummunar tasiri ba a lalacewa a kan miyagun ƙwayoyi da aka rigaya an sani ba shi da mahimmanci ga irin wannan kwayar cutar ciwon daji.
Misalai guda uku na masu cin gashin kanji wanda zai iya taimakawa wajen lura da amsawar mutum ga magungunan ƙwayar magunguna wanda ya hada da:
- Bayanin PD-L1 (ko kwayoyin halitta a cikin ƙwayar tumatir sunada furotin da ake kira shirin mutuwa-ligand 1)
- Matsayi na asali (ko sassan cikin ƙwayar tumo suna ɗauke da ƙananan ƙwayoyin juyawa)
- Matsayin gyaran gyare-gyare (ko kwayoyin halitta a cikin ƙwayar ƙwayar jiki shine gyaran gyare-gyaren gyare-gyare wanda ba shi da ƙarfin hali ko wanda ya dace)
Bari mu bincikar wadannan 'yan kasuwa guda uku a cikin dalla-dalla.
Wannan hanyar za ku iya fahimtar wani abu na kimiyya a baya dalilin da yasa mai hana magungunan dubawa zai iya aiki ga mutum daya kuma ba wani.
PD-L1 Magana
PDL-1 shine gina jiki wanda aka bayyana a kan wasu kwayoyin cututtuka. Manufarta ita ce ta yaudarar tsarin tsarin rigakafi don tunanin cewa kwayoyin cutar kanjamau suna lafiya ko "mai kyau." Wannan hanyar ƙwayar cuta tana kaucewa wani shiri na rigakafi-wani sneaky, amma sophisticated da kuma evasive tactic.
Duk da haka, akwai wasu kwayoyi da toshe PD-L1 . Wannan hanyar ciwon daji ke ganowa ta hanyar rigakafi saboda ciwon kanji sun rasa mashin su, don haka suyi magana. Drugs cewa toshe PD-L1 ana kiransa masu hana kwakwalwa na tsarin bincike ba tare da sun hada da:
- Tecentriq (atezolizumab): tubalan PD-L1
- Bavencio (avelumab): tubalan PD-L1
- Imfinzi (durvalumab): tubalan PD-L1
Wadannan kwayoyi sun taimaka wajen magance ciwon daji daban-daban kamar ciwon daji da ciwon daji, ƙwayar cutar ciwon ƙwayar ƙwayar cutar kwayar cutar, da kuma ciwon daji na Merkel.
Har ila yau, akwai masu hana masu bincike wanda ba su da mahimmanci wanda ke toshe PD-1 (wanda zai ɗauka zuwa PD-L1 kuma za'a iya bayyana shi ta hanyar ciwon daji), kuma waɗannan sun haɗa da:
- Opdivo (nivolumab): tubalan PD-1
- Keytruda (pembrolizumab): tubalan PD-1
Bincike ya nuna cewa wadannan kwayoyi suna da amfani wajen magance cututtuka irin su melanoma, ciwon daji na ƙwayar cutar ciwon daji, ciwon koda, ciwon magungunan ciwon daji, ƙwayoyin kai da wuyansa , da lymphoma Hodgkin.
A cikin binciken masu binciken halitta da zasu iya gane yiwuwar mutumin da yake amsawa zuwa ɗaya daga cikin kwayoyi masu zuwa, masu bincike sun fara gwada kwayoyin cutar kanjamau domin PD-L1. Lalle ne, yayin da bincike ya nuna PD-L1 magana shine ɗaya daga cikin abubuwan da ya fi dacewa da nasaba da mayar da martani ga PD-L1 ko PD-1 blocker, karin bincike har yanzu yana bukatar a yi.
Watau ma'anar PD-L1 kadai bazai kasance mai nuna alama game da ko ciwon daji zai shafe ko ya ɓace tare da ɗaya daga cikin kwayoyi da aka ambata a sama ba. Ba mai cikakken halitta ba, amma mai kyau har yanzu.
Haraji na Mutum
Bayan bayanin PD-L1 a kan kwayoyin cutar kankara, masu bincike sunyi nazarin haɗin kai tsakanin nauyin ƙwayar ƙwayar tumuttu da amsawa ga mai hanawa mai bincike.
Na farko, don fahimtar abin da nauyin nau'i ne, dole ne ka fahimci abin da maye gurbi ne kuma yadda wannan ya shafi ciwon daji.
Menene Mutuwa?
Sauyawa shine canji a cikin jerin DNA wanda ya haifar da wata halitta. Hanyoyi na iya zama haɓaka (ma'anar da suka wuce daga iyayenku) ko samu.
Tare da maye gurbi, maye gurbi ne kawai a cikin sel masu tasowa (dukkanin sel a cikin jiki, amma kwai da kwayoyin halitta), don haka ba za'a iya baza su zuwa tsara na gaba ba. Sauya maye gurbi zai iya faruwa daga abubuwan da ke cikin yanayi, kamar lalacewar rana ko shan taba, ko daga kuskure ɗin da ke faruwa a yayin da DNA ta kewaya ta yin kwafin kansa (wanda ake kira replication).
Kamar yadda a cikin kwayoyin halitta, ana samun maye gurbi kuma yana faruwa a cikin kwayoyin cututtuka, kuma wasu nau'i na cututtuka suna da yawan ƙwayar maye gurbi fiye da wasu. Alal misali, nau'o'in ciwon daji guda biyu da ke da babban halayen maye gurɓatattun cututtuka shine ciwon huhu na huhu , daga daukan hayaki da cigaba, da kuma melanoma , daga fitarwa zuwa rana.
Mene ne Babban Lokaci na Mutum?
Akwai bincike da ke nuna cewa ciwace-ciwacen da aka samu tare da ƙananan juyawa na maye gurbin (mafi girman matsayi na mutunci) sun fi dacewa su amsa maganin magungunan ƙwaƙwalwar ƙwayoyin cuta fiye da ciwace-ciwacen ƙwayar cuta da ƙananan juyawa na maye gurbin.
Wannan yana da mahimmanci saboda, tare da karin maye gurbin, ƙwayar za ta kasance da ƙari ga tsarin rigakafin mutum. A wasu kalmomi, yana da wahala a ɓoye tare da dukan waɗannan nau'i-nau'i masu rarrafe.
A gaskiya ma, waɗannan sababbin jinsunan sun ƙare samar da sababbin sunadarai masu ƙwayoyin cuta wanda ake kira neoantigens. Wadannan neoantigens da aka gane da su ta hanyar rigakafi kuma sun kai farmaki (wanda ake kira ciwon daji na immunogenic neoantigens saboda suna haifar da amsawa mai mahimmanci).
Matsayin gyaran gyare-gyare
Ƙungiyar jikin mutum ta hanyar hanyar gyara ta kullum don gyara abubuwan da aka sanya DNA a yayin da ake yin salula. Wannan tsari na gyaran ƙa'idodin DNA ana kiran gyaran mismatch.
Bincike a cikin masu hana masu bincike a cikin magunguna sun bayyana cewa za'a iya amfani da yanayin gyaran ƙwayar ƙwayar ƙwayoyin cuta don hango nesa da amsawar mutum ga immunotherapy. Musamman, ciwace-ciwacen da ba su dace ba ne (ma'anar ma'anar maɓallin gyaran gyare-gyare ne da aka canza ko kuma shiru) ba zai iya gyara kuskuren DNA ba.
Idan ciwon kanji yana da ƙananan ƙarfin iya gyara lalata DNA, zasu iya tara kuri'a na maye gurbin da zai sa su ganewa ga tsarin na rigakafi . A wasu kalmomi, suna fara dubawa da kuma bambanta da kwayoyin halitta (wadanda ba a da ma'ana ba).
Bincike ya nuna cewa cututtuka da ƙwayoyin cuta marasa tsabta sun ƙunshi ƙwayoyin jini masu yawa wadanda suka bar jini don shigar da alamar kututtuka ta hanyar amsawa mai karfi da kuma nuna cewa wannan ciwon daji ya fi sauki ga immunotherapy.
Wannan ya bambanta da cututtukan da ba a iya gyarawa ba, tare da nuna jinin kututtukan ƙwayar jinin jini.
Ciwon daji da Tsarin Rashin Jima'i: Ƙungiyar Matsala
Sakamakon immunotherapies da ke tattare da sunadarai masu bincike sun kawo jin dadi da kuma bege ga wadanda ke maganin ciwon daji da kuma ciwon daji. Amma saboda mai ba da cikakken bayani game da bayanin kwayoyin PD-L1, wasu masu amfani da abin dogara sun buƙaci a gano su kuma a bincika su. Duk da yake nauyin mutunci da DNA gyaran gyare-gyare na da kyau sosai, gwaje-gwaje har yanzu ana buƙata a inganta don amfani a marasa lafiya.
Tare da wannan, ƙayyade yiwuwar mutum ya amsa ga wani ƙwayar rigakafi mai yiwuwa zai zo ne daga bincike na yawan bayanai-ma'anar kwayar cutar tumo, don haka yayi magana.
Kalma Daga
A bayanin ƙarshe, yana da mahimmanci kada ku yi matukar damuwa tare da bayanai masu mahimmanci da aka gabatar a nan.
Maimakon haka, don Allah fahimci cewa yayinda yake da al'ajabi da kuma farin ciki, masu hana masu zanga-zangar rashin kulawa ne kawai FDA ta amince su bi da wasu nau'ikan iri daban-daban na ciwon daji. Suna iya ko bazai zama amsarku ba ko ƙaunataccen amma yana nuna ci gaba mai girma a ci gaba da sababbin jiyya don ciwon daji. Ko ta yaya, kasancewa da bege kuma ci gaba da tafiya mai karfi.
> Sources:
> Farkona S, Diamandis EP, Blasutig IM. Cancer immunotherapy: farkon karshen ciwon daji? BMC Med . 2016 Mayu 5; 14: 73.
> Le Dt et al. PD-1 yaduwa a cikin ciwace-ciwacen ƙwayoyin cuta tare da rashin daidaitattun ladabi. N Eng J Med . 2015 Yuni 25; 372 (26): 2509-20.
> Masucci GV et al. Tabbatar da masu sarrafa halitta don ganin hangen nesa ga immunotherapy a cikin ciwon daji: Volume 1 - tabbatarwa ta farko da kuma nazari. J Immunother Ciwon daji . 2016 Nov 15; 4: 76. eCollection 2016.
> Mouw KW, Goldberg MS, Konstantinopoulos PA, D'Andrea AD. Dama DNA da gyaran masu sarrafa rayuka na amsawa na immunotherapy. Kankara Discov . 2017 Jul; 7 (7): 675-93.
> Shoushtari AN, Wolchok J, Hellman M. (2017). Ka'idojin ciwon daji immunotherapy. Atkins MB, ed. Na zamani. Waltham, MA: UpToDate Inc.