Immunotherapy yana hanzari ya zama kayan aiki mai karfi don yaki da cutar, musamman cututtuka da wuya a bi da su. Tare da ciwon daji immunotherapy , da tsarin rigakafi yana leveraged don yaki ciwon daji a cikin sababbin hanyoyi. Harkokin rigakafi na immunotherapy zai iya kaddamar da tsarin rigakafin ta hanyar kai tsaye ko gabatar da tsarin rigakafi tare da sunadarai na wucin gadi, ko antigens , don haka suyi tsarin tsarin rigakafi akan ciwace-ciwacen ƙwayoyi.
Magunguna maganin cututtuka sune nau'i na immunotherapy da ake amfani dasu don magance cancers da suka wanzu. Bugu da ƙari, maganin alurar rigakafin ciwon daji shine ilimin halitta, ko biopharmaceuticals. Sauran nazarin halittu sun haɗa da sassan jini, kwayoyin farfadowa, masu ciwo, da sauran alurar rigakafi.
A halin yanzu, kawai maganin alurar rigakafi wanda FDA ya amince da shi ana kiransa Provenge don magance ciwon daji .
Cancer Treatment Vaccines
Antigens wasu abubuwa ne da ke haifar da amsawar tsarin da ba ta dace ba. Mafi yawan maganin alurar rigakafin ciwon daji a cikin ci gaba suna samar da antigens mai ciwon daji zuwa dendritic sel. Wadannan kwayoyin dendritic suna kare kwayoyin da suke kai tsaye a kan magunin (dermis) da aiwatar da antigen. Bugu da ƙari kuma, kwayoyin immunostimulatory da ke gabatarwa a maganin alurar rigakafi don magance ciwon daji, ko ƙara yawan kayan aiki, na kwayoyin da ake buƙata suyi hulɗa tare da kwayoyin T. Na bayanin kula, antigens na hade da ciwon daji zai iya zama takamaiman ko dai ga irin wannan ciwon daji ko rukuni na ciwon daji.
Waɗannan ƙwayoyin dendritic kunnawa sunyi ƙaura zuwa ƙananan ƙwayar lymph, waxanda ƙananan ƙwayoyin cuta ne da ke cikin jiki. Da zarar wadannan kwayoyin dendritic sun kunna shi zuwa kumburi na lymph, suna gabatar da antigen-specific antigen to T cells. Twayoyin T da ke aiki suna tafiya a cikin jiki kuma suna ci gaba da kwayar cutar ciwon daji da ke nuna tare da antigen da lyse, ko kuma karya, cell cancer.
(Ƙarin fasaha na CD4 + T da ke aiki, suna haifar da cytokines wanda ke taimakawa matuƙar ɗakunan CD 8, wanda bayan tafiyar maturation a cikin jiki.)
Bisa ga FDA, wasu maganin rigakafin ciwon daji a halin yanzu a amfani da kwayoyin cuta, ƙwayoyin cuta, ko yisti a matsayin motocin, ko kayan aiki , don daukar nauyin antigens. Kwayoyin cuta, ƙwayoyin ƙwayoyin cuta, yisti da sauransu sune ainihin immunogenic kuma suna haifar da amsawa akan kansu; Duk da haka, an gyara su don kada su haifar da cutar.
A madadin haka, za a iya tsara maganin alurar rigakafi ta hanyar amfani da DNA ko RNA wanda ya adana antigens. Wannan kwayoyin halitta an haɗa shi cikin sel wanda ya samar da antigens. Buri shine cewa wadannan kwayoyin halitta masu canzawa za su samar da isasshen antigens da ke hade da ciwon daji domin su haifar da amsa mai karfi don kashe kashe kwayoyin cutar.
Daga qarshe, dole ne a cika ka'idoji uku don maganin maganin rigakafin kwayoyin tumo:
- Ya kamata a samar da ƙwayoyin cuta mai tsabta da yawa tare da ƙaƙƙarfan alamar daji don ciwon daji
- wadannan ƙwayoyin T za su iya haifar da ciwon sukari
- wadannan ƙwayoyin T za su fara aiki a shafin yanar gizon masu ciwon tumbu don haifar da lalacewar shafin
Yaya Yaduwar Cutar Kankara ta Yarda?
A cikin shekaru da suka wuce, an gwada daruruwan ciwon daji (dendritic-cell) alurar riga kafi.
Duk da haka, karuwar amsawa ga wadannan maganin ba su da kyau-kusan kashi 2.6. A gaskiya ma, wasu nau'o'in immunotherapy sun tabbatar da zama mafi tasiri, wanda ya rinjayi masana da yawa don tambayi maganin maganin ciwon daji na "ciwo".
To, idan magungunan maganin ciwon daji ba su da tasiri a cikin mutane, me yasa muke ci gaba da zuba jari da kuma lokaci zuwa ci gaban maganin alurar rigakafi? Akwai akalla dalilai uku da ke nuna mana sha'awar irin wannan saƙo.
Na farko, maganin alurar rigakafi sunyi tasiri wajen hana ciwon daji, kuma wannan nasarar ya kai ga maganin ciwon daji tare da maganin alurar rigakafi.
A takaice dai, aikin da muka yi wajen bunkasa maganin rigakafin rigakafin rigakafi ya koya mana yadu game da immunology na kwayoyin cutar ciwon daji kuma ya samar da tsarin ka'ida don ci gaba da maganin alurar rigakafi. A halin yanzu akwai maganin alurar rigakafi guda biyu da ke hana ciwon daji: maganin ciwon hepatitis B yana hana ciwon hanta, kuma maganin alurar rigakafi na mutum (HPV) yana hana guru, ciwon ciki, da kuma sauran maycers
Na biyu, maganin alurar rigakafin ciwon daji yana da sauƙin gudanarwa da kuma haifar da mummunar tasiri.
Abu na uku, masu bincike suna nuna damuwa a cikin fassarorin su na gwaji da suka shafi maganin rigakafin cutar ciwon daji, wanda ke ciyar da wannan nau'i na baki. Musamman ma, masu bincike sun fi mayar da hankali kan tarihin tarihi, ko salon salula, ko kuma kwayoyin lymphocyte (T cell) da ke ciwon ciwace-ciwacen ƙwayar ƙwayar cuta ba tare da mayar da hankali akan canji na ainihi ba: rage yawan ƙwayar ƙwayar tumɓir ko ingantawa a cikin bayyanar cututtuka.
Bugu da ƙari kuma, masu bincike masu binciken da ke bincikar maganin alurar rigakafi suna amfani da labarun yaudara da kalmomi don nuna alamun sakamako, irin su "bayyanar cututtuka sun ɓace," "ƙaddamar da ci gaban dan lokaci a wasu matakai na mutum", "tumo necrosis" da kuma "kwanan nan ba da daɗewa ba." Ba tare da ƙarin bayani ba, waɗannan kalmomin suna da kadan.
A bayanin da aka ba da labarin, an gudanar da bincike kan maganin alurar rigakafi a kan ilimin kimiyyar likita ta hanyar amfani da dabbobin dabba. Mice, kamar yadda mutum zai iya jingina daga girmansu, halayyarsa da furta, sun bambanta da mutane. Saboda haka, duk wani nasarar da muke gani a zalunta wadannan dabbobi da maganin rigakafin ciwon daji ba dole ba ne ya fassara wa mutane.
Mafi mahimmanci, ko da yake an riga an tabbatar da maganin alurar rigakafi a cikin dabbobi, yana da wuya a gano irin wannan tasiri a cikin mutane. Musamman, akwai maganin rigakafin ciwon daji wanda Hukumar FDA ta amince don maganin ciwon daji a cikin mutane: Rahoton. Duk da haka, akwai maganin rigakafi na ciwon ciwon gurgu a halin yanzu a cikin gwaje-gwaje na Phase 3 wanda ya tabbatar da cewa yana da tasiri: Prostvac.
Kafin mu dubi duka Provenge da Prostac, bari mu dan kadan a kan iliminmu game da ciwon ciwon sankara .
Ciwon ƙwayar cuta
Baya ga ciwon daji na fata, cutar sankarar ita ce mafi yawan ciwon daji wanda ya shafi mazaunan Amurka. Kodayake kimanin kusan 1 cikin mazauna bakwai na Amirka suna tasowa cutar ciwon gurgu, yawanci daga cutar (kimanin 1 a cikin 39). Maimakon haka, mutane sukan mutu da wasu cututtukan farko, kamar cututtukan zuciya. Duk da haka, a shekara ta 2016, akwai mutuwar mutane 26,120 da cutar ta karu.
Saboda gwadawa mai zurfi don antigen (PSA) antigen, mai ba da ilimin halitta don ciwon ciwon kwari, mun sami damar gano lokuta na ciwon ciwon kwari a baya, yayin da ciwon daji ke har yanzu zuwa prostate, mafi yawanci, maza da ke fama da ciwon ciwon kwari. wanda ya hadu da shi ko yada ga kasusuwa kuma ya zama m.
Abubuwan da ke haɓaka ciwon daji na prostate sun hada da tsofaffi, Afirka na Amirka da tarihin iyali.
Yawancin mutanen da ke fama da ciwon karuwanci ba sa bukatar magani kuma a maimakon haka likitoci suna kiyaye su. Jiyya ga ciwon daji na prostate zai iya haɗawa da kulawa na ido (kulawa mai aiki), tiyata (zubar da ciki ko kuma kawar da prostate), radiotherapy da androgen, ko jima'i na hormone, rashi.
Shawara
Provenge ko sipuleucel-T wani maganin rigakafi ne na dendritic-cell wadda FDA ta amince da shi a 2010. Abinda ake zargi shine abin da ake sani da kwayar halitta na immunotherapy na autologous kuma an yi amfani dasu don magance cututtukan da ba a yada ba tukuna (rashin rinjaye). Bugu da ƙari kuma, Provenge yana maganin ciwon daji wanda ba shi da damuwa ga hormones (hormone refractory).
A wani bayanin da aka ba da labarin, cututtukan cututtuka na hormone suna amsa maganin cututtuka na hormone-deprivation, ko kwayoyi da rikici tare da androgens, ko jima'i na jima'i (yi tunanin gyare-gyaren kiwon lafiya).
An shirya shari'ar ta hanyar yin amfani da kwayoyin jini na jini (masu jini na kwayoyin halitta) wanda aka yi amfani da kwayar da ake kira granulocyte-macrophage-colony-stimulating factor (GM-CSF) da prostatic acid phosphatase, ko PAP, antigen.
Dalilin da ya sa aka ba GM-CSF tare da antigen PAP ne saboda masu bincike sunyi imanin cewa GM-CSF yana inganta gabatar da antigen. Na bayanin kula, kwayoyin halitta na mononuclear jiki suna aiki ne a jikin kwayoyin dendritic wanda aka gabatar da antigen.
Abin takaici, Rahoton yana ƙara rayuwa ta kimanin watanni 4. Duk da haka, wannan lokaci na iya ƙyale mutum ya sami al'amuransa kuma ya ba dan lokaci kadan tare da iyalinsa.
Abubuwa masu banna na Provenge sun haɗa da wadannan:
- zazzabi
- bala'i
- gajiya
- ciwon baya
- ciwon kai
A lokacin gwaji na Provenge, wasu 'yan maza sun fuskanci cututtuka masu tsanani ciki har da matsaloli na numfashi, zafi ciwon zuciya, rashin tausayi na rashin bin doka, rashin tsauraran hanzari da haɓaka cikin karfin jini. Saboda haka, mutanen da ke fama da matsalolin zuciya da matsalolin ya kamata su tattauna wadannan ka'idodin tare da mai bada sabis na kiwon lafiya.
Prostvac
Hanya na Prostvac ya bambanta daga Provenge.
Prostvac ya ƙunshi kwakwalwa na poxvirus (fowlpox), magungunan antitate-specific antigen (PSA) da kuma ƙaddarar da ake kira TRICOM. Wannan maganin na PSA-TRICOM yana shafan tantanin halitta na antigen wadanda ke haifar da su wajen bayyana sunadarai antigen-takamaiman ƙwayoyi a kan su. Wadannan kwayoyin gabatarwar antigen sun gabatar da kwayoyin T kuma su horar da su don magance ciwon daji na prostate.
Prostvac Phase 2 gwaje-gwaje na asibiti sun hada da mambobi 82 wadanda 42 suka sami Prostvac. Prostvac ya cigaba da rayuwa a rukunin gwaji ta darajar median na watanni 8.5. A halin yanzu, Prostvac yana cikin gwajin gwajin gwaji na Phase 3, kuma masu bincike ba kawai ƙoƙarin tabbatar da amfanin rayuwa ba ne kawai amma suna ƙoƙarin gano ko GM-CSF ya kamata a kara wa alurar.
A lokacin gwaje-gwaje na gwaji na 2 na gwaji, matsalolin Prostvac sun haɗa da wadannan:
- halayen shafin yanar gizo (ciwo, kumburi, redness da sauransu)
- gajiya
- zazzabi
- kumburi
- bala'i
- hadin gwiwa
- dizziness
- tashin zuciya
- vomiting
- zawo
- maƙarƙashiya
Labaran ciwon daji na ƙwayar cutar ba sa nufin amfani da su ne a matsayin maganin cutar ta prostate na farko. Maimakon haka, ana gudanar da su a ban da chemotherapy.
Mene Ne Yayi Madi?
A shekarar 2015, FDA ta amince da maganin Imlygic, wani maganin rigakafi na kancolytic don magani ko mummunan melanoma wanda ba shi da amfani. Kodayake ba maganin alurar rigakafin ƙwayar cutar ciwon daji ba, Imlygic na da nasarori biyu kamar maganin rigakafi na ciwon daji.
Kwayoyin cututtuka na kancolytic irin su immunotherapy ne inda cutar ta hanyar sarrafa kwayar cutar ta shiga cikin kwayar cutar kwayar cutar ta ƙwayar cuta ko kuma ta rage ƙwayoyin tumo. Bugu da ƙari ga watsar da kwayoyin halitta, wadannan ƙwayoyin cuta suna da tasiri mafi girma na ɗaukar wani sakamako na antitumor kamar maganin anticancer.
Ciwon daji da maganin cututtukan daji
A halin yanzu, yin amfani da alurar rigakafi a cikin asibitoci iyakance ne. Bugu da ƙari, kamar yadda aka ambata a baya, yana da wuyar samun samo maganin ciwon daji wanda ke da tasiri a kan mahalarta. Ba mai yiwuwa ba ne za mu ga maganin alurar rigakafi da ake amfani dasu don magance magunguna daban-daban kowane lokaci nan da nan.
Duk da haka, alurar rigakafin ciwon daji na nuna ci gaba da tsarin rigakafi da kuma filin immunotherapy. Mafi mahimmanci mu fahimci ƙayyadaddun tsarin, ba za mu iya magance hanyoyin kwantar da hankula ba wanda zai iya ceton rayuka a wata rana.
Sources:
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Kantoff PW et al. Binciken Survival na Ɗauki na II na Halitta Tsarin Gudanar da Ƙarƙashin Ƙarƙashin Ƙarƙashin Magungunan Immunotherapy na PSA wanda ke dauke da kwayoyin cutar a cikin ƙananan ƙwayoyin cuta. J Jara Incol. 2010 Mar 1; 28 (7): 1099-1105.
KJ. Babi na 96. Ciwon ƙwayar cuta. A: Halter JB, Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S. eds. Hazzard na Geriatric Medicine da Gerontology, 6th . New York, NY: McGraw-Hill; 2009. Samun damar Mayu 22, 2016.
Rosenberg SA, Yang JC Restifo NP. Ciwon rigakafi Immunotherapy: Sauyewa Kan Gaggawa Yanzu. Nat Med . 2004 Satumba: 10 (9): 909-915.