Masu bincike ne ke binciko Ka'idojin Magani don kawar da cutar HIV
A shekarar 1984, lokacin da Sakataren Lafiya da Ayyukan Dan Adam Margaret Heckler ya yi furuci cewa wata rigakafin cutar kanjamau "za ta kasance a shirye don gwaji a kimanin shekaru biyu."
Yanzu, fiye da shekaru 35 cikin annoba, har yanzu ba mu ga wani abu da ke kusa da dan takarar mai yiwuwa ba, ko dai don hana ciwon hoto ko don samar wa mutanen da ke dauke da kwayar cutar HIV damar iya sarrafa cutar ba tare da amfani da kwayoyi ba.
Shin hakan yana nufin cewa ba mu samu a duk lokacin ba? Duk da yake yana iya zama irin wannan hanya, tare da irin ƙarancin rashin daidaituwa na jama'a, gaskiyar ita ce, muna da ƙananan kayan aiki a shekarun 1980 da 90 don buɗe asirin kwayoyin cutar.
A yau, tare da ƙari da yawa daga waɗannan kayan aikin da muke dashi-daga madaidaicin microscopy na 3D wanda aka tsara ga tsarawar tsara ta gaba-shin muna kusa da gano maganin cutar HIV?
Ƙalubalanci da ƙaddarawa na Bincike na Farko
Gaskiyar ita ce, har ma a 1984, masu bincike sun san kalubale da suka fuskanta wajen bunkasa maganin alurar rigakafi. A cikin rahoton majalisa wanda Ofishin Harkokin Fasaha ya gabatar, masu binciken sun lura cewa:
"Babu wata maganin rigakafin kwayar cutar kanjamau, ko kuma dukkanin shirye-shiryen da ba a aiwatar da su ba, wadanda ke dauke da kwayoyin cutar AIDS, yanzu suna da alkawurra mai yawa," yayin da yake kara cewa "idan maye gurbi (na HIV) yana da mahimmanci ... zai zama da wuya a ci gaba maganin alurar rigakafi. "
Bugu da ƙari ga matsalar shi ne gaskiyar cewa yawancin fasahohin da ake buƙatar inganta maganin alurar riga kafi sune gwaji a wannan lokaci, musamman ma'anar DNA da aka yi amfani da ita a bincike na rigakafin zamani.
Amma har ma da farkon wannan rushewa, masu bincike sun sami ilmi game da iyakancewar maganin rigakafin gargajiya, wato
- abin da ake kira "all-kashe" maganin alurar rigakafin (wanda kwayar cutar HIV ta shafe ta jiki ta hanyar maganin rigakafi, sunadarai, zafi ko radiation) ba su damu ba.
- cewa kawai kunna nauyin jikin mutum ba shi da iyakancewa tun lokacin da kwayar cutar HIV ta kashe 'yan kwayoyin halitta wadanda ke yin amfani da su ( CD4 T-cell ), da barin jiki wanda ba zai iya ba da damar kare shi ba.
- cewa maye gurbi mai girma na samar da HIV tare da bambancin kwayoyin halitta wanda ke haifar da ƙirƙirar maganin alurar rigakafi daya-wanda zai iya warware dukkan nau'o'in cutar HIV -mai wuya, idan ba zai yiwu ba.
Rashin Magungunan Turawa
A cikin 'yan shekarun nan, an gudanar da bincike mai zurfi a kan ci gaba da maganin alurar rigakafi. A takaice, idan dan takarar mai maganin rigakafi bai iya hana rigakafi ba, zai iya jinkirta ko ma dakatar da cigaba da cutar a cikin wadanda aka rigaya kamuwa. Don maganin alurar rigakafin da za a yi la'akari da shi, hukumomi sun bayar da shawarar cewa ya kamata a dakatar da akalla kashi 50 cikin cututtuka a cikin waɗanda aka yi musu.
Mun yi kusa da wannan manufa a cikin 'yan shekarun nan, babu kuma fiye da gwajin RV144 a shekara ta 2009. Wannan binciken na Thai, wanda ya haɗa da' yan takara guda biyu daban-daban (duka biyu sun yi la'akari da su), ya nuna rashin karuwar kashi 31% cikin cututtuka tsakanin mahalarta a cikin ƙungiyar maganin alurar rigakafi tare da waɗanda ke cikin ƙungiyar placebo.
Wannan gwagwarmaya ba da daɗewa ba ta bi RV505 , wanda ake nufi da fadada a kan waɗannan sakamakon ta haɗar maganin alurar "priming" tare da maganin "inganta" maganin da ake ciki a cikin adenovirus mai nakasa (nau'in kwayar cutar da ke hade da sanyi). Amma a maimakon haka, an dakatar da fitina a watan Afrilun shekarar 2013, lokacin da aka ruwaito cewa mafi yawan mahalarta alurar rigakafi sun kamu da cutar fiye da wadanda basu da maganin alurar riga kafi.
Bayan haka, mutane da yawa a cikin masu bincike suka nuna damuwarsu game da ragowar RV505, wanda ya nuna cewa zai iya mayar da maganin rigakafi na tsawon shekarun da suka gabata.
Mene ne Yau da Cibiyar Nazarin Ciwon Kanjamau HIV?
Duk da rashin nasarar RV505, ƙananan ƙananan gwaje-gwaje sun ci gaba da bincike kan wasu samfurori masu mahimmanci / fasaha.
Na farko daga cikin wadannan, RV305 , ya tattara 167 masu halartar cutar HIV a cikin gwajin RV144 a Thailand. Manufar bincike shi ne don sanin ko ƙarin ƙarin damuwa zai kara kariya fiye da kashi 31 cikin dari.
Nazarin na biyu, wanda aka sani da RV306 , zai bincika tasiri daban-daban na alurar rigakafi idan aka yi amfani da shi tare da maganin rigakafin RV144.
A halin yanzu, yawancin bincike na baya-bayan nan an mayar da hankali ne a kan hanyoyin da ake kira "kick-kill" dabaru. Manufar haɗin kai shine nufin amfani da magungunan miyagun ƙwayoyi don kayar da kwayar cutar kwayar cutar ta HIV yayin da wakili na biyu (ko jami'o'i) ya kashe kwayar cutar marar yaduwa.
Akwai wasu nasarori a cikin share shafukan bidiyo mai ban sha'awa, ciki har da yin amfani da masu hanawa na HDAC (wani nau'i na miyagun ƙwayoyi da aka lasafta shi a matsayin antipsychotic). Duk da yake muna da abubuwa da yawa don koyi game da yaduwar wuraren da aka ɓoye waɗannan tafki a ɓoye, ƙirar ta kasance alamar alkawarin.
Hakazalika, masana kimiyya sun sanya matakai a kan ci gaba da magungunan immunologic da ke iya taimakawa kare lafiyar jiki. Tsakanin wannan yunkurin shine ake kira sunadarin sunadarai (bNabs) - sunadaran sunadarai wadanda zasu iya kawar da kwayar cutar kanjamau (kamar yadda ya saba da tsauraran magungunan da ke iya kashe wani nau'i).
Ta hanyar nazarin masu kula da kwayar cutar HIV (mutanen da ke da tsayayya da HIV), masana kimiyya sun iya ganowa da kuma motsawa samar da dama daga cikin alamun bana. Duk da haka, mahimman tambaya shine: shin malamin kimiyya zai iya haifar da amsar da za ta kashe HIV ba tare da cutar da mutum ba? Zuwa kwanan wata, ci gaba an yi alkawarin, idan m.
A cikakkinsu, waɗannan gwaje-gwaje suna da muhimmanci yayin da suka gina kan darussan da aka koya daga maganin rigakafi na baya, wato:
- Rashin ƙaddamarwa ba yana nufin shan kashi ba. An samu nasarar rigakafi na AIDVAX, wanda yayi nasara a gwajin mutum biyu a shekara ta 2003, an sake dawo da ita a matsayin maganin rigakafi na "booster" don nazarin RV144.
- Rabin kashi 50 baza mu iya isa ba. A gaskiya, bincike na Thai ya nuna cewa adadin maganin alurar riga kafi ya kasance da kashi 60 cikin 100 a farkon shekarar, ya karu sosai yayin da lokaci ya ci gaba. Wannan yana nuna cewa ƙarin ƙuntatawa ko inganta dabarun zai iya samar da kariya mafi girma.
- Muna buƙatar samun hanyoyin da za mu "ƙayyade gasar." Binciken da aka yi kwanan nan ya nuna cewa ƙwayoyin cuta na iya zama a cikin zuciya na RV505. Halittar samfurin halitta yana nuna cewa maganin ba kawai ya motsa samar da kwayoyin immunoglobulin G (IgG) ba, kamar yadda aka yi nufi, amma kuma ya haifar da yaduwar cutar ta immunoglobulin A (IgA), wanda ya rage tasirin kare. Gano su yana nufin haɓaka ko wannan sakamako mai tasiri zai zama babban kalubale na ci gaba.
- Wataƙila ba za mu sami wata alurar riga kafi ba. Yawancin masana sun yarda cewa yana iya ɗaukar matakan haɗuwa don yayata cutar HIV ko kawar da "warkewarta." Ta hanyar hada maganin gargajiya na gargajiyar gargajiya da rigakafi , mutane da yawa sun gaskata cewa zamu iya haifar da kwayar cutar HIV, duk da ikonsa na harbawa da kuma ikon iya ɓoye kansa daga ganewa.
Shin Cibiyar Nazarin Ciwon Nazarin Binciyoyin Biliyoyin da ke Kwarewa?
A lokacin da aka kashe kujerun kwayar cutar ta HIV, wasu sun fara tambayar ko ƙarar da aka tattara ta hanyar ƙararrawa ta hanyar jarrabawar da kuma kuskure-suna bada garantin dala biliyan 8 da aka rigaya an kashe akan bincike na rigakafi. Wadansu sunyi imani da cewa sun zama raguwa ga 'yan Adam da na kudi yayin da wasu kamar Robert Gallo sun yi jayayya cewa rigakafi na yau da kullum ba su da karfi don tabbatar da wani tsari mai mahimmanci.
A wani bangare kuma, yayin da muka fara fahimtar game da rigakafi da kwayoyin halitta da kuma ƙarfafa yawan marasa lafiya, wasu sun yarda cewa ilimin zai iya amfani da wasu sassan binciken HIV.
A cikin ganawar 2013 tare da Jaridar Guardian , Françoise Barre-Sinoussi , wanda aka lasafta shi a matsayin mai bincike na HIV, ya amince da cewa magani zai iya kasancewa a cikin "shekaru 30 masu zuwa".
Ko dai hasashen ya kawo tsammanin ko tsammanin bege, ya tabbata cewa gaba gaba shine ainihin ainihin zaɓi. Kuma cewa kawai ainihin gazawar shi ne wanda daga abin da ba mu koyi kome ba.
> Sources:
> Bincike na Kasuwancin Fasaha. "Bincike game da Ma'aikatar Kiwon Lafiya ta Jama'a game da Sida." Washington, DC: Majalisar {asar Amirka; Fabrairu 2005: p. 28. Makarantar Kasuwancin Kasuwanci Katin Katin 85-600510.
> Rerks-Ngarm, S .; Pitisuttithum, P .; Nitayaphan, S .; et al. "Gurasar rigakafi tare da ALVAC da AIDSVAX don hana cutar HIV-1 a Thailand." New England Journal of Medicine. Disamba 3, 2009; 361 (23): 2209-20.
> Cibiyar Nazarin Allergy da Cututtuka na kasa (NIAID). "NIH ta yanke shawarar rigakafin rigakafin HIV a cikin kwayar cutar HIV." Washington, DC: Cibiyoyin Lafiya na kasa (NIH). Afrilu 25, 2013.
> Shirin Cibiyar Nazarin Harkokin Sigar Amurka (MHRP). "RV144 Nazarin RV305 ya fara a Thailand." Walter Reed Medical Center, Washington, DC; Rahotanni na Afrilu: Afrilu 11, 2012.
> Shirin Ciwon Kanjamau ta Kanjamau (IAVI). "Ci gaba a kan hanyar zuwa ga cutar AIDS." New York, New York; Mai watsa labarai: Yuni 2012.
> Tomaras, G. "E103 HIV-1 Gurasar da aka sanya IgA da IgG ta musamman." Rajistar Jirgin Ƙunƙasar Ƙaƙwalwar Lalacewa. Afrilu 2013; 62 (1): 52.
> MacNeil, J .; Johnson, M .; Birx, D; da kuma Traumont, E. "Gwajin Ciwon Kanjamau ta HIV." Kimiyya. Fabrairu 13, 2004: 303 (5660): 961.
> Connor, S. "Sanarwar maganin HIV shine yanzu yiwuwar yiwuwar." The Independent. An buga Mayu 19, 2013.