Yemberi Ongororo uye Clinical Miedzo yePrimary Progressive MS

Zvemukati

• Mhedziso
• Mhando dzeMS
• Kunzwisisa yekutanga kufambira mberi MS
• PPMS kurapwa
• Ocrevus (Ocrelizumab)
• Inoenderera PPMS kiriniki miedzo
• NurOwn stem cell kurapa
• Biotin
• Masitinib
• Akapedzwa makiriniki miedzo
• Ibudilast
• Idebenone
• Laquinimod
• Fampridine
• Kutsvaga kwePPMS
• Kutora

Mhedziso

Multiple sclerosis (MS) inogara isingaite autoimmune mamiriro. Izvo zvinoitika kana muviri ukatanga kurwisa zvikamu zvecentral nervous system (CNS).

Yakawanda mishonga yazvino uye kurapwa kwakanangana nekudzokazve MS uye kwete pane yekutanga kufambira mberi MS (PPMS). Nekudaro, zvekuedzwa zvemakiriniki zvinogara zvichingobatwa kubatsira zviri nani kunzwisisa PPMS uye kutsvaga mitsva, inoshanda yekurapa.

Mhando dzeMS

Mhando ina dzeMS dzakakura ndeidzi:

• kliniki yakasarudzika chirwere (CIS)
• kudzokerazve-kuregera MS (RRMS)
• yekutanga inofambira mberi MS (PPMS)
• yechipiri inofambira mberi MS (SPMS)

Aya marudzi eMS akagadzirwa kubatsira vanotsvaga vezvekurapa kuisa muzvikamu zvemakiriniki ekuyedza vatori vechikamu vane chirwere chakafanana Aya mapoka anotendera vatsvagiri kuti vaongorore kushanda pamwe nekuchengetedzeka kwemamwe marapirwo pasina kushandisa nhamba huru yevatori vechikamu.

Kunzwisisa yekutanga kufambira mberi MS

Chikamu chegumi neshanu muzana kana zvakadaro chevanhu vese vanoonekwa vane MS vane PPMS. PPMS inobata varume nevakadzi zvakaenzana, nepo RRMS yakajairika muvakadzi kupfuura varume.

Mhando zhinji dzeMS dzinoitika apo immune system inorwisa iyo myelin sheath. Iyo myelin sheath chinhu chine mafuta, chinodzivirira chinotenderedza tsinga mumutsipa wepelinha uye huropi. Kana chinhu ichi chikarwiswa, chinokonzera kuzvimba.

PPMS inotungamira kukuvara kwetsinga uye zvinyama zvitsvuku munzvimbo dzakakuvadzwa. Chirwere ichi chinokanganisa maitiro ehutano hwekutaurirana, zvichikonzera isingafungidzike maitiro ezviratidzo uye kuwedzera kwechirwere.

Kusiyana nevanhu vane RRMS, vanhu vane PPMS vanoona zvishoma nezvishoma kuwedzera basa pasina kutanga kudzokazve kana kuregererwa. Mukuwedzera kune kuwedzera zvishoma nezvishoma mukuremara, vanhu vane PPMS vanogonawo kuona zviratidzo zvinotevera:

• kunzwa kwekugwinha kana kugwinha
• kuneta
• dambudziko nekufamba kana nekubata mafambiro
• inobata nechiono, senge kuona kaviri
• matambudziko nekurangarira uye kudzidza
• mhasuru kana kuomarara kwemhasuru
• kuchinja manzwiro

PPMS kurapwa

Kurapa PPMS kwakanyanya kuomarara pane kurapa RRMS, uye inosanganisira iko kushandisa kwemaunosuppressive Therapies. Aya marapirwo anopa rubatsiro rwechinguva chete. Vanogona chete kuve vakachengeteka uye vachiramba vachishandiswa kwemwedzi mishoma kusvika pagore pane imwe nguva.

Ipo Chikafu neDrug Administration (FDA) ichibvumidza mishonga yakawanda yeRRMS, haasi ese akakodzera mhando dzinofambira mberi dzeMS. Mishonga yeRRMS, iyo inozivikanwawo sehosha-inoshandura mishonga (DMDs), inotorwa ichienderera uye inowanzo kuve nemhedzisiro isingagone.

Vanoshingairira kubvisa maronda uye kukuvara kwetsinga kunogona kuwanikwa mune vanhu vane PPMS. Iwo maronda anonyanya kuzvimba uye anogona kukonzera kukuvara kune myelin sheath. Parizvino hazvizivikanwe kana mishonga inoderedza kuzvimba inogona kunonoka mafambiro eMS.

Ocrevus (Ocrelizumab)

Iyo FDA yakabvumidza Ocrevus (ocrelizumab) sekurapa kune ese maRRMS nePPMS munaKurume 2017. Kusvika parizvino, ndiyo chete mushonga wakave wakabvumidzwa neFDA kurapa PPMS.

Zvemakiriniki miedzo yakaratidza kuti yaikwanisa kudzora kufambira mberi kwezviratidzo muPPMS nekukomberedza 25 muzana kana ichienzaniswa ne placebo.

Ocrevus inobvumidzwawo kurapwa kweRRMS uye "kutanga" PPMS kuEngland. Haisati yatenderwa mune mamwe matunhu eUnited Kingdom.

Sangano reNational Institute for Health Excellence (NICE) rakatanga kuramba Ocrevus nechikonzero chekuti mutengo wekuchipa chakapfuura mabhenefiti acho. Zvisinei, NICE, National Health Service (NHS), pamwe nemugadziri wezvinodhaka (Roche) vakazoongororazve mutengo wayo.

Inoenderera PPMS kiriniki miedzo

Chinhu chakakosha pamberi pevatsvagiri kudzidza zvakawanda nezve mafambiro anofambira mberi eSMS. Mishonga mitsva inofanira kuenda kuburikidza neyakaomarara kuongororwa kwekiriniki FDA isati yavatendera.

Mazhinji emakiriniki ekuedzwa anogara kweanosvika makore matatu kusvika matatu. Nekudaro, nekuti iko kutsvagisa kushoma, kunyangwe miedzo yakareba inodikanwa yePPMS. Mimwe miedzo yeRRMS iri kuitiswa nekuti zviri nyore kutonga kushanda kwemushonga pane kudzoka zvakare.

Ona iyo National Multiple Sclerosis Society webhusaiti yeiyo yakazara runyorwa rwemakiriniki miedzo muUnited States.

Iyi inotevera miedzo yekusarudza iri kuitika.

NurOwn stem cell kurapa

Brainstorm Cell Therapeutics iri kuita chikamu chechipiri chemakiriniki kuyedza kuongorora kuchengetedzeka uye kushanda kwemasero eNurOwn mukurapa MS inofambira mberi. Uku kurapa kunoshandisa maseru emadzinde akatorwa kubva kune vatori vechikamu ayo akakwidziridzwa kuti abudise chaiwo ekukura zvinhu.

MunaNovember 2019, National Multiple Sclerosis Society yakapa Brainstorm Cell Therapeutics $ 495,330 yekutsvagisa rubatsiro mukutsigira kurapwa uku.

Nyaya yacho inotarisirwa kupera munaGunyana 2020.

Biotin

MedDay Pharmaceuticals SA parizvino iri kuita chikamu chechitatu chemakiriniki ekuyedzwa pamusoro pekubudirira kwedhivhosi-biotin capsule yekurapa vanhu vane MS inofambira mberi. Muedzo unovavarirawo kunyatso tarisa kune vanhu vane matambudziko e gait.

Biotin ivhitamini inobatanidzwa mukukanganisa maseru ekukura kwezvinhu pamwe nekugadzirwa kwemyelin. Iyo biotin capsule iri kufananidzwa ne placebo.

Kutongwa uku hakusi kutora vatsva, asi hazvitarisirwe kupera kusvika muna Chikumi 2023.

Masitinib

AB Science iri kuita chikamu chechitatu chemakiriniki ekuedzwa pamushonga masitinib. Masitinib mushonga unovhara mhinduro yekuzvimba. Izvi zvinotungamira kune yakaderera immune mhinduro uye yakadzika nhanho yekuzvimba.

Iko kuyedza kuri kuongorora kuchengetedzeka uye kushanda kwemasitinib kana ichienzaniswa ne placebo. Maitiro maviri ekurapa masitinib ari kufananidzwa neiyo placebo: Iyo yekutanga regimen inoshandisa iwo muyero iwoyo mukati, nepo imwe yacho inosanganisira kuwedzera kwetaisi mushure memwedzi mitatu.

Muedzo hauchisiri kutora vatori vechikamu vatsva. Inotarisirwa kupedzisa munaGunyana 2020.

Akapedzwa makiriniki miedzo

Iyi inotevera miedzo ichangobva kupedzwa. Kune vazhinji vavo, mhedzisiro yekutanga kana yekupedzisira yakaburitswa.

Ibudilast

MediciNova apedza chikamu chechipiri chemakiriniki kuyedzwa pamushonga ibudilast. Chinangwa chayo chaive chekuona kuchengetedzeka uye chiitiko chemushonga muvanhu vane MS inofambira mberi. Muchidzidzo ichi, ibudilast yakafananidzwa ne placebo.

Pakutanga mhedzisiro yekudzidza inoratidza kuti ibudilast yakadzora kufambira mberi kwehuropi atrophy kana ichienzaniswa neiyo placebo kweanopfuura masvondo makumi mapfumbamwe nemasere. Iwo akajairika mhedzisiro mhedzisiro anotaurwa aive ezviratidzo zvemudumbu.

Kunyangwe mhedzisiro iri kuvimbisa, mimwe miedzo inodiwa kuti uone kana mhedzisiro yeiyedzo ichi inogona kuburitswazve uye kuti ibudilast ingaenzaniswa sei neOcrevus nemimwe mishonga.

Idebenone

Sangano reNational Institute of Allergy and Infectious Diseases (NIAID) nguva pfupi yadarika rakapedza chikamu cheI / II kiriniki yekuyedza kuongorora kuitika kwe idebenone pavanhu vane PPMS. Idebenone ndeye synthetic vhezheni ye coenzyme Q10. Zvinotendwa kudzikamisa kukuvara kune tsinga system.

Munguva yese yekupedzisira yemakore maviri ekuyedzwa kweiyi 3-gore, vatori vechikamu vakatora chero chinodhaka kana placebo. Mhedzisiro mhedzisiro yakaratidza kuti, panguva yese yechidzidzo, idebenone haina kupa bhenefiti pamusoro penzvimbo yekuronga.

Laquinimod

Teva Pharmaceutical Maindasitiri akatsigira chikamu II kudzidza mukuedza kumisikidza humbowo hwepfungwa yekurapa PPMS ne laquinimod.

Hazvina kunyatsonzwisiswa mashandiro anoita laquinimod. Zvinotendwa kuti zvinoshandura maitiro emasero ekudzivirira, nekudaro kudzivirira kukuvara kwenzvimbo.

Mhedzisiro inoodza mwoyo yemiedzo yakatungamira mugadziri wayo, Active Biotech, kuti arege kuvandudza laquinimod semushonga weMS.

Fampridine

Muna 2018, University College Dublin yakapedza chikamu chechina IV kuyedza kuongorora zvinoitika zvefampridine mune vanhu vane nhengo yepamusoro yekusagadzikana uye ingave PPMS kana SPMS. Fampridine inozivikanwawo se dalfampridine.

Kunyangwe kuyedzwa uku kwapera, hapana mibairo yakataurwa.

Nekudaro, sekureva kwe2019 Italian kudzidza, mushonga unogona kuvandudza ruzivo rwekugadzirisa kumhanyisa kune vanhu vane MS. Ongororo ye2019 uye meta-ongororo yakagumisa kuti paive nehusimbe humbowo mushonga wakavandudza kugona kwevanhu vane MS kufamba madaro mafupi pamwe nekuona kwavo kugona kufamba.

Kutsvaga kwePPMS

National Multiple Sclerosis Society iri kusimudzira kutsvagurudza kuri kuita mhando dzeMS. Chinangwa ndechekugadzira kurapwa kwakabudirira.

Kumwe kutsvagisa kwakanangana nemusiyano uripo pakati pevanhu vane PPMS nevanhu vane hutano. Ongororo ichangoburwa yakawana kuti masero emadzinde muhuropi hwevanhu vane PPMS anotaridzika kunge akura kupfuura iwo maseru emadzinde mune vane hutano vanhu vezera rakafanana.

Pamusoro pezvo, vaongorori vakaona kuti apo oligodendrocyte, maseru anogadzira myelin, akaoneswa kune aya maseru maseru, vakaratidza mapuroteni akasiyana pane evanhu vane hutano. Kana ichi chirevo cheprotein chikavharwa, iyo oligodendrocyte yakazvibata zvakajairika. Izvi zvinogona kubatsira kutsanangura kuti nei myelin ichikanganiswa mune vanhu vane PPMS.

Chimwe chidzidzo chakawana kuti vanhu vane MS inofambira mberi vaive nematanho akaderera emamorekuru anonzi bile acids. Bile acids ine akawanda mabasa, kunyanya mukugaya. Ivo zvakare vane anti-kupisa simba pane mamwe maseru.

Vanogamuchira bile bile acids vakawanikwawo pamasero muMS tishu. Zvinofungidzirwa kuti kuwedzera ne bile acids kunogona kubatsira vanhu vane MS inofambira mberi. Muchokwadi, kuyedzwa kwekiriniki kuyedza chaizvo izvi zviri kuitika.

Kutora

Zvipatara, mayunivhesiti, uye mamwe masangano muUnited States yose vari kuramba vachishanda kuti vadzidze zvakawanda nezvePPMS neMS mune zvese.

Parizvino mumwe chete mushonga, Ocrevus, unobvumidzwa neDFA yekurapa PPMS. Ipo Ocrevus ichinonoka kufambira mberi kwePPMS, haimise kufambira mberi.

Mimwe mishonga, senge ibudilast, inoita seinovimbiswa zvichibva pamiyedzo yekutanga. Mimwe mishonga, yakadai se idebenone uye laquinimod, haina kuratidzwa kuti inoshanda.

Mimwe miedzo inodiwa kuti uone mamwe marapirwo ePPMS. Kumbira mupiki wako wezvehutano nezvezvazvino kiriniki miedzo uye tsvagurudzo inogona kukubatsira.