Kuvimbisa Shanduko munzvimbo yeMS Kurapwa

Zvemukati

• Chinangwa chekurapa
• Kurapa
• Gilenya (fingolimod)
• Teriflunomide (Aubagio)
• Dimethyl fumarate (Tecfidera)
• Dalfampridine (Ampyra)
• Alemtuzumab (Lemtrada)
• Yakagadziriswa nyaya yekurangarira maitiro
• Myelin peptides
• Iyo Ramangwana reMS Kurapwa

Multiple sclerosis (MS) chirwere chisingaperi chinokanganisa iyo yepakati tsinga system. Mitsipa yakaputirwa muchifukidziro chekudzivirira chinonzi myelin, icho chinomhanyisawo kufambisa kwemaoko etsinga. Vanhu vane MS vanoona kuzvimba kwenzvimbo dze myelin uye kuenderera mberi kwekudzikira uye kurasikirwa kwe myelin.

Tsinga dzinogona kushanda zvisina kujairika kana myelin yakanganisika. Izvi zvinogona kukonzeresa zviratidzo zvinoverengeka. Izvi zvinosanganisira:

• kurwadziwa, kurira, kana kupisa kupisa mumuviri wese
• kurasikirwa kwemaonero
• mafambiro ekufamba
• mhasuru kana kuomarara
• kuoma nekuenzanisa
• kutaura kwakashata
• kukanganisika ndangariro uye kugona kwekuziva

Makore ekutsvaga kwakazvipira akatungamira kumarapirwo matsva eMMS. Hapachina mushonga wechirwere ichi, asi madhimoni emushonga uye maitiro ekurapa anotendera vanhu vane MS kunakirwa nehupenyu huri nani.

Chinangwa chekurapa

Sarudzo dzakawanda dzekurapa dzinogona kubatsira kubata mafambiro uye zviratidzo zvechirwere ichi chisingaperi. Kurapa kunogona kubatsira:

• kunonoka kufambira mberi kweMS
• kurerutsa zviratidzo panguva yekuwedzera kweMS kana kuputika
• kunatsiridza hutano hwepanyama uye hwepfungwa

Kurapa nenzira yemapoka ekutsigira kana kurapwa kwekutaura kunogona kupawo inodiwa-yekusimbisa mweya.

Kurapa

Chero ani zvake anoonekwa aine fomu rinodzokedzana reMS angangotanga kurapwa nechirwere cheDAA-chinotenderwa chinoshandura-chinodhaka. Izvi zvinosanganisira vanhu vanoona yekutanga kiriniki chiitiko chinoenderana neMS. Kurapa nechirwere-chinogadzirisa chinodhaka chinofanira kuenderera nekusingaperi kunze kwekunge murwere awana mhinduro isina kunaka, anowana zvinokanganisika mhedzisiro, kana asingatore mushonga sezvavanofanirwa. Kurapa kunofanirawo kuchinja kana sarudzo iri nani ikavapo.

Gilenya (fingolimod)

Muna 2010, Gilenya yakave yekutanga yekumwa mushonga wekudzokorodza mhando dzeMS kugamuchirwa neKudya neDrug Administration (FDA). Mishumo inoratidza kuti inogona kudzora kudzoka nehafu uye kunonoka kufambira mberi kwechirwere.

Teriflunomide (Aubagio)

Chinangwa chikuru cheMS kurapwa ndechekunonoka kufambira mberi kwechirwere. Zvinodhaka zvinoita izvi zvinonzi mishonga-inoshandura mishonga. Mumwe wemishonga yakadai ndeyemuromo chinwiwa teriflunomide (Aubagio). Yakagamuchirwa kuti ishandiswe muvanhu vane MS muna 2012.

Chidzidzo chakaburitswa muThe New England Journal of Medicine chakawana kuti vanhu vane MS vanodzokazve avo vakatora teriflunomide kamwe pazuva vakaratidza zvakanyanya kudzikira kwechirwere kuwedzera mwero uye kudzoka kushoma pane avo vakatora placebo. Vanhu vakapihwa mwero wepamusoro we teriflunomide (14 mg vs. 7 mg) vakaona kudzikira kwekuwedzera kwechirwere. Teriflunomide yaingova yechipiri chete yemuromo chirwere-chinja mishonga inogamuchirwa kurapwa kweMS.

Dimethyl fumarate (Tecfidera)

Chirwere chechitatu chemuromo-chinoshandura chinodhaka chakawanikwa kune vanhu vane MS munaKurume wa2013. Dimethyl fumarate (Tecfidera) yaimbozivikanwa seBG-12. Inomisa immune system kubva kuzvirwisa uye nekuparadza myelin. Inogona zvakare kuve nechengetedzo pamuviri, yakafanana nemhedzisiro ine antioxidants. Mushonga uyu unowanikwa mune capsule fomu.

Dimethyl fumarate yakagadzirirwa vanhu vakadzokerazve-kugadzirisa MS (RRMS). RRMS chimiro chechirwere umo munhu anowanzoenda mukuregererwa kwenguva yakati zviratidzo zvavo zvisati zvawedzera. Vanhu vane rudzi urwu rweMS vanogona kubatsirwa kubva kaviri-mazuva ese madhizaizi emushonga uyu.

Dalfampridine (Ampyra)

MS-indened myelin kuparadza inokanganisa nzira iyo tsinga dzinotumira uye dzinogashira masaini Izvi zvinogona kukanganisa kufamba uye kufamba. Potasiamu chiteshi akafanana nemapore ari pamusoro peiyo nerve fibers. Kuvhara migero kunogona kuvandudza kuitisa kwetsinga mumitsipa yakakanganiswa.

Dalfampridine (Ampyra) ndeye potassium chiteshi blocker. Zvidzidzo zvakaburitswa zvakawanikwa kuti dalfampridine (yaimbonzi fampridine) yakawedzera kumhanya kwekufamba muvanhu vane MS. Chidzidzo chepakutanga chakaedza kufamba kwekumhanya panguva yekufamba-tsoka makumi maviri neshanu. Izvo hazvina kuratidza dalfampridine kuve inobatsira. Nekudaro, kuongorora kwekumashure kwekudzidza kwakaratidza kuti vatori vechikamu vakaratidza kuwedzera kufamba kwekumhanya panguva yemiyedzo yemaminetsi matanhatu pavanotora 10 mg yemushonga zuva nezuva. Vatori vechikamu vakasangana nekuwedzera kumhanya kwekumhanyisa zvakare vakaratidza kuvandudza musimba gumbo mhasuru.

Alemtuzumab (Lemtrada)

Alemtuzumab (Lemtrada) inorwisa munhu monoclonal antibody (lab yakagadzira mapuroteni anoparadza cancer maseru). Icho chimwe chirwere chinoshandura mumiriri chinotenderwa kurapa kudzokazve mafomu eMS. Inotarisa puroteni inonzi CD52 inowanikwa pamusoro pemasero emumuviri. Kunyangwe zvisingazivikanwe chaizvo kuti alemtuzumab inoshanda sei, inofungidzirwa kuti inosunga CD52 paT uye B lymphocyte (machena masero eropa) uye inokonzeresa lysis (kuparara kwesero). Mushonga uyu wakatanga kutenderwa kurapa leukemia padanho rakakwira kwazvo.

Lemtrada aive nenguva yakaoma kuwana mvumo yeDAA muUnited States. Iyo FDA yakaramba chikumbiro chekubvumidzwa kwaLemtrada kutanga kwa2014. Vakataura nezve kudiwa kwemamwe miedzo yekiriniki inoratidza kuti bhenefiti inodarika njodzi yemhedzisiro. Lemtrada yakazobvumidzwa neDFA munaNovember 2014, asi inouya neyambiro pamusoro peakakomba autoimmune mamiriro, infusion reaction, uye yakawedzera njodzi yezvakaipa senge melanoma uye mamwe cancer. Yakafananidzwa neEMD Serono's MS drug, Rebif, mumatanho maviri echikamu chechitatu. Iyo miedzo yakawana kuti zvaive zvirinani kudzikisa kudzokedzana kwehuwandu uye kuwedzera kwekuremara kweanopfuura makore maviri.

Nekuda kwehunhu hwayo hwekuchengetedza, iyo FDA inokurudzira kuti inge ichinyorerwa chete kune varwere vakave nemhinduro isina kukwana kune maviri kana anopfuura mamwe marapirwo eMS.

Yakagadziriswa nyaya yekurangarira maitiro

MS inobata basa rekuziva pamwe. Iyo inogona kukanganisa kukanganisa ndangariro, kuisa pfungwa, uye mabasa epamusoro senge kuronga uye kuronga.

Vatsvagiri kubva kuKessler Foundation Research Center vakaona kuti yakagadziridzwa nyaya yekurangarira nyaya (mSMT) inogona kushanda kune vanhu vanoona zvinoitika kubva kuMS. Kudzidza uye ndangariro nzvimbo dzehuropi dzakaratidza kumwe kushanda mukuongorora kweMRI mushure memasangano emMSMT. Iyi nzira inovimbisa yekurapa inobatsira vanhu kuchengetedza zviyeuchidzo zvitsva. Izvo zvinobatsirawo vanhu kuyeuka ruzivo rwekare nekushandisa nyaya-yakavakirwa kusangana pakati pemifananidzo uye mamiriro. Yakagadziridzwa nyaya yekurangarira nzira inogona kubatsira mumwe munhu ane MS kurangarira zvinhu zvakasiyana pane runyorwa rwekutenga, semuenzaniso.

Myelin peptides

Myelin inozokuvara zvisingadzoreke muvanhu vane MS. Ongororo yekutanga yakataurwa muJAMA Neurology inoratidza kuti ingangoita mishonga nyowani inobata vimbiso. Rimwe boka diki rezvidzidzo rakagamuchira myelin peptides (mapuroteni zvidimbu) kuburikidza nechigamba chakapfekwa paganda ravo kwegore rimwe chete. Rimwe boka diki rakagamuchira placebo. Vanhu vakagamuchira iyo myelin peptides vakasangana zvakanyanya zvakanyanya maronda uye kudzokazve pane vanhu vakagamuchira iyo placebo. Varwere vakashivirira kurapwa zvakanaka, uye pakanga pasina zviitiko zvakakomba zvakashata.

Iyo Ramangwana reMS Kurapwa

Anoshanda ekurapa MS anosiyana pamunhu nemunhu. Izvo zvinoshanda zvakanaka kune mumwe munhu hazvingashande kune mumwe. Nharaunda yekurapa inoenderera ichidzidza zvakawanda nezvechirwere uye nemabatirwo acho akanaka. Kutsvagisa kwakabatana pamwe nekuyedza uye kukanganisa ndiko kiyi yekuwana mushonga.