I-immunomodulator yeklasi yeyeza-asthma eboniswa kwizigulane ezinzima ukulawula i-asthma. Njengoko unyango olongezelelweyo lwe-asthma yakho, i-immunomodulator yiphilisi yomlawuli kunokuba isilwanyana esifutshane senza imiphumo emihle yempawu ze-asthma . Kuba malunga nesithathu kwisigulane se-asthmatic patients okanye abangaphenduliyo kwi-steroids okanye abangenayo impendulo engafanelekanga, umntu onokuzikhusela nge-immunomodulator unokunika ithemba lokulawula i-asthma engcono.
I-Xolair , i-anti-monoplonal antibody, yodwa yonyango ephunyeziweyo ye-immunomodulator efumanekayo yesifo se-asthma. Lo mzimba ufanelekile ukuba izigulane eziqhubekayo eziqhubekayo okanye ezinzima ziqhubekayo:
- Uvavanyo olusesikhumbeni okanye olunye uvavanyo lwegazi olubonisa ukungabikho komzimba kwi-asthma trigger eyaziwayo, njengothuli, inja, ikati okanye i-cockroach dander.
- Iimpawu ezingalawulwa ngokungafanelekanga nge- corticosteroids ezikhuselweyo .
Elinye i-immunomodulator esetyenziswa rhoqo kwiindlela zokungabikho komzimba kunye nokuzikhusela komzimba namhlanje yiCinryze, unyango lwe-inflammation ephindaphindiweyo ebusweni nasentanyeni ebizwa ngokuba yi-angioedema yefa.
Indlela abaxhamli be-immunomodulators basebenza ngayo
Ama-immunomodulators anciphisa impawu zombini kunye nesidingo se- corticosteroids ye- systemic . Ukuncedisa i-corticosteroids ye-systemic ngaphezu kokuphindwe kabini ngonyaka kukubonakaliswa kolawulo lwe- asthma olubi. Ama-immunomodulators anokunciphisa ukuvutha ngokuchaphazela inani leendawo ezahlukeneyo kwi- pathophysiology ye-asthma , kuquka:
- Basophil
- Eosinophils
- Lymphocytes
- Macrophages
- Amaseli amakhulu
- Neutrophils
- Antioclonal Antibodies
- IgE
- Iiseli
- IiCytokines
- Interleukins
I-immunomodulator ibopha kwi-IgE kwaye iyayinqanda ukuba ingabophelanga kuma-basophil kunye neeseli ezincinci. Ukongezelela, i-immunomodulator iyanciphisa inani lokujikeleza i-basophil kwaye ikhusela iisitrasi ze-mast ukuba zikhulule izinto ezenza iimpawu zakho zibe zibi nakakhulu.
Indlela abancedisa ngayo ii-immunomodulators
Ngezinye izihlandlo i-immunomodulator ibizwa ngokuba yi-steroid-sparing drug that improves workway and lung lung function. Ukongezelela, i-immunomodulator iya kunciphisa iimpawu ze-asthma ezifana:
- Ukugubha
- Ubungqina bebhokisi
- Ukuqhawukelwa ngumphefumlo
- Ukukhwehlela okungapheliyo
Unyango olune-immunomodulator luye lwadibaniswa kunye nokuhla kwehla kwee- asthma eziphuthumayo kunye nokuvakatyelwa kwamagumbi okuphuthuma kunye nokuphuculwa komsebenzi wamaphaphu kunye nomgangatho wobomi. Ngokuqhelekileyo, i-immunomodulator ayiyi kuthatha indawo enye unyango lwe-asthma, kodwa iya kwongezwa kuyo. Ukongezwa kwe-immunomodulator kuye kwadibaniswa kunye neepesenti ezingama-25 ekusebenziseni i-steroid.
Iimpembelelo ezingasemva
Nangona i-immunomodulator yakho ifaneleke ukunyamezeleka, kukho imiphumo emibi echaphazelekayo kunye nemiphumo engavumelekanga ukuba iyazi, kuquka:
- I-Urticaria kunye ne-anaphylactic-reaction -Urticaria, okanye imingxube, isenzo esichaphazelekayo esinokuba nemiphumo emibi xa singaphathwa ngokukhawuleza kwaye ngokufanelekileyo. Ugqirha wakho uzakufuna ukuba ubekwe iliso kwithuba lexesha eofisini emva kwentsholongwane nganye. Nangona iimpendulo ezininzi zenzeka emva kweyure enye ukuya kweyure emva kwesinye seenjini zangaphambili, ukuphendula okuthe tye kwenzeka emva kweentsholongwane ezininzi kunye neeyure ezininzi ukususela ekufumaneni i-injection.
- I-Cancer -Nokuba ingazange icace ngokupheleleyo kule ngongoma, iidlers zixhaphake kakhulu kwizigulane ezithola i-Xolair. Nangona kunjalo, isizathu sokuba olu lwalamano phakathi komhlaza kunye ne-immunomodulator lubonwe alukaqondwa ngokupheleleyo.
- Inhlungu yesifo sensiza -Njengoko nayiphi na injini, intlungu kwisayithi yokujola isiphumo esaziwayo kwaye sinokuvela kuma-20 eepesenti zezigulane ezithobela i-immunomodulator.
- Izifo zokuphefumula eziphezulu -Qiniseka ukuba uxoxisana nodokotela wakho ukuba wenzeni kwaye xa kufanelekile ukufuna unonophelo xa unayo le mpawu.
- Umqala oyimpumlo kunye nentloko - Ukuba ezi zibonakalisi zingasombululi kunye nemilinganiselo yokulondoloza, njengamachiza aphuluzayo kunye nokugqithisa, kufuneka uxoxe nodokotela wakho.
Abaxhamli be-Immunomodulators kwiPhuhliso
Inani leminye i-immunomodulators ejolise kwizigaba ezahlukeneyo ze-pathogenesis yesifo se-asthma sisempayipi:
- I-Daclizumab yi-antioclonal antibody echaphazela inani leendawo kwi-asthma cascade. Kuye kwavavanywa kwilingo leklinikhi yezigulane ezingama-115, kodwa kuboniswa kuphela ukuphucula amancinci kumsebenzi wamaphaphu nokulawula isifo se-asthma.
- I-Lebrikizumab yindoda ephilileyo yomntu ebophezelayo kwaye ibimbela umsebenzi we-interleukin-13, enye inxalenye ye-pathophysiology ye-asthma. Izilingo ezimbini zeekliniki, i-VERSE kunye ne-LUTE, yabonisa izinga lokunciphisa ukuphulukiswa kwesifo se-asthma kunye nokuphucula umgangatho wamagciwane kwizigulane (kungabikho nkxalabo ekhuselekileyo) kunye ne-asthma ekhuselekileyo enokulawulwa kakubi nangona unyango olungumgangatho okhoyo okhoyo. Izigulane ezininzi eziye zaphawulwa ukuba zizuze kulezi zifundo zazinamazinga aphakamileyo e-periostin, iprotheni eyaziwayo yokwandisa amanqanaba okuvuvukala.
- I-Reslizumab i-antioclonal antibody egxininisayo ekujoliswe kuyo kwe-interleukin-5 (IL-5). Kwizilingo zeklinikhi, isetyenziselwe kwizigulane zabantu abadala kunye nabadala abasemagunyeni aphakamileyo ngegazi eliphezulu, nangona i-corticosteroid esebenzayo. I-Reslizumab ibonise ukunciphisa ukuqhuma kwesifuba somphunga kunye nokuphucula umsebenzi wamaphaphu kwizilingo zesigaba se-III kwizonyango ezingaphezu kwe-1,700 eziselula kunye nezigulane zabantu abadala. Ngokusekelwe kwizilingo, kulindeleke ukuba izibonakaliso ziya kufana nezo zeXolair. I-Reslizumab ikhangelwe yi-FDA kunye ne-TEVA ithathe inyathelo kwisicelo sayo emva ko-2016. Ezinye iinkampani zamachiza, ezifana ne-AstraZeneca, zinamachiza afanayo kwiimipayipi, nazo.
- I-Eculizumab (Soliris®) ngumntu osisigxina se-antioclonal antibody ekujoliswe kwinkqubo yokuxhasa kwaye ngoku ivunyiwe yi-FDA yokunyangwa kwe-hemoglobinuria. Icandelo elincinci lonyango libonise uphuculo lomsebenzi wamaphaphu kunye neempawu zokugula. Nangona kunjalo, eli liyeza lidibaniswe nokusuleleka kwingozi yokubulawa kwabantu. Ngenxa yoko, isilwanyana sinqatshelwe kwaye oogqirha kufuneka babhalise ukuze bakwazi ukuyibeka.
- I-Suplatast ibonise iziphumo ezintle ngokunjalo, kodwa amaxesha amathathu ngosuku ukuxhalaba malunga nokuthobela i-asthma.
- I-tumor necrosis-alpha-TN (i-TNF-α) i-immunomodulator esebenza kwiindawo ezininzi kwi-pathophysiology ye-asthma. Ngaphandle kokuphucula ukucwangcisa kwiinkalo zezigulane ze-asthma ezingaphezu komzimba (imeko eyaziwayo ekhokelela kwi-TNF-α exhargement), i-TNF-α ayiyekanga ukunyusa okanye ukuphuculwa komsebenzi wamaphaphu. Ngokukodwa, i-Infliximab (Remicade®) kunye ne-etanercept (i-Enbrel®) i-immunomodulators njengamanje isetyenziselwa ezinye izifo, ezifana ne-rheumatoid arthritis. Ezi zi yobisi zidibene neengozi ezongezelelekileyo zentsholongwane.
- I-Peroxisome proliferator eyenziwe i-receptor-gamma (PPAR-γ) yenye iklasi leyeza kunyango. Ezi zi yobisi sele zisetyenziselwa ukonyango lwesifo sikashukela, apho kwafunyaniswa ukuba babe nezenzo ezinokuthi zichasene. IGigine iigobesi eziphathwe nge-rosiglitazone zifunyenwe ukuba zinciphile kakhulu kwizinga le-IL-5 ne-IgE. Xa izilwanyana zazixuthwa, i-TIL-5 ne-IgE nazo zafunyanwa zincipha emiphakeni. Abaphandi abakhokelayo ukuba bacinge ukuba kungaba yinkqubo yokuncedisa i-asthma, nayo.
- I-Syk kinase yiprotheni ye-intracellular tyrosine kinase evimbela ukubola kwee-cell mast. Isilwanyana safunyanwa ukunciphisa ukudibanisa kwendoda kunye nokukhupha, ukunyunyuza, ukubetha kwempumlo kunye nomqala, ukuqhuma emva kwendoda, ukukhwehlela, intloko yesifo, kunye nentlungu ebusweni kwizigulane ezithatha i-rhinitis ye-allergen kwi-lab. Uhlolisiso usebenzisa i-formulated formulation ilungiselelwe izigulane ze-asthma.
Imithombo:
I-Heart Heart, i-Lung, ne-Blood Institute. Ingxelo yePhaneli yeNgcali 3 (EPR3): Izikhokelo zoLwazi kunye noLawulo lwe-Asthma.
UDimov VV, i-Casale TB. Abaxhamli be-Immunomodulators ye-Asthma. I-allergies Asthma Immunol Res. 2010 Oktobha; 2 (4): 228-234.
Ukuxhaswa kweWW, Israel E, Nelson HS, Baker JW, Charous BL, Young DY, et al. I-Daclizumab iphucula ukulawula i-asthma kwizigulane ezinomlinganiselo othe ngqo kwi-asthma eqhubekayo: ityala elingahleliyo, elilawulayo. Ngaba i-Respiratory Crit Care Med. 2008; 178 (10): 1002-1008.
I-Menzella F, uLusuardi M, uGaleone C, uZucchi L. Ulwaphulo olululisiweyo lwe-Asthma. Imithi yokuphefumula emininzi yamathambo; 10 (1) 201.