I-ZMapp, iFavipiravir, iAntivirals, kwaye ithemba ngakumbi
Impendulo elula: asiyazi, kodwa sinethemba.
Ngaphambi kokuba i-Ebola isasazeke eNtshona Afrika ngo-2013 ukuya ku-2015, akukho nonyango eye yavavanywa ngempumelelo kubantu. Emva kokuba i-bhubhane yaqhambuka, amayeza ayedla ngokunikezelwa imfesane. Izigulane zifumene unyango kwaye ziphuculwe. Nangona kunjalo, inani lezigulane liye lincinci, amayeza amaninzi athile asetyenziswayo, kwaye ngenxa yezizathu zokuziphatha azizange zithelekiswe ngendawo.
Unyango lwezigulane ezinxulumene nophuculo lubandakanya: i-ZMapp, i-favipiravir, kunye negazi kubaxhoba. Olunye uphando lwe-TKM-Ebola aluzange lubonise nayiphi na inzuzo. Nangona kunjalo, ekuqaleni ngaphambi kokunikezelwa kokuqala, ubuncinane abantu aba-10 bafumene i-ZMapp e-US, eLiberia, eSpeyin nase-UK. Kuphela 2 kwafa. Ubuncinane ufumene i-favipiravr (eFransi) kunye ne-TKM (e-US) kwaye isinda. Kamva izigulane ziqalise iBrincindofovir- enye yafa. Kusenjalo, kunzima ukuxelela ezinye zezi zi yobungozi ngaphandle kwezilingo ezingenangqiqo, nokuba isilwanyana okanye ukunakekelwa okunyamekelayo, kwenza umehluko.
Sekunjalo, sinethemba. Inani lokufa kwe-Ebola (EBOV, iZaire) esasazekayo eNtshona Afrika iphezulu kakhulu. Ekuqaleni kucatshangelwa ukuba iphakamileyo njengama-80-90% (njengoko kubonwe kwizifo zesifo esithile ngaphambili). Kubonakala kuku-45-60% eNtshona Afrika. Ukunyamekela okunyamekelayo kunokunciphisa ukufa kwa-1 kwi-3.
Kwakhona kunzima ukuthelekisa ixabiso lokusinda njengoko kudla ukulibaziseka ekufuneni ukunakekelwa okanye ukuhanjelwa ukunakekelwa.
Ingxaki kukuba: i-stocks ye-ZMapp yaphela.
Kodwa ngoku kuya kuba khona-kodwa ukukhawuleza kudlule.
I-WHO (iWorld Health Organisation) kunye nee-arhente karhulumente, kuquka i-US FDA (i-Federal Drug Administration), zixhasa ukusetyenziswa kwemfesane nokuvavanywa kwezi zi yobisi.
Nangona kunjalo, ngaphandle kobungqina bokuba unyango luyasindisa, kukho inkxalabo yokuba izinto ezinokubonakala ziphila zingalimaza - okanye ziphazamise ekunakekeleni ubomi.
Ngoko ivelaphi na?
Serum Concentral Serum
Uvavanyo lokuqala lwe-Ebola lwaqala ngokuphalaza igazi kumaxhoba kubantu abasulelekileyo ukuba banike isifo sokulwa nesifo sengculaza. Umphandi wasinda elandela i-Ebola needlestick ngo-1976 (kunye nogqirha ogonywe ngo-2014) emva kokumpontshelwa kodwa kwakungacaci ukuba i-serum incede. Kamva ngo-1995, izigulane ezili-8 zanikwa igazi kwaye 7 zazisinda, xa ubuninzi (80%) bafa. Uhlalutyo oluthile, nangona kunjalo, lwabonisa ukuba akukho nzuzo yokuxilongwa (ukunyuka kwenyuka ngexesha nje ukususela kwintsholongwane nokugqitywa kokuqala). Nangona kunjalo, i-World Health Organization ibonise umdla ekuphenyweni kwegazi, njengabantu abasindileyo, ngokungafani neziyobisi, ziveliswa yi-bhubhane (nangona iibhanki zegazi zingancinci).
Ukumpontshelwa kwegazi ku-Convalescent kuye kwasetyenziswa eNtshona Afrika, kwakunye kunye nezigulane ezintathu kwi-US.
Antioclonal Antibody
Ama-antibodies, avela kwibhubhoratri kunokuba aphethwe igazi, abe yonyango eluthembekileyo kakhulu. Elinye iyeza, i-ZMapp kwiMaphup Biopharmaceutical, idibansi ye-3 monoclonal (oko kukuthi i-specific specific) i-antibodies (inxamnye ne-glycoproteins yomhlaba).
Unyango, ngokusebenzisa iilisi zonyango ezintathu, lubonakala lubekezelela. Ngelishwa, izitokisi zeziyobisi ziye zaphela, nangona ukuveliswa kweziyobisi ezicwangcisiweyo kulungiselelwe (ngokusebenzisa izityalo zogwayi eziza kukhula iilisi). I-FDA iye yavumela ukusetyenziswa kwesi sicelo sesilwanyana esingenakunyulwa sisifo se-Ebola xa sikhona.
Imithi yokulwa neyeza
Iziyobisi ziyakwazi ukulwa nentsholongwane. Kukho izidakamizwa ezininzi ze-anti-virus: i-TKM-Ebola (i-Tekmira Corporation), i-BCX4430, (i-Biocryst Corporation), i-AVI-7537 (i-Sarepta), i-Favipiravir (i-Fujifilms)
Ezinye iziyobisi azibonakali zisebenza. Uvavanyo lwe-TKM-Ebola lugqitywe ngoJuni 2015 kuba alubonakali lusebenzayo. Kwakuthenjelwe ukuba ngokusebenzisa uhlobo lwe-RNA (i-RNA ephazamisayo ebizwa ngokuthi i-ARRNA) engayinqanda intsholongwane.
Isebenzisa i-RNA ephindwe kabini ukuyeka ukubonakalisa i-jeni kwi-3 Ebola (i-Zaire Ebola L polymerase, iprotheni ye-Viral 24 (VP24) kunye ne-VP35). Uvavanyo lweebhabhi kunye nezilwanyana ziye zaphumelela (kubandakanywa ne-virus efanayo, iMarburg). Ukuxhalabisa ngeempembelelo ezikhuselekileyo zokumelana nomzimba kuye kwanciphisa ukuvavanya okuqhubekayo, kodwa i-FDA iqhuba ngokukhawuleza oku.
I-BCX4430 isebenza njengebhloko yokwakha i-DNA / RNA (adenosine nucleoside analog) yokuyeka ukutshintshwa kwegciwane; uye waphumelela kwisilingo sesilwanyana. 401.
F avipiravir , isicatshulwa esivumelekileyo malunga nomkhuhlane eJapan siye sasebenza kwiimpawu zezilwanyana kwaye sinikezelwe njengonyango lwe-Ebola. Isicatshulwa ngokucacileyo sisilumkiso se-nucleotide esithintela ukuphindaphinda kwintsholongwane.
I-Brincidofovir (i-BCV, i-CMX001) ayisayi kulandelwa i-Ebola. Uphando ngoku lujoliswe kwezinye iigciwane, njenge-Adenovirus kunye ne-CMV.
Enyanisweni, i-BCV yenzelwe ukusetyenziswa kunye ne-DNA virus - CMV (Cytomegalovirus), i-Adenovirus. I-Ebola yintsholongwane ye-RNA, kungekhona i-DNA virus. Iyeza liba cidofovir ngaphakathi kweeseli. Esi sidakamizwa sisetyenziswe ngempumelelo kunye ne-CMV kunye nezinye ii-virus ze-DNA, njengeepillomaviruses. I-Cidofovir yi-analog i-nucleotide; ixelisa i-DNA block block kwaye iphazamise i-DNA ekwandiseni kwii-virus ze-DNA. Ngokubanzi akuzange isetyenziswe kwiiRNA ezinjenge-Ebola. Nangona kunjalo, inkampani eyenza i-Brincindofovir, i-Chimerix, ibonise i-laboratory izifundo kwi-CDC, i-NIH ibonise umsebenzi wokulwa no-Ebola, ezo ziindaba ezilungileyo kakhulu njengoko isilwanyana sisetyenziswe ngokukhuselekileyo kubantu ngaphambili, nangona umsebenzi wayo wokulwa no-Ebola ungagqitywanga izilwanyana okanye abantu. Kuza kuba ngumlomo wesivivinywa, owawunika ingozi yeenaliti nge-Ebola, uya ku thembisa. (I-Brincindofovir ifaka i-lipid, okanye i-fatty, inxalenye eboshwe kwi-cidfovir, evumela ukuba isilwanyana sigxilwe, ingasirwanga).
I-AVI-7537 isebenzisa i-molecule ye-RNA eguquliwe ukuze ihlasele iphrotheni yeVP24.
Amachiza avunyelweyo
Indlela elula yokunyanga i-Ebola kuya kuba ukufumana isicatshulwa esaziwayo sikhuselekileyo esisebenzayo malunga ne-Ebola. Ukuhlolwa kwezidakamizwa ezivumile ukuvunywa kwe-anti-Ebola umsebenzi sele kuchonge i-orogen receptors (i-SERMs) ezikhethiweyo ze-estrogen (i-SERMs), ezifana neComomiphene kunye ne-Torimefene esetyenziselwa unyango lomhlaza wesisu kunye neengonyama zebele.
Ezinye iziyobisi zinokwenzeka. I-Ebola ithinta i-cascade ye-clotting eyenza ama-clots aze aphephe. I-(entsha) isicatshulwa esinokuchaphazela i-clotting rNAPC2 yafundwa kunye nesilwanyana esaziwayo, i-rhAPC (i-Protein C incinciant activated C) eyenziwe ngabantu. Ngokufanayo, abanye bathi i-cholesterol-ehlisa iziyobisi esekelwe kwezinye izifo. Ngokufanayo, i-interferon ikhangelwe ukuba isebenziswe kwi-Ebola. Olunye ugqirha usetyenzise i-HIV, i-Lamivudine, i-nucleoside analog, kwizigulane ze-Ebola ezinokukhokelela ekuqhubeni phambili.
Mayeza
I-FDA ilumkise ngokusetyenziswa kweemithi ezingavumelekanga. Zininzi iziyobisi zivakala kakuhle - kodwa-ke ngaphandle kokuvavanya, akucaci ukuba ngaba luncedo okanye yingozi.
Igciwane
Isitofu sokukhusela usulelo luya kuba luhle. Kukho ngoku i- vaccine evivinywe kwaye ibonakala iyasebenza.
Ngaphambi kokusasazeka kwe-2013-2015, bekukho izitofu eziye zaphuhliswa nge-Ebola, kodwa azizange zihlolwe ngokwaneleyo. Esinye isitofu sagqitywa kwisigulane esinye; mhlawumbi inokunceda emva komphenyi we-Ebola needlestick ka-2009. Oku kugonywa, ukugonya kweVSV (i-vesicular vesicular virus stomatitis vector eveza i-virus ye-Ebola glycoprotein) iye yahlolwa kwakhona kwiimpawu zezilwanyana (kodwa kungabikho nawuphi na umntu) kwaye iboniswe ukuba isebenza ngempumelelo kwiiyure ezingama-24 emva kokuvelela. Kwakuyi-vaccine yeVSV eyavavanywa kwaye iboniswa ukuba iyasebenza kwiGuinea.
Ekuqaleni kwindlala, kwakukho amaqela amaninzi kunye noorhulumente abaye basebenzela ukuvavanya nokusebenzisa iigonti. Urhulumente waseCanada uzinikezele ukusabalalisa iimpahla ezikhoyo ezifumanekayo zale gciwane lokuhlola. I-NIH icebise ukuphonononga ngokukhawuleza omnye umviwa ogonyayo. Urhulumente waseTshayina kamva ngo-2015 naye waqala ukuvavanya isitofu sokugonya, esebenzisa i-adenovirus-vector.
Ekugqibeleni, kunokufumana iigcini ezininzi. Ngelishwa, uninzi lweemvavanyo luya kukhawuleza ukunceda amawaka awafa ngo-2013-2015. Kwakunzima kakhulu ukuvavanya iigciwane xa kukho izifo ezincinci.