Abaphengululi bahlola iNkcazo yokuHlanganiswa kweNveli yokuQeda i-HIV
Kwakukho ngo-1984 xa uNobhala wezeMpilo kunye neNkonzo zoLuntu uMargaret Heckler wachazela ngesibindi ukuba igciwane lokugonywa nguGawulayo "liya kuba silungele ukuvavanya malunga neminyaka emibini."
Ngoku, engaphezu kweminyaka engama-35 engqungqutheleni, asikaze sibone nantoni na isondela kumviwa ofanelekayo, nokuba kuthintela ukusulela kwintsholongwane okanye ukunika abantu abane-HIV amandla okulawula intsholongwane ngaphandle kokusetyenziswa kweziyobisi.
Ngaba oko kuthetha ukuba asifumani ndawo kulo lonke ixesha? Nangona kungathi kubonakale ngale ndlela, ngocwangciso olungapheliyo lwentsilelo yokungaphumeleli koluntu, inyaniso kukuba sinempahla embalwa kakhulu emva kwee-1980 kunye ne-90 ukuvula iimfihlelo zofuzo.
Namhlanje, nangaphezulu nangaphezulu kwezi zixhobo ezisetyenziswayo-ukusuka kwi-3D ye-electron microscopy ukuya kwisizukulwana esilandelayo-ukuveliswa kwemfuza-ngaba sisondele ngakumbi ekufumaneni ukwelashwa okungapheliyo kwe-HIV?
Imingeni kunye nokulinganiselwa koPhando loPhando
Inyaniso kukuba, nangona ngo-1984, abaphandi babesazi kakuhle iingxaki abajamelene nazo ekuphuhliseni i-vaccine esebenzayo. Kwingxelo ye Congressional efakwe yi-Ofisi ye-Technology Assessment, abaphandi bathi:
"Akukho gciwane lokuphila ngegciwane lesandulela ngculazi, kwaye akukho namalungiselelo angenakulungiswa aqulethwe yi-HIV yintsholongwane kaGawulayo, okwangoku unesithembiso esikhulu," ngelixa wongezelela ukuba "ukuba utshintsho lomzimba (lwe-HIV) lubalulekile ngokwaneleyo ... kuya kuba nzima ukuphuhlisa isitofu sokugonywa. "
Ukongeza kwimiba yinto yokuba ubuninzi bezobuchwepheshe obufunekayo ekuphuhliseni isitofu sokugonywa bekuninzi kuvavanyo ngeli xesha, ngokukodwa iindlela zobuDNA ezibuyiswayo ezisetyenziselwa uphando lwezonyango zanamhlanje.
Kodwa nangaloo mathuba okuqala, abaphandi banolwazi oluninzi malunga nokunciphisa umgangatho wokugonywa kwezemveli, oko kukuthi
- izitofu ezithiwa "ezibulawe ngokupheleleyo" (apho i-HIV inokutshabalaliswa ngokwenyama okanye i-antibiotics, iikhemikhali, ukushisa okanye i-radiation) ayiyikukhupha impendulo efanelekileyo yomzimba.
- ukuba kusebenze nje ukukhusela umzimba womzimba akusilo ngokwaneleyo ekubeni i-HIV iyabulala iiseli ezenza isigidimi sokuzivikela ngomzimba (ii- CD4 T-cell ), eshiya umzimba ungakwazi ukukhusela ukukhusela okusebenzayo.
- ukuba izinga eliphezulu lokuguquka kwintsholongwane kaGawulayo linikeza i-HIV kunye neentlobo ezahlukeneyo zofuzo ezenza ukuchithwa kwesinye-sitshintshi-sinokuthi sinciphise yonke imimandla eguquguqukayo ye-HIV- enoba nzima, ukuba ayinakwenzeka.
Ukunyuka kweeNtsholongwane zonyango
Kwiminyaka emva nje, uphando oluninzi lujoliswe ekuphuhliseni izitofu zonyango. Ngamafutshane, ukuba umviwa ogonyayo awanako ukukhusela ngokupheleleyo ukhuseleko, kunokunciphisa okanye ukuyeke ukuqhubela phambili kwesi sifo kulabo sele basulelekile. Ukuze isifo sokugonya sithathwe njengento esisebenzayo, iziphathamandla zibonisa ukuba kufuneka kumeke ubuncinane i-50% yezifo ezithintekayo.
Siye sondela ngakumbi kweso sifundo kwiminyaka yamuva, akukho nanye ngaphezu kwetyala le-RV144 ngo-2009. Olu pho nonongo lwe-Thai, oludibanisa abaviwa abane-vaccine abahlukeneyo (bobabini ababenzileyo ngokwabo), babonisa ukunciphisa ukuthotywa kwe-31% kwiintsholongwane. phakathi kwabathathi-nxaxheba kwiqela lokugonya ngokumelene nalabo beqela le-placebo.
Lelo vavanyo lilandelwa kungekudala yi- RV505 , eyayihloselwe ukwandisa kuloo miphumo ngokudibanisa isitofu sokugonywa "ngokunyusa" kwindawo yokukhusela i-adenovirus ekhubazekileyo (uhlobo olufanayo lwesifo sengqindi echaphazelekayo). Kodwa kunoko, ityala liye lavalwa ngaphambi kuka-Apreli 2013 xa kwabikwa ukuba abathathi-nxaxheba abaninzi abachaphazelekayo baphelelwe ngabachaphazelekayo abathathi-nxaxheba.
Emva koko, abaninzi kwiindawo zophando babonisa ukuxhalabisa malunga nokushiya okushiywe yi-RV505, besifaka ukuba iyakwazi ukubuyisela kakuhle amanyathelo okugonywa ngamashumi eminyaka.
Liliphi Ikamva le-HIV?
Nangona ukungaphumeleli kwe-RV505, iinzame ezincinci zaqhubeka ziphanda iinkqubo ezahlukeneyo zokuqala.
Eyokuqala kwezi, i- RV305 , iye yaqesha aba-167 abathathi-nxaxheba abangenayo i-HIV kwi-RV144 yangaphambili kwetyala eThailand. Injongo yocwaningo kukuqinisekisa ukuba ngaba i-booster eyongezelelweyo i-inoculations iya kwandisa ukhuseleko ngaphaya kwama-31 ekhulwini.
Ucwaningo lwesibini, olubizwa ngokuba ngu- RV306 , luza kuphanda ukuphumelela kweentlobo ezahlukeneyo zokugonywa kwe-booster xa zisetyenziselwa kunye ne-original RV144 vaccines.
Okwangoku, uphando olunzulu luye lwagxila kwiindlela ezibizwa ngokuthi "ukukhaba ukubulala". Indlela yokudibeneyo ijolise ukusebenzisa i-adjethi ezikhethekileyo ukukhaba i-HIV kwiindawo zayo ezifihlakeleyo zamaseyile ngelixa i-arhente yesibini (okanye i-agent) ibulala i-virus ejikelezayo.
Kuye kwaba nempumelelo ekucoceni izibilini zentsholongwane, kuquka ukusetyenziswa kwe-HDAC inhibitors (uhlobo lweziyobisi oluchazwe njenge-antipsychotic). Nangona sinezinto ezininzi zokufunda malunga nendlela ezazisasazeka ngayo le mijelo efihliweyo, indlela ibonakala iyathembisa.
Ngokufanayo, izazinzulu ziye zenza intloko ekuphuhlisweni kwee-immunologic agents ezinokukwazi ukukhusela umzimba. Ephambili kweli qhinga libizwa ngokuba yi- antibodies (i-BNabs) -i- anti-bids (i-BNabs) -i-proteins ezifunyenweyo zikwazi ukuphelisa ulwahlulo olubanzi lwe-HIV subtypes (ngokuchasene ne-antibodies engaphelelangayo inokukwazi ukubulala enye into).
Ngokufunda abalawuli be-HIV abatshabalalayo (abantu abanomdla wokulwa ne-HIV), izazinzulu ziye zakwazi ukuchonga nokukhuthaza umveliso inani le-BNAbs ethembisayo. Nangona kunjalo, umbuzo ophakathi uhlala: usosayensi unokuvuselela impendulo efanelekileyo yokubulala i-HIV ngaphandle kokulimaza umntu osulelekileyo. Okwangoku, ukuqhubela phambili kuye kwathembisa, ukuba kuthobekile.
Ekugqibeleni kwabo, ezi zilingo zibhekwa njengento ebalulekileyo njengoko zakhayo kwizifundo ezifunyenwe kwiingxaki zokugqibela zokugonya, oku:
- Ukungaphumeleli akusoloko kuthetha ukutshatyalaliswa. Ukugonya kwe-AIDVAX, eyahluleka kwizilingo ezimbini zoluntu ngo-2003, yaxilongwa ngokuphumelelayo njenge-"booster" yokugonya kwi-RV144.
- Iipesenti ezingama-50 azikho phantsi kwethu. Enyanisweni, ukufundiswa kwesiThai kubonise ukuba izinga lokuphumelela lezitofu lalingaphezulu kweendlela ezingama-60 ekhulwini kunyaka wokuqala, ukunyuka ngokukhawuleza njengoko ixesha liqhubeka. Oku kuphakamisa ukuba inoculations eyongezelelweyo okanye ukuphucula izixhobo kunokubonelela ngokukhuseleka okukhulu kunye nokuzinzileyo.
- Kufuneka sifumane iindlela zoku "ukunciphisa ukhuphiswano." Uphando olutsha luye lwabonisa ukuba izixhobo zokulwa ezikhuphisanayo zingasentliziyweni ye-RV505 yokuhluleka. I-genetic modeling ibonisa ukuba izitofu azikhuthazanga kuphela ukuveliswa kwamagciwane okuxhamla kwi-immunoglobulin G (IgG), njengoko kwakucwangciswe, kodwa kwaphinde yabangela ukunyuka kwama-immunoglobulin A (IgA) amachiza omzimba, okwenyusa umphumo wokukhusela. Ukuzifumana kuthetha ukunqoba okanye lo mphumo wokhuphiswano uya kuba ngumngeni omkhulu kunzima.
- Kusenokwenzeka ukuba asiyi kufumana esinye isitofu sokugonya. Uninzi lweengcali ziyavuma ukuba kungathatha indlela yokudibanisa ukuba iphumelele ukutshatyalaliswa kwe-HIV okanye inikeze "unyango". Ngokudibanisa ukugonywa kwendabuko kunye neendlela zokuzibulala , abaninzi bakholelwa ukuba sinokungena kwi-HIV, zombini ekukwazi ukutshatyalaliswa kunye nokukwazi ukufihla ekuboneni.
Ngaba Uphando Lwezonyango Lufanele Iibhiliyoni Ukuba Zisebenzise?
Ngexesha apho iimali ze-HIV zitshintshwa okanye ziqondiswa kwakhona, abanye baye baqala ukubuza ukuba indlela yokwandisa indlela yokuqokelela ubungqina ngokuthe ngcembe ngetyala kunye nephutha-iqinisekisa iibhiliyoni eziyi-8 ezichithwe sele zichithwe uphando lokugonya. Abanye bakholelwa ukuba yinkcitho yabantu kunye nemali xa abanye bafana noRobert Gallo baxelele ukuba imodeli yokugonywa kwamanje ayinamandla okwanele ukuba iqinisekise indlela yokwandisa.
Ngakolunye uhlangothi, njengoko siqala ukuqonda ngakumbi malunga ne-immune-mediated cell and the stimulation of antibodies, iyakubakholelwa ukuba ulwazi lunokusetyenziswa ngokukhawuleza kwezinye iinkalo zokuphanda nge-HIV.
Kwingxoxo ye-2013 kunye nephephandaba le- Guardian , uFrançoise Barre-Sinoussi , obizwa ngokuba ngu-disco-cover of HIV, wabonisa ukuqiniseka ukuba unyango osebenzayo unokubonakala emehlweni "kwiminyaka engama-30 ezayo."
Ingaba ukubikezela kukuphakamisa ukulindela okanye kukunciphisa ithemba, kucacile ukuba ukuqhubela phambili kukuphela kokhetho oluchanekileyo. Yaye okokuphela kwehlulekile kweyona nto esingafundi nto.
> Imithombo:
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> I-Rerks-Ngarm, iS .; Pitisuttithum, P .; Nitayaphan, S; okqhubekayo. "Ukugonywa nge-ALVAC kunye ne-AIDSVAX ukukhusela intsholongwane ye-HIV-1 eThailand." I-New England Journal of Medicine. Disemba 3, 2009; 361 (23): 2209-20.
> Isizwe seSizwe soButhathaka kunye neZifo ezithintekayo (iNIAID). "I-NIH iyayeka ukugonywa kwe-HIV kwiNtsholongwane. IWashington, DC: iiNational Institutes of Health (NIH). Aprili 25, 2013.
> Inkqubo yoPhando lwe-HIV ye-Military (i-MHRP) yase-US. "I-RV144 Yokufunda Isifundo RV305 Siqala eThailand." IWalter Reed Medical Centre, eWashington, DC; I-Media Release: Ngo-Apreli 11, 2012.
> I-AIDS ye-AIDS ye-International Initiative (IAVI). "Inkqubela phambili kwindlela eya kwiNtsholongwane kaGawulayo." ENew York, eNew York; I-Media Release: Juni 2012.
> Tomaras, G. "I-E103 I-HIV-1 I-Vaccine yenze i-IgA ne-IgG Antibody Specificities." I-Journal ye-Immune Deficiency Syndromes. Epreli 2013; 62 (1): 52.
> MacNeil, J .; Johnson, M .; Birx, D; kunye ne-Traumont, E. "Uvavanyo lweNtsholongwane kaGawulayo oluCwangcisiweyo." Sayensi. NgoFebruwari 13, 2004: 303 (5660): 961.
> Connor, S. "Ukunyanga kwe-HIV ngoku kunokwenzeka." Ezizimeleyo. Ishicilelwe ngoMeyi 19, 2013.