Ukulinganisa Ubu bungqina kwiNkxaso yeyeza
I-immunoglobulin engabonakaliyo (IVIG) luhlobo lonyango apho umxube we- antibodies (i-immunoglobulins) ifakwe kwi-vein ngenjongo yokuphucula umzimba womntu. Ama-antibodies ngamaprotheni avikelayo aveliswa ngumzimba ngokuphendula kwisifo.
I-IVIG ikholelwa ukuba isebenza kwizifo ze-neurological by stimulating certain parts of system immune system nokuxinzelela abanye.
Akukho mntu uyazi ngokucacileyo ukuba isebenza kanjani, kwaye, ngoko kunjalo, i-IVIG imiselwe ngaphandle-ilebula (ngaphandle kwemvume ethile ye-FDA) kwizifo apho amasosha omzimba omzimba athatyiswa kakhulu.
Ezi zibandakanya i-nepsatal sepsis, intsholongwane kaGawulayo, kunye neemeko ezithile ze- HIV ephambili . Ikwasetyenziswa kwakhona njengonyango lwamayeza okwesibini kunyango ngokuphindaphinda-ukubuyisela i-multiple sclerosis (RRMS) .
Ukusetyenziswa kwe-IVIG kwi-Multiple Sclerosis
I-IVIG isetyenziswe kwi- multiple sclerosis (MS) ukuqhubela phambili kweso sifo nokunciphisa ukukhubazeka okubangelwa sisifo. Nangona kungekho mvumelwano ecacileyo malunga nokuba i-IVIG ibaluleke kangakanani, ibonise isithembiso kwiinkalo ezithile:
- Ukukhusela i- MS kwakhona ukukhulelwa emva kokubeleka
- Ukunyanga abantu abangaphumeleli unyango lokuqala lwe-RRMS kwaye abanako ukunyamezela izidakamizwa eziguqulwa zizifo
- Ukunyangwa kwe- MS encinci (nangona kukho ixubusho malunga nokusebenza kwayo)
Ezinye iziphumo ziye zaphakamisa ukuba i-IVIG eyanikwa ngexesha le-first symptom of neuroloki ye-MS (ebizwa ngokuba yi- syndrome ye - kliniki, okanye i-CIS ) inokunciphisa ithuba lomntu lokuguqula ukuxilongwa ngokucacileyo kwe-MS. Uninzi lwalo phando luye lwadibana nokungaqiniseki okanye ukungaqiniseki.
Ukusebenza kwe-IVIG
Ngeli xesha, akukho mntu uyazi kakuhle indlela i-IVIG esebenzayo ngayo ekuphatheni okanye ekunciphiseni ukuqhubela phambili kwe-MS.
Ubuninzi bo bungqina busekelwe kwimiphumo yazo kwezinye izifo ze-neurological, ezifana ne- Guillain-Barré syndrome kunye ne- myasthenia gravi . Izifundo ezigxilwe ngokugqithiseleyo kwi-IVIG ne-MS zixutywe ngokufanelekileyo.
Olunye uphando lwase-Australia lubonise ukuphuculwa okuncinci kodwa okubalulekayo kokukhubazeka njengoko kulinganiswe nesilinganiselo sezinga lokukhubazeka (EDSS) . Abanye baye babonisa ukuphuculwa kancinci kwinqanaba okanye kwinani leengqondo zengqondo kwi-MRI.
Abanye, okwangoku, ababonanga nomehluko ekusebenzeni kwe-IVIG kuthelekiswa nama-placeboes ekuphatheni i-RRMS.
Mhlawumbi enye indawo yesithembiso yindlela esebenzisa i-IVIG emva kokubeleka, umgangatho oye wabonisa ukunciphisa kakhulu izinga lokubuyela kwakhona koomama abatsha.
Isistim nokuLawula
Nangona i-dosage kunye nokuphindaphinda kwamayeza angasungulwanga kwi-RRMS, abaninzi abagcini bongoli bancoma umlinganiselo wegramu nganye ngeekhigram yesisindo somzimba esinikezwe ngenyanga. Abanye baya kunika i-400 mg / kg ngosuku ngosuku lweentsuku ezintlanu.
Imiphumela
I-Impig yecala eliqhelekileyo eliqhelekileyo le-headache (elingaqhele ukuphathwa kunye ne-painkiller engaphezu kwe-counter like the Tylenol). Ezinye iziphumo ezichaphazelekayo ziquka umkhuhlane, intlungu edibeneyo, intlungu yesifuba, nokuhlanza. Ngokuqhelekanga, ukugqithisa okuphathelele iziyobisi kunokuhlakulela.
Ezinye iziphumo ezinzima kodwa ezinqabile ziye zaphawulwa, kubandakanywa i- aseptic meningitis , ukuhlaselwa kwentliziyo, isifo, isifo se-thrombosis esiswini, ukungasebenzi kweengso kunye nokuhluleka kwezintso.
Ukusebenzisana kunye nokuchasene
I-IVIG ayifanele isetyenziswe kubantu abaneengxaki zeengtso okanye ukungakwazi kwe-IgA (isifo esiyimfuyo esichazwe ukungabi naluphi na umntu okhuselekileyo okhusela ukusuleleka kwiintsholongwane, emoyeni nakwindlela yokutya). A
Okwangoku, i-IVIG kufuneka isetyenziswe ngokuqaphela kubantu abane:
- Iingxaki zeentliziyo
- Sikashukela
- Ukuzwela kwi-immunoglobulins
- Ubuninzi ku-maltose okanye i-sucrose (izithako ezisetyenziselwa ezinye ze-IVIG)
Ukuphela kokuchazwa ngokucacileyo kunye ne-IVIG kubandakanya iigciwane eziphilayo. I-Immunoglobulins inokunikela isitofu sokugonywa singasebenzi kwaye akukho naluphi na ukhuseleko olukhuphayo.
Iindleko zonyango
I-IVIG ibe yabiza kakhulu kwi-100 eyi-gram nganye. Ngomntu onesisindo esingamakhilogremu angu-70 (70 kilogram), umlinganiselo wenyanga okhuthaziweyo uza kugqiba ukubiza iindleko ezijikeleze i-$ 7,000 nge-infusion.
Ezinye iinkampani zomshuwalense zinokuthi zihlawule iindleko, kodwa kunzima ukukhuthaza unyango kwaye ngokuqhelekileyo zifuna inkqubo yokubhenela ukufumana imvume. Ukuba ivunyiwe, i-inshorensi ehlawulwayo ingaba phezulu kakhulu. Nangona kunjalo, abanye abakhiqizi be-IVIG banikela iinkqubo zonyango lwe-patient (PAPs ) ukuba zilahle okanye zikhuphe ngokupheleleyo iindleko zonyango.
ILizwi
Ukuba i-IVIG iyacetyiswa, unokufuna ukuzithethelela ukuze ufumane imvume kwi-inshorensi yakho. Xa kuthethwa oko, kubalulekile ukuqonda iingenelo kunye nemingcele yonyango olucetywayo-ngokubhekiselele oko uphando lusitshela kwaye aluxeleli.
Ukuba awukucaci ngokucacileyo ngale nto, unganqikazi ukufuna uluvo lwesibini kwizakhono ezifanelekileyo.
> Imithombo:
> Bayry, J .; Hartung, H .; kunye neKaveri, S. "IVIg yokubuyiselwa kwakhona-ukubuyisela i-sclerosis ezininzi: izithembiso kunye nokungaqiniseki." Iimpawu zeP Pharm Sci. 2015; 36 (7): 419-421.
> Gilardin, L .; Bayry, R .; kunye neKaveri, S. "I-immunoglobulin engenakuthandana njengonyango lwe-immune-modulating." CMAJ. 2015; 187 (4): 257-264.