Ukutshintshwa kweseli yesitimu yinkalo yokulinga kunye nevelayo ye- Multiple Sclerosis (MS) yophando, kwaye iziphumo zenzululwazi zide zithembisile. Oko kuthethwa, iingcali ziqaphele, njengoko lolu hlobo lonyango lugxotha emzimbeni, kwaye lufuna ukunyamekela ngokucwangcisekileyo kwezinto ezixhomekeke kuyo.
Ukutshintshwa kweStem cell kwi Multiple Sclerosis
Kwixesha elidlulileyo, ukuguqulwa kwamaseli e-stem kugcinelwe abo baneentlobo ezithile zomhlaza wegazi okanye ithambo lomongo, njenge-leukemia, i-lymphoma, okanye i-myeloma eninzi.
Kodwa ngaphezu kweminyaka emininzi edlulileyo, ukutshintshwa kwe-cell stem kuye kwaphandwa ekuphatheni ezinye iimeko zonyango ezichaphazelekayo, kuquka ne-multiple sclerosis.
Ukutshintshwa kwe-cell stem ekuphatheni i-MS iqala ngenkqubo ebizwa ngokuba yi-stem cell harvesting. Le nkqubo ibandakanya ukususa iisensi zomntu ezivela kwigazi labo (ezifakwe kwi-vein) okanye umongo wabo weethambo (ezifakwe ngedaliti kwi-pelvis).
Ixesha lezonyango eliseburhulumenteni leli li-autologous-hematopoietic cell transplant-autologous elisetyenziselwa iistim ze-stem ze-person's kunye ne-hematopoietic ithetha ukuba igazi-cell cell forming.
Xa ama-stem amaseli eqokelelwa kwaye agcinwe, umntu uya kuba ne-immune system (egqityiweyo yokutshintshwa kwe-non-semoablative) okanye ukucinywa (okubizwa ngokuba yi-semoablative transplant). Oku kukhutshwa okanye ukucinywa kuyatholakala ngamayeza e-chemotherapy kunye nama-antibodies-immleting antibodies.
Ukwahlukana phakathi kokunciphisa i-immune system kunye ne-ablation (ukutshabalalisa) kukuba ukucima kufuneka kudinga i-chemotherapy ephezulu, eninzi enobuthi, xa kuthelekiswa nokunciphisa, okufuna iqondo elincinci, elincinci.
Emva kwesi sigaba sigqibeleleyo, umntu uya kuphumla iintsuku ezimbalwa ngaphambi kokuba angene kwi-stem cell infusion-inkqubo apho amangqamuzana esitshixo anikezelwa khona kumntu ngesisu.
Emva kokungeniswa, oku kubonakala ukuba iiseli zihamba ukusuka egazini zibe ngethambo lomnxeba apho zizala khona kwaye zakha isimiso-mzimba somzimba-inqaku lokuba le nkqubo entsha yokuphucula umzimba iya kuba yempilweni kwaye ayiyi kuhlasela isalathisi se-myelin ebuchosheni nasemgodini intambo.
I-Science Behind Stem Cell Transplantation e-MS
Ngophando lwe-Canada lwe-2016 eLancet, abathathi-nxaxheba abakhulu aba-12 abaye baphinda baphinda bahambisa izifo ezili-12 kunye nezigulane ezili-12 ezine-MS eziqhubekayo zeplastiki. Laba bathathi-nxaxheba banesifo esinobundlobongela kunye nesifo esiphezulu kakhulu, esichazela ukuba baninzi baqala ukuphulukiswa kwe-MS kunye nokukhubazeka okuqhubekayo, nangona unyango lwe-MS.
Iziphumo zolu pho nonongo zithembisa. Kwabathathi-24 abathathi-nxaxheba, i-17 (iipesenti ezingama-70) yayingenayo imisebenzi yesifo se-MS emva kweminyaka emithathu emva kokutshintshwa. Akukho msebenzi wesifo se-MS uthetha:
- akukho MS entsha ibuyela kwakhona
- akukho zilonda ze-MS ezintsha kwi-MRI
- akukho bungqina bokukhula kwesifo
Ukongeza, kwiminyaka engama-7.5 emva kokutsalwa, iipesenti ezingama-40 zabathathi-nxaxheba ziye zaphucula ukukhubazeka kwabo kwi-MS. Enyanisweni, abanye babathathi-nxaxheba babenempilo ephawulekayo yokubandakanya:
- isisombululo se-nystagmus ne- ataxia
- buyela emsebenzini okanye esikolweni
- ukutshata okanye ukubandakanya
- ukuba nabantwana abasebenzisa iibhanki / iindiza ezixhaswe ngebhanki
Oku kuthethwa konke, kubalulekile ukuqaphela ukuba abathathi-nxaxheba abangama-24, omnye wafa ngenxa yesifo, isicatshulwa esihambelana nokutshintshwa kwe-cell stem. Omnye inxaxheba naye waba neengxaki ezinxulumene nesibindi kunye nesibhedlele ixesha elide. Kwakhona, kukho imiphumo emalunga neziphumo ezinxulumene nokufakelwa, njengokufana ne- neutropenic fever kunye ne -xicotherapy.
Uphando olongezelelweyo lweStem Cell Transplant Research ku-MS
Ngomhla wokufunda ngo-2015 kwi- JAMA , abathathi-nxaxheba abangu-123 abanomdla wokubuyiselwa kwakhona kwi-MS kunye nabangu-28 abathathi-nxaxheba be-MS abahamba phambili besetyenziselwa ukutshintshwa kweeseli ze-stem.
Abathathi-nxaxheba balandelwa ngokweminyaka eyi-2.5. Ngokungafani nokufunda kwangaphambili, amasosha omzimba kulezi zi gulane ayexinekile, ngokuchasene nokucinywa ngaphambi kokufakelwa kwe-cell stem -ekuthiwa yi -semoablative stem cell transplant .
Iziphumo zaphakamisa ukunciphisa inani lokubuyela kwakhona kunye nenani lezilonda ze-MS eziphucukileyo ze-gadolinium kuzo zonke i-MRIs zokufakelwa kweeseli zokuhamba. I-MRIs yeBongo yayigqityiwe kwiinyanga ezili-6 emva kokutshintshwa kwaye ngonyaka.
Kwakhona, kukho ukuphucula ngenye enye okanye amanqaku amanqaku kwi- EDSS amanqaku kuma-50 ekhulwini abathathi-nxaxheba kwiminyaka emi-2 kunye nama-64 ekhulwini abathathi-nxaxheba kwiminyaka emine. Amanqanaba okulinganisa ama-EDSS amanyathelo okunyusa ama-MS kunye nenkqubela yokukhubazeka. Kodwa oku kuphuculwa kubonakala kuphela kulabo abane-MS-reing-MS (kungekhona kulabo abane-MS-secondary progression), kunye nalabo babeneminyaka eyi-10 okanye ngaphantsi kwe-MS.
Olu pho nonongo lube nefuthe elibi kakhulu-kungabikho ukufa okanye izifo ezinzulu. Oku kusenokwenzeka ukuba kubangelwa ukuxhatshazwa ngokususa ukukhutshwa kwisistim somzimba ngaphambi kokuba amangqamuzana esitshixo afakwe.
ILizwi
Ngoxa lo luphando oluphandle, iingcali ziyaqaphela. Ezi zilingo zincinci kwaye azikho ukulawula amaqela. Kufuneka uphando olubanzi kunye nolunye ixesha elide ukuqonda ngokucacileyo inzuzo kunye nokukhuselwa kokutshintsheliswa kwe-cell stem ekuphatheni i-MS. Kwakhona, imingcipheko yempilo ye-stem cell transplantation yinyani. Ngoko ukufumana iindlela zokunciphisa le mngcipheko ngumngeni okhoyo kunye kunye noxinzelelo.
Ukongeza, nangona ukutshintshwa kwe-cell stem kuvunyiwe kwi-MS, kunokuthi kube yonyango olugcinwe kulabo abane-MS enamandla kakhulu abaye bahluleka ukwelashwa kwendabuko njenge-interferons okanye i-Copaxone-kungekhona ukuba ayiyi kusebenza kulabo abanesifo esibi , kodwa nje ukuba ingozi ayifanelekanga.
Imithombo:
American Cancer Society. Utshintshelo lweStem Cell to Cancer.
Atkins et al. I-immunoablation kunye ne-autologous-hemopoietic stem-cell transplantation ye-aggression multiple sclerosis: isigaba sesi-2 sesilingo esisodwa. Lancet. 2016. 2016 Juni 8. pii: S0140-6736 (16) 30169-6.
Burt RK et al. Umbutho we-hematopoietic stem cell transplantation kunye nokukhubazeka kwamagciwane kwizigulane eziphindaphindiweyo-zokuphelisa i-sclerosis ezininzi. JAMA . 2015 Jan20; 313 (3): 275-84.