Uvavanyo lwegazi luhlola umngcipheko wezifo zengqondo ezihlobene ne-MS
I-leukoencephalopathy ye-multifocal leukoencephalopathy (PML) isifo esingaqhelekanga sesifo sengqondo. Umngcipheko we-PML ngamanye amaxesha ungakhuphuka kubantu abathatha i- Tysabri (natalizumab) , isicatshulwa sokuguqula izifo esetyenziselwa ukuthintela ukuphindaphinda kubantu abane- multiple sclerosis (MS) .
I-PML ibangelwa yintsholongwane kaYohn Cunningham (i-JC virus), ukusuleleka kwintsholongwane kaGawulayo evame ukugcinwa phantsi kolawulo ngumzimba wokhuseleko lomzimba.
Nangona kunjalo, ukuba isistim somzimba siphelelwe amandla, intsholongwane ingaphinda ivuselele kwaye ibangele ukutshabalala kombilini.
Ukuze ugweme lokhu kubantu abane-MS, oogqirha baya kwenza uvavanyo lwe-antibody ukuhlola ubungqina begciwane kwigazi lomntu.
PML kunye ne-JC Virus
Uphando lubonisa ukuba malunga ne-70 ekhulwini labantu base-United States banesifo se-JC. Uninzi lwabantu aluyazi ukuba lunentsholongwane, kwaye bambalwa abahlala begula ngenxa yesifo.
Kuphela xa umntu ekhuselekile ukukhusela umzimba ukuba isifo sinokuthi sibe "ithuba." Oku kuthetha nje ukuba umzimba awunayo indlela yokuzikhusela, kwaye intsholongwane ixhaphaza ithuba lokubangela izifo.
Sibona oku kubantu abane- HIV ephambili . Nentsholongwane kaGawulayo, intsholongwane ihlutha ngokunyanisekileyo amayeza omzimba kwaye ichaza umzimba kwiindawo ezininzi ezichaphazelekayo (ii-OIs).
I-PML iphakathi kwe-OIs yaye ikwahlulelwa njengesimo esichaza i-AIDS kubantu abane-HIV.
Nge-MS, imbangela iyahluke. Kule meko, ukuxilongwa kwe-immunosuppression kubangelwa ngamachiza athile asetyenziswa ukuphathwa kwe-MS. La mayeza aquka i-Tysabri, i-Tecfidera (i-dimethyl fumarate) kunye ne-corticosteroids.
Xa usuyenziwe kwakhona, intsholongwane inokudlula egazini legazi / leengqondo elihlukanisa inkqubo ye-nervous central kuwo wonke umzimba.
Ekugqibeleni, ipesenteji encinci yabantu abathatha i-Tysabri baya kuphuhlisa i-PML kwaye iyanceda bachaphazelekayo:
- Ukugqithiswa kwangaphambili okanye kwangoku kwezinye iziyobisi ezisisigxina (njenge azathioprin, cyclophosphamide, dimethyl fumarate, methotrexate, mitoxantrone, okanye i-mycophenolate mofetil)
- Ukusebenzisa iTysabri ngaphezu kweminyaka emibini
- Uvavanyo oluchanekileyo lwe-JC virus antibody
I-JC Virus Antibody Test Test Blood
Ama-antibodies avikela ama-proteins avikela ama-immune system ekuphenduleni i-pathogen echaphazela izifo ezifana ne-JC virus. I-antibody ngayinye ibhekiselele kuloo pathogen kunye ne-pathogen yodwa. Emva kokuba kuveliswe, loo nkunkuma iya kuhlala emzimbeni ukuphendula kwimeko apho i-pathogen ibuyela.
Ukuqinisekisa intsholongwane, siya kwenza uvavanyo olulula lwegazi olwenzelwe ukufumanisa i-antibodies ethile. Isiphumo sovavanyo singasitshela enye yezinto ezimbini:
- Isiphumo esiphumeleleyo sithetha ukuba umntu ufumaneke kwi-virus.
- Umphumo ongalunganga uthetha ukuba akukho bungqina bokungabikho.
Umngeni apha, ukuba kunjalo kukuba uninzi lwabantu luya kuba lunentsholongwane ne-JC.
Ngoko nangona isiphumo esihle sichaza ingozi eyongeziweyo ye-PML, akukona ukuchasana kunyango. Kunoko, ivumela ugqirha ukuba akhangele le nto kunye nezinye izinto ezinobungozi ukugqiba ukuba ngaba i-Tysabri ifanele okanye ukuba kukho ezinye iindlela ezifanelekileyo.
Ngethuba elifanayo, uvavanyo lwama-antibody alufezekanga, kwaye kukho ithuba elithathu lokwenza ukuba likwazi ukuhlawula iziphumo ezingamanga. Le ngenye yezizathu zokuba uvavanyo lwama-antibody luyenziwa ngaphambi kokuqala i-Tysabri kunye nokuphindaphinda kweenyanga ezintandathu emva kokuhlola nayiphi na intsholongwane.
ILizwi
Nangona uvavanyo lwe-JC yesifo sokuguqula umntu luyincedo ekuqaliseni ukuba ngubani na ongasemngciphekweni ophezulu wokuphuhlisa i-PML xa usebenzisa i-Tysabri, akufanele ibenciphise ukubaluleka kwesilwanyana ekukhuselweni kwe-MS kwakhona.
Ekugqibeleni, isigqibo sokuba sisasebenzisa iTysabri okanye asikho umntu kwaye kufuneka senziwe ngokubonisana nodokotela wengcali. Ukuba unyango lubekwe, ukulandelelaniswa rhoqo kubalulekile ukuba kungapheli nje ukujonga ukusebenza kwonyango kodwa ugweme nayiphi na imiphumo emihle.
> Imithombo
> Gorelik, L .; Lerner, M .; Bixler, S. et al. "I-anti-JC virus antibodies: impembelelo yokuchithwa kwengozi ye-PML." Annals of Neurology. 2010; 68 (3): 295-303.
> Schwab, N .; Schneider-Hohendorf, T .; Pignolet, B. et al. "Unyango kunye ne-natalizumab ludibene ne-JC seroconversion ephezulu kunye nokunyuka kwamaxabiso e-JCV." I-Neurology: I-Neuroimmunology ne-Neuroinflammation. 2016; 3 (1): e195.