Kulonjeza Kusintha Kwazomwe Zachitika ndi MS

Zamkati

• Cholinga cha chithandizo
• Chithandizo
• Gilenya (fingolimod)
• Teriflunomide (Aubagio)
• Dimethyl fumarate (Tecfidera)
• Dalfampridine (Ampyra)
• Alemtuzumab (Lemtrada)
• Njira zosinthidwa zokumbukira nkhani
• Mapuloteni a Myelin
• Tsogolo la Chithandizo cha MS

Multiple sclerosis (MS) ndi matenda osachiritsika omwe amakhudza dongosolo lamanjenje lamkati. Mitsempha imakutidwa ndi chovala choteteza chotchedwa myelin, chomwe chimathandiziranso kufalitsa ma sign a mitsempha. Anthu omwe ali ndi MS amamva kutupa kwa madera a myelin ndikuwonongeka pang'onopang'ono ndi kutayika kwa myelin.

Mitsempha imatha kugwira ntchito modabwitsa myelin ikawonongeka. Izi zitha kuyambitsa zizindikilo zingapo zosayembekezereka. Izi zikuphatikiza:

• kupweteka, kumva kulasalasa, kapena kutentha thupi lonse
• kutaya masomphenya
• zovuta zoyenda
• kutuluka kwa minofu kapena kuuma
• zovuta ndi kusamala
• mawu osalankhula
• kukumbukira kukumbukira ndi magwiridwe antchito

Zaka zambiri zakudzipereka kwadzetsa chithandizo chatsopano cha MS. Palibe machiritso a matendawa, koma mitundu ya mankhwala ndi machitidwe amachitidwe amalola anthu omwe ali ndi MS kuti akhale ndi moyo wabwino.

Cholinga cha chithandizo

Njira zambiri zamankhwala zitha kuthandizira kuthana ndi zovuta za matendawa. Chithandizo chingathandize:

• chepetsani kukula kwa MS
• kuchepetsa zizindikilo pakukulira kwa MS kapena kukulira
• kusintha thupi ndi malingaliro

Chithandizo mwa magulu othandizira kapena chithandizo chamankhwala chimaperekanso chilimbikitso chofunikira pamalingaliro.

Chithandizo

Aliyense amene amapezeka kuti ali ndi MS wobwerezabwereza nthawi zambiri amayamba kulandira mankhwala osokoneza bongo a FDA. Izi zikuphatikiza anthu omwe amakumana ndi chochitika choyamba chachipatala chogwirizana ndi MS. Kuchiza ndi mankhwala osintha matenda kuyenera kupitilira mpaka kalekale pokhapokha ngati wodwalayo sanayankhe bwino, amakumana ndi zovuta zina, kapena samamwa mankhwalawo momwe ayenera. Chithandizo chikuyenera kusintha ngati njira yabwinoko ipezeka.

Gilenya (fingolimod)

Mu 2010, Gilenya adakhala mankhwala oyamba amkamwa obwerezabwereza mitundu ya MS kuti ivomerezedwe ndi Food and Drug Administration (FDA). Malipoti akusonyeza kuti amatha kuchepetsa kubwereranso theka ndikuchepetsa kukula kwa matendawa.

Teriflunomide (Aubagio)

Cholinga chachikulu cha chithandizo cha MS ndikuchepetsa kukula kwa matendawa. Mankhwala omwe amachita izi amatchedwa mankhwala osintha matenda. Imodzi mwa mankhwalawa ndi mankhwala am'kamwa teriflunomide (Aubagio). Idavomerezedwa kuti igwiritsidwe ntchito kwa anthu omwe ali ndi MS mu 2012.

Kafukufuku wofalitsidwa mu The New England Journal of Medicine adapeza kuti anthu omwe abwerera MS omwe amatenga teriflunomide kamodzi patsiku adawonetsa kuchepa kwamatenda ndikubwerera pang'ono kuposa omwe adatenga malowa. Anthu omwe amapatsidwa kuchuluka kwa teriflunomide (14 mg vs. 7 mg) adakumana ndi kuchepa kwa matenda. Teriflunomide inali mankhwala achiwiri okha osintha matenda amlomo ovomerezeka kuchipatala cha MS.

Dimethyl fumarate (Tecfidera)

Mankhwala achitatu osintha matenda amlomo adayamba kupezeka kwa anthu omwe ali ndi MS mu Marichi wa 2013. Dimethyl fumarate (Tecfidera) kale ankadziwika kuti BG-12. Imalepheretsa chitetezo cha mthupi kuti chisamadziteteze ndikuwononga myelin. Itha kukhala ndi chitetezo mthupi, chofanana ndi momwe ma antioxidants amakhala nawo. Mankhwalawa amapezeka mu kapisozi.

Dimethyl fumarate yapangidwa kwa anthu omwe abwezeretsanso MS (RRMS). RRMS ndi mtundu wa matenda omwe munthu amapita kukakhululukidwa kwakanthawi kwakanthawi kuti matenda awonjezeke. Anthu omwe ali ndi MS yamtunduwu amatha kupindula ndi kuchuluka kwa mankhwalawa kawiri-tsiku.

Dalfampridine (Ampyra)

Kuwonongeka kwa myelin komwe kumayambitsa MS kumakhudza momwe mitsempha imatumizira ndi kulandira ma sign. Izi zitha kukhudza kuyenda komanso kuyenda. Njira za potaziyamu zili ngati pores pamwamba pa ulusi wamitsempha. Kuletsa njirayi kumatha kupititsa patsogolo mitsempha m'mitsempha yomwe yakhudzidwa.

Dalfampridine (Ampyra) ndichotseka potaziyamu. Kafukufuku wofalitsidwa adapeza kuti dalfampridine (yemwe kale ankatchedwa fampridine) adachulukitsa liwiro loyenda mwa anthu omwe ali ndi MS. Kafukufuku woyambirira adayesa liwiro loyenda pakadutsa mapazi 25. Sanawonetse dalfampridine kukhala yopindulitsa. Komabe, kuwunika pambuyo pa kafukufuku kudawulula kuti omwe adatenga nawo gawo adawonetsa kuthamanga kwakanthawi pamayeso amphindi zisanu ndi chimodzi akamamwa 10 mg ya mankhwalawa tsiku lililonse. Ophunzira omwe adakumana ndi liwiro lowonjezeranso adawonetsanso kulimba kwamiyendo yamiyendo.

Alemtuzumab (Lemtrada)

Alemtuzumab (Lemtrada) ndi humanized monoclonal antibody (labu yopanga mapuloteni omwe amawononga ma cell a khansa). Ndiwothandizanso wina wosintha matenda wovomerezeka kuti athetse mitundu yobwerezabwereza ya MS. Imalowera puloteni yotchedwa CD52 yomwe imapezeka pamwamba pamaselo achitetezo. Ngakhale sizikudziwika momwe alemtuzumab imagwirira ntchito, amakhulupirira kuti imamatira ku CD52 pama T ndi B ma lymphocyte (maselo oyera amwazi) ndikupangitsa lysis (kuwonongeka kwa khungu). Mankhwalawa anavomerezedwa koyamba kuti athetse khansa ya m'magazi pamlingo wokwera kwambiri.

Lemtrada anali ndi zovuta kupeza chilolezo cha FDA ku United States. A FDA adakana pempholo kuti Lemtrada avomereze koyambirira kwa 2014. Adatchulapo zakufunika kwamayesero azachipatala ambiri omwe akuwonetsa kuti phindu limaposa chiopsezo cha zovuta zoyipa. Lemtrada idavomerezedwa ndi a FDA mu Novembala 2014, koma imadza ndi chenjezo lokhudza zovuta za autoimmune, kulowetsedwa kwa infusion, komanso chiwopsezo chowonjezeka cha zilonda monga khansa ya khansa ndi khansa zina. Idafaniziridwa ndi mankhwala a MSD a EMD Serono, Rebif, m'mayeso awiri achitatu. Mayesowa adapeza kuti zinali bwino pochepetsa kubwereranso komanso kukulira kulemala pazaka ziwiri.

Chifukwa chachitetezo chake, a FDA amalimbikitsa kuti azingopatsidwa kwa odwala omwe sanayankhe mokwanira pamankhwala awiri kapena kupitilira apo a MS.

Njira zosinthidwa zokumbukira nkhani

MS imakhudzanso magwiridwe antchito. Zingasokoneze kukumbukira, kusinkhasinkha, ndi ntchito yayikulu monga kukonza ndi kukonzekera.

Ofufuza kuchokera ku Kessler Foundation Research Center adapeza kuti njira yosinthira kukumbukira nkhani (mSMT) itha kukhala yothandiza kwa anthu omwe amvetsetsa za MS. Madera ophunzirira komanso kukumbukira kwaubongo adawonetsa kuyambitsa kwina pakuwunika kwa MRI pambuyo pa magawo a mSMT. Njira yodalitsidwayi yothandizira anthu imathandiza kukumbukira zinthu zatsopano. Zimathandizanso anthu kukumbukira zambiri zakale pogwiritsa ntchito kulumikizana koyerekeza pakati pazithunzi ndi zochitika. Njira zosinthira kukumbukira nkhani zitha kuthandiza munthu yemwe ali ndi MS kukumbukira zinthu zosiyanasiyana pamndandanda wazogula, mwachitsanzo.

Mapuloteni a Myelin

Myelin imawonongeka mosasinthika mwa anthu omwe ali ndi MS. Kuyesedwa koyambirira komwe kunanenedwa mu JAMA Neurology kukuwonetsa kuti chithandizo chatsopano chomwe chingakhalepo chimakhala ndi lonjezo. Gulu limodzi laling'ono lamaphunziro lidalandira ma peptide a myelin (zidutswa zamapuloteni) kudzera pachikopa chovala pakhungu lawo chaka chimodzi. Gulu lina laling'ono lidalandira malowa. Anthu omwe adalandira ma peptide a myelin adakumana ndi zotupa zochepa ndikubwereranso kuposa anthu omwe adalandira malowa. Odwala adalekerera chithandizo bwino, ndipo panalibe zovuta zoyipa.

Tsogolo la Chithandizo cha MS

Mankhwala othandiza a MS amasiyana malinga ndi munthu. Zomwe zimagwira ntchito bwino kwa munthu wina sizigwirira ntchito wina. Achipatala akupitiliza kuphunzira zambiri zamatendawa ndi momwe angachiritsire bwino. Kafukufuku wophatikizidwa ndi zoyeserera ndizofunikira kwambiri kuti mupeze mankhwala.