Umbhali: Robert Simon
Umhla Wokudalwa: 22 Isilimela 2021
Hlaziya Umhla: 19 Eyenkanga 2024
Anonim
Konke Odinga Ukukwazi Malunga nonyango lwamva nje lwePsoriasis - Zempilo
Konke Odinga Ukukwazi Malunga nonyango lwamva nje lwePsoriasis - Zempilo

Umxholo

Abaphandi bafunde okuninzi kwiminyaka yakutshanje malunga ne-psoriasis kunye nendima edlalwa ngamajoni omzimba kule meko. Oku kufunyanisiweyo kutsha kukhokelele kukhuseleko olukhuselekileyo, olujolise ngakumbi, kunye nolusebenzayo kunyango lwepsoriasis.

Ngaphandle kwazo zonke iindlela zonyango ezikhoyo, uphononongo lubonisa ukuba abantu abaninzi abafumana unyango lwe-psoriasis abanelisekanga ngonyango lwabo okanye banelisekile ngokuthozama.

Ukuba ujonge ukutshintsha unyango ngenxa yokuba olakho ngoku alusebenzi okanye uneziphumo ebezingalindelekanga, licebo elihle ukufunda kangangoko malunga neendlela zamva nje.

I-biologics entsha

I-Biologics yenziwa ngezinto ezifumaneka kwizinto eziphilayo, ezinje ngeeproteni, iswekile, okanye iiicic acid. Nje ukuba usemzimbeni, la mayeza athintela inxenye yamajoni omzimba anegalelo kwiimpawu zakho ze-psoriasis.

I-Biologics iphazamisa oku kulandelayo:

  • I-tumor necrosis factor alpha (TNF-alpha), eyiprotein ekhuthaza ukudumba emzimbeni
  • T iiseli, ezimhlophe iiseli zegazi
  • ii-interleukins, ezizii-cytokines (iiproteni ezincinci ezitshisayo) ezichaphazelekayo kwi-psoriasis

Olu phazamiseko lunceda ukunciphisa ukudumba.


IRisankizumab-rzaa (iSkyrizi)

I-Risankizumab-rzaa (i-Skyrizi) yamkelwe yi-Food and Drug Administration (FDA) ngo-Epreli 2019.

Yenzelwe abantu abane-psoriasis yamacwecwe amodareyithayo abagqatswa be-phototherapy (unyango olukhanyayo) okanye unyango lwenkqubo (yomzimba wonke).

I-Skyrizi isebenza ngokuthintela isenzo se-interleukin-23 (IL-23).

Idosi nganye inezitofu ezimbini ezingaphantsi (phantsi kolusu). Iidosi ezimbini zokuqala zahlulwe phakathi kwiiveki ezi-4 ngokwahlukeneyo. Ezinye zinikwa kanye kwiinyanga ezi-3.

Iziphumo eziphambili zeSkyrizi zezi:

  • izifo eziphezulu zokuphefumula
  • iimpendulo kwindawo yenaliti
  • intloko ebuhlungu
  • ukudinwa
  • usulelo lomngundo

I-Certolizumab pegol (iCimzia)

I-FDA ivume i-certolizumab pegol (i-Cimzia) njengonyango lwe-psoriasis ngoMeyi 2018. Kwakukade kwamkelwe ngaphambili ukunyanga iimeko ezinje ngesifo sikaCrohn kunye nesifo samathambo i-psoriatic (PsA).

UCimzia uphatha i-plaque psoriasis ngokulinganayo kubantu abagqatswa kunyango okanye unyango lwenkqubo. Isebenza ngokujolisa kwiprotein ye-TNF-alpha.


Iyeza linikwa njengezitofu ezimbini ezingena ngaphantsi kwesinye rhoqo ngeveki.

Iziphumo eziqhelekileyo ezichaphazelekayo zeCimzia zi:

  • usulelo oluphezulu lokuphefumla
  • irhashalala
  • Usulelo lwe-urinary tract (UTIs)

ITildrakizumab-asmn (Ilumya)

I-Tildrakizumab-asmn (Ilumya) yayivunyiwe yi-FDA ngo-Matshi 2018. Isetyenziselwa ukunyanga i-plaque psoriasis kubantu abadala abangabagqatswa bonyango okanye unyango lwenkqubo.

Iyeza lisebenza ngokuthintela i-IL-23.

I-Ilumya inikwa njengezitofu zangaphantsi. Inaliti ezimbini zokuqala zahlulwe phakathi kwiiveki ezi-4. Ukusukela ngoko ukuya phambili, inaliti zinikwa iinyanga ezi-3 zohlukene.

Iziphumo eziphambili ze-Ilumya zezi:

  • iimpendulo kwindawo yenaliti
  • izifo eziphezulu zokuphefumula
  • urhudo

IGuselkumab (iTremfya)

I-Guselkumab (Tremfya) yayivunyiwe yi-FDA ngoJulayi 2017. Isetyenziselwa ukunyanga i-plaque psoriasis ngokulinganayo kubantu abangabagqatswa bonyango okanye unyango lwenkqubo.

I-Tremfya yayiyi-biologic yokuqala yokujolisa kwi-IL-23.


Amanqanaba okuqala amabini okuqala anikwa iiveki ezi-4 ngokwahlukeneyo. Emva koko, iTremfya inikwa ngenaliti yangaphantsi rhoqo kwiiveki ezisi-8.

Iziphumo eziqhelekileyo ezichaphazelekayo zibandakanya:

  • intloko ebuhlungu
  • izifo eziphezulu zokuphefumula
  • iimpendulo kwindawo yenaliti
  • intlungu edibeneyo
  • urhudo
  • umkhuhlane wesisu

IBrodalumab (iSiliq)

I-Brodalumab (Siliq) yamkelwe yi-FDA ngoFebruwari 2017. Yenzelwe abantu abahlangabezana nezi mfuno zilandelayo:

  • ube ne-plaque psoriasis ephakathi
  • abagqatswa kunyango lwefototherapy okanye unyango lwenkqubo
  • i-psoriasis yabo ayiphenduli kwezinye iindlela zonyango

Isebenza ngokuzibophelela kwi-IL-17 receptor. Indlela ye-IL-17 idlala indima kukudumba kwaye iyabandakanyeka kuphuhliso lwamacwecwe e-psoriasis.

Kuvavanyo lweklinikhi, abathathi-nxaxheba baphathwa nge-Siliq babenamathuba amaninzi kunabo bafumana indawo ye-placebo yokuba nolusu olucingelwa ukuba lucacile okanye lucacile.

I-Siliq ilawulwa njengenaliti. Ukuba ugqirha wakho ukumisela iyeza, uyakufumana inaliti enye ngeveki kwiiveki zokuqala ezi-3. Emva koko, uyakufumana inaliti enye qho kwiiveki ezi-2.

Njengezinye i-biologics, i-Siliq inyusa umngcipheko wosulelo. Ilebheli yeli chiza ikwanesilumkiso sebhokisi emnyama malunga nomngcipheko ophezulu wokucinga ngokuzibulala kunye nokuziphatha.

Abantu abanembali yokuziphatha ukuzibulala okanye uxinzelelo kufuneka babekwe esweni xa bethatha i-brodalumab.

Ixekizumab (iTaltz)

Ixekizumab (Taltz) yayivunyiwe yi-FDA ngo-Matshi 2016 ukuze inyange abantu abadala abanomodareyitha ukuya kwi-psoriasis. Yenzelwe abantu abagqatswa kwi-phototherapy, unyango lwenkqubo, okanye zombini.

Iithagethi zeTaltz zijolise kwiproteni ye-IL-17A.

Sisisiyobisi esitofwayo. Uyakufumana iinaliti ezimbini kusuku lwakho lokuqala, iinaliti rhoqo kwiiveki ezi-2 kwiinyanga ezi-3 ezizayo, kunye neenaliti rhoqo kwiiveki ezi-4 kwintsalela yonyango lwakho.

Ukuvunywa bekusekwe kwiziphumo zezifundo ezininzi zeklinikhi kunye nenani labathathi-nxaxheba abangama-3,866. Kwezi zifundo, uninzi lwabantu luthatha ichiza lifezekisile ulusu olucacileyo okanye olucacileyo.

Iziphumo eziqhelekileyo ezichaphazelekayo zeTaltz ziquka:

  • izifo eziphezulu zokuphefumula
  • iimpendulo kwindawo yenaliti
  • usulelo lomngundo

Ibhayoloji

I-Biosimilars ayizizo iimpendulo ezichanekileyo zebhayoloji. Endaweni yoko, zenzelwe i-reverse-engineer ukuvelisa iziphumo ezifanayo njenge-biologics.

Njengamachiza enziwe afana nalawo enziwa ngumenzi, ii-biosimilars zenziwa nje ukuba i-biologic yoqobo iphume kwilungelo elilodwa lomenzi wechiza. Uncedo lwee-biosimilars kukuba zihlala zibiza ixabiso elincinci kunemveliso yoqobo.

Ii-Biosimilars ze-psoriasis zibandakanya oku kulandelayo:

Biosimilars ukuya kwiadalimumab (Humira)

  • iadalimumab-adaz (iHyrimoz)
  • iadalimumab-adbm (Cyltezo)
  • iadalimumab-afzb (Abrilada)
  • i-adalimumab-atto (Amjevita)
  • i-adalimumab-bwwd (iHadlima)

Biosimilars kwi-etanercept (i-Enbrel)

  • I-etanercept-szzs (i-Erelzi)
  • I-etanercept-ykro (i-Eticovo)

I-Biosimilars kwi-infliximab (i-Remicade)

  • infliximab-abda (Renflexis)
  • infliximab-axxq (Avsola)
  • I-infliximab-dyyb (Inflectra)

I-Remicade biosimilar Inflectra yayiyeyokuqala ye-psoriasis biosimilar ukufumana imvume ye-FDA. Kwakungo-Epreli ka-2016.

I-Inflectra kunye ne-Renflexis, enye i-Remicade biosimilar, yiyo kuphela ekhoyo ngoku ukuthengwa e-United States. Oku ikakhulu kungenxa yokuba amalungelo awodwa omenzi wechiza agcinwe ngabavelisi be-biologics kusafuneka aphelelwe lixesha.

Unyango olutsha

Unyango lwezihloko, okanye ezo uzihlikihla kulusu lwakho, zihlala zingunyango lokuqala olucebisa ukuba ukhwekhwe. Basebenza ngokunciphisa ukudumba kunye nokucothisa ukuveliswa kweeseli zolusu.

Isithambisi seHalobetasol propionate-tazarotene, 0.01% / 0.045% (iDuobrii)

Nge-Epreli 2019, i-FDA yamkele i-halobetasol propionate-tazarotene lotion, i-0.01 yeepesenti / i-0.045 yeepesenti (iDuobrii) kunyango lwe-plaque psoriasis kubantu abadala.

UDuobrii sisithambisi sokuqala ukudibanisa i-corticosteroid (halobetasol propionate) kunye ne-retinoid (tazarotene). I-corticosteroid echasene nokuvuvukala icoca iipleyiti, ngelixa i-vitamin A-based retinoid inciphisa ukukhula okungaphezulu kweeseli zolusu.

I-Duobrii isetyenziswa kanye ngemini kwiindawo ezichaphazelekayo zolusu.

Iziphumo eziphambili zezi:

  • iintlungu kwindawo yesicelo
  • irhashalala
  • folliculitis, okanye iifollic ezinwele
  • ukunxiba kude nolusu apho kufakwa khona into yokuthambisa
  • ukuzonwabisa, okanye ukukhetha ulusu

IHalobetasol propionate foam, 0.05% (iLexette)

I-Halobetasol propionate foam, i-0.05 yeepesenti yicorticosteroid yesihloko evunyiweyo kuqala yi-FDA, njenge-generic, ngoMeyi 2018. Ngo-Epreli 2019, yafumaneka phantsi kwegama lophawu lweLexette.

Isetyenziselwa ukunyanga i-plaque psoriasis kubantu abadala. Injongo yalo kukucoca ulusu.

Kabini ngemini, amagwebu asetyenziswa kumaleko obhityileyo kwaye atyabukile esikhumbeni. ILexette inokusetyenziselwa ukuya kuthi ga kwiiveki ezimbini.

Iziphumo eziqhelekileyo ezichaphazelekayo zeLexette zintlungu kwindawo yesicelo kunye nentloko.

I-lotion ye-Halobetasol propionate, i-0.01% (iBryhali)

I-Halobetasol propionate lotion, i-0.01 yeepesenti (iBryhali) yamkelwa yi-FDA ngoNovemba 2018. Yenzelwe abantu abadala abane-plaque psoriasis.

Ezinye zeempawu ezincedayo ukujongana zezi:

  • ukoma
  • ukubhabha
  • ukudumba
  • ipleyiti yokwakha

I-Bryhali isetyenziswa yonke imihla. I-lotion ingasetyenziselwa ukuya kwiiveki ezi-8.

Iziphumo eziqhelekileyo zibandakanya:

  • ukutshisa
  • ukuhlaba
  • ukurhawuzelela
  • ukoma
  • usulelo oluphezulu lokuphefumla
  • iswekile ephezulu yegazi

Isitshizi seBetamethasone dipropionate, 0.05% (Sernivo)

NgoFebruwari 2016, i-FDA yavuma i-betamethasone dipropionate spray, i-0.05 yeepesenti (iSernivo). Esi sihloko siphatha i-plaque psoriasis ethambileyo ukuya kuthi ga ngoku kubantu abaneminyaka eli-18 nangaphezulu.

I-Sernivo inceda ukukhulula iimpawu ze-psoriasis njengokurhawuzelela, ukubhabha kunye nokubomvu.

Ufafaza iyeza le-corticosteroid eluswini kabini ngemini kwaye ulithambise ngobunono. Inokusetyenziselwa ukuya kuthi ga kwiiveki ezi-4.

Iziphumo ebezingalindelekanga zixhaphakileyo zezi:

  • ukurhawuzelela
  • ukutshisa
  • ukuhlaba
  • iintlungu kwindawo yesicelo
  • ukubola kolusu

Unyango olutsha lwabantwana

Amachiza ambalwa e-psoriasis ebekade efumaneka kuphela kubantu abadala sele evunyiwe yi-FDA ukuba anyange nabantwana.

Igwebu leCalcipotriene, 0.005% (iSorilux)

Ngo-2019, i-FDA yandise ukuvunywa kwayo kwifom ye-vitamin D ebizwa ngokuba yi-calcipotriene foam, i-0.005 yeepesenti (i-Sorilux). Isetyenziselwa unyango lwe-plaque psoriasis yentloko kunye nomzimba.

Ngo-Meyi, yafumana imvume yokusetyenziswa kwabantwana abaneminyaka eli-12 ukuya kweli-17 ubudala. NgoNovemba olandelayo, kwavunywa ukunyanga i-plaque psoriasis yentloko kunye nomzimba kubantwana abaneminyaka emi-4 ubudala.

I-Sorilux inceda ukucothisa ukukhula kweseli okungaqhelekanga kwi-psoriasis. Le foam iyasetyenziswa kwiindawo ezichaphazelekileyo zolusu kabini ngemini ukuya kuthi ga kwiiveki ezi-8. Ukuba iimpawu aziphucuki emva kweeveki ezisi-8, nxibelelana nogqirha wakho.

Iziphumo ebezingalindelekanga zixhaphakileyo bubomvu kunye neentlungu kwindawo yesicelo.

ICalcipotriene-betamethasone dipropionate foam, 0.005% / 0.064% (Enstilar)

NgoJulayi 2019, i-FDA ivume i-calcipotriene-betamethasone dipropionate foam, i-0.005 yeepesenti / i-0.064 yeepesenti (Enstilar) yokusetyenziswa kulutsha phakathi kweminyaka eli-12 ukuya kweli-17 ubudala. Yenzelwe abantu abane-plaque psoriasis.

ICalcipotriene inciphisa ukukhula kweseli, ngelixa i-betamethasone dipropionate inceda ukunciphisa ukudumba.

Igwebu lisetyenziswa yonke imihla ukuya kwiiveki ezi-4.

Iziphumo eziqhelekileyo zibandakanya:

  • ukurhawuzelela
  • follikulitis
  • ukukhawuleza ngamagqabi abomvu aphakanyisiweyo okanye kwimingxunya
  • i-psoriasis eyandayo

I-Calcipotriene-betamethasone dipropionate yokunqunyanyiswa kwentloko, 0.005% / 0.064% (Taclonex)

NgoJulayi 2019, ukumiswa kwe-calcipotriene-betamethasone dipropionate, i-0.005 yeepesenti / i-0.064 yeepesenti (iTaclonex) yayivunyiwe yi-FDA ukuba isetyenziswe kwiminyaka eli-12 ukuya kweli-17 ubudala ene-plaque psoriasis yomzimba.

Ukunqunyanyiswa kwesihloko kwakukade kuvunyelwe i-FDA yabantwana abaneminyaka eli-12 ukuya kweli-17 ubudala abane-psque ye-plaque ye-scalp. Ioli yeTaclonex yayikade yamkelwe yi-FDA kulutsha nakubantu abadala abane-plaque psoriasis.

Ukumiswa kwe-Taclonex kwimihla ngemihla kusetyenziswa imihla ngemihla ukuya kwiiveki ezisi-8. Kubantwana abaneminyaka eli-12 ukuya kweli-17 ubudala, eyona idosi yeveki ubuninzi yi-60 gram (g). Elona zinga liphezulu leveki kubantu abadala li-100 g.

Iziphumo eziqhelekileyo zibandakanya:

  • ukurhawuzelela
  • ukutshisa
  • ukucaphuka
  • bomvu
  • follikulitis

Ustekinumab (Stelara)

Ngo-Okthobha u-2017, i-FDA yamkela ustekinumab (Stelara) kulutsha oluneminyaka eli-12 ubudala nangaphezulu. Ingasetyenziselwa abantu abancinci abanamodareyitha ukuya kwi-plaque psoriasis abagqatswa bonyango okanye unyango lwenkqubo.

Ukuvunywa kweza emva kohlolisiso lwango-2015 kwafumanisa ukuba ichiza lisuse kakhulu ulusu emva kweenyanga ezintathu. Ngokumalunga nokucoca ulusu kunye nokhuseleko, iziphumo zazifana nezo zibonwa kubantu abadala.

I-Stelara ivimba iiproteni ezimbini eziphambili kwinkqubo yokuvuvukala, i-IL-12 kunye ne-IL-23.

Inikwa ngenaliti yangaphantsi. Umthamo usekwe kubunzima bomzimba:

  • Ulutsha olunobunzima obungaphantsi kwama-60 eekhilogram (132 iiponti) lufumana i-0.75 milligrams (mg) ngekhilogram yesisindo.
  • Ulutsha olunobunzima obuphakathi kwe-60 kg (132 lbs.) Kunye ne-100 kg (i-220 lbs.) Fumana ithamo le-45-mg.
  • Ulutsha olunobunzima obungaphezulu kwe-100 kg (i-220 lbs.) Lufumana i-90 mg, eyidosi esemgangathweni yabantu abadala abanobunzima obufanayo.

Iidosi ezimbini zokuqala zinikwa ngokwahlukeneyo iiveki ezi-4. Emva koko, ichiza unikwa kanye kwiinyanga ezi-3.

Iziphumo ebezingalindelekanga zixhaphakileyo zezi:

  • umkhuhlane kunye nolunye usulelo oluphezulu lokuphefumla
  • intloko ebuhlungu
  • ukudinwa

I-Etanercept (Enbrel)

Ngo-Novemba ngo-2016, i-FDA yavuma i-etanercept (i-Enbrel) ukunyanga i-plaque psoriasis engapheliyo kubantwana abaneminyaka emi-4 ukuya kweli-17 ubudala abagqatswa bonyango okanye unyango lwenkqubo.

I-Enbrel ivunyiwe ukuba inyange abantu abadala abane-plaque psoriasis ukusukela ngo-2004 kunye nokunyanga abantwana abane-juvenile idiopathic arthritis (JIA) ukusukela ngo-1999.

Eli chiza litofwayo lisebenza ngokunciphisa umsebenzi we-TNF-alpha.

Uphononongo luka-2016 lwabaphantse babe ngama-70 abantwana abaneminyaka emi-4 ukuya kweli-17 ubudala bafumanisa ukuba i-Enbrel ikhuselekile kwaye iqhubeke isebenza kangangeminyaka emi-5.

Kwiveki nganye, abantwana kunye nolutsha bafumana i-0.8 mg yesilwanyana ngekhilogram yesisindo somzimba wabo. Elona thamo liphezulu ugqirha wabo aya kuthi limisele ngama-50 mg ngeveki, lelo lelona dose liqhelekileyo kubantu abadala.

Iziphumo ebezingalindelekanga zixhaphakileyo kukusabela kwindawo yenaliti kunye nosulelo oluphezulu lokuphefumla.

Olunye unyango lusondela ekuvunyweni

Amanye amachiza asondele ekuvunyelweni yi-FDA.

IBimekizumab

I-Bimekizumab sisiyobisi se-biologic esiza kuvavanywa njengonyango lwe-plaque psoriasis engapheliyo. Isebenza ngokuthintela i-IL-17.

I-Bimekizumab okwangoku ikwisifundo sesiGaba III. Ukuza kuthi ga ngoku, uphando lubonakalisile ukuba lukhuselekile kwaye lusebenza kakuhle.

KULINGANISWA kuvavanyo lweklinikhi, i-bimekizumab yayisebenza ngakumbi kune-adalimumab (Humira) ekuncedeni abantu bafumane ubuncinci ukuphuculwa kweepesenti ezingama-90 kumanqaku asetyenziselwa ukulinganisa ubungqongqo besifo.

ICalcipotriene-betamethasone dipropionate cream, 0.005% / 0.064% (Wynzora)

Kwi-2019, isicelo esitsha seziyobisi sangeniswa kwi-FDA yeWynzora. I-Wynzora yikhrimu yemihla ngemihla edibanisa i-calcipotriene kunye ne-betamethasone dipropionate.

Kwisifundo sesigaba sesi-III, iWynzora yayisebenza ngakumbi ekucoceni ulusu emva kweeveki ezisi-8 kuneTaclonex yokumiswa kwentloko kunye nekhrim.

I-Wynzora inethuba lokungabinantlungu, ethe yabathathi-nxaxheba bayifumanisa ilunge ngakumbi.

I-JAK inhibitors

I-JAK inhibitors lelinye iqela leziyobisi eziguqula izifo. Basebenza ngokujolisa kwiindlela ezinceda umzimba ukuba wenze iiprotein ezivuthayo.

Sele zisetyenziselwa ukunyanga:

  • isifo samathambo
  • irheumatoid Arthritis
  • ukudumba okwenziwa sisilonda sikabhobhosi

Zimbalwa zikwinqanaba lesibini kunye novavanyo lwesigaba III sokumodareyitha ukuya kwi-psoriasis ebukhali. Abo bafundelwa i-psoriasis ngamachiza omlomo tofacitinib (Xeljanz), baricitinib (Olumiant), kunye neabrocitinib. Isithinteli se-JAK se-topical siphantsi kophando.

Ukuza kuthi ga ngoku, uphononongo lufumene i-JAK inhibitors ukuba isebenze kwi-psoriasis. Zikhuselekile malunga neziyobisi ezikhoyo ze-biologic. Enye inzuzo kukuba beza kwifom yeepilisi kwaye akufuneki banikwe njengezitofu.

Izifundo ezenziweyo ukuza kuthi ga ngoku zilifutshane. Uphando olongezelelekileyo luyafuneka ukwazi ukuba ngaba i-JAK inhibitors iyaqhubeka nokusebenza ngokuhamba kwexesha.

Yise kude

Ukuhlala unolwazi malunga neendlela ezintsha zokunyanga i-psoriasis kubalulekile ekulawuleni imeko yakho.

Akukho bungakanani obulinganayo bonke unyango lwepsoriasis. Kusenokwenzeka ukuba kuya kufuneka uzame unyango oluninzi ngaphambi kokuba ufumane olona lusebenzela wena kwaye alubangeli ziphumo zibi.

Ukufumanisa okutsha kwi-psoriasis kwenzeka ngalo lonke ixesha. Qiniseka ukuba uthethe nogqirha wakho ngeendlela ezintsha zonyango.

Inomdla Namhlanje

Ulwazi lwezempilo kwi-Intanethi-yintoni onokuyithemba?
Iyeza

Ulwazi lwezempilo kwi-Intanethi-yintoni onokuyithemba?

Xa unombuzo ngempilo yakho okanye yo apho lwakho, unokuwujonga kwi-Intanethi. Unokufumana ulwazi oluchanekileyo lwezempilo kwiindawo ezininzi. Kodwa, kunokwenzeka ukuba ubaleke kwizinto ezininzi ezith...
Uhlalutyo lobudoda
Iyeza

Uhlalutyo lobudoda

Uhlalutyo lobudoda, ekwabizwa ngokuba bubudoda, ulingani a ubungakanani kunye nomgangatho wendoda kunye ne idoda. Idlozi lulwelo olumanzi, olumhlophe olukhut hwe kwilungu lobudoda ngexe ha lencopho ye...