Ukuthembisa utshintsho kwiNdawo yonyango lwe-MS

Umxholo

• Injongo yonyango
• Unyango
• IGilenya (fingolimod)
• I-Teriflunomide (Aubagio)
• IDimethyl fumarate (iTecfidera)
• IDalfampridine (Ampyra)
• I-Alemtuzumab (iLemtrada)
• Indlela yokulungisa inkumbulo eguqulweyo
• Iipeptidi ze-Myelin
• Ixesha elizayo lonyango lwe-MS

I-Multiple sclerosis (MS) sisifo esinganyangekiyo esichaphazela inkqubo ye-nervous system. Amathambo agqunywe kwisigqubuthelo esikhuselayo esibizwa ngokuba yi-myelin, ekwakhawulezisa ukuhanjiswa kweempawu zemithambo-luvo. Abantu abanamava e-MS ukudumba kweendawo ze-myelin kunye nokuwohloka okuqhubekayo kunye nelahleko ye-myelin.

Imithambo inokusebenza ngokungaqhelekanga xa i-myelin yonakele. Oku kunokubangela uninzi lweempawu ezingalindelekanga. Oku kubandakanya:

• iintlungu, ukurhawuzelela, okanye ukutshisa emzimbeni wonke
• ukulahleka kombono
• ubunzima bokuhamba
• ukudumba kwezihlunu okanye ukuqina
• ubunzima ngokulinganisela
• intetho engacacanga
• Imemori engalunganga kunye nokusebenza kwengqondo

Iminyaka yophando olunikezelweyo ikhokelele kunyango olutsha lwe-MS. Alukho unyango kwesi sifo, kodwa iirejimeni zamachiza kunye nonyango lokuziphatha zivumela abantu abane-MS ukuba banandiphe umgangatho wobomi obungcono.

Injongo yonyango

Unyango oluninzi olunokukunceda ekulawuleni ikhosi kunye neempawu zesi sifo singapheliyo. Unyango lunokunceda:

• ukucothisa ukuqhubela phambili kwe-MS
• ukunciphisa iimpawu ngexesha lokunyuka kwe-MS okanye i-flare-ups
• ukuphucula ukusebenza komzimba kunye nengqondo

Unyango ngohlobo lwamaqela enkxaso okanye unyango oluthethwayo lunokubonelela ngenkxaso yeemvakalelo eziyimfuneko kakhulu.

Unyango

Nabani na ofunyenwe enefom ebuyayo ye-MS uya kuqala unyango ngonyango olugunyazisiweyo lokuguqula isifo. Oku kubandakanya abantu abafumana umsitho wokuqala weklinikhi ohambelana ne-MS. Unyango ngesiyobisi esiguqula isifo kufuneka luqhubeke ngokungenammiselo ngaphandle kokuba isigulana asinampendulo ibi, sifumana iziphumo ebezingalindelekanga ezinganyamezelekiyo, okanye singathathi iyeza njengoko kufanelekile. Unyango kufuneka lutshintshe kwakhona ukuba ukhetho olungcono luyafumaneka.

IGilenya (fingolimod)

Ngo-2010, uGilenya waba sisiyobisi sokuqala somlomo sokuphinda ubuye kwiindidi ze-MS ukuze zamkelwe yi-Food and Drug Administration (FDA). Iingxelo zibonisa ukuba sinokunciphisa ukubuyela umva ngesiqingatha kwaye sinciphise ukuqhubela phambili kwesi sifo.

I-Teriflunomide (Aubagio)

Eyona njongo iphambili yonyango lwe-MS kukucothisa ukuqhubela phambili kwesi sifo. Iziyobisi ezenza oku kuthiwa ngamayeza okulungisa izifo. Elinye lala machiza sisiyobisi somlomo teriflunomide (Aubagio). Yavunywa ukuba isetyenziswe kubantu abane-MS ngo-2012.

Uphononongo olupapashwe kwiThe New England Journal of Medicine lufumanise ukuba abantu abane-MS ebuyela umva abathathe i-teriflunomide kube kanye ngemini babonisa ngokuthe ngcembe ukuhla kwesifo kunye nokubuyela umva kunabo bathathe i-placebo. Abantu banikwe idosi ephezulu ye-teriflunomide (14 mg vs. 7 mg) abanamava okuhla kwesifo. I-Teriflunomide yayisisiyobisi sesibini sokuguqula isifo somlomo esivunyiweyo kunyango lwe-MS.

IDimethyl fumarate (iTecfidera)

Iyeza lesithathu lokuguqula isifo ngomlomo lafumaneka kubantu abane-MS ngo-Matshi ka-2013. I-Dimethyl fumarate (Tecfidera) ngaphambili yayisaziwa njenge-BG-12. Iyeka amajoni omzimba ekuzihlaseleni nasekutshabalaliseni i-myelin. Inokuba nefuthe lokukhusela emzimbeni, ngokufanayo nefuthe lama-antioxidants. Iyeza lifumaneka kwifomu yecapsule.

I-Dimethyl fumarate yenzelwe abantu abaye baphinda babuyisela kwakhona i-MS (RRMS). I-RRMS luhlobo lwesifo apho umntu esiya kuxolelwa kangangexesha elithile ngaphambi kokuba iimpawu zabo zibe mandundu. Abantu abanolu hlobo lwe-MS banokuxhamla kwiidosi eziphindwe kabini zemihla ngemihla zeliyeza.

IDalfampridine (Ampyra)

Ukutshatyalaliswa kwe-myelin okubangelwa yi-MS kuchaphazela indlela yokuthumela kunye nokufumana imiqondiso. Oku kunokuchaphazela ukuhamba kunye nokuhamba. Iitshaneli zepotassium zinje ngee-pores kumphezulu weentsinga zemithambo-luvo. Ukuthintela amajelo kunokuphucula ukuqhuba kweethambo kwiithambo ezichaphazelekayo.

IDalfampridine (Ampyra) ibhlokhi ye-potassium blocker. Izifundo ezipapashiweyo zifumanise ukuba i-dalfampridine (eyayibizwa ngokuba yi-fampridine) inyuse isantya sokuhamba kubantu abane-MS. Isifundo sokuqala savavanya isantya sokuhamba ngexesha lokuhamba kweenyawo ezingama-25. Ayibonisanga i-dalfampridine ukuba ibe luncedo. Nangona kunjalo, uhlalutyo lwasemva kovavanyo lubonakalisile ukuba abathathi-nxaxheba babonisa ukwanda kwesantya sokuhamba ngexesha lovavanyo lwemizuzu emithandathu xa bethatha i-10 mg yeyeza mihla le. Abathathi-nxaxheba abaye bafumana ukunyuka kwesantya sokuhamba bakwabonisa ukuphucuka kwamandla emisipha yomlenze.

I-Alemtuzumab (iLemtrada)

I-Alemtuzumab (i-Lemtrada) yintsholongwane yomntu e-monoclonal antibody (ilebhu yenze iprotein etshabalalisa iiseli zomhlaza). Yenye iarhente yokuguqula isifo evunyiweyo ukunyanga iifom ezibuyayo ze-MS. Ijolise kwiprotein ebizwa ngokuba yi-CD52 efumaneka ngaphezulu kweeseli zomzimba. Nangona kungaziwa ncam ukuba isebenza njani i-alemtuzumab, kukholelwa ukuba ibophelela kwi-CD52 kwii-lymphocyte ze-T kunye ne-B (iiseli ezimhlophe zegazi) kwaye zibangele i-lysis (ukonakala kweseli). Iyeza lavunywa kuqala ukuba liphathe i-leukemia kwinqanaba eliphezulu kakhulu.

U-Lemtrada wayenzima ukufumana imvume ye-FDA e-United States. I-FDA yasikhaba isicelo sokuvunywa kwe-Lemtrada ekuqaleni konyaka ka-2014. Bacaphula isidingo sezilingo ezininzi zeklinikhi ezibonisa ukuba isibonelelo sigqithile kumngcipheko weziphumo ebezingalindelekanga ezibi. I-Lemtrada yamkelwa kamva yi-FDA ngo-Novemba ngo-2014, kodwa iza nesilumkiso malunga neemeko ezinzulu ze-autoimmune, ukusabela kokunyuswa, kunye nomngcipheko owandayo wobubi njengemelanoma kunye neminye imihlaza. Yathelekiswa nesiyobisi se-MS se-EMD Serono, uRebif, kwizilingo ezimbini zesigaba sesi-III. Izilingo zafumanisa ukuba kungcono ekunciphiseni ukubuyela umva kunye nokuwohloka kokukhubazeka kwiminyaka emibini.

Ngenxa yokhuseleko lwayo, i-FDA icebisa ukuba inikwe kuphela abaguli abanempendulo engonelanga kunyango ezimbini okanye nangaphezulu zonyango lwe-MS.

Indlela yokulungisa inkumbulo eguqulweyo

I-MS ichaphazela nomsebenzi wokuqonda. Inokuchaphazela kakubi inkumbulo, uxinzelelo, kunye nemisebenzi yolawulo njengokucwangciswa nokucwangciswa.

Abaphandi abavela kwiZiko loPhando lweSiseko seKessler bafumanisa ukuba ubuchwephesha bememori eguqulweyo (mSMT) bunokusebenza kubantu abafumana iziphumo zokuqonda ezivela kwi-MS. Iindawo zokufunda kunye neenkumbulo zengqondo zibonise ukwenziwa ngakumbi kwizikena ze-MRI emva kweeseshoni ze-mSMT. Le ndlela yonyango ithembisayo inceda abantu ukuba bagcine iinkumbulo ezintsha. Inceda abantu ukuba bakhumbule ulwazi oludala ngokusebenzisa ubudlelwane obusekwe ebalini phakathi komfanekiso kunye nomxholo. Indlela yokulungisa inkumbulo eguqulweyo inokunceda umntu one-MS ukuba akhumbule izinto ezahlukeneyo kuluhlu lokuthenga, umzekelo.

Iipeptidi ze-Myelin

I-Myelin yonakaliswa ngokungenakuphikwa kubantu abane-MS. Uvavanyo lokuqala oluxeliweyo kwi-JAMA Neurology lubonisa ukuba unyango olunokubakho luthembisa. Elinye iqela elincinci lezifundo lafumana i-myelin peptides (iziqwenga zeproteni) ngesiqwengana esinxitywe eluswini kunyaka omnye. Elinye iqela elincinci lafumana i-placebo. Abantu abafumene iipeptides ze-myelin bafumana ulusu oluncinci kakhulu kwaye babuyela umva kunabantu abafumene i-placebo. Izigulana zilunyamezele kakuhle unyango, kwaye bekungekho ziganeko zibi.

Ixesha elizayo lonyango lwe-MS

Unyango olusebenzayo lwe-MS luyahluka ukusuka komnye umntu ukuya komnye. Into esebenza kakuhle komnye umntu ayizukusebenzela omnye. Uluntu lwezonyango luyaqhubeka nokufunda ngakumbi ngesi sifo kunye nendlela yokunyanga ngcono. Uphando oludibene novavanyo kunye neempazamo ziphambili ekufumaneni unyango.