Ua pau anei ke ʻano hoʻokahi no nā mea āpau? E aʻo kākou e pili ana i ka wā e hiki mai ana o ka lāʻau lapaʻau (Precision Medicine) ma ke ʻano maʻalahi!

E noʻonoʻo ʻoe ua loaʻa iā ʻoe a me kāu hoaaloha maikaʻi loa ka maʻi like, no ka laʻana, ke koko kiʻekiʻe. Ke hele ʻolua i ke kauka, hāʻawi lāua iā ʻoe i ke ʻano lāʻau like. Akā ʻo ka mea kupanaha, ua hoʻomalu maikaʻi ʻia ke koko o kāu hoaaloha me kēlā lāʻau me ka ʻole o nā hopena ʻaoʻao. Akā ke lawe ʻoe i kēlā lāʻau, e poniuniu ʻoe, a i ʻole e loaʻa iā ʻoe kekahi hopena ʻaoʻao ʻē aʻe, a ʻaʻole i hoʻomalu pono ʻia kou koko. No ke aha mai ia? ʻOiai he ʻelua kānaka mākou, he ʻokoʻa loa ko mākou kino i loko, ʻeā? ʻO kēia manaʻo lapaʻau hou loa a mākou e kamaʻilio nei i kēia lā, ʻo ia hoʻi ka Precision Medicine, ke kū mai nei ma ke ʻano he hopena no kēlā pilikia.

I ka ʻōlelo maʻalahi, he aha ka Precision Medicine?

Hiki ke unuhi ʻia ʻo Precision Medicine i ka ʻōlelo Sinhala ʻo "precision medicine". Akā, ʻoi aku ka nui o ka hoʻomaopopo ʻana i ke kumumanaʻo ma mua o ka huaʻōlelo.

E hoʻomaka kākou me kahi laʻana maʻalahi. E noʻonoʻo ʻoe e hele ana ʻoe i kahi hale kūʻai e kūʻai i kahi pālule. Nui nā pālule i ka nui like, "Small", "Medium", "Large". Kiʻi ʻoe i ka "Medium" a hoʻāʻo. Paʻa paha ia, a nui iki paha, a lōʻihi paha nā lima lima. Akā, ʻaʻohe ou koho, no laila kūʻai ʻoe. ʻO kēia ke ʻano kuʻuna "hoʻokahi-nui-kūpono-āpau".

I kēia manawa, e noʻonoʻo ʻoe e hele ana i kahi mea hana lole maikaʻi. Lawe ʻo ia i kāu mau ana a pau, e like me kou kiʻekiʻe, ke kaumaha, ka lōʻihi o ka lima, a me ke anapuni poʻohiwi, a hana i kahi pālule nou. Pehea ka nani a me ka ʻoluʻolu e kūpono ai i kou kino? ʻO ia ke ʻano o Precision Medicine.

Aia kekahi inoa ʻē aʻe no kēia, ʻo ia hoʻi ʻo "Personalized Medicine." Akā, ua hoʻohana pololei ʻia ka huaʻōlelo Precision Medicine i kēia manawa.

Pehea ka ʻokoʻa o kēia mai ke ʻano hana kuʻuna?

E hana kākou i kahi hoʻohālikelike liʻiliʻi e hoʻomaopopo pono ai i ka ʻokoʻa ma waena o kēia mau ʻano ʻelua.

He aha nā pono e loaʻa iā mākou mai ka Precision Medicine?

Ua hoʻonohonoho ʻia kēia ʻano hana hou e hoʻololi i ka lāʻau lapaʻau. Eia kekahi o nā pono nui e lawe mai ai:

• ʻO ka lāʻau lapaʻau kūpono nāu, ma ka nui kūpono: Ma ka hoʻohana ʻana i kāu ʻike genetic, hiki i kāu kauka ke hoʻoholo pololei i ka lāʻau lapaʻau e hana maikaʻi loa iā ʻoe, me nā hopena ʻaoʻao liʻiliʻi loa, a me ka nui kūpono e hāʻawi ai.
• Ke loaʻa ʻana o kahi ʻike hohonu i ke kumu o ka ulu ʻana o nā maʻi: No ke aha i hoʻoili ʻia ai kekahi mau maʻi mai kēlā hanauna a i kēia hanauna? No ke aha i loaʻa ai i kekahi poʻe wale nō ka maʻi kanesa? He mea kōkua nui ka ʻike genetic i ka loaʻa ʻana o nā pane i nā nīnau e like me kēia.
• Ke pale ʻana i ka maʻi ma mua o ka hiki ʻana mai:Inā hiki i kāu hoʻāʻo ʻana i ka genetic ke wānana inā ʻoi aku kou pilikia o ka loaʻa ʻana o ka maʻi diabetes, ka maʻi puʻuwai, a i ʻole kekahi ʻano maʻi kanesa i ka wā e hiki mai ana, pehea ka nui o ka hoʻololi ʻana i kou nohona e pale aku ai? ʻO Precision Medicine ke ala e hele ai.
• ʻOi aku ka pololei o ka hōʻailona: I kekahi manawa, ʻoiai like paha nā hōʻailona, ​​​​aia paha ʻelua mau maʻi like ʻole ma loko. Ke hoʻāʻo ʻia ma ka pae genetic, hiki ke ʻike i ka maʻi kikoʻī.

He aha nā kahua e hoʻohana nei i ka Precision Medicine?

ʻAʻole kēia he mea e hiki mai ana i ka wā e hiki mai ana. Ke hoʻohana pono nei nā kauka ma nā ʻāina holomua a puni ka honua i kēia ʻano hana ma nā ʻano like ʻole. E nānā kākou i kekahi o nā mea nui.

1. Lapaʻau ʻana i ke Kanesa (Precision Oncology)

ʻO kēia ka hoʻohana nui loa a holomua loa o Precision Medicine a hiki i kēia lā. I ka wā ma mua, ua hoʻokaʻawale mākou i ke kanesa ma muli o kona wahi i hoʻomaka ai. Eia kekahi laʻana, "ka maʻi kanesa māmā" a i ʻole "ka maʻi kanesa umauma."

Akā i kēia manawa, ua ʻike nā kānaka ʻepekema hiki i nā maʻi kanesa e ulu ana ma kahi like ke loaʻa nā manamana lima molekala like ʻole. E like me ko kākou mau manamana lima. ʻO ia hoʻi, hiki i nā kānaka ʻelua me ka maʻi kanesa māmā ke loaʻa nā loli genetic like ʻole (mutations) i loko o kā lākou mau cell kanesa.

No laila, ma Precision Oncology, lawe ʻia kahi hāpana liʻiliʻi o ka puʻupuʻu o ka mea maʻi (biopsy), a nānā ʻia nā loli genetic. A laila, hāʻawi ʻia ka mea maʻi i kahi lāʻau (targeted therapy) e hoʻouka wale i kēlā loli genetic kikoʻī .

2. Ka lāʻau pale maʻi kanesa

He ʻanuʻu kupaianaha kēia i mua i ka mālama ʻana i ka maʻi kanesa. Loaʻa i ko kākou kino kahi pūʻali koa e hakakā nei i nā maʻi. Kāhea mākou iā ia ʻo ka ʻōnaehana pale . Hiki i kēia pūʻali koa ke ʻike a luku i nā ʻano ʻē, ʻo ia hoʻi, nā ʻāpana kanesa, e ulu ana i loko o ko kākou kino.

Akā, he maalea loa kekahi mau hunaola kanesa. Ua hūnā maikaʻi ʻia lākou, e peʻe ana mai ko mākou ʻōnaehana pale kino.

Hana ka Immunotherapy ma ke "hoʻomaʻamaʻa" ʻana i kā mākou ʻōnaehana pale ponoʻī e ʻike a hoʻouka i kēia mau hunaola kanesa. Ua like ia me ka hāʻawi ʻana i kā mākou pūʻali koa i kahi ʻōnaehana radar hou e hiki ke ʻike i nā ʻenemi huna. Ua hiki iā mākou ke hoʻohana i nā pale o ko mākou kino ponoʻī e kāohi a hoʻōla paha i ka maʻi kanesa.

3. ʻOihana lāʻau lapaʻau

ʻOiai paha he mea paʻakikī iki kēia huaʻōlelo, he maʻalahi loa ke kumumanaʻo.

Pharmaco = lāʻau lapaʻau

ʻIke Henomika = ʻIke Henomika

ʻO ia hoʻi ke aʻo ʻana pehea e pane ai kāu mau genes i nā lāʻau lapaʻau āu e lawe ai.

He ʻokoʻa iki ko kākou mau genes a pau, no laila e hana like ʻole ka lāʻau like i loko o ko kākou kino.

• Hoʻopau koke ke kino o kekahi poʻe i kahi lāʻau lapaʻau. No lākou, ʻaʻole lawa paha ka nui maʻamau.
• Hoʻopau mālie ke kino o kekahi poʻe i ka lāʻau. No lākou, hiki i kahi mahele maʻamau ke lilo i mea ʻawahia.

ʻO ka Pharmacogenomics e pili ana i ka lawe ʻana i kahi liʻiliʻi o kāu ʻike genetic ma o kahi hoʻāʻo koko maʻalahi ma mua o ke kuhikuhi ʻana i kahi lāʻau, a ʻike pehea e pane ai kou kino i kēlā lāʻau ma mua. Hiki i kēia i kāu kauka ke hoʻoholo i ka lāʻau kūpono loa a me ka nui no ʻoe. Hiki i kēia ke kōkua i ka pale ʻana i nā hopena ʻaoʻao i makemake ʻole ʻia a me nā lāʻau lapaʻau maikaʻi ʻole.

4. Nā maʻi laha ʻole

Aia nā maʻi hoʻoilina laha ʻole a ʻano ʻē ma ka honua. I kekahi manawa, ʻaʻole hiki i nā kauka ke ʻike i ke kumu pololei o ka maʻi. Aia kekahi mau ʻohana e ʻeha nei i kēia maʻi ma hope o ka hele ʻana i nā haukapila no nā makahiki a me nā hoʻokolohua like ʻole, akā ʻaʻole hiki iā lākou ke ʻike i ke ʻano o ka maʻi.

Ua lawe mai ʻo Precision Medicine i ka manaʻolana nui i nā poʻe e like me kēia. I kēia manawa, hiki ke nānā i ke ʻano genetic holoʻokoʻa o ka mea maʻi (Genomic Sequencing) a loaʻa kahi "hewa leka" liʻiliʻi loa (mutation genetic) i loko o kēlā kaulahao DNA. ʻO kēlā hewa liʻiliʻi ke kumu o ka maʻi holoʻokoʻa. Ke loaʻa ke kumu kikoʻī o ka maʻi, e maʻalahi i nā mea noiʻi ke loaʻa kahi lāʻau lapaʻau no ia.

Pehea e hoʻololi ai ʻo Precision Medicine i ko kākou ola i ka wā e hiki mai ana?

Aia nō kēia ʻenehana i kona wā kamaliʻi, akā nui loa kona hiki. I ka wā e hiki mai ana, ke hele ʻoe e ʻike i ke kauka, e loaʻa iā ia kāu ʻike genetic me kāu mau hopena hoʻāʻo koko maʻamau.

• Ma mua o ke kuhikuhi ʻana i kahi lāʻau lapaʻau nāu, nānā ke kauka i ka hōʻike a hoʻoholo, "ʻĀ ... he maʻi āpau paha ʻo ia i kēia lāʻau lapaʻau, no laila e hāʻawi mākou iā ia i kēia."
• Inā loaʻa iā ʻoe kahi maʻi i loaʻa ʻole i kekahi o kou ʻohana, hiki iā ʻoe ke ʻike inā he mau hopena o ke kaiapuni ke kumu, he hewa i kou nohona, a i ʻole kahi loli hoʻoilina hou.
• E hiki iā kākou a pau ke hoʻokumu i kahi hoʻolālā olakino e kūpono ana iā kākou iho.

ʻAʻole kēia he moʻolelo ʻepekema hou. ʻO kēia ka wā e hiki mai ana o ka lāʻau lapaʻau. E lōʻihi ka manawa no kēia mau ʻenehana e hiki mai i Sri Lanka a lilo i mea maʻamau. Akā, ua hoʻohana ʻia nā lāʻau lapaʻau i kuhikuhi ʻia e like me kēia i kekahi ʻano no kekahi mau maʻi kanesa ma ko mākou ʻāina. No laila, he mea nui loa ka ʻike ʻana i kēia.