ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯅꯧꯕꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨꯅꯥ ꯍꯀꯆꯥꯡꯒꯤ ꯌꯦꯛꯅꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ ꯀꯔꯤ ꯇꯧꯒꯅꯤ? ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯒ꯭ꯔꯥꯐꯠ ꯕꯅꯥꯝ ꯍꯣꯁ꯭ꯠ ꯗꯤꯖꯤꯖ (GvHD)ꯒꯤ ꯏꯆꯝ ꯆꯝꯕꯥ ꯃꯌꯦꯛ ꯁꯦꯡꯅꯥ ꯇꯥꯀꯄꯥ꯫

ꯂꯤꯎꯀꯦꯃꯤꯌꯥꯒꯨꯝꯕꯥ ꯂꯥꯌꯅꯥ ꯑꯃꯒꯤ ꯂꯥꯏꯌꯦꯡ ꯑꯣꯏꯅꯥ ꯍꯀꯆꯥꯡ ꯐꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯗꯒꯤ ꯁ꯭ꯇꯦꯝ ꯁꯦꯜ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯑꯃꯥ ꯄꯤꯔꯦ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯃꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨ ꯐꯍꯅꯒꯅꯤ ꯍꯥꯌꯅꯥ ꯊꯥꯖꯔꯤ꯫ ꯑꯗꯨꯕꯨ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ, ꯅꯍꯥꯛꯀꯤ ꯃꯇꯦꯡ ꯄꯥꯡꯅꯕꯥ ꯂꯥꯀꯈꯤꯕꯥ ꯑꯅꯧꯕꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯁꯤꯅꯥ, ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯃꯈꯣꯌꯕꯨ "ꯌꯦꯛꯅꯕꯥ" ꯍꯥꯌꯅꯥ ꯑꯔꯥꯅꯕꯥ ꯃꯑꯣꯡꯗꯥ ꯂꯧꯏ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯏꯁꯥꯒꯤ ꯁꯦꯂꯁꯤꯡꯗꯥ ꯑꯦꯇꯦꯛ ꯇꯧꯕꯥ ꯍꯧꯏ꯫ ꯑꯩꯈꯣꯌꯅꯥ "ꯒ꯭ꯔꯥꯐ꯭ꯠ ꯚꯦꯔꯁꯦꯁ ꯍꯣꯁ꯭ꯠ ꯗꯤꯖꯤꯖ" ꯅꯠꯠꯔꯒꯥ ꯊꯣꯏꯗꯣꯛꯅꯥ GvHD ꯍꯥꯌꯅꯥ ꯀꯧꯕꯥ ꯀꯝꯞꯂꯦꯛꯁ ꯑꯣꯏꯕꯥ ꯐꯤꯚꯝ ꯑꯗꯨꯅꯤ꯫

ꯏꯆꯝ ꯆꯝꯕꯥ ꯋꯥꯍꯟꯊꯣꯛ ꯑꯃꯗꯥ GvHD ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯃꯁꯤ ꯈꯉꯅꯕꯒꯤꯗꯃꯛ ꯑꯩꯈꯣꯌꯅꯥ ꯋꯥꯍꯩ ꯑꯅꯤ ꯈꯉꯕꯥ ꯃꯊꯧ ꯇꯥꯏ꯫ "ꯒ꯭ꯔꯥꯐ꯭ꯠ" ꯍꯥꯌꯕꯁꯤꯅꯥ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯗꯨꯕꯨ ꯍꯥꯌꯕꯗꯤ ꯃꯄꯥꯟꯊꯣꯡꯗꯒꯤ ꯅꯍꯥꯀꯄꯨ ꯄꯤꯕꯥ ꯍꯀꯆꯥꯡ ꯐꯕꯥ ꯁ꯭ꯇꯦꯝ ꯁꯦꯂꯁꯤꯡꯕꯨ ꯈꯪꯅꯩ꯫ "ꯍꯣꯁ꯭ꯠ" ꯍꯥꯌꯕꯁꯤꯅꯥ ꯍꯣꯁ꯭ꯠ ꯑꯗꯨꯕꯨ ꯈꯪꯅꯩ, ꯍꯥꯌꯕꯗꯤ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨ ꯂꯧꯁꯤꯜꯂꯤꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡ ꯑꯗꯨꯕꯨ ꯈꯪꯅꯩ꯫ ꯑꯗꯨꯅꯥ "ꯒ꯭ꯔꯥꯐ꯭ꯠ ꯚꯦꯔꯁꯦꯁ ꯍꯣꯁ꯭ꯠ" ꯍꯥꯌꯕꯁꯤ "ꯒ꯭ꯔꯥꯐ꯭ꯠ ꯚꯦꯔꯁꯦꯁ ꯍꯣꯁ꯭ꯠ" ꯍꯥꯌꯕꯅꯤ꯫

ꯃꯍꯧꯁꯥꯅꯥ, ꯑꯦꯂꯣꯖꯦꯅꯤꯛ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯍꯥꯌꯅꯥ ꯀꯧꯕꯥ ꯁ꯭ꯇꯦꯝ ꯁꯦꯜ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯃꯈꯜ ꯑꯁꯤ ꯂꯤꯎꯀꯦꯃꯤꯌꯥ ꯑꯃꯁꯨꯡ ꯂꯤꯝꯐꯣꯃꯥꯒꯨꯝꯕꯥ ꯀꯦꯟꯁꯔꯁꯤꯡ, ꯅꯠꯠꯔꯒꯥ ꯑꯦꯞꯂꯥꯁ꯭ꯇꯤꯛ ꯑꯦꯅꯤꯃꯤꯌꯥꯒꯨꯝꯕꯥ ꯕꯣꯟ ꯃꯦꯔꯣ ꯐꯦꯏꯂꯔ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯂꯥꯌꯦꯡꯕꯗꯥ ꯇꯧꯏ꯫ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯑꯅꯧꯕꯥ ꯕ꯭ꯂꯗ ꯁꯦꯂꯁꯤꯡ ꯁꯦꯝꯕꯥ ꯍꯧꯍꯜꯂꯤ꯫

ꯑꯗꯨꯕꯨ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯑꯅꯧꯕꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯏꯁꯥꯒꯤ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨ ꯈꯉꯕꯥ ꯉꯃꯗꯦ꯫ ꯃꯈꯣꯌꯅꯥ ꯃꯈꯣꯌꯕꯨ ꯃꯄꯥꯟ ꯂꯩꯕꯥꯛꯀꯤ ꯂꯥꯟꯃꯤꯁꯤꯡꯅꯤ ꯍꯥꯌꯅꯥ ꯈꯜꯂꯤ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ, ꯃꯈꯣꯌꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯁꯦꯜ ꯐꯕꯥ ꯑꯣꯔꯒꯥꯅꯁꯤꯡ, ꯍꯥꯌꯕꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯈꯣꯡ, ꯂꯤꯚꯔ ꯑꯃꯁꯨꯡ ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯁꯤꯡꯗꯥ ꯑꯦꯇꯦꯛ ꯇꯧꯕꯥ ꯍꯧꯏ꯫ ꯖꯤ.ꯚꯤ.ꯑꯩꯆ.ꯗꯤ.

GvHDꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯜ ꯑꯅꯤ ꯂꯩ:

GvHD ꯑꯁꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯜ ꯑꯅꯤꯗꯥ ꯈꯥꯌꯗꯣꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯃꯥꯡꯗꯥ ꯃꯁꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯍꯧꯔꯀꯄꯒꯤ ꯃꯇꯃꯒꯤ ꯃꯇꯨꯡ ꯏꯟꯅꯥ ꯈꯥꯌꯗꯣꯀꯈꯤ꯫ ꯑꯗꯨꯕꯨ ꯍꯧꯖꯤꯛꯇꯤ ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ, ꯇꯦꯁ꯭ꯇꯀꯤ ꯐꯂꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯍꯧꯔꯀꯄꯒꯤ ꯃꯇꯝ ꯌꯦꯡꯗꯨꯅꯥ ꯑꯀꯛꯅꯕꯥ ꯃꯈꯜ ꯑꯗꯨ ꯂꯦꯄꯊꯣꯀꯏ꯫

• ꯑꯦꯛꯌꯨꯠ GvHD (aGvHD): ꯃꯁꯤ ꯃꯍꯧꯁꯥꯅꯥ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯑꯍꯥꯅꯕꯥ ꯅꯨꯃꯤꯠ 100ꯅꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯊꯣꯀꯏ꯫ ꯑꯗꯨꯕꯨ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯇꯨꯡꯗꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯃꯈꯜ ꯑꯁꯤꯅꯥ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯈꯣꯡ, ꯒꯦꯁ꯭ꯠꯔꯣꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯦꯜ ꯁꯤꯁ꯭ꯇꯦꯝ (intestines), ꯑꯃꯁꯨꯡ ꯂꯤꯚꯔꯗꯥ ꯁꯣꯀꯍꯜꯂꯤ꯫
• ꯀ꯭ꯔꯣꯅꯤꯛ GvHD (cGvHD): ꯃꯈꯜ ꯑꯁꯤ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯃꯇꯝ ꯑꯃꯠꯇꯗꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯏ, ꯑꯗꯨꯕꯨ ꯑꯍꯥꯅꯕꯥ ꯆꯍꯤ ꯑꯅꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯀꯃꯟ ꯑꯣꯏ . ꯃꯁꯤꯅꯥ ꯍꯀꯆꯥꯡꯒꯤ ꯁꯔꯨꯛ ꯑꯃꯍꯦꯛꯇꯗꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ, ꯃꯗꯨꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯈꯣꯡ, ꯃꯤꯠ, ꯂꯤꯚꯔ, ꯂꯪꯁ, ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯁꯤꯡ, ꯃꯁꯂꯁꯤꯡ, ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯖꯦꯅꯤꯇꯥꯂꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯎꯏ꯫

ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯅꯥ ꯃꯈꯜ ꯑꯅꯤ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯑꯃꯗꯤ ꯑꯅꯤꯃꯛ ꯂꯥꯀꯄꯥ ꯌꯥꯏ ꯅꯠꯠꯔꯒꯥ ꯃꯈꯣꯌ ꯑꯃꯠꯇꯥ ꯌꯥꯑꯣꯗꯅꯥ ꯍꯀꯆꯥꯡ ꯐꯅꯥ ꯂꯩꯕꯥ ꯌꯥꯏ꯫

GvHDꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

GvHD ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ, ꯃꯌꯥꯏ ꯑꯣꯏꯕꯥ, ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ, ꯑꯃꯁꯨꯡ ꯄꯨꯟꯁꯤꯕꯨ ꯈꯨꯗꯣꯡꯊꯤꯍꯅꯕꯥ ꯐꯥꯎꯕꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫ ꯃꯈꯜ ꯑꯅꯤ ꯑꯁꯤꯒꯥ ꯃꯔꯤ ꯂꯩꯅꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯌꯦꯡꯁꯤ꯫

ꯀꯔꯤꯒꯤꯗꯃꯛꯇꯥ GvHD ꯑꯁꯤ ꯊꯣꯛꯂꯤꯕꯅꯣ?

ꯃꯁꯤ ꯈꯔꯥ ꯁꯥꯏꯟꯇꯤꯐꯤꯛ ꯑꯣꯏꯕꯥ ꯋꯥꯐꯝꯅꯤ ꯑꯗꯨꯕꯨ ꯑꯩꯍꯥꯛꯅꯥ ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯐꯣꯡꯗꯣꯀꯆꯒꯅꯤ꯫

ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯏꯝꯝꯌꯨꯟ ꯁꯤꯁ꯭ꯇꯦꯃꯒꯤ ꯁꯦꯂꯁꯤꯡꯅꯥ ꯚꯥꯏꯔꯁ ꯑꯃꯁꯨꯡ ꯕꯦꯛꯇꯦꯔꯤꯌꯥꯒꯨꯝꯕꯥ ꯃꯄꯥꯟ ꯂꯩꯕꯥꯛꯀꯤ ꯏꯅꯚꯦꯗꯔꯁꯤꯡꯒꯥ ꯂꯥꯟꯊꯦꯡꯅꯗꯨꯅꯥ ꯑꯩꯈꯣꯌꯕꯨ ꯂꯥꯌꯅꯥꯗꯒꯤ ꯉꯥꯀꯊꯣꯀꯏ꯫ ꯑꯗꯨꯕꯨ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯏꯁꯥꯒꯤ ꯁꯦꯂꯁꯤꯡꯗꯥ ꯀꯩꯗꯧꯉꯩꯗꯥ ꯑꯦꯇꯦꯛ ꯇꯧꯗꯦ꯫ ꯃꯁꯤꯒꯤ ꯃꯔꯃꯗꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯦꯜ ꯄꯨꯝꯅꯃꯛꯀꯤ ꯃꯊꯛꯇꯥ ꯑꯈꯟꯅꯕꯥ ꯄ꯭ꯔꯣꯇꯤꯟ ꯑꯃꯥ ꯂꯩꯕꯅꯤ꯫ ꯃꯁꯤꯕꯨ ꯍ꯭ꯌꯨꯃꯦꯟ ꯂꯤꯎꯀꯣꯁꯥꯏꯠ ꯑꯦꯟꯇꯤꯖꯦꯟ (HLA) ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫

ꯃꯥꯟꯅꯕꯥ ꯇ꯭ꯔꯤꯅꯤꯁꯤꯡ ꯅꯠꯇꯅꯥ, ꯃꯤꯄꯨꯝ ꯈꯨꯗꯤꯡꯃꯛꯀꯤ HLA ꯑꯁꯤ ꯇꯣꯉꯥꯜꯂꯤ꯫

ꯅꯍꯥꯛꯅꯥ ꯁ꯭ꯇꯦꯝ ꯁꯦꯜ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯕꯥ ꯃꯇꯃꯗꯥ, ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨꯗꯒꯤ ꯁꯦꯝꯕꯥ ꯑꯅꯧꯕꯥ ꯕ꯭ꯂꯗ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨꯗꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨ ꯅꯍꯥꯀꯄꯨ ꯄꯤꯈꯤꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯗꯨꯒꯤ HLA ꯂꯩ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ HLA ꯑꯗꯨ ꯅꯍꯥꯛꯀꯤ HLAꯒꯥ ꯌꯥꯝꯅꯥ ꯈꯦꯠꯅꯔꯕꯗꯤ, ꯑꯅꯧꯕꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯂꯩꯔꯤꯕꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨ ꯌꯦꯡꯗꯨꯅꯥ "ꯃꯁꯤ ꯏꯅꯚꯦꯗꯔ ꯑꯃꯅꯤ, ꯃꯍꯥꯛꯀꯤ ꯑꯥꯏ.ꯗꯤ.ꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯑꯥꯏ.ꯗꯤ.ꯒꯥ ꯃꯥꯟꯅꯗꯦ" ꯍꯥꯌꯅꯥ ꯈꯜꯂꯤ꯫ ꯃꯗꯨꯗꯥ ꯁꯦꯂꯁꯤꯡ ꯑꯗꯨꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯑꯦꯇꯦꯛ ꯇꯧꯕꯥ ꯍꯧꯔꯀꯏ꯫

ꯃꯔꯝ ꯑꯁꯤꯅꯥ ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯗ꯭ꯔꯤꯉꯩꯒꯤ ꯃꯃꯥꯡꯗꯥ ꯗꯣꯅꯔ ꯑꯃꯁꯨꯡ ꯔꯤꯁꯤꯄꯤꯌꯔꯒꯤ HLA ꯑꯁꯤ ꯌꯥꯔꯤꯕꯃꯈꯩ ꯅꯛꯅꯥ ꯂꯩꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯆꯦꯀꯁꯤꯟꯅꯥ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫ ꯑꯗꯨꯕꯨ ꯁꯦꯂꯁꯤꯡ ꯑꯁꯤ ꯇ꯭ꯔꯤꯟ ꯑꯃꯗꯒꯤ ꯂꯧꯗ꯭ꯔꯕꯗꯤ, ꯃꯇꯝ ꯄꯨꯝꯅꯃꯛꯇꯥ GvHDꯒꯤ ꯔꯤꯁ꯭ꯛ ꯈꯔꯥ ꯂꯩ꯫

GvHD ꯂꯥꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯂꯩꯕꯥ ꯀꯅꯥꯅꯣ?

ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯔꯤꯁ꯭ꯛ ꯐꯦꯛꯇꯔ ꯑꯁꯤ HLA ꯏꯅꯀꯃꯄꯦꯇꯤꯕꯤꯂꯤꯇꯤꯅꯤ, ꯑꯗꯨꯕꯨ ꯑꯇꯩ ꯐꯦꯛꯇꯔ ꯀꯌꯥ ꯑꯃꯁꯨ ꯊꯧꯗꯥꯡ ꯂꯧꯕꯥ ꯌꯥꯏ꯫

ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯥꯟꯅꯅꯥ ꯑꯦꯛꯌꯨꯠ GvHD (aGvHD) ꯂꯩꯔꯕꯗꯤ, ꯅꯍꯥꯛꯅꯥ ꯀ꯭ꯔꯣꯅꯤꯛ GvHD (cGvHD) ꯂꯥꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯟꯅꯥ ꯂꯩ꯫

ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯈꯪꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯂꯥꯏꯌꯦꯡꯕꯒꯦ?

ꯗꯥꯏꯑꯦꯒ꯭ꯅꯣꯁꯤꯁ ꯇꯧꯕꯥ꯫

ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯐꯤꯖꯤꯀꯦꯜ ꯑꯦꯀꯖꯥꯃꯤꯅꯦꯁꯟ ꯑꯃꯥ ꯇꯧꯗꯨꯅꯥ, ꯅꯍꯥꯛꯀꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨ ꯌꯦꯡꯗꯨꯅꯥ, ꯑꯃꯁꯨꯡ ꯕ꯭ꯂꯗ ꯇꯦꯁ꯭ꯠ ꯑꯃꯁꯨꯡ ꯕꯥꯏꯑꯣꯞꯁꯤ ꯇꯧꯗꯨꯅꯥ GvHD ꯈꯪꯗꯣꯛꯀꯅꯤ꯫ ꯕꯥꯏꯑꯣꯞꯁꯤ ꯍꯥꯌꯕꯁꯤ ꯈꯣꯡ ꯅꯠꯠꯔꯒꯥ ꯑꯁꯣꯀꯄꯥ ꯇꯤꯁꯨ ꯑꯃꯒꯤ ꯑꯄꯤꯀꯄꯥ ꯁꯔꯨꯛ ꯑꯃꯥ ꯂꯧꯗꯨꯅꯥ ꯃꯥꯏꯛꯔꯣꯁ꯭ꯀꯣꯄꯀꯤ ꯃꯈꯥꯗꯥ ꯌꯦꯡꯁꯤꯅꯕꯥ ꯑꯁꯤ ꯌꯥꯎꯏ꯫ ꯀ꯭ꯔꯣꯅꯤꯛ GvHDꯒꯤ ꯂꯥꯏꯑꯣꯡ ꯈꯔꯗꯤ ꯑꯇꯩ ꯀꯟꯗꯤꯁꯅꯁꯤꯡꯒꯥ ꯃꯥꯟꯅꯕꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ GvHD ꯈꯪꯗꯣꯛꯠꯔꯤꯉꯩ ꯃꯃꯥꯡꯗꯥ ꯑꯇꯩ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯑꯗꯨ ꯂꯧꯊꯣꯛꯀꯅꯤ꯫

ꯂꯥꯏꯌꯦꯡꯕ

ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ GvHD ꯊꯤꯡꯅꯕꯒꯤꯗꯃꯛ, ꯅꯍꯥꯛꯀꯤ ꯏꯝꯝꯌꯨꯟ ꯁꯤꯁ꯭ꯇꯦꯝ ꯑꯗꯨ ꯁꯣꯀꯍꯜꯂꯤꯕꯥ ꯏꯝꯝꯌꯨꯅꯣꯁꯞꯔꯦꯁꯤꯚ ꯍꯤꯗꯥꯀꯁꯤꯡ ꯄꯤꯒꯅꯤ꯫ ꯍꯤꯗꯥꯀꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯃꯄꯥꯅꯒꯤ ꯁꯦꯂꯁꯤꯡꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯑꯦꯇꯦꯛ ꯇꯧꯕꯥ ꯉꯝꯕꯒꯤ ꯁꯛꯇꯤ ꯍꯟꯊꯍꯟꯗꯨꯅꯥ ꯊꯕꯛ ꯇꯧꯏ꯫

• ꯑꯦꯛꯌꯨꯠ GvHD (aGvHD)ꯒꯤ ꯑꯣꯏꯅꯗꯤ, ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ, ꯀꯣꯔꯇꯤꯀꯣꯁ꯭ꯇꯦꯔꯣꯏꯗꯁꯤꯡ ꯑꯁꯤ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯛ, ꯏꯅꯖꯦꯀꯁꯟ ꯅꯠꯠꯔꯒꯥ ꯈꯣꯡꯗꯥ ꯊꯥꯕꯥ ꯀ꯭ꯔꯤꯝ ꯑꯃꯥ ꯑꯣꯏꯅꯥ ꯄꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯍꯥꯌꯔꯤꯕꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯂꯥꯌꯅꯥ ꯑꯁꯤ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯗ꯭ꯔꯕꯗꯤ, ꯔꯨꯛꯁꯣꯂꯤꯇꯤꯅꯤꯕ (ꯖꯥꯀꯥꯐꯤ®) ꯅꯠꯠꯔꯒꯥ ꯀ꯭ꯂꯤꯅꯤꯀꯦꯜ ꯇ꯭ꯔꯥꯏꯑꯦꯂꯁꯤꯡꯒꯨꯝꯕꯥ ꯑꯇꯣꯞꯄꯥ ꯗ꯭ꯔꯒꯁꯤꯡꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯟꯅꯔꯀꯄꯥ ꯌꯥꯏ꯫
• ꯀ꯭ꯔꯣꯅꯤꯛ GvHD (cGvHD)ꯒꯤ ꯑꯣꯏꯅꯗꯤ: ꯃꯁꯤꯒꯤꯗꯃꯛꯇꯥ ꯂꯣꯡ-ꯇꯔꯝ ꯏꯝꯝꯌꯨꯅꯣꯁꯞꯔꯦꯁꯤꯚ ꯗ꯭ꯔꯒꯁꯤꯡꯁꯨ ꯄꯤꯔꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯍꯥꯌꯔꯤꯕꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯗ꯭ꯔꯕꯗꯤ, ꯔꯨꯛꯁꯣꯂꯤꯇꯤꯅꯤꯕ (ꯖꯥꯀꯥꯐꯤ®), ꯕꯦꯂꯨꯃꯣꯁꯨꯗꯤꯜ (ꯔꯦꯖꯨꯔꯣꯛTM), ꯏꯕ꯭ꯔꯨꯇꯤꯅꯤꯕ (ꯏꯝꯕ꯭ꯔꯨꯚꯤꯀꯥ®) ꯅꯠꯠꯔꯒꯥ ꯐꯣꯇꯣꯐꯦꯔꯦꯁꯤꯁꯒꯨꯝꯕꯥ ꯑꯈꯟꯅꯕꯥ ꯂꯥꯌꯦꯡꯁꯤꯡ ꯑꯁꯤ ꯃꯊꯧ ꯇꯥꯕꯥ ꯌꯥꯏ꯫

ꯂꯥꯏꯌꯦꯡꯕꯒꯤ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡ꯫

ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯏꯝꯝꯌꯨꯟ ꯁꯤꯁ꯭ꯇꯦꯝ ꯑꯗꯨ ꯊꯤꯡꯏ, ꯃꯗꯨꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯊꯦꯡꯅꯕꯒꯤ ꯇꯧꯕꯥ ꯉꯝꯕꯗꯨ ꯍꯟꯊꯍꯜꯂꯤ꯫ ꯃꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯐꯉ꯭ꯒꯦꯜ, ꯕꯦꯛꯇꯦꯔꯤꯌꯥ ꯑꯃꯁꯨꯡ ꯚꯥꯏꯔꯁ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯂꯥꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯅꯒꯠꯍꯜꯂꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯄꯨꯟꯁꯤꯗꯥ ꯈꯨꯗꯣꯡꯊꯤꯕꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯕꯥ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯑꯁꯤ ꯊꯤꯡꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯅꯕꯥ ꯍꯤꯗꯥꯀꯁꯤꯡꯁꯨ ꯄꯤꯒꯅꯤ꯫

GvHDꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯑꯇꯩ ꯏꯐꯦꯛꯇꯁꯤꯡ꯫

GvHD ꯑꯁꯤ ꯄꯨꯟꯁꯤꯗꯥ ꯈꯨꯗꯣꯡꯊꯤꯕꯥ ꯊꯣꯀꯍꯅꯕꯔꯥ?

ꯍꯣꯌ, GvHD ꯑꯁꯤ ꯄꯨꯟꯁꯤꯗꯥ ꯈꯨꯗꯣꯡꯊꯤꯕꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯀ꯭ꯔꯣꯅꯤꯛ GvHD ꯑꯁꯤ ꯄ꯭ꯔꯥꯏꯃꯥꯔꯤ ꯂꯥꯌꯅꯥ ꯅꯠꯇꯕꯥ, ꯁ꯭ꯇꯦꯝ ꯁꯦꯜ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯁꯤꯍꯅꯕꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯔꯃꯅꯤ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯂꯥꯏꯌꯦꯡ ꯑꯃꯠꯇꯥ ꯄꯥꯡꯊꯣꯛꯠꯔꯤꯉꯩ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯔꯤꯁ꯭ꯀꯁꯤꯡꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯟꯅ-ꯅꯩꯅꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯖꯤ.ꯚꯤ.ꯑꯩꯆ.ꯗꯤ.ꯗꯒꯤ ꯀꯥꯟꯅꯕꯥ ꯑꯃꯠꯇꯥ ꯂꯩꯕ꯭ꯔꯥ?

ꯑꯉꯀꯄꯥ ꯑꯣꯏꯅꯥ, ꯍꯣꯌ꯫ ꯖꯤ.ꯚꯤ.ꯑꯩꯆ.ꯗꯤ.ꯅꯥ ꯀꯥꯟꯅꯕꯥ ꯈꯔꯥ ꯄꯤꯔꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡ ꯐꯕꯥ ꯁꯦꯂꯁꯤꯡꯗꯥ ꯑꯦꯇꯦꯛ ꯇꯧꯔꯤꯕꯥ ꯑꯅꯧꯕꯥ ꯏꯝꯝꯌꯨꯟ ꯁꯦꯂꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯂꯩꯕꯥ ꯌꯥꯕꯥ ꯀꯦꯟꯁꯔ ꯁꯦꯜ ꯑꯃꯍꯦꯛꯇꯕꯨꯁꯨ ꯊꯤꯗꯨꯅꯥ ꯃꯥꯡꯍꯜꯂꯤ꯫ ꯃꯁꯤꯕꯨ "ꯒ꯭ꯔꯥꯐ꯭ꯠ-ꯕꯔꯁꯦꯁ-ꯇꯤꯎꯃꯔ ꯏꯐꯦꯛꯇ" ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ, ꯁ꯭ꯇꯗꯤꯁꯤꯡꯅꯥ ꯇꯥꯛꯂꯤ ꯃꯗꯨꯗꯤ GvHD ꯂꯥꯀꯄꯥ ꯄꯦꯁꯦꯟꯇꯁꯤꯡꯗꯥ ꯃꯈꯣꯌꯒꯤ ꯀꯦꯟꯁꯔ ꯍꯜꯂꯀꯄꯒꯤ ꯆꯥꯡ ꯍꯟꯊꯩ꯫

ꯅꯍꯥꯛꯀꯤ ꯁꯦꯐꯇꯤꯒꯤꯗꯃꯛꯇꯥ ꯅꯍꯥꯛꯅꯥ ꯇꯧꯕꯥ ꯌꯥꯕꯥ ꯊꯕꯀꯁꯤꯡ꯫

ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯅꯁꯥꯕꯨ ꯀꯔꯝꯅꯥ ꯌꯦꯡꯁꯤꯅꯒꯗꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯈꯪꯍꯜꯂꯛꯀꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ GvHDꯒꯤ ꯔꯤꯁ꯭ꯛ ꯂꯩꯔꯕꯗꯤ ꯋꯥꯐꯃꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯆꯦꯀꯁꯤꯅꯒꯗꯕꯅꯤ꯫

• ꯅꯨꯃꯤꯠꯀꯤ ꯃꯉꯥꯂꯗꯒꯤ ꯃꯁꯥꯕꯨ ꯉꯥꯀꯊꯣꯀꯆꯕꯥ: ꯅꯨꯃꯤꯠꯀꯤ ꯃꯉꯥꯂꯅꯥ GvHD ꯍꯦꯟꯅꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯃꯄꯥꯟꯗꯥ ꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯂꯪꯂꯥ ꯂꯪꯐꯩ ꯑꯃꯁꯨꯡ ꯂꯝꯕꯥ ꯄꯦꯟꯇꯁꯤꯡ ꯁꯤꯖꯤꯟꯅꯧ꯫ ꯌꯥꯃꯗ꯭ꯔꯕꯗꯥ SPF 50 ꯂꯩꯕꯥ ꯅꯨꯃꯤꯠꯀꯤ ꯃꯉꯥꯂꯒꯤ ꯁ꯭ꯛꯔꯤꯟ ꯑꯃꯥ ꯁꯤꯖꯤꯟꯅꯧ꯫
• ꯑꯣꯔꯦꯜ ꯍꯥꯏꯖꯤꯟ: ꯈꯣꯡ ꯍꯥꯝꯕꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯟꯊꯍꯟꯅꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯥꯀꯆꯥꯡ ꯑꯗꯨ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯕ꯭ꯔꯁ ꯇꯧ꯫
• ꯆꯥꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯊꯛꯅꯕꯥ ꯏꯁꯤꯡ: ꯃꯆꯤꯟꯖꯥꯛ, ꯇꯩꯁꯤꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯃꯤꯠ ꯎꯗꯕꯥ ꯌꯥꯕꯥ ꯆꯤꯟꯖꯥꯀꯁꯤꯡ ꯁꯤꯖꯤꯟꯅꯔꯣꯏꯗꯕꯅꯤ꯫
• ꯖꯔꯃꯁꯤꯡꯗꯒꯤ ꯃꯁꯥ ꯉꯥꯀꯊꯣꯀꯆꯕꯥ : ꯅꯍꯥꯛꯀꯤ ꯏꯝꯝꯌꯨꯟ ꯁꯤꯁ꯭ꯇꯦꯝ ꯑꯁꯤ ꯋꯥꯠꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯂꯥꯌꯅꯥ ꯁꯟꯗꯣꯀꯄꯥ ꯃꯐꯃꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯃꯤ ꯌꯥꯝꯅꯥ ꯇꯤꯅꯕꯥ ꯃꯐꯃꯁꯤꯡꯗꯒꯤ ꯂꯥꯞꯅꯥ ꯂꯩꯌꯨ꯫ ꯃꯇꯝ ꯄꯨꯝꯅꯃꯛꯇꯥ ꯅꯍꯥꯛꯀꯤ ꯈꯨꯠꯁꯥ ꯑꯗꯨ ꯁꯦꯡꯅꯥ ꯊꯝꯃꯨ꯫

ꯑꯩꯅꯥ ꯀꯗꯥꯌꯗꯥ ꯗꯣꯛꯇꯔꯒꯥ ꯎꯅꯒꯗꯒꯦ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯑꯍꯣꯡꯕꯥ ꯑꯃꯥ ꯂꯥꯀꯄꯥ ꯎꯔꯕꯗꯤ, ꯃꯔꯨꯑꯣꯏꯅꯥ ꯏꯅꯐꯦꯛꯁꯅꯒꯤ ꯈꯨꯗꯃꯁꯤꯡ ꯅꯠꯠꯔꯒꯥ ꯁꯦꯂꯁꯤꯌꯁ ꯗꯤꯒ꯭ꯔꯤ 38 (100.4 ꯐꯥꯔꯦꯅꯍꯥꯏꯠ) ꯅꯠꯠꯔꯒꯥ ꯃꯁꯤꯗꯒꯤ ꯍꯦꯅꯕꯥ ꯐꯤꯚꯝ ꯑꯃꯥ ꯂꯥꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯈꯨꯗꯛꯇꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯈꯪꯍꯅꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫ ꯅꯍꯥꯛꯅꯥ ꯏꯝꯝꯌꯨꯟ ꯁꯤꯁ꯭ꯇꯦꯝ ꯁꯣꯀꯍꯜꯂꯤꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯆꯥꯕꯥ ꯃꯇꯃꯗꯥ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯍꯦꯟꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯑꯣꯏꯔꯀꯄꯥ ꯌꯥꯏ꯫

ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯅꯍꯥꯀꯄꯨ GvHDꯒꯨꯝꯕꯥ ꯀꯃꯞꯂꯤꯀꯦꯁꯅꯁꯤꯡ ꯌꯦꯡꯁꯤꯟꯅꯕꯥ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯌꯦꯡꯁꯤꯅꯒꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨ ꯂꯥꯛꯂꯕꯗꯤ, ꯃꯈꯣꯌꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯑꯗꯨ ꯍꯣꯡꯗꯣꯛꯀꯅꯤ ꯅꯠꯠꯔꯒꯥ ꯑꯅꯧꯕꯥ ꯍꯤꯗꯥꯀꯁꯤꯡ ꯄꯤꯒꯅꯤ꯫ ꯄ꯭ꯔꯦꯁ꯭ꯛꯔꯥꯏꯕ ꯇꯧꯔꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯛ ꯄꯨꯝꯅꯃꯛ ꯌꯥꯊꯪꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ ꯂꯧꯕꯥ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯒꯤ ꯏꯅꯁ꯭ꯠꯔꯛꯁꯅꯁꯤꯡ ꯉꯥꯛꯅꯥ ꯆꯠꯄꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫