Nanga bwanji ngati maselo atsopanowo atakhala mdani wa thupi? Kufotokozera kosavuta kwa Matenda a Graft vs. Host (GvHD) pambuyo poika kachilombo ka HIV m'thupi.

Tangoganizani kuti mwapatsidwa chithandizo cha maselo oyambira kuchokera kwa munthu wathanzi ngati chithandizo cha matenda monga khansa ya m'magazi. Izi zikuyembekezeka kuchiza vuto lanu. Koma nthawi zambiri, maselo atsopanowa omwe abwera kudzakuthandizani, thupi lanu limawaona ngati "mdani" ndipo amayamba kuukira maselo anu. Umenewo ndi mkhalidwe wovuta womwe timautcha "Graft versus Host Disease" kapena GvHD mwachidule.

Kodi GvHD ndi chiyani mwachidule?

Kuti timvetse izi, tifunika kudziwa mawu awiri. "Graft" ikutanthauza chinthu chomwe chabzalidwa, kutanthauza maselo athanzi omwe amaperekedwa kwa inu kuchokera kunja. "Host" ikutanthauza host, kutanthauza thupi lanu lomwe limalandira maselo amenewo. Choncho "Graft versus Host" imatanthauza "graft versus host."

Kawirikawiri, mtundu uwu wa kuyika maselo oyambira, wotchedwa allogeneic transplant, umachitidwa pochiza khansa monga khansa ya m'magazi ndi lymphoma, kapena matenda a m'mafupa monga aplastic anemia . Maselo oikidwa m'maselo amenewa ndi omwe amayambitsa thupi lanu kupanga maselo atsopano a magazi.

Koma nthawi zina maselo atsopanowa sazindikira maselo anu. Amaganiza kuti ndi olowa m'malo akunja. Choncho, amayamba kuukira ziwalo zanu zathanzi, monga khungu lanu, chiwindi, ndi matumbo. Ndicho chimene GvHD ili.

Pali mitundu iwiri ikuluikulu ya GvHD:

GvHD ikhoza kugawidwa m'magulu awiri akuluakulu. Kale, izi zinkagawidwa malinga ndi nthawi yomwe zizindikiro zimayamba. Koma tsopano, madokotala amazindikira mtundu weniweni poyang'ana zizindikiro, zotsatira za mayeso, ndi nthawi yomwe zizindikiro zimayamba.

• Matenda a Acute GvHD (aGvHD): Izi nthawi zambiri zimachitika mkati mwa masiku 100 oyambirira mutatenga chiwalocho. Koma nthawi zina zimatha kuchitika pambuyo pake. Mtundu uwu umakhudza kwambiri khungu lanu, m'mimba (matumbo), ndi chiwindi.
• Matenda a GvHD Osatha (cGvHD): Mtundu uwu ukhoza kuchitika nthawi iliyonse mutasinthana, koma umapezeka kwambiri m'zaka ziwiri zoyambirira . Ungakhudze mbali iliyonse ya thupi, kuphatikizapo khungu, pakamwa, chiwindi, mapapo, matumbo, minofu, mafupa, ndi ziwalo zoberekera.

Munthu amene anaikidwapo chiwalo choberekera akhoza kukhala ndi chimodzi mwa mitundu iwiriyi, zonse ziwiri, kapena akhoza kukhala ndi thanzi labwino popanda chilichonse mwa izi.

Kodi zizindikiro za GvHD ndi ziti?

Zizindikiro za GvHD zimatha kuyambira zofatsa kwambiri, mpaka zapakati, mpaka zoopsa kwambiri, komanso zoopsa kwambiri. Tiyeni tiwone zizindikiro zokhudzana ndi mitundu iwiriyi.

Nchifukwa chiyani GvHD iyi imachitika?

Izi ndi zasayansi pang'ono, koma ndifotokoza mwachidule.

Kawirikawiri, maselo a chitetezo chamthupi chathu amatiteteza ku matenda polimbana ndi adani ochokera kunja monga mavairasi ndi mabakiteriya. Koma maselo amenewo samenyana ndi maselo athu. Chifukwa cha izi ndi chakuti pali puloteni yapadera pamwamba pa maselo athu onse. Izi zimatchedwa Human Leukocyte Antigens (HLA) .

Kupatula mapasa ofanana, HLA ya aliyense ndi yosiyana.

Mukapatsidwa chithandizo cha maselo oyambira, maselo atsopano a magazi omwe amapangidwa kuchokera ku maselo amenewo amakhala ndi HLA ya munthu amene anakupatsani maselowo. Ngati HLA imeneyo ndi yosiyana kwambiri ndi HLA yanu, maselo atsopanowo amayang'ana maselo omwe ali m'thupi lanu ndi kuganiza kuti, "Uyu ndi wolowa m'malo, chizindikiritso chake sichikugwirizana ndi chathu." Pamenepo ndi pamene maselo amenewo amayamba kuukira thupi lanu.

Pachifukwa ichi, madokotala amafufuza mosamala HLA ya wopereka ndi wolandirayo kuti atsimikizire kuti ali pafupi kwambiri momwe angathere asanamuike mwana wina. Koma pokhapokha ngati maselo atengedwa kuchokera kwa mapasa, nthawi zonse pamakhala chiopsezo cha GvHD.

Ndani ali pachiwopsezo chachikulu chotenga matenda a GvHD?

Choopsa chachikulu ndi kusagwirizana kwa HLA, koma zinthu zina zingapo zingathandizenso.

Komanso, ngati mwakhalapo kale ndi Acute GvHD (aGvHD), muli pachiwopsezo chachikulu chotenga matenda a Chronic GvHD (cGvHD).

Kodi vutoli limapezedwa bwanji ndi kuchiritsidwa bwanji?

Kuzindikira matenda

Dokotala wanu adzazindikira matenda a GvHD mwa kuchita mayeso akuthupi, kuyang'ana zizindikiro zanu, ndikuyesa magazi ndi biopsy. Biopsy imaphatikizapo kutenga khungu laling'ono kapena minofu yokhudzidwa ndikuiyang'ana pansi pa maikulosikopu. Chifukwa zina mwa zizindikiro za matenda a GvHD osatha zimafanana ndi matenda ena, dokotala wanu adzachotsa matenda ena asanazindikire matenda a GvHD.

Chithandizo

Kuti mupewe GvHD mutapatsidwa mankhwala oletsa chitetezo chamthupi, mudzapatsidwa mankhwala oletsa chitetezo chamthupi omwe amaletsa chitetezo chamthupi chanu. Mankhwalawa amagwira ntchito pochepetsa mphamvu ya maselo akunja kuukira thupi lanu.

• Pa matenda a GvHD (aGvHD): Nthawi zambiri, mankhwala a corticosteroid amaperekedwa ngati mapiritsi, jakisoni, kapena ngati kirimu wopaka pakhungu. Ngati izi sizikuletsa matendawa, mankhwala ena monga Ruxolitinib (Jakafi®) kapena mayesero azachipatala angaganizidwe.
• Pa matenda a GvHD Osatha (cGvHD): Mankhwala oletsa chitetezo chamthupi kwa nthawi yayitali amaperekedwanso pa izi. Ngati vutoli silikulamuliridwa ndi izi, mankhwala monga Ruxolitinib (Jakafi®), Belumosudil (Rezurock™), Ibrutinib (Imbruvica®) kapena mankhwala apadera monga photopheresis angafunike.

Zotsatirapo zoyipa za chithandizo

Mankhwalawa amaletsa chitetezo chamthupi chanu, zomwe zimachepetsa mphamvu ya thupi lanu yolimbana ndi matenda. Izi zimawonjezera chiopsezo chanu chotenga matenda a bowa, mabakiteriya, ndi mavairasi. Dokotala wanu adzakupatsaninso mankhwala othandizira kupewa matenda awa omwe angawononge moyo.

Zotsatira zina zomwe zingachitike chifukwa cha GvHD

Kodi GvHD ndi yoopsa?

Inde, GvHD ikhoza kukhala pachiwopsezo chachikulu. Matenda a GvHD osatha, makamaka, ndiye chifukwa chachikulu cha imfa pambuyo poika maselo oyambira, kupatula matenda oyamba. Ichi ndichifukwa chake ndikofunikira kukambirana zoopsa ndi dokotala wanu musanalandire chithandizo chilichonse.

Kodi pali phindu lililonse kuchokera ku GvHD?

Chodabwitsa n'chakuti inde. GvHD ili ndi ubwino wina. Maselo atsopano a chitetezo chamthupi omwe amaukira maselo anu athanzi amafufuzanso ndikuwononga maselo aliwonse a khansa omwe angatsale m'thupi lanu. Izi zimatchedwa "graft-versus-tumor effect." Chifukwa chake, kafukufuku wasonyeza kuti odwala omwe ali ndi GvHD ali ndi mwayi wochepa woti khansa yawo ibwererenso.

Zinthu zomwe mungachite kuti mukhale otetezeka

Dokotala wanu adzakufotokozerani momwe muyenera kudzisamalira mutatenga kachilomboka. Samalani kwambiri ndi zinthu izi ngati muli pachiwopsezo cha matenda a GvHD.

• Dzitetezeni ku dzuwa: Kutenthedwa ndi dzuwa kungapangitse kuti GvHD ikule kwambiri. Choncho valani malaya a manja aatali ndi mathalauza aatali mukamatuluka panja. Gwiritsani ntchito mafuta oteteza ku dzuwa omwe ali ndi SPF 50 osachepera.
• Ukhondo wa pakamwa: Tsukani mano anu bwino kuti muchepetse chiopsezo cha matenda a chiseyeye.
• Chakudya ndi Zakumwa: Pewani zokometsera, mafuta, ndi zakudya zomwe zingayambitse zilonda mkamwa.
• Dzitetezeni ku majeremusi: Popeza chitetezo chanu cha mthupi ndi chofooka, pewani malo omwe matenda amafalikira komanso malo odzaza anthu. Nthawi zonse sungani manja anu aukhondo.

Ndiyenera kupita kwa dokotala liti?

Ndikofunikira kudziwitsa dokotala wanu nthawi yomweyo ngati muwona kusintha kulikonse m'thupi lanu, makamaka zizindikiro za matenda kapena kutentha thupi kwa madigiri 38 Celsius (100.4 Fahrenheit) kapena kupitirira apo. Matenda amatha kukulirakulira mwachangu mukamwa mankhwala omwe amaletsa chitetezo chamthupi.

Dokotala wanu adzakuyang'anirani nthawi zonse mukangomuika kuti aone ngati pali zovuta monga GvHD. Ngati zizindikiro ziyamba, adzasintha mankhwala anu kapena kukupatsani ena atsopano. Ndikofunikira kwambiri kumwa mankhwala onse omwe mwapatsidwa monga mwalangizidwira ndikutsatira malangizo a dokotala wanu.