Tikamva mawu oti "khansa," tonse timachita mantha pang'ono. Ndi mawu ofunikira kwambiri. Koma sayansi ya zamankhwala yapita patsogolo kwambiri kuposa kale. Mankhwala atsopano akupezedwa pafupifupi tsiku lililonse kuti achiritse ndikulamulira khansa. Lero, tikulankhula za chithandizo chomwe chasintha kwambiri dziko la chithandizo cha khansa ndikubweretsa chiyembekezo chatsopano kwa anthu ambiri. Ndi chithandizo cha chitetezo chamthupi.
Mwachidule, kodi chithandizo cha immunotherapy n'chiyani?
Tangoganizani kuti thupi lathu lili ngati dziko. Pali gulu lankhondo lotha kuteteza dziko lino. Timatcha gulu lankhondo ili chitetezo chamthupi . Asilikali omwe ali mu gulu lankhondo ili (ndiko kuti, maselo a chitetezo chamthupi) amayang'anira thupi lathu tsiku lonse. Ntchito yawo ndi kupeza ndi kuwononga adani ochokera kunja (monga mavairasi ndi mabakiteriya) ndi achiwembu ochokera mkati (monga maselo a khansa).
Kawirikawiri, gulu lankhondo ili limakhala laluso kwambiri pozindikira ndikuwononga maselo a khansa. Koma nthawi zina, maselo a khansa awa amakhala achinyengo kwambiri. Amabisala okha ndipo amabisala kwa asilikali athu. Kapena, amatumiza zizindikiro zomwe zimaletsa asilikali athu kugwira ntchito.
Apa ndi pomwe chithandizo cha immunotherapy chimayambira. Mwachidule, chithandizo cha immunotherapy ndi njira yopatsa chitetezo cha mthupi (asilikali) maphunziro apadera ndi mphamvu zowonjezera kuti zithandize kupeza ndikuwononga maselo obisika a khansa.
Kodi chithandizochi chimagwira ntchito bwanji?
Chithandizo cha immunotherapy chimathandiza chitetezo chathu chamthupi m'njira ziwiri zazikulu:
1. Kuphunzitsa chitetezo chamthupi: Timaphunzitsa maselo athu a chitetezo chamthupi kuzindikira molondola maselo a khansa obisika. Ndiko kuti, amachotsa zophimba nkhope pa maselo a khansa ndi kuzionetsa kwa asilikali, nati, "Apa pali mdani."
2. Kuchulukitsa kupanga maselo opha khansa: Kumathandiza thupi kupanga maselo ambiri oteteza thupi (asilikali) omwe amalimbana ndi khansa. Zikatero zimakhala zosavuta kuti gulu lalikulu lankhondo lipambane nkhondoyo kuposa laling'ono.
Mankhwalawa tsopano akugwiritsidwa ntchito ngati chithandizo choyamba cha mitundu yambiri ya khansa, makamaka khansa yomwe yafalikira ku ziwalo zina za thupi (metastatic). Nthawi zina imaperekedwa pamodzi ndi mankhwala ena, monga chemotherapy.
Kodi mitundu ikuluikulu ya chithandizo cha immunotherapy ndi iti?
Pali mitundu yosiyanasiyana ya chithandizo cha immunotherapy, yomwe iliyonse imagwiritsa ntchito ziwalo zosiyanasiyana za chitetezo chathu chamthupi kuti chithane ndi khansa.
1. Zoletsa Zoyang'ana
Chitetezo chathu cha mthupi ndi champhamvu kwambiri. Ngati chipitirira muyeso, chingawononge maselo athu athanzi. Ndicho chifukwa chake matupi athu mwachibadwa amakhala ndi dongosolo la "malo otetezera" kapena "mabuleki". Pamene selo la chitetezo cha mthupi (monga selo la T) likufuna kuukira selo la khansa, selo la khansa lochenjera limaponda "buleki" uwu ndikulepheretsa selo la chitetezo cha mthupi.
Chomwe mankhwala otchedwa Checkpoint Inhibitor amachita ndikutulutsa "buleki" yomwe selo ya khansa yapondapo. Kenako maselo athu oteteza thupi amatha kubwerera kuntchito. Izi zikutanthauza kuti amatha kupitiriza kuwononga maselo a khansa.
Njira yochizira iyi imagwiritsidwa ntchito pa milandu ya khansa yapamwamba kwambiri.
| Mitundu ya Khansa Yomwe Imagwiritsidwa Ntchito Kwambiri pa Checkpoint Inhibitors | |
|---|---|
| Khansa ya chikhodzodzo | Khansa ya impso |
| Khansa ya pachibelekero | Khansa ya pakhungu (Melanoma) |
| Khansa ya m'mero | Khansa ya m'mapapo (khansa ya m'mapapo yosakhala ya maselo ang'onoang'ono) |
| Khansa ya mutu ndi khosi | Khansa ya m'mawere (khansa ya m'mawere ya katatu) |
2. Chithandizo cha Maselo Otengera Ana
Izi zili ngati kutulutsa asilikali athu m'gulu lankhondo, kuwatumiza ku msasa wapadera wophunzitsira, kuwapatsa mphamvu zazikulu, ndikuwabwezera kunkhondo. Apa, madokotala amatenga maselo ena a chitetezo cha mthupi (ma T-cell) m'thupi lanu ndikuwakulitsa mu labu.
- Chithandizo cha maselo a T-CAR: Apa, maselo a T amasinthidwa majini mu labu kuti akhale ndi "maso" apadera (ma receptors) omwe amatha kuzindikira maselo a khansa. Maselo a T amphamvu kwambiri awa amapangidwa ambiri ndikubwezeretsedwanso m'thupi. Izi zimapita mwachindunji ku maselo a khansa ndikuwononga.
- Chithandizo cha ma lymphocyte olowa m'mimba (TIL):Mwa kutenga maselo ena a chitetezo chamthupi (TILs) omwe ali mkati kapena mozungulira chotupa, kuwakulitsa ambiri mu labu, kenako nkuwabwezera m'thupi, maselo amenewo amatha kulimbana ndi khansa bwino.
3. Ma antibodies a monoclonal
Ma antibodies ndi gawo lina lofunika kwambiri la chitetezo chathu chamthupi. Amalumikizana ndi maselo akunja ndipo amawalemba kuti "nayi mdani" kuti maselo ena a chitetezo chamthupi aone. Ma antibodies a monoclonal ndi ma antibodies opangidwa mu labu omwe amalimbana makamaka ndi maselo a khansa. Ali ngati zida zoyendetsedwa ndi GPS. Angathe:
- Mapuloteni oletsa kukula kwa maselo a khansa.
- Amalumikizana ndi maselo a khansa ndipo amauza chitetezo cha mthupi kuti chiwawononge.
- Perekani zinthu zoopsa kapena zowononga mwachindunji ku maselo a khansa (Kutumiza kolunjika).
4. Katemera wa Khansa
Izi sizili ngati katemera amene timalandira nthawi zambiri kuti titeteze ku matenda opatsirana ndi mavairasi. Katemerayu amaperekedwa khansa ikayamba. Chomwe katemerayu amachita ndikugwiritsa ntchito ziwalo za maselo a khansa kuphunzitsa chitetezo chathu cha mthupi kuzindikira khansa.
5. Zowongolera Chitetezo cha Mthupi
Awa ndi mankhwala omwe nthawi zambiri amalimbitsa chitetezo cha mthupi lathu. Mwachitsanzo, mapuloteni monga `Cytokines`, `Interferons` ndi `Interleukins` amapangidwa mwaluso ndipo amaperekedwa ngati mankhwala. Mankhwala monga `Thalidomide` ndi `Lenalidomide` nawonso ali m'gululi.
Kodi pali zotsatirapo zilizonse pa chithandizochi?
Inde. Ndithudi. Monga chithandizo chilichonse cha khansa, chithandizo cha chitetezo chamthupi chimakhala ndi zotsatirapo zake. Chomwe chimachitika apa ndichakuti chitetezo chathu chamthupi, chomwe chakhala chikugwira ntchito mopitirira muyeso, nthawi zina chimasokoneza maselo a khansa ndi maselo athu athanzi ndipo chimawaukiranso. Izi zimatchedwa `zotsatira zoyipa zokhudzana ndi chitetezo chamthupi (irAE)`.
Izi zili ngati kupita kukaukira mdani ndikuwombera anthu anu mwangozi.
Zotsatira zoyipa kwambiri ndi izi:
- Kumva kutopa kwambiri (Kutopa)
- Ziphuphu zoyabwa
- Kutsegula m'mimba
- Kusanza ndi kusanza
- Mavuto a mahomoni, monga kuchepa kwa mahomoni a chithokomiro.
Zotsatirapozi nthawi zambiri zimakhala zochepa, koma nthawi zina zimakhala zoopsa. Chifukwa chake, ndikofunikira kudziwitsa dokotala wanu nthawi yomweyo ngati mukukumana ndi zizindikiro zachilendo.
Mafunso ofunikira oti mufunse dokotala wanu
Ngati inu kapena wina m'banja mwanu akulangizidwa kuti mulandire chithandizo cha immunotherapy, ndikofunikira kudziwa bwino zomwe mukudwala. Musaope kufunsa dokotala wanu mafunso aliwonse omwe muli nawo. Nazi zitsanzo zina:
- Ndi mtundu wanji wa chithandizo cha immunotherapy chomwe ndikulimbikitsidwa kwa ine?
- Kodi ndidzapatsidwa mankhwala ena (monga chemotherapy) pamodzi ndi chithandizochi?
- Kodi ndingapeze bwanji chithandizochi? Chimatenga nthawi yayitali bwanji? Ndiyenera kuchitenga kangati?
- Kodi zotsatirapo zake zomwe zingakhalepo kwa kanthawi kochepa komanso kwa nthawi yayitali ndi ziti? Kodi zingatheke bwanji kuzithetsa?
- Ndi zotsatirapo ziti zomwe ndiyenera kukudziwitsani nthawi yomweyo zikachitika?
- Kodi chithandizochi chidzakhudza bwanji moyo wanga watsiku ndi tsiku? Kodi ndidzatha kupita kuntchito ndikuchita masewera olimbitsa thupi?
- Kodi tingadziwe bwanji ngati chithandizochi chapambana?
Uthenga Wopita Nawo Kunyumba
- Chithandizo cha Immunotherapy ndi njira yotsogola kwambiri komanso yopambana yomwe imagwiritsa ntchito chitetezo cha mthupi lathu polimbana ndi khansa.
- Izi zimaphunzitsa chitetezo cha mthupi kuzindikira maselo a khansa ndikupanga maselo opha khansa.
- Pali mitundu yosiyanasiyana ya chithandizo cha immunotherapy, monga zoletsa zoyezera matenda ndi chithandizo cha maselo a CAR T. Dokotala wanu adzasankha chithandizo choyenera kwambiri kutengera mtundu wa khansa yanu ndi gawo lake.
- Monga momwe zimakhalira ndi mankhwala onse, pali zotsatirapo zina zomwe zingachitike, choncho ndikofunikira kuuza dokotala wanu za zizindikiro zilizonse zachilendo.
- Ngakhale kuti chithandizo cha immunotherapy sichigwira ntchito mofanana kwa khansa iliyonse kapena wodwala aliyense, ndi chinthu chatsopano chomwe chabweretsa chiyembekezo chachikulu pankhani yochiza khansa.
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