Kodi dokotala adakulemberani mankhwala, koma sanakuthandizeni, ngakhale kuti anagwira ntchito kwa mnzanu? Kapena munakhalapo ndi zotsatirapo zina zomwe inu nokha mumapeza kuchokera ku mankhwala ena omwe ena sagwira ntchito? Mwina munadzifunsapo kuti, "N'chifukwa chiyani mankhwalawa sagwira ntchito kwa ine?" Kodi munayamba mwaganizapo kuti chifukwa cha izi chikhoza kukhala majini anu? Kodi sizodabwitsa? Inde, majini ang'onoang'ono awa omwe ali mkati mwa matupi athu amatha kusintha kwathunthu momwe mankhwala omwe timamwa amagwirira ntchito. Lero tikulankhula za imodzi mwa madera atsopano komanso ofunikira kwambiri azachipatala. Ndi Pharmacogenomics.
Mwachidule, kodi Pharmacogenomics ndi chiyani?
Mawu awa ndi aatali pang'ono ndipo akuoneka ovuta, sichoncho? Koma tiyeni tigawane mwachidule. Ndiye ndi osavuta kwambiri. Apangidwa ndi mawu awiri ophatikizidwa.
1. Ukadaulo wa Zamankhwala: Izi zikutanthauza kuphunzira za mankhwala . Ndiko kuti, momwe mankhwala amagwiritsidwira ntchito, zomwe amachita m'thupi, komanso zotsatira zake.
2. Genomics: Izi zikutanthauza kuphunzira majini ndi ntchito yawo .
Choncho pamene zonsezi zigwirizana, Pharmacogenomics ndi kuphunzira momwe majini athu amayankhira ku mankhwala omwe timamwa. Mwachidule, ndi nkhani yofufuza momwe mankhwala omwe mwapatsidwa angagwire ntchito, kapena ngati angayambitse zotsatirapo zoyipa, kutengera kapangidwe ka majini anu.
Izi ndi za gawo latsopano la zamankhwala lotchedwa "Precision Medicine." Zimatanthauza "mankhwala enieni." M'malo mopatsa aliyense mankhwala ofanana, zimaganizira zinthu monga majini anu, moyo wanu, ndi malo omwe mumakhala, ndikusankha chithandizo chomwe chikukuyenererani . Taganizirani ngati kupita kusitolo ndikugula diresi lomwe lili ndi kukula kofanana kwa aliyense, m'malo mopita kwa katswiri wosoka ndikupangira diresi malinga ndi muyeso wanu. Izi ndi zomwezo.
Pakadali pano, njira iyi ikugwiritsidwa ntchito pa matenda ndi mankhwala ochepa chabe. Mwachitsanzo, ukadaulo uwu umagwiritsidwa ntchito pa matenda a HIV, mitundu ina ya khansa, kuvutika maganizo, ndi mankhwala ena a matenda a mtima. Koma gawoli likukula mofulumira kwambiri. Ofufuza amakhulupirira kuti posachedwa, pharmacogenomics ithandiza madokotala kusankha mankhwala oyenera ngakhale matenda ofala kwambiri.
Kodi majini athu amakhudza bwanji mankhwala?
Kuti timvetse izi, choyamba tiyenera kuyang'ana zomwe majini amachita m'thupi lathu. Ganizirani majini athu ngati buku la malangizo omangira ndi kugwiritsa ntchito matupi athu. Maselo m'thupi lathu amagwira ntchito motsatira malangizo omwe ali m'buku la malangizoli.
Chofunika kwambiri ndi malangizo awa ndi ma enzyme.Kupanga mamolekyu a mapuloteni otchedwa ma enzyme. Ma enzyme ali ngati antchito ang'onoang'ono m'thupi lathu. Ogwira ntchitowa ali ndi ntchito zikwizikwi. Ntchito imodzi yofunika kwambiri pa ntchito zimenezi ndi kuphwanya, kapena kugayitsa, mankhwala omwe timamwa.
Tangoganizani mutamwa piritsi. Silipita mwachindunji kukachiritsa matendawa. Piritsi limenelo liyenera kupita ku mafakitale omwe ali m'thupi lathu (monga chiwindi), komwe ogwira ntchito kumeneko (monga ma enzyme) amaliphwanya, kuliphwanya, ndikulipangitsa kuti ligwiritsidwe ntchito ndi thupi.
Tsopano tangoganizani, chimachitika ndi chiyani ngati ma enzyme amenewa sagwira ntchito bwino chifukwa cha kusintha kwa majini a anthu ena?
- Ngati ma enzyme amagwira ntchito mofulumira kwambiri: Mankhwala omwe mumamwa, asanalowe m'thupi ndikukhudza matendawa, amasweka ndikutuluka m'thupi mwachangu kwambiri. Kenako mlingo wamba sukwanira kwa inu. Mankhwalawo amamveka ngati sakugwira ntchito.
- Ngati ma enzymes amagwira ntchito mofulumira kwambiri: Mankhwala omwe mumamwa amasweka mofulumira kwambiri m'thupi lanu. Kenako mankhwalawo amadzaza m'thupi lanu kwambiri. Izi zingapangitse kuti mugwiritse ntchito mopitirira muyeso ngakhale pa mlingo wamba ndipo zingakhale ndi zotsatirapo zoyipa kwambiri .
- Ngati enzymeyo sigwira ntchito konse: Nthawi zina, chifukwa cha kusintha kwa majini, thupi limatha kusiya kupanga enzyme yomwe ikukambidwa. Kenako mankhwalawo sangagwire ntchito konse kwa inu.
Umu ndi momwe ngakhale kusintha pang'ono m'majini athu kungakhudzire kwambiri mankhwala omwe timamwa.
Ndi mayeso ati omwe amagwiritsidwa ntchito kuzindikira kusintha kwa majini kumeneku?
Timatcha izi kuti mayeso a pharmacogenomic . Izi ndi mayeso a majini. Zimafufuza DNA yanu ndikuwona kusintha kulikonse mu majini amodzi kapena angapo omwe amakhudza momwe mankhwala amawonongeka.
Kuyezetsa kumeneku nthawi zambiri kumagwiritsa ntchito chitsanzo cha magazi kapena buccal swab . N'kosavuta kwambiri. Dokotala wanu amatumiza chitsanzochi ku labotale. Akatswiri kumeneko amafufuza DNA yanu kuti awone kusintha kwa majini oyenera.
Dokotala wanu adzasankha majini oti muwayese kutengera matenda anu komanso mtundu wa mankhwala omwe akukonzekera kukupatsani.
Kodi mayeso a pharmacogenomic amafunikira nthawi ziti?
Kuyesaku sikumachitika pa matenda onse kapena mankhwala aliwonse. Komabe, dokotala wanu angakulangizeni mayesowa akamachiza matenda enaake. Tiyeni tiwone zitsanzo zina. Kuti mumvetse bwino izi, onani tebulo ili m'munsimu.
| Matenda | Jini/enzyme yogwirizana | Zotsatira ndi kufotokozera kosavuta |
|---|---|---|
| Cholesterol yambiri | Jini la SLCO1B1 | Anthu omwe ali ndi mitundu ina ya jini iyi amatha kumva kupweteka kwambiri kwa minofu ndi kufooka akamamwa mankhwala a statin (monga Simvastatin, Atorvastatin) kuti achepetse cholesterol. Ngati izi zapezeka koyambirira kwa mayeso , dokotala wanu akhoza kukupatsani mankhwala ena. |
| Kuvutika maganizo | Majini a CYP2D6 ndi CYP2C19 | Kusintha kwa majini kumeneku kumasintha kuchuluka kwa mankhwala ena oletsa kuvutika maganizo m'thupi. Kwa ena, mankhwalawa amagwira ntchito bwino kwambiri. Kwa ena, amayambitsa zotsatirapo zambiri. Kuyesaku kungathandize kusankha mankhwala ogwira mtima kwambiri omwe ali ndi zotsatirapo zochepa . |
| Khansa | Majini osiyanasiyana (monga HER2, TPMT, UGT1A1, DPD) |
|
| Kuletsa magazi kuundana | Jini la CYP2C19 ndi ena | Mankhwala ochepetsa magazi otchedwa warfarin ayenera kuperekedwa pa mlingo wochepa kwambiri kwa anthu omwe ali ndi majini osiyanasiyana. Komanso, mankhwala a clopidogrel (Plavix®) sangagwire ntchito konse mwa anthu ena chifukwa cha kusiyana kwa enzyme ya CYP2C19. |
| Matenda a HIV | Majini a HLA-B ndi CYP2B6 | Anthu omwe ali ndi mtundu wina wa jini la HLA-B akhoza kukhala ndi vuto lalikulu pakhungu ngati atapatsidwa mankhwala a Abacavir. Chifukwa chake, mayesowa ndi ofunikira musanapereke mankhwalawa. |
| Mavuto a chitetezo chamthupi | TPMT, NUDT15, CYP3A5 | Pambuyo poika chiwalo, monga kuyika impso, kugwira ntchito kwa mankhwala oletsa chitetezo chamthupi (monga Azathioprine, Tacrolimus) kumadalira majini awa. Kusintha kwa majini awa kungapangitsenso kuti thupi likane chiwalo chomwe chaikidwacho . |
Kodi ubwino wa njira iyi ndi wotani?
Pamene gawo la Pharmacogenomics likukula, tidzapindula kwambiri.
- Mankhwala otetezeka: Madokotala amatha kuzindikira mankhwala omwe angayambitse zotsatirapo zoyipa kapena kumwa mopitirira muyeso mwa anthu ena, kotero amatha kupewa mankhwala amenewo ndikukupatsani mankhwala otetezeka kwambiri .
- Kuchita bwino komanso kuchepetsa ndalama zothandizira: Tangoganizirani, muyenera kusintha mankhwala 3-4 a matenda, kenako n’kupeza mankhwala oyenera. Mpaka nthawi imeneyo, nthawi yanu, ndalama zanu, ndi khama lanu zidzatayika. Ndipo mukuvutika mpaka matendawa atachira. Koma ngati mayesowa angathe kuchiza matendawa ndi mankhwala oyamba operekedwa , kodi zimenezo zingakhale zabwino bwanji?
- Kupanga mankhwala ofunikira: Matenda ena amayamba chifukwa cha kusintha kwa jini inayake. Choncho ofufuza amatha kupanga mankhwala atsopano omwe amayang'ana mwachindunji kusintha kwa jini imeneyo . Izi ndizofunikira kwambiri pochiza matenda monga khansa.
Koma izi zili ndi malire ake...
Kaya njira iyi ndi yabwino bwanji, siithetsa vuto lililonse. Dokotala akamasankha mankhwala samangoganizira za majini okha. Pali zinthu zina zambiri zofunika kuziganizira.
Chofunika ndichakuti, majini anu ndi gawo limodzi chabe la nkhaniyi. Pali zinthu zina zambiri zomwe zimakhudza momwe mankhwala amagwirira ntchito.
Dokotala ayeneranso kusamala ndi zinthu zina monga:
- Mankhwala ena omwe mukumwa panopa: Mankhwala omwe mukumwa pa vuto lina ndi ena pa vuto lina angakhudze thupi lanu m'njira yomwe ingayambitse kuwonongeka kwa thupi.
- Matenda ena omwe muli nawo: Mwachitsanzo, ngati muli ndi vuto la chiwindi kapena impso, zingakhudze momwe mankhwala amachotsedwera m'thupi.
- Moyo Wanu: Zimene mumadya ndi kumwa, kaya mumachita masewera olimbitsa thupi kapena ayi, komanso zinthu monga kusuta fodya ndi kumwa mowa zingakhudze momwe mankhwala anu amagwirira ntchito.
Kuphatikiza apo, palinso mavuto ena angapo:
- Mtengo: Ngakhale kuti mtengo wa mayeso a majini awa ukutsika pang'onopang'ono, ukhoza kukhala wokwera mtengo kwambiri moti anthu ena sangakwanitse.
- Kusapezeka: Malo ochitira mayesowa sakupezeka kulikonse ku Sri Lanka. Amapezeka m'malo ochepa okha.
Komabe, gawo ili la "Precision Medicine" likukula mofulumira kwambiri. Ngati muli ndi mafunso okhudza izi, musaope kulankhula ndi dokotala wanu . Mufunseni ngati pali phindu lililonse lochita mayeso amtunduwu chifukwa cha vuto lanu.
Uthenga Wopita Nawo Kunyumba
- Pharmacogenomics ndi kuphunzira momwe majini anu amakhudzira mankhwala omwe mumamwa.
- Kudzera mu njira iyi, dokotala wanu angakusankhireni mankhwala otetezeka komanso ogwira mtima kwambiri.
- Iyi idakali gawo lomwe likukula. Pakadali pano ikugwiritsidwa ntchito pochiza matenda enaake monga HIV, khansa, ndi kuvutika maganizo.
- Si majini anu okha omwe amasankha ngati mankhwala angakugwireni ntchito. Moyo wanu, mankhwala ena omwe mumamwa, ndi matenda ena nawonso amachitapo kanthu.
- Ngati muli ndi mafunso okhudza izi, munthu woyenera komanso woyenera kulankhula naye ndi dokotala wanu.
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