Kodi mankhwala omwe mukupatsidwa ndi oyenera kwa inu? Tiyeni tikambirane za Pharmacogenomics!

Mwina mwamvapo kuti mankhwala omwewo a matenda omwewo amagwira ntchito kwa anthu ena, sagwira ntchito kwa ena, ndipo ali ndi zotsatirapo zake kwa ena. N’chifukwa chiyani zili choncho? Kodi ndi chifukwa chakuti matupi athu ndi osiyana? Inde, ndicho chifukwa chimodzi. Imeneyo ndi nkhani yofanana, yovuta pang'ono, koma yofunika kwambiri yomwe tikambirane lero. Izi zimatchedwa pharmacogenomics.

Kodi Pharmacogenomics ndi chiyani?

Mwachidule, pharmacogenomics ndi kuphunzira momwe timachitira ndi mankhwala kutengera majini athu. Kumbukirani, pharmacology ndi kuphunzira momwe mankhwala amagwiritsidwira ntchito komanso zotsatira zake. Genomics ndi kuphunzira majini ndi ntchito zawo. Kuphatikiza kwa awiriwa kumatchedwa pharmacogenomics. Nthawi zina kumatchedwa pharmacogenetics.

Izi zimagweradi pansi pa gawo lalikulu la 'Precision Medicine' . Izi zikutanthauza kuti, kukupatsani dongosolo la chithandizo lopangidwa ndi inu nokha kutengera zinthu monga majini anu, malo omwe mumakhala, ndi moyo wanu. Pharmacogenomics ingathandize dokotala wanu kusankha mankhwala omwe ali ndi zotsatirapo zochepa kapena omwe amagwira ntchito bwino kwa inu .

Koma ziyenera kudziwika kuti njira iyi sikugwiritsidwa ntchito pa matenda onse kapena mankhwala aliwonse. Pakadali pano, imagwiritsidwa ntchito kwambiri pa matenda ndi mankhwala ochepa, monga HIV, mitundu ina ya khansa, kuvutika maganizo, ndi matenda a mtima. Koma gawoli likukula mofulumira kwambiri. Ofufuza akuyembekeza kuti njira iyi posachedwa ithandiza kusankha mankhwala abwino ngakhale matenda ofala kwambiri.

Kodi majini amakhudza bwanji momwe mankhwala amagwirira ntchito?

Taganizirani izi motere: majini athu ali ngati malangizo a maselo m'thupi lathu. Majini amenewa amatithandiza kupanga mamolekyu a mapuloteni otchedwa ma enzyme . Ma enzyme ali ndi ntchito zambiri m'thupi lathu. Chimodzi mwa izo ndi kuphwanya mankhwala m'thupi, kapena kuwagwiritsa ntchito . Ngati anthu ena sayankha mankhwala monga momwe amayembekezera, zitha kukhala chifukwa chakuti ali ndi kusintha kwina m'majini awo. Kusintha kumeneku kungayambitse kuti ma enzyme asagwire bwino ntchito kapena kuti ma enzyme asagwire ntchito bwino.

Tangoganizirani, chingachitike n’chiyani ngati thupi lanu litawononga mankhwala mofulumira kwambiri, kapena pang’onopang’ono kwambiri, kapena osagwira ntchito konse? Ndiye kuti mankhwalawo, operekedwa pa mlingo wamba, sangagwire ntchito monga momwe amayembekezera. Mwina mankhwalawo angayambitse zotsatirapo zoyipa kwambiri , kapena sangakhudze matenda omwe alipo.

Mwachitsanzo, anthu ena sagona msanga akamamwa khofi, pomwe ena sagona. Chifukwa chimodzi cha izi ndichakuti majini athu amakhudza momwe matupi athu amasungunula khofi mwachangu. Zomwezo zingachitike ndi mankhwala.

Kodi mayeso a pharmacogenomic awa ndi otani?

Kuyesa kwa pharmacogenomic ndi mayeso a majini. Kungayang'ane majini amodzi kapena angapo, makamaka kuti ayang'ane mitundu yeniyeni ya majini yomwe imakhudza kuwonongeka kwa mankhwala. Zili ngati kuyang'ana cholakwika mu 'buku la malangizo' la thupi lathu.

Madokotala nthawi zambiri amagwiritsa ntchito chitsanzo cha magazi kapena buccal swab kuti achite izi. Chitsanzochi chimatengedwa kuchokera kwa inu ndikutumizidwa ku labu. Kumeneko, katswiri amafufuza DNA yanu kuti aone ngati pali kusintha kwina. Jini kapena majini omwe amawafuna adzadalira mayeso omwe dokotala wanu walamula, matenda omwe akuyesera kuchiza, ndi mankhwala omwe akukonzekera kukupatsani.

Kodi ndi liti pamene ndikufunika mayeso a pharmacogenomic?

Ngati mukumwa mankhwala a matenda enaake, mungakhale oyenereranso kuyezetsa mankhwala. Nazi zitsanzo zina (ndipo pakhoza kukhala zina):

Cholesterol yambiri

Chifukwa cha mitundu ina ya ``SLCO1B1 gene`` m'thupi mwathu, ngati mumwa mankhwala ena otchedwa statins a cholesterol yambiri, mutha kumva kupweteka kwa minofu ndi kufooka. Zitsanzo za ma statin awa ndi awa:

• Atorvastatin (monga Lipitor®)
• Fluvastatin (monga Lescol®)
• Lovastatin (monga Altoprev®)
• Pitavastatin (monga Livalo®)
• Pravastatin (mwachitsanzo, Pravachol®)
• Rosuvastatin (monga Crestor®)
• Simvastatin (monga Zocor®)

Choncho musanayambe kumwa mankhwala ngati awa, kapena ngati muli ndi vuto lililonse mukamawagwiritsa ntchito, dokotala wanu akhoza kukuuzani za mayeso ngati awa.

Kuvutika maganizo

Kusiyana kwa majini a CYP2D6 ndi CYP2C19 kungakhudze momwe thupi lanu limagayira mofulumira mankhwala ena oletsa kuvutika maganizo. Zitsanzo za mankhwala awa ndi monga:

• Amitriptyline (monga Elavil®) - Iyi ndi mtundu wa mankhwala oletsa kupsinjika maganizo a tricyclic .
• Gulu la mankhwala a `SSRI` : `Citalopram` (monga `Celexa®`), `Escitalopram` (monga `Lexapro®`), `Sertraline` (monga `Zoloft®`), `Paroxetine` (monga `Paxil®`) ndi `Fluvoxamine` (monga `Luvox®`).
• Venlafaxine (monga Effexor®) - Iyi ndi mtundu wa SNRI.

Kuyesa kumeneku kungakhale kothandiza poyambitsa mankhwala ngati awa, kapena pamene mankhwala ena sakugwira ntchito ndipo mukuyesera kusintha kupita ku ena.

Khansa

Ngati mukumwa mankhwala a mtundu winawake wa khansa, mungapindule ndi mayeso a pharmacogenomic. Nazi zitsanzo zina:

• Khansa ya m'mawere: Mankhwala otchedwa trastuzumab (monga Herceptin®) amagwira ntchito mwa anthu omwe ali ndi khansa ya m'mawere ya HER2 yokha. Izi zikutanthauza kuti maselo a khansa ali ndi kusintha kwa majini komwe kumawapangitsa kupanga mapuloteni ambiri a HER2.
• Matenda a Acute Lymphoblastic Leukemia (ALL): Anthu omwe ali ndi enzyme yochepa ya Thiopurine Methyltransferase (TPMT) akhoza kukhala ndi zotsatirapo zoyipa komanso chiopsezo chowonjezeka cha matenda ngati atapatsidwa mlingo wamba wa Mercaptopurine (monga Purinethol®).
• Khansa ya m'matumbo: Anthu omwe ali ndi enzyme yochepa ya UGT1A1 akhoza kukhala pachiwopsezo chachikulu cha kutsegula m'mimba kwambiri komanso matenda opatsirana ngati atapatsidwa mankhwala a Irinotecan (monga Camptosar®).

Komanso, mankhwala oletsa khansa otchedwa fluorouracil, `5-FU` (monga Adrucil® - `Adrucil®`), angayambitse mavuto aakulu ngati ataperekedwa pa mlingo wabwinobwino kwa anthu omwe ali ndi enzyme yochepa ya dihydropyrimidine dehydrogenase (`Dihydropyrimidine Dehydrogenase - DPD`). Madokotala angapereke mankhwalawa kwa khansa ya m'matumbo, m'mawere, m'mimba ndi khansa ya kapamba.

Kupewa magazi kuundana

Anthu omwe ali ndi majini osiyanasiyana ayenera kumwa mankhwala ochepetsa magazi otchedwa warfarin (monga Coumadin®). Kuchuluka kwambiri kungayambitse kutuluka magazi.

Komanso, kusintha kwa enzyme ya CYP2C19 m'chiwindi chanu kungalepheretse mankhwala oletsa ma platelet a clopidogrel (monga Plavix®) kugwira ntchito bwino . Uwu ndi mankhwala omwe amagwiritsidwa ntchito popewa zinthu monga matenda a mtima ndi sitiroko.

Matenda a HIV

Mtundu wina wa jini ya HLA-B ukhoza kuyambitsa vuto lalikulu pakhungu ku mankhwala a Abacavir (monga Ziagen®).

Komanso, mtundu wina wa jini ya CYP2B6 ukhoza kuwonjezera chiopsezo cha zotsatirapo zoyipa monga kusintha kwa mitsempha kuchokera ku mankhwala a efavirenz (monga Sustiva®).

Mavuto a chitetezo chamthupi

Ngati mukumwa mankhwala oletsa chitetezo chamthupi, mungapindule ndi mayeso a pharmacogenomic:

• Chifukwa cha kusiyana kwa mapuloteni a `TPMT` ndi `NUDT15`, ntchito ya mafuta m'mafupa ingachepe ngati mutenga mankhwala a `Azathioprine` (monga `Imuran®`) mutapatsidwa impso kapena matenda a chitetezo chamthupi monga multiple sclerosis.
• Chifukwa cha kusiyana kwa enzyme ya CYP3A5, ngati mutenga tacrolimus (monga Prograf®) mutatenga chiwalo china, chiopsezo chokana kutenga chiwalo china chingakule.

Kodi ubwino wa pharmacogenomics ndi wotani?

Pamene ofufuza ndi madokotala akupitiriza kuphunzira ndikugwiritsa ntchito mankhwala, izi zitha kupereka zabwino zambiri.

• Chitetezo Chokhazikika: Madokotala adzatha kupewa kupereka mankhwala omwe amayambitsa zotsatirapo zoyipa kwa anthu ena, kapena omwe angayambitse mavuto akamwedwa mopitirira muyeso. Izi zikutanthauza kuti simudzavutika popanda chifukwa.
• Kugwiritsa ntchito bwino komanso kuchepetsa ndalama zothandizira zaumoyo: Ngati madokotala angadziwe pasadakhale mankhwala omwe amagwira ntchito ndi omwe sagwira ntchito, akhoza kupereka mankhwala othandiza kwambiri kaye , zomwe zingapulumutse ndalama ndi nthawi .
• Kupanga mankhwala ofunikira: Matenda ena amayamba chifukwa cha kusintha kwina (kusintha) kwa jini. Pharmacogenomics imalola ofufuza kupeza mankhwala atsopano powalunjika mwachindunji kusintha kwa majini. Monga momwe amapangira mankhwala oyenera matendawa.

Kodi zofooka/zoyipa za pharmacogenomics ndi ziti?

Ngakhale kuti majini anu ndi ofunikira posankha chithandizo chabwino kwambiri cha matenda ambiri, sichifotokoza bwino momwe thupi lanu limagwiritsira ntchito mankhwala. Madokotala ayenerabe kuganizira zinthu zina posankha mankhwala oyenera. Mwachitsanzo:

• Mankhwala ena: Mankhwala omwe mukumwa panopa angasokoneze mphamvu ya mankhwala atsopano.
• Matenda ena: Matenda ena amasintha momwe thupi lanu limagwiritsira ntchito mankhwala. Mwachitsanzo, ngati impso zanu sizikugwira ntchito bwino, mankhwala ena amatuluka m'thupi lanu.
• Moyo: Zinthu monga zomwe mumadya, kuchuluka kwa masewera olimbitsa thupi omwe mumalandira, komanso kugwiritsa ntchito fodya ndi mowa wanu zingakhudze momwe mankhwala anu amagwirira ntchito.

Mavuto ena pakukula ndi kugwiritsa ntchito pharmacogenomics ndi awa:

• Mtengo: Ngakhale kuti mtengo wa mayeso a pharmacogenomic ukuchepa pang'onopang'ono, mtengo wa munthu aliyense, kapena ndalama zoperekedwa ndi ndalama, nthawi zambiri zimasiyana malinga ndi inshuwalansi. Mayesowa sangakhalepo kwa aliyense.
• Kufikika:Kutengera komwe mumakhala komanso mtundu wa dokotala amene akukuchizani, mwayi wanu wopeza mayeso ena a majini ungakhale wochepa.

Pakadali pano, madokotala amatha kugwiritsa ntchito pharmacogenomics pa matenda ndi mankhwala ochepa okha. Komabe, gawo losangalatsali la 'mankhwala olondola' likukula mofulumira. Lankhulani ndi dokotala wanu za momwe pharmacogenomics ingathandizire thanzi lanu komanso zabwino zomwe zingabweretse. Muthanso kufunsa za mayeso azachipatala m'munda uno.

Pomaliza, potsiriza, kumbukirani izi.

Chabwino, ngakhale kuti mawu akuti pharmacogenomics omwe takambirana lero ndi ovuta pang'ono, tanthauzo lake ndilakuti amatithandiza kusankha mankhwala omwe amatiyenerera bwino komanso omwe ali ndi zotsatirapo zochepa, kutengera majini athu.

Majini athu ndi chifukwa chachikulu chomwe mankhwala omwewo sagwira ntchito mofanana kwa aliyense. Pharmacogenomics ndi kuyesa kumvetsetsa chinsinsi chimenecho ndikutipatsa chithandizo chapadera komanso chothandiza kwambiri.

Ngakhale kuti izi zikupita patsogolo, zitha kusintha momwe matenda ambiri amachiritsidwira mtsogolo. Ngati muli ndi mafunso okhudza mankhwala enaake, makamaka ngati angakugwireni ntchito kapena ngati angayambitse zotsatirapo zoyipa, musaope kulankhula ndi dokotala wanu za mayeso awa a pharmacogenomic. Angakuthandizeni kwambiri.

Kumbukirani, majini anu ndi gawo limodzi lofunika kwambiri pa nkhani ya thanzi lanu. Zakudya zabwino, masewera olimbitsa thupi, komanso kutsatira upangiri wa dokotala wanu ndizofunikira kwambiri!

Pharmacogenomics , majini, mankhwala, mankhwala, mankhwala olondola, mayeso a majini, zotsatira zake zoyipa