Ese umuti uhabwa ukwiriye? Reka tuvuge kuri Pharmacogenomics!

Ushobora kuba warumvise ko umuti umwe w’indwara imwe ukorera abantu bamwe, ntukora ku bandi, kandi ukagira ingaruka mbi ku bandi. Kuki ari uko bimeze? Ese ni ukubera ko imibiri yacu itandukanye? Yego, iyo ni imwe mu mpamvu. Iyo ni ingingo ifitanye isano, igoye, ariko y’ingenzi cyane tugiye kuvugaho uyu munsi. Iyi yitwa pharmacogenomics.

Pharmacogenomics ni iki?

Muri make, pharmacogenomics ni inyigo y'uko twitwara ku miti dushingiye ku ngirabuzimafatizo zacu. Wibuke ko pharmacology ari inyigo y'ikoreshwa n'ingaruka z'imiti. Genomics ni inyigo y'uturemangingo n'imikorere yatwo. Uruvange rw'ibi byombi rwitwa pharmacogenomics. Rimwe na rimwe rwitwa pharmacogenetics.

Ibi biri mu rwego rwagutse rwa 'Precision Medicine' . Ni ukuvuga kuguha gahunda yihariye yo kuvura ishingiye ku bintu nk'uturemangingo twawe, ibidukikije utuyemo, n'imibereho yawe. Pharmacogenomics ishobora gufasha muganga wawe guhitamo umuti ufite ingaruka nke cyangwa ukubereye .

Ariko bikwiye kumenyekana ko ubu buryo butarakoreshwa kuri buri ndwara cyangwa buri muti. Muri iki gihe, bukoreshwa cyane ku ndwara nke n'imiti, nka virusi itera SIDA, ubwoko bumwe na bumwe bwa kanseri, kwiheba, n'indwara z'umutima. Ariko ubu buryo burimo gutera imbere vuba cyane. Abashakashatsi bizeye ko ubu buryo buzafasha vuba guhitamo imiti myiza ndetse n'indwara zikunze kugaragara.

Ni gute ingirabuzimafatizo zigira ingaruka ku buryo imiti ikora?

Tekereza kuri ubu buryo: imiterere y’uturemangingo (genes) yacu ni nk’amabwiriza agenewe uturemangingo mu mubiri wacu. Izi ngirabuzimafatizo zidufasha gukora molekile za poroteyine zitwa enzymes . Enzymes zifite akazi ka miliyoni mu mibiri yacu. Imwe muri zo ni ugusenya imiti mu mubiri, cyangwa kuyihindura . Iyo hari abantu badakira imiti nk'uko byari byitezwe, bishobora kuba biterwa n'uko hari impinduka runaka mu ngirabuzimafatizo zabo. Izi mpinduka zishobora gutuma enzymes zidakora neza cyangwa enzymes ntizikore neza.

Noneho tekereza, byagenda bite umubiri wawe uramutse uvunitse umuti vuba cyane, cyangwa buhoro cyane, cyangwa ntuwuvunire na gato? Hanyuma umuti, utanzwe ku gipimo gisanzwe, ntukora uko ubyiteze. Umuti ushobora gutera ingaruka mbi zikomeye , cyangwa ntugire ingaruka ku burwayi buriho ubu.

Urugero, hari abantu badasinzira vuba nyuma yo kunywa ikawa, abandi ntibayisinzira. Impamvu imwe ibi ni uko uturemangingo twacu tugira ingaruka ku buryo umubiri wacu usesagura kafeyine vuba. Ibyo bishobora kubaho no ku miti.

Iki kizamini cya farumasi ni iki?

Ikizamini cya farumasi ni ikizamini cya gene. Gishobora kureba gene imwe cyangwa nyinshi, cyane cyane kugira ngo harebwe ubwoko bwihariye bwa gene bugira ingaruka ku igabanuka ry'umuti. Ni nko gusuzuma amakosa mu 'manual' y'amabwiriza y'umubiri wacu.

Ubusanzwe abaganga bakoresha ikizamini cy'amaraso cyangwa agapira ko mu nda kugira ngo babikore. Iki kizamini gifatwa kikajya muri laboratwari. Aho ngaho, umutekinisiye agenzura ADN yawe kugira ngo arebe niba hari impinduka runaka. Ingirabuzimafatizo cyangwa jeni bashaka bizaterwa n'ikizamini muganga wawe yategetse, indwara barimo kugerageza kuvura, n'imiti bateganya kuguha.

Ni ryari nkeneye ikizamini cya pharmacogenomique?

Niba ufata imiti y’indwara zimwe na zimwe, ushobora no kuba wemerewe gupimwa imiti. Dore ingero zimwe na zimwe (kandi hashobora kuba hari izindi):

Kolesteroli nyinshi

Bitewe n'ubwoko bumwe na bumwe bwa ``SLCO1B1 gene`` mu mubiri wacu, iyo ufashe imiti imwe n'imwe yitwa statins yo kuvura cholesterol nyinshi, ushobora kugira ububabare bw'imitsi n'intege nke. Ingero z'iyi statins ni izi:

• Atorvastatin (urugero: Lipitor®)
• Fluvastatin (urugero: Lescol®)
• Lovastatin (urugero: Altoprev®)
• Pitavastatin (urugero: Livalo®)
• Pravastatin (urugero: Pravachol®)
• Rosuvastatin (urugero: Crestor®)
• Simvastatin (urugero: Zocor®)

Mbere yo gutangira gufata umuti nk'uyu, cyangwa niba ufite ikibazo mu gihe uwukoresha, muganga wawe ashobora kukuganiriza ku isuzuma nk'iri.

Ihungabana

Impinduka mu turemangingo twa CYP2D6 na CYP2C19 zishobora kugira ingaruka ku buryo umubiri wawe wangiza vuba imiti imwe n'imwe igabanya ubukana bw'indwara zo kwiheba. Ingero z'iyi miti zirimo:

• Amitriptyline (urugero: Elavil®) - Iyi ni ubwoko bw'imiti igabanya ubukana bwa tricyclic .
• Ubwoko bw'imiti ya `SSRI` : `Citalopram` (urugero: `Celexa®`), `Escitalopram` (urugero: `Lexapro®`), `Sertraline` (urugero: `Zoloft®`), `Paroxetine` (urugero: `Paxil®`) na `Fluvoxamine` (urugero: `Luvox®`).
• Venlafaxine (urugero: Effexor®) - Ubu ni ubwoko bwa SNRI.

Iki kizamini gishobora kuba ingirakamaro mu gutangira imiti nk'iyi, cyangwa mu gihe umuti umwe udakora kandi ugerageza guhindura undi.

Kanseri

Niba ufata imiti y’ubwoko runaka bwa kanseri, ushobora kungukirwa no gupima imiterere y’umubiri w’umuntu. Dore ingero zimwe na zimwe:

• Kanseri y'ibere: Umuti wa trastuzumab (urugero: Herceptin®) ukora gusa ku bantu barwaye kanseri y'ibere ya HER2 . Ibi bivuze ko uturemangingo twa kanseri dufite impinduka mu ngirabuzimafatizo ituma dukora poroteyine ya HER2 nyinshi cyane.
• Leukemia ikabije ya Lymphoblastic (ALL): Abantu bafite urugero ruto rwa enzyme ya Thiopurine Methyltransferase (TPMT) bashobora kugira ingaruka mbi zikomeye ndetse n'ibyago byo kwandura iyo bahawe urugero rusanzwe rwa Mercaptopurine (urugero: Purinethol®).
• Kanseri y'amara: Abantu bafite enzyme nke ya UGT1A1 bashobora kuba bafite ibyago byinshi byo kurwara impiswi no kwandura cyane iyo bahawe umuti wa Irinotecan (urugero: Camptosar®).

Nanone, umuti urwanya kanseri witwa fluorouracil, `5-FU` (urugero: Adrucil® - `Adrucil®`), ushobora gutera ingaruka mbi zikomeye iyo uhawe ku rugero rusanzwe ku bantu bafite urugero ruto rwa dihydropyrimidine dehydrogenase (`Dihydropyrimidine Dehydrogenase - DPD`). Abaganga bashobora gutanga uyu muti kuri kanseri y'inkondo y'umura, kanseri y'ibere, igifu na kanseri ya pancreas.

Kurinda kuvura amaraso

Abantu bafite ubwoko bumwe na bumwe bw'uturemangingo bagomba gufata dose nto y'umuti ugabanya amaraso wa warfarin (urugero: Coumadin®). Iyo urenze urugero ushobora gutera kuva amaraso.

Nanone, impinduka muri enzyme ya CYP2C19 mu mwijima wawe ishobora kubuza umuti wa clopidogrel urwanya udukoko two mu maraso (urugero: Plavix®) gukora neza . Uyu ni umuti ukoreshwa mu gukumira ibintu nk'indwara z'umutima n'imitsi yo mu bwonko.

ubwandu bwa virusi itera SIDA

Ubwoko bumwe bw'ingirabuzimafatizo ya HLA-B bushobora gutera ingaruka zikomeye ku ruhu ku muti wa Abacavir (urugero: Ziagen®).

Nanone, ubwoko bwa CYP2B6 gene bushobora kongera ibyago byo kugira ingaruka mbi nko guhinduka kw'imitsi biturutse ku muti wa efavirenz (urugero: Sustiva®).

Ibibazo by'ubudahangarwa bw'umubiri

Niba ufata umuti ugabanya ubukana bw'umubiri, ushobora kungukirwa no gupima imiterere y'umubiri w'umuntu:

• Bitewe n'ihindagurika rya poroteyine `TPMT` na `NUDT15`, imikorere y'umusemburo w'amagufwa ishobora kugabanuka iyo ufashe umuti `Azathioprine` (urugero `Imuran®`) nyuma yo guterwa impyiko cyangwa indwara z'ubudahangarwa bw'umubiri nka sclerosis nyinshi.
• Bitewe n'impinduka mu musemburo wa CYP3A5, iyo ufashe tacrolimus (urugero: Prograf®) nyuma yo guterwa urugingo, ibyago byo kwangwa guterwa urugingo bishobora kwiyongera.

Ni izihe nyungu za pharmacogenomics?

Mu gihe abashakashatsi n'abaganga bakomeje kwiga no gukoresha ubu buryo bwa pharmacogenomics, bushobora gutanga inyungu nyinshi. Reba:

• Umutekano urushaho kwiyongera: Abaganga bazashobora kwirinda gutanga imiti itera ingaruka mbi ku bantu bamwe, cyangwa ishobora guteza ibibazo iyo uyinyoye cyane. Ibi bivuze ko utazagomba kubabara bitari ngombwa.
• Ingufu n'igabanuka ry'ikiguzi cy'ubuvuzi: Iyo abaganga bamenye mbere y'igihe imiti ikora n'itakora, bashobora kubanza kwandika imiti ikora neza , bigatuma bazigama amafaranga n'igihe .
• Guteza imbere imiti yibasiwe: Indwara zimwe na zimwe ziterwa n'impinduka runaka (impinduka) muri gene. Pharmacogenomics yemerera abashakashatsi kubona imiti mishya hifashishijwe ikoranabuhanga ritandukanye. Kimwe no gukora umuti ujyanye n'indwara.

Ni izihe mbogamizi/ibibi bya pharmacogenomics?

Nubwo imiterere y'uturemangingo twawe ari ingenzi mu kugena uburyo bwiza bwo kuvura indwara nyinshi, ntabwo isobanura neza uburyo umubiri wawe ukora imiti. Abaganga bagomba kuzirikana izindi ngingo mu gihe bahitamo umuti ukwiye. Urugero:

• Indi miti: Imiti urimo gufata ubu ishobora kubangamira imikorere y'imiti mishya.
• Izindi ndwara: Hari indwara zishobora guhindura uburyo umubiri wawe ukoresha imiti. Urugero, niba impyiko zawe zidakora neza, hari imiti izava mu mubiri wawe.
• Ubuzima: Ibintu nk'ibyo urya, imyitozo ngororamubiri ungana iki, kunywa itabi n'inzoga bishobora kugira ingaruka ku buryo imiti yawe yangirika.

Izindi mbogamizi mu iterambere n'ikoreshwa rya pharmacogenomics zirimo:

• Ikiguzi: Nubwo ikiguzi cyo gupima imiterere y'umubiri (pharmacogenomic test) kigenda kigabanuka buhoro buhoro, ikiguzi cya buri muntu, cyangwa amafaranga atangwa mu mufuka, akenshi atandukana bitewe n'ubwishingizi. Iki kizamini gishobora kuba kitaboneka kuri buri wese.
• Uburyo bwo kugerwaho:Bitewe n'aho utuye n'ubwoko bw'umuganga ukuvura, ubushobozi bwawe bwo gupima bimwe mu bipimo by'uturemangingo bushobora kuba buke.

Muri iki gihe, abaganga bashobora gukoresha pharmacogenomics gusa ku ndwara nke n'imiti. Ariko, uru rwego rushimishije rw' 'ubuvuzi bunoze' rurimo gukura vuba. Vugana na muganga wawe ku buryo pharmacogenomics ishobora gufasha ubuzima bwawe n'inyungu ishobora kuzana. Ushobora kandi kubaza ku igeragezwa ry'ubuvuzi muri uru rwego.

Amaherezo, amaherezo, ibuka ibi.

Nibyo, nubwo ijambo pharmacogenomics twavuze uyu munsi rigoye gato, icyo risobanura ni uko ridufasha guhitamo umuti utubereye kandi ufite ingaruka nke cyane, hashingiwe ku ngirabuzima fatizo zacu.

Ingirabuzimafatizo zacu ni impamvu ikomeye ituma umuti umwe udakora kimwe kuri buri wese. Pharmacogenomics ni uburyo bwo kugerageza gusobanukirwa iryo banga no kuduha uburyo bwo kuvura bwihariye kandi bufite akamaro kurushaho.

Nubwo iki gikorwa kikiri iterambere, gishobora guhindura uburyo indwara nyinshi zivurwa mu gihe kizaza. Niba ufite ikibazo ku muti runaka, cyane cyane niba uzagufasha cyangwa niba uzagutera ingaruka mbi, ntutinye kuvugana na muganga wawe ku bijyanye n'ibi bizamini bya pharmacogenomique. Bishobora kugufasha cyane.

Wibuke ko imiterere y'uturemangingo twawe ari kimwe mu bice by'ingenzi by'ubuzima bwawe. Indyo nziza, imyitozo ngororamubiri, no gukurikiza inama za muganga wawe nabyo ni ingenzi cyane!

` Farumakomunike, jeni, imiti, imiti, ubuganga bugezweho, ibizamini by'uturemangingo, ingaruka mbi