Mushonga wauri kunyorerwa wakakunakira here? Ngatitaurei nezve Pharmacogenomics!

Pamwe wakambonzwa kuti mushonga mumwe chete wechirwere chimwe chete unoshanda kune vamwe vanhu, haushande kune vamwe, uye une migumisiro yakaipa kune vamwe. Sei zvakadaro? Imhaka yekuti miviri yedu yakasiyana here? Ehe, ndicho chimwe chikonzero. Ndiyo nyaya ine hukama, yakaoma zvishoma, asi inokosha zvikuru yatichataura nezvayo nhasi. Izvi zvinonzi pharmacogenomics.

Chii chinonzi Pharmacogenomics?

Zvichitaurwa zviri nyore, pharmacogenomics inyaya yekudzidza maitiro atinoita mishonga zvichibva pamajini edu. Yeuka, pharmacology inyaya yekudzidza mashandisirwo nemigumisiro yemishonga. Genomics inyaya yekudzidza majini nebasa rawo. Musanganiswa wezviviri izvi unonzi pharmacogenomics. Dzimwe nguva unonzi pharmacogenetics.

Izvi zvinonyatsobatanidzwa ne'Precision Medicine' . Kureva kuti, kukupa chirongwa chekurapa chakagadzirirwa iwe pachako zvichibva pazvinhu zvakaita semajini ako, nharaunda yaunogara, uye mararamiro ako. Pharmacogenomics inogona kubatsira chiremba wako kusarudza mushonga une migumisiro mishoma kana kuti unoshanda zvakanaka kwauri .

Asi zvinofanira kucherechedzwa kuti nzira iyi haisati yashandiswa pazvirwere zvese kana mishonga yese. Parizvino, inonyanya kushandiswa pazvirwere zvishoma nemishonga, zvakaita seHIV, mamwe marudzi ekenza, kuora mwoyo, uye chirwere chemwoyo. Asi ndima iyi iri kukura nekukurumidza. Vaongorori vanotarisira kuti nzira iyi ichakurumidza kubatsira kusarudza mishonga iri nani kunyangwe yezvirwere zvakajairika.

Majini anokanganisa sei mashandiro anoita mishonga?

Funga nezvazvo nenzira iyi: majini edu akafanana nemirairo yemasero mumuviri wedu. Majini aya anotibatsira kugadzira mamorekuru eprotein anonzi maenzyme . Maenzyme ane mabasa akawanda mumiviri yedu. Rimwe rawo nderekuputsa mishonga mumuviri, kana kuigadzira . Kana vamwe vanhu vakasapindura kumishonga sezvaitarisirwa, zvinogona kunge zviri nekuda kwekuti vane shanduko mumajini avo. Kuchinja uku kunogona kukonzera kuti maenzyme asashande zvakanaka kana kuti maenzyme asashande nemazvo.

Fungidzira, chii chingaitika kana muviri wako ukapwanya mushonga nekukurumidza, kana zvishoma nezvishoma, kana kusatombozviita? Ipapo mushonga wacho, ukapihwa pachiyero chakajairika, haushande sezvaitarisirwa. Mushonga wacho unogona kukonzera migumisiro yakaipa , kana kuti haungakanganisi chirwere chiripo.

Semuenzaniso, vamwe vanhu havakurumidzi kurara mushure mekunwa kofi, vamwe havakurumidzi kurara. Chimwe chikonzero cheizvi ndechekuti majini edu anokanganisa kuti miviri yedu inobvisa sei caffeine nekukurumidza. Izvi zvinogona kuitikawo nemishonga.

Chii chinonzi bvunzo iyi ye pharmacogenomic?

Kuongororwa kwemakemikari (pharmacogenomic test) inzira yekuongorora majini. Inogona kutarisa majini rimwe chete kana akawanda, kunyanya kutsvaga mamwe majini anokanganisa kuparara kwemushonga. Zvakafanana nekutarisa kana paine zvikanganiso mu 'bhuku remirayiridzo' remuviri wedu.

Vanachiremba vanowanzo shandisa ropa kana buccal swab kuita izvi. Muenzaniso uyu unotorwa kubva kwauri woendeswa ku lab. Ikoko, nyanzvi inoongorora DNA yako kuti ione kana paine shanduko dzakati. Majini kana majini avanotsvaga zvinoenderana nebvunzo yawakarairwa nachiremba wako, mamiriro avari kuedza kurapa, uye mishonga yavari kuronga kukupa.

Ndirini pandinofanira kuongororwa ne pharmacogenomic test?

Kana uri kutora mushonga wemamwe matambudziko ehutano, unogona zvakare kukodzera kuongororwa kwemakemikari. Heano mimwe mienzaniso (uye panogona kunge paine mimwe):

Kolesteroli yakakwira

Nekuda kwemamwe marudzi e "SLCO1B1 gene" mumuviri wedu, kana ukatora mimwe mishonga inonzi statins ye cholesterol yakakwira, unogona kunzwa kurwadziwa kwetsandanyama uye kushaya simba. Mienzaniso yeaya ma statins ndeiyi:

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

Saka usati watanga kutora mushonga wakaita seuyu, kana kuti kana uine matambudziko paunenge uchiushandisa, chiremba wako anogona kutaura newe nezvebvunzo yakaita seyi.

Kuora mwoyo

Kusiyana kwemajini eCYP2D6 neCYP2C19 kunogona kukanganisa kuti muviri wako unokurumidza sei kuputsa mishonga inorwisa kuora mwoyo. Mienzaniso yemishonga iyi inosanganisira:

• Amitriptyline (semuenzaniso Elavil®) - Uyu rudzi rwemushonga we tricyclic antidepressant .
• Rudzi rwemishonga ye `SSRI` : `Citalopram` (semuenzaniso `Celexa®`), `Escitalopram` (semuenzaniso `Lexapro®`), `Sertraline` (semuenzaniso `Zoloft®`), `Paroxetine` (semuenzaniso `Paxil®`) uye `Fluvoxamine` (semuenzaniso `Luvox®`).
• Venlafaxine (semuenzaniso Effexor®) - Uyu rudzi rweSNRI.

Bvunzo iyi inogona kubatsira kana uchitanga mishonga yakaita seiyi, kana kuti kana mumwe mushonga usiri kushanda uye uri kuedza kuchinja kuenda kune mumwe.

Gomarara

Kana uri kutora mushonga werudzi rwakati rwegomarara, unogona kubatsirwa nekuongororwa kwemakemikari mumuviri. Heano mimwe mienzaniso:

• Kenza yemazamu: Mushonga wetrastuzumab (semuenzaniso Herceptin®) unoshanda chete kuvanhu vane kenza yemazamu ine HER2-positive . Izvi zvinoreva kuti masero ekenza ane majini anochinja anoita kuti agadzire puroteni yakawandisa yeHER2.
• Acute Lymphoblastic Leukemia (ALL): Vanhu vane enzyme shoma yeThiopurine Methyltransferase (TPMT) vanogona kusangana nemigumisiro yakaipa uye njodzi yakawedzerwa yehutachiona kana vakapa Mercaptopurine yakajairika (semuenzaniso Purinethol®).
• Gomarara remudumbu: Vanhu vane enzyme shoma yeUGT1A1 vanogona kunge vari panjodzi yakakura yekurwara nemanyoka uye hutachiona kana vakapa mushonga weIrinotecan (semuenzaniso Camptosar®).

Uyewo, mushonga wekurwisa kenza we fluorouracil, `5-FU` (semuenzaniso Adrucil® - `Adrucil®`), unogona kukonzera matambudziko akakomba kana ukapihwa pachiyero chakajairika kuvanhu vane huwandu hwakaderera hwe enzyme dihydropyrimidine dehydrogenase (`Dihydropyrimidine Dehydrogenase - DPD`). Vanachiremba vanogona kunyora mushonga uyu kune kenza ye colorectal, mazamu, dumbu uye pancreatic cancer.

Kudzivirira kuumbwa kweropa

Vanhu vane mamwe majini akasiyana-siyana vanofanira kutora mushonga wakaderera weanticoagulant warfarin (semuenzaniso Coumadin®). Wakawandisa unogona kukonzera kubuda ropa.

Uyewo, kuchinja kweCYP2C19 enzyme muchiropa chako kunogona kudzivirira mushonga weantiplatelet clopidogrel (semuenzaniso Plavix®) kuti usashande zvakanaka . Uyu mushonga unoshandiswa kudzivirira zvinhu zvakaita sekurwadziwa kwemoyo nekurohwa.

hutachiona hweHIV

Imwe mhando yejini reHLA-B inogona kukonzera kukanganiswa kwakanyanya kweganda nemushonga weAbacavir (semuenzaniso Ziagen®).

Uyewo, imwe mhando yeCYP2B6 gene inogona kuwedzera njodzi yemigumisiro yakaipa yakadai sekuchinja kwetsinga kubva kumushonga we efavirenz (semuenzaniso Sustiva®).

Matambudziko emuviri wemuviri

Kana uri kutora mushonga unodzvinyirira muviri, unogona kubatsirwa nekuongororwa kwemakemikari:

• Nekuda kwekusiyana kwemapuroteni ekuti `TPMT` ne`NUDT15`, mashandiro emupfupa anogona kudzikiswa kana ukatora mushonga wekuti `Azathioprine` (semuenzaniso `Imuran®`) mushure mekuisirwa itsvo kana kuti nekuda kwezvirwere zvemuviri zvakaita se multiple sclerosis.
• Nekuda kwekusiyana kweCYP3A5 enzyme, kana ukatora tacrolimus (semuenzaniso Prograf®) mushure mekuisirwa nhengo, njodzi yekuramba kuiswa nhengo inogona kuwedzera.

Ndezvipi zvakanakira zve pharmacogenomics?

Sezvo vaongorori navanachiremba vachiramba vachidzidza nekushandisa pharmacogenomics, zvinogona kuunza mabhenefiti akawanda. Tarisa:

• Kuchengetedzwa kwakawedzerwa: Vanachiremba vachakwanisa kudzivirira kunyora mishonga inokonzera migumisiro yakaipa kune vamwe vanhu, kana iyo inogona kukonzera matambudziko kana ikanwiwa zvakawandisa. Izvi zvinoreva kuti hauzofaniri kutambura zvisina kufanira.
• Kushanda zvakanaka uye kuderedzwa kwemari yekurapwa: Kana vanachiremba vakaziva pachine nguva kuti ndeipi mishonga inoshanda uye isiri kushanda, vanogona kutanga vanyora mishonga inoshanda zvakanyanya , vachichengetedza mari nenguva .
• Kugadzirwa kwemushonga wakanangana nechirwere: Zvimwe zvirwere zvinokonzerwa nekuchinja kwakati (variant) mumajini. Pharmacogenomics inobvumira vaongorori kuwana mishonga mitsva nekutarisa zvakananga kuchinja kwemajini ikoko. Kungofanana nekugadzira mushonga unoenderana nechirwere.

Ndezvipi zvipingamupinyi/zvakaipa zve pharmacogenomics?

Kunyange zvazvo majini ako achikosha pakusarudza mushonga wakanakisisa wezvirwere zvakawanda, haatsananguri zvizere kuti muviri wako unoshandisa sei mishonga. Vanachiremba vachiri kufanira kufunga nezvezvimwe zvinhu pavanenge vachisarudza mushonga wakakodzera. Semuenzaniso:

• Mimwe mishonga: Mishonga yauri kutora inogona kukanganisa kushanda kwemishonga mitsva.
• Mamwe matambudziko ehutano: Zvimwe zvirwere zvinogona kuchinja mashandiro anoita muviri wako mishonga. Semuenzaniso, kana itsvo dzako dzisiri kushanda zvakanaka, mimwe mishonga inoburitswa mumuviri wako.
• Mararamiro: Zvinhu zvakaita sekudya kwaunodya, maekisesaizi aunoita, uye kushandisa kwako fodya nedoro zvinogona kukanganisa kuputsika kwemishonga yako.

Mamwe matambudziko mukugadzirwa nekushandiswa kwe pharmacogenomics anosanganisira:

• Mutengo: Kunyangwe mutengo wekuongororwa kwemishonga uri kudzikira zvishoma nezvishoma, mutengo wemunhu wega wega, kana mari yekutenga kubva muhomwe, inowanzosiyana zvichienderana neinishuwarenzi. Bvunzo iyi ingasawanikwa nemunhu wese.
• Kusvikika:Zvichienderana nekwaunogara uye rudzi rwechiremba ari kukurapa, mukana wako wekuwana mimwe miedzo yejini unogona kunge wakaganhurirwa.

Parizvino, vanachiremba vanogona kushandisa pharmacogenomics chete pazvirwere nemishonga mishoma. Zvisinei, ndima iyi inonakidza ye 'precision medicine' iri kukura nekukurumidza. Taura nachiremba wako nezvekuti pharmacogenomics inogona sei kubatsira hutano hwako uye mabhenefiti ayo angaunze. Unogonawo kubvunza nezvemiedzo yekiriniki munharaunda iyi.

Pakupedzisira, pakupedzisira, yeuka izvi.

Zvakanaka, saka, kunyange hazvo izwi rekuti pharmacogenomics ratataura nezvaro nhasi rakaoma zvishoma, zvarinoreva nderokuti rinotibatsira kusarudza mushonga unotikodzera uye une migumisiro mishoma, zvichibva pamajini edu.

Majini edu ndiwo chikonzero chikuru nei mushonga mumwe chete usingashande zvakafanana kune wese munhu. Pharmacogenomics kuyedza kunzwisisa chakavanzika ichocho uye kutipa mishonga yakagadzirwa nemunhu mumwe chete uye inoshanda zvakanyanya.

Kunyangwe ichi chiri chikamu chiri kukura, chine mukana wekuchinja mabatirwo anoitwa zvirwere zvakawanda mune ramangwana. Kana uine mibvunzo nezvemushonga chaiwo, kunyanya kana uchizoshanda kwauri kana kuti uchizokonzera migumisiro yakaipa, usatya kutaura nachiremba wako nezvemiedzo iyi yemishonga. Inogona kukubatsira zvikuru.

Yeuka kuti majini ako chikamu chimwe chete chakakosha chehutano hwako. Kudya kwakanaka, kurovedza muviri, uye kutevedzera zano rachiremba wako zvakakoshawo!

Pharmacogenomics, majini, mishonga, mishonga , mushonga chaiwo, kuongororwa kwemajini, migumisiro yakaipa