Xa sisiva igama elithi "umhlaza," sonke siyathuthumela kancinci. Ligama elibi kakhulu. Kodwa isayensi yezonyango ihambele phambili kakhulu kunangaphambili. Kufunyanwa unyango olutsha phantse yonke imihla ukunyanga nokulawula umhlaza. Namhlanje, sithetha ngonyango oluguqule ihlabathi lonyango lomhlaza kwaye luzise ithemba elitsha kubantu abaninzi. Loo nto yi-immunotherapy.
Ngoko ke, ngokulula nje, yintoni i-immunotherapy?
Khawuthelekelele ukuba imizimba yethu ifana nelizwe. Kukho umkhosi onamandla nonamandla okukhusela eli lizwe. Lo mkhosi siwubiza ngokuba yinkqubo yomzimba yokuzikhusela . Amajoni akulo mkhosi (oko kukuthi, iiseli zomzimba) ajikeleza imizimba yethu imini yonke. Umsebenzi wawo kukufumana nokutshabalalisa iintshaba ezivela ngaphandle (ezifana neentsholongwane kunye neebhaktheriya) kunye nabangcatshi abangaphakathi (njengeeseli zomhlaza).
Ngokwesiqhelo, lo mkhosi unobuchule kakhulu ekuchongeni nasekutshabalaliseni iiseli zomhlaza. Kodwa ngamanye amaxesha, ezi seli zomhlaza zinobuqhetseba kakhulu. Ziyazifihla kwaye zizimele kumajoni ethu. Okanye, zithumela imiqondiso ethintela amajoni ethu ekusebenzeni.
Kulapho ke unyango lwe-immunotherapy lungena khona. Ngamafutshane, unyango lwe-immunotherapy yinkqubo yokunika inkqubo yomzimba yethu yokuzikhusela (umkhosi) uqeqesho olukhethekileyo kunye namandla ongezelelweyo okusinceda sifumane kwaye sitshabalalise iiseli zomhlaza ezifihlakeleyo.
Lusebenza njani olu nyango?
I-immunotherapy inceda inkqubo yethu yomzimba yokuzikhusela ngeendlela ezimbini eziphambili:
1. Ukuqeqesha amajoni omzimba: Sifundisa amajoni ethu omzimba ukuba azibone ngokuchanekileyo iiseli zomhlaza ezifihliweyo. Oko kukuthi, asusa iimaski kwiiseli zomhlaza aze azibonise umkhosi, esithi, "Nanku utshaba."
2. Ukwandisa imveliso yeeseli ezibulala umhlaza: Inceda umzimba uvelise inani elikhulu leeseli zomzimba ezilwa nomhlaza. Emva koko kulula ukuba umkhosi omkhulu uphumelele edabini kunomncinci.
Olu nyango ngoku lusetyenziswa njengonyango lokuqala kwiintlobo ezininzi zomhlaza, ingakumbi kwiimhlaza ezisasazeke kwamanye amalungu omzimba (i-metastatic). Ngamanye amaxesha lunikwa kunye nezinye iindlela zonyango, ezifana ne-chemotherapy.
Ziziphi iintlobo eziphambili ze-immunotherapy?
Kukho iintlobo ezahlukeneyo ze-immunotherapy, nganye kuzo isebenzisa iindawo ezahlukeneyo zenkqubo yethu yomzimba ukuhlasela umhlaza.
1. Izithinteli zokujonga
Inkqubo yethu yokuzikhusela komzimba inamandla kakhulu. Ukuba idlula kakhulu, inokonakalisa neeseli zethu eziphilileyo. Yiyo loo nto imizimba yethu ngokwendalo inenkqubo "yeendawo zokujonga" okanye "yeenkqubo ze-brake". Xa iseli yokuzikhusela yomzimba (umz., iseli ye-T) iza kuhlasela iseli yomhlaza, iseli yomhlaza enobuqili inyathela kule "brake" ize ikhubaze iseli yokuzikhusela yomzimba.
Oko kwenziwa liyeza elibizwa ngokuba yiCheckpoint Inhibitor kukukhulula "ibhuleki" elinyathelwe yiseli yomhlaza. Emva koko iiseli zethu zomzimba zinokubuyela emsebenzini. Oko kuthetha ukuba zinokuqhubeka zitshabalalisa iiseli zomhlaza.
Le ndlela yonyango isetyenziswa kwiimeko zomhlaza eziphucuke kakhulu.
| Iintlobo zeeCancer ezisetyenziswa kakhulu kwiCheckpoint Inhibitors | |
|---|---|
| Umhlaza wesinyi | Umhlaza wezintso |
| Umhlaza womlomo wesibeleko | Umhlaza wolusu (iMelanoma) |
| Umhlaza wesisu | Umhlaza wemiphunga (umhlaza wemiphunga ongengoweeseli ezincinci) |
| Umhlaza wentloko nentamo | Umhlaza webele (umhlaza webele one-triple-negative) |
2. Unyango lweeSeli zokwamkela umntwana
Oku kufana nokukhupha amajoni ethu emkhosini, siwathumele kwinkampu yoqeqesho ekhethekileyo, siwanike amandla amakhulu, size siwabuyisele emfazweni. Apha, oogqirha bathatha ezinye zeeseli zakho zomzimba (ii-T-cells) emzimbeni wakho baze bazikhulisele kwilebhu.
- Unyango lwee-T-cell ze-CAR: Apha, ii-T-cells ziguqulwa ngokwemfuza kwilebhu ukuze zibe "namehlo" akhethekileyo (ii-receptors) anokuqaphela iiseli zomhlaza. Ezi T-cells zinamandla amakhulu emva koko zenziwa ngamanani amakhulu kwaye ziphinde zibuyiselwe emzimbeni. Ezi ziya ngqo kwiiseli zomhlaza kwaye zitshabalalise.
- Unyango lwe-tumor-infiltrating lymphocytes (TIL):Ngokuthatha ezinye zeeseli zomzimba (ii-TIL) ezingaphakathi okanye ezijikeleze ithumba, uzikhulise ngobuninzi kwilebhu, uze uzibuyisele emzimbeni, ezo seli zinokulwa ngempumelelo nomhlaza.
3. Ii-Antibodies zeMonoclonal
Ii-antibodies zezinye izinto ezibalulekileyo kwinkqubo yethu yokuzikhusela komzimba. Zinamathela kwiiseli zangaphandle kwaye ziphawulwe ngokuthi "nanku utshaba" ukuze ezinye iiseli zokuzikhusela komzimba zibone. Ii-antibodies ze-monoclonal zii-antibodies zokwenziwa ezenziwe kwilebhu ezijolise ngokukodwa kwiiseli zomhlaza. Zifana nee-missile ezikhokelwa yi-GPS. Zingenza oku kulandelayo:
- Vimba iiproteni ezifunekayo ekukhuleni kweeseli zomhlaza.
- Zinamathela kwiiseli zomhlaza kwaye zinika imiqondiso kwinkqubo yomzimba yokuzikhusela ukuba izitshabalalise.
- Ukuhambisa izinto ezinobuthi okanye ezinemitha ngqo kwiiseli zomhlaza (Ukuhanjiswa okujoliswe kuko).
4. Iigonyo zomhlaza
Oku akufani nezitofu esihlala sizifumana ukukhusela izifo ezibangelwa yintsholongwane. Ezi zitofu zinikwa emva kokuba umhlaza uvele. Oko kwenziwa lolu nyango kukusebenzisa iinxalenye zeeseli zomhlaza ukuqeqesha amajoni ethu omzimba ukuba aqaphele umhlaza.
5. IiModulators zeNkqubo yoMzimba
La ngamayeza adla ngokunyusa ukusebenza kwenkqubo yethu yokuzikhusela komzimba. Umzekelo, iiproteni ezifana ne-'Cytokines', 'Interferons' kunye ne-'Interleukins' ziveliswa ngokwenziwa kwaye zinikwa njengonyango. Amayeza afana ne-'Thalidomide' kunye ne-'Lenalidomide' nawo akweli qela.
Ngaba kukho naziphi na iziphumo ebezingalindelekanga kolu nyango?
Ewe. Ngokuqinisekileyo. Njengalo naluphi na unyango lomhlaza, unyango lwe-immunotherapy luneziphumo ebezingalindelekanga. Okwenzekayo apha kukuba inkqubo yethu yomzimba yokuzikhusela, esebenze kakhulu, ngamanye amaxesha iphosisa iiseli zomhlaza ngeeseli zethu eziphilileyo kwaye izihlasele nazo. Oku kubizwa ngokuba yi-'immune-related defects (irAE)'.
Oku kufana nokuya kuhlasela utshaba uze udubule abantu bakho ngempazamo.
Iziphumo ebezingalindelekanga eziqhelekileyo zezi:
- Ndiziva ndidiniwe kakhulu (Ndidinwe kakhulu)
- Ukurhawuzelela okurhawuzelelayo
- Urhudo
- Isicaphucaphu nokuhlanza
- Iingxaki zehomoni, ezifana namanqanaba aphantsi ehomoni ye-thyroid.
Ezi ziphumo bezingalindelekanga zihlala zincinci, kodwa ngamanye amaxesha zinokuba yingozi. Ke ngoko, kubalulekile ukwazisa ugqirha wakho ngokukhawuleza ukuba ufumana naziphi na iimpawu ezingaqhelekanga.
Imibuzo ebalulekileyo yokubuza ugqirha wakho
Ukuba wena okanye umntu kusapho lwakho ucetyiswa ukuba usebenzise i-immunotherapy, kubalulekile ukuba ucacelwe ngento oyenzayo. Musa ukoyika ukubuza ugqirha wakho nayiphi na imibuzo onayo. Nazi ezinye zemizekelo:
- Loluphi uhlobo lwe-immunotherapy endicetyiswayo?
- Ngaba ndiza kunikwa ezinye iindlela zonyango (ezifana ne-chemotherapy) kunye nolu nyango?
- Ndingalufumana njani olu nyango? Luthatha ixesha elingakanani? Kufuneka ndiluthathe kangaphi?
- Zithini iziphumo ezingalindelekanga zexesha elifutshane nezexesha elide zale nto? Zingalawulwa njani?
- Zeziphi iziphumo ebezingalindelekanga ekufuneka ndikwazise ngazo ngoko nangoko ukuba ziyavela?
- Olu nyango luza kuyichaphazela njani ubomi bam bemihla ngemihla? Ngaba ndiza kukwazi ukuya emsebenzini nokuzilolonga?
- Sazi njani ukuba olu nyango luphumelele?
Umyalezo Wokuya Ekhaya
- I-immunotherapy lunyango oluphambili kakhulu nolunempumelelo olusebenzisa amajoni omzimba wethu ukulwa nomhlaza.
- Oku kuqeqesha inkqubo yomzimba yokuzikhusela ukuba ikwazi ukubona iiseli zomhlaza kwaye ivelise iiseli ezibulala umhlaza.
- Kukho iintlobo ezahlukeneyo zonyango lwe-immunotherapy, ezifana ne-checkpoint inhibitors kunye ne-CAR T-cell therapy. Ugqirha wakho uya kumisela unyango olufanelekileyo ngokusekwe kuhlobo lomhlaza wakho kunye nenqanaba lawo.
- Njengakwezinye iindlela zonyango, kukho iziphumo ebezingalindelekanga, ngoko ke kubalulekile ukwazisa ugqirha wakho ngazo naziphi na iimpawu ezingaqhelekanga.
- Nangona unyango lwe-immunotherapy lungasebenzi ngokulinganayo kumhlaza ngamnye okanye kwisigulana ngasinye, lufunyanwe ngendlela entsha oluye lwaphakamisa amathemba amakhulu kwicandelo lonyango lomhlaza.
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