Ingaba amayeza owanikwayo akulungele? Masithethe nge-Pharmacogenomics!

Mhlawumbi ukhe weva ukuba iyeza elifanayo lesifo esifanayo liyasebenza kwabanye abantu, alisebenzi kwabanye, kwaye linemiphumo emibi kwabanye. Kutheni kunjalo? Ingaba kungenxa yokuba imizimba yethu yahlukile? Ewe, sesinye sezizathu. Eso sisihloko esinxulumeneyo, esintsonkothileyo, kodwa esibaluleke kakhulu esiza kuthetha ngaso namhlanje. Oku kubizwa ngokuba yi-pharmacogenomics.

Yintoni i-Pharmacogenomics?

Ngamafutshane, i-pharmacogenomics luphando lwendlela esisabela ngayo kumayeza asekelwe kwiijini zethu. Khumbula, i-pharmacology luphando lokusetyenziswa kunye nemiphumo yamayeza. I-Genomics luphando lweejini kunye nomsebenzi wazo. Ukudibana kwezi zimbini kubizwa ngokuba yi-pharmacogenomics. Ngamanye amaxesha kubizwa ngokuba yi-pharmacogenetics.

Oku kuwela phantsi kweli candelo libanzi le -'Precision Medicine' . Oko kukuthi, ukukunika isicwangciso sonyango esilungiselelwe wena ngokusekelwe kwizinto ezifana ne-genes yakho, indawo ohlala kuyo, kunye nendlela ophila ngayo. I-Pharmacogenomics inokunceda ugqirha wakho ukuba akhethe iyeza elinemiphumo emibi embalwa okanye elisebenza kakuhle kuwe .

Kodwa kufuneka kuqatshelwe ukuba le ndlela ayikasetyenziswa kuzo zonke izifo okanye kuzo zonke iziyobisi. Okwangoku, isetyenziswa kakhulu kwiimeko namayeza ambalwa, njenge-HIV, ezinye iintlobo zomhlaza, ukudakumba, kunye nesifo sentliziyo. Kodwa eli candelo likhula ngokukhawuleza. Abaphandi banethemba lokuba le ndlela iza kunceda kungekudala ekukhetheni amayeza angcono nakwizifo eziqhelekileyo.

Izakhi zofuzo ziyichaphazela njani indlela amayeza asebenza ngayo?

Cinga ngale ndlela: iijini zethu zifana neseti yemiyalelo yeeseli emzimbeni wethu. Ezi jini zisinceda senze iimolekyuli zeproteni ezibizwa ngokuba zii-enzymes . Ii-enzymes zinemisebenzi emininzi emizimbeni yethu. Enye yazo kukuqhekeza iziyobisi emzimbeni, okanye ukuzisebenzisa . Ukuba abanye abantu abaphenduli kumayeza njengoko bekulindelekile, kusenokuba kungenxa yokuba banotshintsho oluthile kwiijini zabo. Olu tshintsho lunokubangela ukuba ii-enzymes zingasebenzi kakuhle okanye ii-enzymes zingasebenzi kakuhle.

Khawucinge nje, kuya kwenzeka ntoni ukuba umzimba wakho uqhekeze iyeza ngokukhawuleza kakhulu, okanye kancinci kakhulu, okanye ungaliqhekezi kwaphela? Emva koko iyeza, elinikwa ngedosi eqhelekileyo, aliyi kusebenza njengoko bekulindelwe. Nokuba iyeza linokubangela iziphumo ebezingalindelekanga ezinzulu , okanye alinakuba nampembelelo kwisifo esikhoyo.

Umzekelo, abanye abantu abalali ngokukhawuleza emva kokusela ikofu, ngelixa abanye bengalali. Esinye isizathu soku kukuba ii-genes zethu zichaphazela indlela imizimba yethu ekhawuleza ngayo ukucola i-caffeine. Oku kunokwenzeka nangamayeza.

Yintoni le vavanyo lwe-pharmacogenomic?

Uvavanyo lwe-pharmacogenomic luvavanyo lwe-genetic. Lunokujonga i-gene enye okanye ezingaphezulu, ngokukodwa ukukhangela iintlobo ezithile ze-genetic ezichaphazela ukuqhekeka kweyeza. Kufana nokujonga impazamo 'kwincwadi yemiyalelo' yomzimba wethu.

Oogqirha badla ngokusebenzisa isampuli yegazi okanye i-buccal swab ukwenza oku. Le sampuli ithathwa kuwe ize ithunyelwe kwilebhu. Apho, ingcali ijonga i-DNA yakho ukuze ibone utshintsho oluthile. I-gene okanye ii-gene abazifunayo ziya kuxhomekeka kuvavanyo oluyalelwe ngugqirha wakho, imeko abazama ukuyinyanga, kunye namayeza abaceba ukukunika wona.

Ndiludinga nini uvavanyo lwe-pharmacogenomic?

Ukuba usela amayeza kwiimeko ezithile zonyango, ungafaneleka nokuvavanywa kwe-pharmacogenomic. Nazi ezinye imizekelo (kwaye zisenokuba zikho nezinye):

I-cholesterol ephezulu

Ngenxa yeentlobo ezithile ze-``SLCO1B1 gene`` emizimbeni yethu, ukuba uthatha amayeza athile abizwa ngokuba yi -statins ye-cholesterol ephezulu, unokufumana iintlungu zemisipha kunye nobuthathaka. Imizekelo yezi statins yile:

• I-Atorvastatin (umz. iLipitor®)
• I-Fluvastatin (umz. iLescol®)
• I-Lovastatin (umz. i-Altoprev®)
• IPitavastatin (umz. iLivalo®)
• Pravastatin (umz. Pravachol®)
• I-Rosuvastatin (umz. iCrestor®)
• I-Simvastatin (umz. iZocor®)

Ngoko ke ngaphambi kokuba uqale ukuthatha amayeza anje, okanye ukuba uneengxaki xa uwasebenzisa, ugqirha wakho angathetha nawe ngovavanyo olunje.

Uxinzelelo

Utshintsho kwi-genes ye-CYP2D6 kunye ne-CYP2C19 lunokuchaphazela indlela umzimba wakho oqala ngayo ukuwohloka ngokukhawuleza kwezinye izidambisi-ntlungu. Imizekelo yala mayeza ibandakanya:

• I-Amitriptyline (umz. i-Elavil®) - Olu luhlobo lwe- tricyclic antidepressant .
• Udidi lwamayeza e-`SSRI` : `Citalopram` (umz. `Celexa®`), `Escitalopram` (umz. `Lexapro®`), `Sertraline` (umz. `Zoloft®`), `Paroxetine` (umz. `Paxil®`) kunye ne-`Fluvoxamine` (umz. `Luvox®`).
• I-Venlafaxine (umz. i-Effexor®) - Olu luhlobo lwe-SNRI.

Olu vavanyo lunokuba luncedo xa uqala amayeza anje, okanye xa elinye iyeza lingasebenzi kwaye uzama ukutshintshela kwelinye.

Umhlaza

Ukuba usela amayeza ohlobo oluthile lomhlaza, ungazuza kuvavanyo lwe-pharmacogenomic. Nazi ezinye zemizekelo:

• Umhlaza webele: Iyeza i-trastuzumab (umz. iHerceptin®) lisebenza kuphela kubantu abanomhlaza webele one-HER2-positive . Oku kuthetha ukuba iiseli zomhlaza zine-genetic change ebangela ukuba zivelise iproteni ye-HER2 eninzi kakhulu.
• I-Acute Lymphoblastic Leukemia (YONKE): Abantu abanamanqanaba aphantsi e-enzyme i-Thiopurine Methyltransferase (TPMT) banokufumana iziphumo ebezingalindelekanga ezibi kunye nomngcipheko owongezelelekileyo wosulelo ukuba banikwa idosi eqhelekileyo ye-Mercaptopurine (umz. iPurinethol®).
• Umhlaza wamathumbu amakhulu: Abantu abanamanqanaba aphantsi e-enzyme i-UGT1A1 banokuba semngciphekweni omkhulu worhudo olukhulu kunye nosulelo ukuba banikwa iyeza i-Irinotecan (umz. iCamptosar®).

Kwakhona, iyeza lokulwa nomhlaza i-fluorouracil, `5-FU` (umz. i-Adrucil® - `Adrucil®`), linokubangela iziphumo ebezingalindelekanga ezibi kakhulu ukuba linikwa ngeedosi eziqhelekileyo kubantu abanamanqanaba aphantsi e-enzyme i-dihydropyrimidine dehydrogenase (`i-Dihydropyrimidine Dehydrogenase - DPD`). Oogqirha banokunika eli yeza lomhlaza we-colorectal, ibele, isisu kunye nomhlaza we-pancreatic.

Ukuthintela ukuqhekeka kwegazi

Abantu abanezakhi ezithile zemfuza kufuneka bathathe idosi ephantsi ye-warfarin yeziyobisi ezilwa nokugabha igazi (umz. iCoumadin®). Ukugqithisa kakhulu kunokubangela ukopha.

Kwakhona, utshintsho kwi-enzyme ye-CYP2C19 esibindini sakho lunokuthintela amayeza e-antiplatelet e-clopidogrel (umz. i-Plavix®) ukuba angasebenzi kakuhle . Eli liyeza elisetyenziselwa ukuthintela izinto ezifana nokuhlaselwa yintliziyo kunye nokubetha.

Usulelo lwe-HIV

Uhlobo oluthile lwe-HLA-B gene lunokubangela ukusabela okukhulu kwesikhumba kwiyeza i-Abacavir (umz. iZiagen®).

Kwakhona, uhlobo oluthile kwi-CYP2B6 gene lunokunyusa umngcipheko weziphumo ebezingalindelekanga ezifana notshintsho lwe-neurological oluvela kwiyeza le-efavirenz (umz. iSustiva®).

Iingxaki zesistim somzimba

Ukuba uthatha i-immunosuppressant, ungazuza kuvavanyo lwe-pharmacogenomic:

• Ngenxa yokwahluka kweeproteni `TPMT` kunye `NUDT15`, umsebenzi womongo wethambo unokuncitshiswa ukuba uthatha iyeza `Azathioprine` (umz. `Imuran®`) emva kokufakelwa izintso okanye kwiimeko zenkqubo yomzimba yokuzikhusela ezifana ne-multiple sclerosis.
• Ngenxa yokwahluka kwe-enzyme ye-CYP3A5, ukuba uthatha i-tacrolimus (umz. iPrograf®) emva kokufakelwa ilungu, umngcipheko wokwaliwa kokufakelwa ilungu unokwanda.

Zithini iingenelo ze-pharmacogenomics?

Njengoko abaphandi kunye noogqirha beqhubeka nokufunda nokusebenzisa i-pharmacogenomics, oku kunokuvelisa iingenelo ezininzi. Jonga:

• Ukhuseleko oluphuculweyo: Oogqirha baya kukwazi ukuphepha ukunika amayeza abangela iziphumo ebezingalindelekanga eziyingozi kwabanye abantu, okanye anokubangela iingxaki xa esetyenziswa kakhulu. Oku kuthetha ukuba akuyi kufuneka ubandezeleke ngokungeyomfuneko.
• Ukusebenza kakuhle kunye neendleko eziphantsi zonyango: Ukuba oogqirha banokukwazi kwangaphambili ukuba ngawaphi amayeza asebenzayo nawaphi angasebenziyo, banokunika amayeza asebenzayo kuqala , okonga imali nexesha .
• Uphuhliso lwamayeza ekujoliswe kuwo: Ezinye izifo zibangelwa lutshintsho oluthile (utshintsho) kwijini. I-Pharmacogenomics ivumela abaphandi ukuba bafumane amayeza amatsha ngokujolisa ngqo kuloo mahluko wejini. Njengokwenza iyeza elifanelana nesifo.

Zithini izithintelo/iingxaki ze-pharmacogenomics?

Nangona ukwakheka kwemfuza yakho kubalulekile ekumiseleni unyango olufanelekileyo kwiimeko ezininzi, ayichazi ngokupheleleyo indlela umzimba wakho osebenza ngayo amayeza. Oogqirha kusafuneka baqwalasele ezinye izinto xa bekhetha amayeza afanelekileyo. Umzekelo:

• Amanye amayeza: Amayeza owasebenzisayo ngoku anokuphazamisana nokusebenza kakuhle kwamayeza amatsha.
• Ezinye iimeko zempilo: Ezinye izifo zinokutshintsha indlela umzimba wakho osebenzisa ngayo amayeza. Umzekelo, ukuba izintso zakho azisebenzi kakuhle, amanye amayeza aya kukhutshwa emzimbeni wakho.
• Indlela yokuphila: Izinto ezifana nokutya okutyayo, umthambo owufumanayo, kunye nokusebenzisa kwakho icuba kunye notywala kunokuchaphazela indlela amayeza akho angasebenzi kakuhle ngayo.

Eminye imingeni ekuphuhlisweni nasekusetyenzisweni kwe-pharmacogenomics ibandakanya:

• Ixabiso: Nangona ixabiso lovavanyo lwe-pharmacogenomic lihla kancinci kancinci, ixabiso lomntu ngamnye, okanye iindleko eziphuma epokothweni, zihlala zahluka ngokuxhomekeke kwi-inshorensi. Olu vavanyo lusenokungafumaneki kuwo wonke umntu.
• Ukufikeleleka:Ngokuxhomekeke kwindawo ohlala kuyo kunye nohlobo logqirha onyangayo, ukufikelela kwakho kwezinye iimvavanyo zemfuza kunokulinganiselwa.

Okwangoku, oogqirha banokusebenzisa i-pharmacogenomics kuphela kwiimeko ezimbalwa kunye namayeza. Nangona kunjalo, eli candelo linomdla 'lonyango oluchanekileyo' likhula ngokukhawuleza. Thetha nogqirha wakho malunga nendlela i-pharmacogenomics enokunceda ngayo impilo yakho kunye neenzuzo ezinokuzisa. Ungabuza nangezilingo zeklinikhi kweli candelo.

Ekugqibeleni, ekugqibeleni, khumbula oku.

Kulungile, ngoko ke, nangona igama elithi pharmacogenomics esilithethe namhlanje liyinkimbinkimbi kancinci, oko likuthethayo kukuba lisinceda sikhethe iyeza elisifaneleyo kwaye lineziphumo ebezingalindelekanga ezimbalwa, ngokusekelwe kwizakhi zofuzo zethu.

Izakhi zofuzo zethu zezona zizathu ziphambili zokuba amayeza afanayo angasebenzi ngendlela efanayo kubo bonke abantu. I-Pharmacogenomics yindlela yokuzama ukuqonda loo mfihlo nokusinika unyango oluqondene nawe kwaye olusebenzayo ngakumbi.

Nangona eli lisengummandla ophuhlisayo, linokuba luncedo kakhulu ekutshintsheni indlela eziphathwa ngayo izifo ezininzi kwixesha elizayo. Ukuba unemibuzo malunga nonyango oluthile, ingakumbi ukuba luza kukusebenzela okanye luza kubangela iziphumo ebezingalindelekanga, ungoyiki ukuthetha nogqirha wakho malunga nolu vavanyo lwe-pharmacogenomic. Lunokuba luncedo kakhulu kuwe.

Khumbula, ii-genes zakho ziyinxalenye ebalulekileyo yebali lakho lempilo. Ukutya okunempilo, ukuzilolonga, kunye nokulandela iingcebiso zikagqirha wakho zibaluleke ngokufanayo!

I- Pharmacogenomics, ii-genes, amayeza, amayeza, unyango oluchanekileyo, uvavanyo lwe-genetic, iziphumo ebezingalindelekanga