Ngaba iyeza elifanayo liyasebenza kuye wonke umntu? Masithethe ngekamva leyeza: I-Precision Medicine!

Ngaba wakha wazibuza ukuba kutheni amayeza afanayo kunye neendlela zonyango zingasebenzi kuzo zonke izifo nakumntu wonke? Ngamanye amaxesha amayeza owanika umhlobo wakho wesifo esifanayo asenokungasebenzi kuwe. Yiyo loo nto ihlabathi lithetha ngale ndlela intsha yezonyango njengesisombululo. Oku kubizwa ngokuba yi-'Precision Medicine' okanye ``(Precision Medicine)''. Makhe sithethe ngale nto ngokweenkcukacha namhlanje.

Yintoni iPrecision Medicine?

Ngamafutshane, olu lunyango olufanelekileyo kuwe, olukhethekileyo kuwe. Khawucinge nje, izakhi zofuzo zakho, indawo ohlala kuyo, indlela ophila ngayo – le yindlela entsha yokuthatha ulwazi ngazo zonke ezi zinto nokuzisebenzisa ukukunika unyango olungcono. Ngale ndlela, izazinzulu noogqirha banokuxela kwangaphambili ukuba loluphi uhlobo lweendlela zokuthintela izifo, loluphi uhlobo lweyeza, kunye nohlobo luni lweqela oluya kufaneleka. Oku kukwabizwa ngokuba 'yiyeza elenzelwe wena'.

Ngokwesiqhelo, sibona ukuba oogqirha badla ngokuceba unyango ngendlela elungele 'umntu oqhelekileyo'. Oko kukuthi, indlela 'efanele bonke'. Kule nto, abacingi kakhulu ngomahluko omncinci phakathi kwabantu. Ngoko ke, le ndlela isebenza kakuhle kwabanye abantu, kwezinye izifo. Kodwa, kwabanye abantu, kwezinye izifo, ayisebenzi konke konke. Eso sisisombululo sale nto, esibizwa ngokuba yi-'(Precision Medicine)'. Oku kubandakanya ukukhetha unyango olufanela umzimba wakho, ii-genes zakho, kunye nendlela yakho yokuphila.

Yintoni le Precision Medicine Initiative?

Le yinkqubo ebaluleke kakhulu, ekhethekileyo eqalwe yiNational Institutes of Health (NIH) eMelika - oko kukuthi, elona ziko likhulu apho eliphanda ngezifo kwaye lisebenza ukuphucula impilo - kunye nezinye iziko zophando ezidumileyo kwihlabathi liphela. Eyona mizamo yabo inkulu kukufumanisa ukuba zeziphi iindlela ezilungileyo zokusebenzisa izinto ezifana nejini zakho, indawo ohlala kuyo, kunye nendlela ophila ngayo ukunyanga nokuthintela izifo.

Eli phulo "lePrecision Medicine Initiative" lineenjongo zexesha elifutshane nezexesha elide.

• " Injongo yexesha elifutshane kukuzisa le ngcamango ye"Precision Medicine" kuphando lomhlaza. Izazinzulu kwi-US National Cancer Institute zifuna ukuqonda ngakumbi ibhayoloji kunye nemfuza yomhlaza kwaye ziphuhlise unyango olutsha nolusebenzayo. Khawuthelekelele, xa umhlaza uvela, ukuba uyazi kakuhle ukuba loluphi uhlobo lomhlaza kwaye loluphi utshintsho lwemfuza olubangele ukuba ube nalo, ungamnika iyeza elisebenza kuwo, akunjalo?"
• " Injongo yexesha elide""Oku kumalunga nokwandisa le `(Precision Medicine)` kuzo zonke iinkalo zezempilo. Ngenxa yesi sizathu, i-`(NIH)` iqalise inkqubo yophando ekhethekileyo ebizwa ngokuba yi-`(All of Us Research Program)`. Ngolu phando, baqokelela ulwazi kwiqela elikhulu labantu abanemvelaphi eyahlukeneyo yemfuza kunye neendlela zokuphila, kwaye besebenzisa loo datha, bazama ukufumana indlela yokwenza ukhathalelo lwempilo lube ngcono kuye wonke umntu."

Zeziphi izibonelelo esizifumanayo kwiPrecision Medicine?

Le ndlela "yePrecision Medicine" ingayiphucula impilo yakho kunye nonyango olufumanayo ngeendlela ezininzi. Jonga ezi zibonelelo:

• Ugqirha wakho angasebenzisa ulwazi lwakho lwemfuza ukunceda ngonyango lwemihla ngemihla. Khawuthelekelele indlela olunokuba luncedo ngayo olo lwazi! Umzekelo, amanye amayeza anokubangela iziphumo ebezingalindelekanga kubantu abanemfuza ethile. Ukwazi ulwazi lwakho lwemfuza kunokukunceda uphephe ukusebenzisa loo mayeza.
• Sifumana ukuqonda okungcono ngesizathu sokuba izifo zivele. Oku kuthetha ukuba endaweni yokunyanga iimpawu, sinokunyanga unobangela wesifo.
• Ungazibona kwangaphambili ukuba zeziphi iindlela zonyango ezifanelekileyo kuwe . Emva koko unganciphisa ukusetyenziswa kwamayeza angeyomfuneko kunye nemiphumo emibi. Wonga ixesha nemali.
• Kukho iindlela eziphucukileyo zokuthintela, ukuxilonga, kunye nokunyanga izifo. Kunokwenzeka nokufumanisa ukuba kukho utyekelo lwemfuza kwezinye izifo ngaphambi kokuba zikhule.
• Iirekhodi zakho zempilo ze-elektroniki (ii-EHR) – iirekhodi zezifo zakho, amayeza, kunye novavanyo olugcinwe kwinkqubo yekhompyutha – ziya kufumaneka lula. Oku kuya kwenza kube lula koogqirha ukufikelela kulwazi lwakho lwezonyango baze bacebe unyango.

Isetyenziswa phi iPrecision Medicine ngoku?

Oogqirha sele besebenzisa le ndlela ethi "Precision Medicine" kwiindawo ezininzi zonyango. Nangona isekwinqanaba lokuqala, iziphumo ziyakhuthaza kakhulu. Nazi imizekelo embalwa:

• I-oncology echanekileyo
• Unyango lwe-immunotherapy yomhlaza
• I-Pharmacogenomics
• Izifo ezingaqhelekanga

Ngaba singathetha ngayo nganye kwezi nkcukacha zibanzi? Emva koko uya kuqonda ukubaluleka kwayo ngcono.

Yintoni i-precision oncology?

Oogqirha badla ngokuhlela umhlaza ngokwenxalenye yomzimba okuyo (umz. umhlaza wemiphunga, umhlaza webele) okanye uhlobo lwezicubu (umz. i-lymphoma). Kodwa ngale "Precision Medicine", ngoku bafumana imiqondiso yeminwe yeemolekyuli zeentlobo ezahlukeneyo zomhlaza.Oko kukuthi, njengeminwe yethu, sichonga iipateni ezincinci zeekhemikhali kunye notshintsho lwemfuza olukhethekileyo kumhlaza ngamnye. Sisebenzisa ezi mpawu, umhlaza wahlulwahlulwa ube ziintlobo kunye neentlobo ezahlukeneyo.

Abaphandi bafumanise ukuba umhlaza okhula kwiindawo ezahlukeneyo zomzimba unokuba nezinto ezininzi ezifanayo kwinqanaba leemolekyuli. Ngoko ke, le "Precision oncology" ivumela oogqirha ukuba bakhethe unyango olusekelwe "kwisiginitsha yeDNA" yomhlaza womntu. Oku kuthetha ukuba endaweni yokunika wonke umntu amayeza afanayo, banokunika unyango olulungiselelwe ngokukodwa loo mhlaza, olo tshintsho lwemfuza. Oku kwenza unyango lube nempumelelo kakhulu.

Yintoni unyango lwe-immunotherapy yomhlaza?

Ubusazi na ukuba inkqubo yomzimba wakho yokuzikhusela inokuthintela ukukhula kwezinye iintlobo zomhlaza? Oku kungenxa yokuba inamandla ngokwemvelo okubona nokutshabalalisa iiseli ezingaqhelekanga. Nangona kunjalo, ngamanye amaxesha iiseli zomhlaza zinobuqili kangangokuba ziyayiphepha le nkqubo yokuzikhusela, zizimele, kwaye zikhule.

Kodwa, ngale ndlela ibizwa ngokuba yi-"Cancer immunotherapy", izazinzulu ngoku zikhohlisa iiseli zomhlaza! Uyazi ukuba zingayenza njani? Ungasebenzisa inkqubo yakho yomzimba ukulawula umhlaza, kwaye ngamanye amaxesha ude uwunyange ngokupheleleyo. Oku kuyamangalisa ngokwenene, akunjalo?

Ezi ntlobo zamayeza "onyango lomhlaza" zinokulinganisa ukusebenza kweemolekyuli zendalo zomzimba wakho, okanye zide ziqinise. Ezi ntlobo zamayeza ziquka:

• Ii-antibodies ezilwa nomhlaza zibopha kwiiseli zomhlaza zize zizitshabalalise.
• Iindlela zokuthatha iiseli zakho zomzimba, "uzigcwalise" kwilebhu, kwaye uzibuyisele emzimbeni wakho.
• Iigonyo zonyango ziigonyo ezikhethekileyo ezifundisa amajoni akho omzimba ukuba ahlasele iiseli zomhlaza.

Yintoni i-Pharmacogenomics?

Le yingongoma enzulu kancinci, kodwa ibaluleke kakhulu. I-Pharmacogenomics luphando lwendlela i-DNA yakho ephendula ngayo kumayeza owasebenzisayo. Eli candelo lidibanisa i-pharmacology - uphando lwamayeza - kunye ne-genomics - uphando lwe-genes - ukudala amayeza akhuselekileyo, asebenzayo kunye needosi ezilungiselelwe utshintsho oluthile kwi-genes yakho.

Ngamafutshane, injongo ye-"Pharmacogenomics" kukuyeka indlela ethi "ubungakanani obufanayo bufanele bonke". Abaphandi ngoku bayazi ukuba kukho izinto ezininzi ezichaphazela indlela umzimba wakho osabela ngayo kumayeza ahlukeneyo. Asikuko nje ubudala bakho, isini, okanye ubungakanani bomzimba wakho. Izakhi zakho zofuzo nazo zidlala indima enkulu koku. I-"Precision Medicine" izama ukukunika amayeza afanelekileyo, ngedosi efanelekileyo, emzimbeni wakho. Emva koko amayeza aya kusebenza ngokufanelekileyo kwaye abe nemiphumo emibi embalwa.

Izifo ezingaqhelekanga kunye namayeza achanekileyo

Ngokutsho kwabaphandi, malunga nezigidi ezingama-25-30 zabantu eMelika kuphela banengxaki yeemeko ezingaqhelekanga zemfuza. Kukho nezigulana ezinjalo eSri Lanka. Ukuchonga nokunyanga ezi zifo kunzima kakhulu. Amakhulu eengxaki zonyango ezintsonkothileyo kangaka afundwe nge-'Undiagnosed Disease Programme' kwi-(NIH). Ngolu phando, baye bakwazi ukufumanisa izifo ezininzi ezinjalo. Ngophuhliso lwetekhnoloji yemfuza, kuye kwenzeka ukuchonga iziphene zemfuza ezibangela ezi zifo zingaqhelekanga.

I-NIH ngoku iyandise le nkqubo kwamanye amaziko aliqela kulo lonke ilizwe ukuze ifunde ngezifo ezingaphezulu. Basebenzisana namanye amaqabane amaninzi ukuze baphuhlise ngokukhawuleza unyango olusebenzayo lwezi zifo zingaqhelekanga. I-Precision Medicine lithemba elikhulu kubantu abanjalo.

Yintoni umahluko phakathi kwe-'Precision Medicine' kunye ne-'Personalized Medicine'?

Ngokutsho kwe-US National Research Council, 'i-Personalized Medicine' ligama elidala elisetyenziselwa ukubhekisa kwi-'Precision Medicine'. Oko kukuthi, la magama mabini athetha into enye.

Nangona kunjalo, ibhunga liye laxhalaba kancinci kukuba xa abantu besithi 'ngokwenzelwe umntu', bacinga ukuba umntu ngamnye uza kufumana unyango olwahlukileyo nolwenzelwe wena. Nangona kunjalo, ingqwalasela ye-"Precision Medicine" ayikuko kuwe kuphela. Endaweni yoko, imalunga nokufumana ukuba loluphi unyango olusebenza kakuhle kumaqela abantu - oko kukuthi, abanye abaneempawu zemfuza kunye nendlela yokuphila efana neyakho. Ngoku, i-"Precision Medicine" lelona gama lisetyenziswa kakhulu kwaye lithathwa njengelifanelekileyo. Nangona kunjalo, abantu basasebenzisa la magama mabini ngokutshintshana. Into ebalulekileyo kukuba le ndlela izama ukubonelela ngonyango oluchanekileyo nolusebenzayo, endaweni yokuphatha wonke umntu ngendlela efanayo.

Yeyiphi eyona nto ibalulekileyo esifuna ukuyithatha kweli bali?

Izakhi zofuzo zakho, indawo ohlala kuyo, indlela ophila ngayo – zonke ezi zinto zichaphazela impilo yakho. Injongo ephambili ye-precision medicine kukufunda zonke ezi zinto uze emva koko uthathe inyathelo lokukhusela nokukunceda. Emva koko, endaweni yokunika wonke umntu unyango olufanayo, oogqirha bakho banokwenza isicwangciso sokuthintela nokunyanga izifo ezifanelekileyo kuwe. Oogqirha sele besebenzisa i-precision medicine kwiindawo ezininzi zonyango. Kodwa, kukho amathuba amaninzi okuba oku kuya kutshintsha ishishini lezempilo kwixesha elizayo kangangokuba kunzima ukulicinga. Ngoko ke, eli lithemba elikhulu ngekamva lethu lezempilo!

"Khumbula, i-"Precision Medicine" ayikokudala iyeza elikhethekileyo lomntu wonke, kodwa kukukhetha unyango olufanelekileyo nolusebenzayo kwiqela labantu abaneempawu ezifanayo nezakho."

Njengoko obu buchwepheshe buqhubeka buhambela phambili, siya kukwazi ukulwa ngempumelelo nezinye izifo ezininzi. Ngoko ke, kubaluleke kakhulu ukuhlala unolwazi ngezinto ezintsha ezifana nale.

Unyango oluchanekileyo , i-Genetics, Unyango lomhlaza, Unyango olulungiselelwe wena, Unyango lwexesha elizayo, iTekhnoloji yezeMpilo