Ake sifunde ngama-Antibody-Drug Conjugates (ama-ADC) - 'isibhamu somlingo' esithola amangqamuzana omdlavuza futhi sinikeze imithi?

Uma sithi "umdlavuza", igama lokuqala elifika engqondweni yi-"chemotherapy". Abantu abaningi bayesaba lokhu kwelashwa ngoba kubangela ukulahlekelwa izinwele futhi kubuhlungu. Kodwa-ke, ngokuthuthuka kwesayensi yezokwelapha, kuye kwaziswa izindlela ezintsha emhlabeni ezingahlasela amangqamuzana omdlavuza kuphela futhi zinciphise kakhulu umonakalo kumaseli anempilo. Namuhla, sizokhuluma ngendlela yokwelapha eye yenza intuthuko enkulu ezweni lokwelashwa komdlavuza, futhi esebenza 'njengesikhali somlingo'. Lokho yi-Antibody-Drug Conjugates, noma ama-ADC njengoba siwabiza ngamafuphi.

Kalula nje, iyini le Antibody-Drug Conjugate (ADC)?

Cabanga nje, udinga ukuhambisa iphasela kumuntu oyedwa endaweni egcwele abantu. Kungaba lula kangakanani ukuthola lowo muntu bese uletha iphasela esikhundleni sokulihambisa kuwo wonke umuntu? Yilokho okwenziwa yi-ADC.

I-ADC iyinhlanganisela yezingxenye ezintathu. Uma sikhuluma iqiniso, ifana 'nebhomu elihlakaniphile' elenziwe ngobuchwepheshe.

1. I-Antibody: Lena 'i-ejenti yethu yokuhlonza'. Kukhona amaprotheni akhethekile (esiwabiza ngokuthi "ama-antigen e-tumor") atholakala kuphela ebusweni bamangqamuzana omdlavuza. Le antibody yenzelwe ukuhamba inamathele kumaprotheni akulawo maseli omdlavuza. Ifana nesihluthulelo esifanelana nokukhiya kwayo okuhambisanayo. Njengoba amangqamuzana anempilo engenawo lawa maprotheni, le antibody ayinamatheli kuwo. Ngenxa yokuthi lawa enziwe ngokukhethekile emalabhorethri, siwabiza nangokuthi "i-Monoclonal Antibody".

2. Umuthi we-Chemotherapy: Yilokhu okungaphakathi kwalelo phakethe. Usebenzisa umuthi onamandla kakhulu wokulwa nomdlavuza kunalowo onikezwa ku-chemotherapy ejwayelekile. Ngenxa yokuthi uya ngqo engqamuzaneni lomdlavuza, unganikeza umuthi onamandla ngaphandle kokulimaza amangqamuzana aphilile ngaphandle.

3. I-Linker: Lena 'i-gum' ebamba i-spy (Antibody) kanye nebhomu (i-Chemo drug). Umsebenzi walesi sixhumi ukuvimbela umuthi ukuthi ungakhishwa kuze kube yilapho i-antibody ithola iseli lomdlavuza bese ingena kulo. Kuphela ngemva kokuba iseli lomdlavuza selingene lapho lesi sixhumi siphuka khona, sikhulule umuthi.

Isebenza kanjani le 'missile yezinto eziphilayo'?

Le nqubo iyathakazelisa kakhulu. Ake sibone ukuthi kwenzekani isinyathelo ngesinyathelo.

• Isinyathelo 1: Umuthi we-ADC ufakwa emthanjeni wesiguli ngesisombululo sikasawoti.
• Isinyathelo 2: Lo muthi uhamba emzimbeni wonke ngegazi. Kodwa-ke, njengoba uhamba, ingxenye ye-antibody isebenza njenge-GPS, ithola ukuthi amangqamuzana omdlavuza akuphi.
• Isinyathelo 3: Uma selitholakale iseli lomdlavuza, i-antibody iyahamba bese 'ivala' iphrotheni ethile (i-antigen) ebusweni balelo seli.
• Isinyathelo 4: Uma selivalelwe kanje, iseli lomdlavuza licabanga ukuthi lokhu kuyinto eliyifunayo. Ngakho lidonsa lonke leli phakethe le-ADC ngaphakathi kwalo.
• Isinyathelo 5: Uma sesingaphakathi kweseli lomdlavuza, ama-enzyme angaphakathi ayaphula leso 'sixhumanisi'.
• Isinyathelo 6: Njengoba i-linker iphuka, umuthi we-chemotherapy onamandla kakhulu owawuboshelwe kuwo ukhishwa ngaphakathi kweseli lomdlavuza.
• Isinyathelo 7: Ngenxa yamandla alo muthi, iseli lomdlavuza liyabhujiswa ngaphakathi.

Yiziphi izinhlobo zomdlavuza eziphathwa nge-ADC?

I-ADC akuyona indlela yokwelapha zonke izinhlobo zomdlavuza. Njengamanje, odokotela babheka lokhu kwelashwa kwezinhlobo ezithile zomdlavuza, ikakhulukazi lapho ezinye izindlela zokwelapha zehlulekile (`(umdlavuza ongaphikisi)`), umdlavuza usubuyile (`(uyabuya)`), noma ususakazekele kwezinye izingxenye zomzimba (`(ukusabalala kwe-metastasize)`).

Ake sichaze lokhu kabanzi kuthebula elingezansi.

Imithi eminingana ye-ADC esetshenziswa emhlabeni

Sekuvele kunemithi engaphezu kweshumi nambili ye-ADC evunyelwe yizikhungo ezifana ne-FDA e-United States. Ezinye izibonelo yilezi:

• I-Brentuximab vedotin (i-Adcetris®): Isetshenziselwa umdlavuza wegazi njenge-Hodgkin lymphoma.
• I-Trastuzumab emtansine (Kadcyla®): Isetshenziselwa umdlavuza webele one-HER2-positive osakazeke emzimbeni wonke.
• I-Sacituzumab govitecan (Trodelvy®): Isetshenziselwa umdlavuza webele onemiphumela emithathu kanye nomdlavuza wesinye.

Ingabe azikho yini imiphumela emibi yalokhu kwelashwa?

Nakuba kuthiwa "ukulimaza amangqamuzana aphilile kuncane kakhulu", lokhu akusho ukuthi azikho imiphumela emibi yalokhu kwelashwa. Kodwa-ke, uma kuqhathaniswa nokwelashwa ngamakhemikhali okuvamile, lokhu kuvame ukulawuleka. Imiphumela emibi eyenzeka ingahluka kuye ngesiguli, kuye ngohlobo lomdlavuza, isigaba sawo, kanye nempilo yesiguli iyonke.

Ithimba lakho le-oncology lizokuqapha eduze phakathi nokwelashwa kwakho. Uma kuvela noma yimiphi imiphumela emibi, lizokunikeza ukwelashwa okusheshayo.

Imiphumela emibi evamile:

• Ukukhathala
• Isicanucanu nokuhlanza
• I-anemia
• I-Leukopenia (inani eliphansi lamaseli amhlophe egazi)
• Inani eliphansi lamaplatelet egazini (`(Thrombocytopenia)`)
• I-Anorexia
• Ukuqunjelwa noma isifo sohudo
• Ikhanda elibuhlungu, umkhuhlane
• I-peripheral neuropathy - ukungazweli kanye nokuthuthumela emilenzeni
• Ukuqhuma kwesikhumba

Kubaluleke kakhulu ukwazisa udokotela wakho ngokushesha nganoma yiziphi zalezi zinto, noma ngabe zincane.

Singaba nethemba ngalokhu kwelashwa?

Yebo, impela. I-ADC iyindlela yokwelapha eyilethe ithemba elisha ezigulini eziningi zomdlavuza. Ucwaningo lukhombisile ukuthi iziguli ezithola ukwelashwa kwe-ADC ziphila isikhathi eside kunalezo ezithola ukwelashwa ngamakhemikhali okuvamile kuphela.

Futhi lo mkhakha uthuthuka ngokushesha okukhulu. Okwamanje, kuqhutshwa izivivinyo zemitholampilo ezingaphezu kwe-100 emhlabeni jikelele. Ososayensi bazama ukuthuthukisa ama-ADC asebenza kahle kakhulu futhi anemiphumela emibi embalwa ezinhlotsheni eziningi zomdlavuza. Ngakho-ke, singathemba ukuthi esikhathini esizayo, sizokwazi ukuthola lo kwelashwa 'omlingo' kwezinhlobo eziningi zomdlavuza.