Uma sizwa igama elithi "umdlavuza," sonke siyathuthumela kancane. Liyigama elingathi sína kakhulu. Kodwa isayensi yezokwelapha isithuthuke kakhulu kunakuqala. Izindlela zokwelapha ezintsha ziyatholakala cishe nsuku zonke ukuze zelaphe futhi zilawule umdlavuza. Namuhla, sikhuluma ngokwelashwa okuguqule umhlaba wokwelashwa komdlavuza futhi kwaletha ithemba elisha kubantu abaningi. Lokho ukwelashwa nge-immunotherapy.
Ngakho-ke, kafushane nje, kuyini ukwelashwa nge-immunotherapy?
Cabanga nje ukuthi imizimba yethu ifana nezwe. Kukhona ibutho elinamandla kakhulu futhi elinamandla okuvikela leli lizwe. Sibiza leli butho ngokuthi amasosha omzimba . Amasosha akuleli butho (okungukuthi, amangqamuzana omzimba) aqapha imizimba yethu usuku lonke. Umsebenzi wawo ukuthola nokubhubhisa izitha ezivela ngaphandle (njengamagciwane namagciwane) kanye nabakhapheli abavela ngaphakathi (njengamangqamuzana omdlavuza).
Ngokuvamile, leli butho lihle kakhulu ekutholeni nasekubhubhiseni amangqamuzana omdlavuza. Kodwa ngezinye izikhathi, lawa mangqamuzana omdlavuza anobuqili obukhulu. Ayazifihla futhi azifihle emasosheni ethu. Noma, athumela izimpawu ezivimba amasosha ethu ekusebenzeni.
Yilapho-ke ukwelashwa nge-immunotherapy kungena khona. Kalula nje, ukwelashwa nge-immunotherapy inqubo yokunikeza amasosha omzimba wethu ukuqeqeshwa okukhethekile kanye namandla engeziwe okusisiza ekutholeni nasekubhubhiseni amangqamuzana omdlavuza afihliwe.
Lokhu kwelashwa kusebenza kanjani?
I-immunotherapy isiza amasosha omzimba wethu ngezindlela ezimbili eziyinhloko:
1. Ukuqeqesha amasosha omzimba: Sifundisa amasosha omzimba ethu ukuba aqaphele ngokunembile amangqamuzana omdlavuza afihliwe. Okusho ukuthi, asusa izifihla-buso emaseli omdlavuza bese ezibonisa ibutho, ethi, "Nasi isitha."
2. Ukwandisa ukukhiqizwa kwamangqamuzana abulala umdlavuza: Kusiza umzimba ukukhiqiza inani elikhulu lamangqamuzana omzimba (amasosha) alwa nomdlavuza. Khona-ke kulula ngebutho elikhulu ukunqoba impi kunelincane.
Lokhu kwelashwa manje sekusetshenziselwa ukwelashwa kokuqala kwezinhlobo eziningi zomdlavuza, ikakhulukazi kumdlavuza osakazekele kwezinye izingxenye zomzimba (i-metastatic). Ngezinye izikhathi kunikezwa kanye nezinye izindlela zokwelapha, njenge-chemotherapy.
Yiziphi izinhlobo eziyinhloko zokwelapha nge-immunotherapy?
Kunezinhlobo ezahlukene zokwelapha nge-immunotherapy, ngayinye esebenzisa izingxenye ezahlukene zesimiso sethu somzimba ukuhlasela umdlavuza.
1. Ama-Checkpoint Inhibitors
Isimiso sethu somzimba sokuzivikela siyinto enamandla kakhulu. Uma sidlula ngokweqile, singalimaza ngisho namaseli ethu aphilile. Yingakho imizimba yethu ngokwemvelo inesimiso "sezindawo zokuhlola" noma "sezinhlelo zokubhuleka". Lapho iseli lomzimba (isib. iseli le-T) selizohlasela iseli lomdlavuza, iseli lomdlavuza elinobuqili linyathela kule "bhuleka" bese likhubaza iseli lomzimba lomzimba.
Lokho okwenziwa umuthi obizwa ngokuthi i-Checkpoint Inhibitor ukukhulula "ibhuleki" elinyathelwe yiseli lomdlavuza. Khona-ke amasosha omzimba ethu angabuyela emsebenzini. Lokho kusho ukuthi angaqhubeka nokubhubhisa amangqamuzana omdlavuza.
Le ndlela yokwelapha isetshenziswa ezimweni zomdlavuza ezithuthukile kakhulu.
| Izinhlobo Zomdlavuza Ezisetshenziswa Kakhulu Kuma-Checkpoint Inhibitors | |
|---|---|
| Umdlavuza wesinye | Umdlavuza wezinso |
| Umdlavuza wesibeletho | Umdlavuza wesikhumba (i-Melanoma) |
| Umdlavuza we-Esophageal | Umdlavuza wamaphaphu (umdlavuza wamaphaphu ongeyona iseli elincane) |
| Umdlavuza wekhanda nentamo | Umdlavuza webele (umdlavuza webele one-triple negative) |
2. Ukwelashwa Kwamaseli Okutholwayo
Lokhu kufana nokukhipha amasosha ethu empini, ukuwathumela ekamu lokuqeqeshwa elikhethekile, ukuwanika amandla amakhulu, nokuwabuyisela empini. Lapha, odokotela bathatha amanye amangqamuzana akho omzimba (ama-T-cell) emzimbeni wakho bawakhulise elabhorethri.
- Ukwelashwa ngamaseli e-CAR T: Lapha, amaseli e-T aguqulwa ngofuzo elabhorethri ukuze abe "namehlo" akhethekile (ama-receptor) angabona amangqamuzana omdlavuza. Lawa maseli e-T anamandla amakhulu abe esenziwa ngobuningi futhi aphinde afakwe emzimbeni. Lawa aya ngqo kumaseli omdlavuza futhi abhubhise.
- Ukwelashwa ngama-lymphocyte angena ngesimila (TIL):Ngokuthatha amanye amangqamuzana omzimba (ama-TIL) angaphakathi noma azungeze isimila, siwakhulise ngobuningi elabhorethri, bese siwabuyisela emzimbeni, lawo maseli angalwa ngempumelelo nomdlavuza.
3. Ama-Antibodies e-Monoclonal
Ama-antibodies ayingxenye ebalulekile yesimiso sethu somzimba sokuzivikela. Anamathela kumaseli angaphandle futhi awaphawule ngokuthi "nasi isitha" ukuze amanye amaseli omzimba asibone. Ama-antibodies e-monoclonal angama-antibodies okwenziwa enziwe elebhu ahlose ngqo amaseli omdlavuza. Afana nemicibisholo eqondiswa yi-GPS. Angenza lokhu:
- Vimba amaprotheni adingekayo ekukhuleni kwamaseli omdlavuza.
- Zinamathela kumaseli omdlavuza futhi zitshele isimiso somzimba sokuzivikela ukuthi siwabhubhise.
- Hambisa izinto ezinobuthi noma ezinemisebe ngqo emangqamuzaneni omdlavuza (Ukulethwa okuqondiwe).
4. Imithi Yokugomela Umdlavuza
Lokhu akufani nemithi yokugoma esivame ukuyithola ukuze siyivikele ezifweni ezibangelwa amagciwane. Le mithi yokugoma inikezwa ngemva kokuba umdlavuza usuvele. Lo mgomo usebenzisa izingxenye zamaseli omdlavuza ukuqeqesha amasosha omzimba ethu ukuba aqaphele umdlavuza.
5. Ama-Modulator Esistimu Yokuzivikela Emzimbeni
Lezi yizidakamizwa ezivame ukukhulisa ukusebenza kwesimiso sethu somzimba. Isibonelo, amaprotheni afana ne-'Cytokines', 'Interferons' kanye ne-'Interleukins' akhiqizwa ngokwenziwa futhi anikezwa njengokwelashwa. Izidakamizwa ezifana ne-'Thalidomide' kanye ne-'Lenalidomide' nazo zingaphansi kwaleli qembu.
Ingabe ikhona imiphumela emibi kulokhu kwelashwa?
Yebo. Impela. Njenganoma yikuphi ukwelashwa komdlavuza, ukwelashwa nge-immunotherapy kunemiphumela emibi. Okwenzekayo lapha ukuthi amasosha omzimba ethu, asesebenze ngokweqile, ngezinye izikhathi aphazamisa amangqamuzana omdlavuza ngamaseli ethu aphilile futhi awahlasele nawo. Lokhu kubizwa ngokuthi 'imiphumela emibi ehlobene ne-immune (irAE)'.
Lokhu kufana nokuyohlasela isitha bese udubula abantu bakini ngengozi.
Imiphumela emibi evame kakhulu yile:
- Ukuzizwa ukhathele kakhulu (Ukukhathala)
- Ukuqhuma okubuhlungu
- Uhudo
- Isicanucanu nokuhlanza
- Izinkinga zama-hormone, njengamazinga aphansi ama-hormone e-thyroid.
Le miphumela emibi ivame ukuba mincane, kodwa ngezinye izikhathi ingaba mibi kakhulu. Ngakho-ke, kubalulekile ukwazisa udokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezingavamile.
Imibuzo ebalulekile okufanele uyibuze udokotela wakho
Uma wena noma othile emndenini wakho enconywa ukwelashwa nge-immunotherapy, kubalulekile ukucaca ngalokho okungena kukho. Ungesabi ukubuza udokotela wakho noma yimiphi imibuzo onayo. Nazi ezinye izibonelo:
- Uhlobo luni lwe-immunotherapy olunconywayo kimi?
- Ingabe ngizonikezwa ezinye izindlela zokwelapha (njenge-chemotherapy) kanye nalokhu kwelashwa?
- Ngiyithola kanjani le ndlela yokwelapha? Kuthatha isikhathi esingakanani? Kudingeka ngiyithathe kangaki?
- Yimiphi imiphumela emibi engaba khona yesikhashana neyesikhathi eside yalokhu? Ingalawulwa kanjani?
- Yimiphi imiphumela emibi okufanele ngikwazise ngayo ngokushesha uma ivela?
- Lokhu kwelashwa kuzothinta kanjani impilo yami yansuku zonke? Ngizokwazi yini ukuya emsebenzini nokuzivocavoca?
- Sazi kanjani ukuthi lokhu kwelashwa kuphumelele?
Umlayezo Wokuya Nawe Ekhaya
- I-immunotherapy iyindlela yokwelapha esezingeni eliphezulu futhi ephumelelayo esebenzisa amasosha omzimba wethu ukulwa nomdlavuza.
- Lokhu kuqeqesha amasosha omzimba ukuba aqaphele amangqamuzana omdlavuza futhi athuthukise amangqamuzana abulala umdlavuza.
- Kunezinhlobo ezahlukene zokwelapha nge-immunotherapy, njengezithibi zokuhlola kanye nokwelashwa ngamaseli e-CAR T. Udokotela wakho uzonquma ukwelashwa okufanele kakhulu ngokusekelwe ohlotsheni lomdlavuza wakho kanye nesigaba.
- Njengakuzo zonke izindlela zokwelapha, kunemiphumela emibi engaba khona, ngakho-ke kubalulekile ukwazisa udokotela wakho nganoma yiziphi izimpawu ezingavamile.
- Nakuba ukwelashwa nge-immunotherapy kungasebenzi ngokulinganayo kuwo wonke umdlavuza noma kuwo wonke umuntu onesifo, kuyimbangela entsha eye yaphakamisa amathemba amakhulu emkhakheni wokwelashwa komdlavuza.
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