Siyazi ukuthi kunzima kangakanani ukuphila nomdlavuza. Kodwa ngokuthuthuka kwesayensi yezokwelapha, izindlela zokwelapha umdlavuza zithuthuke kakhulu namuhla. Esikhundleni sokwelashwa ngamakhemikhali noma ngemisebe njengasesikhathini esidlule, manje sekukhona ukwelashwa okuqondile okuhlose futhi kuhlasele amangqamuzana omdlavuza kuphela. Ama-PARP inhibitors uhlobo lomuthi olulethe ithemba elisha emhlabeni wokwelashwa komdlavuza. Namuhla, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.
Kalula nje, ziyini lezi zithiyo ze-PARP?
Ukuze siqonde lokhu, ake siqale sicabange ngamaseli emzimbeni wethu. Wonke amaseli emzimbeni wethu aqukethe okuthile okubizwa ngokuthi i-DNA. Le DNA ifana 'nohlelo olukhulu' oluqukethe yonke imiyalelo iseli eliyidingayo ukuze lisebenze. Ngezinye izikhathi le DNA ingonakala. Uma yonakala, umzimba wethu unendlela ekhethekile yokuyilungisa.
Omunye wabadlali ababalulekile kule nqubo yokulungisa iphrotheni ebizwa ngokuthi i-PARP. I-PARP imele i-Poly (ADP-ribose) polymerase. Nakuba igama lizwakala liyinkimbinkimbi, umsebenzi walo ulula: Uma kukhona ukuphuka noma ukuphuka ku-DNA, iphrotheni ye-PARP iyangena iyilungise. Lokhu kubalulekile kumaseli anempilo.
Kodwa nansi inkinga. Amaseli omdlavuza nawo asebenzisa le phrotheni ye-PARP ukuze azuze. Lapho amaseli omdlavuza ehlukana ngokushesha, i-DNA yawo iyalimala. Ngemuva kwalokho iseli lomdlavuza lisebenzisa le 'bass' ye-PARP ukulungisa i-DNA yalo, likhule kakhulu, futhi liqale ukusabalala emzimbeni wonke.
Ama-inhibitor e-PARP asebenza ngokuvimba i-'bass' ye-PARP ukuthi isebenze. Ukuze kube sobala, avimbela iphrotheni ye-PARP ekulungiseni i-DNA. Lokhu kuvimbela iseli lomdlavuza ekulungiseni i-DNA yalo, futhi ekugcineni iseli liyafa.
Lokhu kubizwa nangokuthi ukwelashwa okuqondiwe , ngoba le mithi ihlasela futhi ihlasele ubuthakathaka bamangqamuzana omdlavuza kunamaseli aphilile avamile.
Yiziphi izinhlobo zomdlavuza ezisetshenziswa yile mithi?
Imithi yokuvimbela i-PARP ivame ukusetshenziselwa umdlavuza othuthuke kakhulu noma osakazeke kakhulu. Kodwa-ke, ayinikezwa yonke imidlavuza. Isebenza kahle kakhulu kumdlavuza ohlotshaniswa nokuguqulwa kwezakhi zofuzo ezithile.
Ubudlelwano phakathi kwe-BRCA gene kanye ne-PARP inhibitors
Kukhona izakhi zofuzo ezivikelayo emzimbeni wethu ezivimbela ukwakheka kwezimila ezinomdlavuza. Enye yeziyinhloko izakhi zofuzo ze-BRCA . Omunye wemisebenzi yalesi sakhi sofuzo se-BRCA ukulungisa umonakalo ku-DNA. Lokhu kusho ukuthi kunezinhlelo ezimbili eziyinhloko zokulungisa i-DNA emaseli ethu: enye yi-PARP, kanti enye yi-BRCA.
Ake ucabange nje, umuntu uzalwa ene-mutation ku-BRCA gene.Lokho kusho ukuthi enye yezinhlelo zakhe zokulungisa i-DNA isivele ibuthakathaka. Khona-ke iseli lakhe lomdlavuza cishe lincike ngokuphelele kulolo hlelo lwe-PARP ukulungisa i-DNA.
Ngakho-ke kwenzekani uma sinikeza umuntu onjalo i-PARP inhibitor? Ngaphezu kohlelo lwe-BRCA oluvele luphukile, simisa nohlelo lwe-PARP olwalusebenza kahle. Khona-ke iseli lomdlavuza alinandlela yokulungisa i-DNA yalo. Ngenxa yalokhu 'kushaya kabili', iseli lomdlavuza liyabhujiswa kalula kakhulu.
Ngakho-ke, ama-PARP inhibitors ayindlela yokwelapha ephumelela kakhulu yomdlavuza onezinguquko zezakhi zofuzo ze-BRCA.
| Izinhlobo eziyinhloko zomdlavuza eziphathwa ngezithibi ze-PARP |
|---|
| Umdlavuza webele |
| Umdlavuza wesibeletho |
| Umdlavuza we-Fallopian tube |
| Umdlavuza we-prostate |
| Umdlavuza we-pancreatic |
| Umdlavuza oyinhloko we-peritoneal |
Lokhu kwelashwa kunikezwa kanjani futhi isikhathi esingakanani?
Enye inzuzo yalokhu kwelashwa ukuthi akudingeki ukuthi kunikezwe njengomjovo. Zonke lezi zithibi ze-PARP ziza ngesimo samaphilisi noma ama-capsule. Ngokuvamile zinqunyelwe ukuthi zithathwe kanye noma kabili ngosuku.
Ngezinye izikhathi, kuye ngohlobo lomdlavuza onalo, lo muthi unganikezwa njengokwelashwa kuphela. Noma, unganikezwa kanye nezinye izindlela zokwelapha, njenge-chemotherapy. Isibonelo, ngemva kokuba umuntu enikezwe i-chemotherapy namaseli omdlavuza onakele, lo muthi wokuvimbela i-PARP uyaqalwa. Bese, uqeda ngokuphelele ithuba lokuthi lawo maseli omdlavuza onakele azilungise.
Isikhathi sokwelashwa siyahlukahluka kuye ngomuntu nomuntu. Kwabanye, lo muthi unikezwa isikhathi esithile, njengeminyaka emibili kuya kwemithathu ngemva kokuphela kwe-chemotherapy. Kwabanye, uyaqhubeka uma nje umuthi usebenza, okusho ukuthi umdlavuza usulawulwa. Isinqumo esingcono kakhulu ngalokhu ukukhuluma nodokotela wakho bese ulinganisa izinzuzo zokwelashwa nemiphumela emibi engaba khona.
Izinzuzo kanye nemiphumela engemihle engaba khona yalokhu kwelashwa
Ama-PARP inhibitors angase angawelaphi ngokuphelele umdlavuza. Kodwa-ke, inzuzo yawo enkulu ukuthi andisa "ukusinda okungenalo inqubekela phambili." Kalula nje, le mithi isiza ukulawula umdlavuza futhi iwugcine ulawulwa isikhathi eside. Lokhu kusho ukuthi isiguli sinesikhathi esiningi sokuphila impilo enempilo ngaphandle kokuba isifo sibe sibi kakhulu .
Njenganoma yikuphi ukwelashwa komdlavuza, lokhu kungabangela imiphumela emibi, kodwa akuwona wonke umuntu oyitholayo.
| Imiphumela emibi evamile yezithibi ze-PARP | |
|---|---|
| Ukungakhululeki ngokomzimba |
|
| Izinguquko ekuhlolweni kwegazi | |
| Izingozi ezingavamile kodwa ezinkulu | |
Kufanele ushayele nini udokotela ucingo ngokushesha?
Kubaluleke kakhulu ukuhlala useduze nodokotela wakho phakathi nalolu hlobo lokwelashwa. Uma uthola noma yiziphi izimpawu ezintsha noma uma noma yiziphi izimpawu zakho ezikhona ziba zimbi kakhulu, yazisa udokotela wakho ngokushesha. Angase akwazi ukulungisa umthamo wakho noma akunikeze eminye imithi ukusiza ngemiphumela emibi efana nokucasuka.
Uma uhlangabezana nezimpawu ezilandelayo, shayela udokotela wakho ngokushesha :
- Izimpawu zokutheleleka: umkhuhlane, ukubanda, kanye nokuthuthumela.
- Izimpawu zokutheleleka kwamaphaphu (i-Pneumonitis): Ubunzima bokuphefumula, umuzwa wokuqina esifubeni, noma ukuphefumula kanzima.
- Izimpawu zokuqhekeka kwegazi: ukuvuvukala okungazelelwe, ukubomvu, kanye nobuhlungu emlenzeni, noma ubuhlungu besifuba obungazelelwe kanye nobunzima bokuphefumula.
Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezinzima, kufanele ushayele udokotela wakho ucingo ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
Umlayezo Wokuya Nawe Ekhaya
- Ama-inhibitor e-PARP awuhlobo 'lokwelashwa okuqondiwe' okuvimba amangqamuzana omdlavuza ekulungiseni i-DNA yawo futhi awabhubhise.
- Lokhu kusebenza kakhulu ezimweni ezifana nomdlavuza webele, wesibeletho, kanye nomdlavuza we-prostate onezinguquko zezakhi zofuzo ze-BRCA.
- Lokhu kwelashwa kunikezwa njengamaphilisi noma ama-capsule futhi kusiza ukulawula ukukhula komdlavuza futhi kwandise isikhathi ongahlala uphilile ngaso.
- Njengakwezinye izindlela zokwelapha, imiphumela emibi ingenzeka, ngakho-ke kubalulekile ukusebenzisana eduze nodokotela wakho phakathi nesikhathi sokwelashwa.
- Udokotela wakho uzonquma ukuthi ukwelashwa kwe-PARP inhibitor kukufanele yini, ecabangela isimo sakho sezokwelapha, imiphumela yokuhlolwa kwezakhi zofuzo, kanye nempilo iyonke.
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