Wake wanikezwa umuthi ngudokotela, kodwa awusebenzanga kuwe, yize wawusebenza kumngane? Noma wake waba nemiphumela emibi etholwa nguwe kuphela emithini ethile abanye abangayenzi? Kungenzeka ukuthi uke wazibuza, "Kungani lo muthi ungangisebenzeli mina?" Wake wacabanga ukuthi isizathu salokhu kungaba izakhi zofuzo zakho? Akumangalisi yini? Yebo, lawa ma-gene amancane angaphakathi emizimbeni yethu angashintsha ngokuphelele indlela umuthi esiwuthathayo osebenza ngayo. Namuhla sikhuluma ngomunye wemikhakha yezokwelapha emisha nebaluleke kakhulu. Leyo yi-Pharmacogenomics.
Kalula nje, iyini i-Pharmacogenomics?
Leli gama lide kancane futhi libonakala linzima, akunjalo? Kodwa ake silichaze. Khona-ke kulula kakhulu. Lakhiwe ngamagama amabili ehlanganisiwe.
1. I-Pharmacology: Lokhu kubhekisela ocwaningweni lwezokwelapha . Okusho ukuthi, umuthi usetshenziswa kanjani, ukuthi wenzani emzimbeni, nokuthi iyini imiphumela yawo.
2. I-Genomics: Lokhu kubhekisela ekufundweni kwezakhi zofuzo kanye nomsebenzi wazo .
Ngakho-ke uma lokhu kokubili kuhlangana, i-Pharmacogenomics iwucwaningo lokuthi izakhi zethu zofuzo zisabela kanjani emithini esiyithathayo. Kalula nje, kumayelana nokuthola ukuthi umuthi owunikezwayo uzosebenza kahle kangakanani, noma ukuthi ungabangela yini imiphumela emibi, ngokusekelwe kukwakheka kwezakhi zofuzo zakho.
Lokhu kungokwensimu entsha yezokwelapha ebizwa ngokuthi "iPrecision Medicine." Kusho "umuthi othize." Esikhundleni sokunikeza wonke umuntu umuthi ofanayo, kucatshangelwa izici ezifana nezakhi zofuzo zakho, indlela yakho yokuphila, kanye nendawo ohlala kuyo, bese ukhetha ukwelashwa okukufanele ngqo . Cabanga ngakho njengokuya esitolo uyothenga ingubo enobukhulu obufanayo bawo wonke umuntu, esikhundleni sokuya kumthungi bese wenzelwa ingubo ngokwezilinganiso zakho. Lokhu kuyafana.
Njengamanje, le ndlela isetshenziselwa inani elilinganiselwe lezifo nemithi. Isibonelo, lobu buchwepheshe busetshenziselwa i-HIV, ezinye izinhlobo zomdlavuza, ukucindezeleka, kanye neminye imithi yesifo senhliziyo. Kodwa lo mkhakha uthuthuka ngokushesha okukhulu. Abacwaningi bakholelwa ukuthi esikhathini esifushane, i-pharmacogenomics izosiza odokotela ukukhetha imithi efaneleka kakhulu ngisho nezifo ezivame kakhulu.
Izakhi zethu zofuzo zithinta kanjani imithi?
Ukuze siqonde lokhu, sidinga kuqala ukubheka ukuthi izakhi zofuzo zenzani emizimbeni yethu. Cabanga ngezakhi zofuzo zethu njengencwadi yemiyalelo ephelele yokwakha nokusebenza kwemizimba yethu. Amaseli emizimbeni yethu asebenza ngokwemiyalelo ekule ncwadi yemiyalelo.
Into eyinhloko okufanele yenziwe ngale miyalelo ama-enzyme.Ukwenza ama-molecule amaprotheni abizwa ngokuthi ama-enzyme. Ama-enzyme afana nezisebenzi ezincane emizimbeni yethu. Laba basebenzi banezinkulungwane zemisebenzi. Omunye wemisebenzi ebaluleke kakhulu yale misebenzi ukubhidliza, noma ukugaya, imithi esiyithathayo.
Ake sithi uphuza iphilisi. Alihambi ngqo ukuze lilaphe lesi sifo. Lelo philisi kufanele liqale liye ezimbonini ezingaphakathi emizimbeni yethu (isibonelo, isibindi), lapho izisebenzi zalapho (okungukuthi ama-enzyme) ziliphula khona, ziliphule, bese zilisebenzisa emzimbeni.
Ake ucabange nje, kwenzekani uma la ma-enzyme engasebenzi kahle ngenxa yezinguquko ezakhiweni zofuzo zabanye abantu?
- Uma ama-enzyme esebenza ngokushesha kakhulu: Umuthi owuthathayo, ngaphambi kokuba umunceke futhi uthinte lesi sifo, uyaqhekeka bese ukhishwa emzimbeni ngokushesha okukhulu. Khona-ke umthamo ojwayelekile awanele kuwe. Umuthi uzozwakala sengathi awusebenzi.
- Uma ama-enzyme esebenza ngokushesha kakhulu: Umuthi owuthathayo uyaphuka ngokushesha kakhulu emzimbeni wakho. Khona-ke umuthi unqwabelana emzimbeni wakho ngobuningi obukhulu. Lokhu kungabangela ukuthi uphuze ngisho nangomthamo ojwayelekile futhi kube nemiphumela emibi kakhulu .
- Uma i-enzyme ingasebenzi nhlobo: Ngezinye izikhathi, ngenxa yokuguquka kwezakhi zofuzo, umzimba ungayeka ukukhiqiza i-enzyme okukhulunywa ngayo. Khona-ke umuthi ungase ungasebenzi nhlobo kuwe.
Yileyo ndlela ngisho nezinguquko ezincane ezakhiweni zethu zofuzo ezingaba nomthelela omkhulu ngayo emithini esiyiphuzayo.
Yikuphi ukuhlolwa okusetshenziselwa ukuthola lezi zinguquko zofuzo?
Lokhu sikubiza ngokuthi ukuhlolwa kwe-pharmacogenomic . Lokhu futhi ukuhlolwa kwezakhi zofuzo. Kubheka i-DNA yakho futhi kubheke noma yiziphi izinguquko ku-gene eyodwa noma ngaphezulu ezithinta indlela umuthi owohloka ngayo.
Lokhu kuhlolwa kuvame ukusebenzisa isampula yegazi noma i-buccal swab . Kulula kakhulu. Udokotela wakho uthumela lesi sampula elabhorethri. Ochwepheshe lapho bahlola i-DNA yakho ukuze babone izinguquko ezakhiweni zofuzo ezifanele.
Udokotela wakho uzonquma ukuthi yiziphi izakhi zofuzo okufanele uzihlole ngokusekelwe esimweni sakho sezokwelapha kanye nohlobo lomuthi ahlela ukukunika wona.
Kukuziphi izimo lapho kudingeka khona ukuhlolwa kwe-pharmacogenomic?
Lokhu kuhlolwa akwenziwa njengamanje kuzo zonke izifo noma yonke imithi. Kodwa-ke, udokotela wakho angase akuncome lokhu kuhlolwa lapho elapha izimo ezithile ezithile. Ake sibheke ezinye izibonelo. Ukuze uqonde lolu lwazi ngokucacile, bheka ithebula elingezansi.
| Isimo sezokwelapha | Izakhi zofuzo/i-enzyme efanelekile | Umthelela kanye nencazelo elula |
|---|---|---|
| I-cholesterol ephezulu | I-gene ye-SLCO1B1 | Abantu abanezinhlobo ezithile zalesi sakhi sofuzo bangase babe nobuhlungu obukhulu bemisipha kanye nobuthakathaka lapho bethatha imithi ye-statin (isb., i-Simvastatin, i-Atorvastatin) yokwehlisa i-cholesterol. Uma lokhu kutholakala ekuqaleni kokuhlolwa , udokotela wakho angase akwazi ukukunikeza umuthi ohlukile. |
| Ukucindezeleka | Izakhi zofuzo ze-CYP2D6 kanye ne-CYP2C19 | Lokhu kuhlukahluka kwezakhi zofuzo kushintsha izinga lapho eminye imithi yokucindezeleka ihlukaniswa khona emzimbeni. Kwabanye, imithi isebenza kahle kakhulu. Kwabanye, ibangela imiphumela emibi eminingi. Lokhu kuhlolwa kungasiza ekukhetheni umuthi osebenza kahle kakhulu onemiphumela emibi embalwa kakhulu . |
| Umdlavuza | Izakhi zofuzo ezahlukahlukene (isib. i-HER2, i-TPMT, i-UGT1A1, i-DPD) |
|
| Ukuvimbela ukuqhekeka kwegazi | I-CYP2C19 gene kanye nezinye | I-warfarin encipha igazi idinga ukunikezwa ngemithamo ephansi kakhulu kubantu abanezakhi ezithile zofuzo. Futhi, umuthi i-clopidogrel (Plavix®) ungase ungasebenzi nhlobo kwabanye abantu ngenxa yokwehluka kwe-enzyme ye-CYP2C19. |
| Ukutheleleka nge-HIV | Izakhi zofuzo ze-HLA-B kanye ne-CYP2B6 | Abantu abane-gene ethile ye-HLA-B bangaba nokusabela okukhulu kwesikhumba uma benikezwa umuthi i-Abacavir. Ngakho-ke, lokhu kuhlolwa kuyimpoqo ngaphambi kokunikeza lo muthi. |
| Izinkinga zesimiso somzimba sokuzivikela | I-TPMT, NUDT15, CYP3A5 | Ngemva kokufakelwa isitho, njengokufakelwa izinso, ukusebenza kahle kwemithi yokucindezela amasosha omzimba (isib. i-Azathioprine, i-Tacrolimus) kuncike kulezi zakhi zofuzo. Izinguquko kulezi zakhi zofuzo zingandisa nengozi yokuthi umzimba wenqabe isitho esifakwe isitho . |
Yiziphi izinzuzo zale ndlela?
Njengoba insimu ye-Pharmacogenomics ithuthuka, sizozuza kakhulu.
- Ukwelashwa okuphephile: Odokotela bangathola imithi engabangela imiphumela emibi noma ukudlula ngokweqile kwabanye abantu, ukuze bagweme leyo mithi futhi bakunike imithi ephephile .
- Ukusebenza kahle kanye nokunciphisa izindleko zokwelashwa: Cabanga nje, kufanele ushintshe imithi emi-3-4 yesifo, bese ekugcineni uthola umuthi ofanele. Kuze kube yileso sikhathi, isikhathi sakho, imali, kanye nomzamo wakho kuyachithwa. Futhi uhlupheka kuze kube yilapho isifo siba ngcono. Kodwa uma lokhu kuhlolwa kungaqeda lesi sifo ngomuthi wokuqala onikezwayo , kungaba kuhle kangakanani lokho?
- Ukuthuthukiswa kwemithi eqondiwe: Ezinye izifo zibangelwa izinguquko ku-gene ethile. Ngakho-ke abacwaningi bangakha imithi emisha eqondisa ngqo izinguquko ku-gene leyo . Lokhu kubaluleke kakhulu ekwelapheni izifo ezinjengomdlavuza.
Kodwa lokhu kunemingcele yako...
Kungakhathaliseki ukuthi le ndlela inhle kangakanani, ayixazululi konke. Lapho ekhetha umuthi, udokotela akacabangi nje ngezakhi zofuzo. Kunezinye izinto eziningi okufanele azicabangele.
Into ebalulekile ukuthi, izakhi zofuzo zakho ziyingxenye nje yendaba. Kunezinye izinto eziningi ezithinta indlela umuthi osebenza ngayo.
Udokotela kufanele futhi akhathazeke ngezinye izinto ezifana nalezi:
- Eminye imithi oyithathayo njengamanje: Umuthi owuthathayo wesimo esithile kanye nomunye wesinye isimo ungathinta umzimba wakho ngendlela ebangela ukuthi uqhekeke.
- Ezinye izimo zezokwelapha onazo: Isibonelo, uma unezinkinga zesibindi noma zezinso, zingathinta indlela umuthi okhishwa ngayo emzimbeni.
- Indlela yakho yokuphila: Lokho okudlayo nokuphuzayo, kungakhathaliseki ukuthi uyavivinya umzimba noma cha, ngisho nezinto ezifana nokubhema nokusebenzisa utshwala kungathinta indlela imithi yakho ewohloka ngayo.
Ngaphezu kwalokho, kunezinye izinselele eziningana:
- Izindleko: Nakuba izindleko zalezi zivivinyo zofuzo zincipha kancane kancane, zingase zibize kakhulu kwabanye abantu ukuthi bangakwazi ukuzikhokhela.
- Ukungafinyeleleki: Izindawo zokwenza lezi zivivinyo azikatholakali yonke indawo eSri Lanka. Zitholakala ezindaweni ezimbalwa kuphela.
Kodwa-ke, lo mkhakha we-"Precision Medicine" uthuthuka ngokushesha okukhulu. Uma unemibuzo ngalokhu, ungesabi ukukhuluma nodokotela wakho . Mbuze ukuthi kukhona yini izinzuzo zokuba nalolu hlobo lokuhlolwa kwesimo sakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Pharmacogenomics imane nje iwucwaningo lokuthi izakhi zakho zofuzo zithinta kanjani imithi oyiphuzayo.
- Ngale ndlela, udokotela wakho angakhetha umuthi ophephile nosebenza kahle kakhulu kuwe.
- Lona usengumkhakha osathuthuka. Okwamanje usetshenziselwa ukwelapha izifo ezimbalwa ezithile, njenge-HIV, umdlavuza kanye nokucindezeleka.
- Akuzona nje izakhi zofuzo zakho ezinquma ukuthi umuthi uzokusebenzela yini. Indlela yakho yokuphila, eminye imithi oyiphuzayo, kanye nezinye izimo zezokwelapha nazo zidlala indima.
- Uma unemibuzo ngalokhu, umuntu ongcono kakhulu nofaneleke kakhulu ongakhuluma naye udokotela wakho.
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