Ingabe imithi oyinikwayo ikufanele? Ake sixoxe nge-Pharmacogenomics!

Cishe uke wezwa ukuthi umuthi ofanayo wesifo esifanayo usebenza kwabanye abantu, awusebenzi kwabanye, futhi unemiphumela emibi kwabanye. Kungani kunjalo? Ingabe kungenxa yokuthi imizimba yethu ihlukile? Yebo, leso esinye sezizathu. Leso yisihloko esihlobene, esiyinkimbinkimbi kancane, kodwa esibaluleke kakhulu esizokhuluma ngaso namuhla. Lokhu kubizwa ngokuthi i-pharmacogenomics.

Kuyini i-Pharmacogenomics?

Kalula nje, i-pharmacogenomics isifundo sendlela esisabela ngayo ezidakamizweni ngokusekelwe kuzakhi zofuzo zethu. Khumbula, i-pharmacology isifundo sokusetshenziswa nemiphumela yezidakamizwa. I-Genomics isifundo sezakhi zofuzo kanye nomsebenzi wazo. Ukuhlanganiswa kwalokhu okubili kubizwa ngokuthi i-pharmacogenomics. Ngezinye izikhathi kubizwa ngokuthi i-pharmacogenetics.

Lokhu kuwela ngempela ngaphansi kwensimu enkulu ye -'Precision Medicine' . Okusho ukuthi, ukukunikeza uhlelo lokwelashwa oluqondene nawe olusekelwe ezintweni ezifana nezakhi zofuzo zakho, indawo ohlala kuyo, kanye nendlela yakho yokuphila. I-Pharmacogenomics ingasiza udokotela wakho ukuthi akhethe umuthi onemiphumela emibi embalwa noma osebenza kahle kuwe .

Kodwa kufanele kuqashelwe ukuthi le ndlela ayikasetshenziswa kuzo zonke izifo noma kuzo zonke izidakamizwa. Njengamanje, isetshenziswa kakhulu ezimweni nemithi elinganiselwe, njenge-HIV, ezinye izinhlobo zomdlavuza, ukucindezeleka, nesifo senhliziyo. Kodwa lo mkhakha uthuthuka ngokushesha okukhulu. Abacwaningi banethemba lokuthi le ndlela izosiza maduze ekukhetheni imithi engcono ngisho nasezifweni ezivame kakhulu.

Izakhi zofuzo zithinta kanjani indlela izidakamizwa ezisebenza ngayo?

Cabanga ngale ndlela: izakhi zofuzo zethu zifana nesethi yemiyalelo yamaseli emzimbeni wethu. Lawa ma-gene asisiza ekwenzeni ama-molecule amaprotheni abizwa ngokuthi ama-enzyme . Ama-enzyme anemisebenzi eyizigidi emizimbeni yethu. Enye yawo ukuphula izidakamizwa emzimbeni, noma ukuzisebenzisa . Uma abanye abantu bengasabeli ezidakamizweni njengoba bekulindelekile, kungaba ngoba banezinguquko ezithile ezakhini zabo zofuzo. Lezi zinguquko zingabangela ukuthi ama-enzyme angasebenzi kahle noma ama-enzyme angasebenzi kahle.

Ake ucabange nje, bekuzokwenzekani uma umzimba wakho uphula umuthi ngokushesha kakhulu, noma kancane kakhulu, noma ungawuqedi nhlobo? Khona-ke umuthi, onikezwa ngesilinganiso esijwayelekile, ngeke usebenze njengoba bekulindelekile. Noma umuthi ungabangela imiphumela emibi kakhulu , noma awunakuba nomthelela ekuguleni kwamanje.

Isibonelo, abanye abantu abalali ngokushesha ngemva kokuphuza ikhofi, kanti abanye abalali. Esinye isizathu salokhu ukuthi izakhi zofuzo zethu zithinta indlela imizimba yethu ekhipha ngayo i-caffeine ngokushesha. Kungenzeka okufanayo nangemithi.

Iyini le ndlela yokuhlola i-pharmacogenomic?

Ukuhlolwa kwe-pharmacogenomic kuwukuhlolwa kwezakhi zofuzo. Kungabheka izakhi zofuzo eyodwa noma ngaphezulu, ikakhulukazi ukubheka izinhlobo ezithile zezakhi zofuzo ezithinta ukuwohloka komuthi. Kufana nokuhlola iphutha 'ebhukwini lemiyalelo' lemizimba yethu.

Odokotela bavame ukusebenzisa isampula yegazi noma i-buccal swab ukwenza lokhu. Lesi sampula sithathwa kuwe bese sithunyelwa elabhorethri. Lapho, uchwepheshe uhlola i-DNA yakho ukuze abone izinguquko ezithile. I-gene noma izakhi zofuzo abazifunayo zizoncika ekuhlolweni udokotela wakho akuyalele, isimo abazama ukuselapha, kanye nemithi abahlela ukukunika yona.

Ngidinga nini ukuhlolwa kwe-pharmacogenomic?

Uma uphuza imithi yezimo ezithile zezokwelapha, ungase ufanelekele nokuhlolwa kwe-pharmacogenomic. Nazi ezinye izibonelo (futhi kungase kube nezinye):

I-cholesterol ephezulu

Ngenxa yezinhlobo ezithile ze-``SLCO1B1 gene`` emizimbeni yethu, uma uthatha imithi ethile ebizwa ngokuthi ama-statins e-cholesterol ephezulu, ungase uzwe ubuhlungu bemisipha kanye nobuthakathaka. Izibonelo zalezi statins yilezi:

• I-Atorvastatin (isib. i-Lipitor®)
• I-Fluvastatin (isib. i-Lescol®)
• I-Lovastatin (isib. i-Altoprev®)
• I-Pitavastatin (isib. i-Livalo®)
• I-Pravastatin (isb. i-Pravachol®)
• I-Rosuvastatin (isib. i-Crestor®)
• I-Simvastatin (isib. i-Zocor®)

Ngakho-ke ngaphambi kokuba uqale ukuthatha umuthi onjengalona, ​​noma uma unezinkinga ngenkathi uwusebenzisa, udokotela wakho angakhuluma nawe ngokuhlolwa okufana nalokhu.

Ukucindezeleka

Ukwehluka kwezakhi zofuzo i-CYP2D6 kanye ne-CYP2C19 kungathinta ukuthi umzimba wakho usheshe kangakanani ukuphula eminye imithi yokucindezeleka. Izibonelo zale mithi zifaka:

• I-Amitriptyline (isib. i-Elavil®) - Lolu uhlobo lwe- tricyclic antidepressant .
• Uhlobo lwemithi ethi `SSRI` : `Citalopram` (isib. `Celexa®`), `Escitalopram` (isib. `Lexapro®`), `Sertraline` (isib. `Zoloft®`), `Paroxetine` (isib. `Paxil®`) kanye ne-`Fluvoxamine` (isib. `Luvox®`).
• I-Venlafaxine (isib. i-Effexor®) - Lolu uhlobo lwe-SNRI.

Lokhu kuhlolwa kungaba usizo lapho uqala imithi efana nale, noma lapho omunye umuthi ungasebenzi futhi uzama ukushintshela komunye.

Umdlavuza

Uma uthatha imithi yohlobo oluthile lomdlavuza, ungase uzuze ekuhlolweni kwe-pharmacogenomic. Nazi ezinye izibonelo:

• Umdlavuza webele: Umuthi i-trastuzumab (isib. i-Herceptin®) usebenza kuphela kubantu abanomdlavuza webele one-HER2-positive . Lokhu kusho ukuthi amangqamuzana omdlavuza anokuguqulwa kwezakhi zofuzo okubangela ukuthi akhiqize iphrotheni ye-HER2 eningi kakhulu.
• I-Acute Lymphoblastic Leukemia (YONKE): Abantu abanamazinga aphansi e-enzyme i-Thiopurine Methyltransferase (TPMT) bangase babe nemiphumela emibi kakhulu kanye nengozi eyengeziwe yokutheleleka uma benikezwa umthamo ojwayelekile we-Mercaptopurine (isib. i-Purinethol®).
• Umdlavuza wamathumbu amakhulu: Abantu abanamazinga aphansi e-enzyme i-UGT1A1 bangase babe sengozini enkulu yohudo olukhulu kanye nokutheleleka uma benikwa umuthi i-Irinotecan (isib. i-Camptosar®).

Futhi, umuthi wokulwa nomdlavuza i-fluorouracil, `5-FU` (isib. i-Adrucil® - `Adrucil®`), ungabangela imiphumela emibi kakhulu uma unikezwa ngemithamo evamile kubantu abanamazinga aphansi e-enzyme i-dihydropyrimidine dehydrogenase (`i-Dihydropyrimidine Dehydrogenase - DPD`). Odokotela bangase banikeze lo muthi womdlavuza we-colonectal, webele, wesisu kanye nomdlavuza we-pancreatic.

Ukuvimbela ukuqhekeka kwegazi

Abantu abanezinhlobo ezithile zofuzo kudingeka bathathe umthamo ophansi wesidakamizwa esilwa nokuvuvukala kwemithambo yegazi i-warfarin (isib. i-Coumadin®). Ukweqisa kakhulu kungabangela ukopha.

Futhi, ushintsho ku-enzyme ye-CYP2C19 esibindini sakho lungavimbela umuthi we-antiplatelet i-clopidogrel (isb. i-Plavix®) ukuthi usebenze kahle . Lo muthi usetshenziselwa ukuvimbela izinto ezifana nokuhlaselwa yinhliziyo kanye nohlangothi.

Ukutheleleka nge-HIV

Uhlobo oluthile lwe-HLA-B gene lungabangela ukusabela okukhulu kwesikhumba kumuthi i-Abacavir (isib. i-Ziagen®).

Futhi, uhlobo oluthile ku-CYP2B6 gene lungandisa ingozi yemiphumela emibi efana nezinguquko zemizwa ezivela kumuthi i-efavirenz (isib. i-Sustiva®).

Izinkinga zesimiso somzimba

Uma uthatha umuthi wokucindezela amasosha omzimba, ungase uzuze ekuhlolweni kwe-pharmacogenomic:

• Ngenxa yokwehluka kwamaprotheni `TPMT` kanye `NUDT15`, umsebenzi womnkantsha ungase ucindezelwe uma uthatha umuthi `Azathioprine` (isib. `Imuran®`) ngemva kokufakelwa izinso noma ngenxa yezimo zesimiso somzimba sokuzivikela ezifana ne-multiple sclerosis.
• Ngenxa yokwehluka kwe-enzyme ye-CYP3A5, uma uthatha i-tacrolimus (isib. i-Prograf®) ngemva kokufakelwa isitho, ingozi yokwenqatshwa kokufakelwa isitho inganda.

Yiziphi izinzuzo ze-pharmacogenomics?

Njengoba abacwaningi nodokotela beqhubeka nokufunda nokusebenzisa i-pharmacogenomics, lokhu kungaletha izinzuzo eziningi. Bheka:

• Ukuphepha okuthuthukisiwe: Odokotela bazokwazi ukugwema ukunikeza imithi ebanga imiphumela emibi kwabanye abantu, noma engabangela izinkinga uma ithathwa ngokweqile. Lokhu kusho ukuthi ngeke kudingeke uhlupheke ngokungadingekile.
• Ukusebenza kahle kanye nezindleko zokunakekelwa kwempilo ezincishisiwe: Uma odokotela bekwazi kusengaphambili ukuthi yimiphi imithi esebenzayo nengasebenzi, bangakwazi ukukunikeza imithi esebenza kahle kakhulu kuqala , bonge imali nesikhathi .
• Ukuthuthukiswa kwemithi eqondiwe: Ezinye izifo zibangelwa ushintsho oluthile (uhlobo) ku-gene. I-Pharmacogenomics ivumela abacwaningi ukuthola imithi emisha ngokuyiqondisa ngqo kulolo hlobo lwezakhi zofuzo. Njengokudala umuthi ofanelana nesifo.

Yiziphi imikhawulo/ububi be-pharmacogenomics?

Nakuba ukwakheka kwezakhi zofuzo zakho kubalulekile ekunqumeni ukwelashwa okungcono kakhulu kwezimo eziningi, akuchazi ngokugcwele ukuthi umzimba wakho ucubungula kanjani imithi. Odokotela kusadingeka bacabangele ezinye izici lapho bekhetha imithi efanele. Isibonelo:

• Eminye imithi: Imithi oyithathayo njengamanje ingase iphazamise ukusebenza kahle kwemithi emisha.
• Ezinye izimo zempilo: Ezinye izifo zingashintsha indlela umzimba wakho ocubungula ngayo imithi. Isibonelo, uma izinso zakho zingasebenzi kahle, eminye imithi izokhishwa emzimbeni wakho.
• Indlela Yokuphila: Izinto ezifana nalokho okudlayo, ukuthi uvivinya umzimba kangakanani, kanye nokusebenzisa kwakho ugwayi notshwala kungathinta indlela imithi yakho ewohloka ngayo.

Ezinye izinselele ekuthuthukisweni nasekusetshenzisweni kwe-pharmacogenomics zifaka:

• Izindleko: Nakuba izindleko zokuhlolwa kwe-pharmacogenomic zincipha kancane kancane, izindleko zomuntu ngamunye, noma izindleko eziphuma esikhwameni, zivame ukuhlukahluka kuye ngomshwalense. Lokhu kuhlolwa kungase kungabi khona kuwo wonke umuntu.
• Ukufinyeleleka:Kuye ngokuthi uhlalaphi nokuthi uhlobo luni lukadokotela okwelaphayo, ukufinyelela kwakho kwezinye izivivinyo zofuzo kungase kulinganiselwe.

Njengamanje, odokotela bangasebenzisa i-pharmacogenomics kuphela ezimweni ezimbalwa kanye nemithi. Kodwa-ke, lo mkhakha othakazelisayo 'womuthi oqondile' ukhula ngokushesha. Khuluma nodokotela wakho ngokuthi i-pharmacogenomics ingasiza kanjani impilo yakho nokuthi yiziphi izinzuzo ezingaletha. Ungabuza futhi ngezivivinyo zemitholampilo kulo mkhakha.

Ekugcineni, ekugcineni, khumbula lokhu.

Kulungile, ngakho-ke, yize igama elithi pharmacogenomics esikhulume ngalo namuhla liyinkimbinkimbi kancane, okusho ukuthi lisisiza sikhethe umuthi osifanela kangcono futhi onemiphumela emibi embalwa kakhulu, ngokusekelwe ezizakhini zethu zofuzo.

Izakhi zethu zofuzo ziyisizathu esikhulu sokuthi kungani umuthi ofanayo ungasebenzi ngendlela efanayo kuwo wonke umuntu. I-Pharmacogenomics iwumzamo wokuqonda leyo mfihlo nokusinika ukwelashwa okwenziwe ngokwezifiso kakhudlwana futhi okuphumelelayo.

Nakuba lokhu kuseyinsimu ethuthukayo, kunamandla okushintsha indlela izifo eziningi eziphathwa ngayo esikhathini esizayo. Uma unemibuzo mayelana nomuthi othile, ikakhulukazi ukuthi uzokusebenzela noma ukuthi uzodala imiphumela emibi, ungesabi ukukhuluma nodokotela wakho ngalezi zivivinyo ze-pharmacogenomic. Zingaba usizo kakhulu kuwe.

Khumbula, izakhi zofuzo zakho ziyingxenye ebalulekile yendaba yakho yezempilo. Ukudla okuhle, ukuzivocavoca umzimba, nokulandela iseluleko sikadokotela wakho kubaluleke ngendlela efanayo!

I- Pharmacogenomics, izakhi zofuzo, izidakamizwa, imithi, umuthi onembile, ukuhlolwa kwezakhi zofuzo, imiphumela emibi