Ingabe umuthi ofanayo usebenza kuwo wonke umuntu? Ake sixoxe ngekusasa lezokwelapha: I-Precision Medicine!

Wake wazibuza ukuthi kungani imithi efanayo kanye nezindlela zokwelapha zingasebenzi kuzo zonke izifo nakuwo wonke umuntu? Ngezinye izikhathi imithi oyinika umngane wakho yesifo esifanayo ingase ingakusebenzeli. Yingakho umhlaba ukhuluma ngale ndlela entsha yezokwelapha njengesixazululo. Lokhu kubizwa ngokuthi 'i-Precision Medicine' noma '(i-Precision Medicine)'. Ake sixoxe ngalokhu ngokuningiliziwe namuhla.

Iyini i-Precision Medicine?

Kalula nje, lokhu kuyindlela yokwelapha efanele wena, eqondene nawe. Cabanga nje, izakhi zofuzo zakho, indawo ohlala kuyo, indlela yakho yokuphila - lena indlela entsha yokuthatha ulwazi ngazo zonke lezi zinto nokuzisebenzisa ukuze zikunikeze ukunakekelwa kwezempilo okungcono kakhulu. Ngale ndlela, ososayensi nodokotela bangabikezela kusengaphambili ukuthi hlobo luni lwezindlela zokuvimbela izifo, uhlobo luni lomuthi, kanye nohlobo luni lweqembu oluzofaneleka. Lokhu kubizwa nangokuthi 'umuthi oqondene nawe'.

Ngokuvamile, sibona ukuthi odokotela bavame ukuhlela ukwelashwa ngendlela esebenzela 'umuntu ojwayelekile'. Okusho ukuthi, indlela 'efanela wonke umuntu'. Kulokhu, abacabangi kakhulu ngomehluko omncane phakathi kwabantu. Ngakho-ke, le ndlela isebenza kahle kwabanye abantu, kwezinye izifo. Kodwa, kwabanye abantu, kwezinye izifo, ayisebenzi nhlobo. Leso yisisombululo salokhu, esibizwa ngokuthi '(Precision Medicine)'. Lokhu kuhilela ukukhetha ukwelashwa okuhambisana kahle nomzimba wakho, izakhi zofuzo zakho, kanye nendlela yakho yokuphila.

Iyini le Precision Medicine Initiative?

Lolu uhlelo olubaluleke kakhulu, olukhethekile oluqalwe yiNational Institutes of Health (NIH) e-United States - okungukuthi, isikhungo esikhulu kunazo zonke lapho esicwaninga ngezifo futhi sisebenzela ukuthuthukisa impilo - kanye nezinye izikhungo zocwaningo ezidumile emhlabeni wonke. Umzamo wabo omkhulu ukuthola ukuthi yiziphi izindlela ezingcono kakhulu zokusebenzisa izinto ezifana nezakhi zofuzo zakho, indawo ohlala kuyo, kanye nendlela yakho yokuphila ukwelapha nokuvimbela izifo.

Lolu "hlelo lwezokwelapha oluqondile" lunemigomo yesikhathi esifushane neyesikhathi eside.

• " Umgomo wesikhashana ukuletha lo mqondo "we-Precision Medicine" ocwaningweni lomdlavuza. Ososayensi e-US National Cancer Institute bafuna ukuqonda kabanzi ngebhayoloji kanye nezakhi zofuzo zomdlavuza futhi bathuthukise izindlela zokwelapha ezintsha nezisebenza kahle. Cabanga nje, lapho umdlavuza uqala, uma wazi kahle ukuthi uluhlobo luni lomdlavuza nokuthi yiziphi izinguquko zofuzo eziwubangele, ungawunika umuthi owusebenzelayo, akunjalo?"
• " Umgomo wesikhathi eside""Lokhu kumayelana nokwelula lo `(Precision Medicine)` kuzo zonke izici zokunakekelwa kwempilo. Ngenxa yalokhu, `(NIH)` iqale uhlelo olukhethekile locwaningo olubizwa ngokuthi `(All of Us Research Program)`. Ngalolu cwaningo, baqoqa ulwazi eqenjini elikhulu labantu abanezizinda ezahlukene zofuzo kanye nezindlela zokuphila, futhi besebenzisa leyo datha, bazama ukuthola ukuthi bangenza kanjani ukunakekelwa kwempilo kube ngcono kuwo wonke umuntu."

Yiziphi izinzuzo esizitholayo ku-Precision Medicine?

Le ndlela "yokwelapha ngokunemba" ingathuthukisa impilo yakho kanye nokunakekelwa kwezokwelapha okutholayo ngezindlela eziningi. Bheka lezi zinzuzo:

• Udokotela wakho angasebenzisa ulwazi lwakho lwezakhi zofuzo ukusiza ekunakekelweni kwezokwelapha kwansuku zonke. Cabanga ukuthi lokho kungaba usizo kangakanani! Isibonelo, eminye imithi ingabangela imiphumela emibi eminingi kubantu abanezakhi zofuzo ezithile. Ukwazi ulwazi lwakho lwezakhi zofuzo kungakusiza ugweme ukuthatha leyo mithi.
• Sithola ukuqonda okungcono kokuthi kungani izifo zenzeka. Lokhu kusho ukuthi esikhundleni sokwelapha izimpawu nje kuphela, singelapha imbangela eyinhloko yalesi sifo.
• Ungabona kusenesikhathi ukuthi yiziphi izindlela zokwelapha ezifanele kakhulu kuwe . Ngemuva kwalokho unganciphisa ukusetshenziswa kwemithi engadingekile kanye nemiphumela emibi. Wonga isikhathi nemali.
• Kunezindlela ezithuthukisiwe zokuvimbela, ukuxilonga, kanye nokwelapha izifo. Kungenzeka ngisho nokunquma ukuthi kukhona yini ukuthambekela kwezakhi zofuzo kwezinye izifo ngaphambi kokuba zikhule.
• Amarekhodi akho ezempilo kagesi (ama-EHR) – amarekhodi ezifo zakho, imithi, kanye nokuhlolwa okugcinwe ohlelweni lwekhompyutha – azotholakala kalula. Lokhu kuzokwenza kube lula ngodokotela ukufinyelela ulwazi lwakho lwezokwelapha nokuhlela ukwelashwa.

Isetshenziswa kuphi i-Precision Medicine njengamanje?

Odokotela sebevele besebenzisa le ndlela ethi "Precision Medicine" ezindaweni eziningi zezokwelapha. Nakuba isesesigabeni sayo sokuqala, imiphumela iyakhuthaza kakhulu. Nazi izibonelo ezimbalwa:

• I-oncology enembile
• Ukwelashwa nge-immunotherapy yomdlavuza
• I-Pharmacogenomics
• Izifo ezingavamile

Sizoxoxa ngakho konke lokhu ngokuningiliziwe? Khona-ke uzoqonda ukubaluleka kwalokhu kangcono.

Kuyini i-precision oncology?

Odokotela bavame ukuhlukanisa umdlavuza ngengxenye yomzimba okuyo (isib. umdlavuza wamaphaphu, umdlavuza webele) noma uhlobo lwezicubu (isib. i-lymphoma). Kodwa ngalo "Muthi Wokucacisa", manje sebethola izigxivizo zeminwe zama-molecule zomdlavuza ohlukene.Okusho ukuthi, njengeminwe yethu, sibona amaphethini amancane amakhemikhali kanye nezinguquko zofuzo ezihlukile kumdlavuza ngamunye. Sisebenzisa lezi zimpawu, umdlavuza uhlukaniswa ngezinhlobo nezinhlobo ezincane.

Abacwaningi bathole ukuthi umdlavuza okhula ezingxenyeni ezahlukene zomzimba ungaba nokufana okuningi ezingeni lama-molecule. Ngakho-ke, le "Precision oncology" ivumela odokotela ukuthi bakhethe ukwelashwa okusekelwe "kusignesha ye-DNA" yomdlavuza womuntu. Lokhu kusho ukuthi esikhundleni sokunikeza wonke umuntu umuthi ofanayo, banganikeza ukwelashwa okuqondiswe ngqo kulowo mdlavuza, kulolo shintsho lwezakhi zofuzo. Lokhu kwenza ukwelashwa kube yimpumelelo enkulu.

Kuyini ukwelashwa nge-immunotherapy yomdlavuza?

Ubuwazi ukuthi amasosha omzimba wakho angavimbela ukukhula komdlavuza othile? Lokhu kungenxa yokuthi unekhono langaphakathi lokubona nokubhubhisa amangqamuzana angajwayelekile. Kodwa-ke, ngezinye izikhathi amangqamuzana omdlavuza ahlakaniphile kangangokuthi ayagwema lesi simiso sokuzivikela, acashe, futhi akhule.

Kodwa, ngale ndlela ebizwa ngokuthi "i-Cancer immunotherapy", ososayensi manje sebekhohlisa amangqamuzana omdlavuza! Uyazi ukuthi kanjani? Ungasebenzisa amasosha akho omzimba ukulawula umdlavuza, futhi ngezinye izikhathi uze uwalaphe ngokuphelele. Lokhu kuyamangalisa ngempela, akunjalo?

Lezi zinhlobo zemithi "yokwelapha ngomdlavuza" zingalingisa ukusebenza kwama-molecule emvelo omzimba wakho, noma ziwaqinise. Lezi zinhlobo zemithi zifaka:

• Ama-antibodies alwa nomdlavuza anamathela kumaseli omdlavuza futhi awabhubhise.
• Izindlela ezithatha amasosha omzimba wakho, "ziwagcwalise" elabhorethri, bese ziwabuyisela emzimbeni wakho.
• Imithi yokugoma yokwelapha iyimithi yokugoma ekhethekile efundisa amasosha omzimba wakho ukuhlasela amangqamuzana omdlavuza.

Kuyini i-Pharmacogenomics?

Lesi yisihloko esijulile kancane, kodwa sibaluleke kakhulu. I-Pharmacogenomics isifundo sokuthi i-DNA yakho isabela kanjani emithini oyithathayo. Lo mkhakha uhlanganisa i-pharmacology - isifundo semithi - kanye ne-genomics - isifundo sezakhi zofuzo - ukudala imithi ephephile nephumelelayo kanye nemithamo ehambisana nezinguquko ezithile kuzakhi zofuzo zakho.

Kalula nje, umgomo we-"Pharmacogenomics" ukuqhela endleleni ethi "usayizi owodwa ufanelana nakho konke". Abacwaningi manje sebeyazi ukuthi kunezici eziningi ezithinta indlela umzimba wakho osabela ngayo emithini ehlukene. Akuyona nje iminyaka yakho, ubulili, noma usayizi womzimba wakho. Izakhi zakho zofuzo nazo zidlala indima enkulu kulokhu. I-"Precision Medicine" izama ukukunikeza umuthi ofanele, ngesilinganiso esifanele, somzimba wakho. Khona-ke umuthi uzosebenza kahle futhi ube nemiphumela emibi embalwa.

Izifo ezingavamile kanye nemithi enembile

Ngokusho kwabacwaningi, cishe abantu abayizigidi ezingama-25-30 e-United States kuphela bahlushwa yizimo zofuzo ezingavamile. Kukhona neziguli ezinjalo eSri Lanka. Ukuthola nokwelapha lezi zifo kunzima kakhulu. Amakhulu ezinkinga zezokwelapha eziyinkimbinkimbi kangaka afundwe nge-'Undiagnosed Disease Program' e-(NIH). Ngalolo cwaningo, bakwazile ukuthola izifo eziningi ezinjalo. Ngokuthuthuka kobuchwepheshe bezakhi zofuzo, kuye kwenzeka ukuhlonza amaphutha aqondile ezakhi zofuzo abangela lezi zifo ezingavamile.

I-NIH manje isiwandise lolu hlelo kwezinye izikhungo eziningana ezweni lonke ukuze ifunde ngezifo ezengeziwe. Basebenzisana nabanye abalingani abaningana ukuze bathuthukise ngokushesha ukwelashwa okuphumelelayo kwalezi zifo ezingavamile. I-Precision Medicine iyithemba elikhulu kubantu abanjengalaba.

Uyini umehluko phakathi 'kwemithi yokwelapha eqondile' kanye 'nemithi eyenzelwe wena'?

Ngokusho kwe-US National Research Council, igama elithi 'Personalized Medicine' liyigama elidala elisetshenziselwa ukubhekisela ku-'Precision Medicine'. Okusho ukuthi, la magama amabili asho into efanayo.

Kodwa-ke, umkhandlu ubelokhu ukhathazekile kancane ngokuthi uma abantu bethi 'okwenziwe ngokwezifiso', bacabanga ukuthi umuntu ngamunye uzothola ukwelashwa okuhlukile, okwenzelwe wena. Kodwa-ke, ukugxila kwe-"Precision Medicine" akukhona nje kuwe. Kunalokho, kumayelana nokuthola ukuthi yiziphi izindlela zokwelapha ezisebenza kahle kakhulu kumaqembu abantu - okungukuthi, abanye abanezici zofuzo kanye nendlela yokuphila efana neyakho. Manje, igama elithi "Precision Medicine" yilona elisetshenziswa kakhulu futhi elibhekwa njengelifanele kakhulu. Kodwa-ke, abantu basasebenzisa la magama amabili ngokushintshana. Into ebalulekile ukuthi le ndlela izama ukunikeza ukwelashwa okunembe kakhudlwana, okuphumelelayo, kunokuphatha wonke umuntu ngendlela efanayo.

Yini ebaluleke kakhulu esifuna ukuyithatha ekhaya kule ndaba?

Izakhi zofuzo zakho, indawo ohlala kuyo, indlela yakho yokuphila - zonke lezi zinto zithinta impilo yakho. Umgomo omkhulu we-"Precision Medicine" ukutadisha zonke lezi zici nokuthatha isinyathelo sokuvikela nokukusiza. Ngemuva kwalokho, esikhundleni sokunikeza wonke umuntu ukwelashwa okufanayo, odokotela bakho bangakha uhlelo lokuvimbela nokwelapha izifo ezikufanele. Odokotela sebevele basebenzisa i-"Precision Medicine" ezindaweni eziningi zezokwelapha. Kodwa, kunamathuba amaningi kakhulu okuzoshintsha insimu yezempilo esikhathini esizayo kangangokuthi kunzima ukuwacabanga. Ngakho-ke, leli yithemba elihle kakhulu ngekusasa lethu lezempilo!

"Khumbula, "i-Precision Medicine" ayimayelana nokudala umuthi ohlukile wawo wonke umuntu, kodwa imayelana nokukhetha ukwelashwa okufanele futhi okuphumelelayo kakhulu kweqembu labantu abanezimpawu ezifanayo nezakho."

Njengoba lobu buchwepheshe buqhubeka nokuthuthuka, sizokwazi ukulwa ngempumelelo nezifo eziningi ezengeziwe. Ngakho-ke, kubaluleke kakhulu ukuhlala unolwazi ngezinto ezintsha ezinjengalezi.

Umuthi Oqondile, Ufuzo, Ukwelashwa Komdlavuza, Umuthi Owenzelwe Wena, Umuthi Wesikhathi Esizayo, Ubuchwepheshe Bezempilo