Zvibereko zvekutanga kune zvinodhaka zvinotarirwa CGRP uye Receptor Yaro
Calcitonin peptide inokonzerwa nejeni (CGRP), puroteni inogadzirwa nemamwe masero emagetsi mukati mawo maviri ehurumende yenheyo uye purogiramu yenheyo yenheyo, anotenda kuti inotora basa rinokosha mumigraines. Hazvisi chete kuti mapurotini aya akawanikwa akakwidziridzwa panguva yekurwiswa kwemagraine, asi kuderedzwa kwemarwadzo emugraine nemishonga inonzi migraine inonzi Triptan yakabatana nekugadzirisa kwemaitiro eCGRP muropa.
Munguva yekurwisana, zvinokwanisika kuti dzimwe migraine dzinokonzera kukurudzira midziyo yeropa yakapoteredza uropi kuwedzera, kana kuwedzera. Iyi mishonga yeropa inoputika inoshandiswa uye inoshandisa hutatu hwemagetsi. Kana ikashandiswa, hutatu hutachiona hunotumira marwadzo kuhupi - izvo zvinoita kuti kusununguka kwemapuroteni akasiyana-siyana, akafanana neCGRP.
CGRP inokonzera kuwedzera kuwedzera kwemidziyo yeropa uye chinhu chinonzi "neurogenic kuvimba". Sezvo migraine ichirwisa ichifambira mberi, brainstorms inowedzera kukurudzirwa. Izvi zvinokonzera kushungurudza kunorwadza kwekutambudzika kwepamusoro uye kuwedzerwa kunzwisisika kune zvakatipoteredza.
Chii Chinotangira Zvidzidzo paCGRP?
Zvidzidzo zveChikamu II - zvidzidzo zvakaitwa pachidiki chevarwere kuti vaone kubatsirwa nemigumisiro yemigumisiro yemishonga-kusvika ikozvino iri kuvimbisa kuratidza kuti CGRP maviri anodzivirira migraines uye anoregererwa.
Mune rumwe ruzivo, 217 vatori vechikamu vanoona 4 kusvika14 vanofambisa mwedzi, vakangoerekana vaine ruzivo rwekugamuchira pasi peganda majekiseni kaviri vhiki imwe neimwe yezvinodhaka zvinonzi LY2951742 kana placebo - shuga kana kuvhara mvura - kwemavhiki gumi nemaviri.
(LY2951742 is antibody in the calcitonin peptide-related peptide (CGRP) - izvi zvinoreva kuti inosungirirwa kuCGRP uye inodzima kana kuipisa).
Migumisiro inoratidza kuti vatori vechikamu vakagamuchira L22171742 vaiva nekuderera kukuru muhuwandu hwemazuva avo ekumusoro kwemazuva kana vachienzaniswa ne placebo. Nhau dzakanaka ndezvekuti iyi mishonga yakawanikwa yakachengeteka uye inoregererwa zvakanaka nezvidzidzo.
Izvo zvichitaura zvinoshata zvinosanganisira:
- injection site pain pain
- marwadzo emudumbu
- kuputika kwepamusoro mitsva inokonzera zvirwere (segonika)
Imwe mishonga inonzi ALD403 - uyewo calcitonin inonzi gene-related peptide antibody - yakayerwa muna 163 vatori vechikamu vanoona 5 kusvika 14 vanofambisa mwedzi. Imwe hafu yezvikamu zvakagamuchirwa zvakasvibiswa 1000mg inotyisa (kuburikidza nemuviri) chirwere chechirwere, asi imwe hafu yakagamuchira placebo. Zvidzidzo zvakateverwa kwemwedzi 6.
Mumavhiki mashanu kusvika ku8, vatori vechikamu vakagamuchira mishonga vakaona 66% kuderedzwa kwemazuva emazuva avo vakatambura kubva kune migraine kusvika 52 muzana kune avo vakagamuchira placebo.
Uyewo, pamasvondo gumi nemaviri, 16 muzana yevarwere vakagamuchira mishonga iyi yakazara migraine-isina kubhadhara kune avo vakagamuchira placebo.
Pakupedzisira, imwe mishonga, inotarisirwa pasi peganda (subcutaneous injection) inonzi AMG 334 - an antibody inosungirirwa kuCGRP receptor (nzvimbo yekuchengetedza yeCGRP) - ichangobva kuwanikwa kudzivirira migraines zvakare. Kufanana nedzimwe mishonga mbiri, AMG 334 yakanyatsorambidzwa. Mhinduro dzakaipa kwazvo dzakawanda dzaive:
- kutonhora zviratidzo
- kuneta
- musoro kana migraine (kuenda chimiro - duku zvikuru, 3 muzana kusvika 1% muboka re placebo)
- nausea
- kuputika kwepamuviri yeutachiona (sebronchitis).
The Bottom Line
Izvi zviitiko zvinonakidza zvikuru kune vevanhu vemagraine. Kunyange zvakadaro, chikwata chikuru chechikamu chechitatu - zvidzidzo zvakakura uye kuongorora zvirevo zvechikamu chechipiri chechipiri - zvinoda kuitwa musati mishonga iyi ichishandiswa kuvarwere.
Sources:
Bigal ME, Walter S, Rapoport AM. Calcitonin gene-yakataurwa peptide (CGRP) uye migraine kunzwisisa ikozvino uye nyika yekufambira mberi. Headache . 2013; 53 (8): 1230-44.
Durham PL. Calcitonin Gene-Related Peptide (CGRP) uye Migraine. Headache. 2006; 46 (Suppl 1): S3-S8.
Goadsby PJ, & Edvinsson L. Inonzi trigeminovascular system uye migraine: zvidzidzo zvinoratidzira hutachiona uye neuropeptide shanduko inowanikwa kuvanhu nemapoka. Ann Neurol. 1993 Jan; 33 (1): 48-56.
Zvibereko zvekutanga zve ALD403, A New Investigational Medicine yeMigraine Prevention. (nd). MuAmerica Headache Society. Kudzoswa May 18th, 2014.
Sun H et al. Kuchengetedzwa uye kubudirira kwe AMG 334 nekudzivirira kwechirwere chekudzivirira: epasidic, blind-blind, placebo-controlled, phase 2 muedzo. Lancet Neurol. 2016; 15 (4): 382-90.