Mishonga Yakasimba Inosarudzwa nokuda kweKutanga-Mvura Kwekutanga
Integrase inhibitors (inozivikanwawo se integrase strand transfer inhibitors, kana INSTIs) isimba rine simba remishonga inorwisa mabhakitiriya iyo inodzivirira HIV kusabatanidza maitiro ayo ekutengesa (genome) kupinda muDNA yejeri revanhu vane utachiona. Izvo zvinodaro nokuvhara enzyme inonzi integrase uye, nokuita kudaro, inoita kuti zvibvirire kuti HIV iitezve.
Isentress (ratelgravir) ndiyo yekutanga INSTI yakagamuchirwa neU.S. Food and Drug Administration (FDA) musi waOctober 12, 2007.
Zvose zvakataurwa, pane imwe nguva inotenderwa neInstI mishonga yezvinodhaka uye mana inogadziriswa inosanganiswa zvinodhaka umo INSTI iri chikamu
- Isentress (ratelgravir)
- Tivicay (dolutegravir)
- Vitekta (elvitegravir)
- Triumeq (dolutegravir + abacavir + lamivudine)
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine)
- Genvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine)
Kunyange zvazvo integrase inosanganiswa nemishonga, Dutrebis (ratelgravir + lamivudine), yakagamuchirwa neU.S. Food and Drug Administration, haisi yekutengeserana iri kuU.S. panguva ino.
Vashandisi vezvinodhaka ViiV uye Janssen Pharmaceuticals vari kubatanidzwa pane imwe mishonga inodhaka iyo inogona kusanganisira dolutegravir nemushonga waEdurant (rilpilvirine) . Chimwe chivimbiso chekutsvaga INSTI, cabotegravir, iri kuenderera mberi neChiratu III.
Sekirasi yemishonga, integrase inhibitors inonzi inobatsira pakuchengetedza utachiona hweHIV, nepamusoro pekudzivirira kudikanwa, migwagwa yakadzika midzi, kuwedzerwa kushandiswa kwemaprofiles, nekuwedzerwa kwenguva refu.
Sezvo zvakadaro, INSTIs inorondedzerwa sevamwe vekusarudzwa kunoshandiswa kurapwa mumitemo yakawanda yeHIV, kusanganisira iyo yeU.S.
Nhungamiro yemazuva ano kubva muDhipatimendi reHurumende neUnited Services yeUnited States inopa integrase inhibitors seanosarudza, mushandi wekutanga wevanhu vanongobatwa neHIV. Zvechokwadi, pamatanho matanhatu ekurapa ikozvino anorudzirwa kune vatsva vanorapwa, zvishanu zvine integrase inhibitor semasana avo emishonga yemishonga.
Ko Intergrase Inhibitors Inoshanda Sei?
Utachiwana hweHIV hunobatanidza utachiona hwetachiona hwemuviri muDNA yejeri iri mumatanho mashanu:
- Iyo integrase enzyme inosunga kuHIV DNA, iyo yekupedzisira iyo yakasikwa mune imwe nzira inonzi reverse transcription .
- IAIDS DNA inogadzirirwa kubatanidzwa mune imwe nzira inonzi kumira, iyo inobvisa zvachose chirwere chetachiona, ichisiya mapoka akazaruka muhutano hwayo.
- Iyo yakagadziriswa inoshandiswa iyo inopindirwa mukati memusasa memusasa memusasa kuburikidza nenyuchi yenyukireya .
- Kana uchingopinda mukati memukati, HIV DNA inotamirwa kune DNA inowanikwa mune izvo zvinonzi shanduko yekuita. Muchikamu chino, chirwere cheDNA chinorwisa zvakakwana DNA rejena rekuchengetedza, kuparadzanisa zvibatanidza zvinobata DNA pamwe chete uye kuzvibatanidza kuburikidza nemakemikari emakemikari muropa reDNA.
- Kurwiswa kunobatanidza kugadziriswa kwepanyama kunonzi kugadzirwa kwegasi, umo seni rinogadzirisa richagadzirisa chero zvinokonzerwa neDNA, zvichiita kuti kuve nekutsvaga kwekunyora kwayo.
Kungoita nekuvhara enzyme integrase, iyo yose yekubatanidzwa inomiswa, nekugadzirisa kupedza hutachiona 'hupenyu hwehupenyu. Zvisinei, sekubatanidzwa kune imwe chete yematanho akawanda ehupenyu hweHIV, zvimwe zvinodhaka zvinotorwa kuti zvidzivise dzimwe nhanho, nekudzivirira hutachiwana hweHIV kuti dzisadzokorora uye kuve nechokwadi chokuti basa rehutachiona rinopedzwa zvachose (sekuenzaniswa nehutachiona hweHIV).
Migumisiro Yechiri uye Kufungisisa
Kusiyana nedzimwe makirasi eHIV zvinodhaka, integrase inhibitors inoshanda zvakananga pamusoro pezvirongwa zvehutachi ivo pachavo panzvimbo pane masero. Sezvo vakadaro, vanowanzove vashoma pamigumisiro yechirwere, kunyanya kurara, kusuruvara, kuneta, kuora musoro, uye kusuruvara.
Zvizhinji zvemigumisiro yacho, zvisinei, ndeyenguva duku uye kazhinji zvinogadzirisa pachavo pachavo. Nezvo izvo zvataurwa, kana iwe uchinge uchinge uchinge uchitarisana nechiitiko chinotambudza uchitora integrase inhibitor mishonga pamwe chete, kuraira chiremba wako kana kliniki pakarepo. Usarega kurapwa kunze kwekutaura kutaura kune unyanzvi unyanzvi. Kuisa uye kuchinja nguva isati yasvika kunogona kukuvadza kupfuura kunaka.
Saizvozvowo, nepo integrase inhibitor isingakwanisi kutarisana nekusagadzikana kwemishonga , iwe unofanirwa kudzivisa kushayikwa kwemaitiro kana zvipembenene mukurapa. Kurwisana kunowanzoitika apo madhigiriyamu muropa anotanga kuwira, achibvumira zvirwere zvinotenderera zvichibuda uye zvinowedzera. Kana izvi zvichiitika, mishonga yako haikwanise kushanda pamwe chete uye inogona, mune dzimwe nguva, inokundikana.
Sezvo integrase inhibitor ichiri muropa ropa kwenguva refu, vanogona kudzivisa HIV mutants kunyange kana maitiro akangokundikana. Asi zvakakosha kunzwisisa kuti kukanganiswa kwenguva refu hakuna kurayirwa uye kuti kuchengeta zuva nezuva kunoramba kuchikosha pakubudirira kwekurapa.
Sources:
US Food and Drug Administration (FDA). "Kurapa Zvinodhaka Mishonga - Zita reMishonga: Isentress (ratelgravir) 400mg Matetet." Silver Spring, Maryland; Gunyana 12, 2007.
National Institute of Allergies and Infectious Diseases (NIAID) "HIV / AIDS Preclinical Drug Development." Bethesda, Maryland; yakarongedzwa musi waJuly 21, 2015.
Dhipatimendi reHutano neHuman Services (DHHS). "Mirayiridzo yeKushandiswa kweAntiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vari Kuyaruka." Rockville, Maryland; yakarongedzwa naJanuary 28, 2017; yakasvika musi waMarch 24, 2017.
Craigie, R. uye Bushman, F. "HIV DNA Integration." Cold Spring Harbor Mafungiro muMishonga. July 2012; 2 (7): a006890.
Bushman, F .; Fujiwara, D .; uye Craigie, R. "Retroviral DNA kubatanidzwa kunotungamirirwa neprotini inobatanidza HIV mu vitro." Sayenzi. Svondo 28, 1990; 249 (4976): 1555-1558.