An immunomodulator isirasi yemishonga yechirwere inoratidzwa kune varwere vane zvakaoma-ku-kudzora asthma. Sezvo kuwedzerwa-kurapa kwechirwere chako, an immunomodulator mutevedzeri wemishonga pane kungoita mishonga pfupi yekuita mishonga yekununurwa kwakanyanya kwezviratidzo zvechirwere . Nokuti anenge anenge chetatu chevashandi vezvechirwere vasingakwanisi kupindura steroid inoputika kana kuva nehurombo husingaiti, immunomodulator inogona kupa tariro yehutachiona hwepamusoro hwehutachiona.
Xolair , a monoclonal antibody, ndiye chete iye zvino anogamuchirwa maitiro ekudzivirira immunomodulator anowanika kuA asthma. Iyi immunomodulator inokodzera kugadzirisa kuongororwa kusinganzwisisiki kana kurwara kwakasimba kune varwere vane:
- Chirwere chakachena kana rumwe ruzivo rweropa rwuri kuratidza kutenderera kune anozivikanwa nehutachiona hwemafi, zvakadai seguruva mite, imbwa, kati kana jongwe dander.
- Zviratidzo zvisingaitirwi kutongerwa nekarticosteroids inoputika .
Imwe immunomodulator inowanzoshandiswa mumishonga yeveruzhinji uye yekudzivirira mafungiro nhasi ndeyeCinryze, kurapa kwekudzikama kunoramba kuripo mumeso uye mumutsipa unonzi hereditary angioedema.
Maitiro eEmunomodulators Anoshanda sei
Immunomodulators inoderedza zviratidzo zviviri zvechirwere uye kudiwa kwe systemic corticosteroids . Needing systemic corticosteroids kanopfuura kaviri chiratidzo chekushaya masimba ekudzivirira . Masunomodulator anogonawo kuderedza kuputika nekukwira nzvimbo dzakasiyana-siyana mune pathophysiology yemafi , kusanganisira:
- Basophils
- Eosinophils
- Lymphocytes
- Macrophages
- Mast Cells
- Neutrophils
- Monoclonal Antibodies
- IgE
- T-masero
- Cytokines
- Interleukins
An immunomodulator anosungira kuIgE uye anoidzivirira kubva pakusunga kumasophils uye mast cells. Uyezve, immunomodulator inoderedza kuwanda kwenhamba yeasophils uye inodzivirira mast masero kubva pakusunungura zvinhu izvo zvichaita kuti zviratidzo zvako zviwedzere.
Nzira dzekudzivirira mafungidziro
An immunomodulator dzimwe nguva anonzi steroid-sparing zvinodhaka zvinokurudzira kufamba kwemhepo uye mapapu. Kuwedzeresa, an immunomodulator inoderedza zviratidzo zvechirwere zvakadai se:
- Wheezing
- Chest tightness
- Kupfupika kwemhepo
- Kuora mwoyo kusingaperi
Kurapa neine immunomodulator kwave kuchibatanidzwa nekuderera kwemaitiro ekuwedzera kwemafi uye kushanya kwechimbichimbi pamwe chete nekuvandudzwa kwemapapu ekushanda uye hupenyu hwehupenyu. Kazhinji, an immunomodulator haazogadziri kumwe kurapwa kwechirwere, asi ichawedzerwa kwariri. Kuwedzerwa kwema immunomodulator kwave kunobatanidzwa nehuwandu hwe 25% hwekuderera kwe steroid kushandiswa.
Zvichida Zvimwe Maitiro
Kunyange zvazvo immunomodulator yako inofanirwa kuregererwa zvakanaka, pane dzakawanda zvinowanzova nemigumisiro uye zvisingaiti migumisiro yakawanda yekuziva, kusanganisira:
- Urticaria uye anaphylactic reactions -Urticaria, kana mikoko, inokonzera kugadzirisa iyo inogona kuva nemigumisiro yakakomba kana isingatarisirwi nokukurumidza uye yakakodzera. Chiremba wako achakumbira iwe kuti uongororwe kwenguva yakati muhofisi mushure mejeri rimwe nerimwe. Kunyange zvazvo kupindura kwakanyanya kuchiitika mukati memaminitsi maviri kana maviri mushure meimwe yejoi yekutanga, kugadziriswa kwemagetsi kwakaitika mushure memajisi akawanda uye maawa mazhinji kubva pakugamuchira jekisi.
- Kanzira- Kana isina kunyatsojeka panguva ino, kanzira dzaive dzakajairika pakati pevarwere vanogamuchira Xolair. Zvisinei, chikonzero nei ukama huri pakati pekenza uye immunomodulator hwakaonekwa hahuna kunzwisiswa zvachose.
- Injection site pain- As with any injection, marwadzo panzvimbo yejojo inonzi inozivikanwa uye inogona kuitika kusvika kusvika 20 muzana yevarwere vanowana immunomodulator.
- Kumusoro kuputika kwezvirwere zvirwere- Iva nechokwadi chokuti unokurukura nachiremba wako zvaunofanira kuita uye kana zvakakodzera kutsvaga kana iwe uine zviratidzo izvi.
- Muromo uye marwadzo-Kana zviratidzo izvi zvisingagadziriswi nematanho anochengetedza, semishonga inorwarisa uye inopfuura-in-counter, ipapo unofanira kutaura nechiremba wako.
Immunomodulators in Development
Mamwe mazita ekudzivirira mafungiro anokonzera zvikamu zvakasiyana- siyana zvepathogenesis yeAhma ari mune pipeline:
- Daclizumab inonzi monoclonal antibody inokonzera nzvimbo dzakawanda mumhepo inoputika. Yakarongedzwa mumuedzo wekliniki wevarwere vemazana 115, asi vakaratidza kungovandudza kuduku mumapapu ekugadzirisa uye kupora mweya.
- Lebrikizumab munhu anonzi monoclonal antibody anobatanidza uye anovhara basa re interleukin-13, chimwe chikamu chepathophysiology yemafi. Zvirwere zviviri zvemakiriniki, VERSE neLUTE, zvakaratidza kuderera kwehutachiona hwekusimudzira mweya uye kuvandudza mapapu emabasa kune varwere (pasina kunyanya kunetseka kwezvokuchengetedza) neine mwero-kusvika-yakanyanya kushaya simba iyo ine urombo hwakashata pasinei nekugadziriswa kwemazuva ano-kutarisira kurapwa. Varwere vanonyanya kutaurwa kuti vabatsirwe mune zvidzidzo izvi vaiva nehupamhi hwe periostin, puroteni inozivikanwa kuwedzera mazinga ekuputika.
- Reslizumab inonzi humonised monoclonal antibody inobata interleukin-5 (IL-5). Mumakiriniki ekuedzwa, yakashandiswa muvanhu vakuru uye vari kuyaruka vane chirwere chepachimbuzi vane ropa rakasimudzwa eosinophils, pasinei nekurwiswa kwekodticosteroid based regimen. Reslizumab yakaratidza kuderera kwekusimudzirwa kwechirwere chemhepo uye yakagadziridzwa mapapu mumushonga wechikamu chechitatu kuchipatara mumatambudziko anopfuura 1 700 vechidiki uye varwere vakuru. Kubva pamatambudziko, zvinotarisirwa kuti zviratidzo zvichave zvakafanana neya Xolair. Reslizumab iri kutariswa neDefA neTVVA yakatora chiito pakushanda kwavo zvakare muna 2016. Makambani emamwe makambani emishonga, akadai seAspraZeneca, ane zvinodhaka zvakafanana mumapayipi avo, zvakare.
- Eculizumab (Soliris®) inonzi humocidal monoclonal antibody inobatanidza urongwa hwekugadzirisa urongwa uye ikozvino inogamuchirwa neDFA mukurapa kweparoxysmal nocturnal hemoglobinuria. Chirwere chechipatara chiduku chakaratidza kuvandudzwa kwemapapu ekushanda uye zvirwere zvinokonzera zvirwere. Zvisinei, ichi chinodhaka chave chichibatanidza nehupenyu hunotyisa uye hutachiona hwehutachiona hwevanhu. Somugumisiro, mushonga wacho unongorambidzwa uye vanachiremba vanoda kubhadharira kuti vakwanise kuritaura.
- Chikoro chakaratidza mitsva yakanaka, asi katatu pazuva pazuva dosing masikati anokonzerwa nehutachiona hutsika.
- Tumor necrosis factor-alpha (TNF-α) is immunomodulator iyo inoshandawo munzvimbo dzakasiyana-siyana mupathophysiology ye asthma. Zvimwe kunze kwekuvandudzwa kwehutano muhuwandu hwevatachiona hwehutachiona hwepamusoro-soro (inonzi inozivikanwa inotungamirira ku TNF-α overexpression), TNF-α haina kuderedza kuwedzerwa kana kuvandudza mapapu. Kunyanya kunyanya, Infliximab (Remicade®) uye etanercept (Enbrel®) inoshandisa mafungiro emagetsi ikozvino anoshandiswa kune dzimwe zvirwere, zvakadai se rheumatoid arthritis. Iyi mishonga inobatanidza nehuwandu hwehutachiona hwehutachiona
- Peroxisome proliferator yakagadzirirwa receptor-gamma (PPAR-γ) chimwe chikwata chemishonga pasi pekudzidza. Iyi mishonga inenge isati yashandiswa mukurapa chirwere cheshuga, uko yakawanikwa kuti yakanga ine zvingaita zvinopesana nezviito. Guinea yenguruve dzakabatwa ne rosiglitazone zvakananga dzakawanikwa dziine kuderera kukuru muhutano hweI-5 neIgE. Apo mhuka dzaisanganiswa, tIL-5 neIgE dzakawanikwa zvakare kuti dzakaderera mumapapu. Izvi zvinotungamirira vatsva kuti vafungisise kuti ingangodaro kurapa kwakanaka kwechirwere, zvakare.
- Syk kinase inonzi intracellular protein tyrosine kinase inodzivisa kuvhiringidza kwemasero masiti. Chirwere ichi chakawanikwa kuti chideredze kusangana kwemazino uye kubuda, kuchenesa, kuchenesa kwemhino nehuro, kuputika kwemvura, kuora, kuora musoro, uye kurwadziwa kwepasipo kune varwere vanotarisana neerergic rhinitis mubasa iri. Chidzidzo chinoshandiswa kuburikidza nekugadzirwa kwakanyatsorongwa kunorongwa kuvarwere ve asthma.
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National Heart, Lung, uye Blood Institute. Gweta Rinoongorora Gweta 3 (EPR3): Mirayiridzo yeKutsvaga uye Kutungamirirwa kweApmma.
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