Mune Mamwe Mikana, Zvirongwa zveMamiriro Aviri Anogona Kuwedzera
Vanhu vane chirwere chinoputira chirwere (IBD) dzimwe nguva vanoita zvimwe zvirwere kana mamiriro ezvinhu anonzi mazamu -emitambo (kana dzimwe nguva EIM) . Mamiriro eganda anowanzowirirana nevanhu vane IBD, uye imwe inowanzoitika nguva dzose muhuwandu hwevanhu uye kuvanhu vane IBD is psoriasis . Vanhu vazhinji vanogona kufunga nezve psoriasis sechimhanyi, asi inenge yakagadziriswa uye inogona kugovera nzira imwechete yekuputira seCrohn's disease.
Nokuti mamiriro acho maviri angangodaro anokonzerwa nechinetso mukushanda kwezvirwere zvemuviri, vanowanzobatwa nemimwe mishonga imwecheteyo. Kune vanhu vane IBD vanewo psoriasis, mamiriro acho maviri angave chinhu chinokosha pakusarudza kurapwa.
Kune marudzi akasiyana-siyana ekurapa kunobudirira kwe psoriasis akatowanikwa uye akawanda zviri kuitika iye zvino. Vanhu vane zvose psoriasis neBD vachatsvaka kutarisira kubva kune dermatologist ine ruzivo nevarwere vane IBD uye vachashanda pamwe chete ne gastroenterologist .
Chii Chinonzi Psoriasis?
Psoriasis chirwere che systemic chinokonzera kukwidza, kuora kwechivara paganda. Iko rinogona kuonekwa pane chero chikamu chemuviri, asi kazhinji kacho chinoratidzika pamusoro pamakumbo, mabvi, uye chikafu asi chinogona kuwanikwa pamakumbo, misumpi, uye trunk. Rudzi rwakanyanya kunyanya rwe psoriasis runonzi plateque psoriasis uye iyo plaques inogona kukonzera tsvina kana kupisa.
Psoriasis inopedza nguva dzekutadza-ups uye kuregererwa. Muzviitiko zvakawanda, psoriasis inobatwa nemasikiriti emitambo.
Zvinowanzoita sei Psoriasis muvanhu vane IBD?
IBD inofungidzirwa kuti inofungidzirwa nezvirwere. Hazvisi zvisizvo kune vanhu vane chirwere chimwe chekuzvidzivirira pamuviri kukudziridza imwe. IBD uye psoriasis zvose zviri mumamiriro ezvinhu ane zvikonzero zvisingazivikanwi (zvinonzi chirwere cheIdiopathic) uye zvinoguma nekuputika.
Mumakore achangopfuura vatsvakurudzi vari kuzarura zvakawanda nezvehukama pakati peBDD nezvirwere zveporiori. Psoriasis munharaunda yakawanda inongomhanya inenge 2 kusvika ku3 muzana asi vanhu vane IBD inowanzova yakakwirira. Zvidzidzo zvinoratidza kuti vanhu vane Crohn's disease uye ulcerative colitis vanogona kukura psoriasis pachiyero chema13 kubva muzana.
A Common Inflammatory Pathway
Sezvo vatsvakurudzi vanoona zvakawanda pamusoro pekuvhiringidza nzira dzeBD uye psoriasis, zvimwe zvinobatana pakati pezvirwere zviviri zviri kuzarurwa. Chirwere cheCrohn uye psoriasis zvose zvinoonekwa seT1 mamiriro ezvinhu. Th1 mubatsiri wechirwere unokonzera kuputika apo mutezo unopindwa nechirwere chekune dzimwe nyika separasite, mabhakitiriya, kana utachiona. Ulcerative colitis inonzi inonzi Th2-yakafanana nemamiriro ezvinhu. Th2 masero anoshandiswa kana pane bhakitiriya, mhinduro inopisa, kana chepfu inowanikwa. Sezvo basa remasero aya eT akanzwisiswa zviri nani pamusoro pekugadzirwa kweBD uye psoriasis, zvinogona kutungamirira pakugadzirwa kwehutano hunobudirira hwezvirwere izvi.
Kuva nePoreoriasis Kuwedzera Dambudziko Rekuvandudza IBD?
Kune zvidzidzo zvishomanana chete izvo zvakatarisa muhutano hweBD kune vanhu vakamboonekwa vane psoriasis.
Vakaratidza migumisiro inopesana: Vamwe vakaratidza dambudziko rinowedzera reBD kune avo vane psoriasis nevamwe vakaratidza zvakasiyana. Uyezve, nzira dzaishandiswa mune zvidzidzo izvi dzakanga dzisiri kunze kwezvisina kukanganisa, izvo zvinoita kuti mhedziso dzive dzakaoma kumira. Parizvino, hazvizivikanwi kuti chii chinotyisa, asi zvinoita sechiitiko kune vanhu vane psoriasis vane ngozi yakawanda yekukura chirwere cha Crohn. Izvo zvingasava zvechokwadi kune chironda chekurara: Pane humwe uchapupu hushoma hwokuti vanhu vane psoriasis vangave vari pangozi yekuwedzera kukura kweutachiona.
Nyaya dzezvinyorwa uye Chiedza Chirapa Mishonga yePororiasis
Kune mishonga yakasiyana-siyana ye psoriasis, kusanganisira chiedza chekurapa, mishonga yepamusoro, uye mishonga. Muzviitiko zvakawanda, zvinopfuura kurapwa kumwe zvinogona kushandiswa panguva imwechete kurwisa zviratidzo zve psoriasis. Kazhinji, mishonga yepamusoro inogona kuedzwa kutanga, isati yaenderera mberi kuedza kupedza remishonga kana kuti systemic mishonga.
- Mishonga yepamusoro. Kune marudzi akasiyana-siyana emaikisi nemafuta anokwanisa kushandiswa kwe psoriasis, zvose pamusoro pekambani uye mishonga. Zvimwe zvinosanganisa zvinosanganisira corticosteroids , vitamin D , retinoids, anthralin , calcineurin inhibitors (Protopic uye Elidel) , salicylic acid, uye tar . Mune zvimwe zviitiko zvinogadziriswa zvinogona kushandiswawo kurwisa kuoma.
- Light therapy. Chiedza chine ultraviolet A uye ultraviolet B chingashandiswawo kurapa psoriasis. Izvi zvinowanzoshandiswa pamwe chete nedzimwe mishonga. Chiedza chekunze chinogona kushandiswa, kwenguva pfupi. Mikoko yakasvibiswa inogonawo kugadziriswa kuburikidza ne phototherapy neine jira, bhokisi, kana dumba. Mune zviitiko zvakakomba, mushonga unoita kuti ganda rive nehanya ne ultraviolet chiedza rinogona kushandiswawo panguva imwechete sechirwere chechiedza kuitira kuti chibudirire. Mhando yea laser inoshandiswawo dzimwe nguva nokuti inogona kutarisa nzvimbo dzakananga pamuviri une simba rakasimba remuchenjeo weV ultraviolet B.
Mishonga Inoshandiswa Kuita Psoriasis
Nokuti psoriasis chirwere che systemic, mishonga inopiwa nemuromo kana muchijoka inogonawo kushandiswa. Mune zvimwe zviitiko, mishonga inobvumirwa kuporesa psoriasis inopiwawo kurapa imwe kana mamwe maitiro eBD, kusanganisira methotrexate, cyclosporine, uye zvimwe biologics:
- Cosentyx (secukinumab) : Cosentyx inonzi monoclonal antibody inobvumirwa kuporesa psoriasis, psoriatic arthritis, uye chimiro cheArthritis chinosangana neBD chinonzi ankylosing spondylitis, zvisinei kuti hachibvumirwi kubata chero rudzi rweBD. Cosentyx inopiwa pamusha kuburikidza nejairo ne preffect pen kana seringir. Migumisiro inowanzowanzobatanidza zviratidzo zvinotonhora, chirwere, uye kuputika kwezvirwere.
- Cyclosporine : Cyclosporine ine immunosuppressant zvinodhaka zvinoshandiswa kurapa zviitiko zvakanyanya zve psoriasis uye dzimwe nguva zvinoshandiswa muCrohn's disease. Zvimwe zvinowanzovhiringidza zvinosanganisira kushaya misoro, kuora mwoyo, kupererwa kweropa, uye kuneta. Hazviwanzokurudzirwa kushandiswa kwemazuva mazhinji mune imwe nyaya ye psoriasis, uye inowanzoregwa pasi pegore.
- Enbrel (etanercept) : Enbrel imishonga inonzi biologic iyo inogamuchirwa kubata chirwere che psoriasis pamwe nekushongedzerwa kwepondylitis. Iyo ivhavha yeTNF, asi haisati ishandiswa kubata chero chero rudzi rweBD. Enbrel inorowa pamba uye inowanzovhiringidzika yega yega inofanirwa kugadziriswa pane nzvimbo yejojo, zvakadai sekubwinya kana kurwadziwa.
- Humira (adalimumab) : Humira chirwere chinoshandiswa chinoshandiswa kurapa Crohn's disease uye ulcerative colitis pamwe ne psoriasis. Varwere vanogona kuzvipa Huma pamba nokuti inouya mune imwe chirongwa chinonzi injection pen. Iyi mishonga inonzi monoclonal antibody uye inorondedzerwa seN TNF-inhibitor. Nyaya yakanyanya kufanana nayo inorwadza kana kushungurudzika panzvimbo yejojo, iyo inorapwa kumba nechando kana antihistamines.
- Methotrexate : Iyi mishonga inogona kupiwa mumuromo kana kujowa, uye inoshandiswa kurapa psoriasis pamwe neCrohn's disease uye ankylosing spondylitis. Zvimwe zvemigumisiro yakaipa zvinosanganisira kuora mwoyo, kuora musoro uye kurara. Vakadzi vanogamuchira methotrexate vanofanira kudzivisa pamuviri nokuti ichi chirwere chinogona kukonzera kusapera kusina kunaka. Methotrexate inowanzopiwa pamwe nemamwe mishonga yeBD uye / kana psoriasis.
- Otezla (apremilast) : Otezla inorapwa mishonga uye ndiyo yekutanga inobvumidzwa kushandiswa mukurapa psoriatic arthritis kune vanhu vakuru uye inobvumidzwa kuti ishandiswe muparque psoriasis. Zvinowanzoitika zviitiko zvinoshushwa panguva yekuedzwa kwekliniki kwaiva nekunyunyuta, kuora musoro, nekurwara, asi izvi zvinowanzovandudzika mushure memavhiki mashoma ekurapwa.
- Stelara (ustekinumab) : Stelara akatanga kugamuchirwa kurapa psoriasis uye iye zvino anobvumirwawo kubata chirwere cha Crohn. Stelara inonzi biologic mishonga iyo inonzi interleukin (IL) -12 uye IL-23 blocker. Stelara inotanga kupa IV asi mushure mokunge chiremba chekutanga chipiwa kumba kumba. Zvimwe zvinokonzerwa nemigumisiro inosanganisira kusuruvara, kupindira pane nzvimbo yejojo, maziso, uye zviratidzo zvinotonhora.
Shoko Rinobva
Uchapupu huri kukura kuti psoriasis neBD zvinowanzoitika pamwe chete kakawanda kupfuura kufunga mumakumi emakore akapfuura. Hachiri pachena kana vane psoriasis inoita kuti zvive nyore kuti munhu apewo chimiro cheBD. Mune dzimwe nguva mishonga inoshandiswa kurapa IBD inoshandiswawo kubata chirwere che psoriasis. Zviitiko zvakawanda zve psoriasis zvinonzi zvinyoro kuenzanisa uye zvinogona kurapwa nechirwere chechiedza kana mishonga inopikisa. Kune mamwe maitiro akaoma eporioriasis, uko 5 kubva kune 10 kusvika kuzana kubva muzana kana muviri wakawanda unopindwa, mishonga yemuromo kana biologics inogona kushandiswa zvakare. Kungofanana neBD, zvakakosha kupfuurira mushonga we psoriasis kuitira kudzivirira kupisa-ups. Kune mishonga yakawanda mutsva ye psoriasis iye zvino iri pasi, uye remangwana rekurapa psoriasis yakajeka.
> Sources:
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