ZMapp, Favipiravir, Antivirals, uye vane tariro yekuwedzera
Mhinduro iri nyore: isu hatizivi, asi tine tariro.
Pamberi peEbola yakapararira muWest Africa muna 2013 kusvika 2015, hapana kurapwa kwakanga kwambobudirira kuburikidza nevanhu. Kamwe chirwere ichi chakatanga, kurapa kwaiwanzopiwa kune tsitsi. Varwere vakagamuchira kurapwa uye vakavandudza. Zvisinei, nhamba yevarwere yave iri duku, dzimwe nzira dzakawanda dzokurapwa dzinoshandiswa dzimwe nguva, uye nekuda kwezvikonzero zvepamusoro apo hakuna kumbove kuenzaniswa kwepa placebo.
Mishonga yevarwere inobatanidzwa nekuvandudzika yakasanganisira: ZMapp, favipiravir, pamwe neropa kubva kune vakapona. Chimwe chidzidzo cheTKM-Ebola chakakundikana kuratidza chero ruzivo. Zvisinei, pakutanga zvisati zvatanga kugadzirwa, vanhu vanenge 10 vakagamuchira ZMapp muU.S., Liberia, Spain, uye UK. 2 chete vakafa. Pane imwe yakagamuchira favipiravr (muFrance) uye TKM (muU.S.) uye akapona. Gare gare vashandi vakatanga Brincindofovir- mumwe akafa. Kunyange zvakadaro, zvakaoma kutaurira mamwe emishonga iyi pasina chokwadi chekuedza miedzo, kana chiremba kana kuti kutarisira kwakatsigira kwakanaka, kwakagadzira kusiyana.
Kunyange zvakadaro, tine tariro. Kufa kwehuwandu hwehutachiona hweEbola (EBOV, Zaire) inopararira muWest Africa inoshamisa zvikuru. Iko pakutanga yaifungidzirwa kuva yakakura se 80-90% (sezvinoonekwa mune zvirwere zvekare kune imwe nzvimbo). Inoratidzika kuva 45-60% muWest Africa. Zvakanaka kuchengetedza kunogona kuderedza kufa kune 1 mu3.
Izvo zvakaomawo kuenzanisa kuponeswa kwehupenyu sezvo pane kazhinji kunonoka mukutsvaga kuchengetwa kana kuendeswa kunotarisirwa.
Dambudziko nderokuti: matanda eZMapp akabuda.
Asi zvino zvakawanda zviri kuwanika - asi kukurumidza kwadarika.
IWorld (World Health Organization) uye masangano ehurumende, kusanganisira US FDA (Federal Drug Administration), vanotsigira kushandiswa kwetsitsi uye kuongororwa kwemishonga iyi.
Zvisinei, pasina uchapupu hwokuti kurapwa kunoponesa upenyu, pane kunetseka kuti izvo zvingaita sokuti zvinoponesa zvinogona kuva zvinokuvadza - kana kungovhiringidza kubvisa kuchengetedza upenyu.
Saka izvi zvinotisiya kupi?
Convalescent Serum
Kutanga kurapwa kwakaedza Ebola kwakatanga nekuisa ropa kubva kune vakapona kune avo vane utachiona kupa zvirwere zvekurwisa utachiona. Mumwe mutsvakurudzi akapukunyuka achitevera Ebola needlestick muna 1976 (uye chiremba ane utachiona muna 2014) mushure mekuwedzerwa ropa asi zvakanga zvisinganzwisisi kana serum yakabatsira. Gare gare muna 1995, varwere 8 vakapiwa ropa uye 7 vakapona, apo yakawanda (80%) yakafa. Kuongorora kwekupedzisira, zvisinei, kwakaratidza kusinganzwisisiki kwebatsiro rwekuwedzerwa ropa (kupona kunowedzera sechinguva kubva pakuchengetwa uye kuputika kwokutanga kunopfuura). Kunyange zvakadaro, World Health Organization yakaratidza kufarira mukutsvaga kuwedzerwa ropa, sevapukunyuka, kusiyana nemishonga, inokonzerwa nehosha (kunyange mari yebhanga ingave isina kukwana).
Kuwedzerwa ropa kweConvalescent kwave kushandiswa muWest Africa, pamwe chete nevatano vatatu vari muUnited States.
Monoclonal Antibody
Zvirwere, zvinowanikwa mu laboratori panzvimbo pekuwedzerwa ropa, ndizvo zvave zviri kurapwa kunonyanya kuvimbiswa kusvikira zvino. Imwe mishonga, ZMapp kubva kuMapp Biopharmaceutical, inosanganiswa ne 3 monoclonal (kureva yakanyatsonaka) inorwisa mabhodendi (inopikisa glycoprotein pamusoro).
Kurapa, kuburikidza nemishonga inopihwa mishonga 3, inoratidzika zvakanaka. Zvinosuruvarisa, mishonga yemishonga yakabuda, kunyange zvazvo kuwanda kwemishonga yemishonga inorongwa (kuburikidza nemiti yefodya ichakura mushonga). I-FDA yakabvumira kushandiswa pakukumbira kwechirwere ichi chisina kutenderwa chevarwere veEbola apo paine.
Antiviral mishonga
Zvinodhaka zvinogonawo kurwisa zvakananga chirwere. Kune mishonga yakawanda yemishonga inodhaka: TKM-Ebola (Tekmira Corporation), BCX4430, (Biocryst Corporation), AVI-7537 (Sarepta), Favipiravir (Fujifilms)
Mimwe mishonga haifaniri kushanda. Muedzo weTKM-Ebola wakamira munaJune 2015 nokuti wakanga usina kuita sewakagadzirisa Wakanga waitarisira kuti nekushandisa rudzi rweRNA (kupindira kwakanyanya kweRNAs kunonzi siRNA) kunogona kuita kuti utachiona husapararire.
Inoshandisa RNA yakadzika kaviri kuti irege kutaura kwemajini kune 3 Ebola mapuroteni (Zaire Ebola L polymerase, Viral Protein 24 (VP24), uye VP35). Bhuku uye zvidzidzo zvemhuka zvakabudirira (kusanganisira nehutachiona hwakafanana, Marburg). Kufungisisa nezvekukuvara kwemuviri wekuzvidzivirira kwemuviri kwakakonzera kupedzisira kuenderera mberi, asi FDA ikozvino ichikurumidza ichi.
BCX4430 inoshanda sechivakwa chekuvaka DNA / RNA (adenosine nucleoside analog) ichimisa kupindira kwechirwere ; yave ichibudirira mumutsono kutongwa. 401.
F avipiravir , chirwere chinogamuchirwa nehutachiona muJapan chave chakabudirira muhutano hwemhuka uye chakapiwa sekurapwa kweEbola. Mushonga uyu sezviri pachena analogu inonzi nucleotide ichidzivirira kupfuurira kwehutachiona hwekuwedzera.
Brincidofovir (BCV, CMX001) haisati yasarudzwa neEbola. Kutsvakurudza ikozvino kwakanyanya kune mamwe mavairasi, saAdenovirus uye CMV.
Chaizvoizvo, BCV yakagadzirirwa kushandiswa neDNA majekiseni - CMV (Cytomegalovirus), Adenovirus. Ebola iRNA virus, kwete DNA virus. Iyo mishonga inova cidofovir mukati memasero. Ichi chirwere chakashandiswa kubudirira ne CMV nedzimwe zvirwere zveDNA, semapillomaviruses. Cidofovir is analog nucleotide; inoshandura dzimba yekuvaka DNA uye inopesana neDNA inotarisa muropa reDNA. Yakanyanya kushandiswa muRNA mavirusi eEbola. Zvisinei, kambani inoita Brincindofovir, Chimerix, inoburitsa ma laboratory zvidzidzo paCDC, NIH yakaratidza kupesana neEbola basa, iro raive nhau dzakagamuchirwa sezvo mushonga wakashandiswa zvakachengeteka kuvanhu kare, kunyange zvazvo mabasa anorwisa Ebola asina kumbosimbiswa mu mhuka kana vanhu zvakadaro. Icho chichange chichirwisa remuromo, icho chakapa mungozi yeingano neEbola, ingadai ichivimbisa. (Brincindofovir inosanganisira lipid, kana mafuta, chikamu chakasungirirwa cidfovir, icho chinobvumira kuti mishonga inomedzwa, kwete injowa).
AVI-7537 inoshandura rakashandurwa RNA molecule kuti inorwisawo protein yeVP24.
Approved medication
Nzira yakareruka yekurapa Ebola ingadai iri kuwana mishonga inozivikanwa kuti yakachengeteka iyo inoshanda kubudirira neEbola. Kuongorora zvinotenderwa nemishonga yekurwisa Ebola mabasa zvakasarudza S sarudzo estrogen receptor modulators (SERMs), zvakadai seComomiphene uye Torimefene inoshandiswa kwekuberekwa kwevakadzi uye nekamuti, sekurapa.
Mamwe madhiragi anokwanisa. Ebola inokanganisa kuvhara kwekudzivirira kunokonzera kuvhara uye kubuda ropa. A (itsva) zvinodhaka zvinogona kuita kuti kuvhara rNAPC2 kuve kwakadzidzwa pamwe chete nemishonga inozivikanwa, rhAPC (recombinant yeProtein C yakagadzirwa nevanhu) mune tariro. Saizvozvowo, vamwe vanopikisa cholesterol-kuderedza zvinodhaka zvichienderana nezvimwe zvirwere. Saizvozvowo, interferon yakave yakatariswa kushandiswa muEbola. Mumwe chiremba akashandisa utachiona hweHIV, Lamivudine, nucleoside analog, muvatachiona veEbola vanogona kutungamirira mberi.
Fake Mishonga
I-FDA yakanyevera pamusoro pekushandiswa kwemishonga isina kubvumidzwa. Mishonga yakawanda inonzwika zvakanaka - nyanzvi - asi pasina kuongororwa, haisi pachena kana iri yakakosha kana inokuvadza.
Vaccine
Mushonga wokudzivirira utachiona hwaizova hwakanaka. Ikozvino kune chirwere chakave chakaedzwa uye chinenge chichibudirira.
Tisati dambudziko ra2013-2015, pakanga pane zvirwere zvakange zvakagadzirirwa Ebola, asi hazvina kuongororwa zvakaenzana. Chimwe chirwere chaive chichiongororwa kune mumwe murwere; zvinogona kunge zvakabatsira mushure mekutsvaga mutsvaga we 2009 Ebola needlestick. Ichi chirwere, chirwere cheVSV (recombinant vesicular stomatitis virus vector kuratidza Ebola virusi glycoprotein) yakave ichiongororwa mumhuka dzemhando (asi kwete kune vamwe vanhu) uye yakaratidza kuti inoshanda kunyange kusvika maawa makumi maviri nemashure mushure mekuonekwa. Yaiva chirongwa cheVSV chakaedzwa uye chinoratidzika sechichioneka chinoshanda muGuinea.
Pakutanga kwehutachiona, maiva nemapoka akawanda uye hurumende dzakashanda pakuedza nekushandisa zvirwere. Hurumende yeCanada yakapa kuti igovera zvikamu zviduku zvinowanikwa zvechirwere ichi chekuedza. NIH yakanga yakaronga kuedza nokukurumidza mumwe munhu anozvidzivirira. Hurumende yeChinese gare gare muna 2015 yakatangawo kuyera mushonga, uchishandisa adenovirus-vector.
Pakupedzisira, pangava nemishonga yakawanda. Zvinosuruvarisa, zvizhinji zvekuedzwa zvichave zvakanyanyisa kuchera kubatsira mazana akafira muna 2013-2015. Izvo zvakanyanya kuoma kuedza zvirwere apo kune vashoma zvirwere.