Rituxan, Gazyva, uye Anti-CD20 Cancer Therapy
Rituxan inoshandiswa pakugadzirwa kwemagetsi-munhu anosanganiswa nemasikirwo. Inoshandiswa kurapa mamiriro akawanda akabatanidza kusina Hodgkin lymphoma.
Iyo Inoshanda Sei
Kuziva kuti masimba edu ezvirwere zvinogona kuisa sei uye obvisa mabhakitiriya uye mavhairasi munharaunda yedu, masayendisiti akafunga kuti zvingave zvichikwanisa kuenzanisa iyo nzira yekurwisa masero emukenza.
Nhengo dzezvirwere zvemuviri yedu dzinokwanisa kuziva zviratidzo pamusoro pebhakitiriya nemavirusi anoratidza kuti haasi mumuviri.
Apo patinotarirwa kune ma microorganisms aya tinogadzira zviratidzo kuti tibatanidze kune idzi pamusoro penzvimbo, tichirega mamwe masimba edu ehurumende achiziva kurwisa. Zvakawanikwa kuti mamwe maitiro asiri eHodgkin lymphoma anewo zviratidzo zvinogona kuzvitsaura. Ichi chiratidzo chinonzi CD20 antigen uye chiri pamusoro pezvimwe zvemasero edu emumune anozivikanwa seB-lymphocytes, kana masero eB. Aya ndiwo masero anova kenza mune dzimwe nzira dzisina Hodgkin lymphoma uye chronic lymphocytic leukemia.
Nhanho inotevera yaiva yekuwana mishonga inogona kuita semishonga inopikisa muviri we-anti-antibodies iyo yaizozivawo nzvimbo yepamusoro, asi nekenza masero. Rituxan (rituximab) ndiyo "maitiro anonzi antibody" anowanikwa kunamatira kuCD20 antigen pamasero echechi anonzi pre-B uye maB-lymphocytes anokonzera. Pane imwe nguva Rituxan inosunga kuCD20 pane masero anokonzera kenza, pane dzimwe nguva nzira shomanana dzinoshandiswa nekenza dzemasikati dzinoparadzwa.
Masayendisiti anosarudza zvirwere zvakasiyana mumapoka akasiyana-siyana, zvichienderana nehutano hwavo uye basa, uye Rituxan inorongwa seAn immunoglobulin G, kana IgG. Rituxan inorondedzerwa se monoclonal antibody - rudzi rwe immunotherapy runoshandisa "man-made" antibodies kurwisa kenza.
Zvishandiso
Rituxan inoshandiswa kune zvirwere zvekenza uye zvisingava nekenza.
Izvi zvinogoneka sei? Zvakanaka, zvose izvi zvinosangana nemasero machena anozivikanwa seB-masero kana B-lymphocytes, ayo ari chikamu chemuviri wechirwere chemuviri. B-masero-aya masero anokonzera kenza mumarudzi akasiyana-siyana e-lymphomas-anogonawo kuita basa mukuvandudza rheumatoid arthritis nezvimwe zvirwere zvinopisa. Inogona kushandiswa kwekenza uye zvirwere zvisiri zvekenza.
Cancers:
- Vanhu vane mimwe mitero ye-non-Hodgkin's lymphomas kusanganisira follicular lymphoma (FL) uye inoparadzanisa B-cell lymphoma (DLBCL) yakakura.
- Vanhu vane chronic lymphocytic leukemia (CLL) iyo CD20 yakanaka.
Non-Cancerous Diseases:
- Vamwe vanhu vane rheumatoid arthritis.
- Vamwe vanhu vane zvirwere zvisingawanzi zvirwere zveropa zvakadai segranulomatosis ne polyangiitis (GPA) (Wegener's Granulomatosis) uye microscopic polyangiitis (MPA).
- Inenge ichidzidziswa mumakiriniki ekuedzwa kuti zvigone kushandiswa mu multiple sclerosis uye systemic lupus erythematosus.
Targeting B-masero muNi-Hodgkin Lymphoma uye Chronic Lymphocytic Leukemia
Kuwedzerwa kweRituxan kune repertoire yedu yemishonga yekurapa NHL yakaita musiyano mukuru. Isati yasvika pakutanga kwezana remakore rino, chiyero chekufa kubva lymphoma chakanga chichiwedzera. Kubvira panguva iyo yave ichiderera, zvichida nekuda kwekuvandudza kupona kubva kuRituxan.
Mamwe emakiromita ayo Rituxan anoita mutsauko anosanganisira zvinotevera.
Follicular lymphoma - Follicular lymphoma ndiyo inonyanya kurudzirwa nedolent - kureva kukura-kukura-NHL, kazhinji kuonekwa mumakirini nhengo dzomuviri. Semhando inokurumidza kukura yeNHL, FL haisi nguva dzose inoda kurapwa nokukurumidza. Kana chiremba wako asarudza kushandisa Rituxan yeFL, inoshandiswa nenzira mbiri dzakasiyana:
- Pakutanga kurapwa : kuwana kuregererwa
Rituxan inoshandiswa mukubatana nechemotherapy. Kana kurapwa kunokonzera kuregererwa kwakakwana kana kwakakwana, Rituxan inogona kushandiswa sehutano hwekuchengetedza. - Maintenance therapy : kuti ugare mukuregererwa
Chinangwa chekuchengetedza chirwere ndechekubatsira kuchengetedza chirwere ichi mukuregererwa kwenguva refu. Rituxan inoshandiswa yoga, isina chemotherapy, panguva yekurapwa kwechirwere.
Kuparadzanisa B-cell lymphoma yakakura (DLBCL) - Yakapararira huru B-cell lymphoma inoita zvinopfuura 30 muzana yezviitiko zvitsva zveNHL. Rituxan inoonekwa sechinhu chechikamu chekutanga kurapwa pachinoshandiswa ne chemotherapy kusanganiswa seCOP. Zvidzidzo zvitatu zvikuru zvakaratidza kuti kwete chete kuwedzera Rituxan kunonoka chirwere chinodzokorora kana kufambira mberi, zvinogonawo kuita kuti kuponeswa kuve nani. Saka Rituxan inopiwa pamwe nekushanduka kwechemotherapy uye inogona kupfuurirwa kwechinguva chisina kupera chemotherapy maitiro. Kune avo vakamborapwa kare ne chemotherapy chete uye iye zvino vakadzoka zvakare kana vachifambira mberi, Rituxan inogona kutarisirwa sekusarapwa. (Kurapa kwaSarvage kunoreva kurapa kunoderedza zviratidzo uye / kana kupfuurira kupona, asi haigone kurapa chirwere.)
Rituxan Inopa Sei
Rituxan inoshandiswa sechidimbu mumaketeni ako. Rituximab inopiwa kwemaawa mashoma. Kuvharirwa kunotanga zvishoma nezvishoma, uye kana murwere asingaratidze chero kugadziriswa kumushonga, muyero wekupererwa kunowedzerwa awa imwechete kusvikira kuvhara kwapera.
Rituxan inotarisirwa kwevhiki nevhiki kwevhiki 4 kusvika ku8 kana inoshandiswa yoga. Apo inoshandiswa pamwe chete ne chemotherapy, inowanzopiwa pazuva rokutanga roga roga rokumera chemotherapy kune imwe neimwe ye 6 kusvika ku8 maitiro.
Zvimwe zvikanganiso neRituxan:
- Idzo huru migumisiro yeRituxan inobatana nekukanganiswa kwehutano hwemagetsi . Ruzhinji rwevarwere vane mamwe mararamiro ezvo, kunyanya panguva yekudzivirira kwekutanga. Zviratidzo zvinowanzova fever uye chills, pamwe nevamwe varwere vanonzwa vachinetseka kana vhudzi. Izvi zviri nyore kutungamirirwa nevashandi vakarovedzwa uye havasati vashungurudzika.
- Rituxan inogona kukonzera kuwira muhuwandu hweropa, semakemikirini. Izvi zvingangoita kuti pave nefivha uye zvingada kukura mujekiti yekutengesa.
- Nhamba shomanana yevarwere inogona kuve nokukanganiswa uye kubuda kwemvura kunotevera Rituxan. Matambudziko emapapu akakomba haashamisi.
Gazyva
Kusiyana neRituxan, Gazyva inonyatsokonzerwa nemafuta anonzi monoclonal antibody.Gazyva semishonga mitsva inotsvaga "tag" yakafanana neRituxan, iyo CD20 antigen. Rituxan neGazyva zvose zvinotarisa CD20 antigen iyo iripo pamusoro pemamwe masero, kusanganisira masero machena anozivikanwa seB-lymphocytes, kana masero B.
Kufanana neRituxan, Gazyva inonzi monoclonal antibody. Izvozvo, iyo inokosha yemhando yeanoripiki inoshandiswa nevasayendisiti uye inobudiswa nevagadziri. Chigadzirwa chekupedzisira chinosungirirwa muhombodo semvura uye inopiwa kuburikidza nekuputika kwemavara.
Maererano nehurukuro yakabudiswa nevanoita zvinodhaka, Gazyva inofungidzirwa kuva nehuwandu hwekuita kuti sero rinouraya-inokonzera basa guru mukuunganidza masimba ezvirwere mumuviri kurwisa B-seli.
Sources:
Fleury, I., Chevret, S., Pfreundschuh, M. et al. Ritiximab uye mungozi yechipiri chepachirwere chepachipiri mune varwere vane kwete Hodgkin lymphoma: kurongeka kwakarongeka uye meta-analysis. Annals of Oncology . 2015 Dec 17. (Epub pamberi pekunyora).
National Cancer Institute. Kushandisa Immune System mukurwisana neKenza: Discover of Rituximab. Updated 03/07/14.