Stem cell transplantation inzvimbo yekuedza uye inotanga kubuda ye Multiple Sclerosis (MS) tsvakurudzo, uye kusvikira zvino zvesayenzi zviitiko zvave zvichivimbisa. Izvo zvichitaurirwa, nyanzvi dzinongwarira, sezvo rudzi urwu rwehutano huri kutengesa pamuviri, uye hunoda kuongorora zvakanyatsonaka kwezvakawanikwa zvichienderana nehana.
Semaini yeStem Transplantation mu Multiple Sclerosis
Munguva yakapfuura, stem cell transplants yakachengeterwa avo vane dzimwe mhando dzekenza yeropa kana mapfupa emapfupa, saiukemia, lymphoma, kana multiple myeloma.
Asi pamusoro pemakore akawanda apfuura, stem cell transplant yakatsvakurudzwa mukurapa mamwe maitiro ehutano ane chokuita nehutachiwana, kusanganisira multiple sclerosis.
A stem cell transplant pakurapa MS inotanga nemito inonzi stem cell harvesting. Iyi nzira inosanganisira kubvisa masero emunhu kumaropa ayo (anowanikwa kuburikidza nemuviri) kana pfupa ravo remafupa (anowanikwa kuburikidza nenyuchi mumapapiro).
Mhedzisiro yezvokurapa kwechirevo ichi ndeye autologous hematopoietic cell transplant-autologous zvinoreva kuti munhu pachake masero emasero anoshandiswa uye hematopoietic zvinoreva ropa-seki inogadzira.
Kana kamwechete masero emadziro akaunganidzwa uye akachengetwa, munhu achaita kuti zvirwere zvemuviri zvake zvive zvakadzingwa (zvinonzi isiri myeloablative transplant) kana kuputirwa (inonzi myeloablative transplant). Izvi zvinodzingwa kana kucheneswa zvinowanikwa kuburikidza ne chemotherapy nemishonga uye immune-depleting antibodies.
Kusiyana pakati pekuchengetedzwa kwemasikirwo ekudzivirira uye kubvisa (kubvisa kunze) ndiko kuti kupukuta kunoda kuwedzera, kuwedzerwa kuwanda kwemishonga yemakemikrasi, zvichienzaniswa nekuderedza, izvo zvinoda kuderedza, zvishoma kuderedza doses.
Mushure mokunge chikamu ichi chapera, munhu achazorora kwemazuva mashoma asati apfuura stem yero infusion-chirongwa umo masero emadzimai anopiwazve kumunhu kuburikidza nemuviri.
Pane imwe nguva inopindira, idzi dzinoshandiswa masero kubva kubva muropa kuenda mune marora apo vanozvara uye vanovaka maitiro echirwere anozivikanwa-pfungwa yokuti iyi itsva uye inovandudza zvirwere zvesimba zvichave zvine hutano uye haizorwisi myelin sheath muuropi uye mumutsipa cord.
Sayenzi Inotungamirira Stem Cell Transplantation mu MS
Muna 2016 kuCanada kuongorora muLancet, vatori vechikamu gumi nevaviri vanotora chikamu chekudzoka-remitting multiple sclerosis uye nevarwere 12 vane MS-secondary progressively underwent stem cell transplantation. Vaya vatori vechikamu vaiva nechirwere chinotyisa uye huwandu hwakanyanya hurombo hwakanyanya, hunoreva kuti vaive nevana vekutanga veMM vakadzokazve nekuremara kwakasimba, pasinei nekurapa kwaM MS.
Migumisiro yenyaya iyi yakanga ichivimbisa kunyange zvakadaro. Pakati vevadzidzi 24, 17 (70 muzana) vakange vasina mabasa eEIDS makore matatu mushure mokunge tashandurwa. Hapana yezvirwere zveSMS zvaireva:
- hapana itsva MS inodzokera zvakare
- hapana mishonga yeM MS itsva paMRI
- hapana uchapupu hwekuwedzera kwechirwere
Mukuwedzera, pamakore makumi manomwe nemashanu kubva shure kwekuisa, 40 muzana yevatori vechikamu vakave nekuvandudzika mukuremara kwavo kweE-MS. Mune dzimwe chokwadi, vamwe vevatori vechikamu vakave nekudzoka kunoshamisa kusanganisira:
- kugadzirisa nystagmus uye ataxia
- dzokera kubasa kana kuchikoro
- kuroora kana kuroorwa
- kuva nevana vachishandisa bhizinesi kana kupiwa mazai / mbeu
Izvi zvose zvinotaurwa, zvakakosha kuziva kuti kune vatori vechikamu 24, mumwe akafa nekuda kwehutachiona, kusangana kwakabatana ne stem cell transplantation. Mumwe musangano akawedzerawo matambudziko akakomba ane chokuita nechiropa uye akapinda muchipatara kwenguva yakareba. Uyewo, paiva nemigumisiro yakawanda yakabatana nekududzirwa, sekushaya neutropenic fever uye chemotherapy-yakasangana nexicid.
Kuwedzera kweStem Cell Transplant Research mu MS
Mukudzidza muna 2015 muna JAMA , vatori vechikamu 123 vane MS re-reping-rearing MS uye 28 vatori vechidiki veSvondo vanofambira mberi vari pasi pemaitiro epem cell transplantation.
Vadzidzi vacho vakateverwa pamusana pemakore 2.5. Kusiyana nekudzidza kwakapfuura, maitiro ezvirwere zvezvirwere zvezvirwere muvarwere ava akadziviswa, zvisinei nekupukunyuka kunze kwekusimudzirwa kwema-cell infusion-kunonzi non-myeloablative stem cell transplant .
Migumisiro inoratidza kuti kuderera kwenhamba yekudzoka zvakare uye nhamba yegadolinium-yakasimudzirwa mishonga ye MS pazvose post-stem cell transplant MRIs. Ubongo MRIs hwakanga hwave hwakapera mumwedzi mitanhatu mushure mokunge uchisimuka uye gore negore.
Uyewo, pakanga pane kuvandudzwa kweimwe kana humwe humwe humwe muhuwandu hweEEDS muna 50 muzana yevatori vechikamu pamakore maviri uye 64 muzana yevatori vechikamu mumakore mana. IEEDSS mazano matanho MS kushungurudza uye kubudirira kuve akaremara. Asi izvi zvakagadziriswa zvakangoonekwa kune avo vanezve-re-MS remitting (kwete kune avo vane SEC-progressive-progressive MS), uye kune avo vakanga vane MS kwemakore 10 kana kupfuura.
Ichi chidzidzo chakanga chisinganyanyi kunetseka nemigumisiro-pasina kufa kana zvirwere zvakakomba. Izvi zvingangodaro zvinokonzerwa nekudzvinyirirwa nekudzima kunze kwemuviri wemuviri musati masero emasero akaiswa.
Shoko Rinobva
Kunyange zvazvo ichi chiri kufadza kutsvakurudza, nyanzvi dzichiri kungwarira. Iyi miedzo ndeyediki uye haina simba rekudzora mapoka. Zvidzidzo zvakakura uye zvekare kwenguva refu zvinodiwa kuti zvive kunyatsonzwisisa kubatsirwa uye kuchengeteka kwe stem cell transplantation mukurapa MS. Uyewo, utano hwehutano hwe stem cell transplantation huri chaizvo. Saka kutsvaga nzira dzekudzivirira dambudziko iri nderokutambudzika uye kupikisa.
Mukuwedzera, kunyange kana stem cell transplantation inogamuchirwa kune MS, inogona kunge iri kurapa iyo yakachengeterwa avo vane MS yakaoma avo vakakundikana mishonga yemaitiro sevanopirononi kana Copaxone-kwete kuti haigoni kushanda kune avo vane chirwere chakaipa , asi kungoti zviitiko zvingave zvisina kukodzera.
Sources:
American Cancer Society. Cell Cell Stp Transplant for Cancer.
Atkins et al. Immunoablation uye autologous hemopoietic stem-cell transplantation yeguruva multiple sclerosis: iyo yakawanda-yeboka rimwe boka rechikamu chekuedzwa. Lancet. 2016. 2016 Jun 8. pii: S0140-6736 (16) 30169-6.
Burt RK et al. Sangano rekusagadziriswa kwehematopoietic stem cell transplantation nehutano hwehutano kune varwere vanezvezve-remitting multiple sclerosis. JAMA . 2015 Jan20; 313 (3): 275-84.