Omalizumab for the Treatment of Chronic Idiopathic Urticaria
Chii chinonzi Chronic Urticaria?
Urticaria , izwi rezvokurapa kumumkoko, chirwere chinogona kukanganisa kusvika kune mumwe wevanhu vashanu pane imwe nguva munguva yeupenyu hwavo. Kurwiswa kwe urticaria kunowanzosvibiswa, kwakatsvuka uye kunetseka. Izvo zviputi zvinogona kuva zvakakura zveumhutu zvinokurumidzira kutenga mari-mashizha kana makuru, uye inogona kuunganidza pamwe chete muzvimi zvisina kufanira, zvinonzi coalescing.
Icho chiya chinowanzouya nekufamba mukati maawa mashomanana, ichibva panzvimbo imwe pamuviri kune imwe.
Kuvhiringidza kunowanzoenda urticaria, kunonzi angioedema , kunogona kutungamirira mukuputika kwechiso, maoko uye tsoka. Angioedema kazhinji haisi tsvuku kana kuti inotyisa, asi inowanzotaurira uye inopisa, uye inogona kurondedzerwa se "kushaya simba." Kuzvimba kunogona kuva kwakanyanya, uye kana kuchikanganisa kukwanisa kwevanhu kufema, kunogona kutyisidzira upenyu.
Zvose urticaria uye angioedema zvinokonzerwa ne histamine nemamwe makemikari akabudiswa kubva mumasero emuchena uye mucous membrane. Izvi zvinogona kuitika kuburikidza nehutachiona hwemagetsi kana imwe iyo mast masero anosunungura makemikari pasina IgE kubatanidzwa.
Mhosva dze urticaria uye angioedema inogona kuva yakaoma, inogara isingapfuuri masvondo matanhatu, kana isingaperi, inogara kwemavhiki masere. Kusiyana neurticaria yakaoma, inenge 5 kusvika ku10 muzana yehupenyu husingagoneki urticaria uye angioedema inokonzerwa nemishonga.
Chikonzero chekugara kwenguva refu urticaria haigoni kuonekwa nguva dzose, iyo inonzi inonzi chronic idiopathic urticaria (CIU). CIU zvakawanda zvingave zvakakonzerwa kuti zvive nechokuita nezvikonzero zvinokonzerwa nemagadzirirwo evanhu kupfuura zvirwere. Mune chimiro chega CIU, munhu anowanzoita zvirwere zvinopesana nechikamu chemasendi awo (zvichida kune mast cell receptor yeGG antibodies, kana kuti chaiyo IgE yakasungwa kumusero wesimbi), zvichiita kuti kusunungurwa kwe histamine uye kuve nekunokonzera zviratidzo.
Chirwere chikuru cheCIU ndechemuromo antihistamines . Izvi zvinowanzopiwa mumuromo, uye zvinogona kupiwa mukuraira kukuru kana kazhinji kuti zvironge zviratidzo. Zvisinei, vanopfuura 50% yevanhu vane CIU vangave vasina kupindura mushonga pamwe nemaitiro dosing emuromo antihistamines. Zvimwe zverapies zveCI dzinowanzodiwa, asi hazvitenderwi neU.S. Food and Drug Administration (FDA) nokuda kwechinangwa ichi. Nokudaro, mamwe marapirwo eCIU, anogamuchirwa neCDA, anodiwa kuti vanhu ivavo vasapindura maitiro anowanzoitwa anti oral antihistamines.
Chii chinonzi Xolair?
Xolair (omalizumab) imishonga inoshandiswa inogamuchirwa neRDA yekurapa kuenzana kusvika kune yakanyanya chirwere chetachiona muvanhu vane makore gumi nemaviri nekure. Injection inopiwa muhofisi yechiremba kwemavhiki maviri kusvika kuchina, zvichienderana nehuwandu hwemunhu uye yeaergic antibody (IgE). Xolair is anti-IgE anti-anti-IgE, iyo inosunga kuIgE muropa, zvichibvumira muviri kubvisa. Izvi zvinodzivirira IgE kubva pakubatanidza kune mast cells (uye naizvozvo kubva pakisunga kune zvose zvinokonzera) izvo zvinozoguma zvichiguma mukubudiswa kwe histamine nemamwe makemikari. Izvi ndezvikemikari zvinokonzera kuipa kwechirwere uye zvimwe zviratidzo zvekurwisa, kusanganisira urticaria uye angioedema.
Ko Xolair Inogona Kushandiswa Kurapa Uristaria Isingaperi Here?
Zvidzidzo zvepakutanga zvechokwadi zvinopikira. Tsvakurudzo dzinoverengeka dzakasiyana dzakaongorora kubatsira kwe Xolair yekurapa kweCIU. Kunyanya kutsvakurudza kwakaongorora varwere vanopfuura 300 vane CIU avo vakanga vachiri nezviratidzo zvisinei vachiita zvirwere zvinowanzoitwa antihistamine. Vakapiwa Xolair mumatare akasiyana-siyana masvondo mana. Makumi makumi mana nevana kubva kune vanhu vanowana chirwere chakakura che Xolair, uye 22% yevanhu vanogamuchira mizinga-dose Xolair, vaiva nechigadziro chakakwana chemukoko mukati mevhiki imwe chete kusvika kwemaviri ekurapwa. Zviratidzo zvishoma nezvishoma zvakapera mushure mokunge Xolair yakamira, saka pakange pasina chiratidzo chekugara kwenguva refu.
Zvimwe zvidzidzo zvakawana mhindu yakafanana, nemitengo ye "kuregererwa" pane Xolair inenge 30% yevanhu vane CIU. Nyaya yakanakisisa inoratidzika kuva inobva kuchidzidzo chiduku apo chirwere che Xolair chakange chakafanana neicho chinopiwa kune munhu ane astmma. Varwere vari muchidzidzo ichi vane uchapupu hweCIU autoimmune zvichienderana neyero ye autoantibodies (antibodies against yourself) kurwisana nehomoni yehomoni. Makumi makumi manomwe kubva muzana yevanhu vakagamuchira Xolair vaiva nekugadzirisa kwakakwana kwezviratidzo zvavo zveCIU.
Nokudaro, zvidzidzo zvinoratidza kuti Xolair inorapwa uye inobatsira kurapwa kune varwere vane CIU, uye kupindura kurapwa kunoratidzika kunge kusinganyanyi kuenderana nekurema kwevanhu, serum IgE level, kana kuti autoimmune. Zvakanakira Xolair zvinongoramba zvichiripo apo mishonga iri kutorwa, zvinoreva kuti hazvikwanisi kuva kwenguva refu yekuregererwa kunokonzerwa ne Xolair kune vanhu vane CIU. Zvinosuruvarisa, sezvo Xolair inodhura zvikuru, uye vanhu vakawanda vane CIU vanogona kudzorwa nepamusoro maitiro emiromo antihistamines, vashomanana chaizvo vanhu vanogona kuwana Xolair yeCIU. IU.S. Food and Drug Administration yakabvumira kushandiswa kweXolair yeCIU munaMarch 2014.
Sources:
Casale TB. Omalizumab for Chronic Urticaria. J Allergy Clin Immunol Pract. 2014; 1: 118-9.
Kahn DA. Mamwe Mamwe Mashandi muChirangaridzo Chronic Urticaria: Uchapupu uye Kufungisisa pakusarudza kwavo uye Kushandisa. J Allergy Clin Immunol Pract. 2013; 1: 443-40.