Masero emasero akaiswa mumashoko anonzi myelin. Myelin anobatsira mafungiro emagetsi kufamba nenyota. Multiple sclerosis (MS) chirwere chinorambidza muviri umo muviri unotambudza myelin sheaths yeuropi uye musana wemutsara zvichikonzera varwere vane MS kuti vaone kuvhiringidzika kunoonekwa, kushaya simba kwepfungwa, zvinetso zvekunzwisisa, nezvimwe zvakadaro.
Kungofanana nezvirwere zvakawanda, zvinotendwa kuti MS inokonzerwa nemasikirwo uye zvizvarwa zvezvinhu.
MuDisemba 2017 kurongwa kwakarongeka kunonzi "Kurapa zvinodhaka uye mungozi ye multiple sclerosis," Yong uye vanyori vanyori vanoongorora kana mishonga yemishonga-nzvimbo yakasikwa-inogona kukanganisa dambudziko reMS. Muchidzidzo chino, vatsvakurudzi vakatsanangura gumi nezviviri zvidzidzo zvepamusoro zvekuongorora. Izvi zvidzidzo gumi nezviviri zvakaongorora zvidzidzo zvinomwe zvemishonga. Ngatitorei kutungamirirwa kweboka rimwe nerimwe remishonga pa MS.
Amiloride
Amiloride (Midamor) ipotassium-kuchengetedza diuretic inoshandiswa kurapa kuwedzera kwehutano kana kuwedzerwa kweropa. Kunyanya, Midamor inhibits the acid-sensing ion channel 1 (ASIC-1). Mune mhuka dzemhando dzeSMS, ASIC-1 inoparadzaniswa, zvinoreva kuti kune kuwedzera kwemasero mu ASIC-1. Iyi kukura kwemasvondo inowanika munzvimbo dzepakati yenheyo yepamutemo yakange yakanganisa (kureva, mapepa). Mune mhuka idzi, kubvisa ASIC-1 kunoratidzwa kuderedza neurodengeneration, nzira inobatanidza kuipa kwekuremara kune varwere vane MS.
Pasinei nekubudirira mukudzikisa kuderedza mweya muzvikara, Yong nevashandi vakawana kuti pakanga pasina kuwirirana pakati peMidamor kushandiswa uye kuwandisa kweSMS muDanish samples. (Denmark inogadzira mabhuku makuru evanhu, zvichiita kuti zvive nyore kuita zvidzidzo zvevanhu vanoongorora kuongorora hutano hwevanhu.) Sezvineiwo, iyi shanduro yeDanish yakagadzira vanhu vakanga vatova nekupedzisira-MS, izvo vatsvakurudzi vakatsanangura seMMS yakagadzirwa kune vane makore makumi matanhatu kana makumi matanhatu kana zvimwe.
Zuva rekupedzisira MS rinongobatsira 5 muzana yevanhu vane MS; saka, zvinokwanisika kuti izvi zvitsva hazviiti kune vakawanda vemu MS vanhu. Mune mamwe mazwi, hazvizivikanwe kana Midamor inokonzera pathogenesis yeSMS kune vanhu vane MS kunze kwekupedzisira-kusvitsa MS.
Panyaya yakafanana, vatsvakurudzi vakawanawo kusakosha kwe thiazide diuretics, iyo yakadai seMidamor inoshandiswawo kubata mushonga wepamusoro weropa, pane MS.
Valproic Acid
Valproic acid (Valproic) inonzi antiticonvulsant mishonga inoshandiswa kurapa kamufa . "Valproic acid inhibits histone deacetylase iyo inogona kuguma nekugadziriswa kwemapuroteni chaiwo akabatanidzwa muchikamu chekujekesa uye myelin kugadzirisa," nyora Yong nevanyori vanyori. Kunyange zvakadaro, zvichibva pakutsvakurudza kweDanish-data-based data, vatsvakurudzi vakawana kusabatana pakati peValproic uye MS ngozi.
TNF Inhibitors
Maererano neAmerican College of Rheumatology, "TNF inhibitors inorudzi rwezvinodhaka zvinoshandiswa munyika yose kuporesa zvirwere zvinopisa sezvakaita rheumatoid arthritis (RA), psoriatic arthritis, vana arthritis, zvirwere zvinoputira (Crohn's uye ulcerative colitis), ankylosing spondylitis, uye psoriasis Vanoderedza kupisa uye vanomisa chirwere chinowedzera kuburikidza nekutsvaira chinokonzera kupisa-chinokonzera chinonzi Tumor Necrosis Factor (TNF). "
Yong uye vanyori vanyori zvakare vakatarisa zvidzidzo zveDenmark-based kuti vaone kana pane sangano pakati peTAN inhibitors uye MS. Zvose zvidzidzo zvakaongororwa zvaive zvichicherechedza uye zvakabatanidza mazano kana kuti sampuli dzevanhu dzakateverwa nenguva.
Yong uye vaishanda navo havana kuwana sangano pakati pehutano ne TNF inhibitors nokuda kwechirwere chechirwere chekudzivirira uye kukura kweSMS. Kunyanya, kunyange zvazvo pakanga paine kuwedzera kowani muhutano hwekuvandudza MS kune avo vanotora TNF inhibitors nokuda kwechirwere chechirwere chechirwere, uku kusimuka kwakanga kusiyana nehuwandu hune huwandu hwekuti vanhu vane chirwere chechirwere chechirwere chekare vane zviratidzo zvekutsvaira zviitiko zvakadai seMS.
Asi vatsvakurudzi vakawana, zvisinei, kuti varume vanogamuchira TNF inhibitors yeArthritis uye varume nevakadzi vanogamuchira TNF inhibitors zve ankylosing spondylitis vakange vari pangozi ye MS mushure mokutanga kurapwa. Yezvinyorwa, ankylosing spondylitis inowanzoonekwa kuvanhu.
Chimwe chidimbu chezvidzidzo zveDanish zvakaongororwa ndezvokuti zvakanga zvisinganzwisisi kuti ndeapi maitiro eTN inhibitor akashandiswa, uye marudzi akasiyana eTNF inhibitor anokonzera kugomera nenzira dzakasiyana.
Maererano neYong uye vanyori vanyori: "Pamwechete, kutarisa kwekutanga kwekutanga kunomutsa kushushikana pamusoro pekuchengetedzwa kwe-anti-TNFα [TNF inhibitors] nekuremekedza njodzi dzeMM, asi mamwe mabasa anodiwa.Iye zvakare ingakosha kuziva zvigadzirwa zvakananga kana zvinowanikwa kune kirasi yose yekurapa. "
Antibiotics
Zvidzidzo zviviri zvekutonga-imwe mu UK uye imwewo muDenmark-yakaongorora sangano pakati pemishonga inorwisa mabhakitiriya uye MS. Chiitiko chekudzidzira chienzanidzo nevarwere vane mhedzisiro kana chirwere (kureva, matambudziko) nevaya vasingaiti (kureva, kutonga). Nedzidzo-control-study, vatsvakurudzi vanotarisa kumashure vachidzoka zvakare kuti vaone kusunungurwa kune ngozi. Muchikoro chekuUnited States uye chiDanish, mhaka dzaisanganisira varwere vakaonekwa kuti vane MS, uye chiitiko chekuda kwechido chaive mushonga wemishonga inorwisa mabhakitiriya.
Mukudzidza kweUnited States, 163 varwere vane MS vakafananidzwa nevanhu 1523 vasina MS maererano nezera, zvepabonde, nezvimwe zvinhu. Vatsvakurudzi vakawana kuti kushandiswa kwemishonga inorwisa mabhakitiriya kwakanga kusingabatanidzwi neMS. Zvisinei, kana penicillin inoshandisa kwemavhiki anopfuura maviri kana tetracycline kushandiswa kwevhiki inopfuura imwe yakabatanidzwa ne50 muzana inoderedza ngozi ye MS.
Danish vatsvakurudzi vakaedza kudzokorora zvitsva zvevatsvakurudzi vekuKhire vachishandisa kukura kwekukura kwemazana (3259 mhosva). Zvinofadza kuti vaDenmark vaongorori vakawana kuti maitiro akawanda emishonga inoshandiswa nemishonga inoshandiswa nehuwandu hwehuwandu hweSMS-kunyange kune varwere vanongotora imwe nzira yemishonga inouraya kwemazuva manomwe. Ichokwadi kuti ruzivo rwakakura rwemishonga inorwisa mabhakitiriya rwakabatanidzwa neMS rinoratidzika kuti rinoratidzira kuti hutachiwana chaiyo pachahwo-kwete mishonga inorwisa mabhakitiriya-yakabatanidzwa mukugadzirwa kweMS.
Kakawanda, zvinoratidzika kuti maantibhakitiriya haabatanidzwi neMS mune zvizhinji anoongorora, asi humwe tsvakurudzo inoda kuitwa.
Inhaled Short-acting Beta2-adrenergic Receptor Agonists
Mishonga iyi fenoterol (Berotec N) uye salbutamol (ProAir HFA) zvose zvinoputirwa pfupi-acting beta2-adrenergic receptor agonist inoshandiswa kurapa chirwere chechirwere uye chirwere chisingaperi chisinganzwisisiki. Munharaunda-based based control control, vatengesi veTaiwania vakaongorora kana madhiragi aya akakonzera MS ngozi. Vakaona kuti kunyange zvazvo paiva nehuwandu hwekudzivirira hweM MS kune avo vanotora Berotec N, njodzi yekudzikisa MS haina kubatana neProAir HFA.
Vatsvakurudzi veTaiwania vanoti Berotec N inokwanisa kuita chidziviriro nekuda kwekukwanisa kwaro kukwanisa kudzivisa chimiro che superoxide uye degranulation. Sezviri pachena, ProAir HFA haina kunaka sekuita zvinhu izvi; saka, haine simba rokudzivirira.
Uyezve, patinenge tichifunga nezvekuita kwenguva pfupi beta2-adrenergic receptor agonist sekirasi, Yong uye vanyori vanyori vanotaura zvinotevera: "Bhati-acting beta-adrenergic-short-agonists inonzi bronchodilators inodzivisa interleukin-12, cytokine inotungamirira T seyeri kusiyana proinflammatory T anobatsira 1 masero. "Nezvinyorwa, nyanzvi dzinoratidza kuti masero eT (rudzi rwechichena chemuviri weropa) anoratidza basa rinokosha mukukuvadza kwe myelin sheaths inotungamirira ku MS.
Antihistamines
Kushandisa nyaya-control control, vatsvakurudzi vekuKUK vakaongorora kana kunyengedza uye kusina-sedating antihistamines kwakabatanidzwa nekufambiswa kweMS. Zvinhu zvakadai sezvirwere zvinokonzera zvirwere (semuenzaniso, masikati, eczema, uye fever fever) uye kusvuta kwakagadzirirwa. Vatsvakurudzi vakaona kuti kunyange zvazvo kusina kunyengedza antihistamine kwakanga kusina kuwirirana neWS ngozi, kupararira antihistamines kwaibatanidza ne 80 muzana inopedzisira yakaita kuti ibude MS.
Vatsvakurudzi vakaratidza kuti chikonzero chakaita kuti sedating antihistamine inogona kuita chimwe chinhu chekudzivirira iyo--kusiyana ne-anti-anti-anti -istamines-izvi zvinodhaka zvinodarika ropa-rekuvharidza uropi uye zvinowedzera zvimwe zvisingaiti muuropi nemutsipa wepelinha.
Zvipfeko zveMuromo
Yong uye vashandi vakaongorora zvidzidzo zvishanu zvakatsvaga kushamwaridzana pakati pekushandiswa kwemakwenzi ekudzivirira pamuviri uye njodzi ye MS. Pasi pose, pakanga pasina kuwirirana pakati pezvipembenene zviviri izvi.
More Info About Multiple Sclerosis
Multiple sclerosis inoratidzwa nekuparadzwa kusinganzwisisiki kwemaelin mumasero emagunha emukati maitiro emagetsi (brain and spinal cord). Icho hachina kuchinja masero emagunha ari munharaunda yenheyo yenheyo (kureva, nerve uye ganglia iri kunze kweuropi uye rwonzi rwepelinha). Chirwere ichi chichiita autoimmune, zvinoreva kuti muviri unozvirwisa.
Kunze kwechirongwa chemishonga, izvo zvangobva kuzivikanwa sezvinoita etiologic factor, zvimwe zvikonzero zvinokonzera zvakakonzerwa mumapathogenesis e MS kusanganisira zvinotevera:
- Nguva yekutsvaga
- Kusvuta
- Kushungurudzika
- Viral zvirwere zvakadai sa Epstein-Barr Virus
- Kushungurudzika
- Kuderedza chiedza chezuva
- Low vitamin D mazinga
Munyika yose, MS inobata vanhu vane mamiriyoni maviri, uye muUnited States, vanhu vanopfuura 400 000 vane chirwere ichi.
Kutanga kweSMS kungangodaro kana kukurumidza. Zviratidzo zvepakutanga zvingave zvakajeka zvokuti munhu ane MS angatombozvicherechedza kwemwedzi kana makore. Heano zvimwe zviratidzo zveSMS:
- Kushaya simba
- Sensory zviratidzo
- Kuvhiringidzwa kunoonekwa
- Zvinetso ne gait uye kuwirirana
- Urinary urgency
- Urinary frequency
- Kuneta
- Shandisa zvinetso
Zviratidzo izvi zvinogona kumira uye kuputika, nekurwiswa kunowanzogara kwemavhiki kana mwedzi zvichitevedzerwa nedzimwe nzira yekudzikinura. Zviratidzo zvinogona kuitwa zvakanyanya nekupisa, kuneta, kuita muviri, kana kushungurudzika.
Pakupedzisira, MS inorwara yekuregererwa, izvo zvinoreva kuti inongorapwa chete pashure pemamwe zvirwere zvinogona kuitika, zvakadai sepeminha yemakumbo kana kuti zvakanyanya kuparadzirwa encephalomyelitis (yechipiri kune utachiona), inotarirwa kunze. Apo kuongororwa MS, nhoroondo uye kuongorora kwepanyama kuwanikwa pamwe nekuwanikwa kweMRI kunobatsira. Kuchinja kwezvinhu zvinokonzerwa nemiti inonzi cerebrospinal fluid inoonekwa zvakare.
Nhamo, hapana mushonga we MS. Zvisinei, kune marapirwo anowanika, kusanganisira corticosteroids uye kushandiswa kweplasma yekurapwa kwemafuro-ups, uyewo zvirwere zvakasiyana-siyana zvinoshandura zvirwere zvakadai se beta interferons kuti kudzivirirwa kwemasvondo matsva e MS.
Shoko Rinobva
Ramba uchiyeuka kuti kuongorora kwakagadziriswa naYong uye vanyori-vanyori ndivo vokutanga kuongorora kushandiswa kwemishonga yakasiyana-siyana paMS. Migumisiro yechirongwa ichi chekugadziriswa inofanirwa kujekesa pathogenesis yeSMS-chirwere chatisati tisinganzwisisi zvinokonzera.
Panguva ino, hakuna chiremba angashandisa izvi zvakawanikwa kuti atungamirire kurapwa. Chero ruzivo rupi zvaro runotorwa kubva mukugadziriswa kwakarongeka kunodikanwa kusimbiswa uye kudzokororwa. Kana uri kutora imwe yemishonga iyi uye unonetseka nezvokuti inokonzera sei njodzi yaM MS, sarudza wakasununguka kutaura pamusoro pezvawakadzidza nekunyoresa chiremba. Zvisinei, usarega (kana kutanga kutora) mishonga inobva pane zvaunoverenga munyaya ino-uye pasina mazano kubva kuchiremba wako.
> Sources:
> Multiple Sclerosis. Muna: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson J, Loscalzo J. eds. Harrison's Manual of Medicine, 19e New York, NY: McGraw-Hill.
> Multiple Sclerosis. MedlinePlus.
> TNF Inhibitors. American College of Rheumatology.
> Yong HY et al. Kuisa zvinodhaka uye ngozi ye multiple sclerosis: Kuongorora kwakarongeka. Pharmacoepidemiol Drug Saf. 2017; 1-7.