ABPA (Allergic Bronchopulmonary Aspergillosis) chirwere chakakomba chinokonzerwa nehutachiona hwehutachiona hwemhepo. Vanhu vane ABPA vanowanzove neasthma yakanyanya uye kazhinji kutsva kunowanzoda kushandiswa kwenguva refu kweoral steroids nemishonga inorwisa mabhakitiriya kurapa hutachiona hwechipiri hwebhakitiriya.
Mishonga miviri mikuru yeABPA ndeye antifungal mushonga uye nemuromo steroids. Mishonga yeAntifungal inoshanda nekutarisa fungi inokonzera hutachiona, ichidzikamisa kukura kwayo uye kupararira. Izvi zvinogona kubatsira kuderedza kuwanda kwekupisa-ups uye kudzikamisa mamiriro acho asi zvinogona kukonzera mhedzisiro yakadai sekusvotwa uye, kashoma, kukuvara kwechiropa. Oral steroids inoshanda nekudzikisa kuzvimba uye kudzvanya mhinduro ye immune system kune iyo allergen, iyo inogona kubatsira kudzora zviratidzo zveABPA. Zvisinei, kushandiswa kwenguva refu kunogona kukonzera migumisiro inokosha, kusanganisira kuwedzera uremu, kushanduka kwemafungiro, uye adrenal insufficiency.
Izvi zvinokonzeresa zvinogona kukanganisa zvakanyanya kunaka kwehupenyu, asi kurapa kwese kungave kuri madikanwa kudzivirira chirwere ichi kuwedzera. Naizvozvo, kurapwa kutsva kana kunatsiridzwa kunodiwa.
Neraki, kwave nekuitika kwazvino mukugadzirisa ABPA, uye ongororo yakaitwa naRichard Moss (2023) inoratidza maviri anovimbisa marudzi ekurapa:
- Inhaled antifungal mishonga kurapa fungal lung infections nekuendesa mushonga wacho zvakananga kunzvimbo yeutachiona. Izvi zvinobvumira kuwanda kwemushonga kuendeswa kunzvimbo yakakanganisika apo ichideredza kuratidzwa kwemuviri wose uye naizvozvo inoderedza migumisiro. Semuenzaniso, inhaled itraconazole yakaratidzwa kuti inosvika pakakwirira zvakakwana kuuraya kana kurambidza kukura kwefungus. Mimwe miedzo ichapedzwa gore rino (2023) kuti iongorore kuchengetedzeka kwayo uye kushanda kwayo. Kunyangwe ichiri mukusimudzirwa, mishonga iyi inopa tariro yeakanyanya kushanda uye anotenderwa nzira dzekurapa kune varwere vane ABPA.
- Biologic mishonga rudzi rutsva rwekurapa runoshandisa masoja ekugadzira anonangisa maseru kana mapuroteni emuviri wedu wemuviri pane kushandisa musanganiswa wemakemikari. Omalizumab, rudzi rwebiologic, inosungira kune immunoglobulin IgE uye inoimisa. IgE inobatanidzwa mumhinduro yeallergic miviri yedu inotangisa kurwisa vapambi vekunze uye inoita basa rakakura muzviratidzo zveABPA. Deactivation yeIgE yakaratidzwa kuderedza allergic zviratidzo. Mumakiriniki ekuedzwa omalizumab yakaratidzwa zvakanyanya (a) kuderedza nhamba yekuputika-kuenzaniswa nekutanga kurapwa, (b) yakaderedza kudiwa kwemuromo steroid kushandiswa uye kuderedza chiyero chayo chaidiwa, (c) yakawedzera wean off steroids, ( d) yakagadziridzwa basa remapapu uye (e) yakagadziridzwa asthma control. Pamusoro pezvo, mamwe maMonoclonal antibodies (Mabs) akadai semepolizumab, benralizumab, uye dupilumab vakaratidza kudzikiswa kweflare-ups, yakazara IgE uye steroid-sparing effect.
Sekureva kwaMoss (2023), idzi nzira nyowani dzekurapa dzinoshanda zvakanyanya mukuderedza kushanya kwechipatara. Biologics inoita seyakanyanya kushanda, inosvika ku90% kuderedzwa kwemoto-ups kune varwere veABPA uye kusvika ku98% kushanda mukuderedza huwandu hweoral steroid inodiwa nemurwere. Kana mishonga mitsva iyi ikaramba ichishanda zvakanaka, inogona kupa hupenyu hutsva, hwepamusoro kune vanhu vane ABPA. Pakazere, izvi zvakawanikwa zviri kuvimbisa, asi kumwe kutsvagisa kunodiwa kusimbisa kushanda kwekurapa uku kwakanangana neABPA.
Pepa rekutanga: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861760/