Taageerada Bukaanka & Daryeelaha Aspergillosis

Waxaa bixisa NHS National Aspergillosis Center

Biyolojiga iyo neefta eosinophilic

Waa maxay xiiqda eosinophilic?

Neefta Eosinophilic (EA) waa cudur daran oo ku lug leh nooc ka mid ah unugyada dhiiga cad ee loo yaqaan eosinophils. Unugyadan difaaca waxay ku shaqeeyaan soo daynta kiimikooyinka sunta ah ee dila cudurada waxyeelada leh. Inta lagu jiro caabuqa, waxay sidoo kale caawiyaan kicinta caabuqa kaas oo u oggolaanaya unugyada kale ee difaaca in la geeyo aagga si loo hagaajiyo. Si kastaba ha ahaatee, dadka qaba EA eosinophils-yadani waxay noqdaan kuwo aan nidaamsaneyn waxayna sababaan caabuq xad-dhaaf ah oo ku dhaca marinnada hawadu marto iyo habka neefsashada, taasoo keenta calaamadaha neefta. Sidaa darteed, daawaynta EA, ujeedadu waa in la yareeyo heerarka eosinophils ee jirka.

Wax badan oo ku saabsan EA ka baro halkan - https://www.healthline.com/health/eosinophilic-asthma

Bayoolaji

Cilmiga bayoolajiga waa nooc daawa ah oo takhasus leh ( monoclonal antibodies) oo lagu bixiyo irbad oo kaliya waxayna hadda ku jiraan horumar si ay u daweeyaan cuduro kala duwan oo habdhiska difaacayadu ay qayb ka qaataan sida neefta iyo kansarka. Waxa laga soo saaray noolaha dabiiciga ah sida dadka, xayawaanka iyo noolaha yaryar waxaana ku jira noocyo kala duwan oo badeecooyin ah sida tallaalo, dhiig, unugyo iyo daawaynta unugyada hidda-wadaha.

Wax badan oo ku saabsan unugyada difaaca jirka ee monoclonal - https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/monoclonal-antibodies.html

Wax badan oo ku saabsan cilmiga noolaha - https://www.bioanalysis-zone.com/biologics-definition-applications/

Waxay aad uga bartilmaameedsan yihiin daawaynta kale ee neefta sida steroids sababtoo ah waxaa loogu talagalay qayb gaar ah oo ka mid ah habka difaaca jirka, yaraynta waxyeellooyinka. Bayooloji waxaa la qaataa iyada oo lagu daray steroids, laakiin qiyaasta steroids ee loo baahan yahay si weyn ayaa loo dhimay (sidaa awgeed waxyeellooyinka steroid-ka ayaa sidoo kale la dhimay).

Hadda waxaa jira 5 nooc oo bayooloji ah la heli karo. Kuwani waa:

  • Reslizumab
  • Mepolizumab
  • Benralizumab
  • Omalizumab
  • Dupilumab

Labada ugu horreeya ee liiskan (reslizumab iyo mepolizumab) waxay u shaqeeyaan si la mid ah. Waxay beegsadaan unugga ka shaqeeya eosinophils; unuggani waa borotiin yar oo la yiraahdo interleukin-5 (IL-5). Haddii IL-5 laga joojiyo shaqada, markaa firfircoonida eosinophil sidoo kale waa laga hortagayaa bararkana wuu yareeyaa.

Benralizumab sidoo kale waxay bartilmaameedsanaysaa eosinophils laakiin si ka duwan. Waxay ku xidhaa iyaga taas oo soo jiidata unugyada kale ee difaaca dabiiciga ah ee dhiiga si ay u yimaadaan oo ay u burburiyaan eosinophils. Dariiqan daroogada ayaa si xooggan u yaraynaysa/ tirtiraysa eosinophils marka la barbar dhigo reslizumab iyo mepolizumab.

Omalizumab waxay beegsataa antibody loo yaqaan IgE. IgE waxay kicisaa firfircoonida unugyada kale ee bararka si ay u sii daayaan kiimikooyinka sida histamine oo qayb ka ah jawaab-celinta xasaasiyadda. Jawaabtaasi waxay keentaa caabuq gudaha marinnada hawadu marto waxayna kicisaa calaamadaha neefta. Xasaasiyad ku socota aspergillus waxay dejin kartaa dariiqan, taasoo la micno ah in bukaanada qaba ABPA ay badanaa leeyihiin EA. Omalizumab waxa ay xannibi kartaa jawaab-celinta xasaasiyadda oo markaa hoos u dhigi karta calaamadaha neefta ee dambe.

Bayolojiga kama dambaysta ah, dupilumab, ayaa sidoo kale lagula talinayaa dadka qaba xiiqda daran ee la xiriirta xasaasiyadda. Waxay u shaqeysaa iyadoo xannibaysa soo saarista laba borotiin oo la yiraahdo IL-13 iyo IL-4. Barootiinadani waxay kiciyaan jawaab celin barar ah taasoo keenta soo saarista xabka iyo soosaarka IgE. Mar labaad, marka labadan borotiin la xannibo, caabuqu wuu yaraan doonaa.

Macluumaad dheeraad ah oo ku saabsan daawooyinkan, booqo shabakada asthma UK -  https://www.asthma.org.uk/advice/severe-asthma/treating-severe-asthma/biologic-therapies/

Tezepelumab

Muhiimad gaar ah, waxaa suuqa ka jirta daawo bayooloji cusub oo la yiraahdo Tezepelumab. Daawadani waxay aad uga sareysaa dariiqa caabuqa iyadoo la beegsanayo molecule loo yaqaan TSLP. TSLP waxay lagama maarmaan u tahay dhinacyo badan oo ka mid ah jawaab-celinta bararka waxayna leedahay saameyn ballaaran. Tani waxay ka dhigan tahay in dhammaan bartilmaameedyada (xasaasiyadda iyo eosinophilic) ee bayoolojiyada hadda la heli karo ay ku jiraan hal daawo. Tijaabadii ugu dambaysay ee la sameeyay in ka badan hal sano, Tezepelumab (oo ay weheliso corticosteroids) waxay gaadhay 56% hoos u dhac ku yimi heerka sii xumaynta neefta. Dawadan waxa ay ku dhowdahay in ay ansixiso FDA rubuci hore ee 2022. Marka la ansixiyo, waxa la heli doona iyada oo qayb ka ah tijaabooyinka caafimaad ama iyada oo loo marayo maalgelin xaalad-kiis ah oo laga helo kooxaha komishanka caafimaadka, si kastaba ha ahaatee lama heli doono NHS-ta ilaa ay ka ogolaato NICE. Si kastaba ha ahaatee, Tezepelumab waxay siisaa rajo mustaqbalka ah dadka qaba EA.

Tilmaamaha NICE

Nasiib darro, ma aha in dhammaan daawooyinkan si fudud looga heli karo Boqortooyada Midowday (UK) iyo in loo qoro bukaanku waa inuu buuxiyaa shuruudo adag oo ka soo baxa Machadka Qaranka ee Caafimaadka iyo Heerarka Daryeelka (NICE). Si laguu siiyo cilmiga noolaha, waa inaad u hogaansantaa qorshahaaga daawaynta ee hadda oo aad si sax ah u qaadato daawadaada. Cilmi-nafsigan waxa laga helayaa rugaha caafimaadka takhasuska leh sida North West Lung Centre oo ku taal Isbitaalka Wythenshawe, Manchester kuwaas oo qiimeeya bukaan oo codsada maalgelinta bilawga daawada haddii ay u qalmaan.

Fadlan tixraac tilmaamaha NICE ee daawooyinka hadda la heli karo ee hoose:

Haddii aad qaadanaysay daawaynta isteeroodhka oo aan waxtar lahayn oo aad dareemayso inaad ka faa'iidaysan karto daawooyinkan, la hadal la-taliyahaaga neefsashada.