Tšehetso ea Mokuli le Mohlokomeli oa Aspergillosis

E fanoe ke Setsi sa Sechaba sa Aspergillosis sa NHS

Biologics le eosinophilic asthma

Asma eosinophilic ke eng?

Eaosinophilic asthma (EA) ke lefu le matla le amang mofuta oa lisele tse tšoeu tsa mali tse bitsoang li-eosinophils. Lisele tsena tsa 'mele tsa ho itšireletsa mafung li sebetsa ka ho ntša lik'hemik'hale tse chefo tse bolaeang likokoana-hloko tse kotsi. Nakong ea ts'oaetso, li boetse li thusa ho susumetsa ho ruruha ho lumellang hore lisele tse ling tsa 'mele tsa ho itšireletsa mafung li isoe sebakeng seo ho li lokisa. Leha ho le joalo, ho batho ba nang le EA tsena li-eosinophil li fetoha tse sa laoleheng 'me li baka ho ruruha ho feteletseng ha moea le tsamaiso ea ho hema, e leng se lebisang ho matšoao a asthmatic. Ka hona, liphekolong tsa EA, sepheo ke ho fokotsa maemo a li-eosinophil 'meleng.

Fumana ho eketsehileng ka EA mona - https://www.healthline.com/health/eosinophilic-asthma

Baeloji

Biologics ke mofuta o khethehileng oa meriana (monoclonal antibodies) e fanoang ka ente feela 'me hajoale e ntse e tsoela pele ho phekola mafu a fapaneng moo sesole sa rona sa 'mele se bapalang karolo, mohlala, asthma le mofets'e. Li hlahisoa ho tsoa ho lintho tse phelang tsa tlhaho tse kang batho, liphoofolo le likokoana-hloko 'me li kenyelletsa letoto la lihlahisoa tse kang liente, mali, lisele le phekolo ea liphatsa tsa lefutso.

Ho feta ka li-antibodies tsa monoclonal - https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/monoclonal-antibodies.html

Tse ling ka biologics - https://www.bioanalysis-zone.com/biologics-definition-applications/

Li lebisitsoe haholo ho feta liphekolo tse ling tsa asthma tse kang li-steroids hobane li lebisitsoe karolong e itseng ea 'mele oa ho itšireletsa mafung, ho fokotsa litla-morao. Li-biologics li nkoa li kopane le li-steroids, empa tekanyo ea steroid e hlokahalang e fokotsehile haholo (ka lebaka leo litla-morao tse bakoang ke steroid li fokotsehile).

Ho na le hona joale Mefuta e 5 ea bioloji fumaneha. Tsena ke:

  • Reslizumab
  • Mepolizumab
  • Benralizumab
  • Omalizumab
  • Dupilumab

Tse peli tsa pele lethathamong lena (reslizumab le mepolizumab) li sebetsa ka tsela e tšoanang. Li lebisa tlhokomelo sele e etsang hore li-eosinophil li sebetse; sele ena ke protheine e nyenyane e bitsoang interleukin-5 (IL-5). Haeba IL-5 e emisoa ho sebetsa, joale ts'ebetso ea eosinophil e boetse e thibeloa 'me ho ruruha ho fokotseha.

Benralizumab e boetse e hlasela li-eosinophil empa ka tsela e fapaneng. E tlama ho tsona tse hohelang lisele tse ling tsa tlhaho tse bolaeang 'mele maling ho tla le ho senya eosinophil. Tsela ena ea lithethefatsi e fokotsa / e felisa li-eosinophils ka matla ho feta ha e bapisoa le reslizumab le mepolizumab.

Omalizumab e shebana le antibody e bitsoang IgE. IgE e susumetsa ts'ebetso ea lisele tse ling tsa ho ruruha ho lokolla lik'hemik'hale tse kang histamine e le karolo ea karabelo ea ho kula. Karabelo ena e fella ka ho ruruha ka har'a litsela tsa moea 'me e baka matšoao a asma. Ho kula ho aspergillus e ka qala tsela ena, ho bolelang hore bakuli ba ABPA hangata ba na le EA. Omalizumab e ka thibela karabelo ena ea kutlo mme ka hona ea fokotsa matšoao a latelang a asthma.

Biologic ea ho qetela, dupilumab, e boetse e khothalletsoa batho ba nang le asthma e matla e amanang le ho kula. E sebetsa ka ho thibela tlhahiso ea liprotheine tse peli tse bitsoang IL-13 le IL-4. Liprotheine tsena li baka karabelo ea ho ruruha e lebisang tlhahisong ea mucus le tlhahiso ea IgE. Hape, hang ha liprotheine tsena tse peli li koetsoe, ho ruruha ho tla fokotseha.

Bakeng sa tlhaiso-leseling e batsi ka lithethefatsi tsena, etela webosaete ea asthma UK -  https://www.asthma.org.uk/advice/severe-asthma/treating-severe-asthma/biologic-therapies/

Tezepelumab

Habohlokoa, ho na le setlhare se secha sa biologic 'marakeng se bitsoang Tezepelumab. Setlhare sena se sebetsa holimo haholo tseleng ea ho ruruha ka ho lebisa molek'hule e bitsoang TSLP. TSLP e bohlokoa likarolong tse ngata tsa karabo ea ho ruruha 'me e na le mefuta e mengata ea liphello. Sena se bolela hore lipheo tsohle (allergic le eosinophilic) tsa biologics tse teng hona joale li koahetsoe ke sethethefatsi sena se le seng. Tekong ea morao-rao e entsoeng ka nako e fetang selemo, Tezepelumab (hammoho le corticosteroids) e fihletse phokotso ea 56% ea sekhahla sa ho mpefala ha asthma. Setlhare sena se ikemiselitse ho amoheloa ke FDA kotareng ea pele ea 2022. Hang ha se amohetsoe, se tla fumaneha e le karolo ea liteko tsa kliniki kapa ka lithuso tsa lichelete tse tsoang ho lihlopha tsa komisi ea kliniki, leha ho le joalo e ke ke ea fumaneha. ho NHS ho fihlela e amoheloa ke NICE. Leha ho le joalo, Tezepelumab e fana ka tšepo ho batho ba nang le EA.

LItataiso tse ntle

Ka bomalimabe, ha se lithethefatsi tsena kaofela tse fumanehang habonolo UK mme ho laeloa mokuli o tlameha ho fihlela litekanyetso tse thata ho tsoa Setsing sa Naha sa Bophelo bo Botle le Tlhokomelo e Ntle (NICE). E le hore u fuoe biologics, u tlameha ho khomarela moralo oa hau oa phekolo le ho noa meriana ea hau hantle. Li-biologics tsena li fumaneha litleliniking tse khethehileng tse kang North West Lung Center Sepetleleng sa Wythenshawe, Manchester ba hlahlobang mokuli le ho etsa kopo ea lichelete bakeng sa ho qalisoa ha moriana haeba ba tšoaneleha.

Ka kopo sheba litataiso tsa NICE bakeng sa lithethefatsi tse fumanehang ka tlase:

Haeba esale u noa kalafo ea steroid e sa sebetseng hantle 'me u ikutloa hore u ka rua molemo ho lithethefatsi tsena, bua le moeletsi oa hau oa phefumoloho.