ABPA (I-Aspergillosis ye-Allergic Bronchopulmonary) sisifo esiyingozi esibangelwa kukungunda kwimibhobho yomoya. Abantu abane-ABPA badla ngokuba ne-asthma enzima kunye nokuvutha rhoqo okuhlala kufuna ukusetyenziswa kwexesha elide kwe-oral steroids kunye ne-antibiotics ukunyanga usulelo lwesibini lwebhaktiriya.
Awona nyango mabini aphambili e-ABPA ngala amayeza antifungal nangomlomo steroids. Amayeza e-Antifungal asebenza ngokujolisa kwifungi ebangela usulelo, ukunciphisa ukukhula kunye nokusasazeka. Oku kunokunceda ukunciphisa ukuphindaphindeka kokugqabhuka kunye nokuzinzisa imeko kodwa kunokubangela iziphumo ebezingalindelekanga ezifana nesicaphucaphu kwaye, kunqabile, ukonakala kwesibindi. I-Oral steroids isebenza ngokunciphisa ukuvuvukala kunye nokucinezela impendulo ye-immune system kwi-allergen, enokukunceda ukulawula iimpawu ze-ABPA. Nangona kunjalo, ukusetyenziswa kwexesha elide kunokubangela iziphumo ezibi kakhulu, kubandakanya ukuzuza ubunzima, ukuguquka kwemizwelo, kunye nokungaphumeleli kwe-adrenal.
Ezi ziphumo bezingalindelekanga zinokuchaphazela kakhulu umgangatho wobomi, kodwa zombini unyango lunokuba yimfuneko ukunqanda isifo ukuba singabi mandundu. Ngoko ke, unyango olutsha okanye oluphuculweyo luyafuneka.
Ngethamsanqa, kukho uphuhliso lwakutsha nje ekulawuleni i-ABPA, kwaye uphononongo lukaRichard Moss (2023) luqaqambisa iintlobo ezimbini ezithembisayo zonyango:
- Ukuphefumlelwa iyeza le-antifungal banyange usulelo lomngundo lwemiphunga ngokuhambisa iyeza ngqo kwindawo yosulelo. Oku kuvumela ukuba ugxininiso oluphezulu lweyeza lihanjiswe kwindawo echaphazelekayo ngelixa linciphisa ukubonakaliswa komzimba wonke kwaye ngoko kunciphisa imiphumo emibi. Ngokomzekelo, i-itraconazole ephefumulelwe ibonakaliswe ukufikelela kwiindawo eziphezulu ngokwaneleyo ukubulala okanye ukuvimbela ukukhula kwefungus. Amanye amalingo aya kuqukunjelwa kulo nyaka (2023) ukuhlola ukhuseleko nokusebenza kwawo. Nangona zisaphuhliswa, la machiza anika ithemba lokhetho olusebenzayo nolunyamezelwa ngcono kwizigulana ezine-ABPA.
- Ibhayoloji amayeza luhlobo olutsha ngokupheleleyo lonyango olusebenzisa izilwa-buhlungu zokwenziwa ukujolisa kwiiseli ezithile okanye iiproteni zokhuselo lomzimba endaweni yokusebenzisa ikhompawundi yemichiza. I-Omalizumab, uhlobo lwe-biologic, ibophelela kwi-immunoglobulin IgE kwaye iyenze ingasebenzi. I-IgE ibandakanyeka kwimpendulo yokwaliwa yimizimba yethu esungula ngokuchasene nabahlaseli bamanye amazwe kwaye idlala indima enkulu kwiimpawu ze-ABPA. Ukuvalwa kwe-IgE kubonakaliswe ukunciphisa iimpawu zokungalungelani nokwaliwa. Kwizilingo zeklinikhi i-omalizumab ibonakaliswe kakhulu (a) ukunciphisa inani lokuqhambuka xa kuthelekiswa nonyango lwangaphambili, (b) yanciphisa imfuno yokusetyenziswa kwe-oral steroid kunye nokunciphisa umthamo wayo oyimfuneko, (c) ukwanda kwe-wean off steroids, d) ukuphucula ukusebenza kwemiphunga kunye (e) nokuphucula ulawulo lwesifuba. Ukongezelela, ezinye ii-antibodies ze-Monoclonal (i-Mabs) ezifana ne-mepolizumab, i-benralizumab, kunye ne-dupilumab zibonise ukunciphisa i-flare-ups, i-IgE epheleleyo kunye ne-steroid-sparing effect.
NgokukaMoss (2023), ezi ndlela zonyango zitsha zisebenza kakhulu ekunciphiseni ukutyelelwa kwezibhedlele. I-Biologics ibonakala isebenza kakhulu, kunye nokunciphisa i-90% kwi-flare-ups kwizigulane ze-ABPA kunye nokufikelela kwi-98% esebenzayo ekunciphiseni inani le-oral steroid efunekayo yisigulane. Ukuba olu nyango lutsha luyaqhubeka ukusebenza kakuhle, lunokunikezela ngomgangatho omtsha wobomi kubantu abane-ABPA. Ngokubanzi, ezi ziphumo ziyathembisa, kodwa uphando olongezelelweyo luyafuneka ukuqinisekisa ukusebenza kolu nyango ngokukodwa kwi-ABPA.
Iphepha lokuqala: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861760/