Unyango olutsha oluthembisayo olusebenzisa i-immunotherapy ukunyanga i-peanut allergy ngokwakha ukunyamezelana kwexesha.
Amandongomane aleji, enye yezona zinto zixhaphakileyo zikwaliwa kokutya, kuxa inkqubo yethu yomzimba yokuzikhusela ifumanisa ukuba iprotein yamandongomane iyingozi. Indongomane ukungahambi ixhaphake kakhulu ebantwaneni abakumazwe ahambele phambili kwezoqoqosho. Nokuba ukutyhileka okuncinci kwamathuba okulandela izixa zamandongomane kwiiconfectionary okanye ezinye izinto zokutya kunokubangela ukwaliwa kwaye ngamanye amaxesha kulaliswe esibhedlele. Kwiimeko ezingaphezulu kwama-30 eepesenti ukuchasana nokwaliwa kakhulu kwenzeka njenge-anaphylaxis. Alukho unyango lokwaliwa kwamandongomane kwaye akukho ndlela yonyango eyamkelweyo kude kube ngoku. Ukuba kukho naluphi na unyango lwe-peanut allergy luvunyiwe, luya kumiselwa kuphela kwisigulana ngugqirha kwaye isigulana kuya kufuneka siqhubeke sisebenzisa unyango ukuze sikwazi ukuhlala sikhuselekile nakuphi na ukusetyenziswa ngengozi kwepeanut nangaliphi na ixesha. ebomini babo. Unyango olulolo hlobo nalo alusenamsebenzi wakuba uyekiwe umyalelo kagqirha. Abantu abanokwaliwa ngamandongomane kufuneka bahlale bephaphile kubo bonke ubomi babo kwaye oku kunzima kakhulu ukumelana nako ngakumbi kubantwana.
Ukwakha ukunyamezela kwi-peanut ye-allergen
Uphononongo lubonise okokuqala ukuba kunokwenzeka ukuba abantu abanengxaki yokwaliwa ngamandongomane bafumane ukukhuselwa ekutyeni ngamandongomane bengaqondanga ngokuthi bayeke ukuziva bengevani ngokuthe ngcembe ngokuhamba kwexesha. Oku kwenziwa ngokwakha inqanaba lonyamezelo lomntu kwi-peanut ngokusebenzisa utyhileko olwengeziweyo olulawulwayo kwi-aleji enokuthi ngenye indlela ibangele ukusabela okumandundu. Indlela isekelwe phezu umgaqo immunotherapy kwaye ijolise ukwakha unyamezelo amajoni omzimba kwi allergen, kule meko peanut.
Uphononongo olucwangcisiweyo olupapashwe kwi I-New England Journal of Medicine kwaqhutywa kubathathi-nxaxheba abangama-551 beqela leminyaka emi-4 ukuya kwengama-55 ababenokwaliwa ngamandongomane kwaye banikwa ichiza lokulinga unyaka. Eli chiza elibizwa ngokuba yi-AR101 yiprotheyini yepowder ephuma kwi-peanut kwaye iphuhliswe yi-Aimmune Therapeutics Inc. USA. Inani lilonke labathathi-nxaxheba kolu phononongo laliphezulu kwaye kwakhona uhlalutyo olongezelelweyo oluneenkcukacha lwedatha lwenziwe xa kuthelekiswa nazo zonke izifundo zangaphambili ezidityanisiweyo. Isinye kwisithathu sabathathi-nxaxheba sanikwa i-placebo (okt ukuba akukho peanut kwaphela) kwaye abanye banikwa umgubo wepeanut protein (osuka kumgubo wamandongomane) ngokucothayo ngendlela eyongezelekayo de idosi (elingana nendongomane enye yonke imihla) yafikelelwa neyaye yagcinwa de kube sekupheleni isifundo. Phantse ama-80 eepesenti abathathi-nxaxheba bafikelele kolu thamo 'lwesondlo', olwathi ke lwanikezelwa ukuya kutsho kwiinyanga ezintandathu. Iprotein yamandongomane yayiyinxalenye 'yomngeni wokutya okwenziwa ngomlomo' ithathwa njengomgangatho wegolide ekuvavanyeni ukwaliwa kokutya.
Ekupheleni kophononongo, abathathi-nxaxheba bakwazi ukunyamezela i-100-fold dosage ephezulu yepeanut xa kuthelekiswa nokuqala kwabo. Ngexesha lophononongo, iimpawu zikwabonwa zithambile nakwidosi ephezulu xa kuthelekiswa neempawu zedosi esezantsi ekuqaleni kophononongo. Isibini kwisithathu sabathathi-nxaxheba ngoku banokunyamezela ukulingana kwamantongomane amabini imihla ngemihla kwaye emva kweenyanga ze-9-12 inqanaba lokunyamezela kwesiqingatha sabathathi-nxaxheba liye lanyuka lilingana ne-peanuts ezine imihla ngemihla. Iziphumo ezigqwesileyo zabonwa kwiqela lobudala beminyaka emi-4-17 okt abantwana kunye nolutsha. Yipesenti ezi-6 kuphela eziye zayeka ngenxa yesisu / ulusu/ ukuphefumla njl Bonke abantwana abangama-372 baye bachaphazeleka kukwaliwa, nangona babengaphantsi kwesihlanu ekhulwini ababemandundu. Iziphumo ezibukhali zokusabela zabonwa kwi-14 ekhulwini labantwana ezinokuthi zifune ichiza le-epinephrine - ihomoni enamandla - ukulawula.
Olu hlobo lonyango lwe-immunotherapy yomlomo alunakusebenza kuwo wonke umntu onesifo se-peanut kunye ne-drawback enkulu yesifundo apho ababhali babonisa ukuba kunokuba nzima ukuqikelela ukuba ngubani onokuthi okanye ongakwazi ukusebenzisa olu nyango. Nangona kunjalo, olu phononongo lucebisa ukuba unyango olomeleleyo lunokufumaneka kwixesha elizayo elingekude apho abantu abanokwalana ne-peanut kwaye abanokunyamezela olu nyango (oko kukuthi ukunyamezela ipeanut enye ngosuku) bangakwazi ukunyamezela amandongomane amabini kwaye ke banokufumana ukhuseleko kwingozi. ukusetyenziswa okukhokelela kwiintshukumo ezibeka ubomi esichengeni. Ulawulo oluphuma kolu phononongo kufuneka lulandelwe kuphela phantsi kweliso leengcaphephe kwaye injongo ayikokuba wonke umntu atye izixa ezikhulu kodwa kunokuba akwazi ukunyamezela izixa ezincinci zamandongomane ezinokuphucula umgangatho wobomi babo.
Ukwalana kwamandongomane yingxaki emandla ingakumbi phakathi kwabantwana kunye nolutsha kwaye eli qela lingakhuselwa ekutyeni ukutya okunepeanut ngempazamo okanye ngempazamo. Ichiza i-AR101 lijongeka lithembisa ukunciphisa ukuphindaphindeka kunye nobukhali bokungavumelani nepeanut kwaye oko kubonakala kuluncedo. Ukuqonda ukwaliwa kokutya ngundoqo ekuyileni amacebo okuthintela ukuchasana nokwaliwa kakhulu kunye nokusetyenziswa okuchanekileyo kwendlela yonyango yonyango yomlomo. Ukuba oku kuhlangabezana nempumelelo, indlela efanayo ingasetyenziselwa eminye imizekelo ye-allergies eqhelekileyo esuka kwiqanda.
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{Unokufunda iphepha lokuqala lophando ngokunqakraza ikhonkco le-DOI elinikwe ngezantsi kuluhlu lwemithombo ecatshulweyo (s)}
Umthombo (s)
Iqela le-PALISADE labaphandi beClinical 2018, 'AR101 Oral Immunotherapy for Peanut Allergy. I-New England Journal of Medicine. (379). https://doi.org/10.1056/NEJMoa1812856
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