Cutar cututtuka ta autoimmune sakamakon rashin lafiya ne a cikin tsarin garkuwar jiki wanda ke jagorantar na karshen don kai hari ga abubuwan da suka dace na kwayoyin halitta ("kai", saboda haka tushen auto- don yin magana game da wannan cuta ta rigakafi) . An bambamta na al'ada a tsakanin takamaiman cututtukan da suka shafi gabobin jiki, waɗanda ke shafar wata gaɓa ta musamman (kamar cututtukan autoimmune na thyroid), da cututtukan ƙwayoyin cuta na ƙwayoyin cuta, irin su lupus, waɗanda ke iya shafar gabobin da yawa.

Yayin da ya kamata ya kare mu daga cututtukan cututtuka (wanda zai iya haifar da cututtuka), tsarin garkuwar jikin mu na iya fita a wasu lokuta. Daga nan zai iya zama mai kula da wasu abubuwan da ke waje (na waje), kuma yana haifar da rashin lafiyar jiki ko amsawa ga abubuwan da ke cikin kai kuma yana haɓaka bullar cututtuka na autoimmune.

Cututtukan autoimmune sun kafa rukuni wanda a cikinsa muke samun cututtuka daban-daban kamar nau'in ciwon sukari na I, mahara sclerosis, thumatoid arthritis ko cutar Crohn. Dukkansu sun yi daidai da cututtuka na yau da kullun da ke haifar da asarar juriya na kwayoyin halitta ga abubuwan da ke ciki.

Ta yaya ake kafa cututtukan autoimmune?

Sojoji na gaske na cikin gida wanda ya ƙunshi sel fararen jini da yawa, tsarin garkuwar jiki yana kare jiki daga hare-haren waje kamar ƙwayoyin cuta ko ƙwayoyin cuta kuma yawanci yana jurewa abubuwan da ke cikin sa. Lokacin da haƙuri ya rushe, ya zama tushen cututtuka. Wasu fararen jini (autoreactive lymphocytes) suna kai hari musamman ga kyallen takarda ko gabobin.

Kwayoyin rigakafi da aka saba samarwa ta wasu ƙwayoyin rigakafi don kawar da abokan gaba ta hanyar haɗawa da wasu kwayoyin halitta (antigens) kuma na iya bayyana da kuma ƙaddamar da abubuwan jikinmu. Jiki yana ɓoye ƙwayoyin rigakafi daga antigens na kansa waɗanda yake ɗauka na waje.

Misali:

• a cikin nau'in ciwon sukari na I: autoantibodies sun yi niyya ga ƙwayoyin pancreatic masu ɓoye insulin;
• a cikin rheumatoid amosanin gabbai: shi ne membrane wanda ke kewaye da gidajen da aka yi niyya, kumburi ya yada zuwa gungu, kasusuwa, har ma da tendons da ligaments;
• a cikin lupus erythematosus na tsarin, auto-anticoprs ana jagorantar su a kan kwayoyin da ke cikin kwayoyin halitta da yawa na jiki, wanda ke haifar da lalacewa ga gabobin da dama (fata, gidajen abinci, kodan, zuciya, da dai sauransu).

A wasu lokuta, ba mu sami autoantibodies kuma muna magana maimakon cututtukan "autoinflammatory". Layin farko na jiki na rigakafi na rigakafi (neutrophils, macrophages, monocytes, kwayoyin kisa na halitta) kadai yana haifar da kumburi na kullum wanda ke haifar da lalata wasu kyallen takarda:

• fata a psoriasis (wanda ke shafar 3 zuwa 5% na yawan mutanen Turai);
• wasu gidajen abinci a cikin spondylitis na rheumatoid;
• tsarin narkewa a cikin cutar Crohn;
• tsarin kulawa na tsakiya a cikin sclerosis da yawa.

Ko sun kasance masu saurin kamuwa da cutar kansa ko kuma auto-mai kumburi, duk waɗannan cututtukan suna haifar da tabarbarewar tsarin rigakafi kuma suna haɓaka zuwa cututtukan kumburi na yau da kullun.

Wanene ya damu?

A farkon karni na 5, cututtukan autoimmune suna shafar kusan mutane miliyan 80 a Faransa kuma sun zama sanadin mace-mace na uku bayan cutar kansa da cututtukan zuciya da kuma kusan daidai gwargwado. XNUMX% na lamuran sun shafi mata. A yau, idan jiyya ya ba da damar rage ci gaban su, cututtukan autoimmune sun kasance marasa warkewa.

Mafi yawan cututtukan autoimmune suna da yawa. Tare da ƴan kaɗan, ana ɗaukar su bisa ga haɗin gwiwar kwayoyin halitta, endogenous, exogenous da / ko muhalli, hormonal, cututtuka da abubuwan tunani.

Asalin kwayoyin halitta yana da mahimmanci, saboda haka galibin yanayin iyali na waɗannan cututtuka. Misali, yawan nau'in ciwon sukari na I yana zuwa daga 0,4% a cikin yawan jama'a zuwa 5% na dangin mai ciwon sukari.

A cikin ankylosing spondylitis, kwayar HLA-B27 tana cikin kashi 80% na abubuwan da abin ya shafa amma a cikin 7% kawai na batutuwa masu lafiya. Yawancin idan ba ɗaruruwan kwayoyin halitta an haɗa su da kowace cuta ta autoimmune.

Nazarin gwaji ko bayanan cututtukan cututtuka sun bayyana a sarari haɗin gwiwa tsakanin microbiota na hanji (tsarin yanayi na narkewa), wanda ke cikin mahaɗin tsakanin tsarin rigakafi da muhalli, da kuma faruwar cutar ta autoimmune. Akwai musaya, nau'in tattaunawa, tsakanin ƙwayoyin cuta na hanji da ƙwayoyin rigakafi.

Yanayin (bayyanannun ƙwayoyin cuta, wasu sinadarai, haskoki UV, shan taba, damuwa, da sauransu) shima yana taka rawa sosai.

Neman cutar kansa dole ne a koyaushe a yi shi cikin yanayi mai tada hankali. Jarabawa sun hada da:

• bincike don gano gabobin da aka shafa (na asibiti, nazarin halittu, biopsy na gabobin jiki);
• gwajin jini don bincika kumburi (marasa takamaiman) amma wanda zai iya nuna tsananin hare-haren da kuma bincika kimar rigakafi tare da binciken autoantibodies;
• bincike na tsari don yiwuwar rikitarwa (koda, huhu, zuciya da tsarin juyayi).

Kowace cuta ta autoimmune tana amsa takamaiman magani.

Jiyya ya sa ya yiwu a sarrafa alamun cutar: analgesics da zafi, anti-mai kumburi da kwayoyi da rashin jin daɗi na aiki a cikin gidajen abinci, maye gurbin maye gurbin shi yiwuwa a normalize endocrine cuta (insulin ga ciwon sukari, thyroxine a hyothyroidism).

Magungunan da ke sarrafawa ko hana rigakafi kuma suna ba da hanya don iyakance bayyanar cututtuka da ci gaban lalacewar nama. Yawancin lokaci dole ne a sha su na tsawon lokaci saboda ba za su iya warkar da cutar ba. Bugu da ƙari, ba su da takamaiman ga ƙwayoyin cuta masu tasiri na autoimmunity kuma suna tsoma baki tare da wasu ayyuka na gaba ɗaya na tsarin rigakafi.

A tarihi, an yi amfani da magungunan rigakafi (corticosteroids, cyclophosphamide, methotrexate, cyclosporin) saboda suna hulɗa tare da masu tasiri na tsakiya na tsarin rigakafi kuma suna ba da damar iyakance ayyukansa gaba ɗaya. Sau da yawa ana danganta su da ƙara haɗarin kamuwa da cuta don haka suna buƙatar kulawa akai-akai.

Tsawon shekaru ashirin, an samar da magungunan biotherapies: suna ba da mafi kyawun sarrafa alamun bayyanar cututtuka. Waɗannan kwayoyin halitta ne waɗanda ke keɓance musamman ɗaya daga cikin manyan ƴan wasan da ke cikin tsarin da abin ya shafa. Ana amfani da waɗannan jiyya lokacin da cutar ta yi tsanani ko ba ta amsawa ko isa ga masu hana rigakafi.

A cikin yanayin ƙayyadaddun cututtuka irin su Guillain Barre ciwo, plasmapheresis yana ba da damar kawar da autoantibodies ta hanyar tace jini wanda aka sake shigar da shi cikin majiyyaci.