Rumatism mai kumburi, irin su amosanin gabbai, amma kuma ankylosing spondylitis, ciwon ƙanƙara na yara ko amosanin gabbai, yana shafar dubban mutane a Faransa. Yana haifar da ciwo da nakasa aiki tare da lalata haɗin gwiwa, wannan rheumatism na iya haifar da mummunan sakamako. A baya an yi amfani da magunguna kawai azaman magani na asali, yanzu hanyoyin kwantar da hankali sun isa, suna ba da damar gudanar da wannan cutar ta musamman.

An haɓaka hanyoyin ilimin halittar jiki ta amfani da rayayyun halittu, waɗanda injiniyan ƙwayoyin cuta suka gano. Don haka masu binciken sun gano cytokine (furotin na tsarin garkuwar jiki), TNF-alpha, wanda ke aiki akan hanyoyin kumburi. Ta haka waɗannan hanyoyin ilimin halittu suna toshe aikinsa, ta hanyoyi biyu:

• ƙwayoyin monoclonal sun hana TNF alpha;
• mai karɓa mai narkewa yana aiki azaman yaudara kuma yana tarkon wannan TNF.

Har zuwa yau, akwai ƙwayoyin rigakafi guda biyu da mai karɓa mai narkewa a kasuwa.

Dangane da cututtukan kumburi, magani ya sami babban ci gaba a cikin karnin da ya gabata:

• da farko an bi da shi da asfirin a farkon karni na 20, an sassauta cututtukan kumburi kawai, duk da illolin da ba a so na aspirin;
• a cikin shekarun 1950, cortisone ya yi isowarsa na juyin juya hali a cikin maganin tsarin kumburi. Tare da tasiri nan da nan akan kumburi, duk da haka, baya hana cutar, kuma yana da illoli masu yawa marasa daɗi;
• sannan, a cikin shekarun 1970, shine ci gaban aikin tiyata wanda ya ba da damar kula da mutanen da ke fama da kumburi, ta hanyar yin aiki kai tsaye gidajensu da aka lalata sau da yawa;
• Magungunan magunguna na farko sun isa a cikin 1980s: methotrexate, irin maganin da aka ba shi a cikin ilimin oncology amma a cikin raguwar sashi, ya kasance mafi inganci kuma mafi yawan marasa lafiya sun jure. Ba daidai ba ne a yi tunanin cewa ya kamata a yi amfani da wannan maganin a matsayin mafaka ta ƙarshe; amma yanayin gabobin sun lalace yayin wannan asarar lokaci, galibi shekaru biyu na farko. A yau, ana amfani da wannan magani da sauri, a farkon alamun cutar, don adana gidajen abinci. Waɗannan magungunan suna da fa'idar rashin araha: kusan Yuro 80 a kowane wata don methotrexate, mafi inganci daga cikinsu, kuma yana da tasiri a kashi na uku na marasa lafiya da ke fama da amosanin gabbai;
• Daga ƙarshen shekarun 1990s, sarrafa magunguna na waɗannan cututtukan ya haɓaka sosai tare da bullar hanyoyin kwantar da hankali waɗanda ke yin niyyar aiwatar da kumburi, kuma ana ganin sun fi tasiri sosai. A halin yanzu goma sha biyar a cikin adadin, Inshorar Lafiya ta rufe su 100%.

Duk da haɗarurrukan da aka yi hasashe, an tabbatar da fa'idar fa'idodin ilimin halitta.

Yayin da kashi 20 zuwa 30% na marasa lafiya ba sa samun kwanciyar hankali ta hanyar maganin da ake ganin shine mafi inganci (methotrexate), an lura cewa kashi 70% na marasa lafiya suna amsawa da kyau ga jiyya tare da maganin ƙwayar cuta. An rage yawan mummunan tasirin cututtukan kumburin su:

• gajiya;
• zafi;
• rage motsi.

Marasa lafiya galibi suna fuskantar wannan maganin a matsayin sake haifuwa, lokacin da wasu ke tunanin an ƙaddara su ga keken guragu don rayuwa.

Mun kuma kafa fa'idar ilimin halittu dangane da haɗarin cututtukan cututtukan zuciya: za a rage wannan haɗarin ta hanyar sauƙaƙan gaskiyar rage ɓangaren kumburin cutar. Ta haka za a inganta tsawon rayuwar marasa lafiya.

A ƙarshe, binciken da aka buga a Lancet a 2008 ya ɗora fatan samun cikakkiyar gafarar cutar ta hanyar yin amfani da hanyoyin kwantar da hankali. Yawan gafarar da ke ƙarƙashin methotrexate shine 28% kuma ya kai 50% idan an haɗa mai karɓar mai narkewa tare da methotrexate. Manufar wannan gafarar da ke ƙarƙashin magani ita ce a bi ta raguwar magani a hankali, kafin a sami cikakkiyar gafara.

Koyaya, TNF-alpha ba cytokine bane kamar sauran: hakika yana da rawar hana kumburi, yana kuma taimakawa yakar cututtuka da cutar kansa, ta hanyar lalata ƙwayoyin cutar kansa. Ta hanyar tarko wannan kwayar, muna kuma raunana jiki daga haɗarin ciwace -ciwacen daji.

Anyi nazarin waɗannan haɗarin a cikin karatu da yawa tare da gwajin asibiti. Yin la'akari da duk waɗannan karatun, haɗarin mai cutar kansa an auna kamar ninki biyu ko sau uku ta amfani da ƙwayoyin rigakafi na monoclonal; kuma haɗarin ya ninka ta 1,8 ta amfani da mai karɓar maganin TNF mai narkewa.

Koyaya, a ƙasa, gaskiya tana da banbanci sosai: a cikin rajistar marasa lafiya na Turai da Amurka sun bi kuma an bi da su ta hanyar ilimin halittu, irin wannan ƙaruwar cutar kansa ba ta faruwa. Likitoci na ci gaba da yin taka tsantsan kan wannan batu, yayin da suke yarda da matsakaicin haɗarin amma ana kashe su ta fa'idar ilimin halittu.

Dangane da cututtuka, an kiyasta haɗarin kamuwa da cuta mai tsanani a 2% na marasa lafiya a kowace shekara lokacin da kumburin ya fara (ƙasa da watanni 6). Idan ya tsufa, haɗarin shine 5%. Waɗannan sakamakon sun nuna cewa biotherapy yana ba da damar iyakance waɗannan haɗarin a cikin ƙididdiga masu dacewa.

Sarrafa wannan haɗarin kamuwa da cuta ya haɗa da dabarun tantancewa kafin a rubuta wani anti-TNF ga mai haƙuri. Cikakken gwajin asibiti, hira da jerin gwaje -gwaje zai zama dole (ƙididdigar jini, transaminases, serology na hepatitis (A, B, da C), HIV bayan izinin haƙuri, sa ido da sabunta allurar rigakafi, tarihin tarin fuka.).

Don haka dole ne a yiwa marasa lafiya allurar rigakafin mura da pneumococcus kafin magani, kuma su kai ziyara wata guda bayan takardar sayan magani sannan kowane bayan watanni uku, don tantance tasirin magani da haɗarin kamuwa da cuta.