Isici se-Necrosis sezifo: izidakamizwa

I-necrosis factor (TNF) iyisiprotheni esithile seqembu lama-cytokines - izinto ezinjenge-hormone ezikhiqizwa yisistimu yomzimba. Kubangela isithakazelo esikhulu emithini ngenxa yezinto zalo - ikhono lokubangela ukufa kwe-cell (necrosis) yezincuba ze-intracellular. Lokhu kuyimpumelelo yangempela emithi, okuvumela ukusetshenziswa kwezidakamizwa nge-TNF yokwelashwa komdlavuza.

Umlando wokutholakala

Ekuqaleni kwekhulu lama-20, ukujwayela kwakutholakala ekwenzeni ukwelashwa: kwezinye iziguli ama-tumor formations ayancipha futhi / noma ayanyamalala ngemuva kokudluliselwa kwanoma yikuphi ukutheleleka. Ngemva kwalokho, umcwaningi waseMelika uWilliam Coley waqala ngamabomu ukwethula izidakamizwa ze-oncology ezineziqalo ezithathelwanayo (amabhaktheriya kanye ne-toxic). Le ndlela ayizange ibonakale isebenza kahle, njengoba yayinomthelela onamandla emzimbeni wesiguli. Kodwa lokhu kwaba ukuqala kwezifundo eziningana ezaholela ekutholakaleni kweprotheyini okuthiwa i-tumor necrosis factor. Into ehlonziwe ibangela ukufa okusheshayo kwamangqamuzana abulalayo afakwe ngaphansi kwesikhumba samagundane okuhlola. Ngemva kwesikhashana, i-TNF ehlanzekile yahlukaniswa, eyakuvumela ukuyisebenzisa ngezinjongo zocwaningo.

Lokhu kutholakala kwanezela ekuphumeleleni kwangempela ekwelashweni komdlavuza. Ngaphambilini, ngosizo lwamaphrotheni-cytokines, kwakungenzeka ukuphatha ngokuphumelelayo kuphela ukubunjwa kwezinto eziphilayo - isikhumba se-melanoma, umdlavuza wezinso. Kodwa inqubekela phambili eningi kulezi ziqondiso kuye kwavumela ukutadisha izakhiwo ukuthi i-tumor necrosis factor inayo. Ukulungiswa okusekelwe kulo kufakwe inqubo ye-chemotherapy.

Indlela yokusebenza

Isisindo se-necrosis se-tumor sisebenza esitokisini esithile esilitshe. Kunezinqubo eziningi zokwenza:

• Ngokuthola i-receptor ekhethekile ye-TNF, uhlelo olunezinyathelo eziningi lubangelwa-ukufa kwe-cell ehleliwe (i-apoptosis). Lesi senzo sibizwa nge-cytotoxic. Kulokhu, ukunyamalala ngokuphelele kwe-tumor noma ukwehla ngobukhulu bayo kubonakala.
• Ngokuphulwa noma ukuqedwa okuphelele komjikelezo weseli. Iseli lesifo somdlavuza lihluleka ukuhlukaniswa futhi ukukhula kwe-tumor kuyama. Lesi senzo sibizwa nge-cytostatic. Ngokuvamekile, lesi sifo siyeka ukukhula noma sinciphise usayizi.
• Ngokuvimbela ukwakheka kwemikhumbi emisha yezicubu zesisu nokulimaza ama-capillari asevele ekhona. I-tumor engavunyelwe ukudla okunomsoco i-necrotic, iyancipha futhi iyanyamalala.

Kunezimo lapho amangqamuzana omdlavuza angaboni ukuthi izidakamizwa zilawulwa ngenxa yezinguquko. Khona-ke izinqubo ezingenhla azivuki.

Sebenzisa emithi

I-necrosis ye-tumor isetshenziselwa ukwelashwa okuthiwa i-cytokine - ukwelashwa ngamaprotheni athile akhiqizwa ngamangqamuzana egazi anomthwalo wokuzivikela. Inqubo kungenzeka kunoma yisiphi isigaba senqubo yesifo sofuba futhi ayinqatshelwe kubantu abane-pathologies ehambisanayo - inhliziyo, isifo senhliziyo, ne-hepatic. Ukuze unciphise ubuthi, i-recombinant tumor necrosis factor isetshenziswa.

Ukwelashwa nge-cytokines kuyindlela entsha ethuthukayo yokuthuthukisa incology. Kulokhu, ukusetshenziswa kwe-TNF kubhekwa ukuthi kuphumelela kakhulu. Njengoba lesi sici sinobuthi obukhulu kakhulu, sisetshenziselwa okuthiwa i-perfusion yesifunda. Indlela yukuthi isitho esinegciwane lesandulela ngculazi noma ingxenye yomzimba ihlukaniswe nemishini ekhethekile ngokusebenzisa imishini ekhethekile evela ekuphumeni kwegazi lonke. Khona-ke, ukusakazwa kwegazi nge-injected TNF kubangelwa ngokuyisisekelo.

Imiphumela emibi

Ngokwenzokwelapha, isisindo se-tumor necrosis sisetshenziswa ngokuqapha. Ucwaningo oluningi lubonisa ukuthi i-TNF iyisici esiyinhloko ekuthuthukiseni i-sepsis, ukushaqeka okweshukela. Ukutholakala kwaleli protheyini kwandise ukutholakala kwe-pathogenicity yezifo ezithathelwana ngamagciwane kanye nesandulela ngculazi, okuyingozi kakhulu lapho kukhona khona isandulela ngculazi esigulini. Kubonakala ukuthi i-TNF ihileleke ekutheni kwenzeke izifo ezizimele, (isibonelo, isifo samathambo) lapho isimiso somzimba sokuzivikela siphutha ngokuthatha ngokungenangqondo izicubu namaseli omzimba wayo emizimbeni yangaphandle futhi ibalimaze.

Ukuze unciphise umphumela ophezulu onobuthi, izinyathelo ezilandelayo zithathwa:

• Sebenzisa kuphela endaweni yangasese esakhiweni sesisu;
• Hlanganisa nezinye izidakamizwa;
• Sebenza ngamaprotheni angaphansi kwe-TNF enobuthi;
• I-neutralizing antibodies iyethulwa.

Lezi zimo zenza ukusetshenziswa okulinganiselwe kwe-tumor necrosis factor. Ukwelashwa kufanele kuhlelwe kahle.

Inkomba yokuhlola

Ukuhlolwa kwegazi akutholaki i-TNF emzimbeni ophilile. Kodwa izinga layo likhuphuka ngokuqinile ezifweni ezithathelwanayo, lapho i-toxins ye-pathogen ingena egazini. Khona-ke ingaqukatha emcinini. Isifo se-necrosis se-tumor ku-fluid ehlangene sikhuluma ngesifo samathambo esiyingozi.

Futhi, ukwenyuka kule nkomba kubonisa ukusabela okwenziwe, umdlavuza futhi kuyisibonakaliso sokulahlwa kwezitho zomnikeli ezifakelwe kabusha. Kukhona ubufakazi bokuthi ukwanda kwalesi sibonakaliso kungabonisa izifo ezingenakuxhumana, isibonelo, ukwehluleka kwenhliziyo, ukuphefumula kwesifo sofuba.

Ngama-immunodefaces ahlukahlukene (kuhlanganise ne-AIDS) kanye nezifo ezinzima zegciwane, kanye nokuhlukunyezwa nokushisa, izimo zenziwa ukuthi kunciphise isifo se-necrosis yesisu. Isidakamizwa esinomphumela wokuzivivinya umzimba sizonikeza umphumela ofanayo.

Amalungiselelo

Amalungiselelo asekelwe ku-TNF ahloswe - akwazi ukwenza amakhemikhali athile omsele wesifo somdlavuza, okwenza kube sekufeni kwalokhu. Ngesikhathi esifanayo, umphumela kwezinye izitho uhlala ungaphansi, okunciphisa ubuthi obunayo isifo se-tumor necrosis. Amalungiselelo asekelwe ku-TNF asetshenziselwa kokubili ngokuzimela (monotherapy) futhi ahlanganiswe nezinye izidakamizwa.

Namuhla kunezindlela eziningana ngesisekelo se-TNF, okungukuthi:

• I-NGR-TNF iyilungiselelo langaphandle elithintekayo i-TNF. Iyakwazi ukulimaza izitsha ze-tumor, ukulahla ukudla.
• "Alnorin" yintuthuko yaseRussia. Iphumelela kakhulu ngokuhlanganiswa nama-interferons.

"Refnot" yisidakamizwa esisha saseRussia equkethe isifo se-necrosis se-tumor kanye ne-thymosin-alpha 1. Ubuthi bayo buphansi kakhulu, kodwa ukusebenza kulingana ne-TNF yemvelo futhi kuyidlula kakhulu ngenxa yesenzo sokuzivivinya umzimba. Lesi sidakamizwa sidalwe ngo-1990. Siphumelele ngempumelelo zonke izilingo ezidingekayo zomtholampilo futhi sabhaliswe kuphela ngo-2009, esanikeza imvume esemthethweni yokwelashwa kwama-neoplasms amahle.

Ukuziphathisa okwezinye izidakamizwa ezisekelwe kwi-tumor necrosis factor kuvinjelwe ngokweqile. Ukwelashwa komdlavuza kuyinkimbinkimbi eyinkimbinkimbi, eyenzeka kuphela ngaphansi kokuqondiswa kochwepheshe.