Isidakamizwa esisha, i-Aducanumab, sibonisa isithembiso ekwelapheni i-Alzheimer

Isifo se-Alzheimer sabonakala eminyakeni eyi-100 edlule. Nokho, kwakuphakathi nje neminyaka engu-30 edlule lapho yaqashelwa khona njengeqembu imbangela ehamba phambili yokuwohloka komqondo kanye nembangela eyinhloko yokufa. Alikho ikhambi lalesi sifo. Imithi yokwelapha etholakalayo ivikela kuphela, ingasheshi futhi inqande ukusakazeka kwalesi sifo. Ucwaningo oluqhubekayo lokwelapha i-Alzheimer lugxile ekuhlonzweni kusenesikhathi. Inselele enkulu yokutholwa kwezidakamizwa ezintsha ukuthi ukusebenza kokwelashwa ezinyathelweni zakuqala zocwaningo akunawo umthelela ofanayo nokuhlolwa komtholampilo kwesilinganiso esikhulu.   

I-Alzheimer njengesifo 

Isifo i-Alzheimer's sihlukaniswa ngezigaba ukulahlekelwa ukusebenza kwamangqamuzana obuchopho. Lokhu kungaholela ekuqothulweni kwamangqamuzana obuchopho ngokuphelele. Imisebenzi yobuchopho ethintekayo ihlanganisa ukulahlekelwa inkumbulo, ukuguquka kwenqubo yokucabanga, kanye nokulahlekelwa kancane kancane kokuhamba. Lo monakalo kumaseli obuchopho uhlanganisa amaphesenti angama-60 kuya kwangu-80 ezimo zokuwohloka komqondo. 

Izimpawu nokuxilongwa 

Izimpawu zihlukile kuwo wonke umuntu, nakuba kukhona okufana okwenzeka ezimweni eziningi. A inkomba evamile ukungakwazi ukugcina ulwazi olusha. Izifunda zobuchopho ezinikezelwe ekwakheni izinkumbulo ezintsha ngokuvamile ziyizindawo lapho kwenzeka khona umonakalo wokuqala.  

Njengoba isikhathi siqhubeka, ukusakazeka kwalesi sifo kubangela okunye ukulahlekelwa umsebenzi. Izimpawu ezijwayelekile zihlanganisa ukulahlekelwa inkumbulo okuphazamisa imisebenzi yansuku zonke, ubunzima bokuhlela nokwenza izinqumo, izinselele zokuqaphela ubudlelwano obukhethekile nemifanekiso ebonakalayo, ukugwema imisebenzi yomphakathi, ukukhathazeka, nokuqwasha. Kukhona ukwehla kwemisebenzi yokuqonda ngokuhamba kwesikhathi. Abantu bazodinga usizo ekwenzeni imisebenzi yansuku zonke. Izimo ezinzima ziholela ekunakekelweni kombhede. Lokhu kungasebenzi kanye nokuncipha kokuhamba kwandisa amathuba okutheleleka okulimaza amasosha omzimba. 

Ayikho indlela eqondile yokuxilonga i-Alzheimer. Ngosizo lwe-neurologist, kwenziwa ukuhlolwa okuhlukahlukene. Kudingeka umlando wezokwelapha kanye nesizinda sesiguli—lokhu kubikezela ithuba lokuba ne-Alzheimer. Umndeni nabangane babhekene nokubona noma yiziphi izinguquko endleleni yokucabanga namakhono. Ukuhlolwa kwegazi nokuskena kobuchopho nakho kuyasetshenziswa ukuze kuqinisekiswe iminonjana yokuwohloka komqondo. Okokugcina, ukuhlolwa kwemizwa, ingqondo nomzimba kuyenziwa. 

Ukuguqulwa kobuchopho nge-Alzheimer 

I-Alzheimer ibonakala ngendlela yama-tangles (owaziwa nangokuthi ama-tau tangles) noma ama-plaque (ama-beta-amyloid plaques). Ama-Tangles "aphazamisa izinqubo ezibalulekile." Ama-plaque amadiphozithi endaweni ehlakazekile lokho kungaba ubuthi ebuchosheni emazingeni aphezulu. Kuzo zombili izimo, ivimbela ukudluliswa kolwazi phakathi kwama-neurons ngendlela yama-synapse. Ukugeleza kwamasignali ebuchosheni nakho kunesibopho sezinqubo zokucabanga, imizwa, ukuhamba, namakhono. Ukungabikho kwama-synapse kubangela ukufa kwama-neurons. I-Beta-amyloid ivimbela ukuhamba kwama-synapse. Ngenkathi i-tau tangles ivimbela izakhi kanye nama-molecule abalulekile ngaphakathi kwe-neuron. Ukuskena kobuchopho kwabantu abathintwe yi-Alzheimer ngokuvamile kubonisa izithombe zemfucumfucu yokufa kwama-neurons namaseli, ukuvuvukala, kanye nokushwabana kwezifunda zobuchopho ngenxa yokulahleka kweseli.   

Ukwelashwa Kwemithi – I-Aducanumab kanye ne-AADva-1 

Ukwelashwa kwe-Alzheimer kuvame ukukhomba i-beta-amyloid. Iyingxenye eyinhloko yokwakhiwa kwama-plaque. Kunama-enzyme amabili anesibopho sokufihla i-beta-amyloid; I-beta-secretase ne-gamma-secretase. Ukulahlekelwa inkumbulo okuhlobene ne-Alzheimer kwenzeka ngokunqwabelana kwe-beta-amyloid kanye nonxantathu be-tau. Noma kunjalo, kuthatha iminyaka ephakathi kwe-15 kuya kwengama-20 ngaphambi kokuba kube nomphumela ophawulekayo enkumbulweni. Kubalulekile uku phazamisa izinqubo abathintekayo ekwakheni ama-beta-amyloid plaque. Lokhu kuhlanganisa ukuvimbela umsebenzi we-enzyme ekwakheni ama-plaque, ukunciphisa ukwakheka kwe-beta-amyloid aggregates, kanye nokusetshenziswa kwamasosha omzimba ukudiliza i-beta-amyloid ebuchosheni bonke. Ucwaningo lwangaphambilini lubonise ukuthi izidakamizwa eziningi ekuhlolweni kwesigaba sesi-3, zehlulekile ukuba nokuhlobana phakathi kwenani elincishisiwe lamaprotheni e-beta-amyloid kanye nokubambezeleka kokuncipha kwengqondo.  

Inhlangano ye-biotechnology, I-Biogen Idec baphumelele ukudlula isigaba sokuqala somuthi, i-aducanumab. Ucwaningo olwenziwe esigabeni sokuqala luhloselwe ukuhlola ukubekezelelana nokuphepha komuthi. Izivivinyo zesigaba sokuqala zenzeka eqenjini elincane labantu futhi phakathi nenkathi eyizinyanga eziyisithupha kuya onyakeni. Isimo sezempilo sabantu abahililekile esivivinyweni sesigaba sokuqala sihlanganisa abantu abane-beta-amyloid ekhona ebuchosheni nabanye abahlangabezane nezigaba zakuqala ze-Alzheimer.  

I-Aducanumab iyi-antibody ye-monoclonal ngokumelene nokwakhiwa kwe-beta-amyloid. I-antibody isebenza njengethegi futhi ikhombisa amasosha omzimba ukuthi abhubhise amaseli e-beta-amyloid. Ngaphambi kokwelashwa, i-PET scan iyasiza ekubaleni ubukhona bamaprotheni e-beta-amyloid. Kucatshangwa ukuthi ukunciphisa amazinga e-beta-amyloid kuzothuthukisa ukuqonda kumuntu ngamunye. Ngokusekelwe emiphumeleni, kwaphetha ngokuthi i-aducanumab iyisidakamizwa esincike kumthamo. Umthamo owengeziwe ube nomthelela omkhulu ekwehliseni ama-beta-amyloid plaque. 

Enye yamaphutha alolu cwaningo lwezidakamizwa ukuthi akusona sonke isiguli esabonisa izimpawu zokubunjwa kwe-beta-amyloid ebuchosheni. Akuwona wonke umuntu owake wabhekana nakho inzuzo yomuthi. Ukwengeza, akuzona zonke iziguli eziye zaba nokuncipha kwengqondo. Abantu babenemisebenzi yabo eminingi iphelele. Ukulahleka kokusebenza kwengqondo kuhlotshaniswa nokufa kwama-neurons. Imithi yokwelapha ebandakanya amasosha omzimba ihlose ukucekela phansi ukukhula kwama-plaque esikhundleni sokuvuselela ama-neurons alahlekile.  

Impendulo ethembisayo yesigaba sokuqala ichitha ezinye izindlela zokwelapha. Nakuba imithi isizile ekwehliseni inani lama-plaque, i-Aducanumab iwukwelashwa kokuqala kwe-antibody ehlose ukwehlisa ukwehla kwengqondo. 

Kubalulekile ukuveza ukuthi usayizi wesampula wesigaba sokuqala mncane uma kuqhathaniswa. Ngakho-ke, isigaba sesithathu sokuhlolwa komtholampilo sibalulekile esixukwini esikhulu seziguli. Izivivinyo zomtholampilo zesigaba sesithathu zizohlola ukusebenza komuthi kubantu abaningi. Okunye okukhathazayo yizindleko zomuthi. Kulindeleke ukuthi isiguli se-Alzheimer sichithe cishe u-$40,000 ngonyaka ukuze balashwe. 

I-AADva-1 ihlanganisa i- umgomo osebenzayo ukuqalisa ukusabela komzimba kumaprotheni e-tau. Umphumela uba ukuwohloka kwamaprotheni. Uhlolo lwesigaba sokuqala lwakhiwe iziguli ezingama-30 ezibonisa amazinga aphansi kuye kwamaphakathi esifo i-Alzheimer. Umthamo owodwa womjovo wawusetshenziswa njalo ngenyanga. Lapha ukuphepha, ukubekezelelana kanye nokusabela komzimba komuthi kwahlolwa. Kusukela ngo-March 2016, isigaba sesibili sokuqulwa kwecala saqala. Ibandakanye iziguli ezingaba ngu-185. Imijovo yayisetshenziswa ukuze kuhlolwe ukusebenza kwengqondo, ukuphepha, nokusabela komzimba kumuntu ngamunye. Isigaba sesithathu sesilingo somtholampilo sisaqhubeka. Lesi sigaba senzelwe ukuqinisekisa ukuthi i-ADDva-1 ingamisa ukwakheka kwama-tau protein aggregates.