Pehea e hana ai nā ʻōlelo waha no MS?

Anter

• Ke kuleana o nā hunaola B a me nā hunaola T
• Cladribine (Mavenclad)
• ʻO Dimethyl fumarate (Tecfidera)
• ʻO Diroximel fumarate (ka nui)
• Fingolimod (Gilenya)
• Siponimod (Mayzent)
• ʻO Teriflunomide (Aubagio)
• Nā lāʻau hoʻoliʻiliʻi maʻi ʻē aʻe
• Ka hopena kūpono o nā hopena ʻaoʻao mai DMTs
• Ka mālama ʻana i ka hopena o nā hopena ʻaoʻao
• ʻO ka lawe lawe ʻana
• ʻO kēia ka mea e manaʻo e ola me MS

Multiple sclerosis (MS) kahi maʻi autoimmune kahi e hoʻouka ai kāu ʻōnaehana pale i ka uhi pale a puni nā ʻalolo i kāu ʻōnaehana waena (CNS). Hoʻopili pū ka CNS i kou lolo a me kou iwi kuamoo.

ʻO nā mea hoʻoponopono hoʻoponopono maʻi (DMT) nā lāʻau lapaʻau i koi ʻia e kōkua i ka hoʻolohi i ka hoʻomohala ʻana o MS. Hiki i nā DMT ke kōkua i ka hoʻopanee ʻana i ka hemahema a hoʻemi i ke alapine o nā lapalapa i nā poʻe me kēia ʻano.

Ua ʻae ka Food and Drug Administration (FDA) i nā DMT he nui e mālama i nā ʻano relapsing o MS, me nā DMT ʻeono i lawe waha ʻia e like me nā capsule a i ʻole nā ​​papa.

E heluhelu e aʻo hou e pili ana i nā DMT waha a me ka hana a lākou.

Ke kuleana o nā hunaola B a me nā hunaola T

E hoʻomaopopo pehea e kōkua ai ka DMTS waha i ka mālama iā MS, pono ʻoe e ʻike e pili ana i ka hana a kekahi mau pale pale i MS.

Hoʻopili ka nui o nā hunaola a me nā mole i ka pane pale ʻole i kū i ke kumu o ka hoʻowahāwahā a me ka ʻino ma MS.

Hoʻopili kēia i nā pūnaewele T a me nā hunaola B, ʻelua ʻano o ke keʻokeʻo koko keʻokeʻo i ʻike ʻia he lymphocytes. Hana ʻia lākou i loko o ka ʻōnaehana lymphatic o kou kino.

Ke neʻe nā pūnaewele T mai kāu ʻōnaehana lymphatic i kou kahawai koko, hiki iā lākou ke huakaʻi i kāu CNS.

Hana kekahi ʻano o nā hunaola T i nā protein i ʻike ʻia ʻo cytokines, kahi e hoʻāla ai i ka pehu. I ka poʻe me MS, cytokine pro-inflammatory ke kumu o ka hōʻino ʻana i ka myelin a me nā aʻa nerve.

Hoʻokumu pū nā pūnaewele B i nā cytokine pro-inflammatory, i hiki ke kōkua i ka hoʻokele i nā hana o nā maʻi T e hoʻoulu maʻi nei i MS. Hoʻokumu pū nā pūnaewele B i nā mea ʻino, a he mea nui paha ia i MS.

Hana nā DMT he nui ma o ka kaupalena ʻana i ka hoʻoulu ʻana, ke ola ʻana, a i ʻole ka neʻe ʻana o nā pūnaewele T, nā pūnaewele B, a i ʻole ʻelua paha. Kōkua kēia i ka hōʻemi ʻana i ka lū a me ka hōʻino ma ka CNS. Pale kekahi mau DMT i nā hunaola nerve mai ka poino ma nā ʻano ʻē aʻe.

Cladribine (Mavenclad)

Ua ʻae ka FDA i ka hoʻohana ʻana o cladribine (Mavenclad) e mālama ai i nā ʻano relapsing o MS i nā mākua. I kēia lā, ʻaʻole i pau nā noiʻi i ka hoʻohana ʻana o Mavenclad i nā keiki.

Ke lawe kekahi i kēia lāʻau, komo i loko o nā pūnaewele T a me nā hunaola B i loko o ko lākou kino a keʻakeʻa i ka hiki i nā pūnaewele ke synthesize a hoʻoponopono iā DNA. ʻO kēia ke kumu e make ai nā hunaola, e hoʻemi ana i nā hunaola T a me nā hunaola B i loko o kā lākou ʻōnaehana pale.

Inā loaʻa iā ʻoe ka lapaʻau me Mavenclad, lawe ʻoe i ʻelua papa o ka lāʻau i loko o 2 makahiki. E hoʻopili ana kēlā me kēia papa i 2 mau pule hoʻomaʻamaʻa, hoʻokaʻawale ʻia e 1 mahina.

I loko o kēlā me kēia pule hoʻomaʻamaʻa, e aʻo aku kāu kauka iā ʻoe e lawe i hoʻokahi a i ʻole ʻelua mau lā o ka lāʻau no 4 a 5 mau lā.

ʻO Dimethyl fumarate (Tecfidera)

Ua ʻae ka FDA i ka dimethyl fumarate (Tecfidera) no ka mālama ʻana i nā ʻano MS i hoʻi i nā mākua.

ʻAʻole i ʻae ʻo FDA iā Tecfidera no ka mālama ʻana iā MS i nā keiki. Eia nō naʻe, hiki i nā kauka ke kuhikuhi i kēia lāʻau i nā keiki i kahi hana i ʻike ʻia ma ke ʻano he inoa "off-label".

ʻOiai ʻoi aku ka nui o ka noiʻi e pono ai, nā noiʻi e hōʻike i kēia lāʻau he palekana a maikaʻi hoʻi no ka mālama ʻana iā MS i nā keiki.

ʻAʻole ʻike maopopo ka poʻe loea i ka hana a Tecfidera. Eia nō naʻe, ua ʻike nā mea noiʻi hiki i kēia lāʻau ke hōʻemi i ka nui o kekahi ʻano o nā keena T a me nā hunaola B, a me nā cytokine pro-inflammatory.

Hōʻike pū ʻo Tecfidera i kahi protein i ʻike ʻia ma ke ʻano he kumu nukelea erythroid 2-pili mea (NRF2). Hoʻopuka kēia i nā pane pūnaewele e kōkua ai i ka pale ʻana i nā hunaola nerve mai ke koʻikoʻi oxidative.

Inā kuhikuhi ʻia ʻoe iā Tecfidera, e aʻo aku kāu kauka iā ʻoe e lawe i ʻelua 120-milligram (mg) i kēlā me kēia lā no nā lā 7 mua o ka mālama ʻana. Ma hope o ka hebedoma mua, e haʻi lākou iā ʻoe e lawe i ʻelua mau 240-mg i kēlā me kēia lā i ka hoʻomau mau.

ʻO Diroximel fumarate (ka nui)

Ua ʻae ka FDA i diroximel fumarate (Vumerity) e mālama i nā ʻano relapsing o MS i nā mākua. ʻAʻole maopopo ka poʻe loea inā palekana a maikaʻi paha kēia lāʻau i nā keiki.

ʻO ka nui he ʻāpana o ka papa like o nā lāʻau e like me Tecfidera. E like me Tecfidera, manaʻoʻiʻo ʻia e hoʻoulu i ka protein NRF2. Hoʻonohonoho kēia i nā pane pūnaewele e kōkua i ka pale ʻana i ka hōʻino ʻana i nā hunaola nerve.

Inā loaʻa i kāu papa hana hoʻomaʻamaʻa ka helu, e aʻo aku kāu kauka iā ʻoe e lawe i ka 231 mg o ka lāʻau i ʻelua mau lā i kēlā me kēia lā no nā lā 7 mua. Mai kēlā manawa mai, pono ʻoe e lawe i ka 462 mg o ka lāʻau i ʻelua mau manawa i kēlā me kēia lā.

Fingolimod (Gilenya)

Ua ʻae ka FDA i ka fingolimod (Gilenya) no ka mālama ʻana i nā ʻano MS o nā mākua a me nā keiki he 10 mau makahiki a ʻoi paha.

ʻAʻole i ʻae ʻo FDA i kēia lāʻau no ka mālama ʻana i nā keiki ʻōpio, akā hiki i nā kauka ke kuhikuhi aku iā ia i ka lepili i nā keiki ma lalo o 10 mau makahiki.

Paukū kēia lāʻau i kekahi ʻano mole mole i ʻike ʻia ʻo sphingosine 1-phosphate (S1P) mai ka hoʻopaʻa ʻana i nā pūnaewele T a me nā hunaola B. A laila, pale kēia i kēlā mau pūnaewele mai ke komo ʻana i ke kahe o ke koko a hele i ka CNS.

Ke hoʻopau ʻia kēlā mau pūnaewele mai ka hele ʻana i ka CNS, ʻaʻole hiki iā lākou ke hana i ka hoʻāpā a me ka hōʻino ma laila.

Lawe ʻia ʻo Gilenya i hoʻokahi manawa i ka lā. I ka poʻe i kaupaona ma mua o 88 paona (40 kilokilo), ʻo ka paukū i koi ʻia i kēlā me kēia lā he 0.5 mg. I ka poʻe i kaupaona ka liʻiliʻi ma mua o kēlā, ʻo ka paukū i koi ʻia i kēlā me kēia lā he 0.25 mg.

Inā hoʻomaka ʻoe i ka lāʻau lapaʻau me kēia lāʻau a laila haʻalele i ka hoʻohana ʻana iā ia, ʻike paha ʻoe i kahi ahi nui.

Ua hoʻomohala kekahi poʻe me MS i ka piʻi nui loa o ke kīnā a me nā maʻi lolo hou ma hope o ko lākou oki ʻana i ka lawe ʻana i kēia lāʻau.

Siponimod (Mayzent)

Ua ʻae ʻo FDA i ka siponimod (Mayzent) no ka mālama ʻana i nā ʻano MS i hoʻi i nā mākua. I kēia manawa, ʻaʻole i hoʻopau nā mea noiʻi i kekahi mau noiʻi e pili ana i ka hoʻohana ʻana o kēia lāʻau i nā keiki.

Aia ʻo Mayzent i ka papa like o nā lāʻau e like me Gilenya. E like me Gilenya, ālai ʻo ia iā S1P mai ka hoʻopaʻa ʻana i nā pūnaewele T a me nā pūnaewele B. Kū kēia i kēlā mau hunaola pale mai ka hele ʻana i ka lolo a me ka iwi kuamoo, kahi e hiki ai iā lākou ke hōʻino.

Lawe ʻia ʻo Mayzent i hoʻokahi manawa i ka lā. No ka hoʻoholo ʻana i kāu mea ʻoi loa i kēlā me kēia lā, e hoʻomaka kāu kauka ma ke kānana ʻana iā ʻoe no kahi hōʻailona genetical i hiki ke kōkua i ka wānana i kāu pane i kēia lāʻau.

ʻO kāu hopena hopena hōʻike e hōʻike maikaʻi paha kēia lāʻau no ʻoe, e kauoha ana kāu kauka i kahi lāʻau liʻiliʻi e hoʻomaka. E hoʻonui mālie lākou i kāu lāʻau i kauoha ʻia i kahi hana i ʻike ʻia ma ke ʻano he titration. ʻO ka pahuhopu e hoʻonui i nā keu pono ke kaupalena ʻia nā hopena ʻaoʻao.

Inā ʻoe e lawe i kēia lāʻau a laila haʻalele i ka hoʻohana ʻana iā ia, eʻoi aku ana ka maikaʻi o kou maʻi.

ʻO Teriflunomide (Aubagio)

Ua ʻae ka FDA i ka hoʻohana ʻana o teriflunomide (Aubagio) no ka mālama ʻana i nā ʻano MS i hoʻi i nā mākua. ʻAʻole i paʻi ʻia kahi noiʻi i kēia manawa no ka hoʻohana ʻana o kēia lāʻau i nā keiki.

Palaka ʻo Aubagio i kahi enzyme i kapa ʻia ʻo dihydroorotate dehydrogenase (DHODH). Pili kēia enzyme i ka hana o pyrimidine, kahi paʻa hale DNA e koi ʻia no ka synthes DNA i nā pūnaewele T a me nā hunaola B.

Ke hiki ʻole i kēia enzyme ke komo i ka nui o ka pyrimidine e synthesize DNA, palena ia i ka hoʻokumu ʻia ʻana o nā hunaola T hou a me nā hunaola B.

Inā loaʻa iā ʻoe ka lāʻau lapaʻau me Aubagio, hiki i kāu kauka ke kuhikuhi i kahi lāʻau 7- a i ʻole 14-mg i kēlā me kēia lā.

Nā lāʻau hoʻoliʻiliʻi maʻi ʻē aʻe

Ma waho aʻe o kēia mau lāʻau lapaʻau waha, ua ʻae ka FDA i kekahi mau DMT i kiki ʻia ma lalo o ka ʻili a i hāʻawi ʻia paha ma o ka infravenous infusion.

Pākuʻi ʻia lākou:

• alemtuzumab (Lemtrada)
• glatiramer acetate (Copaxone, Glatect)
• interferon beta-1 (Avonex)
• interferon beta-1a (Rebif)
• interferon beta-1b (Betaseron, Extavia)
• mitoxantrone (Novantrone)
• natalizumab (Tysabri)
• ocrelizumab (Ocrevus)
• peginterferon beta-1a (Plegridy)

E kamaʻilio me kāu kauka e aʻo hou e pili ana i kēia mau lāʻau.

Ka hopena kūpono o nā hopena ʻaoʻao mai DMTs

Hiki i ka mālama ʻana me DMT ke hana i nā hopena ʻino, a i kekahi mau hihia koʻikoʻi.

Hoʻololi nā hopena ʻē aʻe o ka mālama ʻana i ka ʻano o ka DMT kikoʻī āu e lawe ai.

ʻO kekahi mau hopena ʻaoʻao maʻamau e pili pū me:

• ʻeha poʻo
• nausea
• ka luaʻi
• pāhoehoe
• ʻāwīwī o ka ʻili
• poho lauoho
• lohi ka helu o ka naʻau
• ʻōniʻoni maka
• ʻoluʻolu o ka ʻōpū

Pili pū nā DMT i ka hoʻonui ʻia o ka makaʻu o ka maʻi, e like me:

• maʻi palū
• bronchitis
• maʻi puʻu
• ʻalalā
• kekahi mau maʻi ʻino
• ka leukoencephalopathy multifocal holomua, kahi ʻano laha ʻole o ka maʻi lolo

ʻO ka māhuahua o ka maʻi o ka maʻi ma muli o ka hoʻololi ʻana o kēia mau lāʻau i kou ʻōnaehana pale a hoʻoliʻiliʻi paha i ka helu o nā maʻi keʻokeʻo e hakakā ana i ka maʻi i kou kino.

Hiki i nā DMT ke hana i nā hopena ʻino ʻē aʻe, e like me ka hōʻino o ke ake a me nā hopena maʻi maʻi. Hiki paha i kekahi mau DMT ke piʻi aʻe i kou kaʻe koko. Hiki i kekahi ke hoʻonā i kou puʻuwai e lohi.

E hoʻomanaʻo e kauka ana kāu kauka i kahi DMT inā manaʻoʻiʻo lākou i nā pōmaikaʻi kūpono ma mua o nā pilikia.

ʻO ka noho ʻana me MS i mālama ʻole ʻia ka maikaʻi e halihali pū ana i nā pilikia nui. E kamaʻilio i kāu kauka e aʻo hou e pili ana i nā hopena a me nā pono o nā DMT like ʻole.

ʻAʻole manaʻo ʻia nā DMT he palekana no ka poʻe hāpai a hānai waiu paha.

Ka mālama ʻana i ka hopena o nā hopena ʻaoʻao

Ma mua o kou hoʻomaka ʻana me ka DMT, pono i kāu kauka e nānā iā ʻoe no nā maʻi ʻino, nā ʻino o ke ake, a me nā pilikia olakino ʻē aʻe e hoʻāla i nā makaʻi o ka lawe ʻana i ka lāʻau.

Paipai paha kāu kauka iā ʻoe e loaʻa i kekahi mau lāʻau lapaʻau ma mua o kou hoʻomaka ʻana i ka lāʻau me DMT. Pono ʻoe e kali i mau mau pule ma hope o ka loaʻa ʻana o nā lāʻau āpau ma mua o kou hoʻomaka ʻana i ka lāʻau.

ʻOiai ke loaʻa nei ʻoe i ka lāʻau me DMT, e ʻōlelo paha kāu kauka iā ʻoe e hōʻalo i kekahi mau lāʻau, nā mea hoʻopihapiha, a me nā huahana ʻē aʻe. E nīnau iā lākou inā aia kekahi mau lāʻau a i ʻole nā ​​huahana ʻē aʻe i hiki ke launa a hoʻopilikia paha i ka DMT.

E nānā pono kāu kauka iā ʻoe no nā hōʻailona o nā hopena i ka wā a ma hope o ka mālama ʻana me kahi DMT. ʻO kahi laʻana, e kauoha paha lākou i nā hoʻokolohua koko maʻamau e nānā i ka helu o kou aʻa koko a me nā ʻenema ate.

Inā manaʻo ʻoe e loaʻa ana paha iā ʻoe nā hopena, e hoʻomaopopo koke i kāu kauka.

ʻO ka lawe lawe ʻana

Ua ʻae ʻia nā DMT he nui e mālama iā MS, me ʻeono mau ʻano o ka oral therapy.

ʻOi aku paha ka palekana o kekahi o kēia mau lāʻau a i ʻole kūpono paha i kekahi poʻe ma mua o nā poʻe ʻē aʻe.

Ma mua o kou hoʻomaka ʻana i kahi DMT, e nīnau i kāu kauka e pili ana i nā pono kūpono a me nā pilikia o ka hoʻohana ʻana iā ia. Hiki iā lākou ke kōkua iā ʻoe e hoʻomaopopo i ka hopena o nā ʻano ʻokoʻa i kou kino a me ka nānā lōʻihi me MS.

ʻO kēia ka mea e manaʻo e ola me MS