Kurapa Neropa: Kusimuka uye Kudonha kweCOVID Convalescent Plasma Therapy
Kurapa Neropa: Kusimuka uye Kudonha kweCOVID Convalescent Plasma Therapy
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Pakutanga kwedenda, masayendisiti akafunga kuti "convalescent plasma" ingave nzira yekurapa COVID-19.

Nekupa varwere plasma yevanhu vakange vapora (kana kupora) kubva kuCOVID-19, pfungwa yaive iyi antibody-rich infusion yaizobatsira immune system yavo kurwisa hutachiona. Iro zano rakaedzwa, rine madhigirii akasiyana ekubudirira, kune zvimwe zvirwere zvinotapukira, kusanganisira Ebola.

Asi humbowo huri kukura, kusanganisira ongororo yepasi rose yakaburitswa svondo rino, inoratidza convalescent plasma haiponesi hupenyu hwevanhu vanorwara zvakanyanya neCOVID-19. Vatsvakurudzi vakagumisa kuti kurapa "hakuna maturo."

Chii chinonzi convalescent plasma?

Convalescent plasma chigadzirwa cheropa chine masoja ekudzivirira chirwere anotapukira (senge SARS-CoV-2, iyo coronavirus inokonzera COVID-19). Inobva muropa rinounganidzwa kubva kuvanhu vakapora kubva kuchirwere chinotapukira.

Masayendisiti anoshandisa nzira inonzi apheresis kuparadzanisa zvikamu zveropa zvakasiyana. Masero matsvuku nemachena, uye maplatelet anobviswa achisiya plasma, ine masoja ekudzivirira chirwere akapfuma.

Nyaya yeconvalescent plasma therapy (kana serum therapy) yakatanga kuma1890s. Apa ndipo apo chiremba Emil von Behring akatapurira mabhiza neutachiona hunokonzera diphtheria.

Pakangopora mabhiza, Behring akaunganidza ropa ravo-rakapfuma-antibody kurapa vanhu vane chirwere. Izvi zvakaita kuti apiwe mubairo wekutanga weNobel mufiziyoroji kana mushonga, muna 1901.

Nei convalescent plasma yakashandiswa kurapa COVID?

Convalescent plasma yakashandiswa kurapa zvirwere zvinotapukira kweanopfuura zana. Izvi zvinosanganisira: scarlet fever, pneumonia, tetanus, diphtheria, mumps uye chickenpox.

Munguva pfupi yapfuura, convalescent plasma yakaongororwa sekurapa kweSARS (yakanyanya acute respiratory syndrome), MERS (Middle East Respiratory Syndrome) uye Ebola.

Saka kutanga kwedenda, vaongorori vaitarisira kuti convalescent plasma inogona kushandiswa kurapa COVID-19 zvakare.

Zvidzidzo zvekutanga uye mimwe miedzo yekiriniki yaive ichivimbisa. Izvi zvakakonzera kushandiswa kwakapararira kweconvalescent plasma yevarwere vane COVID-19 muUnited States, danho rinotsigirwa neFood and Drug Administration.

Pakazosvika Chivabvu gore rino zvinopfuura zana miedzo yekiriniki yakanga yaitwa neconvalescent plasma muvanhu vane COVID-100; chinenge chikamu chimwe muzvitatu cheizvi zvidzidzo chakanga chapedza kana kuti chakamiswa nokukurumidza.

Kutanga kwegore rino, mhedzisiro yemuyedzo weUnited Kingdom weRECOVERY wakashumwa. Izvi zvakaongorora convalescent plasma therapy (ichienzaniswa neyakajairwa tsigiro yekutarisira) mune vanopfuura zviuru gumi vanhu vakaiswa muchipatara neCOVID-10.

Kurapa hakuna kudzikisa njodzi yerufu (24% mumapoka ese ari maviri), pasina mutsauko muhuwandu hwevarwere vakapora (66% vakaburitswa muchipatara mumapoka ese ari maviri) kana kuti vakawedzera kuipa (29% yaida kufefeterwa nemhepo kutsigira kufema mukati. mapoka maviri).

Saka kune vanhu vakapinzwa muchipatara neCCIDID-19, vaongorori vakagumisa convalescent plasma yakapa rubatsiro.

Ongororo yeCochrane, iyo yakagadziridzwa muna Chivabvu gore rino uye yakaongorora miedzo yese iripo, yakasimbisa mhedzisiro iyi. Iyi miedzo yaisanganisira vanhu vanopfuura zviuru makumi mana vane mwero-kusvika-yakaoma COVID-40,000 vakagamuchira convalescent plasma.

Ongororo yakawana kurapwa kwacho kwaisava nemhedzisiro panjodzi yekufa kubva kuCOVID-19, haina kudzikisa njodzi yekuda kurapwa muchipatara kana kudiwa kweventilator yekubatsira kufema kana ichienzaniswa ne placebo kana kutarisirwa kwakajairwa.

MuAustralia, iyo National COVID-19 Clinical Evidence Taskforce haikurudzire kushandisa convalescent plasma muvanhu vane COVID-19, kunze kwekunge iri mukuedzwa kwekiriniki.

Ndedzipi nhau dzichangoburwa?

Mhedzisiro yemuyedzo yakashumwa svondo rino inouya kubva muyedzo huru yekiriniki inosanganisira vangangosvika zviuru zviviri zvevarwere vari muchipatara vane pakati-kusvika-yakanyanya COVID-19.

Varwere vakarongeka kuti vagamuchire convalescent plasma kana kutarisirwa kwakajairika. Vese varwere vaive nekuwana mimwe mishonga inotsigira yaishandiswa muchipatara vairwara zvakanyanya neCOVID, senge dexamethasone uye remdesivir.

Chikwata chepasi rose chevaongorori chaisanganisira avo vanobva kuAustralia, Canada, UK neUS.

Kunyangwe mhedzisiro uye ongororo yakadzama zvakaburitswa svondo rino, kutongwa kwakamiswa muna Ndira. Apa ndipo apo komiti yekuedza yakaongorora mhedzisiro yenguva uye yakataura kuti "convalescent plasma yanga isingaite kubatsira varwere vane COVID-19 vanoda rutsigiro rwenhengo mukamuri yekuchengeta zvakanyanya". Saka kuenderera mberi nekutongwa kwainzi hakuna maturo.

Convalescent plasma kurapwa hakuna kuderedza njodzi yerufu muchipatara pamusoro pemwedzi mushure mekurapwa (37.3% convalescent plasma yakarapwa, 38.4% yakajairika kutarisirwa, isina kurapwa neconvalescent plasma). Nhamba yepakati pemazuva pasina kudiwa kwerutsigiro rweorgan (senge mechanical ventilator kana tsigiro yemoyo) aive mazuva gumi nemana mumapoka ese ari maviri. Zviitiko zvakakomba zvakashata zvakataurwa mu3.0% yevanhu vakabatwa neconvalescent plasma uye chete 1.3% muboka rinowanzotarisirwa.

Zvakatorwa pamwechete, huremu hwehumbowo hunoratidza zvakajeka convalescent plasma haisi nzira yekurapa kune vanhu vane hunyoro, huri pakati nepakati kana hwakanyanya COVID-19.

Ndekupi kunotevera kurapwa kweCOVID-19?

Kunyange majekiseni achiramba ari zano hombe rekudzivirira COVID-19, kutarisisa kwave kutendeukira kune mamwe ari kubuda uye anovimbisa marapiro ekudzivirira COVID-19 kuwedzera.

Izvi zvinosanganisira kurapa kwehutachiona hwehutachiona hunogona kushandiswa kutanga kwechirwere, kusanganisira monoclonal antibodies senge sotrovimab uye AZD7442. Kozoitawo mishonga yekunwa antiviral, yakadai semolnupiravir nePF-07321332.

Andrew McLachlan, Musoro weChikoro uye Dean weFarmacy, Yunivhesiti yeSydney naSophie Stocker, Mudzidzisi Mukuru, Sydney Pharmacy School, University of Sydney.

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