I-RSV imele ๐ฅ๐ฒ๐๐ฝ๐ถ๐ฟ๐ฎ๐๐ผ๐ฟ๐ ๐๐๐ป๐ฐ๐๐๐ถ๐ฎ๐น ๐๐๐ป๐ฐ๐๐๐ถ๐ฎ๐น ๐๐๐ถ. UMbutho wezeMpilo weHlabathi (i-WHO) uchonge i-RSV njengomba wezempilo kwihlabathi jikelele. Abaviwa abambalwa bogonyo kunye ne-monoclonal antibody bakuphuhliso/kuvavanyo, ngenjongo yokuba neendlela ezifikelelekayo zokuthintela i-RSV.
Okwangoku eMzantsi Afrika isitofu sokugonya i-vector, esihlelwa njengokuguqulwa kofuzo, sitsala izimvo ezininzi ukususela oko isaziso sokuqhuba ulingo lwezonyango sapapashwa.
๐พ๐๐ ๐ ๐ ๐๐ ๐๐๐๐ ๐๐ ๐๐๐๐๐๐ ๐น๐น๐๐ ๐๐๐๐๐๐?
I-RSV sesona sizathu siphambili semiphunga sokusweleka kwabangaphantsi kweminyaka emi-5 yeqela, apho kungekho sitofu sikhoyo. Uqikelelo kubantwana abangaphantsi kweminyaka emi-5 ubudala lubonisa iziqendu ezingama-33.1 ezigidi zosulelo olubukhali lwendlela yokuphefumla (ALRI). Kwiqela leminyaka efanayo, i-3.2 yezigidi ezilaliswa esibhedlele kunye nokusweleka kwe-118 200 kwakubangelwa yi-RSV emhlabeni jikelele ngo-2015. Koku kufa, i-50% yenzeke kwiinyanga zokuqala ze-6 zobomi (ukufa komntwana osanda kuzalwa kwiintsuku ze-0-28 rhoqo) kwaye ama-99% avela kumazwe asakhasayo, njengoMzantsi Afrika. Ezi zicingelwa ukuba zingaphantsi koqikelelo, ngenxa yokunqongophala kovavanyo lokuxilonga, ngakumbi kwiindawo ezinengeniso ephantsi.
I-Case Fatality Rate (CFR) uqikelelo lwe-2015 kwiintsana ezi-0-5 kunye ne-6-11 iinyanga zeminyaka kumazwe asaphuhlayo zi-2.2 (1.8-2.7) kunye ne-2.4 (1.9-3.2). Uhlalutyo lwesibini lwemeta luchonge awona mazinga aphezulu okufa eKenya, eMorocco, eMzantsi Afrika naseMozambique. Idatha esuka kwinkqubo yokucupha ye-SARI iqikelela ukuba izehlo ze-LRTI zizonke kubantwana baseMzantsi Afrika <iminyaka emi-5 yobudala ukuya kuma-2530-3173 kwi-100,000 kunye nezehlo eziphezulu kubantwana abaneminyaka engaphantsi komnyaka (uluhlu lonyaka 1-8446 kwi-10532). Olunye uphononongo lwaseMzantsi Afrika lubonisa ukuba iintsana ezinesifo esinxulumene ne-RSV zi-100,000-fold (4.6% CI, 95- to 2.4-fold) kunokwenzeka ukuba zilaliswe esibhedlele kwiintsuku ezili-8.6 zokugula kunezinye izifo zokuphefumla. Abantwana abaninzi abancinci abalaliswe esibhedlele ngenxa ye-RSV (ingakumbi iintsana ezingaphambi kwexesha elide) bafuna ungenelelo lokuphefumla, olufana nezixhobo zokuphefumla kwaye bahlala befumana iziphumo zexesha elide zosulelo lwe-RSV. Oku kubandakanya umonakalo wemiphunga kunye nokuphefumla okungapheliyo. Ukongezelela, ukusuleleka kwe-RSV kwiintsana akuphumeleli iimpendulo zokhuselo lomzimba ngokuchasene nosulelo oluzayo kwaye iintsana zihlala zosulelwa kwakhona. Okwangoku, kukho iimveliso ezimbini (zombini izilwa-buhlungu ze-monoclonal) ezinelayisensi yokuthintela i-RSV, ezibiza kakhulu. Ezi ngokuqhelekileyo azifikeleleki kwiimeko zomvuzo ophantsi. Enye i-monoclonal antibody ikulingo lwezonyango olubonisa isithembiso kwaye inokuba neendleko ezithelekisekayo kwizitofu zokugonya.
Isitofu sokugonya se-RSV esithintela isifo esimandundu kwiintsana eziselula, kwaye sithintele usulelo lomntu ukuya emntwini luyafuneka ukunciphisa ukugula nokufa, ngakumbi kwiqela leminyaka engaphantsi kwemi-5.
Ngaphandle kokuba uvavanyo lwenqanaba lophuhliso lwezonyango lubonisa ukusebenza okunokwenzeka kunye nokhuseleko lwesitofu, aluyi kungena kulingo lwezonyango. Kanye kwizigaba zolingo, isitofu sokugonya kuya kufuneka kuqala singqinwe sikhuselekile kwaye siyasebenza kubantu abadala abasempilweni phambi kokuba siye kumaqela asemngciphekweni aphezulu njengeentsana. Kwi-2015, i-RSV yokuthintela kunye nezicwangciso zonyango zahlaziywa nguMazur et al. Bachonge abaviwa abalishumi lokugonya kuphuhliso lwezonyango, kwaye ngama-40% kuphela aqhubayo kulingo lwezonyango. Phakathi ku-2018, abaviwa bogonyo abali-19 kunye ne-monoclonal antibodies kuluntu olwahlukeneyo ekujoliswe kulo bebekulingo lwezonyango, kwaye uninzi lwabo bakuphuhliso lwangaphambi kweklinikhi. Ezine kwezi zitofu zisebenzisa uhlobo lwe-adenovirus. Ngelixa ugqatso luza kufumana isitofu sokugonya esiyimpumelelo, esikhuselekileyo kwiintsana eziselula, sijolise kwintsholongwane engabangeli ukugonyeka kwexesha elide kweli qela, bekunzima. Isitofu sokugonya esicetywayo siye safikelela kumanqanaba aphezulu ovavanyo lwezonyango. Ukongeza, izikhokelo zonyango olululo lwaseMzantsi Afrika kunye nemithetho elawula ulingo lwezonyango imisela ukuba isitofu sokugonya asinakuvavanywa kubathathi-nxaxheba boMzantsi Afrika ngaphandle kokuba sijonge ukubhaliswa ukuthintela ukugula eMzantsi Afrika.
๐ป๐๐ ๐๐๐๐๐๐๐๐ ๐ฝ๐๐๐๐๐๐: ๐ช๐๐จ๐ ๐ฝ155-
I-ChAd155 ibhekisa kwi-chimpanzee engasebenzi kakuhle (Ch) derived adenovirus (Ad), serotype 155. Oku kuthetha ukuba yintsholongwane yetshimpa engakwaziyo ukuphindaphinda okanye ukosulela abantu. Le ntsholongwane iphinde yaguqulwa ngokwemfuza ukubonisa iiproteni ze-RSV. Oku kuthetha ukuba i-ChAd155 iya "kubonisa" iiprotheni ze-RSV. Ezi ziyi-F-protein (iprotheyini ye-fusion ejongene ne-RSV i-attachment kwi-cell host), i-N-protein (i-protein ye-nucleocapsid yangaphakathi, oko kukuthi: i-encapsulates i-RNA) kunye ne-M2-1 (iprotheni efunekayo kwi-viral transcription). Oku kuhloswe ukuba kubangele i-humoral kunye ne-cell mediated immunity, kubandakanywa i-B- kunye ne-T-cell response, i-antibody engathathi hlangothi ngokuchasene ne-F-antigen kunye ne-CD8T-cells ngokumelene ne-F-, N- kunye ne-M2-1- antigens. Oku kuthetha ukuba emva kokugonywa, usana lunokuba nokhuselo lwexesha elide lokugonywa kusulelo lwe-RSV. Eyona njongo iphambili kukulawula oku kubantwana ukusuka kwiinyanga ezi-2 ubudala ecaleni kweshedyuli yesitofu sokugonya esiqhelekileyo (esingesonyaka).
Ukuba uninzi lwabantwana lugonywa besebancinane kakhulu, oku kuya kuthintela iintsana eziselula ekuguleni, kwaye kwakhona kuphazamise ukosuleleka komntu emntwini. Ukuba olu gonyo lunephepha-mvume, lunokusindisa ubomi babantwana abaninzi boMzantsi Afrika, ngakumbi abantwana abakwimeko yemivuzo ephantsi.
I-Simian adenoviruses ziluncedo kwi-vector-vaccines. Banokhuselo lomzimba olusezantsi olukhoyo ebantwini (ngoko ke oku akuyi kuphazamisa impendulo yamajoni omzimba), bane-immunogenic ephezulu (ngoko ke benokubangela ukhuseleko oluphezulu lokhuselo lomzimba) kwaye banokutshintshwa ukuze bavale ukuphindaphinda kwiiseli eziqhelekileyo zomntu. Icala elisezantsi kukuba ezi zitofu zifuna i-booster kwi-T-cell response.
Esi sitofu sele sivavanyiwe kubantu abadala abanempilo (iSigaba 1: Jul-15 ukuya kuJul-17. I-NCT02491463) yokhuseleko kunye ne-immunogenicity (i-inducing B-cell kunye ne-RSV neutralizing antibodies kwi-RSV-seropositive abadala). Ngamafutshane ikhuselekile. Isigaba sesi-2 (i-NCT02927873) siya kuvavanywa kwiintsana ze-RSV-seropositive ezineminyaka eyi-12 ukuya kwiinyanga ze-23 kwaye kufuneka zigqitywe ngo-2020. : Iinyanga ezi-6-12 ubudala. Ukhuseleko kunye ne-immunogenicity kwiqela ngalinye liya kuhlolwa ngaphambi kokuba kuqhutywe.
Uwiso-mthetho uluphatha olu gonyo njengemveliso ye-GMO (izinto eziphilayo eziguqulwe ngofuzo). Oku kuthetha ukongeza kuzo zonke iitshekhi kunye nokulinganisa okubandakanyekayo kwimimiselo yamachiza, kufuna ukubandakanyeka koluntu, i-ERA (uvavanyo lomngcipheko wokusingqongileyo) kunye novavanyo olongezelelweyo lomgangatho, ukhuseleko kunye nokusebenza kakuhle kwemveliso ngaphambi kokuba ingene kulingo lwezonyango okanye izigaba zokuthengisa.
๐ป๐๐ ๐ ๐๐๐๐๐๐?
Ngaba likhona ithuba lokuba i-GMO Simian adenovirus inokwenza umxube oneentsholongwane zendalo?
Hayi: Isitofu sokugonya siqulethe โisiphene esiphindaphindayoโ i-adenovirus. Ayinakuphinda-phinda/ukudala โinzalaโ.
Ngaba kukho ithuba lokuba iya kubangela usulelo lwe-adenovirus ebantwini?
Hayi: Impendulo iyafana nalapha ngasentla, ukongezelela le adenovirus ayilosuleli abantu.
Ngaba likho ithuba lokuba i-RNA yangaphandle, ngakumbi i-GMO yentsholongwane ye-RNA inokudityaniswa neyethu kwaye ibangele ezinye iinkxalabo zempilo?
Akunjalo, yonke imihla sisela izinto eziphilayo ezineDNA โyasemziniโ. Sine-microbes ezihlala ngaphakathi emizimbeni yethu ezine-"DNA yangaphandle". Iiseli zethu aziyifaki le DNA. Ezinye iintsholongwane zeRNA zinokuqweqwedisa iiseli zomzimba wethu ukuze ziphindaphinde iigenome zazo. Oku kwenziwa kuphela kwezo seli kwaye ayitshintshi eyethu iDNA. Kwakhona, le yintsholongwane enengxaki yokuphindaphinda, ngoko ke ayinakwenzeka.
๐บ๐๐๐๐๐๐:
Indawo yokugonya intsholongwane yokuphefumla ye-syncytial: izifundo ezivela emangcwabeni kunye nabaviwa abathembisayo. UNatalie I Mazur, uDeborah Higgins, uMarta C Nunes, uJosรฉ A Melero, u-Annefleur C Langedijk, uNicole Horsley, u-Ursula J Buchholz, uPeter J Openshaw, uJason S McLellan, uJanet A Englund, u-Asuncion Mejias, u-Ruth A Karron, u-Eric I-AFANAMI Kรตvikรณwka, u-Eric I-AFNAK ESEMENES , u-Eric I-AFNAK ESEMENES UPiedra, uHelen Y Chu, uAnn R Falsey, uHarish Nair, uLeyla Kragten-Tabatabaie, u-Anne Greenough, uEugenio Baraldi, uNikolaos G Papadopoulos, uJohan Vekemans, uFernando P Polack, uMair Powell, uAshish Satav, uEdward E Walsh, uRenato T Stein, uJ. ngokubambisana neRespiratory Syncytial Virus Network (ReSViNET) Foundation, iLancet Infect Dis 2018, https://linkinghub.elsevier.com/retrieve/pii/S1473309918302925
Umthwalo wosulelo lwentsholongwane yokuphefumla ehambelanayo kwintsholongwane yaseMzantsi Afrika eyosulelwe yintsholongwane ye-HIV (HIV) kunye ne-HIV-Abafazi abakhulelweyo nabasemva kokubeleka: Uphononongo lweqela elide. USabir A Madhi Clare L Cutland Sarah Downs UStephanie Jones Nadia van Niekerk Eric AF Simoes Marta C Nunes. Izifo ezithathelwanayo zeKlinikhi 2018, uMqulu 66, Ushicilelo 11, Amaphepha 1658โ1665, https://academic.oup.com/cid/article/66/11/1658/4749671
Uphononongo lwe-SARI: http://www.paediatrics.uct.ac.za/national-syndromic-surveillance-pneumonia-south-africa?fbclid=IwAR1z30OPOWSihb5o0dnDrWaxg3AH47iOX7pKTsN2QWrgRle_9c6m6yF3pPQ
Intsholongwane ye-Respiratory syncytial virus ngumbulali "ongenamathuba". UMauricio T. Caballero kunye noFernando P. Polack MD. https://onlinelibrary.wiley.com/doi/full/10.1002/ppul.23963 I-Pediatric Pulmonology 2018.
Iigonyo eziguqulwe ngokwemfuza ezisekelwe kwiVector: Ukusebenzisa kakubi ilifa likaJenner. UBahar Ramezanpoura, uIngrid Haana, uAb Osterhaus, uEric Claassen. Igonyo, ngo-2016. Umqulu 34, Ushicilelo 50, Amaphepha 6436-6448. https://www.sciencedirect.com/science/article/pii/S0264410X16305102?via%3Dihub
Ulwazi oluthe kratya malunga nokuba lithetha ukuthini izinga lokufa kwabantu abaswelekileyo: https://www.britannica.com/science/case-fatality-rate