Matenda a autoimmune amayamba chifukwa cha kusokonekera kwa chitetezo chamthupi komwe kumapangitsa kuti omalizawo awononge ziwalo za thupi ("mwini", chifukwa chake muzu wodziyimira pawokha wonena za vuto la chitetezo chamthupi). Kusiyana kwachikale kumapangidwa pakati pa matenda amtundu wa autoimmune, omwe amakhudza chiwalo china (monga matenda a autoimmune a chithokomiro), ndi matenda a autoimmune, monga lupus, omwe amatha kukhudza ziwalo zingapo.

Ngakhale kuti ziyenera kutiteteza ku tizilombo toyambitsa matenda (zomwe zingayambitse matenda), chitetezo chathu cha mthupi nthawi zina chimatha kuchoka. Zitha kukhala zokhudzidwa kwambiri ndi zigawo zina zakunja (zakunja), ndikuyambitsa ziwengo kapena kuchitapo kanthu motsutsana ndi zomwe zili mkati mwake ndikulimbikitsa kutuluka kwa matenda a autoimmune.

Matenda a autoimmune amapanga gulu lomwe timapeza matenda osiyanasiyana monga matenda a shuga I, multiple sclerosis, nyamakazi ya thumatoid kapena matenda a Crohn. Zonsezi zimagwirizana ndi matenda aakulu omwe amayamba chifukwa cha kuwonongeka kwa thupi la immunological kwa zigawo zake.

Kodi matenda a autoimmune amapangidwa bwanji?

Gulu lankhondo lenileni lamkati lopangidwa ndi maselo oyera amagazi angapo, chitetezo chamthupi chimateteza thupi ku kuukira kwakunja monga mabakiteriya kapena ma virus ndipo nthawi zambiri amalekerera zigawo zake. Kudzilekerera kukanatha, kumakhala magwero a matenda. Maselo oyera a magazi (autoreactive lymphocytes) amaukira makamaka minofu kapena ziwalo.

Ma antibodies omwe nthawi zambiri amapangidwa ndi maselo ena oteteza thupi kuti achepetse mdani polumikizana ndi mamolekyu ena (ma antigen) amathanso kuwonekera ndikuwongolera zinthu zathupi lathu. Thupi limatulutsa ma antibodies motsutsana ndi ma antigen ake omwe amawaona achilendo.

Mwachitsanzo:

• mu mtundu Woyamba wa matenda a shuga: ma autoantibodies amayang'ana ma cell a kapamba omwe amapanga insulin;
• mu nyamakazi ya nyamakazi: ndi nembanemba yomwe imazungulira mafupa omwe amayang'ana, kutupa kumafalikira ku ma cartilages, mafupa, ngakhale tendons ndi ligaments;
• mu systemic lupus erythematosus, auto-anticoprs amalimbana ndi mamolekyu omwe amapezeka m'maselo ambiri a thupi, zomwe zimapangitsa kuwonongeka kwa ziwalo zingapo (khungu, mafupa, impso, mtima, etc.).

Nthawi zina, sitipeza ma autoantibodies ndipo timalankhula m'malo mwa matenda a "autoinflammatory". Mzere woyamba wa chitetezo cha mthupi (neutrophils, macrophages, monocytes, maselo akupha achilengedwe) okha amayambitsa kutupa kosatha komwe kumabweretsa kuwonongeka kwa minofu ina:

• khungu la psoriasis (lomwe limakhudza 3 mpaka 5% ya anthu a ku Ulaya);
• ziwalo zina mu rheumatoid spondylitis;
• matenda a Crohn;
• chapakati mantha dongosolo mu multiple sclerosis.

Kaya ali ndi autoimmune kapena autoimmune, matenda onsewa amayamba chifukwa cha kusokonekera kwa chitetezo chamthupi ndikusanduka matenda otupa osatha.

Ndani akukhudzidwa?

Kumayambiriro kwa zaka za zana lachisanu, matenda a autoimmune amakhudza anthu pafupifupi 5 miliyoni ku France ndipo akhala chifukwa chachitatu chakufa / kudwala pambuyo pa khansa ndi matenda amtima komanso pafupifupi chimodzimodzi. 80% ya milandu imakhudza amayi. Masiku ano, ngati mankhwala akuthandizira kuchepetsa kukula kwawo, matenda a autoimmune amakhalabe osachiritsika.

Matenda ambiri a autoimmune ndi multifactorial. Kupatulapo pang'ono, amaonedwa kuti amachokera ku kuphatikiza kwa chibadwa, endogenous, exogenous ndi / kapena chilengedwe, mahomoni, matenda opatsirana komanso maganizo.

Ma genetic ndi ofunikira, chifukwa chake nthawi zambiri m'banja la matendawa. Mwachitsanzo, kuchuluka kwa matenda a shuga amtundu woyamba kumayambira 0,4% mwa anthu wamba kufika 5% mwa achibale omwe ali ndi matenda ashuga.

Mu ankylosing spondylitis, jini ya HLA-B27 imapezeka mu 80% ya anthu omwe akhudzidwa koma 7% yokha ya maphunziro athanzi. Ma jini ambiri kapena mazana ambiri amalumikizidwa ndi matenda a autoimmune.

Maphunziro oyesera kapena chidziwitso cha matenda a epidemiological amafotokoza momveka bwino mgwirizano pakati pa intestinal microbiota (digestive ecosystem), yomwe ili pamtunda wapakati pa chitetezo cha mthupi ndi chilengedwe, komanso kuchitika kwa matenda a autoimmune. Pali kusinthanitsa, ngati kukambirana, pakati pa mabakiteriya a m'mimba ndi maselo a chitetezo cha mthupi.

Chilengedwe (kukhudzana ndi tizilombo toyambitsa matenda, mankhwala ena, kuwala kwa UV, kusuta, kupsinjika maganizo, etc.) kumathandizanso kwambiri.

Kusaka matenda a autoimmune kuyenera kuchitidwa nthawi zonse m'njira yosangalatsa. Mayeso akuphatikizapo:

• kufufuza kuti azindikire ziwalo zomwe zakhudzidwa (zachipatala, zamoyo, zamoyo);
• kuyezetsa magazi kuti afufuze kutupa (osati mwachindunji) koma komwe kungasonyeze kuopsa kwa ziwopsezo ndikuwunika kuwunika kwa chitetezo chamthupi pofufuza ma autoantibodies;
• Kufufuza mwadongosolo zovuta zomwe zingatheke (impso, mapapo, mtima ndi mitsempha).

Matenda aliwonse a autoimmune amayankha chithandizo chapadera.

Kuchiza kumapangitsa kuti athe kuwongolera zizindikiro za matendawa: ma analgesics motsutsana ndi ululu, mankhwala oletsa kutupa motsutsana ndi kusagwira bwino kwa mafupa, mankhwala olowa m'malo omwe amachititsa kuti matenda a endocrine asamayende bwino (insulin ya shuga, thyroxine mu hyothyroidism).

Mankhwala osokoneza bongo omwe amaletsa kapena kuletsa autoimmunity amaperekanso njira yochepetsera zizindikiro ndi kupitirira kwa kuwonongeka kwa minofu. Nthawi zambiri amayenera kumwa mosalekeza chifukwa sangathe kuchiza matendawa. Kuphatikiza apo, iwo sali achindunji kwa ma cell a autoimmunity effecter ndipo amasokoneza ntchito zina zachitetezo chamthupi.

Zakale, mankhwala osokoneza bongo (corticosteroids, cyclophosphamide, methotrexate, iclosporin) akhala akugwiritsidwa ntchito chifukwa amalumikizana ndi zotsatira zapakati pa chitetezo chamthupi ndikupangitsa kuti zitheke kuchepetsa ntchito yake yonse. Nthawi zambiri amakhudzidwa ndi chiopsezo chowonjezereka cha matenda ndipo motero amafunikira kuwunika pafupipafupi.

Kwa zaka makumi awiri, ma biotherapies apangidwa: amapereka kuwongolera bwino kwazizindikiro. Awa ndi mamolekyu omwe amayang'ana m'modzi mwa omwe akutenga nawo gawo pantchitoyo. Mankhwalawa amagwiritsidwa ntchito pamene matendawa ali aakulu kapena sakuyankha kapena mokwanira kwa immunosuppressants.

Pankhani ya matenda enieni monga Guillain Barre syndrome, plasmapheresis imalola kuchotsedwa kwa autoantibodies ndi kusefera kwa magazi komwe kumabwezeretsedwanso mwa wodwalayo.