Ukuhlaba ngomunwe okulula, okufana nalokho abantu abanesifo sikashukela abakusebenzisa ukukala amazinga abo kashukela, kungaba ithuluzi elibalulekile ukuthuthukisa ukutholakala kwesifo i-Alzheimer'sIthimba elikhulu labacwaningi baseYurophu naseNyakatho Melika, elinokuhlanganyela okuvelele kakhulu okuvela ezikhungweni zaseSpain, liqinisekisile indlela evumela ukuhlaziywa kwezimpawu zesifo kusuka ethonsini elincane legazi le-capillary elomile.
Lolu hlelo, olusesesigabeni salo sokuqala, luthembisa ukwenza lula ukutholwa kusenesikhathi kwesifo i-Alzheimer's uma kuqhathaniswa namasu asetshenziswa njalo, abiza kakhulu, angenasidingo, futhi anokufinyelela okulinganiselwe. Umsebenzi, oshicilelwe kumagazini Umuthi WemveloKusikisela ukuthi leli qhinga lingasebenza njengethuluzi lokuhlola ezimweni zocwaningo futhi, esikhathini esimaphakathi, livule umnyango wezinhlelo zokuxilonga ezifinyeleleka kalula eYurophu.
Ucwaningo lwamazwe ngamazwe oluneqhaza eliqinile laseSpain
Uphenyo luhlanganiswe yi- inhlangano yamazwe ngamazwe yaseYurophu naseNyakatho MelikaLe phrojekthi ihilela izikhungo eSweden, e-United Kingdom, e-Italy, eDenmark, eSpain naseNyakatho Melika. Umsebenzi uhlanganisa ukubambisana nezikhungo ezifana ne-University of Gothenburg kanye ne-Banner Sun Health Research Institute e-Arizona, kanye nezikhungo eziholayo zaseSpain ezifana ne- Isikhungo se-Ace Alzheimer eBarcelona, the I-Carlos III Health Institute noma i Iyunithi Yenkumbulo Yesibhedlela saseSant Pau.
Sekukonke, okulandelayo kuye kwafundwa: Abantu abangu-337, aqashwe ezikhungweni eziyisikhombisa zaseYurophu. Lokhu kwakuhlanganisa iziguli ezinezimpawu zokukhubazeka kwengqondo, izisebenzi zokuzithandela ezingenazo izimpawu, kanye nabantu abane- IDown's Syndromeiqembu elisengozini enkulu kakhulu yokuthola i-Alzheimer's. Cishe ingxenye yabahlanganyeli ivela eSpain, okugcizelela ukubaluleka kwe Ucwaningo lwaseSpain ekuthuthukisweni kwale ndlela.
Udokotela wezinzwa nomcwaningi UDaniel Alcolea, evela eSibhedlela sase-de Sant Pau, kanye nodokotela wezinzwa I-Mercè Boada, umsunguli we-Ace Alzheimer Center, baphakathi kwabacwaningi abaphambili abaphethe ucwaningo ezweni lakithi. Eceleni kwabo kukhona usokhemisi kanye nososayensi wezinzwa UXavier Morató, umqondisi wezivivinyo zemitholampilo e-Ace, ugcizelele ukuthi umgomo wokugcina "ukwenza kube lula ukufinyelela ekuxilongweni kusenesikhathi," okusho ukuthi akufanele kuncike kakhulu ekutheni isiguli sihlala kuphi noma izinsizakusebenza zohlelo lwaso lwezempilo.
Le phrojekthi igxile enhlosweni ethile: ukuhlola ukuthi ngabe amasampula egazi le-capillary elomile atholwe ngokuhlatshwa ngomunwe (esihlokweni somunwe) inikeza ulwazi olufana nokuhlolwa kwegazi okujwayelekile kwemithambo yegazi, futhi ngaphezu kwakho konke, kuma-biomarker akhona ku-cerebrospinal fluid, indinganiso yegolide ekuxilongweni kwe-Alzheimer's ngokwebhayoloji.
Indlela yokuconsa igazi elomile esebenza ngayo
Inqubo ilula kakhulu ngokombono wesiguli: a ukuzijova ngomunwe (ngokuvamile ngomunwe wokukhomba noma wendandatho) nge-lancet, kuqoqwa ithonsi legazi bese lifakwa ku- ikhadi lephepha lokuhlunga elikhethekileLelo consi lishiywa lomile, ukuze kutholakale isampula yegazi elomile, lizinzile ekushiseni kwegumbi.
Uma seyomile, ikhadi lingakwazi kuthunyelwe ngeposi elivamile elabhorethri, ngaphandle kwesidingo sokubanda noma ukuthuthwa okukhethekile. Lapho, isampula iyacutshungulwa ukuze kulinganiswe uchungechunge lwe- ama-biomarker amaprotheni abalulekile okuhambisana nesifo i-Alzheimer's. Le ndlela ikhumbuza "ukuhlaselwa kwesithende" okwenziwa ezinsaneni ezisanda kuzalwa ukuze kuhlolwe izifo ze-metabolic, kodwa okuye kwaguqulwa ukuze kutholakale ukuwohloka kwemizwa.
Ucwaningo lubonisa ukuthi amaprotheni anjengalawa maconsi egazi elomile angalinganiswa ngempumelelo. i-p-tau217, i-GFAP kanye ne-NfLLawa ma-molecule asebenza njengezibonakaliso zokuqala zezinqubo ze-pathological ebuchosheni. Abacwaningi baqhathanisa imiphumela etholakale ngale ndlela nokuhlaziywa kwe- i-plasma yemithambo yegazi kanye noketshezi lomgogodlaukuhlola ukuthi ulwazi beluhambisana yini.
Ngokusho kwedatha eshicilelwe, amazinga p-tau217 Amanani kumasampula egazi e-capillary omisiwe ahlobene kakhulu nalawo atholakala ekuhlaziyweni okujwayelekile futhi avumela ukuthola ukuthi kukhona i-amyloid pathology ngokunemba kokuxilonga okungaba ngu-86%. Ngaphezu kwalokho, izimpawu I-GFAP (iphrotheni ye-glial fibrillary acidic) kanye I-NFL (i-neurofilament ekhanyayo) nayo ibonise izinga eliphezulu lokuvumelana nezivivinyo zokubhekisela.
Lelo phesenti alikafinyeleli ekunembileni okungaphezu kuka-90% okubikwe kwezinye izivivinyo zegazi lemithambo yegazi ngokusekelwe ku-p-tau217, kodwa abalobi bacabanga ukuthi ibhalansi phakathi ukulula kwempahla nokuthembeka Lokhu sekuvele kubeka le ndlela njengendlela ekhangayo kakhulu yezifundo ezinkulu kanye nezimo lapho ingqalasizinda yezempilo ilinganiselwe khona.
Yini i-p-tau217, i-GFAP, ne-NfL, futhi kungani zibalulekile?
Inhliziyo yale ndlela entsha ilele ekhonweni lokulinganisa, ngethonsi elilodwa legazi, ama-biomarker abonisa okwenzekayo ebuchosheni eminyakeni ngaphambi kokuba kuvele izimpawu zokuqala ezicacile ze-dementia. Endabeni ye-Alzheimer's, kugxilwe ezinhlotsheni eziningana zamaprotheni.
La p-tau217 Kuyindlela efakwe i-phosphorylated yeprotheni ye-tau, exhunywe kakhulu ne- ukwakheka kwama-neurofibrillary tangles ngaphakathi kwama-neurons, esinye sezibonakaliso zalesi sifo. Izifundo eziningana ezigxile eSpanishi, njengalezo ezenziwa yi- Isikhungo Sokucwaninga Ubuchopho se-Beta saseBarcelona kusukela ku-Pasqual Maragall Foundation noma i-Sant Pau Research Institute, kanye izifundo zangaphambi kokwelashwa emagundwiniBase bevele bebonisile ukuthi amazinga e-p-tau217 egazini lemithambo yegazi avumela ukuhlonza abantu abangenakho ukuphazamiseka kwengqondo okubonakalayo kodwa abanakho. ukuqongelela kwe-beta amyloid ebuchosheni.
Amaprotheni I-GFAP Kuhlotshaniswa nokusebenza kwamaseli okusekela i-glial ohlelweni lwezinzwa oluphakathi. Ukuphakama kwayo kuhlobene nokuba khona kwe- ama-plaque e-amyloid kanye nezinguquko zokuvuvukala ezicutshini zobuchopho, ngakho-ke kusebenza njengesibonakaliso sokuqala sezinguquko ezihlobene ne-Alzheimer's kanye nezinye izifo zokuphazamiseka kwengqondo.
Ngokwengxenye yayo, i I-NFL (i-neurofilament elula) ikhishwa egazini uma kwenzeka ukulimala kwe-neuronalAkuyona nje i-Alzheimer's, kodwa iwuphawu olubucayi lokuwohloka kwemizwa, oluwusizo ekuqapheni ukuvela kwesifo noma ukuhlukanisa phakathi kwezinhlobo ezahlukene zokuwohloka kwemizwa.
Ukuhlanganiswa kwalezi zimpawu ezintathu kunikeza uhlobo "lweminwe" yezinto eziphilayo zalesi sifo. Okusha kuseqinisweni lokuthi lesi sibonakaliso seminwe manje singatholakala ku- amasampula amancane atholakale ngaphandle kwendawo yesibhedlela, ngengqalasizinda elula kakhulu kunaleyo edingekayo, isibonelo, yokubhoboza i-lumbar noma i-PET scanner.
Izinzuzo ngaphezu kokuhlolwa kwamanje: akuhlaseli kakhulu futhi kufinyeleleka kalula
Emikhubeni yezokwelapha yanamuhla, ukuqinisekiswa kwezinto eziphilayo kwe-Alzheimer's ngokuvamile kudinga izinhlobo ezimbili eziyinhloko zokuhlolwa: ukuhlaziywa koketshezi lomgogodla, etholakala ngokubhoboza i-lumbar, kanye amasu okuthwebula izithombe zobuchophonjenge-amyloid noma i-tau PET scans. Zombili izinketho zinikeza ulwazi olunembile kakhulu, kodwa zifaka phakathi izinqubo zokuhlasela, izindleko eziphakeme, kanye nemishini eyinkimbinkimbi, okwenza kube nzima ukuzihlanganisa nabantu bonke.
Eminyakeni yamuva nje, i- ukuhlolwa kwegazi emithanjeni ukulinganisa ama-biomarker e-plasma alesi sifo, njenge-p-tau217 uqobo. Lokhu kuhlolwa kufinyelele ukunemba kokuxilonga okungaphezu kuka-90% kwezinye izifundo futhi sekuqalile ukuthola ukuvunyelwa komthetho emazweni athile. Kodwa-ke, kusadinga abasebenzi abaqeqeshiwe bokukhipha, izinhlelo zokuthola ukucubungula kanye nokugcina okubandayo, kanye nezifunda zokuthutha ezilawulwayo.
Isiphakamiso esishicilelwe manje ku- Umuthi Wemvelo Izama ukunqoba ngqo lezo zithiyo zezokuthutha. Ngokuncika ku amaconsi egazi le-capillary elomile Ngenxa yokuthi zihlala zizinzile ekushiseni kwegumbi, le ndlela inciphisa ukuncika ezingqalasizindani eziyinkimbinkimbi futhi ivumela ukuqoqwa kwamasampula ukuthi kwenziwe. ekhaya lesiguli, yiqembu elinentshisekelo, ngaphandle kokuba khona kwabasebenzi bezempilo.
Abalobi basikisela ukuthi lolu hlobo lokuhlolwa lungaba usizo kakhulu ku- izindawo zasemakhaya, izifunda ezinezinsizakusebenza zezempilo ezilinganiselwe noma ngokwezifundo ezinkulu ze-epidemiological kanye nezivivinyo zemitholampilo, lapho ukuqoqwa kwamasampula mathupha kubantu abangamakhulu noma ezinkulungwaneni kunzima futhi kubiza kakhulu. Ngaphezu kwalokho, ithuba lokuhlolwa okulula kwabahlanganyeli abane-Down syndrome livula indlela ebalulekile kubantu lapho amasu okuhlasela ngokuvamile kunzima ukuwasebenzisa.
Ngokusho kokuhlaziywa, le ndlela ivumela ukukhishwa okusheshayo kwengxenye enkulu yabantu abangenabo ubufakazi be-amyloid pathology, ngaleyo ndlela kugxilwe kakhulu kulezo zinsiza ezibiza kakhulu nezihlaselayo (njenge-PET scans noma ukubhobozwa kwe-lumbar) kulabo bantu. Cishe ama-30% amacala anemiphumela engabaza noma esolisayookungadinga ukuhlolwa okuningiliziwe kumayunithi enkumbulo akhethekile.
Isimo sesifo i-Alzheimer kanye nesidingo sokuxilongwa kusenesikhathi
Isifo sika-Alzheimer sisekhona, kuze kube namuhla, ezingelaphekiEnye yezinkinga ezinkulu ukuthi i-pathology ingaqhubeka ngesikhathi sokukhulelwa. iminyaka noma ngisho namashumi eminyaka ngaphandle kokubonisa izimpawu ezicacileNgesikhathi kuvela izikhalazo zokuqala mayelana nenkumbulo noma eminye imisebenzi yokuqonda, ukulimala kobuchopho ngokuvamile kusuke sekuvele sekuqinisekisiwe.
Izilinganiso ze I-World Health Organization Bakhuluma ngabantu abangaphezu kwezigidi ezingu-55 emhlabeni wonke abanohlobo oluthile lwe-dementia, kanti i-Alzheimer's iyindlela evame kakhulu, ebangela phakathi kuka-60% no-70% wamacala. Eminye imithombo ikhombisa ukuthi cishe oyedwa kubantu abayisishiyagalolunye abaneminyaka engaphezu kwengu-65 ubudala angahlushwa yilesi simo.
ESpain, i- I-Spanish Society of Neurology Kulinganiselwa ukuthi ngaphezu kwengxenye yamacala amancane e-Alzheimer's awatholakali. Ngokwezindlela zamanje, isikhathi esiphakathi kokuqala kwezimpawu zokuqala kanye nokuxilongwa ngokuvamile siphakathi iminyaka emibili nemithathu, isikhathi lapho amathuba okungenelela kusenesikhathi kanye nokuhlela umndeni kanye nomphakathi elahleka khona.
Ngesikhathi esifanayo, imithi yokuguqula izifo isiqalile ukufinyelela emakethe, nakuba ingasebenzi kahle, ingakwazi ukubambezeleka kokuvela Izimpawu ziyanyamalala cishe ngemva konyaka nesigamu lapho zinikezwa ezigabeni zokuqala kanye nakubantu abanesifo se-amyloid esiqinisekisiwe. Lokhu kuqinisa ukubaluleka babe namathuluzi okuthola kusenesikhathi okuvumela ukuhlonza abantu abafanelekayo ngaphambi kokuba isifo siqhubekele phambili kakhulu.
Kulesi simo, kungenzeka ukuthi kube nendlela elula, engabizi kakhulu, futhi engangenisi kakhulu, esekelwe ethonsini elilodwa legazi elomile, ibhekwa njengesinyathelo esibalulekile esiya ku- isu lokuhlola elibanzi, yize kusalokhu kukhawulelwe emkhakheni wocwaningo kanye nezimo zezokwelapha ezilawulwayo.
Imibono yochwepheshe: intshiseko ethambile kanye nesicelo sokuqapha
Intshiseko edalwa yilokhu kuthuthuka ihambisana ne- isicelo esicacile sokuqapha ngochwepheshe be-neurology kanye ne-dementia. Ochwepheshe abaningana baseSpain bagcizelela ukuthi, naphezu kwemiphumela ethembisayo, le ndlela ayikakulungeli ukusetshenziswa kabanzi emisebenzini yezokwelapha.
Udokotela wezinzwa URaquel Sánchez ValleUDkt. [Name], ovela e-Hospital Clínic yaseBarcelona kanye nomkhulumeli we-Spanish Society of Neurology, ukholelwa ukuthi lolu hlobo lokuhlolwa "lwenza izinto zibe lula kakhulu ezifundweni ezinkulu zocwaningo," kodwa uveza ukuthi Akufanele zisetshenziswe njengethuluzi lokunakekela. ngaphandle komongo wezokwelapha ohlelekile. Uchwepheshe weluleka ngokumelene nokuhlolwa kwabantu abaningi noma ukuhlolwa okuqondile kumthengi, uma ucabangela ukuthi ukuxilongwa kwe-Alzheimer's kufanele kuhlelwe ngaphakathi kwesimo sezokwelapha esihleliwe. ukuhlolwa kwemitholampilo yomhlaba wonke kwenziwa ezikhungweni ezikhethekile.
Enye yezinto ezibangela ukwesaba ukuthi izinkampani ezizimele zizozama ukumaketha lezi zivivinyo ngaphandle kokuqashwa kwezokwelaphaLokhu kuyinto engeke ivunyelwe njengamanje e-European Union, kodwa kungenzeka kwezinye izindawo zomthetho, njenge-United States. Ngokombono wakhe, ukusetshenziswa ngokungakhethi kwalezi zivivinyo kungadala Ukukhathazeka okungadingekile, ukuchazwa kabi kwemiphumela kanye nokwanda kwezingxoxo ezingafaneleki ngaso sonke isikhathi.
Ngendlela efanayo, udokotela wezinzwa UDavid Perez, evela eSibhedlela i-12 de Octubre eMadrid, uchaza lo msebenzi “njengothakazelisayo” futhi onamathuba acacile okuthi ukwenza kube lula ukufinyelela ekuxilongweni kwasekuqaleniKodwa-ke, ugcizelela isidingo "sokuba ngokoqobo," ekhumbula ukuthi ukuzwela kwale ndlela kuyinto ngaphansi kwalokho kokuhlolwa kwegazi emithanjeni okuvamile nokuthi kunemikhawulo yobuchwepheshe ekuqoqweni nasekucutshungulweni kwamasampula egazi e-capillary omisiwe.
Ababhali bocwaningo ngokwabo baxwayisa nangokuthi kuseyi- ubufakazi bomqondoBagcizelela ukuthi kudingeka izivivinyo ezinkulu ezinamasampula abanzi futhi ahlukahlukene, kanye nezinqubo ezijwayelekile, ngaphambi kokucabangela ukufakwa kwayo njalo emtholampilo. Ikakhulukazi, baveza ukuthi le ndlela ingase ingabi bucayi ngokwanele ukuthola izinguquko ezicashile kakhulu kubantu abangenazo izimpawu nhlobo, ngakho ukusetshenziswa kwayo kokuqala kungagxila izimo zengozi eyanda noma ekuqinisekisweni kwesifo esivele sikhona.
Izinhlelo zokusebenza ezingaba khona: ukuhlolwa, izindawo ezingenazo izinsiza ezidingekayo, kanye nezinye izinkinga
Ngaphandle kokwelashwa okusheshayo, enye yemikhakha lapho le ndlela ingaba nomthelela osheshayo khona ise- ucwaningo olukhuluIthuba lokuthi abahlanganyeli benze ukuhlolwa komunwe ekhaya bese bethumela ikhadi ngeposi lenza kube lula ukufakwa. abantu abahlakazekile ngokwendawo noma labo, ngenxa yezizathu zomnotho noma zokuhamba, abazoba nobunzima bokufika esibhedlela noma esikhungweni socwaningo.
Lokhu kuvula umnyango izifundo ze-epidemiological ezimele kakhuluokuhlanganisa imiphakathi evame ukungamelwa kahle, kokubili eYurophu nakwezinye izindawo zomhlaba. Ngokusho kwabalobi balolu cwaningo, indlela entsha ingafakwa ku- izinhlelo zokuhlola abantu noma ekulandeleni isikhathi eside kweziguli ezihlanganyela ekuhlolweni kokwelashwa okusha.
Enye yezinzuzo ezivelele ukuthi ingaba usizo kakhulu abantu abane-Down syndromeKubantu abane-Down syndrome, ukuthola igazi elisemithambo yegazi nokwenza izivivinyo ezihlaselayo kuvame ukuba nzima kakhulu. Abacwaningi baqaphele ukuthi amasampula egazi e-capillary omisiwe avumela ukutholakala kwamazinga aphezulu e-p-tau217 kanye ne-GFAP kubantu abazithandelayo abane-Down syndrome asebevele benesifo sengqondo sokulahlekelwa yingqondo, uma kuqhathaniswa nalabo abahlala bengenazo izimpawu, okungenza kube lula ukuhlola nokuqapha kwabo esikhathini esizayo.
Ababhali baphakamisa nokuthi ipulatifomu esetshenziselwa ukukala ama-biomarker egazini elomile ingashintshwa ukuze ifundwe. ezinye izifo zemizwa, njengesifo sikaParkinson, i-multiple sclerosis noma i-amyotrophic lateral sclerosis (ALS), besebenzisa ikhono lamaprotheni athile e-plasma lokubonisa izinqubo zokuvuvukala kwe-neuroinflammation noma ukulimala kwe-neuronal ezifweni ezahlukene.
Naphezu kwalo mbono obanzi, labo abaphethe umsebenzi baphikelela ngokuthi le ndlela isadinga ukuqinisekiswa okwengeziwe kanye nokulungiswaikakhulukazi maqondana nobudlelwano phakathi kokuhlushwa kwe-biomarker egazini le-capillary kanye ne-plasma yemithambo yegazi lapho amazinga ephansi kakhulu, iphuzu elibalulekile uma ukuhlolwa kuzosetshenziswa ukuhlonza izinguquko zakuqala kulesi sifo.
Lokhu kuhlaziywa okusha okusekelwe ethonsini elilodwa legazi elomile kumele isinyathelo esibalulekile sokuthola izindlela zokuxilonga i-Alzheimer's ezilula, ezifinyeleleka kalula futhi ezingangenisi kakhuluNgeminikelo ebalulekile evela eSpain nakwamanye amazwe aseYurophu, le ndlela, yize isadinga izinyathelo ezengeziwe ngaphambi kokuba ihlanganiswe nokubonisana okuvamile, ivula indlela ethembisayo yokwenza ukuxilongwa kusenesikhathi kufinyeleleke kalula futhi kuncishiswe izithiyo ezikhawulela ukufinyelela ekuhlolweni okuthuthukisiwe njengamanje.
