Te puru metilīni me ngā kerēme mō ngā huaketo herpes: ngā tūwhenua ngutu, EBV, me te whakakorenga hohe o te huaketo

E rua ngā ariā kei raro i te kupu kotahi i tēnei tautohetohe, ā, me whai ingoa motuhake. Ko te ariā tuatahi, ko te whakakorenga hohe o te matūriki huaketo: ka tūtaki te waikano, te hāora, me te aho ki tētahi matūriki huaketo i roto i te wē, ka tūkinotia kia kore ai e tārua. Ko te ariā tuarua, ko te maimoatanga o te pokenga i roto i te tangata: kia iti ake ngā tūwhenua ngutu, kia tere ake te whakaora, kia iti ake te putanga huaketo, kia iti ake rānei te rahinga huaketo Epstein-Barr. Kua whakaaturia anō, anō te tuatahi mō te huaketo herpes simplex i te taiwhanga. Kāore anō te tuarua kia whakaaturia mō te puru metilīni ā-waha ki te herpes simplex, ki te huaketo Epstein-Barr rānei. Ina mārama taua rerekētanga, he ngāwari te whakarōpū i ngā tuhinga rangahau.

He pōhēhētanga tuarua kei tōna taha. Nō te whānau huaketo nui kotahi a HSV rāua ko EBV, engari he rerekē ngā mate ka hua mai, me ngā kiko e pāngia ana. He tūwhenua pāpaku te tūwhenua ngutu, ā, ka tārua te huaketo ki reira mā te huringa e wāwāhi ana i ngā pūtau: ka taea te pani waikano ki runga, me te tuku aho ki taua wāhi tonu. Ka noho huna tonu a EBV i ngā puna pūtau B e marara ana i roto i te toto me ngā kiko waitinana, kāore hoki te waikano ā-kiri, te rama whero rānei e tae ki te puna katoa. Kāore te hua o tētahi horopaki e hāngai aunoa ki tētahi atu. Ka kitea e ngā kaipānui e hiahia ana ki te tikanga whānui o tēnei whakarōpūtanga i roto i te aratohu ki te pānui rangahau mō te puru metilīni.

Te whakakorenga hohe mā te aho i te taiwhanga: HSV kei waho i ngā pūtau, me whai aho

I whakamahia e te whakamātautau hāngai tōmua rawa ngā huaketo kātahi anō ka wehea mai i ngā tūroro, kaua ko tētahi momo taiwhanga kotahi. I roto i te rangahau 1975 mō te whakakorenga hohe o herpesvirus hominis mā te tauhohenga aho, i konatunatua ngā huaketo 37 i wehea mai i ngā tūwhenua taihemahema me te waha ki te puru metilīni i te 10 micromolar, ka puritia mō te kotahi hāora i te pōuri, kātahi ka wehea kia rua: he wāhanga pōuri, he wāhanga i tukua ki te aho mō te rima meneti mai i ngā ngongo rama kōrekoreko e rua, 15 watt ia ngongo, i te tawhiti 15 cm. O ngā huaketo 37 i wehea, i ngaro te kaha whakapoke ka taea te kite i te 27 i te aho anake, ā, i heke te 4 ki raro iho i te hautahi o te 100 o tō rātou kaha tuatahi. I mau tonu te kaha whakapoke o ngā tauira whakahaere i te pōuri: ki te kore he aho, kāore tēnei kukūtanga i whakakore katoa i ngā huaketo hohe o te tauira.

I whakaatu tētahi rangahau o muri mai he iti noa te pānga o te waikano me te aho anake i ētahi āhuatanga. I roto i ngā whakamātautau 1979 mō te puru metilīni, te aho, me te hiko ki HSV-1 me HSV-2, nā te waikano 10 micromolar me te aho rama aho-wera mō te 180 hēkona i whakaiti te HSV-1 whakapoke mā te 60 percent pea, arā, tata ki te 0.4 log. Mā te tāpiri anake i tētahi iahiko tōtika iti ka eke taua pūnaha ki tua atu i te ngaronga 99.99 percent. He iti noa te pānga o te aho anake, o te iahiko anake, me te aho me te iahiko kāore he waikano. Me whai taputapu hiko kia puta te pānga nui, nō reira kaua taua tuhinga e whakahuahia hei taunakitanga ka puta auau te whakamatenga e whā log i te waikano noa me te rama.

Kātahi ka ui ngā rangahau tikanga-mahi he aha tonu ngā mea ka taea e ngā matūriki kua maimoatia. I kitea e tētahi rangahau 1980 i te Journal of Clinical Investigation mō ngā tikanga-mahi aho o HSV ngā whatinga whenu kotahi i roto i te DNA huaketo, kāore ko ngā whatinga whenu rua te mea matua: i piri tonu ngā matūriki kua maimoatia, i uru tonu hoki ki ngā pūtau, engari i tū te whanaketanga ki te pakaritanga. I whakaū tētahi rangahau 1997 mō te huringa pokenga i muri i te puru metilīni me te aho i tēnei mā te waikano 1 micromolar me te aho whero: kāore he whakangaromanga nui o te kōpaki, i mau tonu te urunga me te tukunga DNA, engari i whakakorea te tāruatanga me te whakakino DNA e whakawhirinaki ana ki te whakamāramatanga. I tohu tētahi whakataurite 1995 mō te hāora takitahi ki te whai wāhi o te hāora takitahi, me te āhua nei he tauhohenga matū tuwhena anō. Ka whakamārama ngā kōrero mō te ngongo aho a te puru metilīni me tana whakaputa hāora tauhohe i te take me noho tahi te waikano, te hāora, me ngā pūaho ki te wāhi e whāia ana.

Ko te whakaaturanga ā-rahinga tino mārama nō ngā mahi mō ngā hua toto, ā, koirā hoki te whakatūpato tino mārama kia kaua e whānui rawa te whakamāori i ngā hua. I roto i tētahi rangahau 2013 mō te whakaiti tukumate i te wē toto mā ngā LED whero i te 627 nm, i heke te HSV i tāpirihia ki te wē toto mā te 5.2 log pea i te 1 micromolar, me te 6.0 log i te 10 micromolar, i muri i te 60 meneti. He tango poke tēnā i tētahi wē e whakamāramatia ana, ehara i te maimoatanga o te noho huna i ngā pūtau io, ā, kāore e matapae ana i te mahi a tētahi wairewa kua horomia i roto i te tinana pōuri.

Te maimoatanga ā-rohe o ngā tūwhenua: he iti, he tawhito, he rerekē ngā hua

I ngā pūrongo ā-rohe, ka pania te waikano ki te tūwhenua, ka whakamāramatia hoki, nō reira e mau ana te whakatakotoranga o te taiwhanga. Ko te mea tōmua rawa he pūrongo tūroro kotahi mō te eczema herpeticum, he pokenga HSV whānui ki runga i te katoatia kua pā kē. I whakaahua te pūrongo 1975 mō te puru metilīni me te aho ki te eczema herpeticum i te tere o te pai ake i muri i te waikano ā-rohe me te aho; i whakamate huaketo te waikano 10 micromolar i te aho, engari kāore i te pōuri. I tautuhia e ngā kōrero whakamārama he wairewa 0.1 percent ki te haurua o te wāhi hei whakataurite i roto i taua tūroro anō. Hei taunakitanga mō ngā tūwhenua ngutu, he kitenga nō te wā o ngā pūrongo tūroro kotahi, ā, he ngoikore te ine i te rahinga maimoatanga.

Ko te raupapa hītori nui ake i pā ki ngā tūwhenua taihemahema. I roto i te raupapa 1975 mō te herpes taihemahema o ngā tūroro 56, i whiwhi te 36 i te puru metilīni, engari ko te 35 tuatahi anake i tohaina matapōkeretia ki ngā waikano e toru, nō reira ehara te rōpū i te whakamātautau tino tōtika. I pūrongotia te pai ake o te 70 percent pea o ngā kēhi auau i maimoatia i roto i te 48 hāora pea, engari kāore i tino heke te auau o te hoki mai. Kāore i whakahaerehia te whakamāramatanga i te kāinga mā te rama kōrekoreko, mā te aho rā rānei. E hāngai ana te pai ake wawe me te kore whakaiti i ngā hokinga mai ki tētahi tukanga ā-rohe e pā ana ki te tūwhenua o nāianei, engari kāore ki te puna huaketo huna. Me mau taua tūpato anō ki ngā kawa maimoatanga tauhohenga aho e whakamahi ana i te puru metilīni.

He iti ngā whakamātautau tūwhenua ngutu o ēnei rā, ā, kāore e kotahi ana ngā hua. I whakamahia e tētahi raupapa 2009 o ngā tūroro herpes labialis tokowhā te waikano 0.01 percent me tētahi taiaho 660 nm i te 120 J mō ia square cm, ā, i pūrongotia te whakaora tere, engari kāore he rōpū whakahaere, ā, i whai mai te whakarerekē mahi koiora mā te aho, e whakaahuatia ana i te raupapa kēhi 2009 mō te maimoatanga tauhohenga aho o herpes labialis. I tētahi tohanga matapōkere o ngā tūroro 75 ki te maimoatanga tauhohenga aho, te acyclovir ā-kiri, ki ēnei e rua rānei, kāore i kitea he rerekētanga i te wā whakaora, i te mamae rānei, e ai ki te whakamātautau 2021 mō te maimoatanga tauhohenga aho me te acyclovir. Kāore tētahi whakamātautau matapōkere o ngā tūroro 24 me te qPCR mō HSV-1 i kite i te rerekētanga i te ngaronga o ngā tohu, i te hokinga mai i roto i te kotahi tau rānei, e whakaahuatia ana i te whakamātautau matapōkere 2025 mō te maimoatanga tauhohenga aho patu moroiti ki te herpes simplex. I pūrongotia e tētahi whakamātautau 2025 o ngā tūroro 60, mō tētahi huinga o te maimoatanga tauhohenga aho me te waikano, te whakarerekē mahi koiora mā te aho, me te whakaheke wē i ngā opupu, he tere ake te whakamāmā mamae; kāore e taea te kī nā te waikano taua hua, e ai ki te pūrongo 2025 mō te whakakotahi i te maimoatanga tauhohenga aho me te whakarerekē mahi koiora mā te aho.

He iti ngā pūrongo pānga kino i konei. Kāore ngā tuhinga 1975 i whai i ngā tikanga kimi pānga o ēnei rā. He iti, he kore rānei ngā pānga wawe i pūrongotia i ngā rangahau iti o muri mai, engari ka puta tonu te poke puru, ā, ka taea tonu te whakapataritari ā-rohe nā te pānga paitini o te aho. He rerekē te poke waikano me te rama i te horomi i te waikano; koia te pūkete haumaru o te puru metilīni e wehe ai i ngā ara whakamahi.

EBV: kāore he taunakitanga hāngai mō te puru metilīni

Mō EBV, kāore te rapunga i kitea he taunakitanga. Kāore tētahi whakamātautau kua arotakengia e ngā hoa mātanga, tētahi whakamātautau whakahaere rānei i kitea mō tēnei arotake e whakaatu ana ka whakaiti te puru metilīni, me te aho, me te kore aho rānei, i te kaha whakapoke o EBV, ka tāmi i te hohe anō, ka whakaheke rānei i te rahinga huaketo i roto i te tangata. Ka whakamahi ngā mahi mō ngā pūtau mate pukupuku kōhao ihu-korokoro whai EBV i ētahi atu matū whakapiki tairongo ki te aho, ā, ka ine i te oranga o te puku, kaua i te whakakorenga huaketo mā te puru metilīni. Ka whakarārangi ngā arotake i a EBV hei huaketo e hiahia ana ki ngā whakamātautau ā muri ake, kaua hei take whakamahi kua whakaūngia.

Ka whakamārama te koiora he aha e kore ai e taea te whakamahi i te hua HSV o te ngongo whakamātautau mō EBV. Ka whakanohoia e te maimoatanga tūwhenua ngutu ngā whakaritenga e toru katoa, te waikano, te hāora, me ngā pūaho, ki te mata kotahi ka taea te toro atu. Kei roto te noho huna o EBV i te nuinga o te wā i ngā pūtau B e marara ana i te toto me ngā kiko waitinana. Kāore te aho whero ā-kiri e whakamārama i taua puna marara, ā, kāore te waikano kua horomia e whakarato aho kua arohia ki aua wāhi. Ko te whakamate i tētahi pūtau puku whai EBV mā tētahi matū whakapiki tairongo kē he whakamate pūtau, ehara i te taunakitanga mō te mahi patu huaketo. He mea nui taua āputa ina pānuihia te āhua o te ine i te rahinga huaketo me ngā tohu o te hohe anō.

Te maimoatanga ā-waha me te whakaaro hē mō te wā kāore e hoki mai

Kāore tētahi whakamātautau tangata whai rōpū whakahaere i kitea mō tēnei arotake e whakaatu ana ka whakaiti te puru metilīni ā-tinana whānui, ā-waha rānei, i te hokinga mai o ngā tūwhenua ngutu, ka whakapoto i te wā whakaora, ka whakaiti i te putanga huaketo, ka whakarerekē rānei i tētahi putanga EBV pērā i ngā kape DNA i te toto, i te huware rānei, i ngā tohu kua tautuhia mō te huringa wāwāhi pūtau rānei. Ka whakamahi ngā tuhinga herpes tangata i te waikano ā-kiri me te aho ā-rohe. He wawaotanga rerekē te tuku ā-tinana whānui kāore he whakamāramatanga kua arohia, ā, me whai i tōna ake whakamātautau: he tohanga matapōkere, he whakamātautau huna, he rōpū whakahaere rongoā horihori, me ngā kēhi auau kua whakaūngia, he wā tīmatanga hei whakarite i te auau taketake, he tirohanga kua tautuhia i mua mō te pānga ki te maimoatanga, he aroturuki mō te ono ki te tekau mā rua marama, he tīpako pani auau me te qPCR, he tuhi i ngā take whakaoho, me te aroturuki haumaru. Kāore ngā mātāpono whānui mō te tuku ā-waha me te ngongo o te puru metilīni e whakakapi i aua putanga ine.

Koinei te wāhi e hē ai tētahi kōrero e rangona nuitia ana. Ka tīmata tētahi tangata i ētahi wawaotanga i te wā kotahi, ka pūrongo kāore he tūwhenua ngutu mō ngā marama, ā, ka whakatau nā tētahi o aua wawaotanga. Ka whakarōpū ngā putanga HSV, kātahi ka ngaro mō ngā marama, ahakoa kāore anō te huaketo kia whakakorea i ngā kāhui pūtau io tairongo. Ka rerekē ngā take whakaoho, ka whakarerekē ngā tūmanako i te pūrongo, ā, mā te tūpono noa ka puta ngā wā āputa. Ki te maha ngā whakarerekētanga i te wā kotahi, kāore he whakataurite ki te āhuatanga kāore i mahia taua whakarerekētanga hei whakatau nā tētahi wāhanga kotahi te āputa. I whakaatu te raupapa taihemahema 1975 i te tauira kōaro: he pai ake wawe, engari kāore i pai ake te auau o te hoki mai. Ehara te whakaora i tēnei putanga i te ariā kotahi ki te ārai i te putanga e whai ake nei.

Ripanga taunakitanga mō ia huaketo me tōna horopaki

Me pēhea te whakamahi i ēnei taunakitanga

Me pātai kia whā ngā pātai mō ia tohutoro. He aho, he pōuri rānei, nā te mea kāore te whakamatenga mā te tauhohenga aho e matapae ana i te whakamatenga ā-tinana whānui. He matūriki huaketo herekore, he tūwhenua o nāianei, he puna huna rānei, nā te mea ko te whāinga e hāngai ana anake ka whakautu i te kerēme. He kaha whakapoke, he whakaora, he hokinga mai, he rahinga huaketo rānei, nā te mea kāore tētahi tau mō te kaha whakapoke e whakautu i te pātai mō te hokinga mai. He HSV, he EBV rānei, nā te mea he raruraru rerekē te tūwhenua ka taea te toro atu me te puna pūtau B marara. Kotahi noa te kōrero whāiti e tautokona ana e te pūkete: ka kaha te puru metilīni ki te whakakore i te hohe o HSV mā te aho ina tūtaki te huaketo kei waho i ngā pūtau ki te waikano, te hāora, me te aho e tika ana. He iti, he rerekē hoki ngā taunakitanga mō te maimoatanga whai tikanga haumanu o ngā tūwhenua auau; kāore he taunakitanga mō te ārai ā-waha, ā, kāore he taunakitanga hāngai mō te pānga patu EBV. Kāore tētahi wā marino, kāore he tūwhenua ngutu i te wā e whai ana i tētahi huinga maimoatanga maha, e whakarerekē i ēnei whakatau.