Nkhani
Methylene blue pa COVID-19 ndi COVID yokhalitsa: umboni
Chidwi cha kugwiritsa ntchito methylene blue pa COVID chinayamba ndi funso lomveka. Mankhwalawa ndi otsika mtengo, akhala akugwiritsidwa ntchito m'zachipatala kwa nthawi yaitali, ndipo ntchito ya mu labotale inasonyeza kuti angakhudze SARS-CoV-2. Koma funso limodzi limenelo posakhalitsa linagawika kukhala mafunso atatu osiyana, ndipo owerenga omwe amawasakaniza adzatanthauzira umboni molakwika.
Mafunso atatuwo ndi awa: kodi amathandiza kuchiza matenda a gawo loyambirira mwa odwala, kodi amalepheretsa kachirombo kugwira ntchito kunja kwa thupi, ndipo kodi amathandiza pa zizindikiro za pambuyo pa gawo loyambirira zomwe zimatchedwa COVID yokhalitsa? Lililonse lili ndi njira yake yochitira kafukufuku, chotsatira chake choyezedwa, ndi yankho lake. Nkhaniyi imawasiyanitsa ndipo imamaliza ndi kaundula yemwe mungayang'ane musanapange chisankho chilichonse limodzi ndi katswiri wa zachipatala.
Matenda a gawo loyambirira: zizindikiro zobwerezabwereza za kusintha kwa okosijeni popanda umboni wa kuchira
Mfundo zoyambirira zogwiritsira ntchito mankhwalawa pa cholinga chatsopano zinafotokozedwa mu ndemanga yofotokoza ya 2021 yomwe inawunika mmene methylene blue imagwirira ntchito ngati mankhwala ndipo inandandalika mayeso asanu olembetsedwa a methylene blue posamalira COVID-19. Ndemangayo ndi yothandiza ngati chitsogozo choyambira, osati ngati umboni. Inapereka njira zomwe zingafotokoze mmene imagwirira ntchito, monga kusinthasintha pakati pa oxidation ndi reduction komanso kuchepetsa kuwonongeka kobwera chifukwa cha oxidation, ndipo inalemba mayeso omwe ambiri anali asanamalizidwe panthawiyo. Mkhalidwe wa mayeso wasintha kuyambira pamenepo, choncho cholemba chilichonse chiyenera kuyang'anidwanso m'malo mongodalira mndandanda wa 2021.
Zomwe zikuoneka m'mabuku a kafukufuku omwe anatuluka pambuyo pake n'zofanana mokwanira kuti zifotokozedwe. Kafukufuku angapo wa m'zipatala ku Iran anayesa methylene blue ngati gawo la mankhwala osakanizidwa owonjezedwa pa chisamaliro chokhazikika, ndipo ananena kuti okosijeni anawongokera kwa nthawi yochepa komanso nthawi yokhala m'chipatala inafupika. Mu lipoti limodzi la gawo 2 la odwala 80, nthawi yokhala m'chipatala inali pafupifupi masiku 7 ndi mankhwala osakanizidwawo, poyerekeza ndi pafupifupi masiku 12 ndi chisamaliro chokhazikika chokha. Lipoti lalikulu la mtundu wa gawo 3 la odwala 223 linasonyeza zomwezo, koma kusiyana kwa imfa sikunafike pa mulingo wofunika mwa ziwerengero. Amenewa ndi mayeso omwe odwala ndi ofufuza ankadziwa mankhwala omwe akuperekedwa, a njira ya chithandizo yokhala ndi zinthu zambiri. Izi n'zofunika pazifukwa zomwe tibwereranso m'munsimu.
Kafukufuku watsopano wogawa odwala mwachisawawa akumveketsa bwino chithunzichi. Mwa odwala 122 a COVID-19 okhala ndi ARDS omwe anali m'chipatala, gulu lomwe linalandira methylene blue yomwedwa pamodzi ndi chithandizo chokhazikika linasonyeza kuwonjezeka kwakukulu kwa kuchuluka kwa okosijeni m'magazi kuposa gulu la chithandizo chokhazikika chokha. Kusiyana kwa kusintha kwa maguluwa m'kupita kwa nthawi kunali kofunika mwa ziwerengero. Komabe, nthawi yokhala m'chipatala komanso imfa pa mwezi umodzi ndi miyezi itatu sizinasiyane mofunika mwa ziwerengero mu mayeso a ARDS ogawa odwala mwachisawawa. Mndandanda waung'ono wa odwala 50 odwala kwambiri, opanda gulu loyerekezera, omwe anapatsidwa methylene blue kudzera mumtsempha ngati chithandizo chopulumutsa, unanena kuti chiŵerengero cha okosijeni chinakwera pambuyo pa chithandizo. Koma chifukwa panali imfa 20 komanso palibe gulu loyerekezera, mndandanda wa odwala opatsidwa chithandizo chopulumutsa sungasonyeze kuti mankhwalawo ndi amene anachititsa kusinthako.
Mayeso amphamvu kwambiri omwe anayerekezera ndi mankhwala opanda chinthu chogwira ntchito pofuna kuona mphamvu yolimbana ndi kachirombo akusonyeza zosiyana. Mayeso a NCT04635605 anagawa odwala akunja mwachisawawa kuti alandire mlingo umodzi wa methylene blue yomwedwa kapena mankhwala opanda chinthu chogwira ntchito, ndipo anayeza kuchuluka kwa kachirombo ndi kuchotsedwa kwake m'thupi. Zotsatira sizinasonyeze mphamvu yolimbana ndi kachirombo, monga tafotokozera mu lipoti lofalitsidwa la mayesowo. Kugonekedwa m'chipatala sikunachepenso mu mayeso ena okhudzana nawo koma osiyana, omwe anayesa madzi a m'magazi a anthu omwe anachira, okonzedwa ndi methylene blue asanaperekedwe kwa wodwala. Kafukufuku ameneyo wa odwala akunja 376 anapeza kuti kuchuluka kwa kugonekedwa m'chipatala ndi kusintha kwa kuchuluka kwa kachirombo zinali pafupifupi zofanana m'magulu a madzi a m'magazi ndi a mankhwala opanda chinthu chogwira ntchito mu mayeso a madzi a m'magazi a COnV-ert. Kukonza madzi a m'magazi ndi methylene blue ndi njira yokonzera zinthu zochokera m'magazi, osati chithandizo cha methylene blue chogwira ntchito m'thupi lonse. Choncho sikuyenera kuwerengedwa ngati mayeso a kumwa mankhwalawa.
Kunena mosavuta: methylene blue pa COVID imasonyeza mobwerezabwereza kusintha kwa miyeso ya okosijeni, koma palibe umboni wokhutiritsa wakuti imachotsa kachirombo mofulumira, imachepetsa kugonekedwa m'chipatala, kapena imachepetsa imfa. Kuchuluka kwa okosijeni m'magazi n'kofunika kutsatira, koma sikutanthauza chimodzimodzi ndi kuchiza matendawa kuti athe.
Owerenga omwe akungoyamba kumvetsa mmene methylene blue imagwirira ntchito ngati chinthu cha redox nthawi zina amaganiza kuti kuwongokera kwa okosijeni kumatanthauza kupha kachirombo. Sizitero. Kuchuluka kwa okosijeni kumakhudzana ndi kuwonongeka kwa mapapo, ntchito ya hemoglobin, ndi kuyenda kwa magazi. Kuchuluka kwa kachirombo kumakhudzana ndi kuberekana kwake. Mankhwala angakhudze chimodzi popanda kukhudza chinacho.
Kulepheretsa kachirombo kugwira ntchito mu labotale: zotsatira zamphamvu, tanthauzo lochepa
Mu labotale zotsatira zimaoneka zamphamvu kwambiri, ndipo kusiyana kumeneku kumasokoneza zofotokozera mwachidule zambiri. Ntchito yoyambirira yokulitsa maselo inanena kuti milingo yochepa ya micromolar inachititsa theka la mphamvu yaikulu kwambiri yolimbana ndi SARS-CoV-2 m'maselo a Vero E6. Izi zinapereka maziko a mayeso a anthu omwe anatchulidwa mu kafukufuku woyambirira wokulitsa maselo. Kenako mayeso oika kachirombo ndi methylene blue pamodzi mwachindunji anasonyeza kuti methylene blue inkawononga RNA ya kachirombo pambuyo pokhudzana kwa maola angapo, ngakhale popanda kuyiyambitsa ndi kuwala, monga mu ntchito ya Cagno ndi anzake.
Ikagwiritsidwa ntchito ndi kuwala, mphamvu yake imakula kwambiri. Kusakaniza methylene blue ndi kuunikira kwa laser yofiira kunalepheretsa kotheratu kugwira ntchito kwa kachirombo kochuluka m'madzi ndipo kunateteza maselo oyala wosanjikiza umodzi mu kafukufuku wa kulepheretsa kachirombo kugwira ntchito pogwiritsa ntchito kuwala. Ntchito yokhudza zinthu zochokera m'magazi imasonyeza zomwezo: methylene blue ya pafupifupi 0.8 micromolar pamodzi ndi kuwala kooneka inachepetsa mphamvu ya SARS-CoV-2 yopatsira matenda m'madzi a m'magazi ndi pafupifupi maulendo 10 okwezedwa ku mphamvu ya zisanu. Methylene blue yopanda kuwala inachita zochepa kwambiri, malinga ndi mayeso ochepetsa tizilombo toyambitsa matenda m'madzi a m'magazi. Kuchotsa tizilombo mofananako m'zitsanzo za kuchipatala pogwiritsa ntchito kuunikira kwakanthawi kochepa kunanenedwa mu kafukufuku wotsatira wa kuchotsa tizilombo m'zitsanzo.
Njira yoyenera yomvetsera izi ndi yakuti ndi chinthu chopha kachirombo kunja kwa maselo, osati mankhwala olimbana ndi kachirombo mkati mwa maselo. Kafukufuku wa 2024 wa mmene imagwirira ntchito anafotokoza kusiyanaku momveka bwino: methylene blue inalepheretsa kosasinthika kugwira ntchito kwa tinthu ta coronavirus tomwe tinali kunja kwa maselo mumdima. Komabe, sinali ndi mphamvu yeniyeni maselo atakhala kale ndi kachirombo, ndipo kupereka mankhwalawa pakamwa sikunateteze mbewa zomwe zingatenge matendawa ku matenda opha, mu kuyerekezera kwa kunja ndi mkati mwa maselo.
Kusiyanaku kumafotokoza zomwe zikuoneka m'zachipatala. Chinthu chingakhale chabwino kwambiri pochotsa tizilombo pamalo, m'zitsanzo, kapena m'madzi a m'magazi, makamaka chikagwiritsidwa ntchito ndi kuwala, koma n'kulephera ngati mankhwala olimbana ndi kachirombo m'thupi lonse. Izi zili choncho chifukwa minofu ya njira zopumira yomwe ili ndi kachirombo ndi malo osiyana ndi chubu choyesera. Kulepheretsa kachirombo kugwira ntchito mu labotale kumathandizira kugwiritsa ntchito kwake pa zipangizo ndi chitetezo cha magazi. Sikutsimikizira kuti methylene blue pa COVID ndi chithandizo chotsimikiziridwa cha odwala.
COVID yokhalitsa: lingaliro lokha, palibe mayeso ogawa odwala mwachisawawa omwe amalizidwa
Umboni wa methylene blue pa COVID yokhalitsa uli pa mlingo wotsikirapo. Nkhani ya 2021 yomwe imatchulidwa pafupipafupi, yokhala ndi mawu akuti "post COVID blues" pamutu wake, ndi kalata ya lingaliro loyenera kuyesedwa, osati mayeso. Imapereka lingaliro la njira zokhudza mitochondria ndi kutupa kwa minofu ya mitsempha zomwe zingabweretse phindu, koma siinapereke zotsatira za pambuyo pa gawo loyambirira zoyerekezeredwa ndi gulu lina mu kalata ya lingaliro lokhudza zizindikiro za pambuyo pa COVID. Limenelo ndi lingaliro loyambira, osati zotsatira.
Kufikira chakumapeto kwa 2026, sitikupeza mayeso olembetsedwa, ogawa odwala mwachisawawa, omwe amalizidwa ndipo amayesa methylene blue makamaka pa mavuto okhazikika a pambuyo pa gawo loyambirira. Malipoti ang'onoang'ono omwe anatsatira odwala a gawo loyambirira atalandira methylene blue kapena chithandizo chogwiritsa ntchito mankhwala ndi kuwala, n'kuwafunsa za zizindikiro zomwe zinkapitirira, sangathetse kusowa kwa umboni kumeneku. Ndi ang'onoang'ono, alibe magulu oyerekezera, ndipo nthawi zambiri amasakaniza methylene blue ndi chithandizo cha kuwala kapena mankhwala ena. Choncho sangathe kusonyeza kupewa kapena kuchiza COVID yokhalitsa.
Aliyense amene akuwunika zimene zikunenedwa apa ayenera kufunsa mafunso atatu. Kodi gululo linafotokozedwa kuti linali la pambuyo pa gawo loyambirira m'malo mokhala m'gawo loyambirira? Kodi panali gulu loyerekezera? Kodi kutopa, kulephera kupirira ntchito yolimbitsa thupi, kuvutika kuganiza, kapena chizindikiro china chosankhidwa pasadakhale chinayezedwa ndi sikelo yotsimikiziridwa? Ngati yankho pa lililonse mwa mafunso amenewa ndi ayi, lipotilo ndi la chidziwitso cha maziko, osati umboni wa mphamvu ya chithandizo.
Zokhudza njira zosakaniza mankhwala ndi naltrexone ya mlingo wochepa
Njira zina za chithandizo zomwe zimapezeka pa intaneti zimaphatikiza methylene blue ndi naltrexone ya mlingo wochepa pa kutopa kwa pambuyo pa matenda a kachirombo. Izi zimabweretsa vuto la kudziwa chimene chachititsa kusintha. Njira ziwiri za chithandizo zikayamba nthawi imodzi ndipo zizindikiro zikusintha, kusinthako sikusonyeza kuti ndi njira iti yomwe yathandiza, ngati pali iliyonse yomwe yathandiza, kapena ngati kuzisakaniza n'kotetezeka. Kuchira kwachibadwa, kupuma, kuyankha ku mankhwala opanda chinthu chogwira ntchito, ndi chisamaliro china cholandiridwa nthawi yomweyo zingafotokozenso kuwongokerako.
Mfundo imeneyo imagwiranso ntchito pa mayeso a mankhwala osakanizidwa a COVID ya gawo loyambirira omwe tafotokoza pamwambapa, momwe methylene blue inaperekedwa ndi vitamin C, N-acetylcysteine, kapena zinthu zina pamodzi ndi chisamaliro chokhazikika. Nthawi yofupika yokhala m'chipatala m'gulu la mankhwala osakanizidwa siisonyeza ntchito ya methylene blue yokha. Owerenga omwe amagwiritsa ntchito methylene blue ndi zowonjezera zina kapena mankhwala ayenera kuwunika ndi katswiri wa zachipatala mfundo za kugwirizana kwa mankhwala ndi mikhalidwe yomwe siyenera kugwiritsidwa ntchito, m'malo moganiza kuti nkhani ya munthu amene anagwiritsa ntchito zosakaniza ingagwirenso ntchito kwa iwo. Mfundo za chitetezo cha methylene blue n'zofunika kwambiri chifukwa mankhwala okhudza serotonin, kusowa kwa G6PD, kulephera kwa impso kugwira ntchito bwino, ndi mimba zimasintha kotheratu kuwunika kwa chiopsezo.
Kaundula wa mayeso ndi kafukufuku wokhala ndi zotsatira zoyezedwa zogwirizana ndi mkhalidwe uliwonse
Gwiritsani ntchito tebulo ili ngati gwero loyambirira lotchulira m'nkhaniyi. Mkhalidwe womwe ukuyesedwa ndi umene umatsimikizira chotsatira choyezedwa choyenera kuwerengedwa. Zolemba za kaundula zikusonyeza mkhalidwe monga unanenedwera kufikira chakumapeto kwa 2026; tsimikizirani mkhalidwe wamakono musanazitchule, chifukwa zolemba za kaundula zimachedwa kusinthidwa poyerekeza ndi zofalitsa.
| Kafukufuku | Mkhalidwe woyesedwa | Chithandizo | Zotsatira zoyezedwa zogwirizana ndi mkhalidwewo | Mkhalidwe ndi zotsatira |
|---|---|---|---|---|
| NCT04370288 | COVID-19 ya gawo loyambirira, yoopsa | Methylene blue 1 mg pa kg pamodzi ndi vitamin C ndi N-acetylcysteine, kenako njira za methylene blue yomwe ili mumkhalidwe wa reduction yomwedwa, pamodzi ndi chisamaliro chokhazikika | Kusafunikira makina othandiza kupuma pa tsiku 7; malipoti otsatira: kuchuluka kwa okosijeni m'magazi, liwiro la kupuma, nthawi yokhala m'chipatala, imfa | Malipoti a mtundu wa gawo 1 ndi 2 amafotokoza kuwongokera kwa okosijeni ndi kufupika kwa nthawi yokhala m'chipatala; odwala ndi ofufuza ankadziwa mankhwala operekedwa, njira yosakaniza mankhwala, magulu ang'onoang'ono |
| NCT04547127 | COVID-19 ya gawo loyambirira | Njira ya chithandizo yozikidwa pa methylene blue pamodzi ndi chisamaliro chokhazikika | Okosijeni, miyeso ya kuchira kwa wodwala | Yalembedwa mu ndemanga ya 2021; yang'anani kaundula kuti mudziwe mkhalidwe wamakono, palibe zotsatira za mayeso omalizidwa apamwamba zotsimikizira mphamvu ya chithandizo |
| NCT04376788 | COVID-19 ya gawo loyambirira | Chithandizo cha methylene blue monga chalembedwera mu kaundula | Zotsatira zoyezedwa za mkhalidwe wa wodwala monga zili mu kaundula | Yalembedwa mu ndemanga ya 2021; yang'anani kaundula kuti mudziwe mkhalidwe wamakono musanaitchule |
| NCT04619290 | Pulogalamu ya matenda a mapapo kuphatikiza nkhani ya COVID | Chithandizo cha methylene blue monga chalembedwera mu kaundula | Zotsatira zoyezedwa za kupuma monga zili mu kaundula | Yalembedwa mu ndemanga ya 2021; yang'anani kaundula kuti mudziwe mkhalidwe wamakono musanaitchule |
| NCT04635605 | COVID-19 ya gawo loyambirira, odwala akunja | Mlingo umodzi wa methylene blue yomwedwa poyerekeza ndi mankhwala opanda chinthu chogwira ntchito | Kusintha kwa kuchuluka kwa kachirombo, kuchotsedwa kwa kachirombo m'thupi | Yamalizidwa; siinasonyeze mphamvu yolimbana ndi kachirombo |
| NCT04621123 (COnV-ert) | COVID-19 ya gawo loyambirira, odwala akunja | Madzi a m'magazi a anthu omwe anachira, ochepetsedwa tizilombo toyambitsa matenda ndi methylene blue ndi kuwala, poyerekeza ndi madzi amchere opanda chinthu chogwira ntchito | Kugonekedwa m'chipatala, kuchuluka kwa kachirombo pa tsiku 7 | Yamalizidwa mwa odwala 376; palibe kusiyana pa kugonekedwa m'chipatala kapena kuchuluka kwa kachirombo; imayesa njira yokonzera madzi a m'magazi, osati kupereka mankhwala ogwira ntchito m'thupi lonse |
| IRCT20200409047007N2 | COVID-19 ya gawo loyambirira yokhala ndi ARDS, odwala ogonekedwa m'chipatala | Methylene blue yomwedwa pamodzi ndi chithandizo chokhazikika (n ndi 62) poyerekeza ndi chithandizo chokhazikika (n ndi 60) | Kusintha kwa kuchuluka kwa okosijeni m'magazi m'kupita kwa nthawi, nthawi yokhala m'chipatala, imfa pa miyezi 1 ndi 3 | Yamalizidwa mwa odwala 122; kuchuluka kwa okosijeni m'magazi kunawongokera, nthawi yokhala m'chipatala ndi imfa sizinasiyane mofunika mwa ziwerengero |
| Mndandanda wa odwala opatsidwa chithandizo chopulumutsa cha IV wopanda gulu loyerekezera | COVID-19 ya gawo loyambirira, kuchepa koopsa kwa okosijeni m'magazi | Methylene blue yoperekedwa kudzera mumtsempha 1 mg pa kg mpaka milingo isanu | Chiŵerengero cha okosijeni, kufunikira kwa makina othandiza kupuma, kutulutsidwa m'chipatala, imfa | Odwala 50; chiŵerengero cha okosijeni chinakwera, 30 anatulutsidwa m'chipatala, 20 anamwalira; palibe gulu loyerekezera choncho sizinganenedwe kuti chithandizocho ndi chimene chinachititsa kusintha |
| Pulogalamu yolepheretsa kachirombo kugwira ntchito mu labotale | Ex vivo ndi in vitro, osati mwa odwala | Methylene blue yokhala kapena yopanda kuwala kofiira kapena kooneka; njira yokonzera madzi a m'magazi pa pafupifupi 0.8 micromolar | Kuchepa kwa mphamvu yopatsira matenda koyezedwa mwa log, TCID50, kuwonongeka kwa RNA | Zotsatira zamphamvu za kulepheretsa kachirombo kugwira ntchito kunja kwa maselo, makamaka ndi kuwala; zimathandizira kugwiritsa ntchito pochotsa tizilombo kokha |
| COVID yokhalitsa ndi mavuto a pambuyo pa gawo loyambirira | Zizindikiro zokhazikika za pambuyo pa gawo loyambirira | Palibe mayeso a methylene blue ogawa odwala mwachisawawa omwe amalizidwa omwe apezeka | Masikelo a zizindikiro zosankhidwa pasadakhale, miyeso ya kuthekera kogwira ntchito | Umboni palibe; pali nkhani za malingaliro okha ndi zomwe zaonedwa potsatira odwala popanda magulu oyerekezera |
Mmene mungagwiritsire ntchito umboniwu
Siyanitsani zochitika zitatuzi. Pa matenda a gawo loyambirira, kufotokoza moona mtima n'koti okosijeni angawongokere, koma mphamvu pa kuchotsedwa kwa kachirombo, kugonekedwa m'chipatala, kapena kupulumuka sinatsimikiziridwe. Pa ntchito za mu labotale, methylene blue ndi kuwala ndi njira yotsimikiziridwa yolepheretsa kachirombo kugwira ntchito m'mikhalidwe yomwe yayesedwa. Pa COVID yokhalitsa, pakali pano palibe maziko a mayeso othandizira kugwiritsa ntchito ngati chithandizo.
Aliyense amene akuganizira kugwiritsa ntchito ayenera kukambirana ndi katswiri wa zachipatala za mlingo, nthawi yoperekera, mankhwala omwe angagwirizane nayo, ndi ngati ali woyenera kulandira chithandizocho. Ayeneranso kuyang'ana ngati zotsatira za mayeso otsatira zikusintha kuwunika kwa ubwino ndi chiopsezo. Zolemba za mayeso zimasinthidwa ndemanga zitapita kale kukasindikizidwa, ndipo nkhaniyi yasintha kale kamodzi kuchoka pa lingaliro kupita pa zotsatira zina zosakwanira. Chizolowezi choyang'ananso kaundula n'chofunika kwambiri kuposa kafukufuku aliyense payekha.