Ubururu bwa metilene kuri COVID-19 na COVID imara igihe kirekire: ibimenyetso

Kwitondera ubururu bwa metilene kuri COVID byatangiranye n'ikibazo gifite ishingiro. Iyi mvange ihendutse, imaze igihe kirekire ikoreshwa mu buvuzi, kandi ubushakashatsi bwo muri laboratwari bwerekanye ko igira icyo ikora kuri SARS-CoV-2. Ariko icyo kibazo kimwe cyahise kigabanyikamo ibibazo bitatu bitandukanye, kandi abasomyi babivanga basobanukirwa nabi ibimenyetso.

Ibyo bibazo bitatu ni ibi: ese ivura ubwandu bwo mu gihe cya mbere mu barwayi, ese ituma virusi iri hanze y'umubiri idakora, kandi ese ifasha ku bimenyetso bikomeza nyuma y'icyo gihe, bizwi nka COVID imara igihe kirekire? Buri kibazo gifite uburyo bwacyo bwo gukora ubushakashatsi, igipimo cyacyo cy'ibisubizo, n'igisubizo cyacyo. Iyi nyandiko ibitandukanya kandi isoza itanga urutonde rw'igerageza ushobora kugenzura mbere yo gufata icyemezo icyo ari cyo cyose uri kumwe n'umuganga.

Ubwandu bwo mu gihe cya mbere: ibimenyetso bisubirwamo bya ogisijeni nta gihamya yo gukira

Impamvu za mbere zo kongera gukoresha uyu muti ku kindi kibazo zasobanuwe mu isesengura ry'ubushakashatsi ryo mu 2021 ryasuzumye uko ubururu bwa metilene bukora mu mubiri kandi rigatanga urutonde rw'igerageza ritanu ryanditswe kuri ubururu bwa metilene mu kwita ku barwayi ba COVID-19. Iryo sesengura ni ingirakamaro nk'icyerekezo cyo gutangiriraho, si nk'igihamya. Ryatanze uburyo bushoboka bwo gukora, nko guhererekanya okisidasiyo no kugabanya okisidasiyo no kugabanya kwangirika guterwa na okisidasiyo, kandi ryashyize ku rutonde igerageza ryinshi ryari ritararangira icyo gihe. Aho igerageza rigeze harahindutse kuva icyo gihe, bityo buri ryanditswe rigomba kongera kugenzurwa aho kwishingikiriza ku rutonde rwo mu 2021.

Ishusho igaragara mu nyandiko zakurikiyeho irasa bihagije ku buryo ishobora gusobanurwa. Ubushakashatsi bwinshi bwakorewe mu bitaro byo muri Irani bwagerageje ubururu bwa metilene nk'igice cy'uruvange rwongewe ku buvuzi busanzwe, kandi bwatangaje ko ogisijeni yiyongereye mu gihe gito n'uko igihe cyo kumara mu bitaro cyagabanutse. Muri raporo imwe y'icyiciro cya 2 irimo abarwayi 80, igihe cyo kumara mu bitaro cyari hafi iminsi 7 ku bahawe uruvange, ugereranyije n'iminsi hafi 12 ku bahawe ubuvuzi busanzwe gusa. Raporo nini kurushaho, yakoresheje uburyo busa n'ubwo mu cyiciro cya 3 kandi irimo abarwayi 223, yagaragaje icyerekezo nk'icyo ariko itandukaniro ku mpfu ntiryageze ku rwego rw'ubusobanuro mu ibarurishamibare. Ubu ni ubushakashatsi butahishaga ubuvuzi buri murwayi yahabwaga, bwakoresheje gahunda y'imiti irimo ibice byinshi; ibyo bifite akamaro kubera impamvu tugarukaho hepfo.

Ubushakashatsi bushya bwagabanyije abarwayi mu matsinda ku buryo bwa tombola butuma iyo shusho irushaho gusobanuka. Mu barwayi 122 bari barwariye mu bitaro bafite COVID-19 na ARDS, itsinda ryahawe ubururu bwa metilene bunyobwa hiyongereyeho ubuvuzi busanzwe ryagaragaje izamuka rinini kurushaho ry'urugero rwa ogisijeni mu maraso kurusha abahawe ubuvuzi busanzwe gusa; imikoranire hagati y'itsinda n'igihe yari ifite ubusobanuro mu ibarurishamibare. Nyamara igihe cyo kumara mu bitaro n'impfu nyuma y'ukwezi kumwe n'amezi atatu ntibyagaragaje itandukaniro rifite ubusobanuro mu ibarurishamibare muri iryo gerageza rya ARDS ryagabanyije abarwayi mu matsinda ku buryo bwa tombola. Raporo nto y'abarwayi 50 barembye bahawe ubururu bwa metilene mu mutsi nk'ubutabazi, idafite itsinda ryo kugereranya, yatangaje ko ibipimo by'igereranya rya ogisijeni byazamutse nyuma y'ubuvuzi. Ariko kubera impfu 20 no kutagira itsinda ryo kugereranya, iyo raporo y'abarwayi bahawe ubutabazi ntishobora kwerekana ko umuti ari wo wateye impinduka.

Igerageza rikomeye kurusha ayandi ryagereranyije umuti na placebo kugira ngo risuzume ingaruka zo kurwanya virusi ryerekana ibitandukanye. Igerageza NCT04635605 ryagabanyije abarwayi batari barwariye mu bitaro ku buryo bwa tombola, ribaha ubururu bwa metilene bunyobwa inshuro imwe cyangwa placebo, hanyuma ripima ingano ya virusi n'ivaho ryayo. Ntirryagaragaje ubushobozi bwo kurwanya virusi, nk'uko byavuzwe mu raporo y'igerageza yatangajwe. Kujyanwa mu bitaro na byo ntibyagabanutse mu rindi gerageza rifitanye isano n'iryo ariko ritandukanye na ryo, ryagerageje plasma y'abakize yari yabanje gutunganywa hakoreshejwe ubururu bwa metilene mbere yo kuyitera abarwayi. Ubwo bushakashatsi ku barwayi 376 batari barwariye mu bitaro bwabonye ko urugero rwo kujyanwa mu bitaro n'impinduka z'ingano ya virusi byari hafi kimwe mu matsinda ya plasma na placebo mu igerageza rya plasma COnV-ert. Plasma yatunganyijwe hakoreshejwe ubururu bwa metilene ireba uburyo bwo gutunganya ibikomoka ku maraso, si ubuvuzi bw'ubururu bwa metilene bukwirakwira mu mubiri, bityo ntigomba gufatwa nk'igerageza ryo gufata uwo muti.

Mu magambo yoroshye: ubururu bwa metilene kuri COVID bugaragaza kenshi impinduka ku bipimo bya ogisijeni, ariko nta gihamya yemeza ko butuma virusi ivaho vuba, bugabanya abajyanwa mu bitaro, cyangwa bugabanya impfu. Urugero rwa ogisijeni mu maraso rukwiye gukurikiranwa, ariko si kimwe no gukiza ubwandu.

Abasomyi batamenyereye uko ubururu bwa metilene bukora mu mikorere ya okisidasiyo no kugabanya okisidasiyo rimwe na rimwe batekereza ko kwiyongera kwa ogisijeni bivuze kwica virusi. Si ko biri. Ogisijeni igera mu maraso igaragaza uko ibihaha byangiritse, imikorere ya hemoglobine, n'itembera ry'amaraso. Ingano ya virusi igaragaza uko yiyongera. Umuti ushobora kugira icyo ukora kuri kimwe utagize icyo ukora ku kindi.

Gutuma virusi idakora muri laboratwari: ibisubizo bikomeye, ariko bifite ubusobanuro bugarukira ku kintu kimwe

Muri laboratwari, ibisubizo bisa n'ibikomeye cyane kurushaho, kandi iryo tandukaniro ritera urujijo mu ncamake nyinshi. Ubushakashatsi bwa mbere bwakorewe ku ngirabuzimafatizo zororerwa muri laboratwari bwatangaje ko ingano nto zipimwa muri micromolar zagezaga kuri kimwe cya kabiri cy'ingaruka ntarengwa kuri SARS-CoV-2 mu ngirabuzimafatizo za Vero E6. Ibyo byatanze impamvu yo gukora igerageza ku bantu, nk'uko byavuzwe mu bushakashatsi bwa mbere ku ngirabuzimafatizo zororerwa muri laboratwari. Igerageza ryo guhuza virusi n'ubururu bwa metilene mu buryo butaziguye ryaje kwerekana ko bwangiza RNA ya virusi nyuma y'amasaha bihuye, n'iyo butari bwakoreshejwe hamwe n'urumuri, nko mu bushakashatsi bwa Cagno na bagenzi be.

Hamwe n'urumuri, ingaruka ziba nini cyane kurushaho. Guhuza ubururu bwa metilene n'urumuri rwa lazeri itukura byatumye virusi zose ziri mu mvange zirimo ingano nyinshi ya virusi zidakora, kandi birinda uturemangingo tugizwe n'urwego rumwe rw'ingirabuzimafatizo mu bushakashatsi bwo gutuma virusi idakora hifashishijwe urumuri. Ubushakashatsi ku bikomoka ku maraso bugaragaza ibintu bisa: hafi 0.8 micromolar y'ubururu bwa metilene hamwe n'urumuri ruboneka byagabanyije ubushobozi bwa SARS-CoV-2 bwo kwanduza muri plasma ku kigero cy'inzego hafi eshanu z'ubwikube bwa cumi, mu gihe ubururu bwa metilene butarimo urumuri bwagize ingaruka nke cyane, nk'uko byagaragajwe mu igerageza ryo kugabanya udukoko dutera indwara muri plasma. Gutunganya ingero zafashwe ku barwayi kugira ngo virusi zidakora, hifashishijwe urumuri mu gihe gito, na byo byatangajwe mu bushakashatsi bwakurikiyeho bwo gusukura ingero zafashwe ku barwayi.

Uburyo bukwiye bwo kubyumva ni nk'ikintu cyica virusi hanze y'ingirabuzimafatizo, atari umuti urwanya virusi imbere mu ngirabuzimafatizo. Ubushakashatsi bwo mu 2024 ku buryo bukora bwasobanuye iryo tandukaniro neza: ubururu bwa metilene bwatumye uduce twa coronavirus turi hanze y'ingirabuzimafatizo tudakora burundu mu mwijima, ariko ntibwagize ingaruka zigaragara igihe ingirabuzimafatizo zari zamaze kwandura. Kandi kubuha imbeba zibasha kwandura binyujijwe mu kanwa ntibyazirinze ubwandu bwica muri iryo gereranya ry'ingaruka hanze no imbere mu ngirabuzimafatizo.

Iryo tandukaniro risobanura ishusho iboneka mu barwayi. Imvange ishobora kuba nziza cyane mu gusukura ubuso, ingero zafashwe ku barwayi, cyangwa plasma kugira ngo virusi zidakora, cyane cyane hamwe n'urumuri, ariko ikananirwa nk'umuti urwanya virusi mu mubiri. Ibyo ni ukubera ko uturemangingo two mu myanya y'ubuhumekero twanduye turi mu buryo butandukanye n'ubwo mu muyoboro w'igerageza. Gutuma virusi idakora muri laboratwari bishyigikira ikoreshwa mu mutekano w'ibikoresho n'amaraso. Ntibyemeza ko ubururu bwa metilene kuri COVID ari ubuvuzi bwagaragajwe ko bukora mu barwayi.

COVID imara igihe kirekire: igitekerezo gusa, nta gerageza ryagabanyije abarwayi ku buryo bwa tombola ryarangiye

Ibimenyetso ku bururu bwa metilene kuri COVID imara igihe kirekire biri ku rwego rwo hasi kurushaho. Inyandiko yo mu 2021 ikunze kuvugwa, ifite amagambo “agahinda nyuma ya COVID” mu mutwe wayo, ni ibaruwa itanga igitekerezo, si igerageza. Itanga inzira zijyanye na mitokondiriya n'ibyimbire mu rwungano rw'imyakura zishobora gutuma habaho inyungu, ariko nta bisubizo byo mu gihe gikurikira ubwandu yatanze bishingiye ku igereranya n'itsinda rigenzura muri iyo baruwa y'igitekerezo ku bimenyetso bya nyuma ya COVID. Icyo ni igitekerezo cyo gutangiriraho, si igisubizo cy'ubushakashatsi.

Kugeza mu mpera za 2026, nta gerageza ryanditswe, ryarangiye kandi ryagabanyije abarwayi mu matsinda ku buryo bwa tombola twabonye, ryagerageje ubururu bwa metilene by'umwihariko ku ngaruka zimaze kugaragara zikomeza nyuma y'igihe cya mbere cy'ubwandu. Raporo nto zakurikiranye abarwayi bari mu gihe cya mbere cy'ubwandu nyuma yo guhabwa ubururu bwa metilene cyangwa ubuvuzi bukoresha urumuri, zikababaza ku bimenyetso byakomeje, ntizishobora kuziba icyo cyuho. Ni nto, nta matsinda yo kugereranya zifite, kandi akenshi zihuza ubururu bwa metilene n'ubuvuzi bw'urumuri cyangwa indi miti, bityo ntizishobora kwerekana ko birinda cyangwa bivura COVID imara igihe kirekire.

Umuntu wese usuzuma ikivugwa kuri iki kibazo akwiye kubaza ibibazo bitatu. Ese abo ubushakashatsi bwakoreweho basobanuwe nk'abari mu gihe gikurikira ubwandu aho kuba mu gihe cya mbere? Ese hari itsinda ryo kugereranya? Ese umunaniro, kutihanganira ibikorwa bisaba imbaraga, ingorane zo gutekereza, cyangwa ikindi kimenyetso cyatoranyijwe mbere byapimwe hakoreshejwe igipimo cyemejwe ko cyizewe? Niba igisubizo kuri kimwe muri ibyo ari oya, iyo raporo ni amakuru y'inyuma afasha gusobanukirwa, si ibimenyetso by'uko ubuvuzi bukora.

Icyitonderwa ku kuvanga uburyo bw'ubuvuzi na naltrexone ku rugero ruto

Gahunda zimwe zo kuri interineti zihuza ubururu bwa metilene na naltrexone ku rugero ruto ku munaniro ukurikira ubwandu bwa virusi. Ibi bitera ikibazo cyo kumenya icyateye impinduka. Iyo uburyo bubiri bw'ubuvuzi butangiriye hamwe maze ibimenyetso bigahinduka, iyo mpinduka ntiyerekana uburyo bwagize uruhare, niba hari n'ubwagize uruhare, cyangwa niba kubuhuza ari umutekano. Gukira bisanzwe, kuruhuka, igisubizo kuri placebo, n'ubundi buvuzi butangwa icyarimwe na byo bishobora gusobanura kumera neza.

Ibyo binareba igerageza ryo kuvanga imiti ku barwayi bari mu gihe cya mbere cya COVID ryavuzwe haruguru, aho ubururu bwa metilene bwatanzwe hamwe na vitamine C, N-acetylcysteine, cyangwa ibindi bintu, hiyongereyeho ubuvuzi busanzwe. Kumara igihe gito mu bitaro mu itsinda ryahawe uruvange ntibyerekana uruhare rw'ubururu bwa metilene bwonyine. Abasomyi bafata ubururu bwa metilene hamwe n'ibindi byunganira imirire cyangwa imiti bakwiye gusuzuma amakuru ku mikoranire yabyo n'ibihe bidakwiye gukoreshwamo bari kumwe n'umuganga, aho gutekereza ko inkuru y'umuntu wakoresheje uruvange na bo ibareba. Amakuru y'umutekano w'ubururu bwa metilene afite akamaro by'umwihariko, kuko imiti igira icyo ikora kuri serotonine, ibura rya G6PD, imikorere mibi y'impyiko, no gutwita bihindura rwose isuzuma ry'ibyago.

Urutonde rw'igerageza n'ubushakashatsi rufite ibipimo by'ibisubizo byihariye kuri buri kibazo

Koresha iyi mbonerahamwe nk'isoko ry'ibanze ry'amakuru y'iyi nyandiko. Ikibazo gisuzumwa ni cyo kigena igipimo cy'ibisubizo gifite agaciro. Ibyanditswe muri uru rutonde bigaragaza aho ubushakashatsi bwari bugeze nk'uko byatangajwe kugeza mu mpera za 2026; genzura aho bugeze ubu mbere yo kubuvuga nk'isoko, kuko amakuru yo mu nyandiko z'igerageza ashobora gutinda ugereranyije n'inyandiko zitangazwa.

Uko wakoresha ibi bimenyetso

Tandukanya ibyo bihe bitatu. Ku bwandu bwo mu gihe cya mbere, incamake y'ukuri ni uko hashobora kubaho kwiyongera kwa ogisijeni, ariko ingaruka ku ivaho rya virusi, kujyanwa mu bitaro, cyangwa kubaho ntizemejwe. Mu gutunganya ibintu muri laboratwari, ubururu bwa metilene hamwe n'urumuri ni uburyo bwagaragajwe ko butuma virusi idakora mu buryo bwageragejwe. Kuri COVID imara igihe kirekire, ubu nta shingiro ry'igerageza ryo kubukoresha nk'ubuvuzi rihari.

Umuntu wese utekereza kubukoresha akwiye kuganira n'umuganga ku rugero rw'umuti, igihe cyo kuwufata, imiti ishobora gukorana na wo, n'uko yaba yemerewe kuwukoresha, kandi akagenzura niba ibisubizo by'igerageza rishya bihindura uko ibintu bisuzumwa. Inyandiko z'igerageza ziravugururwa nyuma y'uko amasesengura atangajwe, kandi uru rwego rwamaze guhinduka rimwe, ruva ku bitekerezo bijya ku bisubizo bimwe by'igerageza. Iyo ngeso yo kongera kugenzura inyandiko z'igerageza ifite akamaro kurusha ubushakashatsi bumwe ubwo ari bwo bwose.