I-methylene blue ne-herpes: izilonda ezindebeni, i-EBV, nokwenza amagciwane angasebenzi ngokukhanya

Igama elilodwa limelela imiqondo emibili kule mpikiswano, futhi le miqondo idinga amagama ahlukene. Umqondo wokuqala uwukwenza izinhlayiya zegciwane zingasebenzi: udayi, umoya-mpilo, nokukhanya kuhlangana nohlayiya lwegciwane oketshezini bese kululimaza ukuze lungakwazi ukuziphindaphinda. Umqondo wesibili uwukwelapha ukutheleleka kumuntu: izilonda ezindebeni ezinciphile, ukuphola okusheshayo, ukukhishwa kwegciwane okunciphile, noma umthamo ophansi wegciwane le-Epstein-Barr. Owokuqala uboniswe ngokuphindaphindiwe ngegciwane le-herpes simplex elabhorethri. Owesibili awukaboniswa nge-methylene blue ephuzwa ngomlomo ngokumelene ne-herpes simplex noma negciwane le-Epstein-Barr. Uma lowo mehluko usucacile, kuba lula ukuhlukanisa imibhalo yocwaningo.

Kukhona nokunye ukudideka okuhambisana nalokhu. I-HSV ne-EBV ziyingxenye yomndeni owodwa omkhulu wamagciwane kodwa zibangela izifo ezihlukene ezicutshini ezihlukene. Isilonda esindebeni siyisilonda esingaphezulu lapho igciwane liziphindaphinda khona libulala amaseli endaweni: udayi ungagcotshwa kuso futhi ukukhanya kuqondiswe kuleyo ndawo. I-EBV ihlala ifihlekile emaselini e-B asakazeke egazini nasezicutshini ze-lymphoid, lapho udayi ogcotshwayo noma isibani esibomvu kungenakufinyelela kuyo yonke indawo egcina igciwane. Umphumela wesimo esisodwa awudluleli kwesinye. Abafundi abafuna indlela ejwayelekile esetshenziswa kulokhu kuhlukanisa bazoyithola kumhlahlandlela wokufunda ucwaningo lwe-methylene blue.

Ukwenza igciwane lingasebenzi ngokukhanya elabhorethri: i-HSV engaphandle kwamaseli, kudingeka ukukhanya

Ukuhlolwa okuqondile okudala kakhulu kwasebenzisa amasampula amagciwane ayesanda kuthathwa ezigulini kunokuba kusebenzise uhlobo olulodwa lwaselabhorethri. Ocwaningweni lwango-1975 lokwenza i-herpesvirus hominis ingasebenzi ngendlela ye-photodynamic, amasampula amagciwane angu-37 avela ezilondeni zezitho zangasese nezomlomo ahlanganiswa ne-methylene blue engu-10 micromolar, agcinwa ebumnyameni ihora elilodwa, abese ehlukaniswa abe yizingxenye ezigcinwe ebumnyameni nezingxenye ezakhanyiswa imizuzu emihlanu ngamashubhu amabili e-fluorescent angu-15 watt ebangeni elingu-15 cm. Kwamasampula angu-37, angu-27 alahlekelwa amandla okuthelelana ayengatholakala kuphela lapho ekhanyisiwe, kanti angu-4 ehla ngaphezu kokuphindwe izikhathi ezingu-100. Amasampula okuqhathanisa agcinwe ebumnyameni ahlala ekwazi ukuthelela: ngaphandle kokukhanya, lokhu kugxila kukadayi akuzange kuqede amandla okuthelelana esampuleni.

Ucwaningo lwakamuva lwabonisa ukuthi udayi ovamile uhlanganiswe nokukhanya ungaba nomphumela omncane kangakanani ngaphansi kwezinye izimo. Ezivivinyweni zango-1979 ze-methylene blue, ukukhanya, nogesi ku-HSV-1 ne-HSV-2, udayi ongu-10 micromolar nokukhanya kwesibani sentambo eshisayo imizuzwana engu-180 kwehlisa i-HSV-1 ekwazi ukuthelela cishe ngo-60 percent, okulinganiselwa ku-0.4 log. Ukwengezwa kuphela kukagesi omncane ogelezayo oqondile kwenza lesi simiso silahlekelwe amandla okuthelelana ngaphezu kuka-99.99 percent. Ukukhanya kukodwa, ugesi wodwa, nokukhanya kanye nogesi ngaphandle kukadayi kwaba nomphumela omncane. Umphumela omkhulu wawudinga imishini kagesi, ngakho lo mbhalo akufanele ucashunwe njengobufakazi bokuthi udayi ovamile kanye nesibani ngokuvamile kubulala igciwane ngezinga lokwehla elingu-4 log.

Ucwaningo lwendlela lokhu okusebenza ngayo lwabe selubuza ukuthi izinhlayiya ezase zilashwe zazisakwazi ukwenzani. Ucwaningo lwango-1980 lwe-Journal of Clinical Investigation ngezindlela ze-photodynamic ku-HSV lwathola ukuphuka komucu owodwa ku-DNA yegciwane, ngaphandle kokuba ukuphuka kwemicu emibili kube yikho okwakuvame kakhulu: izinhlayiya zegciwane ezilashiwe zazisakwazi ukunamathela nokungena emaselini, kodwa ukuvuthwa kwazo kwama. Ucwaningo lwango-1997 lomjikelezo wokutheleleka ngemva kwe-methylene blue nokukhanya lwaqinisekisa lokhu ngodayi ongu-1 micromolar nokukhanya okubomvu: kwakungekho ukubhujiswa okukhulu kolwelwesi olungaphandle, ukungena nokukhishwa kwe-DNA kwakungaphazamisekile, kodwa ukuziphindaphinda kwamiswa ngokuphelele ngokubhidlika kwe-DNA okwakuncike ekukhanyisweni. Ukuqhathaniswa kwango-1995 komoya-mpilo we-singlet kwabonisa ukubandakanyeka komoya-mpilo we-singlet, cishe kuhambisana nokunye ukusabela kwamakhemikhali kwama-radical. Imininingwane yokuthi i-methylene blue imunca kanjani ukukhanya futhi ikhiqize umoya-mpilo osebenza kakhulu ekuphenduleni kwamakhemikhali ichaza ukuthi kungani udayi, umoya-mpilo, nama-photon kufanele kuhlangane endaweni okuqondiswe kuyo.

Ukuboniswa okucace kakhulu ngezilinganiso kuvela ocwaningweni lwemikhiqizo yegazi, oluphinde lube yisixwayiso esicace kakhulu sokungahumushi imiphumela ngokweqile. Ocwaningweni lwango-2013 lokunciphisa amagciwane abangela izifo ku-plasma ngama-LED abomvu angu-627 nm, i-HSV efakwe ku-plasma yehla cishe ngo-5.2 log ku-1 micromolar nango-6.0 log ku-10 micromolar ngemva kwemizuzu engu-60. Lokho kuwukususa ukungcola kwegciwane oketshezini olukhanyisiwe, hhayi ukwelapha igciwane elifihlekile emaselini ezinzwa, futhi akubikezeli ukuthi isixazululo esigwinyiwe senzani ngaphakathi emzimbeni ongakhanyisiwe.

Ukwelapha izilonda endaweni yazo: ucwaningo oluncane, oludala, nolunemiphumela exubile

Imibiko yokwelapha endaweni igcoba udayi esilondeni bese isikhanyisa, okuyinto okungenani egcina ukuhlelwa okufana nokwaselabhorethri. Owokuqala ngumbiko wesiguli esine-eczema herpeticum, ukutheleleka okwengeziwe kwe-HSV okusabalele esikhunjeni esine-eczema. Umbiko wango-1975 we-eczema herpeticum nge-methylene blue nokukhanya wachaza ukuthuthuka okusheshayo ngemva kokusetshenziswa kukadayi nokukhanya endaweni, lapho udayi ongu-10 micromolar wawubulala igciwane ekukhanyeni kodwa hhayi ebumnyameni. Ukuphawula kwacacisa ukuthi isixazululo esingu-0.1 percent sasifakwe engxenyeni yendawo ethintekile ukuze kuqhathaniswe ngaphakathi kwesiguli esifanayo. Njengobufakazi ngezilonda ezindebeni, lokhu kuwukuqaphela kwesiguli esisodwa kwangenkathi yakudala, lapho ukulinganiswa komthamo wokukhanya kwakunganele khona.

Uchungechunge olukhulu lomlando lwaluphathelene nezilonda zezitho zangasese. Ochungechungeni lwango-1975 lweziguli ezingu-56 ezine-herpes yezitho zangasese, ezingu-36 zathola i-methylene blue, kodwa ezokuqala ezingu-35 kuphela ezabelwa ngokungahleliwe phakathi kodayi abathathu, ngakho leli qembu lalingelona isivivinyo esakhiwe ngokucacile. Cishe u-70 percent wezimo ezilashiwe ezaziphindaphinda wabikwa njengothuthukile phakathi kwamahora acishe abe ngu-48, kodwa ukuvama kokubuya kwezilonda akuzange kunciphe ngokuphawulekayo. Ukukhanyiswa ekhaya ngesibani se-fluorescent noma ngelanga kwakungalawulwa. Ukuthuthuka kwesilonda esikhona ngaphandle kokuncipha kokubuya kwezilonda kuyahambisana nenqubo yendawo ethinta isilonda esikhona kodwa engathinti indawo egcina igciwane elifihlekile. Isixwayiso esifanayo siyasebenza ezinqubweni zokwelapha nge-photodynamic kusetshenziswa i-methylene blue.

Izivivinyo zanamuhla zezिलonda ezindebeni zincane futhi azihambisani ngemiphumela. Uchungechunge lwango-2009 lweziguli ezine ezine-herpes labialis lwasebenzisa udayi ongu-0.01 percent nge-laser engu-660 nm ku-120 J nge-square cm futhi lwabika ukuphola okusheshayo, kodwa lwalungenalo iqembu lokuqhathanisa futhi lwalandelwa yi-photobiomodulation, njengoba kuchazwe ochungechungeni lwango-2009 lwezimo ze-herpes labialis ezalashwa nge-photodynamic. Ukwabiwa ngokungahleliwe kweziguli ezingu-75 ekwelashweni nge-photodynamic, nge-acyclovir egcotshwayo, noma ngakho kokubili akutholanga mehluko esikhathini sokuphola noma ebuhlungwini, ngokusho kwesivivinyo sango-2021 sokwelapha nge-photodynamic nange-acyclovir. Isivivinyo seziguli ezingu-24 ezabelwa ngokungahleliwe, esasebenzisa i-HSV-1 qPCR, asitholanga mehluko ekupheleni kwezilonda noma ekubuyeni kwazo phakathi konyaka owodwa, njengoba kuchazwe esivivinyweni sango-2025 esabelwe ngokungahleliwe sokwelapha i-herpes simplex nge-photodynamic elwa namagciwane. Isivivinyo sango-2025 seziguli ezingu-60 senhlanganisela yokwelapha, i-photodynamic ngodayi kanye ne-photobiomodulation kanye nokukhipha uketshezi emabhamuzaneni, sabika ukwehla okusheshayo kobuhlungu okungenakuthiwa kwadalwa udayi, ngokusho kombiko wango-2025 we-photodynamic ne-photobiomodulation okuhlanganisiwe.

Ukubikwa kwemiphumela engemihle lapha kuncane. Imibhalo yango-1975 ayinakho ukuhlolwa nokutholwa kwemiphumela ngendlela yanamuhla. Ucwaningo oluncane lwakamuva lwabika imiphumela esheshayo embalwa noma engekho, kodwa ukungcoliswa ngombala oluhlaza okwesibhakabhaka kuyingxenye yokusetshenziswa kukadayi futhi ukucasuka kwendawo ngenxa yobuthi obuvuswa ukukhanya kusengenzeka. Ukungcoliswa ngombala kanye nesibani kuhlukile ekugwinyeni udayi, yingakho umlando wokuphepha kwe-methylene blue ubheka izindlela zokuyisebenzisa ngokwehlukana.

I-EBV: abukho ubufakazi obuqondile nge-methylene blue

Nge-EBV, ukusesha akuvezi bufakazi. Akukho sivivinyo esibuyekezwe ngontanga noma isivivinyo esilawulwayo esitholwe kulokhu kubuyekeza esibonisa ukuthi i-methylene blue, inokukhanya noma ingenakho, inciphisa amandla e-EBV okuthelelana, ivimbela ukuvuka kwayo kabusha, noma yehlisa umthamo wegciwane kubantu. Ucwaningo ngamaseli omdlavuza we-nasopharyngeal ane-EBV lusebenzisa ezinye izinto ezizwela ukukhanya futhi lukala ukuphila kwamaseli esimila, hhayi ukususa igciwane nge-methylene blue. Ukubuyekezwa kubala i-EBV phakathi kwamagciwane adinga izivivinyo zesikhathi esizayo, hhayi phakathi kwezimo osekuqinisekisiwe ukuthi ziyelapheka ngayo.

Isayensi yezinto eziphilayo ichaza ukuthi kungani umphumela we-HSV eshubhini ungenakubolekwa. Ukwelapha isilonda esindebeni kubeka zonke izidingo ezintathu, udayi, umoya-mpilo, nama-photon, endaweni eyodwa efinyelelekayo. I-EBV efihlekile itholakala ikakhulukazi emaselini e-B asakazeke egazini nasezicutshini ze-lymphoid. Ukukhanya okubomvu okuqondiswe endaweni ethile akukwazi ukukhanyisa zonke lezi zindawo ezigcina igciwane, futhi udayi ogwinyiwe awulethi ukukhanya okuqondiswe kulezo zindawo. Ukubulala iseli lesimila eline-EBV ngenye into ezwela ukukhanya kuwukubulala iseli, hhayi ubufakazi bomsebenzi olwa negciwane. Leso sikhala sibalulekile lapho kufundwa ukuthi umthamo wegciwane nezimpawu zokuvuka kwalo kabusha zikalwa kanjani ngempela.

Ukwelapha ngokuyiphuza nephutha lokucabanga ngesikhathi esingenakho ukubuya kwezilonda

Akukho sivivinyo esilawulwayo kubantu esitholwe kulokhu kubuyekeza esibonisa ukuthi i-methylene blue efakwa emzimbeni wonke noma ephuzwa ngomlomo inciphisa ukubuya kwezilonda ezindebeni, ifinyeza isikhathi sokuphola, yehlisa ukukhishwa kwegciwane, noma ishintsha noma yimuphi umphumela olinganiswayo we-EBV njengamakhophi e-DNA egazini noma ematheni noma izimpawu ezichaziwe zesigaba sokuziphindaphinda esibulala amaseli. Imibhalo ye-herpes kubantu isebenzisa udayi ogcotshwayo kanye nokukhanya kwendawo. Ukufakwa emzimbeni wonke ngaphandle kokukhanyisa okuqondisiwe kuwukungenelela okuhlukile futhi kudinga esakho isivivinyo: esabelwa ngokungahleliwe, esifihla ukwabiwa kokwelashwa, nesilawulwa nge-placebo, esinezimo eziqinisekisiwe eziphindaphindayo, isikhathi sokuqala sokuthola izinga eliyisisekelo, ukuhlolwa kokuchayeka okunqunywe kusengaphambili, ukulandelela izinyanga eziyisithupha kuya kweziyishumi nambili, amasampula athathwa ngokuswayipha ngokulandelana nge-qPCR, izimbangela ezivusa izilonda ezibhalwayo, nokuqapha ukuphepha. Izimiso ezijwayelekile zomthamo ophuzwa ngomlomo nokumuncwa kwe-methylene blue azithathi indawo yaleyo miphumela olinganiswayo.

Kulapha lapho indaba evamile ihluleka khona. Umuntu uqala izindlela zokungenelela eziningana ngesikhathi esisodwa, abike ukuthi akabanga nezilonda ezindebeni izinyanga, bese encoma eyodwa yazo. Iziqephu ze-HSV ziyabuthelana bese zingabonakali izinyanga ngaphandle kokuthi igciwane liqedwe ezinqwabeni zamaseli ezinzwa zokuzwa. Izimbangela ezivusa izilonda ziyashintsha, okulindelwe kushintsha indlela yokubika, futhi ukuzifanela kwenhlanhla kukodwa kudala izikhawu. Uma kunezinguquko eziningana ezenzeka ngesikhathi esisodwa, abukho ubufakazi bokuthi bekuzokwenzekani ngaphandle kwazo obungahlobanisa leso sikhawu nengxenye eyodwa. Uchungechunge lwe-herpes yezitho zangasese lwango-1975 lwabonisa iphethini ephambene: ukuthuthuka kwesilonda esikhona kuhambisana nokungathuthuki kokuvama kokubuya kwaso. Ukupholisa lesi siqephu akuwona umqondo ofanayo nokuvimbela esilandelayo.

Ithebula lobufakazi ngokwegciwane nangesimo

Igciwane nesimo	Ukungenelela	Umphumela oyinhloko	Lokho elingenakukubonisa
Amasampula e-HSV, ngaphandle kwamaseli, 1975, n=37	Udayi ongu-10 micromolar, isibani se-fluorescent 5 min	Angu-27 enziwa angasebenzi ngokuphelele ekukhanyeni, angu-4 ancipha ngaphezu kokuphindwe izikhathi ezingu-100, amasampula okuqhathanisa agcinwe ebumnyameni awathintekanga	Ukuphola ezigulini, ukuqedwa kwegciwane elifihlekile, imithamo yabantu
Izinhlayiya ze-HSV-1 ne-HSV-2, 1979	Udayi ongu-10 micromolar, ukukhanya kwesibani sentambo eshisayo 180 s, kukhona futhi kungekho ugesi ogelezayo	Udayi nokukhanya kuphela kwehlisa cishe ngo-60 percent; ngaphezu kuka-99.99 percent kuphela lapho kwengezwe ugesi ogelezayo	Ukuthi udayi ovamile nesibani kunikeza ukubulawa kwegciwane okuphezulu kakhulu
Indlela esebenza ku-genome ye-HSV, 1980 no-1997	Udayi osezingeni eliphansi le-micromolar nokukhanya	Ukungena kwagcinwa, ukulimala komucu owodwa we-DNA, ukuziphindaphinda kwavinjwa, ukubhidlika kwahambisana nesikhathi sokukhanyisa	Ukubulawa okuqondile kwamaseli asevele ethelelekile
I-HSV ku-plasma yabantu, 2013	Udayi ongu-1 no-10 micromolar, ama-LED angu-627 nm, 60 min	Ukwehla cishe ngo-5.2 no-6.0 log	Ukwelapha ngokuyiphuza noma umphumela egciwaneni elifihlekile emaselini ezinzwa
I-eczema herpeticum, 1975, umbiko wesiguli	Ukugcoba u-0.1 percent engxenyeni yendawo kanye nokukhanya	Kwabikwa ukuthuthuka okusheshayo kwezimpawu zesiguli nezilinganiso zegciwane	Ukusebenza okujwayelekile ezilondeni ezindebeni; umthamo wokukhanyisa awukwazi ukutholwa
I-herpes yezitho zangasese, 1975, iziguli ezingu-56	Ukugcoba u-0.1 percent, ukukhanya kwe-fluorescent noma kwelanga ekhaya	Cishe u-70 percent wokuthuthuka kwezilonda ezikhona; ukubuya kwazo akunciphanga ngokuphawulekayo	Ukuvimbela ukubuya kwezilonda
I-herpes labialis, 2009, n=4	0.01 percent, 660 nm, 120 J nge-square cm, bese kuba yi-photobiomodulation	Kwabikwa ukuphola okusheshayo	Umphumela obangelwe udayi; ukubuya kwezilonda akuhunyushwanga
I-labialis ephindaphindayo, 2021, n=75	I-photodynamic engu-0.005 percent uma iqhathaniswa ne-acyclovir noma nakho kokubili	Akukho mehluko esikhathini sokuphola noma ebuhlungwini	Ukubulawa kwezinhlayiya zegciwane ngomsebenzi olwa negciwane
I-herpes simplex yomlomo, 2025, n=24	I-photodynamic elwa namagciwane uma iqhathaniswa ne-acyclovir, nge-qPCR	Akukho mehluko ekupheleni kwezilonda noma ekubuyeni kwazo phakathi konyaka owodwa	Inzuzo emzimbeni wonke noma ku-EBV
I-labialis ephindaphindayo, 2025, n=60	Inhlanganisela ye-photodynamic, i-photobiomodulation, nokukhipha uketshezi	Ukwehla okusheshayo kobuhlungu eqenjini elathola inhlanganisela	Umphumela we-methylene blue kuphela
I-EBV, kunoma yisiphi isimo kubantu	Noma iyiphi indlela yokusebenzisa i-methylene blue	Akukho cwaningo oluqondile olutholakele; akukho mphumela obonisiwe kumthamo wegciwane noma ekuvukeni kwalo kabusha	Ukubolekwa kokwenza i-HSV ingasebenzi ngokukhanya njengobufakazi be-EBV
Ukusebenzisa emzimbeni wonke noma ngomlomo ku-HSV noma ku-EBV	Udayi ophuzwa ngomlomo noma ofakwa emzimbeni wonke ngaphandle kokukhanya okuqondisiwe	Akukho sivivinyo esilawulwayo sokusebenza okulwa negciwane esitholakele	Inzuzo yezimpawu zesiguli noma yezilinganiso zegciwane

Indlela yokusebenzisa lobu bufakazi

Buza imibuzo emine ngomthombo ngamunye ocashuniwe. Ukukhanya noma ubumnyama, ngoba ukubulala nge-photodynamic akubikezeli ukubulala emzimbeni wonke. Izinhlayiya zegciwane ezikhululekile, isilonda esikhona, noma indawo egcina igciwane elifihlekile, ngoba yilokho okuqondiswe kukho okuhambisana nesimangalo kuphela okungasiphendula. Amandla okuthelelana, ukuphola, ukubuya kwezilonda, noma umthamo wegciwane, ngoba inombolo yamandla okuthelelana ayikwazi ukuphendula umbuzo wokubuya kwezilonda. I-HSV noma i-EBV, ngoba isilonda esifinyeleleka kalula nezindawo ezisakazekile zamaseli e-B ezigcina igciwane ziyizinkinga ezihlukene. Ubufakazi obukhona busekela isitatimende esisodwa esinomkhawulo: i-methylene blue ingenza i-HSV ingasebenzi ngamandla ngokukhanya lapho igciwane elingaphandle kwamaseli lihlangana nodayi, umoya-mpilo, nokukhanya okufanele. Ubufakazi bokwelapha izilonda eziphindaphindayo ngendlela ebalulekile empilweni yesiguli bunomkhawulo futhi buxubile, ubufakazi bokuvimbela ngokuyiphuza abukho, futhi ubufakazi obuqondile bomphumela olwa ne-EBV abukho. Isikhathi esizolile esingenazo izilonda ezindebeni ngesikhathi kusetshenziswa izindlela eziningi zokwelapha asishintshi lutho kulokho.