I-methylene blue ekunciphiseni amagciwane abangela izifo ku-plasma: indlela inqubo esebenza ngayo

I-methylene blue ingasiza ekunciphiseni amagciwane abangela izifo ku-plasma enikelwe uma iyingxenye yesistimu yokucubungula elawulwayo. Lokhu kwelashwa kwenzeka ngaphandle komzimba, ngaphambi kokuba i-plasma ikhishwe ukuze impontshelwe esigulini. Kuhlanganisa imishini ebekiwe, ukuchaywa kudayi, ukukhanyisa, ukuhlunga, nokuhlolwa kwengxenye yegazi etholakala ekugcineni.

Lowo mehluko unquma ukuthi ubufakazi busho ukuthini. Ucwaningo olubonisa ukuthi isistimu yokucubungula inciphisa amavayirasi akwazi ukubangela ukutheleleka esikhwameni se-plasma luqinisekisa umphumela waleyo nto naleyo nqubo. Aluqinisekisi ukuthi ukuthatha i-methylene blue kwelapha ukutheleleka kumuntu.

Umbuzo obalulekile ekunakekelweni kweziguli nawo unezinhlangothi ezimbili: inqubo iwanciphisa kangakanani amagciwane abangela izifo, futhi kungakanani ukusebenza okuwusizo kwe-plasma okusalayo?

Qala nge-plasma, hhayi ngomkhiqizo wegazi ongacacisiwe

I-plasma iyingxenye ewuketshezi yegazi equkethe amaprotheni, kuhlanganise nezici zokujiyisa igazi. Akufanele kucatshangwe ukuthi isistimu yokucubungula i-plasma ifanele igazi eliphelele, izingxenye ezinamangqamuzana abomvu egazi aminyene, noma izingxenye ezinama-platelet. Lezi zinto zihluke ngokwakheka kwazo nangemisebenzi okufanele igcinwe.

Njengesibonelo esicacile, isistimu ye-THERAFLEX MB-Plasma yakwa-Macopharma icubungula amayunithi e-plasma avela kumnikeli oyedwa. Ukulandelana kwayo okubhaliwe kuhlanganisa ukunciphisa amangqamuzana, ukufaka i-methylene blue, ukukhanyisa, ukususa udayi, nokugcina. Umkhiqizi uchaza izinhlelo ezihlukene ze-plasma etholakala egazini eliphelele kanye namaqoqo amakhulu atholakala nge-apheresis. Ngakho-ke, into okuqalwa ngayo nesethi esetshenziswa kanye bese ilahlwa kubalulekile ngaphambi kokuba ukukhanyisa kuqale.

“I-plasma ye-methylene blue” iyincazelo yengxenye ecubunguliwe, hhayi imininingwane ephelele yezidingo zayo. Ukuqhathanisa okuwusizo kubeka igama lesistimu, indlela ehlelwe ngayo, umthombo we-plasma, nenguqulo yemiyalelo yokusebenza.

Landela into ecubungulwayo phakathi nenqubo nokuhlolwa

Umdwebo ongenhla uhlukanisa izigaba. Leli thebula elihambisana nawo lichaza ukuthi isigaba ngasinye sinikela ngani nokuthi yini esingakwazi ukuyiqinisekisa sisodwa.

Ithebula liyisiqondiso sokufunda inqubo eqinisekisiwe, hhayi into ethatha indawo yenqubo yokusebenza. Ikakhulukazi, isihlungi sokususa nomthombo wokukhanya zenza imisebenzi ehlukene. I-Macopharma ichaza i-Blueflex njengenciphisa i-methylene blue nezinto ezivela kuyo, kuhlanganise nezinhlanganisela ze-azure ne-thionine. Isitatimende sokususa amakhemikhali kufanele siqondwe njengokuncipha okukaliwe, hhayi isithembiso sokuthi akukho molekhuli esalayo.

Kungani umthombo wokukhanya uyingxenye yenqubo

I-methylene blue isabela ekukhanyeni. Ukukhanyisa kungabangela umonakalo wamakhemikhali ezintweni eziphilayo okuqondiswe kuzo, yingakho le nhlanganisela icwaningiwe ukuze kwenziwe amavayirasi angasebenzi. Ocwaningweni luka-Mohr nozakwabo ngodayi be-phenothiazine nokukhanya, ukushintsha umthombo wokukhanyisa kwashintsha kokubili ukwenziwa kwamavayirasi angasebenzi nokulimala kwamaprotheni e-plasma.

Lokhu kuvimbela indlela emfushane evamile: ukuphatha igama likadayi sengathi lichaza yonke inqubo. Isibani, isikhwama, indlela ukukhanya okudlula kuyo, noma into ecubungulwayo ehlukile kungashintsha ukuchaywa. Umhlahlandlela obanzi wendlela ukwelashwa nge-methylene blue okusebenzisa ukukhanya okucwaningwa ngayo uchaza ukuthi kungani ukwakheka komkhiqizo nokukhanyisa kufanele kufakwe encazelweni efanayo.

Izinga lokushisa linikeza isibonelo esiwusizo kakhulu. Ucwaningo lwango-2018 lokucubungula nge-THERAFLEX emazingeni okushisa ahlukene lwaqhathanisa i-plasma emazingeni asondele ku-5°C, 22°C, kanye no-30°C. Ezingeni lokushisa eliphansi kakhulu, abacwaningi babona ukuthi ithebhulethi incibilika kabi kakhulu nokuthi ukwenziwa kwamavayirasi amathathu acwaningiwe angasebenzi kwakuphansi. Amazinga okushisa aphezulu andisa izinguquko esikhathini sokujiyisa igazi nokulahleka kokusebenza kwezici zokujiyisa igazi.

Lokho okutholakele akunikezi ububanzi obusha bezimo zokusebenza. Kuchaza ukuthi kungani insizakalo yegazi kufanele isebenzise izimo ezibekiwe: ukwenza umphumela owodwa ube ngcono ngokushintsha ipharamitha kungase kulimaze omunye.

Iyiphi ingxenye yesistimu eyanciphisa into ephilayo?

Ukuncipha kwamagciwane abangela izifo okukalwa ngemva kwenqubo ephelele akunakubhekwa ngokuzenzakalela njengokubangelwe udayi owenziwe wasebenza ngokukhanya kuphela.

Ocwaningweni lwango-2015 lokuhlola ukusebenza kusetshenziswa i-plasma engcoliswe ngamabomu, abacwaningi bathatha amasampula ngemva kwezigaba zokucubungula ngazinye. Ukuhlunga amangqamuzana kwabangela ingxenye enkulu yokuncipha kwamabhaktheriya. Ebhaktheriyeni elincane elithi Brevundimonas diminuta, leso sinyathelo sokuqala safinyelela ukuncipha okungu-1.7-log; ukwelashwa ngokukhanya okwalandela nokuhlunga udayi kwaletha ukuncipha okuphelele okungenani ku-3.7 logs, ngaphansi komkhawulo wokuthola wokuhlolwa.

Lona ngumผลumela wesistimu ehlanganisiwe. Awubonisi ukuthi isixazululo esivamile se-methylene blue senza amabhaktheriya anciphe ngendlela efanayo. Lo mehluko uyasebenza nalapho kufundwa ucwaningo olubanzi lwe-methylene blue lokulwa namagciwane.

Ukuncipha kwe-log kuchaza isilinganiso phakathi kwenani elikaliwe ekuqaleni lenzinto ezikwazi ukubangela ukutheleleka nenani elisele. Ukuncipha kwama-log amathathu kuwukuncipha okuphindwe ngenkulungwane. “Ngaphansi komkhawulo wokuthola” kusho ukuthi ukuhlolwa akukwazanga ukukala inani lalokho okusele ngaphansi kwezimo zako zokuhlola. Akubona ubufakazi bokungabi namagciwane nhlobo noma bokusebenza kuzo zonke izinto eziphilayo ezingahloliwe. Uhlobo lwevayirasi, inani elikhona ekuqaleni, ukwakheka kwesampula, nokuzwela kokuhlolwa kuseyizingxenye ezidingekayo zesitatimende.

Gcina ukusebenza i-plasma ezosetshenziselwa kona

Inqubo inganciphisa amandla okubangela ukutheleleka ngesikhathi ishintsha amaprotheni abalulekile ekunakekelweni kweziguli. Ngakho-ke, ukukala ukuncipha kwamagciwane abangela izifo kuphela kushiya ukuhlola kungaphelele.

Ekuqhathaniseni kwango-2014 kwemithombo ye-plasma nezikhathi zokucubungula, ukugcinwa kwe-factor VIII ngemva kokwelashwa nge-methylene blue kwakusukela ku-78% kuya ku-89% ochungechungeni locwaningo. Ukugcinwa kwakuncike emthonjeni we-plasma, futhi abacwaningi bahlola ne-fibrinogen. Lezi yizilinganiso zaselabhorethri ezenziwa engxenyeni ecubunguliwe. Aziwona amaphesenti okusebenza kokwelashwa ezigulini.

Cabanga ngamayunithi amabili e-plasma anamazingana ahlukene ezici zokujiyisa igazi ekuqaleni. Ngisho noma egcina ingxenye efanayo yokusebenza ngesikhathi sokwelashwa, amazinga awo okugcina azohluka. Ngokuphambene nalokho, iphesenti eliphezulu lokugcinwa akusho ngempela ukuthi ukugcwala kokugcina kuzoba phezulu. Funda kokubili izilinganiso zangaphambi nangemva kwenqubo kanye nezidingo ezisebenzayo zokukhulula umkhiqizo.

Imiphumela ezigulini idinga olunye uhlobo lobufakazi. Ucwaningo lwekhwalithi yengxenye alukwazi, lulodwa, ukuqinisekisa ukulingana kokulawulwa kokopha, kwezidingo zokumpontshelwa igazi, noma kwamazinga ezehlakalo ezingathandeki eqenjini elithile leziguli.

Hlukanisa ubufakazi bokucubungula nezitatimende zokwelapha

Isikhwama se-plasma senza ukuchaywa okulawulwayo kwenzeke: sinomthamo, ukwakheka, nokulandelana kokucubungula okubekiwe, kanye nomphumela ongakalwa. Umuntu unezicubu, ukujikeleza kwegazi, ukuguqulwa kwezinto emzimbeni, nezindawo zokutheleleka lokhu kuhlola okungazilingisi.

Ngenxa yalokho, izitatimende zokwelapha i-HIV uma ziqhathaniswa nobufakazi bokwenza amavayirasi angasebenzi ku-plasma kanye nobufakazi be-methylene blue nge-COVID-19 ne-COVID ehlala isikhathi eside kudinga ukuhlolwa kwakho okuhlukile kwezokwelashwa. Awukho kule mibuzo ophendulwa ngokubonisa ukuncipha kwamandla okubangela ukutheleleka ezintweni ezinikelwe.

Uma kuzosetshenziswa ezinsizakalweni zegazi, hlola ingxenye eqondile nesistimu evunyelwe endaweni, ukuqinisekiswa kwayo okuqondene nohlobo ngalunye lwento ephilayo, ukusebenza kwamaprotheni okugcinwayo, amakhemikhali asele, nezilawuli zokukhulula umkhiqizo. Ukutholakala komkhiqizo kuyahluka ngezwe, njengoba umkhiqizi esho. Ukusetshenziswa esikhathini esedlule noma ukuhlola okuphumelele akuqinisekisi imvume yamanje kuyo yonke indawo. Iyunithi ewusizo yobufakazi yinqubo ephelele eqinisekisiwe esetshenziswa engxenyeni yayo ye-plasma ebekiwe.