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Photodynamic Far don Ciwon daji
Menene maganin farfadowa na photodynamic?
Photodynamic therapy (PDT) magani ne wanda yake amfani da magani, wanda ake kira mai daukar hoto ko wakili na sanya hotuna, da wani nau'in haske. Lokacin da masu daukar hoto suka fallasa zuwa takamaiman tsawon nisan haske, sai su samar da wani nau'in oxygen wanda yake kashe kwayoyin dake kusa (1 ?? 3).
Kowane mai daukar hoto yana aiki ta hasken takamaiman tsayin (3, 4). Wannan tsayin yana nisan yadda haske zai iya tafiya zuwa cikin jiki (3, 5). Don haka, likitoci suna amfani da takamaiman hotunan hotuna da ƙarfin haske don magance wurare daban-daban na jiki tare da PDT.
Yaya ake amfani da PDT don magance ciwon daji?
A mataki na farko na PDT don maganin ciwon daji, ana allurar wakili mai sanya hotuna a cikin jini. Kwayoyin suna ɗauke da wakili a jiki duka amma ya zauna a cikin ƙwayoyin cutar kansa fiye da yadda yake a cikin ƙwayoyin al'ada. Kimanin awanni 24 zuwa 72 bayan allura (1), lokacin da akasarin wakili ya bar ƙwayoyin al'ada amma ya kasance cikin ƙwayoyin kansa, ƙari ya bayyana ga haske. Fotensenser a cikin kumburin yana ɗaukar haske kuma yana samar da wani nau'in oxygen wanda ke lalata ƙwayoyin kansa na kusa (1 ?? 3).
Baya ga kashe kwayoyin cutar kansa kai tsaye, PDT ya bayyana yana raguwa ko lalata ciwace-ciwace a cikin wasu hanyoyi biyu (1 ?? 4). Mai daukar hoton zai iya lalata jijiyoyin jini a cikin kumburin, don haka hana cutar kansa karɓar abubuwan gina jiki da suka dace. PDT kuma na iya kunna tsarin rigakafi don afkawa ƙwayoyin tumo.
Hasken da aka yi amfani da shi don PDT na iya zuwa daga laser ko wasu tushe (2, 5). Ana iya jagorantar hasken laser ta wayoyin kebul na fiber (ƙananan siraran da ke watsa haske) don isar da haske zuwa yankunan da ke cikin jiki (2). Misali, ana iya saka kebul na fiber optic ta hanyar na'urar kare jijiyoyin jiki (na bakin ciki, bututu mai haske wanda ake amfani da shi don duba kyallen takarda a cikin jiki) a cikin huhu ko esophagus don magance cutar daji a cikin waɗannan gabobin. Sauran hanyoyin samun haske sun hada da diodes masu bada haske (LEDs), wadanda za'a iya amfani dasu don ciwace ciwan jiki, kamar kansar fata (5).
PDT yawanci ana yin shi azaman hanyar marasa lafiya (6). Hakanan za'a iya maimaita PDT kuma ana iya amfani dashi tare da wasu hanyoyin kwantar da hankali, kamar su tiyata, radiation radiation, ko chemotherapy (2).
Extracorporeal photopheresis (ECP) wani nau'i ne na PDT wanda ake amfani da inji don tattara ƙwayoyin jinin marasa lafiya, yi musu magani a waje da jiki tare da wakili mai sanya hotuna, a fallasa su zuwa haske, sannan a mayar dasu ga mai haƙuri. Hukumar Abinci da Magunguna ta Amurka (FDA) ta amince da ECP don taimakawa rage ƙarancin alamun bayyanar cututtukan fata na cututtukan T-cell wanda ba a amsa wasu hanyoyin ba. Ana ci gaba da karatu don tantance ko ECP na iya samun wasu aikace-aikace na sauran cututtukan jini, da kuma taimakawa rage ƙin yarda bayan dasawa.
Waɗanne nau'ikan cutar kansa ake kulawa da PDT a halin yanzu?
Zuwa yau, FDA ta amince da wakili na sanya hotuna wanda ake kira porfimer sodium, ko Photofrin®, don amfani da shi a cikin PDT don magance ko sauƙaƙa alamun cutar sankarar hanji da ƙananan ƙwayoyin cuta na huhu. An yarda da sinadarin Porfimer sodium don taimakawa bayyanar cututtukan cututtukan hanji lokacin da ciwon kansa ya toshe hanta ko kuma lokacin da ba za a iya magance kansa ta hanyar gamsarwa ba tare da maganin laser shi kaɗai. Ana amfani da sinadarin sodium na Porfimer don magance ƙananan ƙananan ƙwayoyin huhu a cikin marasa lafiya waɗanda magungunan da aka saba basu dace da su ba, da kuma sauƙaƙa alamomin marasa lafiya tare da ƙananan ƙwayar cutar huhu wanda ke toshe hanyoyin iska. A cikin 2003, FDA ta amince da sinadarin sodium don magance cututtukan da suka shafi marasa lafiya da ke da cutar Barrett, yanayin da zai iya haifar da cutar kansa.
Menene iyakokin PDT?
Hasken da ake buƙata don kunna yawancin masu daukar hoto ba zai iya wucewa sama da kashi ɗaya cikin uku na inci na nama (santimita 1). Saboda wannan, PDT yawanci ana amfani dashi don magance ƙari a kan ko kawai ƙarƙashin fata ko kan rufin gabobin ciki ko kogo (3). PDT shima ba shi da tasiri sosai wajen magance manyan ciwace-ciwacen, saboda hasken ba zai iya wucewa zuwa cikin waɗannan marurai ba (2, 3, 6). PDT magani ne na cikin gida kuma gabaɗaya ba za'a iya amfani dashi don magance ciwon daji wanda ya bazu ba (ƙaddarawa) (6).
Shin PDT yana da wata matsala ko illa?
Sodium na Porfimer yana sanya fata da idanu masu saurin haske kusan makonni 6 bayan jiyya (1, 3, 6). Don haka, ana ba marasa lafiya shawarar su guji hasken rana kai tsaye da kuma hasken cikin gida mai ƙarancin aƙalla makonni 6.
Photoensitizers sukan haɓaka a cikin ciwace-ciwace kuma hasken kunnawa yana mai da hankali akan ƙari. A sakamakon haka, lahani ga lafiyayyen nama bai da yawa. Koyaya, PDT na iya haifar da ƙonewa, kumburi, zafi, da tabo a cikin lafiyayyun nama kusa (3). Sauran illolin PDT suna da alaƙa da yankin da aka kula da shi. Suna iya haɗawa da tari, matsalar haɗiye, ciwon ciki, numfashi mai zafi, ko ƙarancin numfashi; wadannan illoli suna yawanci na ɗan lokaci.
Menene makomar PDT?
Masu bincike suna ci gaba da nazarin hanyoyin don inganta tasirin PDT da faɗaɗa shi zuwa wasu cututtukan kansa. Gwajin asibiti (binciken bincike) suna kan hanya don kimanta amfani da PDT don cutar kansa na ƙwaƙwalwa, fata, prostate, cervix, da rami ta jiki (sararin samaniya wanda ke ɗauke da hanji, ciki, da hanta). Sauran binciken suna mai da hankali kan ci gaban masu daukar hotuna wadanda suka fi karfi (1), wadanda suka fi mayar da hankali kan kwayoyin cutar kansa (1, 3, 5), kuma ana kunna su ta hanyar haske wanda zai iya shiga cikin nama kuma ya kula da ciwan mai zurfi ko babba (2). Masu binciken suna kuma bincika hanyoyin inganta kayan aiki (1) da kuma isar da hasken kunnawa (5).
Zaɓaɓɓun Nassoshi
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- Wilson BC. Photodynamic far don ciwon daji: ka'idoji. Jaridar Kanada ta Gastroenterology 2002; 16 (6): 393–396. [Abun da aka buga PubMed]
- Vrouenraets MB, Visser GW, Snow GB, van Dongen GA. Mahimman ka'idoji, aikace-aikace a cikin ilimin ilimin halittar jiki da ingantaccen zaɓi na maganin photodynamic. Binciken Anticancer 2003; 23 (1B): 505-522. [Abun da aka buga PubMed]
- Dougherty TJ, Gomer CJ, Henderson BW, et al. Photodynamic far. Jaridar Cibiyar Cancer ta Kasa ta 1998; 90 (12): 889–905. [Abun da aka buga PubMed]
- Gudgin Dickson EF, Goyan RL, Pottier RH. Sabbin hanyoyi a cikin maganin hoto. Kwayar salon salula da kwayoyin halitta 2002; 48 (8): 939–954. [Abun da aka buga PubMed]
- Capella MA, Capella LS. Haske cikin juriya da magunguna da yawa: maganin photodynamic na ciwace-ciwace da ke jure magunguna da yawa. Jaridar Kimiyyar Biomedical 2003; 10 (4): 361-366. [Abun da aka buga PubMed]
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