PEGylated interferons yog synthesized los ntawm cov pa ib txwm los ntawm kev hloov kho lawv. Cov khoom uas tau tshwm sim tau txhim kho cov yam ntxwv uas siv rau hauv kev kho mob ntawm cov kab mob viral (feem ntau yog kab mob siab). Muaj 2 yam tseem ceeb ntawm cov tshuaj no. Feem ntau lawv tau siv ua ke nrog Ribavirin thiab NS3/4A protease inhibitor.
Txoj kev xav
PEGylated interferons yog cov tshuaj tiv thaiv kab mob uas cuam tshuam rau tib neeg lub cev tiv thaiv kab mob. Lawv lwm lub npe yog peginterferons, peg-INF. Lub prefix "peg" los ntawm ib tug luv luv version ntawm "polyethylene glycol". Nws cov molecules tau nkag mus rau hauv cov muaj pes tsawg leeg ntawm cov pa interferon txhawm rau txhawm rau ua kom lub sijhawm ua haujlwm ntawm cov tshuaj nquag hauv lub cev.
Pegylated interferon npaj muaj qhov zoo hauv qab no ntawm lawv cov kev hloov kho tus qauv:
- zoo heev (clinically proven);
- muaj peev xwm txo tus naj npawb ntawm kev txhaj tshuaj(vim ncua ib nrab neej);
- siab ruaj khov ntawm cov khoom nquag;
- tsawg dua cov kev mob tshwm sim (kev tsis haum tshuaj thiab cov txheej txheem tiv thaiv kab mob tsis zoo).
Lub tshuab pegylation tau piav qhia thawj zaug hauv xyoo 1977. Ua ntej qhov no, nws tau ntseeg tias cov proteins tsuas tuaj yeem koom ua ke rau hauv cov qauv ntawm cov khoom hnyav molecular. Nyob rau tib lub sijhawm, qhov hnyav molecular hnyav ntawm hloov pauv interferons ua rau lub ntsiab tsis zoo ntawm cov tshuaj no - nyuaj excretion los ntawm lub cev. Excretion feem ntau tshwm sim los ntawm ob lub raum thiab nrog quav.
Polydispersity (kev sib xyaw ntawm cov molecules sib txawv ntawm qhov sib txawv ntawm qhov sib txawv ntawm qhov sib txawv ntawm qhov sib txawv ntawm polyethylene glycol txuas) thiab qhov ntim loj ntawm kev faib tawm hauv lub cev cuam tshuam qhov pom ntawm cov khoom hauv lub raum. Nyob rau hauv no hais txog, kev cog lus cov kev taw qhia nyob rau hauv cov cuab yeej ntawm cov tshuaj no yog kev txhim kho cov txheej txheem pegylation. Keeb kwm ntawm kev siv cov hloov pauv interferons hauv cov tshuaj muaj txog 10 xyoo.
Views
Cov tshuaj hauv qab no ntawm pab pawg no yog siv hauv kev kho mob:
- 2 hom kev hloov pauv alpha (pegylated interferon alpha-2a thiab 2b). Cov txhais tau tias ua los ntawm lawv lub hauv paus yog tus cwj pwm los ntawm cov qauv tshuaj sib txawv. Tsis muaj qhov sib txawv ntawm lawv. Pegylated interferon alpha muaj qhov hnyav dua molecular (kwv yees 40 kDa) dua li hom thib ob. Yog li ntawd, nws yog tus cwj pwm los ntawm kev ua haujlwm ntev dua.
- Beta peg-INF. Tsimpegylated interferon beta tshuaj yog ib tiam tshiab ntawm cov tshuaj. Lawv siv los kho ntau yam sclerosis. Cov tshuaj no tau txais los ntawm biotechnology ntawm recombinant proteins zus nyob rau hauv cell kab lis kev cai, uas yog cais los ntawm lub zes qe menyuam ntawm hamsters. Lub ntsiab mechanism ntawm cov nyhuv ntawm cov active tshuaj yog tsis paub. Nws koom nrog kev txhawb nqa ntawm kev tiv thaiv kab mob thiab kev tawm tsam ntawm pro-inflammatory polypeptide tub txib molecules.
Raws li kev tshawb fawb kho mob tshiab, qhov zoo tshaj plaws tshuaj tiv thaiv kab mob tau pom los ntawm kev tswj hwm kev sib koom ua ke ntawm ob qho tib si alpha-interferons, nrog rau kev tswj hwm ib txhij ntawm cov tshuaj "Ribavirin".
Daim ntawv tso tawm thiab khaws cia
Pegylated interferons alpha 2b thiab 2a raug muag ntawm Lavxias teb sab chaw lag luam raws li ib feem ntawm 4 tshuaj:
- "Pegasis" (tsim los ntawm Roche, Switzerland). Kev daws rau kev tswj hwm subcutaneous, ntshiab lossis lub teeb daj. Nws yog tsim nyob rau hauv daim ntawv tiav nyob rau hauv syringes-tubes ntawm 180 (135) mcg. Lub pob muaj 1 lossis 4 syringes.
- "Pegintron" (kev lag luam kws tshuaj Schering-Plough, Tebchaws Asmeskas). Nws yog tsim nyob rau hauv daim ntawv ntawm ob-chamber syringe cwj mem, nyob rau hauv ib tug compartment muaj ib tug qhuav lyophilisate, nyob rau hauv lub thib ob - ib tug hnyav.
- "PegAltevir" ("BioProcess", Russia). Lub pob muaj 2 lub raj mis - ib qho nrog cov tshuaj nquag hauv daim ntawv ntawm cov hmoov dawb, qhov thib ob nrog cov kuab tshuaj.
- "Algeron" (tsim los ntawm lub tuam txhab tshiab thoob ntiaj teb "Biocad"). Cov tshuaj tsis muaj xim los yog yellowish. Lub pob muaj 1 lossis 4 syringes.
Txhua yam tshuajyuav tsum tau khaws cia thiab thauj mus rau hauv qhov chaw tsaus ntawm qhov kub ntawm +2 … +8 ° C. Lub neej txee ntawm thawj peb cov tshuaj los ntawm cov npe saum toj no yog 3 xyoos, qhov kawg yog 2 xyoos.
Properties
Cov khoom tseem ceeb ntawm pegylated interferons yog raws li hauv qab no:
- kev tawm tsam ntawm cov haujlwm tseem ceeb thiab kev tsim tawm ntawm cov kab mob tshwm sim vim muaj kev cuam tshuam ntawm cov txheej txheem ntawm kev hloov pauv ntawm lawv cov noob;
- cov tshuaj nquag muaj nyob hauv tib neeg cov ntshav tom qab 3-6 teev, thiab nws qib siab tshaj plaws tau mus txog hnub 3-4;
- qeeb zuj zus hauv cov ntshav siab vim yog kev tso tawm cov tshuaj tsis tu ncua;
- cov khoom nquag nquag khaws cia hauv cov ntshav thiab hauv lub siab ua haujlwm;
- ib nrab-lub neej yog 80 thiab 160 teev raws li kev txhaj tshuaj hauv cov hlab ntsha thiab subcutaneous (rau tus qauv interferon - 4 teev);
- peginterferon-alpha 2b molecules me dua, yog li lawv nquag nkag mus rau hauv cov ntshav peripheral, lymph nodes, ob lub raum thiab lwm yam kabmob;
- Excretion feem ntau yog los ntawm ob lub raum.
Vim qhov nce ib nrab-lub neej ntawm cov tshuaj no hauv tib neeg lub cev, tus naj npawb ntawm kev txhaj tshuaj tsim nyog hauv ib lub lis piam raug txo qis - los ntawm 3 (rau tus qauv interferon) mus rau 1 (rau kev hloov pauv pegylated). Nyob rau tib lub sij hawm, ib tug loj tus naj npawb ntawm bound molecules txo cov roj ntsha kev ua si ntawm cov khoom. Yog li, hauv peg-INF alpha 2b, nws yog nyob rau theem ntawm 37% ntawm tus qauv uas tsis yog pegylated interferon, thiabHloov kho alpha 2a muaj 7%.
Composition
Cov tshuaj muaj pes tsawg leeg raws li peg-interferons muaj nyob hauv cov lus hauv qab no.
| Drug name | tshuaj muaj zog | Cov khoom ntxiv |
| Pegsis | Peginterferon alfa-2a | Ascorbic acid, acetic acid, sodium chloride, hnyav - dej, phenylcarbinol, sodium acetate, polysorbate-80 emulsifier |
| Algeron | Peginterferon alfa-2b | Sodium acetate trihydrate, acetic acid, disodium edetate, sodium chloride, polysorbate-80, dej |
| PegAltevir, Pegintron | Peginterferon alfa-2b | Sodium Phosphate, Sucrose, Polysorbate-80, Dej |
YPegylated interferons: indications
Peginterferons alfa raug pom zoo hauv kev kho kab mob siab:
- hom B - nrog rau qhov zoo thiab qhov tsis zoo ntawm kab mob siab B anti-HBe antigen, nrog nce qib ntawm cov enzyme alanine aminotransferase hauv cov ntshav, nrog o, fibrosis thiab lwm yam kab mob siab;
- hom C - rau cov neeg mob uas muaj lossis tsis muaj cirrhosis, muaj kab mob HIV.
Tshuaj siv tau ob qho tib si hauv kev kho mob monotherapy thiab ua ke nrog ib leeg thiab lwm yam tshuaj tiv thaiv kab mob.
Daim ntawv thov nta
Kev kho mob nrog pegylated interferons yog tus yam ntxwv ntawm cov hauv qab no:
- "Pegasis" - txhaj tshuaj rau hauv tus ncej puab lossis plab 1 zaug hauv 7 hnub. Duration ntawm kev kho mob - 48 lub lis piam.
- "Algeron", "PegAltevir" - txhaj tshuaj subcutaneous rau hauv ncej puab lossis phab ntsa plab. Qhov chaw txhaj tshuaj yuav tsum tau hloov. Kev txhaj tshuaj yog ua tiav ib zaug ib lub lim tiam, nws raug nquahu kom txhaj tshuaj thaum mus pw. Lub sijhawm ntawm kev kho mob yog tib yam li kev kho mob yav dhau los. Thaum tsis muaj qhov tshwm sim ntawm tus kab mob thaum ntxov (EVR) tom qab 12 lub lis piam lossis kuaj pom tus kab mob RNA tom qab 24 lub lis piam, kev kho mob nres. Txhua tus kab mob genotype muaj nws tus kheej txoj kev kho mob.
- "Pegintron" - txhaj tshuaj subcutaneously, lub sijhawm kho - 24-52 lub lis piam thiab 6 lub hlis rau kab mob siab B thiab C, raws li. Txhawm rau txo qhov mob, qhov chaw txhaj tshuaj hloov pauv. Yog tias, tom qab kev kho RNA, tus kab mob tseem pom, tom qab ntawd kev kho mob txuas ntxiv rau rau lub hlis. Thaum kuaj pom tus kab mob dua, nws nres.
Cov tshuaj noj yog ua raws li cov lus qhia. Nws suav nrog qhov hnyav ntawm tus neeg mob thiab kev kho mob - ob npaug (nrog Ribavirin), triple (nrog Ribavirin thiab NS3 / 4A protease inhibitor) lossis monotherapy. Ribavirin noj txhua hnub nrog zaub mov. Cov tshuaj tsuas yog siv raws li kws kho mob tau sau tseg thiab nyob rau hauv nws kev saib xyuas.
YContraindications
Pegylated interferon therapy tsis muaj nyob rau hauv cov xwm txheej hauv qab no:
- cev xeeb tub thiab lactation (vim tsis muaj kev tshawb fawb txog kev tshem tawm cov tshuaj nquag hauv cov mis nyuj thiab lawv cov txiaj ntsig ntawm tus menyuam hauv plab);
- hypersensitivity rau tshuaj tivthaiv;
- decompensated cirrhosis ntawm daim siab;
- autoimmune kab mob siab;
- ntshav qab zib mellitus nyob rau theem ntawm decompensation;
- hnub nyoog txog 18 xyoo (rau triple thiab monotherapy) thiab mus txog 3 xyoos (rau kev kho dual);
- pathology ntawm cov thyroid caj pas (tsis muaj peev xwm thiab ntau dhau ntawm nws cov tshuaj hormones).
Nrog ceev faj, cov tshuaj no tau muab rau cov neeg mob uas muaj kev puas siab puas ntsws, kab mob ntawm lub raum, kab mob plawv, autoimmune pathologies thiab thaum noj cov tshuaj uas muaj cov nyhuv myelotoxic (txo cov kev ua haujlwm hematopoietic ntawm cov pob txha).
Side effects
Cov kev mob tshwm sim feem ntau (cuam tshuam 20-30% ntawm cov neeg mob) nrog cov tshuaj no yog:
- kev qaug zog;
- nce lub cev kub;
- mob taub hau;
- pw tsis tsaug zog;
- chim siab;
- kev nyuaj siab.
Nyob rau hauv 10-14% ntawm cov neeg mob, tshuaj tsis siv vim lawv intolerance.
Lwm cov kev mob tshwm sim muaj xws li hauv qab no:
- neutropenia (tus mob ua rau muaj kev phom sij rau lub neej uas cov neutrophils hauv cov ntshav txo qis);
- xeev siab, ntuav;
- mob plab;
- mob pob qij txha;
- tawv nqaij khaus;
- hair poob;
- ncentshav siab;
- tachycardia;
- stunting thiab kev loj hlob ntawm cov menyuam yaus thiab cov tub ntxhais hluas;
- mob hlwb hnyav (kev xav tua tus kheej, mania, kev puas siab puas ntsws bipolar thiab lwm yam).
