Cutar Alzheimer ta kasance ɗaya daga cikin manyan ƙalubalen lafiya na ƙarni na 21. Tare da mutane sama da miliyan 57 da suka kamu da cutar a duk duniya kuma hasashen da ke nuna cewa mutane miliyan 139 nan da shekarar 2050, al'ummar kimiyya da tsarin kiwon lafiya suna neman kayan aiki don gano cutar da magani da wuri don rage ci gabanta. A wannan mahallin, ci gaba a cikin alamun cutar da abubuwan haɗari suna mamaye labarai, amma kuma suna haifar da muhawara mai zafi game da samun damar shiga gare su daidai gwargwado.
A ƙasar Spain, shawarar da Ma'aikatar Lafiya ta yanke kwanan nan na cire magungunan lecanemab (Leqembi) da donanemab (Kisunla), magungunan farko da aka nuna suna rage ci gaban cutar Alzheimer, daga tallafin gwamnati ya haifar da rashin jituwa tsakanin gwamnati da manyan ƙungiyoyin marasa lafiya da ƙwararru. A halin yanzu, bincike yana ci gaba da sauri: daga gwaje-gwajen jini waɗanda ke gano cutar da daidaito sama da kashi 90% zuwa ƙananan ƙwayoyin cuta waɗanda ke iya sake farfaɗo da ƙwayoyin jijiyoyi a cikin samfuran dabbobi. Duk wannan yana faruwa ne a cikin mahallin da kyamar zamantakewa ta kasance cikas ga ganewar asali da wuri.
Gwaje-gwajen jini: juyin juya halin da aka samu a farkon ganewar asali
Tabbatar da cutar Alzheimer ta hanyar gargajiya ta dogara ne akan hanyoyi masu haɗari ko masu tsada, kamar su hudawar lumbar ko hotunan positron emission tomography (PET). Duk da haka, gwaje-gwajen jini na biomarker suna canza wasan . Kwanan nan Hukumar Abinci da Magunguna ta Amurka (FDA) ta ba da izinin gwajin Elecsys pTau217, wanda Roche da Eli Lilly suka haɓaka, wanda ke auna furotin p-tau217 kuma yana annabta taruwar plaques na beta-amyloid a cikin kwakwalwa daidai. Wannan gwajin, wanda aka riga aka amince da shi a Turai a watan Mayu, zai kasance a kan na'urorin nazarin dakin gwaje-gwaje sama da 4.500 a Amurka, wanda hakan ke faɗaɗa damar samun kimantawa mara tsauri.
Amma wannan sabuwar dabarar ba ta tsaya a nan ba. Wata ƙungiyar masu bincike a Asibitin Xuanwu na Jami'ar Kiwon Lafiya ta Beijing Capital ta ƙirƙiro wata hanyar bincike ta jini wadda ke amfani da na'urar duban dan tayi mai sarrafa furotin (PMCA) a ainihin lokaci don gano aikin shukar beta-amyloid a cikin jini. Sakamakon, wanda aka buga a cikin Mujallar Kiwon Lafiya ta China, ya nuna daidaiton ganewar asali ya wuce kashi 90% a cikin ƙungiyar tabbatarwa, wanda ya haɗa da mahalarta 429. Wannan dabarar, wacce ke kammala ganowa cikin awanni 24, za ta iya gano oligomers na Aβ a cikin yawan da bai kai 1 femtomol ba, wanda hakan ya sa ta zama kayan aiki mai kyau don tantance cutar Alzheimer ta farko ta amfani da alamun cutar a cikin kulawa ta farko.
Yana da mahimmanci a lura cewa waɗannan gwaje-gwajen jini ba gwaje-gwajen ganewar asali ba ne kawai. Kamar yadda dakin gwaje-gwajen da suka samar da Elecsys pTau217 suka yi gargaɗi, sakamako mai kyau yana nuna babban yuwuwar kamuwa da cutar amyloid, amma ba ya kafa ganewar asali da kansa ba tare da cikakken kimantawa na asibiti ba . Dole ne a yi fassarar tare da wasu bayanan asibiti, kuma akwai yuwuwar samun sakamako na ƙarya ko sakamako mara tabbas. Duk da haka, sauƙin waɗannan gwaje-gwajen, kamar amfani da digo ɗaya na jini don ci gaba da ganewar asali , zai taimaka wa marasa lafiya da iyalai su tabbatar ko kawar da cutar Alzheimer a farkon matakai, lokacin da hanyoyin magancewa za su iya zama mafi tasiri.
Spain, a tsakiyar muhawara kan samun damar yin magani
Shawarar da Hukumar Kula da Farashin Magunguna (CIPM) ta yanke a ranar 15 ga Yuli na cire lecanemab da donanemab daga cikin tsarin kula da lafiyar jama'a na Tsarin Lafiya na Ƙasa (SNS) ta haifar da martani mai ƙarfi. Ƙungiyar Kula da Jijiyoyin Jijiyoyi ta Spain (SEN), Ƙungiyar Kula da Alzheimer da Sauran Hawan Jini ta Spain (Ceafa), da Cibiyar Alzheimer ta Barcelona sun yi imanin cewa wannan keɓewa ya karya ƙa'idar daidaito a cikin NHS kuma yana barin marasa lafiya su yi watsi da su . Shugaban SEN, Jesús Porta-Etessam, ya yi gargaɗin cewa ana hana mutanen da za su iya fuskantar raguwar ci gaban cutar samun magani da Hukumar Magunguna ta Turai (EMA) ta amince da shi.
Rikicin yana da wani ɓangare na ɗabi'a da ba za a iya mantawa da shi ba. Masana ilimin jijiyoyi na iya haɗuwa da marasa lafiya waɗanda suka cika sharuɗɗan karɓar magani wanda zai iya rage cutar, amma waɗanda ba za su iya samun ta ba saboda dalilai na tattalin arziki idan dole ne su koma ga kamfanoni masu zaman kansu. Takaita damar shiga ga waɗanda za su iya samunta yana haifar da shingen tattalin arziki wanda ya karya ƙa'idar daidaito , in ji Porta-Etessam. A nasa ɓangaren, babban darektan Ceafa, Jesús María Rodrigo, ya kira shawarar "ba ta da tushe" kuma ya nuna cewa waɗannan magunguna suna samuwa a cikin ƙasashe sama da hamsin da kuma tsarin kula da lafiya na masu zaman kansu na Spain. "Ba za ku iya sanya farashi kan kirkire-kirkire ba," in ji shi.
Kwararru ba sa ba da shawarar haɗa waɗannan magungunan ba tare da wani sharaɗi ba a cikin tsarin kula da lafiyar jama'a, a'a, samun damar shiga cikin tsari da tsari wanda zai ba da damar tsarin ya daidaita zuwa wani sabon mataki a cikin maganin Alzheimer. Gudanar da waɗannan magungunan yana buƙatar gano cutar a farkon matakanta, tabbatar da ganewar cutar ta hanyar alamun cutar, da kuma kafa wani bibiya na musamman , wanda zai ba da hujjar tsarin samun damar shiga cikin lokaci. Cibiyar Alzheimer's ta Barcelona ta aika wa Ma'aikatar Lafiya wasiƙa a buɗe tana neman dabarar haɗa waɗannan magungunan cikin tsarin jama'a, tana mai gargaɗin cewa "Spain ba za ta iya rasa wannan damar ba."
Binciken da aka yi kwanan nan: ƙwayoyin nano da kuma maganadisu
Yayin da ake ci gaba da muhawara kan kuɗaɗen tallafi, kimiyya tana binciken sabbin hanyoyi. Wani bincike da aka buga a mujallar Cell Biomaterials ya nuna cewa ƙwayoyin nanoparticles da aka ƙera na iya sake farfaɗo da ƙwayoyin jijiyoyi a cikin ƙwayoyin kwakwalwa na ɗan adam da kuma dawo da da'irar jijiyoyi a cikin beraye . Tsarin Nano-ERASER, wanda Jami'ar South Carolina ta ƙirƙiro, yana amfani da ƙwayoyin rigakafi don lalata furotin PTBP1 a cikin ƙwayoyin astrocytes, wanda ke sa su zama ƙwayoyin jijiyoyi masu aiki. Bayan allurai biyu kacal, beraye da aka yi wa magani sun nuna ƙaruwar yawan ƙwayoyin jijiyoyi, raguwar kumburin jijiyoyi, da kuma ci gaba mai mahimmanci a koyo da ƙwaƙwalwa.
A wani bincike kuma, masana kimiyya a Cibiyar Nazarin Jiki ta Mass General Brigham sun gano cewa yanayin lalacewar kwakwalwa da ake gani a kan na'urar MRI na iya hasashen yadda cutar Alzheimer ke ci gaba da sauri da wuri . Binciken, wanda aka buga a cikin Neurology, ya yi nazari kan bayanai daga mutane 130 tsakanin shekaru 40 zuwa 64 tare da ɗan raunin fahimta. A lokacin bin diddigin shekaru biyu, kashi 65% sun ci gaba zuwa cutar hauka, kuma waɗanda ke da babban rauni a fannonin da ke da alhakin ƙwaƙwalwa da tunani sun fi kamuwa da cutar hauka da wuri. Wannan bayanin zai iya taimaka wa marasa lafiya, iyalai, da likitoci su tsara yadda za a kula da su da kuma gidaje a nan gaba.
Bugu da ƙari, wani bincike da mai bincike Teodora Markova ta Jami'ar Brandeis ta jagoranta ya nuna cewa ƙaruwar matakan furotin na tau yana da alaƙa da ƙaruwar raguwar yanayi yayin tsufa . Binciken, wanda aka buga a cikin JNeurosci, ya lura cewa yawan tarin tau a cikin kwakwalwa yana daidaita yadda yanayin mahalarta ke ta'azzara cikin sauri, har ma a cikin mutanen da ke da ƙwarewar fahimta. Waɗannan binciken sun nuna cewa sa ido kan hanyoyin tunani na iya ƙara wasu matakan likita wajen tantance haɗarin kamuwa da cututtukan jijiyoyi.
Dalilin ɗan adam: karya ƙyama
A tsakiyar ci gaban kimiyya da muhawarar siyasa, labarin ɗan wasan kwaikwayo ɗan Birtaniya mai shekaru 85, Peter Marinker, ya ba da darasi game da ɗan adam da juriya. An gano yana da cutar Alzheimer shekaru biyu da suka gabata, Marinker yana shirin yin wasan kwaikwayo mai ƙarfi na Samuel Beckett mai suna "Krapp's Last Tape" a gidan wasan kwaikwayo na Cockpit da ke Landan. Ƙungiyar masu shirya wasan sun daidaita wasan kwaikwayon ta hanyar allon teleprompter, ƙaramin belun kunne, da kuma manajan dandamali a kan dandamali don tunatar da shi labaransa idan ya manta da su. Darakta Dave Wybrow ya dage cewa ba wai game da "ɓoye" cutar ba ne, amma game da nuna cewa aikin haɗin gwiwa da ƙirƙira har yanzu yana yiwuwa bayan an gano cutar.
Labarin Marinker ya ɗauki wani muhimmin abu dangane da bayanai daga Ƙungiyar Alzheimer's Society: Kashi 42% na mutanen da ke fama da cutar dementia suna jin kunyar alamun cutar , kuma mutum ɗaya cikin biyar da ke fama da matsalar ƙwaƙwalwa yana guje wa zuwa wurin likita saboda tsoron martanin da abokai da dangi ke bayarwa. Ƙiyayya ta kasance babban shinge ga ganewar asali da wuri. "Abin da Peter ke yi ya nuna cewa ganewar asali ba shine ƙarshen ba," in ji Taiyaba Zeria, darektan ayyukan tallafawa cutar dementia a Ƙungiyar Alzheimer's Society da ke Landan. Marinker, wanda a da ya taka wannan rawar a 1983, ya bayyana aikin a matsayin "waƙar swan mai ban mamaki": "Ina cikin farkon cutar, don haka ina buƙatar yin amfani da wannan matakin sosai kuma in shirya kaina gwargwadon iyawata don matakin tsakiya," in ji shi da dariya mai ban tsoro.
A ƙarshe, haɗakar ci gaban bincike, sabbin hanyoyin magani, da yaƙi da tsangwama yana nuna hoto mai cike da bege amma mai sarkakiya. Al'ummar kimiyya ta yarda cewa gano cutar da wuri da kuma samun damar yin magani daidai gwargwado su ne mabuɗin canza yanayin cutar . Yayin da Spain ke muhawara kan yadda za a haɗa sabbin magunguna cikin tsarin kula da lafiyar jama'a, bincike ya ci gaba da ci gaba zuwa ga kayan aikin da suka fi daidaito da rashin mamayewa. Kalubalen ba wai kawai kimiyya ba ne, har ma da zamantakewa da siyasa: tabbatar da cewa fa'idodin kirkire-kirkire sun isa ga duk marasa lafiya, ba tare da la'akari da kuɗinsu ba. Labarin Peter Marinker, ci gaban da aka samu a cikin alamun cutar, da sabbin hanyoyin magani suna ba da dalilai na bege, amma kuma suna aiki a matsayin tunatarwa cewa akwai abubuwa da yawa da za a yi don canza cutar Alzheimer daga mummunan ganewar asali zuwa yanayin da za a iya sarrafawa wanda mutum zai iya rayuwa da shi cikin mutunci.
