Isifo se-autoimmune siwumphumela wokuphazamiseka kwesimiso somzimba sokuzivikela ezifweni okuholela ekugcineni ekuhlaseleni izingxenye ezivamile zomzimba (“uqobo”, yingakho kuyimpande yokukhuluma ngalokhu kuphazamiseka kokuzivikela komzimba). Umehluko wakudala wenziwa phakathi kwezifo ezithile ezithinta ukuzivikela komzimba ezithweni ezithile, ezithinta isitho esithile (njengezifo ze-autoimmune zegilo), kanye nezifo ze-systemic autoimmune, njenge-lupus, ezingathinta izitho ezimbalwa.

Nakuba kufanele kusivikele emagciwaneni (angase abangele izifo), isimiso sethu somzimba sokuzivikela ezifweni ngezinye izikhathi singase singasebenzi. Ingase ibe bucayi kakhulu ezingxenyeni ezithile zangaphandle (zangaphandle), futhi iqalise ukungezwani komzimba noma isabele ngokumelene nezakhi zakho futhi ikhuthaze ukuvela kwezifo ezizimele.

Izifo ezizimele zakha iqembu lapho sithola khona izifo ezihlukene njengohlobo lwesifo sikashukela sohlobo I, i-multiple sclerosis, i-thumatoid arthritis noma isifo sika-Crohn. Zonke zihambisana nezifo ezingelapheki ezibangelwa ukulahlekelwa komzimba kokubekezelelana kwe-immunological kumalungu awo.

Zisungulwa kanjani izifo ze-autoimmune?

Ibutho langempela langaphakathi elakhiwe amangqamuzana egazi amhlophe amaningana, amasosha omzimba avikela umzimba ekuhlaselweni kwangaphandle okufana namagciwane noma amagciwane futhi ngokuvamile abekezelela izakhi zawo. Lapho ukuzibekezelela kubhidlika, kuba umthombo wezifo. Amanye amangqamuzana egazi amhlophe (autoreactive lymphocyte) ahlasela izicubu noma izitho ezithile.

Ama-antibodies ngokuvamile akhiqizwa amangqamuzana athile omzimba ukuze anciphise isitha ngokunamathela kuma-molecule athile (ama-antigen) nawo angavela futhi aqondise izakhi zomzimba wethu. Umzimba ukhiqiza amasosha omzimba ngokumelene nama-antigen awo awathatha njengangaphandle.

Ngokwesibonelo:

• ohlotsheni I lwesifo sikashukela: ama-autoantibodies aqondise kumaseli e-pancreatic akhiqiza i-insulin;
• ku-arthritis ye-rheumatoid: yi-membrane ezungeze amalunga ahlosiwe, ukuvuvukala kusakazeka kuma-cartilages, amathambo, ngisho nama-tendon kanye nemigqa;
• ku-systemic lupus erythematosus, ama-auto-anticoprs aqondiswe kuma-molecule akhona kumaseli amaningi omzimba, okuholela ekulimaleni kwezitho eziningana (isikhumba, amalunga, izinso, inhliziyo, njll.).

Kwezinye izimo, asiwatholi ama-autoantibodies futhi sikhuluma ngezifo "zokuzikhukhumeza". Umugqa wokuqala wokuzivikela wokuzivikela komzimba (ama-neutrophils, ama-macrophage, ama-monocyte, amangqamuzana abulalayo emvelo) ewodwa abangela ukuvuvukala okungapheli okuholela ekubhujisweni kwezicubu ezithile:

• isikhumba ku-psoriasis (ethinta i-3 kuya ku-5% yabantu baseYurophu);
• amalunga athile ku-spondylitis ye-rheumatoid;
• umgudu wokugaya ukudla ku-Crohn's disease;
• isimiso sezinzwa esimaphakathi ku-multiple sclerosis.

Kungakhathaliseki ukuthi i-autoimmune eqinile noma i-auto-inflammatory, zonke lezi zifo zibangelwa ukungasebenzi kahle kwamasosha omzimba futhi zikhule zibe izifo ezivuthayo ezingapheli.

Ngubani othintekayo?

Ekuqaleni kwekhulu lesi-5, izifo ze-autoimmune zithinta abantu ababalelwa ezigidini ezingama-80 eFrance futhi seziphenduke imbangela yesithathu yokufa / ukugula ngemuva komdlavuza kanye nezifo zenhliziyo nemithambo yegazi futhi cishe ngezilinganiso ezifanayo. U-XNUMX% wamacala athinta abesifazane. Namuhla, uma ukwelashwa kwenza kube nokwenzeka ukunciphisa ukukhula kwabo, izifo ezizimele zihlala zingelapheki.

Iningi lezifo ze-autoimmune ziyi-multifactorial. Ngaphandle kokumbalwa, kubhekwa njengokusekelwe ekuhlanganisweni kwezakhi zofuzo, ezingapheli, ezingaphandle kanye / noma ezemvelo, ama-hormonal, ezithathelwanayo nezingokwengqondo.

Isizinda sofuzo sibalulekile, yingakho imvelo evame ukuvela emndenini yalezi zifo. Isibonelo, imvamisa yesifo sikashukela sohlobo I isuka ku-0,4% kubantu abaningi iye ku-5% ezihlotsheni ezinesifo sikashukela.

Ku-ankylosing spondylitis, isakhi sofuzo se-HLA-B27 sikhona ku-80% wezifundo ezithintekile kodwa ku-7% kuphela wezifundo ezinempilo. Amashumi amaningi uma kungewona amakhulu ezakhi zofuzo ahlotshaniswe nesifo ngasinye se-autoimmune.

Izifundo zokuhlola noma idatha ye-epidemiological ichaza ngokucacile ukuhlobana phakathi kwe-intestinal microbiota (i-digestive ecosystem), etholakala endaweni yokuhlangana phakathi kwamasosha omzimba nendawo ezungezile, kanye nokuvela kwesifo esizimele. Kukhona ukushintshana, uhlobo lwenkhulumomphendvulwano, phakathi kwamagciwane amathumbu kanye namaseli omzimba.

Imvelo (ukuchayeka kumagciwane, amakhemikhali athile, imisebe ye-UV, ukubhema, ukucindezeleka, njll.) nakho kunendima enkulu.

Ukusesha isifo sokuzivikela komzimba kufanele ngaso sonke isikhathi kwenziwe ngendlela evusa inkanuko. Izivivinyo zihlanganisa:

• ukuhlola ukuxilonga izitho ezithintekile (emtholampilo, eziphilayo, i-organ biopsy);
• ukuhlolwa kwegazi lokufuna ukuvuvukala (okungaqondile) kodwa okungakhomba ubunzima bokuhlaselwa kanye nokuhlola ukuhlolwa kwe-immunology ngokusesha amasosha omzimba;
• ukucinga okuhlelekile kwezinkinga ezingase zibe khona (izinso, amaphaphu, inhliziyo nesimiso sezinzwa).

Isifo ngasinye se-autoimmune siphendula ekwelapheni okuthile.

Ukwelashwa kwenza kube nokwenzeka ukulawula izimpawu zesifo: ama-analgesics ngokumelene nobuhlungu, izidakamizwa ezilwa nokuvuvukala ngokumelene nokungahambi kahle kokusebenza kwamalunga, izidakamizwa ezishintshayo ezenza kube nokwenzeka ukujwayelekile ukuphazamiseka kwe-endocrine (i-insulin yesifo sikashukela, i-thyroxine ku-hyothyroidism).

Izidakamizwa ezilawula noma ezivimbela i-autoimmunity nazo zinikeza indlela yokunciphisa izimpawu kanye nokuqhubeka kokulimala kwezicubu. Ngokuvamile kufanele zithathwe ngokungalapheki ngoba azikwazi ukwelapha lesi sifo. Ngaphezu kwalokho, aziqondile kumaseli we-autoimmunity effector futhi ziphazamisa imisebenzi ethile evamile yamasosha omzimba.

Ngokomlando, izidakamizwa ze-immunosuppressive (i-corticosteroids, i-cyclophosphamide, i-methotrexate, i-ciclosporin) ziye zasetshenziswa ngoba zisebenzisana nemiphumela emaphakathi yesimiso somzimba sokuzivikela ezifweni futhi zenza kube nokwenzeka ukukhawulela umsebenzi wawo jikelele. Zivame ukuhlotshaniswa nengozi eyengeziwe yokutheleleka ngakho-ke zidinga ukuqapha njalo.

Sekuyiminyaka engamashumi amabili, ama-biotherapies athuthukiswa: anikeza ukulawula okungcono kwezimpawu. Lawa ama-molecule aqondise ngokukhethekile oyedwa wabadlali ababalulekile ababandakanyekayo kunqubo ethintekayo. Lezi zindlela zokwelapha zisetshenziswa lapho isifo sinzima noma singaphenduli noma ngokwanele kuma-immunosuppressants.

Endabeni ye-pathologies ecacile kakhulu njenge-Guillain Barre syndrome, i-plasmapheresis ivumela ukuqedwa kwama-autoantibodies ngokuhlunga igazi elibuye libuyiselwe esigulini.