ʻO kahi maʻi autoimmune ka hopena o kahi anomaly i loko o ka ʻōnaehana immune e alakaʻi ana i ka mea hope e hoʻouka i nā mea maʻamau o ke kino (ʻo ka "self", no laila ke kumu aʻa e ʻōlelo ai i kēia maʻi palekana). Hoʻokaʻawale ʻia ka ʻokoʻa ma waena o nā maʻi autoimmune kikoʻī o ke kino, e pili ana i kekahi okana (e like me nā maʻi autoimmune o ka thyroid), a me nā maʻi autoimmune systemic, e like me ka lupus, hiki ke hoʻopilikia i kekahi mau kino.

ʻOiai e manaʻo ʻia e pale iā mākou mai nā pathogens (hiki ke hoʻoulu i ka maʻi), hiki i kā mākou ʻōnaehana pale i kekahi manawa ke hele ʻole. Hiki iā ia ke lilo i mea paʻakikī loa i kekahi mau mea exogenous (waho), a hoʻoulu i nā allergies a i ʻole ke ʻano kūʻē i nā constituent o ke kino iho a paipai i ka puka ʻana o nā maʻi autoimmune.

Hoʻokumu ʻia nā maʻi autoimmune i kahi hui kahi e ʻike ai mākou i nā maʻi ʻokoʻa e like me ka maʻi diabetes type I, multiple sclerosis, thumatoid arthritis a i ʻole ka maʻi o Crohn. Hoʻopili lākou a pau i nā maʻi maʻi i hoʻoulu ʻia e ke kino o ka nalo ʻana o ka hoʻomanawanui immunological i kona mau mea ponoʻī.

Pehea i hoʻokumu ʻia ai nā maʻi autoimmune?

He pūʻali koa kūloko maoli i hana ʻia i kekahi mau keʻokeʻo keʻokeʻo, pale ka ʻōnaehana pale i ke kino mai nā hoʻouka ʻana o waho e like me ka bacteria a i ʻole nā ​​maʻi maʻi a ʻae pinepine i kāna mau mea ponoʻī. Ke haki ka hoʻomanawanui iā ia iho, lilo ia i kumu o ka maʻi. ʻO kekahi mau keʻokeʻo keʻokeʻo keʻokeʻo (autoreactive lymphocytes) e hoʻouka pono i nā ʻiʻo a i ʻole nā ​​​​okano.

ʻO nā antibodies maʻamau i hana ʻia e kekahi mau cell immune e hoʻokaʻawale i ka ʻenemi ma o ka hoʻopili ʻana i kekahi mau mole (antigens) hiki ke ʻike ʻia a ʻike ʻia nā mea o ko mākou kino. Huna ke kino i nā antibodies e kūʻē i kāna mau antigens i manaʻo ʻia he haole.

ʻo kahi laʻana:

• i ka maʻi maʻi maʻi ʻano I: ʻo nā autoantibodies e hoʻopaʻa i nā pūnaewele pancreatic huna i ka insulin;
• i ka rheumatoid arthritis: ʻo ia ka membrane e hoʻopuni ana i nā ami i hoʻopaʻa ʻia, hoʻolaha ka mumū i nā cartilages, iwi, a hiki i nā tendons a me nā ligaments;
• i loko o ka systemic lupus erythematosus, ua kuhikuhi ʻia nā auto-anticoprs e kūʻē i nā molekala i loaʻa i loko o nā cell he nui o ke kino, e alakaʻi ana i ka hōʻino ʻana i kekahi mau kino (ka ʻili, nā hui, nā puʻupaʻa, naʻau, a pēlā aku).

I kekahi mau hihia, ʻaʻole mākou e ʻike i nā autoantibodies a ʻōlelo mākou i nā maʻi "autoinflammatory". ʻO ka laina mua o ke kino o ka pale ʻana i nā cell immune (neutrophils, macrophages, monocytes, natural killer cell) wale nō ka mea e hoʻoulu ai i ka mumū mau loa e alakaʻi ana i ka luku ʻana i kekahi mau kiko.

• ʻili i psoriasis (e pili ana i ka 3 a 5% o ka heluna kanaka ʻEulopa);
• kekahi mau ami i ka rheumatoid spondylitis;
• ʻo ka ʻāpana digestive i ka maʻi o Crohn;
• ʻo ka ʻōnaehana hoʻokele waena i ka sclerosis lehulehu.

Inā he autoimmune lākou a i ʻole auto-inflammatory, loaʻa kēia mau maʻi āpau ma muli o ka hana ʻole o ka ʻōnaehana pale a hoʻomohala i nā maʻi ʻeha mau.

ʻO wai ka hopohopo?

I ka hoʻomaka ʻana o ke kenekulia 5, ua pili nā maʻi autoimmune ma kahi o 80 miliona mau kānaka ma Farani a ua lilo ʻo ia i ke kolu o ke kumu o ka make / morbidity ma hope o ka maʻi kanesa a me nā maʻi cardiovascular a ma nā ʻāpana like. ʻO ka XNUMX% o nā hihia pili i nā wahine. I kēia lā, inā hiki i nā lāʻau lapaʻau ke hoʻolōʻihi i ko lākou ulu ʻana, mau ka maʻi autoimmune i hiki ʻole ke hoʻōla.

ʻO ka hapa nui o nā maʻi autoimmune he multifactorial. Me nā ʻokoʻa liʻiliʻi, manaʻo ʻia lākou e pili ana i ka hui pū ʻana o nā genetic, endogenous, exogenous a / a i ʻole kaiapuni, hormonal, infectious a me nā kumu noʻonoʻo.

He mea koʻikoʻi ke ʻano genetic, no laila ke ʻano ʻohana pinepine o kēia mau maʻi. No ka laʻana, hele ka pinepine o ka maʻi diabetes type I mai 0,4% i ka heluna nui a i 5% i nā ʻohana o ka maʻi maʻi.

I ka spondylitis ankylosing, aia ka gene HLA-B27 ma 80% o nā mea i hoʻopilikia ʻia akā ma 7% wale nō o nā kumuhana olakino. He mau haneli inā ʻaʻole he mau haneli o nā genes i pili i kēlā me kēia maʻi autoimmune.

ʻO nā haʻawina hoʻokolohua a i ʻole ka ʻikepili epidemiological e wehewehe maopopo i kahi hui ma waena o ka microbiota intestinal (digestive ecosystem), aia ma ke kikowaena ma waena o ka ʻōnaehana pale a me ke kaiapuni, a me ka loaʻa ʻana o kahi maʻi autoimmune. Aia nā hoʻololi, kahi ʻano kamaʻilio, ma waena o ka bacteria intestinal a me nā cell immune.

ʻO ke kaiapuni (ka ʻike ʻana i nā microbes, kekahi mau kemika, nā kukuna UV, ka puhi ʻana, ke kaumaha, a me nā mea ʻē aʻe) kekahi hana nui.

Pono e hana mau ʻia ka ʻimi ʻana i kahi maʻi autoimmune ma kahi ʻano evocative. Aia nā hoʻokolohua:

• ka ʻimi ʻana e ʻike i nā kino i hoʻopilikia ʻia (clinical, biological, organ biopsy);
• he ho'āʻo koko no ka ʻimi ʻana i ka mumū (ʻaʻole kikoʻī) akā hiki ke kuhikuhi i ka paʻakikī o ka hoʻouka ʻana a me ka ʻimi ʻana i ka loiloi immunological me ka ʻimi ʻana i nā autoantibodies;
• ʻimi ʻōnaehana no nā pilikia e hiki mai ana (kidney, māmā, naʻau a me nā ʻōnaehana nerve).

ʻO kēlā me kēia maʻi autoimmune e pane i ka lāʻau kūikawā.

Hiki i nā lāʻau lapaʻau ke hoʻomalu i nā hōʻailona o ka maʻi: analgesics e kūʻē i ka ʻeha, nā lāʻau anti-inflammatory e kū'ē i ka ʻeha hana i loko o nā hui, nā lāʻau lapaʻau e hiki ai ke hoʻoponopono i nā maʻi endocrine (insulin no ka maʻi diabetes, thyroxine i ka hyothyroidism).

ʻO nā lāʻau lapaʻau e hoʻomalu a hoʻopaʻa i ka autoimmunity ke hāʻawi pū i kahi ala e kaupalena ai i nā hōʻailona a me ka piʻi ʻana o ka pōʻino kino. Pono lākou e lawe maʻamau no ka mea hiki ʻole ke hoʻōla i ka maʻi. Eia kekahi, ʻaʻole lākou kikoʻī i nā cell autoimmunity effector a hoʻopilikia i kekahi mau hana maʻamau o ka ʻōnaehana pale.

ʻO ka mōʻaukala, ua hoʻohana ʻia nā lāʻau immunosuppressive (corticosteroids, cyclophosphamide, methotrexate, cyclosporin) no ka mea e pili pū ana lākou me nā mea hoʻokō kikowaena o ka ʻōnaehana pale a hiki ke kaupalena i kāna hana holoʻokoʻa. Hoʻopili pinepine ʻia lākou me ka piʻi ʻana o ka maʻi a no laila pono ke nānā mau.

No iwakālua mau makahiki, ua hoʻomohala ʻia nā biotherapies: hāʻawi lākou i ka mana maikaʻi o nā hōʻailona. ʻO kēia nā molekala e kuhikuhi pono ana i kekahi o nā mea pāʻani nui e pili ana i ke kaʻina hana. Hoʻohana ʻia kēia mau lāʻau lapaʻau ke koʻikoʻi ka maʻi a ʻaʻole pane a lawa paha i nā immunosuppressants.

I ka hihia o nā pathologies kiko'ī e like me Guillain Barre syndrome, plasmapheresis hiki ke hoʻopau i nā autoantibodies ma o ka kānana ʻana o ke koko a laila hoʻihoʻi ʻia i loko o ka mea maʻi.