nkhani

Pansi pa mthunzi wa mliri wa Covid-19, thanzi la anthu padziko lonse lapansi likukumana ndi zovuta zomwe sizinachitikepo. Komabe, muvuto lomweli m'pamene sayansi ndi luso lazopangapanga zawonetsa kuthekera kwawo kwakukulu ndi mphamvu zawo. Chiyambireni mliriwu, asayansi padziko lonse lapansi ndi maboma agwirizana kwambiri kulimbikitsa chitukuko chofulumira ndi kupititsa patsogolo katemera, zomwe zimabweretsa zotsatira zabwino. Komabe, nkhani monga kugawa kwa katemera komanso kusafuna kwa anthu kulandira katemera zikuvutitsabe nkhondo yapadziko lonse yolimbana ndi mliriwu.

Mliri wa Covid-19 usanachitike, chimfine cha 1918 chinali mliri wowopsa kwambiri m'mbiri ya US, ndipo anthu omwe anamwalira chifukwa cha mliri wa Covid-19 anali pafupifupi kuwirikiza kawiri chimfine cha 1918. Mliri wa Covid-19 wayendetsa patsogolo kwambiri pankhani ya katemera, kupereka katemera wotetezeka komanso wogwira mtima kwa anthu ndikuwonetsa kuthekera kwa azachipatala kuyankha mwachangu zovuta zazikulu poyang'anizana ndi zofunikira paumoyo wa anthu. Ndizokhudza kuti pali dziko losalimba pantchito ya katemera wadziko lonse komanso wapadziko lonse lapansi, kuphatikiza nkhani zokhudzana ndi kagawidwe ka katemera ndi kasamalidwe. Chochitika chachitatu ndichakuti mgwirizano pakati pa mabizinesi abizinesi, maboma, ndi ophunzira ndizofunikira kwambiri pakupititsa patsogolo chitukuko cham'badwo woyamba wa katemera wa Covid-19. Kutengera ndi maphunziro awa, bungwe la Biomedical Advanced Research and Development Authority (BARDA) likufuna thandizo kuti likhazikitse m'badwo watsopano wa katemera wotukuka.

Pulojekiti ya NextGen ndi njira ya $ 5 biliyoni yothandizidwa ndi dipatimenti ya zaumoyo ndi Human Services yomwe cholinga chake ndi kupanga m'badwo wotsatira wa mayankho azaumoyo ku Covid-19. Dongosololi lithandizira kuyesa kwapawiri, koyendetsedwa mwachangu kwa Phase 2b kuti awunike chitetezo, mphamvu, ndi chitetezo chamthupi cha katemera woyesera wokhudzana ndi katemera wovomerezeka wamitundu yosiyanasiyana komanso mitundu. Tikuyembekeza kuti mapulaneti a katemerawa agwire ntchito pa katemera wina wa matenda opatsirana, zomwe zimathandiza kuti athe kuyankha mwamsanga ku zoopsa zamtsogolo za thanzi ndi chitetezo. Kuyesera uku kudzaphatikiza malingaliro angapo.

Mapeto ake a mayeso achipatala a Phase 2b omwe akuyembekezeredwa ndi kupititsa patsogolo mphamvu kwa katemera kupitirira 30% pa nthawi yowonera miyezi 12 poyerekeza ndi katemera wovomerezeka kale. Ofufuza awunika mphamvu ya katemera watsopanoyo potengera momwe amatetezera kuzizindikiro za Covid-19; Kuphatikiza apo, ngati chomaliza chachiwiri, otenga nawo mbali azidziyesa okha ndi mphuno zamphuno sabata iliyonse kuti apeze zambiri za matenda asymptomatic. Makatemera omwe akupezeka ku United States amachokera ku ma antigen a spike protein ndipo amaperekedwa kudzera mu jakisoni wa intramuscular, pomwe m'badwo wotsatira wa katemera udzadalira njira zosiyanasiyana, kuphatikiza ma jini a spike protein ndi zigawo zotetezedwa za kachilomboka, monga majini otsekera nucleocapsid, membrane, kapena mapuloteni ena osakhazikika. Pulatifomu yatsopanoyi imatha kukhala ndi katemera wophatikizanso wa ma virus omwe amagwiritsa ntchito ma vector omwe ali ndi / osatha kubwereza komanso kukhala ndi ma gene omwe ali ndi ma encoding a SARS-CoV-2 opangidwa ndi mapuloteni osakhazikika. Katemera wa m'badwo wachiwiri wodzikulitsa wa mRNA (samRNA) ndi njira yaukadaulo yomwe ikubwera mwachangu yomwe ingawunikidwe ngati njira ina. Katemera wa samRNA amaphatikiza zotengera zomwe zasankhidwa kukhala immunogenic kukhala lipid nanoparticles kuti ayambitse mayankho olondola a chitetezo chamthupi. Ubwino womwe ungakhalepo wa nsanjayi ndi monga Mlingo wocheperako wa RNA (omwe ungachepetse kuyambiranso), mayankho a chitetezo chamthupi kwa nthawi yayitali, komanso katemera wokhazikika pa kutentha kwa firiji.

Tanthauzo la kulumikizana kwa chitetezo (CoP) ndikuyankha kwachidziwitso cham'thupi komanso chitetezo cham'manja chomwe chingapereke chitetezo ku matenda kapena kupatsirananso ndi tizilombo toyambitsa matenda. Kuyesa kwa Phase 2b kuwunika ma CoP omwe angakhalepo a katemera wa Covid-19. Kwa ma virus ambiri, kuphatikiza ma coronavirus, kudziwa CoP nthawi zonse kwakhala kovuta chifukwa zigawo zingapo za chitetezo chamthupi zimagwirira ntchito limodzi kuti kachilomboka kagwire ntchito, kuphatikiza ma antibodies osalowerera (monga ma antibodies agglutination, ma antibodies amvula, kapena ma antibodies owonjezera), ma antibodies a isotype, CD4 + ndi CD8 + T maselo, ma cell antibody Fc magwiridwe antchito. Chovuta kwambiri, gawo lazigawozi pokana SARS-CoV-2 limatha kusiyanasiyana kutengera malo a anatomical (monga kuzungulira, minofu, kapena kupuma kwa mucous membrane) ndi mathero omwe amaganiziridwa (monga matenda asymptomatic, matenda azizindikiro, kapena matenda oopsa).

Ngakhale kuzindikiritsa CoP kumakhalabe kovuta, zotsatira za mayeso a katemera wovomerezeka atha kuthandizira kuwerengera ubale womwe ulipo pakati pa kufalikira kwa ma antibody ndi mphamvu ya katemera. Dziwani zambiri zaubwino wa CoP. CoP yathunthu imatha kupanga maphunziro oletsa chitetezo chamthupi pamapulatifomu atsopano a katemera mwachangu komanso otsika mtengo kuposa mayeso akulu olamulidwa ndi placebo, ndikuthandizira kuwunika mphamvu zoteteza katemera wa anthu omwe sanaphatikizidwe pamayesero a katemera, monga ana. Kuzindikira CoP kumathanso kuwunika nthawi ya chitetezo chamthupi pambuyo potenga matenda atsopano kapena katemera wolimbana ndi mitundu yatsopano, ndikuthandizira kudziwa nthawi yomwe kuwombera kolimbikitsa kumafunika.

Mtundu woyamba wa Omicron udawonekera mu Novembala 2021. Poyerekeza ndi zovuta zoyambira, uli ndi pafupifupi ma amino acid 30 omwe adalowetsedwa m'malo (kuphatikiza ma amino acid 15 mu protein ya spike), motero amatchulidwa ngati mtundu wina wodetsa nkhawa. Mliri wam'mbuyomu womwe udayambitsidwa ndi mitundu ingapo ya COVID-19 monga alpha, beta, delta ndi kappa, ntchito yoletsa ma antibodies opangidwa ndi matenda kapena katemera wotsutsana ndi mtundu wa Omikjon idachepetsedwa, zomwe zidapangitsa Omikjon m'malo mwa kachilombo ka delta padziko lonse lapansi mkati mwa milungu ingapo. Ngakhale kuthekera kobwerezabwereza kwa Omicron m'maselo opumira otsika kwatsika poyerekeza ndi zovuta zoyambira, poyamba zidapangitsa kuti ziwopsezo ziwonjezeke kwambiri. Kusintha kotsatira kwa mtundu wa Omicron pang'onopang'ono kunakulitsa luso lake lozemba ma antibodies omwe analipo kale, ndipo ntchito yake yomangirira ku angiotensin converting enzyme 2 (ACE2) receptors idakweranso, zomwe zidapangitsa kuti kuchuluka kwa kufalikira. Komabe, kulemedwa kwakukulu kwa zovuta izi (kuphatikizapo ana a JN.1 a BA.2.86) ndi ochepa. Non humoral chitetezo chokwanira kungakhale chifukwa m'munsi kuopsa kwa matendawa poyerekeza ndi m'mbuyomu HIV. Kupulumuka kwa odwala a Covid-19 omwe sanapange ma antibodies (monga omwe ali ndi vuto la kuchepa kwa B-cell) kumawonetsanso kufunikira kwa chitetezo cham'manja.

Zomwe taziwonazi zikuwonetsa kuti ma antigen-specific memory T maselo sakhudzidwa kwambiri ndi kusintha kwa mapuloteni a spike mumitundu yosinthika poyerekeza ndi ma antibodies. Maselo a Memory T akuwoneka kuti amatha kuzindikira ma epitopes osungidwa bwino a peptide pazigawo zomangira ma spike protein receptor ndi ma virus ena omwe amapangidwa ndi ma virus komanso osapangana. Kupezeka uku kutha kufotokozera chifukwa chomwe ma mutant omwe ali ndi chidwi chochepa ndi ma antibodies omwe alipo angagwirizane ndi matenda ocheperako, ndikuwonetsa kufunikira kowongolera kuzindikira kwa mayankho a chitetezo chamthupi a T cell.

Njira yopumira yakumtunda ndiye malo oyamba kukhudzana ndi kulowa kwa ma virus opumira monga ma coronaviruses (epithelium ya m'mphuno imakhala ndi ma ACE2 receptors), pomwe mayankho obadwa nawo komanso osinthika a chitetezo chamthupi amapezeka. Makatemera omwe alipo panopa ali ndi mphamvu zochepa zokopa chitetezo champhamvu cha mucosal. M'magulu omwe ali ndi katemera wambiri, kuchulukirachulukira kwa mitundu yosiyanasiyana kungayambitse kupanikizika kosiyanasiyana, kuonjezera mwayi wa chitetezo cha mthupi. Katemera wa mucosal amatha kulimbikitsa kuyankhidwa kwa chitetezo cham'thupi ndi chitetezo cha mthupi, kuchepetsa kufala kwa anthu ammudzi ndikuzipanga kukhala katemera woyenera. Njira zina zopezera katemera ndi monga intradermal (microarray patch), oral (piritsi), intranasal (spray kapena drop), kapena inhalation (aerosol). Kutuluka kwa katemera wopanda singano kungachepetse kukayikira kwa katemera ndikuwonjezera kuvomereza kwawo. Mosasamala kanthu za njira yomwe ingatsatidwe, kuchepetsa katemera kumachepetsa mtolo kwa ogwira ntchito yachipatala, potero kumapangitsa kuti katemera athe kupezeka ndikuthandizira njira zothetsera mliri wamtsogolo, makamaka ngati kuli kofunikira kukhazikitsa mapulogalamu akuluakulu a katemera. Kugwira ntchito kwa katemera wowonjezera wa mlingo umodzi pogwiritsa ntchito mapiritsi otsekemera, kutentha kwa kutentha ndi katemera wa m'mphuno kudzawunidwa poyesa mayankho a antigen-enieni a IgA m'matumbo ndi kupuma.

M'mayesero achipatala a gawo 2b, kuyang'anira mosamala chitetezo cha omwe akutenga nawo mbali ndikofunikira monga kukonza mphamvu ya katemera. Tidzasonkhanitsa mwadongosolo ndikusanthula deta yachitetezo. Ngakhale chitetezo cha katemera wa Covid-19 chatsimikiziridwa bwino, zovuta zimatha kuchitika pambuyo pa katemera aliyense. Mu kuyesa kwa NextGen, pafupifupi 10000 omwe atenga nawo mbali adzawunikidwa pa chiwopsezo ndipo adzapatsidwa mwachisawawa kuti alandire katemera woyeserera kapena katemera wovomerezeka mu chiyerekezo cha 1:1. Kuwunika mwatsatanetsatane za zoyipa zam'deralo komanso zadongosolo kumapereka chidziwitso chofunikira, kuphatikiza zochitika zazovuta monga myocarditis kapena pericarditis.

Vuto lalikulu lomwe opanga katemera amakumana nalo ndilofunika kukhalabe ndi kuthekera koyankha mwachangu; Opanga akuyenera kupanga mazana mamiliyoni amilingo ya katemera mkati mwa masiku 100 kuchokera ku mliri, womwenso ndi cholinga chokhazikitsidwa ndi boma. Mliri ukayamba kufooka komanso kutha kwa mliri kukuyandikira, kufunikira kwa katemera kudzachepa kwambiri, ndipo opanga adzakumana ndi zovuta zokhudzana ndi kusunga maunyolo, zida zoyambira (ma enzymes, lipids, buffers, ndi nucleotides), komanso kudzaza ndi kukonza. Pakadali pano, kufunikira kwa katemera wa Covid-19 m'gulu la anthu ndikotsika poyerekeza ndi zomwe zidachitika mu 2021, koma njira zopangira zomwe zimagwira ntchito pang'onopang'ono kuposa "mliri wathunthu" ziyenera kutsimikiziridwa ndi oyang'anira. Kupititsa patsogolo kwachipatala kumafunikanso kutsimikiziridwa ndi olamulira, omwe angaphatikizepo maphunziro a inter batch consistence ndi ndondomeko zotsatila za Gawo 3. Ngati zotsatira za kuyesa kwa Phase 2b zomwe zakonzedweratu zili ndi chiyembekezo, zidzachepetsa kwambiri zoopsa zomwe zingachitike poyesa mayeso a Gawo 3 ndikuyambitsa ndalama zachinsinsi pamayesero oterowo, motero kutha kukwaniritsa zamalonda.

Kutalika kwa nthawi yomwe mliriwu ukutha sikudziwikabe, koma zomwe zachitika posachedwa zikuwonetsa kuti nthawiyi siyenera kuwononga. Nthawi imeneyi yatipatsa mwayi wokulitsa kumvetsetsa kwa anthu za katemera wa chitetezo chamthupi ndikukhazikitsanso chikhulupiriro ndi chidaliro cha katemera kwa anthu ambiri momwe angathere.