Chirwere chekuzvimiririra mhedzisiro inokonzerwa nekusagadzikana mu immune system inotungamira iyo yekupedzisira kurwisa zvakajairika zvikamu zvemuviri (iyo "yega", saka mudzi auto- kutaura nezve ichi hutachiona kusagadzikana). Musiyano wekare unogadzirwa pakati pechirume-chakanangana ne autoimmune hosha, iyo inokanganisa imwe nhengo (senge autoimmune hosha yeiyo thyroid), uye systemic autoimmune hosha, senge lupus, iyo inogona kukanganisa nhengo dzinoverengeka.

Ipo ichifanirwa kutidzivirira kubva kuzvirwere (izvo zvinogona kukonzera chirwere), immune system yedu dzimwe nguva inogona kubuda mushe. Iyo inogona kubva yakanyanya kunetseka kune zvimwe exogenous (zvekunze) zvinoriumba, uye inokonzeresa kurwara kana kuita inopesana nezvinowanikwa zveiyo yega uye kukurudzira kubuda kwezvirwere zve autoimmune.

Zvirwere zvekuzvimiririra zvinoumba boka matinoona zvirwere zvakasiyana nerudzi rwechirwere cheshuga, multiple sclerosis, thumatoid arthritis kana chirwere cheCrohn. Dzese dzinoenderana nezvirwere zvisingaperi zvinokonzerwa nekurasikirwa nemuviri weiyo immunological shiviriro kune ayo mairi.

Zvirwere zve autoimmune zvinogadziriswa sei?

Uto rechokwadi remukati rinoumbwa nemasero eropa akati wandei, immune system inodzivirira muviri pakurwisa kwekunze senge mabhakitiriya kana mavhairasi uye kazhinji inotsungirira nhengo dzayo. Kana kuzvidzora kuchipera, chinova chikonzero chechirwere. Mamwe machena masero eropa (autoreactive lymphocyte) anonyanya kurwisa nyama kana nhengo.

Maantibodies anowanzo kugadzirwa nemamwe maseru ekudzivirira kuti muvengi asaumbwe nekubatanidza mamwe mamorekuru (maantigen) anogona zvakare kuoneka uye kunongedza zvinhu zvemuviri wedu. Muviri unoviga masoja ekudzivirira marwisi maringe nemaantigen ayo aanoona sekunze.

Semuyenzaniso:

• murudzi I chirwere cheshuga: autoantibodies inotarisa insulin-yekuchengetedza pancreatic maseru;
• mu rheumatoid arthritis: ndiyo membrane iyo inotenderedza majoini ayo anotarirwa, iko kuzvimba kunopararira kune shwashwa, mapfupa, kunyangwe tendon uye ligaments;
• mu systemic lupus erythematosus, auto-anticoprs inotungamirwa kunopesana nema mamorekuru aripo mumasero mazhinji emuviri, zvichikonzera kukuvara kunhengo dzinoverengeka (ganda, majoini, itsvo, moyo, nezvimwewo).

Mune zvimwe zviitiko, isu hatiwani autoantibodies uye isu tinotaura pane nezve "autoinfigueatory" zvirwere. Mutsara wekutanga wemasero ekudzivirira immune (neutrophils, macrophages, monocyte, maseru anouraya chaiwo) ega anokonzeresa kuzvimba kusingaperi kunotungamira mukuparadzwa kwemamwe matukisi:

• ganda mu psoriasis (iyo inobata 3 kusvika ku5% yevagari vemuEurope);
• mamwe majoini mu rheumatoid spondylitis;
• wokugaya turakiti muna Crohn chirwere;
• iyo yepakati tsinga system mu multiple sclerosis.

Kunyangwe ivo vari autoimmune kana auto-kuzvimba, ese aya hosha anokonzerwa nekushomeka kweye immune system uye anokura kuita asingagumi ekurwisa zvirwere.

Ndiani ane hanya?

Pakutanga kwezana ramakore rechishanu, zvirwere zve autoimmune zvinokanganisa vanhu vanosvika mamirioni makumi masere muFrance uye chave chikonzero chechitatu chekufa / kurwara mushure mekenza nezvirwere zvemwoyo uye mune zviyero zvakafanana. 5% yematambudziko ane chekuita nevakadzi. Nhasi, kana kurapwa kuchikwanisa kunonotsa kukura kwavo, autoimmune hosha dzinoramba dzisingarapike.

Hukuru huzhinji hwezvirwere zve autoimmune zvakawandisa. Kunze kwekusara kushoma, ivo vanoonekwa sevakanangana nekubatanidzwa kwemajini, endogenous, exogenous uye / kana zvakatipoteredza, mahormone, anotapukira uye epfungwa zvinhu.

Iko kuberekwa kwakakosha, saka kazhinji hunhu hwemhuri hwezvirwere izvi. Semuenzaniso, kuwanda kwerudzi rwechirwere cheshuga kunobva ku0,4% muhuwandu hwevanhu kusvika pa5% mune hama dzemunhu ane chirwere cheshuga.

Mune ankylosing spondylitis, iyo HLA-B27 geni iripo mu80% yezvakakanganiswa zvidzidzo asi mune chete 7% yezvidzidzo zvine hutano. Mazana kana asiri mazana emagen'a ave achibatanidzwa nechimwe nechimwe autoimmune chirwere.

Ongororo dzeongororo kana denda redenda rinotsanangura zvakajeka kusangana pakati pematumbo microbiota (dumbu rekugaya), iyo iri panzvimbo yekubatana pakati pe immune system pamwe nezvakatipoteredza, uye kuitika kwechirwere chemuviri. Kune kuchinjana, mhando yekutaurirana, pakati pematumbu emukati uye masero ekudzivirira.

Iyo nharaunda (kutariswa nema microbes, mamwe makemikari, UV mwaranzi, kuputa, kushushikana, nezvimwewo) zvinoita basa rakakura.

Kutsvaga kwe autoimmune chirwere kunofanira kugara kuchiitwa mune evocative mamiriro. Bvunzo dzinosanganisira:

• kuongorora kuongorora nhengo dzakakanganiswa (kiriniki, bhayoroji, nhengo biopsy);
• kuongororwa kweropa kutsvaga kuzvimba (kusiri-kwakasarudzika) asi izvo zvinogona kunongedza kukomba kwekurwiswa uye kuongorora kuongororwa kwemajoni nekutsvaga autoantibodies;
• kutsvagisa kwakarongeka kweanogona kuitika matambudziko (itsvo, mapapu, moyo uye huta system).

Chirwere chega chega chemoto chinopindura kurapwa chaiko.

Kurapa kunoita kuti zvikwanisike kudzora zviratidzo zvechirwere: analgesics marwadzo, anti-anogumbura madhiragi kusagadzikana kweanoshanda mumajoini, kutsiva zvinodhaka zvinoita kuti zvive nyore kugadzirisa endocrine kusagadzikana (insulin yeshuga, thyroxine mu hyothyroidism).

Zvinodhaka zvinodzora kana kudzivirira autoimmunity zvakare zvinopa nzira yekudzora zviratidzo uye kufambira mberi kwekukuvara kwetishu. Vanowanzo fanirwa kutorwa zvenguva refu nekuti havagone kurapa chirwere. Uye zvakare, iwo haana kujeka kune autoimmunity anoshanda maseru uye anopindira nemamwe mabasa akajairwa e immune system.

Nhoroondo, immunosuppressive madhiragi (corticosteroids, cyclophosphamide, methotrexate, ciclosporin) ave achishandiswa nekuti iwo anofambidzana neanogadzira epakati immune system uye anoita kuti zvikwanise kudzikamisa mashandiro ayo zvizere. Ivo vanowanzo kuve pamwe neyakawedzera njodzi yehutachiona uye nekudaro inoda kugara ichiongororwa.

Kwemakore makumi maviri, biotherapies akagadzirwa: iwo anopa zvirinani kudzora kwezviratidzo. Aya mamorekuru anonangidzira zvakanangana nemumwe wevatambi vakakosha vanobatanidzwa muchiitiko chakatarisana. Aya marapirwo anoshandiswa kana chirwere ichi chakanyanya kana kusapindura kana kukwana zvakakwana kune immune immunosuppressants.

Panyaya yezvakanyanya kurwara kwakadai saGuillain Barre syndrome, plasmapheresis inobvumira kubviswa kwema autoantibodies nekusefa kweropa iro rinobva radzoserwa mumurwere.