amakuru

Mu gicucu cy’icyorezo cya Covid-19, ubuzima rusange bw’abaturage ku isi burahura n’ibibazo bitigeze bibaho. Nubwo bimeze bityo ariko, mu bihe bikomeye ni bwo siyanse n'ikoranabuhanga byagaragaje imbaraga n'imbaraga zabo nyinshi. Kuva iki cyorezo cyatangira, umuryango mpuzamahanga w’ubumenyi na guverinoma byafatanyije cyane mu guteza imbere iterambere ryihuse no guteza imbere inkingo, bigera ku musaruro udasanzwe. Icyakora, ibibazo nko gukwirakwiza inkingo zingana ndetse n’ubushake buke bw’abaturage bwo kwakira inkingo biracyafite ibibazo byo kurwanya icyorezo ku isi.

Mbere y’icyorezo cya Covid-19, ibicurane byo mu 1918 nicyo cyorezo cyanduye cyane mu mateka y’Amerika, kandi umubare w'abahitanwa n’iki cyorezo cya Covid-19 wikubye hafi kabiri ibicurane bya 1918. Icyorezo cya Covid-19 cyateye intambwe idasanzwe mu bijyanye n’inkingo, gitanga inkingo zifite umutekano kandi zifatika ku bantu no kwerekana ubushobozi bw’ubuvuzi bwo gukemura vuba ibibazo bikomeye mu gihe byihutirwa by’ubuzima rusange. Nibijyanye nuko hari leta yoroheje murwego rwinkingo zigihugu ndetse nisi yose, harimo ibibazo bijyanye no gukwirakwiza inkingo nubuyobozi. Inararibonye ya gatatu ni uko ubufatanye hagati y’ibigo byigenga, guverinoma, na za kaminuza ari ingenzi mu guteza imbere iterambere ryihuse ry’urukingo rwa mbere rwa Covid-19. Hashingiwe kuri aya masomo twize, Ikigo gishinzwe ubushakashatsi n’iterambere rya Biomedical (BARDA) kirashaka inkunga yo guteza imbere igisekuru gishya cy’inkingo zinoze.

Umushinga NextGen ni gahunda ya miliyari 5 z'amadorali yatewe inkunga n’ishami ry’ubuzima n’imirimo ya muntu igamije guteza imbere ibisekuruza bizaza by’ubuvuzi kuri Covid-19. Iyi gahunda izashyigikira impumyi ebyiri, igenzurwa cyane nicyiciro cya 2b kugirango isuzume umutekano, imikorere, nubudahangarwa bwinkingo zigeragezwa ugereranije ninkingo zemewe mubaturage batandukanye. Turateganya ko izi nkingo zizakoreshwa ku zindi nkingo z’indwara zandura, zibafasha guhita bakemura ibibazo by’ubuzima n’umutekano bizaza. Ubu bushakashatsi buzaba bukubiyemo ibitekerezo byinshi.

Iherezo ry’ibanze ryateganijwe mu cyiciro cya 2b ni uburyo bwo gukingira urukingo hejuru ya 30% mu gihe cy’amezi 12 yo kwitegereza ugereranije n’inkingo zimaze kwemezwa. Abashakashatsi bazasuzuma akamaro k'urukingo rushya rushingiye ku ngaruka zarwo zo kwirinda Covid-19; Byongeye kandi, nkibisobanuro byanyuma, abitabiriye amahugurwa bazisuzumisha hamwe nizuru ryicyumweru buri cyumweru kugirango babone amakuru yindwara zidafite ibimenyetso. Inkingo ziboneka muri Reta zunzubumwe zamerika zishingiye kuri spike protein antigens kandi zitangwa hakoreshejwe inshinge zo mu nda, mu gihe igisekuru kizaza cy’inkingo z’abakandida zizashingira ku buryo butandukanye, harimo ingirabuzimafatizo za spike ndetse n’uturere twinshi twabungabunzwe na virusi ya virusi, nka gen zigizwe na nucleocapsid, membrane, cyangwa izindi poroteyine zidafite imiterere. Ihuriro rishya rishobora kuba rikubiyemo urukingo rwa virusi ya recombinant rukoresha vectors zifite / zidafite ubushobozi bwo kwigana no kubamo gen zigizwe na SARS-CoV-2 za poroteyine zubaka kandi zidafite imiterere. Igisekuru cya kabiri cyiyongera urukingo rwa mRNA (samRNA) nuburyo bwikoranabuhanga bugenda bwihuta bushobora gusuzumwa nkubundi buryo. Urukingo rwa samRNA rugizwe na kopi zitwara urukurikirane rw'ubudahangarwa bw'umubiri muri lipide nanoparticles kugira ngo habeho ibisubizo nyabyo byo kurwanya indwara. Ibyiza byuru rubuga birimo dosiye ya RNA yo hasi (ishobora kugabanya reaction), ibisubizo birebire byumubiri, hamwe ninkingo zihamye kubushyuhe bwa firigo.

Igisobanuro cyo guhuza kurinda (CoP) nigisubizo cyihariye cyo kurwanya imihindagurikire y’imyororokere n’ingirabuzimafatizo zishobora kurinda indwara cyangwa kwandura indwara ziterwa na virusi. Ikizamini cya Phase 2b kizasuzuma CoPs zishobora gukingirwa Covid-19. Kuri virusi nyinshi, harimo na coronavirus, kumenya CoP yamye ari ingorabahizi kuko ibice byinshi bigize ubudahangarwa bw'umubiri bifatanyiriza hamwe mugutangiza virusi, harimo kutabuza no kutabuza antibodiyite (nka antibodiyite za agglutination, antibodies zangiza, cyangwa kuzuza antibodi zo gukosora), antibodiyite za isotype, CD4 + na CD8 + T selile, na selile yibuka. Ikirushijeho kuba ingorabahizi, uruhare rwibi bice mu kurwanya SARS-CoV-2 rushobora gutandukana bitewe na anatomique (nko kuzenguruka, ingirangingo, cyangwa imyanya myanya y'ubuhumekero) hamwe n'ahantu harebwa (nk'indwara zidafite ibimenyetso, kwandura ibimenyetso, cyangwa indwara zikomeye).

Nubwo kumenya CoP bikomeje kuba ingorabahizi, ibisubizo by'ibizamini byo gukingirwa mbere yo kwemezwa birashobora gufasha kumenya isano iri hagati yo gukwirakwiza antibody no kutagira ingaruka nziza. Menya inyungu nyinshi za CoP. CoP yuzuye irashobora gukora ubushakashatsi bwikiraro ku mbuga nshya zinkingo byihuse kandi bihendutse kuruta ibigeragezo binini bigenzurwa na platbo, kandi bigafasha gusuzuma ubushobozi bwo gukingira urukingo rwabaturage batashyizwe mubigeragezo byinkingo, nkabana. Kumenya CoP irashobora kandi gusuzuma igihe ubudahangarwa nyuma yo kwanduzwa nubwoko bushya cyangwa gukingirwa imiti mishya, kandi bigafasha kumenya igihe amafuti ya booster akenewe.

Impinduka ya mbere ya Omicron yagaragaye mu Gushyingo 2021. Ugereranije n’umwimerere wambere, ifite aside amine igera kuri 30 yasimbuwe (harimo aside amine 15 muri poroteyine ya spike), bityo ikaba yagenwe nkimpinduka zimpungenge. Mu cyorezo cyabanje cyatewe na COVID-19 zitandukanye nka alpha, beta, delta na kappa, ibikorwa byo kutabogama kwa antibodi zatewe no kwandura cyangwa gukingira virusi ya Omikjon byagabanutse, bituma Omikjon asimbuza virusi ya delta ku isi mu byumweru bike. Nubwo ubushobozi bwo kwigana Omicron mu ngirabuzimafatizo zo mu myanya y'ubuhumekero bwaragabanutse ugereranije n'imiterere yo hambere, mu ntangiriro byatumye ubwiyongere bukabije bw'ubwandu. Ubwihindurize bwakurikiyeho bwa Omicron bwahinduye buhoro buhoro ubushobozi bwayo bwo kwirinda antibodiyide zisanzwe zidafite aho zibogamiye, kandi ibikorwa byayo bihuza na angiotensin ihindura enzyme 2 (ACE2) nazo ziyongera, bituma umuvuduko w’ubwiyongere wiyongera. Nyamara, umutwaro uremereye wiyi miterere (harimo JN.1 urubyaro rwa BA.2.86) ni muto. Ubudahangarwa budasetsa bushobora kuba impamvu yuburemere buke bwindwara ugereranije nubwandu bwabanje. Kubaho kw'abarwayi ba Covid-19 batigeze bakora antibodiyite zidafite aho zibogamiye (nk'abafite imiti itera kubura B-selile) biragaragaza kandi akamaro k'ubudahangarwa bw'uturemangingo.

Ubu bushakashatsi bwerekana ko selile yibuka ya antigen T itagerwaho cyane na spike protein ihunga ihinduka ryimiterere ihindagurika ugereranije na antibodies. Memory T selile isa nkaho ishoboye kumenya epitopa yabitswe cyane kuri spike protein reseptor ihuza domaine hamwe nizindi virusi zifata poroteyine zubaka kandi zidafite imiterere. Ubu buvumbuzi bushobora gusobanura impamvu imiterere ya mutant ifite sensibilité nkeya kuri antibodiyite zisanzwe zidafite aho zibogamiye zishobora kuba zifitanye isano n'indwara zoroheje, kandi bikerekana ko ari ngombwa kunonosora uburyo bwo kumenya ibisubizo by’ubudahangarwa bwa T-selile.

Inzira y'ubuhumekero yo hejuru niyo ngingo yambere yo guhura no kwinjira muri virusi zubuhumekero nka coronavirus (epitelium yizuru ikungahaye kuri reseptor ya ACE2), aho usanga ibisubizo byubudahangarwa bw'umubiri ndetse no guhuza n'imiterere. Inkingo ziboneka muri iki gihe zifite ubushobozi buke bwo gukingira indwara ya mucosal ikomeye. Mubantu bafite igipimo cyinshi cyo gukingirwa, ubwinshi bwikwirakwizwa ryubwoko butandukanye burashobora gutera igitutu cyubwoko butandukanye, bikongerera amahirwe yo guhunga ubudahangarwa. Urukingo rwa Mucosal rushobora gukangura ubudahangarwa bw'imyanya myanya y'ubuhumekero hamwe n'ibisubizo by’ubudahangarwa bw'umubiri, bikagabanya kwanduza abaturage no kubagira urukingo rwiza. Izindi nzira zo gukingira zirimo intradermal (microarray patch), umunwa (tablet), intranasal (spray cyangwa igitonyanga), cyangwa guhumeka (aerosol). Kugaragara kwinkingo zidafite urushinge birashobora kugabanya gushidikanya ku nkingo no kongera kubyakira. Hatitawe ku buryo bwafashwe, koroshya inkingo bizagabanya umutwaro ku bakozi bashinzwe ubuzima, bityo bitezimbere uburyo bwo gukingira no koroshya ingamba zo guhangana n’icyorezo, cyane cyane iyo bibaye ngombwa gushyira mu bikorwa gahunda nini zo gukingira. Ingaruka z'inkingo imwe ya dose booster ikoresheje enteric yashyizweho, ibinini bikingira urukingo hamwe ninkingo zo mu nda bizasuzumwa hifashishijwe gusuzuma ibisubizo byihariye bya antigen IgA mu bice bya gastrointestinal na respiratory.

Mu cyiciro cya 2b ibizamini byamavuriro, gukurikirana neza umutekano wabitabiriye ni ngombwa kimwe no kunoza imikorere yinkingo. Tuzakusanya kuri gahunda no gusesengura amakuru yumutekano. Nubwo umutekano w’inkingo za Covid-19 wagaragaye neza, ingaruka mbi zishobora kubaho nyuma yinkingo iyo ari yo yose. Mu igeragezwa rya NextGen, abagera ku 10000 bazitabira isuzuma ry’ingaruka ziterwa n’ingaruka kandi bazahabwa amahirwe yo kwakira urukingo rw’igeragezwa cyangwa urukingo rwemewe ku kigereranyo cya 1: 1. Isuzuma rirambuye ryibisubizo byaho kandi bya sisitemu bizatanga amakuru yingenzi, harimo no guhura nibibazo nka myocarditis cyangwa pericarditis.

Ikibazo gikomeye abahura ninkingo bahura nacyo ni ngombwa gukomeza ubushobozi bwihuse bwo gusubiza; Ababikora bagomba kuba bashoboye gutanga amamiriyoni amagana yinkingo mugihe cyiminsi 100 icyorezo kikaba ari nayo ntego leta yashyizeho. Mugihe icyorezo kigenda kigabanuka no kwanduza icyorezo cyegereje, icyifuzo cyinkingo kizagabanuka cyane, kandi ababikora bazahura ningorane zijyanye no kubungabunga urunigi rutangwa, ibikoresho byibanze (enzymes, lipide, buffers, na nucleotide), hamwe nubushobozi bwo kuzuza no gutunganya. Kugeza ubu, icyifuzo cy’inkingo za Covid-19 muri sosiyete kiri munsi y’icyifuzo cyo mu 2021, ariko inzira y’umusaruro ikora ku rugero ruto ugereranije n’icyorezo cya “icyorezo cyuzuye” iracyakeneye kwemezwa n’inzego zibishinzwe. Iterambere ry’amavuriro risaba kandi kwemezwa n’ubuyobozi bugenzura, bushobora kuba bukubiyemo ubushakashatsi buhoraho hamwe na gahunda yo gutangiza icyiciro cya 3. Niba ibisubizo byateganijwe mu cyiciro cya 2b biteganijwe neza, bizagabanya cyane ingaruka zijyanye no gukora ibizamini byo mu cyiciro cya 3 kandi bitume ishoramari ryigenga muri ibyo bigeragezo, bityo bigere ku iterambere ry’ubucuruzi.

Igihe icyorezo cy’icyorezo kigezweho ntikiramenyekana, ariko uburambe bwa vuba bwerekana ko iki gihe kitagomba guta igihe. Iki gihe cyaduhaye amahirwe yo kwagura abantu gusobanukirwa n’ikingira ry’inkingo no kongera kwizerana n’icyizere ku nkingo ku bantu benshi bashoboka.