labarai

Cutar mura na lokaci-lokaci na haifar da mutuwar mutane 290,000 zuwa 650,000 masu alaƙa da cututtukan numfashi a duk duniya kowace shekara. Kasar na fama da mummunar cutar mura a wannan lokacin sanyi bayan kawo karshen cutar ta COVID-19. Alurar riga kafi ita ce hanya mafi inganci don rigakafin mura, amma maganin mura na gargajiya bisa al'adar amfrayo kaji yana da wasu kurakurai, kamar bambancin immunogenic, ƙarancin samarwa da sauransu.

Isowar rigakafin cutar mura na ƙwayar furotin HA na sake haɗawa zai iya magance lahani na maganin amfrayo na gargajiya. A halin yanzu, Kwamitin Ba da Shawarwari na Amurka kan Ayyukan rigakafi (ACIP) yana ba da shawarar allurar rigakafin mura mai yawa ga manya ≥65 shekaru. Duk da haka, ga mutanen da ba su wuce shekaru 65 ba, ACIP ba ta ba da shawarar kowace allurar mura mai dacewa da shekaru a matsayin fifiko saboda rashin kwatanta kai da kai tsakanin nau'ikan alluran rigakafi.

An amince da maganin rigakafi na recombinant hemagglutinin (HA) ta hanyar RIV4 don tallatawa a ƙasashe da yawa tun daga 2016 kuma a halin yanzu shine babban maganin mura da ake amfani da shi. Ana samar da RIV4 ta amfani da dandamalin fasahar furotin mai sake haɗawa, wanda zai iya shawo kan gazawar samar da allurar rigakafin da ba a kunna ba ta gargajiya ta iyakance ta hanyar samar da amfrayo kaji. Haka kuma, wannan dandali yana da gajeriyar zagayowar samarwa, ya fi dacewa don maye gurbin lokaci na ɗan takara nau'in maganin rigakafi, kuma yana iya guje wa sauye-sauyen daidaitawa wanda zai iya faruwa a cikin tsarin samar da ƙwayoyin cuta wanda zai iya rinjayar tasirin kariya na gama-gari. Karen Midthun, sannan darektan Cibiyar Nazarin Halittu da Bincike a Hukumar Abinci da Magunguna ta Amurka (FDA), ta yi tsokaci cewa "shigowar allurar rigakafin mura na wakiltar ci gaban fasaha a cikin samar da allurar rigakafin mura… Bugu da ƙari, RIV4 ya ƙunshi furotin na hemagglutinin sau uku fiye da daidaitaccen maganin mura na al'ada, wanda ke da ƙarfin rigakafi [2]. Binciken da aka yi ya nuna cewa RIV4 ya fi kariya fiye da daidaitattun allurar rigakafin mura a cikin tsofaffi, kuma ana buƙatar ƙarin cikakkun shaida don kwatanta biyun a cikin ƙananan mutane.

A ranar 14 ga Disamba, 2023, Jaridar New England Journal of Medicine (NEJM) ta buga Nazari daga Amber Hsiao et al., Kaiser Permanente Vaccine Study Center, KPNC Health System, Oakland, Amurka. Binciken wani bincike ne na ainihi na duniya wanda yayi amfani da tsarin bazuwar yawan jama'a don kimanta tasirin kariya na RIV4 tare da allurar rigakafin mura mai ƙima (SD-IIV4) a cikin mutanen da ke ƙasa da shekaru 65 a cikin yanayi biyu na mura daga 2018 zuwa 2020.

Dangane da yankin sabis da girman kayan aiki na wuraren KPNC, an ba su bazuwar zuwa ko dai rukunin A ko Rukunin B (Hoto na 1), inda rukunin A ya karɓi RIV4 a cikin makon farko, Rukunin B ya karɓi SD-IIV4 a cikin makon farko, sannan kowane wurin yana karɓar alluran rigakafin biyu a kowane mako har zuwa ƙarshen lokacin mura na yanzu. Babban ƙarshen binciken shine shari'o'in mura na PCR da aka tabbatar, kuma ƙarshen ƙarshen na biyu sun haɗa da mura A, mura B, da asibitoci masu alaƙa da mura. Likitoci a kowane wuri suna yin gwajin PCR mura bisa ga ra'ayinsu, bisa ga gabatarwar asibiti na majiyyaci, kuma suna samun ganewar asibiti da na waje, gwajin dakin gwaje-gwaje, da bayanan rigakafi ta hanyar bayanan likitancin lantarki.

Binciken ya haɗa da manya masu shekaru 18 zuwa 64, tare da shekaru 50 zuwa 64 waɗanda aka bincika rukunin farko. Sakamakon ya nuna cewa tasirin kariyar dangi (rVE) na RIV4 idan aka kwatanta da SD-IIV4 akan cutar da aka tabbatar da PCR shine 15.3% (95% CI, 5.9-23.8) a cikin mutane masu shekaru 50 zuwa 64 shekaru. Kariyar dangi akan mura A shine 15.7% (95% CI, 6.0-24.5). Ba a nuna wani tasiri mai mahimmanci na kariya na dangi don mura B ko asibiti masu alaƙa da mura ba. Bugu da ƙari, nazarin binciken ya nuna cewa a cikin mutanen da ke da shekaru 18-49, duka biyu don mura (rVE, 10.8%; 95% CI, 6.6-14.7) ko mura A (rVE, 10.2%; 95% CI, 1.4-18.2), RIV-II ya nuna kariya fiye da 4.

Wani bazuwar da ta gabata, makafi biyu, ingantaccen gwajin gwajin gwaji na asibiti ya nuna cewa RIV4 yana da mafi kyawun kariya fiye da SD-IIV4 a cikin mutane 50 shekaru da mazan (rVE, 30%; 95% CI, 10 ~ 47) [3]. Wannan binciken ya sake nunawa ta hanyar manyan bayanai na ainihi na duniya cewa magungunan mura na sake haɗawa suna ba da kariya mafi kyau fiye da maganin alurar riga kafi na gargajiya, kuma ya cika shaidar cewa RIV4 kuma yana ba da kariya mafi kyau a cikin ƙananan jama'a. Binciken ya yi nazarin abubuwan da suka faru na kamuwa da cutar syncytial na numfashi (RSV) a cikin ƙungiyoyin biyu (cututtukan RSV ya kamata ya kasance daidai a cikin ƙungiyoyin biyu saboda maganin mura ba ya hana kamuwa da RSV), ya cire wasu abubuwa masu ruɗani, kuma ya tabbatar da ƙarfin sakamakon ta hanyar nazarin hankali da yawa.

Ƙungiyar novel ɗin da aka tsara bazuwar hanyar ƙira da aka ɗauka a cikin wannan binciken, musamman madaidaicin allurar rigakafin gwaji da rigakafin rigakafi a kowane mako, mafi kyawun daidaita abubuwan da ke tsakanin ƙungiyoyin biyu. Duk da haka, saboda rikitarwa na ƙira, abubuwan da ake buƙata don aiwatar da bincike sun fi girma. A cikin wannan binciken, rashin wadataccen maganin rigakafin cutar mura ya haifar da yawan adadin mutanen da ya kamata su karbi RIV4 suna karɓar SD-IIV4, wanda ya haifar da babban bambanci a cikin yawan mahalarta tsakanin ƙungiyoyin biyu da kuma yiwuwar yiwuwar nuna bambanci. Bugu da kari, an shirya gudanar da binciken tun daga shekarar 2018 zuwa 2021, kuma bullar cutar ta COVID-19 da matakan rigakafinta da kuma kula da ita sun shafi duka binciken da kuma tsananin cutar mura, gami da takaita lokacin mura na 2019-2020 da kuma rashin kamuwa da cutar ta 2020-2021. Bayanai daga yanayi biyu na “marasa kyau” na mura daga 2018 zuwa 2020 suna samuwa, don haka ana buƙatar ƙarin bincike don tantance ko waɗannan binciken sun ci gaba da kasancewa a cikin yanayi da yawa, nau'ikan yaduwa daban-daban da abubuwan rigakafin.

Gabaɗaya, wannan binciken ya ƙara tabbatar da yuwuwar sake haɗa magungunan ƙwayoyin cuta da aka yi amfani da su a fagen rigakafin mura, sannan kuma ya kafa ƙwararrun ginshiƙi na fasaha don bincike da haɓaka sabbin rigakafin mura. Dandalin fasahar rigakafin ƙwayar cuta ta sake haɗawa ba ta dogara da amfrayo na kaji ba, kuma yana da fa'idodin gajeriyar zagayowar samarwa da kwanciyar hankali na samarwa. Koyaya, idan aka kwatanta da alluran rigakafin mura na gargajiya, ba shi da wani fa'ida mai mahimmanci a cikin kariya, kuma yana da wahala a warware matsalar kubuta na rigakafi da ƙwayoyin cuta da suka rikiɗe suka haifar daga tushen tushen. Hakazalika da maganin mura na gargajiya, ana buƙatar hasashen damuwa da maye gurbin antigen kowace shekara.

Dangane da bambance-bambancen mura masu tasowa, ya kamata mu mai da hankali kan haɓaka rigakafin mura na duniya a nan gaba. Samar da rigakafin mura na duniya ya kamata sannu a hankali fadada iyakokin kariya daga nau'ikan ƙwayoyin cuta, kuma a ƙarshe samun ingantaccen kariya daga kowane nau'in cikin shekaru daban-daban. Saboda haka, ya kamata mu ci gaba da inganta zane na m bakan immunogen dangane da HA sunadaran a nan gaba, mayar da hankali a kan NA, wani surface furotin na mura cutar, a matsayin key alurar riga kafi manufa, da kuma mayar da hankali a kan numfashi rigakafi hanyoyin fasaha da cewa su ne mafi m inducing Multi-girma m martani ciki har da gida salon salula rigakafi (kamar hanci fesa maganin, inhalable bushe foda maganin alurar riga kafi, da dai sauransu). Ci gaba da haɓaka binciken rigakafin mRNA, alluran jigilar jigilar kayayyaki, sabbin adjuvants da sauran dandamali na fasaha, da fahimtar haɓaka ingantaccen rigakafin mura na duniya waɗanda ke “amsa ga duk canje-canje ba tare da canji ba”