Kusan dukkanmu mun ji ko karanta labarai game da yaduwar cutar coronavirus. Kamar yadda yake tare da kowace cuta, ganewar asali da wuri yana da mahimmanci a cikin yaƙi da sabuwar ƙwayar cuta. Duk da haka, ba duka masu kamuwa da cutar ba ne ke nuna alamun iri ɗaya, kuma hatta na'urorin daukar hoto na filin jirgin sama da aka kera don gano alamun kamuwa da cuta ba sa samun nasarar gano majiyyaci a cikin tarin fasinjoji. Tambayar ta taso: me yasa kwayar cutar guda ɗaya ke bayyana kanta daban a cikin mutane daban-daban? A zahiri, amsar farko ita ce rigakafi. Duk da haka, wannan ba shine kawai ma'auni mai mahimmanci ba wanda ke rinjayar sauye-sauyen bayyanar cututtuka da kuma tsananin cutar. Masana kimiyya daga Jami'ar California da Arizona (Amurka) sun gano cewa ƙarfin juriya ga ƙwayoyin cuta ya dogara ba kawai ga nau'in murabba'in mutum ba a tsawon rayuwarsa, har ma da tsarinsu. Menene ainihin masana kimiyya suka gano, waɗanne hanyoyi ne aka yi amfani da su a cikin binciken, kuma ta yaya wannan aikin zai taimaka wajen yaƙi da annoba? Za mu sami amsoshin waɗannan tambayoyin a cikin rahoton ƙungiyar bincike. Tafi
Tushen bincike
Kamar yadda muka sani, mura yana bayyana kanta daban a cikin mutane daban-daban. Bugu da ƙari, abubuwan da ke cikin ɗan adam (tsarin rigakafi, shan magungunan rigakafi, matakan rigakafi, da dai sauransu), wani muhimmin al'amari shi ne kwayar cutar kanta, ko ma dai nau'insa, wanda ke cutar da wani mara lafiya. Kowane nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'in nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i nau'i) wanda ya haɗa da yawan abin da ya shafi ƙungiyoyi daban-daban. Masana kimiyya sun lura cewa H1N1 ("murar alade") da H3N2 (murar Hong Kong), wadanda suka zama ruwan dare a yanzu, suna shafar mutane masu shekaru daban-daban: H3N2 yana haifar da mafi tsanani lokuta na cutar a cikin tsofaffi. kuma ana danganta shi da yawancin mutuwar; H1N1 ba shi da kisa amma galibi yana shafar masu matsakaicin shekaru da matasa.
Irin waɗannan bambance-bambancen na iya kasancewa saboda duka bambancin ƙimar juyin halittar ƙwayoyin cuta da kansu da kuma bambancin a ciki rigakafin rigakafi* a cikin yara.
Immune bugawa* - wani nau'i na ƙwaƙwalwar ajiyar lokaci mai tsawo na tsarin rigakafi, wanda aka samo asali a kan gogaggun hare-haren kwayar cutar hoto a jiki da halayensa.
A cikin wannan binciken, masu binciken sun yi nazarin bayanan cututtukan cututtuka don sanin ko buga yara yana rinjayar cututtukan cututtukan mura na yanayi kuma, idan haka ne, ko ta fara aiki ta hanyar farko. homosubtypic* ƙwaƙwalwar rigakafi ko ta hanyar fadi heterosubtypic* ƙwaƙwalwar ajiya.
Immunity na Homosubtypic* - kamuwa da kamuwa da mura na lokaci-lokaci ƙwayoyin cuta na ƙwayoyin cuta suna haɓaka haɓaka garkuwar rigakafi daga takamaiman nau'in ƙwayar cuta.
Heterosubtypic rigakafi* - kamuwa da kamuwa da mura na lokaci-lokaci ƙwayoyin cuta na ƙwayoyin cuta suna haɓaka haɓaka garkuwar rigakafi daga ƙananan nau'ikan da ba su da alaƙa da wannan ƙwayar cuta.
A wasu kalmomi, rigakafin yaro da duk abin da ya fuskanta ya bar alamarsa a kan tsarin rigakafi na rayuwa. Binciken da aka yi a baya ya nuna cewa manya suna da karfin rigakafi daga nau'ikan ƙwayoyin cuta da suka kamu da su tun suna yara. Hakanan an nuna alamun kwanan nan don karewa daga sabbin nau'ikan ƙwayoyin cutar mura na Avian iri ɗaya na rukunin phylogenetic na hemagglutinin (hemaglutinin, HA), kamar yadda yake tare da kamuwa da cuta na farko a cikin yara.
Har zuwa kwanan nan, ƙunƙarar rigakafi ta keɓaɓɓu ga bambance-bambancen nau'in nau'in HA guda ɗaya ana ɗaukarsa babban yanayin kariya daga mura na yanayi. Duk da haka, akwai sababbin shaidun da ke nuna cewa samuwar rigakafi na iya tasiri ta hanyar ƙwaƙwalwar wasu antigens na mura (misali, neuraminidase, NA). Tun daga 1918, an gano nau'ikan nau'ikan AN guda uku a cikin mutane: H1, H2 da H3. Haka kuma, H1 da H2 suna cikin rukunin phylogenetic 1, da H3 zuwa rukuni na 2.
Ganin cewa bugawa yana iya haifar da sauye-sauye masu yawa a ƙwaƙwalwar ajiyar rigakafi, ana iya ɗauka cewa waɗannan canje-canje suna da takamaiman matsayi.
Masana kimiyya sun lura cewa tun daga 1977, nau'ikan mura guda biyu A-H1N1 da H3N2-sun yadu lokaci-lokaci a tsakanin yawan jama'a. A lokaci guda, bambance-bambance a cikin kididdigar alƙaluma na kamuwa da cuta da kuma alamun bayyanar sun kasance a bayyane, amma ba a yi nazari sosai ba. Waɗannan bambance-bambancen na iya kasancewa musamman saboda bugawar yara: kusan tsofaffi sun kamu da cutar H1N1 tun suna yara (daga 1918 zuwa 1975 ita ce kawai nau'in nau'in da ke yawo a cikin mutane). Saboda haka, waɗannan mutanen yanzu an fi samun kariya daga nau'ikan ƙwayoyin cuta na zamani na wannan nau'in. Hakazalika, a tsakanin matasa, mafi girman yiwuwar buga yara shine don H3N2 na baya-bayan nan (hoto #1), wanda ya yi daidai da ƙarancin adadin da aka ba da rahoton asibiti na H3N2 a cikin wannan alƙaluma.
Hoto No. 1: bambance-bambancen samfura na dogaro da rigakafi akan bugu a ƙuruciya da kuma dalilin juyin halittar hoto.
A gefe guda, waɗannan bambance-bambancen suna iya alaƙa da juyin halittar ƙwayoyin cuta da kansu. Don haka, H3N2 yana nuna sauri yawo* phenotype na antigenic fiye da H1N1.
Antigen drift* - canje-canje a cikin abubuwan da ke haifar da rigakafi na ƙwayoyin cuta.
Saboda wannan dalili, H3N2 na iya zama mafi kyawun iya guje wa riga-kafi da aka rigaya a cikin ƙwararrun ƙwararrun rigakafi, yayin da H1N1 na iya zama ɗan iyakancewa a cikin tasirinsa kawai akan yara marasa butulci.
Don gwada duk wani hasashe masu ma'ana, masanan kimiyya sun bincika bayanan annoba ta hanyar ƙirƙirar ayyuka masu yuwuwa ga kowane bambance-bambancen ƙididdiga, waɗanda aka kwatanta ta amfani da Ma'aunin Bayanin Akaike (AIC).
An kuma gudanar da ƙarin bincike kan hasashe wanda bambance-bambancen ba su kasance ba saboda bugawa a cikin juyin halittar ƙwayoyin cuta.
Shiri na karatu
Ƙirar ƙira ta yi amfani da bayanan Sashen Sabis na Kiwon Lafiya na Arizona (ADHS) na lokuta 9510 na yanayi na H1N1 da H3N2 a duk faɗin jihar. Kusan kashi 76% na adadin da aka ruwaito an rubuta su a asibitoci da dakunan gwaje-gwaje, sauran lokuta ba a bayyana su ba a dakunan gwaje-gwaje. Haka kuma an san cewa kusan rabin lamuran da aka gano a dakin gwaje-gwaje sun yi tsanani da ya kai su asibiti.
Bayanan da aka yi amfani da su a cikin binciken sun shafi tsawon shekaru 22 daga lokacin mura na 1993-1994 zuwa kakar 2014-2015. Ya kamata a lura cewa girman samfurin ya karu sosai bayan cutar ta 2009, don haka an cire wannan lokacin daga samfurin (Table 1).
Tebur Na 1: Bayanan annoba daga 1993 zuwa 2015 game da rubutattun lokuta na ƙwayoyin cuta H1N1 da H3N2.
Hakanan yana da mahimmanci a yi la'akari da cewa tun shekara ta 2004, ana buƙatar dakunan gwaje-gwaje na kasuwanci a Amurka don isar da duk bayanan game da kamuwa da cutar hoto ta hoto ga hukumomin kiwon lafiya na gwamnati. Koyaya, yawancin shari'o'in da aka bincika (9150/9451) sun faru ne daga lokacin 2004-2005, bayan da dokar ta fara aiki.
Daga cikin dukkan shari'o'i 9510, an cire 58 saboda sun kasance mutanen da suke da shekara ta haihuwa kafin 1918 (ba za a iya tantance matsayinsu a fili ba), da kuma wani shari'ar 1 saboda ba a bayyana shekarar haihuwa ba daidai ba. Don haka, an haɗa shari'o'i 9541 a cikin samfurin bincike.
A matakin farko na ƙirar ƙira, an ƙaddara yiwuwar buga wa ƙwayoyin cuta H1N1, H2N2 ko H3N2, musamman ga shekarar haihuwa. Wadannan yuwuwar suna nuna yanayin kamuwa da mura A a cikin yara da kuma yaduwarta a kowace shekara.
Yawancin mutanen da aka haifa a tsakanin 1918 da 1957 annoba sun fara kamuwa da nau'in H1N1. Mutanen da aka haifa tsakanin 1957 da 1968 annoba ta kusan kusan dukkansu sun kamu da nau'in H2N2 (1A). Kuma tun daga 1968, babban nau'in kwayar cutar shine H3N2, wanda ya zama sanadin kamuwa da yawancin mutane daga rukunin matasa.
Duk da yawaitar H3N2, H1N1 har yanzu yana yaɗuwar yanayi a cikin jama'a tun daga 1977, yana haifar da bugawa a cikin adadin mutanen da aka haifa tun tsakiyar 1970s (1A).
Idan bugawa a matakin nau'in nau'in AN yana siffanta yiwuwar kamuwa da cuta a lokacin mura na yanayi, to, bayyanar da H1 ko H3 AN subtypes a farkon ƙuruciya yakamata ya ba da kariya ta rayuwa ga bambance-bambancen kwanan nan na nau'in nau'in AN iri ɗaya. Idan rigakafin rigakafi yana aiki da yawa akan wasu nau'ikan NA (neuraminidase), to kariya ta rayuwa zata kasance siffa ta N1 ko N2 (1B).
Idan bugawa ya dogara ne akan mafi girman NA, i.e. Kariya a kan kewayon da ke fadi da subtypes yakan faru, to mutane masu sa su ne daga H1 da H2 ya kamata a kiyaye su daga zamani zamani h1n1. A lokaci guda, mutanen da aka buga zuwa H3 za a kiyaye su kawai daga yanayin H3N2 na zamani (1B).
Masana kimiyya sun lura cewa collinearity (kusan magana, daidaici) na tsinkaya na nau'ikan bugawa daban-daban (1D-1I) ya kasance babu makawa idan aka yi la'akari da ƙayyadaddun nau'in murabba'in antigenic da ke yawo a cikin yawan jama'a a cikin ƙarni da suka gabata.
Muhimmiyar rawa wajen bambancewa tsakanin bugawa a nau'in nau'in HA, nau'in NA ko matakin rukuni na HA yana taka rawa ta hanyar masu matsakaicin shekaru waɗanda suka fara kamuwa da H2N2 (1B).
Kowane samfurin da aka gwada yayi amfani da haɗin kai tsaye na kamuwa da cuta mai alaƙa da shekaru (1С), da ciwon da ke tattare da shekarar haihuwa (1D-1F), don samun rarraba H1N1 ko H3N2 lokuta (1G - 1I).
An ƙirƙiri jimillar nau'ikan nau'ikan nau'ikan 4: mafi sauƙi wanda ya ƙunshi nau'ikan shekaru kawai, kuma ƙarin ƙira masu rikitarwa sun ƙara abubuwan bugu a matakin nau'in HA, a matakin ƙaramin nau'in NA, ko a matakin ƙungiyar HA.
Matsakaicin adadin shekarun yana da nau'in aikin mataki wanda aka saita haɗarin kamuwa da cuta zuwa 1 a cikin rukunin shekaru 0-4. Baya ga rukunin shekarun farko, akwai kuma masu zuwa: 5–10, 11–17, 18–24, 25–31, 32–38, 39–45, 46–52, 53–59, 60–66, 67-73, 74- 80, 81+.
A cikin ƙira waɗanda suka haɗa da tasirin bugawa, adadin daidaikun mutane a kowace shekara ta haihuwa tare da ɗaukar hoto na ƙuruciya an ɗauka ya yi daidai da rage haɗarin kamuwa da cuta.
An kuma yi la'akari da yanayin juyin halittar hoto a cikin ƙirar ƙira. Don yin wannan, mun yi amfani da bayanan da suka bayyana ci gaban antigenic na shekara-shekara, wanda aka bayyana a matsayin matsakaicin nisa na antigenic tsakanin nau'in jinsin kwayar cutar hoto (H1N1 kafin 2009, H1N1 bayan 2009, da H3N2). "Nisan antigenic" tsakanin nau'ikan mura guda biyu ana amfani dashi azaman mai nuna kamanni a cikin phenotype na antigenic da yuwuwar kariyar giciye.
Don tantance tasirin juyin halitta na antigenic akan rarraba shekarun annoba, an gwada canje-canje a cikin adadin lokuta a cikin yara a lokacin lokutan da canje-canjen antigenic mai ƙarfi ya faru.
Idan matakin drift na antigenic yana da mahimmanci a cikin haɗarin kamuwa da cuta da ke da alaƙa da shekaru, to, adadin lokuta da aka lura a cikin yara yakamata a danganta shi da mummunan ci gaban antigenic na shekara. A wasu kalmomi, nau'ikan da ba su sami sauye-sauye na antigenic ba daga kakar da ta gabata ya kamata su kasa tserewa riga-kafi da aka rigaya a cikin manya masu ilimin rigakafi. Irin waɗannan nau'ikan za su fi aiki a tsakanin al'ummomi ba tare da ƙwarewar rigakafi ba, wato, tsakanin yara.
Sakamakon bincike
Binciken bayanan da aka yi a shekara ya nuna cewa H3N2 na yanayi shine babban dalilin kamuwa da cuta a tsakanin tsofaffi, yayin da H1N1 ya shafi masu matsakaici da matasa (hoto #2).
Hoto No. 2: Rarraba cutar H1N1 da H3N2 ta shekaru a lokuta daban-daban.
Wannan tsarin ya kasance duka a cikin bayanan kafin cutar ta 2009 da kuma bayanta.
Bayanan sun nuna cewa bugawa a matakin nau'in nau'in NA ya fi rinjaye akan bugawa a matakin HA (ΔAIC = 34.54). A lokaci guda kuma, kusan kusan babu buguwa a matakin ƙungiyar HA (ΔAIC = 249.06), da kuma cikakkiyar ƙarancin bugawa (ΔAIC = 385.42).
Hoto #3: Tantance dacewa da samfuran zuwa bayanan bincike.
Ƙimar gani na samfurin dacewa (3C и 3D) ya tabbatar da cewa samfuran da ke ɗauke da tasirin bugawa a ƙananan matakan NA ko HA sun ba da mafi dacewa ga bayanan da aka yi amfani da su a cikin binciken. Gaskiyar cewa samfurin wanda babu shi ba zai iya samun goyan bayan bayanai ba yana nuna cewa bugawa abu ne mai mahimmanci na ci gaban rigakafi a cikin yawan jama'a dangane da nau'in mura na yanayi. Koyaya, alamu masu alaƙa da ƙwararrun ƙwayoyin cuta, wannan shine, yana aiki a kan takamaiman subatespe, kuma ba a kan takamaiman ambaliyar mura da mura ba.
Tebur No. 2: kima na dacewa da samfurori zuwa bayanan bincike.
Bayan sarrafawa don rarraba shekarun alƙaluma, ƙididdiga masu alaƙa da shekaru sun kasance mafi girma a cikin yara da tsofaffi, daidai da tarawar ƙwaƙwalwar ajiya a cikin ƙuruciya da raunin aikin rigakafi a cikin tsofaffi (a 3A an nuna madaidaicin lankwasa daga mafi kyawun samfurin). Ƙididdiga masu buguwa ba su kai ɗaya ba, yana nuna raguwa kaɗan a haɗarin dangi (Table 2). A cikin mafi kyawun samfurin, ƙididdige ƙimar haɗarin dangi daga bugawar yara ya fi girma ga H1N1 (0.34, 95% CI 0.29-0.42) fiye da na H3N2 (0.71, 95% CI 0.62-0.82).
Don gwada tasirin juyin halitta na hoto ko bidiyo mai zagaya yanar gizo da sauri akan shekarun rarraba haɗarin kamuwa da cuta, masu binciken sun nemi raguwar adadin cututtuka a tsakanin yara yayin lokutan da ke da alaƙa da canjin antigenic, lokacin da nau'ikan ɗigon antigenic mai girma ya fi tasiri wajen cutar da manyan ƙwararrun rigakafi.
Binciken bayanai ya nuna ƙaramin ƙima amma mara ƙima tsakanin haɓakar shekara-shekara a cikin ayyukan antigenic da adadin cututtukan H3N2 da aka lura a cikin yara.4A).
Hoto A'a. 4: tasirin juyin halitta na hoto ko bidiyo mai zagaya yanar gizo da sauri akan abubuwan haɗari masu alaƙa da shekaru don kamuwa da cuta.
Duk da haka, ba a sami kyakkyawar dangantaka tsakanin canje-canje na antigenic da kuma yawan lokuta da aka gani a cikin yara fiye da shekaru 10 da kuma manya. Idan juyin halitta na hoto ya taka muhimmiyar rawa a cikin wannan rarraba, sakamakon zai zama mafi bayyane shaida na tasirin juyin halitta a tsakanin manya, ba kawai lokacin kwatanta manya da yara masu kasa da shekaru 10 ba.
Haka kuma, idan matakin canjin juyin halitta na hoto ko bidiyo mai zagaya yanar gizo da sauri ya mamaye don takamaiman takamaiman bambance-bambance a cikin rarraba shekarun annoba, to lokacin da nau'ikan H1N1 da H3N2 suka nuna irin wannan adadin yaduwar antigen na shekara-shekara, rarraba shekarun su na cututtukan yakamata ya zama kama.
Don ƙarin cikakken sani tare da nuances na binciken, Ina ba da shawarar dubawa .
Epilogue
A cikin wannan aikin, masana kimiyya sun binciki bayanan cututtukan cututtuka game da kamuwa da cuta tare da H1N1, H3N2 da H2N2. Binciken bayanai ya nuna kyakkyawar alaƙa tsakanin bugawa a cikin ƙuruciya da haɗarin kamuwa da cuta a cikin girma. Ma’ana, idan yaro dan shekara 50 ya kamu da cutar a lokacin da H1N1 ke yawo kuma H3N2 ba ya nan, to a lokacin girma yiwuwar kamuwa da cutar H3N2 zai fi karfin kamuwa da cutar H1N1.
Babban mahimmancin wannan binciken shine cewa yana da mahimmanci ba kawai abin da mutum ya sha wahala ba a lokacin yaro, amma kuma a cikin wane tsari. Ƙwaƙwalwar rigakafi, wanda ke tasowa a duk tsawon rayuwa, yana aiki da "rikodi" bayanai daga cututtukan cututtuka na farko, wanda ke taimakawa wajen magance su a cikin girma.
Masana kimiyya suna fatan cewa aikinsu zai ba da damar yin hasashen mafi yawan shekarun da suka fi kamuwa da cutar mura. Wannan ilimin na iya taimakawa wajen hana yaduwar cututtuka, musamman idan ana bukatar a raba wa al’umma takaitaccen adadin alluran rigakafi.
Wannan binciken ba shi da nufin nemo manyan magunguna ga kowace irin mura, kodayake hakan zai yi kyau. Ana nufin abin da ya fi gaske kuma mai mahimmanci a yanzu - hana yaduwar kamuwa da cuta. Idan ba za mu iya kawar da kwayar cutar nan take ba, to dole ne mu sami dukkan kayan aikin da za mu iya dauke ta. Daya daga cikin amintattun amintattun duk wata annoba shine halin rashin kula da ita a bangaren jihar gaba daya da kuma kowane mutum musamman. Firgita, ba shakka, ba lallai ba ne, domin yana iya yin muni kawai, amma yin taka tsantsan ba zai taɓa yin rauni ba.
Na gode da karantawa, ku kasance da sha'awar, kula da kanku da ƙaunatattun ku kuma ku sami babban mutanen karshen mako! 🙂
Wasu tallace-tallace 🙂
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