Cishe sonke sike sezwa noma safunda izindaba mayelana nokusabalala kwe-coronavirus. Njenganoma yisiphi esinye isifo, ukuxilongwa kusenesikhathi kubalulekile ekulweni negciwane elisha. Nokho, akubona bonke abantu abanaleli gciwane ababonisa izimpawu ezifanayo, futhi ngisho nezithwebuli zesikhumulo sezindiza eziklanyelwe ukubona izimpawu zokutheleleka azikwazi ukuhlonza isiguli ngempumelelo phakathi kwesixuku sabagibeli. Umbuzo uphakama: kungani igciwane elifanayo lizibonakalisa ngendlela ehlukile kubantu abahlukene? Ngokwemvelo, impendulo yokuqala iwukuzivikela. Kodwa-ke, lokhu akuyona ukuphela kwepharamitha ebalulekile ethonya ukuhlukahluka kwezimpawu kanye nobukhulu besifo. Ososayensi abavela eNyuvesi yaseCalifornia nase-Arizona (USA) bathole ukuthi amandla okumelana namagciwane awaxhomekile nje kuphela ekutheni yiziphi izinhlobo zomkhuhlane umuntu abe nazo kukho konke ukuphila kwakhe, kodwa futhi nokulandelana kwawo. Yini ngempela eyatholwa ososayensi, yiziphi izindlela ezasetshenziswa ocwaningweni, futhi lo msebenzi ungasiza kanjani ekulweni nezifo eziwumshayabhuqe? Sizothola izimpendulo zale mibuzo embikweni weqembu locwaningo. Hamba.
Isisekelo socwaningo
Njengoba sazi, umkhuhlane uzibonakalisa ngendlela ehlukile kubantu abahlukene. Ngaphezu kwesici somuntu (isimiso sokuzivikela komzimba, ukuthatha izidakamizwa ezilwa namagciwane, izinyathelo zokuvimbela, njll.), isici esibalulekile yigciwane ngokwalo, noma kunalokho i-subtype yalo, ethelela isiguli esithile. I-subtype ngayinye inezici zayo, kufaka phakathi izinga lapho amaqembu ezibalo zabantu athintekayo. Ososayensi baphawula ukuthi amagciwane e-H1N1 (“umkhuhlane wezingulube”) kanye ne-H3N2 (Hong Kong flu), aseyinsakavukela umchilo wesidwaba njengamanje, athinta abantu beminyaka ehlukene ngokwehlukana: I-H3N2 ibangela izifo ezinzima kakhulu kubantu asebekhulile, futhi kuthiwa kungenxa yokufa kwabantu abaningi; I-H1N1 ayibulali kangako kodwa ivamise ukuphatha abantu abaneminyaka ephakathi nendawo kanye nentsha.
Umehluko onjalo ungase ubangelwe kokubili umehluko wezinga lokuvela kwamagciwane ngokwawo kanye nomehluko kuwo imprinting immune* ezinganeni.
Ukuphrinta kwamasosha omzimba* - uhlobo lwenkumbulo yesikhathi eside yesimiso somzimba sokuzivikela ezifweni, esakhiwe ngesisekelo sokuhlaselwa kwegciwane elihlangene nomzimba kanye nokusabela kwalo kubo.
Kulolu cwaningo, abacwaningi bahlaziye idatha ye-epidemiological ukuze banqume ukuthi ukuphrinta kwezingane kunomthelela ku-epidemiology yomkhuhlane wonyaka futhi, uma kunjalo, noma ngabe usebenza ngokuyinhloko. i-homosubtypic* inkumbulo omzimba noma ngokusebenzisa ebanzi i-heterosubtypic* inkumbulo.
I-Homosubtypic immunity* - ukutheleleka ngegciwane le-influenza A lonyaka likhuthaza ukuthuthukiswa kokuzivikela komzimba ngokumelene nohlobo oluthile lwegciwane.
I-Heterosubtypic immunity* - ukutheleleka ngegciwane le-influenza A lonyaka likhuthaza ukuthuthukiswa kokuzivikela komzimba ngokumelene nezinhlobo ezincane ezingahlobene naleli gciwane.
Ngamanye amazwi, ukungatheleleki kwengane nakho konke ekutholayo kushiya uphawu lwalo esimisweni somzimba sokuzivikela ezifweni zokuphila konke. Ucwaningo lwangaphambilini lubonise ukuthi abantu abadala banokuvikeleka okuqinile ezinhlotsheni zamagciwane abangenwe ngawo beseyizingane. Ukuphrinta futhi muva nje kuboniswe ukuthi kuvikela kuma-subtypes egciwane lomkhuhlane wezinyoni weqembu elifanayo le-hemagglutinin phylogenetic (i-hemagglutinin, HA), njengokutheleleka kokuqala ebuntwaneni.
Kuze kube muva nje, ukuzivikela okuphambana okuminyene okuqondene nezinhlobonhlobo ze-HA subtype eyodwa bekubhekwa njengendlela eyinhloko yokuvikela emkhuhlaneni wesizini. Kodwa-ke, kunobufakazi obusha obubonisa ukuthi ukwakheka kokuzivikela komzimba kungase kuthonywe inkumbulo yamanye ama-antigens omkhuhlane (isibonelo, i-neuraminidase, i-NA). Kusukela ngo-1918, izinhlobo ezintathu ze-AN zihlonzwe kubantu: H1, H2 kanye ne-H3. Ngaphezu kwalokho, i-H1 ne-H2 ingeyeqembu le-phylogenetic 1, kanye ne-H3 yeqembu lesi-2.
Njengoba kunikezwe iqiniso lokuthi ukuphrinta cishe kudala izinguquko eziningi kwinkumbulo yokuzivikela komzimba, kungacatshangwa ukuthi lezi zinguquko zinokulandelana okuthile.
Ososayensi bayaqaphela ukuthi kusukela ngo-1977, izinhlobo ezimbili ezincane zomkhuhlane A—H1N1 kanye ne-H3N2—ziye zasakazwa ngezikhathi ezithile zonyaka phakathi kwabantu. Ngaso leso sikhathi, umehluko wezibalo zabantu bokutheleleka kanye nezimpawu wawusobala, kodwa wafundwa kabi. Lo mehluko ungahle ubangelwe ikakhulukazi ukuphrinta kwasebuntwaneni: abantu asebekhulile cishe bachayeka ku-H1N1 besengabantwana (kusukela ngo-1918 kuya ku-1975 kwakuyiyona yodwa i-subtype eyayizungeza kubantu). Ngenxa yalokho, laba bantu manje sebevikeleke kangcono ezinhlobonhlobo zenkathi yesimanje zegciwane lalolu hlobo oluncane. Ngokufanayo, phakathi kwentsha yabantu abadala, amathuba aphezulu okuphrinta kwezingane awe-H3N2 yakamuva (isithombe #1), esihambisana nenani eliphansi uma kuqhathaniswa lezigameko ezibikiwe emtholampilo ze-H3N2 kule nombolo yabantu.
Isithombe No. 1: amamodeli ahlukile wokuncika kokuvikeleka ekugxilweni ebuntwaneni kanye nesici sokuvela kwegciwane.
Ngakolunye uhlangothi, lo mehluko ungase uhlotshaniswe nokuvela kwezinhlobo ezincane zegciwane ngokwazo. Ngakho, i-H3N2 ikhombisa ngokushesha ukukhukhuleka* i-phenotype yayo ye-antigenic kune-H1N1.
I-antigen drift* - izinguquko ezintweni ezakha amasosha omzimba amagciwane.
Ngenxa yalesi sizathu, i-H3N2 ingase ikwazi kangcono ukugwema ukuzivikela okukhona kakade kubantu abadala abanolwazi lwe-immunologically, kuyilapho i-H1N1 ingase ibe nomkhawulo emiphumeleni yayo kuphela ezinganeni ezingenayo i-immunologically.
Ukuze kuhlolwe yonke imibono enengqondo, ososayensi bahlaziye idatha ye-epidemiological ngokudala amathuba emisebenzi okuhluka ngakunye kwamamodeli ezibalo, aqhathaniswe kusetshenziswa i-Akaike Information Criterion (AIC).
Ukuhlaziywa okwengeziwe kwenziwa futhi ku-hypothesis lapho umehluko ungekho ngenxa yokuphrinta ekuziphendukeleni kwamagciwane.
Ukulungiselela ucwaningo
Ukumodela kwe-hypothesis kusetshenziswe idatha evela ku-Arizona Department of Health Services (ADHS) kwezingu-9510 izimo zesizini zezwe lonke ze-H1N1 kanye ne-H3N2. Cishe u-76% wamacala abikiwe aqoshwa ezibhedlela nasemalabhorethri, amacala asele ayengashiwongo ezindaweni zokucwaninga. Kuyaziwa futhi ukuthi cishe uhhafu wamacala ahlonzwe elabhorethri ayebucayi ngokwanele ukuthi aholele ekulalisweni esibhedlela.
Idatha esetshenziswe ocwaningweni ihlanganisa isikhathi seminyaka engama-22 kusukela kusizini yomkhuhlane ka-1993-1994 kuya kusizini ka-2014-2015. Kuyaphawuleka ukuthi amasampula osayizi anyuke kakhulu ngemva kobhadane lwango-2009, ngakho lesi sikhathi asifakwanga kusampula (Ithebula 1).
Ithebula No. 1: idatha ye-epidemiological kusukela ngo-1993 kuya ku-2015 mayelana nezimo ezirekhodiwe ze-H1N1 kanye ne-H3N2 virus.
Kubalulekile futhi ukucabangela ukuthi kusukela ngo-2004, amalabhorethri ezentengiselwano e-United States kudingeke ukuba adlulisele yonke idatha ephathelene nokutheleleka ngegciwane kweziguli kuziphathimandla zezempilo zikahulumeni. Kodwa-ke, iningi lamacala ahlaziywayo (9150/9451) enzeka kusukela ngesizini ka-2004-2005, ngemuva kokusebenza komthetho.
Kuwo wonke amacala angu-9510, angu-58 ayengafakwanga ngoba kwakungabantu abanonyaka wokuzalwa ngaphambi kuka-1918 (isimo sabo sokuphrinta asikwazi ukucaciswa ngokucacile), kanti elinye icala elingu-1 ngoba unyaka wokuzalwa wawuchazwe ngokungalungile. Ngakho-ke, amacala angama-9541 afakiwe kumodeli yokuhlaziya.
Esigabeni sokuqala sokumodela, amathuba okuphrinta amagciwane e-H1N1, H2N2 noma H3N2, aqondene nonyaka wokuzalwa, anqunywa. Lawa mathuba abonisa iphethini yokuchayeka kumkhuhlane A ezinganeni kanye nokusabalala kwawo ngonyaka.
Abantu abaningi abazalwa phakathi kuka-1918 no-1957 izifo eziwumshayabhuqe baqala ukungenwa yi-H1N1 subtype. Abantu abazalwa phakathi kuka-1957 no-1968 ubhubhane cishe bonke bangenwa yi-H2N2 subtype (I-1A). Futhi kusukela ngo-1968, i-subtype evelele yegciwane kwakuyi-H3N2, eyaba imbangela yokutheleleka kweningi labantu abavela eqenjini labantu abasha.
Naphezu kokusabalala kwe-H3N2, i-H1N1 isalokhu isakazwa ngezikhathi ezithile zonyaka kubantu kusukela ngo-1977, okubangela ukunyatheliswa kwenani labantu abazalwa kusukela maphakathi nawo-1970.I-1A).
Uma ukuphrinta ezingeni le-AN subtype kulokha amathuba okutheleleka ngesikhathi somkhuhlane wesizini, khona-ke ukuchayeka ku-H1 noma i-H3 AN subtypes ebuntwaneni kufanele kunikeze ukuvikeleka kwempilo yonke ezinhlobonhlobo zakamuva zohlobo oluncane lwe-AN. Uma ukuzivikela komzimba okugxilile kusebenza kakhulu ngokumelene nezinhlobo ezithile ze-NA (neuraminidase), khona-ke ukuvikela impilo yonke kuyoba isici se-N1 noma i-N2 (I-1B).
Uma ukuphrinta kusekelwe ku-NA ebanzi, i.e. ukuvikelwa kuhlu olubanzi lwezinhlobo ezincane kwenzeka, khona-ke abantu abaphrintiwe ku-H1 kanye ne-H2 kufanele bavikelwe ku-H1N1 yesimanje yesizini. Ngesikhathi esifanayo, abantu abaphrintelwe ku-H3 bazovikelwa kuphela ku-H3N2 yesikhathi samanje (I-1B).
Ososayensi baphawula ukuthi i-collinearity (ekukhulumeni kancane, ukufana) kokuqagela kwamamodeli ahlukahlukene wokuphrinta (1D-1I) bekungenakugwenywa uma kubhekwa ukuhlukahluka okulinganiselwe kwezinhlobo ezincane ze-antigenic zomkhuhlane ezizungeza inani labantu phakathi nekhulunyaka eledlule.
Indima ebaluleke kakhulu ekuhlukaniseni phakathi kokuphrinta ku-HA subtype, i-NA subtype noma izinga leqembu le-HA idlalwa ngabantu abaneminyaka ephakathi abangenwe okokuqala nge-H2N2 (I-1B).
Imodeli ngayinye ehloliwe isebenzise inhlanganisela eqondile yokutheleleka okuhlobene neminyaka (I-1С), kanye nokutheleleka okuhlobene nonyaka wokuzalwa (1D-1F), ukuthola ukusatshalaliswa kwamacala e-H1N1 noma i-H3N2 (1G - 1I).
Ingqikithi yamamodeli angu-4 adalwe: elula kunazo zonke iqukethe kuphela isici sobudala, futhi amamodeli ayinkimbinkimbi engeza izici zokunyathelisa ezingeni le-HA subtype, ezingeni le-NA subtype, noma ezingeni leqembu le-HA.
Ijika lesici sobudala linohlobo lomsebenzi wesinyathelo lapho ingozi ehlobene yokutheleleka isethwe ku-1 eqenjini lobudala 0-4. Ngaphandle kweqembu leminyaka yobudala, kwakukhona nalokhu okulandelayo: 5–10, 11–17, 18–24, 25–31, 32–38, 39–45, 46–52, 53–59, 60–66; 67–73, 74–80, 81+.
Kumamodeli ahlanganisa imiphumela yokuphrinta, ingxenye yabantu onyakeni ngamunye wokuzalwa ngokuphrinta kokuvikela ebuntwaneni kwakucatshangwa ukuthi ilingana nokuncipha kwengozi yokutheleleka.
I-factor of virus evolution nayo yacatshangelwa ekumodeleni. Ukwenza lokhu, sisebenzise idatha echaza ukuqhubeka konyaka kwe-antigenic, eyachazwa njengebanga eliphakathi nendawo le-antijeni phakathi kwezinhlobo zohlu oluthile lwegciwane (H1N1 ngaphambi kuka-2009, H1N1 ngemva kuka-2009, kanye ne-H3N2). "Ibanga le-antigenic" phakathi kwezinhlobo ezimbili zomkhuhlane lisetshenziswa njengenkomba yokufana kwe-antigenic phenotype kanye nokuvikela okungase kube khona amasosha omzimba.
Ukuhlola umthelela wokuziphendukela kwemvelo kwe-antigenic ekusabalaleni kweminyaka yobhubhane, izinguquko esilinganisweni samacala ezinganeni zahlolwa phakathi nezinkathi zonyaka lapho kwenzeka khona izinguquko ezinamandla ze-antigenic.
Uma izinga lokukhukhuleka kwe-antigenic liyisici esibalulekile engozini ehlobene neminyaka yokutheleleka, khona-ke ingxenye yamacala abonwa ezinganeni kufanele ihlotshaniswe kabi nenqubekelaphambili yonyaka ye-antigenic. Ngamanye amazwi, izinhlobo ezingazange zibe nezinguquko ezibalulekile ze-antigenic kusukela kusizini edlule kufanele zingakwazi ukubalekela ukungatheleleki okukhona kakade kubantu abadala abanolwazi lokuzivikela komzimba. Izinhlobo ezinjalo zizosebenza kakhulu phakathi kwabantu abangenaso isipiliyoni se-immunological, okungukuthi, phakathi kwezingane.
Imiphumela yocwaningo
Ukuhlaziywa kwedatha ngonyaka kubonise ukuthi i-H3N2 yesizini yayiyimbangela ehamba phambili yokutheleleka phakathi kwabantu abadala, kuyilapho i-H1N1 ithinta abantu abaneminyaka ephakathi nentsha (isithombe #2).
Isithombe esingu-2: Ukusatshalaliswa komkhuhlane we-H1N1 ne-H3N2 ngobudala ngezikhathi ezihlukene.
Le phethini yayikhona kokubili kudatha ngaphambi kobhubhane lwango-2009 nangemuva kwalo.
Idatha ibonise ukuthi ukuphrinta ezingeni le-NA subtype kudlula ukuphrinta ezingeni le-HA subtype (ΔAIC = 34.54). Ngesikhathi esifanayo, kwakukhona ukungabikho okuphelele kokunyathelisa ezingeni leqembu le-HA (ΔAIC = 249.06), kanye nokungabikho okuphelele kokuphrinta (ΔAIC = 385.42).
Isithombe #3: Ukuhlola ukulingana kwamamodeli kudatha yocwaningo.
Ukuhlolwa okubonakalayo kokulingana kwemodeli (3C и 3D) iqinisekise ukuthi amamodeli aqukethe imiphumela yokuphrinta kumazinga amancane we-NA noma ama-HA subtypes ahlinzeke ngokulingana okungcono kakhulu kwedatha esetshenziswe ocwaningweni. Iqiniso lokuthi imodeli lapho ukuphrinta kungekho khona ayikwazi ukusekelwa idatha liphakamisa ukuthi ukuphrinta kuyisici esibaluleke kakhulu sokuthuthukiswa kokuvikeleka kubantu abadala ngokuphathelene nezinhlobo ezincane zomkhuhlane wesizini. Kodwa-ke, ukuphrinta kusebenza ngokukhethekile okuncane kakhulu, okungukuthi, kusebenza kuphela kuhlobo oluthile oluthile, hhayi kuwo wonke ama-subtypes omkhuhlane.
Ithebula No. 2: ukuhlolwa kokulingana kwamamodeli kudatha yocwaningo.
Ngemva kokulawula ukusatshalaliswa kweminyaka yobudala, ubungozi obulinganiselwe obuhlobene nobudala babuphezulu kakhulu ezinganeni nakubantu abadala, obuhambisana nokunqwabelana kwenkumbulo yokuzivikela komzimba ebuntwaneni kanye nokuncipha kokuzivikela komzimba kubantu abadala asebekhulile (ngokuvamile). I-3A ijika elicishe lifane nemodeli ehamba phambili liyaboniswa). Izilinganiso zepharamitha yokuphrinta bezingaphansi kokukodwa, okubonisa ukwehliswa kancane kwengozi ehlobene (Ithebula 2). Kumodeli engcono kakhulu, ukuncishiswa kwengozi okulinganiselwe kusukela ekunyatheliseni kwasebuntwaneni kwakukhulu ku-H1N1 (0.34, 95% CI 0.29–0.42) kune-H3N2 (0.71, 95% CI 0.62–0.82).
Ukuhlola umthelela wokuguquguquka kwegciwane ekusabalaliseni kweminyaka yobudala bengozi yokutheleleka, abacwaningi babheke ukwehla kwenani lokutheleleka phakathi kwezingane ngezikhathi ezihambisana nokushintsha kwe-antigenic, lapho izinhlobo ezine-antigenic drift ephezulu zisebenza kangcono ekutheleleni abantu abadala abanolwazi lwe-immunologically.
Ukuhlaziywa kwedatha kubonise ukuhlangana okuncane okungalungile kodwa okungabalulekile phakathi kokunyuka konyaka komsebenzi we-antigenic kanye nenani lamacala e-H3N2 abonwa ezinganeni (I-4A).
Isithombe esingu-4: umthelela wokuguquguquka kwegciwane engcupheni ehlobene neminyaka yokutheleleka.
Kodwa-ke, abukho ubuhlobo obucacile obutholakala phakathi kwezinguquko ze-antigenic kanye nenani lamacala abonwa ezinganeni ezingaphezu kweminyaka engu-10 ubudala nakubantu abadala. Uma i-viral evolution ibambe iqhaza elikhulu kulokhu kusatshalaliswa, umphumela ubungaba ubufakazi obucacile bethonya lokuziphendukela kwemvelo phakathi kwabantu abadala, hhayi nje lapho kuqhathaniswa abantu abadala nezingane ezingaphansi kweminyaka eyi-10 ubudala.
Ngaphezu kwalokho, uma izinga lokuguquguquka kokuguquguquka kwegciwane lilawula ukuhluka okucacisiwe kwe-subtype ekusatshalalisweni kweminyaka yobhubhane, lapho-ke ama-H1N1 kanye ne-H3N2 subtypes ekhombisa amazinga afanayo okusabalala kwe-antigen yonyaka, ukusatshalaliswa kwawo kwezifo kufanele kubonakale kufana kakhulu.
Ukuze uthole ulwazi oluningiliziwe ngama-nuances ocwaningo, ngincoma ukubheka .
Epilogue
Kulo msebenzi, ososayensi bahlaziye idatha ye-epidemiological ezimweni zokutheleleka nge-H1N1, H3N2 ne-H2N2. Ukuhlaziywa kwedatha kubonise ubudlelwano obucacile phakathi kokuphrinta ebuntwaneni kanye nengozi yokutheleleka lapho usumdala. Ngamanye amazwi, uma ingane eneminyaka engu-50 ithelelekile lapho i-H1N1 ijikeleza futhi i-H3N2 ingekho, khona-ke lapho esekhulile amathuba okutheleleka nge-H3N2 ayoba makhulu kakhulu kunethuba lokubamba i-H1N1.
Isiphetho esiyinhloko salolu cwaningo ukuthi akubalulekile nje kuphela lokho umuntu ahlupheka ngakho ebuntwaneni, kodwa futhi ngakuphi ukuhleleka. Inkumbulo yamasosha omzimba, ekhula kukho konke ukuphila, “ibhala” ngenkuthalo idatha evela ezifweni zokuqala ezibangelwa amagciwane, okunomthelela ekuphikiseni okuphumelelayo kubo lapho sebekhulile.
Ososayensi banethemba lokuthi umsebenzi wabo uzokwenza kube nokwenzeka ukubikezela kangcono ukuthi yimaphi amaqembu obudala angathonywa kalula yimiphumela yezinhlobo ezincane zomkhuhlane. Lolu lwazi lungasiza ekuvimbeleni ukusabalala kwezifo eziwumshayabhuqe, ikakhulukazi uma inani elilinganiselwe lemithi yokugoma lidinga ukusatshalaliswa kubantu.
Lolu cwaningo aluhloselwe ukuthola amakhambi aphezulu anoma yiluphi uhlobo lomkhuhlane, nakuba lokho kungaba kuhle. Iqondiswe kulokho okungokoqobo kakhulu futhi okubalulekile okwamanje - ukuvimbela ukusabalala kokutheleleka. Uma singeke sikwazi ukuliqeda ngokushesha leli gciwane, kufanele sibe nawo wonke amathuluzi okuliqukatha. Omunye wabasekeli abathembeke kakhulu kunoma yiluphi ubhubhane isimo sengqondo sokunganaki ngaso sohlangothini lombuso ngokujwayelekile kanye nomuntu ngamunye ikakhulukazi. Ukwethuka, yiqiniso, akudingekile, ngoba kungenza izinto zibe zimbi nakakhulu, kodwa izinyathelo zokuphepha azilimazi.
Siyabonga ngokufunda, hlala unelukuluku lokwazi, uzinakekele wena nobathandayo futhi ube nempelasonto enhle bafana! 🙂
Ezinye izikhangiso 🙂
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Source: www.habr.com