Convalescent plasma therapy tuav tus yuam sij rau kev kho tam sim ntawm cov neeg mob hnyav COVID-19. Kab lus no tham txog kev ua tau zoo ntawm txoj kev kho no thiab nws cov xwm txheej tam sim no txog nws kev siv los kho COVID-19
Tus kab mob COVID-19 tau kis thoob plaws ntiaj teb nrog ntau yam teebmeem hauv ntau lub tebchaws txog cov neeg mob thiab cov neeg tuag. Muaj li ntawm 2 lab tus tib neeg tau kis tus kab mob thoob ntiaj teb thiab cov lej nce ntxiv txhua hnub. Txog niaj hnub no, tseem tsis tau muaj kev kho mob uas tau sau tseg thiab pom zoo rau tus kab mob no . Tag nrho cov kws kho mob tab tom tos ntsoov rau kev kho mob uas tsis tsuas yog muab kev kho rau cov neeg mob xwb tab sis kuj tiv thaiv cov neeg noj qab haus huv uas tsis kis tus kab mob los ntawm tus kab mob no. Cov tuam txhab tshuaj thiab biotech thiab cov koom haum tshawb fawb thoob ntiaj teb twb tau pib tshawb fawb txog ntau txoj hauv kev los nrhiav kev kho rau COVID-19. Cov txheej txheem no suav nrog kev siv cov tshuaj me me (1), kev tsim tshuaj tiv thaiv kab mob (2) thiab kev kho mob antibody (3). Txawm li cas los xij, tag nrho cov txheej txheem no yuav ua rau muaj kev kho mob uas yuav siv sijhawm tsawg kawg ib xyoos lossis ob peb xyoos ua ntej kev kho mob tau txais kev pom zoo los ntawm cov tub ceev xwm, txawm tias yog kev pom zoo sai rau kev siv thaum muaj xwm txheej ceev. Qhov xav tau ntawm lub sijhawm yog nrhiav kev kho mob tam sim ntawd uas tuaj yeem pab cov neeg raug tsim txom ntawm COVID-19. Kev kho mob ntshav qab zib Convalescent plasma (CPT) yog ib qho kev kho mob uas siv tau los kho cov neeg mob uas muaj kab mob hauv lub sijhawm luv luv thaum tos lwm yam kev kho mob kom tsim tau. Tsab xov xwm no yuav tham txog keeb kwm thiab lub tswv yim ntawm kev kho mob ntshav qab zib convalescent, nws qhov tseem ceeb thiab kev ua tau zoo hauv kev kho cov neeg mob COVID-19 thiab txoj hauv kev uas cov tub ceev xwm kho mob thiab cov neeg tswj hwm thoob ntiaj teb tau siv rau nws.
Cov keeb kwm ntawm CPT hnub rov qab mus rau xyoo 1890, thaum tus kws kho mob German, Emil von Behring, tau ua tiav zoo hauv kev kho cov tsiaj txhu uas muaj kab mob diptheria siv cov ntshav los ntawm cov tsiaj uas tau txhaj tshuaj tiv thaiv kab mob diptheria ua rau corynebacterium. Cov tshuaj tiv thaiv uas muaj nyob rau hauv cov ntshav los ntawm cov tsiaj txhaj tshuaj tiv thaiv kab mob kom tsis txhob kis tus kab mob.
Convalescent plasma therapy suav nrog kev cais cov ntshav los ntawm cov neeg mob uas tau zoo los ntawm tus kab mob thiab txhaj rau hauv cov neeg mob uas muaj tus kab mob, yog li muab kev tiv thaiv kab mob tsis zoo los ntawm cov ntshav plasma uas muaj cov tshuaj tiv thaiv kab mob tsim tawm los ntawm cov kab mob hauv cov tib neeg zoo. Cov txheej txheem muaj xws li nqus cov ntshav los ntawm cov neeg pub dawb uas tau zoo los ntawm tus kab mob, cais cov ntshav thiab kuaj cov tshuaj tiv thaiv kab mob ua ntej muab rau cov neeg mob. Txoj kev kho no tau ua tiav siv yav dhau los rau kev kis mob khaub thuas Spanish xyoo 1918, Ebola, SARS, MERS, thiab 2009 H1N1 kis thoob qhov txhia chaw (4-9). Nyob rau hauv rooj plaub ntawm tus mob khaub thuas Spanish, cov neeg tuag tau txo mus rau 50% rau cov neeg mob uas tau muab CPT piv rau cov uas tsis muaj (10), nrog rau cov thev naus laus zis tseem ceeb nyob rau lub sijhawm ntawd rau kev cais cov ntshav los ntawm cov ntshav. Vim qhov zoo sib xws ntawm cov kab mob no ua rau cov kab mob nrog rau lawv cov yam ntxwv kho mob nrog tus kab mob SARS-CoV-2, kev kho cov ntshav plasma tuaj yeem ua pov thawj tias yog qhov kev xaiv zoo rau kev kho mob cov neeg mob uas muaj ntshav plasma los ntawm cov neeg pub dawb uas tau zoo los ntawm COVID- 19 kab mob. Nyob rau hauv rooj plaub ntawm COVID-19, tus naj npawb ntawm cov neeg mob rov qab los tuav tus yuam sij rau kev ua tiav ntawm kev kho ntshav plasma. Qhov txaus siab thiab ntawm qhov zoo, txij li lub Plaub Hlis 16th 2020, 25% ntawm cov neeg mob kis nrog COVID-19 (sib npaug rau ~ 523,000 tus neeg thoob ntiaj teb) tau zoo (11) thiab cov ntshav plasma los ntawm cov neeg no tuaj yeem siv tam sim thiab luv luv. kho cov neeg mob, tshwj xeeb tshaj yog cov uas pom cov tsos mob hnyav.
Cov teb chaws thoob plaws ntiaj teb twb tau pib lossis tab tom pom zoo CPT rau kev tshawb nrhiav siv rau kev kho mob ntawm COVID-19. Ib qho kev sim me me hauv Suav teb rau CPT ntawm 10 tus neeg mob (rau tus txiv neej thiab plaub tus poj niam) uas muaj hnub nyoog nruab nrab ntawm 52.5 xyoo tau ua nrog cov txiaj ntsig tseem ceeb ntawm kev nyab xeeb thiab cov txiaj ntsig thib ob ntawm kev txhim kho cov tsos mob. Cov kev kho mob tau txais txiaj ntsig zoo yam tsis muaj kev cuam tshuam tsis zoo thiab muaj qhov txo qis hauv cov tsos mob tshwm sim hauv 3 hnub ntawm kev tswj hwm kev kho mob (12), txawm hais tias cov txiaj ntsig thiab lub sijhawm siv rau cov neeg mob SARS-CoV-2 tsis zoo, muaj ntau yam sib txawv ntawm cov neeg mob. . Qhov no tau muab qhov tseem ceeb txaus thiab kev cia siab rau CPT los siv ntxiv rau hauv kev sim tshuaj hauv lwm thaj chaw hauv ntiaj teb cuam tshuam los ntawm COVID-19.
Lub apex lub cev ntawm kev tshawb fawb kho mob hauv Is Nrias teb, ICMR (Indian Council of Medical Research) tau tso cai rau Sree Chitra Tirunal Institute for Medical Sciences thiab Technology (SCTIMST) hauv Kerala rau kev ua CPT hauv qhov chaw sim tshuaj (13). Txoj kev tshawb no yuav ua rau cov neeg mob tsawg tsawg uas kis tus kab mob COVID-19 hnyav hauv kev koom tes nrog tsib lub tsev kho mob hauv tsev kho mob. Cov neeg mob hnyav hnyav sawv cev rau cov neeg uas nyob hauv kev saib xyuas hnyav uas ua tsis taus pa luv, cov ntshav oxygen tsis txaus (tsawg dua 93%), septic shock thiab / lossis ntau yam kabmob tsis zoo nrog rau cov uas tab tom yuav muab tso rau hauv lub tshuab ua pa. ICMR kuj tau thov kev koom tes los ntawm lwm cov kws tshawb fawb txog kev kho mob thoob plaws lub tebchaws los koom nrog kev sim tshuaj siv CPT rau cov neeg mob COVID-19 nrog lub hom phiaj los ntsuas kev nyab xeeb thiab kev ua tau zoo ntawm cov txheej txheem no (14).
European Union kuj tau pom zoo siv CPT raws li kev cog lus kho mob rau COVID-19 thiab tab tom nrhiav kev pab los ntawm cov tswvcuab hauv lub tebchaws los sau cov ntshav los ntawm cov neeg pub dawb rov qab los ua CPT (15). Nws tseem tab tom tsim cov ntaub ntawv hauv kev koom tes nrog European Blood Alliance (EBA), rau kev sau ntshav thiab cov txiaj ntsig ntawm kev sim tshuaj, uas yuav muab qhia rau cov tswvcuab hauv tebchaws.
Cov Kev Pabcuam Kev Noj Qab Haus Huv Hauv Tebchaws ( NHS ) hauv UK kuj tseem thov cov neeg mob uas tau zoo los ntawm COVID-19 pub lawv cov ntshav los ntawm ntau lub chaw thoob plaws UK kom pib sim tshuaj CPT rau cov neeg mob COVID-19 uas mob hnyav heev (16).
US FDA thaum Lub Plaub Hlis 13th 2020, tau tshaj tawm cov lus qhia siv CPT raws li cov txheej txheem tshawb fawb hauv kev sim tshuaj raws li txoj kev cai IND ib txwm muaj (21 CFR Part 312) rau cov neeg mob cuam tshuam loj heev los ntawm COVID-19 (17). Lub luag haujlwm ntawm kev tshuaj xyuas cov lus thov los ntawm cov neeg txhawb nqa yuav tau ua los ntawm Lub Chaw Haujlwm Saib Xyuas Kev Tshawb Fawb thiab Tshuaj Ntshav, ib chav ntawm CBER (Center for Biologics Evaluation and Research).
Raws li nrog rau tag nrho lwm yam kev kho mob, CPT kuj tuaj nrog nws cov kev cov nyom. Thawj thiab qhov tseem ceeb tshaj plaws yog kom nkag mus rau cov neeg mob uas tau zoo lawm thiab txhawb kom lawv pub lawv cov ntshav plasma. Cov tib neeg rov qab los yuav tsum tsis muaj lwm yam kab mob, uas yog qhov teeb meem tiag tiag thaum muaj COVID-19 qhov twg feem ntau ntawm cov neeg raug tsim txom yog cov neeg laus uas muaj keeb kwm ntawm lwm yam mob xws li mob plawv, ntshav qab zib, ntshav siab thiab lwm yam. Plasma tau txais yuav tsum muaj qhov txaus thiab muaj cov tshuaj tiv thaiv kab mob siab kom cov neeg txaus tuaj yeem tau txais txiaj ntsig zoo ib yam. Cov ntshav los ntawm cov neeg pub ntshav plasma yuav tsum tau kuaj xyuas cov kab mob sib kis thiab pab pawg ntshav sib raug zoo nrog tus neeg txais. Tag nrho cov no yuav xav tau kev sib koom tes loj ntawm cov neeg ua haujlwm kho mob, pom zoo cov neeg pub dawb uas tau zoo los ntawm tus kab mob thiab cov neeg mob tau txais CPT, rau tag nrho cov txheej txheem kom tau txais txiaj ntsig zoo.
Txawm li cas los xij, txawm tias muaj qhov tsis zoo los xij, CPT tseem muaj kev cia siab, nrog kev nyab xeeb thiab kev ua tau zoo yog qhov tseem ceeb, rau kev kho mob luv luv rau cov neeg mob COVID-19. Yog tias CPT rau tus kab mob Spanish tuaj yeem txo tus nqi tuag mus rau 50%, nws tau xav tias qhov kev txo qis ntawm tus nqi tuag siv CPT rau COVID-19 yuav tsum ntau dua 80%, nco ntsoov cov thev naus laus zis niaj hnub no rau kev sib cais plasma, khaws cia thiab kev tswj hwm nrog rau cov chaw saib xyuas neeg mob niaj hnub. Cov kws kho mob yuav tsum tsis txhob tawm pob zeb tsis tig los siv CPT rau kev kho mob COVID-19 kom txog thaum pom zoo rau cov tshuaj me me, tshuaj tiv thaiv kab mob lossis tshuaj tiv thaiv kab mob uas yuav siv sijhawm nrog kev cia siab tias tshuaj tiv thaiv kab mob yuav raug tsim sai tshaj plaws (ib mus rau ob xyoos), ua raws li cov tshuaj me me tshiab thiab / lossis rov siv cov tshuaj me me uas twb muaj lawm thiab kev kho mob tiv thaiv kab mob.
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