Tus kab mob autoimmune yog tshwm sim los ntawm qhov tsis zoo hauv lub cev tiv thaiv kab mob ua rau yav tom ntej los tawm tsam cov kab mob ib txwm muaj ("tus kheej", yog li cov hauv paus auto- hais txog qhov kev tiv thaiv kab mob no). Ib qho kev sib txawv classic yog tsim los ntawm cov kab mob tshwj xeeb autoimmune, uas cuam tshuam rau ib lub cev (xws li kab mob autoimmune ntawm cov thyroid), thiab cov kab mob autoimmune, xws li lupus, uas tuaj yeem cuam tshuam rau ntau lub cev.

Thaum nws yuav tsum tiv thaiv peb ntawm cov kab mob (uas tuaj yeem ua rau muaj kab mob), peb lub cev tiv thaiv kab mob qee zaum tuaj yeem tawm mus. Tom qab ntawd nws tuaj yeem dhau los ua qhov nkag siab rau qee cov khoom siv sab nraud (sab nraud), thiab ua rau muaj kev fab tshuaj lossis ua rau muaj kev cuam tshuam rau tus kheej thiab txhawb kev tshwm sim ntawm cov kab mob autoimmune.

Cov kab mob autoimmune tsim ib pab pawg uas peb pom cov kab mob sib txawv xws li mob ntshav qab zib hom I, ntau yam sclerosis, mob caj dab thumatoid lossis Crohn tus kab mob. Lawv txhua tus sib raug rau cov kab mob ntev uas tshwm sim los ntawm lub cev tsis muaj kev tiv thaiv kab mob rau nws tus kheej.

Cov kab mob autoimmune tsim tau li cas?

Ib pab tub rog muaj tseeb ua los ntawm ntau cov qe ntshav dawb, lub cev tiv thaiv kab mob tiv thaiv lub cev tiv thaiv kev tawm tsam sab nraud xws li cov kab mob los yog kab mob thiab feem ntau zam rau nws tus kheej cov khoom. Thaum nws tus kheej kam rau siab ntsoos, nws dhau los ua tus kab mob. Qee cov qe ntshav dawb (autoreactive lymphocytes) tshwj xeeb tua cov ntaub so ntswg lossis cov kabmob.

Cov tshuaj tiv thaiv ib txwm tsim los ntawm qee lub cev tiv thaiv kab mob kom tsis txhob muaj cov yeeb ncuab los ntawm kev txuas rau qee cov molecules (antigens) tuaj yeem tshwm sim thiab lub hom phiaj ntawm peb lub cev. Lub cev secretes antibodies tawm tsam nws tus kheej antigens uas nws suav tias txawv teb chaws.

Piv txwv li:

• Hauv hom ntshav qab zib hom I: autoantibodies tsom cov tshuaj insulin-secreting pancreatic hlwb;
• nyob rau hauv rheumatoid mob caj dab: nws yog daim nyias nyias uas nyob ib puag ncig cov pob qij txha uas yog tsom, qhov mob kis mus rau pob txha mos, pob txha, txawm tias tendons thiab ligaments;
• Nyob rau hauv lub systemic lupus erythematosus, auto-anticoprs yog qhia tawm tsam molecules uas muaj nyob rau hauv ntau lub hlwb ntawm lub cev, ua rau kev puas tsuaj rau ntau yam kabmob (tawv nqaij, pob qij txha, ob lub raum, lub plawv, thiab lwm yam).

Qee qhov xwm txheej, peb tsis pom autoantibodies thiab peb hais ntau yam "autoinflammatory" kab mob. Lub cev thawj kab ntawm kev tiv thaiv kab mob (neutrophils, macrophages, monocytes, natural killer cells) ib leeg ua rau mob ntev ua rau kev puas tsuaj ntawm qee cov ntaub so ntswg:

• daim tawv nqaij hauv psoriasis (uas cuam tshuam 3 mus rau 5% ntawm cov neeg nyob sab Europe);
• qee cov pob qij txha hauv rheumatoid spondylitis;
• kev zom zaub mov hauv Crohn tus kab mob;
• central paj hlwb nyob rau hauv ntau yam sclerosis.

Txawm hais tias lawv nruj me ntsis autoimmune lossis auto-inflammatory, tag nrho cov kab mob no tshwm sim los ntawm kev ua haujlwm ntawm lub cev tsis muaj zog thiab tsim mus rau cov kab mob inflammatory.

Leej twg txhawj?

Thaum pib ntawm lub xyoo pua 5, cov kab mob autoimmune cuam tshuam rau ib ncig ntawm 80 lab tus tib neeg hauv Fab Kis thiab tau dhau los ua qhov thib peb ntawm kev tuag / kev tuag tom qab mob qog noj ntshav thiab cov kab mob plawv thiab nyob rau hauv kwv yees li qhov sib npaug. XNUMX% ntawm cov neeg mob txhawj xeeb txog poj niam. Niaj hnub no, yog tias kev kho mob ua rau nws tuaj yeem ua rau lawv txoj kev loj hlob qeeb, cov kab mob autoimmune tseem kho tsis tau.

Feem ntau ntawm cov kab mob autoimmune yog multifactorial. Muaj qee qhov kev zam, lawv raug suav hais tias yog raws li kev sib xyaw ntawm cov noob caj noob ces, endogenous, exogenous thiab / lossis ib puag ncig, hormonal, kis kab mob thiab kev puas siab puas ntsws.

Cov keeb kwm caj ces yog qhov tseem ceeb, yog li feem ntau tsev neeg ntawm cov kab mob no. Piv txwv li, qhov zaus ntawm hom ntshav qab zib hom I mus los ntawm 0,4% ntawm cov pej xeem mus rau 5% ntawm cov txheeb ze ntawm cov ntshav qab zib.

Hauv ankylosing spondylitis, HLA-B27 noob muaj nyob rau hauv 80% ntawm cov neeg mob, tab sis tsuas yog 7% ntawm cov neeg noj qab haus huv. Kaum ob yog tias tsis yog ntau pua cov noob tau cuam tshuam nrog txhua tus kab mob autoimmune.

Cov kev tshawb fawb los yog cov ntaub ntawv kab mob kis tau piav qhia meej txog kev sib koom ua ke ntawm plab hnyuv microbiota ( digestive ecosystem ), uas nyob ntawm qhov sib cuam tshuam ntawm lub cev tiv thaiv kab mob thiab ib puag ncig, thiab tshwm sim ntawm tus kab mob autoimmune. Muaj kev sib pauv, ib hom kev sib tham, nruab nrab ntawm cov kab mob hauv plab hnyuv thiab lub cev tiv thaiv kab mob.

Ib puag ncig (tshwj xeeb rau microbes, qee yam tshuaj, UV rays, haus luam yeeb, kev ntxhov siab, thiab lwm yam) kuj ua lub luag haujlwm tseem ceeb.

Kev tshawb nrhiav tus kab mob autoimmune yuav tsum tau ua nyob rau hauv cov ntsiab lus evocative. Kev xeem suav nrog:

• Kev tshawb nrhiav los kuaj xyuas cov kab mob cuam tshuam (kev kho mob, kab mob, kab mob hauv nruab nrog cev);
• kev kuaj ntshav txhawm rau tshawb xyuas qhov mob (tsis yog tshwj xeeb) tab sis uas tuaj yeem taw qhia qhov hnyav ntawm kev tawm tsam thiab tshawb nrhiav kev ntsuas kev tiv thaiv kab mob nrog kev tshawb nrhiav autoantibodies;
• kev tshawb fawb txog cov teeb meem tshwm sim (lub raum, lub ntsws, lub plawv thiab lub paj hlwb).

Txhua tus kab mob autoimmune teb rau kev kho mob tshwj xeeb.

Kev kho mob ua rau nws muaj peev xwm tswj tau cov tsos mob ntawm tus kab mob: analgesics tiv thaiv qhov mob, tshuaj tiv thaiv kab mob tiv thaiv kev ua haujlwm tsis zoo nyob rau hauv cov pob qij txha, cov tshuaj hloov pauv ua rau nws muaj peev xwm ua rau cov kab mob endocrine normalizes (insulin rau ntshav qab zib, thyroxine hauv hypothyroidism).

Cov tshuaj uas tswj lossis inhibit autoimmunity kuj tseem muaj txoj hauv kev los txwv cov tsos mob thiab kev loj hlob ntawm cov ntaub so ntswg puas. Lawv feem ntau yuav tsum tau noj mus ntev vim lawv kho tsis tau tus kab mob. Tsis tas li ntawd, lawv tsis yog tshwj xeeb rau autoimmunity effector hlwb thiab cuam tshuam rau qee yam kev ua haujlwm ntawm lub cev tiv thaiv kab mob.

Keeb kwm, cov tshuaj tiv thaiv kab mob (corticosteroids, cyclophosphamide, methotrexate, ciclosporin) tau siv vim tias lawv cuam tshuam nrog cov txiaj ntsig ntawm lub cev tiv thaiv kab mob thiab ua rau nws muaj peev xwm txwv nws txoj haujlwm tag nrho. Lawv feem ntau cuam tshuam nrog kev pheej hmoo kis mob ntxiv thiab yog li yuav tsum tau saib xyuas tsis tu ncua.

Tau nees nkaum xyoo, biotherapies tau tsim: lawv muaj kev tswj xyuas cov tsos mob zoo dua. Cov no yog cov molecules uas tshwj xeeb tsom rau ib qho ntawm cov neeg tseem ceeb koom nrog hauv cov txheej txheem cuam tshuam. Cov kev kho mob no yog siv thaum tus kab mob hnyav los yog tsis teb lossis txaus rau cov tshuaj tiv thaiv kab mob.

Nyob rau hauv cov ntaub ntawv ntawm cov kab mob tshwj xeeb xws li Guillain Barre syndrome, plasmapheresis tso cai rau kev tshem tawm ntawm autoantibodies los ntawm kev pom cov ntshav uas yog tom qab txhaj rau hauv tus neeg mob.