Kutanthauzira Mabuku
Kafukufuku waposachedwa wokhudza kukhazikitsa mayeso a pharmacogenetic (PGx) ku Italy, wofalitsidwa mu European Journal of Human Genetics, akufotokoza mwatsatanetsatane kufalikira kwa ntchito zoyesera za PGx, ntchito zaukadaulo, kukhazikitsa kwachipatala, kusiyana kwa madera, ndi mavuto omwe alipo ku Italy, kupereka umboni wozikidwa pa maziko olimbikitsira muyezo wa pharmacogenetics ku Italy ndi mayiko ena aku Europe.
I. Mbiri ndi Cholinga
Pakadali pano, kugwiritsa ntchito ukadaulo wa PGx ku Italy kuli kogawikana, popanda mgwirizano wogwirizana padziko lonse komanso njira yodziwirana. Pofuna kufotokoza bwino momwe dzikolo limayesera mankhwala, gulu lofufuza lidachita kafukufuku wa labotale mdziko lonse kuyambira Januwale mpaka Okutobala 2025. Zolinga zazikulu zinali:
-Kujambula mapu ogawa ndi mautumiki a ma laboratories oyesera ma pharmacogenetic ku Italy;
-Kufotokozera bwino njira zoyesera, mapanelo a majini, njira zaukadaulo, ndi miyezo yotanthauzira;
-Kuwulula kusiyana kwa madera ndi zopinga zoyendetsera ntchito, kupereka chithandizo cha deta kuti pakhale miyezo ya dziko lonse.
II. Zotsatira Zofunika
Makhalidwe oyambira a ma laboratories
Khalidwe la bungwe: Mabungwe 49 adatenga nawo mbali, omwe 82% anali mabungwe aboma ndipo 18% okha ndi achinsinsi.
-Madipatimenti Ogwira Ntchito: Madipatimenti a majini azachipatala anali ndi gawo lalikulu kwambiri (39%), kutsatiridwa ndi madipatimenti a matenda a matenda ndi biochemistry (18%), ndi madipatimenti a zamankhwala a zamankhwala (12%).
Kuyesa ntchito ndi zolinga za majini
Zochitika zazikulu zogwiritsira ntchito:Kuyesa kwa PGx ku Italy kumachitika kwambiri pa khansa. 94% (ma laboratories 46) adachita mayeso a dihydropyrimidine dehydrogenase gene (DPYD) okhudzana ndi kugwiritsa ntchito fluoropyrimidine, ndipo 84% (ma laboratories 41) adachita mayeso a uridine diphosphate glucuronosyltransferase 1A1 gene (UGT1A1) okhudzana ndi kugwiritsa ntchito irinotecan.
Mayeso ena:Ma laboratories omwe ankachita mayeso a majini okhudzana ndi azathioprine, clopidogrel, warfarin, ndi zina zotero. (TPMT, CYP2C19, CYP2C9, VKORC1, ndi zina zotero) anali osowa kwambiri.
Ukadaulo ndi kutsatira muyezo
Njira yoyesera: 100% ya mayeso a DPYD ndi 97% ya mayeso a UGT1A1 anali mayeso asanayambe chithandizo; CYP2C19 ndi HLA B makamaka anali mayeso a theka la preemptive; mayeso a CYP2D6 anali ambiri omwe anali ndi mphamvu, omwe ankachitika pambuyo poti zotsatira zoyipa zachitika.
Njira zaukadaulo:Njira yodziwika kwambiri yogwiritsira ntchito nthawi yeniyeni ya PCR inali njira yodziwika bwino; NGS idagwiritsidwa ntchito makamaka kupeza jini la HLA B; pakati pa mabungwe omwe adapereka zotsatira, labotale imodzi yokha ndi yomwe idagwiritsa ntchito kusanthula kwathunthu kwa exome (WES).
Kutsatira malamulo:Chiwerengero chachikulu cha ma laboratories chinatsatira malangizo a Italian Society of Pharmacology/Italian Association of Medical Oncology (SIF/AIOM) ndi malangizo a Clinical Pharmacogenetics Implementation Consortium (CPIC)/Dutch Pharmacogenetics Working Group (DPWG).
Kutanthauzira zotsatira ndi kufunsira upangiri
Kusaina lipoti:65% ya malipoti a mayeso adasainidwa ndi akatswiri a majini, 31% ndi akatswiri a matenda amisala/biochemistry.
Kutanthauzira kwachipatala: Ma laboratories 90% adapereka tanthauzo, 73% adawonetsa chiopsezo cha poizoni/kusagwira ntchito bwino, koma 24% yokha ndi omwe adapereka malangizo enieni okhudza mlingo wa mankhwala.
Uphungu wa Zamankhwala:Ma laboratories 29% okha ndi omwe amapereka chithandizo cha upangiri wa zamankhwala, ndipo izi zinali pafupifupi zoperekedwa ndi madipatimenti azachipatala okha - madipatimenti a majini ndi matenda a matenda anali ochepa kwambiri.
Chilolezo chodziwitsidwa:73% ya ma laboratories adakhazikitsa malamulo enieni kapena ovomerezeka odziwika bwino okhudza pharmacogenetics.
Kugawa kwa madera:Ntchito zoyesera zinali zambiri kumpoto kwa Italy. Pakati pa ma laboratories omwe anali ndi kuchuluka kwa mayeso apachaka opitilira 200, 23 anali kumpoto, 4 pakati, ndi 6 kum'mwera ndi zilumba - kugawa malo oyesera m'madera osiyanasiyana.
Kuchuluka kwa mayeso:69% ya ma laboratories anali ndi kuchuluka kwa mayeso apachaka >200, 19% anali ndi 100 200.
Ndondomeko yobwezera ndalama:Pakati pa ma laboratories omwe adafunsidwa, 73% adalandira ndalama zonse kuchokera ku National Health System (NHS), 22% ya ndalama zochepa, ndipo 4% sanalandire ndalama. Malamulo obwezera ndalama m'madera osiyanasiyana sanali ogwirizana. Pakadali pano, Italy ilibe malamulo enieni olipira/kubwezera ndalama zoyezetsa mankhwala, zomwe zachititsa chisokonezo chachikulu pakugwiritsa ntchito mankhwalawa m'madera osiyanasiyana.
III. Kukambirana ndi Mapeto Ofunika
Udindo wotsogola wa oncology– Kuyesa kwa DPYD ndi UGT1A1 kuli ponseponse chifukwa cha kukwezedwa kwa malangizo ochokera ku European Medicines Agency (EMA) ndi Italian Medicines Agency (AIFA). Komabe, kugwiritsa ntchito mayeso a pharmacogenetic m'magawo omwe si a khansa sikukwanira kwenikweni.
Ukadaulo ndi kutanthauzira kosagwirizana- Palibe muyezo wogwirizana wa ma panel oyesera, ma reagents, zida za bioinformatics, kapena njira zotanthauzira, zomwe zimapangitsa kuti zotsatira zisafanane bwino.
Kusagwirizana kokwanira kwa akatswiri osiyanasiyana- Kuchepa kwa akatswiri a zamankhwala komanso kusapereka chithandizo chokwanira cha mankhwala kuchipatala.
Kusalingana kwakukulu kwa madera- Zipangizo zoyesera za PGx zimapezeka kwambiri m'mabungwe azachipatala akumpoto, pomwe zinthu sizikupezeka m'madera apakati ndi akum'mwera - kusowa kwa ndalama.
Thandizo lofooka la mfundo- Italy ilibe dongosolo logwirizana la dziko lonse la mayeso a pharmacogenetic, zomwe zimapangitsa kuti pakhale dongosolo lokwanira lokwanira lobwezera ndalama, malamulo, maphunziro, ndi zina zotero.
Chidule
Kafukufukuyu ndi woyamba padziko lonse lapansi kuwunika momwe mankhwala amagwiritsidwira ntchito ku Italy. Akutsimikizira kuti mankhwala opangidwa ku Italy adagwiritsidwa ntchito kale m'munda wa khansa, koma mwachidule ndi ogawanika, osakhazikika, osafanana m'chigawo, komanso osagwirizana m'magawo osiyanasiyana. Chifukwa chake, kukhazikitsa dongosolo logwirizanitsa dziko lonse, kuphatikiza miyezo yaukadaulo ndi kutanthauzira, komanso kukonza mfundo ndi maphunziro ndizofunikira mtsogolo kuti Italy ikwaniritse kugwiritsa ntchito mayeso opangidwa ndi mankhwala, zomwe zikupereka chidziwitso chofunikira kumayiko ena aku Europe.
Macro & Micro-Test'sYankho Lokha la Pharmacogenomics Yokha
-Zosavuta: Kuyika zitsanzo ndi machubu oyambilira, kuyendetsa kiyi imodzi, kudzipangira zokha kwa zitsanzo kuchokera ku zotsatira, kuphatikiza kosasokonekera ndi LIS/HIS.
-MwachanguZotsatira zimapezeka mu ola limodzi pa ndondomeko yonseyi, zomwe zikutsogolera bwino njira zochiritsira zomwe munthu ayenera kutsatira.
-ZosinthasinthaNdi nsanja ya HWTS AIO800, kuyesa kwa PGx sikulinso ndi malire a malo - kusinthasintha komanso kusinthasintha.
-Zonse: Mndandanda wazinthu zambiri zokhudzana ndi matenda a mtima ndi mitsempha yamagazi, matenda amisala, chithandizo cha khansa, matenda obereka, matenda a akazi ndi kubereka, ndi madera ena.
-Kugwirizana:Chowunikira Chowonjezera cha Nucleic Acid Amplification HWTS AIO800 ndi machitidwe a PCR a nthawi yeniyeni.
Zowonjezera:ZofananaMatendaesMankhwala Ogwirizana, ndi Zolinga Zofananira Zoyesera Majini
Nthawi yotumizira: Meyi-11-2026