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Ngaba iisampulu zethishu zinokuqokelelwa kubantu abasempilweni ukuqhubela phambili inkqubela yezonyango?

Indlela yokwenza ulungelelwaniso phakathi kweenjongo zenzululwazi, iingozi ezinokubakho, kunye nomdla wabathathi-nxaxheba?

Ekuphenduleni ikhwelo leyeza elichanekileyo, ezinye izazinzulu zeklinikhi kunye nesiseko zitshintshile ekuhloleni ukuba zeziphi iindlela zokungenelela ezikhuselekileyo nezisebenzayo kwizigulane ezininzi ukuya kwindlela ecocekileyo ejoliswe ekufumaneni unyango oluchanekileyo kwisigulane esifanelekileyo ngexesha elifanelekileyo. Inkqubela phambili yezenzululwazi, ekuqaleni equlethwe kwintsimi ye-oncology, ibonise ukuba iiklasi zeklinikhi zinokuhlulwa zibe yi-molecular intrinsic phenotypes, kunye neendlela ezahlukeneyo kunye neempendulo ezahlukeneyo zonyango. Ukuze uchaze iimpawu zeentlobo zeeseli ezahlukeneyo kunye namaziko e-pathological, izazinzulu ziye zaseka iimephu zezicubu.

Ukukhuthaza uphando lwesifo sezintso, iNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) ibambe i-workshop kwi-2017 Ababekho baquka izazinzulu ezisisiseko, i-nephrologists, abalawuli be-federal, i-Institutional Review Board (IRB) izitulo, kwaye mhlawumbi kubaluleke kakhulu, izigulane. Amalungu eSemina axubushe ngexabiso lezenzululwazi kunye nokwamkeleka kokuziphatha kwee-biopsies zezintso kubantu abangazidingi kukhathalelo lweklinikhi kuba bathwele umngcipheko omncinci kodwa ocacileyo wokufa. Iindlela zangoku "ze-omics" (iindlela zophando ze-molecular ezifana ne-genomics, i-epigenomics, i-proteomics, kunye ne-metabolomics) zingasetyenziselwa uhlalutyo lwezicubu ukucacisa iindlela zezifo ezingaziwa ngaphambili kunye nokuchonga iithagethi ezinokubakho zokungenelela ngamachiza. Abathathi-nxaxheba bavuma ukuba i-biopsies yezintso zamkelekile kuphela ngeenjongo zophando, ngaphandle kokuba zikhawulelwe kubantu abadala abanika imvume, baqonde iingozi kwaye abanalo umdla wobuqu, ukuba ulwazi olufunyenweyo lusetyenziselwa ukuphucula impilo-ntle yesigulane kunye nolwazi lwesayensi, kunye nokuba iqumrhu lokuphonononga, i-IRB, ivume isifundo.

Ukulandela esi sindululo, ngoSeptemba ka-2017, iProjekthi ye-Kidney Precision Medicine (KPMP) exhaswa ngemali yi-NIDDK (KPMP) yaseka iindawo ezintandathu zokuqokelela izicubu kwizigulana ezinesifo sezintso ezazingenayo inkcazo ye-clinical biopsy. Ii-biopsies ze-156 zenziwa kwiminyaka emihlanu yokuqala yophando, kubandakanywa ne-42 kwizigulane ezinokulimala kwezintso kunye ne-114 kwizigulane ezinezifo ezingapheliyo. Akukho kufa kwenzeka, kwaye iingxaki ezibandakanya ukopha kweempawu kunye ne-asymptomatic zazihambelana nezo zichazwe kwiincwadi kunye neefom zemvume yokufunda.

Uphando lwe-Omics luphakamisa umbuzo obalulekileyo wesayensi: Izicubu eziqokelelwa njani kwizigulana ezinesifo xa zithelekiswa nezicubu "eziqhelekileyo" kunye "nereferensi"? Lo mbuzo wenzululwazi uphakamisa umbuzo obalulekileyo wokuziphatha: Ngaba kwamkelekile ngokusesikweni ukuthatha iisampulu zethishu kumavolontiya asempilweni ukuze zithelekiswe neesampulu zezicubu zesigulana? Lo mbuzo awuphelelanga kuphando lwesifo sezintso. Ukuqokelela izicubu zereferensi enempilo kunamandla okuqhubela phambili uphando kuluhlu lwezifo. Kodwa iingozi ezinxulumene nokuqokelela izicubu ezivela kumalungu ahlukeneyo ziyahluka ngokuxhomekeke ekufikeleleni kwezicubu.