Gusobanura Ubuvanganzo
Ubushakashatsi buherutse gukorwa ku ishyirwa mu bikorwa ry’ibizamini bya farumasi (PGx) mu Butaliyani, bwasohotse mu kinyamakuru cy’Uburayi cya Human Genetics, busobanura neza uko serivisi zo gupima PGx zikwirakwizwa, uburyo tekiniki zikoreshwa, uburyo bwo kuzishyira mu bikorwa, itandukaniro ry’uturere, n’ibibazo biriho ubu mu Butaliyani, butanga ishingiro rishingiye ku bimenyetso byo guteza imbere farumasi mu Butaliyani no mu bindi bihugu by’Uburayi.
I. Amavu n'amavuko n'intego
Kugeza ubu, ikoreshwa ry’ikoranabuhanga rya PGx mu Butaliyani ryaracitsemo ibice, nta guhuza ibikorwa by’igihugu no kumenyana hagati y’abantu. Kugira ngo basobanure neza imiterere y’ibizamini by’imiti mu gihugu, itsinda ry’ubushakashatsi ryakoze ubushakashatsi muri laboratwari mu gihugu hose kuva muri Mutarama kugeza mu Ukwakira 2025. Intego z’ingenzi zari izi zikurikira:
-Gutanga ikarita y'ikwirakwizwa n'ikarita ya serivisi za laboratwari zipima imiti mu Butaliyani;
-Gusobanura neza imikorere y'ibizamini, imiterere y'uturemangingo, uburyo bwa tekiniki, n'amahame ngenderwaho yo gusobanura;
-Guhishura itandukaniro ry’uturere n’imbogamizi mu ishyirwa mu bikorwa, gutanga inkunga y’amakuru ku bijyanye n’amabwiriza agenga ubuziranenge ku rwego rw’igihugu.
II. Ibisubizo by'ingenzi
Ibiranga by'ibanze bya laboratwari
Imiterere y’ikigo: Ibigo 49 byitabiriye, muri byo 82% byari ibigo bya leta naho 18% byigenga gusa.
-Amashami akora: Amashami y’ubuvuzi bw’ibinyabutabire niyo yari afite umubare munini (39%), hagakurikiraho amashami y’indwara z’imitsi n’ibinyabutabire by’ibinyabuzima (18%), n’amashami y’imiti y’ubuvuzi (12%).
Gupima porogaramu n'intego za gene
Ibintu by'ingenzi birebana n'ikoreshwa:Isuzuma rya PGx mu Butaliyani ryibanda cyane ku ndwara ya kanseri. 94% (laboratoire 46) bakoze isuzuma rya dihydropyrimidine dehydrogenase gene (DPYD) rijyanye no gukoresha fluoropyrimidine, naho 84% (laboratoire 41) bakoze isuzuma rya uridine diphosphate glucuronosyltransferase 1A1 gene (UGT1A1) rijyanye no gukoresha irinotecan.
Ibindi bizamini:Laboratwari zakoraga ibizamini bya za gene zijyanye na azathioprine, clopidogrel, warfarin, nibindi. (TPMT, CYP2C19, CYP2C9, VKORC1, nibindi) zari nke cyane.
Ikoranabuhanga n'uburyo bukurikizwa
Ingamba zo gupima: 100% bya DPYD na 97% by'ibizamini bya UGT1A1 byari ibizamini mbere yo kuvurwa; CYP2C19 na HLA B byari ibizamini byihariye byo mu rwego rwo hasi; ibizamini bya CYP2D6 byiganjemo ingaruka, byakozwe nyuma y'uko habayeho ingaruka mbi.
Uburyo bwa tekiniki:Uburyo bwa PCR bwo gupima mu gihe nyacyo ni bwo bwakoreshejwe cyane; NGS yakoreshejwe cyane mu gupima jeni ya HLA B; mu bigo byatanze ibisubizo, laboratwari imwe gusa ni yo yakoresheje uburyo bwose bwo gupima exome (WES).
Gukurikiza amategeko ngenderwaho:Umubare munini w’amalaboratwari yakurikije amabwiriza y’Umuryango w’Abataliyani w’Imiti/Ishyirahamwe ry’Abataliyani ry’Imiti ya Oncology (SIF/AIOM) n’amabwiriza y’Itsinda ry’Abakozi ba Clinical Pharmacogenetics Implementation Consortium (CPIC)/Dutch Pharmacogenetics Working Group (DPWG).
Gusobanura no kugisha inama ibyavuye mu bushakashatsi
Gusinya raporo:Raporo z’ibizamini 65% byashyizweho umukono n’inzobere mu by’uturemangingo, 31% n’inzobere mu by’indwara/ubutabire bw’ibinyabuzima.
Gusobanura ubuvuzi: 90% by'amalaboratwari yatanze ibisobanuro, 73% bagaragaje ko hari ingaruka z'uburozi/kudashobora gukora neza, ariko 24% gusa ni bo batanze inama zihariye zo gutanga imiti.
Ubujyanama ku buvuzi bw'imiti:29% by'amalaboratwari ni yo yatangaga serivisi zo gutanga inama ku miti, kandi izi serivisi zatanzwe hafi ya zose n'amashami y'imiti yo mu buvuzi - amashami y'uturemangingo n'ay'indwara yatanzwe make cyane.
Ubwemere butanzweho amakuru arambuye:73% bya laboratwari byashyize mu bikorwa amasezerano yihariye cyangwa rusange yerekeye imiterere y’imiti.
Ikwirakwizwa ry'uturere:Ibikorwa byo gupima byagaragaye cyane mu majyaruguru y'Ubutaliyani. Muri laboratwari zifite umubare w'ibizamini bya buri mwaka ugera kuri 200, 23 zari mu majyaruguru, 4 hagati, na 6 mu majyepfo no mu birwa - aho ibikoresho byo gupima byakwirakwizwaga mu turere dutandukanye cyane.
Ingano y'ikizamini:69% bya laboratwari zari zifite umubare w’ibizamini bya buri mwaka >200, 19% zari zifite 100 200.
Politiki yo kwishyura amafaranga:Muri laboratwari zakoreweho ubushakashatsi, 73% byahawe amafaranga yose yatanzwe na National Health System (NHS), 22% by'amafaranga y'igice, naho 4% nta mafaranga yatanzwe. Amategeko agenga kwishyura amafaranga mu karere ntabwo yari ahuye. Ubu, Ubutaliyani nta tegeko ryihariye ry’ubwishyu/ubwishyu bufite mu gupima imiti, bigatera urujijo rukomeye mu ishyirwa mu bikorwa mu turere twose.
III. Ibiganiro n'Imyanzuro y'ingenzi
Umwanya w'ingenzi mu bijyanye n'indwara ya kanseri– Gupima DPYD na UGT1A1 birakwirakwiriye cyane bitewe no kwamamaza amabwiriza atangwa n’Ikigo cy’Uburayi gishinzwe Ubuvuzi (EMA) n’Ikigo cy’Ubutaliyani gishinzwe Ubuvuzi (AIFA). Ariko, gukoresha ibizamini bya farumasi mu nzego zitari iza kanseri ntibihagije cyane.
Ikoranabuhanga ritajyanye n'uburyo bukoreshwa mu gusobanura no gusobanura ibintu kimwe– Nta gipimo rusange gihari ku matsinda y’ibizamini, ibikoresho by’ubuhanga mu by’ibinyabuzima, cyangwa ibipimo ngenderwaho byo gusobanura, bigatuma ibisubizo bitagera ku rugero rwiza.
Ubufatanye budahagije mu nzego zitandukanye- Abahanga mu by'imiti batanga ubwitabire buke kandi serivisi zo kugisha inama ku miti zitangwa n'abaganga ntizihabwe serivisi zihagije.
Ubusumbane bukabije mu turere– Imikoreshereze y’ibikoresho byo gupima PGx iboneka cyane cyane mu bigo by’ubuvuzi byo mu majyaruguru, aho imitungo mike mu turere two hagati n’utwo mu majyepfo y’igihugu – hakaba hari icyuho mu ishoramari.
Inkunga idahagije ya politiki– Ubutaliyani nta rwego rw’igihugu ruhuriweho rwo gupima imiti, bigatuma habaho uburyo bwuzuye bwo kwishyura, amabwiriza, amahugurwa, nibindi.
Incamake
Ubu bushakashatsi ni bwo bwa mbere mu gihugu hose bugaragaza uko ishyirwa mu bikorwa ry’imiti mu Butaliyani rihagaze. Byemeza ko imiti mu Butaliyani yabanje gushyirwa mu bikorwa mu rwego rwa kanseri, ariko muri rusange ni ibice bitandukanye, ntabwo bihuje, ntaho bihuriye n’uturere, kandi nta nzego nyinshi zihari. Kubwibyo, gushyiraho urwego rw’igihugu ruhuza ibikorwa, guhuza ikoranabuhanga n’ibipimo ngenderwaho, no kunoza politiki n’amahugurwa ni byo bizakenerwa mu gihe kizaza kugira ngo Ubutaliyani bugere ku ikoreshwa ry’ibizamini by’imiti mu buvuzi, bitanga icyerekezo cy’ingenzi ku bindi bihugu by’i Burayi.
Isuzuma rya Macro na Micro'sIgisubizo cyuzuye cy’imashini zikora ku buryo bwikora
-Byoroshye: Gushyiramo ingero hakoreshejwe imiyoboro y'umwimerere, gukoresha urufunguzo rumwe, gukora ikizamini cyo kwihutisha ibisubizo, guhuza neza na LIS/HIS.
-Byihuse: Ibisubizo biboneka mu isaha imwe mu gikorwa cyose, biyobora neza uburyo bwo gufata imiti yihariye.
-Yoroshye: Hamwe na platform ya HWTS AIO800, igeragezwa rya PGx ntirigishobora kugabanywa n'imbogamizi z'urubuga - zoroshye kandi zishobora gukoreshwa mu buryo butandukanye.
-Byuzuye: Imbonerahamwe y'ibicuruzwa byinshi ikubiyemo indwara z'umutima n'imitsi, indwara zo mu mutwe, kuvura kanseri, kubyara, kuvura abagore n'imyororokere, n'izindi nzego.
-Kuba bihuye n'ibyo umuntu asanzwe akoresha:Isesengura ryikora ry’aside ya nucleique HWTS AIO800 hamwe na sisitemu zisanzwe za PCR mu gihe nyacyo.
Umugereka:BijyanyeIndwaraes, Imiti Ifitanye Isano, n'Intego zo Gupima Genetiki Bijyanye Nabyo
Igihe cyo kohereza ubutumwa: Gicurasi-11-2026