Kangangeminyaka, uvavanyo lweFractional Exhaled Nitric Oxide (FeNO) luye lwaba ngumhlobo obalulekileyo kwisixhobo sogqirha we-asthma, ngokuyintloko lukhokela izigqibo zolawulo. Uhlaziyo luka-2025 kwizikhokelo zeGlobal Initiative for Asthma (GINA) lubonisa utshintsho olukhulu, ngokusesikweni lwandisa indima ye-FeNO ngaphaya kovavanyo kunye nolawulo ukuze ngoku ixhase ngokukhutheleyo ukuxilongwa kwe-Type 2 (T2) inflammatory asthma. Olu hlaziyo luvuma indima ephambili ye-phenotyping kunyango lwanamhlanje lwe-asthma kwaye lubonelela ngendlela echanekileyo, esekelwe kwibhayoloji yokuxilongwa kokuqala.
I-FeNO: Ifestile yokuvuvukala komoya
I-FeNO ilinganisa uxinaniso lwe-nitric oxide kumoya ophumayo, osebenza njenge-biomarker ethe ngqo, engangenisi umkhuhlane kwi-eosinophilic, okanye i-T2, ukudumba komoya. Oku kudumba, okuqhutywa zii-cytokines ezifana ne-interleukin-4, -5, kunye ne-13, kubonakala nge-IgE ephezulu, ii-eosinophils egazini nakwi-sputum, kunye nokusabela kwi-corticosteroids. Ngokwesiko, i-FeNO ibisoloko isetyenziswa uku:
Qagela impendulo kwii-corticosteroids ezifunxwayo (ICS): Amanqanaba aphezulu e-FeNO abonisa ngokuthembekileyo amathuba aphezulu okufumana inzuzo kunyango lwe-ICS.
Jonga ukunamathela kunye nolawulo lokudumba: Ukulinganisa ngokulandelelana kunokuvavanya ngokungathandabuzekiyo ukunamathela kwesigulana kunyango lokulwa nokudumba kunye nokuncitshiswa kokudumba okungaphantsi kwe-T2.
Isikhokelo sokulungiswa konyango: Iindlela zeFeNO zinokunceda ekwenzeni izigqibo zokunyusa okanye ukwehlisa umthamo we-ICS.
Utshintsho luka-2025: i-FeNO kwindlela yokuxilonga
Inkqubela ephambili kwingxelo ye-GINA ka-2025 kukuqinisekiswa okuqinisiweyo kwe-FeNO njengoncedo lokuxilonga ekuchongeni i-asthma ephezulu ye-T2 kwindawo yokubonakaliswa kwayo. Oku kubaluleke kakhulu kwimeko yeentetho ezahlukeneyo ze-asthma.
Ukwahlula iiPhenotypes ze-Asthma: Ayizizo zonke ii-wheeze okanye ukungakwazi ukuphefumla ezibizwa ngokuba yi-T2 asthma eqhelekileyo. Izigulana ezine-non-T2 okanye i-pauci-granulocytic inflammation zinokubonakala zineempawu ezifanayo kodwa zinamanqanaba aphantsi e-FeNO. Inqanaba le-FeNO elihlala liphezulu (umz., >35-40 ppb kubantu abadala) kwisigulana esineempawu ezibonisa ukuba kukho isifo (ukukhwehlela, ukuphefumla, umda wokuhamba komoya oguquguqukayo) ngoku kunika ubungqina obuqinisekileyo be-endotype ephezulu ye-T2, kwanangaphambi kovavanyo lonyango.
Ukuxhasa Ukuxilongwa Kwiimeko Ezinzima: Kwizigulane ezineempawu ezingaqhelekanga okanye apho iziphumo ze-spirometry zingacacanga okanye ziqhelekile ngexesha lovavanyo, i-FeNO ephezulu inokuba bubungqina obubalulekileyo obubonisa inkqubo yokudumba ye-T2 engaphantsi. Inceda ukuhambisa ukuxilongwa ukusuka kolunye ngokusekelwe kuphela kwiimpawu eziguquguqukayo ukuya kolunye oluquka uphawu lwebhayoloji.
Ukwazisa Icebo Lonyango Lokuqala: Ngokufaka i-FeNO kwinqanaba lokuxilonga, oogqirha banokuhlulahlula unyango ngokwengqiqo kwasekuqaleni. Inqanaba eliphezulu le-FeNO alixhasi nje kuphela ukuxilongwa kwesifo sesifuba kodwa likwaxela kwangaphambili impendulo elungileyo kunyango lwe-ICS lomgca wokuqala. Oku kwenza kube lula indlela yonyango eyenzelwe wena, "efanelekileyo ngexesha lokuqala", enokuphucula ulawulo lwangethuba kunye neziphumo.
Iziphumo zeKlinikhi kunye noHlanganiso
Izikhokelo zika-2025 zicebisa ukuhlanganisa uvavanyo lwe-FeNO kumsebenzi wokuqala wokuxilonga xa kukho ukurhanelwa kwe-asthma kwaye ukufikelela kuvavanyo kufumaneka. Ingcaciso ilandela imodeli ehluliweyo:
I-FeNO ephezulu (>50 ppb kubantu abadala): Ixhasa kakhulu ukuxilongwa kwe-asthma ye-T2-high kwaye iqikelela ukuba isabela njani kwi-ICS.
I-FeNO ephakathi (25-50 ppb kubantu abadala): Ifanele itolikwe ngokwemeko yeklinikhi; inokubonisa ukudumba kwe-T2 kodwa inokuchatshazelwa yi-atopy, ukuvezwa kwe-allergen kutshanje, okanye ezinye izinto.
I-FeNO ephantsi (<25 ppb kubantu abadala): Yenza ukudumba okuphezulu kwe-T2 kungabi lula, nto leyo ebangela ukuba kuqwalaselwe ezinye iindlela zokuxilonga (umz., ukungasebenzi kakuhle kwelizwi, iimpawu ze-asthma ezingezizo ze-T2, i-COPD) okanye izizathu ezingezizo zokudumba zeempawu.
Olu hlaziyo alwenzi i-FeNO ibe luvavanyo lokuxilonga oluzimeleyo kodwa luyibeka njengenkxaso enamandla kwimbali yeklinikhi, iipatheni zeempawu, kunye novavanyo lwe-spirometry/reversibility. Longeza umaleko wokungabi nacala ophucula ukuzithemba kokuxilonga.
Isiphelo
Izikhokelo ze-GINA zika-2025 zimele utshintsho oluqhelekileyo, oluqinisa imeko yovavanyo lwe-FeNO ukusuka kwisongezelelo solawulo ukuya kumxhasi obalulekileyo wokuxilongwa kwe-Type 2 asthma. Ngokubonelela ngomlinganiselo okhawulezileyo nongakhethiyo wokudumba kwe-T2 okusisiseko, i-FeNO inika amandla oogqirha ukuba benze ukuxilongwa kwe-phenotypic okuchanekileyo ngakumbi kwintlanganiso yokuqala. Oku kukhokelela kunyango lokuqala olujolise ngakumbi nolusebenzayo, oluhambelana ngokugqibeleleyo nomnqweno wanamhlanje weyeza elichanekileyo kunyango lwe-asthma. Njengoko ukufikelela kwitekhnoloji ye-FeNO kusanda, indima yayo ekuxilongeni nasekulawuleni unyango lwe-T2-high asthma imiselwe ukuba ibe ngumgangatho wonyango, ekugqibeleni ijolise kwiziphumo ezingcono zesigulana ngokungenelela kwangaphambili nangokuchanekileyo.
Inkqubo yoHlalutyo lweGesi yoMoya ye-UBREATH (BA200) sisixhobo sezonyango esiyilwe kwaye senziwa yi-e-LinkCare Meditech ukuze sidibane novavanyo lwe-FeNO kunye ne-FeCO ukuze kubonelelwe ngomlinganiselo okhawulezileyo, ochanekileyo, nowobungakanani ukuze kuncedwe ekuxilongweni nasekulawulweni kwezonyango ezifana ne-asthma kunye nezinye izifo ezingapheliyo zomoya.
Ixesha leposi: Jan-23-2026