{"id":24470,"date":"2025-04-30T09:20:36","date_gmt":"2025-04-30T13:20:36","guid":{"rendered":"https:\/\/www.emilysentourage.org\/?p=24470"},"modified":"2025-04-30T11:05:04","modified_gmt":"2025-04-30T15:05:04","slug":"cf-before-birth-how-one-couple-used-modulators-for-in-utero-treatment-to-improve-health-outcomes-for-their-child","status":"publish","type":"post","link":"https:\/\/www.emilysentourage.org\/tr\/cf-before-birth-how-one-couple-used-modulators-for-in-utero-treatment-to-improve-health-outcomes-for-their-child\/","title":{"rendered":"Do\u011fumdan \u00d6nce KF: Bir \u00c7ift \u00c7ocuklar\u0131n\u0131n Sa\u011fl\u0131k Sonu\u00e7lar\u0131n\u0131 \u0130yile\u015ftirmek \u0130\u00e7in \u0130n Utero Tedavi Mod\u00fclat\u00f6rlerini Nas\u0131l Kulland\u0131?"},"content":{"rendered":"<p style=\"text-align: center;\"><i>Emily's Entourage, KF Fark\u0131ndal\u0131k Ay\u0131 boyunca KF toplulu\u011fu \u00fcyelerini hikayelerini payla\u015fmaya davet ediyor. Bug\u00fcnk\u00fc blog yaz\u0131s\u0131nda, KF te\u015fhisi konulan do\u011fmam\u0131\u015f k\u0131zlar\u0131n\u0131 tedavi etmek i\u00e7in harekete ge\u00e7en, rahimde tedavi sa\u011flamak ve sa\u011fl\u0131k sonu\u00e7lar\u0131n\u0131 iyile\u015ftirmek i\u00e7in t\u0131bbi g\u00f6zetim alt\u0131nda CFTR mod\u00fclat\u00f6rleri kullanan bir \u00e7ift olan Chris ve Erica Molaro yer al\u0131yor.<\/i><\/p>\n<p>Ocak 2023'te hayat\u0131m\u0131z\u0131 de\u011fi\u015ftirecek bir haber ald\u0131k: yak\u0131nda do\u011facak k\u0131z\u0131m\u0131z kistik fibrozis (KF) hastas\u0131 olarak d\u00fcnyaya gelecekti.<\/p>\n<p>\u00d6zellikle de F508del gen mutasyonunun iki kopyas\u0131yla do\u011facakt\u0131. Bu haber \u015fok etkisi yaratt\u0131; her ikimizin ailesinde de KF ge\u00e7mi\u015fi yoktu; en az\u0131ndan bizim bildi\u011fimiz kadar\u0131yla. Her ikimizin de gen mutasyonu ta\u015f\u0131y\u0131c\u0131s\u0131 oldu\u011fumuzu ancak ona te\u015fhis konulduktan sonra \u00f6\u011frendik.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignright wp-image-24473\" src=\"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-768x1024.jpg\" alt=\"\" width=\"412\" height=\"550\" srcset=\"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-768x1024.jpg 768w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-225x300.jpg 225w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-1152x1536.jpg 1152w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-1536x2048.jpg 1536w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-9x12.jpg 9w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-600x800.jpg 600w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_06902-scaled.jpg 1920w\" sizes=\"(max-width: 412px) 100vw, 412px\" \/>KF'li olarak do\u011faca\u011f\u0131n\u0131 \u00f6\u011frendi\u011fimiz g\u00fcn sonsuza dek haf\u0131zam\u0131zda yer edecek. Ger\u00e7ek \u015fu ki, bu haber korkun\u00e7 bir haberdi. Trajikti. Y\u0131k\u0131c\u0131yd\u0131.<\/p>\n<p>Bu, k\u0131z\u0131m\u0131z\u0131n hayat\u0131n\u0131n geri kalan\u0131nda korkun\u00e7, \u00f6l\u00fcmc\u00fcl ve ilerleyici bir hastal\u0131kla ya\u015fayaca\u011f\u0131 anlam\u0131na geliyordu. Hastanede kal\u0131\u015f s\u00fcresi, g\u00fcnl\u00fck ila\u00e7lar, g\u00fcnl\u00fck g\u00f6\u011f\u00fcs fizik tedavisi, hava yolunun temizlenmesi i\u00e7in g\u00fcnde birka\u00e7 kez tedavi; yetersiz beslenme riski; muhtemelen acil ba\u011f\u0131rsak ameliyat\u0131 ve daha fazlas\u0131 anlam\u0131na geliyordu.<\/p>\n<p>Y\u00fcrek par\u00e7alay\u0131c\u0131 prognoza ra\u011fmen, duruma iyimser yakla\u015fmaya kararl\u0131yd\u0131k.<\/p>\n<blockquote><p>Marcus Aurelius'un stoac\u0131 felsefesinden g\u00fc\u00e7 alarak, neye odakland\u0131k? <i>olabilir<\/i> CF'nin ilk \u00e7ocu\u011fumuzu beklemenin sevincini g\u00f6lgelemesine izin vermeyi reddederek kontrol.<\/p><\/blockquote>\n<p>\u00d6n\u00fcm\u00fczdeki zorluklar \u00fcrk\u00fct\u00fcc\u00fc olsa da, KF bak\u0131m\u0131ndaki ilerlemeler ve evimizin yak\u0131n\u0131ndaki d\u00fcnya standartlar\u0131ndaki t\u0131bbi destek bizi umutland\u0131rd\u0131. Umutlu olmak i\u00e7in hala \u00e7ok \u015fey vard\u0131 - \u00f6zellikle de k\u0131z\u0131m\u0131z yoldayken.<\/p>\n<p>Bebe\u011fimiz i\u00e7in m\u00fcmk\u00fcn olan en iyi sonucu sa\u011flamaya y\u00f6nelik bu sars\u0131lmaz arzudan hareketle, umut aray\u0131\u015f\u0131m\u0131z bizi mutasyon hedefli yeni bir CFTR mod\u00fclat\u00f6r tedavisinin vaadine g\u00f6t\u00fcrd\u00fc. G\u00fcnde iki kez al\u0131nan ila\u00e7, h\u00fccrelerin i\u00e7ine ve d\u0131\u015f\u0131na tuz ve su ak\u0131\u015f\u0131n\u0131 d\u00fczenleyen CFTR (kistik fibroz transmembran iletkenlik d\u00fczenleyicisi) proteinini mod\u00fcle ederek, sadece semptomlar\u0131ndan ziyade KF'nin temel nedenini ele al\u0131yor.<\/p>\n<p>Bu mutasyon hedefli CFTR mod\u00fclat\u00f6r tedavisini \u00f6\u011frenmek i\u00e7in yeterince erken olamazd\u0131. Bebe\u011fimizin do\u011fmas\u0131na \u00fc\u00e7 ay kalm\u0131\u015ft\u0131 ve ultrasonda ekojenik bir ba\u011f\u0131rsak g\u00f6steriyordu. KF'nin yayg\u0131n bir erken belirtisi olan bu durum, d\u00fczeltilmedi\u011fi takdirde ba\u011f\u0131rsak perforasyonu, sepsis ve \u00f6l\u00fcm gibi ciddi komplikasyonlara yol a\u00e7abilir.<\/p>\n<blockquote><p>Erica, t\u0131bbi ekibinin g\u00f6zetiminde, k\u0131z\u0131m\u0131z\u0131 rahimde tedavi etmek i\u00e7in hamilelik s\u0131ras\u0131nda CFTR mod\u00fclat\u00f6r\u00fc alan d\u00f6rd\u00fcnc\u00fc anne oldu.<\/p><\/blockquote>\n<p>Ekojenik ba\u011f\u0131rsa\u011f\u0131 stabilize olmu\u015f gibi g\u00f6r\u00fcn\u00fcyordu.<\/p>\n<p>22 May\u0131s 2023'te g\u00fczel k\u00fc\u00e7\u00fck k\u0131z\u0131m\u0131z d\u00fcnyaya geldi. Ba\u011f\u0131rsak sorunlar\u0131 d\u00fczelmi\u015f olsa da tamamen \u00e7\u00f6z\u00fclmedi ve KF'li bebeklerde s\u0131k g\u00f6r\u00fclen bir semptom olan mekonyum ileus ile m\u00fccadele ederek 16 g\u00fcn boyunca YYB\u00dc'de kald\u0131.<\/p>\n<p>Zorluklarla kar\u015f\u0131la\u015fmam\u0131za ra\u011fmen, ameliyattan ka\u00e7\u0131n\u0131ld\u0131\u011f\u0131 i\u00e7in minnettarl\u0131\u011f\u0131n \u00f6tesindeydik ve fark\u0131na bile varmadan evdeydik, birlikte yolculu\u011fumuza ba\u015flamaya haz\u0131rd\u0131k.<\/p>\n<p><img decoding=\"async\" class=\"alignleft wp-image-24475\" src=\"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-1024x984.jpg\" alt=\"\" width=\"537\" height=\"516\" srcset=\"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-1024x984.jpg 1024w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-300x288.jpg 300w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-768x738.jpg 768w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-1536x1476.jpg 1536w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-2048x1968.jpg 2048w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-12x12.jpg 12w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/IMG_66403-600x577.jpg 600w\" sizes=\"(max-width: 537px) 100vw, 537px\" \/>Erica hastaneden taburcu olduktan sonra, t\u0131bbi ekibinin rehberli\u011finde CFTR mod\u00fclat\u00f6r tedavisine devam ederek cesur bir ad\u0131m daha att\u0131. Bu kez tedaviyi anne s\u00fct\u00fc yoluyla sa\u011flayarak bunu yapan ilk annelerden biri, hatta birincisi oldu.<\/p>\n<p>KF'nin te\u015fhis edilmesinin yollar\u0131ndan biri\u00a0<a href=\"https:\/\/www.cff.org\/intro-cf\/sweat-test\">ter-klor\u00fcr testi<\/a>. KF'li ki\u015filer v\u00fccutlar\u0131ndaki tuzu d\u00fczenleyemezler, bu nedenle terleri kelimenin tam anlam\u0131yla daha tuzludur. Klor\u00fcr de\u011ferinin 60mmol\/L'den y\u00fcksek olmas\u0131 KF i\u00e7in tan\u0131 koydurucudur.<\/p>\n<p>K\u0131z\u0131m\u0131z\u0131n do\u011fduktan yakla\u015f\u0131k bir hafta sonra yap\u0131lan ilk ter testi sonucu 83't\u00fc. Te\u015fhisi nedeniyle bu \u015fa\u015f\u0131rt\u0131c\u0131 olmasa da, sonucun mutasyon tipi i\u00e7in tipik olandan daha d\u00fc\u015f\u00fck oldu\u011funu g\u00f6rmek umut vericiydi.<\/p>\n<p>K\u0131z\u0131m\u0131z\u0131n ilerlemesini takip etmek i\u00e7in, anne s\u00fct\u00fc yoluyla tedavinin onu nas\u0131l etkiledi\u011fini de\u011ferlendirmek amac\u0131yla birka\u00e7 ayda bir d\u00fczenli ter testleri planlamak i\u00e7in t\u0131bbi ekibimizle birlikte \u00e7al\u0131\u015ft\u0131k - ancak o zamanlar bu y\u00f6ntem kan\u0131tlanmam\u0131\u015f ve test edilmemi\u015fti.<\/p>\n<p>\u0130lk ter testinden birka\u00e7 ay sonra, ikinci testinin sonu\u00e7lar\u0131 geldi. Sa\u011fl\u0131k ekibi bizi co\u015fkuyla arad\u0131: \"Sonu\u00e7lar\u0131 g\u00f6rd\u00fcn\u00fcz m\u00fc?! Ter testi sonu\u00e7lar\u0131 57 olarak \u00f6l\u00e7\u00fclm\u00fc\u015f!\"<\/p>\n<p>K\u0131sa bir s\u00fcre sonra, \u00fc\u00e7\u00fcnc\u00fc ter testi sonu\u00e7lar\u0131 daha da iyile\u015ferek 33'e y\u00fckseldi.<\/p>\n<p>\u015eimdi, k\u0131z\u0131m\u0131z ikinci ya\u015f g\u00fcn\u00fcne yakla\u015f\u0131rken, son ter testi 27 \u00e7\u0131kt\u0131. Pankreas yetmezli\u011fi var ve herhangi bir yeni y\u00fcr\u00fcmeye ba\u015flayan \u00e7ocu\u011fun ruhuna (ve tutumuna) sahip.<\/p>\n<p>Evet, hala KF hastas\u0131; bu bir tedavi hikayesi de\u011fil ama bir umut ve ilerleme hikayesi. KF'si hala ciddi ama kontrol alt\u0131nda tutuluyor. Ge\u00e7enlerde Emily's Entourage Bilimsel Sempozyumuna kat\u0131l\u0131rken, k\u0131z\u0131m\u0131z\u0131n CFTR mod\u00fclat\u00f6r\u00fcn\u00fc \u00fcreten \u015firketin ara\u015ft\u0131rmac\u0131lar\u0131ndan biri \"KF'si var ama KF ile ya\u015fam\u0131yor\" dedi.  Bu, her g\u00fcn nas\u0131l hissetti\u011fimizi \u00f6zetliyor - hastal\u0131k hala onun hayat\u0131n\u0131n bir par\u00e7as\u0131 olsa da, onu tan\u0131mlam\u0131yor.<\/p>\n<p>Modern bilim inan\u0131lmaz ilerlemeler getirdi. Bunlardan biri olan bu CFTR mod\u00fclat\u00f6r\u00fc ailemiz i\u00e7in bir nimet oldu, ancak ger\u00e7ek \u015fu ki, KF'li bir\u00e7ok insan i\u00e7in hala ula\u015f\u0131lamaz durumda. Tedavi pahal\u0131, bulunabilirli\u011fi s\u0131n\u0131rl\u0131 ve yaln\u0131zca belirli KF mutasyonlar\u0131na sahip olanlar i\u00e7in etkili oldu\u011fundan KF'li ki\u015filerin yakla\u015f\u0131k 10%'sini se\u00e7eneksiz b\u0131rak\u0131yor. Ara\u015ft\u0131rman\u0131n s\u0131n\u0131rlar\u0131n\u0131 zorlamaya devam etmeli, daha geni\u015f KF toplulu\u011fu i\u00e7in etkili tedaviler bulmaya \u00e7al\u0131\u015fmal\u0131 ve nihai hedefe do\u011fru \u00e7al\u0131\u015fmal\u0131y\u0131z: KF'yi bu korkun\u00e7 hastal\u0131kla ya\u015fayan herkes i\u00e7in ge\u00e7mi\u015fte kalan bir \u015fey haline getirmek.<\/p>\n<h1>Yazarlar<\/h1>\n<p><img decoding=\"async\" class=\"alignleft wp-image-24477\" src=\"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/Molaro-Featured-Image.png\" alt=\"\" width=\"175\" height=\"175\" srcset=\"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/Molaro-Featured-Image.png 300w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/Molaro-Featured-Image-150x150.png 150w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/Molaro-Featured-Image-12x12.png 12w, https:\/\/www.emilysentourage.org\/wp-content\/uploads\/Molaro-Featured-Image-100x100.png 100w\" sizes=\"(max-width: 175px) 100vw, 175px\" \/><\/p>\n<p>Chris, davran\u0131\u015fsal sa\u011fl\u0131k entegrasyonunu ve davran\u0131\u015fsal sa\u011fl\u0131k sa\u011flay\u0131c\u0131lar\u0131n\u0131 destekleyen bir veri analizi ve bak\u0131m etkinle\u015ftirme platformu olan NeuroFlow'un CEO'sudur.  West Point'teki ABD Askeri Akademisi ve Pennsylvania \u00dcniversitesi'ndeki Wharton Okulu'ndan mezun olmu\u015ftur.  ABD Ordusunda Y\u00fczba\u015f\u0131 olarak Irak'ta g\u00f6rev yapt\u0131\u011f\u0131 s\u0131rada Bronz Y\u0131ld\u0131z ile \u00f6d\u00fcllendirilmi\u015f ve NeuroFlow'u kurduktan sonra EY'nin Y\u0131l\u0131n Giri\u015fimcisi \u00f6d\u00fcl\u00fcn\u00fc kazanm\u0131\u015ft\u0131r.<\/p>\n<p>Erica, Jefferson Health'te ba\u011f\u0131ml\u0131l\u0131k t\u0131bb\u0131 alan\u0131nda uzmanla\u015fm\u0131\u015f bir Doktor Asistan\u0131d\u0131r.  Pittsburgh \u00dcniversitesi ve Marywood \u00dcniversitesi mezunudur ve \u015fu anda Thomas Jefferson \u00dcniversitesi'nde Sa\u011fl\u0131k Bilimleri Doktoras\u0131 (DHs) derecesini s\u00fcrd\u00fcrmektedir.<\/p>\n<p>Molaro Ailesi Philadelphia'da ya\u015f\u0131yor ve y\u00fcr\u00fcy\u00fc\u015f yapmaktan, ke\u015ffetmekten ve seyahat etmekten ho\u015flan\u0131yor.  Madison, hen\u00fcz 23 ayl\u0131kken, 6 \u00fclke, 8 eyalet ve 40'tan fazla u\u00e7u\u015f yaparak seyahat etmekten keyif al\u0131yor ve elbette \u00f6\u011fleden sonralar\u0131n\u0131 yerel park\u0131n sal\u0131ncak setinde ge\u00e7irmekten ho\u015flan\u0131yor.<\/p>","protected":false},"excerpt":{"rendered":"<p>Emily's Entourage, KF Fark\u0131ndal\u0131k Ay\u0131 boyunca KF toplulu\u011fu \u00fcyelerini hikayelerini payla\u015fmaya davet ediyor. Bug\u00fcnk\u00fc blog yaz\u0131s\u0131nda, KF te\u015fhisi konulan do\u011fmam\u0131\u015f k\u0131zlar\u0131n\u0131 tedavi etmek i\u00e7in harekete ge\u00e7en, rahimde tedavi sa\u011flamak ve sa\u011fl\u0131k sonu\u00e7lar\u0131n\u0131 iyile\u015ftirmek i\u00e7in t\u0131bbi g\u00f6zetim alt\u0131nda CFTR mod\u00fclat\u00f6rleri kullanan Chris ve Erica Molaro \u00e7ifti yer al\u0131yor. Ocak ay\u0131nda... <\/p>\n<div class=\"clear\"><\/div>\n<p><a href=\"https:\/\/www.emilysentourage.org\/tr\/cf-before-birth-how-one-couple-used-modulators-for-in-utero-treatment-to-improve-health-outcomes-for-their-child\/\" class=\"excerpt-read-more\">Daha fazla bilgi edinin<\/a><\/p>","protected":false},"author":1719,"featured_media":24477,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_titles_title":"%%post_title%%","_seopress_titles_desc":"%%post_excerpt%%","_seopress_robots_index":"","_seopress_robots_follow":"","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"none","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"","_seopress_social_fb_img_attachment_id":0,"_seopress_social_fb_img_width":0,"_seopress_social_fb_img_height":0,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"","_seopress_social_twitter_img_attachment_id":0,"_seopress_social_twitter_img_width":0,"_seopress_social_twitter_img_height":0,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"both","_seopress_redirections_param":"","_seopress_redirections_type":301,"_seopress_analysis_target_kw":"","_seopress_news_disabled":"","_seopress_video_disabled":"","_seopress_video":[],"_seopress_pro_schemas_manual":[],"_seopress_pro_rich_snippets_disable_all":"","_seopress_pro_rich_snippets_disable":[],"_seopress_pro_schemas":[],"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[6],"tags":[211,215,209,214,213,137],"class_list":["post-24470","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emilys-entourage-blog","tag-cf-advocacy","tag-cf-before-birth","tag-cfa","tag-cfa-month","tag-cystic-fibrosis-awareness","tag-cystic-fibrosis-awareness-month"],"acf":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/www.emilysentourage.org\/wp-content\/uploads\/Molaro-Featured-Image.png","post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/posts\/24470","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/users\/1719"}],"replies":[{"embeddable":true,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/comments?post=24470"}],"version-history":[{"count":3,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/posts\/24470\/revisions"}],"predecessor-version":[{"id":24478,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/posts\/24470\/revisions\/24478"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/media\/24477"}],"wp:attachment":[{"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/media?parent=24470"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/categories?post=24470"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.emilysentourage.org\/tr\/wp-json\/wp\/v2\/tags?post=24470"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}