Var olan\u0131 ke\u015ffedebilmek… Bir \u015feyin varl\u0131\u011f\u0131n\u0131, varolu\u015funu kavrayabilmek… \u0130nsan\u0131n do\u011faya ilgisini, ili\u015fkisini m\u00e2n\u00e2land\u0131rmak\u2026 Onu hikmetle s\u00fcz\u00fcp ilimle harmanlamak\u2026 Rahat bir ya\u015fam\u0131n \u00e7abalar\u0131 aras\u0131nda insan\u0131n do\u011faya ve di\u011fer canl\u0131lara \u00fcst\u00fcnl\u00fck sa\u011flama arzusu, bilimin her temel ta\u015f\u0131n\u0131 olu\u015fturan birer nedenler k\u0131y\u0131s\u0131d\u0131r. \u0130lgili kitaplardaki tan\u0131mlardan birine g\u00f6re bilim, ya\u015fad\u0131\u011f\u0131m\u0131z evrenin belirli bir alan\u0131ndaki olay\u0131 ele alan, deneysel y\u00f6ntemlere ve ger\u00e7ekli\u011fe dayand\u0131rmaya \u00e7al\u0131\u015fan, sistemli bir ara\u015ft\u0131rma s\u00fcrecidir.<\/p>\n
ANT\u0130B\u0130YOT\u0130K<\/strong><\/p>\n Kanuni Sultan S\u00fcleyman\u2019\u0131n k\u0131\u015f aylar\u0131nda sefere g\u00f6nderdi\u011fi askerlerinin hepsine seferden \u00f6nce hastalanmamalar\u0131 i\u00e7in k\u00fcfl\u00fc peynir yedirdi\u011fi bilgisi tarih kitaplar\u0131nda yer almaktad\u0131r. Bat\u0131l\u0131 gezginlerin notlar\u0131nda yer edinen bir di\u011fer bilgi ise, T\u00fcrk askerlerinin yaralar\u0131na k\u00fcfl\u00fc peynir s\u00fcrd\u00fckleri vakidir. \u201cAntibiyotik \u00e7a\u011f\u0131\u201dn\u0131n hen\u00fcz ba\u015flamad\u0131\u011f\u0131 y\u0131llara \u015fahitlik etmi\u015flerdir.<\/p>\n Antibiyotikler \u00e7e\u015fitli veya belirli t\u00fcrde mikroorganizman\u0131n geli\u015fimini ve \u00fcremesini durdurmas\u0131n\u0131, son olarak da \u00f6l\u00fcm\u00fcyle sonu\u00e7lanmas\u0131na yol a\u00e7an bir kimyasal bile\u015fen b\u00fct\u00fcn\u00fcd\u00fcr. Antibiyotik \u00e7a\u011f\u0131, Alexender Fleming\u2019in 1928 tarihinde penisilini ke\u015ffedi\u015fiyle ba\u015flam\u0131\u015ft\u0131r. Louis Pasteur 1857 y\u0131l\u0131nda yay\u0131mlad\u0131\u011f\u0131 bir \u00e7al\u0131\u015fmas\u0131nda, laktik asidin fermantasyonunda antimikrobik etkinin ili\u015fkisinden s\u00f6z etmi\u015ftir. Ama ger\u00e7ek anlamda kayda de\u011fer \u00e7al\u0131\u015fma, Fleming\u2019in 1929 y\u0131l\u0131nda \u00e7\u0131kard\u0131\u011f\u0131 makalesinde \u201cPenicillum notatum k\u00fcf\u00fcn\u00fcn salg\u0131lad\u0131\u011f\u0131 maddeler, stafilakok t\u00fcr\u00fc mikroplar\u0131n \u00e7\u00f6z\u00fclmesini sa\u011fl\u0131yor.\u201d \u015feklinde bahsetmesiyle vaki olmu\u015ftur. Londra\u2019da bulunan St. Mary Hastanesi\u2019ndeki \u00e7al\u0131\u015fmalar\u0131nda Fleming, k\u00fclt\u00fcr \u00fcretim kaplar\u0131ndaki streptokoklar\u0131n, penisilin bulundu\u011fu<\/em> bir ye\u015fil alan olu\u015fumunu g\u00f6zlemlemi\u015fti. Bunun anlam\u0131 ise k\u00fcf\u00fcn, streptokoklar\u0131n \u00fcretimini engelliyor olmas\u0131yd\u0131. Fleming penisilinle ilgili g\u00f6zlemin etik deney sonu\u00e7lar\u0131n\u0131 1929 y\u0131l\u0131nda Penicillium K\u00fclt\u00fcr\u00fcn\u00fcn Antibakteriyel Etkisi \u00dczerine ba\u015fl\u0131kl\u0131 makalesinde a\u00e7\u0131klad\u0131. Fleming deneylerini daha sonraki y\u0131llarda da s\u00fcrd\u00fcrm\u00fc\u015ft\u00fcr fakat penisilinin bakteriyel hastal\u0131klarda kullan\u0131labilir bir ila\u00e7 i\u00e7ermesinden bahsetmemi\u015ftir.<\/p>\n Howard Florey ve Ernst Boris Chain y\u00f6netimindeki bir patoloji grubu ise, penisilinle ilgili bu \u00e7al\u0131\u015fmay\u0131 yeniden ba\u015flatm\u0131\u015flard\u0131r. 1939 y\u0131l\u0131nda safla\u015ft\u0131rmay\u0131 ba\u015farm\u0131\u015flard\u0131r. Daha sonra fareler \u00fczerinde bu maddeyi denemi\u015flerdir. Deney sonucunda ise al\u0131nan veriler \u00f6l\u00fcmc\u00fcl dozda streptokokla enfekte edilmi\u015f farelerden penisilin verilmeyenlerin birka\u00e7 saat i\u00e7inde \u00f6ld\u00fckleri, penisilin verilen farelerin ise hepsinin hayatta kald\u0131\u011f\u0131 idi. Sonu\u00e7 olarak penisilinin tedavi edici \u00f6zelli\u011fi kesinlik kazanm\u0131\u015f oldu.<\/p>\n Fleming, penisilinin antibakteriyel oldu\u011funu ilk kez fark eden bakteriyologdu. Penisilini ilk ke\u015ffeden Florey ve Chain olmu\u015ftu. Ancak, k\u0131sa bir s\u00fcre sonra unutulmu\u015f ve penisilinin ke\u015ffinde sadece Fleming\u2019in ad\u0131 an\u0131lmaya ba\u015flanm\u0131\u015ft\u0131r. \u0130lk defa 1941 y\u0131l\u0131nda salg\u0131n ve enfekte hastal\u0131klar aras\u0131nda uygulanmaya ba\u015flanan penisilin, \u0130kinci D\u00fcnya Sava\u015f\u0131 boyunca yo\u011fun olarak kullan\u0131lmaya ba\u015flanm\u0131\u015ft\u0131r. ABD\u2019de 1943\u2019te ilk be\u015f y\u0131lda 400 milyon birim penisilin \u00fcretilmi\u015ftir.<\/p>\n ABD ila\u00e7 firmalar\u0131n\u0131n ayl\u0131k penisilin \u00fcretimi 650 milyon birimi bulmu\u015ftur. 1940\u2019l\u0131 y\u0131llar\u0131n sonlar\u0131nda penisilin art\u0131k frengi, zat\u00fcrre, menenjit olmak \u00fczere baz\u0131 bakteri hastal\u0131klar\u0131n\u0131n kullan\u0131lmas\u0131nda elveri\u015fli hale gelmi\u015ftir. Her \u015feyin fazlas\u0131 zarar ilkesi, antibiyotiklerde de ge\u00e7erliydi. Belirli bir d\u00f6nem boyunca doktorlar\u0131n alt\u0131n re\u00e7etesi olarak an\u0131lan antibiyotik, a\u015f\u0131r\u0131ya ka\u00e7\u0131ld\u0131\u011f\u0131nda yol a\u00e7t\u0131\u011f\u0131 sonu\u00e7lar bak\u0131m\u0131ndan hi\u00e7 de hafife al\u0131nacak t\u00fcrden de\u011fildi. V\u00fccudun metabolizmas\u0131n\u0131 bozmakla kalm\u0131yor, ger\u00e7ek alt\u0131n re\u00e7etemiz olan ba\u011f\u0131\u015f\u0131kl\u0131k sistemimizin zay\u0131flamas\u0131na, ba\u011f\u0131rsak floram\u0131z\u0131n bozulmas\u0131na sebep oluyordu.<\/p>\n A\u015eI<\/strong><\/p>\n Antik Yunan tarih\u00e7isi Thucydides\u2019e g\u00f6re, M\u00d6.429 y\u0131l\u0131nda Atina\u2019da \u00e7i\u00e7ek hastal\u0131\u011f\u0131 ge\u00e7iren bir ki\u015fi tekrar ayn\u0131 hastal\u0131\u011f\u0131 ge\u00e7irmi\u015ftir. 1695 y\u0131l\u0131nda ise \u00c7inli doktor Zhang Lu\u2019nun yazd\u0131\u011f\u0131 kitapta \u00e7i\u00e7ek hastal\u0131\u011f\u0131na kar\u015f\u0131 koymak i\u00e7in uygulanan \u201cvariolasyon\u201d i\u00e7in farkl\u0131 tekniklerden bahsetmi\u015ftir: \u201c\u00c7i\u00e7ek p\u00fcst\u00fcllerindeki p\u00fcye bula\u015ft\u0131r\u0131lan pamuk par\u00e7as\u0131 sa\u011flam \u00e7ocu\u011fun burnuna tutulmaktad\u0131r. Bir di\u011fer y\u00f6ntemde ise; sa\u011fl\u0131kl\u0131 bir \u00e7ocu\u011fa hastal\u0131ktan iyile\u015fmi\u015f bir \u00e7ocu\u011fun giysileri giydirilmekte. Variolasyondan sonra \u00e7ocuk yakla\u015f\u0131k 7 g\u00fcnde ate\u015flenmekte ve \u00e7i\u00e7ek hastal\u0131\u011f\u0131n\u0131 daha hafif olarak ge\u00e7iren \u00e7ocuk daha sonra tekrar \u00e7i\u00e7ek hastal\u0131\u011f\u0131 ge\u00e7irmemektedir.\u201d \u00c7in\u2019den Orta Asya\u2019ya yay\u0131lan bu teknik Kafkaslara ge\u00e7mi\u015ftir ve y\u00f6ntemlerde de\u011fi\u015fiklikler olu\u015fmu\u015ftur:<\/p>\n \u201c18. y\u00fczy\u0131l\u0131n ba\u015flar\u0131nda variolasyon Avrupa\u2019ya ge\u00e7meye ba\u015flam\u0131\u015ft\u0131r. 1714\u2019de Emanuel Timoni \u0130stanbul\u2019da g\u00f6n\u00fcll\u00fc olarak variolasyon yapt\u0131rm\u0131\u015ft\u0131r ve 1716\u2019da Giacomo Pilarino Londra Kraliyet Derne\u011fi\u2019ne variolasyon tekni\u011fini tan\u0131mlayan mektup yazm\u0131\u015flard\u0131r. \u0130ngiliz hekimler bu mektuplar\u0131 hi\u00e7 dikkate almad\u0131lar. Daha sonra \u0130ngiltere\u2019nin Osmanl\u0131 \u0130mparatorlu\u011fu B\u00fcy\u00fckel\u00e7isi\u2019nin o\u011flunu ve k\u0131z\u0131n\u0131 a\u015f\u0131latmas\u0131 \u00fczerine y\u00f6ntem kabul g\u00f6rd\u00fc. B\u00f6ylece variolasyon Avrupa ve Amerika\u2019da da yayg\u0131nla\u015fmaya ba\u015flad\u0131.\u201d<\/p>\n Louis Pasteur\u2019un 1885\u2019deki \u00e7al\u0131\u015fmalar\u0131 devrim niteli\u011fi ta\u015f\u0131maktad\u0131r. Canl\u0131 a\u015f\u0131lar\u0131n geli\u015ftirilmesine y\u00f6nelik ara\u015ft\u0131rmalar\u0131n yap\u0131ld\u0131\u011f\u0131 y\u0131llar\u0131nda bakteri ve vir\u00fcs \u00e2lemi hen\u00fcz ke\u015ffedilmemi\u015fti. Ayn\u0131 y\u0131l\u0131n May\u0131s ay\u0131nda Pasteur\u2019a d\u00f6rt g\u00fcn \u00f6nce kuduz bir k\u00f6pek taraf\u0131ndan \u0131s\u0131r\u0131lan bir \u00e7ocuk getirilir. Pasteur \u00e7ocu\u011fu tedavi edip etmemekte karars\u0131z kald\u0131ktan sonra, \u00e7ocu\u011fu a\u015f\u0131lar. Pasteur\u2019un k\u00f6pekler \u00fczerinde denedi\u011fi serumu i\u015fe yarar ve \u00e7ocuk kurtulur. Louis Pasteur\u2019\u00fcn \u00fcn\u00fc yay\u0131l\u0131r ve d\u00fcnyan\u0131n her yerinde kuduz enstit\u00fcleri kurulmaya ba\u015flan\u0131r.<\/p>\n \u201c1910 y\u0131l\u0131nda, Calmette ve Guerin, insan t\u00fcberk\u00fclozuna kar\u015f\u0131 koruma sa\u011flayacak bir \u201csu\u015f\u201d elde etmek i\u00e7in bir veteriner olan Nocard\u2019dan ald\u0131klar\u0131 inek t\u00fcberk\u00fcloz bakterisini yapay bir vasatta 39 kez pasaj yapt\u0131ktan sonra, bakterinin hayvanlarda \u00f6ld\u00fcr\u00fcc\u00fcl\u00fc\u011f\u00fcn\u00fc kaybetti\u011fini g\u00f6zlemlemi\u015flerdir. 1923\u2019de difteri toksinini \u0131s\u0131 ve formelinle inh\u00fcbe ederek stabil, toksik olmayan bir difteri toksoidini elde etmeyi ba\u015farm\u0131\u015ft\u0131r. Frans\u0131z T\u0131p Akademisi 1926\u2019da bu a\u015f\u0131y\u0131 \u00e7ocuklar i\u00e7in onaylam\u0131\u015ft\u0131r. 1954\u2019de Virolog John Enders ve pediatrist Thomas Peebles k\u0131zam\u0131k vir\u00fcs\u00fcn\u00fc b\u00f6brek h\u00fccre k\u00fclt\u00fcrlerinde \u00fcretmeyi ba\u015faran ilk bilim adamlar\u0131d\u0131r. Enders ve \u00e7al\u0131\u015fma arkada\u015f\u0131 Samuel Katz bu vir\u00fcsle k\u0131zam\u0131\u011fa kar\u015f\u0131 a\u015f\u0131 geli\u015ftirme \u00e7al\u0131\u015fmalar\u0131na ba\u015flam\u0131\u015flard\u0131r. 1959 y\u0131l\u0131nda ilk duyarl\u0131 \u00e7ocuk a\u015f\u0131lanm\u0131\u015ft\u0131r. 1963\u2019de ABD\u2019de canl\u0131 k\u0131zam\u0131k a\u015f\u0131s\u0131 lisans alm\u0131\u015ft\u0131r. G\u00fcn\u00fcm\u00fczde t\u00fcm d\u00fcnyada bu a\u015f\u0131 kullan\u0131lmaktad\u0131r.\u201d<\/p>\n \u00dclkemizde a\u015f\u0131 \u00fcretimi i\u00e7in \u00e7al\u0131\u015fmalar ilk olarak Osmanl\u0131 d\u00f6neminde ba\u015flam\u0131\u015ft\u0131r. 1721 y\u0131l\u0131nda \u0130ngiltere B\u00fcy\u00fckel\u00e7isi\u2019nin e\u015fi Lady Mary Montagu \u00fclkesine yazd\u0131\u011f\u0131 bir mektupta \u0130stanbul\u2019da \u00e7i\u00e7ek hastal\u0131\u011f\u0131na kar\u015f\u0131 \u201ca\u015f\u0131 denilen bir \u015fey\u201d (varilasyon metodu) yap\u0131ld\u0131\u011f\u0131n\u0131 hayretle bildirmektedir. Bu mektup a\u015f\u0131 yap\u0131m\u0131na ili\u015fkin ula\u015f\u0131lm\u0131\u015f en eski belgedir.<\/p>\n A\u015f\u0131 \u00fcretim \u00e7al\u0131\u015fmalar\u0131n\u0131 y\u00fcr\u00fctmekte olan Pasteur, \u00e7al\u0131\u015fmalar\u0131n\u0131 s\u00fcrd\u00fcrebilmek i\u00e7in d\u00f6nemin devlet ba\u015fkanlar\u0131na maddi katk\u0131 i\u00e7in yaz\u0131 yazar, yaz\u0131lardan birinin Sultan II. Abd\u00fclhamid\u2019e ula\u015fmas\u0131 sonras\u0131nda, II. Abd\u00fclhamid, yard\u0131m yapabilece\u011fini ancak \u00e7al\u0131\u015fmalar\u0131n\u0131 \u0130stanbul\u2019da s\u00fcrd\u00fcrmesini ister,<\/p>\n Bu teklif Pasteur taraf\u0131ndan kabul g\u00f6rmeyince ikinci teklif olu\u015fturulur, Pasteur\u2019a Mecidiye Ni\u015fan\u0131 ile birlikte 10.000 alt\u0131n (baz\u0131 kaynaklarda 800 lira olarak ge\u00e7iyor, ama bakt\u0131\u011f\u0131n\u0131zda d\u00f6nemin \u0130stanbul\u2019unda yakla\u015f\u0131k 180-200 ev paras\u0131 kar\u015f\u0131l\u0131\u011f\u0131) yollan\u0131r.<\/p>\n Ayn\u0131 zamanda Osmanl\u0131\u2019dan \u00fc\u00e7 ki\u015finin de yan\u0131nda asistan olarak yeti\u015ftirilmesi istenir. Kurtulu\u015f sava\u015f\u0131 s\u0131ras\u0131nda zor ko\u015fullar alt\u0131nda da hayvan ve insan a\u015f\u0131lar\u0131 \u00fcretilmeye devam edilmi\u015ftir. \u0130stanbul\u2019un i\u015fgali sonras\u0131nda a\u015f\u0131 merkezi \u00f6nce Eski\u015fehir, daha sonra da K\u0131r\u015fehir\u2019e ta\u015f\u0131nm\u0131\u015ft\u0131r. Ayn\u0131 d\u00f6nemde Afyon\u2019da da \u00e7i\u00e7ek a\u015f\u0131s\u0131 \u00fcretilmeye devam edilmi\u015ftir. Erzurum\u2019daki serum laboratuvar\u0131 Rus i\u015fgali s\u0131ras\u0131nda Halep, Ni\u011fde, Sivas ve Erzincan\u2019a ta\u015f\u0131nm\u0131\u015f. Kastamonu\u2019da da a\u015f\u0131 \u00fcretimi yap\u0131lm\u0131\u015ft\u0131r.<\/p>\n Benzeri \u00fcretim Cumhuriyet d\u00f6neminde de devam etmi\u015f, 1928\u2019de H\u0131fz\u0131s\u0131hha Enst\u00fct\u00fcs\u00fc ile \u00fcretim merkezile\u015ftirilmi\u015ftir. 1940\u2019l\u0131 y\u0131llara kadar tifo, tif\u00fcs, difteri, BCG, kolera, bo\u011fmaca, tetanos, kuduz a\u015f\u0131lar\u0131 seri \u00fcretimle olu\u015fturulmu\u015ftur. 1968\u2019de kurulan serum \u00e7iftli\u011finde tetanos, gazl\u0131 gangren, difteri, kuduz, \u015farbon akrep serumlar\u0131 da \u00fcretilmi\u015ftir. \u00dclkede hastal\u0131klar\u0131n yok olmas\u0131 ile 1971\u2019de tif\u00fcs, 1980\u2019de \u00e7i\u00e7ek a\u015f\u0131s\u0131 \u00fcretimi sonlanm\u0131\u015ft\u0131r.<\/p>\n \u00dclkemizde a\u015f\u0131 \u00fcretimi 1996\u2019da DBT ve kuduz a\u015f\u0131s\u0131, 1997\u2019de BCG a\u015f\u0131 \u00fcretiminin kesilmesi ile sona ermi\u015ftir. Osmanl\u0131 \u0130mparatorlu\u011funda ilk a\u015f\u0131 \u00fcretimi ve uygulanmas\u0131n\u0131n ba\u015f\u0131ndan beri a\u015f\u0131 lojisti\u011fi, uygulanmas\u0131 ile hastal\u0131klar\u0131n \u00f6nlenmesi \u00fccretsiz olarak devlet eliyle y\u00fcr\u00fct\u00fclmektedir. A\u015f\u0131 \u00fcretiminin sona ermesi ile a\u015f\u0131lar sat\u0131n al\u0131narak temin edilmektedir. 2000\u2019li y\u0131llarda a\u015f\u0131lar\u0131n T\u00fcrkiye\u2019de \u00fcretimi konusunda tekrar ilgi artm\u0131\u015ft\u0131r.<\/p>\n 2009 y\u0131l\u0131nda be\u015fli karma (DaBT-IPV-Hib), 2011 y\u0131l\u0131nda d\u00f6rtl\u00fc karma (DaBT-IPV) \u00fc\u00e7 y\u0131ll\u0131k al\u0131m\u0131 yap\u0131l\u0131rken kademeli olarak paketleme ve enjekt\u00f6re dolum teknolojisi \u00fclkemize getirilmi\u015ftir. Bu a\u015f\u0131lara \u015f\u00fcphe ile yakla\u015fan bir kesim mevcuttur. 2010 y\u0131l\u0131nda zat\u00fcrre a\u015f\u0131s\u0131 (KPA-Konjuge Pn\u00f6mokok) yine \u00fc\u00e7 y\u0131ll\u0131k al\u0131m garantisi kar\u015f\u0131l\u0131\u011f\u0131 paketleme, enjekt\u00f6re dolum yan\u0131nda formulasyon teknolojisinin de \u00fclkemize getirilmesi sa\u011flanm\u0131\u015ft\u0131r. Halen yerli bir firma taraf\u0131ndan akrep ve y\u0131lan antiserumlar\u0131 da \u00fcretilmektedir.<\/p>\n \u0130LA\u00c7<\/strong><\/p>\n Bilimin k\u0131y\u0131lar\u0131ndan bir tanesi de t\u0131p ve farmakolojidir. \u0130nsan b\u00fcnyesi ge\u00e7mi\u015ften g\u00fcn\u00fcm\u00fcze ara\u015ft\u0131r\u0131lan bir s\u0131r oldu ve olmaya devam etmektedir. Son y\u00fczy\u0131llarda ger\u00e7ekle\u015ftirilen h\u00fccresel anlamda i\u015fleyi\u015flerin, hastal\u0131k fizyolojisinin bak\u0131ld\u0131\u011f\u0131ndan daha karma\u015f\u0131k \u015fekilde ilerledi\u011fi ortaya \u00e7\u0131km\u0131\u015ft\u0131r.<\/p>\n Bu \u00e7al\u0131\u015fmalar s\u00fcregelirken hedef odakl\u0131 tedavi giri\u015fimleri kanser ve di\u011fer hastal\u0131klar\u0131n tedavilerinin de yetersiz oldu\u011fu ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Bu sonu\u00e7 ve \u201comik\u201d teknolojisi ile beraber tedavi sisteminin par\u00e7alar\u0131n\u0131 birle\u015ftirebilmek sistemin t\u00fcm\u00fcn\u00fc kavramada ila\u00e7 ke\u015ffini ge\u00e7mi\u015ften g\u00fcn\u00fcm\u00fcze kadar farkl\u0131 farkl\u0131 boyutlara ta\u015f\u0131m\u0131\u015ft\u0131r.<\/p>\n Ge\u00e7mi\u015fte a\u011f\u0131rl\u0131kl\u0131 olarak sezgisel, deneme yan\u0131lma veya g\u00f6zlemlere dayanan ila\u00e7 ke\u015fifleri, g\u00fcn\u00fcm\u00fczde yerini h\u00fccre i\u00e7i olaylar\u0131n\u0131n i\u015fleyi\u015fiyle ilgili y\u00fcksek d\u00fczeylerde do\u011fru sonu\u00e7 al\u0131nabilen deneyler kullan\u0131larak olu\u015fan veriyi en do\u011fru ila\u00e7 tedavilerine b\u0131rakmaya ba\u015flam\u0131\u015ft\u0131r.<\/p>\n Bitkilerle tedavi g\u00f6r\u00fc\u015f\u00fc, 19. y\u00fczy\u0131la kadar devam etti\u011fi i\u00e7in bu zaman dilimine \u201cBotanik \u00e7a\u011f\u0131\u201d denilmi\u015ftir. 1800\u2019l\u00fc y\u0131llarda art\u0131k teknolojik geli\u015fmeler \u0131\u015f\u0131\u011f\u0131nda hastal\u0131klar yava\u015f yava\u015f anla\u015f\u0131lmaya ba\u015flanm\u0131\u015f, bu y\u00fczy\u0131l\u0131n sonlar\u0131na do\u011fru homeopati ila\u00e7 end\u00fcstrisinin temelleri at\u0131lmaya ba\u015flanm\u0131\u015ft\u0131r.<\/p>\n Kimya alan\u0131 ve farmakoloji i\u015fbirli\u011fi ile kimyasal bile\u015fenler resept\u00f6rlerin alt birimlerini tan\u0131mlanmaya yo\u011funla\u015farak resept\u00f6r-ligand (anahtar-kilit uyumu) dedi\u011fimiz, v\u00fccudumuzun mekanizmalar\u0131na bir d\u0131\u015f etkinin veya v\u00fccut i\u00e7i ba\u011flant\u0131s\u0131n\u0131n alg\u0131lad\u0131\u011f\u0131 sorun veya etkinin olu\u015fumunda a\u00e7\u0131\u011fa \u00e7\u0131kan cevap veya \u00e7\u00f6z\u00fcm elde edilmi\u015ftir.<\/p>\n 1980\u2019li y\u0131llarda ortaya \u00e7\u0131kan AIDS gibi hastal\u0131klar\u0131n y\u00fcksek d\u00fczeyde \u00f6nemli hale geli\u015fi v\u00fccudumuzun hastal\u0131klara kar\u015f\u0131 verdi\u011fi imm\u00fcn cevaplar\u0131n do\u011furdu\u011fu yetersizlik, ila\u00e7lara tepki veremeyi\u015fi ve uygulanan tedaviye diren\u00e7 g\u00f6stermesi, ila\u00e7 \u00fcretiminin \u00f6nemini artt\u0131rm\u0131\u015ft\u0131r. Yine bu d\u00f6nemde geli\u015fen kromatografi (\u00e7e\u015fitli molek\u00fcllerin ayr\u0131\u015ft\u0131r\u0131lmas\u0131, safla\u015ft\u0131r\u0131lmas\u0131nda kullan\u0131lan miktar tayinini belirleyen y\u00f6ntem) ve klonlama teknolojileri, iyon kanallar\u0131, enzimler veyahut resept\u00f6rler gibi hedef molek\u00fcllerin izole edilerek ara\u015ft\u0131r\u0131lmas\u0131 s\u00fcreci h\u0131zlanm\u0131\u015ft\u0131r.<\/p>\n Tedavi y\u00f6ntemlerinde kullan\u0131lan, tek bir hedefe y\u00f6nelik \u00e7al\u0131\u015fmalar\u0131n yeterli kalmay\u0131p \u00e7oklu hedef b\u00f6lgeleri ele al\u0131nmas\u0131 gerekti\u011fini anl\u0131yoruz. \u00c7orap s\u00f6k\u00fc\u011f\u00fc gibi diyebiliriz. Hepsi tek bir ipe ba\u011fl\u0131 ama her ilme\u011fin g\u00f6revi farkl\u0131 her ilmekte verilen-al\u0131nan cevaplar, t\u00fcm mekanizmaya do\u011fru veya yanl\u0131\u015f cevap niteli\u011finde yans\u0131yor. Bu kadar geli\u015fme ve \u00e7al\u0131\u015fmalara ra\u011fmen tek bir hastal\u0131k veya hedef b\u00f6lgeye y\u00f6nelik tedavi a\u015famas\u0131 s\u0131n\u0131rl\u0131 \u00f6rnekler d\u0131\u015f\u0131nda tam anlam\u0131yla ba\u015far\u0131ya ula\u015fabilmi\u015f de\u011fildir.<\/p>\n \u00a0<\/strong><\/p>\n Sistem Farmakolojisi<\/strong><\/p>\n G\u00fcncel bir tan\u0131m olarak bahsedece\u011fimiz \u2018sistem farmakolojisi deneysel ve hesaplamal\u0131 y\u00f6ntemleri kullanarak ila\u00e7 ve hedefleri aras\u0131ndaki etkile\u015fimi h\u00fccre i\u00e7i sistemin t\u00fcm par\u00e7alar\u0131n\u0131 b\u00fct\u00fcnc\u00fcl olarak ele alarak inceleyen alan\u2019 olarak ifade edilebiliriz. Y\u00fcksek \u00e7\u0131kt\u0131l\u0131 biyolojik ve klinik veri bilgilerini kullanarak tedavi olu\u015fturma a\u00e7\u0131s\u0131ndan tahmin ve yetki karar\u0131 verme a\u00e7\u0131s\u0131ndan mekanistik bir y\u00f6n olu\u015fturmay\u0131 sa\u011flar. Bu ama\u00e7lar do\u011frultusunda ila\u00e7 m\u00fcdahalelerinin \u00e7e\u015fitlili\u011fini, patolojik vakalar\u0131n olu\u015fturdu\u011fu proteomik, genomik, metabolik ve transkriptomik \u00e7al\u0131\u015fmalar\u0131n verilerini i\u015flemeyi baz al\u0131r. Fazla miktardaki verileri i\u015fleyebilmek i\u00e7in sistem biyolojisinin deneysel veri-tabanl\u0131 t\u00fcmevar\u0131m (bottom-up) ve hipotez temelli t\u00fcmden gelim (top-down) bak\u0131\u015f a\u00e7\u0131lar\u0131ndan yararlanmaktad\u0131r.<\/p>\n Biyolojik olarak bir a\u011fda ise proteinler, genler, microRNA\u2019lar vb. molek\u00fcller gen ifadesi, gen-gen, protein-gen, protein-protein gibi daha y\u00fczlerce etkile\u015fim bile\u015feni birbirleriyle kompleks bir a\u011f yap\u0131s\u0131 olu\u015fturur. Bu a\u011f yap\u0131lar\u0131n\u0131n analizleri ve \u00e7al\u0131\u015fmalar\u0131 ise molek\u00fcller, h\u00fccreler, organlar, sistemler veya organizma ya da organizmalar seviyesinde cevap niteli\u011fi ta\u015f\u0131mas\u0131, birbirleriyle etkile\u015fimine olanak sa\u011flar. T\u00fcmdengelim yakla\u015f\u0131m\u0131nda ise t\u00fcmevar\u0131m a\u011f modelinin tam tersi i\u015flemler ger\u00e7ekle\u015fmektedir. Deneysel \u00e7al\u0131\u015fma verilerinden ziyade biyolojik bir durumdan veya fenotipik (\u00e7evre, d\u0131\u015f) etkilerin modellenmesi \u00f6ne \u00e7\u0131kmaktad\u0131r.<\/p>\n \u015e\u00f6yle bir geriye yaslan\u0131p resme bakt\u0131\u011f\u0131m\u0131zda sistem farmakolojisinin bunca geli\u015fimine ra\u011fmen alan\u0131n daha yeni olu\u015fu, bilgi k\u0131s\u0131tl\u0131\u011f\u0131, insan v\u00fccudunun verece\u011fi tepkileri \u00f6ng\u00f6rememek, sistemin kompleksli\u011fi ve a\u011f modellerinin de\u011fi\u015fken ba\u011flant\u0131 olu\u015fturmas\u0131 bu alan\u0131n daha b\u00fcy\u00fcmesine y\u0131llar var dedirtiyor mu? Maalesef… \u0130nsan dedi\u011fimiz varl\u0131k \u00f6yle bir karma\u015f\u0131k yap\u0131ya sahip ki, t\u00fcm bu molek\u00fcler bile\u015fenlerimizin, organlar\u0131m\u0131z\u0131n hatta t\u00fcm v\u00fccut bile\u015fenlerimizin duyarl\u0131 \u00f6l\u00e7\u00fcm analizlerini \u2018omik\u2019 teknolojisiyle inceleyip sonuca varmam\u0131z m\u00fcmk\u00fcn g\u00f6z\u00fckm\u00fcyor bizlere.<\/p>\n T\u00fcm bunlara ek olarak da de\u011fi\u015fken etkiler var. Hastal\u0131k, ila\u00e7 etkileri, ila\u00e7lara verilen cevaplar, v\u00fccudun yetersiz cevap \u00fcretmesi gibi etkilerin hepsi dinamik s\u00fcre\u00e7ler i\u00e7erisinde kar\u015f\u0131m\u0131za \u00e7\u0131k\u0131yor. T\u00fcm bu sistemi m\u00fckemmel \u015fekilde i\u015fleyebilmek i\u00e7in b\u00fcy\u00fck \u00f6l\u00e7\u00fclerde zaman-ba\u011f\u0131ml\u0131 verilerin sistem i\u00e7erisine aktar\u0131m\u0131n\u0131 sa\u011flayan modellemelere ihtiya\u00e7lar vard\u0131r. Bu da hem deneysel anlamda \u00e7ok \u00e7al\u0131\u015fmaya hem de b\u00fcy\u00fck bir veriyi aktar\u0131mda kapasitenin fazla olu\u015fuyla ba\u011flant\u0131l\u0131 s\u00fcre\u00e7ler i\u00e7eriyor.<\/p>\n G\u00fcn\u00fcm\u00fcz teknolojisi t\u00fcm bu s\u00fcre\u00e7leri %100 do\u011frulukta sa\u011flayabilecek i\u015fletim modellerini bulundurmasa da, molek\u00fcler biyoloji, genetik m\u00fchendisli\u011fi, farmakoloji, t\u0131p, sistem farmakolojisi ve kimya gibi bilim dallar\u0131n\u0131n k\u0131y\u0131s\u0131na vuran geli\u015fmeler bilim insanlar\u0131n\u0131n \u00e7al\u0131\u015fmalar\u0131yla disiplin i\u00e7erisinde b\u00fcy\u00fcmeye devam ediyor.<\/p>\n \u0130la\u00e7lar\u0131n hedefledi\u011fi v\u00fccudumuzdaki odak noktalar\u0131, yeni ila\u00e7lar\u0131n olu\u015fturulmas\u0131, eski ila\u00e7lar\u0131n\u0131n g\u00fcncellenmesi, iyile\u015ftirilmesi, sinerjistik ila\u00e7lar\u0131n kombinasyonlar\u0131n\u0131n ke\u015ffedilmesi gelece\u011fin gelmekte oldu\u011funu g\u00f6zlerinizin \u00f6n\u00fcne sihir g\u00f6sterisi olarak sunmuyor mu? Aynaya bakt\u0131\u011f\u0131n\u0131zda bir y\u00fcz de\u011fil yery\u00fcz\u00fcnde en \u00e7ok alg\u0131lanamaz olan sihirbaz beliriyor. Bir \u201csilah\u015f\u00f6r\u201d kolay yeti\u015fmiyor. Hele de mutfakta bir \u201csihirbaz\u201d var ise…<\/p>\n <\/p>\n Kaynaklar:<\/strong><\/p>\n -Bilim ve Teknik Dergisi, Eyl\u00fcl 2019 say\u0131s\u0131<\/p>\n -A\u015f\u0131lama ve A\u015f\u0131lar\u0131n Tarih\u00e7esi \u2013 Do\u00e7. Dr. Melahat AKDEN\u0130Z<\/p>\n -Mikroorganizmalar\u0131n Biyolojisi Ek alan\u0131 \u2013 Ethem KAVUKCU,<\/p>\n –tr.khanacademy.org \u203a … \u203a Antibiyotikler ve Antibiyotik Direnci<\/a><\/p>\n
\nMekteb-i T\u0131bbiye-i Askeriye-i \u015e\u00e2h\u00e2ne\u2019den m\u00fcderris Alexander Zoeros Pa\u015fa\u2019n\u0131n ba\u015fkanl\u0131\u011f\u0131 alt\u0131nda, Kaymakam (yarbay) Dr. H\u00fcseyin Remzi ve Kaymakam (yarbay) Veteriner H\u00fcseyin H\u00fcsn\u00fc beylerin g\u00f6nderilmesine karar verilir. Daha sonra bu ekip \u00e7al\u0131\u015fmalara temel te\u015fkil etmesi i\u00e7in \u201ckuduz mikrobu\u201d enjekte edilmi\u015f bir kemik ili\u011fi ile Osmanl\u0131\u2019ya geri d\u00f6ner. 1887\u2019nin Ocak ay\u0131nda Zoeros Pa\u015fa\u2019n\u0131n klini\u011finde Da\u00fbl-Kelp ve Bakteriyoloji Ameliyathanesi (Kuduz Tedavi M\u00fcessesesi) kurulur. Bu kurum d\u00fcnyan\u0131n \u00fc\u00e7\u00fcnc\u00fc, do\u011funun ise ilk kuduz merkezi olmu\u015ftur. Daha sonra bu merkez difteri serumu da \u00fcretmi\u015ftir.<\/p>\n