ʻO ka holomua i ka maʻi maʻi maʻi maʻi: CAR-T Cell Therapy Cures Lupus Maʻi

I Iune 2023, ua loaʻa iā Uresa he 15 mau makahiki ka lāʻau cell CAR-T ma Erlangen University Hospital, e hōʻailona ana i ka hoʻohana mua ʻana o kēia lāʻau lapaʻau e hoʻolōʻihi i ka holomua o ka systemic lupus erythematosus (SLE), kahi maʻi autoimmune koʻikoʻi. I hoʻokahi makahiki ma hope mai, manaʻo ʻo Uresa i ke olakino e like me ka wā ma mua, ʻokoʻa mai nā anu liʻiliʻi.

ʻO Uresa ke keiki mua i mālama ʻia no SLE me ka immunotherapy ma Erlangen University's German Center for Immunotherapy (DZI). Ua paʻi ʻia ka kūleʻa o kēia lapaʻau pilikino ma The Lancet.

Ua wehewehe ʻo Dr. Tobias Krickau, he pediatric rheumatologist ma Erlangen University Hospital's Department of Pediatrics and Adolescent Medicine, i ke ʻano o ka hoʻohana ʻana i nā cell CAR-T e mālama i nā maʻi autoimmune. Ma mua, ua ʻae ʻia ka lāʻau lapaʻau CAR-T no kekahi mau maʻi maʻi koko kiʻekiʻe.

Ma hope o ka hiki ʻole o nā lāʻau lapaʻau ʻē aʻe ke hoʻomalu i ka maʻi SLE ʻino a Uresa, ua kū ka hui noiʻi i kahi hoʻoholo paʻakikī: pono anei e hoʻohana ʻia kēia mau ʻenekini i hoʻohana ʻia no ke keiki me kahi maʻi autoimmune? ʻAʻole i loaʻa ka pane ma mua, no ka mea, ʻaʻohe mea i hoʻāʻo i ka mālama ʻana i ka CAR-T no nā maʻi autoimmune pediatric ma mua.

ʻO ka hoʻomaʻamaʻa cell CAR-T ka lawe ʻana i kekahi o nā keena immune o ka mea maʻi (T cell), e hoʻolako iā lākou me nā mea hoʻokipa antigen chimeric (CAR) i loko o kahi keʻena maʻemaʻe kūikawā, a laila e hoʻokomo hou i kēia mau cell i hoʻololi ʻia i loko o ka mea maʻi. Ke holo nei kēia mau pūnaewele CAR-T i loko o ke koko, e ʻimi ana a luku i nā pūnaewele B autoreactive (pōʻino).

Ua hoʻomaka nā hōʻailona o Uresa i ka hāʻule 2022, me ka migraines, ka luhi, ka ʻeha a me ka ʻeha o ka ʻiʻo, a me ka ʻeha o ka maka — nā hōʻailona maʻamau o ka lupus. ʻOiai ʻo ka hoʻomaʻamaʻa koʻikoʻi, ua ʻoi aku ka ʻino o kona maʻi, e pili ana i kona mau puʻupaʻa a me nā pilikia koʻikoʻi.

I ka hoʻomaka ʻana o 2023, ma hope o ka nui o nā halemai a me nā mālama ʻana, me ka immunosuppressive chemotherapy a me ka hoʻololi ʻana i ka plasma, ua emi ke kūlana o Uresa a hiki i kahi e koi ai ʻo ia i ka dialysis. Hoʻokaʻawale ʻia mai nā hoaaloha a me ka ʻohana, ua hāʻule kona maikaʻi o ke ola.

Ua ʻae ka hui lapaʻau ma ke Kulanui ʻo Erlangen, alakaʻi ʻia e Professor Mackensen, e hana a hoʻohana i nā cell CAR-T no Uresa ma hope o nā kūkākūkā kikoʻī. Ua hoʻomaka ʻia kēia hoʻohana aloha i ka lāʻau lapaʻau CAR-T ma lalo o ke kānāwai lāʻau lapaʻau o Kelemania a me nā lula hoʻohana aloha.

ʻO ka papahana CAR-T cell therapy ma Erlangen, alakaʻi ʻia e Professor Georg Schett a me Professor Mackensen, ke mālama nei i nā maʻi me nā maʻi autoimmune like ʻole, me SLE, mai 2021. Ua paʻi ʻia ko lākou kūleʻa me 15 mau maʻi ma ka New England Journal of Medicine i Pepeluali 2024, a ke alakaʻi nei lākou i ka haʻawina CASTLE me 24 mau mea komo, e hōʻike ana i nā hoʻomaikaʻi koʻikoʻi.

No ka hoʻomākaukau ʻana no ka lāʻau lapaʻau CAR-T, ua hana ʻo Uresa i ka chemotherapy haʻahaʻa no ka hoʻokaʻawale ʻana i nā cell CAR-T i loko o kona koko. Ma Iune 26, 2023, ua loaʻa iā Uresa kāna mau keena CAR-T pilikino. Ma ke kolu o ka pule ma hope o ka mālama ʻana, ua hoʻomaikaʻi ʻia kāna hana ʻāʻī a me nā hōʻailona lupus, a ua nalowale kona mau hōʻailona.

ʻO ke kaʻina hana lapaʻau e pili ana i ka hoʻonohonoho pono ʻana e hōʻoia i ka maikaʻi o ka chemotherapy a me ka pale ʻana i ke koena o ka hana kīkī. Ua loaʻa iā Uresa nā hopena liʻiliʻi wale nō a ua hoʻokuʻu ʻia ma ka lā 11 ma hope o ka mālama ʻana.

Ma ka hopena o Iulai 2023, ua hoʻi ʻo Uresa i ka home, hoʻopau i kāna mau hoʻokolohua, a hoʻonohonoho i nā pahuhopu hou no kona wā e hiki mai ana, ʻo ia hoʻi ke kūʻokoʻa a loaʻa i kahi ʻīlio. Ua hauʻoli ʻo ia i ka launa pū ʻana me nā hoaaloha a hoʻomau i ke ola ʻōpio maʻamau.

Ua wehewehe ʻo Polofesa Mackensen, aia nō ʻo Uresa i kahi helu nui o nā cell CAR-T i loko o kona koko, ʻo ia hoʻi, pono ʻo ia i ka hoʻokomo ʻana o ka antibody i kēlā me kēia mahina a hiki i ka hoʻōla ʻana o kāna mau cell B. Ua hoʻokūpaʻa ʻo Kauka Krickau i ka kūleʻa o ka mālama ʻana iā Uresa ma muli o ka hui pū ʻana o nā ʻano lapaʻau lehulehu ma ka German Center for Immunotherapy.

ʻAʻole pono hou ʻo Uresa i kekahi lāʻau lapaʻau a i ʻole dialysis, a ua ola piha kona mau puʻupaʻa. Ke hoʻolālā nei ʻo Kauka Krickau a me kāna hui i nā noiʻi hou aʻe e ʻimi i ka hiki o nā cell CAR-T i ka mālama ʻana i nā maʻi autoimmune pediatric ʻē aʻe.

Hōʻike kēia hihia hōʻailona i ka hiki o ka CAR-T cell therapy e hāʻawi i ke kala lōʻihi no nā maʻi pediatric me nā maʻi autoimmune koʻikoʻi e like me SLE. ʻO ka holomua o ka mālama ʻana iā Uresa e hōʻike ana i ke koʻikoʻi o ka hana mua a me ka hui like ʻana o nā multidisciplinary. Pono nā haʻawina hauʻoli hou aʻe e hōʻoia i ka palekana lōʻihi a me ka pono o ka CAR-T cell therapy no nā keiki me nā maʻi autoimmune.