Systemic lupus erythematosus (SLE)-05

He wahine 32 makahiki ʻo Ms. C me ka mōʻaukala o ka loaʻa ʻana o ka systemic lupus erythematosus (SLE) ʻelua makahiki i hala. ʻO kāna mau hōʻailona mua, ʻo ia ka nephritis koʻikoʻi, ka maʻi ʻāʻī, a me nā ʻōpala. ʻOiai ka loaʻa ʻana o nā lāʻau lapaʻau immunosuppressive he nui (me nā glucocorticoids, hydroxychloroquine, a me rituximab), ʻaʻole mālama ʻia kona kūlana.

Kūlana ma mua o ka mālama ʻana:

Nā hōʻailona: ʻO ka ʻeha a me ka pehu ʻana o ka hui, ka ʻūhū mau, ka luhi nui, a me ka ʻāʻī ʻana o ka nephritis.

ʻIke ʻia o ka Laboratory:

# SLEDAI-2K helu: 16

# Serum anti-double-stranded DNA antibody pae: Hoʻokiʻekiʻe ʻia ma luna o ka pae maʻamau

# Hoʻopiha i nā pae C3 a me C4: Ma lalo o ka pae maʻamau

Kaʻina Hana:

1. Koho ma'i: Ma muli o ka maika'i'ole o nā lā'au ma'amau a me ke ko'iko'i o kona ma'i, ua ho'okomo 'ia 'o Ms.

2. Hoʻomākaukau: Ma mua o ka loaʻa ʻana o ka infusion cell CAR-T, ua hana ʻo Ms. C i ka hoʻomaʻamaʻa chemotherapy maʻamau e hoʻopau i nā lymphocytes i loaʻa a hoʻomākaukau no ka hoʻokomo ʻana i nā cell CAR-T.

3. Hoʻomākaukau Cell:

Ua hoʻokaʻawale ʻia ʻo # T mai ke koko o Ms. C.

# Ua hana ʻia kēia mau pūnaewele T i loko o ka lab e hōʻike i nā mea hoʻopaʻa antigen chimeric (CAR) e kuhikuhi ana i nā antigens CD19 a me BCMA.

4.Cell Infusion: Ma hope o ka hoʻonui ʻana a me ka hoʻāʻo ʻana i ka maikaʻi, ua hoʻokomo hou ʻia nā pūnaewele CAR-T i hana ʻia i loko o ke kino o Ms.

5. Ka nānā ʻana i ka maʻi maʻi: Ua nānā ʻia ʻo Ms. C ma ka haukapila no 25 mau lā ma hope o ka infusion e nānā i nā hopena ʻaoʻao a nānā i ka pono.

Nā hopena lapaʻau:

1. Pane no ka manawa pōkole:

# Hoʻomaikaʻi i nā hōʻailona: I loko o ʻekolu pule ma hope o ka hoʻokomo ʻana, ua ʻike ʻo Ms.

# Nā hualoaʻa Laboratory: ʻElua lā ma hope o ka hoʻokomo ʻia ʻana, ua hoʻopau loa ʻia nā pūnae B i loko o ke koko o Ms.

2. Ka Loiloi Kauwaena (3 mahina):

# SLEDAI-2K helu: Hoʻemi ʻia i 2, e hōʻike ana i ke kala ʻana o ka maʻi nui.

# Hana Hana: Hoʻemi nui i ka proteinuria, me ka nephritis ma lalo o ka hoʻomalu.

# Immunological Markers: Hoʻemi ʻia nā pae o nā antibodies DNA anti-double-stranded, a hoʻopiha i nā pae C3 a me C4 i hoʻi i ka maʻamau.

3. Nā hopena lōʻihi (12 mahina):

# Hoʻokuʻu Paʻa: Ua mālama ʻo Ms. C i ke kala kala ʻole i ka lāʻau no hoʻokahi makahiki me ka ʻole o nā hōʻailona o ka hoʻi hou ʻana o ka SLE.

# Palekana: Ma waho aʻe o ka mild cytokine release syndrome (CRS), ʻaʻole i loaʻa iā Ms. C nā hopena ʻino. Ua ho'ōla mālie kona ʻōnaehana pale ma hope o ka mālama ʻana, a ʻaʻole i hōʻike ʻia ka maʻi pathogenicity.

Ma ka holoʻokoʻa, ua hōʻike ka maʻi o Ms. C i ka hoʻomaikaʻi maikaʻi ʻana a me ke kala mau ʻana ma hope o ka hoʻomaʻamaʻa cell CAR-T, e hōʻike ana i ka hiki o kēia lapaʻau no ka SLE koʻikoʻi a me ka refractory.

Hōʻike hoʻāʻo cell CART: