Usoro lupus erythematosus (SLE) -05

Nwada C bụ nwanyị dị afọ 32 nwere akụkọ ihe mere eme nke achọpụtara ya na lupus erythematosus systemic (SLE) afọ abụọ gara aga. Ihe mgbaàmà ya bụ isi gụnyere nnukwu nephritis, ogbu na nkwonkwo, na rashes. N'agbanyeghị ịnata ọtụtụ ọgwụgwọ immunosuppressive (gụnyere glucocorticoids, hydroxychloroquine, na rituximab), ọnọdụ ya ka na-achịkwaghị achịkwa.

Ọnọdụ ọgwụgwọ tupu oge eruo:

 Mgbaàmà: mgbu nkwonkwo siri ike na ọzịza, ọzịza na-adịgide adịgide, ike ọgwụgwụ dị ukwuu, na ọkụ nephritis na-agaghachi.

 Nchọpụta ụlọ nyocha:

# SLEDAI-2K akara: 16

# Ọkwa mgbochi mgbochi DNA nke serum okpukpu abụọ: Elugoro karịa oke nkịtị

# Mmeju ọkwa C3 na C4: N'okpuru oke nkịtị

Usoro ọgwụgwọ:

1.Nhọrọ ndidi: N'iburu enweghị ike nke ọgwụgwọ ọdịnala na ịdị njọ nke ọnọdụ ya, Ms. C debanyere aha na nnwale ụlọ ọgwụ maka ọgwụgwọ cell CAR-T.

2.Nkwadebe: Tupu ịnata infusion cell CAR-T, Ms. C nwere usoro nhazi nke chemotherapy iji mebie lymphocytes dị ugbu a ma kwadebe maka iwebata mkpụrụ ndụ CAR-T.

3.Nkwadebe cell:

sel # T dịpụrụ adịpụ n'ọbara Nwada C.

# A na-emezi mkpụrụ ndụ T ndị a n'ime ụlọ nyocha iji gosipụta chimeric antigen receptors (CAR) na-elekwasị anya na CD19 na BCMA antigens.

4.Cell Infusion: Mgbe mgbasawanye na nyocha dị mma, a na-agbanyeghachi mkpụrụ ndụ CAR-T n'ime anụ ahụ Ms. C.

5.Inpatient Monitoring: A na-enyocha Ms. C n'ụlọ ọgwụ maka ụbọchị 25 ka ọ gafesịrị infusion iji hụ maka mmetụta ndị nwere ike ime ma chọpụta ịdị irè.

Nsonaazụ ọgwụgwọ:

1. Nzaghachi dị mkpụmkpụ:

# Mmelite mgbaàmà: N'ime izu atọ ka mmịnye ahụ gachara, Oriakụ C nwetara mbelata dị ukwuu na mgbu nkwonkwo na ọzịza, na rashes ya ji nke nta nke nta daa.

# Nsonaazụ ụlọ nyocha: ụbọchị abụọ ka a gbasịrị ntụtụ, mkpụrụ ndụ B n'ime ọbara Ms. C kpochapụrụ kpamkpam, na-egosi ebumnuche dị mma site na mkpụrụ ndụ CAR-T.

2.Mid-term Evaluation (ọnwa 3):

Akara # SLEDAI-2K: belatara ruo 2, na-egosi mgbaghara ọrịa.

# Ọrụ gbasara akụrụ: Mbelata dị ukwuu na proteinuria, na-achịkwa nephritis.

# Ihe nrịbama ọrịa immuno: Mbelata ọkwa nke mgbochi mgbochi DNA nwere eriri abụọ, yana ọkwa C3 na C4 mejuputara laghachiri na nkịtị.

3. Nsonaazụ ogologo oge (ọnwa iri na abụọ):

# Mgbaghara na-adịgide adịgide: Oriakụ C jigidere mgbaghara na-enweghị ọgwụ maka otu afọ na-enweghị akara nke nlọghachi SLE.

# Nchekwa: Ewezuga ọrịa ntọhapụ cytokine dị nro (CRS), Oriakụ C ahụghị mmetụta ọ bụla siri ike. Usoro ahụ ji alụso ọrịa ọgụ na-eji nwayọọ nwayọọ nwetaghachi ọgwụgwọ mgbe a gwọchara ya, mkpụrụ ndụ B ndị na-apụtaghachikwa egosipụtaghị ọrịa.

N'ozuzu, ọnọdụ Ms. C gosipụtara mmụba dị ịrịba ama na mgbaghara na-esochi usoro ọgwụgwọ cell CAR-T, na-egosipụta ikike ọgwụgwọ a nwere maka SLE siri ike na nke na-adịghị mma.

Akuko ule cell CART: