Kupambana mu Matenda a Autoimmune a Ana: Chithandizo cha Ma cell a CAR-T Chichiritsa Wodwala Lupus

Mu June 2023, Uresa wazaka 15 adalandira chithandizo cha CAR-T pachipatala cha Erlangen University, zomwe zikuwonetsa kugwiritsa ntchito koyamba kwa mankhwalawa kuti achepetse kupita patsogolo kwa systemic lupus erythematosus (SLE), matenda oopsa a autoimmune. Patatha chaka chimodzi, Uresa amadzimva kuti ali wathanzi monga kale, kupatula kuzizira pang'ono.

Uresa ndi mwana woyamba kulandira chithandizo cha SLE ndi immunotherapy ku Erlangen University's German Center for Immunotherapy (DZI). Kupambana kwa chithandizo chamunthu payekhachi kwasindikizidwa mu The Lancet.

Dr. Tobias Krickau, katswiri wa matenda a rheumatologist ku Dipatimenti ya Pediatrics ndi Adolescent Medicine ku Erlangen University Hospital, anafotokoza zapadera kugwiritsa ntchito maselo a CAR-T kuti athetse matenda a autoimmune. M'mbuyomu, chithandizo cha CAR-T chinali chovomerezeka pamakhansa ena apamwamba amagazi.

Mankhwala ena onse atalephera kuwongolera kuwonjezereka kwa SLE kwa Uresa, gulu lofufuza lidakumana ndi chigamulo chovuta: kodi maselo otetezedwa otetezedwawa ayenera kugwiritsidwa ntchito kwa mwana yemwe ali ndi matenda a autoimmune? Yankho linali lisanakhalepo, popeza palibe amene adayesapo chithandizo cha CAR-T cha matenda a autoimmune m'mbuyomu.

CAR-T cell therapy imaphatikizapo kuchotsa ena mwa maselo a chitetezo cha mthupi (T cell), kuwakonzekeretsa ndi chimeric antigen receptors (CAR) mu labu yapadera yoyera, ndikubwezeretsanso maselo osinthidwawa mwa wodwalayo. Maselo a CAR-Twa amazungulira m'magazi, kulunjika ndi kuwononga ma B cell autoreactive (ovulaza).

Zizindikiro za Uresa zidayamba m'dzinja mu 2022, kuphatikiza mutu waching'alang'ala, kutopa, kupweteka m'mafupa ndi minofu, komanso zotupa kumaso - zizindikiro zodziwika bwino za lupus. Ngakhale kuti anapatsidwa chithandizo chambiri, matenda ake anaipiraipira, kukhudza impso zake ndi kuchititsa mavuto aakulu.

Kumayambiriro kwa chaka cha 2023, atagonekedwa m'chipatala kangapo ndi kulandira chithandizo, kuphatikiza mankhwala a immunosuppressive chemotherapy ndi kusinthana kwa plasma, matenda a Uresa adafika poipa kwambiri mpaka amafunikira dialysis. Chifukwa chotalikirana ndi abwenzi ndi achibale, moyo wake unatsika pansi.

Gulu lachipatala ku yunivesite ya Erlangen, motsogoleredwa ndi Pulofesa Mackensen, adavomereza kupanga ndi kugwiritsa ntchito maselo a CAR-T ku Uresa pambuyo pokambirana mwatsatanetsatane. Kugwiritsa ntchito mwachifundo kwa chithandizo cha CAR-T kudayambika pansi pa lamulo la Germany la mankhwala osokoneza bongo komanso malamulo ogwiritsira ntchito mwachifundo.

Pulogalamu ya CAR-T cell therapy ku Erlangen, motsogozedwa ndi Pulofesa Georg Schett ndi Pulofesa Mackensen, wakhala akuchiza odwala omwe ali ndi matenda osiyanasiyana a autoimmune, kuphatikizapo SLE, kuyambira 2021. Kupambana kwawo ndi odwala 15 kunasindikizidwa mu New England Journal of Medicine mu February. 2024, ndipo pano akuchita kafukufuku wa CASTLE ndi anthu 24, onse akuwonetsa kusintha kwakukulu.

Pokonzekera chithandizo cha CAR-T cell, Uresa analandira mankhwala amphamvu amphamvu amphamvu amphamvu kuti apange malo a maselo a CAR-T m’mwazi wake. Pa Juni 26, 2023, Uresa adalandira ma cell ake amtundu wa CAR-T. Pofika sabata yachitatu atalandira chithandizo, impso zake zimagwira ntchito bwino komanso zizindikiro za lupus zidayamba kuyenda bwino, ndipo zizindikiro zake zidazimiririka.

Njira yochiritsirayi inaphatikizapo kugwirizanitsa mosamala kuti atsimikizire kuti chemotherapy ikugwira ntchito komanso kuteteza impso zotsalira. Uresa adakumana ndi zovuta zazing'ono zokha ndipo adatulutsidwa patsiku la 11 atalandira chithandizo.

Pofika kumapeto kwa Julayi 2023, Uresa adabwerera kwawo, ndikumaliza mayeso ake, ndikukhazikitsa zolinga zatsopano zamtsogolo, kuphatikiza kudziyimira pawokha komanso kukhala ndi galu. Anali wokondwa kugwirizananso ndi anzake ndikuyambanso moyo wabwinobwino wachinyamata.

Pulofesa Mackensen anafotokoza kuti Uresa akadali ndi chiwerengero chachikulu cha maselo a CAR-T m'magazi ake, zomwe zikutanthauza kuti amafunikira kulowetsedwa kwa mwezi ndi mwezi mpaka ma B cell ake atachira. Dr. Krickau anatsindika kuti kupambana kwa chithandizo cha Uresa chinali chifukwa cha mgwirizano wapamtima wa maphunziro angapo azachipatala ku German Center for Immunotherapy.

Uresa sakufunikanso mankhwala kapena dialysis, ndipo impso zake zachira. Dr. Krickau ndi gulu lake akukonzekera maphunziro owonjezereka kuti afufuze zomwe zingatheke za maselo a CAR-T pochiza matenda ena a autoimmune a ana.

Mlanduwu ukuwonetsa kuthekera kwa CAR-T cell therapy kuti apereke chikhululukiro chanthawi yayitali kwa odwala omwe ali ndi matenda oopsa a autoimmune monga SLE. Kupambana kwa chithandizo cha Uresa kukuwonetsa kufunikira kwa kulowererapo koyambirira komanso mgwirizano wamagulu osiyanasiyana. Maphunziro ena azachipatala amafunikira kuti atsimikizire chitetezo chanthawi yayitali komanso mphamvu ya chithandizo cha cell cha CAR-T kwa ana omwe ali ndi matenda a autoimmune.