Iterambere mu Indwara ya Autoimmune y'abana: CAR-T ivura selile ikiza umurwayi wa Lupus
Muri Kamena 2023, Uresa w'imyaka 15 y'amavuko yakiriye imiti ya CAR-T mu bitaro bya kaminuza ya Erlangen, bikaba bigaragaza ko hakoreshejwe uburyo bwa mbere bwo kuvura udushya kugira ngo umuvuduko wa lupus erythematosus (SLE), indwara ikomeye ya autoimmune. Umwaka umwe, Uresa yumva ifite ubuzima bwiza nkibisanzwe, usibye ibicurane bike.
Uresa ni umwana wa mbere wavuwe na SLE hamwe na immunotherapie mu kigo cya kaminuza ya Erlangen cyo mu Budage gishinzwe Immunotherapy (DZI). Intsinzi yubu buvuzi bwihariye yasohotse muri The Lancet.
Dr. Tobias Krickau, inzobere mu kuvura indwara z’abana mu ishami ry’ibitaro bya kaminuza bya Erlangen ishami ry’abana n’ubuvuzi bw’abangavu, yasobanuye umwihariko wo gukoresha selile CAR-T mu kuvura indwara ziterwa na autoimmune. Mbere, CAR-T ivura ryemerewe gusa kanseri zimwe na zimwe zateye imbere.
Nyuma yuko indi miti yose yananiwe kurwanya SLE ikabije, itsinda ry’ubushakashatsi ryahuye nicyemezo kitoroshye: izo selile zikingira umubiri zikwiye gukoreshwa kumwana urwaye autoimmune? Igisubizo nticyari cyarigeze kibaho, kubera ko nta muntu wagerageje kuvura CAR-T kuvura indwara ziterwa na autoimmune y'abana mbere.
Ubuvuzi bwa CAR-T bukubiyemo gukuramo zimwe mu ngirabuzimafatizo z'umubiri z'umurwayi (T selile), kuziha ibikoresho bya chimeric antigen reseptors (CAR) muri laboratoire yihariye isukuye, hanyuma ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongera ukongerera umurwayi. Utugingo ngengabuzima twa CAR-T tuzenguruka mu maraso, twibasiye kandi twangiza selile autoreactive (yangiza) B.
Ibimenyetso bya Uresa byatangiye mu mpeshyi 2022, harimo migraine, umunaniro, ububabare bw'imitsi n'imitsi, ndetse no mu maso - ibimenyetso bisanzwe bya lupus. Nubwo yivuwe cyane, ubuzima bwe bwarushijeho kuba bibi, bigira ingaruka ku mpyiko kandi bitera ibibazo bikomeye.
Mu ntangiriro za 2023, nyuma yo gushyirwa mu bitaro no kuvurwa inshuro nyinshi, harimo na chimiotherapie immunosuppressive no guhanahana plasma, ubuzima bwa Uresa bwarushijeho kuba bwiza kugeza aho asaba dialyse. Yitandukanije n'incuti n'umuryango, ubuzima bwe bwaragabanutse.
Itsinda ry'ubuvuzi muri kaminuza ya Erlangen, riyobowe na Porofeseri Mackensen, ryemeye gukora no gukoresha selile CAR-T muri Uresa nyuma y'ibiganiro birambuye. Uku gukoresha impuhwe zo kuvura CAR-T byatangijwe hakurikijwe amategeko y’ibiyobyabwenge by’Ubudage n’amabwiriza agenga impuhwe.
Gahunda yo kuvura selile CAR-T muri Erlangen, iyobowe na Porofeseri Georg Schett na Porofeseri Mackensen, kuva mu 2021. Kuvura abarwayi bafite indwara zitandukanye ziterwa na autoimmune, harimo na SLE, kuva mu 2021. Intsinzi yabo hamwe n’abarwayi 15 yasohotse mu kinyamakuru cy’ubuvuzi cy’Ubwongereza muri Gashyantare. 2024, kandi kuri ubu barimo gukora ubushakashatsi bwa CASTLE hamwe nabitabiriye 24, bose bagaragaza iterambere ryinshi.
Mu rwego rwo kwitegura kuvura selile CAR-T, Uresa yakorewe chimiotherapie nkeya kugirango ibone umwanya wa selile CAR-T mumaraso ye. Ku ya 26 Kamena 2023, Uresa yakiriye selile yihariye ya CAR-T. Mugihe cyicyumweru cya gatatu nyuma yubuvuzi, imikorere yimpyiko n'ibipimo bya lupus byateye imbere, ibimenyetso bye birashira.
Igikorwa cyo kuvura cyarimo guhuza neza kugirango harebwe neza imiti ya chimiotherapie no kurinda imikorere yimpyiko zisigaye. Uresa yagize ingaruka nkeya gusa hanyuma asezererwa kumunsi wa 11 nyuma yo kuvurwa.
Mu mpera za Nyakanga 2023, Uresa yasubiye mu rugo, arangiza ibizamini, kandi ashyiraho intego nshya z'ejo hazaza, harimo kwigenga no kubona imbwa. Yishimiye kongera guhura n'inshuti maze akomeza ubuzima busanzwe bw'ingimbi.
Porofeseri Mackensen yasobanuye ko Uresa igifite umubare munini w'uturemangingo twa CAR-T mu maraso ye, bivuze ko akenera kwinjiza buri kwezi antibody kugeza selile B ikize. Dr. Krickau yashimangiye ko gutsinda kwa Uresa byatewe n’ubufatanye bwa hafi bw’ubuvuzi butandukanye mu kigo cy’Ubudage gishinzwe Immunotherapy.
Uresa ntagikeneye imiti cyangwa dialyse, kandi impyiko zayo zimaze gukira neza. Dr. Krickau n'itsinda rye barateganya ubushakashatsi bwimbitse kugira ngo barebe ubushobozi bwa selile CAR-T mu kuvura izindi ndwara ziterwa na autoimmune z'abana.
Uru rubanza rwibanze rwerekana ubushobozi bwo kuvura selile CAR-T kugirango itange imiti yigihe kirekire kubarwayi babana bafite uburwayi bukabije bwa autoimmune nka SLE. Intsinzi yo kuvura Uresa yerekana akamaro ko gutabara hakiri kare nubufatanye butandukanye. Iyindi nyigisho yubuvuzi irakenewe kugirango hemezwe umutekano muremure ningaruka zo kuvura selile CAR-T kubana barwaye autoimmune.