Lupus sisitemu erythematosus (SLE) -05

Madamu C numugore wimyaka 32 ufite amateka yo gupimwa na sisitemu ya lupus erythematosus (SLE) hashize imyaka ibiri. Mu bimenyetso bye by'ibanze yarimo neprite ikabije, arthrite, ndetse no kurwara. Nubwo yakiriye imiti myinshi ikingira indwara (harimo glucocorticoide, hydroxychloroquine, na rituximab), ubuzima bwe bwakomeje kutagenzurwa.

Imbere yo kuvurwa Imiterere:

Ibimenyetso: Kubabara cyane hamwe no kubyimba, guhubuka bikabije, umunaniro ukabije, hamwe na nephritis yaka umuriro.

Ibyavuye mu bushakashatsi:

# SLEDAI-2K amanota: 16

# Serumu irwanya kabiri-urwego rwa antibody ya ADN: Yashyizwe hejuru kurwego rusanzwe

# Uzuza urwego C3 na C4: Munsi yurwego rusanzwe

Uburyo bwo kuvura:

1. Guhitamo abarwayi: Bitewe no kutagira imiti gakondo hamwe n'uburemere bw'imiterere ye, Madamu C yiyandikishije mu igeragezwa ry’amavuriro kugira ngo CAR-T ivurwe.

2.Imyiteguro: Mbere yo kwakira infashanyo ya CAR-T, Madamu C yakorewe imiti isanzwe ya chimiotherapie kugirango yandure lymphocytes zisanzwe kandi yitegura kwinjiza selile CAR-T.

3.Gutegura guhamagara:

# T selile yitandukanije namaraso ya Madamu C.

# Utugingo ngengabuzima T twakozwe muri laboratoire kugira ngo tugaragaze imiti ya chimeric antigen reseptor (CAR) yibasira antigene ya CD19 na BCMA.

4.Cell Infusion: Nyuma yo kwaguka no gupimwa ubuziranenge, selile CAR-T yakozwe yongeye gushyirwa mumubiri wa Madamu C.

5.Gukurikirana abarwayi: Madamu C yakurikiranwe mu bitaro iminsi 25 nyuma yo gushiramo kugira ngo arebe ingaruka zishobora guterwa no gusuzuma ingaruka.

Ibisubizo byo kuvura:

1.Igisubizo kigufi:

# Gutezimbere Ibimenyetso: Mugihe cibyumweru bitatu nyuma yo gushiramo, Mme C yagize igabanuka rikabije mububabare hamwe no kubyimba, maze ibisebe bye bigenda bishira buhoro buhoro.

# Ibisubizo bya Laboratoire: Iminsi ibiri nyuma yo gushiramo, selile B mu maraso ya Madamu C yaranduwe burundu, byerekana ko ingirabuzimafatizo CAR-T yibasiwe neza.

2.Isuzuma ryigihe gito (amezi 3):

# SLEDAI-2K amanota: Yagabanutse kuri 2, byerekana indwara zikomeye.

# Imikorere yimpyiko: Kugabanuka gukomeye kwa proteinuria, hamwe na nephritis iyobowe.

# Ibimenyetso byikingira: Kugabanuka kurwego rwa antibodiyite zirwanya kabiri-ADN, kandi ikuzuza urwego C3 na C4 rwasubiye mubisanzwe.

3.Ibisubizo by'igihe kirekire (amezi 12):

# Kurekura Kuramba: Mme C yakomeje kuvura ibiyobyabwenge umwaka umwe nta kimenyetso cyerekana ko SLE yasubiye.

# Umutekano: Usibye syndrome yoroheje ya cytokine (CRS), Madamu C ntabwo yigeze agira ingaruka zikomeye. Ubudahangarwa bw'umubiri we bwakize buhoro buhoro nyuma yo kuvurwa, kandi selile B yongeye kuvuka ntiyagaragaje indwara.

Muri rusange, imiterere ya Madamu C yerekanye iterambere ridasanzwe ndetse no gukira gukabije nyuma yo kuvura selile CAR-T, byerekana ubushobozi bwo kuvura SLE ikabije kandi itavunika.

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