Kubudirira muPediatric Autoimmune Disease: CAR-T Cell Therapy Inorapa Lupus Murwere
Muna Chikumi 2023, Uresa ane makore gumi nemashanu ekuberekwa akawana CAR-T cell therapy paErlangen University Hospital, zvichiratidza kushandiswa kwekutanga kweiyi nzira itsva yekurapa kunonotsa kufambira mberi kwe systemic lupus erythematosus (SLE), chirwere chakakomba che autoimmune. Kwapera gore, Uresa anonzwa aine hutano sezvaamboita, kunze kwedzihwa shoma shoma.
Uresa ndiye mwana wekutanga kurapwa SLE neimmunotherapy paErlangen University's German Center for Immunotherapy (DZI). Kubudirira kwekurapa kwakasarudzika kwakaburitswa muThe Lancet.
Dr. Tobias Krickau, rheumatologist yevana paErlangen University Hospital yeDhipatimendi rePediatrics uye Adolescent Medicine, yakatsanangura kusiyana kwekushandisa masero eCAR-T kurapa zvirwere zvekudzivirira muviri. Pakutanga, kurapwa kweCAR-T kwaibvumidzwa chete kune mamwe magomarara eropa.
Mushure mokunge mimwe mishonga yose yakundikana kudzora kuwedzera kweSLE yeUresa, boka rekutsvagisa rakatarisana nesarudzo yakaoma: masero aya ekudzivirira ekudzivirira anofanira kushandiswa kumwana ane chirwere che autoimmune? Mhinduro yaive isati yamboitika, sezvo pasina akamboedza kurapwa neCAR-T yezvirwere zvevana autoimmune.
CAR-T cell therapy inosanganisira kubvisa mamwe masero ezvirwere zvemurwere (T masero), achivagadzirira chimeric antigen receptors (CAR) mune imwe nyanzvi yakachena lab, uyezve kudzorera aya masero akagadziridzwa mumurwere. Aya masero eCAR-T anotenderera muropa, akananga uye kuparadza autoreactive (inokuvadza) B masero.
Zviratidzo zveUresa zvakatanga mumatsutso 2022, kusanganisira migraines, kuneta, kurwadziwa kwemajoini nemhasuru, uye kuputika kumeso — zviratidzo zvelupus. Pasinei nokurapwa kwakasimba, mamiriro ake ezvinhu akawedzera kuipa, zvichikanganisa itsvo dzake uye zvichikonzera zvinetso zvakakomba.
Mukutanga kwa2023, mushure mekurapwa kwakawanda uye kurapwa, kusanganisira immunosuppressive chemotherapy uye kuchinjanisa plasma, mamiriro aUresa akawedzera kusvika pakuda dialysis. Aparadzaniswa neshamwari nemhuri, mararamiro ake akaderera.
Chikwata chekurapa paErlangen University, inotungamirwa naProfessor Mackensen, yakabvuma kugadzira nekushandisa masero eCAR-T eUresa mushure mehurukuro dzakadzama. Uku kushandiswa kwetsitsi kweCAR-T kurapwa kwakatangwa pasi pemutemo weGermany wezvinodhaka uye netsitsi dzekushandisa mitemo.
The CAR-T cell therapy chirongwa paErlangen, inotungamirirwa naProfessor Georg Schett uye Purofesa Mackensen, vave vachirapa varwere vane zvirwere zvakasiyana-siyana zvekudzivirira muviri, kusanganisira SLE, kubvira 2021. Kubudirira kwavo nevarwere ve15 kwakabudiswa muNew England Journal of Medicine munaFebruary. 2024, uye parizvino vari kuita chidzidzo cheCASTLE nevatori vechikamu makumi maviri nevana, vese vachiratidza kuvandudzika kukuru.
Kuti agadzirire kurapwa neCAR-T cell, Uresa akaitwa chemotherapy ine-low-dose kuti awane nzvimbo yemasero eCAR-T muropa rake. Musi waChikumi 26, 2023, Uresa akagamuchira masero ake eCAR-T. Pakupera kwevhiki rechitatu mushure mekurapwa, kushanda kweitsvo dzake uye zviratidzo zve lupus zvakavandudzika, uye zviratidzo zvake zvishoma nezvishoma zvakanyangarika.
Kurapa kwacho kwaisanganisira kurongeka kwakanyatsoita kuti kuve nechokwadi chekushanda kwechemotherapy uye kuchengetedzwa kweitsvo dzakasara. Uresa yakangosangana nemhedzisiro uye yakaburitswa pazuva regumi nerimwe mushure mekurapwa.
Pakupera kwaChikunguru 2023, Uresa akadzokera kumba, akapedza bvunzo dzake, uye akaisa zvinangwa zvitsva zveramangwana rake, kusanganisira kuzvimiririra uye kuwana imbwa. Akafara kuonanazve neshamwari uye kutangazve upenyu hwemazuva ose hwokuyaruka.
Muzvinafundo Mackensen akatsanangura kuti Uresa ichine huwandu hwakakosha hwemasero eCAR-T muropa rake, zvinoreva kuti anoda kuisirwa mwedzi nemwedzi antibody kusvika masero ake eB apora. Dr. Krickau akasimbisa kuti kubudirira kwekurapa kweUresa kwakakonzerwa nekubatana kwepedyo kwemaitiro akawanda ekurapa paGermany Center yeImmunotherapy.
Uresa haachadi chero mushonga kana dialysis, uye itsvo dzake dzanyatsopora. Dr. Krickau neboka rake vari kuronga zvimwe zvidzidzo zvekuongorora zvingaita masero eCAR-T mukurapa zvimwe zvirwere zvekudzivirira zvirwere zvevana.
Ichi chiitiko chakakosha chinoratidza kugona kweCAR-T cell therapy kupa kuregererwa kwenguva refu kune varwere vevana vane chirwere chakakomba che autoimmune seSLE. Kubudirira kwekurapa kweUresa kunoratidza kukosha kwekutanga kupindira uye kubatana kwemarudzi akawanda. Zvimwe zvidzidzo zvekiriniki zvinodikanwa kusimbisa kuchengetedzwa kwenguva refu uye kushanda kweCAR-T cell therapy kuvana vane autoimmune zvirwere.