Ngaba uNyango lweSellula lulikamva leSifo esizenzekelayo?
Unyango lwenguquko lwemihlaza lusenokukwazi ukunyanga kunye nokuseta ngokutsha amajoni omzimba ukunika uxolelo lwexesha elide okanye mhlawumbi nokunyanga izifo ezithile ezizimela ngokwazo.
I-Chimeric antigen receptor (CAR) unyango lwe-T-cell lunikeze indlela entsha yokunyanga i-hematologic cancers ukususela ngo-2017, kodwa kukho iimpawu zokuqala zokuba ezi immunotherapies zeselula zinokuphinda zisetyenziswe kwi-B-cell mediated autoimmune izifo.
NgoSeptemba wonyaka ophelileyo, abaphandi baseJamani banike ingxelo yokuba abaguli abahlanu abane-refractory systemic lupus erythematosus (SLE) banyangwa ngonyango lwe-CAR T-cell zonke zifumene uxolelo ngaphandle kweziyobisi. Ngexesha lopapasho, akukho zigulana zibuyeleyo ukuya kuthi ga kwiinyanga ezili-17 emva konyango. Ababhali bachaze i-seroconversion ye-antinuclear antibodies kwizigulana ezibini ezinexesha elide lokulandela, "ebonisa ukuba ukuchithwa kwe-autoimmune B-cell clones kunokukhokelela kulungiso olubanzi lwe-autoimmunity," abaphandi babhala.
Kwesinye isifundo esipapashwe ngoJuni, abaphandi basebenzisa i-CD-19 ejoliswe kwiiseli ze-CAR-T ukunyanga indoda eneminyaka engama-41 ubudala ene-refractory antisynthetase syndrome kunye ne-myositis eqhubekayo kunye nesifo se-lung interstitial. Kwiinyanga ezintandathu emva kokonyango, kwakungekho zimpawu ze-myositis kwi-MRI kunye ne-CT scan yesifuba yabonisa ukuguqulwa ngokupheleleyo kwe-alveolitis.
Ukususela ngoko, iinkampani ezimbini ze-biotechnology - i-Cabaletta Bio e-Philadelphia kunye ne-Kyverna Therapeutics e-Emeryville, eCalifornia - sele inikwe ukutyunjwa ngokukhawuleza kwi-US Food and Drug Administration ye-CAR T-cell therapy ye-SLE kunye ne-lupus nephritis. I-Bristol-Myers Squibb ikwaqhuba ulingo lwesigaba soku-1 kwizigulane ezine-SLE enzima, ephikisayo. Iinkampani ezininzi ze-biotechnology kunye nezibhedlele e-China ziqhuba ulingo lwezonyango lwe-SLE. Kodwa oku kuphela kwencam ye-iceberg malunga nonyango lweselula lwesifo esizimelayo, utshilo uMax Konig, MD, PhD, unjingalwazi oncedisayo kwezamayeza kwicandelo le-rheumatology kwiYunivesithi yaseJohns Hopkins yeSikolo sezoNyango eBaltimore.
"Lixesha elimnandi kakhulu. Ayizange ibonwe kwimbali yokuzimela, "waphawula.
A "Reboot" kwi-Immune System
I-B-cell ejoliswe kunyango sele ikhona ukusukela ekuqaleni koo-2000 ngamachiza afana ne-rituximab, iyeza le-antibody elijolisa kwi-CD20, i-antigen echazwe kumphezulu weeseli ze-B. Iiseli zeCAR T ezikhoyo ngoku zijolise enye i-antigen yomhlaba, i-CD19, kwaye lunyango olunamandla kakhulu. Zombini ziyasebenza ekupheliseni iiseli ze-B egazini, kodwa ezi seli ze-T ze-CD19 ezinobunjineli zinokufikelela kwiiseli ze-B ezihleli kwizicubu ngendlela amayeza onyango lwe-antibody angenako, wacacisa uKonig.