Systemic lupus erythematosus (SLE)-05

UNksz C ngumfazi oneminyaka engama-32 ubudala kunye nembali yokufunyaniswa ne-systemic lupus erythematosus (SLE) kwiminyaka emibini edlulileyo. Iimpawu zakhe eziphambili ziquka i-nephritis enzima, i-arthritis, kunye ne-rash. Ngaphandle kokufumana unyango oluninzi lwe-immunosuppressive (kubandakanya i-glucocorticoids, i-hydroxychloroquine, kunye ne-rituximab), imeko yakhe yahlala ingalawuleki.

Imeko yonyango lwangaphambili:

 Iimpawu: Iintlungu ezibuhlungu ezihlangeneyo kunye nokudumba, irashes eqhubekayo, ukudinwa okubonakalayo, kunye ne-nephritis flares ephindaphindiweyo.

 Iziphumo zeLebhu:

# SLEDAI-2K amanqaku: 16

# Amanqanaba e-antibody e-Serum echasene ne-double-stranded DNA: Inyuswe ngaphezu koluhlu oluqhelekileyo

# Gcwalisa amanqanaba eC3 kunye neC4: Ngaphantsi koluhlu oluqhelekileyo

Inkqubo yoNyango:

I-1. Ukukhetha isigulane: Ngenxa yokungasebenzi kakuhle kwezonyango zendabuko kunye nobunzima bemeko yakhe, uNksz C wabhaliswa kulingo lwezonyango lwe-CAR-T cell therapy.

I-2.Ukulungiselela: Ngaphambi kokufumana i-CAR-T cell infusion, uNksz C waba ne-standard chemotherapy conditioning ukucima i-lymphocytes ekhoyo kwaye ulungiselele ukuqaliswa kweeseli ze-CAR-T.

3.Ukulungiselela iSeli:

# Iiseli ze-T zahlukaniswa negazi likaNksz C.

# Ezi seli ze-T zenziwe ngofuzo kwilebhu ukuvakalisa i-chimeric antigen receptors (CAR) ezijolise kwi-CD19 kunye ne-BCMA antigens.

I-4.I-Cell Infusion: Emva kokwandiswa kunye nokuvavanywa komgangatho, iiseli ze-CAR-T ezenziwe ngobunjineli zaphinda zafakwa kumzimba kaNksz C.

I-5.I-Inpatient Monitoring: UNksz C wayebekwe esweni esibhedlele iintsuku ze-25 emva kokunyuswa ukuze abone iziphumo ezinokuthi zibe nemiphumo emibi kunye nokuvavanya ukusebenza kakuhle.

Iziphumo zonyango:

1.Impendulo yexesha elifutshane:

# Ukuphuculwa kweempawu: Kwiiveki ezintathu emva kokufakwa, uNksz C wafumana ukuncipha okuphawulekayo kwintlungu edibeneyo kunye nokuvuvukala, kwaye i-rash yakhe yaphela ngokuthe ngcembe.

# Iziphumo zeLebhu: Kwiintsuku ezimbini emva kokuxilwa, iiseli ze-B kwigazi likaNksz C zapheliswa ngokupheleleyo, ezibonisa ukujoliswa okusebenzayo ngamaseli e-CAR-T.

2. UVavanyo Lwexesha Eliphakathi (iinyanga ezi-3):

# I-SLEDAI-2K amanqaku: Yehlisiwe ukuya kwi-2, ebonisa ukuxolelwa okukhulu kwesifo.

# Umsebenzi weRenal: Ukuncipha okubonakalayo kwiproteinuria, kunye ne-nephritis ephantsi kolawulo.

# Iimpawu ze-Immunological: Amanqanaba anciphayo e-anti-double-stranded antibodies ye-DNA, kunye nokuhambelana ne-C3 kunye ne-C4 amanqanaba abuyele ngokuqhelekileyo.

3.Iziphumo zexesha elide (iinyanga ezili-12):

# Uxolelo oluZinzileyo: UNksz.

# Ukhuseleko: Ngaphandle kwe-cytokine yokukhululwa kwe-syndrome (CRS), uNksz C akazange abe nemiphumo emibi kakhulu. Umxokomelwano wakhe wokuzikhusela ngokuthe ngcembe wachacha emva konyango, kwaye iiseli ze-B eziphinda zivele azizange zibonakalise ukugula.

Ngokubanzi, imeko kaNksz C ibonise ukuphuculwa okuphawulekayo kunye nokuxolelwa okuqhubekayo emva kwe-CAR-T yonyango lwe-cell, ebonisa amandla alo nyango kwi-SLE enzima kunye ne-refractory.

Ingxelo yovavanyo lweseli ye-CART: