Ingabe Ukwelashwa Kweselula Kuyikusasa Lezifo Ezizenzakalelayo?
Ukwelashwa okuguquguqukayo komdlavuza kungase futhi kukwazi ukwelapha nokusetha kabusha amasosha omzimba ukuze anikeze ukuxolelwa kwesikhathi eside noma mhlawumbe ngisho nokwelapha izifo ezithile ezizimele.
I-Chimeric antigen receptor (CAR) T-cell therapy inikeze indlela entsha yokwelapha umdlavuza we-hematological kusukela ngo-2017, kodwa kunezimpawu zakuqala zokuthi lawa ma-immunotherapies eselula angase aphinde ahloselwe izifo ze-B-cell mediated autoimmune.
NgoSepthemba wonyaka odlule, abacwaningi baseJalimane babika ukuthi iziguli ezinhlanu ezine-refractory systemic lupus erythematosus (SLE) ezelashwe nge-CAR T-cell therapy zonke zazuza ukukhululwa ngaphandle kwezidakamizwa. Ngesikhathi sokushicilela, azikho iziguli ezazibuye zabuyela emuva ezinyangeni eziyi-17 ngemuva kokwelashwa. Ababhali bachaze ukuguqulwa kwe-seroconversion yama-anti-antinuclear antibodies ezigulini ezimbili ezinokulandelwa okude kakhulu, "okubonisa ukuthi ukuhoxiswa kwama-autoimmune B-cell clones kungase kuholele ekulungisweni okusabalele kwe-autoimmunity," abacwaningi babhala.
Kwesinye isifundo esishicilelwe ngoJuni, abacwaningi basebenzisa i-CD-19 eqondiswe kumaseli e-CAR-T ukuphatha indoda eneminyaka engu-41 ubudala ene-refractory antisynthetase syndrome ene-myositis eqhubekayo nesifo se-interstitial lung. Ezinyangeni eziyisithupha ngemva kokwelashwa, azikho izimpawu ze-myositis ku-MRI futhi i-CT scan yesifuba yabonisa ukuhlehla okugcwele kwe-alveolitis.
Kusukela lapho, izinkampani ezimbili ze-biotechnology - i-Cabaletta Bio e-Philadelphia kanye ne-Kyverna Therapeutics e-Emeryville, e-California - sezivele zinikezwe amagama asheshayo avela ku-US Food and Drug Administration for CAR T-cell therapy ye-SLE kanye ne-lupus nephritis. I-Bristol-Myers Squibb futhi yenza uhlolo lwesigaba 1 ezigulini ezine-SLE eqinile, ephikisayo. Izinkampani ezimbalwa ze-biotechnology nezibhedlela e-China nazo zenza izivivinyo zomtholampilo ze-SLE. Kodwa lokhu kumane kuyiphuzu le-iceberg mayelana nokwelashwa kwamaselula kwesifo esizimele, kusho uMax Konig, MD, PhD, uprofesa osizayo wezokwelapha ophikweni lwe-rheumatology e-Johns Hopkins University School of Medicine e-Baltimore.
"Isikhathi esijabulisa ngendlela emangalisayo. Asikaze sibe khona emlandweni we-autoimmunity," esho.
"Qalisa kabusha" Yesistimu Yamasosha omzimba
Imithi yokwelapha eqondiswe kumaseli ka-B kade ikhona kusukela ekuqaleni kwawo-2000 ngemithi efana ne-rituximab, umuthi ovikela umzimba we-monoclonal oqondise i-CD20, i-antigen evezwa ebusweni bamaseli B. Amaseli e-CAR T atholakalayo njengamanje aqondise enye i-surface antigen, i-CD19, futhi ayindlela yokwelapha enamandla kakhulu. Womabili ayasebenza ekuqedeni amaseli B egazini, kodwa lawa maseli T ahloselwe unjiniyela e-CD19 angafinyelela kumaseli B ehlezi ezicutshini ngendlela imithi yokwelapha yamasosha omzimba engakwazi ngayo, kuchaza u-Konig.