I-Systemic lupus erythematosus (SLE)-05

UNksz C ungowesifazane oneminyaka engu-32 ubudala onomlando wokutholakala ne-systemic lupus erythematosus (SLE) eminyakeni emibili edlule. Izimpawu zakhe eziyinhloko zazihlanganisa i-nephritis enzima, isifo samathambo, nokuqubuka. Naphezu kokuthola izindlela zokwelapha eziningi ze-immunosuppressive (okuhlanganisa i-glucocorticoids, i-hydroxychloroquine, ne-rituximab), isimo sakhe sahlala singalawuleki.

Isimo sokwelashwa kwangaphambili:

 Izimpawu: Ubuhlungu obukhulu emalungeni kanye nokuvuvukala, ukuqubuka okungapheli, ukukhathala okukhulu, nokuqubuka kwe-nephritis okuphindaphindiwe.

 Imiphumela Yaselabhorethri:

# SLEDAI-2K amaphuzu: 16

# Amazinga e-anti-stranded e-DNA e-Serum elwa ne-double-stranded: Akhuphuke ngaphezu kwebanga elijwayelekile

# Gcwalisa amazinga e-C3 ne-C4: Ngaphansi kwebanga elijwayelekile

Inqubo Yokwelapha:

1.Ukukhethwa Kwesiguli: Uma kubhekwa ukungasebenzi kokwelashwa kwendabuko kanye nobucayi besimo sakhe, uNksz C wabhaliswa esivivinyweni somtholampilo sokwelashwa kweseli ye-CAR-T.

2.Ukulungiselela: Ngaphambi kokuthola i-CAR-T cell infusion, uNksz C wabhekana ne-chemotherapy conditioning evamile ukuze aqede ama-lymphocyte akhona futhi alungiselele ukwethulwa kwamaseli e-CAR-T.

3.Ukulungiswa Kweseli:

Amaseli T ahlukaniswa negazi likaNksz C.

# Lawa maseli e-T enziwe ufuzo elebhu ukuze aveze i-chimeric antigen receptors (CAR) eqondise kuma-CD19 nama-antigen e-BCMA.

4.Ukufakwa Kweseli: Ngemva kokunwetshwa nokuhlolwa kwekhwalithi, amaseli e-CAR-T anjiniyela aphinde afakwa emzimbeni ka-M. C.

5.Ukuqapha Kweziguli: UNksz C wayeqashwe esibhedlela izinsuku ezingu-25 ngemva kokumnika ukuze abheke imiphumela emibi engase ibe khona futhi ahlole ukusebenza kahle.

Imiphumela Yokwelashwa:

1.Impendulo Yesikhathi Esifushane:

# Ukuthuthukiswa Kwezimpawu: Phakathi namasonto amathathu ngemva kokumnika, uNksz C wabhekana nokuncipha okuphawulekayo kobuhlungu bamalunga nokuvuvukala, futhi ukuqubuka kwakhe kwanyamalala kancane kancane.

# Imiphumela Yaselabhorethri: Ezinsukwini ezimbili emva kokujova, amaseli B egazini likaNkz C aqedwa ngokuphelele, okubonisa ukuqondiswa okuphumelelayo ngamaseli e-CAR-T.

2.Ukuhlolwa Kwesikhathi Esimaphakathi (izinyanga ezi-3):

Isikolo se-# SLEDAI-2K: Sehliselwe ku-2, okubonisa ukuxolelwa okukhulu kwezifo.

# Umsebenzi Wezinso: Ukuncipha okuphawulekayo kwe-proteinuria, ne-nephritis elawulwayo.

# Omaki Bezivikeli mzimba: Amazinga anciphile amasosha omzimba e-DNA anemicu ekabili, kanye namazinga ahambisana ne-C3 kanye ne-C4 abuyela kokujwayelekile.

3. Imiphumela yesikhathi eside (izinyanga eziyi-12):

# Ukuxolelwa Okuqhubekayo: UNksz C ulondoloze ukuthethelelwa ngaphandle kwezidakamizwa unyaka owodwa ngaphandle kwezimpawu zokuphinda kwe-SLE.

# Ukuphepha: Ngaphandle kwe-mild cytokine release syndrome (CRS), uNksz C akazange abe nemiphumela emibi kakhulu. Amasosha omzimba akhe alulama kancane kancane ngemva kokwelashwa, futhi amangqamuzana e-B avela kabusha awazange abonise i-pathogenicity.

Sekukonke, isimo sikaNksz C sibonise ukuthuthuka okuphawulekayo kanye nokuxolelwa okuqhubekayo kulandela ukwelashwa kweseli ye-CAR-T, okubonisa amandla alokhu kwelashwa kwe-SLE eqinile nengafuni.

Umbiko wokuhlolwa kweseli ye-CART: