Ciwon lupus erythematosus na tsarin jiki (SLE)-05

Ms. C mace ce 'yar shekara 32 wadda ta taɓa kamuwa da cutar lupus erythematosus (SLE) shekaru biyu da suka gabata. Manyan alamominta sun haɗa da matsanancin ciwon nephritis, amosanin gabbai, da kuraje. Duk da shan magungunan rage garkuwar jiki da yawa (gami da glucocorticoids, hydroxychloroquine, da rituximab), yanayinta bai daidaita ba.

Yanayin Kafin Jiyya:

Alamomin: Ciwon gaɓɓai mai tsanani da kumburi, kuraje masu ɗorewa, gajiya mai yawa, da kuma sake kamuwa da kumburin nephritis.

Binciken Dakunan Gwaji:

# Sakamakon SLEDAI-2K: 16

# Matakan rigakafin DNA mai hana garkuwar jiki biyu a jini: Ya karu sama da matsakaicin da aka saba samu

# Cika matakan C3 da C4: Kasa da matsakaicin iyaka na yau da kullun

Tsarin Magani:

1. Zaɓin Marasa Lafiya: Ganin rashin ingancin magungunan gargajiya da kuma tsananin yanayinta, an shigar da Ms. C a wani gwaji na asibiti don maganin ƙwayoyin CAR-T.

2. Shiri: Kafin a yi amfani da maganin CAR-T, Ms. C ta yi amfani da maganin chemotherapy na yau da kullun don rage ƙwayoyin lymphocytes da ke akwai da kuma shirya don gabatar da ƙwayoyin CAR-T.

3. Shiri na Kwayoyin Halitta:

An ware ƙwayoyin T daga jinin Ms. C.

# An ƙera waɗannan ƙwayoyin T a cikin dakin gwaje-gwaje don bayyana masu karɓar antigen na chimeric (CAR) waɗanda ke nufin antigens na CD19 da BCMA.

4. Jikowar Kwayoyin Halitta: Bayan faɗaɗawa da gwajin inganci, an sake saka ƙwayoyin CAR-T da aka ƙera a jikin Ms. C.

5. Kula da Marasa Lafiya a Asibiti: An kula da Ms. C a asibiti na tsawon kwanaki 25 bayan an yi mata allurar domin a lura da illolin da ke tattare da hakan da kuma tantance ingancinta.

Sakamakon Magani:

1. Amsawa ta ɗan gajeren lokaci:

# Inganta Alamomin Ciwon: Cikin makonni uku bayan an yi mata allurar, Ms. C ta sami raguwar ciwon gaɓɓai da kumburi sosai, kuma kurajen jikinta sun ɓace a hankali.

# Sakamakon Dakunan Gwaji: Kwanaki biyu bayan an yi amfani da maganin, an kawar da ƙwayoyin B a cikin jinin Ms. C gaba ɗaya, wanda ke nuna cewa ƙwayoyin CAR-T sun yi nasarar kai hari.

2. Kimantawa na Tsakiyar Lokaci (Watanni 3):

# Maki na SLEDAI-2K: An rage zuwa 2, wanda ke nuna raguwar cutar sosai.

# Aikin Koda: Rage yawan sinadarin proteinuria sosai, tare da rage nephritis.

# Alamomin Rigakafi: Raguwar matakan garkuwar jiki ta DNA masu hana garkuwar jiki biyu, da kuma daidaita matakan C3 da C4 sun koma daidai.

3. Sakamako na Dogon Lokaci (Watanni 12):

# Rage ...

# Tsaro: Baya ga ciwon sakin cytokine mai sauƙi (CRS), Ms. C ba ta fuskanci wata mummunar illa ba. Tsarin garkuwar jikinta ya dawo a hankali bayan an yi mata magani, kuma ƙwayoyin B da suka sake fitowa ba su nuna wata illa ba.

Gabaɗaya, yanayin Ms. C ya nuna ci gaba mai ban mamaki da kuma ci gaba da samun sauƙi bayan maganin ƙwayoyin CAR-T, wanda ke nuna yuwuwar wannan maganin ga SLE mai tsanani da rashin ƙarfi.

Rahoton gwajin ƙwayoyin CART: