He Huarahi Hou i roto i te Mate Pūnaha Ārai Mate o ngā Tamariki: Ka Whakaora te Maimoatanga Pūtau CAR-T i te Tūroro Lupus

I te marama o Hune 2023, i whiwhi a Uresa, 15 tau te pakeke, i te rongoā pūtau CAR-T i te Hōhipera o te Whare Wānanga o Erlangen, koinei te whakamahinga tuatahi o tēnei maimoatanga auaha hei whakaroa i te whanaketanga o te pūnaha lupus erythematosus (SLE), he mate pūnaha ārai mate kino. I te tau i muri mai, kei te ora tonu a Uresa, haunga ētahi makariri iti.

Ko Uresa te tamaiti tuatahi i rongoatia mō te SLE me Te rongoā ārai mate i te Pokapū Tiamana mō te Ārai Mate (DZI) o Te Whare Wānanga o Erlangen. Kua whakaputaina te angitu o tēnei maimoatanga takitahi ki roto i te The Lancet.

I whakamārama a Tākuta Tobias Krickau, he tākuta mate rumatiki tamariki i te Tari Rongoā Tamariki me te Taiohi o te Hōhipera o te Whare Wānanga o Erlangen, i te ahurei o te whakamahi i ngā pūtau CAR-T hei rongoā Ngā Mate Pūnaha Ārai MateI mua, i whakaaetia te rongoā CAR-T mō ētahi matepukupuku toto kua whanake haere anake.

I muri i te korenga o ngā rongoā katoa ki te whakahaere i te SLE e kino haere ana o Uresa, ka tūtaki te tīma rangahau ki tētahi whakatau uaua: me whakamahi rānei ēnei pūtau ārai mate kua hangaia mō tētahi tamaiti he mate pūnaha ārai mate? Kāore i kitea i mua te whakautu, nā te mea kāore anō kia whakamātauhia e tētahi te maimoatanga CAR-T mō ngā mate pūnaha ārai mate o ngā tamariki i mua.

Ko te rongoā pūtau CAR-T ko te tango i ētahi o ngā pūtau ārai mate (ngā pūtau-T) o te tūroro, te whakarato i a rātou ki ngā kaiwhakawhiwhi antigen chimeric (CAR) i roto i tētahi taiwhanga ma, kātahi ka whakauru anō i ēnei pūtau kua whakarerekētia ki roto i te tūroro. Ka rere ēnei pūtau CAR-T i roto i te toto, ka aro atu, ka whakangaro hoki i ngā pūtau-B autoreactive (kino).

I tīmata ngā tohu o Uresa i te ngahuru o te tau 2022, tae atu ki ngā migraines, te ngenge, te mamae o ngā hononga me ngā uaua, me te ponana o te mata—he tohu noa o te lupus. Ahakoa te maimoatanga nui, i kino haere tōna āhua, i pā ki ōna whatukuhu, ā, i puta ai ngā raruraru nui.

I te tīmatanga o te tau 2023, whai muri i ngā whakaurunga maha ki te hōhipera me ngā maimoatanga, tae atu ki te chemotherapy ārai mate me te whakawhiti plasma, ka kino haere te āhua o Uresa tae noa ki te wā i hiahiatia ai he dialysis. I te wehenga atu i ngā hoa me te whānau, ka tino heke te kounga o tōna oranga.

I whakaae te tīma hauora o Te Whare Wānanga o Erlangen, i raro i te kaiārahi o Ahorangi Mackensen, ki te whakaputa me te whakamahi i ngā pūtau CAR-T mō Uresa i muri i ngā kōrero taipitopito. I tīmatahia tēnei whakamahinga aroha o te rongoā CAR-T i raro i te ture rongoā me ngā ture whakamahinga aroha o Tiamana.

Ko te kaupapa whakaora pūtau CAR-T i Erlangen, i arahina e Ahorangi Georg Schett rāua ko Ahorangi Mackensen, kei te rongoā i ngā tūroro he maha ngā mate pūnaha ārai mate, tae atu ki te SLE, mai i te tau 2021. I whakaputaina tō rātou angitu ki te 15 tūroro i roto i te New England Journal of Medicine i te Hui-tanguru 2024, ā, kei te whakahaerehia e rātou te rangahau CASTLE me te 24 ngā kaiuru, ā, e whakaatu ana i ngā whakapainga nui.

Hei whakarite mō te rongoā pūtau CAR-T, i tukuna a Uresa ki te chemotherapy iti-horopeta hei hanga wāhi mō ngā pūtau CAR-T i roto i ōna toto. I te 26 o Hune, 2023, i whiwhi a Uresa i āna pūtau CAR-T whaiaro. I te wiki tuatoru i muri i te maimoatanga, i pai ake te mahi a ōna whatukuhu me ngā tohu lupus, ā, i memeha haere ōna tohu.

I roto i te tukanga maimoatanga i whai wāhi te mahi tahi ātaahua hei whakarite i te whai huatanga o te rongoā mate pukupuku me te tiaki i te toenga o te mahi a te whatukuhu. He iti noa ngā pānga taha i pā ki a Uresa, ā, i tukuna ia ki te hōhipera i te 11 o ngā rā i muri i te maimoatanga.

I te mutunga o Hōngongoi 2023, ka hoki a Uresa ki te kāinga, ka oti āna whakamātautau, ka whakatakoto whāinga hou mō tōna heke mai, tae atu ki te noho motuhake me te whiwhi kurī. I harikoa ia ki te hono anō ki ngā hoa me te hoki anō ki te oranga taiohi noa.

I whakamārama a Ahorangi Mackensen kei te mau tonu te maha o ngā pūtau CAR-T i roto i te toto o Uresa, ko te tikanga me werohia ia ki ngā paturopi ia marama kia ora rā anō ōna pūtau-B. I whakanui a Tākuta Krickau ko te angitu o te maimoatanga a Uresa nā te mahi tahi tata a ngā momo rongoā maha i te German Center for Immunotherapy.

Kāore a Uresa e hiahia ana ki tētahi rongoā, ki tētahi dialysis rānei, ā, kua tino ora ake ōna whatukuhu. Kei te whakamahere a Tākuta Krickau me tana tīma i ētahi atu rangahau hei tūhura i te kaha o ngā pūtau CAR-T ki te rongoā i ētahi atu mate pūnaha ārai mate o ngā tamariki.

E whakaatu ana tēnei take nui i te kaha o te rongoā pūtau CAR-T ki te whakarato i te murunga mō te wā roa mō ngā tūroro tamariki e pāngia ana e ngā mate pūnaha ārai mate kino pērā i te SLE. Ko te angitu o te rongoā a Uresa e whakaatu ana i te hiranga o te wawaotanga wawe me te mahi tahi a te tini me te tini o ngā kaupapa. Me whai atu i ngā rangahau haumanu hei whakaū i te haumaru me te whai huatanga mō te wā roa o te rongoā pūtau CAR-T mō ngā tamariki e pāngia ana e ngā mate pūnaha ārai mate.