Te mate lupus erythematosus pūnaha (SLE)-05

He wahine 32-tau te pakeke a Whaea C, ā, kua kitea kētia tōna mate pūnaha lupus erythematosus (SLE) i ngā tau e rua kua pahure. Ko ōna tohu matua ko te nephritis kino, te rumatiki, me ngā ponana. Ahakoa i whiwhi ia i ngā maimoatanga ārai mate maha (tae atu ki ngā glucocorticoids, hydroxychloroquine, me te rituximab), i mau tonu tōna āhua kāore i taea te whakahaere.

Āhuatanga i mua i te maimoatanga:

Ngā Tohu: Te mamae nui me te pupuhi o ngā hononga, ngā ponana pumau, te ngenge nui, me te mura haere o te nephritis.

Ngā kitenga o te taiwhanga:

# Kaute SLEDAI-2K: 16

# Ngā taumata paturopi DNA anti-whiri-rua i roto i te toto: Kua teitei ake i te awhe noa

# Tāpirihia ngā taumata C3 me C4: Kei raro i te awhe noa

Tukanga Maimoatanga:

1. Kōwhiringa Tūroro: I te koretake o ngā maimoatanga tuku iho me te kaha o tōna āhua, i whakaurua a Whaea C ki tētahi whakamātautau haumanu mō te rongoā pūtau CAR-T.

2. Te Whakarite: I mua i te whiwhinga o te werohanga pūtau CAR-T, i whai wāhi a Whaea C ki te rongoā chemotherapy paerewa hei whakaiti i ngā pūtau lymphocytes o nāianei, hei whakarite hoki mō te whakaurunga mai o ngā pūtau CAR-T.

3. Te Whakarite Pūtau:

# I wehea ngā pūtau-T i te toto o Whaea C.

# I hangaia ēnei pūtau-T i roto i te taiwhanga hei whakaatu i ngā kaiwhakawhiwhi antigen chimeric (CAR) e aro ana ki ngā antigens CD19 me BCMA.

4. Te Werohanga Pūtau: Whai muri i te whakawhanuitanga me te whakamātautau kounga, i werohia anō ngā pūtau CAR-T kua hangaia ki roto i te tinana o Whaea C.

5. Aroturukitanga Tūroro Noho: I aroturukitia a Whaea C i te hōhipera mō ngā rā 25 i muri i te werohanga hei tirotiro mō ngā pānga taha pea me te aromatawai i te whai huatanga.

Ngā Hua Maimoatanga:

1. Whakautu Poto:

# Te Whakapai Ake i ngā Tohu: I roto i ngā wiki e toru i muri i te werohanga, i kite a Whaea C i te hekenga nui o te mamae me te pupuhi o ngā hononga, ā, i memeha haere ōna ponana.

# Ngā Hua Taiwhanga: I ngā rā e rua i muri i te werohanga, i tino whakangaromia ngā pūtau-B i roto i te toto o Ms. C, e tohu ana i te whai huatanga o te arotahi a ngā pūtau CAR-T.

2. Aromatawai Waenga-wā (3 marama):

# Kaute SLEDAI-2K: Kua heke ki te 2, e tohu ana kua tino memeha te mate.

# Mahi a te Whatukuhu: He tino hekenga o te pūmua mimi, me te whakahaere i te nephritis.

# Ngā Tohu Ārai Mate: Kua heke ngā taumata o ngā paturopi DNA anti-whiringa-rua, ā, kua hoki ngā taumata tāpiringa C3 me C4 ki te noa.

3. Ngā Huanga mō te Wā Roa (12 marama):

# Te Whakamarietanga Pūmau: I noho a Whaea C hei kaiwhakamarie mō te tau kotahi, kāore he tohu o te hokinga mai o te SLE.

# Haumaru: Haunga te mate tuku cytokine ngawari (CRS), kāore a Whaea C i pāngia e ngā pānga kino kino. I muri i te maimoatanga, ka ora haere tana pūnaha ārai mate, ā, kāore ngā pūtau-B e puta mai ana i whakaatu i te mate.

I te nuinga o te wā, i kitea he whakapainga whakamiharo i te āhua o Whaea C, ā, i mau tonu te whakaoranga i muri i te rongoā pūtau CAR-T, e whakaatu ana i te kaha o tēnei maimoatanga mō te SLE kino me te uaua ki te rongoā.

Pūrongo whakamātautau pūtau CART