- Mankhwala
- Umboni
- Neuroblastoma
- Chotupa Cholimba
- Umboni
- TILS
- Chithandizo cha Maselo a NK
- Myasthenia Gravis (MG)
- Khansa ya m'magazi ya Lymphoblastic (B-ALL)
- Systemic Lupus Erythematosus (SLE)
- Matenda a khansa ya m'magazi (T-ALL)
- Non Hodgkin Lymphoma (NHL)
- Matenda a Myeloma Yambiri (MM)
- Kufalitsa Lymphom Yaikulu ya B-cell
- B-lymphocytic Leukemia
- Myeloma
CAR-T ya Glioblastoma
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Selo ya CAR-T
Chithandizo cha CAR-T (Chimeric Antigen Receptor T-cell) ndi njira yatsopano yochiritsira matenda a immunotherapy. Zimaphatikizapo kusintha maselo anu a T—mtundu wa maselo oteteza thupi—kuti azindikire ndikuukira maselo a khansa omwe ali ndi zizindikiro zinazake. Pa glioblastoma, chithandizochi cholinga chake ndi kupereka chithandizo chapadera chomwe chingathe kupititsa patsogolo moyo ndikuchepetsa zizindikiro, makamaka zikaphatikizidwa ndi njira zina.
Zolinga mu Chithandizo cha CAR-T cha Glioblastoma
Mu glioblastoma, mapuloteni ena pamwamba pa maselo otupa amakhala ngati zolinga zabwino kwambiri pa chithandizo cha CAR-T chifukwa cha kuchuluka kwa maselo a khansa komanso kupezeka kochepa pa minofu yathanzi. Ku Bioocus, tikuyang'ana kwambiri zolinga ziwiri zazikulu:
- GD2: Iyi ndi glycolipid antigen yomwe imapezeka kwambiri pa maselo a glioblastoma, komanso zotupa zina za muubongo monga ma gliomas apakati. GD2 imagwira ntchito popereka mauthenga a maselo ndipo imawonekera kwambiri m'zotupa zoopsa, zomwe zimapangitsa kuti ikhale chizindikiro chabwino chothandizira chitetezo cha mthupi.
- B7-H3: Yodziwikanso kuti CD276, puloteni iyi yoteteza chitetezo chamthupi imapangidwa mopitirira muyeso mu glioblastoma ndipo imathandizira kupewa chotupa m'thupi. Imagwira ntchito yolimbikitsa kukula kwa khansa ndikuletsa chitetezo chamthupi, zomwe zimapangitsa kuti ikhale chandamale chothandiza pakuwonjezera kuukira kwa maselo a T.
Mwa kupanga maselo a CAR-T kuti azindikire GD2 kapena B7-H3, chithandizochi chimatsogolera kuukira kwapadera kwa maselo otupa pomwe chimachepetsa kuwonongeka kwa minofu ya ubongo wabwinobwino.
Momwe Chithandizo cha CAR-T Chimagwirira Ntchito: Njira Yogwirira Ntchito
Chithandizo cha CAR-T chimayamba ndi kusonkhanitsa chitsanzo cha maselo anu a T kudzera mu njira yofanana ndi yopereka magazi. Kenako maselo amenewa amasinthidwa majini mu labotale kuti awonetse chimeric antigen receptor (CAR)—cholandirira chapadera chomwe chimagwira ntchito ngati "chipangizo chofikira" maselo a khansa.
- Kuzindikira: CAR pa maselo a T imagwirizana makamaka ndi GD2 kapena B7-H3 pa maselo a glioblastoma, mofanana ndi loko ndi kiyi.
- Kutsegula: Akangomangidwa, CAR imayambitsa maselo a T kuti ayambitse, achuluke, ndikutulutsa mamolekyu odziwitsa omwe amasonkhanitsa maselo ena oteteza thupi kuti agwirizane nawo pankhondoyi.
- Kuwonongedwa: Maselo a T omwe amagwira ntchito amaukira mwachindunji ndikupha maselo a khansa omwe akufuna, zomwe zingayambitse kuchepa kwa chotupa ndikuchepetsa kuchuluka kwa matenda.
Njira imeneyi nthawi zambiri imaphatikizapo kubwezeretsanso maselo a T osinthidwa m'thupi lanu, nthawi zambiri kudzera m'mitsempha kapena njira zoperekera kuti zifike ku ubongo. Cholinga chake ndikupanga chitetezo chamthupi chomwe chimapitiliza kuyang'anira ndikuchotsa maselo otsala a khansa pakapita nthawi.
Njira zathu zochiritsira za CAR-T zimayang'ana kwambiri GD2 ndi B7-H3 chifukwa cha Glioblastomaakuwonetsa kuti ndi othandiza kwambiri m'mayesero azachipatala.
Kwa GD2 CAR-TKafukufuku wa odwala 37 omwe ali ndi matenda a glioma omwe amabwereranso kapena omwe sachira adawonetsa kuti ali ndi matenda a shuga. 72% ya kuchuluka kwa mayankho olondolandi 42% akupeza chikhululukiro chathunthu pa masabata 6 ndipo 56% akupitirizabe kukhala ndi chikhululukirocho patatha zaka 1.7..
Kwa B7-H3 CAR-T, mayeso a akuluakulu 39 omwe ali ndi glioblastoma yobwerezabwereza adanenanso za Chiŵerengero cha mayankho cha 30–40% ndi Chiŵerengero cha 60–70% cha matendandi Kupulumuka kwapakati kwa miyezi 11 (monotherapy) ndi miyezi 13.6 (kuphatikiza), kuposa mbiri yakale.
Mankhwala onsewa ndi otetezeka, ali ndi zotsatirapo zochepa komanso zotha kuthetsedwa. Bioocus yadzipereka kupititsa patsogolo njira zatsopanozi kuti ziwongolere zotsatira za odwala a glioblastoma.
Chithandizo cha X-ray
Kuchiza ndi radiotherapy ya stereotactic (SRT) kapena chithandizo cha radiotherapy cha thupi la stereotactic (SBRT) Zitha kuphatikizidwa ndi CAR-T kuti zigwire bwino malo otupa, kuchepetsa kukula kwake ndikuwonjezera mwayi wopezera maselo a chitetezo chamthupi. Njira yolondola kwambiri iyi imachepetsa kuwonongeka kwa minofu yathanzi ndipo ingathandize kuti CAR-T ilowe bwino.
Njira Zothandizira
Kuyika tinthu tating'onoting'ono Zimaphatikizapo kuyika tinthu ta radioactive mwachindunji mu chotupacho kuti tipeze radiation yapafupi, zomwe zimathandizana ndi CAR-T pofooketsa maselo a khansa pasadakhale. Kuti ubongo ufike, Malo osungiramo madzi a Ommaya Kuyika mankhwala kumathandiza kuti mankhwala alowe mwachindunji mu cerebrospinal fluid, zomwe zingalimbikitse kufalikira kwa CAR-T.
Ommaya Reservoir
Chipangizo chapaderachi, chomwe chimayikidwa pansi pa khungu la mutu, mwa opaleshoni, imalola kutumiza mankhwala mwachindunji mu cerebrospinal fluid kudzera mu catheter kupita ku ventricles ya ubongoKwa odwala matenda a glioblastoma, makamaka omwe ali ndi leptomeningeal virus, Malo osungiramo zinthu a Ommaya amalola kuperekedwa molondola kwa maselo a CAR-T kapena njira zina zochiritsira, kuonetsetsa kuti mankhwala ambiri m'thupi la mitsempha yapakati amakhala ndi ululu wochepa poyerekeza ndi kuphulika kwa lumbar.
Ndondomeko iyi ya njira zambiri ikufuna kukulitsa kulamulira matendawa pamene mukuthandiza kuchira kwanu komanso kukhala ndi thanzi labwino.
Mafunso Ofunsidwa Kawirikawiri
- Kodi ndine woyenera kulandira chithandizo cha CAR-T?Kuyenerera kumadalira zinthu monga mtundu wa chotupa, chithandizo cham'mbuyomu, komanso thanzi lonse. Kufunsana ndi akatswiri athu kungakuthandizeni kudziwa ngati chikukuyenererani.
- Kodi zotsatirapo zake zingakhale zotani?Zofala kwambiri ndi kutopa, zizindikiro zokhudzana ndi kutupa, ndi machitidwe a chitetezo chamthupi, zomwe zimayang'aniridwa ndikuwongoleredwa mosamala.
- Kodi njirayi imatenga nthawi yayitali bwanji?Kuyambira kusonkhanitsa maselo mpaka kulowetsedwa m'thupi, nthawi zambiri zimatenga milungu ingapo, ndipo chisamaliro chotsatira chikupitilira.
Ngati mukuganiza Chithandizo cha CAR-T chifukwa cha glioblastoma, tili pano kuti tikuthandizeni ndi chisamaliro chachifundo komanso chozikidwa pa umboni. Lumikizanani ndi gulu lathu ku Bioocus kuti mukonze nthawi yokambirana ndikuphunzira momwe njira yatsopanoyi ingagwirizanire ndi dongosolo lanu la chithandizo. Thanzi lanu ndi chiyembekezo chanu ndizofunikira kwa ife—tiyeni tikambirane njira zina pamodzi.
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