Iterambere mu ndwara z’ubwiyongere bw’umubiri ku bana: Ubuvuzi bwa CAR-T Selire bwakijije umurwayi wa Lupus

Muri Kamena 2023, Uresa w'imyaka 15 yahawe ubuvuzi bwa CAR-T cell therapy mu bitaro bya Kaminuza ya Erlangen, bikaba ari bwo bwa mbere bwakoreshejwe ubu buryo bushya bwo kugabanya ikwirakwira rya lupus erythematosus (SLE), indwara ikomeye y’ubwirinzi bw’umubiri. Nyuma y’umwaka umwe, Uresa yumva ameze neza kurusha mbere hose, usibye ibicurane bike.

Uresa ni we mwana wa mbere wavuwe indwara ya SLE Ubudahangarwa bw'umubiri Mu kigo cy’Abadage cy’Ubuvuzi bw’Indwara z’Ubudahangarwa (DZI) cya Kaminuza ya Erlangen. Intsinzi y’ubu buvuzi bw’umuntu ku giti cye yasohotse mu kinyamakuru The Lancet.

Dr. Tobias Krickau, inzobere mu ndwara z'imitsi y'abana mu ishami ry'ubuvuzi bw'abana n'ingimbi mu bitaro bya Kaminuza ya Erlangen, yasobanuye umwihariko wo gukoresha uturemangingo twa CAR-T mu kuvura Indwara z'ubudahangarwa bw'umubiriMbere, uburyo bwo kuvura bwa CAR-T bwemerwaga gusa ku ndwara zimwe na zimwe za kanseri y’amaraso iteye imbere.

Nyuma y’uko indi miti yose inaniwe kugenzura SLE ya Uresa ikomeje kwiyongera, itsinda ry’ubushakashatsi ryahuye n’ikibazo gikomeye: ese izi selile z’ubudahangarwa bw’umubiri zakozwe mu buryo bwa “developed unit cells” zigomba gukoreshwa ku mwana ufite indwara y’ubudahangarwa bw’umubiri? Igisubizo cyari kidasanzwe, kuko nta muntu n’umwe wari warigeze agerageza kuvura indwara z’ubudahangarwa bw’umubiri z’abana mbere.

Uburyo bwo kuvura uturemangingo twa CAR-T bukubiyemo gukuramo uturemangingo tumwe na tumwe tw’umubiri w’umurwayi (T cells), kuduha ibikoresho bya antigen ya chimeric (CAR) muri laboratwari yihariye isukuye, hanyuma ukongera gushyira utwo turemangingo twahinduwe mu murwayi. Utwo turemangingo twa CAR-T tuzenguruka mu maraso, tuganisha ku turemangingo twa B twikora ku mubiri (twangiza) kandi tukangiza.

Ibimenyetso bya Uresa byatangiye mu gihe cy'umuhindo wa 2022, birimo migraines, umunaniro, ububabare bw'ingingo n'imitsi, ndetse no kugira uduheri mu maso—ibimenyetso bisanzwe bya lupus. Nubwo yavuwe cyane, indwara ye yarushijeho gukomera, igira ingaruka ku mpyiko ze ndetse inamutera ingorane zikomeye.

Mu ntangiriro za 2023, nyuma yo kujya mu bitaro kenshi no kuvurwa, harimo imiti igabanya ubudahangarwa bw'umubiri ndetse no guhinduranya plasma, ubuzima bwa Uresa bwarushijeho kuba bubi ku buryo byamusabye kuvurwa dialyse. Kubera ko yari yigunze ku nshuti n'umuryango, ubuzima bwe bwaragabanutse cyane.

Itsinda ry’abaganga bo muri Kaminuza ya Erlangen, riyobowe na Porofeseri Mackensen, ryemeye gukora no gukoresha uturemangingo twa CAR-T kuri Uresa nyuma y’ibiganiro birambuye. Uku gukoresha neza ubuvuzi bwa CAR-T byatangijwe hakurikijwe itegeko ry’Ubudage rigenga imiti n’amabwiriza agenga ikoreshwa ry’imiti.

Gahunda yo kuvura abarwayi ba CAR-T cell therapy muri Erlangen, iyobowe na Porofeseri Georg Schett na Porofeseri Mackensen, imaze igihe ivura abarwayi bafite indwara zitandukanye ziterwa n’umubiri, harimo na SLE, kuva mu 2021. Intsinzi yabo ku barwayi 15 yasohotse mu kinyamakuru cya New England Journal of Medicine muri Gashyantare 2024, kandi ubu barimo gukora ubushakashatsi bwa CASTLE hamwe n’abantu 24 bitabiriye, bose bagaragaza iterambere rigaragara.

Kugira ngo yitegure kuvurwa na CAR-T cell, Uresa yafashwe imiti igabanya ubukana bw’uturemangingo twa CAR-T mu maraso ye. Ku ya 26 Kamena 2023, Uresa yahawe uturemangingo twa CAR-T twihariye. Mu cyumweru cya gatatu nyuma yo kuvurwa, imikorere y’impyiko ze n’ibimenyetso bya lupus byararushijeho kuba byiza, kandi ibimenyetso bye byaragiye bishira buhoro buhoro.

Uburyo bwo kuvura bwasabye guhuza neza kugira ngo hamenyekane ko imiti ya chimiotherapie ikora neza kandi ko impyiko zisigaye zikingirwa. Uresa yagize ingaruka nke gusa, maze avanwa mu bitaro ku munsi wa 11 nyuma yo kuvurwa.

Mu mpera za Nyakanga 2023, Uresa yasubiye mu rugo, arangiza ibizamini bye, yishyiriraho intego nshya z'ejo hazaza he, harimo kwigenga no kubyara imbwa. Yishimiye kongera kubonana n'inshuti no gukomeza ubuzima busanzwe bw'ingimbi n'abangavu.

Porofeseri Mackensen yasobanuye ko Uresa igifite umubare munini w’uturemangingo twa CAR-T mu maraso ye, bivuze ko akeneye guterwa antibody buri kwezi kugeza igihe uturemangingo twa B twose tukiri bazima. Dr. Krickau yashimangiye ko uburyo Uresa yavuwe bwagenze neza bitewe n’ubufatanye bwa hafi bw’amashami menshi y’ubuvuzi mu kigo cy’Abadage gishinzwe kuvura indwara z’imyororokere.

Uresa ntagikeneye imiti cyangwa dialyse, kandi impyiko ze zarakize neza. Dr. Krickau n'ikipe ye barimo gutegura ubundi bushakashatsi kugira ngo basuzume ubushobozi bw'uturemangingo twa CAR-T mu kuvura izindi ndwara ziterwa n'ubudahangarwa bw'umubiri mu bana.

Uru rubanza rw’ingenzi rugaragaza ubushobozi bwa CAR-T selile mu kuvura abana bafite indwara zikomeye zo mu mutwe nka SLE. Intsinzi y’ubuvuzi bwa Uresa igaragaza akamaro ko gufata ingamba hakiri kare no gukorana n’inzego zitandukanye. Hakenewe izindi nyigo zo kwa muganga kugira ngo hemezwe umutekano n’akamaro k’igihe kirekire k’ubuvuzi bwa CAR-T selile ku bana bafite indwara zo mu mutwe.