Ubuvuzi bwa CAR-T: Ejo hazaza heza ku ndwara za T-cell

Ubuvuzi bwa Chimeric Antigen Receptor T-cells (CAR-T) bwahinduye uburyo bwo kuvura kanseri ya B-cells, butanga uburyo bwo koroshya indwara ndetse bunavura abarwayi benshi. Batewe inkunga n'izi ntambwe, abashakashatsi bibanze ku ikoreshwa rya CAR-T mu ndwara za T-cells, harimo Lymphoma ya T-cells (TCL) na leukemia y’urukerera rwa T-cell acute lymphoblastic (T-ALL). Ariko, izi kanseri za T-cell zitanga imbogamizi zidasanzwe mu iterambere ry’ubuvuzi bwa CAR-T.

Kanseli zo mu bwoko bwa T-cell, zigize igice kinini cya kanseri zo mu bwana no mu bantu bakuru, zizwiho ubukana bwazo no kudakira imiti isanzwe. T-ALL na TCL biratandukanye cyane, kandi ingaruka mbi ziboneka mu gihe indwara zongeye kugaruka cyangwa zigacika intege (r/r), ibi bikaba bigaragaza ko hakenewe uburyo bushya bwo kuvura. Uburyo bwo kuvura kanseri zo mu bwoko bwa T-cell bwakunzwe cyane bitewe n’ubushobozi bwazo bwo gutanga igisubizo cyihariye kandi gifatika.

Ikibazo kiri mu kugaragaza hamwe intego za antigen hagati y’uturemangingo twa T-seli mbi na T-seli zisanzwe, bishobora gutera "fratricide," aho uturemangingo twa CAR-T twangiza uturemangingo twa T-seli nzima mu buryo butamenyekanye. Byongeye kandi, aplasia ya T-seli, ishobora gutuma abarwayi bandura indwara, itera indi ngorane ikomeye. Nubwo hari izi mbogamizi, iterambere riherutse kugaragara mu buvuzi ryagaragaje umusaruro mwiza kuri CAR-T muri T-ALL na TCL.

Isuzuma riherutse gusohoka muri Iterambere ry'Amaraso igaragaza igeragezwa ry’ubuvuzi ritanga icyizere. Uburyo bumwe burimo kwibasira CD7, poroteyine igaragara ku buso bwa T-ALL na limfoma zimwe na zimwe za T-cell. Mu igerageza rya mbere, ubuvuzi bwa CAR-T bwibasiwe na CD7 bwagaragaje umusaruro utangaje, butuma abarwayi benshi bakira burundu. Byongeye kandi, ingamba zigamije kugabanya "fratricide" no kunoza ikorwa ry’uturemangingo twa CAR-T zirimo gutegura inzira yo gutera imbere mu buvuzi.

Igerageza riherutse kandi ryagerageje guhindura utunyangingo twa T kugira ngo hongerwe umwihariko n'uburambe bwa tunyangingo twa CAR-T. Urugero, ikoreshwa ry'ikoranabuhanga rya CRISPR-Cas9 mu kwibasira antigens runaka nka CD5, CD7, na TRBC ryagaragaje ko rishobora kunoza umutekano n'imikorere yaryo. Ibisubizo bya mbere bigaragaza ko ubuvuzi bwa CAR-T, iyo bukozwe neza, bushobora kuba intwaro ikomeye yo kurwanya kanseri ya T-cell.

Byongeye kandi, guhuza uburyo bwo kuvura bwa CAR-T n'ubundi buryo bwo kuvura, nko gutera uturemangingo tw’amaraso mu maraso (allo-HSCT), byagaragaje icyizere mu kongera igihe cyo kubaho no gukumira gusubira inyuma kw'indwara. Mu igerageza ryakozwe mu cyiciro cya kabiri cy'ubuvuzi bwa CAR-T bushingiye ku maraso bwakozwe na CD7, 63.5% by'abarwayi bakomeje koroherwa nyuma y'imyaka ibiri, aho abahawe uburyo bwo kuvura bwa CAR-T bagize amahirwe menshi yo kubaho badakomeza kubaho (PFS).

Uko ubushakashatsi bukomeza, imiterere y’ubuvuzi bwa CAR-T mu ndwara za kanseri za T isa n’aho irushaho kuba myiza. Nubwo hakiri imbogamizi zikomeye zigomba kugerwaho, harimo no guhangana n’indwara ikomeye yo gusohora cytokine (CRS) n’uburozi bw’ubwonko, gusobanukirwa ikoranabuhanga rya CAR-T bikomeje kwagura uburyo rikoreshwa.

Muri BIOOCUS, twiyemeje gukomeza kuba ku isonga mu iterambere ry’ubuvuzi bwa CAR-T kandi twishimiye gutanga ubu buvuzi bugezweho ku barwayi ku isi yose. Uko igeragezwa ry’ubuvuzi rikomeza gutera imbere, dukomeje kugira icyizere ko ubuvuzi bwa CAR-T buzatuma umunsi umwe butanga uburyo bwo kuvura abafite kanseri ya T-cells, bigatanga icyizere gishya ku barwayi n’imiryango bakeneye uburyo bwo kuvura butanga umusaruro.

Kugira ngo ubone amakuru arambuye kuri gahunda zacu zo kuvura CAR-T, sura urubuga rwacu cyangwa uhamagare itsinda ryacu rishinzwe gufasha abarwayi.