CAR-T yo kuvura indwara ya Systemic Lupus Erythematosus (SLE)

Ms.C ni umurwayi wavuwe neza kubera indwara ya SLE binyuze mu buvuzi bwa CAR-T. Dore inkuru ye.

Incamake y'urubanza:

Madamu C, umugore w'imyaka 32, yari amaze imyaka ibiri arwaye indwara ya lupus erythematosus (SLE). Nubwo yavurwaga kenshi, indwara ye ntiyakomeje kuyirwanya. Yagize ibimenyetso bikomeye, birimo nephritis, ububabare mu ngingo, n'uduheri tudashira, byagize ingaruka zikomeye ku mibereho ye.

Imiterere y'igihe umuntu atangiye kuvurwa:

SLE ya Madamu C yaranzwe n'ibimenyetso bikomeye, birimo ububabare bukabije mu ngingo, nephritis isubira, ndetse n'uduheri tudakira. Ibizamini byo muri laboratwari byagaragaje ko antibodies za ADN zifite uduce duto two kugabanya ingano ya C3 na C4, bigaragaza ko indwara ikora. Kubera amanota 16 yatanzwe na Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K), indwara ya Madamu C yafatwaga nk'ikomeye, kandi uburyo busanzwe bwo kuvura ubudahangarwa bw'umubiri ntibwashoboye kugabanya ububabare.

Icyemezo cyo kuvura CAR-T:

Bitewe n’uko indwara ye idakira, Madamu C yiyandikishije mu igerageza rya muganga ku buvuzi bwa CAR-T cell therapy—uburyo bwakorewe ku ndwara zimwe na zimwe za kanseri, ariko ubu burimo gukorerwa ubushakashatsi ku ndwara ziterwa n’umubiri nka SLE. Ubuvuzi bwa CAR-T bukora mu guhindura uturemangingo twa T tw’umurwayi kugira ngo bwibasire uturemangingo twihariye tw’ubudahangarwa bw’umubiri tugira uruhare runini mu ndwara.

Uburyo bwo kuvura CAR-T:

1. Amahitamo y'abarwayi: Uburwayi bwa Madamu C bwo mu bwoko bwa SLE bukomeye kandi butuma aba umukandida ukwiriye kuvura CAR-T.

2. Imyiteguro: Mbere yo guhabwa uturemangingo twa CAR-T, Madamu C yafashwe imiti ivura kanseri, intambwe isanzwe yo kugabanya umubare w’uturemangingo tw’umubiri we no gutegura ubudahangarwa bw’umubiri we kugira ngo ahabwe CAR-T.

3. Ubwubatsi bw'uturemangingo twa T: Uturemangingo twa T twa Madamu C twakusanyijwe kandi duhindurwa muri laboratwari kugira ngo tugaragaze ko antigen za chimeric (CAR) zireba antigen za CD19 na BCMA. Izi antigen zikunze kuboneka ku buso bw'uturemangingo twa B, zigira uruhare runini mu kugabanuka k'ubudahangarwa bw'umubiri kugaragara muri SLE.

4. Gutera Seli za CAR-T: Nyuma yo kwaguka no gupimwa ubuziranenge, uturemangingo twa CAR-T twahinduwe twongeye gushyirwa mu mubiri wa Madamu C. Uku guterwa kwabaye intangiriro y'igice gishya mu rugamba rwe rwo kurwanya lupus.

5. Gukurikirana abarwayi bari mu bitaro: Madamu C yakurikiranwe yitonze mu minsi 25 nyuma yo guterwa umuti kugira ngo hamenyekane umutekano n'ubushobozi bw'umuti. Abakozi b'abaganga bakurikiraniye hafi ibimenyetso by'ingaruka mbi, nka cytokine release syndrome (CRS), ingaruka isanzwe iterwa no kuvurwa na CAR-T.

Ibisubizo by'ubuvuzi:

1. Igisubizo cy'igihe gito: Mu byumweru bitatu gusa nyuma yo guterwa, Madamu C yagize ihinduka rikomeye mu bimenyetso bye. Ububabare bwe mu ngingo no kubyimba byaragabanutse, kandi uduheri twamubayeho mu myaka myinshi twatangiye kugabanuka. Ibizamini bya laboratwari byagaragaje kandi ko uturemangingo twa B mu maraso ye twari twarakuweho neza, byemeza ko uturemangingo twa CAR-T twari twaribasiriye neza ibice by’umubiri we bitari bigikora neza.

2. Isuzumabumenyi ry'igihe cyo hagati (amezi 3): Mu mezi atatu, imikorere ya Madamu C yari hafi kubura, amanota ye ya SLEDAI-2K yagabanutse ava kuri 16 agera kuri 2. Indwara ye ya nephritis, yari ihangayikishije cyane mbere yo kuvurwa, ubu yari iri mu nzira yo kugenzurwa, poroteyine igabanuka cyane. Byongeye kandi, urugero rw'uturemangingo twa ADN twa anti-stranded stranded rwagabanutse, kandi urugero rwe rwa C3 na C4 rwongeye kumera neza, bigaragaza ko ubudahangarwa bw'umubiri bwagarutse.

3. Ingaruka z'igihe kirekire (amezi 12): Nyuma y'umwaka umwe ahawe imiti ya CAR-T, Madamu C yakomeje kumererwa neza nta miti afite nta kimenyetso na kimwe cyo gusubira inyuma kwa SLE. Ubudahangarwa bw'umubiri bwe bwagiye bugaruka buhoro buhoro, kandi nubwo uturemangingo twa B twongeye kugaragara, nta kintu na kimwe cyagaragaye cyatera indwara. Uretse kuba Madamu C yarahuye na CRS nto, nta ngaruka mbi zikomeye yagize mu gihe cyose cyo kuvurwa.

Amakuru menshi ku buvuzi:

Ubuvuzi bwa CAR-T bwagaragaje icyizere gikomeye mu kuvura indwara ya lupus erythematosus (SLE), cyane cyane ku barwayi bafite ubwoko bukomeye bw'iyi ndwara budashobora kuvurwa. Ubushakashatsi buherutse gukorwa bwerekana ko bufite akamaro, aho abarwayi benshi bakira indwara igihe kirekire nta miti ikoreshwa.

Mu bushakashatsi bwakorewe ku barwayi umunani, bose bagaragaje ko indwara igenda neza nyuma yo guhabwa imiti ya CAR-T igamije kuvura selile za CD19. Iyi miti yatumye izi selile za B zigabanuka, ari zo zikora uturemangingo twangiza mu mubiri wa SLE. Icy'ingenzi ni uko na nyuma yo kuvugurura selile za B, iyi ndwara ntiyagarutse, kandi abarwayi bashoboye gukomeza kugira ubudahangarwa bw'umubiri ku nkingo. Ibi bigaragaza ko ubuvuzi bwa CAR-T burambye ku budahangarwa bw'umubiri, cyane cyane mu guhagarika ibitero by'ubwirinzi bw'umubiri birangwa na SLE.

Inyigo yakurikiranye abarwayi mu mezi 13 yagaragaje ko abitabiriye bose bagabanutse cyane mu mikorere y’indwara, kandi nta gusubira inyuma kwagaragaye. Byongeye kandi, ubu buvuzi muri rusange bwihanganiwe neza, aho ingaruka mbi nke nka cytokine release syndrome (CRS) zashoboraga gukemuka.

Ibi bisubizo bitanga icyizere bigaragaza ko uburyo bwo kuvura bwa CAR-T bushobora gutanga igisubizo cy’igihe kirekire ku barwayi bafite SLE idakira, bikaba byakuraho gukenera imiti igabanya ubudahangarwa bw’umubiri ubuzima bwabo bwose.