Indwara ya lupus erythematosus (SLE)-05

Madamu C ni umugore w'imyaka 32 ufite amateka yo kurwara indwara ya lupus erythematosus (SLE) mu myaka ibiri ishize. Ibimenyetso bye by'ibanze byari nephritis ikomeye, rubagimpande, n'uduheri. Nubwo yahawe imiti myinshi igabanya ubudahangarwa bw'umubiri (harimo glucocorticoids, hydroxychloroquine, na rituximab), indwara ye yakomeje kugabanuka.

Imiterere y'igihe umuntu atangiye kuvurwa:

Ibimenyetso: Kubabara cyane mu ngingo no kubyimba, uduheri tudashira, umunaniro mwinshi, no kurwara indwara ya nephritis isubira.

Ibyavuye muri Laboratwari:

Amanota ya # SLEDAI-2K: 16

# Igipimo cy'uturemangingo twa ADN dufite imiterere ibiri mu maraso: Cyazamutse hejuru y'urugero rusanzwe

# Kongera urwego rwa C3 na C4: Munsi y'urwego rusanzwe

Uburyo bwo kuvura:

1. Guhitamo umurwayi: Bitewe n'uko uburyo gakondo bwo kuvura butari bwiza ndetse n'ubukana bw'indwara ye, Madamu C yiyandikishije mu igerageza rya muganga ku buvuzi bwa CAR-T cell.

2. Kwitegura: Mbere yo guhabwa inshinge za CAR-T, Madamu C yabanje guhabwa imiti isanzwe kugira ngo agabanuke lymphocytes zari zihari kandi yitegure kwinjira kwa CAR-T selile.

3. Gutegura uturemangingo:

# Uturemangingo twa T twakuwe mu maraso ya Madamu C.

# Izi selile T zahinduwe muri laboratwari kugira ngo zigaragaze antigen ya chimeric (CAR) zigamije kurwanya antigen za CD19 na BCMA.

4. Gutera Seli: Nyuma yo kwaguka no gupima ubuziranenge, uturemangingo twa CAR-T twongeye gushyirwa mu mubiri wa Madamu C.

5. Gukurikirana abarwayi bari mu bitaro: Madamu C yakurikiranwe mu bitaro iminsi 25 nyuma yo guterwa imiti kugira ngo arebe ingaruka zishobora kubaho no gusuzuma ingaruka nziza.

Ibisubizo by'ubuvuzi:

1. Igisubizo cy'igihe gito:

# Kuzamura ibimenyetso: Mu byumweru bitatu nyuma yo guterwa, Madamu C yagabanutse cyane ububabare bw'ingingo no kubyimba, kandi ibisebe bye byagiye bigabanuka buhoro buhoro.

# Ibisubizo bya Laboratwari: Nyuma y'iminsi ibiri yo guterwa, uturemangingo twa B mu maraso ya Madamu C twaraciwe burundu, bigaragaza ko uturemangingo twa CAR-T twakoreshejwe neza mu kwibasira.

2. Isuzumabumenyi ry'igihe cyo hagati (amezi 3):

Amanota ya # SLEDAI-2K: Yagabanutseho 2, bigaragaza ko indwara yagabanutse cyane.

# Imikorere y'impyiko: Igabanuka rikomeye rya poroteyine mu muyoboro w'amaraso, hamwe n'indwara ya nephritis iri mu nzira yo kuyigenzura.

# Ibimenyetso by'Ubudahangarwa bw'umubiri: Igabanuka ry'ibipimo bya antibodies za ADN zirwanya imigozi ibiri, hamwe n'urugero rwa C3 na C4 byuzuzanya byasubiye ku buryo busanzwe.

3. Ingaruka z'igihe kirekire (amezi 12):

# Gusubira mu buzima burambye: Madamu C yakomeje kuruhuka nta miti afite mu gihe cy'umwaka umwe nta bimenyetso by'uko SLE yongeye kugaruka.

# Umutekano: Uretse indwara yo kubura amaraso mu buryo buciriritse (CRS), Madamu C nta ngaruka mbi zikomeye yagize. Ubudahangarwa bwe bw’umubiri bwaragarutse buhoro buhoro nyuma yo kuvurwa, kandi uturemangingo twa B twongeye kugaragara ntabwo twagaragaje ko ari indwara.

Muri rusange, indwara ya Madamu C yagaragaje iterambere ritangaje no koroherwa nyuma yo kuvurwa na CAR-T cells, bigaragaza ubushobozi bw'ubu buryo bwo kuvura SLE ikomeye kandi idakira.

Raporo y'ikizamini cy'uturemangingo twa CART: