Kubudirira muChirwere cheAutoimmune muVana: Kurapa kweCAR-T Cell Kunorapa Murwere weLupus

Muna Chikumi 2023, Uresa ane makore gumi nemashanu ekuberekwa akapihwa CAR-T cell therapy paErlangen University Hospital, zvichiratidza kushandiswa kwekutanga kwemushonga uyu mutsva kuderedza kufambira mberi kwesystemic lupus erythematosus (SLE), chirwere chakakomba che autoimmune. Gore rakatevera, Uresa anonzwa akagwinya semazuva ese, kunze kwekunge aine dzihwa diki.

Uresa ndiye mwana wekutanga kurapwa chirwere cheSLE Kurapa nekudzivirira muviri paErlangen University's German Center for Immunotherapy (DZI). Kubudirira kwekurapwa uku kwakagadzirwa nemunhu mumwe nemumwe kwakabudiswa muThe Lancet.

Dr. Tobias Krickau, chiremba wezvirwere zvevana paErlangen University Hospital's Department of Pediatrics and Adolescent Medicine, akatsanangura kusiyana kwekushandisa masero eCAR-T kurapa. Zvirwere zveAutoimmuneKare, kurapwa kweCAR-T kwaingobvumidzwa chete kune mamwe magomarara eropa akanyanya kukura.

Mushure mekunge mimwe mishonga yese yakundikana kudzora SLE yeUresa iri kuramba ichiipa, timu yekutsvagurudza yakatarisana nesarudzo yakaoma: masero aya ekudzivirira muviri akagadzirwa anofanira kushandiswa here kumwana ane chirwere che autoimmune? Mhinduro yacho yakanga isati yamboitika, sezvo pasina akamboedza kurapwa kweCAR-T kwezvirwere zve autoimmune zvevana kare.

Kurapa nemasero eCAR-T kunosanganisira kubvisa mamwe masero emuviri emurwere (masero eT), kuapa chimeric antigen receptors (CAR) murabhoritari yakachena, uye wozoisazve masero aya akagadziriswa mumurwere. Masero aya eCAR-T anotenderera muropa, achinanga nekuparadza masero eB anokuvadza (anozviuraya).

Zviratidzo zvaUresa zvakatanga mumatsutso a2022, zvinosanganisira migraines, kuneta, kurwadziwa kwemajoini netsandanyama, uye mapundu kumeso—zviratidzo zvinowanzoonekwa zve lupus. Pasinei nekurapwa kwakanyanya, mamiriro ake akawedzera kuipa, zvichikanganisa itsvo dzake uye zvichikonzera matambudziko akakomba.

Pakutanga kwa2023, mushure mekurapwa kakawanda muchipatara, kusanganisira chemotherapy inodzvinyirira immune system uye plasma exchange, mamiriro aUresa akawedzera kuipa kusvika pakuda dialysis. Akaparadzaniswa neshamwari nemhuri, hupenyu hwake hwakaderera.

Chikwata chevanachiremba paYunivhesiti yeErlangen, chaitungamirwa naProfessor Mackensen, chakabvumirana kugadzira nekushandisa masero eCAR-T eUresa mushure mekukurukurirana kwakadzama. Kushandiswa uku kwekurapa kweCAR-T netsitsi kwakatangwa pasi pemutemo weGermany wemishonga nemitemo yekushandiswa kwetsitsi.

Chirongwa chekurapa nemasero eCAR-T kuErlangen, chinotungamirwa naProfessor Georg Schett naProfessor Mackensen, chave chichirapa varwere vane zvirwere zvakasiyana-siyana zve autoimmune, kusanganisira SLE, kubvira muna 2021. Kubudirira kwavo nevarwere gumi nevashanu kwakabudiswa muNew England Journal of Medicine muna Kukadzi 2024, uye parizvino vari kuita chidzidzo cheCASTLE nevanhu makumi maviri nevana, vese vachiratidza kuvandudzika kukuru.

Kuti agadzirire kurapwa nemasero eCAR-T, Uresa akarapwa nechemotherapy shoma kuti awane nzvimbo yemasero eCAR-T muropa rake. Musi wa26 Chikumi 2023, Uresa akagamuchira masero ake eCAR-T aakagadzirirwa iye. Pakazosvika vhiki yechitatu mushure mekurapwa, mashandiro ake eitsvo uye zviratidzo zve lupus zvakavandudzika, uye zviratidzo zvake zvakanyangarika zvishoma nezvishoma.

Kurapwa kwacho kwaisanganisira kunyatsorongeka kuti pave nechokwadi chekuti chemotherapy inoshanda uye kuti itsvo dzasara dzisashande zvakanaka. Uresa akasangana nedambudziko diki uye akaburitswa muchipatara pazuva rechigumi nerimwe mushure mekurapwa.

Pakupera kwaChikunguru 2023, Uresa akadzokera kumba, akapedza bvunzo dzake, uye akaisa zvinangwa zvitsva zveramangwana rake, kusanganisira kuzvimirira uye kuwana imbwa. Akafara kusangana neshamwari dzake uye kutangazve hupenyu hwemazuva ese hwevechidiki.

Purofesa Mackensen vakatsanangura kuti Uresa achiri nemasero akawanda eCAR-T muropa rake, zvinoreva kuti anoda kuiswa maantibody mwedzi wega wega kusvika masero ake eB apora. Dr. Krickau vakasimbisa kuti kubudirira kwekurapwa kwaUresa kwakakonzerwa nekushanda pamwe chete kwenyanzvi dzakawanda dzekurapa paGerman Center for Immunotherapy.

Uresa haachadi mushonga kana dialysis, uye itsvo dzake dzapora zvizere. Dr. Krickau nechikwata chake vari kuronga zvimwe zvidzidzo zvekuongorora kugona kwemasero eCAR-T mukurapa zvimwe zvirwere zvevana zvinodzivirira muviri.

Nyaya iyi inokosha inoratidza mukana wekurapa neCAR-T cell therapy kuti ipe zororo kwenguva refu kuvarwere vevana vane zvirwere zvakakomba zve autoimmune seSLE. Kubudirira kwekurapwa kweUresa kunoratidza kukosha kwekupindira nekukurumidza uye kushanda pamwe chete mumabasa akasiyana-siyana. Zvimwe zvidzidzo zvekiriniki zvinodiwa kusimbisa kuchengetedzeka kwenguva refu uye kushanda zvakanaka kweCAR-T cell therapy kuvana vane zvirwere zve autoimmune.