Kurapa kweCAR-T: Ramangwana Rine Tariro Yezvirwere Zvikuru zveT-Cell
Kurapa neChimeric Antigen Receptor T-cell (CAR-T) kwakachinja kurapa kweB-cell bundu, zvichipa kupora kwenguva refu uye kunyange kurapa varwere vazhinji. Vakurudzirwa nekubudirira uku, vaongorori vakatendeukira kukushandiswa kweCAR-T kune T-cell bundundu, kusanganisira T-Cell Lymphomas (TCL) uye T-cell acute lymphoblastic leukemia (T-ALL). Zvisinei, kenza idzi dzeT-cell dzinopa matambudziko akasiyana ekuvandudza kurapwa kweCAR-T.
Maronda eT-cell, ayo anokonzera kenza yevana nevakuru, anozivikanwa nekurwisa kwawo uye kuramba kurapwa kwakajairika. T-ALL neTCL zvakasiyana-siyana, uye hazvina kunaka kana vanhu vakadzokera shure kana kuti vakasateerera (r/r), zvichiratidza kudiwa kukuru kwenzira itsva dzekurapa. Kurapa kweCAR-T kwekenza yeT-cell kwawana kutariswa kukuru nekuda kwekugona kwayo kupa mhinduro yakananga uye inoshanda.
Dambudziko riripo pakuratidzwa kwezvibodzwa zveantigen pakati pemasero eT ane kenza nemasero eT akajairika, izvo zvinogona kutungamira ku "fratricide," uko masero eCAR-T anoparadza masero eT ane hutano netsaona. Pamusoro pezvo, T-cell aplasia, iyo inogona kusiya varwere vari panjodzi yekutapukirwa nehutachiona, ine imwe njodzi huru. Pasinei nezvipingamupinyi izvi, kufambira mberi kwekiriniki munguva pfupi yapfuura kwakaratidza mhedzisiro inovimbisa yeCAR-T muT-ALL neTCL.
Ongororo ichangobva kuburitswa mu Kufambira Mberi Kweropa inoratidza miedzo yakati wandei yekiriniki inovimbisa. Imwe nzira inosanganisira kutarisa CD7, puroteni inowanikwa pamusoro peT-ALL nemamwe maT-cell lymphomas. Mumiedzo yekutanga, kurapwa kweCAR-T kwakanangana neCD7 kwakaratidza kushanda kwakanaka, zvichiita kuti varwere vazhinji varegererwe zvachose. Pamusoro pezvo, nzira dzakanangana nekuderedza "fratricide" uye kuvandudza kugadzirwa kweCAR-T cells dziri kugadzira nzira yekubudirira kwekiriniki.
Miedzo yazvino yakaedzawo kugadzirisa maT-cells kuti vawedzere kurongeka uye kugara kwenguva refu kwemasero eCAR-T. Semuenzaniso, kushandiswa kwetekinoroji yeCRISPR-Cas9 kunanga maantigen chaiwo akadai seCD5, CD7, uye TRBC kwakaratidza mukana wekuvandudza kuchengetedzeka uye kushanda zvakanaka. Mhedzisiro yekutanga inoratidza kuti kurapwa kweCAR-T, kana kwakagadzirwa zvakanaka, kunogona kuva chombo chine simba chekurwisa kenza yeT-cell.
Uyezve, kusanganisa CAR-T therapy nedzimwe nzira dzekurapa, dzakadai seallogeneic hematopoietic hematopoietic stem cell transplantation (allo-HSCT), kwakaratidza tarisiro mukuwedzera nguva yekurarama uye kudzivirira kudzokera shure. Muchikamu chechipiri chekuyedzwa kweCAR-T therapy yakanangana neCD7, 63.5% yevarwere vakaramba vari muzororo mushure memakore maviri, uye avo vakagamuchira allo-HSCT vakavandudza zvakanyanya hupenyu hwavo husina progression-free survival (PFS).
Sezvo tsvakurudzo ichienderera mberi, mamiriro ekurapa kweCAR-T muzvirwere zveT-cell anotaridzika kunge ari kuwedzera kuva netariro. Kunyange hazvo kuchine matambudziko makuru ekurwisa, anosanganisira kugadzirisa chirwere checytokine release syndrome (CRS) uye chepfu muuropi, kunzwisisa kuri kuita tekinoroji yeCAR-T kuri kuramba kuchiwedzera mashandisirwo ayo.
KuBIOOCUS, takazvipira kuramba tiri pamberi mukuvandudzwa kweCAR-T therapy uye tinofara kupa kurapa uku kwepamberi kuvarwere pasi rese. Sezvo miedzo yekiriniki ichiramba ichichinja, tinoramba tiine tariro yekuti CAR-T therapy rimwe zuva ichapa sarudzo yekurapa kune avo vanotambura neT-cell mognancies, zvichiunza tariro itsva kuvarwere nemhuri dzinoda nzira dzekurapa dzinoshanda.
Kuti uwane rumwe ruzivo nezvezvirongwa zvedu zvekurapa zveCAR-T, shanyira webhusaiti yedu kana kuti bata timu yedu yekutsigira varwere.