Ngaba unyango lweCellular luza kuba yikamva leSifo esiZikhuselayo?
Unyango oluphucukileyo lomhlaza lunokukwazi ukunyanga nokubuyisela inkqubo yomzimba yokuzikhusela ukuze inike uxolo lwexesha elide okanye mhlawumbi iphilise ezinye izifo. Izifo ezichaphazela umzimba.
Unyango lwe-T-cell lwe-Chimeric antigen receptor (CAR) lubonelele ngendlela entsha yokunyanga umhlaza we-hematologic ukusukela ngo-2017, kodwa kukho iimpawu zokuqala zokuba ezi immunotherapy zeseli zinokusetyenziselwa izifo ze-autoimmune ezibangelwa ziiseli ze-B.
NgoSeptemba wonyaka ophelileyo, abaphandi eJamani baxele ukuba izigulane ezihlanu ezine-refractory systemic lupus erythematosus (SLE) ezinyangwe ngonyango lwe-CAR T-cell zonke zifumene uxolelo olungenamayeza. Ngexesha lokupapashwa, akukho zigulana ziphinde zabuyela umva ukuya kuthi ga kwiinyanga ezili-17 emva konyango. Ababhali bachaze ukuguqulwa kwe-seroconversion yee-antinuclear antibodies kwizigulane ezibini ezilandelelanayo ixesha elide, "okubonisa ukuba ukurhoxiswa kwee-autoimmune B-cell clones kunokukhokelela ekulungisweni okubanzi kwe-autoimmune," babhala abaphandi.
Kolunye uphando olupapashwe ngoJuni, abaphandi basebenzise iiseli ze-CAR-T ezijoliswe kwi-CD-19 ukunyanga indoda eneminyaka engama-41 ubudala ene-refractory antisynthetase syndrome ene-progressive myositis kunye nesifo semiphunga esiphakathi kwe-interstitial. Emva kweenyanga ezintandathu emva konyango, bekungekho zimpawu ze-myositis kwi-MRI kwaye i-CT scan yesifuba ibonise ukwehla ngokupheleleyo kwe-alveolitis.
Ukususela ngoko, iinkampani ezimbini ze-biotechnology — iCabaletta Bio ePhiladelphia kunye neKyverna Therapeutics e-Emeryville, eCalifornia — sele zinikwe izikhundla ezikhawulezileyo ezivela kwi-US Food and Drug Administration for CAR T-cell therapy for SLE kunye ne-lupus nephritis. IBristol-Myers Squibb ikwaqhuba uvavanyo lwesigaba soku-1 kwizigulana ezine-SLE enzima, enganyangekiyo. Iinkampani ezininzi ze-biotechnology kunye nezibhedlele eTshayina nazo zenza uvavanyo lweklinikhi lwe-SLE. Kodwa oku kukuphela kwengcinga malunga nonyango lweseli lwesifo sokuzikhusela komzimba, utshilo uMax Konig, MD, PhD, uprofesa oncedisayo wezonyango kwicandelo le-rheumatology kwiJohns Hopkins University School of Medicine eBaltimore.
"Lixesha elinomdla kakhulu. Akukaze kwenzeke ngaphambili kwimbali yokuzikhusela komzimba," utshilo.
"Ukuqalisa kwakhona" kwenkqubo yomzimba yokuzikhusela
Unyango olujoliswe kwiiseli ze-B belukho ukususela kwiminyaka yoo-2000 ngamayeza afana ne-rituximab, iyeza le-antibody ye-monoclonal elijolise kwi-CD20, i-antigen ebonakala kumphezulu weeseli ze-B. Iiseli ze-CAR T ezikhoyo ngoku zijolise kwenye i-antigen yomphezulu, i-CD19, kwaye lolona nyango lunamandla ngakumbi. Zombini zisebenza kakuhle ekupheliseni iiseli ze-B egazini, kodwa ezi seli ze-T ezijoliswe kwi-CD19 zenziwe ngendlela yokuba unyango lwe-antibody lungakwazi ukufikelela kwiiseli ze-B ezihleli kwizicwili ngendlela unyango lwe-antibody olungenako ngayo, uKonig ucacisile.