I-systemic lupus erythematosus (SLE)-05

UNksz C ngumfazi oneminyaka engama-32 ubudala onembali yokufunyaniswa ene-systemic lupus erythematosus (SLE) kwiminyaka emibini eyadlulayo. Iimpawu zakhe eziphambili zaziquka i-nephritis enzima, isifo samathambo, kunye nokurhawuzelelwa. Nangona efumene unyango oluninzi lokuthintela amasosha omzimba (kuquka i-glucocorticoids, i-hydroxychloroquine, kunye ne-rituximab), imeko yakhe ayizange ilawuleke.

Imeko yangaphambi konyango:

Iimpawu: Intlungu ebuhlungu yamalungu kunye nokudumba, amaqhuqhuva angapheliyo, ukudinwa okukhulu, kunye nokuvela kwe-nephritis ephindaphindayo.

Iziphumo zeLabhoratri:

# SLEDAI-2K amanqaku: 16

# Amanqanaba e-serum anti-double-stranded DNA antibody: Aphezulu ngaphezu komlinganiselo oqhelekileyo

# Qedela amanqanaba e-C3 kunye ne-C4: Ngaphantsi koluhlu oluqhelekileyo

Inkqubo Yonyango:

1. Ukukhethwa Kwesigulane: Ngenxa yokungasebenzi kakuhle konyango lwesintu kunye nobunzima bemeko yakhe, uNksz C wabhaliswa kwisilingo seklinikhi sonyango lweeseli zeCAR-T.

2. Ukulungiselela: Ngaphambi kokuba afumane i-CAR-T cell infusion, uNksz C wenziwa i-chemotherapy conditioning eqhelekileyo ukuze anciphise ii-lymphocytes ezikhoyo aze alungiselele ukungeniswa kwee-CAR-T cells.

3. Ukulungiswa kweeSeli:

# Iiseli ze-T zahlulwe kwigazi likaNksz. C.

# Ezi seli ze-T zenziwe ngokwemfuza kwilebhu ukuze ziveze ii-chimeric antigen receptors (CAR) ezijolise kwi-CD19 kunye ne-BCMA antigens.

4. Ukufakwa kweeSeli: Emva kokwandiswa novavanyo lomgangatho, iiseli ze-CAR-T ezenziwe ngobunjineli zaphinda zafakwa emzimbeni kaNks. C.

5. Ukubeka iliso kwizigulane ezilaliswe ngaphakathi: UNksz. C ubekwe iliso esibhedlele iintsuku ezingama-25 emva kokufakwa ukuze ajonge iziphumo ebezingalindelekanga ezinokubakho aze ahlole ukusebenza kakuhle.

Iziphumo Zonyango:

1. Impendulo yexesha elifutshane:

# Ukuphuculwa kweempawu: Kwiiveki ezintathu emva kokufakwa, uNksz C wafumana ukwehla okukhulu kwentlungu yamalungu kunye nokudumba, kwaye amaqhuqhuva akhe aphela kancinci kancinci.

# Iziphumo zeLebhu: Emva kweentsuku ezimbini emva kokufakwa, iiseli ze-B egazini likaNksz C zasuswa ngokupheleleyo, nto leyo ebonisa ukuba iiseli ze-CAR-T zijolise ngempumelelo.

2. Uvavanyo lwexesha eliphakathi (iinyanga ezi-3):

# Amanqaku e-SLEDAI-2K: Ancitshisiwe ukuya kwi-2, nto leyo ebonisa ukukhululeka okukhulu kwisifo.

# Umsebenzi Wezintso: Ukuncipha okukhulu kweproteinuria, kunye ne-nephritis ephantsi kolawulo.

# Iimpawu ze-Immunological: Amanqanaba anciphileyo e-anti-double-stranded DNA antibodies, kunye namanqanaba e-C3 kunye ne-C4 abuyele kwisiqhelo.

3. Iziphumo zexesha elide (iinyanga ezili-12):

# Ukukhululwa Okuqhubekayo: UNksz. C uphumelele ngaphandle kwamayeza unyaka wonke ngaphandle kwempawu zokubuyela kwi-SLE.

# Ukhuseleko: Ngaphandle kwe-mild cytokine release syndrome (CRS), uNksz C akazange afumane naziphi na iziphumo ebezingalindelekanga. Inkqubo yakhe yokuzikhusela komzimba yabuyela kwimeko yayo emva konyango, kwaye ii-B cells eziphinda zivela azizange zibonakalise ukuba yingozi.

Lilonke, imeko kaNksz. C ibonakalise ukuphucuka okumangalisayo kunye nokuxolelwa okuqhubekayo emva konyango lweeseli zeCAR-T, nto leyo ebonisa amandla olu nyango kwi-SLE enzima nengalawulekiyo.

Ingxelo yovavanyo lweseli yeNQAKU: