Ukwelashwa Kwamaseli e-NK Kuhlanganiswe Nomuthi Wokugoma we-DC Kubonisa Ukuthuthuka Okumangalisayo Kumdlavuza Wesibindi Osesigabeni Sokugcina
Intuthuko yakamuva kwezokwelapha Ukwelashwa nge-immunotherapy inikeza ithemba elisha ezigulini ezinomdlavuza wesibindi osesigabeni sokugcina, ikakhulukazi lezo ezinezinketho zokwelashwa ezilinganiselwe. Esimweni esiyingqayizivele esivela eJapane, isiguli esine-carcinoma yesibindi esithuthukisiwe (i-HCC) sithole ukwelashwa okuhlangene okusha okubandakanya amangqamuzana okubulala emvelo (i-NK), imijovo yeseli le-dendritic (DC), kanye ne-Nivolumab, okwaholela ekuthuthukisweni okumangalisayo emavikini ayisithupha nje.
Isiguli, esitholakale sine-HCC esesigabeni sokugcina kanye nokusabalala kwe-metastases kuma-lymph node, emaphashini, nasemathanjeni, sasinesibikezelo esibi ngokwelashwa kwendabuko. Njengoba sasingasebenzi kahle kwesibindi, inani eliphansi lama-lymphocyte, kanye nokugcinwa okuncane kwesibindi, ithimba lakhe lezokwelapha lalingenazo izinketho eziningi. Baqala uhlelo oluphelele lwe-immunotherapy, olwaluhlanganisa imijovo ye-DC ne-Nivolumab kanye ne- Iseli le-Nk ukwelashwa okunikezwa njalo emavikini amathathu ngemijikelezo emithathu.
Ngokumangalisayo, ngemva kwamasonto ayisithupha nje okwelashwa, ukusebenza kwesibindi sesiguli kwathuthuka kakhulu, kusuka esigabeni se-Child-Pugh sika-C (esiphansi kakhulu ngangokunokwenzeka) kuya ku-A (isimo esinempilo kakhulu). Lokhu kuguqulwa kwahambisana nokwehla okukhulu kosayizi wesimila, ukunyamalala kwama-ascites, kanye nokwehla kwezimpawu zesimila.
Amaseli e-NK, noma amaseli okubulala emvelo, awuhlobo lweseli lokuzivikela elinekhono lokutholwa nokubhujiswa kwamaseli angajwayelekile, njengamaseli omdlavuza, ngaphandle kwesidingo sokuqeqeshwa kwangaphambilini. Lokhu kuwenza aphumelele kakhulu ekuqondeni nasekuqedeni amaseli omdlavuza ngokushesha. Kodwa-ke, ezigulini ezinezifo ezingamahlalakhona noma umdlavuza othuthukile, ukusebenza kahle kwamaseli e-NK kungaba sengozini. Ukuze kulungiswe lokhu, abacwaningi basungule izindlela zokuthuthukisa umsebenzi wamaseli e-NK ngokusebenzisa ubunjiniyela bezakhi zofuzo kanye nokwelashwa okuhlanganisiwe.
Kulesi simo, ukwelashwa kwe-NK cell kwahlanganiswa nomuthi wokugomela i-DC, owenzelwe ukuvuselela amasosha omzimba esiguli, kanye ne-Nivolumab, i-checkpoint inhibitor evimba ikhono lomdlavuza lokugwema izimpendulo zomzimba. Ngomjikelezo wesithupha wokwelashwa, ama-CT scan aveze ukwehla okukhulu kosayizi wesimila, futhi isimo sesiguli sonke sathuthuka ngokwanele ukushintshela ohlelweni olujwayelekile lwe-chemotherapy. Imiphumela yelabhorethri iphinde yabonisa ukwehla okuphawulekayo kwezimpawu zesimila, okuhlanganisa i-vitamin K-induced deficiency protein-Ⅱ (PIVKA-II), kanye nokubuyiselwa kwenani lamaseli amhlophe egazi kanye namazinga e-lymphocyte esiguli.
Leli cala liyisibonakaliso esithembisayo sokuthi ukwelashwa nge-immunotherapy, ikakhulukazi ukwelashwa okusekelwe kumaseli e-NK, kungaba yindlela yokuphila yeziguli ezinomdlavuza othuthukile ezinezinketho zokwelapha ezivamile ezilinganiselwe. Ukuhlanganiswa okuphumelelayo kwamaseli e-NK nezinye izindlela zokwelapha nge-immunotherapy njengemithi yokugomela i-DC kanye nemithi yokuvimbela umdlavuza kuvula ithuba lamathuba amasha okwelashwa ngomdlavuza, ikakhulukazi kulabo ababhekwa njengabangasebenzi noma abangabekezeleli ukwelashwa okuphansi.
Amandla okwelashwa ngamaseli e-NK okushintsha izindlela zokwelapha umdlavuza awakwazi ukukhungathekiswa. Akugcini nje ngokunikeza umzila wokuphila ezigulini ezinezinketho ezimbalwa ezisele, kodwa futhi kuvula indlela yokuthuthuka kwesikhathi esizayo kwezokwelapha ezenzelwe wena kanye nokwelashwa okusekelwe kumasosha omzimba. Nakuba leli cala linikeza umbono wethemba, liphinde ligcizelele isidingo socwaningo oluqhubekayo ukuqinisekisa ukuthi lezi zindlela zokwelapha ezintsha ziyafinyeleleka kalula futhi zijwayelekile kubantu abaningi abagulayo.
Njengoba insimu yokwelapha nge-immunotherapy iqhubeka nokukhula, leli cala lisebenza njengobufakazi bamandla amakhulu okwelashwa okusekelwe kumasosha omzimba okuguqula ikusasa lokunakekelwa komdlavuza.