I-systemic lupus erythematosus (SLE)-05

UNksz C ungowesifazane oneminyaka engu-32 ubudala onomlando wokutholwa ene-systemic lupus erythematosus (SLE) eminyakeni emibili edlule. Izimpawu zakhe eziyinhloko zazihlanganisa i-nephritis enzima, i-arthritis, kanye nokuqubuka. Naphezu kokuthola ukwelashwa okuningi okucindezela amasosha omzimba (kufaka phakathi i-glucocorticoids, i-hydroxychloroquine, kanye ne-rituximab), isimo sakhe sahlala singalawuleki.

Isimo Sangaphambi Kokwelashwa:

Izimpawu: Ubuhlungu obukhulu bamalunga nokuvuvukala, ukuqubuka okuqhubekayo, ukukhathala okukhulu, kanye nokuqubuka kwe-nephritis okuphindaphindiwe.

Okutholakele Elabhorethri:

# Isilinganiso se-SLEDAI-2K: 16

# Amazinga e-serum anti-double-stranded DNA antibody: Aphakeme ngaphezu kwebanga elijwayelekile

# Qedela amazinga e-C3 kanye ne-C4: Ngaphansi kwebanga elijwayelekile

Inqubo Yokwelapha:

1. Ukukhethwa Kwesiguli: Ngenxa yokungasebenzi kahle kokwelashwa kwendabuko kanye nobunzima besimo sakhe, uNksz C wabhaliswa esivivinyweni somtholampilo sokwelashwa kwamaseli e-CAR-T.

2. Ukulungiselela: Ngaphambi kokuthola ukufakwa kweseli le-CAR-T, uNksz C wenziwa ukwelashwa okujwayelekile kwe-chemotherapy ukuze aqede ama-lymphocyte akhona futhi alungiselele ukwethulwa kwamaseli e-CAR-T.

3. Ukulungiswa Kwamaseli:

Amaseli e-T angu-# ahlukaniswe egazini likaNksz C.

# Lawa maseli e-T aklanywe ngokwezakhi zofuzo elabhorethri ukuze aveze ama-receptor e-chimeric antigen (CAR) aqondise kuma-antigen e-CD19 kanye ne-BCMA.

4. Ukufakwa Kwamaseli: Ngemva kokunwetshwa nokuhlolwa kwekhwalithi, amaseli e-CAR-T aklanywe ngobunjiniyela aphinde afakwa emzimbeni kaNks. C.

5. Ukuqapha Isiguli Esilele: UNksz C waqashwa esibhedlela izinsuku ezingu-25 ngemuva kokumnika ukuze abheke imiphumela emibi engaba khona futhi ahlole ukusebenza kahle kwayo.

Imiphumela Yokwelashwa:

1. Impendulo Yesikhashana:

# Ukuthuthukiswa Kwezimpawu: Phakathi namasonto amathathu ngemva kokumuncwa, uNksz C wezwa ukwehla okukhulu kobuhlungu bamalunga nokuvuvukala, futhi ukuqubuka kwakhe kwaphela kancane kancane.

# Imiphumela Yelabhorethri: Ezinsukwini ezimbili ngemva kokufakwa, amaseli e-B egazini likaNks. C asuswa ngokuphelele, okubonisa ukuthi amaseli e-CAR-T aqondiswe kahle.

2. Ukuhlolwa Kwesikhathi Esimaphakathi (izinyanga ezi-3):

# Isilinganiso se-SLEDAI-2K: Sehlisiwe saba ngu-2, okubonisa ukuphulukiswa okukhulu kwesifo.

# Umsebenzi Wezinso: Ukwehla okukhulu kwe-proteinuria, kanye ne-nephritis elawulwayo.

# Ama-Immunological Markers: Amazinga anciphile ama-antibody e-DNA alwa ne-double-stranded, kanye namazinga e-C3 kanye ne-C4 ahambisanayo abuyele esimweni esijwayelekile.

3. Imiphumela Yesikhathi Eside (izinyanga ezingu-12):

# Ukuxolelwa Okuqhubekayo: UNksz C waqhubeka nokukhululwa ngaphandle kwemithi unyaka wonke ngaphandle kwezimpawu zokubuyela emuva kwe-SLE.

# Ukuphepha: Ngaphandle kwe-mild cytokine release syndrome (CRS), uNksz C akazange abhekane nemiphumela emibi kakhulu. Amasosha akhe omzimba alulama kancane kancane ngemva kokwelashwa, futhi amaseli e-B aphinde avele awazange abonise ukugula.

Sekukonke, isimo sikaNksz C sibonise ukuthuthuka okuphawulekayo kanye nokululama okuqhubekayo ngemuva kokwelashwa ngamaseli e-CAR-T, okubonisa amandla alolu hlobo lokwelashwa kwe-SLE enzima nengaphenduli.

Umbiko wokuhlolwa kweseli leNKANTOLO: