New Therapy Inobudisa Mhinduro Dzakanaka Mukutanga Kwemiedzo
Yakagadziriswa seyakagadzirisa kushandiswa kwemasero (ACT), ichi chirongwa chitsva chinobatanidza kuisa hutachiona masero ezvirwere zvevarwere kuti vaone uye varwise maitiro avo emarara. Kunyange zvazvo rudzi urwu rwechirwere ichi chiri kuongororwa uye rwakarongedzwa kune zvishomanana zvirwere zvemakirini kusvikira zvino, zvakaratidza dzimwe mhinduro dzinoshamisa kune varwere vane kenza yakanyanya.
Iyo Inoshanda Sei
T-masero, rudzi rwemagetsi, anowanikwa nemapapiro pasi, anonzi T-cell receptors, kana TCRs. Kazhinji idzi TCRs dzinosungira maantigens kuti igadzire mhinduro dzekuzvidzivirira pamuviri. Mukuedza kushandura T-masero ekurapa kenza, T-masero anounganirwa kubva kumurwere wega pachake. Zvadaro, mu laboratori, ma-T-cells akashandurwa kuti agadzire zvakagadziriswa zvakagadziriswa pamusoro penzvimbo inonzi chimeric antigen receptors, kana kuti CAR, dzinokwanisa kusunga kune dzimwe mapuroteni epamusoro emamwe masero emukenza.
Iyo yakagadzirwa neC CAR T-cells inokohwa mubazi uye inobvumirwa kuwedzera nhamba yavo kusvikira pane mabhiriyoni ayo. Zvichienderana nekugadziriswa nekukohwa, aya T-masero, ayo anouya neCARs anogona kuona nekuuraya mamwe masero emukenza, anodzorerwa zvakare mumurwere.
Aya maCAR ndiwo mapuroteni anoita kuti T-seli dzione chipurojekiti chaiyo, kana antigen, pamatomu masero.
Ijjini reC CAR T-cells rinokura mubasa uye rinobvumirwa kuwedzera nhamba yavo kusvika kune mabhiriyoni ezvo. Kusvika parizvino, maitiro avanoshanda zvakaita seanoenderana nechepamusoro pamusana pekukwanisa kwavo kukura uye kuramba vari kushingaira mumurwere mushure mekunge vapindira zvakare.
Pfungwa yekushandisa masero mhenyu ekurapa kenza haisi itsva.
Zvidzidzo zvadzidza kubva kune zvinowanikwa nemishonga yakafanana munguva yakapfuura zvakakonzera kuwanikwa mune ruzivo rwekuti T-masero anobata sei , izvo zvakaita kuti zviwanikwe zvakawanda. Vatsvakurudzi vari kushanda mundima iyi vanonyevera kuti kuchine zvakawanda zvekudzidza nezve CAR T-cell therapy. Asi mhedzisiro yekutanga kubva kumidzo yakaita seyi yakaita kuti tive netariro.
Successes So Far
Vamwe vakafananidza rudzi urwu rwemishonga pakubatanidzwa kwemhando mbiri dzakasiyana-siyana dzokurapa: zvinorwisana nemasikirwo, sezvakaita rituximab, nechinangwa chavo; uye kenza-cell-killing-agents vane simba re cytotoxicity - zvose izvi nehuwandu hwekugara kwenguva refu kwehupenyu cytotoxic T-cells, kutarisira kuti varambe vachifamba, kutarisa kudzokorora.
Tsvakurudzo ichiri itsva, saka nyanzvi dzinokurudzira kuchenjerera, asi kuongororwa kwekliniki kwave kutotanga kushandisa CAR T-cell kurapwa mumatachiwana anotevera:
- Manyokoma akawedzerwa
- Yakawedzerwa acute lymphoblastic leukemia (ALL)
- Anoparadzira chikuru B-cell lymphoma
I-FDA yakasarudza CAR T-cell therapy kurapwa kwehutano kweHOSE. Icho chiri kuedzwa zvakare mukudzokorora uye kusavhiringidza kusina Hodgkin lymphoma, myeloma, uye chronic lymphocytic leukemia (CLL) , pamwe chete nevarwere vasina Hodgkin lymphoma uye myeloma.
Vatsvakurisi vanotarisira CAR T-cell therapy imwe zuva ichava mushonga wepamusoro weimwe B-cell malignancies yakadai seYOSE uye chronic lymphocytic leukemia. Vatsvakurudzi vari kushanda neCAR-T-cells vakaonawo rudzi urwu rwechirwere se "bhulogi" kumapfupa ekuputira marora kune VARV vose vanorega kupindura chemotherapy.
Chimwe chiedzo chakaongorora kushandiswa kweC CAR T-cells mune 15 varwere vakura, uye vazhinji vavo vakanga vawedzera zvikuru B-cell lymphoma. Kunyange zvazvo pasina mubvunzo dambudziko duku, tariro ndeyekuti vakawanda vevarwere ava vakabata neC CAR T-seli dzaive dzakaperera kana zvishoma.
Kunewo tariro iyo CAR T-cell therapy inogona kushandiswa kudzivirira kudzokera zvakare. Zvimwe zviwanikwa zvinoshanda kuti zvive netariro zvakasanganisira kuwedzera kwemasero ekurapa mushure mekunyudzwa, zvakapetwa ka1 000 pane vamwe vanhu; uye kuvapo kweC CAR T-cells mukati-kati yenheyo, "nzvimbo tsvene" apo masero emukenza ega anenge apukunyuka chemotherapy kana kuti mazaisai anokwanisa kuvanza. Mune varwere vaviri mune chirongwa cheCI-chaitungamirirwa nekurapa vana, somuenzaniso, chirwere cheC CAR t-cell chakagadziriswa kenza yakange yapararira kune nheyo yenheyo.
Migumisiro Yechiri
Apo nhamba yakawanda yejini T-seli inodzokororwazve mumurwere, aya maT-seli anosunungura maktokines akawanda. Izvi zvinogona kukonzera cytokine-release syndrome, iyo inoratidzirwa nemhepo ine ngozi uye inodonha muropa. MaCytokine maitiro emakemikari, uye cytokine-release syndrome idambudziko rinowanzoitika kune varwere vanobatwa neC CAR T-cells.
Varwere vane huwandu hwakazara hwekenza vasati vagamuchira CAR T-cells vanoita kuti vave nematambudziko akaoma e-cytokine-release syndrome. Vatsvakurudzi vanonyevera kuti pasinei nekubudirira, tsvakurudzo dzakawanda dzinotarisirwa pamberi peC CAR T-cell therapy inogona kuva inowanzosarudzwa, kune varwere vane ALL muenzaniso. Kuongorora kune vamwe varwere uye kwenguva yakareba yekutevera nguva yakadanwa uye yakatevedzwa.
PaIri Horizon
Kubva pakubudirira kusvika ikozvino, mazvikwata akawanda ekutsvakurudza munyika yose ari kutarisa kukudziridza injini dzeT-seli dzevamwe kanzira, kusanganisira zvipembenene zvakasimba sepancreatic uye kansarudzo dzepfungwa.
> Sources:
> CAR T-Cell Therapy: Injiniya Mishonga 'Immune Cells Yokurapa Yavo Cancers. http://www.cancer.gov/cancertopics/research-updates/2013/CAR-T-Cells.
> Barrett DM, Singh N, Porter DL, Grupp SA, June CH. Chimeric Antigen Receptor Therapy yeCarcer. Annu Rev Med . 2014; 65: 333-347.
> Chimeric Antigen Receptor T-Cells. http://www.lymphomation.org/programing-t-cells.htm.