Indlela i-Immunotherapy inokunceda ngayo iiNkqubo zethu zokuzikhusela nge-immune zilwa neCarcer
Ukuba uziva udidekile ngokuchanekileyo malunga nendlela yokugonywa kwe-immunotherapy isebenza ngayo ukunyanga umdlavuza, kunesizathu esihle. I-Immunotherapy ayilona uhlobo olulodwa lonyango; kunokuba kukho iintlobo ezahlukeneyo zonyango eziwela phantsi kwesi sihloko. Ukuqhelekileyo kukuba ezi zonyango zingasebenzisa isimiso somzimba, okanye imigaqo yokuphendula komzimba, ukulwa nomhlaza.
Ngamanye amazwi, ezi zonyango, ezibizwa ngokuba yi-biologic therapy, zisetyenziselwa ukuguqula umzimba womzimba okanye ukusebenzisa izinto ezenziwe ngamajoni omzimba wokulwa nomhlaza.
Kutheni i-Immunotherapy ivuyisa kangaka?
Ukuba ufunde ipapasho nje kutshanje, mhlawumbi uye wabona imiyalezo ephawulekayo njengokuthi "unyango lusondele" xa uchaza i-immunotherapy. Ngaba le nto inokuyixhaphaza, okanye ngaba yinto nje ye-media hype?
Ngethuba sisanda kuqalisa ukufunda malunga nalezi zonyango, kwaye ngokuqinisekileyo azisebenzi kuzo zonke i-cancer, intsimi ye-immunotherapy yinto enokuyithandayo. Enyanisweni, i-immunotherapy yabizwa ngokuba ngu-2016 umhlaza wesifo somhlaza we-Clinical Oncology. Kulabo abaphila nomhlaza, le ntsimi, kunye neentuthuko zonyango ezifana nezigulane ezijoliswe kuzo, zizathu zokuvakalelwa ngethemba-kungekhona nje kwikamva, kodwa namhlanje.
Ngokungafani nenkqubela phambili ye-oncology eyakhayo kunyango lwangaphambili, i-immunotherapy ininzi indlela entsha yokunyanga umdlavuza (abangaxhomekiyo abathile be-immune-modulator ezifana ne-interferon baye bajikeleza kwiminyaka embalwa). Ukuthelekiswa nezinye ezininzi unyango:
- Ezinye zezi zonyango zingasebenza kwimimandla yomhlaza (ngamanye amagama, isilwanyana singasebenza, sithi, i-melanoma nomdlavuza wamaphaphu).
- Ezinye zezo zonyango zingasebenza kwizona zihamba phambili kwaye zinzima kakhulu ukunyanga iisomhlaza (umzekelo, zingaphumelela kumdlavuza ezifana nomhlaza wesifo somdlavuza wamaphaphu okanye umdlavuza wamaphakreti).
- Kwezinye iimeko, iziphumo zihlala zihlala-zeziphi i-oncologists zibhekisela "njengempendulo ehlala njalo." Uninzi lwemithi yomhlaza lwezondo eziqinileyo, ezifana ne-chemotherapy kunye neziyobisi ezijolise kwiinguqu ezithile zentsholongwane kumaseli omhlaza, zilinganiselwe; Iiseli zomhlaza ekugqibeleni zinokumelana nonyango. Nangona kungekho mntu uyazama ukukrazula igama elithi "unyango" okwamanje, kukho ithemba lokuba kumncinci wabantu abanamanye iintlobo zamanomdla-nanto-la mayeza anganika ithuba lokulawula ixesha elide lomhlaza wabo.
Imbali ye-Immunotherapy
Ingqiqo ye-immunotherapy iye yahlala ijikeleze ixesha elide. Kwinkulungwane edlulileyo, udokotela owaziwa njengoWilliam UColey waphawula ukuba ezinye izigulane, xa zitheleleke ngebhakteria, zabonakala zilwa neekhansela zazo. Omnye ugqirha ogama linguSteven Rosenberg uthiwa kubuza imibuzo malunga neemeko ezahlukeneyo zomhlaza. Ngezihlandlo ezingaqhelekanga, umdlavuza usenokuphuma ngaphandle kwonyango. Ukuxolelwa ngokukhawuleza okanye ukunyanzeliswa komhlaza kuye kwaqulunqwa, nangona kuyinto engavamile kakhulu.
Ingqungquthela kaDkt Rosenberg kukuba isistim somzimba sakhe somzimba sasihlasele kwaye sawukhupha umhlaza.
Iingcamango Ezingemva kwe-Immunotherapy
Inyiyo ye-immunotherapy kukuba amasosha omzimba wethu sele esazi indlela yokulwa nomhlaza. Njengoko imizimba yethu iyakwazi ukuchonga, ityhafile, kwaye iphakame iimpendulo zokuzivikela ngamagciwane kunye neentsholongwane ezihlasela imizimba yethu, iiseli zomhlaza zingasetyenzwa njengezinto ezingavamile kwaye zisuswe ngumzimba wokuzivikela.
Emva koko Kutheni IziNkqubo Zethu Zokuzikhusela Zisayi Kulwa NamaKhansela?
Ukufunda malunga nendlela yokwenza izidakamizwa ze-immunotherapy ibuza umbuzo: "Ukuba amasosha omzimba ethu ayazi njani ukulwa nomhlaza, kutheni?
Kufika njani omnye amadoda amabini nomnye kwabafazi abathathu ukuba bahlakulele umhlaza ngexesha lokuphila kwabo? "
Okokuqala, amasosha omzimba ethu asebenza ngokugqithiseleyo kwinkqubo yokucoca iiseli ezonakaliswe ekugqibeleni zibe ngamaseli omhlaza. Sineendiza eziliqela ezakhiwe kwi-DNA yethu, eyaziwa ngokuba yi- tumor suppressor genes , ezibonelela ngeproteins ezilungisa kunye nokulahla umzimba weeseli ezilimele. Mhlawumbi umbuzo ongcono unokuthi, "kutheni sonke singaba nomdlavuza rhoqo?"
Akukho mntu uyazi kakuhle ukuba kutheni amanye amangqamuzana omhlaza angabonwa kwaye atshabalaliswe ngumzimba womzimba. Ingxenye yesizathu, kucingelwa, kukuba iiseli zomhlaza zingaba nzima ukujonga ngaphezu kweibhaktheriya okanye iintsholongwane ngenxa yokuba zivela kwiiseli ezijongwa njengesiqhelo ngamasosha omzimba wethu. Amaseli omzimba ayenzelwe ukwahlula into abayibona njengeyakho okanye engeyena, kwaye ekubeni iiseli zomhlaza zivela kwiiseli eziqhelekileyo emizimbeni yethu, zinokuthi zitshatye ngokuqhelekileyo. Umthamo omkhulu weeseli zomhlaza unokudlala indima, kunye nenani lomhlaza weselondazi esiqhaqhaqhaqha amandla okuncinci kwenani le-immune.
Kodwa isizathu sinokuba sisisigxina kunokuba siqaphele okanye manani-okanye ubuncinci, iiseli zomhlaza zithintela. Ngokuqhelekileyo iiseli zomhlaza ziphuma kumzimba wokuzivikela ngokuthi "zizenza ngathi" zibukeka njengeeseli eziqhelekileyo. Ezinye iiseli zomhlaza ziye zacinga iindlela zokuziguqula, ukufaka imaski ukuba uthanda. Ngokufihla ngale ndlela bangakwazi ukusinda ekufumaneni. Enyanisweni, uhlobo oluthile lweziyobisi ze-immunotherapy lusebenza ngokusususa imaski kwiiseli zesisu.
Njengengxelo yokugqibela, kubalulekile ukuba uqaphele ukuba isimiso somzimba sokuzivikela sinexabiso elihle lokuhlola kunye nezilinganiso. Kwelinye icala kubalulekile ukulwa nabahlaseli bamanye amazwe. Ngakolunye uhlangothi, asifuni ukulwa namaseli emizimbeni yethu, kwaye eqinisweni, izifo ezizimele njenge-rheumatoid arthritis zihlobene "nesistim somzimba esipheleleyo."
Imida ye-Immunotherapy
Njengoko ufunda, kubalulekile ukuqaphela ezinye zeemingcele ze-immunotherapy kweli nqanaba lophuhliso. Omnye we-oncologist uthethe ngale ndlela: i-immunotherapy yonyango lomhlaza njengoko abazalwana baseWright baqala ukuhamba ngeenqwelo. Intsimi ye-immunotherapy isekwenzeni.
Siyazi ukuba ezi zonyango azisebenzi kuwo wonke umntu, okanye nangona uninzi lwabantu abanomdlavuza. Ukongezelela, asinaso isibonakaliso esicacileyo sokuba ngubani oya kuzuza ngokufanelekileyo kwezi zi yobisi. Ukukhangela i-biomarkers, okanye ezinye iindlela zokuphendula lo mbuzo, yindawo esebenzayo yophando ngeli xesha.
Ukuhlaziywa okufutshane kweSistim yoKhuselo kunye neCarcer
Ukuqonda okufutshane malunga nendlela ezi zonyango zisebenza ngayo, kunokuba luncedo ukuphonononga ngokufutshane indlela inkqubo yokuzivikela ngayo yokulwa nomhlaza. Amasosha ethu omzimba ayenziwe ngamaseli egazi ezimhlophe kunye nezicubu zenkqubo ye-lymphatic ezifana ne-lymph nodes. Nangona kukho iintlobo ezininzi ezahlukeneyo zeeseli kwakunye neendlela zamathambo ezenza ukuba kususwe iiseli zomhlaza, "izibhamu ezinkulu" kumdla wokulwa zi- T-cell (i-T lymphocyte) kunye neeseli zombulali zendalo . Esi sikhokelo esipheleleyo sokuqonda umzimba wokhuseleko lomzimba unikeza ingxoxo ejulile yezinto ezisiseko zokuphendula ngomzimba.
Indlela Yomzimba Yokulwa Nomzimba Ilwa Nomhlaza?
Ukuze silwe namaseli esifo somhlaza, kukho imisebenzi emininzi yokuzivikela ekufuneka iyenze. Ngokulula, ezi ziquka:
- Ukuqwalaselwa: I-immune system kuqala ifuna ukufumana nokuchonga amaseli omhlaza. Amaseli ethu omzimba kufuneka ahlolisise zonke iiseli eziphakathi kwazo kwaye akwazi ukubona amangqamuzana omhlaza njengengewona. Ukufanisa kwakuza kuba ngumsebenzi wehlathi ohamba ehlathini efuna imithi ebulawayo.
- Ukumakisha: Xa sele kufunyenwe, isistim somzimba sethu sokuzivikela kufuneka simakishe okanye sibhale iileli zesifo somhlaza. Ukulandela ukufanekisa, umqeshwa wehlathi kufuneka ngoko kufuneka athathwe okanye atyathele imithi echaphazelekayo kunye nopende lwe-orange.
- Ukubonakalisa: Emva kokuba amaseli omhlaza aphawulwe, amaseli ethu omzimba kufuneka ahlasele i-alamu, atyelele amangqamuzana omzimba omelana nomhlaza kummandla apho ufunyenwe khona. Ukuqhubeka nomfanekiso, umqeshwa wehlathi kufuneka abuyele eofisini kunye nefowuni, itekisi, kunye ne-imeyile inkonzo yomthi ukuba ifike kwaye isuse imithi ebhubhane.
- Ukulwa: Emva kokuba iiseli zomhlaza ziqatshelwa kwaye ziphawulwe, kwaye iiseli ze-immune ziphendule kwi-alamu kwaye zafudukela kwindawo leyo, ii-cell ze-cytotoxic kunye neeseli zombulali zendalo zihlasela kwaye zisusa amangqamuzana omhlaza emzimbeni. Ekugqibeleni, ngomzobo, abasebenzi benkonzo yomthi baya kunqumla kwaye basuse imithi ebhubhane.
Eli nqaku malunga nendlela amaseli e-T asebenza ngayo ukulwa nomhlaza ichaza inkqubo eyenziwa ngayo la ma nyathelo, kwaye eli nqaku malunga nomjikelezo wokukhuselwa ngumhlaza unika imifanekiso yamanyathelo athile.
Iisetyana zeCanscer zifihla njani kwiNkqubo yoKhuselo?
Kunokukunceda ukwazi ukuba iiseli zomhlaza zihlala zikwazi njani ukuphepha okanye ukuhlaselwa ngamajoni ethu omzimba. Iiseli zomhlaza zingafihla ngoku:
- Ukunciphisa ukubonakaliswa kwama-antigens kumgangatho weeseli. Oku kuya kufana nemithi yokususa iimpawu zesifo sabo kumasebe okanye kumacembe awo.
- Ukubonakalisa izinto phezu kweseli engacwangcisi isistim somzimba. Iiseli zomhlaza zingenza iimfomula eziphazamise ukuphendula komzimba. Ngokufana, imithi iya kwenza into ekuxosheni abasebenzi basehlathini kunye nenkonzo yomthi.
- Iiseli zengqumbo zingabangela ukuba iiselula ezingekho komhlaza zenze i-secrete izinto ezinciphisa ukusebenza kwe-immune system. Le ndlela ibhekiswa kuyo njengokutshintsha i-microenvironment, indawo ejikeleze iiseli zomhlaza. Ukutshintshisa ukufana, imithi ebhubhane yayiza kubangela ukuba i-ferns kunye ne-lilacs bajoyine ukuze bancedise ukuba abasebenzi behlathi bangabikho.
Ukuba udidekile malunga nolunye ulwahlulo phakathi kweeseli zomhlaza, kwaye yintoni eyenza amangqamuzana omhlaza ahlukile, amanqaku alandelayo achaza ukuba yintoni eyenza iseli ngumhlaza weselfowuni , kunye nokwahlukana phakathi kweeseli zomhlaza kunye neeseli eziqhelekileyo .
Iintlobo kunye neendlela ze-Immunotherapy
Usenokuva ukuxilongwa kwe-immunotherapy echazwe njengonyango "olukhuthaza" umzimba wokhuseleko lomzimba. Ezi zonyango ziyinkimbinkimbi kunokuba nje ukunika amandla omzimba amandla. Makhe sibone ezinye zeendlela ezisebenza ngayo, kunye neentlobo zonyango ezisetyenziswayo okanye ezifundiswayo namhlanje.
Iinkqubo ze-Immunotherapy
Ezinye iinkqubo ezenziwa ngamayeza omzimba angaphatha umhlaza ziquka:
- Ukunceda amajoni omzimba aqonde umhlaza
- Ukuvuselela kunye nokwandisa amaseli omzimba
- Ukungena kwi-cell cell's ability to hide (de-masking)
- Ukungena kwi-microenvironment yeeseli zomhlaza ngokuguqula umqondiso wesifo somhlaza
- Ukusebenzisa imigaqo yamasosha ethu omzimba njengetemplate yokuyila umhlaza wegciwane
Iintlobo ze-Immunotherapy
Izindlela ze-Immunotherapy ezivunyiweyo okanye ezivavanywayo kwiimvavanyo zeclini ziquka:
- I-antioclonal antibodies
- Inhibitors yokuHlola
- Iigcini zegciwane
- Izithintelo zetekisi ezisetyenziswayo ezifana ne-CAR T-cell yonyango
- Ii-oncolytic virus
- IiCytokines
- I-adjuvant immunotherapy
Kubalulekile ukuba uqaphele ukuba kukho ukuphahlazeka okukhulu phakathi kwezi zonyango. Ngokomzekelo, iyeza elisebenzisiweyo njenge-inhibitor ye-checkpoint inokuthi i-antibody monoclonal.
Antioclonal Antibodies (IiNtsholongwane zonyango)
Ama-antibodies aseMonoclonal asebenza ngokwenza amangqamuzana omhlaza ajoliswe kuwo kwaye asetyenziswe ixesha elithile, ngokukodwa kwii-cancer ezifana neentlobo ze-lymphoma.
Xa amajoni ethu omzimba adibanisa neibhaktheriya kunye neentsholongwane, imiyalezo ithunyelwa ebangela ukuveliswa kwama-antibodies. Emva koko, ukuba umtshayeli ofanayo uya kubonisa kwakhona, umzimba ulungele. Ukugonywa okunjengomkhuhlane wokuguqula umsebenzi ngokubonisa indlela yokuzivikela yintsholongwane yokubulala igciwane lesifo (intshutshiso) okanye igciwane lesifo esingenasifo (i-spray).
Amagciwane omzimba okanye asemanyeni asebenza ngendlela efanayo kodwa endaweni yoko "yenziwe ngabantu" ngamagciwane okujoliswe ekuhlaseleni amangqamuzana omhlaza kunokuba ama-microorganisms. Ama-antibodies afakwe kwii-antigens (iiprotheni markers) kumphezulu wamaseli omhlaza, njengesihluthulelo kuya kufakwa kwi-lock. Emva kokuba iiseli zomhlaza ziphawulwe okanye zifakiwe, ezinye iiseli kumajoni omzimba zikwaziswa ngokutshabalalisa iseli. Unokucinga ngamagciwane e-monoclonal afana nepeyinti ye-orange spray ongayibona emthini ogulayo. Ilebula ngumqondiso wokuthi iseli (okanye umthi) kufuneka isuswe.
Olunye uhlobo lwe-anti-monoglonal antibody lungasetyenziselwa ukudibanisa ne-antigen kumgca wesifo somhlaza ukuze uvimbele uphawu lokukhula ekufumaneni ukufikelela. Kule meko, kuya kuba njengokubeka isitshixo kwiskhiya, ukuze enye ikhiye-uphawu lokukhula-alukwazi ukuxhuma. Amachiza e-Erbitux (cetuximab) kunye neVectibix (panitumumab) esebenza ngokudibanisa kunye nokuvimbela i-EFGR receptor (i-antigen) kumaseli omhlaza. Ekubeni i-receptor ye-EGFR "ivinjiwe" uphawu lokukhula alukwazi ukuxhoma kunye nokuxelela iseli lomhlaza ukuba luhlukane kwaye lukhule.
I-anti-monoplonal antibody esetyenziswe ngokubanzi yiyeza lymphoma iRituxan (rituximab). Ezi zikhuhlane zibophelela kwi-antigen ebizwa ngokuba yi- CD20-uphawu lwe-tumor efunyenwe kwi-B lymphocyte yomhlaza kwi-B cell lymphomas.
Amanqamzana e-Monoclonal okwangoku avunyelwe amaninzi emdlavuza. Imizekelo ibandakanya:
- Avastin (bevacizumab)
- Herceptin (trastuzumab)
- Rituxan (rituximab)
- Vectibix (panitumumab)
- Erbitux (ceuximab)
- Gazyva (obinutuzumab)
Olunye uhlobo lwe-anti-monoglonal antibody luyi-antipecific antibody. Ezi ziqhwala zibophelwa kuma-antigen ahlukeneyo. Elinye iteksi yeseli yomhlaza kwaye enye isebenza ukufumana isitr eT kunye nokuzisa ezo zibini. Umzekelo nguBlincyto (blinatumomab).
I-Conjugated Antioclonal Antibodies
Ama-antibodies angama-monoclonal angaphezu komsebenzi wodwa, kodwa izixhobo ezinokuthi zidibene nazo zinokuqhotyosheliswa kwiziyobisi zamakhemikhali, into enetyhefu okanye i-particle radioactive kwindlela yokwelapha ebizwa ngokuthi i- conjugated antibolonal antibodies . Igama elithi conjugated lithetha "uqhotyoshelweyo." Kule meko, "inkokhelo" ihanjiswa ngokuthe ngqo kwiseli yomhlaza. Ngokuba nomntu olwa nxamnye ne-antigen kumgca wesifo somhlaza kwaye ahambise "utyhefu" (izidakamizwa, i-toxin okanye i-particle reactive) ngqo kumthombo, kunokungabonakali kancinci kwizicubu ezinempilo. Amanye amayeza kuloluhlu olwamkelwe yi-FDA lubandakanya:
- I-Kadcyla (ado-trastuzumab): ngu-anti-monoclonal antibody oqhotyoshelwe kwisikr
- I-Adcetris (i-brentuximab vedotin ): le nyi-antibody ifakwe kwisizabisi se-chemotherapy
- I-Zevalin (ibritumomab tiuxetan): le nqununu iqhotyoshelwe kwi-particle ye-radioactive
- Ontak ( denileukin i-difitox ): eli liyeza lidibanisa i-antioclonal antibody kunye ne-toxin evela kwibhaktheriya ebangela i-diphtheria
I-Immune Checkpoint Inhibitors
I-immune checkpoint inhibitors isebenza ngokuthatha amabhuleki kwisistim somzimba.
Njengoko kuphawuliwe ngasentla, i-immune system ihlola kunye nezilinganiso ukwenzela ukuba ingaphelelanga okanye ingaphantsi. Ukuze uyigcine kwi-overperforming-kwaye ibangele izifo ezizimelayo-zikhona iziphawuliso zokungasebenzi ezikufutshane nomzila wokuzivikela omzimba olawulwayo, nje ngeebhuleki zisetyenziselwa ukunciphisa okanye ukuyeka imoto.
Njengoko kuphawuliwe ngasentla, amangqamuzana omhlaza angamaqhinga aze akhohlise isistim somzimba. Enye indlela abenza ngayo ngeproteni. Iiprotheni ze-Checkpoint zizinto ezisetyenziselwa ukunqanda okanye ukunciphisa umzimba. Ekubeni iiseli zomhlaza zivela kwiiseli eziqhelekileyo, zinako ukwenza ezi proteins kodwa zizisebenzise ngendlela engavamile yokubalekela ukufunyanwa ngumzimba womzimba. I-PD-L1 kunye ne-CTLA4 ziyi-protein ezithengiswayo kwinani lamaninzi lomdlavuza Ngamanye amazwi, ezinye iiseli zomhlaza zifumana indlela yokusebenzisa "iiprotheni eziqhelekileyo" ngendlela engavamile; Ngokungafani nentombazana enokuthi inokuthotyelwa kwinqwelo yeemoto, ezi proteyini zibeka unyawo oluhamba phambili kwiibhuleki zamasosha omzimba.
Imithi ebizwa ngokuba yi-checkpoint inhibitors ingazibopha ngeeprotheni ezinjenge-PD-L1, ngokukhawuleza zikhulule iibhuleki, ngoko ke isistim somzimba singakwazi ukubuyela emsebenzini kwaye silwe namaseli omhlaza.
Imizekelo ye-inhibitors yokubhekisisa esetyenziswayo iquka:
- Opdivo (nivolumab)
- I-Keytruda (pembrolizumab)
- Yervoy (ipilimumab)
Uphando ngoku lujonge kwiingenelo zokudibanisa ezimbini okanye ngaphezulu izidakamizwa kule candelo. Umzekelo, ukusebenzisa i-PD-1 kunye ne-CTLA-4 inhibitors kunye (i-Opdivo ne-Yervoy) ibonisa isithembiso.
UkuTshintshiselwa kweSeli kunye neCAR T-cell Therapy
Isalathisi esithathayo kunye neendlela ze-CAR ze-T-cell zindlela zokuzikhusela i-immunotherapy ezomeleza izixhobo zethu zokuzivikela. Ngokulula, zijika iiseli zethu zokulwa nomhlaza zibe ngabadlali abakhulu ngokunyusa amandla abo okulwa okanye iinombolo zabo.
Ukutshintshwa kweSeli
Njengoko kuphawuliwe kwangaphambili, esinye sezizathu zokuzivikela iintsholongwane zethu zokuzikhusela komzimba akuzilwisanga nezicubu ezinkulu kukuba ziphelile kwaye zininzi. Njengomfanekiso, usenokucinga ukuba unamajoni ama-10 kwimida yangaphambili echasene nekhulu lamaqela abachasi (iseli zomhlaza). Ezi zonyango zixhaphaza izenzo zokulwa zamajoni kodwa zongeza amanye amasosha kumgca wangaphambili.
Ngaloo unyango, oogqirha baqala ukususa iiseli zakho ze-T ezivela kwingingqi ejikeleze i-tumor yakho. Xa sele iqokelelwa iiseli zakho ze-T, zikhulile kwibrabhu (kwaye isebenze nge-cytokines). Emva kokuba zandiswe ngokukhawuleza, zibuyiswa kwakhona emzimbeni wakho. Olu unyango luye lwaphumela ekunyangeni kwabanye abantu abane-melanoma.
I-T cell yesifo se-CAR
Ukuqhubela phambili nomfanekiso wezimoto ezivela ngasentla, i- CAR ye-T cell itrapha ingacingelwa njengendlela yokuzivikela ngomzimba. I-CAR imele i-receptor yamerican antigen. I-Chimericli igama elibhekisela ekuthiwa "bahlangene ndawonye." Kule nyango, i-antibody idibene kunye (iqhotyoshelweyo) kwi-T-cell receptor.
Njengoko kunye nokutshintshwa kweeseli ezithathayo, i-T-cell ukusuka kummandla wesifo sakho sehlamba iqokelelwa kuqala. Ii-T zakho zeeseli ziguqulwa ukubonisa iprotheni ebizwa ngokuba yi-receptor ye-anti-regen okanye i-CAR. Lo mkamkeli kwii-T-cell uvumela ukuba banamathele kuma-receptors kummandla wamaseli omhlaza ukuba abatshabalalise. Ngamanye amagama, incedisa i-T-cell yakho ekuqapheliseni iiseli zomhlaza.
Azikho iipilisi ze-CAR T-cell ezivunyiweyo, kodwa zivavanywa kwizilingo zesikliniki kunye neziphumo ezikhuthazayo, ngokukodwa malunga ne-leukemia kunye ne-melanoma.
Unyango lweNtsholongwane
Iigcini zentsholongwane zegciwane zigonywayo ezisebenza ngokusesikweni ngokumelana nomzimba womzimba nomdlavuza. Unokuva ngeentlovinya ezinokukunceda ukukhusela umdlavuza, njenge-hepatitis B ne-HPV, kodwa izitofu zonyango zonyango zisetyenziselwa injongo ehlukile-ukuhlaselwa ngumhlaza osele ukhona.
Xa ugonywe, tshela, i-tetanus, isistim somzimba sakho saso sichazwe kwisixa esincinci seTetanus ebulawe. Xa ubona oku, umzimba wakho uyayibona njengento yangaphandle, uyifake kwi- B-cell (B-lymphocyte) eyenza ivelise izifo. Ukuba uphinde ubonakaliswe kwi-tetanus, njengokungathi uhamba ngesilumko esinomkhuhlane, isistim sakho somzimba sithandwa kwaye silungele ukuhlaselwa.
Kukho iindlela ezimbalwa apho ezi zitofu ziveliswa khona. Iigcini zentsholongwane zingenziwa ngokusebenzisa iiseli zesisu, okanye izinto eziveliswa ngama-tumor cells.
Umzekelo wesitofu somhlaza wonyango osetyenziswe eUnited States yiMpahla (i-spuleucel-T) yomhlaza wesibeletho. Iigcini zentsholongwane zonyango zihlolwe iindiza ezinomdlavuza, kunye nokukhusela ukuphindaphinda komdlavuza webele.
Ngomdlavuza wamaphaphu, izitofu ezimbini ezihlukeneyo, i-CIMAvax EGF kunye ne-Vaxina (racotumomab-alum), sele ifundiswe eCuba ngenxa yomhlaza wesifo somhlaza wamangqamuzana. Ezi zitofu, ezithe zafunyanwa ukwandisa ukuqhubekeka kokuhamba-nkululeko kwabanye abantu abanomdlavuza wesifo samangqamu omncinane , baqala ukufundiswa eMelika. Ezi zitofu zisebenza ngokufumana i-immune system ukwenza i-antibodies malunga ne-epidermal growth receptors (EGFR). I-EGFR yiprotheyini ephezulu yeeseli ezixhalabisayo kwabanye abantu abanomdlavuza wamaphaphu.
IIvolytic Virus
Ukusetyenziswa kweevolytic virus kuhanjiswe ngokufanayo ngokuthi "i-dynamite yamaseli omhlaza." Xa sicinga ngeentsholongwane, sisoloko sicinga into embi. Iintsholongwane ezifana nebandayo ezifayo zichaphazela iiseli zethu ngokungena kwiiseli, zanda, kwaye ekugqibeleni zenze ukuba iiseli ziqhume.
Ii-virus ze-oncolytic zisetyenziselwa "ukuthelela" iiseli zomhlaza. Ezi zonyango zibonakala zisebenza ngeendlela ezimbalwa. Bangena iseli somhlaza, bandise kwaye bangela ukuba iseli iqhume, kodwa kwakhona ikhulule ama-antigen egazini ekhangele iisensi ezininzi ze-immune ukuba zize zihlasele.
Akukho naluphi uhlobo lwezonyango lwe-oncolytic virus oluye lwavunywa e-United States, kodwa luye lwafundwa kwizilingo zeekliniki ezininzi zamanomdlavuza.
IiCytokines (i-Immune System Modulators)
Iimodyuli zezixhobo zomshosha-mzimba zihlobo lwe-immunotherapy oluye lwafumaneka iminyaka emininzi. Ezi zonyango zibhekiselwe "njenge-immunotherapy engeyiyo." Ngamanye amagama, basebenza ukuze bancede amajoni omzimba alwe naluphi na umhlaseli, kuquka nomhlaza. Ezi zixhobo ze-immunoregulatory- cytokines- kuquka i-interleukines (ILs) kunye nee-interferon (i-IFNs) zigxininisa amandla omzimba omzimba ukulwa nomhlaza.
Imizekelo ibandakanya i-IL-2 kunye ne-IFN-alpha esebenzisa umhlaza wesifo kunye ne-melanomas phakathi kwamanye amagciwane.
Adjuvant Immunotherapy
I-BCG yindlela enye ye-adjuvant immunotherapy okwangoku ivunyiwe ukunyanga umdlavuza. I-BCG imele iBillill Calmette-Guerin kwaye isitofu esasetyenziswa kwezinye iindawo zehlabathi ukukhusela isifo sofuba. Ingasetyenziselwa ukuphatha umhlaza wesisu. Isitofu sokugonya, endaweni yokunikezelwa njengogonyo, kunokuba ijojowe kwi-bladder. Kwi-bladder, isitofu sokugonywa sivelisa impendulo engabonakaliyo enceda ukulwa nomhlaza.
Imiphumela
Enye yeethemba kuye kwaba, ngokuba imithi yesifo se-immunotherapy ngokubhekiselele, ukuba ezi zonyango ziza kuba nemiphumo embalwa kunezidakamizwa zendalo. Njengazo zonke izifo zonyango, nangona kunjalo, imishanguzo ye-immunotherapy ingabangela ukuphendula okungathandekiyo, eyahlukahluka kuxhomekeke kwinqanaba le-immunotherapy kunye nemichiza ethile. Enyanisweni, enye yeendlela ezi zichazwe ngayo "nantoni na nge-itis" - "itis" iyona nto isichazela ukutshitshisa.
Ngelixa elizayo
Intsimi ye-immunotherapy iyavuya, kodwa sinokuningi okunokuyifunda. Ngombulelo, ubuninzi bexesha elithathayo ukuthatha le zonyango zonyango ukuba zisetyenziselwe abantu abanomhlaza uya kuphucula, kanti ekudlulileyo kwakukho ixesha elide phakathi kokufunyanwa kweziyobisi kunye nexesha elisetyenziselwa ukliniki. Ngamachiza afana nalawa, apho izidakamizwa ziphuhliswa zikhangela imiba ethile kwimpilo yonyango, ukuba ixesha lokuphucula lidla ngokukhawuleza.
Ngaloo ndlela, ukusetyenziswa kwezilingo zeklinikhi kuya kutshintsha. Kwixesha elidlulileyo, izilingo zesigaba 1-izilingo zokuqala apho isilwanyana esitsha savavanywa kubantu-zazibhekwa njengengakumbi "yomgudu wokugqibela". Ziye zenzelwe ngakumbi njengendlela yokuphucula unyango lwezonyango kulabo beza kwixesha elizayo kunokuba umntu uthatha inxaxheba kwilingo. Ngoku ezi zilingo ezinjalo zingabanika abantu ithuba elilodwa lokuhlala nesifo sabo. Thatha umzuzwana ukuba ufunde kabanzi malunga nezilingo zamachiza , kunye nendlela abantu abafumana ngayo izilingo zamachiza ngomhlaza .
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