Ulwaphulo olutsha luvelisa iimpendulo ezimangalisayo kwiimvavanyo zokuqala
Eyaziwa ngokusemthethweni njenge-transfer transfer cell (ACT), le yonyango olutsha olubandakanya ubunjineli izilwanyana zegciwane ukuze ziqaphele kwaye zihlasele iiseli zazo zentlungu. Nangona olu hlobo lonyango okwangoku luzama kwaye lunqunyelwe ukuvavanywa kwamancinci ambalwa kancinci, luye lwabonisa iimpendulo eziphawulekayo kwizigulane ezinomhlaza ophezulu.
Ingaba isebenza kanjani
I-T-cell, uhlobo lweeseli ze-immune, zikhoyo kunye nama-receptors phezu komhlaba, ezibizwa ngokuba yi-T-cell receptors, okanye i-TCRs. Ngokuqhelekileyo ezi TCR zibophelela kuma-antigen ukuze zikhuphe iimpendulo zomzimba. Ngomzamo wokusebenzisa i-T-seli ngomhlaza wonyango, ii-T-seli ziqokelelwa kwigazi lomguli. Emva koko, kwi-laboratory, i-T-cell iguqulwa ukuvelisa i-receptors ekhethekileyo phezu komhlaba ebizwa ngokuthi i-chimeric antigen receptors, okanye i-CAR, ezikwazi ukubopha kwiiprotheni ezithile zomhlaba zamaseli athile omhlaza.
Iilwimi ze-CAR T-cell zivunwa ebhodini kwaye zivunyelwe ukwandisa amanani abo de kubekho iibhiliyoni zazo. Emva kokuguqulwa nokuvuna, ezi T-cell, ezikhoyo ngeCAR ezikwazi ukubona nokubulala amaseli omhlaza, ziphinda ziphindwe kwisigulane.
Ezi zi-CAR ziyi-proteins ezivumela i-T-seli zibone iprotheni ethile, okanye i-antigen, kwiiseli zesisu.
Iilwimi ze-CAR T-cell zikhulile ebhodini kwaye zivunyelwe ukwandisa amanani abo de kubekho iibhiliyoni zazo. Kuze kube ngoku, indlela esebenzayo ngayo ibonakala ixhomekeka ubuncinci kwinqanaba lokukwazi ukukhula kwaye lihlale likhuthele kwisigulane emva kokungena ngaphakathi.
Iingcamango zokusebenzisa iiseli eziphilayo ukunyanga umdlavuza empeleni azilutsha.
Izifundo ezifunyenwe kwiziphumo zonyango ezifanayo kwixesha elidlulileyo zakhokelela ekuzuzeni ulwazi malunga nendlela i-T cell isebenza ngayo , eyabangela ukufumana okungakumbi. Abaphandi abasebenza kule ndawo bayalumkisa ukuba kusekho into eninzi yokufunda malunga ne-CAR T-cell. Kodwa iziphumo zakuqala ezivela kwizilingo ezinjengezi zinto ziye zavelisa kakhulu ithemba.
Impumelelo kakhulu
Abanye baye bafanisa olu hlobo lonyango ekuhlanganiseni iintlobo ezimbini zokwahlula: izixhobo ezijoliswe kuzo, njenge-rituximab, kunye neenkcukacha zabo zobuntu; kunye ne-cancer-cell-kill-agents ephethe amandla e- cytotoxicity- konke oku kunye nexesha elide elikhoyo lokuphila kwe-T-cell cells, ekubeni nethemba lokuhlala, ukujonga ukuphindaphinda.
Uphando lusemtsha kakhulu, ngoko ke iingcali zikhuthaza ukuba ziqaphele, kodwa izilingo zekliniki sele ziqalise ukusebenzisa i-CAR T-cell treatra elandelayo:
- I-melanoma ephezulu
- I-acute lymphoblastic leukemia (ALL)
- Ukuhambisa i-cell-cell lymphoma enkulu
I-FDA inyule i-CAR T-cell yonyango unyango lophuhliso lwawo wonke. Kuye kwavavanywa kwakhona kwi-relapsed kunye ne-refractical non-Hodgkin lymphoma, i-myeloma, kunye ne-lymphocytic leukemia (CLL) engapheliyo , kunye nezigulane ezingekho nge-Hodgkin lymphoma kunye ne-myeloma.
Abaphandi bathemba ukuba i-CAR T-cell yonyango iya kuthi ibe lunye unyango oluqhelekileyo lwezilwanyana ezithile zeB-cell ezifana ne-ALL and chronic lymphocytic leukemia. Abaphandi abasebenza kunye neCAR-T-seli baye bafumanisa olu hlobo lonyango njengelithi "ibhuloho" ekutshintsheni komongo we-ALL bone patients abayeka ukuphendula kwi-chemotherapy.
Esinye isilingo sahlola ukusetyenziswa kwee-CAR T-cell kwiigulane ezingama-15 zabantu abadala, kwaye ezininzi zazo zaziqhubekile zihamba nge-B-cell lymphoma. Nangona ngokuqinisekileyo yayingumlingo omncinci, ithemba livela kwinto yokuba ezininzi zezi gulane ziphathwa nge-CAR T-seli zineempendulo ezipheleleyo okanye ezikhethiweyo.
Kukho nethemba lokuba i-CAR T-cell yonyango ingasetyenziselwa ukuthintela ukubuyela kwakhona. Ezinye iziphumo ezenza ukuba nethemba libandakanya ukwandiswa kweeseli zonyango emva kokungcoliswa, ngokuphindaphindiweyo kumawaka angama-1000; kunye nobukho be-CAR T-cell kwi-system ye-nervous system, "indawo engcwele" apho iiseli zomhlaza zodwa eziye zasinda kwi-chemotherapy okanye i-radiation zifihla. Kwizigulane ezimbini kwiilingo ze-NCI ezikhokelwa ngamathambo, ngokomzekelo, unyango lweC-T olususwe ngumhlaza oye lwasasazeka kwinkqubo yesantya.
Imiphumela
Xa inani elikhulu lee-T-cell livuselelwa kwisigulane, ezi T-cell zikhulula i-cytokines ngexabiso elikhulu. Oku kunokubangela i-cytokine-release release, ebonakaliswa yimfiva ephakamileyo engozini kwaye iphonsela kwixinzelelo legazi. Iicytokines zibonakaliso zamakhemikhali, kunye ne-cytokine-release release syndrome yingxaki eqhelekileyo kwizigulane eziphathwe nge-CAR T-cell.
Izigulane ezinokubandakanya kakhulu umhlaza ngaphambi kokufumana i-CAR T-cell zibonakala ziba neemeko ezinzima ze-cytokine-release release. Abaphandi baqaphele ukuba nangona kukho impumelelo, kufuna uphando olungakumbi ngaphambi kokuba unyango lwe-CAR T-cell lube yinto eqhelekileyo, kwizigulane ezine-ALL. Izifundo ngezigulane ezininzi kunye nexesha elide lokulandelelana liye labizelwa kwaye lilandelwa.
Kulo
Ngokusekelwe kwimpumelelo ngoku, amaqela amaninzi ephandeleleyo kweli lizwe aphendulela ekuphuhliseni i-T-cell injini zezinye i-Cancer, ezibandakanya izicubu ezinzima ezifana ne-pancreatic and brain cancer.
> Imithombo:
> I-CAR T-Cell Ionyango: Ubunjineli Izilwanyana ze-Immune ze-Immune cells zokuphatha ii-Cancers zazo. http://www.cancer.gov/cancertopics/research-updates/2013/CAR-T- Izixhobo.
> Barrett DM, Singh N, Porter DL, Grupp SA, Juni CH. I-Anti-Acne Acceptor Acceptor yeCarcer. Annu Rev Med . 2014; 65: 333-347.
> I-Chimeric Antigen I-T-cells. http://www.lymphomation.org/programing-t-cells.htm.