Therapy e ncha e hlahisa likarabo tse hlaheletseng litsing tsa pele
Ka mokhoa o tloaelehileng o tsejoang e le ho fetisetsa cell cell (ACT), ena ke phekolo e ncha e akarelletsang ho ingolla lisele tsa 'mele tsa bakuli hore li lemohe le ho hlasela lisele tsa bona tse hlabang. Le hoja mofuta ona oa phekolo o ntse o lekoa 'me o thibetsoe litekong tse seng kae tsa meriana ho fihlela joale, o bontšitse likarabo tse tsotehang ho bakuli ba nang le kankere e tsoetseng pele.
Kamoo e Sebetsang Kateng
T-cell, mofuta oa sele ea 'mele ea ho itšireletsa mafung, e teng ka li-receptors holim'a tsona, tse bitsoang T-cell receptors, kapa TCRs. Ka tloaelo tsena TCRs li tlama likokoana-hloko ho etsa hore ho be le karabo ea 'mele ea ho itšireletsa mafung. Ka boiteko ba ho sebelisa lisele tsa T bakeng sa phekolo ea kankere, lisele tsa T li bokelloa ho tsoa mali a mokuli. Joale, laboratory, li-T-cell li fetotsoe ho hlahisa li-receptor tse khethehileng holim'a metsi a tsona a bitsoang chimeric antigen receptors, kapa li CAR, tse khonang ho khomarela liprotheine tse itseng tsa lisele tse itseng tsa kankere.
Lisele tsa CAR T-cells li kotuloa ka laborateng 'me li lumelloa ho eketsa linomoro tsa tsona ho fihlela ho na le libilione tsa tsona. Ka mor'a ho fetoloa le ho kotuloa, lisele tsena tsa T, tse hlahisang li-CAR tse ka tsebang le ho bolaea lisele tse itseng tsa kankere, li kenngoa hape ho mokuli.
Li-CAR tsena ke liprotheine tse lumellang li-T-cell hore li lemohe protheine e itseng, kapa antigen, lisele tse hlahisang likokoana-hloko.
Linaleli tsa CAR T-cells li hōlisitsoe ka laborateng 'me li lumelloa ho eketsa linomoro tsa tsona ho fihlela ho na le libilione tsa tsona. Hajoale, ho sebetsa ha bona hantle ho bonahala ho itšetlehile ka bonyane ka bokhoni ba bona ba ho hōla le ho lula ba mafolofolo ho mokuli ka mor'a hore ba kene hape.
Khopolo ea ho sebelisa lisele tse phelang ho phekola kankere ha e le hantle ha e ncha.
Lintho tseo re ithutileng tsona liphelong tsa mekhoa e tšoanang ea phekolo nakong e fetileng li entse hore re fumane phaello ea tsebo ea kamoo T-lisele li sebetsang kateng , e leng se ileng sa etsa hore ho fumanoe lintho tse eketsehileng. Bafuputsi ba sebetsang tšimong ena ba hlokomelise hore ho ntse ho e-na le lintho tse ngata tse lokelang ho ithuta ka therapy ea CAR T-cell. Empa liphello tsa pele ho liteko tse kang tsena li entse hore ho be le tšepo e kholo.
E atleha Hakaale
Ba bang ba 'nile ba bapisa mofuta ona oa phekolo ho kenngoa ha mefuta e' meli ea phekolo: li-antibodies tse loantšitsoeng, joaloka rituximab, le litšobotsi tsa bona; le kankere-cell-kill-agents e nang le matla a cytotoxicity - kaofela ha tsona ka ho ba teng ha nako e telele ea li-cytotoxic T-cell, ho tšepa hore li tla lula li le teng, ho behoa leihlo bakeng sa ho pheta-pheta.
Phuputso e sa ntsane e le ncha, kahoo litsebi li khothalletsa ho ba hlokolosi, empa liteko tsa lits'oaelo li se li qalile ho sebelisa litlhare tsa CAR T-cell li-cancer tse latelang:
- Melanoma e tsoetseng pele
- Advanced acute lymphoblastic leukemia (ALL)
- E fokotsa khōlō B-cell lymphoma
FDA e khethile phekolo ea CAR T-cell phekolo ea katleho ho bohle. Hape ho hlahlojoa hape ka ho hlahlojoa hape le ho hanyetsa e seng Hodgkin lymphoma, myeloma, le chronic lymphocytic leukemia (CLL) , hammoho le bakuli ba se nang Hodgkin lymphoma le myeloma.
Bafuputsi ba na le tšepo ea hore lefu la CAR T-cell le tla fetoha phekolo e tloaelehileng bakeng sa lipolelo tse ling tsa B-cell tse kang LIV le le leng le le leng la lefu la kankere ea mali. Bafuputsi ba sebetsang le CAR-T-lisele ba boetse ba khethile mofuta ona oa phekolo e le "borokho" ho fetisetsa motsoako oa masapo ho bakuli bohle ba khaotsang ho arabela chemotherapy.
Teko e 'ngoe e ile ea hlahloba tšebeliso ea li-CAR T-cell ho bakuli ba baholo ba 15,' me ba bangata ba bona ba ne ba se ba tsoetse pele haholo B-cell lymphoma. Le hoja e ne e le teko e nyenyane, ho na le tšepo ea hore boholo ba bakuli bana ba tšoaroa le CAR T-cells e ne e le likarabo tse feletseng kapa tse fapaneng.
Hape ho na le tšepo ea hore phekolo ea CAR T-cell e ka sebelisoa ho thibela ho khutlela morao. Liphuputso tse ling tse fanang ka tšepo e kholo li akarelletsa ho atolosoa ha lisele tsa kalafo ka mor'a ho phalleloa, tse ka bang 1 000 ho batho ba bang; le ho ba teng ha CAR T-lisele tsamaisong ea methapo e meholo, sebaka sa "sehalalelo" moo lisele tsa kankere tse le mong tse pholohileng chemotherapy kapa mahlaseli a kotsi li ka pata. Bakeng sa bakuli ba babeli ba nyeoeng ea bana ba likhutsana le bana ba tlokotsing, ka mohlala, phekolo ea CAR-cell e ile ea felisa kankere e neng e hasane ho tsamaiso ea methapo ea mantlha.
Litla-morao
Ha palo e kholo ea lisebelisoa tsa T tse kenngoa meleng, li-T-cell tsena li lokolla li-cytokines ka bongata. Sena se ka etsa hore cytokine-release syndrome, e tsejoang ka feberu e kotsi le ho theoha khatello ea mali. Li-cytokine ke lik'hemik'hale tsa lik'hemik'hale, 'me lefu la cytokine-release syndrome ke bothata bo tloaelehileng ho bakuli ba tšoaroang ke CAR T-cells.
Bakuli ba nang le ts'oaetso e kholo ka ho fetisisa ea kankere pele ba fumana li-CAR T-cell ba bonahala eka ho na le menyetla e matla ea ho ba le matšoao a matla a lefu la cytokine-release. Bafuputsi ba hlokomelisa hore ho sa tsotellehe katleho, lipatlisiso tse ling li hlokahala pele lefu la CAR T-cell le ka fetoha tloaelo e tloaelehileng, bakeng sa bakuli ba ALL ka mohlala. Lithuto tse nang le bakuli ba bangata le linako tse telele tsa ho latellana li 'nile tsa bitsoa ebile li phehelloa.
Ho Lebelloa
Ho itšetlehile ka katleho ho fihlela joale, lihlopha tse 'maloa tsa lipatlisiso ho pholletsa le naha li lebisa tlhokomelo ea bona ho hlaolela lisele tse nang le lisebelisoa tse ling tse nang le kankere bakeng sa lik'hemik'hale tse ling, ho kenyeletsa lihlahala tse matla joaloka kankere ea pancreatic le ea boko.
> Mehloli:
> T-TB ea T-Cell: Boenjiniere ba Lisele tsa Immune Bakeng sa Lik'hemik'hale Bakeng sa ho Tšoara Cancer ea Bona. http://www.cancer.gov/cancertopics/research-updates/2013/CAR-T- Mecha.
> Barrett DM, Singh N, Porter DL, Grupp SA, June CH. Chimeric Antigen Receptor Therapy bakeng sa Kankere. Annu Rev Med . 2014; 65: 333-347.
> Lik'hemik'hale tsa Chimeric Antigen Receptor. http://www.lymphomation.org/programing-t-cells.htm.