Mohlomong tsamaiso ea 'mele ea ho itšireletsa mafung e tlisa kelello litšoantšong tsa lisele tse tšoeu tsa mali tse qobellang libaktheria, kapa li-antibodies tse hlaselang ho hlasela linaheng tse ling-tsena ke' mele oa hao o sireletsang libaktheria le likokoana-hloko tse ka u kulang. Leha ho le joalo, tsamaiso ea 'mele ea ho itšireletsa mafung e tsebahala ka matla a eona a ho lemoha, ho batla le ho senya lisele tsa kankere.
Ka matla a joalo a matla joaloka tsamaiso ea 'mele ea ho itšireletsa mafung, ho hlokahala hore ho be le tsela ea ho bitsa lintho fatše e le hore lisele tse tloaelehileng, tse phetseng hantle li se ke tsa hlaseloa ka phoso.
Ka lehlohonolo, tsamaiso ea 'mele ea ho itšireletsa mafung e etselitsoe ka ho hlahloba ts'ireletso sebakeng sena. Leha ho le joalo, lisele tsa kankere, tse hlahisitsoeng ke lisele tseo pele li neng li tloaelehile, ka linako tse ling li ka sebelisa liteko tsena tsa tšireletseho molemong oa tsona ho qoba ho hlaseloa ke tsamaiso ea 'mele ea ho itšireletsa mafung. Ts'ebetso ena ea ts'ireletso (e sa tsejoeng, e hlileng) e tsejoa ka saense e le ho hlahloba 'mele ea ho itšireletsa mafung ,' me lithethefatsi tse nkang li-checkpoints ke checkpoint inhibitors.
Immune Checkpoints
Feela joaloka mekhoa e meholo ea khoebo le lisebelisuoa, qeto ea 'mele ea ho chesa tšoaetso ea' mele ea ho itšireletsa mafung hangata e hloka hore ho be le "matšoao" a mangata le "tumello" pele maoto a kenngoa-lekala le leng le le leng le ka 'na la e-ba le boima bo lekanang kapa bo se nang' ngoe Lefapha ha le bolele hore ke laela qeto.
Ka lebaka leo, li sireletsehile tse 'maloa li thusa ho sireletsa tsamaiso ea' mele ea ho itšireletsa mafung hore e se ke ea fetela ho motho ea tsoang linaheng tse ling kapa ho etsa phoso ea "moeeng" bakeng sa mohlaseli ea kotsi. Litšireletso tsena li ka sebelisoa ka bokhutšoanyane ka lisele tsa kankere ho qoba ho fumanoa ka 'mele empa li ka boela tsa sebelisoa ke baetsi ba lithethefatsi ho hlakola lisele tsa kankere e le hore ba se ba sa "bonahale" tsamaisong ea ' mele ea ho itšireletsa mafung .
Khetho ea khoebo ea biologic ea ho eketsa karabelo ea 'mele ea ho itšireletsa mafung ka linako tse ling e bohlokoa ho kenyeletsa ts'ebetso le "lefapha la lefutso la sele" -ke hore, lefu le hlophisitsoeng 1 (PD-1) le laolang likarabo tsa ho ruruha.
Li-Inhibitor tsa Checkpoint li na le lithethefatsi ho thusa li-Cells ho fumana litaelo tsa ho tsamaisa
Tsela ea PD-1 e na le "moelelo o tobileng" ho li-T-cell, masole a mmele a tsoang le ho bolaea lisele tsa kankere; Leha ho le joalo, ho hang ha ho letho le tiileng leo masole a T-cell a tla itlhophisa, a theha pele, 'me a qala ho senya lisele tsa kankere.
Ke hobane mafapha a mang a boetse a kenya letsoho ho T-cell le mesebetsi ea bona. Ho na le li-off-off tse ngata tse lokelang ho etsahala pele masole a fumana litaelo tsa bona.
E 'ngoe ea lintho tse fanang ka qeto ea hore na litaelo tsa ho tsamaea li fanoa ke mokelikeli oa PD1, o sebetsang ka mokhoa o kang oa molaoli ea tummeng ka har'a taelo ea taelo. Ba "baeletsi" ba babeli ho kakaretso eo ka ho fetisisa ba eletsang khahlanong le ho phatlalatsa ntoa ka lisele tsa kankere ke PDL-1 le PDL-2. Baeletsi bana ba khahlanong le ntoa, PDL-1 le PDL-2, ha e le hantle ke limolek'hule tse khomarelang li-PD-receptors tse T-cell. Ha ba tlama ba bolella lisele tsa T hore li eme, hore ha li na litaelo tsa ho tsamaea khahlanong le kankere.
Mefuta ea kankere e ka 'na ea leka ho hlahisa "Baeletsi ba Ntoa ea Ntoa"
Ka linako tse ling lisele tsa kankere li etsa baeletsi ba bangata ba khahlanong le ntoa, ka boithati ba bona. Pona e le 'ngoe kapa ka bobeli ea PD-L1 le PD-L2, lisele tsa lisele, ho akarelletsa le lisele tsa kankere, li ka tlama li-receptor tsa PD1 li-T-cell le ho thibela mosebetsi oa tsona.
Ho thibela kamano ena pakeng tsa PD-1 ho T-cell le libapali tsa eona tse peli, tse ka holim'a lisele tse ling, li ka fella ka ts'ebetso e matla ea lisele tsa T, le letoto la liketsahalo tse hlahisang karabo e potlakileng ea ho ruruha.
Mekhoa e Sebetsang PD-1 kapa PD-L1
Lisele tse ling tsa kankere li hlahisa PD-L1 e ngata, e ba thusang hore ba qobe tlhaselo ea 'mele.
Bafuputsi ba nts'etsopele ea lithethefatsi ba ka etsa phekolo ea meriana ea monoclonal e lebisang mofuteng oa PD-1 (ka kakaretso) kapa ligand ea PD-L1 (moeletsi oa mohanyetsi oa ntoa) ho matlafatsa likarabo tsa 'mele khahlanong le lisele tsa kankere,' me li sebelisitsoe ho phekola kankere.
Qalong, katleho e ne e bonoa ka li-tumor tse tiileng, empa hona joale lipheo tsena li ntse li hlahlojoa ka kankere ea hematologic, kapa kankere ea mali , hammoho le kankere ea mali, lymphoma le myeloma. Ho Hodgkin lymphoma ea khale, ho ekelitsoe tlhahiso ea PD-1 ligand (PD-L1 / 2) lisele tsa kankere kahoo ho na le tšepo ea hore ho tla ba le tšoaetso ea Hodgkin lymphoma ho thibela PD-1.
Kaha litlhare tsena li matlafatsa tsamaiso ea 'mele ea ho itšireletsa mafung ka ho tlosa tse ling tsa tšireletso ea eona, ho na le ho ameha hore sena se ka baka kotsi ho lisele tse phetseng hantle le litla-morao tse amanang le batho ba bang. Liketsahalo tse bohloko tse atisang ho amahanngoa le li-antibodies tsa PD-1 tse thibelang li kenyeletsa ho senya, ho phatloha le letšollo. Hangata li ka baka mathata a tebileng haholo matšoafong, mala, sebete, liphio, litšoelesa tsa hormone, kapa litho tse ling.
Mefuta e meng e mengata ea phekolo e sebetsanang le PD-1 kapa PD-L1 e ntse e lekoa litsing tsa meriana, ka bobeli le ho kopana le lithethefatsi tse ling. Ke tse seng kae feela tsa phekolo ena tse amohetseng tumello ea FDA bakeng sa tšebeliso ea kankere ho fihlela joale, empa ba bang ba bangata ba ntse ba ithutoa litekong tsa meriana. Ha lipatlisiso li tsoela pele, re tla utloisisa tsamaiso le mokhoa oa ho li laola.
> Mehloli:
Ansell SM, Lesokhin AM, Borrello I, le al. PD-1 Blockade le Nivolumab ka Lothphoma ea Hodgkin e khutliselitsoeng hape kapa e tsitsitseng. N Engl J Med. 2015; 372 (4): 311-319.
Pardoll DM. Ho thibela ho itšireletsa mafung ka kankere ea immunotherapy. Kan Rev Kankere. 2012; 12 (4): 252-64.
Romano E, Romero P. Tšepiso ea phekolo ea ho senya kotsi ea ho itšireletsa mafung ea PD-1 / PD-L1 ka kankere: ho tlosa tšebetso ea CD8 T ea li-anti-tumor ho etsa hore ho be le katleho e kholo ea meriana e sa tšoaneng e sebetsang. J Monyane Kankere . 2015; 3: 15.
Mokhatlo oa Kankere oa Amerika. Immune checkpoint inhibitors ho tšoara kankere.