Daaweyn cusub ayaa soo saartay jawaabaha cajiibka ah ee hortaagan tijaabooyinka hore
Sida caadiga ah loo yaqaan 'transfer cell transfer' (ACT), kani waa daaweyn cusub oo ku lug leh injineernimada bukaannada unugyada difaaca si ay u aqoonsadaan una weeraraan unugyada burooyinka. Inkasta oo noocan ah daaweyntu hadda tijaabinayso, waxaana la xakameyn jirey tijaabooyin yar yar ee kiliinikada ah, waxay muujisay qaar ka mid ah jawaabaha cajiibka ah ee bukaanada qaba kansarka sare.
Sida ay u shaqeyneyso
T-yada, nooc ka mid ah unugyada difaaca jidhka, waxay la joogaan rijeetooyinka dusha sare, oo la yiraahdo Receptors T-cell, ama TCRs. Caadi ahaan tan TCR-gu waxay ku xidhan yihiin antigens si ay u fuushaan jawaab celin. Marka la isku dayo in la isticmaalo T-duubo daaweynta kansarka, T-cells ayaa laga soo qaadaa dhiigga bukaanka. Ka dib, kaadida, T-cells ayaa wax laga beddelay si ay u soo saaraan qashin khaas ah oo la yiraahdo sooyaalayaasha chimeric antigen reseptors, ama CARS, kuwaas oo awood u leh inay ku xiraan qaar ka mid ah borotiinada dusha sare ee unugyada kansarka gaarka ah.
Machadka T-injirta ee T-Mobile ayaa lagu soo ururiyey shaybaar waxaana loo ogolyahay inuu kor u qaado lambarradooda ilaa ay ka jiraan balaayiin iyaga ka mid ah. Ka dib isbedelka iyo goosashada, T-yada T-yada, kuwaas oo soo bandhigaya CAR-yada oo aqoonsan kara lana dilo unugyada kansarka qaas ah, ayaa dib loo dhigayaa bukaanka.
Kaararkani waa borotiino u oggolaanaya in T-unda ay u aqoonsadaan protein gaar ah, ama antigen, oo ku jira unugyada kansarka.
Machadka T-injirta ee T-Mobile ayaa koray shaybaarka waxaana loo ogolyahay inuu kordhiyo lambarkooda illaa ay jiraan balaayiin iyaga ka mid ah. Ilaa hadda, sida fiican ee ay u shaqeeyaan waxay u muuqdaan inay ugu yaraan ku xiran yihiin awooddooda inay koraan oo ay sii wadaan firfircoonida bukaan-socodka ka dib marka ay ku soo noqdaan.
Fikradda ah isticmaalka unugyada nool ee lagu daaweeyo kansarka dhab ahaantii maaha.
Casharrada laga bartay natiijooyinka daaweynta isku midka ah ee hore waxay keeneen aqoon u yeeshaan sida T-cells u shaqeynayo , taasoo kor u qaadday helitaano badan. Baarayaasha ka shaqeeya arimahan waxay ka digayaan in ay jiraan wax badan oo ay ka bartaan daaweynta T-cell ee T-cell. Laakiin natiijooyinka hore ee tijaabooyinka sida kuwan ayaa abuuray waxoogaa rajo wanaagsan.
Guuleysi sidaa daraadeed
Qaar waxay u ekeeyeen nooca daaweynta noocan ah ee isku darka laba nooc oo kala duwan oo daaweyn ah: Noocyada difaaca, sida rituximab, oo leh astaamahooda gaarka ah; iyo walxaha kansarka-unugyada dila ee leh awoodda cytotoxicity - taas oo ay la socoto joogitaanka dheer ee joogitaanka noolaha T-cells ee cytotoxic, si loogu rajeynayo inay sii socoto wareegga, kormeerka dib u soo noqoshada.
Cilmi-baaristu wali waa mid cusub, sidaas darteed khubarada ayaa ku boorinaya taxadar, laakiin tijaabooyinka kiliinikada ayaa durbadiiba bilaabay isticmaalka daaweynta CAR T-unugyada kansarka soo socda:
- Melanoma-ga sareeya
- Cudurka lymphoblastic-ka ee degdega ah (ALL)
- Iska wareeji lymphoma ballaaran B-unug
FDA waxay u qoondeeysay daaweynta CAR T-cell-ka ah daaweynta degdega ah ee DHAMMAAN. Waxaa sidoo kale lagu tijaabiyaa lutefoma non-Hodgkin lymphoma, myeloma, iyo lymphocytic leukemia (CLL) , iyo sidoo kale bukaannada leh lymphoma non-Hodgkin iyo myeloma.
Baadhayaasha ayaa rajaynaya in daaweynta T-cell-ka ay maalin uun noqoto daweyn caadi ah oo loogu talagalay qanjirrada B-cell-ka qaarkood sida DHAMAAN iyo lymphocytic leukemia. Cilmi-baareyaasha la shaqeeya CAR-T-yada ayaa sidoo kale qeexay daaweynta noocan oo kale ah "buundada" laf-dhabarka laf-dhabarka loogu talagalay dhammaan bukaannada joojiya daweynta kemotherabi.
Hal tijaabo ayaa baadhis ku samaysay isticmaalka T-un-tiknoolajiyada ee 15 bukaan oo qaan-gaar ah, badankoodana waxay lahaayeen jimicsi balaadhan oo waaweyn B-unug B-cell weyn. Inkastoo ay ahayd shaki la'aan maxkamad yar, rajo xumo ayaa ka timid xaqiiqda ah in bukaankan badankood lagu daaweeyo CAR T-yari lahaa jawaab celin dhamaystiran ama qayb ahaan.
Waxa kale oo jira rajo ah in daaweynta T-cell ee T-cell loo isticmaalo si looga hortago soo noqoshada. Natiijooyinka kale ee u adeega hurinta rajo-gelinta waxaa ka mid ah ballaarinta unugyada daaweynta ka dib faleebo, sida ugu badnaan 1,000-laab dadka qaarkood; iyo joogitaanka unugyada T-da T-yada ee habka dhexe ee neerfaha, oo ah "meesha lagu magacaabo" oo ah unugyada kansarka lafaha oo ka baxsaday kiimiko ama shucaac. Laba bukaan oo ku jira tijaabada cudurada wadnaha ee NCI, tusaale ahaan, daaweynta CAR-T-cell ayaa ciribtirtay kansar kaas oo ku faafay habka dhexe ee neerfayaasha.
Waxyaabaha kale ee saameynaya
Marka tiro badan oo ah unugyada T-injineerka ah ayaa dib loo soo saaro bukaanka, kuwan T-cells ayaa cyokokines sii deynaya tiro badan. Tani waxay sababi kartaa cytokine-release-syndrome, taas oo lagu garto qallafsanaanta qulqulka badan iyo cadaadiska dhiigga. Cytokines waa calaamado kiimiko ah, iyo cytokin-release syndrome waa dhibaato caadi ah ee bukaannada lagu daaweeyo CAR T-cells.
Bukaan-jiifka qaba ka-qaybqaadashada ugu badan ee kansarka ka hor inta aan la helin T-yada T-yari waxay u muuqdaan inay qabaan xaaladaha daran ee xanuunka cytokine-release. Cilmi-baadhayaashu waxay ka digayaan in kastoo ay guulo ka soo baxeen, cilmi-baaris dheeraad ah ayaa loo baahan yahay ka hor intaan CAR-TT-ku-daweyntu noqon karin xulasho caadi ah, oo loogu talagalay bukaanka qaba ALL. Daraasado badan oo bukaanjiif ah iyo waqti dheer oo la socda ayaa loo yeeray oo la dabagalay.
On Horizon
Iyadoo lagu saleynayo guusha illaa iyo hadda, kooxo cilmi-baaris ah oo waddanka oo dhan ah ayaa diiradda saaraya inay horumariyaan T-unugyada injineerada ee kansarrada kale, oo ay ku jiraan burooyinka adag sida kansarka mindhicirka iyo kansarka maskaxda.
> Ilo:
> Daaweynta Qalabka T-Cell: Qalabka Isku-xirka Bukaan-socodka ee Bukaan-socodka ee Daaweynta Kansarka. http://www.cancer.gov/cancertopics/research-updates/2013/CAR-T-Celles.
> Barrett DM, Singh N, Porter DL, Grupp SA, Juunyo CH. Daaweynta Chimeric Antigen Qalabaynta Daaweynta Kansarka. Annu Rev Med . 2014; 65: 333-347.
> Qalabka Daawada Chimeric Antigen T-Cells. http://www.lymphomation.org/programing-t-cells.htm.