April 2022: Ngokuvamile, inqubo yokukhiqiza amaseli yokwelashwa kwe-CAR T-cell ithatha izinsuku eziyisishiyagalolunye kuya kweziyishumi nane; Nokho, abacwaningi eNyuvesi yasePennsylvania bakwazile ukwenza amaseli e-CAR T asebenzayo anamandla okulwa nesimila ngamahora angu-24 kuphela besebenzisa indlela entsha.
Uhlobo olusha lwe-immunotherapy olubizwa nge-autologous CAR T-cell therapies lusebenzisa ama-T cell esiguli, luwaguqule ngaphandle komzimba ngokungeza isakhi sofuzo se-CAR esibenza baveze ama-receptors aqondise kangcono amangqamuzana omdlavuza, bese iwabuyisela esigulini. . Lezi zindlela zokwelapha, ngakolunye uhlangothi, zidume kabi ngezikhathi zazo zokukhiqiza ezinde, ezingaphazamisa amandla eseli okuphindaphinda futhi ngenxa yalokho kunciphise amandla okwelapha, ingasaphathwa eyokudala ukuthi iziguli ezigula kakhulu ziwohloke ngenkathi zilinde ukwelashwa. Ngenxa yalokho, abakhiqizi bokwelashwa kwamangqamuzana e-autologous baye babeka phambili kakhulu ekunciphiseni isikhathi phakathi kokukhishwa kwegazi kanye nokushintshwa kabusha kweseli, okubuye kwaziwe ngokuthi isikhathi se-vein-to-vein.
Ucwaningo lwangaphambi komtholampilo olwanyatheliswa ku-Nature Biomedical Engineering lubonise ukuthi inani lesikhathi, izinto zokwakha, nomsebenzi odingekayo ukuze kukhiqizwe amaseli e-CAR T kungase kwehle kakhulu. Ngokwabacwaningi, lokhu kungaba yinzuzo ikakhulukazi kubantu abanezifo ezithuthuka ngokushesha nasezilungiselelweni zasesibhedlela abanezinsiza ezilinganiselwe.
“Nakuba izindlela zendabuko zokukhiqiza amaseli e-CAR T athatha izinsuku ezimbalwa kuya emasontweni ziqhubeka nokusebenza ezigulini ezinomdlavuza 'owuketshezi' njenge-leukemia, sisenesidingo esikhulu sokunciphisa isikhathi nezindleko zokukhiqiza lezi zindlela zokwelapha eziyinkimbinkimbi," kusho uDkt. .Michael Milone, uprofesa osebenza naye we-pathology kanye nemithi yaselabhorethri futhi ongomunye wabaholi ababambisene nalolu cwaningo. Indlela yokukhiqiza ebikwe kulolu cwaningo iwubufakazi bekhono lokusungula nokwenza ngcono ukukhiqizwa kwe CAR T cell zokwelapha ukuze kuzuze iziguli eziningi, sakhela ocwaningweni lwethu kusukela ngo-2018 olwanciphisa indlela yokukhiqiza ejwayelekile yaba yizinsuku ezintathu, futhi manje yaba ngaphansi kwamahora angama-24.
Abacwaningi bathole ukuthi ikhwalithi yomkhiqizo we-CAR T cell, esikhundleni senombolo yawo, iwumshayeli obalulekile wempumelelo yawo kumamodeli ezilwane. Ucwaningo lwabo lubonise ukuthi inani elincane lamaseli e-CAR T ekhwalithi ephezulu adalwe ngaphandle komzimba ngaphandle kokunwetshwa okukhulu kwakungcono kunenani elikhulu lamaseli e-CAR T ekhwalithi ephansi anwetshwa kakhulu ngaphambi kokuba abuyele esigulini.
Ama-T cell kufanele enziwe asebenze ngendlela eyenza ukuthi ande futhi aphindaphindeke ukuze asetshenziswe ezindleleni zokukhiqiza ezivamile. Besebenzisa izindlela zobunjiniyela ezisekelwe engxenyeni yokuqonda ukuthi i-HIV ingena kanjani ngokwemvelo kuma-T cell, abacwaningi bakwaPenn bakwazi ukuqeda lesi sinyathelo senqubo yokukhiqiza. Ithimba lithole indlela yokudlulisa izakhi zofuzo ziqonde kuma-T cell angacushiwe asanda kukhishwa egazini. Lokhu kwanikeza izinzuzo ezimbili zokusheshisa yonke inqubo yokukhiqiza kuyilapho kugcinwa amandla ama-T cell. Le nqubo ayivumeli iziguli ukuthi zitheleleke nge-HIV.
Ukufinyelela kwesiguli ekwelashweni kwamaseli kukhawulelwe ngenxa yezindleko. Abacwaningi balindele ukuthi ngokunciphisa izindleko nesikhathi esihlobene nokukhiqiza, lezi zindlela zokwelapha zingenziwa zingabizi kakhulu, zivumele iziguli eziningi ukuthi zifinyelele kukho.
“Le ndlela entsha iyamangalisa ngoba ingakwazi ukusiza iziguli ebezingeke zikwazi ukusizakala Ukwelashwa kwamaseli e-CAR T, njengalabo abanomdlavuza okhula ngokushesha, ngenxa yesikhathi esibalulekile esidingekayo ukuze kukhiqizwe lezi zindlela zokwelapha,” kusho uDkt. Saba Ghassemi, uprofesa ongumsizi wocwaningo we-pathology kanye nemithi yaselabhorethri kanye nomunye umholi ohlanganyele wocwaningo. "Ukuhlelwa kabusha okusebenzayo kwamaseli e-T ane-CAR emahoreni angama-24 ngendlela elula yokukhiqiza ngaphandle kokwenza kusebenze i-T cell noma isiko elibalulekile langaphandle komzimba nakho kuvula inketho yokwandisa ukuthi lezi zindlela zokwelapha zikhiqizwa kuphi futhi nini." Ngeke nje kukhuphule umthamo wezikhungo zokukhiqiza ezimaphakathi, kodwa uma kulula futhi kungaguquguquki ngokwanele, kungenzeka ukuthi kukhiqizwe lezi zindlela zokwelapha endaweni eduze nesiguli, kubhekwane nezinselelo eziningi ezithikameza ukulethwa kwalokhu kwelashwa okusebenzayo, ikakhulukazi kubantu abampofu. imvelo.”
Abacwaningi bathi ucwaningo lwabo "luyimbangela yocwaningo olwengeziwe lomtholampilo ukuze kuqondwe ukuthi amaseli e-CAR T ashintshiwe asebenza kanjani ezigulini ezinamathumba athile zisebenzisa leli su elifushanisiwe."
Ngokuhlanganyela ne-Novartis kanye neSibhedlela Sezingane sase-Philadelphia, ochwepheshe bakwa-Penn bahola ucwaningo, ukuthuthukiswa, nokuhlolwa kwemitholampilo yalokhu kwelashwa kwe-CAR T okuyisisekelo. U-Novartis unikeze ilayisense obunye ubuchwepheshe obusetshenziswa kulolu phenyo oluvela eNyuvesi yasePennsylvania.
