Septhemba 2022: Ukwelashwa kwamathumba ahlukahlukene kuye kwaguqulwa nge-cell-based immunotherapy, evame ukubizwa ngokuthi Ukwelashwa kwamaseli e-CAR-T. Ukuze uqondise futhi ulwe nezinhlobo ezithile ze-leukemia ne-lymphoma, ukwelashwa kusebenzisa amaseli e-T akhiwe ngofuzo. Yize inamandla okwelapha umdlavuza kubantu abathile abebengadlula kulesi sifo, iphinde ibe nobungozi bemiphumela emibi eminingi, eminye yayo engaba yingozi ebulalayo futhi iphazamise ukusebenza kobuchopho.
Ngokocwaningo lwakamuva oluvela eWashington University School of Medicine e-St. Louis, ukuhlolwa kwegazi okusheshayo kungasiza odokotela banqume ukuthi yiziphi iziguli okungenzeka zibe nemiphumela engemihle ye-neurotoxic ezinsukwini nasemavikini alandelayo. Ukwelashwa kwamaseli e-CAR-T. Abacwaningi bathole ukuthi amazinga ephrotheni ebizwa nge-neurofilament light chain (NfL) aphezulu kubantu abaqhubeka nokuba nezinkinga ze-neurotoxic ngemva kokutadisha amasampula egazi athathwe ezigulini ngaphambi, phakathi, nangemuva kokwelashwa kweseli ye-CAR-T. Ngaphambi kokuthi ukwelapha kuqale, kukhona amanani aphezulu amaprotheni akhona, futhi lawo mazinga ahlala ephezulu ngesikhathi sokwelashwa futhi kuze kube yinyanga ngemva kwalokho.
Ucwaningo, olwakhishwa ngoSepthemba 1 kujenali i-JAMA Oncology, lungasiza ochwepheshe bezokwelapha babone kusengaphambili le miphumela engemihle engase ibe yingozi futhi ibenze bakwazi ukuqala ukunikeza imithi enganciphisa imiphumela ye-neurotoxic kusenesikhathi ekwelashweni kwesiguli. Ukwengeza, inikeza inkundla yokuvimbela umphumela ongaseceleni wokwelashwa kweseli ye-CAR-T ngaphambi kwesikhathi noma ucwaningo lokunciphisa ubungozi.
Umbhali oholayo u-Omar H. Butt, MD, PhD, umfundisi wezokwelapha obona iziguli eSiteman Cancer Center esibhedlela i-Barnes-Jewish Hospital naseWashington University School of Medicine, uthe, "Ucwaningo lwethu lubonisa ukuthi ezinye iziguli ezithola ukwelashwa kwamaseli e-CAR-T zine umonakalo ongakaze ubonwe kuma-neurons okhona ekuqaleni, ngaphambi kokuthi siqale ukuwalungiselela lokhu kwelashwa. " “Asiyazi imvelaphi yalokhu kulimala, kodwa kubonakala kubeka abantu engozini yokuba nezinkinga ze-neurotoxic. Singanqanda noma sinciphise ubukhali bale miphumela uma sazi ukuthi ubani osengozini ngenxa yayo.
Iphrotheni ye-NfL, inkomba ebanzi yokulimala kwe-neuronal, isetshenziselwe ukulinganisa noma ukulandelela ukuqina kwezimo eziningi zemizwa, okuhlanganisa isifo se-Alzheimer kanye ne-multiple sclerosis.
Ngokusho komlobi osesikhundleni esiphezulu kanye noDaniel J. Brennan onguProfesa weNeurology uBeau M. Ances, MD, PhD, “izilinganiso ze-NfL egazini zisetshenziswa njengethuluzi lokuhlola ukusebenza kahle kwemithi yokwelapha esanda kuzalwa ye-multiple sclerosis.” “Sihlose ukwenza ucwaningo olwengeziwe ukuze sithole ukuthi yini edala umonakalo we-neuronal kulezi ziguli ezinomdlavuza. Ngenxa yokuthi iYunivesithi yaseWashington inochwepheshe abangcono kakhulu be-CAR-T cell therapy nolwazi lwezinga eliphezulu ezifweni ze-neurodegenerative, lokhu kubambisana okungajwayelekile kwenziwe kwaba nokwenzeka. Inikeza ithuba elihle lokugcwalisa izikhala nokuhlanganisa ubungcweti obuhlukahlukene ngomzamo wokuthola isisombululo esikhungathekisayo futhi kuzuze abantu.
30 individuals underwent treatment at Cleveland’s Siteman Cancer Center and Case Comprehensive Cancer Center, both of which are affiliated with Case Western Reserve University.
Iziguli ezingazange zithole noma yimiphi imiphumela emibi ye-neurotoxic zingase zihlukaniswe kulabo abenze kanjalo ngokusekelwe emazingeni abo okuqala e-NfL. Ukubona ukuthi usayizi wesampula omkhulu uzobenza bakwazi ukuhlonza iziguli ezisengozini yezinkinga ezithambile, ezimaphakathi, noma ezinzima, abacwaningi bahlose ukuqhubeka nokuhlola idatha yeziguli eziningi.
Izinkinga zingasukela kakhulu kusukela ekuphathweni ikhanda, ukuquleka, ukushaywa unhlangothi, nokuvuvukala kobuchopho kuye ebunzimeni bokugxilisa ingqondo, izinkinga zenkumbulo, ukudideka, ukufunda kanzima, kanye nekhanda elibuhlungu. Ama-steroid anedosi ephezulu kanye nezikhathi ezithile zokwelapha amasosha omzimba ahlose ukunciphisa ukuvuvukala yizindlela eziyinhloko odokotela abaphatha ngazo lezi zinkinga. Njengoba lezi zindlela zokwelapha, ngokudabukisayo, zingase ziphazamise umphumela wokulwa nomdlavuza wamangqamuzana e-CAR-T, odokotela bangakhetha ukukugwema ukuwasebenzisa noma nini lapho kungenzeka, ngakho-ke kuwusizo kakhulu ukwazi ukuthi ubani osengozini yemiphumela emibi kakhulu eyingozi.
Enye indida ukuthi njengoba ezinye iziguli zinemiphumela emibi ye-neurotoxic futhi kamuva zilulama kuzo, amazinga e-NfL aphakanyisiwe asevele ekhona futhi ngokuvamile awashintshi. Lokhu kusho ukuthi nakuba amazinga e-NfL engameleli ngempela okwenzekayo ukuze abangele ubunzima beziguli, abonisa ukuthi kukhona okungalungile.
Mayelana nenqubo yokugula yangempela, "sibona isiqongo seqhwa, futhi yilapho uphenyo lwethu lwesikhathi esizayo luphokophele khona," kusho u-Butt. “Sizama ukuqonda ngokucacile ukuthi yini ekuqaleni eholele kulezi zinguquko. Futhi kamuva, ngisho nalapho izimpawu seziphelile, lawa mazinga aphezulu e-NfL asekhona.
We have a study ongoing at Siteman to see if, in fact, these patients continue to have subtle symptoms in terms of cognitive changes or deficits that persist long term,” added co-senior author Armin Ghobadi, MD, an associate professor of medicine and clinical director of the Center for Gene and Cellular immunotherapy at Washington University School of Medicine and Siteman Cancer Center.
