Amacala e-NK cell immunotherapy womdlavuza wesibindi osezingeni eliphakeme
Isiguli somdlavuza esithuthukile esineminyaka engama-92 sithethelelwe ngokuphelele
Eminyakeni eyisikhombisa edlule, uNkz. M, owayeseminyakeni yawo-80, kwatholakala ukuthi une-hepatocellular carcinoma (eyabangelwa umdlavuza esikhathini esidlule ngenxa yokumpontshelwa igazi nokungenwa yigciwane le-hepatitis C). Ngenxa yokuthi wayenempilo enhle ngaleso sikhathi, wakhishwa ngempumelelo ngokuhlinzwa.
Ngo-2016, umdlavuza wabuya futhi, kodwa uma kubhekwa ukuthi uNkk M wayesevele esemdala ngalesi sikhathi, ukuhlinzwa kwakungasanconywa.
Ms. M. was born into a medical family, and her daughter is also a doctor. She consulted on many treatments suitable for mothers other than surgery. Due to the poor location of the isisu, radiofrequency and embolization treatments are not feasible. Among the most cutting-edge radiotherapy methods, the first is to exclude heavy ions, which are not applicable at all, and the second is ukwelashwa kweproton, futhi amandla angokomzimba kamama awabekezeleleki. Ekugcineni, ummese we-TOMO kuphela ongakwazi ukuthola ngokunembile isifo esiyinkimbinkimbi sikamama. Ukukhipha imisebe.
Doctors suggest that Ms. M should be treated conservatively at such an old age. You can try a mild systemic treatment-NK cell reinfusion to improve immunity without using the toxic and side effects of drug treatment. At the same time, combined with Tom knife radiotherapy to kill amangqamuzana omdlavuza.
Isikhathi esiphezulu sokusebenza kwe-NK cell reinfusion emzimbeni yizinsuku ezingama-2-3, ngakho-ke uNks M wenza i-NK cell reinfusion ngempelasonto ngemuva kwe-radiotherapy yendawo ngommese we-TOMO. Amaseli we-NK angahamba negazi emzimbeni wonke ukufeza ukusebenzisana kwendawo + yokwelashwa okusebenzayo Umphumela wokwelashwa ongcono onomphumela wokulwa nomdlavuza.
Ngemuva kokwelashwa, ukuhlolwa kwe-ultrasound ne-PET-CT kukhombisile ukuthi i-lesion yesiguli ibisesimweni esibucayi. Isilonda sendawo sanyamalala, ukukhathazeka kwesiguli nge-metastasis akuvelanga, ayikho i-jaundice ne-ascites, futhi umzimba wesiguli walulama kancane kancane.
Ukwelashwa kwe-NK cell systemic anti-cancer
I-NK (i-natural killer cell, NK) iyingqamuzana lomzimba elinamandla okulwa nomdlavuza. Into enamandla kakhulu ukuthi ayidingi inqubo yokwethulwa kwe-antigen futhi ayidingi amanye amaseli omzimba ukuthi alawule. Ingathatha isinyathelo, iqondise, futhi isuse ngokushesha imizimba yangaphandle (Igciwane lesandulela ngculaza lithelela amaseli, amaseli omdlavuza, amaseli ezinzwa, njll.) Ukulungiswa kwe-Fa Yendawo.
Nakuba ekwazi ukuvikela ngokushesha futhi ahlasele ngokuqondile amangqamuzana e-tumor, ngeshwa, amaseli e-NK ayingxenye encane yamasosha omzimba, ebala kuphela i-10% yamaseli amhlophe egazi. Futhi ucwaningo lwathola ukuthi ngemva kweminyaka engu-25 ubudala, ukuzivikela komuntu kuncipha futhi inani lamaseli e-NK liyancipha. Inombolo kanye nomsebenzi wamaseli e-NK ezigulini zesimila kanye neziguli ngemuva kokuhlinzwa kwesimila kushintshile ngokwezinga elithile, futhi abakwazi ukwenza ngempumelelo imiphumela yokulwa nomdlavuza.
Abaphenyi manje sebegxile ekwelapheni-ukuqoqa amaseli e-NK cell "eqoqa amaseli we-NK avela kubaxhasi abasondelene futhi bawajova ezigulini. Lokhu kufakazelwe ukuthi kuphephile, futhi ngokungafani nokwelashwa kwe-T cell, amaseli we-NK awasibangeli isifo se-graft-versus-host kwizicubu zomamukeli.
Ukuze kuthuthukiswe ukusebenza nenombolo yamaseli e-NK emzimbeni, ososayensi baseJapan basungule indlela yokuphindaphinda, okuwukukhipha u-50ml egazini lomuntu, ukuhlukanisa inani elincane lamaseli we-NK bese kunweba isiko ukukhulisa inani liye ku Izikhathi zokuqala eziyi-1000, inani lifinyelela ku-1 billion laya ezigidini ezi-5, bese libuyiselwa emzimbeni, inani elikhulu lamaseli we-NK lizohamba izikhathi ezingama-3000 kuye kwezingu-4000 ngegazi emzimbeni wonke, kubulale amangqamuzana omdlavuza, amangqamuzana agugayo, amaseli agulayo, amagciwane kanye namagciwane emzimbeni Kuyaphinda futhi, ukufeza inhloso yokulwa nomdlavuza kanye nokulwa nomdlavuza, ukwenza ngcono ukuzivikela komzimba nokwandisa isikhathi sokuphila.
Njengamanje, kunenqwaba yobufakazi bokuthi i-immunocytotherapy (amaseli e-NK) ngaphambi nangemva kwesikhathi sokuhlinzwa inganciphisa ubungozi bokuphindeka kanye ne-metastasis.
Kungani iziguli ezinomdlavuza wesibindi zilungele ukwelashwa kwe-NK cell
Amaseli we-NK, njenge "Molecular Patrol", ahamba egazini kuyo yonke indawo. Lapho nje sebethole amaseli angaphandle noma amaseli aguqukile alahlekelwe wukuzazisa kwawo (abizwa nge-MHC), i-receptor yeseli le-NK ngokushesha ithumela isignali futhi igijimele kulwelwesi lweseli okuqondiswe kulo Okusho ukuthi, amaseli e-NK kufanele abe semgqeni wangaphambili we impi. Idedela izinhlayiya ezinobuthi kuyo, isheshe incibilikise amangqamuzana abhekiswe kuwo, futhi ibangele ukuthi amangqamuzana omdlavuza afe kungakapheli imizuzu emihlanu.
Kumele kuqashelwe ukuthi amangqamuzana e-NK, njengengxenye eyinhloko yamasosha omzimba, angamaseli omzimba abaluleke kakhulu emzimbeni womuntu, kepha mancane kakhulu egazini lomuntu, elibala kuphela ama-lymphocyte ayi-5% -10%. Esibindi, ama-NK cell abalwa ngama-lymphocyte angama-30-50%.
Uma kuqhathaniswa nokujikeleza kwamaseli we-NK, amaseli we-NK esibindi anezici ezihlukile ze-phenotypic nezici zokusebenza, okukhombisa ukuphakama kwe-cytotoxicity kumaseli we-tumor.
During the occurrence of umdlavuza wesibindi, the proportion of NK cells and the function of cytokines (interferon-γ) production and cytotoxic activity are reduced.
Amangqamuzana e-NK abulala kanjani amangqamuzana omdlavuza?
Isizathu sokuthi amangqamuzana e-NK angabulala amangqamuzana omdlavuza kungenxa yokulinganiswa kwezimpawu zama-receptors asebenzayo kanye nama-receptors avimbelayo ebusweni bamaseli we-NK. Ama-molecule we-receptor asebenzayo akhonjiswa ebusweni bamaseli womdlavuza namaseli athelelekile futhi abonwa ngamaseli we-NK. Ngaphezu kwalokho, amangqamuzana omdlavuza namaseli anegciwane avame ukulahlekelwa ama-MHC I molecule, okwenza ukuthi batholakale ekuqashelweni kwamaseli we-NK.
Amaseli e-NK akhona egazini lomuntu futhi "angabaphenduli bokuqala". Kufana nephoyisa ekade lisemsebenzini emzimbeni. Njengoba igazi ligijima, amaseli e-NK axhumana namanye amaseli ngenkathi ezulazula. Uma okungavamile kutholakala emzimbeni Amangqamuzana, azinzile ngokushesha, anembile, alinda ngonya isikhathi sokubhekana nawo. Bahlasela futhi bakhulule izinhlayiya ze-cytotoxic eziqukethe i-perforin ne-granzyme kulwelwesi lweseli okuhlosiwe ngaphambi kokuba kusetshenziswe ama-T cell, okubangela ukuzibhubhisa kwamangqamuzana omdlavuza. Bangakwazi futhi ukuqeda amangqamuzana omdlavuza ajikelezayo emzimbeni futhi basize ukuvimbela i-metastasis.
Izinzuzo zokwelashwa kwe-NK cell
1. Ukwelashwa kwamangqamuzana amasosha omzimba kuyindlela yesine yokwelapha ngemva kokuhlinzwa, ukwelapha ngamakhemikhali kanye ne-radiotherapy. I-NK cell therapy ehlanganiswe ne-radiotherapy kanye ne-chemotherapy ingasusa ngokuphumelelayo amangqamuzana e-tumor angakwazi ukususwa ngokuphelele ngokuhlinzwa;
2. Ukwelashwa kwamaseli e-NK okuhlanganiswe ne-radiochemotherapy kungathuthukisa ukusebenza kwe-radiochemotherapy futhi kunciphise imiphumela emibi;
3. Ezigulini zomdlavuza osezingeni eliphezulu ezingakulungele ukuhlinzwa noma i-radiotherapy kanye ne-chemotherapy, i-NK cell therapy iyindlela engcono;
4. Ukwelashwa njalo ngamaseli we-NK ngemuva kokuhlinzwa kungavimbela ukuphindaphinda kanye ne-metastasis yomdlavuza;
5. Ukudambisa izinhlungu zomdlavuza, ukuthuthukisa ukulala, ukuthuthukisa ikhwalithi yempilo yesiguli, nokwandisa umjikelezo wokuphila wesiguli;
6. Kubantu abanempilo encane, ukusetshenziswa kwe-NK cell therapy kunganciphisa ingozi yomdlavuza.
Yiziphi iziguli ezifanele ukwelashwa kwe-NK cell?
Iziguli ezinomzimba omubi ngaphambi kokuhlinzwa, ukululama kancane ngemuva kokuhlinzwa, nokwesaba amaseli omdlavuza wemilingo ukuthi akuqediwe ngokuphelele.
Ngemuva kwe-radiotherapy kanye ne-chemotherapy, amasosha omzimba aphansi, futhi imiphumela emibi isobala (njengokulahlekelwa isifiso sokudla, isicanucanu, ukulahleka kwezinwele, ukuvuvukala kwesikhumba, njll.), Neziguli ezilindele ukwandisa umphumela we-chemoradiation.
Ngenxa yokwesaba imiphumela emibi ye-radiotherapy kanye ne-chemotherapy, iziguli ezinethemba lokusebenzisa izindlela ezahlukahlukene zokwelapha ukufeza imiphumela yokwelashwa.
Amaseli womdlavuza kwizicubu ezisezingeni eliphakeme asabalale wonke umzimba, kepha izindlela zokwelashwa ezivamile bezingenamandla, neziguli ezilindele ukwelula isikhathi sokuphila nokwenza ngcono impilo.
Inqubo yokwelashwa kwe-NK cell therapy
1. Ukuqoqwa kwegazi
Dweba u-30-50ml wegazi eliseceleni o
f iziguli ezinomdlavuza futhi zikhiphe amangqamuzana e-mononuclear;
2. Ukulinywa kwelabhorethri
E-laboratory, yenza ukufakwa kwe-NK cell nokwandiswa kwezinsuku ezingama-5-7;
3. Buyisa
Ngemuva kokuthi isiko le-NK seliqediwe, libuyiselwa esigulini somdlavuza njengokufakwa.
