Njira yatsopano yogwiritsira ntchito maselo anu kuti amenyane ndi khansa (CAR T-cell Therapy)

Kodi munayamba mwaganizapo kuti thupi lathu lingathe kulimbana ndi khansa lokha? Ndipotu, thupi lathu lili ndi chitetezo chanzeru kwambiri chotchedwa chitetezo chamthupi. Lili ndi gawo lapadera lotchedwa T-cells, lomwe lili ngati asilikali. Ntchito yawo ndi kupeza ndi kuwononga majeremusi achilendo ndi maselo osinthika omwe amalowa m'thupi. Koma nthawi zina, maselo a khansa amakhala achinyengo kwambiri. Amabisala ku maselo a T awa, kuwanyenga ndikukula mkati mwa thupi. Panthawi ngati zimenezi, tikambirana za chithandizo chatsopano, chodabwitsa chomwe chimathandiza maselo athu a T kuzindikira ndi kuwononga maselo a khansa powapatsa "maphunziro apadera."

Mwachidule, kodi chithandizo cha maselo a CAR T n'chiyani?

Ngakhale dzinalo lingamveke lovuta, lingaliro lake ndi losavuta. Chithandizo cha maselo a CAR T ndi mtundu wa chithandizo cha chitetezo chamthupi. Chimaphatikizapo kutenga maselo ena a T anu ndikuwasintha majini mu labotale.

Ganizirani maselo anu a T ngati apolisi. Maselo a khansa ali ngati akuba obisika. Nthawi zambiri, apolisi sangazindikire akuba awa. Chithandizo cha maselo a CAR T chili ngati kupatsa apolisi anu magalasi apadera. Galasi iyi imatchedwa 'Chimeric Antigen Receptor' (CAR) . Imapangidwa mu labu ndipo imalumikizidwa ku maselo a T.

Tsopano, galasi lapaderali likayikidwa, maselo a T amatha kuzindikira molondola mapuloteni enaake (antigens) pamwamba pa maselo a khansa. Maselo a khansa omwe anali atabisika kale tsopano akuwoneka bwino. Maselo a T, omwe apeza mphamvu zazikuluzikulu, amapita mwachindunji kukaukira maselo a khansa ndikuwononga. Chithandizochi ndi chothandiza kwambiri pochiritsa mitundu ina ya khansa ya m'magazi komanso pothandiza ena kukhala ndi moyo wautali ndi khansa.

Ndi mitundu iti ya khansa ya m'magazi yomwe mankhwalawa amachiritsa?

Pakadali pano, chithandizo cha maselo a CAR T chimagwiritsidwa ntchito pa mitundu ina ya khansa ya m'magazi yomwe sinayankhepo ku mankhwala ena (monga chemotherapy) kapena yomwe yabweranso pambuyo pa chithandizo. Popeza akadali chithandizo chatsopano kwambiri, sichiperekedwa ku khansa zonse.

Gome ili m'munsimu likuwonetsa mitundu ya khansa yomwe chithandizochi chikuvomerezedwa pakadali pano.

Kodi njira imeneyi ya chithandizo imachitika bwanji?

Ntchito yonseyi imachitika m'magawo angapo. Zili ngati kuphunzitsa asilikali ankhondo kenako nkuwabwezera kunkhondo.

Gawo 1: Kusonkhanitsa maselo anu a T

Choyamba, thupi lanu liyenera kusonkhanitsa maselo oyera a magazi, makamaka maselo a T. Izi zimachitika kudzera mu njira yotchedwa leukapheresis . Izi zimaphatikizapo kutumiza magazi anu kudzera mu makina, omwe amalekanitsa maselo oyera okha, ndikubwezera magazi otsalawo m'thupi lanu. Izi zili ngati kupereka magazi, koma gawo limodzi lokha la magazi limatengedwa ndipo lotsalalo limabwezedwa.

2. Gawo: Tumizani maselo a T ku labu ndikuwasintha

Kenako, maselo a T omwe atengedwa kuchokera kwa inu amatumizidwa ku labu yapadera. Kumeneko, asayansi amagwiritsa ntchito ukadaulo wa majini kuti aike CAR (Chimeric Antigen Receptor) yomwe tidakambirana kale m'maselo a T. Kenako, maselo atsopano a CAR T amphamvu kwambiri amakula mu labu mpaka atakhala ndi mamiliyoni ambiri. Izi zimatenga milungu itatu mpaka isanu ndi umodzi.Zingatenge nthawi.

3. Gawo: Kukonzekera thupi lanu

Mpaka maselo a CAR T atapangidwa mu labu, dokotala wanu angakupatseni mankhwala ena (bridging therapy), monga chemotherapy, kuti muchepetse khansa yanu.

Kenako, masiku angapo musanapatsidwe ma CAR T-cells atsopano, mudzapatsidwa mankhwala a chemotherapy ochepa. Amatchedwa lymphodepleting chemotherapy . Izi zimagwira ntchito pochepetsa chitetezo cha mthupi cha thupi lanu, ndikupanga malo abwino kuti ma CAR T-cell atsopano, apamwamba, agwire ntchito.

4. Gawo: Kubwezeretsa ma super T cells m'thupi

Ichi ndi chochitika chachikulu. Monga momwe zimakhalira popereka madzi amchere, maselo atsopano a CAR T amalowetsedwa m'thupi lanu kudzera mu mtsempha (mzere wa m'mitsempha - IV). Izi zimatenga pakati pa mphindi 5 ndi 30. Maselo amenewa akangolowa m'thupi, amayamba kuchulukana okha, kufunafuna ndikuwononga maselo a khansa. Chifukwa maselowa amakhala m'thupi kwa nthawi yayitali ndipo amalimbana ndi khansa, ena amatcha chithandizochi kuti "mankhwala amoyo."

Kodi chimachitika ndi chiyani mukalandira chithandizo? Kodi zoopsa zake ndi ziti?

Popeza chithandizochi ndi champhamvu kwambiri, nthawi zina zotsatirapo zoyipa zimatha kuchitika. Chifukwa chake, muyenera kukhala kuchipatala kwa pafupifupi sabata imodzi mpaka masiku khumi mutalandira chithandizocho. Madokotala ndi anamwino adzakuyang'anirani mosamala.

Zotsatirapo Zazikulu

Pali zotsatira ziwiri zazikulu komanso zofala kwambiri za chithandizochi. Ngakhale kuti izi zitha kukhala zoopsa, magulu azachipatala ali ndi zida zokwanira zochizira.

Kodi chithandizochi chikuyenda bwino bwanji?

Chithandizo cha maselo a CAR T chabweretsa chiyembekezo chatsopano kwa anthu ambiri omwe akulimbana ndi khansa ya m'magazi, makamaka omwe sanalandire chithandizo china.

• Mwachitsanzo, ana opitilira 85% omwe adalandira chithandizo ichi cha ana aang'ono a acute lymphoblastic leukemia (ALL) adachira khansa yawo yonse atalandira chithandizo. Ndipo, 60% mwa iwo analibe khansa chaka chimodzi atalandira chithandizo.

Ukadaulo uwu ukusinthabe. Ofufuza padziko lonse lapansi akuyesetsa nthawi zonse kukonza chithandizochi, kuchepetsa zotsatirapo zake, ndikuwona ngati chingagwiritsidwe ntchito pa mitundu ina ya khansa.

Kodi muyenera kupita kwa dokotala liti?

Zotsatirapo za chithandizochi, makamaka Cytokine Release Syndrome ndi mavuto a mitsempha, zitha kukhala zoopsa kwa moyo . Choncho musanatuluke kuchipatala, funsani dokotala wanu zizindikiro zomwe muyenera kudziwa bwino.

Ngati zizindikiro monga malungo, kuzizira, mutu, ndi nseru zikupitirira, zikhoza kukhala chizindikiro cha matenda aakulu. Ngati ndi choncho, imbani dokotala wanu nthawi yomweyo kapena pitani ku Dipatimenti Yoona za Zadzidzidzi (ETU) ya chipatala.

Ngati inu kapena munthu amene mumamudziwa ali ndi khansa ya m'magazi, lankhulani ndi dokotala wanu ngati chithandizo cha maselo a CAR T chili choyenera kwa inu. Ngakhale kuti chithandizochi si cha aliyense, chingakhale chosintha moyo wa munthu woyenera.