He 10 mau makahiki ʻelua me ka leukemia ma muli o ka lāʻau lapaʻau e hoʻōla ai i ka maʻi kanesa: CAR-T

E ho'ōla ka lāʻau lapaʻau CAR-T i nā maʻi me ka ʻike. ʻO kēia ke ʻano o ka paʻakikī o kekahi o nā paionia o kēia mālama ʻana, ʻo Carl June, i ka wā e pili ana i ka mālama ʻana i hoʻololi i ka mālama ʻana i kēia maʻi maʻi hematological a hōʻoia i kona pono lōʻihi, 10 mau makahiki, i loko o kahi ʻatikala i paʻi ʻia i kēia lā ma »Nature ” kahi i hōʻike ʻia ai nā hopena ma hope o ke kua o nā maʻi mua i mālama ʻia ma US.

CAR-T therapy (Chimeric Antigen Receptor T-Cell) ʻaʻole ia he lāʻau e hoʻohana ai. He lāʻau 'ola' ia i hana ʻia e kēlā me kēia maʻi me kahi wehewehe kikoʻī: ua unuhi ʻia nā cell o ka ʻōnaehana immune (T lymphocytes) o ka mea maʻi, hoʻololi ʻia e hoʻonui iā lākou.

Mana a koho a ʻike ʻia e hoʻokomo i loko o ka mea maʻi, wehewehe ʻo Lucrecia Yáñez San Segundo, hematologist ma ka Halemai Marqués de Valdecilla.

ʻO Doug Olson kekahi o nā maʻi mua ʻelua i loaʻa i kēia lāʻau hoʻopilikia a i kēia lā, 10 mau makahiki ma hope o ka mālama ʻana, ua manaʻo ʻia ʻo ia ua ola.

Hoʻopaʻa ka ʻatikala "Nature" i ka hahai ʻana o kēia mau maʻi mua ʻelua i ho'ōla ʻia e kēia lāʻau lapaʻau hou a hōʻike i nā pane o kēia mau pūnaewele CAR-T mau loa a hāʻawi, no ka manawa mua, ka ʻike e pili ana i ka lōʻihi o ka hopena. ʻO ka lāʻau lapaʻau, ʻoiai ʻo kekahi o nā kānalua me ka lāʻau lapaʻau ʻo ke ola o nā pūnae T transplanted.

ʻO ka hana i hoʻonohonoho ʻia e J. Joseph Melenhorst, mai ke Kulanui o Pennsylvania (USA) e hōʻike ana, he 10 mau makahiki ma hope mai, ʻaʻohe ʻike o nā maʻi leukemia i kekahi o nā maʻi ʻelua, a ʻo ia hoʻi, e like me kā Carl June i hōʻike ai, ʻo ka T ke koe. i nā maʻi a loaʻa iā ia ka hiki ke pepehi i nā maʻi kanesa.

"Ke kamaʻilio nei ʻoe e pili ana i kēia lāʻau lapaʻau, pono ʻoe e ʻōlelo he mālama ola ia," wahi a Carl June, ka luna o ka Center for Cellular Immunotherapies a me ka Parker Institute for Cancer Therapy ma ke Kulanui o Pennsylvania. ʻO nā pūnaewele T "e ulu aʻe i ka manawa a, e like me ka hōʻike ʻana o kēia hana, hoʻololi a loaʻa iā ia ka hiki ke pepehi i nā maʻi maʻi maʻi 10 mau makahiki ma hope o ka mālama ʻana."

ʻAʻole ʻike ʻia nā maʻi maʻi leukemia i kēlā me kēia maʻi a ua mau ka T cell i loko o nā maʻi a hiki ke pepehi i nā maʻi maʻi.

Ua ʻike ʻia ʻo Doug i ka maʻi leukemia i ka makahiki 1996, i ke 49 o kona mau makahiki. "I ka hoʻomaka - ʻōlelo ʻo ia - ua hana nā lāʻau lapaʻau akā ma 6 mau makahiki ua loaʻa iaʻu kahi kala."

I ka makahiki 2010 "50% o nā pūnaewele i loko o koʻu iwi iwi he maʻi ʻaʻai a ua kū ka maʻi kanesa i ka lāʻau maʻamau".

ʻO ia ka manawa i hāʻawi manawaleʻa ai ka hui o Melenhorst e komo i kahi hoʻokolohua lapaʻau paionia me kēia lāʻau lapaʻau hou, a ma Kepakemapa 2010 ua loaʻa iā ia kāna infusion T-cell mua. "Ua manaʻo wau ʻo koʻu manawa hope loa ia."

I kēia manawa, 10 mau makahiki ma hope, ua manaʻo ʻo Doug ua hoʻōla ʻia ʻo ia. "I hoʻokahi makahiki ma hope mai ua haʻi mai ʻo ia iaʻu ua hana ka mālama ʻana. Ua lohe koke ʻo ia ua lanakila wau i kaʻu kaua me ka maʻi kanesa. Ua loaʻa iaʻu ka pōmaikaʻi o ka hiki ke komo i kēia lapaʻau a ke manaʻo nei au e hiki pū i nā poʻe ʻē aʻe. "

Hoʻohālikelike kēia mau hoʻoholo i ka mea i loaʻa i nā kano RNA ma Covid-19. Hōʻoia lākou i ka hiki o ka noiʻi ke hoʻololi i ka hōʻailona o kekahi mau maʻi

I kēia makahiki hoʻokahi, he 9 mau mahina ma hope mai, ua loaʻa iā Doug a me kekahi mea maʻi i ke kala piha i kēlā makahiki a ke hōʻike nei i kēia manawa ua ʻike mau ʻia nā cell CAR-T no nā makahiki he 10 o ka hahai ʻana.

Ua lohe koke ʻo ia ua lanakila wau i kaʻu kaua me ka maʻi kanesa

I ka wā mua, kuhikuhi ʻo Melenhorst, "ua kānalua mākou. ʻOiaʻiʻo, ua hana mākou i ʻelua biopsies e hōʻoia i nā hopena. Akā he ʻoiaʻiʻo: mai ka ʻike ʻepekema hiki iā mākou ke kamaʻilio e pili ana i ka ho'ōla".

Ma Sepania, ua hoʻomaka ka mālama ʻana i ka hoʻohana ʻana i ka makahiki 2019 i nā mea maʻi me ka leukemia i koho ʻia - ka poʻe i pane ʻole i ka hapa nui o nā lāʻau lapaʻau-, wehewehe ka hematologist ma ka haukapila Cantabrian. Akā, wehewehe ʻo ia, "ʻo kekahi mau ʻikepili mai nā hoʻokolohua lapaʻau e hōʻike ana e ʻoi aku ka nui o nā hopena inā e lawe ʻia ka manawa o ka hoʻohana ʻana i ka lāʻau lapaʻau a hui pū ʻia me nā lāʻau lapaʻau o kēia manawa."

ʻO Doug Olson - hōʻaiʻē Penn Medicine

Manaʻo ka mea paionia o kēia lāʻau lapaʻau i ka wā e hiki mai ana, ma kekahi ʻano a i ʻole, "e mālama ʻia nā maʻi koko a pau me CAR-T".

No laila, ua paʻi hou ʻia nā hopena o kahi noiʻi i alakaʻi ʻia e Jesús San Miguel, ka luna lapaʻau o Clínica Universidad de Navarra a me Clinical and Translational Medicine o ka Universidad de Navarra, a i paʻi ʻia ma The New England Journal of Medicine, e hōʻike ana i kēia lāʻau lapaʻau. ua kūpono i nā poʻe maʻi me nā maʻi meli he nui, ʻoi aku ka maʻi maʻi hematological lua.

Ke manaʻoʻiʻo nei ka paionia o kēia lāʻau lapaʻau i ka wā e hiki mai ana, ma kekahi ala a i ʻole, e mālama ʻia nā ʻōpū koko āpau me CAR-T

Ma nā ʻāina hou, ʻoi aku ma mua o 200 mau mea maʻi CAR-T pāʻoihana i nā hoʻokolohua lapaʻau a me 50 me nā inoa kula, i hana ʻia i nā halemai. "ʻO ka maikaʻi o ka mea hope ʻoi aku ka maʻalahi," wahi a Yañez.

ʻO ka paʻakikī i kēia manawa ʻo ka unuhi ʻana i kēia mau hopena i nā ʻōpū paʻa, wahi a Iune, no ka mea, ʻo ka maʻi maʻi koko he 10% wale nō o nā ʻōpū.

Pono nō hoʻi ka hoʻolohe ʻana, wahi a Melenhorst, no ka mea, ʻaʻole hana ʻo CAR-T therapy no nā maʻi āpau. "Ma ka hahai ʻana i ka wā lōʻihi, ua ʻike ʻia ka hana ʻana o nā CAR-T kalepa ma 40% o nā maʻi me ka lymphoma cell nui. Aia he 60% o nā hihia i pōmaikaʻi ʻole, ʻaʻole lākou e pane a i ʻole ma muli o nā hopena ʻaoʻao, no ka mea "i wehewehe ʻo Yáñez.

Akā e like me ka ʻōlelo a kēia loea, ʻo ia ka mana mua o ka CART-T. "I ka wā e hiki mai ana, aia nā ʻano like ʻole o ka CAR-T no nā maʻi maʻi ʻē aʻe, ʻo ke koko a me ka paʻa."

hope hina

Akā ʻelua mau pōʻino o ka CAR-T. ʻO kekahi o lākou kona kumukūʻai kiʻekiʻe, aia ma kahi o 300.000 a i ʻole 350.000 euros i kēlā me kēia maʻi, inā hoʻohui ʻia ka hale hoʻokipa a me ke komo ʻana i ka ICU.

ʻO kekahi, he mea nui hoʻi, ʻaʻole hiki iā ʻoe ke hoʻopili iā ia i kekahi haukapila. No kēia kumu, ua hoʻolālā ka Ministry of Health i kahi hoʻolālā National no Advanced Therapies. ʻO nā halemai ʻumikūmākahi i ʻae ʻia a puni ka ʻāina, ʻelima ma Barcelona (Clínic, Sant Pau, Vall d'Hebron - ʻelua ʻāpana, no nā keiki a me nā mākua-, Sant Joan de Deu), ʻelua ma Madrid (Gregorio Marañón a me Niño Jesús) a Valencia (La Fe a me Clínico), a me kekahi ma Andalusia (Virgen del Rocío ma Seville) a me Castilla y León (Salamanca Healthcare Complex).

Manaʻo ʻo Yañez e kanu paha kēia hoʻolālā i kekahi ʻano like ʻole no nā poʻe maʻi ma ke kūkulu ʻākau o Sepania, Galicia, Asturias, Cantabria, Basque Country a i ʻole Navarra, no ka mea, pono lākou e loaʻa i kēia mau kikowaena e loaʻa ai ka lāʻau lapaʻau.

Hōʻike ka hematologist o ka Spanish Society of Hematology and Hemotherapy i nā poʻe maʻi mai kēia mau wahi o Sepania e kū nei i nā ʻano e loaʻa ai kēia lapaʻau pono e hele i nā kikowaena kuhikuhi no ka lawe ʻana i kā lākou mau cell a, ma hope o ʻekolu a ʻehā pule, ʻo ia ka manawa pono e hana i ka lāʻau lapaʻau ma ke koi, e hoʻi i ke kikowaena i ʻōlelo ʻia ma mua e loaʻa ai ka infusion o nā cell. "Hiki iā mākou ke hahai wale aku."

No Carl June, he hōʻike kēia o ka hiki ke hoʻololi i ka ʻepekema i ka hana o ka lāʻau lapaʻau. "Hoʻohālikelike ʻia kēia mau hoʻoholo i ka mea i loaʻa i nā kano RNA ma Covid-19. Hōʻoia lākou i ka hiki o ka noiʻi ke hoʻololi i ka hōʻailona o kekahi mau maʻi ".