Kurapa kweCAR-T kucharapa varwere vane ruzivo. Aya ndiwo maitiro asina kujeka mumwe wemapiyona ekurapa uku, Carl June, ari kutaura nezve kurapwa kwakashandura kurapwa kwekenza iyi yehematological uye yakasimbisa kushanda kwayo kwenguva refu, makore gumi, mune chinyorwa chakabudiswa nhasi mu »Nature ” umo mhedzisiro inounzwa kumashure kwevarwere vekutanga kurapwa muUS.
CAR-T therapy (Chimeric Antigen Receptor T-Cell) haisi mushonga wekushandisa. Mushonga 'mhenyu' unogadzirwa nemurwere wega wega ane tsananguro yakati: maseru e immune system (T lymphocytes) yemurwere anotorwa, anogadziridzwa genetically kuti awedzere.
Ane simba uye anosarudza uye anoonekwa kupinza mumurwere, akatsanangura Lucrecia Yáñez San Segundo, hematologist paMarques de Valdecilla Hospital.
Doug Olson aive mumwe wevarwere vaviri vekutanga kugamuchira kurapwa kunovhiringidza uku uye nhasi, makore gumi mushure mekurapwa, anonzi akaporeswa.
Nyaya ye "Nature" inonyora kutevera kwevarwere vaviri vekutanga vakaporeswa nemishonga iyi itsva uye inoratidza mhinduro dzemasero aya eCAR-T anogara kwenguva refu uye inopa, kwekutanga, ruzivo rwekuti migumisiro inogona kugara kwenguva yakareba sei. yokurapa, sezvo kumwe kusava nechokwadi nokurapa kwaiva upenyu hwemasero eT akasimwa.
Basa rakarongwa naJ. Joseph Melenhorst, kubva kuYunivhesiti yePennsylvania (USA) rinotaura kuti, makore gumi gare gare, hapana kana masero eleukemia mune mumwe wevarwere vaviri uye, zvakare, sezvakataurwa naCarl June, T inoramba iripo. muvarwere uye vane kugona kuuraya cancer maseru.
"Paunotaura nezvekurapa uku, unofanirwa kutaura kuti kurapa mhenyu," akadaro Carl June, director weCentre for Cellular Immunotherapies uye Parker Institute for Cancer Therapy paYunivhesiti yePennsylvania. T masero "anoshanduka nekufamba kwenguva uye, sezvinoratidzwa nebasa iri, anogadzirisa uye ane simba rekuuraya kenza masero makore gumi mushure mekurapa."
Iko hakuna mutsara wemasero eukemia mune chero murwere uye T masero anoramba ari muvarwere uye ane kugona kuuraya cancer maseru.
Doug akaonekwa kuti aiva neleukemia muna 1996, ava nemakore 49. "Pakutanga - anoti - marapirwo akashanda asi pamakore matanhatu ndakava nekuregererwa."
Muna 2010 "50% yemasero mumwongo wangu aive negomarara uye gomarara rainge ratoramba kurapwa".
Ndipo apo boka raMelenhorst rakazvipira kutora chikamu mukuedza kwekiriniki yekupayona nekurapa kutsva uku, uye munaGunyana 2010 akagamuchira kuisirwa kwake kwekutanga kweT-cell. "Ndakafunga kuti ndiwo mukana wangu wekupedzisira."
Zvino, makore gumi gare gare, Doug akazviona seaporeswa. “Papera gore akandiudza kuti kurapwa kwacho kwakashanda. Akabva angonzwa kuti ndainge ndakunda muhondo yangu negomarara. Ndave nemukana wekukwanisa kuwaniswa kurapwa uku uye ndinovimba kuti vamwe vanhu vanokwanisawo.”
Kutemerwa uku kunofananidzwa neakawana vaccines yeRNA muCovid-19. Vanosimbisa kugona kwekutsvaga kushandura chiratidzo chezvimwe zvirwere
Gore rimwe chetero, mwedzi ye9 chete gare gare, vese Doug nemumwe murwere vakawana kuregererwa kwakakwana mugore iroro uye zvino vanotaura kuti masero eCAR-T akaonekwa zvachose kwemakore anopfuura gumi ekutevera.
Akabva angonzwa kuti ndainge ndakunda muhondo yangu negomarara
Pakutanga, Melenhorst anoti, “takanga tisina chokwadi nazvo. Muchokwadi, isu takaita mabiopsies maviri kuti tione mhedzisiro. Asi chaive chokwadi: kubva pakuona kwesainzi taigona kutaura nezve kuporeswa”.
MuSpain, kurapwa kwakatanga kushandiswa muna 2019 muvarwere vane leukemia yakasarudzwa - avo vasina kupindura kurapwa kwakawanda-, akatsanangura chiremba wehematologist kuchipatara cheCantabrian. Asi, anojekesa, "dzimwe dhata kubva kumakiriniki ekuedzwa dzinoratidza kuti zvigumisiro zvingave zvakakura kana nguva yekushandiswa kwekurapa yakaunzwa mberi uye yakabatanidzwa nemishonga yemazuva ano."
Doug Olson - chikwereti Penn Mushonga
Mupiyona wechirwere ichi anotenda kuti mune ramangwana, nenzira imwe kana imwe, "mamota ose eropa achabatwa neCAR-T".
Nokudaro, migumisiro yeongororo yakatungamirirwa naJesús San Miguel, mutungamiriri wezvokurapa weClínica Universidad de Navarra uye weClinical and Translational Medicine yeUniversidad de Navarra, uye yakabudiswa muThe New England Journal of Medicine yakabudiswa munguva pfupi yapfuura, zvichiratidza kuti kurapwa uku. yaibudirira kune varwere vane huchi dzakawanda chirwere, kenza yechipiri yehematological inowanzoitika.
Iye piyona wekurapa uku anotenda kuti mune ramangwana, neimwe nzira kana imwe, mamota ese eropa acharapwa neCAR-T.
Munyika itsva kune vanopfuura 200 vezvokutengeserana veCAR-T varwere mumakiriniki ekuedzwa uye makumi mashanu ane mazita ezvidzidzo, ayo anogadzirwa muzvipatara. "Chakanakira chekupedzisira ndechekuti dzakachipa," anodaro Yañez.
Chinonetsa pari zvino ndere kushandura mhedzisiro iyi kumamota akasimba, anodaro June, nekuti gomarara reropa rinomiririra chikamu chegumi kubva muzana chemamota.
Kuteerera kunodiwa zvakare, akadaro Melenhorst, nekuti kurapwa kweCAR-T hakushande kune vese varwere. "Mukutevera kwenguva refu, zvakaonekwa kuti yekutengesa CAR-Ts inoshanda mu40% yevarwere vane hombe cell lymphoma. Kune makumi matanhatu muzana emakesi asingabatsiri, angave asingapindure kana nekuda kwemhedzisiro, nekuti "Yáñez akatsanangura.
Asi sekubvuma kunoita nyanzvi iyi, iyi ndiyo yekutanga vhezheni yeCART-T. "Mune ramangwana, pachava nemhando dzakasiyana dzeCAR-T kune mamwe mamota, zvose ropa uye zvakasimba."
musana zvigumbuso
Asi iyo CAR-T ine makomba maviri. Imwe yacho mutengo wayo wakakwira, uyo ungangoita mazana matatu ezviuru kana mazana matatu nemakumi mashanu emaeuro pamurwere, kana kuraswa muchipatara nekumanikidzwa kubvumidzwa kuICU zvawedzerwa.
Chimwe, chakakoshawo, ndechekuti haugone kuishandisa kune chero chipatara. Nechikonzero ichi, Bazi rezvehutano rakagadzira Chirongwa cheNyika cheMarapirwo epamusoro. Pazvipatara gumi nerimwe zvakatenderwa munyika yose, zvishanu zviri muBarcelona (Clínic, Sant Pau, Vall d'Hebroni - zvikamu zviviri, zvevana nevakuru-, Sant Joan de Deu), zviviri muMadrid (Gregorio Marañón naNiño Jesús) uye Valencia (La Fe neClínico), uye imwe muAndalusia (Virgen del Rocío muSeville) uye Castilla y León (Salamanca Healthcare Complex).
Comment Yañez kuti chirongwa ichi chinogona kudyara kumwe kusaenzana kwevarwere kuchamhembe kweSpain, Galicia, Asturias, Cantabria, Basque Country kana Navarra, sezvo vachifanira kunge vaine nzvimbo idzi kuti vawane kurapwa.
Nyanzvi yehematologist yeSpanish Society yeHematology uye Hemotherapy inotaura kuti varwere vanobva munzvimbo idzi dzeSpain vanosangana nehunhu hwekugamuchira kurapwa uku vanofanirwa kuenda kunzvimbo dzekutarisisa kuti vatorerwe maseru uye, mushure memavhiki matatu kana mana, inova nguva inodiwa kugadzira mushonga paunoda, dzokera kunzvimbo yambotaurwa kuti ugamuchire infusion yemasero. "Tinogona kutevera chete."
Kuna Carl June, uhwu humbowo hwekuti sainzi inogona kuchinja sei maitiro ekurapa. "Izvi zvakatemerwa zvakafanana nezvakawanikwa neRNA vaccines muCovid-19. Vanosimbisa kugona kwekutsvaga kushandura chiratidzo chezvimwe zvirwere ”.
