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Kutanthauzira Kwathunthu kwa Chithandizo cha Ma cell a CAR T
CAR-T (Chimeric Antigen Receptor T-Cell), yomwe imayimira chimeric antigen receptor T-cells, ndi njira yomwe maselo a T a munthu amapangidwa majini kunja kwa thupi kuti asinthidwe, zomwe zimawapatsa mphamvu yozindikira ndikupha bwino maselo a khansa asanalowetsedwenso m'thupi la wodwalayo, potero kukwaniritsa cholinga chochiza zotupa zoopsa.
Ndipotu, chithandizo cha CAR-T sichimangogwiritsidwa ntchito pochiza khansa komanso chili ndi mphamvu zambiri m'magawo a matenda odziteteza ku matenda opatsirana, matenda osatha, matenda a mtima, ndi matenda okhudzana ndi ukalamba.
Maselo a T, omwe amadziwikanso kuti T lymphocytes, ndi omwe ali m'gulu la ma lymphocytes ndipo makamaka ndi omwe amachititsa kuti chitetezo cha mthupi chizigwira ntchito komanso kuteteza matenda. Amagwira ntchito monga kupha maselo omwe akufuna kudwala mwachindunji, kuthandiza ndikuletsa maselo a B kupanga ma antibodies, kuyankha ma antigen ndi mitogens enaake, komanso kupanga ma cytokines.
Zachidziwikire, chitetezo chamthupi cha munthu sichimangokhala pa maselo a T okha; chimaphatikizaponso maselo a B, ma neutrophils, maselo a K, maselo a NK, ndi ena ambiri. Amagwira ntchito yochotsa zinyalala m'thupi, kuzindikira ndikupanga ma antibodies, komanso kuzindikira ndi kupha tizilombo toyambitsa matenda ndi maselo a khansa.
Popeza maselo a T ali kale ndi ntchito yozindikira ndi kupha maselo a khansa, n’chifukwa chiyani kuli kofunikira kuwonjezera CAR ku maselo a T mwadala kuti apange maselo a CAR-T kuti aphe maselo a khansa? Izi zikutifikitsa ku lingaliro la kupewa chitetezo cha mthupi, lomwe ndi limodzi mwa makhalidwe ofunikira kwambiri a khansa.
Chithandizo cha CAR-T, kapena chithandizo cha maselo a CAR-T, chimaphatikizapo kulekanitsa maselo a T a wodwalayo, kuwakulitsa kunja kwa thupi, kenako n’kuyambitsa chotupa cha CAR (chimeric antigen receptor) chopangidwa mwaluso ku maselo a T. Pambuyo pokonza, ntchito yolimbana ndi chotupa ya ma lymphocyte a T imawonjezeka kwambiri isanalowetsedwenso m’thupi la wodwalayo, motero kubwezeretsa mphamvu ya maselo a T kuzindikira ndi kupha maselo a khansa. Ichi ndiye cholinga cha chithandizo cha maselo a CAR-T.
Chithandizo cha CAR-T cha Impact Bio cha IMPT-514 chavomerezedwa ndi FDA.
Pa Ogasiti 21, 2024, Impact Bio idalengeza kuti FDA yavomereza kugwiritsa ntchito kwake kwa IND pa chithandizo cha IMPT-514 chomwe idapanga. IMPT-514 ndi chithandizo cha CD19/CD20 CAR-T chogwiritsidwa ntchito pochiza matenda a lupus erythematosus (SLE) omwe sagwira ntchito. Mu deta yoyesera zachipatala, IMPT-514 idawonetsedwa kuti imagwira ntchito bwino kwambiri popanga kuchokera kwa odwala omwe ali ndi chitetezo chamthupi chofooka kwambiri kuchokera ku matenda osiyanasiyana a autoimmune, ndipo idawonetsa mphamvu yamphamvu yochotsera maselo a B ndi mawonekedwe ofatsa a cytokine. Chithandizo cha Axicabtagene ciloleucel CAR-T cha lymphoma yayikulu ya B-cell chikuwonetsabe kuyankha kosalekeza patatha zaka zisanu. Pa Ogasiti 2, 2024, American Society of Clinical Oncology (ASCO) idatulutsa lipoti la deta yokhudza kuchuluka kwa anthu omwe apulumuka nthawi yayitali pambuyo pa chithandizo cha maselo a CAR-T. Zotsatira zake zinasonyeza kuti pakati pa odwala omwe adalandira chithandizo cha CAR-T, chiwerengero cha kupulumuka kwa zaka 5 chopanda kupita patsogolo chinali 29%, chiwerengero cha kupulumuka kwa zaka 5 (OS) chinali 40%, ndipo chiwerengero cha kupulumuka kwa zaka 5 chokhudzana ndi lymphoma chinali 53%, ndipo kubwereranso mwakale kunali kochepa. Axicabtagene ciloleucel ndi chithandizo cha maselo a autologous CD19 chimeric antigen receptor CAR-T chomwe chavomerezedwa kuchiza lymphoma yayikulu ya B-cell yobwereranso kapena yokana. Kutsiliza: Mu chisamaliro chokhazikika, zotsatira za chithandizo cha axicabtagene ciloleucel CAR-T zimagwirizana ndi zotsatira zomwe zanenedwa m'mayesero azachipatala, ndi mayankho okhazikika komanso okhazikika omwe adawonedwa pazaka 5.
Chithandizo choyamba cha CAR-T chopambana padziko lonse lapansi cha matenda odziteteza ku matenda a autoimmune.Pa Okutobala 4, 2024, tsamba la Nature linalemba nkhani yofotokoza zotsatira za kafukufuku wochokera ku gulu la ku China. Asayansi adagwiritsa ntchito ukadaulo wosintha majini a CRISPR-Cas9 kuti apange maselo athanzi a CAR-T ochokera kwa opereka omwe akuyang'ana CD19, ndikupanga mbadwo watsopano wa chithandizo cha CAR-T chomwe chinathandiza odwala atatu omwe ali ndi matenda oopsa a autoimmune kuti athetse vutoli kwa nthawi yayitali.
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Mavuto azachipatala omwe amaswa ayezi chifukwa cha "kuphulika kwa mphuno m'mapapo"
Kusamalira nthawi zonse ma nodules a m'mapapo kumaphatikizapo biopsy ndi pneumonectomy.
Mavuto monga pneumothorax ndi hemothorax ndi osavuta kuchitika panthawi ya biopsy.
Pali zoopsa za kutayika kwa maselo a chotupa ndi kufalikira kwa maselo. N'zovuta kuzindikira matendawa chifukwa cha kuchepa kwa minofu yodziwika bwino ya biopsy.
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Khansa ya m'mapapo
Khansa ya m'mapapo (yomwe imadziwikanso kuti khansa ya m'mapapo) ndi khansa yoopsa ya m'mapapo yomwe imayambitsidwa ndi minofu ya epithelial ya bronchial yokhala ndi caliber yosiyana. Malinga ndi mawonekedwe ake, imagawidwa m'magulu apakati, a m'mphepete ndi akuluakulu (osakanikirana).
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Khansa ya M'mimba
Poyamba khansa ya m'mimba, palibe zizindikiro zosasangalatsa komanso palibe ululu woonekeratu, koma maselo ofiira a magazi m'ndowe amapezeka kudzera mu kufufuza ndowe nthawi zonse komanso kuyezetsa magazi, zomwe zimasonyeza kutuluka magazi m'mimba. Gastroscopy imatha kupeza tizilombo tatsopano m'matumbo pachiyambi.
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Khansa ya Pancreatic
Khansa ya kapamba ndi imodzi mwa khansa zoopsa kwambiri zomwe zimakhudza kapamba, chiwalo chomwe chili kumbuyo kwa mimba. Imachitika pamene maselo osazolowereka mu kapamba ayamba kukula mopitirira muyeso, ndikupanga chotupa. Magawo oyamba a khansa ya kapamba nthawi zambiri samayambitsa zizindikiro zilizonse. Pamene chotupacho chikukula, chingayambitse zizindikiro monga kupweteka m'mimba, kupweteka kwa msana, kuchepa thupi, kusowa chilakolako cha chakudya, ndi jaundice. Zizindikirozi zitha kuyambitsidwanso ndi matenda ena, choncho ndikofunikira kuonana ndi dokotala ngati mukukumana ndi chilichonse mwa izi.
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Khansa ya Prostate
Khansa ya prostate ndi chotupa chofala kwambiri chomwe chimapezeka maselo a khansa ya prostate akamakula ndikufalikira m'thupi la mwamuna, ndipo kuchuluka kwake kumawonjezeka ndi ukalamba. Ngakhale kuti kuzindikira msanga ndi chithandizo ndikofunikira kwambiri, njira zina zothandizira zingathandize kuchepetsa kupitirira kwa matendawa ndikuwonjezera kuchuluka kwa odwala omwe ali ndi matendawa. Khansa ya prostate imatha kuchitika pa msinkhu uliwonse, koma nthawi zambiri imakhala yofala kwambiri mwa amuna opitirira zaka 60. Odwala ambiri a khansa ya prostate ndi amuna, koma pakhoza kukhalanso akazi ndi amuna ogonana amuna kapena akazi okhaokha.
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Khansa ya M'chiberekero
Chiberekero cha mazira ndi chimodzi mwa ziwalo zofunika kwambiri zoberekera za akazi, komanso chiwalo chachikulu choberekera cha akazi. Ntchito yake ndi kupanga mazira ndikupanga ndi kutulutsa mahomoni, zomwe zimafala kwambiri pakati pa akazi. Zimawopseza kwambiri miyoyo ndi thanzi la akazi.
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Khansa ya Impso
Kansa ya maselo a impso ndi chotupa choipa chochokera ku dongosolo la epithelial la mkodzo wa parenchyma ya impso. Mawu aukadaulo ndi renal cell carcinoma, yomwe imadziwikanso kuti renal adenocarcinoma, yomwe imatchedwa renal cell carcinoma. Imakhala ndi mitundu yosiyanasiyana ya renal cell carcinoma yochokera m'magawo osiyanasiyana a mkodzo, koma sikuphatikizapo zotupa zochokera ku renal interstitium ndi renal pelvis. Kale mu 1883, Grawitz, katswiri wa matenda aku Germany, adawona kuti... -
Khansa ya Mafupa
Kodi khansa ya m'mafupa ndi chiyani? Iyi ndi njira yapadera yoberekera, chimango, ndi mafupa a anthu. Komabe, ngakhale dongosolo looneka ngati lolimbali lingathe kuchepetsedwa ndikukhala pothawirapo pa zotupa zoopsa. Zotupa zoopsa zimatha kukula paokha ndipo zimathanso kupangidwa kudzera mu kukonzanso zotupa zosaopsa. Nthawi zambiri, tikamalankhula za khansa ya m'mafupa, tikutanthauza khansa yotchedwa metastatic, pamene chotupacho chimakula m'ziwalo zina (mapapo, mawere, prostate) ndikufalikira kumapeto kwa gawo, kuphatikizapo fupa ... -
Khansa ya Chiwindi
Kodi khansa ya chiwindi ndi chiyani? Choyamba, tiyeni tiphunzire za matenda otchedwa khansa. Muzochitika zabwinobwino, maselo amakula, amagawikana, ndikusintha maselo akale kuti afe. Iyi ndi njira yokonzedwa bwino yokhala ndi njira yowongolera yomveka bwino. Nthawi zina njira imeneyi imawonongeka ndipo imayamba kupanga maselo omwe thupi silifuna. Zotsatira zake n'zakuti chotupacho chikhoza kukhala chosaopsa kapena choipa. Chotupa chosaopsa si khansa. Sichifalikira ku ziwalo zina za thupi, ndipo sichidzakulanso pambuyo pa opaleshoni. Komabe... -
Kansa ya m'mimba
Khansa ya m'matumbo otchedwa colonectum, ndi chotupa chofala kwambiri m'mimba, chomwe chimapezeka ndi chachiwiri pambuyo pa khansa ya m'mimba ndi m'mero, ndipo ndi khansa yofala kwambiri ya m'matumbo otchedwa colonectum (pafupifupi 60%). Odwala ambiri ali ndi zaka zoposa 40, ndipo pafupifupi 15% ali ndi zaka zosakwana 30. Amuna ndi omwe amapezeka kwambiri, chiŵerengero cha amuna kwa akazi ndi 2-3:1 malinga ndi zomwe apeza kuchipatala, zapezeka kuti gawo la khansa ya m'matumbo limachokera ku rectal polyps kapena schistosomiasis; kutupa kosatha kwa m'matumbo, ena angayambitse khansa; zakudya zamafuta ambiri komanso mapuloteni ambiri zimayambitsa kuchuluka kwa cholic acid secretion, yomalizayi imasungunuka kukhala unsaturated polycyclic hydrocarbons ndi intestine anaerobes, zomwe zingayambitsenso khansa.
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Khansa ya M'chiberekero
Khansa ya pachibelekero, yomwe imadziwikanso kuti khansa ya pachibelekero, ndi chotupa chofala kwambiri cha amayi m'njira yoberekera ya akazi. HPV ndiye chinthu chofunikira kwambiri chomwe chimayambitsa matendawa. Khansa ya pachibelekero imatha kupewedwa poyesa ndi kulandira katemera nthawi zonse. Khansa ya pachibelekero ikayamba imachiritsidwa bwino ndipo zizindikiro zake zimakhala zabwino.
Bungwe lachipatala logwirizana la Chipatala cha Khansa cha Beijing