Njira Yatsopano Yopewera Zotsatira Zazikulu za Machiritso a Khansa Oteteza Chitetezo

Written by mkonzi

Akatswiri a Cincinnati Children's lipoti, mu mbewa, kuti chithandizo cha antibody chikhoza kukhala ndi moyo pamene mtundu wina wa 'cytokine mkuntho' ugunda.

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Kaya ndi ana omwe akulimbana ndi matenda osowa kwambiri a autoimmune kapena odwala khansa omwe akufunafuna chithandizo chatsopano cha chitetezo chamthupi, anthu ambiri akuphunzira za njira yomwe nthawi zambiri imapha kwambiri chitetezo chamthupi chotchedwa "mkuntho wa cytokine."              

Madokotala ndi asayansi omwe adziwa za namondwe wa cytokine kwa nthawi yayitali amadziwanso kuti zinthu zambiri zimatha kuyambitsa, ndipo ndi mankhwala ochepa okha omwe angachedwetse. Tsopano, gulu lochokera ku Cincinnati Children's lipoti lachita bwino poyambilira kuthana ndi mphepo yamkuntho ya cytokine posokoneza ma siginecha otuluka kuchokera ku ma T cell omwe ali m'thupi lathu. 

Zotsatira zatsatanetsatane zidasindikizidwa Januware 21, 2022, mu Science Immunology. Phunziroli lili ndi olemba atatu otsogolera: Margaret McDaniel, Aakanksha Jain, ndi Amanpreet Singh Chawla, PhD, onse omwe kale anali ndi Cincinnati Children's. Wolemba wamkuluyo anali Chandrashekhar Pasare, DVM, PhD, Pulofesa, Division of Immunobiology ndi Co-Director of Center for Inflammation and Tolerance ku Cincinnati Children's.

"Kupeza kumeneku ndikofunikira chifukwa tawonetsa, mu mbewa, kuti njira zotupa zamtundu wamtundu wa T cell zoyendetsedwa ndi cytokine mkuntho zitha kuchepetsedwa," akutero Pasare. "Padzafunika ntchito yowonjezereka kuti titsimikizire kuti njira yomwe timagwiritsa ntchito mbewa ingakhalenso yotetezeka komanso yothandiza kwa anthu. Koma tsopano tili ndi cholinga chenicheni choti tikwaniritse.”

Kodi mkuntho wa cytokine ndi chiyani?

Ma Cytokines ndi timinofu tating'onoting'ono tomwe timapangidwa ndi pafupifupi mtundu uliwonse wa selo. Ma cytokine ambiri odziwika amagwira ntchito zosiyanasiyana zofunika. Mu chitetezo chamthupi, ma cytokines amathandizira kutsogolera ma T-maselo ndi maselo ena oteteza chitetezo kumenyana ndi kuchotsa ma virus ndi mabakiteriya omwe akubwera komanso kuthana ndi khansa.

Koma nthawi zina, “mkuntho” wa cytokine umabwera chifukwa chokhala ndi ma T cell ochuluka pankhondoyo. Chotsatiracho chikhoza kukhala kutupa kwambiri komwe kungayambitse kwambiri, ngakhale kuwononga minofu yathanzi.

Kafukufuku watsopano akuwunikira njira yowonetsera pamlingo wa maselo. Gululi likuti pali njira ziwiri zodziyimira pawokha zomwe zimayambitsa kutupa m'thupi. Ngakhale pali njira yodziwika bwino komanso yokhazikitsidwa yotupa yochita nawo omwe abwera kunja, ntchitoyi ikufotokoza njira yosamvetsetseka yomwe imayendetsa chitetezo cha "chosabala" kapena chosakhudzana ndi matenda.

Nkhani zabwino za chisamaliro cha khansa

Ziwiri mwazosangalatsa za chisamaliro cha khansa mzaka zaposachedwa zakhala chitukuko cha ma checkpoint inhibitors ndi chimeric antigen receptor T cell therapy (CAR-T). Mitundu yamankhwala imeneyi imathandiza maselo a T kuzindikira ndi kuwononga maselo a khansa omwe poyamba ankazemba chitetezo chachilengedwe cha thupi.

Mankhwala angapo otengera luso la CAR-T amavomerezedwa pochiza ma patent omwe akulimbana ndi B-cell lymphoma (DLBCL), follicular lymphoma, mantle cell lymphoma, multipleeloma, ndi B-cell acute lymphoblastic leukemia (ALL). Panthawiyi. angapo a checkpoint inhibitors akuthandiza anthu omwe ali ndi khansa ya m'mapapo, khansa ya m'mawere ndi matenda ena angapo. Mankhwalawa akuphatikizapo atezolizumab (Tecentriq), avelumab (Bavencio), cemiplimab (Libtayo), dostarlimab (Jemperli), durvalumab (Imfinzi), ipilimumab (Yervoy), nivolumab (Opdivo), ndi pembrolizumab (Keytruda).

Komabe, kwa odwala ena, mankhwalawa amatha kulola kuti ma cell a T-cell awononge minofu yathanzi komanso khansa. Pazoyeserera zingapo za mbewa ndi labotale, gulu lofufuza la Cincinnati Children's lipoti likuyang'ana komwe kumayambitsa kutupa komwe kumachitika chifukwa cha khalidwe loipa la T cell ndikuwonetsa njira yopewera.

"Tazindikira mfundo yofunika kwambiri yomwe imagwiritsidwa ntchito ndi effector memory T cell (TEM) kuti tithandizire kulimbikitsa chitetezo cham'thupi," akutero Pasare. "Tidapeza kuti poizoni wa cytokine ndi autoimmune pathology zitha kupulumutsidwa kwathunthu mumitundu ingapo ya kutupa koyendetsedwa ndi ma T cell posokoneza mazizindikirowa mwina kudzera mukusintha ma jini kapena mamolekyu ang'onoang'ono."

Popanda chithandizo, 100 peresenti ya mbewa zomwe zinachititsidwa ndi mkuntho wa cytokine monga zomwe zinayambitsidwa ndi chithandizo cha CAR-T zinafa mkati mwa masiku asanu. Koma 80 peresenti ya mbewa zothandizidwa ndi ma antibodies kuti atseke zidziwitso zochokera ku maselo a T omwe adatsegulidwa adapulumuka masiku osachepera asanu ndi awiri.

Kupezeka sikugwira ntchito ku COVID-19

Anthu ambiri omwe ali ndi matenda oopsa kuchokera ku kachilombo ka SARS-CoV-2 nawonso adakumana ndi mkuntho wa cytokine. Komabe, pali kusiyana kwakukulu pakati pa kutupa kwapang'onopang'ono komwe kumayambitsidwa ndi matenda a virus ndi mtundu "wosabala" wa kutupa komwe kumachitika chifukwa cha ma T cell omwe atsegulidwa.

"Tazindikira gulu la majini omwe amapangidwa mwapadera ndi maselo a TEM omwe sakhudzidwa ndi kuyankha kwa ma virus kapena mabakiteriya," akutero Pasare. "Izi zikuwonetsa kusinthika kosiyana kwa njira ziwirizi zoyambitsa mwachibadwa."

Zotsatira zotsatira

Mwachidziwitso, chithandizo chamankhwala chofanana ndi chomwe chimagwiritsidwa ntchito m'maphunziro a mbewa chikhoza kuperekedwa kwa odwala khansa asanalandire chithandizo cha CAR-T. Koma kafukufuku wochulukirapo akufunika kuti adziwe ngati njira yotereyi ndi yotetezeka kuti ayesedwe m'mayesero achipatala a anthu.

Kuwonjezera pa kupanga mtundu wodalirika wa chithandizo cha khansa kuti anthu ambiri azitha kupeza, kuyang'anira njira yotupa yotupayi kungakhale kothandiza kwa ana obadwa ndi chimodzi mwa matenda atatu osowa kwambiri a autoimmune, kuphatikizapo IPEX syndrome, yomwe imayambitsidwa ndi kusintha kwa jini ya FOXP3; Matenda a CHAI, omwe amayamba chifukwa cha kusokonezeka kwa jini ya CTLA-4; ndi matenda a LATIAE, omwe amayamba chifukwa cha masinthidwe amtundu wa LRBA. 

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mkonzi

Mkonzi wamkulu wa eTurboNew ndi Linda Hohnholz. Amakhala ku eTN HQ ku Honolulu, Hawaii.

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