CAR-T ni iki (Chimeric Antigen Receptor T-selile)?
Ubwa mbere, reka turebe sisitemu yumubiri yumuntu.
Sisitemu yubudahangarwa igizwe nurusobe rw'utugingo ngengabuzima, ingirangingo, n'ingingo zikorana mu kurinda umubiri.Imwe mu ngirabuzimafatizo zikomeye zirimo selile yamaraso yera, nayo yitwa leukocytes, iza muburyo bubiri bwibanze buhuza gushaka no kurimbura ibinyabuzima cyangwa ibintu bitera indwara.
Ubwoko bubiri bwibanze bwa leukocytes ni:
Ø phagocytes, selile zihekenya ibinyabuzima byinjira
Ø lymphocytes, selile zemerera umubiri kwibuka no kumenya abateye mbere kandi bigafasha umubiri kubatsemba
Umubare wingirabuzimafatizo zitandukanye zifatwa nka fagocytes.Ubwoko bukunze kugaragara ni neutrophil, irwanya cyane cyane bagiteri.Niba abaganga bahangayikishijwe n'indwara ya bagiteri, barashobora gutegeka kwipimisha amaraso kugirango barebe niba umurwayi afite umubare munini wa neutrophile uterwa n'ubwandu.Ubundi bwoko bwa fagocytes bufite akazi kabwo kugirango umenye neza ko umubiri witabira muburyo bwihariye bwabateye.
Ubwoko bubiri bwa lymphocytes ni B lymphocytes na Lymphocytes T.Lymphocytes itangirira mu magufa hanyuma igumeyo kandi ikuze muri selile B, cyangwa ziva muri glande ya thymus, aho zikurira muri selile T.Lymphocytes B na Lymphocytes T bifite imirimo itandukanye: B lymphocytes B ni nka sisitemu yubutasi ya gisirikare yumubiri, ishakisha intego zayo no kohereza kwirwanaho kugirango ibafunge.T selile zimeze nkabasirikare, zirimbura abateye sisitemu yubutasi yamenye.
Sisitemu yubudahangarwa igizwe nurusobe rw'utugingo ngengabuzima, ingirangingo, n'ingingo zikorana mu kurinda umubiri.Imwe mu ngirabuzimafatizo zikomeye zirimo selile yamaraso yera, nayo yitwa leukocytes, iza muburyo bubiri bwibanze buhuza gushaka no kurimbura ibinyabuzima cyangwa ibintu bitera indwara.
Ubwoko bubiri bwibanze bwa leukocytes ni:
Ø phagocytes, selile zihekenya ibinyabuzima byinjira
Ø lymphocytes, selile zemerera umubiri kwibuka no kumenya abateye mbere kandi bigafasha umubiri kubatsemba
Umubare wingirabuzimafatizo zitandukanye zifatwa nka fagocytes.Ubwoko bukunze kugaragara ni neutrophil, irwanya cyane cyane bagiteri.Niba abaganga bahangayikishijwe n'indwara ya bagiteri, barashobora gutegeka kwipimisha amaraso kugirango barebe niba umurwayi afite umubare munini wa neutrophile uterwa n'ubwandu.Ubundi bwoko bwa fagocytes bufite akazi kabwo kugirango umenye neza ko umubiri witabira muburyo bwihariye bwabateye.
Ubwoko bubiri bwa lymphocytes ni B lymphocytes na Lymphocytes T.Lymphocytes itangirira mu magufa hanyuma igumeyo kandi ikuze muri selile B, cyangwa ziva muri glande ya thymus, aho zikurira muri selile T.Lymphocytes B na Lymphocytes T bifite imirimo itandukanye: B lymphocytes B ni nka sisitemu yubutasi ya gisirikare yumubiri, ishakisha intego zayo no kohereza kwirwanaho kugirango ibafunge.T selile zimeze nkabasirikare, zirimbura abateye sisitemu yubutasi yamenye.
Chimeric antigen reseptor (CAR) T tekinoroji ya selile: ni ubwoko bwimikorere ya immunotherapy (ACI).T selile yumurwayi igaragaza CAR ikoresheje tekinoroji yo kongera kubaka genetike, ituma ingirabuzimafatizo T yibasirwa cyane, yica kandi ikomeza kurenza ingirabuzimafatizo zisanzwe z’umubiri, kandi irashobora gutsinda mikorobe y’ibidukikije ikingira ikibyimba kandi ikananirwa kwihanganira ubudahangarwa bw'umubiri.Ubu ni uburyo bwihariye bwo kwirinda indwara - kuvura ibibyimba.
Ihame rya CART ni ugukuramo "verisiyo isanzwe" yingirabuzimafatizo y’umurwayi wa T hanyuma ugakomeza gukora injeniyeri ya gene, guteranya muri vitro kugirango ibibyimba byibasiwe nintwaro nini ya antipersonnel "chimeric antigen reseptor (CAR)", hanyuma ushiremo ibyahinduwe T selile zisubira mumubiri wumurwayi, reseptor nshya zahinduwe zizaba nko gushiraho sisitemu ya radar, ibasha kuyobora selile T kumenya no gusenya selile.
Ibyiza bya CART kuri BPIH
Bitewe nuburyo butandukanye mumiterere yikimenyetso cyerekana ibimenyetso, CAR yateje imbere ibisekuru bine.Dukoresha ibisekuru bigezweho CART.
1stigisekuru: Hariho ibimenyetso bimwe gusa byerekana ibimenyetso kandi ingaruka zo kubuza ibibyimba byari bibi.
2ndigisekuru: Hiyongereyeho molekile ikangura-ishingiye ku gisekuru cya mbere, kandi ubushobozi bwa selile T bwo kwica ibibyimba bwaratejwe imbere.
3rdigisekuru: Dushingiye ku gisekuru cya kabiri cya CAR, ubushobozi bwa selile T bwo kubuza ikwirakwizwa ry’ibibyimba no guteza imbere apoptose.
4thigisekuru: selile CAR-T irashobora kugira uruhare mukurandura abaturage bingirangingo yibibyimba mugukora ibintu byandikirwa hasi NFAT kugirango itere interleukin-12 nyuma yuko CAR imenye antigen.
Uburyo bwo kuvura
1) Akagari k'amaraso yera yitaruye: T selile yumurwayi yitandukanije namaraso ya peripheri;
2) T selile ikora: amasaro ya magnetique (selile dendritic selile) yashizwemo na antibodies zikoreshwa mugukora selile T;
Kwimura: T selile zakozwe muburyo bwa genetike kugirango zigaragaze CAR muri vitro.
3) Amplification: T selile yahinduwe genetike yongerewe imbaraga muri vitro.
4) Chimiotherapie: Umurwayi yabanje kuvurwa na chimiotherapie mbere yuko T selile yongera;
5) Kongera gushiramo: T yahinduwe genetike T selile yinjira mumurwayi.
Ibyiza:
1)CAR T selile yibasiwe cyane kandi irashobora kwica selile yibibyimba hamwe na antigen yihariye.
2)Ubuvuzi bwa CAR-T busaba igihe gito.CAR T isaba igihe gito kumuco T selile kuko isaba selile nkeya muburyo bumwe bwo kuvura.Umuco wa vitro cycle urashobora kugabanywa kugeza kumyumweru 2, ibyo bikaba byaragabanije cyane igihe cyo gutegereza.
3)CAR ntishobora kumenya antigene ya peptide gusa, ariko kandi irashobora kumenya isukari na antipine ya lipide, ikagura intego ya antigene yibibyimba.Ubuvuzi bwa CAR T nabwo ntibugarukira kuri poroteyine antigene ya selile yibibyimba.CAR T irashobora gukoresha isukari hamwe na lipide itari proteyine ya selile yibibyimba kugirango imenye antigene mubipimo byinshi.
4)CAR-T ifite ubugari runaka - imyororokere yimyororokere.Kubera ko imbuga zimwe zigaragarira mu ngirabuzimafatizo nyinshi, nka EGFR, gene CAR kuri iyi antigen irashobora gukoreshwa cyane iyo yubatswe.
5)CAR T selile ifite imikorere yibuka kandi irashobora kubaho mumubiri igihe kirekire.Ni ingirakamaro cyane mubuvuzi kugirango ikibyimba kitazongera kubaho.