CAR-T (Chimeric Antigen Receptor T-cell) ni iki?
Ubwa mbere, reka turebere hamwe ubudahangarwa bw'umubiri bw'umuntu.
Ubudahangarwa bw'umubiri bugizwe n'urusobe rw'uturemangingo, ingirabuzimafatizo, n'ingingo zikorana kugira ngo zirinde umubiri. Imwe mu ngirabuzimafatizo z'ingenzi zigize uruhare ni uturemangingo tw'amaraso, twitwa kandi leukocytes, tuza mu bwoko bubiri bw'ibanze buhuriza hamwe kugira ngo bushake kandi busenye ibinyabuzima cyangwa ibintu bitera indwara.
Ubwoko bubiri bw'ibanze bwa leukocytes ni:
Ø phagocytes, uturemangingo turya ibinyabuzima byinjira
Ø lymphocytes, uturemangingo dufasha umubiri kwibuka no kumenya ibyateye mbere no gufasha umubiri kubirimbura
Uturemangingo twinshi dutandukanye dufatwa nk'uturemangingo twa phagocytes. Ubwoko bukunze kugaragara cyane ni neutrophil, irwanya cyane cyane bagiteri. Iyo abaganga bahangayikishijwe n'ubwandu bwa bagiteri, bashobora gusaba ko umurwayi apimwa amaraso kugira ngo barebe niba umubare wiyongereye wa neutrophils uterwa n'ubwandu. Ubundi bwoko bwa phagocytes bufite akazi kabwo ko kugenzura ko umubiri witabira neza ubwoko runaka bw'ubwandu.
Ubwoko bubiri bwa lymphocytes ni lymphocytes B na lymphocytes T. Lymphocytes zitangirira mu musokoro w'amagufwa zikaguma aho ngaho zigakura zikagera mu tunyangingo twa B, cyangwa zigasohoka zijya muri thymus gland, aho zikura zikagera mu tunyangingo twa T. Lymphocytes B na lymphocytes T zigira imirimo itandukanye: Lymphocytes B ni nk'urwego rw'ubutasi rwa gisirikare rw'umubiri, zishakisha intego zazo kandi zikohereza ubwirinzi kugira ngo zibafatire. T selile ni nk'abasirikare, zirimbura abateye urwo rwego rw'ubutasi rwabonye.
Ubudahangarwa bw'umubiri bugizwe n'urusobe rw'uturemangingo, ingirabuzimafatizo, n'ingingo zikorana kugira ngo zirinde umubiri. Imwe mu ngirabuzimafatizo z'ingenzi zigize uruhare ni uturemangingo tw'amaraso, twitwa kandi leukocytes, tuza mu bwoko bubiri bw'ibanze buhuriza hamwe kugira ngo bushake kandi busenye ibinyabuzima cyangwa ibintu bitera indwara.
Ubwoko bubiri bw'ibanze bwa leukocytes ni:
Ø phagocytes, uturemangingo turya ibinyabuzima byinjira
Ø lymphocytes, uturemangingo dufasha umubiri kwibuka no kumenya ibyateye mbere no gufasha umubiri kubirimbura
Uturemangingo twinshi dutandukanye dufatwa nk'uturemangingo twa phagocytes. Ubwoko bukunze kugaragara cyane ni neutrophil, irwanya cyane cyane bagiteri. Iyo abaganga bahangayikishijwe n'ubwandu bwa bagiteri, bashobora gusaba ko umurwayi apimwa amaraso kugira ngo barebe niba umubare wiyongereye wa neutrophils uterwa n'ubwandu. Ubundi bwoko bwa phagocytes bufite akazi kabwo ko kugenzura ko umubiri witabira neza ubwoko runaka bw'ubwandu.
Ubwoko bubiri bwa lymphocytes ni lymphocytes B na lymphocytes T. Lymphocytes zitangirira mu musokoro w'amagufwa zikaguma aho ngaho zigakura zikagera mu tunyangingo twa B, cyangwa zigasohoka zijya muri thymus gland, aho zikura zikagera mu tunyangingo twa T. Lymphocytes B na lymphocytes T zigira imirimo itandukanye: Lymphocytes B ni nk'urwego rw'ubutasi rwa gisirikare rw'umubiri, zishakisha intego zazo kandi zikohereza ubwirinzi kugira ngo zibafatire. T selile ni nk'abasirikare, zirimbura abateye urwo rwego rw'ubutasi rwabonye.
Ikoranabuhanga rya T cells rya Chimeric antigen receptor (CAR): ni ubwoko bwa adoptive cell immunotherapy (ACI). T cells z'umurwayi zigaragaza CAR binyuze mu ikoranabuhanga ryo gusana imiterere y'uturemangingo, bigatuma T cells zikora zibasirwa cyane, zica kandi zigakomeza kurusha uturemangingo dusanzwe tw'ubudahangarwa bw'umubiri, kandi zishobora gutsinda uduce duto duto tw'ubudahangarwa bw'umubiri duto duto dutuma turwara kanseri kandi tugatuma umubiri udashobora kwihanganira indwara. Ubu ni uburyo bwihariye bwo kuvura uturemangingo tw'ubudahangarwa bw'umubiri.
Ihame rya CART ni ugukuramo "uburyo busanzwe" bw'uturemangingo twa T tw'umubiri w'umurwayi no gukomeza gukora igenamigambi rya gene, guteranya in vitro kugira ngo habeho intego zihariye za kanseri y'intwaro nini yo kurwanya abakozi "chimeric antigen receptor (CAR)", hanyuma ukongera gushyira uturemangingo twa T twahinduwe mu mubiri w'umurwayi, uturemangingo dushya twahinduwe tuzamera nk'aho dushyiraho sisitemu ya radar, ishobora kuyobora uturemangingo twa T mu gushaka no gusenya uturemangingo twa kanseri.
Akamaro ka CART muri BPIH
Bitewe n'itandukaniro mu miterere y'aho itumanaho rikorera mu turemangingo, CAR yateye imbere mu bisekuru bine. Dukoresha CART iheruka.
1stivuka: Hari igice kimwe gusa cy'ikimenyetso cyo mu ngirabuzimafatizo kandi ingaruka zo gukumira ikibyimba zari mbi.
2ndivuka: Hiyongereyeho molekile ifasha mu gutera imbaraga hashingiwe ku ivuka rya mbere, kandi ubushobozi bw'uturemangingo twa T bwo kwica ibibyimba bwariyongereye.
3rdivuka: Hashingiwe ku gisekuru cya kabiri cya CAR, ubushobozi bw'uturemangingo twa T bwo gukumira ikwirakwira ry'ibibyimba no guteza imbere apoptosis bwarushijeho kwiyongera cyane.
4thivuka: Uturemangingo twa CAR-T dushobora kugira uruhare mu gukuraho uturemangingo twa kanseri binyuze mu gukora transcription factor NFAT kugira ngo itere interleukin-12 nyuma yuko CAR imenye antigen.
Uburyo bwo kuvura
1) Gutandukanya uturemangingo tw’amaraso: Uturemangingo twa T tw’umurwayi dutandukanywa n’amaraso yo mu gice cy’imbere;
2) Gukora ku tunyangingo twa T: udusaro twa magnetiki (utunyangingo twa dendritic artificial) dutwikiriwe n'utunyangingo tw'umubiri dukoreshwa mu gukora ku tunyangingo twa T;
Guhindura Uturemangingo: Uturemangingo twa T twahinduwe mu buryo bwa genetiki kugira ngo tugaragaze CAR mu buryo bwa vitro.
3) Kuzamura: Uturemangingo twa T twahinduwe mu buryo bw'uturemangingo twongerwa mu buryo bwa vitro.
4) Chimiotherapie: Umurwayi abanza kuvurwa na chimiotherapie mbere yo kongera gukoresha selile T;
5) Kongera gutera: Uturemangingo twa T twahinduwe mu buryo bw'uturemangingo twongera kwinjira mu murwayi.
Ibyiza:
1)Uturemangingo twa CAR T twibasirwa cyane kandi dushobora kwica uturemangingo twa kanseri dufite antigen nziza kurushaho.
2)Ubuvuzi bwa selile za CAR-T busaba igihe gito. CAR T isaba igihe gito cyo gupima selile za T kuko ikenera selile nkeya munsi y’ingaruka zimwe zo kuvura. Igihe cyo gupima selile za vitro gishobora kugabanywa kikagera ku byumweru 2, ibyo bikaba byaragabanyije cyane igihe cyo gutegereza.
3)CAR ishobora kumenya antigens za peptide gusa, ndetse na antigens z'isukari na lipide, yongera urwego rw'ingenzi rwa antigens za kanseri. Ubuvuzi bwa CAR T ntibugarukira kandi kuri antigens za poroteyine zo mu turemangingo twa kanseri. CAR T ishobora gukoresha antigens z'isukari na lipide zitari protein zo mu turemangingo twa kanseri kugira ngo imenye antigens mu buryo butandukanye.
4)CAR-T ifite ubushobozi bwo kongera kugaragara mu buryo bwagutse. Kubera ko ahantu hamwe na hamwe hagaragara mu turemangingo twinshi twa kanseri, nka EGFR, gene ya CAR y’iyi antigen ishobora gukoreshwa cyane iyo imaze gukorwa.
5)Uturemangingo twa CAR T dufite ubushobozi bwo kwibuka ubudahangarwa bw'umubiri kandi dushobora kubaho mu mubiri igihe kirekire. Ni ingenzi cyane mu gukumira ko ikibyimba kizongera kugaruka.