Habka Cusub ee looga Hortagayo Saamaynnada halista ah ee Daawaynta Difaaca Kansarka

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Khubarada Cincinnati Children's ayaa ka warbixinaya jiirarka, in daawaynta ka hortagga jidhka ay hagaajin karto badbaadada marka nooc ka mid ah 'dabaysha cytokine' ay ku dhufato.

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Haddi ay tahay carruurta la tacaalaysa cudurrada difaaca jirka ee naadirka ah ama bukaannada kansarka oo raadinaya daawayn difaac oo cusub oo rajo leh, dad badan ayaa wax ka baranaya nooc inta badan dilaa ah ee hab-dhiska difaaca ee falcelinta xad-dhaafka ah ee loo yaqaan "dabaylaha cytokine."              

Dhakhaatiirta caafimaadka iyo saynisyahano muddo dheer wax ka ogaa duufaannada cytokine waxay sidoo kale og yihiin in arrimo badan ay ku lug yeelan karaan kicinta iyaga, oo kaliya dhowr daaweyn ayaa hoos u dhigi kara. Hadda, koox ka socota Cincinnati Children's ayaa ka warbixisay guusha marxaladda hore ee lagu xakameynayo qaar ka mid ah duufaannada cytokine iyaga oo carqaladeynaya calaamadaha ka soo baxaya unugyada T ee firfircoon ee nidaamka difaacayada. 

Natiijooyin faahfaahsan ayaa lagu daabacay Jan. 21, 2022, gudaha Sayniska Immunology. Daraasadu waxay leedahay saddex qoraayaal hormuud ah: Margaret McDaniel, Aakanksha Jain, iyo Amanpreet Singh Chawla, PhD, oo dhamaantood hore ula socday Cincinnati Children's. Qoraaga sare ee u dhigma wuxuu ahaa Chandrashekhar Pasare, DVM, PhD, Professor, Qaybta Immunobiology iyo Iskuduwaha Xarunta Caabuqa iyo Dulqaadka ee Carruurta Cincinnati.

"Daahfurkaani waa mid muhiim ah sababtoo ah waxaan ku muujinnay, jiirarka, in dariiqyada caabuqa ee nidaamka ah ee ku lug leh nooca T-cells ee duufaanka cytokine-ka waa la yarayn karaa," Pasare ayaa yidhi. "Shaqo badan ayaa loo baahan doonaa si loo xaqiijiyo in habka aan u isticmaalnay jiirarka ay sidoo kale noqon karto badbaado iyo waxtar u leh bini'aadamka. Laakiin hadda waxaan leennahay bartilmaameed cad oo aan ku daba galno.”

Waa maxay duufaanka cytokine?

Cytokines waa borotiinno yaryar oo ay soo daayaan nooc kasta oo unug ah. Daraasiin cytokines ah oo la yaqaan ayaa qabta shaqooyin kala duwan oo muhiim ah, oo caadi ah. Nidaamka difaaca, cytokines waxay caawisaa inay hagto unugyada T-unugyada iyo unugyada kale ee difaaca si ay u weeraraan oo ay u nadiifiyaan fayrasyada iyo bakteeriyada soo duulaya iyo sidoo kale la dagaallanka kansarka.

Laakiin mararka qaarkood, cytokine "dabaylo" waxay ka dhalataa in unugyo badan oo T ah ay ku jiraan dagaalka. Natiijadu waxay noqon kartaa barar xad-dhaaf ah oo sababi kara dhaawac aad u daran, xitaa dhaawac halis ah oo soo gaara unugyada caafimaadka qaba.

Cilmi-baarista cusubi waxay iftiiminaysaa habka calaamadaynta heerka molecular. Kooxdu waxay soo warisay in ugu yaraan laba dariiqo oo madaxbannaan ay jiraan kuwaas oo kicinaya caabuqa jirka. In kasta oo ay jirto waddo si fiican loo yaqaan oo la aasaasay oo barar ah oo loogu talagalay ka falcelinta kuwa dibadda soo duulay, shaqadani waxay qeexaysaa waddo aan la fahmin oo kaxaysa "madhalays" ama dhaqdhaqaaqa difaaca aan la xiriirin caabuqa.

Warar rajo leh oo ku saabsan daryeelka kansarka

Laba ka mid ah horumarinta daryeelka kansarka ee ugu xiisaha badan sannadihii la soo dhaafay ayaa ahaa horumarinta isbaarada isbaarada iyo daawaynta unug-qaadayaasha antigen-ka (CAR-T). Noocyadan daawaynta ayaa ka caawiya unugyada T inay ogaadaan oo burburiyaan unugyada kansarka ee hore uga baxsan jiray difaaca dabiiciga ah ee jidhka.

Daawooyin dhowr ah oo ku salaysan tignoolajiyada CAR-T ayaa loo oggolaaday daawaynta shatiyada la dagaallama fidinta B-cell lymphoma (DLBCL), lymphoma follicular, lymphoma unugga mantle, myeloma badan, iyo unugyada B-cell lymphoblastic leukemia (ALL). Dhanka kale. Tiro ka mid ah isbaarooyinka ayaa caawinaya dadka qaba kansarka sanbabada, kansarka naasaha iyo dhowr cudur oo kale. Daawayntan waxaa ka mid ah atezolizumab (Tecentriq), avelumab (Bavencio), cemiplimab (Libtayo), dostarlimab (Jemperli), durvalumab (Imfinzi), ipilimumab (Yervoy), nivolumab (Opdivo), iyo pembrolizumab (Keytruda).

Si kastaba ha noqotee, bukaannada qaarkood, daawayntani waxay u oggolaan karaan raxan unugyada T-yada xun inay weeraraan unugyada caafimaadka qaba iyo sidoo kale kansarka. Tijaabooyin taxane ah oo jiirka iyo shaybaadhka ah, kooxda cilmi-baadhista ee Cincinnati Children's ayaa sheegaysa in ay isha ku hayaan isha caabuqa ee ka dhasha dhaqan-xumada unugga T oo ay muujiyaan hab looga hortago.

"Waxaan aqoonsannay noode calaamad muhiim ah oo ay adeegsadaan xusuusta T-cells (TEM) si ay u abaabulaan barnaamij ballaaran oo proinflammatory ah oo ku jira habka difaaca gudaha," ayuu yiri Pasare. "Waxaan ogaanay in sunta cytokine iyo cudurada difaaca jirka si buuxda loo samatabbixin karo noocyo badan oo unugyo ah oo barar ah iyadoo la carqaladeynayo calaamadahan iyada oo loo marayo tafatirka hidda-socodka ama xeryahooda molecule yaryar."

Daawaynta la'aan, 100 boqolkiiba jiirarka ayaa ku kalifay inay la kulmaan duufaan cytokine ah sida kuwa ay kicisay daawaynta CAR-T waxay ku dhinteen shan maalmood gudahood. Laakiin 80 boqolkiiba jiirarka lagu daweeyay unugyada difaaca si loo xakameeyo calaamadaha ka soo baxa unugyada T ee firfircoon ayaa badbaaday ugu yaraan toddobo maalmood.

Helitaanka laguma dabaqi karo COVID-19

Dad badan oo qaba caabuqyo daran oo ka yimid fayraska SARS-CoV-2 ayaa sidoo kale la kulmay duufaannada cytokine. Si kastaba ha ahaatee, waxaa jira kala duwanaansho muhiim ah oo u dhexeeya caabuqa habdhiska ah ee uu keeno caabuqa fayrasku iyo qaabkan "madhalays ah" ee bararka cararka ah ee uu keeno unugyada T ee firfircoon.

"Waxaan aqoonsannay koox hidde-sideyaal ah oo ay si gaar ah u kiciyaan unugyada TEM ee aan ku lug lahayn jawaabta caabuqa fayras ama bakteeriyada," Pasare ayaa yidhi. "Tani waxay muujinaysaa isbeddelka kala duwan ee labadan hab ee hawlgelinta gudaha."

Talaabooyinka xiga

Aragti ahaan, daawaynta antibody-ka oo la mid ah tan lagu isticmaalo daraasaadka jiirka ayaa la siin karaa bukaanka kansarka ka hor intaysan helin daawaynta CAR-T. Laakiin cilmi baaris dheeraad ah ayaa loo baahan yahay si loo go'aamiyo haddii habkan oo kale uu yahay mid ammaan ah oo ku filan in lagu tijaabiyo tijaabooyinka bukaan-socodka ee bini'aadamka.

Marka laga soo tago samaynta qaab rajo leh oo daryeel kansar ah oo ay heli karaan dad badan, xakamaynta dariiqan caabuqa ee nadiifka ah ayaa laga yaabaa inay waxtar u leedahay carruurta ku dhasha mid ka mid ah saddexda cudur ee difaaca jirka ee dhifka ah, oo ay ku jiraan IPEX syndrome, kaas oo uu keeno isbeddel ku yimaadda hidda-wadaha FOXP3; Cudurka CHAI, kaas oo ka yimaada cilladaha hiddaha CTLA-4; iyo cudurka LATIAE, oo uu keeno isbeddellada hidda-wadaha LRBA. 

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War ku saabsan qoraaga

editor

Tifaftiraha madaxa eTurboNew waa Linda Hohnholz. Waxay ku salaysan tahay eTN HQ ee Honolulu, Hawaii.

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