Momwemo chitetezo cha mthupi chimabweretsa kukumbukira zithunzi za maselo oyera a m'magazi omwe amawombera mabakiteriya, kapena ma antibodies omwe akumenyana ndi adani ena. Izi ndizitetezera mabakiteriya ndi mavairasi omwe angakuchititseni kudwala. Komabe, chitetezo cha mthupi chimadziwika kuti chimatha kuzindikira, kufufuza, ndi kuwononga maselo a khansa.
Ndi mphamvu yamphamvu monga chitetezo cha mthupi, payenera kukhala njira yojambula zinthu pansi pa zokopa kuti maselo abwino, osamalidwa asagwidwe ndi zolakwika.
Mwamwayi, mawonekedwe a chitetezo cha mthupi apangidwa ndi mayeso otetezekawa. Komabe, maselo a khansa, atuluka kuchokera ku maselo omwe poyamba anali osowa, nthawi zina amagwiritsa ntchito njirazi zotetezera kuntchito zawo kuti asagwidwe ndi chitetezo cha mthupi. Kufufuza kwa chitetezo chimenechi (zosavuta, kwenikweni) zimadziwika kuti zasayansi, ndipo mankhwala omwe amachokera ku checkpoints ndi checkpoint inhibitors.
Zofufuza Zachimake
Monga njira zowonongeka pamalonda ndi zomangamanga, chigamulo cha thupi chowombera chitetezo cha mthupi kawirikawiri chimakhala ndi "zizindikiro" ndi "zololeka" zambiri zisanayendetsedwe-magulu onse amatha kapena sangakhale ndi zofanana zofanana Dipatimenti sikuti imangopereka chisankho.
Choncho, chitetezo chochuluka chimathandiza kuti chitetezo cha mthupi chisakhumudwitse munthu wina wamba kapena kuti awononge gawo la "mwini" kwa wowononga wowopsa. Zitetezo zoterezi zingagwiritsidwe ntchito mopepuka ndi maselo a khansa kuti apewe chitetezo cha mthupi koma akhoza kupewedwanso ndi osokoneza bongo kuti awononge maselo a khansa kuti asakhalenso "osawoneka" ku chitetezo cha mthupi .
Chisankho ichi cha bizinesi chokwanira kuteteza chitetezo cha mthupi nthawi zina chofunikira chimaphatikizapo kugwirizanitsa ndi "dipatimenti ya selo imfa" -ndiyo, njira yokhayokha ya imfa ya 1 (PD-1) yomwe imayankha kupweteka m'magazi.
Zizindikiro Zowonongeka Zili ndi Mankhwala Othandiza Maselo A T Get Commanding Order
Msewu wa PD-1 uli ndi "mzere wolunjika" kwa ma T-maselo, asilikali omwe amateteza mthupi omwe amapita ndi kupha maselo a kansa; Komabe, ziri kutali ndi chinthu chotsimikizirika kuti asirikali a T-selo adzadzikonzekera okha, apange kutsogolo, ndi kuyamba kuwononga maselo a kansa.
Ndichifukwa chakuti madipatimenti ena amathandizanso pa T-maselo ndi ntchito zawo. Pali zolemba zambiri zomwe zimayenera kuchitika musanayambe asilikali.
Chimodzi mwa zinthu zomwe zimatsimikizira ngati malemba oyendetsa amapatsidwa ndi PD1 receptor, yomwe imakhala ngati wamkulu wotchuka mndandanda wa lamulo. Awiri "alangizi" kwa akuluakuluwa omwe amalangiza kwambiri kuti asamenye nkhondo pa maselo a kansa ndi PDL-1 ndi PDL-2. Aphungu a anti-nkhondo awa, PDL-1 ndi PDL-2, alidi maselo omwe amamatira ku PD1 receptors pa T-maselo. Pamene amanga amauza a T-maselo kuti aime pansi, kuti alibe malamulo oyendetsa khansa.
Maselo a Khansa Angayese Kutulutsa "Odziwitsa Atsutsa Nkhondo"
Nthawi zina maselo a khansa amapanga aphungu ambiri a anti-nkhondo, paokha omwe amawathandiza. Diso limodzi kapena onse awiri PD-L1 ndi PD-L2, omwe ali m'kati mwa maselo, kuphatikizapo maselo a khansa, amatha kumanga ma CD PD komanso amaletsa ntchito yawo.
Kuletsa kugwirizana kumeneku pakati pa PD-1 pa T-maselo ndi osewera ake awiri, omwe ali pamwamba pa maselo ena, kungachititse kuti maselo a T asamangidwe bwino, ndi zochitika zambiri zomwe zimapangitsa kuti ayambe kuthamanga mofulumira.
Mankhwala Amene Amayang'ana PD-1 kapena PD-L1
Maselo ena a khansa amapanga PD-L1 ambiri, omwe amawathandiza kuthawa chitetezo cha mthupi.
Ochita kafukufuku wa mankhwala osokoneza bongo angathe kupanga mankhwala omwe amachititsa kuti pakhale mankhwala othandiza kuti asamakhale ndi matenda a khansa ya PD-1 (wamkulu) kapena PD-L1 ligand (mlangizi wotsutsa nkhondo) khansa.
Poyamba, kupambana kunkawoneka ndi ziwalo zolimba, koma tsopano zovutazi zikufufuzidwa ndi khansa ya hematologic, kapena khansa ya magazi , komanso khansa ya magazi , monga khansa ya m'magazi, lymphoma, ndi myeloma. Mu Hodgkin lymphoma yapamwamba, kuwonjezeka kwa PD-1 ligand (PD-L1 / 2) kupanga maselo a kansa kotero pali chiyembekezo chokhudzana ndi kuopsa kwa Hodgkin lymphoma ku PD-1 blockade.
Popeza izi zimathandiza kuti chitetezo cha mthupi chitetezeke mwa kuchotsa zina mwa chitetezo chake, pali nkhawa kuti izi zingawononge maselo abwino ndi zotsatira zina zowonongeka kwa anthu ena. Zovuta zomwe zimagwirizanitsidwa ndi ma antibodies a PD-1 zimakhala zotsutsa, kuthamanga, ndi kutsekula m'mimba. Nthawi zambiri amatha kuyambitsa mavuto aakulu m'mapapu, m'matumbo, chiwindi, impso, zopangira mahomoni, kapena ziwalo zina.
Mankhwala ena ambiri omwe amawunikira PD-1 kapena PD-L1 akuyesedwa m'mayesero a kachipatala, onse awiri komanso mankhwala ena. Ochepa chabe mwa mankhwalawa adalandira chivomerezo cha FDA kuti agwiritse ntchito khansa mpaka pano, koma ena ambiri tsopano akuphunziridwa mu mayesero a zamankhwala. Pamene kufufuza kukupitirira, tidzamvetsa bwino kayendedwe kake komanso momwe tingapezeretse mphamvu.
> Zotsatira:
Ansell SM, Lesokhin AM, Borrello I, et al. PD-1 Blockade ndi Nivolumab mu Lobphoma ya Hodgkin kapena yobwezeretsedwa. N Engl J Med. 2015; 372 (4): 311-319.
Pardoll DM. Kutetezedwa kwa chitetezo cha mthupi ku khansa ya immunotherapy. Kan Rev Cancer. 2012; 12 (4): 252-64.
Romano E, Romero P. Malonjezano othandizira kuti asokoneze chitetezo cha chitetezo cha PD-1 / PD-L1 mu khansa: kutsegula ntchito ya CD8 T yomwe imagwiritsidwa ntchito poyambitsa matenda okhudzana ndi zotupa kumabweretsa zotsatira zodziwika bwino, zogwira ntchito m'matumbo osiyanasiyana. J Mayi Kansa . 2015; 3:15.
American Cancer Society. Zowonongeka kwa ma chitetezo cha m'mthupi kuti zithetse khansa.