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Ø CAR(Chimeric
Antigen Receptors) T-CELLS:

 

Definition:

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CAR T-cells are
those T cells in which we insert the gene for Chimeric Antigen Receptor (CAR)
and these receptors are then displayed on CAR T cells surfaces. 

 

Ø CHIMERIC T
CELLS RECEPTORS:

 

Definition:

Chimeric T
Cells receptors are those recombinant Receptors that provide both antigen
binding and T-cells activating functions.

Ø CAR T-cells
THERAPY:

 

Definition:

A type of
treatment in which the gene for a specific 
receptors called CAR are inserted into T cells in order to modify them
invitro is called Chimeric Antigen Receptors T therapy.

 

Ø CAR T-CELLS
THERAPY STEPS:

 

1.     
Blood
from the vein in the patient’s arm is collected and flows through a tube to
apheresis machine.

2.     
This
machine removes the White blood cells from the blood including T cells .

3.     
The
rest of blood excluding T cells is sent back to the patient.

4.     
Now
the gene for special receptors called Chimeric antigen receptors (CAR) is
inserted into T cells in vitro.

5.     
Millions
of CAR t cells are grown in the lab and given to patient by infusion.

6.     
These
CAR t cells can bind to antigen on cancer cells and kill them.

Ø ADVERSE EFFECTS
OF CAR T-CELLS THERAPY:

 

1.     
Cytokine-release
Syndrome (CRS): A serious side effect associated with Chimeric antigen receptors
T-cells therapy is CRS. CRS is the result of T-cell activation. CRS may result
in high fever, headache, low blood pressure.

 

2.     
B-cells
Aplasia: T-cell therapy
targeting antigen (found on B-cells surface) not only destroys cancerous B
cells but also normal B cells. Hence, B-cells absence results in low production
of antibodies.

 

3.     
Tumor
lysis syndrome: It is a group
of metabolic complications that can occur due to breakdown of dying cells (cancerous
cells). TLS can threat life.

 

 

 

Ø BENEFITS/ADVANTAGES:

CARs don’t require the antigen processing
and presentation by HLA( Human leukocytes antigen) and are therefore
applicable to HLA-diverse patient population.
CARs
provide a wider range of functional properties than transduced T-cell
receptors (TCR), where strength 
of  signaling, which  is 
for  the  most 
part  determined  by 
the  TCR’s  attraction for antigen, is the principal
cause of T-cell fate.
This therapy utilizes body’s own immune
system to fight cancer.

 

Ø  ADVANCEMENT IN
CAR T-CELLS THERAPY:

 

FDA Approvals:

Recently, two
different CD19 CAR T-cell products got FDA approval.

 

1.     
Tisagenlecleucel
(Kymirah) : The first CAR T-cell product to be
approves and is used to treat B-cell acute lymphoblastic leukemia (B-ALL).

 

2.     
Axicabtagene
ciloleucel (Yescarta) : After
the few months of  approval of Kymirah,
another CAR T-cells product was approved that is used to treat adult  refactory diffuse large  B-cell lymphoma .

 

 

Ø FUTURE GOALS OF
CAR T THERAPY:

 

CAR T-cell
therapy has got preliminary  approval for
treatment of children and young adults with a specific form of  leukemia that has not been cures with
chemotherapy. 

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