雅思阅读 103: Resetting the Immune System (重启免疫系统)

改编自 Associated Press（2025年11月）。雅思阅读 Section 3 难度，约 1050 词。 素材来源：https://www.ap.org/news-highlights/spotlights/2025/lifelong-drugs-for-autoimmune-diseases-dont-work-well-now-scientists-are-trying-something-new/

Reading Passage

A. For millions of people living with rheumatoid arthritis, lupus, multiple sclerosis and type 1 diabetes, the present treatment regimen is wearyingly familiar: a lifetime of expensive pills, injections or infusions that dampen the body's misplaced counterattack but never address its root cause. Existing therapies suppress the friendly fire. They do not repair the misfiring system that opened fire in the first place. Patients cycle through medications, struggle with side effects, and too often watch their disease continue to progress. Some end up hospitalised when their illness attacks delicate organs — a spine, a kidney, a lung — that the drugs can no longer shield. "We're entering a new era," remarked one rheumatologist at Johns Hopkins University, describing a shift from merely calming symptoms to actually rewriting the patient's own immune machinery. What makes the shift striking is that many of the most promising tools were originally engineered for a completely different adversary: cancer. The goal is no longer to hold an illness at bay until the next prescription, but to reset the rogue system so that, like a computer restarting after a malfunction, it comes back to life behaving as it should. Researchers speak of a "drug-free remission" — a phrase that, in chronic autoimmune medicine, once sounded like wishful thinking.

B. The therapy making the biggest noise is CAR-T, a treatment borrowed from the ward where it already slays hard-to-treat blood cancers. In those malignancies, the cells that run amok are immune cells called B cells; in many autoimmune diseases, those same B cells go wrong in a different way, manufacturing antibodies that attack the patient's own organs. The procedure is gruelling. T cells are filtered out of a patient's blood, shipped to a laboratory, and reprogrammed so that, once returned, they hunt and destroy their B-cell relatives. A short course of chemotherapy clears away additional immune cells, after which millions of these so-called "living drugs" are infused back. Conventional autoimmune drugs can target some B cells but cannot reach those hidden deep in the body. CAR-T clears them almost wholesale. The leading theory is that this deep depletion gives the system a fresh start: when replacement B cells eventually mature, they behave normally. Early German results in severe lupus, in which one woman remained medication-free for years after a single infusion, triggered an explosion of clinical trials worldwide.

C. CAR-T is, however, punishing, time-consuming and extraordinarily costly, in part because each dose is custom-built for one patient; a cancer course can run to half a million dollars. Researchers are therefore pursuing parallel routes. One draws on the very biology that won the 2025 Nobel Prize in Physiology or Medicine: regulatory T cells, rare "peacekeeper" cells that normally tamp down inflammation and restrain other cells from mistaking healthy tissue for an invader. Biotech firms are engineering these cells from patients so that they do not attack but instead pacify. A second approach repurposes another cancer weapon, T-cell engagers: ready-made antibodies that, like a matchmaker, redirect the body's own T cells toward antibody-producing B cells without bespoke lab work. In one small trial, a course of one such drug left almost all of ten patients markedly improved and six of them free of medication entirely. The appeal is obvious: these matchmakers are manufactured in batches, behave like conventional antibodies, and avoid the weeks of bespoke engineering, hospital stays and bone-jarring chemotherapy that CAR-T demands. They are, on present evidence, gentler — but also, so far, tested only in tiny groups, with no long-term follow-up to show how durable the improvement really is.

D. The next ambition is surgical precision. Rather than wiping out swathes of the immune system, clinicians want to eliminate only the tiny population of renegade cells that actually does the damage. B cells carry biological barcodes marking those predisposed to produce faulty antibodies, and engineers are designing matchmakers that would tag only the "bad" ones for destruction while leaving the healthy defenders in place. Nearby, a biomedical engineer is packaging instructions in messenger RNA inside biodegradable nanoparticles, instructing certain immune "generals" to multiply the peacekeepers and restrain the troublemakers; the human studies are still years away. A separate front looks further ahead. Because type 1 diabetes unfolds gradually and blood tests can flag people who are developing it, a drug already approved delays its first symptoms. Researchers hope to spot similar early warning signatures in rheumatoid arthritis, mapping the immune changes that precede swollen joints by years, and then intervene before damage begins.

E. Enormous uncertainty remains. Questions about CAR-T's long-term safety and durability are unresolved, and no therapy yet offers guarantees. Yet the early recoveries are striking: one woman who had been unable to lift her own small child regained the strength to run after her; another, after three decades of severe lupus, woke one morning and realised she no longer felt ill. Such accounts have lent the field a rare optimism. Even the chemotherapy that precedes the infusion, and the rare but serious side effects that can delay recovery, are tolerated by patients who have already exhausted every gentler option. "We've never been closer," one investigator said, to a possible cure. Whether the next decade genuinely transforms the treatment of autoimmune disease, or merely adds another costly option for the desperate, will depend on whether researchers can shrink the price tag, widen access beyond patients who have exhausted every older treatment, and prove that a one-time reset outlasts the years. Off-the-shelf versions, built in advance from the cells of healthy donors rather than custom-built for each patient, are one route toward that broader reach. What is no longer in doubt is that the dominant model of lifelong, dampening medication is finally being challenged by a model that promises, at least in principle, to switch the immune system off and back on again.

Questions 1-4

Choose the correct heading for paragraphs B, C, D and E from the list of headings below.

List of Headings i. How CAR-T wipes the slate clean ii. The history of chemotherapy in cancer iii. Cheaper and gentler alternatives iv. The race to target only the rogue cells v. What the early recoveries mean — and what remains uncertain vi. Why autoimmune drugs cost half a million dollars vii. The role of hospitals in treating lupus

1. Paragraph B: ____
2. Paragraph C: ____
3. Paragraph D: ____
4. Paragraph E: ____

Questions 5-8

Choose the correct letter, A, B, C or D.

5. According to the first paragraph, what is the main limitation of current autoimmune treatments? A. They are too expensive for most patients. B. They suppress symptoms but do not fix the underlying cause. C. They work only for rheumatoid arthritis. D. They cannot be given to cancer patients.

6. Why does the writer say CAR-T "clears them almost wholesale"? A. It destroys nearly all B cells, including hidden ones. B. It destroys every cancer in the body. C. It targets only healthy immune cells. D. It removes all medication from the blood.

7. What is the advantage of T-cell engagers over CAR-T? A. They require chemotherapy. B. They are ready-made and need no custom engineering. C. They work only in cancer patients. D. They cost half a million dollars.

8. What is the goal of the mRNA nanoparticle approach described in paragraph D? A. To replace insulin in the pancreas. B. To instruct immune cells to multiply peacekeepers and restrain troublemakers. C. To destroy all B cells in the blood. D. To delay the first symptoms of diabetes by ten years.

Questions 9-13

Do the following statements agree with the claims of the writer?

Write:

• TRUE if the statement agrees with the information
• FALSE if the statement contradicts the information
• NOT GIVEN if there is no information on this

9. CAR-T therapy was originally developed to treat autoimmune diseases.
10. A cancer course of CAR-T can cost around half a million dollars.
11. Regulatory T cells are sometimes described as "peacekeeper" cells.
12. The mRNA nanoparticle treatment is already widely used in human patients.
13. CAR-T treatment is currently offered free of charge to all lupus patients.

Questions 14-15

Complete the summary below using NO MORE THAN TWO WORDS from the passage.

CAR-T treatment reprogrammes a patient's T cells so that, once returned, they hunt and destroy their (14) __________ relatives. The theory is that this deep depletion gives the immune system a fresh (15) __________ so that replacement cells behave normally.

答案与解析

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