German scientists may have demonstrated a new way to treat and possibly even cure chronic lupus. In a study On Thursday, the team describes how patients who received a form of immunotherapy currently used to treat certain cancers experienced prolonged remission of their symptoms, as well as autoantibodies that trigger the disease. However, more data will be needed to confirm the breakthrough potential of the treatment.
Lupus is a complex chronic disease, caused by a capricious immune system, which affects approximately 1.5 million Americans. There are several forms of lupus, some of which affect specific parts of the body, such as the skin. But the most common version is systemic lupus erythematosus (SLE), which can affect almost any organ in the body. Symptoms of SLE often vary from person to person and it can sometimes take years for a person to know they have lupus. That said, a common hallmark of the condition is chronic inflammation, which can manifest as joint pain, fever, and rash.
Most cases of lupus are diagnosed between the ages of 15 and 44 and have no clear cause, although a person’s genetics and environmental triggers like viral infection are suspected to play a vital role. Once symptoms appear, people tend to have disease flare-ups. These flare-ups can be lessened or managed with treatments, but there is currently no cure for lupus itself.
The underlying defect behind lupus are antibodies that attack body tissues. These autoantibodies are produced by a subset of B cells, the antibody-making machinery of the immune system. There are currently treatments for lupus that attempt to deplete the body’s supply of B cells to shut down these antibodies, but these drugs have so far had limited effectiveness. In recent years, supported by early animal data, some scientists have theorized that a form of immunotherapy known as CAR T cell therapy can succeed where these drugs have failed.
The basic concept of CAR T cell therapy is to take a person’s T cells – immune cells trained to attack a specific target, such as a foreign germ – and modify them in the lab to recognize targets on the surface of the body. a cell they would normally struggle to find. , like those of some cancer cells. But according to study author Georg Schett, an immunologist at the University of Erlangen-Nuremberg in Germany, the same antigen that can be found on B cells of malignant leukemia and lymphoma can also be found on cells B that produce lupus autoantibodies. This antigen is called CD19.
In their new research, published Thursday in Nature Medicine, Schett and his team infused five patients with treatment-resistant SLE with engineered anti-CD19 T cells. And so far, all have had a remarkable recovery. Their symptoms all improved, with none showing signs of lupus-related internal damage up to 17 months later and minimal side effects from therapy. Importantly, the patients’ autoantibodies apparently disappeared as well, perhaps for good, since the antibodies did not return once their B cells began to replenish after an average of 100 days later. As a result, the patients did not need additional treatment of any kind.
“It’s fundamentally different from any other treatment so far,” Schett told Gizmodo in an email.
These findings could herald a medical breakthrough for lupus. But for now, they are still based on a very small sample, and there remain many questions about the effectiveness of the therapy, including whether these patients are truly cured and whether this will be the case for others with the disease as well. lupus. However, other research teams are studying CAR T cell therapy for lupus, so we are sure to have more data soon. If this research is validated, the therapy could not only radically change the outlook for lupus patients, but also many people with similar autoimmune diseases, a possibility that Schett’s team is already working to investigate in the near future. .
“Our patients will be followed longer to see if they remain healthy without treatment. We want to know if they are cured or not,” Schett said. “We will also start a basket study, which will include different autoimmune diseases (lupus, myositis and systemic sclerosis) in order to advance this program.”