Scientists in Germany may have demonstrated a new way to treat and possibly even cure the chronic disease lupus. In a to study On Thursday, the team describes how patients with a form of immunotherapy currently used to treat certain cancers have experienced sustained remission of their symptoms, along with the autoantibodies that trigger the disease. However, more data will be needed to confirm the breakthrough potential of the treatment.
Lupus is one complex chronic disease, caused by a misguided immune system, which affects about 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 every organ in the body. SLE symptoms often vary from person to person, and it can take years for someone to know they have lupus. That said, a common trademark of the disease is chronic inflammation, which can manifest as joint pain, fever, and skin rashes.
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 such as viral infection are suspected to play a vital role. Once symptoms appear, people will tend to experience flare-ups. These flare-ups can be reduced or managed with treatments, but there is currently no cure for lupus itself.
The underlying defect behind lupus is antibodies that attack the body’s tissues. These autoantibodies are produced by a subset of B cells, the antibody-making machinery of the immune system. There are current treatments for lupus that try to deplete the body’s supply of B cells to shut down these antibodies, but these drugs have had limited effectiveness so far. In recent years, supported by the first animal data, some scientists have done just that theorized that a form of immunotherapy known as CAR T-cell therapy may succeed when 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 laboratory to recognize targets in the surface of a cell that they would normally have trouble finding. , like those of certain 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 the malignant B cells of leukemia and lymphoma can also be found on the cells. B cells that produce lupus autoantibodies. This antigen is known as CD19.
In his new research, published On Thursday in Nature Medicine, Schett and his team infused five patients with treatment-resistant SLE with modified anti-CD19 T cells. And so far, all have experienced remarkable recovery. All of her symptoms have improved, with none showing signs of lupus-related internal damage up to 17 months later and minimal side effects from therapy. Crucially, the patients’ autoantibodies also appear to have disappeared, perhaps permanently, as the antibodies did not return once their B cells began to replenish after an average of 100 days later. As a result, patients have not required further treatment of any kind.
“This is fundamentally different from any other treatment to date,” 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 size, and many questions remain about the effectiveness of the therapy, including whether these patients are truly cured and whether this will also be the case for others with lupus. Other research teams are studying CAR T-cell therapy for lupus, so I’m sure we’ll have more data soon. If this research is validated, the therapy could dramatically change the outlook not only for lupus patients, but also for many people with similar autoimmune conditions, a possibility that Schett’s team is already working to study in the near future.
“Our patients will be followed for longer to see if they stay healthy without treatment. We want to know if they’re curable or not,” Schett said. “We’re also going to start a basket study, which will include different autoimmune diseases (lupus, myositis and systemic sclerosis) in order to take this program forward.”