Five severely ill lupus patients saw their disease go into remission with a single injection of modified immune cells, in a small trial. Cancer A treatment to harvest patients’ own cells to treat an autoimmune condition.
They are scientists. Calling Calling the results “impressive” and “incredibly exciting,” the findings could herald a new era in the management of hard-to-treat autoimmune diseases, such as cancer.
Lupus is a lifelong disease that, at its worst, affects more than just the joints, affecting about 1 in 1,000 people. Mostly women Childbearing age.
As with many other autoimmune diseases, the underlying causes of lupus remain unclear. Genetics and environmental conditions.
Symptoms such as swelling They are usually treated with courses of steroids and immunosuppressants to eliminate the pathogens.
However, this could change if the promising results of a new study led by rheumatologist George Schett at the University of Nuremberg in Erlangen, Germany show that it is possible to safely ‘reboot’ the immune system of many lupus patients.
The success of cell-based therapies called chimeric antigen receptor (CAR) T-cell therapies has led to some Amazing results in blood cancerResearchers have been experimenting methodically Does the approach also work for lupus? – Try the treatment first in ratsthen inside A patientAnd now another four.
CAR-T therapies work by recruiting a patient’s own immune cells and engineering them to identify and destroy rogue cells, whether cancer cells or other immune cells that invade the body.
During this particular trial, the therapy was designed to hunt down errant B cells, specifically those decorated with a cell surface protein called CD19, which produces autoantibodies that mistakenly attach to the body’s cells in individuals with lupus.
Following orders, the immune system quickly moves in to attack those tissues, damaging organs and causing joint pain, fatigue and skin rashes.
The blood test showed that a single treatment wiped out the patient’s errant B cells without serious side effects, and that the disease-causing antibodies subsequently fell below detectable levels. The patients’ symptoms improved so much that months later, they no longer needed the medications they once took to manage their condition.
While it is too early to say whether the patients are cured, and what proportion of lupus patients will respond to treatment, the findings are encouraging.
Five patients (four women and one man) were in remission for 5 to 17 months, at which time their disease had not relapsed despite B-cell recovery a few months after treatment.
Crucially, those newly formed B cells didn’t get rid of the autoantibodies that preceded them, so the researchers suspect they were successful in resetting the patients’ immune systems — though only time will tell.
“We were surprised at how effective it was,” Schett They spoke STAT News reporter Isabella Cueto. “I have to say we were blown away.”
Immune system function is not completely suppressed. Instead, the therapy selected B cells that produce antibodies while maintaining immunity to the chicken pox, measles, mumps, and rubella for which the patients had previously been vaccinated.
“It seems like the holy grail of medicine,” said Mark Leek, a medical oncologist at Massachusetts General Hospital who was not involved in the trial. They spoke STAT news
Of course, the treatment needs to be tested in a larger group of lupus patients; Whether this lasts, and whether it works for some, all or most patients. Researchers should monitor CAR-T therapy for side effects that may cause systemic inflammation in some blood cancer patients.
Sheth’s team is planning another trial to test whether other autoimmune diseases, such as rheumatoid arthritis and scleroderma, also respond to CAR-T therapy. Scientists have for many years This is assumed to be possible.And now it seems like a real possibility.
Even if it proves safe and effective for treating lupus or other autoimmune diseases, that’s another hurdle to spreading the therapy.
Because CAR-T therapies are customized for each patient and require specialized production capacity of modified immune cells, CAR-T therapies may only be used as a last resort for lupus patients with severe disease unresponsive to other drugs. .
The study was published in Natural medicine.